A efectividade de um programa de exercícios terapêuticos na doença osteo-articular no idoso

RESUMO: O presente estudo teve como objectivo avaliar a efectividade de um programa de intervenção de fisioterapia comparativamente ao tratamento conservador (calor húmido, ultra-som e massagem), relativamente à dor e capacidade funcional, no utente idoso com doença osteoarticular do joelho. A amostra foi aleatória, tendo sido seleccionados 20 utentes que respeitaram os critérios de inclusão, e que foram distribuídos aleatoriamente pelos dois grupos de tratamento, 9 no grupo A (experimental) e 11 no grupo B (controle). Todos os utentes deram o seu consentimento informado. Trata-se de um estudo experimental, controlado aleatorizado (RCT). A intervenção em estudo consistiu em 15 sessões de tratamento individuais, efectuadas 3 vezes por semana. O programa terapêutico efectuado pelo grupo A incluiu o tratamento conservador (20 minutos calor húmido, 5 minutos ultra-som (contínuo; 1,5W/cm2) e aproximadamente 10 minutos de massagem local) e o protocolo de exercícios terapêuticos em estudo. Este protocolo de exercícios foi progredindo semanalmente em termos da sua intensidade. Os utentes do Grupo B efectuaram apenas o tratamento conservador (tal como no grupo A). Para avaliar a dor e a capacidade funcional foi utilizado o Questionário knee Injury and Osteoarthritis Outcome Score. A análise dos resultados foi realizada através dos testes Mann-Whitney e Kruskal-Wallis para a comparação entre grupos. Os resultados sugerem não haver diferenças estatisticamente significativos entre os grupos, embora o grupo de controle tenha obtido melhores resultados. O grupo B apresentou uma diminuição da dor de 17,33, comparativamente aos valores de -3,00 no grupo A (p=0,101), e melhoria da capacidade funcional de 13,00, mantendo-se a capacidade funcional igual, no grupo A (0,00) p=0,080). Estes resultados parecem sugerir que não há diferenças significativas entre as duas modalidades de intervenção, realçando a necessidade de continuar a investigar este protocolo de exercícios e a sua efectividade.-----------------ABSTRACT: The aims of this study was to evaluate the effectiveness of a treatment program compared with conventional treatment (post hoots, ultrasound and massage), for the outcomes pain and functional ability in elderly with knee osteoarthritis. The sample was non-probability, and 20 patients have been selected that fulfilled the criteria for inclusion and who were randomly assigned to the two treatment groups, in group A and 11 in group B. All of the patients gave their informed consent. This is an experimental, randomized controlled trial (RCT) with blinded assessment, of comparative design. This study protocol program was carry out in 15 individual treatment sessions, 3x per week. The therapeutic program made by group A consisted of the performance of conservative treatment: 20 minutes of hot packs, 5 minutes of ultrasound (continuous, 1.5 W/cm2) and 10 minutes of massage plus the exercise protocol therapy consisted of: isometric exercises of quadriceps contractions, muscle strengthening for knee and aerobic training. This exercise protocol was progressing every week in terms of its intensity. The users in Group B, only made the conservative treatment (such as in group A). In this study there were evaluated the pain and functional capacity, assessed by questionnaire knee Injury Osteoarthritis Outcome Score. For comparison between groups were used Mann-Whitney and Kruskal-Wallis tests. The results revealed that in group B was that it obtained better results, although they are not statistical significance. The group B show a decrease in pain of 17.33 compared to -3.00 in group A (p = 0.101), and improved capacity functional of 13.00, keeping in group A (0.00) (p = 0.080). However, the differences are not statistically significant. These results show that there are not statistically significant in both treatments, but more studies are needed

Feature extraction using Poincaré plots for gait classification

The aim of this study is to evaluate different features, extracted from a Poincaré plot of gait signals, in their ability to classify the gait of patients with neurodegenerative diseases: Parkinson’s disease (PD) and Huntington’s disease (HD). Five different features that describe gait variability were extracted from the Poincaré plots of two gait signals: stride time and percentage of stride time spent in swing phase. Among the set of extracted features, those that displayed significant differences between the two groups and were not correlated with each other, were used as input to the support vector machine classifier. It was found that all extracted features (with exception of one feature in PD vs healthy group comparison) are significantly different between healthy and pathological subjects and are suitable to discriminate them (with accuracies greater than 80%). When comparing PD vs HD, just three features were significantly different, however, a relatively good classification accuracy (around 72%) was achieved using two of them. The results demonstrate that it is feasible to apply variability measures extracted from Poincaré plots of gait data signals in gait classification problems

A rare de novo unbalanced complex rearrangement involving chromosomes 12, 18 and 20 in a child with dysmorphic features

Complex chromosomal rearrangements (CCRs) are rare structural abnormalities that involve three or more breakpoints located on two or more chromosomes and are often associated with developmental delay, mental retardation and congenital anomalies. Here, we report the case of a rare de novo CCR in a girl who was 9 months old when first reported to us. At 15 months old, her clinical features included marked hypotonia, severe psychomotor delay, progressive postnatal microcephaly, strabismus, depressed nasal root, hands and feet malformations, heart defects, recurrent respiratory infections and bilateral hearing deficit still in study. Conventional cytogenetic analysis revealed an unbalanced complex rearrangement, involving chromosomes 12, 18 and 20, and an apparent loss of material of chromosome 18 resulting from an interstitial deletion. Further molecular cytogenetic studies were performed: whole chromosome painting probes for the involved chromosomes and chromosomal comparative genomic hybridization. These studies revealed that apparently no other chromosomes were involved and confirmed a del(18)(q21.1q22) of approximately 17 Mb on the derivative chromosome 18. The latter chromosome also had material from der(12) to der(20) in its constitution. As most CCRs involving chromosome 18q show rearrangements in the q21, some authors argue that this region might be a breakpoint “hotspot”. On the other hand, cases of single deletions on 18q are predominantly terminal. Interstitial deletions are much rarer, and to our knowledge, this is the first report of a CCR with a del(18)(q21.1q22). The phenotype of patients with deletions within this region, reported so far, seems very similar to the one of our patient, and this may contribute to a better understanding of the genotype–phenotype correlation in this type of structural abnormalities

Impact of combined training with different exercise intensities on inflammatory and lipid markers in type 2 diabetes : a secondary analysis from a 1-year randomized controlled trial

© The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creat ivecommons .org/licen ses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creat iveco mmons .org/publi cdoma in/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Background: Exercise is a well-accepted strategy to improve lipid and infammatory profle in individuals with type 2 diabetes (T2DM). However, the exercise intensity having the most benefts on lipids and infammatory markers in patients with T2DM remains unclear. We aimed to analyse the impact of a 1-year combined high-intensity interval training (HIIT) with resistance training (RT), and a moderate continuous training (MCT) with RT on infammatory and lipid profle in individuals with T2DM. Methods: Individuals with T2DM (n=80, aged 59 years) performed a 1-year randomized controlled trial and were randomized into three groups (control, n=27; HIIT with RT, n=25; MCT with RT, n=28). Exercise sessions were super‑ vised with a frequency of 3 days per week. Infammatory and lipid profles were measured at baseline and at 1-year follow-up. Changes in infammatory and lipid markers were assessed using generalized estimating equations. Results: After adjusting for sex, age and baseline moderate-to-vigorous physical activity (MVPA), we observed a time-by-group interaction for Interleukin-6 (IL-6) in both the MCT with RT (β=−0.70, p=0.034) and HIIT with RT (β=−0.62, p=0.049) groups, whereas, only the HIIT with RT group improved total cholesterol (β=−0.03, p=0.045) and LDL-C (β=−0.03, p=0.034), when compared to control. No efect was observed for C-reactive protein (CRP), cortisol, tumour necrosis factor-α (TNF-α), soluble form of the haptoglobin-hemoglobin receptor CD163 (sCD163), triglycerides and HDL-C in both groups (p>0.05). Conclusions: Favorable adaptations on IL-6 were observed in both the HIIT and MCT combined with RT groups fol‑ lowing a long-term 1-year exercise intervention in individuals with T2DM. However, only the HIIT with RT prevented further derangement of total cholesterol and LDL-C, when compared to the control group. Therefore, in order to encourage exercise participation and improve infammatory profle, either exercise protocols may be prescribed, however, HIIT with RT may have further benefts on the lipid profle.This work was supported by fellowships from the Portuguese Foundation for Science and Technology (JM grant: SFRH/BD/85742/2012; IRC grant: IRC: SFRH/BD/149394/2019). This work is also fnanced by a national grant through the FCT–Fundação para a Ciência e Tecnologia within the unit I&D 447 (UIDB/00447/2020).info:eu-repo/semantics/publishedVersio

Portuguese study of familial dilated cardiomyopathy: the FATIMA study

Dilated cardiomyopathy (DCM) is a myocardial disease, characterized by ventricular dilatation and impaired systolic function, that in more than 30% of cases has a familial or genetic origin. Given its age-dependent penetrance, DCM frequently manifests in adults by signs or symptoms of heart failure, arrhythmias or sudden death. The predominant mode of inheritance is autosomal dominant, and in these cases mutations are identified in genes coding for cytoskeletal, sarcomeric or nuclear envelope proteins. To date, most studies aimed at molecular diagnosis of DCM have been in selected families, or in larger groups of patients, but screening for mutations in a limited number of genes. Consequently, the epidemiology of mutations in familial DCM remains unknown. There is thus a need for multicenter studies, involving screening for a wide range of mutations in several families and in cases of idiopathic DCM. The present article describes the methodology of a multicenter study, aimed at clinical and molecular characterization of familial DCM patients in the Portuguese population.A miocardiopatia dilatada (MCD) é uma doença do músculo cardíaco caracterizada pela dilatação ventricular e compromisso da função sistólica, sendo possível identificar, numa percentagem superior a 30% dos casos, uma origem familiar ou genética. Dada a penetrância dependente da idade, manifesta-se muitas vezes em adultos por sinais ou sintomas de insuficiência cardíaca, arritmias ou morte súbita. O padrão autossómico dominante predomina, sendo possível identificar, nestes casos, mutações em genes de proteínas do citoesqueleto celular, sarcómero ou membrana nuclear. Até ao momento, a maioria dos trabalhos visando o diagnóstico molecular nos casos de MCD foi realizada em famílias seleccionadas, ou em grupos mais abrangentes de doentes, mas rastreando mutações num número restrito de genes. Consequentemente a epidemiologia das mutações nos casos familiares de MCD continua por esclarecer. É neste contexto que se coloca a necessidade de efectuar estudos multicêntricos, envolvendo uma pesquisa mutacional diversificada em várias familias e nos casos idiopáticos de MCD. O presente artigo descreve a metodologia de um estudo multicêntrico que tem como objectivo a caracterização clínica e molecular de casos familiares de MCD na população portuguesa

A second polymorph of bis(triphenyl-λ5-phosphanylidene)ammonium chloride–boric acid adduct

The title crystal structure is a new triclinic polymorph of [(Ph3P)2N]Cl·(B(OH)3) or C36H30NP2+·Cl−·BH3O3. The crystal structure of the orthorhombic polymorph was reported by [Andrews et al. (1983). Acta Cryst. C39, 880–882]. In the crystal, the [(Ph3P)2N]+ cations have no significant contacts to the chloride ions nor to the boric acid molecules. This is indicated by the P—N—P angle of 137.28 (8)°, which is in the expected range for a free [(Ph3P)2N]+ cation. The boric acid molecules form inversion dimers via pairs of O—H...O hydrogen bonds, and each boric acid molecule forms two additional O—H...Cl hydrogen bonds to one chloride anion. These entities fill channels, created by the [(Ph3P)2N]+ cations, along the c-axis direction

Navigation and docking maneuvers control of an autonomous omnidirectional platform in a dynamic internal logistics environment

This paper presents a method to control and generate motion for omnidirectional mobile manipulators that operate in internal logistics scenarios. It proposes transport and maneuvering operations where human operators may coexist. Thus, to ensure that human operators can easily infer the vehicle's movements, the vehicle preferentially performs non-holonomic (i.e., like a differential drive vehicle), and only takes advantage of holonomic movements in narrow spaces and when maneuvering. On the other hand, the docking maneuvers method enables the system to perform the approach and departure processes to the workstation or parking slot. These behaviors are orchestrated by a dedicated management controller, designing a unified solution. Simulation results demonstrate the system's performance and robustness to perform a complex industrial service in a dynamic environment.This work is supported by: European Structural and Investment Funds in the FEDER component, through the Operational Competitiveness and Internationalization Programme (COMPETE 2020) [Project nº 42778; Funding Reference: POCI-01-0247-FEDER-042778]; and by FCT – Fundação para a Ciência e Tecnologia within the R&D Units Project Scope: UIDB/00319/202

A 1-year randomized controlled trial

The authors declare that the research was conducted in the absence of any commercial or fnancial relationships that could be construed as a potential competing interest. JM and RTR are supported by a scholarship from the Portuguese Foundation for Science and Technology (JM grant: SFRH/ BD/85742/2012, RTR grant: SFRH/BPD/110426/2015). This work is also fnanced by a national grant through the FCT—Fundação para a Ciência e Tecnologia within the unit I&D 472 (UID/DTP/00447/2019).Background: Exercise, when performed on a regular basis, is a well-accepted strategy to improve vascular function in patients with type 2 diabetes. However, the exercise intensity that yields maximal adaptations on structural and functional indices in patients with type 2 diabetes remains uncertain. Our objective was to analyze the impact of a 1-year randomized controlled trial of combined high-intensity interval training (HIIT) with resistance training (RT) vs. a combined moderate continuous training (MCT) with RT on structural and functional arterial indices in patients with type 2 diabetes. Methods: Patients with type 2 diabetes (n = 80) were randomized into an exercise intervention with three groups: control, combined HIIT with RT and combined MCT with RT. The 1-year intervention had 3 weekly exercise sessions. High-resolution ultrasonography of the common carotid artery and central and peripheral applanation tonometry were used to assess the changes in structural and functional arterial indices. Generalized estimating equations were used to model the corresponding outcomes. Results: After adjusting the models for sex, baseline moderate-to-vigorous physical activity, and mean arterial pressure changes, while using the intention-to-treat analysis, a significant interaction was observed on the carotid intima-media thickness (cIMT) for both the MCT (β = - 4.25, p < 0.01) and HIIT group (β = - 3.61, p < 0.01). However, only the HIIT observed favorable changes from baseline to 1-year on peripheral arterial stiffness indices such as carotid radial arterial pulse wave velocity (β = - 0.10, p = 0.044), carotid to distal posterior tibial artery pulse wave velocity (β = - 0.14, p < 0.01), and on the distensibility coefficient (β = - 0.00, p < 0.01). No effect was found for hemodynamic variables after the intervention. Conclusions: Following a 1-year intervention in patients with type 2 diabetes, both the MCT and HIIT group reduced their cIMT, whereas only the HIIT group improved their peripheral arterial stiffness indices and distensibility coefficient. Taken together, HIIT may be a meaningful tool to improve long-term vascular complications in type 2 diabetes. Trial registration clinicaltrials.gov ID: NCT03144505publishersversionpublishe