VARIABILITY IN VERTICAL JUMP HEIGHT AND LOWER LIMB KINEMATICS BETWEEN DAYS

The purpose of this study was to determine the variability of lower limb range of motion (ROM) during vertical jumps using inertial-based systems. Ten participants attended three laboratorial session to familiarise with the countermovement jump (session 1) and to perform three maximum countermovement jumps (session 2 and 3). Motion from the lower limbs and pelvis were tracked using an inertial-based system and sagittal plane ROM computed for the hip, knee and ankle joints. ROM was compared between sessions using t-test, typical error and effect sizes. Moderate effect sizes were observed with differences in angular data varying from12° for similar heights of the jump (p = 0.27 and d = 0.21). Moderate differences in sagittal plane ROM for the lower limbs were observed for vertical countermovement jumps which limits the use of joint ROM between sessions from inertial-based system

Telerehabilitation for Knee Osteoarthritis in Brazil: A Feasibility Study

Background: The effectiveness of telerehabilitation for a patient with knee osteoarthritis may depend upon the person’s adherence to intervention. Thus, the aim of this study was to investigate whether people with knee osteoarthritis would adhere to exercise-therapy facilitated via multiple media in Brazil, a newly industrialized country. Method: This is a feasibility study, pre-post intervention. Middle aged (40-50 years) and elderly (?70 years) people with knee osteoarthritis received in-person exercise-therapy instructions on the first day, along with a booklet and DVD (videos) to take home. Participants also received six motivational phone calls throughout the 12-week treatment. Satisfaction and adherence were assessed one week after intervention with the Exercise Adherence Rating Scale (EARS), sections B and C. Preference on the method used to adhere to exercises was recorded. Conclusion: Telerehabilitation was well accepted by middle-aged and elderly Brazilians with knee osteoarthritis. The preferred media to enhance adherence, was a booklet with descriptions of the exercises, especially for the elderly cohort

Impacto das Mudanças Climáticas no Equilíbrio Econômico-Financeiro da Gestão do Saneamento Básico

[Purpose] The scientific community has been issuing warnings about anomalies in the hydrological cycle caused by climate change since the 70s, which were and are corroborated by competent national and international bodies, which confirmed the anthropic intervention and point to the worsening of the effects of climate change. However, the management of basic sanitation, despite increasingly suffering from water stress, has made very little progress in facing this challenge. In the last decade, the water crisis has been constantly present, and already constitutes a concrete shortage risk for the country. Thus, this article aims to analyze the impact of the water crisis resulting from climate change on the management of basic sanitation, the way in which the water event is designated by risk matrices and concession contracts, and also the existence or not of legal and institutional mechanisms that can contribute to overcoming the challenge of water stress. [Methodology/approach/design] This article was used as a deductive scientific method to guide the achievement of the proposed objective. Additionally, an applied and descriptive research was carried out, in which both a bibliographical and documental review and a case study with an interview were used. [Findings] The results obtained with this article can be fruitful, as it may lead to reflections, discussions and debates on the impact of the water crisis on the management of basic sanitation, the modeling of risk matrices and concession contracts, as well as legal solutions - institutional to overcome the unavailability of water.[Propósito] A comunidade cientifica vem emitindo alertas sobre as anomalias do ciclo hidrológico provocadas pelas mudanças climáticas desde a década de 70, que confirmaram a intervenção antrópica e apontam o agravamento dos efeitos das mudanças do clima. A gestão do saneamento básico sofre cada vez mais com o estresse hídrico, mas avançou muito pouco no enfrentamento deste desafio. Na última década, a crise hídrica se intensificou, e constitui um risco de desabastecimento concreto para o país. Assim, o presente artigo tem por objetivo analisar o impacto da crise hídrica decorrente das mudanças climáticas na gestão do saneamento básico, a forma como o evento hídrico é designado pelas matrizes de risco e pelos contratos de concessão e, ainda, a existência ou não de mecanismos jurídicos e institucionais que possam contribuir para a superação deste desafio. [Metodologia/abordagem/design] Para tanto, o presente artigo utilizou como método o científico dedutivo para orientar o alcance do objetivo ora proposto. Adicionalmente, promoveu-se uma pesquisa aplicada e descritiva, em que se empregou tanto uma revisão bibliográfica e documental quanto um estudo de caso com realização de entrevista. [Resultados] Os resultados obtidos com o presente artigo podem ser profícuos, pois poderão levar a reflexões, discussões e debates sobre o impacto da crise hídrica na gestão do saneamento básico, a modelagem das matrizes de riscos e os contratos de concessão, assim como as soluções jurídico-institucionais para a superação da indisponibilidade hídrica.[Propósito] A comunidade cientifica vem emitindo alertas sobre as anomalias do ciclo hidrológico provocadas pelas mudanças climáticas desde a década de 70, que confirmaram a intervenção antrópica e apontam o agravamento dos efeitos das mudanças do clima. A gestão do saneamento básico sofre cada vez mais com o estresse hídrico, mas avançou muito pouco no enfrentamento deste desafio. Na última década, a crise hídrica se intensificou, e constitui um risco de desabastecimento concreto para o país. Assim, o presente artigo tem por objetivo analisar o impacto da crise hídrica decorrente das mudanças climáticas na gestão do saneamento básico, a forma como o evento hídrico é designado pelas matrizes de risco e pelos contratos de concessão e, ainda, a existência ou não de mecanismos jurídicos e institucionais que possam contribuir para a superação deste desafio. [Metodologia/abordagem/design] Para tanto, o presente artigo utilizou como método o científico dedutivo para orientar o alcance do objetivo ora proposto. Adicionalmente, promoveu-se uma pesquisa aplicada e descritiva, em que se empregou tanto uma revisão bibliográfica e documental quanto um estudo de caso com realização de entrevista. [Resultados] Os resultados obtidos com o presente artigo podem ser profícuos, pois poderão levar a reflexões, discussões e debates sobre o impacto da crise hídrica na gestão do saneamento básico, a modelagem das matrizes de riscos e os contratos de concessão, assim como as soluções jurídico-institucionais para a superação da indisponibilidade hídrica

Avaliação das adaptações transculturais e propriedades de medida de questionários em língua portuguesa relacionados às desordens temporomandibulares: uma revisão sistemática

The aim of this study was to identify, through a systematic review, which questionnaires used to assess temporomandibular (TMD) disorders are available in the Portuguese language, describing and analyzing the procedures used to translate and adapt the questionnaire into Portuguese, as well their measurement properties. Systematic searches were performed in five electronic databases (MEDLINE by PubMed, Embase, CINAHL by EBSCO, SciELO and LILACS). All studies were analyzed according to the criteria of quality guidelines for the procedures for cross-cultural adaptation and measurement properties. There were 1.418, of which only six were eligible. Manual search retrieved two additional articles and a book chapter, totaling nine eligible studies. Four instruments were translated/adapted into Portuguese: The Research Diagnostic Criteria for Temporomandibular Disorders: Axis II (RDC/TMD); the Fonseca Questionnaire and Anamnestic Index; the Questionnaire from the American Academy of Orofacial Pain (QAADO); and Mandibular Function Impairment Questionnaire (MFIQ), but none of these questionnaires where fully submitted to the steps for translation and adaptation recommended by the followed guidelines and none of the questionnaires had all measurement properties tested. The RDC/TMD and tehe MFIQ are the best available questionnaires in Portuguese to assess TMD, as were those with the most measurement properties acceptable results tested.El objetivo de este estudio fue identificar, por medio de una revisión sistemática, los cuestionarios que evalúan los trastornos temporomandibulares (TTM) disponible en portugués, además de describir y analizar los procedimientos de traducción y adaptación al portugués de los mismos y sus respectivas propiedades de medida. Fueron realizadas búsquedas sistemáticas en cinco bases de datos (MEDLINE vía PubMed, Embase, CINAHL a través de EBSCO, SciELO y LILACS). Se analizaron todos los estudios de acuerdo a los criterios de calidad de directrices para los procedimientos de adaptación transcultural y propiedades de medida. Fueron encontrados 1.418 estudios, siendo que solo 6 fueron considerados elegibles. Fueron incluidos en búsqueda manual dos artículos y un capítulo de libro, totalizando nueve estudios. Cuatro instrumentos fueron traducidos/adaptados al portugués: Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), Questionário e Índice Anamnésico de Fonseca, Questionário da Academia Americana de Dor Orofacia (QAADO) y Mandibular Function Impairment Questionnaire (MFIQ), pero ninguno de estos llevó a cabo plenamente las etapas de traducción y análisis de las propiedades de medida. El RDC/TMD y el MFIQ fueron considerados los instrumentos más adecuados, ya que fueron los que presentaron más propiedades de medida apropiadamente examinadas.O objetivo deste estudo foi identificar, por meio de uma revisão sistemática, os questionários que avaliam as desordens temporomandibulares (DTM) disponíveis em português, bem como descrever e analisar os procedimentos de tradução e adaptação para a língua portuguesa dos mesmos e suas respectivas propriedades de medida. Foram realizadas buscas sistematizadas em cinco bases de dados (MEDLINE via PubMed, Embase, CINAHL via EBSCO, SciELO e LILACS). Todos os estudos foram analisados de acordo com os critérios de qualidade de diretrizes para os procedimentos de adaptação transcultural e propriedades de medida. Foram encontrados 1.418 estudos, sendo que apenas 6 foram considerados elegíveis. Foram incluídos em busca manual dois artigos e um capítulo de livro, totalizando nove estudos. Quatro instrumentos foram traduzidos/adaptados para a língua portuguesa: Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), Questionário e Índice Anamnésico de Fonseca, Questionário da Academia Americana de Dor Orofacia (QAADO) e Mandibular Function Impairment Questionnaire (MFIQ), porém nenhum desses realizou completamente as etapas de tradução ou análise das propriedades de medida. O RDC/TMD e o MFIQ foram considerados os instrumentos mais adequados, pois foram os que apresentaram mais propriedades de medida apropriadamente testadas

Imagética motora no tratamento da entorse lateral de tornozelo em atletas de futebol de campo: um estudo piloto

A entorse de tornozelo é uma lesão comum em atletas de futebol e apresenta um alto índice de recidivas. A imagética motora (IM) pode ser uma alternativa no tratamento para diminuir as consequências neuromusculares apresentadas pós-lesão. Dessa forma, este estudo teve como objetivo verificar os resultados preliminares da efetividade da IM na reabilitação de atletas de futebol com entorse aguda de tornozelo. Participaram 20 jovens atletas do sexo masculino, que foram divididos de forma aleatória em dois grupos: intervenção (GI) e controle (GC). Os participantes passaram por um processo de reabilitação convencional (crioterapia, eletroterapia e cinesioterapia) para entorse de tornozelo, porém apenas o GI realizava exercício de imagética ao tentar reconhecer as figuras do tornozelo-pé, projetados em um computador, em várias perspectivas e ângulos de orientação. Foram mensurados as amplitudes de movimento (ADM) de flexão dorsal e plantar, controle postural, edema e estabilidade funcional. Após o tratamento não foi observada nenhuma diferença entre os grupos quanto à ADM de flexão dorsal (p=0,23), ADM de flexão plantar (p=0,50), Star Excursion Balance Test (SEBT) na direção anterior (p=0,70), SEBT na direção póstero-lateral (p=0,29), SEBT na direção póstero-medial (p=0,79), perimetria em "8" (p=0,50) e questionário CAIT-P para instabilidade funcional (p=0,70). A IM não foi um método eficaz no tratamento de entorse de tornozelo em atletas de futebol de campo para melhora de ADM, equilíbrio dinâmico, edema e estabilidade funcional. Entretanto, este é um estudo piloto e maiores investigações são necessárias.El esguince de tobillo es una lesión común en los atletas de fútbol y presenta una alta tasa de recaídas. La imagética motora (IM) puede ser un tratamiento alternativo para disminuir las consecuencias neuromusculares presentadas post-lesión. Por lo tanto, el objetivo de este estudio fue verificar los resultados preliminares de la efectividad de la IM en la rehabilitación de atletas de fútbol con esguince agudo de tobillo. Participaron 20 atletas jóvenes del sexo masculino, divididos de manera aleatoria en dos grupos: intervención (GI) y control (GC). Los participantes experimentaron un proceso de rehabilitación convencional (crioterapia, electroterapia y cinesioterapia) para esguince de tobillo, sin embargo sólo el GI realizaba ejercicio de imagética al tratar de reconocer las figuras del tobillo-pie, proyectados en una computadora, en diferentes perspectivas y ángulos de orientación. Se midió las amplitudes de movimiento (ADM) de flexión dorsal y plantar, control postural, edema y estabilidad funcional. Después del tratamiento no se observó ninguna diferencia entre los grupos en relación a la ADM de flexión dorsal (p=0,23), ADM de flexión plantar (p=0,50), Star Excursion Balance Test (SEBT) en dirección anterior (p=0,70), SEBT en la dirección posterolateral (p=0,29), SEBT en la dirección posteromedial (p=0,79), perimetría en "8" (p=0,50) y cuestionario CAIT-P a la inestabilidad funcional (p=0,70). La IM no fue un método eficaz en el tratamiento de esguinces de tobillo en atletas de fútbol de campo para la mejora de ADM, equilibrio dinámico, edema y estabilidad funcional. Sin embargo este es un estudio piloto y mayores investigaciones son necesarias.Ankle sprain is a common injury in soccer athletes and has a high relapse rate. Motor imagery (MI) may be an alternative treatment to diminish the neuromuscular consequences after the injury. Thus, this study aimed to verify the preliminary results of the effectiveness of MI in the rehabilitation of soccer athletes with acute ankle sprain. Twenty young athletes of the male sex participated in the study. They were randomly divided into two groups: intervention (IG) and control (CG). Participants underwent conventional rehabilitation (cryotherapy, electrotherapy and kinesiotherapy) for ankle sprain, but only the IG performed imagery exercises to try to recognize the ankle-foot figures, projected by a computer, from various perspectives and angles. The ranges of motion (ROM) were measured for dorsiflexion and plantar postural control, edema and functional stability. After treatment, no difference between groups were observed regarding dorsiflexion ROM (p=0.23), plantar flexion ROM (p=0.50), Star Excursion Balance Test (SEBT) in the anterior direction (p=0.70), SEBT in the posterolateral direction (p=0.29), SEBT in the posteromedial direction (p=0.79), perimetry in "8" (p=0.50) and the Cumberland Ankle Instability Tool (CAIT) questionnaire for functional instability (p = 0.70). The MI was not an effective method for ankle sprains treatment in field soccer athletes to improve ROM, dynamic balance, edema and functional stability. However, this is a pilot study and further investigations are required

Innate and adaptive immunity gene expression of human keratinocytes cultured of severe burn injury

PURPOSE:Evaluate the expression profile of genes related to Innate and Adaptive Immune System (IAIS) of human Primary Epidermal keratinocytes (hPEKP) of patients with severe burns.METHODS: After obtaining viable fragments of skin with and without burning, culture hKEP was initiated by the enzymatic method using Dispase (Sigma-Aldrich). These cells were treated with Trizol(r) (Life Technologies) for extraction of total RNA. This was quantified and analyzed for purity for obtaining cDNA for the analysis of gene expression using specific IAIS PCR Arrays plates (SA Biosciences).RESULTS: After the analysis of gene expression we found that 63% of these genes were differentially expressed, of which 77% were repressed and 23% were hyper-regulated. Among these, the following genes (fold increase or decrease): IL8 (41), IL6 (32), TNF (-92), HLA-E (-86), LYS (-74), CCR6 (- 73), CD86 (-41) and HLA-A (-35).CONCLUSIONS: This study contributes to the understanding of the molecular mechanisms underlying wound infection caused by the burn. Furthermore, it may provide new strategies to restore normal expression of these genes and thereby change the healing process and improve clinical outcome.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)UNIFESP-EPM Department of SurgeryUNIFESP-EPMUNIFESPUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Department of SurgeryUNIFESP, EPM, Department of SurgeryUNIFESP-EPMUNIFESP, EPM, Department of SurgeryFAPESP: 2011/12945-4FAPESP: 2013/10.905-0SciEL

Effect of Citric Acid and Ethylenediaminetetraacetic Acid on the Surface Morphology of Young and Old Root Dentin

Introduction: The aim of this in vitro study was to evaluate the effect of 10% citric acid and 17% ethylenediaminetetraacetic acid (EDTA) irrigating solutions on the surface morphology of young and old root dentin by determining the number and diameter of dentinal tubules using scanning electron microscopy (SEM). Methods and Materials: Fifty healthy human teeth collected from young (≤30 years) and old (≥60 years) individuals (n=25) were first prepared with a Largo bur #2 to produce smear layer on the root canal surface. Subsequently, the crowns and the root middle and apical thirds were sectioned and removed, and the cervical thirds were sectioned vertically in the buccal-lingual direction into two equal halves. The obtained samples were then immersed in 2.5% sodium hypochlorite for 30 min and randomly separated into two treatment groups for each age group. In each age group, ten samples were selected as controls and did not receive any type of treatment. The rest of the specimens were then rinsed, dried and treated for 4 min with 10% citric acid or 17% EDTA. The samples were then assessed with SEM regarding the number and diameter of dentinal tubules. All data were assessed using Student’s t-test. The level of significance was set at 0.05. Results: Regardless of the type of treatment, no significant differences were observed in the number of open tubules between the young and old root dentin (P>0.05). Nonetheless, the diameter of the tubules in the old root dentin was larger when 17% EDTA was used (P<0.05). Both, young and old root dentin did not differ with the 10% citric acid treatment (P>0.05). Conclusion: The results showed that 17% EDTA treatment induced a significant demineralization in old root dentin.Keywords: Citric Acid; Dentinal Tubule; Ethylenediaminetetraacetic Acid; Scanning Electron Microscopy; Surface Morpholog

Keratinocyte growth factor, tumor necrosis factor-alpha and interleukin-1 beta gene expression in cultured fibroblasts and keratinocytes from burned patients

PURPOSE: To evaluate the gene expression of KGF, TNF-alpha and IL-1 beta in skin fibroblasts and keratinocytes cultured from burned patients. METHODS: Three patients with large burns and three patients with small burns, as well as two controls, were included. The cell culture was initiated by the enzymatic method. After extraction and purification of mRNA, qPCR was used to assess the gene expression of KGF, TNF-alpha and IL-1 beta. RESULTS: The expression of KGF was increased on average 220-fold in large burns and 33.33-fold in small burns in fibroblasts, and 11.2-fold in large burns and 3.45-fold in small burns in keratinocytes compared to healthy patients (p<0.05). Expression of TNF-alpha was not observed. IL-1 beta is down-regulated in fibroblasts of burned patients, and much more repressed in small burns (687-fold, p<0.05). In keratinocytes, the repression of IL-1 beta expression occurs in patients with small burns (28-fold), while patients with large burns express this gene intensively (15-fold). CONCLUSIONS: The study showed a quantitative pattern in the expression of KGF gene, which is more expressed according to the size of the burn. TNF-alpha was not expressed. A qualitative pattern in the expression of IL-1 beta gene was demonstrated.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)UNIFESP-EPM Department of SurgeryUNIFESP-EPMUNIFESP-EPM Department of GynecologyUNIFESP, EPM, Department of SurgeryUNIFESP-EPMUNIFESP, EPM Department of GynecologySciEL

Keratinocyte growth factor, interleukins (1 beta, 6, 8, 10, 12), and tumor necrosis factor alpha in culture medium of dermal fibroblast of burned patients

PURPOSE:To evaluate the level of cytokines and keratinocyte growth factor (KGF) or Fibroblast Growth Factor 7 (FGF-7) in the culture medium of cultured human dermal fibroblasts from patients with large burn in comparison to small burn.METHODS:Fibroblasts of 10 patients (four large burns, four small burns and two controls) were initiated by the enzymatic method using collagenase. Cytokines and KGF in the supernatant of the culture medium was measured by, respectively, flow cytometry using Cytometric Bead Array Human Inflammation kit (CBA, BD Biosciences, USA) and the enzyme immunoassay method using the Quantikine (r) Human KGF. The experiments were performed in triplicate.RESULTS:The expression of IL-12 protein in patients with large burns showed a tendency to increase. IL- 6, IL- 10, and IL- 1beta were observed no difference. For IL - 8, TNF - alpha and KGF was observed a significant difference between the expression in large and small burned patient.CONCLUSION:That IL-8, TNF-alpha and KGF showed higher expression in cultured fibroblasts of large burned patients.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)UNIFESP-EPM Department of SurgeryUNIFESP-EPMUNIFESP-EPM Department of GynecologyUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Department of SurgeryUNIFESP, EPM, Department of SurgeryUNIFESP-EPMUNIFESP, EPM Department of GynecologyUNIFESP, EPM, Department of SurgeryFAPESP: 2011/12945-4FAPESP: 2011/23.985-7SciEL