Evaluation of the passive resistive torque in female athletes with ankle sprain

INTRODUÇÃO: A entorse de tornozelo é uma das lesões mais comuns em atletas. Uma forma de avaliar a frouxidão ligamentar pode ser através da medida da amplitude passiva dos movimentos de inversão e eversão do pé para estimar a resistência passiva das estruturas capsuloligamentares do tornozelo, o qual pode ser chamado de torque de resistência passiva. Existem poucos estudos que utilizam a avaliação do torque passivo do tornozelo para avaliar a resistência da cápsula e dos ligamentos. OBJETIVO: O objetivo deste estudo foi comparar o torque passivo dos movimentos de inversão e eversão do pé em atletas com e sem história de entorse de tornozelo. MÉTODO: Participaram do estudo 32 atletas de basquetebol e voleibol feminino (16,06 ± 0,8 anos, 67,63 ± 8,17kg, 177,8 ± 6,47cm). Seus tornozelos foram divididos em dois grupos: grupo controle (29), composto por tornozelos sem sintomas, e grupo entorse de tornozelo, composto por tornozelos que sofreram lesão (29). O torque dos movimentos passivos do tornozelo foi registrado por um dinamômetro isocinético, e a atividade dos músculos fibular longo e tibial anterior foi medida por um eletromiógrafo. As atletas realizaram duas repetições do movimento de inversão e eversão, nas velocidades de 5, 10 e 20°/s e, em seguida, o mesmo protocolo foi repetido apenas para o movimento de inversão máxima do pé. RESULTADOS: O torque de resistência passiva durante os movimentos de inversão e eversão do pé foi menor no grupo com entorse do tornozelo. Este grupo também mostrou menor torque durante o movimento de inversão máxima do pé. Não foram observadas diferenças entre o movimento de inversão e eversão. CONCLUSÕES: A entorse de tornozelo leva a um menor torque de resistência passiva, indicando redução da resistência dos ligamentos colaterais do tornozelo e uma frouxidão articular mecânica

Cirurgia Hepática e Encefalopatia: Análise dos Efeitos Neuropsiquiátricos

Introduction: Liver surgery and hepatic encephalopathy (HE) are closely linked, with HE representing a significant neuropsychiatric complication resulting from liver dysfunction. During surgical procedures on the liver, the accumulation of toxins, especially ammonia, can worsen HE symptoms, which range from mental confusion to coma. This review focuses on understanding the neuropsychiatric effects of liver surgery and developing management strategies to improve clinical outcomes for affected patients. Objective: To investigate how surgical procedures on the liver contribute to the development or worsening of hepatic encephalopathy. Methodology: The Cochrane, Scielo and Medline databases were used, searching for articles published between 2020 and 2024, in Portuguese or English. Final Considerations: Liver surgery can intensify hepatic encephalopathy (HE) due to the accumulation of neuroactive toxins, such as ammonia. As a result, patients with advanced cirrhosis are particularly susceptible. Therefore, a multidisciplinary approach, including the use of interventions such as lactulose and rifaximin, is crucial to minimize these effects and improve patients' quality of life.Introdução: A cirurgia hepática e a encefalopatia hepática (EH) estão intimamente ligadas, com a EH representando uma complicação neuropsiquiátrica significativa decorrente da disfunção hepática. Durante procedimentos cirúrgicos no fígado, a acumulação de toxinas, especialmente amônia, pode agravar os sintomas de EH, que variam de confusão mental a coma. Esta análise foca em compreender os efeitos neuropsiquiátricos da cirurgia hepática e desenvolver estratégias de manejo para melhorar os desfechos clínicos dos pacientes afetados. Objetivo: Investigar como os procedimentos cirúrgicos no fígado contribuem para o desenvolvimento ou agravamento da encefalopatia hepática. Metodologia:  Foram utilizadas as bases de dados Cochrane, Scielo e Medline, buscando artigos publicados entre os anos de 2020 e 2024, nos idiomas Português ou Inglês. Considerações Finais: A cirurgia hepática pode intensificar a encefalopatia hepática (EH) devido ao acúmulo de toxinas neuroativas, como a amônia. Como resultado, pacientes com cirrose avançada são particularmente suscetíveis. Assim, uma abordagem multidisciplinar, incluindo o uso de intervenções como lactulose e rifaximina, é crucial para minimizar esses efeitos e melhorar a qualidade de vida dos pacientes

Mechanical instability after acute ankle ligament injury: randomized prospective comparison of two forms of conservative treatment

OBJECTIVE: This trial has the objective to investigate the incidence of mechanical ankle instability after the conservative treatment of first episode, severe ankle ligamentar lesions. This common lesion affects young, professional and physical active patients, causing important personal and economic consequences. There are difficulties related to adequate diagnosis and treatment for these lesions. METHOD: 186 patients with severe ankle ligament lesions were included in this trial. They were randomized in two treatment options. In group A patients were treated using ankle long orthoosis, weight bearing allowed as confortable, pain care, ice, elevation with restricted joint mobilization for three weeks. After that they were maintained in short, functional orthosis (air cast), starting the reabilitation program. In group B patients were immobilized using a functional orthosis (air cast), following the same other sequences that patients in group A. RESULTS: We did not find significant differences in relation to the residual mechanical ankle instability between both groups. We did not find differences in the intensity of pain, but the functional evaluation using AOFAS score system showed better results in the functional treatment group. CONCLUSION: The functional treatment (Group B) had better AOFAS score and few days off their professional activities, comparing with patients treated with rigid orthosis (Group A), without increased chance in developing ankle mechanical instability

Cartilage lesions and ankle osteoarthrosis: review of the literature and treatment algorithm,

The main etiology of ankle osteoarthrosis is post-traumatic and its prevalence is highest amongyoung individuals. Thus, this disease has a great socioeconomic impact and gives rise to significant losses of patients' quality of life. The objective of its treatment is to eliminate pain and keep patients active. Therefore, the treatment should be staged according to the degree of degenerative evolution, etiology, joint location, systemic condition, bone quality, lower-limb alignment, ligament stability and age. The treatment algorithm is divided into non-surgical therapeutic methods and options for surgical treatment. Joint preservation, joint replacement and arthrodesis surgical procedures have precise indications. This article presents a review on this topic and a proposal for a treatment algorithm for this disease

Cartilage lesions and ankle osteoarthrosis: review of the literature and treatment algorithm,

The main etiology of ankle osteoarthrosis is post-traumatic and its prevalence is highest amongyoung individuals. Thus, this disease has a great socioeconomic impact and gives rise to significant losses of patients' quality of life. The objective of its treatment is to eliminate pain and keep patients active. Therefore, the treatment should be staged according to the degree of degenerative evolution, etiology, joint location, systemic condition, bone quality, lower-limb alignment, ligament stability and age. The treatment algorithm is divided into non-surgical therapeutic methods and options for surgical treatment. Joint preservation, joint replacement and arthrodesis surgical procedures have precise indications. This article presents a review on this topic and a proposal for a treatment algorithm for this disease

A reanalysis of Cognitive-functional performance in older adults: investigating the interaction between normal aging, mild cognitive impairment, mild Alzheimer's disease dementia and depression

Depressive symptoms are associated with cognitive-functional impairment in normal aging older adults (NA). However, less is known about this effect on people with mild Cognitive Impairment (MCI) and mild Alzheimer’s disease dementia (AD). We investigated this relationship along with the NA-MCI-AD continuum by reanalyzing a previously published dataset. Participants (N=274) underwent comprehensive neuropsychological assessment including measures of Executive Function, Language/Semantic Memory, Episodic Memory, Visuospatial Abilities, Activities of Daily Living (ADL), and the Geriatric Depression Scale. MANOVA, logistic regression and chi-square tests were performed to assess the association between depression and cognitive-functional performance in each group. In the NA group, depressed participants had a lower performance compared to non-depressed participants in all cognitive and functional domains. However, the same pattern was not observed in the MCI group or in AD. The results suggest a progressive loss of association between depression and worse cognitive-functional performance along the NA-MCI-AD continuum

Charcot neuroarthropathy: realignment of diabetic foot by means of osteosynthesis using intramedullary screws – case report,

Diabetes mellitus is a serious disease that affects a large portion of the population. Charcot neuroarthropathy is one of its major complications and can lead to osteoarticular deformities, functional incapacity, ulcers and ankle and foot infections. Realignment of the foot by means of arthrodesis presents a high rate of implant failure due to weight-bearing on an insensitive foot. The aim of this report was to describe successful use of intramedullary osteosynthesis with compression screws to stabilize the deformed foot, in a diabetic patient with neuroarthropathy