Doenças neuromusculares: rediscutindo o overtraining

Centro Universitário Augusto MottaUniversidade de São Paulo School of Medicine Department of Physical TherapyUniversidade Federal FluminenseUniversidade Federal de São Paulo (UNIFESP) Neurology DepartmentUNIFESP, Neurology DepartmentSciEL

Mills’ syndrome: case report

The syndrome of progressive, ascending or descending hemiplegia, with no significant sensory impairment was first describes by Mills in 1900, which several cases were reported later. However after diagnostic tests and image improvements, the number of reports has shortened. A possible explanation for this shortage is the identification of other diseases that could mimic the clinical picture. Currently, the syndrome has an uncertain nosological status, since it was described based on clinical examination only. We can find this clinical presentation (Mills syndrome) in cases of amyotrophic lateral sclerosis (ALS), predominant upper motor neuron amyotrophic lateral sclerosis (UMN-ALS) and primary lateral sclerosis (PLS), besides its symptomatic (secondary) forms. We describe a case (initial presentation and one year follow-up) of progressive ascending hemiplegia with clinical isolated upper neuron signs and normal sensory examination, discussing its nosological status, electromyographic findings, differential diagnosis and prognosis

Investigating the contribution of geometry on the failure of cellular core structures obtained by additive manufacturing

The aim of this work is to evaluate the mechanical properties and failure analysis of cellular core structures with different geometries that were obtained by additive manufacturing. Sandwich panels are widely used in the aerospace and automotive industry. In general, the core of the panels is made of a two dimensional cellular with a honeycomb geometry. With the development of additive manufacturing methods it is possible to produce samples with complex geometries which may compete with conventional designs. Thus an investigation was conducted to evaluate the mechanical behavior of three core geometries, specifically, regular honeycombs, lotus and hexagonal honeycombs with Plateau borders. Samples were produced in PLA (polylactic acid) by fused deposition modelling (FDM). Experimental compressive loading in three different directions, and finite element simulations of the samples permit to evaluate their deformation and failure mechanisms. Load direction angles were found to have a strong influence in the failure mode. Among the three structures, and for the same relative density, the lotus geometry exhibited the highest stiffness and strength. However, the absorbed energy was found to be higher for honeycomb, at two loading directions. Some of the structures studied may be alternative to conventional designs pursuing the strategy of design with low weight and high stiffness

Amyotrophic lateral sclerosis: one or multiple causes?

The Amyotrophic lateral sclerosis (ALS) is the most common form of motor neuron disease in the adulthood, and it is characterized by rapid and progressive compromise of the upper and lower motor neurons. The majority of the cases of ALS are classified as sporadic and, until now, a specific cause for these cases still is unknown. To present the different hypotheses on the etiology of ALS. It was carried out a search in the databases: Bireme, Scielo and Pubmed, in the period of 1987 to 2011, using the following keywords: Amyotrophic lateral sclerosis, motor neuron disease, etiology, causes and epidemiology and its similar in Portuguese and Spanish. It did not have consensus as regards the etiology of ALS. Researches demonstrates evidences as regards intoxication by heavy metals, environmental and occupational causes, genetic mutations (superoxide dismutase 1), certain viral infections and the accomplishment of vigorous physical activity for the development of the disease. There is still no consensus regarding the involved factors in the etiology of ALS. In this way, new research about these etiologies are necessary, for a better approach of the patients, promoting preventive programs for the disease and improving the quality of life of the patients

Coordenação na saúde pública: os paradigmas das relações intraorganizacionais no contexto amazônico

A coordenação tem sido apontada como um desafio para as organizações públicas, pois envolve grupos, jogos de interesse, a comunicação, a capacidade de liderança, dentre outros fatores que influenciam o ambiente interno de muitas organizações públicas. À vista disso, o presente artigo tem como objetivo analisar as relações intraorganizacionais de uma secretaria de saúde no contexto amazônico com intuito de entender como essas relações afetam o desempenho e a coordenação das ações organizacionais e, consequentemente, a entrega do serviço de saúde pública. Para tanto, foram realizadas entrevistas com diferentes servidores da secretaria para captar a percepção e posições acerca das interações organizacionais. As entrevistas foram analisadas no software IRAMUTEQ, seguindo os preceitos da análise de conteúdo. Observaram-se falhas na estrutura hierárquica, na de relacionamento, na de comunicação, dentre outras que impactam a estrutura de coordenação da secretaria e acabam por limitar a eficiência organizacional. Além do mais, a rotatividade dos coordenadores faz os servidores perseguir objetivos com os quais estão comprometidos, fato que acaba por gerar ineficiência. Constata-se a necessidade de mudanças para melhorar o processo de coordenação e eficiência organizacional

Benign fasciculations and corticosteroid use: possible association? An update

Fasciculations are characterized by visible subtle and fast contractions of muscle, even wormlike in movement, by the contraction of a fascicle of muscle fibers. The authors present the case study of a 28-year-old patient with the appearance of migratory and diffuse fasciculations with an onset after partial tapering off of oral corticosteroides (60 mg total dose) indicated for treatment of Minimal change Glomerulopathy. Clinical Neurological physical exam allied with an ENMG, besides other complementary laboratory exams were used for screening the above-mentioned patient. Afterwards, current research relating to the topic at hand was made in order to update the data available in the Bireme, Scielo and PubMed Data Banks using the following key words: Fasciculation's, motor neuron disease, and benign fasciculations in the Portuguese, English as well as Spanish language. Although fasciculation's are most commonly associated with Motor neuron disease as well as with certain metabolic disorders, they may also be present in individuals with absolutely no underlying pathological disorders. In our case, fasciculation potentials that have been present for six months, with no other signs of a neurogenic disorder as well as absence of laboratory findings, the patient received a diagnosis of Benign Fasciculation Syndrome (BFS).We believe that the use of corticosteroides in high doses with subsequent tapering contributed to the fasciculation's, especially due to the changes that this causes on the ionic channels. Fasciculation's are symptoms seen in a large range of conditions, and also being the main symptom of the so-called Benign Fasciculation Syndrome. We have presented an example of this clinical syndrome in a patient whose complaint was fasciculation's, with complete clinical remission of symptoms following complete tapering off of corticosteroid six months previously

PRODUÇÃO DE FITOMASSA E TEOR DE ÓLEO ESSENCIAL DE OCIMUM BASILICUM L. SUBMETIDO AO ESTRESSE SALINO

O manjericão (Ocimum basilicum L.) apresenta grande importância econômica, pois além de ser utilizado in natura, o seu óleo essencial é usado em cosméticos, perfumes, repelentes de insetos e na indústria farmacêutica. Com vista nisso, objetivou-se nesse estudo avaliar o efeito do estresse salino na produção de biomassa e no teor de óleo essencial desta espécie. O experimento foi desenvolvido no Centro de Ciências Agrárias e da Biodiversidade da Universidade Federal do Cariri, no município do Crato, Ceará. Utilizou-se o delineamento inteiramente casualizado em esquema fatorial 2x4, correspondendo a duas cultivares de manjericão (Basilicão e Folha Fina) e quatro concentrações de NaCl (0, 50, 75, 100 mM), com cinco repetições, totalizando 40 parcelas experimentais. Foram avaliados os seguintes parâmetros comprimento de parte aérea (cm), comprimento de raiz (cm), massa fresca da parte aérea (g), massa fresca da raiz (g), massa seca da raiz (g), número de inflorescências (unidade) e rendimento de óleo essencial. Os dados foram submetidos à análise de variância e quando significativos foi realizada análise de regressão. O rendimento de biomassa foi afetado pelo aumento da concentração do sal, porém, todas as plantas concluíram o ciclo de vida. A variedade Folha Fina apresentou uma maior tolerância ao estresse salino. No entanto, as duas variedades foram intolerantes à concentração 100 mM de NaCl. O rendimento de óleo essencial foi afetado positivamente pelo estresse salino até a concentração 75 mM de NaCl. A variedade Basilicão obteve um maior rendimento de óleo essencial quando comparada à Folha Fina

SÍNDROME DE BURNOUT E QUALIDADE DE VIDA EM POLICIAIS MILITARES DE GOIÁS DAS RONDAS OSTENSIVAS TÁTICAS METROPOLITANAS (ROTAM)

Burnout syndrome (SB) is an emotional disorder with symptoms of stress, extreme exhaustion and physical exhaustion, the main cause of the syndrome being excessive work. Burnout is common in professionals who work daily under constant pressure, such as police officers, doctors, nurses, teachers, journalists and physiotherapists. The aim of this study was to investigate the presence of Burnout Syndrome in police officers from ROTAM (Metropolitan Tactical Ostensive Rounds), assess the level of quality of life and associate it with BS and sociodemographic profile. This is a cross-sectional, descriptive study with police officers assigned to the ROTAM battalion in Goiânia, which involves a systematic collection of information through the sociodemographic profile, Maslach Burnout Inventory (MBI) and WHOQOL-bref. The MBI results showed that the majority of participating police officers did not show significant symptoms of SB. The survey showed that 81.3% of officers in ROTAM have a low risk of developing burnout syndrome, 13.9% show trends and 4.8% are indicative of SB. It was found that the quality of life of police officers in ROTAM is considered good, with a final average score of 77, with a higher score in the psychological domain of 80.28 and a lower score in the environmental domain of 69.72.El síndrome de Burnout (SB) es un trastorno emocional con síntomas de estrés, agotamiento extremo y agotamiento físico, siendo la principal causa del síndrome el exceso de trabajo. El Burnout es común en los profesionales que trabajan a diario bajo una presión constante, como policías, médicos, enfermeras, profesores, periodistas y fisioterapeutas. El objetivo de este estudio fue investigar la presencia del Síndrome de Burnout en policías de ROTAM (Metropolitan Tactical Ostensive Rounds), evaluar el nivel de calidad de vida y asociarlo con BS y perfil sociodemográfico. Se trata de un estudio descriptivo de corte transversal con policías adscritos al batallón ROTAM en Goiânia, que involucra una recolección sistemática de información a través del perfil sociodemográfico, Maslach Burnout Inventory (MBI) y WHOQOL-bref. Los resultados de MBI mostraron que la mayoría de los agentes de policía participantes no mostraron síntomas significativos de SB. La encuesta mostró que el 81,3% de los agentes de ROTAM tienen un riesgo bajo de desarrollar síndrome de burnout, el 13,9% muestran tendencias y el 4,8% son indicativos de SB. Se encontró que la calidad de vida de los policías en ROTAM se considera buena, con una puntuación media final de 77, con una puntuación más alta en el dominio psicológico de 80,28 y una puntuación más baja en el dominio ambiental de 69,72.A síndrome de Burnout (SB) é um distúrbio emocional com sintomas de estresse, exaustão extrema e esgotamento físico, sendo a principal causa da síndrome, o excesso de trabalho. O Burnout é comum em profissionais que atuam diariamente sob pressão constante, como policiais, médicos, enfermeiros, professores, jornalistas e fisioterapeutas. O objetivo deste estudo foi investigar a presença da Síndrome de Burnout em policiais de ROTAM (Rondas Ostensivas Táticas Metropolitanas), avaliar o nível da qualidade de vida e associá-lo com a SB e o perfil sociodemográfico. Trata-se de um estudo transversal, descritivo com policiais que estão lotados no batalhão de ROTAM em Goiânia que envolve uma coleta sistemática de informações através do perfil sóciodemografico, Maslach Burnout Inventory (MBI) e WHOQOL-bref. Os resultados do MBI mostraram que a maioria dos policiais participantes não apresentam sintomas significativos da SB. A pesquisa evidenciou que 81,3% dos policiais de ROTAM apresentam baixo risco de desenvolver a síndrome de burnout, 13,9% demonstram tendências e 4,8% é indicativo para SB. Verificou-se que a qualidade de vida dos policiais de ROTAM é considerada boa com escore de média final 77, com maior escore no domínio psicológico 80,28 e menor escore no domínio de meio ambiente 69,72

Charcot-Marie-Tooth disease and rehabilitation: a perfect match

Reabilitação e doença de Charcot-Marie-Tooth: um casamento perfeit