Electrophysiological studies in healthy subjects involving caffeine

Copyright ©2012 IOS Press All rights reserved.We review the electrophysiological studies concerning the effects of caffeine on muscle, lower and upper motor neuron excitability and cognition. Several different methods have been used, such as electromyography, recruitment analysis, H-reflex, transcranial magnetic stimulation (TMS), electroencephalography and event-related potentials. The positive effect of caffeine on vigilance, attention, speed of reaction, information processing and arousal is supported by a number of electrophysiological studies. The evidence in favor of an increased muscle fiber resistance is not definitive, but higher or lower motor neuron excitability can occur as a consequence of a greater excitation of the descending input from the brainstem and upper motor neurons. TMS can address the influence of caffeine on the upper motor neuron. Previous studies showed that cortico-motor threshold and intracortical excitatory and inhibitory pathways are not influenced by caffeine. Nonetheless, our results indicate that cortical silent period (CSP) is reduced in resting muscles after caffeine consumption, when stimulating the motor cortex with intensities slightly above threshold. We present new data demonstrating that this effect is also observed in fatigued muscle. We conclude that CSP can be considered a surrogate marker of the effect of caffeine in the brain, in particular of its central ergogenic effect

Health-related quality of life in hereditary transthyretin amyloidosis polyneuropathy: a prospective, observational study

Background Hereditary Transthyretin Amyloidosis Polyneuropathy is a rare life-threatening neurologic disease that imposes considerable mortality and it is associated with progressive related disabilities. In this study, we aimed to assess the effect of the disease across health-related quality of life dimensions, in both carriers of the mutation and patients, to compare health-related quality of life with general population, as well as to explore health-related quality of life prognostic factors among patients, including disease progression and treatment. Methods This study was a multi-institutional, longitudinal, prospective, observational study of hereditary Transthyretin Amyloidosis Polyneuropathy Portuguese adult subjects (621 asymptomatic carriers and 733 symptomatic patients) enrolled in the Transthyretin Amyloidosis Outcomes Survey. Health-related quality of life was captured with the preference-based instrument EQ-5D-3 L. For general population the dataset included all subjects enrolled in a representative national study (n = 1500). Different econometric models were specified; multivariate probit, generalized linear model and generalized estimating equations model; including demographic and clinical covariates. Results Hereditary Transthyretin Amyloidosis Polyneuropathy patients have their health status severely impaired in all quality of life dimensions and more anxiety/depression problems were found among asymptomatic carriers. No differences on utility were found between carriers and general population (p = 0.209). Among patients, the utility value is estimated to be 0.51 (0.021), a decrement of 0.27 as compared with general population utility. Higher disease duration, advanced disease stage and not receiving treatment are associated with impaired health-related quality of life. No differences were found between genders (p = 0.910) or between late (≥50 years) and early-onset patients (p = 0.254). The utility estimate ranged from 0.63 (0.009) in stage I to 0.01 (0.005) in stage IV. Conclusions Hereditary Transthyretin Amyloidosis Polyneuropathy symptoms and progressive associated disabilities substantially decrease patient’s health-related quality of life. Clinical strategies focused on health-related quality of life preservation such as close follow-up of asymptomatic carriers, prompt diagnosis and adequate, early treatment would benefit patient’s long-term outcomes, slowing the progressive decline in health-related quality of life.info:eu-repo/semantics/publishedVersio

SVC Is a Marker of Respiratory Decline Function, Similar to FVC, in Patients With ALS

Introduction: Respiratory function is a critical predictor of survival in amyotrophic lateral sclerosis (ALS). We aimed to determine if slow vital capacity (SVC) is a predictor of functional loss in ALS as compared to forced vital capacity (FVC).Methods: Consecutive ALS patients in whom respiratory tests were performed at baseline and 6 months later were included. All patients were evaluated with revised ALS functional rating scale (ALSFRS-R) and the respiratory tests, SVC, and FVC. Significant independent variables of functional decay were assessed by univariate Kaplan-Meier log-rank test and multivariate Cox proportional hazards model. A monthly decay not exceeding 0.92 in ALSFRS was considered as the time event.Results: We included 232 patients (134 men; mean onset-age 59.1 ± 11.23 years; mean disease duration from first symptoms to first visit: 14.5 ± 12.9 months; 166 spinal and 66 bulbar onset). All variables studied declined significantly between the two evaluations (p < 0.001). FVC and SVC were strongly correlated at study entry (r2 = 0.98, p < 0.001) and FVC and SVC decays between first evaluation and 6 months after were the only significant prognostic variables of functional decay (p < 0.001).Conclusion: FVC and SVC decay are inter-changeable in predicting functional decay in ALS. Pharmacological interventions reducing the decline rate of FVC and SVC can have a positive impact on the global functional impairment, with relevant implications for clinical trials' design and interpretation

Diaphragmatic Neurophysiology and Respiratory Markers in ALS

The main reason for short survival in amyotrophic lateral sclerosis (ALS) is involvement of respiratory muscles. Severe compromise of diaphragmatic function due to marked loss of motor units causes poor inspiratory strength leading to symptomatic respiratory fatigue, and hypercapnia and hypoxemia, often firstly detected while sleeping supine. Weakness of expiratory muscles leads to cough weakness and poor bronchial clearance, increasing the risk of respiratory infection. Respiratory tests should therefore encompass inspiratory and expiratory function, and include measurements of blood gases during sleep. Non-volitional tests, such as phrenic nerve stimulation, are particularly convenient for investigating respiratory function in patients unable to perform standard respiratory function tests due to poor cooperation or facial weakness. However, SNIP is a sensitive test when patients with bulbar involvement are able to perform the necessary maneuvers. It is likely that central respiratory regulation is disturbed in some ALS patients, but its evaluation is more complex and not regularly implemented. Practical tests should incorporate tolerability, sensitivity, easy application for regular monitoring, and prognostic value. Impending respiratory failure can cause increased circulating inflammatory markers, but molecular assessment of respiratory distress requires further study. In future, home-monitoring of patients with accessible devices should be developed

Tempo Social, Confiança e Tutela Ambiental: A Ambivalência para o Direito na (Re)Configuração do Espaço Urbanísticoambiental

This study aims to analyze the interrelationship between social time, onfidence and the tutelage of balance of urban and environmental, as well as the ambivalence between these elements and the law. Initially treat the dialectic between time, law and environmental protection, with the theoretical basis of the lessons Niklas Luhmann and François Ost. Secondly will be analyzed in the fundamental protection of confidence by law. Finally, we analyze the time, the law and confidence in re (configuration) of urban and environmental influence on the quick time of contemporaneity.Este trabalho tem por objetivo a análise da inter-relação entre o tempo social a confiança e a tutela do equilíbrio do meio urbanístico-ambiental, bem como a ambivalência entre tais elementos e o Direito. Trataremos inicialmente a dialética entre tempo, Direito e tutela ambiental, tendo como base teórica as lições de Niklas Luhmann e François Ost. Num segundo momento será objeto de análise a proteção fundamental da confiança pelo Direito. Por fim, analisaremos o tempo, o Direito e a confiança na re(configuração) do meio urbanístico-ambiental diante da influência do rápido tempo da contemporaneidade

Manipulação das Preferências de Consumo: Alienação Humana e Degradação Ambiental nos Caminhos de um Modelo Social Insustentável

This work aims at the study and analysis of theories of "commodity fetishism" developed by Karl Marx and the "fetishism of subjectivity" of Zygmunt Bauman, the substitution of relations between people and objects for disposal and those of the natural environment through manipulation mechanisms arising from Capitalism Control. Will also be analyzed the difference between consumption and consumerism and whether and to what extent the latter via modulation of individual and social subjectivities away the man of your being and converts it to object. To do so, joining analysis of modern capitalism and its media tools on a global scale in human alienation and the natural environment.Este trabalho tem por objetivo a análise das teorias do fetichismo da mercadoria desenvolvida por Karl Marx e do fetichismo da subjetividade de Zygmunt Bauman, na substituição das relações entre pessoas por objetos, a alienação daquelas e a degradação do meio ambiente natural através de mecanismos de manipulação decorrentes do Capitalismo Mundial Integrado. Também será analisada a influência da publicidade voltada ao consumo conspícuo e suas manobras na modulação de subjetividades individuais e coletivas, afastando o homem e o meio de suas essências para converter ambos em objetos mercantis. Para tanto, adentraremos na análise do capitalismo moderno e suas ferramentas midiáticas em escala global na alienação humana e do meio ambiente natural, num modelo de organização social cada vez mais insustentável

Neuromodulation of lower limb motor pathways with trans-spinal direct current stimulation: an overview of current findings

Abstract in proceedings of the Fourth International Congress of CiiEM: Health, Well-Being and Ageing in the 21st Century, held at Egas Moniz’ University Campus in Monte de Caparica, Almada, from 3–5 June 2019.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/publishedVersio

Molecular biomarkers associated with respiratory insufficiency in amyotrophic lateral sclerosis

Abstract in proceedings of the Fourth International Congress of CiiEM: Health, Well-Being and Ageing in the 21st Century, held at Egas Moniz’ University Campus in Monte de Caparica, Almada, from 3–5 June 2019.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/publishedVersio

Processamento de umbu-cajá, variedade suprema, na forma de geleia dietética e convencional.

A umbu-cajazeira (Spondias sp.), pertencente à família Anarcadiaceae, é nativa das regiões semiáridas do Nordeste e encontra-se difundida principalmente entre os estados do Rio Grande do Norte, Ceará, Piauí, Pernambuco e Bahia (CARVALHO et al., 2008; NARAIN et al., 2007). Seus frutos apresentam pH que varia entre 2,4 a 3,0 e sabor ácido acentuado, que dificulta o seu consumo in natura (CARVALHO et al., 2008).bitstream/item/55928/1/CircularTecnica-102-1.pd

Sensitivity of MUP parameters in detecting change in early ALS

h i g h l i g h t s Detailed knowledge on the earliest changes of the motor unit morphology in ALS is critical for evaluating reinnervation with electromyography, in future clinical trials with drugs promoting axonal sprouting. Increased motor unit duration and jitter are very sensitive and consistent markers of early motor unit adaptation in very early affected muscles in ALS. Mean motor unit duration is a measure easily applicable in clinical trials of compounds considered likely to be of value in promoting reinnervation. a b s t r a c t Objectives: We aimed to identify the most appropriate MUP parameter to evaluate reinnervation in very early ALS. Methods: We studied tibialis anterior (TA), initially of normal strength with normal MUP analysis parameters, in 15 patients with ALS of recent onset. They were studied at the initial diagnostic assessment, and then 3 and 6 months later. Spontaneous EMG activity was recorded. Conventional MUP analysis included mean amplitude, mean area, mean duration, mean number of phases, mean number of turns, % polyphasic potentials, mean jitter, % unstable pairs and % pairs with blocking. Non-parametric statistics were utilised in the analysis. Results: Fasciculations were recorded in 72% in TA and increased jitter in 33% at study entry, but without EMG features of denervation. Mean amplitude, mean duration, mean area and the three measures of neuromuscular transmission increased significantly and linearly at each evaluation. Median duration showed the lowest variation and, together with jitter, the largest relative time effect. Conclusions: Mean duration and mean jitter are the most effective measures of early reinnervation in a very early affected muscle, in ALS. Significance: Mean MUP duration is a simple and easy measure that should be useful in evaluating reinnervation, for example in a future clinical trial