Accuracy of MRI skeletal age estimation for subjects 12–19. Potential use for subjects of unknown age

In forensic practice, there is a growing need for accurate methods of age estimation, especially in the cases of young individuals of unknown age. Age can be estimated through somatic features that are universally considered associated with chronological age. Unfortunately, these features do not always coincide with the real chronological age: for these reasons that age determination is often very difficult. Our aim is to evaluate accuracy of skeletal age estimation using Tomei's MRI method in subjects between 12 and 19 years old for forensic purposes. Two investigators analyzed MRI images of the left hand and wrist of 77 male and 74 female caucasian subjects, without chronic diseases or developmental disorders, whose age ranged from 12 to 19 years. Skeletal maturation was determined by two operators, who analyzed all MRI images separately, in blinded fashion to the chronological age. Inter-rater agreement was measured with Pearson (R (2)) coefficient. One of the examiners repeated the evaluation after 6 months, and intraobserver variation was analyzed. Bland-Altman plots were used to determine mean differences between skeletal and chronological age. Inter-rater agreement Pearson coefficient showed a good linear correlation, respectively, 0.98 and 0.97 in males and females. Bland-Altman analysis demonstrated that the differences between chronological and skeletal age are not significant. Spearman's correlation coefficient showed good correlation between skeletal and chronological age both in females (R (2) = 0.96) and in males (R (2) = 0.94). Our results show that MRI skeletal age is a reproducible method and has good correlation with chronological age

EFFECT OF PILATES BASED EXERCISE ON BODY SWAY AND SHOOTING PERFORMANCE OF BRAZILIANS POLICE

This study investigated the effect of a 10-week Pilates practice on core stability, shooting performance and body sway in fifteen policemen (25.3 ± 3 years; 171 ± 9 cm; 71.6 ± 12.1 kg). The policeman performed 10 pistol shots and had the three dimensional ground reaction forces data (AMTI-OR-06, USA and gun target fluctuation point (SCATT USB Professional Trainer) registered during 5s prior shooting. Shooting score was also determined. Core stability was accessed by the double lowering limb (DLL) test. Although the Mann- Whitney U test showed that the Pilates practice significantly improve the core stability, no changes was observed on body sway or shooting performance. Ten weeks of Pilates practice was effective to improve core stability in policemen, but it was not able to decrease body sway during shooting or the ability of the shooter hit the target

Aplicação de estrategias de integração de bancos de dados : um estudo de caso

Orientador: Marcos Sfair SunyeDissertação (mestrado) - Universidade Federal do Parana, Setor de Ciencias Exata

Prospective evaluation of glutamine and phospholipids levels in first degree relatives of patients with Type 1 Diabetes from a multiethnic population

A dysregulation in the metabolism of lipids may be an early marker of autoimmunity in Type 1 Diabetes (T1D). It would be of general importance to identify metabolic patterns that would predict the risk for T1D later in life. The aim of this study was to perform a prospective evaluation of glutamine and phospholipids levels in Brazilian first degree relatives (FDR) of patients with T1D in a mean interval of 5 years

A influência de duas mochilas sobre a cinemática da coluna de crianças

This study aimed to analyze the effect of backpack load carriage over the spine. The studies that have investigated load carriage using backpacks have analyzed the lower limb dynamics and have not focused on the spine. In addition, the strategies applied by children may differ from adults as the relative weight differs between adolescents and adults. Methods: Ten schoolboys (13.9 ± 0.6 years-old; 1.53 ± 0.05 m; 44.9 ± 3.3 kg) volunteered to participate after their parents sign an informed consent form. Participants walked in a treadmill during approximately 15 minutes carrying a specially built backpack with a load that corresponded to 0.10 and 20% BW. A number of landmarks were placed over the subjects back and allowed reconstruction of the spinal profiles in the sagittal and frontal planes. The relation between the segments formed between acromium markers and the posterior superior iliac crest markers was used as a spinal rotation index. The maximum, minimal, mean and range of motion of the thoracic and lumbar regions and the whole spine were analyzed. The gait cycle was applied to normalize the gait cycle. Results indicated differences between the two loads (10%BW and 20%BW). A number of changes in the spinal kinematics was found. In the saggital plane the range of movement was unaltered, although there was an increased in the flexion, which was interpreted as a compensatory strategy to counteract the effect of the load. These results are in line with the idea that the use of a backpack increases anterior leaning of the trunk, but are in disagreement with the notion that pronounced changes in the range of motion occur. Carrying a backpack did not produce a clear effect over the variables selected to identify thoracic and lumbar spine regions in the sagittal plane. Conclusion: Carrying a load that corresponded to 20%BW influences spinal kinematics in all planes of movements. These changes may impose an important change in posture and stress applied over the posterior aspect of the vertebral column. The slow walking speed used in the present study may have not induced large changes in the kinematics of the vertebral column as in other studies in which walking was performed in greater speeds. Thus, it is suggested that weight of the backpack is not the only factor that determines the movements of the vertebral column.Este estudo visou analisar o efeito do carregamento de cargas por meio de mochilas sobre a coluna. Os estudos que investigaram o carregamento de cargas utilizando mochilas têm analisado a dinâmica de membros inferiores e não tem focado a coluna vertebral. Em adição, as estratégias aplicadas por crianças podem diferir visto que as cargas relativas podem diferir entre adolescentes e adultos. Métodos: dez escolares (13,9 ± 0,6 anos; 1,53 ± 0,05 m; 44,9 ± 3,3 kg) foram voluntários para participar do estudo após seus pais consentirem e assinarem um formulário livre e esclarecido. Os participantes caminharam em uma esteira. Durante aproximadamente 15 minutos carregando uma mochila especialmente feita que correspondia a 0,10 e 20% do peso corporal. Um número de marcas corporais foi colocada nas costas dos sujeitos que permitiram a reconstrução dos perfis da coluna nos planos sagital e frontal. A relação entre os segmentos formados pelas marcas entre os acrômios e as cristas ilíacas foi usada como um índice de rotação da coluna. Os valores máximos, mínimos, médios e as amplitudes de movimento das regiões torácica e lombar e a coluna toda foram analisados. O ciclo da marcha foi normalizado pelo contato sucessivo de dois contatos do calcanhar com o solo. Resultados indicaram diferenças entre as cargas (10 e 20% PC). Um número de mudanças na cinemática da coluna foi encontrada. No plano sagital a amplitude de movimento permaneceu inalterada, todavia, houve um aumento na flexão a qual foi interpretada como uma estratégia compensatória em resposta ao efeito da carga. Os resultados estão em linha com a idéia que o uso de mochilas aumenta a inclinação anterior do tronco, mas em discordância com a noção que pronunciadas mudanças na amplitude de movimento ocorrem. O carregamento de cargas não produz um efeito claro sobre as variáveis selecionadas para identificar as alterações nas regiões lombar e torácica no plano sagital. Conclusão: o carregamento de cargas que correspondem a 20% PC influenciam a cinemática da coluna em todos os planos de movimento. Essas mudanças podem impor importantes mudanças sobre a postura e o estresse aplicado sobre os aspectos anteriores e posteriores da coluna vertebral. A baixa velocidade de deslocamento usada no presente estudo podem não ter induzido grandes mudanças na cinematica da coluna vertebral, como demonstrado em outros estudos que usaram maiores velocidades de deslocamento. Desta forma, sugere-se que o peso da mochila não é o único ator que determina os movimentos da coluna vertebral

A short review of drug-food interactions of medicines treating overactive bladder syndrome

Background Overactive bladder syndrome is a condition where one or more of the symptoms such as pollakiuria, urgent need to urinate, nocturia and urinary incontinence is observed. Its prevalence ranges between 7 and 27 % in men and 9–43 % in women. The role of a pharmacist is to educate the patient on medications administration scheme, and drug interactions with particular food or food components. Aim of the review To assess a potential impact of food and fruit juice on the pharmacokinetic and therapeutic effects of medications used in treating overactive bladder syndrome. This information will enhance pharmaceutical care and is vital and helpful for pharmacists counseling their patients. Method In order to gather information on interactions of medications employed in bladder dysfunctions, the English language reports published in the PubMed, Embase, Cochrane and CINAHL database over the years 1996–2015 were studied. Additionally, other resources, namely drugs.com, Medscape, UpToDate, Micromedex, Medical Letter, as well as Stockley Drugs Interaction electronic publication were included in the study. The analysis also covered product data sheets for particular medicinal products. Results Meals and the consumption of grapefruit juice were found to exert a diversified effect on the pharmacokinetics of drugs employed in overactive bladder syndrome therapy. Neither tolterodine, nor mirabegron interact with food and citrus fruit juice, whereas darifenacin, fesoterodine, oxybutynin and solifenacin do interact with grapefruit and others citrus fruit juice. The effects of such interactions may potentially be negative to patients. Trospium absorption is significantly decreased by food. Conclusion For selected medicines used in treating bladder dysfunctions food and grapefruit juice consumption may significantly affect efficacy and safety of the therapy. All information on the topic is likely to enhance the quality of pharmaceutical care

Efeito agudo do alongamento na marcha de idosas em terreno inclinado

Introdução: O envelhecimento causa modificações musculares que influenciam negativamente a capacidade funcional dos idosos na locomoção, em especial durante a transposição de superfícies inclinadas. Essas mudanças geram redução da performance, diminuindo a mobilidade e aumentando o risco de queda na execução de tal tarefa. Os exercícios de alongamento podem reduzir a influência de dessas degenerações, preservando a capacidade muscular e a mobilidade. Objetivo: O objetivo deste estudo foi avaliar a atuação do efeito agudo de uma sessão de exercícios de alongamento sobre a marcha de idosas durante a locomoção em uma rampa. Materiais e métodos: Doze mulheres idosas, saudáveis e independentes, caminharam subindo e descendo uma rampa com inclinação de 10%. A análise cinemática (2D) e eletromiográfica foi realizada durante uma única sessão experimental, imediatamente antes (PRÉ) e após (PÓS) a realização de um exercício de alongamento estático dos flexores do quadril. Resultados: O exercício de alongamento gerou aumento da amplitude (PRÉ 52,3 ± 18,30; PÓS 63,6 ± 16,90) e velocidade (PRÉ 195,8 ± 31,20/s; PÓS 241,8 ± 29,80/s) do quadril, assim como redução do tempo de ativação do tibial anterior (PRÉ TAFIN1 29,7 ± 6,7%; TAFIN2 100,0 ± 0,0%; PÓS TAFIN1 23,3 ± 7,4%; TAFIN2 87,7 ± 3,4%) e do bíceps femoral (PRÉ 45,0 ± 5,4%; PÓS 36,1 ± 10,4%) na subida na rampa. Na descida ocorreu aumento na velocidade da marcha (PRÉ 0,95 ± 0,18 m.s-1; PÓS 1,01 ± 0,22 m.s-1) e tamanho do passo (PRÉ 1,02 ± 0,15 m; PÓS 1,08 ± 0,18 m). Conclusão: Os exercícios utilizados foram capazes de alterar de forma significativa os parâmetros avaliados, permitindo uma marcha mais veloz e reduzindo a ativação muscular. Estudos longitudinais são necessários para que os resultados aqui encontrados de forma temporária possam ser confirmados de forma permanente

O impacto do território e das relações com a terra nas identidades das irmãs Bibiana e Belonísia na obra Torto Arado de Itamar Vieira Junior

Esta pesquisa pretendeu analisar e buscar compreender a territorialidade e as relações com a terra nas identidades das personagens irmãs Bibiana e Belonisia do livro Torto Arado de Itamar ́ Vieira Junior, a partir de uma análise documental com pesquisas bibliográficas. Para tal análise se fez necessário aprofundar nas pesquisas e teorias de identidade de Antônio da Costa Ciampa, pioneiro nos estudos de identidade na psicologia brasileira. Em seu principal estudo, esse autor construiu o sintagma identidade-metamorfose-emancipação. A partir disso, pretendeu-se investigar o conceito de identidade aproximando-a à questão com conceitos de território e territorialidade, em busca de uma tentativa de compreensão de como a identidade se dá a partir das relações com a terra. Este tema se faz importante quando tratamos de estudar as questões e vivências das comunidades quilombolas, nas quais questões políticas, laborais e culturais são intrínsecas à vida das pessoas. O pano de fundo desta pesquisa é a Fazenda Água Negra, comunidade fictícia da obra Torto Arado, mas de fictícia tem somente o nome, pois todas as passagens e temas trazidos são baseados na vida de homens e mulheres quilombolas brasileirosThis research intended to analyze and seek to understand the territoriality and relations with the land in the identities of the sister characters Bibiana and Belonísia from the book Torto Arado by Itamar Vieira Junior, based on a documentary analysis with bibliographical research. For such an analysis, it was necessary to delve into the research and theories of identity by Antônio da Costa Ciampa, a pioneer in identity studies in Brazilian psychology. In his main study, this author constructed the identity-metamorphosis-emancipation syntagm. From this, it was intended to investigate the concept of identity, bringing it closer to the question with concepts of territory and territoriality, in search of an attempt to understand how identity takes place from the relations with the land. This theme becomes important when we try to study the issues and experiences of quilombola communities, in which political, labor and cultural issues are intrinsic to people's lives. The background of this research is the Água Negra Farm, a fictional community in the work Torto Arado, but it is fictitious only in name, as all passages and themes brought are based on the lives of Brazilian quilombola men and wome

Front crawl arm stroke trajectories of physically impaired swimmers: A preliminary study

© 2019 Elsevier Masson SAS. Introduction: This study evaluated three-dimensional kinematic parameters of the front crawl stroke in physically impaired swimmers across a range of functional classification levels. Facts and Results: Eight highly-trained competitive swimmers (5 male and 3 female) from IPC classes S5 to S9 performed 50 m maximal front crawl trials while being video-taped by six cameras (four under- and two above water). The most distal point of the right upper limb was manually digitised at 50 Hz to allow three-dimensional reconstruction of the limb's trajectory through the water. Conclusion: The stroke presented large inter-swimmer variability, reflecting individual characteristics and severity of the impairment. The swimmers who combined shallow and narrow stroke movements produced a shorter trajectory. This study provides swimmers and coaches with an overview of the kinematic characteristics of a range of physically impaired swimmers

Diet and nutritional factors in inflammatory bowel diseases

Inflammatory bowel disease (IBD) development is affected by complex interactions between environmental factors, changes in intestinal flora, various predisposing genetic properties and changes in the immune system. Dietary factors seem to play an underestimated role in the etiopathogenesis and course of the disease. However, research about food and IBD is conflicting. An excessive consumption of sugar, animal fat and linoleic acid is considered a risk factor for IBD development, whereas a high fiber diet and citrus fruit consumption may play a protective role. Also, appropriate nutrition in particular periods of the disease may facilitate achieving or prolonging remissions and most of all, improve the quality of life for patients. During disease exacerbation, a low fiber diet is recommended for most patients. In the remission time, an excessive consumption of alcohol and sulfur products may have a negative effect on the disease course. Attempts are also made at employing diets composed in detail in order to supplement IBD therapy. A diet with a modified carbohydrate composition, a semi-vegetarian diet and a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols are under investigation. Due to chronic inflammation as well as side effects of chronically used medications, patients with IBD are also at increased risk of nutritional factor deficiencies, including iron, calcium, vitamin D, vitamin B12, folic acid, zinc, magnesium and vitamin A. It should also be remembered that there is no single common diet suitable for all IBD patients; each of them is unique and dietary recommendations must be individually developed for each patient, depending on the course of the disease, past surgical procedures and type of pharmacotherapy