Influência do alinhamento do pé nos Ajustes Posturais Antecipatórios em crianças com Paralisia Cerebral

Introdução: A dificuldade na organização dos ajustes posturais antecipatórios (APAs) é frequentemente associada ao défice de controlo postural (CP) em crianças/jovens com um quadro motor de hemiplegia espástica, resultante de paralisia cerebral. As alterações biomecânicas da tibiotársica e do pé são características comummente observadas nestas crianças/jovens e influenciam o CP na sua globalidade. Objectivo(s): descrever o comportamento dos APAs associados ao início da marcha, face à modificação do alinhamento do pé em crianças/jovens com hemiplegia espástica, após 12 semanas de intervenção, segundo o Conceito Bobath-TND e aplicação de uma Ligadura Funcional (LF). Métodos: Foram avaliadas quatro crianças/jovens num momento inicial (M0) e após 12 semanas de intervenção e de aplicação de uma LF (M1). Recorrendo à eletromiografia de superfície, registaram-se os timings de activação dos músculos tibial anterior, solear, recto abdominal e erector da espinha (bilateralmente). O início do movimento foi calculado a partir da alteração do sinal obtido através da plataforma de pressões. Recorreu-se à aplicação da TMFM-88 para avaliar a função motora global e à aplicação da CIF-CJ para classificar a funcionalidade mediante as actividades e a participação. Procedeu-se ao registo de imagem para facilitar a observação/avaliação das componentes de movimento das crianças/jovens em estudo. Resultados: Após o período de intervenção, verificou-se uma modificação nos valores dos timings de ativação dos músculos em análise, que se aproximaram da janela temporal definida como APAs, bem como na distribuição de carga na base de suporte, nos scores da TMFM-88 e nos qualificadores das “Actividades e Participação”, sugestivos de uma melhor organização dos mecanismos de controlo postural. Conclusão: As crianças/jovens em estudo evidenciaram, após uma intervenção de fisioterapia baseada no Conceito Bobath- TND e aplicação de uma LF, uma evolução favorável tanto ao nível do CP da tibiotársica e do pé, apresentando timings de ativação muscular temporalmente mais ajustados à tarefa, com repercussões positivas nas actividades e participação.Background: The difficulty in the organization of anticipatory postural adjustments (APAs) is often associated with lack of postural control (PC) in children/young people with motor spastic hemiplegia, resulting from cerebral palsy. Biomechanical changes of the tibiotarsal and foot characteristics are commonly observed in these children/young people and influence the PC as a whole. Aim(s): describe the behavior of APAs associated with gait initiation, due to modification of the foot alignment in children/young people with spastic hemiplegia, after 12 weeks of intervention, according to the Bobath Concept-TND and application of a functional bandage (FB). Methods: Four children/youth were assessed in an initial moment (M0) and after 12 weeks of intervention and implementation of an FB (M1). Using surface electromyography, the activation timings of the anterior tibialis, soleus, rectus abdominus and erector spinae (bilaterally) were registered, obtained by electromyography. The beginning of movement was calculated from the change of the signal obtained through the pressure platform. Resorting to the application of TMFM-88 to assess the global motor function and the application of the CIF-CJ the functionality by activities and participation were classified. And proceededing to the registration of the image to facilitate the observation/rating of the components movement of the children/young people in the study. Results: After the intervention period, there was a modification in the values of the activation timings of the muscles in question, which approached the temporal window defined on APAs as well as the load distribution on the support base, the scores of the TMFM-88, and in the carrying out of the "Activities and Participation". Suggestive of a better organization of PC mechanisms. Conclusion: Children/young people in the study showed, after a physiotherapy intervention based on Bobath Concept-TND and application of a FB, a favorable evolution of both the PC of the tibiotarsal and foot level, with muscle activation timings temporally more adjusted to the task, and positive repercussions on the activities and participation

Influence of foot alignment in anticipatory postural adjustments in children with cerebral palsy

The difficulty in the organization of anticipatory postural adjustments (APAs) is often associated with lack of postural control (PC) in children/young people with motor spastic hemiplegia, resulting from cerebral palsy (CP). Biomechanical changes of the tibiotarsal and foot characteristics are commonly observed in these children/young people and influence the PC as a wholeinfo:eu-repo/semantics/publishedVersio

HIDROXICLOROQUINA: USO POTENCIAL EM CORONAVIROSES?

A hidrocloroquina (HCQ) é um análogo da cloroquina, que foi projetada para terapêutica da malária. A longo das últimas décadas têm se observado o potencial de aplicação em outras patologias, como doenças autoimunes, oncologia e infecções virais. Neste ultimo grupo, enquadra-se o desafio da pandemia de coronavírus 2019 (COVID-19) que têm infectado centenas de milhares de pessoas e acarretado em milhares de mortes em todo mundo. Nesta conjuntura, objetivou-se discorrer acercar do uso potencial da hidrolcloroquina em infecções do coronovavírus. Através dos dados coletados, observou-se que a HCQ pode inibir a replicação viral pelo seu acúmulo no lisossoma e complexo de golgi celular, apresentando baixo custo e auxiliado na estabilização de pacientes graves com COVID-19. Entretanto, não evidência quanto a sua eficácia como droga profilática, existem diversas reações adversas e contra-indicações clínicas, de forma que seu uso deve ser devidamente prescrita por profissional de saúde. Além disso, ensaios clínicos randomizados, cegos, de tratamentos de coronoviroses devem ser estabelecidos, de forma que protocolos clínicos possam ser adequamente utilizados para a HCQ

Coronavirus in Pregnant Women: Literature Review

The coronavirus viruses cause infectious conditions that evolve with greater severity in patients with reduced immunity, a fact that can be observed in pregnant women. In these, anatomical and physiological changes occur that can compromise immunity, which can lead to complications. Faced with the pandemic by COVID-19, the present study aimed to discuss the possible risk of the pregnant woman and the fetus facing infection with this virus, which initially presents respiratory symptoms and with lower gastrointestinal prevalence. . Based on the data collected, it was observed that, in many cases, pregnant women develop respiratory, renal and cardiovascular complications, requiring ICU admission and mechanical ventilation. This can lead to fetal distress, placental detachment, spontaneous abortion, reduced fetal growth and risk of maternal-fetal death. Thus, attention must be redoubled in health surveillance and education for this group, as well as the availability of the health care system and clinical, epidemiological and laboratory diagnosis is required, since most patients tend to evolve with clinical complications

Coronavirus Outbreaks: Literature Review

Coronaviruses are observed in birds and mammals and can be transmitted to humans, leading to outbreaks and pandemics. Among the most recent ones are SARS-CoV, MERS-CoV, and COVID 19. Thus, the objective was to describe a discussion about coronaviruses, with an emphasis on Sars-Cov-2. From the data collected, it can be seen that the current pandemic has had impacts on public health and socioeconomic life in more than 170 countries worldwide, to date, with tens of millions of people infected and hundreds of thousands of deaths. In this regard, prevention actions must be intensified, especially among the most vulnerable patients (the elderly and those with comorbidities that affect immunity). In addition, new studies should be carried out so that vaccines and antivirals can be implemented for application to COVID-19

Development of caprine preantral follicles after orthotopic autotransplantation of ovarian tissue

Objective: The aim of this study was to evaluate the follicle morphology, density, development and hormone production after orthotopic autransplantation of fresh or vitrified goat ovarian tissue. Methods: Fresh and vitrified ovarian cortex was orthotopically autotransplanted for six months in two and three adults bilaterally ovariectomized goats, respectively. The animals were monitored during 196 days and blood samples collected. Results: It was observed that the percentage of morphologically normal preantral follicles (MNPF) after grafting of fresh ovarian tissue was similar to control. The follicular density in the fresh graft reduced significantly when compared to fresh control. unfortunately, after transplantation of vitrified tissue it was not possible to identified any follicles after recovery. Furthermore, the proportion of developing follicles was higher (P < 0.05) in the fresh auto-grafts than in control fragments. Moreover, progesterone plasma levels increased significantly from day 179 to day 195 of transplantation. Conclusion: In conclusion, orthotopic transplantation of fresh ovarian tissue was able to keep healthy the preantral follicles, as well as the restoration of goat endocrine function

Modulation of the peripheral blood transcriptome by the ingestion of probiotic yoghurt and acidified milk in healthy, young men

The metabolic health benefits of fermented milks have already been investigated using clinical biomarkers but the development of transcriptomic analytics in blood offers an alternative approach that may help to sensitively characterise such effects. We aimed to assess the effects of probiotic yoghurt intake, compared to non-fermented, acidified milk intake, on clinical biomarkers and gene expression in peripheral blood. To this end, a randomised, crossover study was conducted in fourteen healthy, young men to test the two dairy products. For a subset of seven subjects, RNA sequencing was used to measure gene expression in blood collected during postprandial tests and after two weeks daily intake. We found that the postprandial response in insulin was different for probiotic yoghurt as compared to that of acidified milk. Moreover changes in several clinical biomarkers were associated with changes in the expression of genes representing six metabolic genesets. Assessment of the postprandial effects of each dairy product on gene expression by geneset enrichment analysis revealed significant, similar modulation of inflammatory and glycolytic genes after both probiotic yoghurt and acidified milk intake, although distinct kinetic characteristics of the modulation differentiated the dairy products. The aryl hydrocarbon receptor was a major contributor to the down-regulation of the inflammatory genesets and was also positively associated with changes in circulating insulin at 2h after yoghurt intake (p = 0.05). Daily intake of the dairy products showed little effect on the fasting blood transcriptome. Probiotic yoghurt and acidified milk appear to affect similar gene pathways during the postprandial phase but differences in the timing and the extent of this modulation may lead to different physiological consequences. The functional relevance of these differences in gene expression is supported by their associations with circulating biomarkers

Understanding the relation between Zika virus infection during pregnancy and adverse fetal, infant and child outcomes: a protocol for a systematic review and individual participant data meta-analysis of longitudinal studies of pregnant women and their infants and children

IntroductionZika virus (ZIKV) infection during pregnancy is a known cause of microcephaly and other congenital and developmental anomalies. In the absence of a ZIKV vaccine or prophylactics, principal investigators (PIs) and international leaders in ZIKV research have formed the ZIKV Individual Participant Data (IPD) Consortium to identify, collect and synthesise IPD from longitudinal studies of pregnant women that measure ZIKV infection during pregnancy and fetal, infant or child outcomes.Methods and analysisWe will identify eligible studies through the ZIKV IPD Consortium membership and a systematic review and invite study PIs to participate in the IPD meta-analysis (IPD-MA). We will use the combined dataset to estimate the relative and absolute risk of congenital Zika syndrome (CZS), including microcephaly and late symptomatic congenital infections; identify and explore sources of heterogeneity in those estimates and develop and validate a risk prediction model to identify the pregnancies at the highest risk of CZS or adverse developmental outcomes. The variable accuracy of diagnostic assays and differences in exposure and outcome definitions means that included studies will have a higher level of systematic variability, a component of measurement error, than an IPD-MA of studies of an established pathogen. We will use expert testimony, existing internal and external diagnostic accuracy validation studies and laboratory external quality assessments to inform the distribution of measurement error in our models. We will apply both Bayesian and frequentist methods to directly account for these and other sources of uncertainty.Ethics and disseminationThe IPD-MA was deemed exempt from ethical review. We will convene a group of patient advocates to evaluate the ethical implications and utility of the risk stratification tool. Findings from these analyses will be shared via national and international conferences and through publication in open access, peer-reviewed journals.Trial registration numberPROSPERO International prospective register of systematic reviews (CRD42017068915).</jats:sec

Recovery of Decreased Bone Mineral Mass After Lower-Limb Fractures in Adolescents

BACKGROUND: Loss of bone mineral mass, muscle atrophy, and functional limitations are predictable consequences of immobilization and subsequent weight-bearing restriction due to leg or ankle fractures. The aim of this study was to prospectively determine whether decreased bone mineral mass following lower-limb fractures recovers at follow-up durations of six and eighteen months in adolescents

A screening design to analyze the influence of technological configurations on techno-economic parameters for autonomous distilleries in Brazil

This study aims to assess how Internal Rate of Return of the enterprise, Ethanol Output and Surplus Electricity vary according to changes in existing scenarios of an autonomous distillery, that is, a distillery producing ethanol and electricity, but not sugar. A simulation procedure using the Virtual Sugarcane Biorefinery (VSB) framework according to a screening design is used for this purpose. The VSB is composed of a set of computer-aided tools to simulate the sugarcane agricultural production system, its transport as well as the industrial processing. The sensitivity of operational variables, such as fermentation yield, steam consumption, boiler steam pressure, juice extraction yield, residual ethanol concentration in vinasse and alcohol content in wine were varied in a realistic basis, constrained by operational limits, which resulted in forty-five scenarios following a Central Composite Design (CCD). This design was used to describe ethanol production possible scenarios in autonomous distilleries in Brazil. This procedure has allowed evaluating scenarios with different technological configurations. The influence of these operational variables on the techno-economic parameters was studied through a screening procedure for statistical evaluation of results37307312FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP2011/51902- 9International Conference on BioMass (iconBM 2014