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Introduction and Hypothesis: Surface electromyography is commonly applied to measure the electrophysiological activity of the neuromuscular system. However, there is no consensus regarding the best protocol to assess pelvic floor muscles., Methods: A scoping literature review was carried out in six databases, using MeSH descriptors. It included studies with electromyographic assessment in adult women presenting or not with pelvic floor dysfunction. The results were presented in categories to contribute to the development of a protocol considering the most used parameters for non-invasive assessment of myoelectric activity of pelvic floor muscles., Results: A total of 1,074 articles were identified, and 146 studies were selected for analysis. The intravaginal probe was used in 80.8% of the studies, the bipolar sensor with metallic plates placed on both sides of the vagina was the most frequent (71.3%), with a reference electrode positioned on the anterior superior iliac spine (33.5%). The supine position with hip and knee flexed (45.2%) was the most frequent position used. Of the studies, 44.5% normalized the data by maximum voluntary contraction (MVC) whereas 44.5% performed an average of 3 MVCs., Conclusions: The most frequently used protocol for the pelvic floor is the bipolar intracavitary probe with metal plates positioned at 3-9 o'clock and introduced distally to the vaginal introitus with the volunteer in the supine position and the hip and knee flexed with the reference placed on the anterior-superior iliac spine., (© 2024. The International Urogynecological Association.)

Background: Brachial plexus injuries (BPI) affect not only body structure and function, but also several aspects of individual's well-being. Considering the crescent need for assessing such patients through a biopsychosocial perspective, linking meaningful concepts of BPI instruments to the International Classification of Functioning, Disability and Health (ICF) provides a useful overview of how the ICF components are contemplated on the current measurements available., Purpose: To identify patient-reported outcome measures (PROMs) specifically designed for BPI assessment and link the content with the ICF., Study Design: Content Analysis through ICF linking., Methods: The study was conducted in two steps: the first one encompassed a literature review to identify questionnaires specifically designed for assessing patients with BPI, where two PROMs were eligible: the Brachial Assessment Tool (BrAT) and the Impact of Brachial Plexus Injury Questionnaire (IBPIQ); in the second phase, the items of such instruments were linked to the ICF by two independent reviewers, in accordance to the methodology proposed by Cieza et al., Results: 54 different significant concepts were identified from the 74 questionnaire items and linked to 49 distinct ICF categories. The categories were mostly related to the activities and participation component (56.9%, n = 29), followed by body functions (27.45%, n = 14), body structures (9.8%, n = 5) and environmental factors component (1.96%, n = 1)., Conclusion: The questionnaires developed for adults with BPI were BrAT and IBPIQ. Although both instruments presented with a diverse coverage of ICF components, their content had a major focus on activities and participation domain and poorly or did not addressed environmental factors. Thus, other instruments could be considered in a complementary way for clinical assessment., (Copyright © 2021. Published by Elsevier Inc.)

Objective: The objective of this review is to identify the most frequently used protocols for analyzing the myoelectric activity of the pelvic floor muscles during surface electromyography in women aged 18 years or older., Introduction: Surface electromyography is normally used in assessment and treatment for research purposes when it is intended to quantitatively measure the electrophysiological behavior of the neuromuscular system. However, although there are internationally standardized, non-invasive assessment protocols for most muscle groups, there is no consensus for pelvic floor muscles, which makes it difficult to standardize in scientific research and clinical applicability., Inclusion Criteria: Studies that explore registration protocols and filtering parameters of surface electromyographic signals in women aged over 18 years old with or without pelvic floor dysfunction will be considered. Studies encompassing either electromyographic biofeedback as a treatment resource only or electroneuromyography (needle electrode) will be excluded., Methods: Primary studies published in the previous 10 years in MEDLINE, Embase, Scopus, Web of Science, CINAHL, and Cochrane Central databases will be included. The search will encompass descriptors registered in MeSH. The identified articles will be assessed for eligibility by two independent reviewers in three stages: evaluation by title, abstract, and full text. If there is any disagreement, a third reviewer will be consulted. Data will be extracted and organized in standardized spreadsheets. The results will be assigned to categories in order to facilitate the organization of a protocol with the most commonly used parameters for non-invasive assessment of myoelectric activity of pelvic floor muscles., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 JBI.)

Background: Traumatic upper plexus injury affects daily living activities performance and participation of individuals. Physical therapy treatment has a fundamental role on functional recovery, but it is still an unexplored and challenging field., Aim: To develop a protocol to evaluate the efficacy of Proprioceptive Neuromuscular Facilitation (PNF) compared to conventional physiotherapy (CPT group) on functionality and quality of life., Methods: A committee was formed by four physical therapists to develop the treatment protocol. A Delphi study was carried out in order to quantify the level of agreement. A protocol for a randomized controlled trial was proposed to evaluate the effectiveness of the protocol in improving functionality and quality of life, according Consolidated Standards of Reporting Trials. Participants will be randomly assigned (1:1) to PNF or CPT group and two weekly sessions will be carried out for 12 months postsurgery, with a three-month follow-up. The main outcome measurements are: upper limb functionality, quality of life, range of motion, muscle strength, tactile sensitivity, and pain, which will be assessed at baseline, on the 6th, 9th, and 12th months postsurgery., Result: A PNF protocol was developed for traumatic upper brachial plexus injury, consisting of 11 illustrated exercises, three for immediate postoperative and eight for postoperative. Biomechanical objectives, observations, positions of patients and therapists and PNF principles, procedures and techniques have been described. An 80% agreement on all items in the first round of the Delphi study was achieved., Conclusion: A protocol based on the PNF-concept was developed with the aim of improving the functionality and quality of life of individuals undergoing nerve transfer after traumatic injury to the upper plexus. The detailed description of a physical therapy treatment protocol through an appropriate method will allow its use in clinical practice and in future studies with this population., (© 2020 John Wiley & Sons Ltd.)

Objective: This study aims to investigate morphological alterations caused by partial sciatic nerve ligation (PNL) and the efficacy of a moderate-intensity swimming training as therapeutic strategy for nerve regeneration., Methods: A number of 30 male adult mice were equally divided in control, 14 days after PNL (PNL 14 days), 42 days after PNL (PNL 42 days), 70 days after PNL (PNL 70 days) and 5-week exercise training after 7 days post-lesion (PNL trained 35 days) groups. PNL trained 35 days group began with a 10-min session for 3 days and this time was gradually increased by 10 min every three sessions until the animals had swum for 50 min per session. Morphoquantitative analysis was carried out to assess nerve regeneration in each group., Results: PNL 14 days group exhibited less degenerating signs than PNL 42 days group, where most post-lesion alterations were visualized. Nerve area and minimum diameter were significantly lower (p < 0.05) than control group. PNL 70 days group showed a greater degree of regenerating fibers and similar morphometric parameters to control group. PNL trained 35 days demonstrated signs of regeneration, reaching control group values in the morphometric analysis., Discussion: PNL promotes great histopathological changes, which became more visible at 42 post-injury days. A natural nerve-regeneration tendency was observed throughout time, as observed in PNL 70 days group; nevertheless, moderate swimming training was found to be a therapeutic resource for nerve regeneration, accelerating such process from a morphoquantitative perspective., Abbreviations: ANOVA: One-way analysis of variance; BDNF: Brain-derived neurotrophic factor; FGF-2: Fibroblast growth factor 2; GDNF: Glial cell line derived neurotrophic factor; IGF: Insulin-link growth factor; IL-1β: Interleukin-1β; NGF: Neural growth factor; PBS: Phosphate-buffered saline; PNL: Partial sciatic nerve ligation.

Background: Deep sternal wound infection and mediastinitis determine high in-hospital mortality. International studies show that these patients are also at increased cardiovascular mortality risk in long-term follow-up. However, data are scarce and there is no national data., Objectives: The aim of this study is to evaluate the mortality and incidence of cardiovascular events in long-term follow-up of patients suffering from deep sternal wound infection and mediastinitis., Methods: Case-control study, matched by propensity score in a 1:1 proportion, in patients submitted to coronary artery bypass grafting between 2005 and 2008 at the Institute Dante Pazzanese of Cardiology (São Paulo, SP, Brazil). The primary outcome was death. As a secondary outcome, we analyzed the composite event of myocardial infarction, new revascularization, stroke or death., Results: Of 1975 patients, 114 developed one of the infections. During the mean follow up of 3.6 years, deep sternal wound infection and mediastinitis increased the risk of death by 8.26 (95% CI 1.88-36.29, P = 0.005) and the incidence of combined end point by 2.61 (95% CI 1.2-5.69, P = 0.015). The Kaplan-Meier curves for both outcomes demonstrated that the greatest risk occurs in the first six months, followed by a period of stabilization and further increase in the incidence of events after 4 years of hospital discharge. The similarity between the curves of primary and secondary outcomes may be consequent to the predominance of death on the combined cardiovascular events., Conclusion: The presence of deep sternal wound infection or mediastinitis increased mortality in long-term follow-up in this sample of the Brazilian population according to the same pattern displayed by the developed countries.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) can increase embryo development to the blastocyst stage in cattle. The objective of the present study was to determine whether GM-CSF is present in the reproductive tract. Using Western blotting, immunoreactive GM-CSF was detected in uterine flushings from cows at days 0, 7, and 14 of the estrous cycle and from cows at days 14-17 of pregnancy. Also, GM-CSF was localized immunohistochemically to endometrium and oviduct. Patterns of immunohistochemical localization and intensity of reaction product were similar for all days of the estrous cycle. While present in several cell types, immunoreactive product in the endometrium was greatest in epithelium (especially luminal epithelium). Immunoreactive GM-CSF was also localized to epithelium in ampullary and isthmic regions of the oviduct, with intensity greater in ampulla. Staining was observed for both ciliated and non-ciliated cells. In conclusion, the bovine oviduct and endometrium contain immunoreactive GM-CSF and this molecule is present in uterine secretions. Thus, this cytokine is a potentially important intracellular regulator of endometrial, oviductal and embryonic function during early pregnancy in the cow.

Interleukin-1 (IL-1) is a pleiotropic cytokine implicated in endometrial and embryonic physiology. Our objective was to determine the presence of IL-1 in the endometrium, oviduct, and uterine fluid of cows at days 0, 7, and 14 of the estrous cycle. Immunoreactive IL-1beta was identified in endometrial and oviductal tissues throughout the estrous cycle by immunohistochemistry. Both glandular and luminal endometrial epithelium exhibited intense IL-1beta staining. For luminal epithelium, staining was strongest at day 0 and least at day 7. Staining in glandular epithelium was similar at all stages of the estrous cycle examined. There was a diffuse immunostaining throughout the endometrial stroma, and some isolated stromal cells stained strongly, as did endothelial cells. Immunoreactive IL-1beta was detected in uterine flushings by Western blotting, and the frequency of positive samples and intensity of immunoreactive bands did not differ between days of the estrous cycle. In the oviduct, immunoreactive IL-1beta was found in the epithelium and stroma of ampulla and isthmus. The staining intensity score for the oviduct was not different between isthmus and ampulla or between days of the estrous cycle. The presence of IL-1beta in the bovine endometrium, oviduct, and uterine flushings supports the idea that this cytokine may play an important role in regulating embryonic and endometrial function in cattle.

Experiments were performed to determine the actions of recombinant bovine interleukin-1beta (IL-1beta) on the growth of preimplantation embryos. In the first series of studies, IL-1beta was added at 8-10 h after insemination, and the percentage of oocytes developing to the blastocyst stage was evaluated. IL-1beta increased development to the blastocyst stage when embryos were cultured at high density ( approximately 25-30 embryos/drop) but decreased or had no effect on development when cultured at low density ( approximately 10 embryos/drop). Thus, the positive effect of IL-1beta depends upon some other embryo-derived product. The effect of IL-1beta on embryonic development was maintained in completely denuded embryos, indicating that cumulus cells do not mediate the actions of IL-1beta. Maximum development of embryos cultured at approximately 25-30/drop occurred at 0.1-1 ng/ml; 10 ng/ml was less effective. Addition of IL-1beta to groups of approximately 25-30 embryos/drop at 8-10 h after insemination also increased embryo cell number at Day 5 postinsemination by increasing the proportion of embryos that reached the 9- to 16-cell stage. However, IL-1beta had no effect on the proportion of blastocysts when added at Day 5 postinsemination. Thus, IL-1beta probably acts to increase blastocyst numbers by exerting actions on embryo growth before Day 5. In contrast to its effect on embryos, addition of IL-1beta during oocyte maturation did not affect cumulus expansion, cleavage rate of oocytes, or subsequent development to the blastocyst stage. In conclusion, IL-1beta can modulate growth of bovine embryos at early stages of development in a manner dependent upon embryo density.

The objective was to determine whether granulocyte-macrophage colony-stimulating factor (GM-CSF) stimulates development of bovine embryos. In each experiment, oocytes were fertilized in vitro, GM-CSF was added to embryo culture medium at 8-10 h or 5 days after insemination, and development was monitored as the proportion of oocytes that formed blastocysts. Addition of recombinant bovine GM-CSF to serum-free medium at 8-10 h after insemination increased the percentage of oocytes that formed blastocysts (7.2% and 15.2% for control and GM-CSF, respectively). GM-CSF did not affect cleavage rate. Rather, the effect of GM-CSF seems to be exerted after Day 5 after insemination, as indicated by the following findings: 1) GM-CSF did not alter embryo cell number at Day 5 after insemination; 2) administration of GM-CSF at Day 5 increased the proportion of oocytes that developed to the blastocyst stage (6.7%, 13.0%, and 22.4% for control and 1 and 10 ng/ml GM-CSF, respectively); and 3) addition of serum at Day 5 increased development but prevented a further increase due to addition of GM-CSF at 10 h after insemination. Blastocysts from GM-CSF-treated cultures tended to be at earlier stages of morphological development (i.e., fewer blastocysts expanded at Day 7 and fewer were hatching or hatched at Day 9 after insemination). GM-CSF may play a role in the early development of bovine embryos and might be a useful molecule for increasing blastocyst production rates in serum-free culture systems.

Three experiments tested the effects of recombinant bovine granulocyte-macrophage colony-stimulating factor (rbGM-CSF) on the preimplantation bovine and ovine conceptus. There was no effect of rbGM-CSF on the secretion of total radiolabeled protein in conditioned medium, immunoreactive interferon-tau (IFN tau), antiviral activity, or prostaglandin E2 from Day 16-18 bovine conceptuses cultured for 24 hr with, [3H]leucine and +/- 10 ng/ml rbGM-CSF. Similarly, there was no effect of 1 ng/ml rbGM-CSF on the secretion of total radiolabeled protein. IFN tau, or antiviral activity from Day 17 ovine conceptuses. There was also no beneficial effect of 1 or 10 ng/ml rbGM-CSF on the presence of immunoreactive IFN tau in conditioned medium from in vitro-produced bovine blastocysts at Day 7-8 after fertilization. Results indicate that IFN tau secretion from bovine and ovine conceptuses are unresponsive to rbGM-CSF at the concentrations tested.

Carotid bifurcation aneurysms have, as a group, certain characteristics. They account for about 7% of all intracranial aneurysms. They appear to be mostly leftsided and there does not seem to be any particular sex predominance. When associated with other aneurysms, the carotid bifurcation aneurysm was the symptomatic lesion. Demonstration of small aneurysms may be difficult and accurate definition of the neck may not be possible at angiography. They appear to associate themselves with one or the other division of the internal carotid artery. With careful exposure and appropriate positioning of the head it is possible to occlude these aneurysms with a clip, but we feel that the inexperienced surgeon should not tackle these cases. Carotid artery ligation may not prevent rebleeding in this group of aneurysms.