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The successful fabrication of biosensors is greatly limited by the immobilization of their bioreceptor, thus we propose a facile and reproducible two-step method to modify graphite electrodes with a bacterial laccase, relying on a fast and controllable potentiostatic process to coat graphite surfaces with biomolecule-compatible thin films of polynorepinephrine (ePNE) and polydopamine (ePDA). Both polymers, synthesized with a similar thickness, were functionalized with bacterial laccase, displaying distinct electrochemical transducing behaviours at pH 5.0 and 7.0. ePNE layer enables adequate electron transfer of anionic and cationic species in acidic and neutral media, whereas transduction across ePDA strongly depends on pH and redox probe charge. ePNE stands out by improving the amperometric responses of the biosensing interface towards a phenolic acid (gallic acid) and a flavonoid (catechin), in respect to ePDA. The optimal graphite/ePNE/laccase interface outperforms biosensing interfaces based on fungal laccases at neutral pH, displaying detection sensitivities of 104 and 14.4 µA cm -2 mM -1 for gallic acid and catechin, respectively. The fine synthetic control of the ePNE bio-inspired transduction layer and the use of an alkaliphilic bacterial laccase enabled the construction of an amperometric biosensing interface with extended pH range of polyphenols detection present in food products and agro-industrial waste., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Housing is considered a social determinant of health. In Catalonia and Spain, ensuring affordable housing is challenging and cooperative housing under a grant-of-use emerges as an alternative, challenging traditional housing models. This study aims to quantify its impact on health before and after moving to the cooperative house., Methods: A longitudinal study of individuals in cooperative housing projects in Catalonia (July 2018-April 2023) was conducted. Data, including sociodemographic, housing information, and health-related details, were collected through baseline and follow-up surveys., Results: Seventy participants (42 women, 28 men) showed positive changes in housing conditions during follow-up. Improved perceptions of health, mental health, and social support were observed. Despite limitations in sample size and short follow-up, initial findings suggest improvements in health., Conclusions: Cooperative housing under a grant-of-use in Catalonia appears promising for improving health and living conditions. Further research is warranted to explore its full potential as an alternative amid housing challenges in the region., (© 2024. The Author(s).)

Respiratory dysfunction is an important hallmark of amyotrophic lateral sclerosis (ALS). Elevation of creatine kinase (CK) has been reported in 23-75% of ALS patients, but the underlying mechanisms remain unknown. This work aims to enlighten the role of CK as a prognostic factor of respiratory dysfunction in ALS. A retrospective analysis of demographic and clinical variables, CK, functional decline per month (ΔFS), forced vital capacity (%FVC), and mean amplitude of the phrenic nerve compound motor action potential (pCMAP) in 319 ALS patients was conducted. These measurements were evaluated at study entry, and patients were followed from the moment of first observation until death or last follow-up visit. High CK values were defined as above the 90th percentile (CK ≥ P90) adjusted to sex. We analyzed survival and time to non-invasive ventilation (NIV) as proxies for respiratory impairment. Linear regression analysis revealed that high CK was associated with male sex ( p < 0.001), spinal onset ( p = 0.018), and FVC ≥ 80% ( p = 0.038). CK was 23.4% higher in spinal-onset ALS patients ( p < 0.001). High CK levels were not linked with an increased risk of death ( p = 0.334) in Cox multivariate regression analysis. CK ≥ P90 (HR = 1.001, p = 0.038), shorter disease duration (HR = 0.937, p < 0.001), lower pCMAP (HR = 0.082, p < 0.001), and higher ΔFS (HR = 1.968, p < 0.001) were risk factors for respiratory failure. The association between high CK levels and poorer respiratory outcomes could derive from cellular metabolic stress or a specific phenotype associated with faster respiratory decline. Our study suggests that CK measurement at diagnosis should be more extensively investigated as a possible marker of poor respiratory outcome in future studies, including a larger population of patients., Competing Interests: The authors declare no conflicts of interest.

Purpose: This study compares the acute effects of a static stretching and a warmup protocol on the active and passive shear modulus of the hamstring muscles., Methods: Muscle shear modulus was assessed at rest and during isometric contractions at 20 % of maximal voluntary isometric contraction (MVIC)., Results: After stretching, the passive shear modulus pattern was not altered, while at 20 % MVIC the biceps femoris short head (BFsh) and semimembranosus showed a shear modulus increase and decrease, respectively, which resulted on BFsh-SM pair differences (pre: 3.8 ± 16.8 vs. post: 39.3 ± 25.1 kPa; p < 0.001; d = 1.66) which was accompanied by a decrease of 18.3 % on MVIC. Following the warmup protocol, passive shear modulus remained unchanged, while active shear modulus was decreased for the semitendinosus (pre: 65.3 ± 13.5 vs. post: 60.3 ± 12.3 kPa; p = 0.035; d = 0.4). However, this difference was within the standard error of measurement (10.54 kPa), and did not impact the force production, since it increased only 1.4 % after the warmup., Conclusions: The results of this study suggest that the passive and active shear modulus responses of the individual hamstring muscles to static stretching are muscle-specific and that passive and active hamstring shear modulus are not changed by a standard warmup intervention., Competing Interests: Declaration of interest statement The authors declare that they have no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

This paper investigates the complexity of DNA sequences in maize and soybean using the multifractal detrended fluctuation analysis (MF-DFA) method, chaos game representation (CGR), and the complexity-entropy plane approach. The study aims to understand the patterns and structures of these DNA sequences, which can provide insights into their genetic makeup and improve crop yield and quality. The results show that maize and soybean DNA sequences exhibit fractal properties, indicating a complex and self-organizing structure. We observe the persistence trend between sequences of base pairs, which indicates long-range correlations between base pairs. We also identified the stochastic nature of the DNA sequences of both species., (© 2024. The Author(s).)

This study aimed to determine whether changes in hamstrings passive and active shear modulus after a warmup protocol are correlated. Twenty males without a history of hamstring strain injury participated. Muscle shear modulus was assessed using ultrasound-based shear wave elastography at rest and during isometric contractions at 20% of maximal voluntary isometric effort before and immediately after a warmup protocol. Changes in passive shear modulus did not seem to be associated with changes in active shear modulus. The results of this study suggest that changes in passive and active hamstring shear modulus are not associated after a standardized warmup intervention., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Although the underlying mechanisms behind upper limb (e.g., finger) motor slowing during movements performed at the maximum voluntary rate have been explored, the same cannot be said for the lower limb. This is especially relevant considering the lower limb's larger joints and different functional patterns. Despite the similar motor control base, previously found differences in movement patterns and segment inertia may lead to distinct central and peripheral manifestations of fatigue in larger joint movement. Therefore, we aimed to explore these manifestations in a fatiguing knee maximum movement rate task by measuring brain and muscle activity, as well as brain-muscle coupling using corticomuscular coherence, during this task. A significant decrease in knee movement rate up to half the task duration was observed. After an early peak, brain activity showed a generalized decrease during the first half of the task, followed by a plateau, whereas knee flexor muscle activity showed a continuous decline. A similar decline was also seen in corticomuscular coherence but for both flexor and extensor muscles. The electrophysiological manifestations associated with knee motor slowing therefore showed some common and some distinct aspects compared with smaller joint tasks. Both central and peripheral manifestations of fatigue were observed; the changes seen in both EEG and electromyographic (EMG) variables suggest that multiple mechanisms were involved in exercise regulation and fatigue development. NEW & NOTEWORTHY The loss of knee movement rate with acute fatigue induced by high-speed movement is associated with both central and peripheral electrophysiological changes, such as a decrease in EEG power, increased agonist-antagonist cocontraction, and impaired brain-muscle coupling. These findings had not previously been reported for the knee joint, which shows functional and physiological differences compared with the existing findings for smaller upper limb joints.

Introduction: This study examined the effects of ultrasound transducer pressure and examiner experience on the biceps femoris long head and semitendinosus muscle active shear modulus in healthy individuals (n = 28)., Methods: Active shear modulus was assessed using shear wave elastography at 20% of knee flexor maximal voluntary isometric contraction. Examiners with different experience levels measured the muscles' shear modulus with three pressure levels: mild, moderate, and hard., Results: A main effect of transducer pressure was found for both biceps femoris long head (p < 0.001; η 2 p  = 0.314) and semitendinosus muscles (p < 0.001; η 2 p  = 0.280), whereas differences were found between mild-moderate (biceps femoris long head: p = 0.013, d = 0.23; semitendinosus: p = 0.024, d = 0.25), and mild-hard pressures (biceps femoris long head: p = 0.001, d = 0.47; semitendinosus: p = 0.002, d = 0.47). Examiners performed similar shear modulus measurements in the biceps femoris long head (p = 0.299; η 2 p  = 0.041) and semitendinosus (p = 0.177; η 2 p  = 0.066), although the experienced examiner showed a higher measurement repeatability (biceps femoris long head: ICC = 0.86-0.95, semitendinosus: ICC = 0.89-0.96; vs. biceps femoris long head: ICC = 0.78-0.87, semitendinosus: ICC = 0.66-0.87)., Conclusion: Transducer pressure influences the active shear modulus measurement between mild and moderate or hard pressures. Additionally, examiner experience seems to have no influence on muscle active shear modulus measurement when assessed at the same site (using casts)., Implications for Practice: Future studies assessing active muscle shear modulus should use mild transducer pressure and having experienced examiners in order to improve measurement reliability., Competing Interests: Conflicts of interest No potential conflict of interest was reported by the author(s)., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The purpose of the present study was to examine the acute effects of a maximum repeated sprint protocol on (1) hamstring shear modulus and (2) knee flexor neuromuscular parameters such as peak torque (PT) and rate of torque development (RTD). Muscle shear modulus was assessed in 18 healthy males using shear wave elastography at rest and during 30° isometric knee flexion at 20% of maximal voluntary isometric contraction, before and after a 10 × 30 m repeated sprint protocol. There was a 9% decrease in average speed between the fastest and slowest sprint (p < 0.001; d = 2.27). A pre-post decrease was observed in PT (p = 0.004; η 2 p  = 0.399) and in the 0-50 ms (p = 0.042; η 2 p  = 0.222), and 50-100 ms (p = 0.028; η 2 p  = 0.254) RTD periods. For the active shear modulus, the only significant change after the sprint task was in the biceps femoris long head (BFlh) with an increase of 10% (Pre: 26.29 ± 8.89 kPa; Post: 28.93 ± 8.31 kPa; p = 0.015; d = 0.31). The present study provides evidence that repeated sprinting leads to significant decreases in average speed, PT, early RTD (0-50 ms; 50-100 ms), and to an increase in BFlh active shear modulus without changing the shear modulus of the other hamstrings muscles., (© 2023. Springer Nature Limited.)

This study examined the effects of fatigue on hamstring muscles and gluteus maximus passive and active shear modulus in hip extension (HE) and knee flexion (KF) at 20% of maximal voluntary isometric contraction performed until task failure. Measurements were taken before and after the fatigue tasks and the delta (post-pre) was calculated. No differences in the fatigue effects on passive shear modulus were seen between muscles nor between tasks. For the active shear modulus: a task × muscle interaction was seen ( p  = 0.002; η 2 p  = 0.401). The results for the tasks separately demonstrated only a significant effect for muscle in KF ( p  < 0.001; η 2 p  = 0.598), with different individual contributions identified between BFlh-SM ( p  = 0.006; d  = 1.10), BFlh-ST ( p  = 0.001; d  = 1.35) and SM-ST ( p  = 0.020; d  = 0.91). The comparisons between tasks for each muscle demonstrated significant differences for SM ( p  = 0.025; d  = 0.60) and ST ( p  = 0.026; d  = 0.60); however, no differences were seen for BFlh ( p  = 0.062; d  = 0.46). Therefore, fatigue effects induce different patterns on the hamstring muscles in HE and KF tasks when performed at 20% MVIC.

This study sought to examine the active stiffness of semitendinosus (ST) and biceps femoris long head (BFlh) during a knee flexor isometric contraction at 20% of maximal voluntary isometric contraction until failure in elite footballers ( n  = 50, age: 22.3 ± 5.3 years; height: 1.82 ± 0.08 m; body mass: 74.7 ± 9.0 kg). Active stiffness was assessed using ultrasound-based shear wave elastography by means of shear modulus quantification. Comparisons were performed between limbs with ( n  = 11) vs. without ( n  = 89) previous hamstring injury. A similar time until failure in the knee flexor fatigue task was observed between groups ( p  = .401). At the start of the task, lower limbs with previous hamstring injury showed a lower BFlh active stiffness (31.0.1 ± 10.4 kPa, p  = .023) and BFlh/ST active stiffness ratio (0.50 ± 0.29), and no differences for ST (72.8 ± 26.8 kPa, p  = .221) compared to lower limbs without previous hamstring injuries (BFlh: 38.0 ± 9.6 kPa; ST: 64.0 ± 18.4 kPa; BFlh/ST: 0.65 ± 0.27). During the task, the ST active stiffness in both groups decreased from 80% of task time ( p  = .032), in the absence of changes in BFlh active stiffness ( p  = .534), resulting in an increase in BFlh/ST active stiffness from 80% of task time ( p  = .029). No differences between limbs were observed during the fatigue task for all parameters ( p  > .099). Future research is warranted to verify if the differences found represent an increased risk of hamstring injury. HighlightsThe hamstring's active stiffness response to a fatigue protocol in soccer athletes with a history of injury is unknown.Athletes with previous injury showed less active stiffness in the biceps femoris long head.Similar response to fatigue was observed between athletes with and without hamstring injury history.

Background: Spondylodiscitis is a severe condition where standalone antibiotic therapy resolves most cases. In refractory infections, open surgery may aid with infection debulking. However, significant morbidity can occur. Nowadays, endoscopic approaches are emerging as an alternative. However, until now, only small-scale studies exist. Being so, we carried the first systematic review on spondylodiscitis endoscopic debridement indications, technique details, and outcomes., Methods: Search for all English written original studies approaching the spondylodiscitis endoscopic treatment was performed using PubMed and EBSCO host. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and a pre-specified protocol was registered at PROSPERO (CRD42020183657)., Results: Fourteen studies involving 342 participants were included for analysis. Data overall quality was fair. Indications for the endoscopic approach were poorly defined. The most consensual indication was refractory infection to conservative treatment. Spinal instability or neurological deficits were common exclusion criteria. All authors described similar techniques, and despite the frequent severe co-morbidities, procedure morbidity was low. Re-interventions were common. Microorganism identification varied from 54.2 to 90.4%. Treatment failure among studies ranged from 0 to 33%. Pain, functional status, and neurological deficits had satisfactory improvement after procedures., Conclusions: The endoscopic debridement of spondylodiscitis seems to be an effective and safe approach for refractory spondylodiscitis. A novel approach with initial endoscopic infection debulking and antibiotic therapy could improve the success of spondylodiscitis treatment., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The ability to produce high movement speeds is a crucial factor in human motor performance, from the skilled athlete to someone avoiding a fall. Despite this relevance, there remains a lack of both an integrative brain-to-behavior analysis of these movements and applied studies linking the known dependence on open-loop, central control mechanisms of these movements to their real-world implications, whether in the sports, performance arts, or occupational setting. In this review, we cover factors associated with the planning and performance of fast limb movements, from the generation of the motor command in the brain to the observed motor output. At each level (supraspinal, peripheral, and motor output), the influencing factors are presented and the changes brought by training and fatigue are discussed. The existing evidence of more applied studies relevant to practical aspects of human performance is also discussed. Inconsistencies in the existing literature both in the definitions and findings are highlighted, along with suggestions for further studies on the topic of fast limb movement control. The current heterogeneity in what is considered a fast movement and in experimental protocols makes it difficult to compare findings in the existing literature. We identified the role of the cerebellum in movement prediction and of surround inhibition in motor slowing, as well as the effects of fatigue and training on central motor control, as possible avenues for further research, especially in performance-driven populations., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

Maintaining the range of motion in repetitive movement tasks is a crucial point since it directly influences the movement rate. Ensuring the movement amplitude can be reliably maintained when motor function is assessed by measuring the maximum movement rate is therefore a key consideration. However, the performed range of motion during such tasks is often not reported. This study aimed to determine whether individuals are able to maintain an intended range of motion during a knee flexion/extension maximum movement rate task in the absence of tactile and visual feedback. Twelve healthy male individuals performed knee flexion/extension at maximum speed for eight 10-s blocks in a 45° arc between 45° and 90°. The range of motion was monitored using a marker system and the movement rate was measured. The performed range of motion was not significantly different from the 45° arc during the task despite a 13.47% decrease in movement rate from the start to the end of the task. Nevertheless, there was only anecdotal evidence of no difference from 45° in most blocks, while on the second and seventh blocks, there was anecdotal evidence of differences in the Bayesian one-sample test. There was also no significant shift in the maximum flexion/extension angles throughout the task. Healthy male individuals were thus able to perform a consistent average predefined knee range of motion in a maximum movement rate task despite decreases in movement rate. This was achieved without constraint-inducing devices during the task, using only basic equipment and verbal feedback.

Competing Interests: The authors report no conflicts of interest

Introduction and Aim: in capsule endoscopy (CE), small bowel subepithelial lesions (SBSL) are difficult to distinguish from innocent mucosal protrusions. The SPICE score (smooth, protruding lesions index on CE) and a score that assesses the SBSL protrusion angle were developed. The aim of the study was to determine if a composite score is superior to the proposed models., Methods: all CE between 01/2010 and 12/2020 were included in the study if a smooth, round protruding lesion was identified. Both scores and a composite score (SPICE > 2 and angle < 90°) were calculated after video review. Mucosal protrusions were defined as SBSL if they had a histological/imaging diagnosis and innocent protrusions if otherwise. All patients without at least one appointment and an additional diagnostic exam after CE were excluded., Results: a total of 34 CE were included; 64.7 % were males, aged 65.4 ± 14.7 years. The most common indication for CE was anemia (52.9 %). SBSL was identified in 17 cases, with lipomas (14.7 %) being the most frequent diagnosis. Both the SPICE (AUROC 0.90, p < 0.001) and protrusion angle scores (AUROC 0.74, p = 0.019) accurately distinguished SBSL from innocent protrusions. Applying a 90° cut-off, the protrusion angle had a sensitivity of 52.9 % and specificity of 88.2 %. Applying a cut-off of > 2 points, the SPICE score has a sensitivity of 64.7 % and specificity of 94.2 %. The composite score had a sensitivity, specificity, positive and negative predictive value of 47.0 %, 100 %, 100 % and 65.4 %., Conclusion: we propose that additional follow-up investigation should always be undertaken in cases where both a SPICE > 2 and angle of < 90° are obtained, as the likelihood of SBSL is high.

Background: Bowel preparation is a major quality criterion for colonoscopies. Models developed to identify patients with inadequate preparation have not been validated in external cohorts. We aim to validate these models and determine their applicability., Methods: Colonoscopies between April and November 2019 were retrospectively included. Boston Bowel Preparation Scale ≥2 per segment was considered adequate. Insufficient data, incomplete colonoscopies, and total colectomies were excluded. Two models were tested: model 1 (tricyclic antidepressants, opioids, diabetes, constipation, abdominal surgery, previous inadequate preparation, inpatient status, and American Society of Anesthesiology [ASA] score ≥3); model 2 (co-morbidities, tricyclic antidepressants, constipation, and abdominal surgery)., Results: We included 514 patients (63% males; age 61.7 ± 15.6 years), 441 with adequate preparation. The main indications were inflammatory bowel disease (26.1%) and endoscopic treatment (24.9%). Previous surgery (36.2%) and ASA score ≥3 (23.7%) were the most common comorbidities. An ASA score ≥3 was the only identified predictor for inadequate preparation in this study ( p < 0.001, OR 3.28). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of model 1 were 60.3, 64.2, 21.8, and 90.7%, respectively. Model 2 had a sensitivity, specificity, PPV, and NPV of 57.5, 67.4, 22.6, and 90.5%, respectively. The AUC for the ROC curves was 0.62 for model 1, 0.62 for model 2, and 0.65 for the ASA score., Conclusions: Although both models accurately predict adequate bowel preparation, they are still unreliable in predicting inadequate preparation and, as such, new models, or further optimization of current ones, are needed. Utilizing the ASA score might be an appropriate approximation of the risk for inadequate bowel preparation in tertiary hospital populations., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2021 by Sociedade Portuguesa de Gastrenterologia. Published by S. Karger AG, Basel.)

Pain in masticatory muscles is one of the most frequent symptoms in patients with temporomandibular disorders (TMD) and can lead to changes in the patterns of neuromuscular activity of masticatory muscles and decrease in bite force. This study assesses the effects of three eight-week exercise programs on pain intensity, neuromuscular activation, and bite force of masticatory muscles in patients with TMD. Forty-five patients were divided into three groups: a therapeutic exercise program (G1), a therapeutic and aerobic exercise program (G2), and an aerobic exercise program (G3). The masticatory muscles' pain was evaluated using the numeric pain rating scale (NPRS), surface electromyographic (sEMG) activity of the masseter was recorded during maximum voluntary contraction and at rest, and bite force was evaluated using a dynamometer. These parameters were evaluated twice at baseline (A01/A02), at the end of the eight-week intervention period (A1), and 8-12 weeks after the end of the intervention (A2). After intervention, G2 showed the best results, with a significantly decrease in masticatory muscles' pain and increase in bite force. These results suggest that interventions to reduce pain in patients with TMD should be multimodal.

Background: Intracranial chondromas account for 0.2-0.3% of all intracranial neoplastic lesions and less than a quarter arise in the convexity or falx. Despite its benign nature, exceedingly rare malignant transformations exist. The misdiagnosis with meningiomas is frequent and may be related with chondromas' similar insidious clinical presentation and imaging features. Standalone surgery is advised and complete resection provides the definitive treatment., Case Description: A 44-year-old female presents with insidious headache, visual disturbances, and papilledema. The imaging studies were compatible with frontal parasagittal meningioma. Surgery revealed a meningeal based mass, mostly avascular and with a well-demarked surgical plane from the brain parenchyma. Complete resection with meningeal margins was achieved and the histopathologic examination revealed a chondroma. The patient symptoms subsided and no surgical complications existed., Conclusion: Intracranial convexity chondromas constitute a rare differential diagnosis for meningiomas. The present case reinforces the current scarce data and serves as reminder for clinicians diagnosing and treating intracranial tumors., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Surgical Neurology International.)

Background: Several gastroenterology societies have created recommendations in order to reduce nonessential exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Our aim is to evaluate the national gastroenterologists' perspective on the impact of COVID-19 and the impact of reorganization of a gastroenterology department during the COVID-19 pandemic., Methods: For the first purpose, an online survey was distributed to gastroenterologists nationwide. For the second purpose, the authors conducted an analysis of some endoscopic procedures performed at the Gastroenterology Department of the Centro Hospitalar Vila Nova de Gaia/Espinho (CHVNG/E) between March 16 and May 8 during the years 2019 and 2020., Results: Sixty-seven gastroenterologists answered our survey. Only 14.9% were residents and 86.6% worked in a hospital with COVID-19 patients, with 16.4% assigned to assist those patients. All of the departments suffered modifications. Ninety percent of the residents affirmed that their activity had changed. Ninety-four percent declared having nonessential endoscopic procedures postponed, and 85.1% maintained in-person medical visits, 88.1% were already having remote consultations, and 11.9% did not have any clinical visit. In our gastroenterology unit, the number of endoscopic procedures decreased by 73.1% from 2019 to 2020. In 2020, the proportion of urgent procedures was higher compared to 2019., Conclusion: The advent of COVID-19 has led to important changes in gastroenterology activities in Portugal, and national gastroenterology units are complying with the recommendations. Furthermore, Portuguese gastroenterologists believed that the decrease in endoscopic activity can compromise residents' education and training. The gastroenterology department at CHVNG/E has shown a significant reduction in the number of endoscopic procedures., Competing Interests: The authors have no conflict of interests to declare., (Copyright © 2021 by Sociedade Portuguesa de Gastrenterologia Published by S. Karger AG, Basel.)

This study sought to investigate whether the stiffness of the biceps femoris long head differs between proximal and distal regions during isometric knee flexion at different contraction intensities and muscle lengths. Twelve healthy individuals performed knee flexion isometric contractions at 20% and 60% of maximum voluntary isometric contraction, with the knee flexed at 15 and 45 degrees. Muscle stiffness assessment was performed using ultrasound-based shear wave elastography. Proximal and distal regions of the biceps femoris long head were assessed. Biceps femoris long head muscle showed a greater stiffness (i) in the distal region, (ii) at higher contraction intensity, and (iii) at longer muscle length. The proximal-to-distal stiffness ratio was significantly lower than 1 (i.e., heterogenous) at lower contraction intensity regardless of the muscle length. However, this was not observed at higher contraction intensity. This study is the first to show heterogeneity in the active stiffness of the biceps femoris long head. Given the greater incidence of injury at the proximal region of biceps femoris long head, this study opens new directions for future research. Additionally, the present study results indicate that studies assessing muscle stiffness at one single muscle region should be interpreted with caution.

We report a straightforward and reproducible electrochemical approach to develop polydopamine-ethanolamine (ePDA-ETA) films to be used as immunosensing interfaces. ETA is strongly attached to polydopamine films during the potentiodynamic electropolymerization of dopamine. The great advantage of the electrochemical methods is to generate the oxidized species (quinones), which can readily react with ETA amine groups present in solution, with the subsequent incorporation of this molecule in the polymer. The presence of ETA and its effect on the electrosynthesis of polydopamine was accessed by cyclic voltammetry, ellipsometry, atomic force microscopy, FTIR and X-ray photoelectron spectroscopy. The adhesive and biocompatible films enable a facile protein linkage, are resilient to flow assays, and display intrinsic anti-fouling properties to block non-specific protein interactions, as monitored by real-time surface plasmon resonance, and confirmed by ellipsometry. Immunoglobulin G (IgG) and Anti-IgG were used in this work as model proteins for the affinity sensor. By using the one-step methodology (ePDA-ETA), the lower amount of immobilized biorecognition element, IgG, compared to that deposited on ePDA or on ETA post-modified film (ePDA/ETA), allied to the presence of ETA, improved the antibody-antigen affinity interaction. The great potential of the developed platform is its versatility to be used with any target biorecognition molecules, allowing both optical and electrochemical detection.

This study examined whether a knee flexor isometric contraction at 20% of maximal voluntary isometric contraction until exhaustion would alter the biceps femoris long head (BFlh) and semitendinosus (ST) active stiffness, assessed using ultrasound-based shear wave elastography. Twelve healthy individuals participated in 2 sessions separated by 7 days. Time to exhaustion was similar in both sessions (day 1: 443.8 ± 192.5 s; day 2: 474.6 ± 131.7 s; p = 0.323). At the start of the fatigue task, the ST showed greater active stiffness than the BFlh (p < 0.001), with no differences between days (p = 0.08). The ST active stiffness then decreased from 40% of the task time to exhaustion (- 2.2 to - 13.3%, p = 0.027) until the end of the task (- 16.1 to - 22.9%, p = 0.012), while no significant changes were noted in the BFlh (p = 0.771). Immediately after the fatigue task, a decrease in active stiffness was observed in the ST (- 11.8 to - 17.8%, p < 0.001), but not in the BFlh (p = 0.551). Results were consistent between the 2 testing sessions (p = 0.07-0.959). The present results indicate that fatigue alters the hamstring active stiffness pattern.

Background: A spontaneous cervical epidural hematoma (SCEH) is a rare occurrence. It usually presents with quadriparesis, but it may present with hemiparesis or hemiplegia and can easily be misdiagnosed as stroke. We present a case of stroke mimicking SCEH with hemiparesis worsened after tissue plasminogen activator therapy (tPA) followed by emergency cervical decompression laminectomy., Case Description: A 63-year-old female presented to the emergency department with sudden onset of posterior neck and left shoulder pain with the right side hemiparesis. On neurological examination, the patient had motor power of the right upper and lower limb of 2/5 Medical Research Council, and her whole left extremities were intact. Her medical history was unremarkable for trauma, hemorrhagic diathesis, or anticoagulation therapy. A head computed tomography was ordered ruling out intracranial hemorrhage. Assuming an acute ischemic stroke as the most likely diagnosis, alteplase (tPA) was administered 3 h after symptoms onset, however without any improvement in patient symptoms. A cervical magnetic resonance was performed revealing a right paramedian epidural mass-like lesion between C3-C6. The patient underwent cervical laminectomy C3-C6 with evacuation of epidural hematoma with significant clinical status improvement after surgery., Conclusion: tPA treatment is frequently used as first-line therapy for acute ischemic stroke. Therefore, physicians should be aware of the potential for the SCEH in patients presenting with hemiparesis, as tPA administration may increase cervical hematoma leading to clinical deterioration. With this case, we intended to warn about SCEH as a rare but possible entity, since its early recognition and prompt clinical intervention may improve neurological outcomes., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Surgical Neurology International.)

Marine ecosystems are constantly being threatened by contaminants produced by human activities. There is an urge to better understand their impacts on marine organisms and develop reliable tools for biomonitoring studies, while also assessing their potential impacts on human health. Given their position on top of food webs, sharks are particularly susceptible to bioaccumulation, making them potential sentinel species of marine contamination. The main objective of this study was to find suitable biomarkers for future marine pollution biomonitoring studies by correlating biochemical responses with tissue contaminant body burden in blue sharks (Prionace glauca), a species heavily caught and consumed by humans, while also addressing their general health. The chemical contaminants analysed comprised different persistent organic pollutants (POPs) families from polychlorinated compounds to brominated flame retardants (BFRs) and perfluorinated compounds (PFCs) and different trace and heavy metals. Concentrations of some contaminants in sharks' tissues were found to be above the legally allowed limits for human consumption. A canonical correspondence analysis (CCA) was performed and some strong associations were found between biochemical responses and contaminants' accumulation levels. DNA damage and lipid peroxidation levels, as well as the inhibition of the antioxidant enzyme glutathione peroxidase, were the main effects and consequences of contamination. The impact of contamination on these vital macromolecules underlines the suboptimal conditions of the sampled P. glauca, which can ultimately lead to the degradation of core ecological aspects, such as swimming, feeding, and reproduction. It can be concluded that P. glauca demonstrates great potential to be used as environmental sentinel and suitable biomarker candidates were identified in this work. Moreover, this study also highlights the risks that the consumption of blue shark derived products can pose to human health, which is of upmost interest as the sampled organisms were still juveniles and already presented values above regulatory limits., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Netrin-1 is an essential extracellular chemoattractant that signals through its receptor DCC to guide commissural axon extension in the embryonic spinal cord. DCC directs the organization of F-actin in growth cones by activating an intracellular protein complex that includes the Rho GTPase Cdc42, a critical regulator of cell polarity and directional migration. To address the spatial distribution of signaling events downstream of netrin-1, we expressed the FRET biosensor Raichu-Cdc42 in cultured embryonic rat spinal commissural neurons. Using FLIM-FRET imaging we detected rapid activation of Cdc42 in neuronal growth cones following application of netrin-1. Investigating the signaling mechanisms that control Cdc42 activation by netrin-1, we demonstrate that netrin-1 rapidly enriches DCC at the leading edge of commissural neuron growth cones and that netrin-1 induced activation of Cdc42 in the growth cone is blocked by inhibiting src family kinase signaling. These findings reveal the activation of Cdc42 in embryonic spinal commissural axon growth cones and support the conclusion that src family kinase activation downstream of DCC is required for Cdc42 activation by netrin-1.

Objectives: To analyze differences in trunk endurance time, fatigue and activation in tennis players with and without low back pain., Design: Observational study, cross-sectional design., Methods: Thirty-five tennis players completed an isometric trunk endurance protocol comprising four tasks (flexor, extensor and side bridge tests). LBP history was obtained through the Nordic Musculoskeletal Questionnaire. Endurance time was recorded for each test. Surface electromyographic activity was recorded bilaterally from rectus abdominis, external obliques, iliocostalis lumborum and longissimus thoracis. Average electromyographic amplitude and median frequency slopes during the tests were calculated and used as indicators of change in muscle activation and fatigue., Results: Asymptomatic players had greater flexor (p=0.004) and right side bridge (p=0.043) endurance times. These players produced a greater increase in avrEMG during the right side bridge test for the left ES-I (p=0.046) and right EO (p=0.008). Players with LBP in the last 7 days showed reduced activation of the left (p=0.014) and right (p=0.013) ES-I and left longissimus thoracis (ES-L, p=0.047) in the extensor test. In the left side bridge test there was a lower avrEMG slope of the left EO (p=0.024) and left RA MF slope (p=0.011). In the right side bridge test a lower left ES-I avrEMG slope was found (p=0.048)., Conclusions: Symptomatic players show lower activation of extensor muscles, less co-contraction patterns and less abdominal endurance. Tennis coaches and clinicians should consider these factors in their approach to players with LBP., (Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Electrochemical-total internal reflection ellipsometry (EC-TIRE) has been proposed as a technique to observe the redox reactions on the electrode surface due to its high phase sensitivity to the electrolyte/electrode interface. In this paper, we mainly focus on the influence of the potential modulation on the TIRE response. The analysis suggests that both dielectric constant variation of gold and the electric double layer transformation would modulate the reflection polarization of the surface. For a nonfaradaic process, the signal of TIRE would be proportional to the potential modulation. To testify the analysis, linear sweep voltammetry and open circuit measurement have been performed. The results strongly support the system analysis.

Chagas disease is caused by Trypanosoma cruzi and affects about two to three million people in Brazil, still figuring as an important public health problem. A study was conducted in a rural area of the municipality of Limoeiro do Norte - CE, northeastern Brazil, aiming to determine the prevalence of T. cruzi infection. Of the inhabitants, 52% were examined, among whom 2.6% (4/154) were seropositive in at least two serological tests. All seropositive individuals were older than 50 years, farmers, with a low education and a family income of less than three minimum wages. Active surveillance may be an alternative for early detection of this disease.

Interactions with local extracellular cues direct cell migration. A versatile method to study cell response to a protein consists of patterning the protein cue on a substrate and quantifying the distribution of cells between patterned and non-patterned areas. Here, we define the concepts of (i) cell-surface affinity to describe cell choices, and of (ii) reference surface (RS) to clarify that the choice is made relative to a reference. Furthermore, we report a method to systematically tune the RS and show that it can dominate the experimental cell response to a protein cue. The cell response to a cue can be switched from strong preference to strong aversion by only changing the RS. Using microcontact printing, we patterned the extracellular matrix proteins fibronectin or netrin-1 adjacent to a series of RSs with different ratios of poly-D-lysine (PDL) and polyethylene glycol (PEG), which are of high affinity and of low-affinity for cells, respectively. C2C12 myoblasts or primary neurons seeded on substrates with a high affinity RS (high % PDL) did not respond to a printed protein of interest, and conversely on RSs of low affinity (high % PEG) the cells preferred the printed protein even in the absence of a specific interaction. However, when testing cell response to a standardized series of RSs varying from high to low affinity, a specific response curve was obtained that was unique to each cell type-protein pair. Importantly, for intermediate RSs with moderate affinity, the cell response to the cue was dependent on the activation of biologically relevant protein-specific biochemical signal transduction pathways. Our results establish that choices made by cells in response to a surface-bound cue must take into account, and be interpreted in the context of, the RS. The use of a series of RSs with varying cell-surface affinity reveals specific response curves of cells to a cue that can be compared quantitatively and that may help gain new insights into cellular responses to extracellular proteins., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

A whale shark Rhincodon typus was found in a set-net in southern Portugal in October 2011. This was the first record for continental Europe and represents an increase of the species' known range. Upwelling events and increase in sea-surface temperatures are possible reasons for this occurrence., (© 2012 The Authors. Journal of Fish Biology © 2012 The Fisheries Society of the British Isles.)

A novel approach was developed for the energetic valorisation and treatment of olive mill wastewater (OMW), combining anaerobic digestion and electrochemical oxidation. The electrochemical treatment was proposed as the final step to mineralize the remaining OMW fraction from the anaerobic reactor. The electrooxidation of anaerobically digested OMW was investigated over dimensionally stable anodes (DSAs). RuO(2) based anode was significantly more efficient than IrO(2)-type DSA, mainly for the COD removal. IrO(2) based anode promoted a selective oxidation of phenols and colour removal. For instance, after an electrolysis charge of 10.4 × 10(4) C L(-1), COD removals of 14 and 99%, phenols removals of 91 and 100% and colour removals of 85 and 100% were obtained for IrO(2) and RuO(2) DSAs-type, respectively. The electrochemical post-treatment was effectively performed without using a supporting electrolyte and in the presence of the solids that remained from the anaerobic process. The achievement of the required effluent quality for sewer systems disposal depends on the operating conditions of the anaerobic process. Consequently, special care must be taken with the chloride and nitrogen levels that may surpass the legal discharge limits. The electrochemical oxidation over RuO(2) based DSA is an appropriate second-step treatment for OMW disposal, after the recovery of its energetic potential., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

During the second semester of 2009, three trips were made from Olhão (Southern Portugal) to Stralsund (Northern Germany) carrying 2.122 animals, which included multiple teleosts, elasmobranchs and invertebrates. This group included scombrids, such as 1.869 Scomber japonicus and 9 Sarda sarda, which are notoriously difficult to transport. However, multiple adaptations to transport regimes adopted regularly have allowed the authors to successfully move these animals by road and air over a total of up to 25 hr. Such adaptations included maintaining oxygen saturation rates at approximately 200%, and also the constant addition of AmQuel(®) , sodium bicarbonate, and sodium carbonate. Different formulations were used during the three trips, with the best results corresponding to 20/30/30 ppm of the three aforementioned chemicals, respectively. The authors suggest, however, that a modified formula of 20/40/40 ppm will allow for an even more stable pH on future trips., (© 2010 Wiley-Liss, Inc.)

Netrins are secreted proteins that were first identified as guidance cues, directing cell and axon migration during neural development. Subsequent findings have demonstrated that netrins can influence the formation of multiple tissues, including the vasculature, lung, pancreas, muscle and mammary gland, by mediating cell migration, cell-cell interactions and cell-extracellular matrix adhesion. Recent evidence also implicates the ongoing expression of netrins and netrin receptors in the maintenance of cell-cell organisation in mature tissues. Here, we review the mechanisms involved in netrin signalling in vertebrate and invertebrate systems and discuss the functions of netrin signalling during the development of neural and non-neural tissues.

The study of cellular responses to changes in the spatial distribution of molecules in development, immunology and cancer, requires reliable methods to reproduce in vitro the precise distributions of proteins found in vivo. Here we present a straightforward method for generating substrate-bound protein patterns which has the simplicity required to be implemented in typical life science laboratories. The method exploits photobleaching of fluorescently tagged molecules to generate patterns and concentration gradients of protein with sub-micron spatial resolution. We provide an extensive characterization of the technique and demonstrate, as proof of principle, axon guidance by gradients of substrate-bound laminin peptide generated in vitro using LAPAP.

Electrochemical treatment of oleate using RuO2 and IrO2 type dimensionally stable anodes in alkaline medium was performed to develop a feasible anaerobic pre-treatment of fatty effluents. The results showed that the pre-treated solutions over RuO2 were faster degraded by anaerobic consortium than the raw oleate solutions or the electrolysed solutions using IrO2. In batch experiments carried out with pre-treated solutions over RuO2 (100-500mg/L), no lag phases were observed before the methane production onset. On the other hand, raw oleate and pre-treated oleate over IrO2 had originated lag phases of 0-140 and 0-210h, respectively. This study demonstrated that it is advantageous to apply the electrochemical treatment carried out on the RuO2 type DSA in order to achieve a faster biodegradation of lipid-containing effluent and consequently to obtain a faster methane production.

Molecular cues, such as netrin 1, guide axons by influencing growth cone motility. Rho GTPases are a family of intracellular proteins that regulate the cytoskeleton, substrate adhesion and vesicle trafficking. Activation of the RhoA subfamily of Rho GTPases is essential for chemorepellent axon guidance; however, their role during axonal chemoattraction is unclear. Here, we show that netrin 1, through its receptor DCC, inhibits RhoA in embryonic spinal commissural neurons. To determine whether netrin 1-mediated chemoattraction requires Rho function, we inhibited Rho signaling and assayed axon outgrowth and turning towards netrin 1. Additionally, we examined two important mechanisms that influence the guidance of axons to netrin 1: substrate adhesion and transport of the netrin receptor DCC to the plasma membrane. We found that inhibiting Rho signaling increased plasma membrane DCC and adhesion to substrate-bound netrin 1, and also enhanced netrin 1-mediated axon outgrowth and chemoattractive axon turning. Conversely, overexpression of RhoA or constitutively active RhoA inhibited axonal responses to netrin 1. These findings provide evidence that Rho signaling reduces axonal chemoattraction to netrin 1 by limiting the amount of plasma membrane DCC at the growth cone, and suggest that netrin 1-mediated inhibition of RhoA activates a positive-feedback mechanism that facilitates chemoattraction to netrin 1. Notably, these findings also have relevance for CNS regeneration research. Inhibiting RhoA promotes axon regeneration by disrupting inhibitory responses to myelin and the glial scar. By contrast, we demonstrate that axon chemoattraction to netrin 1 is not only maintained but enhanced, suggesting that this might facilitate directing regenerating axons to appropriate targets.

This study reports on the first experimental research designed specifically for Manta birostris behavior. The authors attempted to learn about the feeding behavior and environmental cues influencing this behavior, as well as general cognitive ability. The preconditioned Manta's ability to identify food, on the basis of a fraction of the ordinary food signal complex, was tested. The opening of cephalic fins was considered a good indicator of feeding motivation level. The study subject animal used its biological clock to predict time and also associated a specific location with food, suggesting an ability to build up a cognitive map of its environment. Both underwater visual stimuli and olfactory stimuli had a very intense effect on food searching behavior over a 30 m distance, in contrast to visual signs from above the water surface. In addition, although an underwater visual signal resulted in a more intense response than from an olfactory signal, the specimen did not discriminate between different objects tested on the basis of visual sensation. It could therefore be suggested that food searching behavior of Mantas are governed by triggering stimuli, including smell or visual recognition, and modulated by the cognitive spatial map stored in their long-term memory. These findings will hopefully prove useful while devising protecting policies in the natural environment and/or while keeping these animals in captivity. Zoo Biol 27:294-304, 2008. (c) 2008 Wiley-Liss, Inc.

Between September 2006 and April 2007 the authors transported one 0.9 m wingspan Mobula mobular from Olhão (South of Portugal) to Valencia (East of Spain), 12 approximately 1.0 m long Argyrosomus regius to Tarragona (Northeast of Spain) and four approximately 0.4 m long Mola mola to Atlanta (GA, USA). These journeys had a total "water to water" duration of 17, 22 and 33 hr, respectively. The first two transports were conducted by road whereas the third involved a combination of road and air travel. Water quality parameters-specifically dissolved oxygen, temperature, pH and ammonia-were monitored continuously throughout the duration of the trips and were maintained at optimum levels through the use of battery-powered filtration and chemical supplements. All animals arrived alive and well at their destinations. This paper reports on the specific transport regime adopted in each case and provides some insight for potential improvements in future similar transports., (Zoo Biol 27:234-250, 2008. (c) 2008 Wiley-Liss, Inc.)

Electrochemical pre-treatment of oleate on anaerobic digestion was investigated using two anaerobic filters (AF and AFm) working, respectively, with increasing concentrations of electrochemically pre-treated oleate and oleate. Influents containing 25% and 50% of chemical oxygen demand (COD) of these substrates did not cause relevant alterations in either digester's performance. Comparatively, the pre-treated oleate unit (AF) showed a higher gas production but a lower COD removal than AFm (2.0 vs 1.5 m(3) CH4 m(-3) d(-1) 76-85 vs 91-93% COD removal). The raised AFm COD removal together with the larger proportion of VSS in its effluent than in AF (5.69 vs 0.26 kg m(-3)) indicate that the biomass washout can be a consequence of the encapsulated solids by lipidic compounds that were not fairly degraded. Further increases of oleate in AFm feed (75 and 100% COD) led to decreases of biogas production to half and COD removal from values higher than 90% to 83-75%. The simultaneous increase of effluent VSS concentrations to 10-12 kg m(3) emphasizes the oleate negative effect. The use of pretreated oleate as the only carbon source did not influence negatively the AF behaviour in terms of methane production. COD removal was maintained at values higher than 80% and the effluent VSS at low concentrations (0.15 kg m(-3)). The significantly higher methane yield achieved by AF than AFm indicates a higher accumulation of oleate than pre-treated oleate. Therefore, electrochemical process stands for a suitable pre-treatment for lipid rich effluents, allowing the application of higher organic loads keeping a higher methane yield.

Fetal hydrothorax refers to a collection of fluid within the fetal thorax that may be the result of chylous leak from the thoracic duct (primary hydrothorax) or generalized fluid retention associated with immune or no immune fetal hydrops (secondary hydrothorax). The authors' presents a case report occurred in 2002, of a pregnant woman that at 25 weeks' gestation that was referred to Maternidade Bissaya-Barreto-Coimbra because of a fetal hydrothorax at left, under tension and with cardiac decompensation signs. A fetal thoracocentesis was performed and the diagnosis was chylothorax. Because of a rapid reaccumulation of fluid a pleuroamniotic shunt was placed. The effusion and the cardiac decompensation signs regressed. The delivery was at 38 weeks' gestation. The newborn had been stable. Actually he has 10 months, is healthy and has a normal grow and development.

Recognition of DNA sequences by biochemical sensor is generally performed by analysis after completion of hybridization. Using a technique able to directly translate the biological event into an electrical signal allows the in situ monitoring of the hybridization kinetics. In this aim, the photoelectrochemical behavior of one electroactive polymeric sensor based on a copolymer of polypyrrole and polypyrrole-oligonucleotide has been investigated in aqueous solution. This sensor has been studied as such (i) and in two other situations: (ii) when the copolymer is in presence of non-complementary oligonucleotides; and (iii) when the copolymer is in presence of complementary oligonucleotides. From the photocurrent spectra obtained at -0.6 V/SCE versus incident energy the allowed direct and indirect transitions for each polymer have been evidenced. The photocurrent evolution during hybridization and adsorption processes has been recorded in real time and the hybridization kinetics has revealed to be comparable with mass variations obtained by quartz crystal microbalance under the same experimental conditions.

SISCOPE is an integrated data management system for use in gastrointestinal endoscopy units which operates in the multiuser mode on UNIX minicomputers or MS-DOS personal computers and can be used for patient bookings, endoscopic data entry and retrieval, and automatic report generation in upper gastrointestinal endoscopy, proctologic examinations, colonoscopy and peritoneoscopy. The description of endoscopic findings is remarkably detailed and data entry very rapid due to an advanced design of input screens that incorporates several recent concepts, including windows, menu bars and pull-down menus; typing is eliminated as data is entered with a mouse by pointing at options within menus. Endoscopic findings can be described under eight headings: morphology, topography, qualifiers, modifiers, signs of bleeding, endoscopic diagnosis, pathological diagnosis and etiology. Terminology is based strictly 3on the OMED system. SISCOPE also allows recording of details on endoscopic procedures, indications for the examination, preparation, premedication, complications and late entry of pathology reports. After entering all data, a report in natural language is produced automatically, the entire process taking one minute on average. Data retrieval programs give on-line access to previous examinations of a given patient and automatically generate activity reports. A formal language allows direct queries to the database and transfer of data for statistical analysis or other data processing. The system is simple to learn and use because operation is intuitive and all endoscopic techniques share the same basic menu structure and screen design.

Nutritional and clinical responses to three nutritional regimens were retrospectively evaluated in 81 Crohn's patients with active disease. Group 1 (n = 42) received a low residue oral diet, group 2 (n = 15) received chemically defined diets, and group 3 (n = 24), parenteral nutrition (PN). Weight gain was observed in a similar percentage of patients, whereas serum albumin increase was significant only in group 3: 3.15 +/- 0.66 versus 3.54 +/- 0.61 g/100 ml (p less than 0.05). Mean activity index decreased significantly in all groups (p less than 0.001), and length of stay in hospital was similar. Patients with intestinal obstruction had a better immediate response when submitted to PN: clinical remission was achieved in 75% of those in group 3, but in only 50% in groups 1 and 2 (p less than 0.05). Otherwise, short- and long-term outcome was similar.