Perfil do desempenho neuroneuromuscular, marcha e equilíbrio em indivíduos acometidos pelo acidente vascular encefálico em comparação a controle pareados

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Educação Física, 2015.Introdução: O acidente vascular cerebral (AVC) pode ocasionar a hemiparesia, caracterizada por alterações do tônus muscular, do controle motor e da força em um dos hemicorpos, também denominado membro parético. Sabe-se que também há comprometimento do lado não parético (ipsilateral a lesão encefálica). A força muscular de cada hemicorpo apresentam correlação a marcha e equilíbrio postural. A análise concomitante da força dos dois hemicorpos através da divisão ou subtração do membro não parético pelo membro parético também apresentam correlação com a marcha. Porém não existem estudos no momento que avaliaram a soma da força dos membros inferiores (SPT) e a relação isquiossurais quadríceps funcional (I/QF) em indivíduos acometidos pelo AVC. Objetivo: Comparar o desempenho neuromuscular, marcha, qualidade de vida e equilíbrio de indivíduos acometidos pelo AVC com um grupo controle sem lesão neurológica. Métodos: Dois grupos: Grupo experimental (GAVC) com 28 indivíduos acometidos pelo AVC com idade em mediana (25-75%) de 52,5 (47-58) anos e tempo de lesão em anos (SD) de 43,4 (31,5) meses; Grupo Controle (GCONT) sem lesão encefálica com idade pareada. Avaliação da força muscular concêntrica dos extensores de joelho e excêntrica dos flexores do joelho no dinamômetro isocinético do lado parético e não parético do grupo experimental e dos dois hemicorpos do grupo controle. Avaliação da marcha com o teste de 10 metros e teste de caminhada de 6 minutos. A qualidade de vida foi avaliada pela Stroke Impact Scale. O equilíbrio postural foi avaliado pela escala de Berg. Resultados: 1) o tempo para atingir o pico de torque e a I/QF do lado não parético foram semelhantes ao comparar GCONT e o GAVC. As outras todas variáveis apresentaram valores inferiores para o GAVC; 2) a SPT apresentou maior fator preditivo para a marcha; 3) o pico de torque, a potência média, o trabalho total do membro não parético e a potência média do membro parético foram as variáveis que melhor discriminaram o GAVC do GCONT. Conclusão: o tempo para atingir o pico de torque e a I/QF do lado não parético foram as únicas variáveis semelhantes ao comparar indivíduos com AVC e controle, além disso a SPT foi o maior fator preditivo para a marcha e o pico de torque, a potência média, o trabalho total (não parético) e a potência média (parético) foram as variáveis que melhor discriminaram os indivíduos com AVC.Introduction: The stroke can lead to hemiparesis, characterized by changes in muscle tone, motor control and strength in one of hemibodies, also called paretic limb. It is known that there is also involvement of the non-paretic side (ipsilateral brain injury). Muscle strength of each hemisphere correlate gait and postural balance. Concomitant analysis of the strength of the two hemibodies by division or subtraction member of the non-paretic paretic member also correlate with the march. But there are no studies when evaluating the sum of the strength of the lower limbs (SPT) and the relationship hamstring quadriceps functional (H/QF) in individuals affected by stroke. Objective: To compare the neuromuscular and functional performance of chronic post-stroke with healthy subjects. Methods: twenty eight patients with median (25-75%) of 52,5 (47-58) years, onset stroke with mean (SD) 43,4 (31,5) months, and twenty eight age-matched controls. Concentric isokinetic torque of the extensor muscles of the knee and eccentric isokinetic torque of the flexor muscles of the knee of the affected and unaffected limb; in post-stroke patients and the two limbs in normal subjects, was assessed by isokinetic dynamometer. Walking performance was evaluated by using the 12-meter walking test and 6 minute walking test. Quality of life as measure by the Stroke Impact Scale and the Berg Scale to determine postural balance. Results: No difference in time to peak torque and functional hamstring to quadriceps ratio between patients and normal subjects was observed. The highest predictive value for walking performance are SPT. The peak torque, average power, total work of the affected limb and average power of the affected limb came out as the strongest’s determinants of differentiation between chronic post-stroke with healthy subjects. Conclusion: the time to peak torque and the H/QF side not paretic were the only variables similar when comparing individuals with stroke and control, in addition to SPT was the most predictive factor for the walking performance and the peak torque, average power, total work (non-paretic) and the average power (paretic) were the variables that best discriminated individuals with stroke

HANDEBOL EM CADEIRA DE RODAS DA INICIAÇÃO AO JOGO: PROPOSTA DE ENSINO

Wheelchair handball (WH) is an adapted sport which began in Brazil in 2005. Considering the variables of improvement of the modality, become relevant to the development of studies on WH. The aim of this study was to describe a proposal for teaching wheelchair handball from initiation of the sport to the competitive game. The present study used a descriptive methodology considering the evolution of the simple task to the most complex and theoretical model of the pedagogy of sport. The proposal involves the following steps: initial approach, person-wheelchair, person-wheelchair-ball and person-wheelchair-ball-person, contemplating the domains of human movement, multiple intelligences, psychological and philosophical aspects, social learning, in addition, the domain of health. The proposal presented may contribute to the development of the modality,  the adhesion of new practitioners and application to different age groups and skill levels, based on the theoretical models of motor learning and pedagogy of sport. In addition, it presented a practical application of these theoretical models, contributing to the maturation of the field of parasport pedagogy and not only of sport. Received on: 2022/11/3- Reformulated on: 2022/12/14 Accepted: 2022/12/14O handebol em cadeira de rodas (HCR) é um esporte adaptado com início no Brasil em 2005. Considerando as variáveis de crescimento da modalidade, torna-se relevante o desenvolvimento de estudos sobre o HCR. O objetivo é descrever uma proposta de ensino-aprendizagem do HCR desde a iniciação da modalidade até o jogo competitivo. O presente estudo utilizou uma metodologia descritiva e propositiva considerando a evolução da tarefa simples para a mais complexa e modelo teórico da pedagogia do esporte. A proposta envolve as seguintes etapas: abordagem inicial, pessoa-cadeira, pessoa-cadeira-bola e pessoa-cadeira-bola-pessoa, contemplando os domínios do movimento humano, inteligências múltiplas, aspectos psicológicos e filosóficos, aprendizagem social, além do domínio da saúde. A proposta apresentada poderá contribuir com o desenvolvimento da modalidade, adesão de novos praticantes e aplicação às diferentes faixas etárias e níveis de habilidade, embasados nos modelos teóricos da aprendizagem motora e pedagogia do esporte. Além disso, apresenta-se uma aplicação prática desses modelos teóricos, contribuindo para o amadurecimento do campo da pedagogia do paradesporto e não apenas do esporte. Recebido em: 30/11/2022 Reformulado em: 14/12/2022 Aceito em: 14/12/2022

Accuracy, precision and robustness of in vivo dry matter digestibility estimates by different markers in ovine

O objetivo foi avaliar a acurácia, precisão e robustez das estimativas da digestibilidade aparente da matéria seca obtidas utilizando-se como indicadores fibra em detergente ácido indigestível (FDAi), fibra em detergente neutro (FDNi) indigestível, lignina em detergente ácido (LDA), LDA indigestível (LDAi) e óxido crômico em comparação ao método de coleta total de fezes. Dezoito ovinos (56,5 ± 4,6 kg PV) foram designados aleatoriamente a dietas compostas de 25, 50 ou 75% de concentrado e feno de Coast cross por 25 dias. As fezes foram coletadas por cinco dias para determinação da digestibilidade aparente da MS. As amostras de alimentos e fezes foram incubadas no rúmen de três bovinos por 144 horas, para obtenção das frações indigestíveis. Óxido crômico foi administrado a 4,0 g/animal/dia. A acurácia foi avaliada pela comparação do viés médio (DAMS predito - DAMS observado) entre os indicadores; a precisão, por meio da raiz quadrada do erro de predição e do erro residual; e a robustez, pelo estudo da regressão entre o viés e o consumo de matéria seca, o nível de concentrado e o peso vivo. A recuperação fecal e a acurácia das estimativas da digestibilidade aparente da MS foram maiores para FDAi, seguida pela FDNi, LDAi, pelo óxido crômico e depois pela lignina em detergente ácido. O viés linear foi significativo apenas para FDAi, FDNi e LDAi. O uso de óxido crômico permitiu estimativas mais precisas da digestibilidade aparente da MS. Todos os indicadores foram robustos quanto à variação no consumo de matéria seca e apenas LDAi e óxido crômico foram robustos quanto aos níveis de concentrado na dieta. O óxido crômico não foi robusto quando houve variação no peso vivo animal. Assim, a FDAi é o indicador mais recomendado na estimativa da digestibilidade aparente da MS em ovinos quando o objetivo é comparar aos dados da literatura, enquanto o óxido crômico é mais recomendado quando o objetivo é comparar tratamentos dentro de um mesmo experimento.This study aimed at evaluating the accuracy, precision and robustness of in vivo dry matter apparent digestibility estimates (DMAD), using as markers indigestible acid detergent fiber, indigestible neutral detergent fiber, acid detergent lignin, indigestible acid detergent lignin and chromic oxide in comparison to the fecal total collection. Eighteen wethers (56.5 ± 4.6 kg BW) were randomly assigned to diets containing 25, 50 or 75% of concentrate and Coast cross hay for 25 days. Feces were collected during the five days to determine apparent digestibility of dry matter and samples of feed and feces were incubated for 144 hours in bovine rumen to obtain the indigestible fractions. Chromic oxide (4.0 g/animal) was offered daily. Accuracy was evaluated by comparing mean bias of estimates (predicted dry matter apparent digestibility - observed dry matter apparent digestibility) among markers. Precision was assessed by the root mean square prediction error and the residual error; robustness was studied by the regression between bias and dry matter intake, diet concentrate level and animal body weight. Fecal recovery and accuracy of dry matter apparent digestibility estimates were higher for indigestible acid detergent fiber, followed by indigestible neutral detergent fiber, indigestible acid detergent lignin and chromic oxide, and at last for acid detergent lignin. Linear bias was significant only for indigestible acid detergent fiber, indigestible neutral detergent fiber and indigestible acid detergent lignin. By using chromic oxide it was possible to estimate dry matter apparent digestibility more precisely. All markers were robust regarding to variation of dry matter intake while only indigestible acid detergent lignin and chromic oxide were robust regarding to concentrate levels in the diet. Chromic oxide was not robust when animal body weight varied. In this experimental condition, indigestible acid detergent fiber is the most recommended marker to estimate dry matter apparent digestibility in ovine when the objective is to compare the results with the ones found in literature. On the other hand, chromic oxide is the most recommended marker when the objective is to compare treatments within the same experiment

The development of a didactic model to facilitate the understanding of the components and anatomical relations of the middle ear

The middle ear is important from an anatomical and clinical point of view, seeing that it contains and allows the passages of structures, in addition to establishing relations with other regions of the head. However, the middle ear is small and difficult to dissect, making difficult the study in cadavers and understanding. In this context, professors and students from Universidade Estadual do Oeste do Paraná developed an anatomical model of themiddle ear, showing its main bones, membranes, muscles and nerves. The model was developed with acrylic plates joined to form a cube, each side representing one of the middle ear’s walls. The tympanic membrane and the secondary tympanic membrane were represented by an elastic fabric, which covered openings on the membranous wall and the labyrinthic wall, respectively. The auditory ossicles, the muscles and the nerves were made from polymer clay and positioned inside the cube, according to their characteristics and anatomicalposition in the middle ear. Furthermore, the auditory tube was represented by a plastic cone projecting from the carotid wall. The use of these low-cost anatomical models is an alternative to enable and improve learning. These initiatives favor the teaching of Human Anatomy, increasing understanding, the establishment of clinical correlations, and improving the academic education of health professionals.A orelha média é importante do ponto de vista anatômico e clínico, pois contém e permite a passagem de estruturas, além de estabelecer relações com outras regiões da cabeça. Porém, a orelha média é pequena e dissecação, o que dificulta seu estudo em cadáveres e a compreensão por parte dos alunos. Nesse contexto, docentes e discentes da Universidade Estadual do Oeste do Paraná desenvolveram um modelo anatômico da cavidade timpânica, apresentando seus principais componentes membranáceos, ósseos, musculares e nervosos. Para a confecção da maquete, placas de acrílico transparente foram unidas formando um cubo, com cada placa representando uma das paredes da cavidade timpânica (exceto a parede tegmental). Tecidos elásticos foram colocados em orifícios feitos nas paredes membranácea e labiríntica para representação da membrana timpânica e da membrana timpânica secundária, respectivamente. Os ossículos da audição, músculos e nervos foram confeccionados em biscuit e posicionados no espaço interno do cubo, observando-se as características e a posição anatômica dessas estruturas na orelha média. A tuba auditiva foi representada pela colocação de um cone plástico projetando-se a partir da parede carótica. A confecção de modelos didáticos é uma alternativa de baixo custo para facilitar o ensino e a compreensão da Anatomia Humana. O aprendizado de conceitos básicos favorece o entendimento das correlações anatomoclínicas, melhorando a formação acadêmica dos profissionais de saúde

Um dashboard para a percepção dos professores sobre as atividades de estudantes em ambiente virtual de aprendizagem

Este estudo apresenta o desenvolvimento de um dashboard para ser incorporado a um ambiente virtual de aprendizagem. O dashboard permite aos professores um maior acompanhamento das atividades dos estudantes no ambiente. As diretrizes da pesquisa foram definidas a partir da análise de três outras propostas similares, sendo o método Design Science Research escolhido para o percurso metodológico. Os resultados apontam que o dashboard obteve bons indicadores, tanto para questões de usabilidade quanto para aceitação do artefato proposto

Sit to stand test and handgrip strength in men and women with post-COVID-19 syndrome without invasive ventilator support: insights from a Brazilian observational study

Two valid tests have been used in patients with post-COVID-19 syndrome (coronavirus disease 2019) due to their fast application, feasibility, and accessible procedures, facilitating data collection in large groups: the 1-minute sit-to-stand test (STS) and handgrip strength (HGS) dynamometry. The present study aimed to: i) assess the STS and HGS in men and women with post-COVID-19 syndrome who did not require invasive ventilator support; ii) correlate STS repetitions and HGS with time since the COVID-19 diagnosis. Six hundred and twenty-two men and women with post-COVID-19 syndrome who did not require invasive ventilatory support performed the STS and HGS tests at the beginning of the rehabilitation process at a Reference Hospital Centre. Women over 55 years presented significantly lower results compared to participants under 55 years. For the HGS, the median ranged from 42 to 48 kg and 70 to 81 kg for the female and male groups, respectively. The correlations of time since COVID-19 diagnosis with STS and HGS ranged from -0.16 to 0.02 (p>0.05) for women and men, respectively.The test results could be used for the initial analysis of normality ranges and comparisons with other populations. Although STS repetitions and HGS presented low and non-significant correlations with time since the COVID-19 diagnosis, some COVID-19 sequelae were not measured, so these data should be interpreted with caution

Chitosan microparticles loaded with essential oils inhibit duo-biofilms of Candida albicans and Streptococcus mutans

Oral candidiasis is a common fungal infection that affects the oral mucosa, and happens when Candida albicans interacts with bacteria in the oral microbiota, such as Streptococcus mutans, causing severe early childhood caries. C. albicans and S. mutans mixed biofilms are challenging to treat with conventional antimicrobial therapies, thus, new anti-infective drugs are required. Objective: This study aimed to test a drug delivery system based on chitosan microparticles loaded with geranium and lemongrass essential oils to inhibit C. albicans and S. mutans mixed biofilms. Methodology: Chitosan microparticles loaded with essential oils (CM-EOs) were obtained by spray-drying. Susceptibility of planktonic were performed according CLSI at 4 to 2,048 µg/mL. Mixed biofilms were incubated at 37ºC for 48 h and exposed to CM-EOs at 256 to 4,096 µg/mL. The antimicrobial effect was evaluated using the MTT assay, with biofilm architectural changes analyzed by scanning electron microscopy. RAW 264.7 cell was used to evaluate compound cytotoxicity. Results: CM-EOs had better planktonic activity against C. albicans than S. mutans. All samples reduced the metabolic activity of mixed C. albicans and S. mutans biofilms, with encapsulated oils showing better activity than raw chitosan or oils. The microparticles reduced the biofilm on the slides. The essential oils showed cytotoxic effects against RAW 264.7 cells, but encapsulation into chitosan microparticles decreased their toxicity. Conclusion: This study demonstrates that chitosan loaded with essential oils may provide an alternative method for treating diseases caused by C. albicans and S. mutans mixed biofilm, such as dental caries

Effects of microbial inoculants and amino acid production by-product on fermentation and chemical composition of sugarcane silages

The objective of this study was to evaluate the chemical composition, fermentation patterns and aerobic stability of sugarcane silages with addition of amino acid production (monosodium glutamate) by-product (APB) and microbial inoculants. Mature sugarcane was chopped and ensiled in laboratory silos (n = 4/treatment) without additives (control) and with APB (10 g/kg), Pioneer 1174® (PIO, 1.0 mg/kg, Lactobacillus plantarum + Streptoccoccus faecium, Pioneer), Lalsil Cana (2.0 mg/kg, Lactobacillus buchineri, Lallemand) or Mercosil Maís 11C33® (1.0 mg/kg, Lactobacillus buchineri + Lactobacillus plantarum + Streptoccoccus faecium, Timac Agro). Fresh silage and silage liquor samples were obtained to assess pH, chemical composition and organic acid concentrations. Silage temperature was recorded throughout seven days to evaluate aerobic stability. The addition of APB decreased lactic acid levels, increased pH and N-NH3 and did not alter ethanol, acetic and butyric acids concentrations or dry matter (DM) losses. Microbial inoculants enhanced acetic acid levels, although only Pioneer 1174® and Mercosil Maís 11C33® lowered ethanol, butyric acid and DM losses. The addition of APB increased CP content and did not modify DM, soluble carbohydrates contents or in vitro dry matter digestibility. Additives did not alter silage maximum temperature or temperature increasing rate; however, Pioneer 1174® and Mercosil Maís 11C33® increased the time elapsed to reach maximum temperature. Monosodium glutamate production by-product does not alter fermentation patterns or aerobic stability of sugarcane silages, whereas homofermentative bacteria can provide silages of good quality

Imaging findings in COVID-19 pneumonia

The coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), emerged in Wuhan city and was declared a pandemic in March 2020. Although the virus is not restricted to the lung parenchyma, the use of chest imaging in COVID-19 can be especially useful for patients with moderate to severe symptoms or comorbidities. This article aimed to demonstrate the chest imaging findings of COVID-19 on different modalities: chest radiography, computed tomography, and ultrasonography. In addition, it intended to review recommendations on imaging assessment of COVID-19 and to discuss the use of a structured chest computed tomography report. Chest radiography, despite being a low-cost and easily available method, has low sensitivity for screening patients. It can be useful in monitoring hospitalized patients, especially for the evaluation of complications such as pneumothorax and pleural effusion. Chest computed tomography, despite being highly sensitive, has a low specificity, and hence cannot replace the reference diagnostic test (reverse transcription polymerase chain reaction). To facilitate the confection and reduce the variability of radiological reports, some standardizations with structured reports have been proposed. Among the available classifications, it is possible to divide the radiological findings into typical, indeterminate, atypical, and negative findings. The structured report can also contain an estimate of the extent of lung involvement (e.g., more or less than 50% of the lung parenchyma). Pulmonary ultrasonography can also be an auxiliary method, especially for monitoring hospitalized patients in intensive care units, where transfer to a tomography scanner is difficult

Intradermal melanocytic nevus of the external auditory canal: case report and literature review

Introdução: Nevos são neoplasias melanocíticas benignas e são os tipos mais comuns de tumores de pele. Podem ocorrer em qualquer parte da pele, mas o aparecimento no meato acústico externo é muito raro. Há pouco menos de 50 casos descritos na literatura inglesa sobre nevo melanocítico em meato acústico e, no Brasil, foi encontrado apenas um caso relatado em 2005. Objetivo: Apresentar um caso de nevo melanocítico intradérmico em meato acústico externo e discutir uma conduta conservadora, diferente dos demais casos já relatados na literatura após uma revisão desta. Importância do problema: Alertar à comunidade científica sobre os possíveis diagnósticos diferenciais das lesões em meato acústico externo e riscos da manipulação deste, frente a uma lesão benigna e assintomática. Comentários: Ressaltamos a possibilidade em conduzir de forma conservadora uma lesão assintomática ou minimamente sintomática, desde que seja descartada qualquer suspeita de malignidade, transformação maligna ou excluídos diagnósticos diferenciais que necessitem de uma intervenção mais invasiva, visto que uma meatoplastia poderia trazer mais danos (estenose meatal) do que benefícios para os pacientes, inclusive para o apresentado neste relato.Introduction: Nevi are benign melanocytic neoplasms and are the most common types of skin tumors. They can occur anywhere on the skin, but the appearance in the external auditory canal is very rare. There are only a fewer than 50 cases described in English literature regarding melanocytic nevus of external auditory canal and, in Brazil, only one case was reported in 2005. Objective: To present a case of intradermal melanocytic nevus in external auditory canal and to discuss a conservative conduct, different from the other cases already reported in the literature after a review of this. Importance of the problem: To alert the scientific community about the possible differential diagnoses of lesions in the external auditory canal and risks of manipulation of this, in front of a benign and asymptomatic lesion. Comments: We emphasize the possibility of conservatively conducting an asymptomatic or minimally symptomatic lesion, provided that any suspicion of malignancy, malignant transformation or other differential diagnosis, that requires a more invasive intervention, is ruled out, since a meatoplasty could bring more damage (meatal stenosis) than benefits for the patients, including for the presented in this report