Cognitive and functional performance of elderly with Alzheimer\u27s disease after program of physical activity

The neurophysiologic feature of Alzheimer\u27s disease (AD) is the formation of senile plaques and decrease of acetylcholine causing neuronal death, decline of cognitive performance and functional capacity. The physical activity (PA) brings benefits in these functions. The aim of the study was to analyze the cognitive profile and functional capacity of elderly with AD after PA. Twelve elderly with AD (mean age: 79±7.9 years old), five of the Training Group (TG), and seven of the Control Group (CG), from the Program of Cognitive and Functional Kinesiotherapy in Elderly with AD (PRO-CDA), for six months, three times a week for 60 minutes per day. Functional capacity was evaluated using agility tests and dynamic balance (AGIL), flexibility (FLEX) and Mini-Mental State Examination (MMSE) to cognitive functions. For data analysis was used the Wilcoxon test for the MMSE and Anova Two Way for AGIL and FLEX. The mean of pre and post training were, respectively, TG (FLEX 51.4; 50.8; AGIL 66.8; 57.2; MMSE 17.8; 16.6) for CG (FLEX 48.1; 48.7; AGIL 48.7; 56.8; MMSE 14.2; 11.4). The Wilcoxon test showed significant deterioration to the CG in post evaluation (p\u3c0.04), and maintenance of TG on cognitive status. ANOVA showed significant difference between groups in AGIL (p\u3c0.03). On Maintenance of flexibility and MMSE was significant improvement in agility for the TG, while the CG was worsened in agility, and MMSE. Possible neurophysiological mechanisms that contributed to maintenance of the cognitive performance, regular practice of PA include improvement in cerebral blood flow, increased synthesis of neurotransmitters and neurotrophic factors

The memory in elderly with Alzheimer\u27s disease participants of a physical activity program

The physiopathology of Alzheimer\u27s disease (AD) is characterized by the formations of senile plaques and tangles fibro-neurals causing neural death, leading to impairment of memory. The aim of this study was to analyse the effects of a systematic program of physical activity on the learning and evocational memories in elderly with AD. Participated of the study 11 elderly people with AD, five elderly people (mean age = 81.4 ± 5.03 years old) participated in the training group (TG), while the control group (CG) had six elderly people (mean age = 82.1 ± 3.06 years old). The subjects performed three weekly sessions of physical activity, for 60 minutes, during six months. To analyse the memories, the Brief Battery of Cognitive Screening (BBRC) was used. Data analysis was performed with descriptive statistics, U-test and Mann Writney Wilcoxon test with a significance level of 5% (p\u3c0.05). To learning memory, the mean obtained by the CG and TG respectively, in the initial evaluation was 4.00 ± 1.55 and 3.4 ± 2.07 and in the final evaluation, the mean was 4.00 ± 2, 90 and 3.60 ± 1.82. To evocation memory, were found the following means: in the initial and final evaluations for the CG and TG respectively, 2.33 ± 2.25 and 1.50 ± 2.35, 1.64 and 1.8 ± 1.8 ± 1.79. The Wilcoxon test did not show significant differences in the data. The physical activity was not enough to cause changes in memories. The result can be explained by the fact that patients already have an irreversible neuronal loss, however the maintenance of the memory was observed and this is an important finding for AD elderly patients

A assistência pré-natal segundo os profissionais de saúde e as usuárias do Programa de Saúde da Família em Juiz de Fora - MG

-Introdução/ Justificativa: Em Juiz de Fora/MG, os índices preocupantes de mortalidade materna (razão média = 97/100mil nascidos vivos, entre 1996e 2004) motivaram uma análise da evolução de adequação da assistência pré-natal, realizada entre 2002 e 2004, que constatou alta cobertura (99%)e baixa adequação do atendimento prestado no município. Entre os principais serviços locais, o Programa de Saúde da Família (PSF) apresentou apior evolução. Tendo em vista que a gestação é fortemente influenciada pelas características socioeconômico-culturais da população, facilidade deacesso e qualidade dos serviços de saúde locais, e que as equipes do Programa de Saúde da Família (PSF) deverão ser responsáveis, num futuropróximo, pela assistência majoritária às gestações de baixo risco em nosso município, o presente trabalho pretende avaliar a percepção de usuáriase profissionais de saúde sobre a qualidade do pré-natal prestado pelo PSF e comparar com o atendimento das equipes tradicionais do SistemaÚnico de Saude (SUS). Desenvolvimento: No segundo semestre de 2007, foram aplicados questionários a: 1) 50 puérperas atendidas pelo PSF e 50pelo SUS tradicional (grupo controle), equivalentes no perfil epidemiológico e na utilização da assistência; 2) 50 profissionais de saúde pertencentes aequipes do PSF. A análise estatística utilizou o teste de Ç2, com 5% de significância. Resultados: A qualidade da atenção foi considerada adequadamajoritariamente pelos dois grupos de pacientes (PSF: 80% vs controle: 90%; p>0,05). Contudo, foram identificadas lacunas na assistência prestadapelo Programa, dentre as quais podemos destacar a dificuldade de agendamento da consulta inicial que foi significativamente maior entre as usuáriasdo PSF (PSF: 84% vs controle: 12%; p<0,001). A maioria dos profissionais mostrou-se insatisfeita quanto ao papel dos gestores (68%) e à atuaçãoparticipativa da população (61%) na adequação do atendimento pelo PSF, mas considerou adequada a sua própria participação (82%). Conclusão: Aavaliação positiva apenas das usuárias sobre o pré-natal prestado pelo PSF sugere a inexistência de uma relação estreita e coordenada entre osprofissionais e os gestores, que é fundamental para a melhoria da atenção municipal ao ciclo gravídico-puerperal

A influência de um treinamento de caratê nas funções cognitivas e funcional em idoso com demência mista

Dentre as diferentes e recentes formas de intervenções não-farmacológicas para pacientes com demência realizadas no Brasil, não foram encontrados estudos que investigaram o efeito de um protocolo de caratê em pacientes com este quadro clínico, mais especificamente em idosos com diagnóstico de demência mista, doença de Alzheimer associada com demência vascular. Objetivo: O presente estudo teve como objetivo analisar os efeitos de um treinamento de caratê nas funções cognitivas e funcionais de um idoso com demência mista. Método: O participante, clinicamente diagnosticado com demência mista, passou por uma anamnese, seguida de avaliação cognitiva e funcional, antes e depois de um treinamento de quatro meses. O treinamento de caratê foi adaptado e sistematizado, visando fortalecimento muscular, flexibilidade, técnicas de posturas, ataque (socos e chutes), bloqueios (defesas) e katas (luta imaginária com vários oponentes), três vezes por semana, com duração de uma hora sessão em dias não consecutivos. Resultados: Os resultados encontrados foram manutenção das funções cognitivas e melhora no equilíbrio estático e dinâmico. Conclusão: Conclui-se que o treinamento adaptado e sistematizado do caratê contribui para melhora de equilíbrio estático e dinâmico e manutenção do status cognitivo. Podendo contribuir assim para uma nova alternativa de intervenção não-farmacológica em idosos com demência mista.Among the different forms and recent non-pharmacological interventions for dementia patients already performed in Brazil, there are no studies that have investigated the effect of a protocol of karate in patients with this clinical conditions, more specifically in the elderly with a diagnosis of mixed dementia, Alzheimer’s disease associated with vascular dementia. Objective: Thus, the present study aimed to analyze the effects of a karate training in cognitive and functional with an elderly mixed dementia. Method: The participant, clinically diagnosed with mixed dementia, underwent a anamnesis, followed by cognitive and functional assessment, pre and post training four months. The karate training was adapted and systematized, in order to muscle strengthening, flexibility, posture techniques, attack (punches and kicks), blocks (defenses) and kata (imaginary fight with multiple opponents), three times per week, lasting an hour session on nonconsecutive days. Results: The findings were maintaining cognitive function and improvement in static and dynamic balance. Conclusion: It was concluded that training adapted and systematized karate contributes to improved static and dynamic balance and maintenance of cognitive status. May, thus contribute to a new alternative non-pharmacological intervention in elderly patients with mixed dementia

Feasibility of reducing frailty components in older adults with Alzheimer's dementia:a randomized controlled home-based exercise trial (AD-HOMEX)

Objectives: There is a need for interventions to reduce frailty in older people with Alzheimer's dementia (AD). The purpose of this study was to investigate the effect of a home-based multimodal exercise program for older adults with AD (AD-HOMEX) on frailty. Design: A parallel single-blind randomized controlled trial comparing a home-based exercise program and usual care. Setting and participants: A home-based program in Brazil. Forty individuals aged 65 years or older with mild to moderate AD. Methods: The intervention group (IG) participated in a 16-week protocol involving three 60-minute sessions per week of progressive individualized physical exercises supervised by a physical therapist. The participants in the control group (CG) maintained their usual care. Frailty was assessed using the FRAIL questionnaire, the Edmonton Frail Scale (EFS) and a subjective assessment by the evaluator (SAE) at baseline and follow-up. Per-protocol analysis was performed. Results: Thirty-five participants completed the program (IG = 16; CG = 19). Frailty improved in the IG based on the EFS (P = .004) and FRAIL (P Conclusions and implications: AD-HOMEX seems to reduce frailty and improve frailty transition patterns. Our findings provide a further theoretical basis for designing home-based physical interventions as routine practice for older frail adults with AD

RECICLAGEM DE CATETERES PARA COLHEITA DE EMBRIÃO EM EQÜINOS: UMA FERRAMENTA PARA REDUÇÃO DE CUSTOS

A transferência de embriões está se tornando uma prática largamente utilizada. Apesar disso, na indústria de equinos, a colheita dos embriões é realizada a partir de ovulações simples, resultando em recuperação de, aproximadamente, 50%, o que aumenta os custos de produção. Cite-se como exemplo o custo do cateter para colheita do embrião, que varia de R$350,00 a R$ 450,00 (US$194,00 a US$ 250,00). Assim, com este trabalho objetivou-se verificar se cateteres com balão danificado podem ser recuperados sem alterar a sua eficiência. Para o estudo utilizaram-se dois grupos: controle (GI - n=10), em que a colheita não cirúrgica dos embriões das éguas foi realizada com cateter original; e o tratamento (GII - n=20), submetido à colheita do embrião com cateter recuperado. O custo do material utilizado para recuperar os cateteres foi de R$30,00 (US$ 16,66). Para as éguas do GI, obteve-se uma taxa de recuperação embrionária de 60% e no GII de 55%, não havendo diferença (P>0,05) entre os grupos. Considerando o baixo custo do material utilizado para recuperar os cateteres, conclui-se que sua recuperação, visando à reutilização na colheita de embrião de éguas, pode reduzir consideravelmente o custo final da técnica, sem comprometer as taxas de recuperação embrionária. PALAVRAS-CHAVES: Equino, recuperação de cateter, redução de custos, transferência de embrião

Educational topics for school from the perspective of professionals in the Mobile Emergency Service

Objective To systematize, with professionals from the Mobile Emergency Care Service of Santa Catarina municipality, the main issues for the development of an educational tool of attention to the emergency room, dedicated to the school-age population. Method Qualitative study, conducted through meetings in the focus group format, with 19 professionals who develop their activities in the city Emergency Mobile Emergency Service. Data were categorized and analyzed using thematic analysis technique. Results The contents discussed at the meetings were grouped into four thematic categories: The Mobile Emergency Service and the school: education and health promotion for children; As the Mobile Emergency Care Service works: What is important to know ?; Something’s wrong, what now? and; We are nearly finished, give your opinion. Conclusions The specific issues arising from the meetings contributed to the production of an educational tool on the activities of the Mobile Emergency Service, which may be used by the School Health Program to promote health education in the care area to the emergency room with the population schoolchildren

Investigação dos métodos avaliativos utilizados por fisioterapeutas na especificidade da neurologia funcional

Neurofunctional clinical evaluation represents one of the most important activities of physical therapists. However, differences in diagnostic methods cause discrepancies between physical therapy prescription and prognosis. Thus, the aim of this study was to analyze and discuss the evaluation methods and techniques used by physical therapists bound to popular healthcare assistance, in the specificity of the neurofunctional area. To accomplish this research, a cross-sectional design study was conducted. The sample consisted of physical therapists specialized in neurofunctional rehabilitation registered in the Regional Council for Physical Therapy and Occupational Therapy of Mato Grosso do Sul (Conselho Regional de Fisioterapia e Terapia Ocupacional, CREFITO - 13), who work in hospitals, universities and clinics of the city of Campo Grande, Brazil. Data were analyzed using descriptive and inferential (χ²) statistics, under a 5% level of significance (pLa evaluación fisioterapéutica neuro-funcional representa una de las acciones más importantes del profesional. Sin embargo, los desacuerdos en los métodos utilizados para la elaboración diagnóstica hacen que haya discrepancias en la prescripción y pronóstico fisioterapéutico. Así, el objetivo de este trabajo fue analizar y discutir los métodos y técnicas de evaluación utilizados por fisioterapeutas vinculados a la atención de salud de la población, en la especificidad de la neurología funcional. Para la concretización de esta investigación fue realizado un estudio cuali-cuantitativo de delineamiento transversal. La muestra fue compuesta por fisioterapeutas, especialistas en el área de rehabilitación neuro-funcional, registrados en el Consejo Regional de Fisioterapia y Terapia Ocupacional del estado Mato Grosso do Sul (CREFITO-13). La investigación involucra profesionales presentes en hospitales, universidades y clínicas de la ciudad de Campo Grande/MS. Los datos fueron analizados por medio de estadística descriptiva e inferencial (test χ²), sobre un nivel de significancia de 5% (pA avaliação fisioterapêutica neurofuncional representa uma das ações mais importantes do profissional. Contudo, divergências nos métodos utilizados para elaboração diagnóstica fazem com que haja discrepâncias na prescrição e no prognóstico fisioterapêutico. Assim, o objetivo deste trabalho foi analisar e discutir métodos e técnicas de avaliação utilizados por fisioterapeutas vinculados à atenção à saúde da população, na especificidade da neurologia funcional. Para a concretização desta pesquisa, foi realizado um estudo quali-quantitativo de delineamento transversal. A amostra foi composta por fisioterapeutas registrados no Conselho Regional de Fisioterapia e Terapia Ocupacional da comarca de Mato Grosso do Sul (CREFITO-13), especialistas na área da reabilitação neurofuncional, e atuantes em hospitais, universidades e clínicas da cidade de Campo Grande (MS). Os dados foram analisados por meio da estatística descritiva e inferencial (teste do χ²), sob um nível de significância de 5% (

Clinical comparison between two stabilization methods in distal tibial angular deviation corrected by the CORA method

Background: Angular deformity is characterized by the deviation of part of the bone that can occur in three different planes, frontal, sagittal and transverse. Trauma on physeal plates is the most common cause of angular deviations of the limbs in dogs. Currently the CORA (Center of Rotation of Angulation) methodology is the best way to evaluate and surgically correct these deformities. The objective of this study is to describe the surgical procedures performed to treat the uniapical valgus deviation affecting both tibial bones in a dog, comparing the outcomes of hybrid external skeletal fixator used in the right pelvic limb in relation to the locking plate used in the left pelvic limb.Case: A 10-month old Border Collie dog was attended at the University Veterinary Hospital with history of lameness and deviation of both pelvic limbs. In the orthopedic examination, it was possible to identify bilateral valgus deviation in the region of the tibio-tarsal joints and moderate lameness, with absence of pain or joint crepitation. Radiographic examination showed that the deformity was only uniapical in the frontal plane, affecting both tibial bones of the dog. Signs of osteoarthrosis were not observed and the preoperative examinations were within the normal limits for the species. The deformities were corrected in two surgical times starting with the procedure in the right tibia, which appeared to be clinically worse. Due to the fact that it was a bilateral affection and there was not a healthy pelvic limb to obtain the normal angles values of this dog, for planning according to the CORA methodology, the values of the tibial mechanical angles for dogs of similar size were taken from the literature. For surgical correction of the right tibia, a closed wedge osteotomy was performed following the second rule of Paley, with bone stabilization using type IB hybrid external skeletal fixator (ESF). The radiographic follow-up was done every 30 days postoperatively, however at 60 days the dog presented with severe lameness and the ESF had to be removed due to the breaking of one of the wires that composed the ring of the hybrid system. The limb continued to be treated by external bandages and total bone healing occurred at 210 days after surgery. Only after the complete recovery of the right limb, the left pelvic limb was operated and was also corrected by closed wedge osteotomy from the second Paley's rule. However, the bone stabilization was achieved with the use of a T-shaped locking plate. Radiographic follow-up was performed every 30 days postoperatively and at 60 days the osteotomy gap was already consolidated and the dog showed good weight bearing in the pelvic limbs without signs of lameness or pain.Discussion: Currently, it is indicated that bone deformities in small animals should be corrected using the CORA methodology. The hybrid ESF is one of the most commonly used fixation systems for bone stabilization after corrective osteotomies due to great versatility, however, the reported complication rates are relatively high. The locking plates with special shapes, such as the "T" plate used in this study, provide the stable fixation of osteotomies with limited bone stock, as they allow the introduction of larger number of screws per area. Thus, this latter type of implant becomes advantageous for the correction of bone deformities close to the joints. It is concluded that CORA methodology is really effective in the planning of corrective surgeries of angular deviations in dogs. In this case report, the resulting tibial angles after the surgical corrections were within the normal range for healthy dogs of similar size. However, the use of locking plate provided better results with early bone healing and fewer complications than the type IB hybrid ESF

Raiva: o papel do veterinário no sus e do núcleo de apoio à saúde da família na atenção básica

O vínculo entre os animais de estimação e seus donos cresce a cada dia e amplifica o potencial de doenças infecciosas entre animais e humanos. A doença da raiva está entre elas, sendo uma de tipo viral, contagiosa e zoonótica, que causa danos à pecuária e à saúde pública. O vírus é contido na saliva dos animais infectados e transmitida através de mordidas, arranhões ou lambeduras em ferimentos abertos. É uma doença de alta taxa de mortalidade, sendo disseminada através da infiltração do vírus rábico neurotrópico do gênero Lyssavirus, que afeta o sistema nervoso central dos mamíferos. O objetivo do presente trabalho é analisar o que desencadeia o ciclo de transmissão dessa doença e enfatizar a importância das equipes multidisciplinares no combate contra a raiva. Diante disso, realizou-se um estudo acerca desse quadro, com ênfase principal e fundamental no Médico Veterinário, dentro do Sistema Único de Saúde (SUS) e do Núcleo de Apoio à Saúde da Família (NASF) no exercício único e objetivo de suas funções designadas