<b> Instruments for the assessment of physical balance in the elderly </b>

Esse trabalho objetivou identifi car os instrumentos mais utilizados para avaliação do equilíbrio corporal estático, dinâmico e risco de quedas em idosos no âmbito internacional e no Brasil. O estudo foi do tipo revisão sistemática qualitativa da literatura, os trabalhos consultados foram localizados por meio de pesquisa eletrônica nas bases de dados LILACS e MEDLINE e a partir das referências bibliográfi cas citadas em artigos científi cos. Uma vez escolhidos os instrumentos, realizou-se a investigação do histórico, utilização e adaptação transcultural dos mesmos. Vários testes têm sido desenvolvidos com o objetivo de medir funcionalmente o equilíbrio e estabelecer parâmetros para identificação de idosos com maior suscetibilidade de cair. De acordo com os critérios de seleção desse trabalho, chegou-se a escolha de cinco instrumentos com as propriedades psicométricas bem estabelecidas, o Teste de Alcance Funcional (FRT), o teste “Timed Up and Go” (TUG), o Teste de Performance Física (PPT), a Escala de Equilíbrio de Berg e a porção do equilíbrio da Avaliação da Mobilidade Orientada pelo Desempenho (POMA), tendo sido apenas esses dois últimos adaptados para a língua portuguesa. Diante disso, conclui-se que focalizar a atenção apenas em sinais e sintomas dos pacientes é extremamente limitado quando se deseja decidir qual intervenção melhorará a condição funcional do idoso, portanto, a avaliação funcional é o ponto de partida para uma reabilitação efetiva nessa população. Sendo necessária a existência de instrumentos de medida adaptados e validados para a população brasileira que avaliem o domínio do equilíbrio e contribuam para uma intervenção eficaz. <p> <b> ABSTRACT </b> The objective of this study was to identify the instruments that are most often used to assess seniors for static and dynamic physical balance and risk of falling, both internationally and in Brazil. This was a systematic, qualitative review of the literature for which articles were identifi ed by means of electronically searching the LILACS and MEDLINE databases and from the bibliographic references of work cited in scientifi c papers. Once the instruments had been chosen, their history, utilization and transcultural adaptation were investigated. Many different tests have been developed with the objective of functionally measuring balance and establishing criteria for the identifi cation of those elderly people most susceptible to falls. Based on the selection criteria established, fi ve instruments were chosen with well-established psychometric properties; the Functional Reach Test (FRT), the Timed Up and Go (TUG) test, the Physical Performance Test (PPT), the Berg Balance Scale and the balance section of the Performance Oriented Mobility Assessment, (POMA), only the last two of which have been adapted for the Portuguese language. It was concluded that to focus attention exclusively on patient signs and symptoms is extremely limited when the intention is to decide which interventions will improve the functional status of an elderly patient and that functional assessment is therefore the starting point for effective rehabilitation of this population. There is a need for evaluation instruments that have been adapted and validated for the Brazilian population, that assess the domain of balance and which contribute to effective intervention

PAPEL DE LOS staphylococcus spp. EN LA MUCOSITIS ORAL: REVISIÓN DE LA LITERATURA

Se estima que m&aacute;s de 500 especies bacterianas habitan el medio ambiente oral de seres humanos. Entre ellas, son conocidas m&aacute;s de 400 especies, adem&aacute;s de una gran diversidad de microorganismos que han sido descubiertos gracias a innovaciones en las t&eacute;cnicas de biolog&iacute;a molecular. Con relaci&oacute;n a los staphylococcus spp., su presencia en el medio ambiente oral de individuos saludables, local o sist&eacute;micamente comprometidos es bastante controversia, lo que remite a la necesidad de estudios cuidadosos con intenci&oacute;n de aclarar el papel de esas bacterias en la ecolog&iacute;a de ese microambiente, as&iacute; como en la etiolog&iacute;a de enfermedades orales y sist&eacute;micas. Ese estudio propuso reunir los conocimientos actuales sobre la presencia de staphylococcus en el medio ambiente oral y sus implicaciones en el desarrollo de mucositis oral, denominada en ese caso de "mucositis estafiloc&oacute;cica oral", una condici&oacute;n cl&iacute;nica que afecta m&aacute;s com&uacute;nmente pacientes mayores, sist&eacute;micamente debilitados o inmunol&oacute;gicamente comprometidos.ABSTRACTIt is estimated that more than 500 bacterial species inhabit the human oral environment. Among them, more than 400 species are known, and also a huge diversity of microorganisms that have been discovered because of the innovations in molecular biology techniques. Talking about staphylococcus spp., its presence in oral environment of health individuals and local or systemic wounded ones is at least controversial, what guides to the necessity of accurate studies in order to clarify this bacteria profile in this microenvironment ecology, as well as in oral and systemic disease etiology. This study aimed to gather the current knowledge concerning the staphylococcal presence in oral environment and its implications in oral mucositis development, in this case called "oral staphylococcal mucositis", a clinical condition that affects more commonly ancient patients, systemic weakened or immunologically wounded

A TUTELA PENAL DO CONSUMIDOR SOB O ENFOQUE DOS DIREITOS À SAÚDE E À SEGURANÇA

A Constituição Federal de 1988 estabeleceu a defesa do consumidor como garantia fundamental, a qual inclui a tutela penal do consumidor. Algumas condutas foram tipificadas na legislação esparsa como sendo crimes, dado o alto grau de ofensividade à pessoa humana. Serão analisadas neste trabalho as espécies delituosas que mais ofendem o direito à saúde e segurança do consumidor, nas esferas individual e coletiva. Assim, o legislador reservou também ao braço armado do Estado a salvaguarda dos direitos do consumidor, especialmente no que diz respeito à saúde e segurança. Estes direitos devem ser seguramente resguardados. A proteção efetiva da incolumidade física do consumidor, bem como formas de previnir e reprimir estes delitos serão desenvolvidos neste trabalho, além de serem apresentadas situações fáticas envolvendo o tema

Azilsartan reduced TNF-α and IL-1β levels, increased IL-10 levels and upregulated VEGF, FGF, KGF, and TGF-α in an oral mucositis model.

Oral mucositis (OM) is a common complication of treatments for head and neck cancer, particularly radiotherapy with or without chemotherapy. OM is characterised by oral erythema, ulceration, and pain. The aim of this study was to evaluate the effect of azilsartan (AZT), an angiotensin II receptor antagonist, on 5-fluorouracil (5-FU)-induced oral mucositis (OM) in Syrian hamsters. OM was induced by the intraperitoneal administration of 5-FU on experimental days 1 (60 mg/Kg) and 2 (40 mg/Kg). Animals were pretreated with oral AZT (1, 5, or 10 mg/kg) or vehicle 30 min before 5-FU injection and daily until day 10. Experimental treatment protocols were approved by the Animal Ethics Committee Use/CEUA (Number 28/2012) of the UFRN. Macroscopic analysis and cheek pouch samples were removed for histopathologic analysis. Myeloperoxidase (MPO), Malonyldialdehyde (MDA), interleukin-1 beta (IL-1β), interleukin-10 (IL-10), and tumour necrosis factor-alpha (TNF-α) were analysed by Enzyme Linked Immuno Sorbent Assay (ELISA). Vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), keratinocyte growth factor (KGF), and transforming growth factor (TGF)-α were measured by immunohistochemistry. Analysis of variance followed by Bonferroni's test was used to calculate the means of intergroup differences (p ≤ 0.05). Treatment with 1 mg/kg AZT reduced levels MPO (p<0.01), MDA (p<0.5) and histological inflammatory cell infiltration, and increased the presence of granulation tissue. AZT treatment at 1 mg/kg reduced the TNF-α (p<0.05) and IL-1β (p<0.05) levels, increased the cheek pouch levels of IL-10 (p<0.01), and upregulated VEGF, FGF, KGF, and TGF-α. Administration of AZT at higher doses (5 and 10 mg/kg) did not significantly reverse the OM. AZT at a dose of 1 mg/kg prevented the mucosal damage and inflammation associated with 5-FU-induced OM, increasing granulation and tissue repair

Photomicrographs of hamsters cheek pouches showing immunoreactivity to TGF-α, FGF, KGF and VEGF.

<p>Hamsters subjected to Normal (A, D, G, J, M, P, S); Hamsters subjected to 5- FU/saline (B, E, H, K, N, Q, T); Hamsters subjected to treated with AZT1/5-FU (C, F, I, L, O, R, U) and Hamsters subjected to treated with AZT5/5-FU (C, F, I, L, O, R, U). Images are shown at 40× magnification. Bar = 100 μm. Arrow indicates high or moderate labeling in the oral mucosa. Asterisk indicates mild or moderate labeling in the oral mucosa. Triangle and asterisk indicate oral mucosa. Triangle and arrow indicate high labeling of oral mucosa. Asterisk and triangle indicate mild labeling of oral mucosa.</p

Levels of IL-1β (A), TNF- α (B) and IL-10 (C), and, Normal, MT, 5-FU/saline and groups AZT1/5-FU, AZT5/5-FU and AZT10/5-FU (#<i>p</i> <0.05, ##<i>p</i> < 0.01, compared group with 5-FU/saline).

<p>Levels of IL-1β (A), TNF- α (B) and IL-10 (C), and, Normal, MT, 5-FU/saline and groups AZT1/5-FU, AZT5/5-FU and AZT10/5-FU (#<i>p</i> <0.05, ##<i>p</i> < 0.01, compared group with 5-FU/saline).</p

MPO (A) and MDA (B) in Normal, MT, 5-FU/saline and groups treated with AZT1/5-FU, AZT5/5-FU and AZT10/5-FU (#<i>p</i> <0.05, ##<i>p</i> < 0.01, compared groups with 5-FUT/saline Group; *p<0.05, compared groups with Normal Group).

<p>MPO (A) and MDA (B) in Normal, MT, 5-FU/saline and groups treated with AZT1/5-FU, AZT5/5-FU and AZT10/5-FU (#<i>p</i> <0.05, ##<i>p</i> < 0.01, compared groups with 5-FUT/saline Group; *p<0.05, compared groups with Normal Group).</p

Macroscopic aspects of hamster cheek pouches.

<p>Representative cheek pouches are shown for animals subjected to: A: saline (Normal Group); B: mechanical trauma (MT Group); C: i.p. 5-FU on days 1 and 2 (60 mg/kg and 40 mg/kg, respectively), and MT of the cheek pouches on day 4 (5-FU/Saline Group); D: daily oral AZT (1 mg/kg), i.p. 5-FU on days 1 and 2 (60 mg/kg and 40 mg/kg, respectively), and MT of the cheek pouches on day 4 (AZT1/5-FU Group); E: daily oral AZT (5 mg/kg), i.p. 5-FU on days 1 and 2 (60 mg/kg and 40 mg/kg, respectively), and MT of the cheek pouches on day 4 (AZT5/5-FU Group); F: daily oral AZT (10 mg/kg), i.p. 5-FU on days 1 and 2 (60 mg/kg and 40 mg/kg, respectively), and MT of the cheek pouches on day 4 (AZT10/5-FU Group).</p