Genetic structure and origin of peopling in the Azores islands (Portugal): the view from mtDNA

The Azores islands (Portugal), uninhabited when discovered by Portuguese navigators in the fifteenth century, are located in the Atlantic Ocean 1500 km from the European mainland. The archipelago is formed by nine islands of volcanic origin that define three geographical groups: Eastern (S. Miguel and Sta. Maria), Central (Terceira, Faial, Pico, Graciosa and S. Jorge) and Western (Flores and Corvo). To improve the genetic characterisation of the Azorean population, and to clarify some aspects related to the history of settlement, a study of mtDNA was conducted in the population of the archipelago. The HVRI region was sequenced and specific RFLPs were screened in 146 samples obtained from unrelated individuals with Azorean ancestry (50 from the Eastern group, 60 from the Central group, and 37 from the Western group). Samples were classified into haplogroups based on the information obtained from both sequencing and RFLP analysis. All the analyses performed support the idea that, in the whole group of islands, the majority of mtDNA lineages originated from the Iberian Peninsula, mainly from Portugal (mainland). However contributions from other European populations, especially from Northern Europe, cannot be disregarded. The values obtained for the various diversity parameters in the Azores archipelago indicate that the Azorean population, as a whole, does not exhibit the typical characteristics of an isolated population. The analysis of genetic data by groups of islands showed that the Western group exhibited particular features. The distribution of haplogroups in the Western group is very atypical, being significantly different from what is observed in the Eastern and Central groups. Furthermore, the diversity values are, in general, lower than those observed in other populations used for comparison. African haplogroups were found in all the groups of islands. Therefore the presence of Moorish and African slaves on the islands, as reported in historical sources, is supported by the mtDNA genetic data, especially in the Eastern group. The presence of Jews in the Central group is also supported by the mtDNA data. Neither historical nor genetic data (phylogeography of mtDNA) supports the idea of a differential settlement history for the Western group; however, it is represented in the phylogenies as an isolated branch. The effect of genetic drift, induced by the reduced population size since peopling occurred, has led to a very atypical distribution of haplogroups/haplotypes in this group of islands. We cannot ignore the influence of biodemographic and genetic processes, namely founder effect, genetic drift, migration, and even recent mutational events in the mtDNA lineages of the Azorean populations. Nevertheless, a great part of the variation in the Azorean mtDNA can be explained by the settlement history.

Effectiveness of lateral slide exercise in an anterior cruciate ligament reconstruction rehabilitation home exercise program

STUDY DESIGN

Two-group repeated measures design using a sample of convenience of subjects with anterior cruciate ligament (ACL) reconstructive surgery.

OBJECTIVES

To determine the effect of incorporating one specific weight-bearing exercise (lateral slide exercise using a slide board) into an ACL reconstruction home exercise program.

BACKGROUND

Reduced clinic visits have increased the importance of home exercise programs in knee ligament reconstruction rehabilitation. Few studies have been conducted to test the efficacy of specific exercises as part of a home-based treatment program on subjects who have undergone ACL reconstruction.

METHODS AND MEASURES

Fourteen subjects who underwent patella tendon autograft reconstruction on one of their ACLs were studied. Testing consisted of the following 4 measurements: peak isometric knee extension torque, peak isometric knee flexion torque, maximum lateral step height, and lateral step-up repetitions to fatigue. Subjects were pretested at 8 weeks after surgery and were randomly placed into either a control or experimental group. The postsurgical rehabilitation was similar for both groups, except the experimental group incorporated lateral slide exercise into their home exercise program. All subjects were re-evaluated 14 weeks after surgery.

RESULTS

A 2-way repeated measure ANOVA (group by test session), and posthoc testing revealed significant improvements in the slide group for quadricep strength (101.9 +/- 31.3 N m to 140.5 +/- 31.3 N m of torque), while the control group showed no significant increase (125.1 +/- 61.7 N m to 125.8 +/- 45.1 N m of torque). Lateral step height also improved in the slide group (from 22.9 +/- 5.3 cm to 28.7 +/- 5.6 cm), while the control group showed no increase (20.0 +/- 4.5 cm to 20.7 +/- 3.4 cm). Both groups increased in lateral step-up repetitions to fatigue.

CONCLUSION

Including lateral slide exercise in a home exercise program after ACL reconstruction appears to improve knee extension strength.

Optical coherence angiography for pre-treatment assessment and treatment monitoring following photodynamic therapy: a basal cell carcinoma patient study

Microvascular networks of human basal cell carcinomas (BCC) and surrounding skin were assessed with optical coherence angiography (OCA) in conjunction with photodynamic therapy (PDT). OCA images were collected and analyzed in 31 lesions pre-treatment, and immediately/24 hours/3-12 months post-treatment. Pre-treatment OCA enabled differentiation between prevalent subtypes of BCC (nodular and superficial) and nodular-with-necrotic-core BCC subtypes with a diagnostic accuracy of 78%; this can facilitate more accurate biopsy reducing sampling error and better therapy regimen selection. Post-treatment OCA images at 24 hours were 98% predictive of eventual outcome. Additional findings highlight the importance of pre-treatment necrotic core, vascular metrics associated with hypertrophic scar formation, and early microvascular changes necessary in both tumorous and peri-tumorous regions to ensure treatment success.

Clinical benefits of music-based interventions on preterm infants' health: A systematic review of randomised trials

AIM

This systematic review aimed to differentiate and isolate the results of different music-based interventions used with preterm infants in the neonatal intensive care unit and explore their clinical benefits.

METHODS

The last search was performed on 5 July 2021 on Web of Science, Scopus, EMBASE, PsycINFO, CINAHL, LILACS and CENTRAL. Only randomised clinical trials that explored the health benefits of music-based interventions were considered.

RESULTS

A total of 39 studies were included. All music-based interventions were divided into music medicine and music therapy. The overall results suggested that music medicine interventions were associated with a significant improvement in pain relief; in turn, improvements in cardiac and respiratory function, weight gain, eating behaviour, and quiet alert and sleep states were more consistent in studies that followed a music therapy approach with the presence of a music therapist.

CONCLUSION

This review supports the beneficial effects of music-based interventions on the health of preterm infants in a neonatal intensive care unit; however, it also offers suggestions for future studies in order to increase the number of interventions with music therapists, since the results of music therapy approaches were more consistent for physiological and behavioural outcomes.

Prolactin inhibition at mid-lactation influences adiposity and thyroid function in adult rats

Maternal hypoprolactinemia at the end of lactation (a precocious weaning model) increases milk leptin transfer and results in overweight, leptin resistance, and secondary hypothyroidism at adulthood. We studied the effects of prolactin (PRL) inhibition during mid-lactation (a partial malnutrition model) on milk leptin transfer, leptinemia, body composition, and thyroid function. Lactating rats were treated with bromocryptine (BRO, 1 mg/twice daily) or saline on days 7, 8, and 9 of lactation. Offspring were sacrificed 10, 21, and 90 days after birth. After treatment, BRO-treated dams showed hypoprolactinemia and hyperleptinemia, and produced less milk with lower levels of lactose and higher milk triglycerides. Milk leptin levels were lower at weaning. Offspring of BRO-treated dams had lower body weight and length as well as less visceral fat during lactation and adulthood. Total fat was also lower at weaning and adult life, whereas total protein was higher at 90 days-old. BRO offspring presented lower serum T4 and TSH at 10 days-old and weaning, respectively. When adults, these rats exhibited hypoleptinemia, lower levels of thyroid hormones, and higher TSH. Early inhibition of PRL therefore leads to offspring malnutrition and affects subsequent growth. Also, inhibition of PRL during lactation predisposes offspring to hypothyroidism; however, when the inhibition occurs during late lactation, the hypothyroidism is secondary, whereas when it is restricted to mid-lactation, the thyroid hypofunction is primary. The programming effect of milk suppression thus depends on the developmental stage of offspring.

Double-layer force suppression between charged microspheres

In this paper we propose a protocol to suppress double-layer forces between two microspheres immersed in a dielectric medium, being one microsphere metallic at a controlled potential ψ_{M} and the other a charged one either metallic or dielectric. The approach is valid for a wide range of distances between them. We show that, for a given distance between the two microspheres, the double-layer force can be totally suppressed by simply tuning ψ_{M} up to values dictated by the linearized Poisson-Boltzmann equation. Our key finding is that such values can be substantially different from the ones predicted by the commonly used proximity force approximation, also known as the Derjaguin approximation, even in situations where the latter is expected to be accurate. The proposed procedure can be used to suppress the double-layer interaction in force spectroscopy experiments, thus paving the way for measurements of other surface interactions, such as Casimir dispersion forces.

West syndrome: early remission is not assurance of normal final outcome

BACKGROUND

West syndrome (WS), an age-specific epilepsy of infancy and early childhood, considered of poor prognosis, may have remission. With the objective of describing the clinical features, treatment and outcome of the children with WS followed in a Latin American country, we devised a retrospective study.

METHODS

Infants with recurrent spasms, and typical or atypical hypsarrhythmia on electroencephalography (EEG) were included, and their medical report reviewed with particular interest on therapy (anti-epileptic drug, steroids) and outcome. Short-term (remission of spasms up to 6 months after the beginning) and long-term outcome (development and seizure status over the age of 2 years) were focused.

RESULTS

Of the 37 selected infants, most (29/37, 78.3%) were classified as symptomatic, and neonatal history of hypoxia (10/29) was the most frequent etiology. The majority had a typical hypsarrhythmia EEG pattern. Most used a combination of anti-epileptic drugs and steroids. A favourable short-term outcome occurred in 20 infants, but only three had normal development and were seizure free after the age of 2 years.

CONCLUSION

Early seizure remission is not assurance of normal final outcome in WS.

Hypertrophic reversed palmaris longus muscle: a cadaveric finding

Variations of the forearm musculature are vastly described in the literature. The palmaris longus muscle is one of the most variable structures of the human body. It usually arises from the medial epicondyle of the humerus and inserts itself into the palmar aponeurosis. Anatomy textbooks and recent papers state that this muscle may act as a weak wrist flexor. The present work aims to report an anatomical variation where the palmaris longus muscle was abnormally hypertrophied and was completely fleshy throughout the whole forearm. Anatomical variations of the palmaris longus may induce symptoms of neurovascular bundle compression, especially of the median nerve. The palmaris longus muscle may be used in tendon graft or muscle graft, due to its lack of apparent function. Furthermore, it is one of the anatomical landmarks for local anaesthesia procedures. (Folia Morphol 2018; 77, 2: 403-405).

Negative optical torque on a microsphere in optical tweezers

We show that the optical force field in optical tweezers with elliptically polarized beams has the opposite handedness for a wide range of particle sizes and for the most common configurations. Our method is based on the direct observation of the particle equilibrium position under the effect of a transverse Stokes drag force, and its rotation around the optical axis by the mechanical effect of the optical torque. We find overall agreement with theory, with no fitting, provided that astigmatism, which is characterized separately, is included in the theoretical description. Our work opens the way for characterization of the trapping parameters, such as the microsphere complex refractive index and the astigmatism of the optical system, from measurements of the microsphere rotation angle.

The venous patterns of the cubital fossa in subjects from Brazil

Venous punctures are among the most common procedures performed by healthcare professionals. In particular, the cubital fossa is the site where the venous accesses are frequently made due to the number of superficial veins and the numerous anastomoses in this region. The arrangement of these venous connections is of particular interest for clinical application in several areas, thus, the healthcare professional must possess knowledge about these vessels and their anatomical relationships. The present study aims to analyze the venous pattern of the cubital fossa among individuals from Brazil. This study was approved by a Research Ethics Committee. The sample had 100 healthy individuals (50 men and 50 women). The superficial veins of the cubital fossa were analyzed with the aid of a sphygmomanometer. When inflated, the pressure in the forearm increased and the veins became prominent. It was observed that in the selected sample the types with the highest prevalence were the Type I and Type VII, both with 22% in 200 limbs studied. The chi² test showed a significant statistical difference between the anastomosis pattern and the sex of the studied sample. The anastomotic pattern of the superficial veins of the studies sample is similar to African, European and Asian populations. The study of these variations is necessary to provide scientific basis for the healthcare professional during a venipuncture in order to avoid iatrogenic errors and damages in cutaneous nerves or neighboring arteries.

Radiographic evaluation of the bicipital groove morphology does not predict intraarticular changes in the long head of biceps tendon

INTRODUCTION AND OBJECTIVES

This study aimed to examine the clinical utility of the radiographic evaluation of the bicipital groove in predicting long head of biceps tendon (LHBT) pathology.

MATERIAL AND METHODS

A prospective study was conducted, and sixty consecutive patients proposed to shoulder arthroscopic surgery were selected. Before surgery, a radiographic evaluation was performed with a supine and a Fisk radiograph. Most supine radiographs (>75%) were non-interpretable and were excluded from the study. As some Fisk radiographs (26.7%) were also non-interpretable, that left 44 interpretable radiographs in the study. These were measured for medial opening angle, total opening angle, width and depth of the bicipital groove. The radiographic measurements and the presence of LHBT pathology, as assessed at arthroscopy, were correlated.

RESULTS

Radiographic evaluation of the bicipital groove showed a mean medial opening angle of 53 ± 15° (23-90), a mean total opening angle of 80 ± 26° (30-135), a mean width of 10.3 ± 2.5 mm (6-19) and a mean depth of 4.1 ± 1.5 mm (1-8). Men had higher medial opening angle (60 vs 50°, p = 0.044) and wider grooves (11.9 vs 9.7 mm, p = 0.019). Twenty-five patients (56.8%) were found to have an abnormal LHBT. No correlation was found between the radiographic measurements and LHBT pathology. Only age was correlated with a LHBT lesion (61.8 vs 46.3 years, p < 0.001).

CONCLUSIONS

Our results show that there is no correlation between radiographic morphologic evaluation of the bicipital groove and LHBT pathology.

P1346 Not all chest pains are scary: a case report of an important - but often forgotten - diagnosis

INTRODUCTION

Epipericardial fat necrosis (EFN) is an uncommon self-limiting benign condition that curses with chest pain. The first case was reported in 1957 and since than only few cases were reported. Recently, new imaging modalities have increased its diagnosis.

CASE REPORT

An otherwise healthy 42 years-old man presented with severe left-sided pleuritic chest pain, non-radiating, with 4 days duration, mildly relieved by an analgesic. No other symptoms nor history of infection. Physical examination, chest x-ray (CXR), ECG, routine laboratory testing, d-dimer and troponin measurements were unrevealing. Chest CT with contrast showed an increased density of anterior pericardial fat with nodular appearance consistent with EFN. The transthoracic echocardiogram was normal. For better characterization, a cardiac MRI was performed, and confirmed a small nodular lesion (10x17mm) with regular contours, externally to the pericardium, in relation to the apex of the right ventricle and the anterior thoracic wall (hypersignal on T1 and T2, loss of signal in fat saturation sequences, no contrast capture during the first pass nor late enhancement). The mass was delimited from the remaining pericardiac fat by a regular halo. Combined antiinflamatory therapy was started with favourable evolution. Cardiac surgery concluded that there was no need to perform a biopsy of the lesion unless there was recurrence of the symptoms. At 3 and 6-month follow-up, chest pain had resolved (no recurrence) - CT was performed for comparison and still showed a slight densification of the anterior mediastinum’s fat.

DISCUSSION

EFN is an often-overlooked etiology of chest pain in patients with a negative cardiopulmonary workup. The aetiology of EFN is still unknown but appears to be similar to other analogous conditions such as epiploic appendagitis and fat necrosis in the omentum or breast. It’s not expectable that patients with EFN have a higher risk of coronary heart disease. Onset is usually acute but can persist up to a year. Increased heart rate and diaphoresis may be found. ECG and lab tests are usually normal. CXR often shows a paracardiac opacity, occasionally with an associated pleural effusion. CT typically shows a fatty lesion anterior to the pericardium, in the epipericardial fat, with stranding of surrounding soft tissue. In most cases the adjacent pericardium is also thickened. CT enables prompt diagnosis in most cases, preventing further invasive procedures. No evidence-based treatment guidelines are available due to the rarity and benign behaviour of the disease. Treatment is usually conservative with analgesics and non-steroidal anti-inflammatory drugs. Follow-up imaging is recommended to confirm resolution and exclude neoplastic diseases such as liposarcoma. It is important to be familiar with its features since the clinical and radiologic characteristics suggest a presumptive diagnosis, thereby avoiding more aggressive techniques.

Abstract P1346 Figure. MRI - small nodular lesion

Radiographic evaluation of the bicipital groove morphology does not predict intraarticular changes in the long head of biceps tendon

INTRODUCTION AND OBJECTIVES

This study aimed to examine the clinical utility of the radiographic evaluation of the bicipital groove in predicting long head of biceps tendon (LHBT) pathology.

MATERIAL AND METHODS

A prospective study was conducted, and sixty consecutive patients proposed to shoulder arthroscopic surgery were selected. Before surgery, a radiographic evaluation was performed with a supine and a Fisk radiograph. Most supine radiographs (>75%) were non-interpretable and were excluded from the study. As some Fisk radiographs (26.7%) were also non-interpretable, that left 44 interpretable radiographs in the study. These were measured for medial opening angle, total opening angle, width and depth of the bicipital groove. The radiographic measurements and the presence of LHBT pathology, as assessed at arthroscopy, were correlated.

RESULTS

Radiographic evaluation of the bicipital groove showed a mean medial opening angle of 53±15o (23 - 90), a mean total opening angle of 80±26o (30 - 135), a mean width of 10.3±2.5mm (6 - 19) and a mean depth of 4.1±1.5mm (1 - 8). Men had higher medial opening angle (60 vs 50o, p=0.044) and wider grooves (11.9 vs 9.7mm, p=0.019). Twenty-five patients (56.8%) were found to have an abnormal LHBT. No correlation was found between the radiographic measurements and LHBT pathology. Only age was correlated with a LHBT lesion (61.8 vs 46.3 years, p <0.001).

CONCLUSIONS

Our results show that there is no correlation between radiographic morphologic evaluation of the bicipital groove and LHBT pathology.