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Objetivo: Verificar o efeito de 30 sessões do Método Pilates na postura corporal estática no plano sagital e na flexibilidade da cadeia muscular posterior de mulheres adultas. Método: 10 mulheres foram submetidas a 30 sessões de Mat Pilates, ministradas por profissional capacitado, três vezes na semana por 50 minutos. Foram avaliados, pré e pós-intervenção, a flexibilidade da cadeia muscular posterior por meio do banco de Wells, e a postura corporal estática no plano sagital (equilíbrio ântero-posterior do tronco, posição da cabeça, da pelve - inclinação e pulsão -, e dos joelhos), por meio do protocolo e software DIPA. A análise estatística, descritiva e inferencial, foi realizada no software SPSS v. 20.0. A normalidade dos dados escalares foi verificada pelo teste de Shapiro- Wilk, sendo realizados, para comparação do fator tempo, testes t de amostra em pares e de Wilcoxon, para os dados com distribuição normal e não normal, respectivamente, onde α0.05). Conclusão: 30 sessões de Mat Pilates promoveram melhora na flexibilidade da cadeia muscular posterior, contudo, não foram suficientes para surtir mudanças significativas na postura corporal estática no plano sagital. Objective: To verify the effect of 30 sessions of the Pilates Method on the body static posture in the sagittal plane and on the flexibility of the posterior muscular chain of adult women. Method: 10 women underwent 30 sessions of Mat Pilates, taught by a trained professional, three times a week for 50 minutes. The flexibility of the posterior muscular chain through Wells’ bench, and the body static posture in the sagittal plane (anteroposterior trunk balance and the position of the head, pelvis - tilt and drive - and knees) through protocol and software DIPA were assessed pre and post intervention. Statistical analysis, descriptive and inferential, was performed in SPSS v. 20.0. The normality of the scalar data was verified by the Shapiro-Wilk test, being conducted for comparison of the time factor, paired sample t-test and Wilcoxon test for data with normal and non-normal distribution, respectively, where α0.05). Conclusion: 30 sessions of Mat Pilates promoted improvement in the flexibility of the posterior muscle chain, however, were not enough to make significant changes in the static body posture in the sagittal plane. Objetivo: Verificar el efecto de 30 sesiones de Método Pilates en la postura corporal estática en el plano sagital y en la flexibilidad de la cadena muscular posterior en mujeres adultas. Método: 10 mujeres realizaron 30 sesiones de Mat Pilates, impartidas por un profesional capacitado, tres veces a la semana durante 50 minutos. Fueron evaluadas antes y después de la intervención, la flexibilidad de la cadena muscular posterior a través del banco de Wells, y la postura corporal estática en el plano sagital (equilibrio anteroposterior del tronco, posición de la cabeza, de la pelvis – inclinación y pulsión - y de las rodillas), por medio de software y protocolo DIPA. Las estadísticas, análisis descriptivo e inferencial se realizó con el software SPSS v. 20.0. La normalidad de los datos escalares se verificó mediante el test de Shapiro-Wilk, siendo realizados, para la comparación del factor tiempo, test t de muestras pareadas y de Wilcoxon, para datos con distribución normal y no normal, respectivamente, donde α0.05). Conclusión: 30 sesiones de Mat Pilates fomentaron la mejora de la flexibilidad de la cadena muscular posterior, aunque no fueron suficientes para surtir cambios significativos en la postura corporal estática en el plano sagital.

Background Although pediatric Clostridium difficile infections (CDIs) are increasing, C. difficile transmission patterns among children are poorly understood. Methods We performed whole genome sequencing (WGS) on C. difficile isolates collected from children diagnosed with CDI between December 2012 and December 2013 at a single academic medical center. Genome sequences of isolates from CDIs diagnosed ≥8 weeks after study initiation were compared to all study isolate genome sequences. Among patients with isogenic isolates (≤2-3 core genome single nucleotide variants [SNVs] identified by pairwise SNV analyses), common inpatient and/or outpatient healthcare exposures were investigated. Results Among 131 CDIs in 107 children, WGS identified 104 genetically distinct isolates. Of 84 incident CDIs occurring ≥8 weeks after study initiation, only 10 (11.9%) were caused by a strain isogenic to another cohort CDI isolate (putative transmission events). Proportions of each CDI class putatively associated with transmission were hospital-onset healthcare facility-associated (HCFA), 2/16 (12.5%); community-onset HCFA, 1/17 (5.9%); indeterminate, 1/11 (9.1%); community-associated (CA), 5/40 (12.5%); and recurrent, 1/21 (4.8%). Transmission events among CA and HCFA CDIs were similarly infrequent (5/40 [12.5%] vs 3/33 [9.1%]; P = .64). Shared healthcare facility exposures were only identified among 7/10 putative transmission events. Potential community transmission (same postal code) was not identified. Conclusions WGS identified a highly diverse group of C. difficile isolates among children with CDI, including those with HCFA CDI. Clostridium difficile transmission among symptomatic children was very uncommon. Among putatively transmitted cases, investigation of shared healthcare exposures often did not identify a potential transmission source.

We read with interest the article by Vigarios et al.1 describing eight patients treated with a variety of BRAF inhibitors who developed asymptomatic hyperkeratotic oral mucosal lesions. These were frequently multifocal and presented following a mean onset of three months of treatment with a BRAF inhibitor. In one patient, one such lesion rapidly developed into oral squamous cell carcinoma requiring excision. We would like to highlight delayed oral toxicity in a long-term responder to a BRAF inhibitor.

We evaluated histologically 10 biopsy specimens taken preoperatively from the anterior-inferior glenohumeral ligament from patients with atraumatic instability who had undergone radiofrequency capsular shrinkage, 10 taken immediately postoperatively, and 13 taken before revision. The synovial and subsynovial layers returned to normal histology in biopsy specimens taken from 6 months onwards. Collagen bundles in the fibrous layer continued to have a reparative histology during the period of the study (up to 37 months). The type of radiofrequency probe used (monopolar or bipolar) had no effect on the histologic healing process (P0.5, chi2 test). A histologic score was introduced, and this was found to have an excellent intraobserver agreement (weighted kappa, 0.840) and a moderate interobserver agreement (weighted kappa, 0.698).

Tumors of endothelial cell origin are relatively common. Soft tissue tumors and numerous subtypes of benign and malignant vascular tumors have been described; the histogenesis of many of these tumors is uncertain, and distinguishing between benign and malignant vascular tumors, some of which express lymphatic endothelial cell markers, can be problematic. In the present study, immunophenotypic expression of a novel hyaluronan receptor (LYVE-1), which is expressed by endothelial cells of normal lymphatic vessels but not blood vessels, was determined in benign and malignant vascular tumors. It was found that, except in lymphangiomas, intramuscular hemangiomas, and Masson's hemangiomas, endothelial cells in benign blood vessel tumors (including capillary and cavernous hemangiomas, glomus tumors, pyogenic granulomas, and epithelioid hemangiomas) were negative for LYVE-1, and that all angiosarcomas and Kaposi's sarcomas were positive for LYVE-1. Expression of LYVE-1 and other lymphatic endothelial cell markers in relatively few vascular neoplasms has implications for the histogenesis of these lesions, and may prove useful in distinguishing angiosarcoma and Kaposi's sarcoma from most common benign vascular tumors.

Objective: To determine the clinical and laboratory features, malignancy, outcome and their association in a Hispanic mestizo population with Inflammatory Idiopathic Myopathies (IIM). Material and methods: The medical records of Hispanic mestizo patients with dermatomyositis, polymyositis or overlap syndrome from a single center were reviewed. Several variables were studied with emphasis on malignancy. Results: We report the clinical and laboratorial features of 118 patients with IIM; the female to male ratio was 2.3:1. Elevated CK, proximal weakness, compatible biopsy and elevated LDH were the most frequent findings. Malignancy was found in 9,3%, gynecological tumors were the most common (55%). Mortality was 10.2%, mainly related to infections and respiratory failure. Conclusions: The overall rate of malignancy in this large series of patients with IIM was 9.3%. The majority of our patients reached a good outcome. No risk factors for malignancy were found.