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Background: Overuse injuries are a frequent occurrence among competitive athletes. When analysing the incidence of overuse injuries in tennis players, it has been determined that a significant number of these injures occur in the upper limb area. In this study, we describe five cases of a stress-induced injury to the middle and distal humerus occurring mainly due to repetitive serving., Methods: Athletes studied were competitive tennis players and elite junior players, two of whom played at international level. Four of the five were male. In all cases, diagnosis was confirmed by magnetic resonance imaging examination. The treatment of middle and distal humeral stress reactions consisted of physical therapy, which focused on analgesia and muscle strengthening. In addition, we analysed each tennis player's strokes in order to identify modifications that would decrease the amount of stress that the upper limbs were subjected to during the service motion., Results: The players in our study missed on average 3 weeks of play and at follow-up after 1 year were able to play symptom free., Conclusions: Our study highlights the need for coaches, physicians and players to be aware of distal humeral pain and understand treatment options in order to prevent further injury, including stress fractures.

Hydrogen peroxide and trace metals (K+, Ca2+, Na+, Mg2+, Mn2+, and Li+) were determined in 14 samples of Brazilian commercial honeys. The method for the determination of H2O2 is based on selective oxidation of H2O2 using an on-line tubular reactor containing peroxidase immobilized on Amberlite IRA-743 resin. Reactors presented high stability for at least 2 weeks under intense use. The results show a simple, accurate, selective, and readily applied method to the determination of H2O2 in honey. The trace metals were determined by capillary zone electrophoresis. Mean contents of 656, 69.1, 71.8, 36.0, 21.4, and 1.70 mg/kg were found, respectively, for K+, Ca2+, Na+, Mg2+, Mn2+, and Li+ in the analyzed honeys. The cations were identified by comparison of the relative migration times of their peaks with the Ba2+ migration time used as reference. The electrophoretic analysis was simple and rapid and did not require any other preparation of sample than dilution and filtration.

A descriptive, retrospective study which aimed to characterize suicide in the municipality of Teresina, Piaui, the period of 2000-2005, in regards to the social demographic aspects, means of death and period (month) of the act. The results were obtained through the Institute of Legal Medicine, they show a greater rate of suicide among men (71.3%) with a greater frequency of the youth population, predominance among the single (54.9%). The occupational groups with the greatest percentage were students (23.8%). The most frequently used method was hanging (66%) followed by firearms (13.1%). The use of interventions in hopes of lowering the current rates is imperative, as suicide occupies fourth place in relation to all causes of violent deaths in the municipality.

Isolated Complex I (CI) deficiency, the most frequent cause of mitochondrial disease, is a clinically and genetically heterogeneous condition. Complex I is a giant multiheteromeric enzyme composed of seven ND subunits encoded by mitochondrial DNA (mtDNA) genes, and at least 38 subunits encoded by nuclear genes. To establish the contribution to human mitochondrial encephalopathy of ND versus nuclear gene mutations, we have been undertaking a systematic analysis of CI genes in a cohort of 46 adult and paediatric patients with biochemically defined CI defect. Sequence analysis of the entire mtDNA let us identify six patients with mutations in ND genes. The clinical presentations varied, from infantile Leigh syndrome, to childhood MELAS, to adult-onset encephalopathic syndromes of variable severity. Three of the mutations were not previously reported (3481G > A, 14600G > A and 13063G > A, in ND1, ND6 and ND5 genes, respectively) and were further investigated in mutant transmitochondrial cybrids. Tight correlation between mutation load and decrease in CI activity was observed in each of the three mutant cybrid lines, supporting the pathogenic role of the novel mutations. Structural studies on mutant cybrids showed impaired assembly or reduced stability of the holoenzyme complex. In our experience ND gene mutations are relatively common in CI-defective mitochondrial encephalopathy of both children and adults.

Purpose: To evaluate the treatment of subfoveal and juxtafoveal choroidal neovascularization (CNV) using verteporfin photodynamic therapy (vPDT) in patients affected by punctate inner choroidopathy (PIC)., Methods: A chart review of 8 patients with CNV associated with PIC treated with vPDT was done., Results: The 8 patients (8 eyes) included 4 men and 4 women with a mean age of 30.9 years. Six of them presented juxtafoveal CNVs, and two had subfoveal CNVs, at presentation. Mean follow-up time was 22.7 months. The VA improved in five eyes, and three eyes declined. One patient developed a new CNV a few days after vPDT, and one had multiple CNVs at presentation. Two of the 3 patients with longer follow-up period presented late recurrences., Conclusions: vPDT is a beneficial resource in stabilizing and also improving VA in PIC patients affected with subfoveal and juxtafoveal CNV, although one third of the patients retain poor visual acuity.

Objects: The objectives were to present magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) findings in three patients with deletion on mitochondrial DNA (mtDNA) and nonclassical mitochondrial disorders (NCMD), correlating these findings with the percentage of deleted mtDNA., Results: Our study confirms the high prevalence of white matter (WM), basal ganglia, and posterior fossa lesions in NCMD, ranging from mild to severe involvement. The subcortical WM, caudate, thalamus, globus pallidus, and dorsal brain stem were more frequently affected. A lactate peak was the most frequent finding at the MRS. We found a correlation between the percentage of mtDNA deletion and degree of MRS abnormalities., Conclusions: Our findings showed that MRS is a useful investigational tool in patients with NCMD. Supplementary studies are necessary to elucidate the correlation of quantitative mtDNA deletion and neuroimaging phenotype.

Objective: To establish normative data for muscle performance during isokinetic horizontal abduction and adduction of the shoulder in elite junior tennis players., Methods: Thirty six tennis players were evaluated (23 male, 13 female; mean age 14 years (range 12-18)). An isokinetic dynamometer was used to test the shoulder horizontal abductors and adductors at 60 and 180 degrees/s. Absolute and relative peak torque (PT and PT/BW), total work (TW), endurance ratio (ER), and the ratio of the peak torque between horizontal abductors and adductors (HAB/HAD ratio) were recorded. Data were compared for the dominant and non-dominant shoulders, horizontal abductor and adductor muscles, and between players grouped according to age., Results: The dominant shoulder was significantly (p<0.05) stronger than the non-dominant shoulder in all variables except ER and HAB/HAD ratio. The abductors were significantly (p<0.05) weaker than the adductors in all subjects. The type of backhand (one handed or two handed) did not influence the strength of the shoulder horizontal abductors on the dominant side. The number of years of tennis practice had an effect on muscle strength as evaluated by absolute data (PT and TW) but not relative measurements (PT/BW and TW/BW)., Conclusion: The findings confirm that horizontal abduction and adduction are stronger in the dominant shoulder of junior tennis players. The clinical relevance of these findings is not established, and more studies are needed to compare tennis players with athletes from other sports and non-athletes.

Colletotrichum acutatum may develop one or more secondary conidia after conidial germination and before mycelial growth. Secondary conidia formation and germination were influenced by conidia concentration. Concentrations greater than 1x105 conidia/mL were associated with germination decrease and with secondary conidia emergence. Secondary conidia can form either alone or simultaneously with germ tubes and appressoria. Confocal analysis showed numerous lipid bodies stored inside ungerminated conidia, which diminished during germ tube and appressoria formation, with or without secondary conidia formation. They were also reduced during secondary conidia formation alone. While there was a decrease inside germinated conidia, lipid bodies appeared inside secondary conidia since the initial stages. Intense vacuolization inside primary germinated conidia occurred at the same time as the decrease in lipid bodies, which were internalized and digested by vacuoles. During these events, small acidic vesicles inside secondary conidia were formed. Considering that the conidia were maintained in distilled water, with no exogenous nutrients, it is clear that ungerminated conidia contain enough stored lipids to form germ tubes, appressoria, and the additional secondary conidia replete with lipid reserves. These results suggested a very complex and well-balanced regulation that makes possible the catabolic and anabolic pathways of these lipid bodies.

The neuronal ceroid lipofuscinoses (NCL) are a group of inherited progressive neurodegenerative disorders with presentation from infancy to adulthood. Three main childhood forms can be established on the basis of age of onset, clinical course, and ultrastructural morphology: infantile (INCL), late infantile (LINCL), and juvenile (JNCL). Several variant subtypes have been described. Genetic and biochemical analysis are helping to better understand, diagnose and classify these disorders. We report on clinical, neurophysiological, neuroradiological, and morphological data from 17 patients with different forms (infantile, late infantile, and juvenile ) of neuronal ceroid lipofuscinoses (NCL) evaluated at Hospital de Clínicas de Porto Alegre, Southern Brazil, during 6 years (1992-1997). Seven cases were infantile; 5 were late infantile; and 5 were juvenile NCL. Gender ratio was male:female, 11:6. Age at presentation varied from 2-24 months for INCL; 2,5 to 5 years for LINCL; and 4-10 years for the JNCL cases. Seizures (6 patients) and psychomotor retardation (1 patient) were the initial symptoms in the INCL group. All the patients in the group of LINCL had the usual findings. JNCL patients manifested different initial symptoms, although tending to follow a similar clinical picture within familial cases. Epidemiological data on the prevalence of NCLs in Brazil are not available, we expect this series of cases to contribute to further research in our population.

The objective of this prospective multicenter study was to determine whether cisapride is associated with increased risk of malformations, spontaneous abortions, or decreased birthweight when used during pregnancy. Cases were paired for age, smoking, and alcohol consumption with controls exposed to nonteratogens, as well as with disease-paired controls. One hundred and twenty-nine pregnant women were exposed to cisapride during pregnancy, including 88 during the period of fetal organogenesis. There were no differences in maternal history, birthweight, gestational age at delivery, and rates of livebirths, spontaneous or therapeutic abortions, fetal distress, and major or minor malformations among groups. It is concluded that exposure to cisapride during pregnancy is not associated with a major increased risk of malformations or spontaneous abortions or with decreased birthweight.