Fisioterapia em pacientes com doença de Alzheimer: uma revisão sistemática de ensaios clínicos randomizados controlados

The objective of this study is to evaluate the effects of physical therapy on the cognitive and functional capacity of patients with Alzheimer’s Disease (AD). This is a systematic review of randomized or quasi-randomized clinical trials, using the descriptors: AD, dementia and physical therapy. Two studies were included with a total of 207 participants. In study 1, no statistically significant difference was found on the mini-mental state examination (MMSE) (MD 0.0, 95%CI −5.76 to 5.76), neuropsychiatric inventory (MD −4.50, 95%CI −21.24 to 12.24) and Pfeffer instrumental activities questionnaire (MD 0.0 95%CI −6.48 to 6.48). In study 2, there was no statistically significant difference on the MMSE (MD −1.60, 95% CI −3.57 to 0.37), clock-drawing test (MD −0.20, 95%CI −0.61 to 0.21) and Alzheimer’s Disease Assessment Scale – cognitive subscale (MD 1.0, 95%CI −2.21 to 4.21) after 12 months. There was no consistent evidence on the effectiveness of physiotherapeutic intervention in improving cognitive function and functional capacity of patients with AD. More studies should be conducted for better evidence.O objetivo do estudo é avaliar os efeitos da fisioterapia na capacidade cognitiva e funcional de pacientes com doença de Alzheimer (DA). Trata-se de revisão sistemática de ensaios clínicos randomizados ou quasi-randomizados utilizando os descritores: DA, demência e fisioterapia. Dois estudos foram incluídos, com um total de 207 participantes. No Estudo 1, não houve diferença estatisticamente significativa no miniexame do estado mental (MEEM) (MD 0,0, IC 95% 5,76−5,76), inventário neuropsiquiátrico (MD −4,50, IC 95% 12,24−21,24) e questionário de atividades instrumentais Pfeffer (MD 0,0 IC 95% −6,48 a 6,48). No Estudo 2, não houve diferença estatisticamente significativa no MEEM (MD −1,60, IC 95% −3,57 a 0,37), teste do desenho do relógio (MD −0,20, IC95% −0,61 a 0,21) e escala de avaliação da doença de Alzheimer – subitem cognição (MD 1,0, IC95% −2,21 a 4,21) após 12 meses. Não houve evidência consistente da eficácia da intervenção fisioterapêutica na melhora da função cognitiva e capacidade funcional na DA. Recomenda-se a produção de mais estudos para encontrar possíveis evidências.El presente estudio tiene como objetivo evaluar los efectos de la fisioterapia en la capacidad cognitiva y funcional de pacientes con enfermedad de Alzheimer (EA). Se trata de una revisión sistemática de ensayos clínicos aleatorizados o casi-aleatorizados, en que se utilizó los descriptores: EA, demencia y fisioterapia. Se incluyeron dos estudios, con un total de 207 participantes. En el Estudio 1, no hubo diferencias estadísticamente significativas en el Miniexamen del estado mental (MEEM) (MD 0,0, IC 95%: 5,6 –5,76), en el inventario neuropsiquiátrico (MD –4,50, IC 95%: 12,24 –21,24) y en el cuestionario de actividades instrumentales de Pfeffer (MD: 0,0 IC 95% IC: –6,48 a 6,48). En el Estudio 2, no hubo diferencias estadísticamente significativas en el MEEM (MD −1,60, IC 95% −3,57 a 0,37), el test de diseño del reloj (MD −0,20, IC 95% −0,61 a 0,21) y la escala de evaluación de la enfermedad de Alzheimer: subítem de cognición (MD 1,0, IC 95% −2,21 a 4,21) tras 12 meses. No hubo evidencia consistente de la eficacia de la intervención fisioterapéutica en la mejora de la función cognitiva y de la capacidad funcional en la EA. Se recomienda realizar estudios adicionales para encontrar posibles evidencias

Norm scores of cancelation and bisection tests for unilateral spatial neglect: data from a Brazilian population

OBJECTIVE: Unilateral spatial neglect (USN) results in a consistent and exaggerated spatial asymmetry in the processing of information about the body or space due to an acquired brain injury. There are several USN tests for clinical diagnosis, but none of them are validated in Brazil. The aim was to obtain normative values from a healthy sample in Brazil and to evaluate the effects of demographic variables on USN tests. METHODS: This was a cross-sectional study performed with 150 neurologically healthy individuals. USN was evaluated using the line cancelation (LC), star cancelation (SC), and line bisection (LB) tests in the A3 (29.7 x 42.0 cm) sheet format. RESULTS: In LC, 143 participants had 0 omissions, and the occurrence of failure was significantly associated with aging (OR=1.1[1.02-1.2]; p=0.012). In SC, 145 participants had fewer than 1 omission, and the occurrence of failure was significantly associated with aging (OR=1.07[1.03-1.11]; po0.001). In LB, deviations were the lowest for those with the highest level of education (r=0.20; p=0.015), and the deviation was 9.5 mm. CONCLUSION: The cutoff points presented in this study may be indicative of USN, but due to performance differences based on age, we suggest using different norm scores for different age groups. These norm scores can be used in the clinic immediately for USN diagnosis

HYGIENIC-SANITARY QUALITY OF LETTUCE (Lactuca sativa) AND ARUGULA (Eruca sativa) PRODUCED IN AN ORGANIC FARM SYSTEM IN CUIABÁ, MT, BRAZIL

Demand for organic food has increased as a result of awareness of the health risks posed by the presence of chemical residues. In this context, this study aimed to verify the safety of lettuce (Lactuca sativa) and arugula (Eruca sativa) produced organically in the metropolitan region of Cuiabá, MT, Brazil, and identify the main microbiological contamination sources of this production system. Fifty-five samples, 10 lettuces and 10 arugula, were collected in a farm and supermarket, in addition to five samples of each agricultural adjuvant used in the production system (irrigation water, vegetable and animal fertilizers). No Salmonella spp. was detected, although thermotolerant coliforms above the maximum acceptable limit established by the Commission on Microbiological Specifications for Foods (ICMSF) were observed in 90% (9/10) and 50% (5/10) of the farm arugula and lettuce samples, 20% (2/10) and 10% (1/10) of the supermarket arugula and lettuce samples, 60% of animal and vegetable fertilizers (6/10) and 40% (2/5) of irrigation water samples. Over half of the vegetable samples analyzed herein were, thus, unfit for consumption, indicating the relatively high influence of system inputs on the hygienic-sanitary quality of the arugula and lettuce produced in the investigated organic farm.Demand for organic food has increased as a result of awareness of the health risks posed by the presence of chemical residues. In this context, this study aimed to verify the safety of lettuce (Lactuca sativa) and arugula (Eruca sativa) produced organically in the metropolitan region of Cuiabá, MT, Brazil, and identify the main microbiological contamination sources of this production system. Fifty-five samples, 10 lettuces and 10 arugula, were collected in a farm and supermarket, in addition to five samples of each agricultural adjuvant used in the production system (irrigation water, vegetable and animal fertilizers). No Salmonella spp. was detected, although thermotolerant coliforms above the maximum acceptable limit established by the Commission on Microbiological Specifications for Foods (ICMSF) were observed in 90% (9/10) and 50% (5/10) of the farm arugula and lettuce samples, 20% (2/10) and 10% (1/10) of the supermarket arugula and lettuce samples, 60% of animal and vegetable fertilizers (6/10) and 40% (2/5) of irrigation water samples. Over half of the vegetable samples analyzed herein were, thus, unfit for consumption, indicating the relatively high influence of system inputs on the hygienic-sanitary quality of the arugula and lettuce produced in the investigated organic farm. Keywords: fertilization; organic farming; sanitary quality; contamination.   Qualidade higiênico-sanitária de alface (Lactuca sativa) e rúcula (Eruca sativa) produzidas em sistema de produção orgânica em Cuiabá, MT, Brasil   RESUMO: A procura por alimentos orgânicos tem aumentado devido a conscientização sobre os riscos à saúde decorrentes da presença de resíduos químicos. Nesse contexto, este estudo teve como objetivo verificar a segurança de alface (Lactuca sativa) e rúcula (Eruca sativa) produzidas organicamente na região metropolitana de Cuiabá, MT, Brasil, e identificar as principais fontes de contaminação microbiológica desse sistema de produção. Cinquenta e cinco amostras, sendo 10 de alfaces e 10 de rúculas foram coletadas em uma fazenda e supermercado, além de quinze amostras de adjuvantes agrícola utilizados no sistema de produção. Nenhuma Salmonella spp. foi detectada, embora coliformes termotolerantes acima do limite máximo aceitável estabelecido pela Comissão de Especificações Microbiológicas para Alimentos (ICMSF) tenham sido observados em 90% (9/10) e 50% (5/10) das amostras de rúcula e alface da fazenda, 20 % (2/10) e 10% (1/10) das amostras de rúcula e alface de supermercado, 60% de fertilizantes animais e vegetais (6/10) e 40% (2/5) de amostras de água de irrigação. Mais da metade das amostras de hortaliças aqui analisadas estavam, portanto, impróprias para consumo, indicando a influência relativamente alta dos insumos do sistema na qualidade higiênico-sanitária da rúcula e alface produzidas na fazenda orgânica investigada. Palavras-chave: fertilização; agricultura orgânica; qualidade sanitária; contaminação.

Unilateral spatial neglect in the acute phase of ischemic stroke can predict long-term disability and functional capacity

OBJECTIVE: The aim of this study was to assess the relationship between the degree of unilateral spatial neglect during the acute phase of stroke and long-term functional independence. METHODS: This was a prospective study of right ischemic stroke patients in which the independent variable was the degree of spatial neglect and the outcome that was measured was functional independence. The potential confounding factors included sex, age, stroke severity, topography of the lesion, risk factors, glycemia and the treatment received. Unilateral spatial neglect was measured using the line cancellation test, the star cancellation test and the line bisection test within 48 hours of the onset of symptoms. Functional independence was measured using the modified Rankin and Barthel scales at 90 days after discharge. The relationship between unilateral spatial neglect and functional independence was analyzed using multiple logistic regression that was corrected for confounding factors. RESULTS: We studied 60 patients with a median age of 68 (34-89) years, 52% of whom were male and 74% of whom were Caucasian. The risk for moderate to severe disability increased with increasing star cancellation test scores (OR=1.14 [1.03-1.26], p=0.01) corrected for the stroke severity, which was a confounding factor that had a statistically positive association with disability (OR=1.63 [1.13-2.65], p=0.01). The best chance of functional independence decreased with increasing star cancellation test scores (OR=0.86 [0.78-0.96], p=0.006) corrected for the stroke severity, which was a confounding factor that had a statistically negative association with independence (OR=0.66 [0.48-0.92], p=0.017). CONCLUSION: The severity of unilateral spatial neglect in acute stroke worsens the degree of long-term disability and functional independence

Comportamento de bactérias deteriorantes e Salmonella enterica subespécie entérica O:4,5 em carne bovina embalada a vácuo durante refrigeração

In this study, the kinetic parameters of mesophilic, psychrotrophic and lactic acid bacteria in vacuum-packed beef at 1 °C and 4 °C were estimated from experimental growth curves produced by samples stored during 21 and 60 days, respectively. In a separate experiment, the survival of multidrug resistant (MDR) Salmonella enterica O:4,5 at 1°C was also characterized. The shelf-life of vacuum-packed beef stored at 4 °C was estimated at 16.1 days (95% CI: 14.8 – 17.3 days), whereas at 1 °C it was longer than 21 days because the mesophiles count estimated towards the end of the experiment was 12.5 ln CFU.g-1 (95% CI: 11.8 – 13.3 ln CFU.g-1) which is lower than the shelf-life reference value. At 1 °C, inoculated Salmonella was reduced in 6.61 ln CFU.g-1 (2.87 log CFU.g-1). These results demonstrated the importance of establishing in legislation, especially in Brazil, standard values of deteriorating microorganisms in beef for maintaining product quality.Neste estudo, os parâmetros cinéticos de bactérias mesófilas, psicrotróficas e ácido lácticas foram estimados em carne bovina embalada a vácuo a 1 °C e 4 °C, a partir de curvas experimentais produzidas em amostras estocadas durante 21 e 60 dias, respectivamente. Em um experimento separado, a sobrevivência de Salmonella enterica O:4,5 multirresistente (MDR) a 1°C também foi caracterizada. A vida de prateleira da carne bovina embalada a vácuo, estocada a 4°C, foi estimada em 16.1 dias (95% CI: 14.8 – 17.3 dias), enquanto que a 1 °C o período foi maior que 21 dias, porque a contagem estimada de mesófilos ao final do experimento foi de 12.5 ln UFC.g-1 (95% CI: 11.8 – 13.3 ln UFC.g-1), o qual é mais baixo que o valor referência de shelf-life. A 1 °C, Salmonella inoculada reduziu em 6.61 ln UFC.g-1 (2.87 log UFC.g-1). Estes resultados demonstram a importância de estabelecimento em legislação, especialmente no Brasil, de valores padrões para contagem de microrganismos deteriorantes em carnes visando manter a qualidade do produto.The authors thank the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil, for supporting the first author with a scholarship from the International Sandwich Exchange Program (PDSE) approved at the Call 047/2017/Process: 88881.189927/2018- 01. We also thank the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil (Process: 310462 / 2018-5), and the Instituto Federal de Educação, Ciência e Tecnologia de Mato Grosso (IFMT) for their support. Our gratitude also to the “Ad hoc” evaluators who reviewed our work and contributed to its improvement.info:eu-repo/semantics/publishedVersio

Evidence of Aquaporin 4 Regulation by Thyroid Hormone During Mouse Brain Development and in Cultured Human Glioblastoma Multiforme Cells

Accumulating evidence indicates that thyroid function and the thyroid hormones L-thyroxine (T4) and L-triiodothyronine (T3) are important factors contributing to the improvement of various pathologies of the central nervous system, including stroke, and various types of cancer, including glioblastoma multiforme (GBM). Low levels of T3 are correlated with the poorest outcome of post-stroke brain function, as well as an increased migration and proliferation of GBM tumor cells. Thyroid hormones are known to stimulate maturation and brain development. Aquaporin 4 (AQP4) is a key factor mediating the cell swelling and edema that occurs during ischemic stroke, and plays a potential role in the migration and proliferation of GBM tumor cells. In this study, as a possible therapeutic target for GBM, we investigated the potential role of T3 in the expression of AQP4 during different stages of mouse brain development. Pregnant mice at gestational day 18, or young animals at postnatal days 27 and 57, received injection of T3 (1 μg/g) or NaOH (0.02 N vehicle). The brains of mice sacrificed on postnatal days 0, 30, and 60 were perfused with 4% paraformaldehyde and sections were prepared for immunohistochemistry of AQP4. AQP4 immunofluorescence was measured in the mouse brains and human GBM cell lines. We found that distribution of AQP4 was localized in astrocytes of the periventricular, subpial, and cerebral parenchyma. Newborn mice treated with T3 showed a significant decrease in AQP4 immunoreactivity followed by an increased expression at P30 and a subsequent stabilization of aquaporin levels in adulthood. All GBM cell lines examined exhibited significantly lower AQP4 expression than cultured astrocytes. T3 treatment significantly downregulated AQP4 in GBM-95 cells but did not influence the rate of GBM cell migration measured 24 h after treatment initiation. Collectively, our results showed that AQP4 expression is developmentally regulated by T3 in astrocytes of the cerebral cortex of newborn and young mice, and is discretely downregulated in GBM cells. These findings indicate that higher concentrations of T3 thyroid hormone would be more suitable for reducing AQP4 in GBM tumorigenic cells, thereby resulting in better outcomes regarding the reduction of brain tumor cell migration and proliferation

Estrógeno exógeno no início do ciclo estral de vacas leiteiras na indução do estro e na dinâmica ovariana

O objetivo do presente trabalho foi verifi car o efeito do estrógeno exógeno, em fase precoce do ciclo estral, de vacas leiteiras, na indução do comportamento (sinais) de estro e na dinâmica ovariana. Foram utilizadas 16 vacas mestiças holandês-zebu ciclando regularmente, sem apresentar qualquer alteração clínica ou reprodutiva. As vacas foram incluídas ao acaso nos respectivos tratamentos. Tratamento 1: oito vacas receberam 2,5mL de cipionato de estradiol no 1º dia do ciclo estral, (considerando dia 0 o dia do estro). Tratamento 2 (controle): oito vacas sem tratamento. A manifestação de estro foi monitorada visualmente. Os exames ultrassonográfi cos foram realizados diariamente pela manhã, iniciando no dia do estro. As coletas de sangue para as dosagens de progesterona tiveram início no dia do estro (dia 0) e foram realizadas a cada três dias até o próximo estro. Os animais que receberam estrógeno no 1o dia após o estro natural manifestaram os sinais característicos de estro (psíquicos, útero túrgido e muco abundante) um dia após o tratamento. Esta redução do intervalo de estro para apenas dois dias pode favorecer a eliminação de bactérias do útero (quando presentes), aumentando, consequentemente, a eficiência reprodutiva. Excetuando o dia da emergência da 1a onda folicular, todas as outras variáveis estudadas (número e comprimento de ondas, características dos folículos dominantes e subordinados, assim como os parâmetros relacionados ao corpo lúteo e produção de progesterona) não foram afetadas pela aplicação de estrógeno um dia após o estro. A aplicação de cipionato de estradiol em vacas mestiças, um dia após o estro natural promove o aparecimento de sinais deestro (psíquicos, útero túrgido e muco abundante) dois dias após o estro natural, sem afetar as características do ciclo estral subsequente