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Parkinson's disease patients experience motor signs and non-motor symptoms caused by the disease. Deep brain stimulation of the Subthalamic Nucleus (STN) itself or its ventral or dorsal borders is one of the treatment options indicated to treat the refractory symptoms of this disease. However, it is still unknown which edge, when stimulated, generates more beneficial effects for these patients, which is the objective of this systematic review. To answer this question, electronic and manual searches were conducted in five databases and gray literature to identify studies that answered the question in this review. The selection of studies, data extraction, and analysis of the risk of bias of the included studies were performed. In total, seven studies were included in this systematic review. Most studies presented a minimal risk of bias, and their main methodological limitation was related to the sample inclusion criteria. Stimulation of the dorsal or ventral borders of the STN resulted in improved motor signs of Parkinson's disease, with some of the studies tending towards the choice of dorsal border stimulation for better motor effects, while the improvement in non-motor symptoms and inhibitory control was due to stimulation of the ventral border. The findings of this systematic review suggest that the improvement in the motor signs of Parkinson's disease can be brought about by stimulating the dorsal or ventral borders of the subthalamic nucleus, whereas non-motor symptoms such as anxiety improve with stimulation of the ventral border.
Pacientes com doença de Parkinson frequentemente experimentam sinais motores e sintomas não motores ocasionados pela doença. A estimulação cerebral profunda do Núcleo Subtalâmico (NST) ou de suas bordas ventral ou dorsal é uma das opções de tratamento indicada para tratar sintomas refratários dessa doença. No entanto, ainda não se sabe qual a borda que, ao ser estimulada, gera mais efeitos benéficos a esses pacientes, sendo esse o objetivo dessa revisão sistemática. Para responder essa questão foram realizadas buscas eletrônicas e manuais em cinco bancos de dados e na literatura cinzenta para identificar estudos que abordassem essa temática. Foram executados a seleção dos estudos, extração de dados e análise do risco de viés dos estudos incluídos. No total, sete artigos foram selecionados para comporem o estudo. A maioria dos estudos apresentou baixo risco de viés, sendo que a principal limitação metodológica deles se relacionou com os critérios de inclusão da amostra. A estimulação da borda dorsal ou ventral do NST resultou na melhora dos sinais motores da doença de Parkinson, com alguns dos estudos inclusos com tendência para a escolha da estimulação da borda dorsal para melhores efeitos motores, enquanto a melhora dos sintomas não motores e do controle inibitório foi devido à estimulação da borda ventral. Os achados sugerem que a melhora dos sinais motores da doença de Parkinson pode ser ocasionada ao estimular a borda dorsal ou ventral do Núcleo subtalâmico, enquanto os sintomas não motores, como a ansiedade, melhoram com a estimulação da borda ventral.
Asunto(s)
Enfermedad de Parkinson/terapia , Núcleo Subtalámico , Estimulación Encefálica Profunda , Estudios Transversales , Estudios Observacionales como AsuntoRESUMEN
OBJECTIVE: To study the combined and isolated effects of melatonin and metformin in the ovarian tissue of rats with PCOS. DESIGN: Experimental study using a rat model of PCOS induced by continuous light exposure. INTERVENTION(S): Forty adult female rats were divided into 5 groups: physiological estrus phase (Sham); permanente estrus with PCOS induced by continuous lighting exposure for 60 consecutive days (control); with PCOS treated with melatonin; with PCOS treated with metformin; with PCOS treated with melatonin + metformin. After 60 days of treatments, all rats were killed, and ovaries were collected and processed for paraffin-embedding. Formalin-fixed paraffin-embedded sections were stained with hematoxylin and eosin or subjected to immunohistochemistry for proliferation (Ki-67) and apoptosis (cleaved caspase 3) detection markers. SETTING: Federal University of São Paulo, Brazil. ANIMALS: Forty adult female Wistar rats (Rattus norvegicus albinus). MAIN OUTCOME MEASURE(S): Number of corpus luteum and ovarian cysts, number of ovarian follicles (primary and antral follicles), number of interstitial cells, percentage of ovarian follicles (primary and antral follicles), and of interstitial cells immunostained to cleaved caspase-3 and Ki-67. RESULTS: Absence of corpus luteum, a higher number of cysts, and increased nuclear volume and area of interstitial cells, along with a decrease in primary and antral follicle numbers, were noticed in the control group compared with the Sham group. Melatonin and metformin treatments attenuated these effects, although the combined treatment did not mitigate the increased number of cysts and ovaries induced by PCOS. An increase in theca interna cell apoptosis was observed in the control group, whereas melatonina and metformin treatments reduced it significantly. A higher percentage of caspase-3-immunostained granulosa cells was noted in the Sham and all treated groups compared with the control group; no aditive effects on ovarian cell apoptosis were observed in the combined treatment. The percentage of Ki-67- immunostained granulosa cells was significantly higher in the control group compared with the Sham group. However, the combined treatment, not melatonin and metformin alone, mitigated this effect. A higher percentage of Ki-67-immunostained interstitial cells was observed in all treated groups compared with the Sham and control groups, whereas no additive effects in that immunoreactivity were observed in the combined treatment. CONCLUSIONS: Melatonin and metformin may improve ovarian function in rats with PCOS. The combined melatonin and metformin treatment is more effective in attenuating excessive granulosa cell proliferation, but it is not more effective in improving ovarian function than these drugs applied alone in rats with PCOS.
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Melatonina , Metformina , Ovario , Síndrome del Ovario Poliquístico , Ratas Wistar , Animales , Femenino , Metformina/farmacología , Metformina/administración & dosificación , Síndrome del Ovario Poliquístico/tratamiento farmacológico , Síndrome del Ovario Poliquístico/patología , Síndrome del Ovario Poliquístico/inducido químicamente , Melatonina/farmacología , Melatonina/administración & dosificación , Ovario/efectos de los fármacos , Ovario/patología , Ratas , Apoptosis/efectos de los fármacos , Caspasa 3/metabolismo , Modelos Animales de Enfermedad , Antígeno Ki-67/metabolismo , Antígeno Ki-67/análisisRESUMEN
INTRODUCTION: one of the characteristics of Down Syndrome (DS) is muscle hypotonia. Different therapeutic approaches have a positive influence, between them Physiotherapy applications with different therapeutic approaches such as Hippotherapy have a positive effect on the physical health and quality of live of individuals with DS. OBJECTIVE: to evaluate the effects of both treatments on the strength and electromyographic activity of the lower limbs of children and adolescents with DS. METHODS: fourteen individuals, aged between 10 and 18 years, participated in two groups: Physiotherapy group (n = 5) and Hippotherapy group (n = 9). Thirty interventions were performed for each type of therapy, once a week, lasting 30 min. Pre and post-interventions, the 30-Second Chair Stand Test (30s-CST) was used to assess the strength of the lower limbs and the surface electromyography equipment (EMG 800RF) to assess the lower limb myoelectric activity. RESULTS: there was a reduction in the post-intervention electromyographic values for both treatments (pË0.001), with significantly less myoelectric activity in Hippotherapy compared to Physiotherapy for all evaluated muscles (pË0.001) and a significant increase in muscle strength for the Hippotherapy, post-intervention group (p = 0.0007). CONCLUSION: Physiotherapy and Hippotherapy are interventions that promote positive changes in the myoelectric activities of individuals with DS. However, only hippotherapy promoted an increase in strength of the lower limbs.
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Síndrome de Down , Terapía Asistida por Caballos , Niño , Adolescente , Humanos , Extremidad Inferior , Músculo Esquelético/fisiología , Modalidades de FisioterapiaRESUMEN
Excessive alcohol consumption is considered a risk factor for bone health, as it causes a reduction in mass and increases the risk of fracture. However, the determination of bone mineral density (BMD) has not always been an adequate predictor of bone fragility. Thus, the hypothesis arises that chronic alcohol consumption interferes with collagen synthesis and the quality of bone trabeculae, with consequent bone fragility. Groups: Control (n = 6; water intake only during the entire study period); Ethanol (n = 6; ingestion of ethyl alcohol according to the protocol for inducing chronic alcohol consumption). The chronic alcohol consumption model did not cause a significant change in BMD, but there was a significant reduction of 20% in the thickness of the bone trabeculae and of 1.56% in the collagen located in the neck region of immature rat femurs. Although there was no significant change in the mineral matrix, the changes in the organic matrix were able to provide a significant reduction in bone strength. The results suggest harmful effects of alcohol intake on the bone quality of young adult animals and draw attention to the need to also consider methods for the diagnosis of collagen as an element of bone fragility.
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Consumo de Bebidas Alcohólicas , Densidad Ósea , Consumo de Bebidas Alcohólicas/efectos adversos , Animales , Colágeno , Etanol/efectos adversos , Minerales/farmacología , RatasRESUMEN
The three-dimensional movement of the horse in physical therapy is a valuable kinesio-therapeutic phenomenon that simultaneously affects several body systems, including particularly the neuromuscular system. However, the effects of equine-assisted services (EAS) on neuromuscular activation patterns in older adults have not been thoroughly investigated. In this study, we evaluated the impact of a 10-weeks EAS program on trunk muscles in older adults who used a saddle and placed their feet in stirrups for the first 15 minutes and out of stirrups for the remaining 15 minutes of 30-minute EAS sessions. We gathered electromyographic (EMG) data of the trunk muscles five times each on the first, fifth, and 10th sessions: pre-EAS and post-EAS on a stationary horse and at 1-minute, 15-minutes, and 30-minutes on a horse in motion. Participants were 20 adults, aged 60-79 years. We analyzed normalized EMG data with 5 (session time) by 3 (session number) analyses of variance (ANOVAs) with repeated measures and with Bonferroni's testing (p ≤ .05). There was a significant difference over the number of interventions for the right thoracic paravertebral muscle (p = .025) and session time effect for the left trapezius (p = .042), right thoracic paravertebral (p < .001), right and left multifidus (p < .001), and right and left rectus abdominis muscles (p < .001). Thus, trunk muscles in older adults showed complex neuromuscular activation synchronized with the horse's movement, which was influenced by session time and number of interventions. The practical implication of these findings is that EAS can reduce fall risk among elderly adults of both sexes.
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Terapía Asistida por Caballos , Animales , Electromiografía , Terapía Asistida por Caballos/métodos , Femenino , Caballos , Humanos , Masculino , Movimiento , Músculo Esquelético/fisiología , TorsoRESUMEN
Introdução: o tabagismo é uma das principais causas evitáveis de mortes no mundo representando um problema de saúde pública. Objetivo: investigar a relação da exposição passiva à fumaça principal do cigarro e as possíveis alterações histomorfométricas das células gliais, arteríolas e da matriz extracelular do nervo olfatório de ratas. Metodologia: trata-se de um estudo experimental, analítico e quantitativo. Vinte ratas randomizadas divididas em dois grupos, controle e tabaco, foram expostas à inalação da fumaça principal do cigarro por 60 dias utilizando dispositivo validado na literatura. Resultados: a exposição à inalação da fumaça principal do cigarro resultou em alterações significativas no grupo tabaco, tais como, elevação nos níveis de cotinina no plasma sanguíneo, aumento na espessura da parede dos vasos sanguíneos, aumento na porcentagem do colágeno total do tecido, diminuição no número total de astrócitos e aumento no número total de micróglias. Conclusão: a exposição à fumaça principal do cigarro resulta em alterações histomorfométricas que poderiam causar alterações funcionais no nervo olfatório como perda sensorial olfativa. Os achados constatados são fortes o suficiente para servir como alerta a toda a população e às autoridades de saúde, no que se refere às leis antifumo, principalmente em ambientes fechados.
Introduction: smoking is one of the main preventable causes of death in the world and represents a worldwide public health problem. Objective: to investigate the relationship of second hand tobacco smoke and possible histomorphometric changes of glial cells, arterioles and extracellular matrix of the olfactory nerve in rats. Methodology: experimental, analytical and quantitative study, twenty wistar animals randomized into two control and tobacco groups, were exposed to inhalation of main cigarette smoke for 60 days using a device validated in the literature. Results: exposure to inhalation of main cigarette smoke resulted in changes in the tobacco group, such as increased levels of cotinine in the blood plasma, increased thickness of the blood vessel wall, increased percentage of total tissue collagen, decreased in the total number of astrocytes and increase in the total number of microglia. Conclusion: exposure to main cigarette smoke results in histomorphometric changes that can cause changes in the olfactory nerve such as sensory olfactory loss. Our findings are strong enough to serve as a warning to the entire population and to health authorities in relation to smokefree laws especially in closed environments.
Asunto(s)
Animales , Masculino , Femenino , Nervio Olfatorio , Ratas , Tabaquismo , Neuroglía , Colágeno , Productos de Tabaco , Anatomía , Métodos de Análisis de Laboratorio y de CampoRESUMEN
A esclerose múltipla (EM) é uma doença crônica inflamatória e desmielinizante do sistema nervoso central, levando a incapacidades funcionais e sociais e piora da qualidade de vida dos indivíduos. O objetivo deste trabalho foi verificar a correlação entre a qualidade de vida e o grau de acometimento funcional de paciente com EM. Trata-se de um estudo do tipo transversal, descritivo e quantitativo. Foi utilizado a The World Health Organization Qualityof Life (WHOQOL - BREF) para avaliação da qualidade de vida, e a Expanded Disability Status Scale (EDSS) para avaliação das incapacidades. Foram analisados 34 indivíduos com EM, com média de idade de 41,14 anos e com predomínio do gênero feminino (61,76%). Dessa amostra, 76,47% apresentaram a forma clinica remitente-recorrente, e a média da EDSS foi de 2,95, com pontos de correlação estatisticamente significante entre EDSS e WHOQOOL-BREF. Conclui-se que nesse grupo estudado existem pontos de correlação entre a qualidade de vida e as incapacidades decorrentes da doença.
Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of the central nervous system, leading to functional and social disabilities and worsening of the quality of life of these individuals. The aim of this study was to verify the quality of life and degree of functional impairment of MS patients. This is a cross-sectional and descriptive study. The World Health Organization Quality of Life (WHOQOL - BREF) was used to evaluate quality of life and the Expanded Disability Status Scale (EDSS) for the evaluation of disabilities. Thirty four individuals with MS were evaluated, with a mean age of 41.14 years, predominantly female (61.76%). Of this sample, 76.47% had recurrent and recurrent clinical forms and 17.65% had a secondary progressive form; the mean EDSS was 2.95. It is concluded that in this group studied there are points of correlation between quality of life and the incapacities resulting from the disease.
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INTRODUCTION: Physical activity programs in the elderly aim to prevent and/or reduce the functional decline resulting from the senescence process. Several studies provide evidence that Equine Assisted Therapy (EAT) is an effective means of improving health. However, studies addressing the effects of EATon the cardiovascular system are scarce. OBJECTIVE: To evaluate the effect of Equine Assisted Therapyon the cardiovascular responses of participants divided into two groups: normotensive and hypertensive. METHODS: Twenty individuals participated, aged between 60 and 79 years, divided into three groups: Normotensive Group (n=14), Hypertensive Group (n=6) and all participants, Total Group (n=20). The Omron® HEM 742 blood pressure monitor was used to measure blood pressure and the Gerathem® portable finger oximeter to measure heart rate and blood oxygen saturation. Ten visits were made once a week, lasting 30 minutes. RESULTS: Between the first and tenth interventions, there was a reduction in blood pressure and heart rate, with statistical significance of systolic blood pressure for the Hypertensive Group (p=0.0478), the Total Group (p=0.0201) and diastolic pressure for the Total Group (p=0.0421). There was also a statistically significant difference in systolic blood pressure and heart rate during some visits. Blood oxygen saturation increased after the intervention, but without statistical significance. CONCLUSION: Equine Assisted Therapy can promote a reduction in blood pressure in the elderly, especially hypertensive individuals.
INTRODUÇÃO: Programas de atividade física em idosos visam prevenir e/ou reduzir o declínio funcional decorrente do processo de senescência. Vários estudos fornecem evidências de que a Terapia Assistida por Equinos (TAE) é um meio eficaz de melhorar a saúde. No entanto, estudos que abordam os efeitos da TAE no sistema cardiovascular são escassos. OBJETIVO: Avaliar o efeito da Terapia Assistida por Eqüinos nas respostas cardiovasculares dos participantes dividos em dois grupos: normotensos e hipertensos. MÉTODOS: Participaram 20 indivíduos, com idade entre 60 a 79 anos, distribuídos em três Grupos: Grupo Normotenso (n=14), Grupo Hipertenso (n=6) e todos os participantes, Grupo Total (n=20). Foi utilizado o monitor de pressão arterial Omron® HEM 742 para aferir a pressão arterial e o oxímetro de dedo portátil Gerathem® para medir a freqüência cardíaca e a saturação de oxigênio no sangue. Foram realizados dez atendimentos uma vez por semana, com duração de 30 minutos. RESULTADOS: Entre a primeira e décima intervenção, houve redução da pressão arterial e da frequência cardíaca, com significância estatística da pressão arterial sistólica para o Grupo Hipertenso (p=0,0478), o Grupo Total (p=0,0201) e da pressão diastólica para o Grupo Total (p=0,0421). Também houve diferença estatisticamente significante da pressão arterial sistólica e da frequência cardíaca durante alguns atendimentos. A saturação de oxigênio no sangue aumentou após a intervenção, porém sem significância estatística. CONCLUSÃO: A Terapia Assistida por Eqüinos pode promover redução da pressão arterial em idosos, principlamente de hipertensos.
Asunto(s)
Humanos , Anciano , Enfermedades Cardiovasculares , Salud del Anciano , Terapía Asistida por Caballos , Presión Arterial , Frecuencia Cardíaca , Ejercicio FísicoRESUMEN
The aging process affects the entire human body, including the stomatognathic system, and can trigger not only occlusal but also postural imbalances involving other muscular chains. Hippotherapy has been used to promote cervical, postural, and balance control in individuals with diverse impairments. The present study used electromyography to evaluate the masseter and temporal muscles in an elderly population pre- and post-hippotherapy. Participants included 17 individuals, mean age 66,5±7 years. Electromyographic recording of the bilateral masseter and temporal muscles was performed during the postural resting condition and activities that involved the active participation of these muscles in different conditions. The practitioner performed no other type of activity or exercise during the intervention because the objective is to evaluate the effect of the three-dimensional movement provided by the horse. Raw electromyographic data were tabulated using commercially available software (IBM® SPSS® Statistics 234.0) and subjected to statistical analysis, in which p ≤ 0.05 was considered to be statistically significant. Post-hippotherapy, there was lower electromyographic activity for the masseter and temporalis muscles in all the static mandibular tasks, with significant effect for time for the right temporal muscle (p = 0.038), the left temporal muscle (p = 0.028) and in the all dynamic mandibular tasks for the left temporal muscle (p = 0.025) and the left masseter muscle (p = 0.027). Hippotherapy promotes a reduction in the myoelectric activity of the masticatory muscles of elderly individuals.
Asunto(s)
Electromiografía , Terapía Asistida por Caballos , Músculo Esquelético/fisiología , Anciano , Femenino , Humanos , Masculino , Masticación/fisiología , Persona de Mediana EdadRESUMEN
Equine-assisted therapy uses the horse in rehabilitation and/or education of people, such as Down syndrome(SD), cerebral palsy(PC)and intellectual disability(DI). In context, the rehabilitation program and horse riding equipment should be usedaccording to the specific characteristics of each individual, becoming an ally in the quest for excellence in equine-assisted therapy programs. The aim was to evaluate the effect of riding equipment used in equine-assisted therapy on the muscular activityof trunk and lower limb of individuals with SD, PC and DI. The study included 15 individuals equally assigned to each group: SD, PC and DIwith a mean age of 16.2 (±1.10), 16 (±1.22)e 16 (±0) years,respectively. The analysis of muscle activity was performed through surface electromyography, using four variations of horse riding equipment: saddle with and without feet supported on the stirrups and blanket with and without feet supported on the stirrups. Sigma Stat 3.5®software was used for statistical analysis.The Shapiro Wilk's test was used for normality of the data, the Bartlett test for homogeneity of the variances and the Kruskal-Wallis test for repeated measures with no normal distribution.Statistically significant differences were observed forp<0.05.The SDgroup presented a greater muscular activity of trunk and lower limbs with blanket equipment without the feet supported in the stirrups (H = 15.078, p = 0.002), as in the DI group (H=8.302, p = 0.040), while inPCgroup was the saddle with feet supported in the stirrups (H=11.137,p = 0.011). The choice of riding equipment used in equine-assisted therapy interferes differently in the pattern of muscular activation of the trunk and the lower limbs, according to the pathological processes of the practitioners. It should be an important aspect to consider when planninga treatment.
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Humanos , Masculino , Femenino , Adolescente , Extremidad Inferior/patología , Terapía Asistida por Caballos/instrumentación , Torso/patología , Anomalías Musculoesqueléticas/terapia , Programas Informáticos/provisión & distribución , Daño Encefálico Crónico/terapia , Parálisis Cerebral/terapia , Adolescente , Síndrome de Down/terapia , Electromiografía/instrumentación , Discapacidad Intelectual/terapiaRESUMEN
OBJECTIVE: To assess the effect of chronic alcohol consumption on the longitudinal growth of the tibia and bone quality parameters in young rats under an experimental setup. METHODS: The control (n=10) rats received only water. The ethanol (n=10) rats received ethyl alcohol at concentrations established in the protocol for the induction of chronic alcohol consumption. The blood samples were immediately collected via cardiac puncture and processed to evaluate the levels of alkaline phosphatase by automated spectrophotometry. Following blood sample collection, both tibias were dissected, and weighed; the tibial length was measured., and the samples were stored in a freezer for future analysis of the bone mineral content and mechanical resistance, known as maximal load and stiffness. RESULTS: Compromised bone health, with a 35.3% decrease in the serum alkaline phosphatase levels (p < 0.01), a 10% decrease in the tibial mass (p < 0.05), and a 5.3% decrease in the tibial length (p < 0.0001) were noted. Furthermore, a 10% decrease in the bone mineral density was observed (p < 0.01), which led to a 17.2% decrease in the maximum strength (p < 0.01) and 22.6% decrease in stiffness (p < 0.001). CONCLUSION: Chronic consumption of alcohol affected the bones of young rats, making them weaker and osteopenic. In addition, the long bones were shorter, suggesting interference with growth. Level of Evidence III, Case Control Study.
OBJETIVO: Verificar a influência do consumo experimental crônico de álcool no crescimento longitudinal da tíbia e em parâmetros de qualidade óssea de ratos jovens. MÉTODOS: Dez ratos controle receberam água, outros dez receberam álcool etílico nas concentrações estabelecidas no protocolo para indução. Após eutanásia, as amostras de sangue foram coletadas por punção cardíaca e processadas para avaliar os níveis de fosfatase alcalina por espectrofotometria automatizada. Após a coleta de sangue, ambas as tíbias foram dissecadas, pesadas e medidas em comprimento. Foram realizadas análises do conteúdo mineral ósseo e resistência mecânica, por meio da análise da força máxima e rigidez. RESULTADOS: Houve comprometimento da saúde óssea, com redução de 35,3% no nível de fosfatase alcalina no plasma (p<0,01), redução de 10% na massa da tíbia (p<0,05) e queda de 5,3% no comprimento das tíbias (p<0,0001). Também foi observada redução de 10% na densidade mineral óssea (p<0,01), que levou à redução de 17,2% na força máxima (p<0,01) e 22,6% na rigidez (p<0,001). CONCLUSÃO: O consumo crônico de álcool afetou os ossos de ratos jovens, tornando-os mais fracos e osteopênicos. Ainda, os ossos longos eram mais curtos, sugerindo interferência no crescimento. Nível de evidência III, Estudo caso-controle.
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ABSTRACT Objective: To assess the effect of chronic alcohol consumption on the longitudinal growth of the tibia and bone quality parameters in young rats under an experimental setup. METHODS: The control (n=10) rats received only water. The ethanol (n=10) rats received ethyl alcohol at concentrations established in the protocol for the induction of chronic alcohol consumption. The blood samples were immediately collected via cardiac puncture and processed to evaluate the levels of alkaline phosphatase by automated spectrophotometry. Following blood sample collection, both tibias were dissected, and weighed; the tibial length was measured., and the samples were stored in a freezer for future analysis of the bone mineral content and mechanical resistance, known as maximal load and stiffness. RESULTS: Compromised bone health, with a 35.3% decrease in the serum alkaline phosphatase levels (p < 0.01), a 10% decrease in the tibial mass (p < 0.05), and a 5.3% decrease in the tibial length (p < 0.0001) were noted. Furthermore, a 10% decrease in the bone mineral density was observed (p < 0.01), which led to a 17.2% decrease in the maximum strength (p < 0.01) and 22.6% decrease in stiffness (p < 0.001). CONCLUSION: Chronic consumption of alcohol affected the bones of young rats, making them weaker and osteopenic. In addition, the long bones were shorter, suggesting interference with growth. Level of Evidence III, Case Control Study.
RESUMO Objetivo: Verificar a influência do consumo experimental crônico de álcool no crescimento longitudinal da tíbia e em parâmetros de qualidade óssea de ratos jovens. Métodos: Dez ratos controle receberam água, outros dez receberam álcool etílico nas concentrações estabelecidas no protocolo para indução. Após eutanásia, as amostras de sangue foram coletadas por punção cardíaca e processadas para avaliar os níveis de fosfatase alcalina por espectrofotometria automatizada. Após a coleta de sangue, ambas as tíbias foram dissecadas, pesadas e medidas em comprimento. Foram realizadas análises do conteúdo mineral ósseo e resistência mecânica, por meio da análise da força máxima e rigidez. Resultados: Houve comprometimento da saúde óssea, com redução de 35,3% no nível de fosfatase alcalina no plasma (p<0,01), redução de 10% na massa da tíbia (p<0,05) e queda de 5,3% no comprimento das tíbias (p<0,0001). Também foi observada redução de 10% na densidade mineral óssea (p<0,01), que levou à redução de 17,2% na força máxima (p<0,01) e 22,6% na rigidez (p<0,001). Conclusão: O consumo crônico de álcool afetou os ossos de ratos jovens, tornando-os mais fracos e osteopênicos. Ainda, os ossos longos eram mais curtos, sugerindo interferência no crescimento. Nível de evidência III, Estudo caso-controle.
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Introdução: A fisioterapia favorece a flexibilidade e diminue a espasticidade de crianças com paralisia cerebral (PC). Objetivos: avaliar os benefícios da fisioterapia convencional para a flexibilidade a curto e longo prazo de crianças com PC espástica. Métodos: participaram seis pacientes com PC espástica, idade de seis a 14 anos, ambos os gêneros. Foram realizadas 16 sessões de fisioterapia convencional com alongamentos passivos. Para avaliação da flexibilidade, aplicou-se o Teste de Sentar e Alcançar utilizando o Banco de Wells antes e após cada sessão. Para a análise estatística foi utilizado o Software Sigma-Stat® versão 3.5 com significância estatística (p<0,05). Resultados: houve aumento significativo da flexibilidade da cadeia muscular posterior comparando pré e pós individualmente (p<0,05) e da média pré e pós sessões (p<0,0001). Conclusão: fisioterapia convencial por meio de exercícios de alongamentos passivos melhora a flexibilidade da cadeia muscular posterior de crianças com PC espástica a curto ou a longo prazo.
Introduction: Physiotherapy favors flexibility and reduce the spasticity of children with spastic cerebral palsy. Objectives: To evaluate the benefits of conventional physiotherapy to improve the flexibility of the posterior muscle chain in the short and long term of children with spastic cerebral palsy. Methods: participated six patients with a diagnosis of Cerebral Palsy, age of six to 14 years, both genders. There were 16 sessions of conventional physiotherapy with passive stretching. For the assessment of flexibility, the sit and reach test was applied using the Wells's box before and after each session. For statistical analysis, Sigma-Stat® Software version 3.5 was used with statistical significance (p <0.05). Results: There was a significant increase in the flexibility of the posterior muscular chain of the children when comparing pre and post individually (p <0.05) and the mean before and after the sessions (P <0.0001). Conclusion: Conventional physiotherapy through passive stretching exercises improves the flexibility of the posterior muscular chain of children with spastic Cerebral Palsy in the short or long term.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Parálisis Cerebral/rehabilitación , Ejercicios de Estiramiento Muscular , Epidemiología Descriptiva , Estudios Longitudinales , Rango del Movimiento Articular , Epidemiología AnalíticaRESUMEN
Abstract Objectives: to compare the percentage of collagen fibers in the autopsied women's uterine body and cervix with and without the Acquired Immunodeficiency Syndrome (Aids). Methods: 30 autopsied women's medical files were selected from 1988 to 2013. 30 fragments of the uterine body and 30 cervix were collected and then divided into two groups, 15 with Aids and 15 without, The quantification of the collagen fibers of the uterine body and cervix was performed on slides stained with picrosirius, using the KS-300® system. Results: the percentage of collagen fibers was lower for cervix (U=336544; p=0.001) and higher for the uterine body (U=308726,5; p=0.004) in the retroviral group when compared to the group without the disease. The percentage was higher for cervix than the uterine body in the group with Aids (t=0,4793; p=0.0031). the same result was found in the group without Aids (t=2,397; p=0.0637). Conclusions: the increase in the percentage of collagen fibers in the uterine body of women with Aids' indicates an immune response for viral infection and reveals a failure in keeping the infection restricted to the cervix. The interpretation of the histochemical and morphometric parameters can be useful in the diagnosis associated to HIV infection, contributing for clinical improvement and life expectancy.
Resumo Objetivos: comparar a porcentagem de fibras colágenas no corpo e colo uterino de mulheres autopsiadas com e sem a Síndrome da Imunodeficiência Adquirida (Aids). Métodos: foram selecionados 30 prontuários de mulheres autopsiadas no período de 1988 a 2013. Foram coletados 30 fragmentos do corpo uterino e 30 do colo uterino, dividido em dois grupos, 15 com Aids e 15 sem. A quantificação das fibras colágenas do corpo e colo uterino foi feita nas lâminas coradas por picrosirius, utilizando-se o sistema KS-300®. Resultados: a porcentagem de fibras colágenas foi menor no colo (U=336544; p=0,001) e maior no corpo uterino (U=308 726,5; p=0,004) no grupo com a retrovirose quando comparado ao grupo sem a doença. A porcentagem no grupo com Aids foi maior no colo uterino do que no corpo (t=0,4793; p=0,0031). Sendo o mesmo resultado encontrado para o grupo sem Aids (t=2.397; p=0,0637). Conclusões: um aumento da porcentagem de fibras colágenas no corpo uterino das mulheres com Aids indica uma resposta imune frente a infecção viral e revela uma falha em manter a infecção restrita ao colo. A interpretação dos parâmetros histoquímicos e morfométricos podem ser úteis no diagnóstico das condições associadas à infecção pelo HIV, contribuindo para a melhora clínica e expectativa de vida.
Asunto(s)
Humanos , Femenino , Adulto , Pacientes , Autopsia , Cuello del Útero/anatomía & histología , Colágeno , Síndrome de Inmunodeficiencia Adquirida/fisiopatología , Brasil , Estudios TransversalesRESUMEN
INTRODUCTION:: Alcoholism is a major public health problem, which has a high social cost and affects many aspects of human activity. Liver disease is one of the first consequences of alcohol abuse, and steatosis, liver cirrhosis and hepatitis may occur. Other organs are also affected with pathological changes, such as pancreatitis, cardiomyopathies, dyslipidemias and atherosclerosis. OBJECTIVE:: To identify the occurrence and degree of atherosclerosis in alcohol-dependent individuals with liver cirrhosis, observing macroscopic and microscopic changes in lipid and collagen deposits and in the liver. We also aimed to verify the association of lipid and collagen fiber deposits with gender, age and body mass index, and to relate alcoholism, liver cirrhosis and atherosclerosis. METHOD:: We performed a study based on autopsy reports of patients with alcoholic liver cirrhosis, with analysis of aorta and liver fragments to verify the occurrence and degree of atherosclerosis, as well as collagen contents. RESULTS:: Microscopic atherosclerosis was higher in young subjects (early injury) and in patients with alcoholic liver cirrhosis. The macroscopic analysis of atherosclerosis in aortas showed that patients in more advanced age groups presented more severe classifications. Atherosclerosis, both micro and macroscopically, and the percentage of fibrosis in the liver and aorta were more expressive in females. CONCLUSION:: Cirrhotic patients presented a higher percentage of fibrosis and lipidosis, and may represent a group susceptible to the accelerated progression of cardiovascular diseases. Investigative studies contribute to targeting health-promoting interventions, reducing the mortality and costs of treating cardiovascular disease.
Asunto(s)
Enfermedades de la Aorta/etiología , Enfermedades de la Aorta/patología , Aterosclerosis/etiología , Aterosclerosis/patología , Cirrosis Hepática Alcohólica/complicaciones , Cirrosis Hepática Alcohólica/patología , Alcoholismo/complicaciones , Aorta/patología , Índice de Masa Corporal , Colágeno/análisis , Femenino , Fibrosis/patología , Humanos , Masculino , Índice de Severidad de la Enfermedad , Factores Sexuales , Estadísticas no ParamétricasRESUMEN
Summary Introduction: Alcoholism is a major public health problem, which has a high social cost and affects many aspects of human activity. Liver disease is one of the first consequences of alcohol abuse, and steatosis, liver cirrhosis and hepatitis may occur. Other organs are also affected with pathological changes, such as pancreatitis, cardiomyopathies, dyslipidemias and atherosclerosis. Objective: To identify the occurrence and degree of atherosclerosis in alcohol-dependent individuals with liver cirrhosis, observing macroscopic and microscopic changes in lipid and collagen deposits and in the liver. We also aimed to verify the association of lipid and collagen fiber deposits with gender, age and body mass index, and to relate alcoholism, liver cirrhosis and atherosclerosis. Method: We performed a study based on autopsy reports of patients with alcoholic liver cirrhosis, with analysis of aorta and liver fragments to verify the occurrence and degree of atherosclerosis, as well as collagen contents. Results: Microscopic atherosclerosis was higher in young subjects (early injury) and in patients with alcoholic liver cirrhosis. The macroscopic analysis of atherosclerosis in aortas showed that patients in more advanced age groups presented more severe classifications. Atherosclerosis, both micro and macroscopically, and the percentage of fibrosis in the liver and aorta were more expressive in females. Conclusion: Cirrhotic patients presented a higher percentage of fibrosis and lipidosis, and may represent a group susceptible to the accelerated progression of cardiovascular diseases. Investigative studies contribute to targeting health-promoting interventions, reducing the mortality and costs of treating cardiovascular disease.
Resumo Introdução: O alcoolismo é um grande problema de saúde pública, de elevado custo social e que afeta vários aspectos da atividade humana. Hepatopatia é uma das primeiras consequências do abuso de álcool, podendo ocorrer esteatose, cirrose hepática e hepatite. Outros órgãos, porém, também são afetados, ocorrendo alterações patológicas, como pancreatite, cardiomiopatias, dislipidemias e aterosclerose. Objetivo: Identificar a ocorrência e a intensidade de aterosclerose em alcoolistas com cirrose hepática, observando alterações macro e microscópicas do depósito lipídico e de fibras colágenas e fígado. Verificar a associação de depósito lipídico e de fibras colágenas com gênero, idade e índice de massa corporal (IMC). Relacionar alcoolismo, cirrose hepática e aterosclerose. Método: Foi realizado estudo com base em laudos de autópsias de pacientes com cirrose hepática alcoólica, sendo estudados aortas e fígados para verificar a ocorrência e a intensidade de aterosclerose, bem como a quantidade de colágeno encontrada. Resultados: A aterosclerose microscópica foi maior em jovens (lesão inicial) e em pacientes com cirrose hepática alcoólica. A análise macroscópica da aterosclerose nas aortas mostrou que pacientes com faixas etárias mais avançadas apresentaram classificações mais intensas. A aterosclerose, tanto micro quanto macroscopicamente, e a porcentagem de fibrose no fígado e na aorta foram mais expressivas no gênero feminino. Conclusão: Os pacientes cirróticos apresentaram maior porcentagem de fibrose e lipidose, e podem representar um grupo susceptível à acelerada progressão de doenças cardiovasculares. Estudos investigativos contribuem para o direcionamento das intervenções promotoras da saúde, reduzindo a mortalidade e os custos no tratamento das doenças cardiovasculares.
Asunto(s)
Humanos , Masculino , Femenino , Enfermedades de la Aorta/etiología , Enfermedades de la Aorta/patología , Aterosclerosis/etiología , Aterosclerosis/patología , Cirrosis Hepática Alcohólica/complicaciones , Cirrosis Hepática Alcohólica/patología , Aorta/patología , Índice de Severidad de la Enfermedad , Fibrosis/patología , Índice de Masa Corporal , Factores Sexuales , Colágeno/análisis , Estadísticas no Paramétricas , Alcoholismo/complicacionesRESUMEN
Hippotherapy is a therapeutic method that uses the horse's movement to achieve functional results in practitioners with Down syndrome (DS), who present motor and neurophysiological changes that affect the musculoskeletal system. Evaluating the motor behavior related to the control and the improvement of muscle activation in practitioners with Down syndrome subjected to hippotherapy. 10 practitioners were divided into two groups: Down Group (DG) practitioners with DS, and Healthy Group (HG) practitioners with no physical impairment. The muscles gluteus medius, tensor fasciae latae, rectus femoris, vastus medialis, vastus lateralis, biceps femoris, tibialis anterior and gastrocnemius were evaluated by electromyography using gross RMS values, which correspond to muscle activation; the evaluations were performed on the 1st and 10th hippotherapy sessions (frequency: once a week), and after 2 months interval without treatment, they were performed on the 1st and 10th hippotherapy sessions (frequency: twice a week). It was noted that activation of the studied muscles increased with the passing of sessions, regardless the weekly frequency of attendance; however, the period without treatment resulted in reduction of this effect. Practitioners with DS presented satisfactory changes in muscle activation pattern, in learning and in motor behavior during hippotherapy sessions.
Equoterapia é um método terapêutico que utiliza o movimento do cavalo para alcançar resultados funcionais, realizada em praticantes com síndrome de Down (SD), que apresentam alterações neurofisiológicas e motoras que afetam o sistema musculoesquelético. Avaliar o comportamento motor relacionado ao controle e melhora a ativação muscular em praticantes com SD submetidos ao tratamento equoterapêutico. Participaram dez praticantes divididos em dois grupos: grupo Down (GD) - praticantes com SD, e grupo Saudável (GS) - praticantes sem comprometimento físico. Os músculos glúteo médio, tensor da fáscia lata, reto femoral, vasto medial, vasto lateral, bíceps femoral, tibial anterior e gastrocnêmio foram avaliados por meio da eletromiografia, utilizando o valor de RMS bruto que corresponde à ativação muscular, e as avaliações foram realizadas na primeira e décima sessões de equoterapia (frequência: 01 vez por semana); e após intervalo de dois meses sem tratamento, foi realizada na primeira e décima sessões de equoterapia (frequência: 02 vezes por semana). Observou-se que a ativação muscular dos músculos estudados aumentou com o passar das sessões, independente da frequência semanal de atendimento; mas o período sem tratamento resultou em redução deste efeito. Os praticantes com SD apresentaram mudanças satisfatórias no padrão de ativação muscular, na aprendizagem e no comportamento motor no decorrer das sessões de equoterapia.
Asunto(s)
Humanos , Preescolar , Niño , Estudios Transversales , Síndrome de Down , Desarrollo de Músculos , Electromiografía , Terapía Asistida por CaballosRESUMEN
Introdução: A equoterapia é uma modalidade terapêutica que atende em grande parte os indivíduos com síndrome de Down, por apresentarem alterações motoras, cognitivas e sócio-afetivas. Sabe-se que as alterações na frequência cardíaca são moduladas pelo Sistema Nervoso Autônomo, entretanto, na literatura não há descrições sobre a Variabilidade de Frequência Cardíaca nestes praticantes, sobretudo na atividade relacionada à equoterapia. Objetivos: Avaliar a Variabilidade da Frequência Cardíaca de pacientes com Síndrome de Down antes, durante e após sessões de equoterapia. Métodos: Foram recrutadas 6 crianças com Síndrome de Down, idade média 12 ± 1,6 anos. A Frequência Cardíaca foi avaliada com um cardiofrequencímetro - Polar (RS800CX), antes, durante e após 5 sessões semanais. Resultados: Houve tendência a diminuição da atividade parassimpática no repouso inicial entre primeira e quinta sessão; e diminuição significativa da atividade parassimpática observada pelo índice pNN50 ao comparar a Frequência Cardíaca durante a primeira e quinta sessões. Conclusão: O tratamento equoterapêutico apresentou uma tendência à diminuição da Variabilidade da Frequência Cardíaca nas crianças estudadas.
Introduction: The hippotherapy is a therapeutic modality that serves largely individuals with Down syndrome, because they have motor, cognitive and socioemotional changes. It is known that changes in heart rate are modulated by the autonomic nervous system, however, in the literature there are no descriptions of the variability of heart rate in these practitioners, especially in the activity related to hippotherapy. Objectives: To evaluate Heart Rate Variability in practitioners of hippotherapy with Down Syndrome. Methods: Six children with Down Syndrome were recruited, age rate of 12 ± 1.6 years. The Heart Rate were evaluate using a cardiofrequencimetre Polar (RS800CX), before, during and after 5 sessions of hippotherapy once weekly. Results: There were tendency of decrease in the parasympathetic activity during initial rest between first and fifth sessions, and significant decrease of the parasympathetic activity observed by the value of pNN50 compared to the Heart Rate during the first and fifth sessions. Conclusions: This study has shown that children treated with hippotherapy had tendency to have their Heart Rate Variability decreased.
Asunto(s)
Humanos , Masculino , Niño , Adolescente , Síndrome de Down/terapia , Frecuencia Cardíaca , Sistema Nervioso Autónomo , Proyectos Piloto , Estudios TransversalesRESUMEN
Abstract Introduction: Individuals with Down syndrome (DS) have alterations that affect the musculoskeletal system, causing abnormal patterns, and alter the morphological anatomical and mechanical axes that provide intrinsic stability to the skeleton, and can trigger misalignments and orthopedic disorders in adulthood. Objective: The objective of student to evaluate posture and postural alignment before and after the hippotherapyin individuals with DS. Methods: Posture of five individuals with DS was evaluated by the software SAPO before and after 27 sessions the hippotherapy. Data were subjected to qualitative descriptive analysis using cluster and statistical analysis with the aid of the software Sigma Stat 2.0, considering differences as statistically significant at p-value < 5%. Results: Improvements were achieved for the alignment of shoulder, head, hip, and lower limbs, in addition to decrease in kyphosis and head protrusion. Conclusion: Patients with DS demonstrated satisfactory changes in motor behavior reflected in improved static posture after treatment with hippotherapy.
Resumo Introdução: Indivíduos com síndrome de Down (SD) apresentam alterações que afetam o sistema musculoesquelético, provocando padrões anormais e alterando os eixos anatômicos morfológicos e mecânicos que proporcionam uma estabilidade intrínseca ao esqueleto, podendo desencadear desalinhamentos e alterações ortopédicas na vida adulta. Objetivo: O objetivo desse estudo foi avaliar a o alinhamento postural antes e após o tratamento equoterapêutico em indivíduos com SD. Métodos: Foram avaliados cinco indivíduos com SD por meio do aplicativo SAPO de avaliação postural, antes e após vinte e sete sessões. Realizou-se a análise qualitativa descritiva por meio do Cluster e análise estatística utilizando o programa Sigma Stat 2.0, considerando estatisticamente significativas as diferenças em que o valor p foi menor que 5%. Resultados: Foi possível verificar melhoras no alinhamento de ombro, de cabeça, de quadril e membros inferiores, bem como diminuição da cifose e da protrusão de cabeça. Conclusão: Os indivíduos com SD apresentaram mudanças satisfatórias no comportamento motor que refletiram em uma melhora da postura estática após o tratamento na equoterapia.
RESUMEN
To evaluate the equilibrium and flexibility of elderly people submitted to a training program involving physical therapy exercises. Six elderly people were selected, average age 69.66 years. Wells's Bench and the Functional Reach Test (FRT) plus Timed Up and Go Test (TUG) were employed respectively to assess muscle flexibility and balance analysis. Tests were performed before and after the exercise program which consisted of thirty-five 50 min physical therapy group sessions, twice a week, with stretching exercises, gait training, active exercises, postural correction exercises and breathing exercises. Statistical analysis was done with Sigma-Stat® 3.5. Assessments occurred before and after sessions, and the final test was undertaken after 35 sessions. There was a statistically significant increase in the flexibility of the posterior muscle chain. In the TUG test, the group achieved a shorter time after treatment, with statistical significance between tests. There was a statistically significant increase in the average FRT after the sessions. Current study showed better results in the execution of tests evaluated after the program of physiotherapy activities, contributing towards the improvement of muscle flexibility and balance of elderly people
Avaliar o equilíbrio e a flexibilidade de idosos submetidos a um programa de treinamento físico fisioterapêutico. Foram selecionados 6 idosos, com idades média de 69,66 anos. A flexibilidade muscular foi avaliada com o banco de Wells, e para a análise do equilíbrio, o Teste de alcance funcional (TAF) e o teste de levantar e caminhar - Timed Up and Go (TUG). Os testes foram realizados antes e após o programa de exercícios físicos, que consistiu em 35 sessões de fisioterapia em grupo, de 50 min, duas vezes por semana, com exercícios de alongamentos, treino de marcha, exercícios ativos, exercícios de correção postural e exercícios respiratórios. Utilizou-se do software Sigma-Stat® 3.5 para a análise estatística. A análise foi feita antes e após as sessões, sendo que no teste final, após as 35 sessões, houve um aumento estatisticamente significante da flexibilidade da cadeia muscular posterior. No teste TUG, o grupo apresentou menor tempo após o tratamento, com significância estatística entre os testes realizados, bem como apresentou aumento estatisticamente significativo no valor médio do TAF após as sessões. Este trabalho demonstrou melhores resultados na execução dos testes avaliados após o programa de treinamento físico fisioterapêutico, colaborando para melhora da flexibilidade muscular e do equilíbrio dos idosos estudados.