Motor prognosis and current perspectives in cerebral palsy

A paralisia cerebral é uma sequela de agressão encefálica caracterizada por transtorno motor não evolutivo quanto à sua lesão. De acordo com o local da lesão pode provocar diferentes seqüelas que resultam em incapacidade funcional. OBJETIVO: revisar de forma não sistemática sobre o tema paralisia cerebral, enfocando o seu prognóstico motor, incluindo expectativa de vida e funcionalidade. MÉTODO: utilização das bases de dados Medline e LILACS, dos últimos quinze anos, com os unitermos paralisia cerebral, quadriplegia, diplegia, hemiplegia, prognóstico. RESULTADOS: foram listados 474 artigos científicos, sendo selecionados para esta revisão 34 artigos com base em: título, resumo, assunto, originalidade e disponibilidade de acesso pelo portal da CAPES. Foram identificadas as variáveis que podem influenciar o prognóstico motor nas crianças com paralisia cerebral. O prejuízo motor das crianças com paralisia cerebral está diretamente relacionado com o nível de gravidade da paralisia cerebral, assistência terapêutica e o tipo apresentado pelas crianças. Os pacientes com hemiplegia resultante de paralisia cerebral apresentam um prognóstico motor mais favorável comparado aos diplégicos e quadriplégicos.Cerebral palsy it is a consequence characterized by non-progressive motor disturbance referring to his lesion. According to the lesion area, can promote different outcomes that result in functional disabilities. OBJECTIVE: to review by non-systematic way the theme cerebral palsy focusing motor prognosis, including life expectancy and functionality. METHODS: using the Medline and LILACS, data bases searching for the last fifteen years with the terms cerebral palsy, quadriplegia, diplegia, hemiplegia, prognosis. RESULTS: a total of 474 scientific papers were listed and 34 select based on: title, abstract, subject, original article and access through CAPES homepage. Were identified variables that could affect motor prognosis in children with cerebral palsy. The motor impairment from children is directly related to cerebral palsy severity level, therapeutic assistance and cerebral palsy type presented in children. The patients with hemiplegic cerebral palsy showed most favorable motor outcomes compared to diplegic and quadriplegic ones

Intracavitary electrical stimulation as treatment for overactive bladder: systematic review

Introduction: Overactive bladder (OAB) is a clinical diagnosis of irritating urinary symptoms that influence on sufferers´ life quality. There are effective treatments described in literature, but most of them present adverse effects. One way of treatment is the use of electrical stimulation, which has been widely used, but studies show varying results. Objective: To verify if intracavitary electrical stimulation can be effective in patients with OAB. Methods: online databases were searched with specific descriptors to find randomized clinical trials on overactive bladder treated with intracavitary electrical stimulation. Only articles with score equal or higher than 5 in methodological PEDro scale were used and those that described intra and / or inter-group P-value. Results: 217 articles were found, but only 6 were analyzed by the selection criteria. The studies show that electrical stimulation promotes the reduction of urinary frequency, urinary incontinence, nocturia, urgency and the number of protectors used, and improvements in maximum cystometric bladder capacity, symptoms of OAB and quality of life. Conclusion: Electrical stimulation was effective in patients with OAB and can be used before any invasive treatment due to none side effects

Intracavitary electrical stimulation as treatment for overactive bladder: systematic review

Abstract Introduction: Overactive bladder (OAB) is a clinical diagnosis of irritating urinary symptoms that influence on sufferers' life quality. There are effective treatments described in literature, but most of them present adverse effects. One way of treatment is the use of electrical stimulation, which has been widely used, but studies show varying results. Objective: To verify if intracavitary electrical stimulation can be effective in patients with OAB. Methods: online databases were searched with specific descriptors to find randomized clinical trials on overactive bladder treated with intracavitary electrical stimulation. Only articles with score equal or higher than 5 in methodological PEDro scale were used and those that described intra and / or inter-group P-value. Results: 217 articles were found, but only 6 were analyzed by the selection criteria. The studies show that electrical stimulation promotes the reduction of urinary frequency, urinary incontinence, nocturia, urgency and the number of protectors used, and improvements in maximum cystometric bladder capacity, symptoms of OAB and quality of life. Conclusion: Electrical stimulation was effective in patients with OAB and can be used before any invasive treatment due to none side effects

Human Dental Pulp Cells: A New Source of Cell Therapy in a Mouse Model of Compressive Spinal Cord Injury

Strategies aimed at improving spinal cord regeneration after trauma are still challenging neurologists and neuroscientists throughout the world. Many cell-based therapies have been tested, with limited success in terms of functional outcome. In this study, we investigated the effects of human dental pulp cells (HDPCs) in a mouse model of compressive spinal cord injury (SCI). These cells present some advantages, such as the ease of the extraction process, and expression of trophic factors and embryonic markers from both ecto-mesenchymal and mesenchymal components. Young adult female C57/BL6 mice were subjected to laminectomy at T9 and compression of the spinal cord with a vascular clip for 1 min. The cells were transplanted 7 days or 28 days after the lesion, in order to compare the recovery when treatment is applied in a subacute or chronic phase. We performed quantitative analyses of white-matter preservation, trophic-factor expression and quantification, and ultrastructural and functional analysis. Our results for the HDPC-transplanted animals showed better white-matter preservation than the DMEM groups, higher levels of trophic-factor expression in the tissue, better tissue organization, and the presence of many axons being myelinated by either Schwann cells or oligodendrocytes, in addition to the presence of some healthy-appearing intact neurons with synapse contacts on their cell bodies. We also demonstrated that HDPCs were able to express some glial markers such as GFAP and S-100. The functional analysis also showed locomotor improvement in these animals. Based on these findings, we propose that HDPCs may be feasible candidates for therapeutic intervention after SCI and central nervous system disorders in humans