Quality of Life and low back pain in primary caregivers of children with cerebral palsy / Qualidade de vida e dor lombar em cuidadores primários de crianças com paralisia cerebral

The aim of this study was to evaluate the quality of life of primary caregivers of children with CP, correlating with the presence of low back pain and motor impairment level of the child. For this research to have been carried out there was the participation of 55 primary caregivers that completed the questionnaires of Roland & Morris (QRM) and WHOQOL-Bref. The evaluation of children's motor impairment was measured by Gross Motor function Classification System (GMFCS). The results show that primary caregivers of children with CP had a loss in their quality of life, especially in the environmental domain and facet pain and discomfort (30.45), negative feelings (34.09), and recreation and leisure (37.27). There were no significant correlations between motor impairment in children with CP, the quality of life of their primary caregivers, and the symptoms of low back pain. However, it was observed that the average symptoms of low back pain are lower in caregivers of children with minor motor impairment (p=0.488), and that there is a significant negative correlation (r=-0.508, p<0.001) between the symptoms of back pain and quality of life of caregivers.

O objetivo deste estudo foi avaliar a qualidade de vida dos cuidadores primários de crianças com PC, correlacionando-a com a presença de dor lombar e o nível de comprometimento motor da criança. Para a realização dessa pesquisa houve a participação de 55 cuidadores primários com o preenchimento dos questionários de Roland & Morris (QRM) e WHOQOL-Bref. A avaliação do comprometimento motor das crianças foi verificada pelo Gross Motor function Classification System (GMFCS). Os resultados demonstram que os cuidadores primários de crianças com PC apresentaram um prejuízo na qualidade de vida, especialmente no domínio ambiente e nas facetas: dor e desconforto (30,45), sentimentos negativos (34,09) e recreação e lazer (37,27). Não foram observadas correlações significativas entre o comprometimento motor de crianças com PC, a qualidade de vida de seus cuidadores primários e os sintomas de dor lombar. Entretanto, observou-se que a média de sintomas de dor lombar é menor em cuidadores de crianças com menor comprometimento motor (p=0,488) e uma correlação negativa significativa (r=-0,508; p<0,001) entre os sintomas de dor lombar e a qualidade de vida do cuidadores.

Relação entre o consumo de macronutrientes e a menarca em adolescentes / Relationship between consumption of macronutrients and the menarche in adolescents

OBJETIVO: Identificar a relação da ingestão de macronutrientes e a idade da menarca em jovens de Curitiba. METODOLOGIA: Foram avaliadas 400 meninas divididas em dois grupos de acordo com a ingesta de gordura saturada da alimentação. Mensurou-se a estatura e o peso corporal, calculou-se o IMC. A idade da menarca foi obtida por autorrelato. Para avaliar o consumo alimentar das jovens participantes, o questionário de frequência de consumo alimentar (QFCA) foi aplicado. Para análise dos dados foi utilizada a estatística descritiva, o teste t de student e regressão linear stepwise, com nível de significância de 0,05. RESULTADOS: Diferenças significativas não foram observadas para as variáveis de composição corporal, apenas para a idade da menarca sendo menor no grupo de meninas que ingeriam menos de 10% de ácidos graxos saturados (G2). Foi observada uma maior ingestão pelo grupo das meninas que ingerem mais de 10% de ácidos graxos saturados (G1) nas variáveis calorias consumidas, proteínas, gordura total, colesterol e AGSA. Na regressão linear para a idade da menarca, observou-se o consumo de ácido graxo saturado com valores r=0,232 e r²=0,05. CONCLUSÃO: Dos macronutrientes avaliados, os ácidos graxos saturados apresentaram correlação com a idade da menarca.

OBJECTIVE: Identify the relationship between macronutrient intake and age at menarche in young girls of Curitiba-PR. METHODOLOGY: A total of 400 girls divided into two groups according to the intake of saturated fat diet. Was measured height and weight, and after, calculated BMI. The age of menarche was obtained by self-report. To assess the nutritional intake of young participants, the questionnaire frequency of food consumption (FFQ) was applied. For data analysis we used descriptive statistics, Student's t test and stepwise linear regression with a significance level of 0.05. RESULTS: Significant differences were observed for body composition variables, only age at menarche was lower in the group of girls who consumed less than 10% of saturated fatty acids (G2). There was a higher intake of protein, total fat, cholesterol and AGSA by the group of girls who eat more than 10% of saturated fatty acids (G1). By linear regression analysis it was found that consumption of saturated fatty acids may influence age of menarche and r=0.232 and r²=0.05. CONCLUSION: Of the nutrients studied, the saturated fatty acids presented correlated with age at menarche.

Combretum leprosum Mart. (Combretaceae): potential as an antiproliferative and anti-inflammatory agent.

ETHNOPHARMACOLOGICAL RELEVANCE: Combretum leprosum is a species that is popularly used in Brazil as a healing agent to treat skin problems and lesions. In this study we investigated the possible potential of this extract to treat inflammatory and hyperproliferative skin conditions. MATERIALS AND METHODS: Classical models of skin inflammation such as TPA- and croton oil-induced mouse ear oedema were applied in order to verify the potential topical anti-inflammatory activity of the ethanolic extract from flowers of Combretum leprosum. RESULTS: Topical application of ethanolic extract promoted a dose-dependent inhibition of phorbol ester-induced ear oedema, reduced myeloperoxidase activity and IL-6 tissue levels with inhibition comparable to dexamethasone (positive control). Histological and immunohistochemical analysis revealed that ethanolic extract also suppressed cell infiltration. Ethanolic extract altered inflammatory parameters on a chronic skin inflammation model induced by repeated applications of croton oil, decreasing ear oedema, epidermal hyperproliferation and cell infiltration. In addition, immunohistochemical analysis showed that the extract decreased PCNA expression on the epidermis. CONCLUSION: Taken together, these results suggest that the extract from flowers of Combretum leprosum could be considered as a new potential tool for the treatment of several skin inflammatory diseases since it reversed the skin inflammatory and hyperproliferative process in a very significant manner. Further investigations are needed in order to verify the cellular mechanism and safety of Combretum leprosum extract.

B1 and B2 kinin receptor participation in hyperproliferative and inflammatory skin processes in mice.

BACKGROUND: Kinins are released during dermal injury and inflammation and seem to contribute to the pathogenesis of cutaneous diseases. OBJECTIVE: Participation of kinins in skin inflammatory process was evaluated using knockout mice and non-peptide kinin receptor antagonists. METHODS: Chronic skin inflammation was induced by multiple applications of TPA in mice ear. RESULTS: The B(2) knockout mice (B(2)(-/-)) showed a significant increase of ear weight (23 ± 10%) and epidermal cellular hyperproliferation and acanthosis formation upon histological analysis when compared with wildtype mice. Also, evaluation of PCNA levels by Western blot and immunohistochemistry confirmed the increase in the epidermis hyperproliferation in the ear skin of B(2)(-/-) mice. In contrast, no modification in these parameters was detected in B(1) knockout mice (B(1)(-/-)). However, mice lacking both kinin receptors (B(1)B(2)(-/-)) presented a considerable reduction of epidermis thickness and in PCNA levels. Following the establishment of skin inflammation (5th day of TPA application) treatment with the non-peptide antagonists SSR 240612 (B(1) receptor antagonist), FR 173657 (B(2) receptor antagonist), or SSR 240612 plus FR 173657 topically applied, caused a significant inhibition of ear weight (20 ± 5%, 34 ± 4% and 32 ± 6%, respectively). In the histological analysis, the antagonists produced a reduction in epidermal hyperplasia and acanthosis formation; but the treatment with a combination of the two antagonists did not increase efficacy. CONCLUSION: Kinin receptors seem to be involved in the control of the keratinocyte hyperproliferative process, and non-peptide kinin receptor antagonists may be useful tools in the treatment of hyperproliferative skin disorders.

Analysis of the Potential Topical Anti-Inflammatory Activity of Averrhoa carambola L. in Mice.

Inflammatory skin disorders, such as psoriasis and atopic dermatitis, are very common in the population; however, the treatments currently available are not well tolerated and are often ineffective. Averrhoa carambola L. (Oxalidaceae) is an Asian tree that has been used in traditional folk medicine in the treatment of several skin disorders. The present study evaluates the topical anti-inflammatory effects of the crude ethanolic extract of A. carambola leaves, its hexane, ethyl acetate, and butanol fractions and two isolated flavonoids on skin inflammation. Anti-inflammatory activity was measured using a croton oil-induced ear edema model of inflammation in mice. Topically applied ethanolic extract reduced edema in a dose-dependent manner, resulting in a maximum inhibition of 73 ± 3% and an ID(50) value of 0.05 (range: 0.02-0.13) mg/ear. Myeloperoxidase (MPO) activity was also inhibited by the extract, resulting in a maximum inhibition of 60 ± 6% (0.6 mg/ear). All of the fractions tested caused inhibition of edema formation and of MPO activity. Treatment with the ethyl acetate fraction was the most effective, resulting in inhibition levels of 75 ± 5 and 54 ± 8% for edema formation and MPO activity, respectively. However, treatment of mice with isolated compounds [apigenin-6-C-ß-l-fucopyranoside and apigenin-6-C-(2″-O-α-l-rhamnopyranosyl)-ß-l-fucopyranoside] did not yield successful results. Apigenin-6-C-(2″-O-α-l-rhamnopyranosyl)-ß-l-fucopyranoside caused only a mild reduction in edema formation (28 ± 11%). Taken together, these preliminary results support the popular use of A. carambola as an anti-inflammatory agent and open up new possibilities for its use in skin disorders.

Spinal antinociception evoked by the triterpene 3beta, 6beta, 16beta-trihydroxylup-20(29)-ene in mice: evidence for the involvement of the glutamatergic system via NMDA and metabotropic glutamate receptors.

The present study investigated the possible involvement of the glutamatergic and neurokinin systems in the antinociception caused by triterpene 3beta, 6beta, 16beta-trihydroxylup-20(29)-ene (TTHL) in mice. TTHL given by intraperitoneal (i.p., 2.1-65.5micromol/kg), intraplantar (i.pl., 6.5-65.5nmol/paw) or intrathecal (i.t., 21.8-655nmol/site) routes, produced dose-dependent inhibition of glutamate-induced nociception with ID(50) values of 12micromol/kg; 34.2nmol/paw; 233.8nmol/site and inhibitions of 78+/-6; 82+/-4 and 77+/-8%, respectively. I.t. injection of TTHL (6.5-218nmol/site, co-administered) also caused significant and dose-dependent reduction of nociceptive response induced by i.t. injection of glutamate (175nmol/site), with ID(50) value of 54.5nmol/site and inhibition of 51+/-6%. Moreover, TTHL (65.5nmol/site) co-injected by i.t. route with agonist caused marked reduction of nociceptive responses induced by N-methyl-d-aspartate (NMDA, 450pmol/site), (+/-)-1-aminocyclopentane-trans-1,3 dicarboxylic acid (trans-ACPD, 10nmol/site) and substance P (100pmol/site), with inhibitions of 81+/-7; 79+/-7; 81+/-11%, respectively. Conversely, TTHL had no effect on alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA, 135pmol/site) and kainic acid (kainate, 110pmol/site)-induced nociception. Moreover, the association of sub-effective doses of TTHL (6.5nmol/site, i.t.) and MK-801(1nmol/site, i.t.; non-competitive NMDA antagonist) or (RS)-MCPG (30nmol/site, i.t.; non-selective group I/group II metabotropic glutamate receptor antagonist) produced a synergic antinociceptive effect in the nociception induced by NMDA or trans-ACPD, respectively. Together, these results provide experimental evidence for the involvement of the glutamatergic system (NMDA and metabotropic glutamate receptors) in the antinociceptive action caused by TTHL in mice.

The non-peptide kinin receptor antagonists FR 173657 and SSR 240612: preclinical evidence for the treatment of skin inflammation.

Peptide and non-peptide kinin receptor antagonists were evaluated in cutaneous inflammation models in mice. Topical and i.p. application of kinin B(1) and B(2) receptor antagonists caused a significant inhibition of the capsaicin-induced cutaneous neurogenic inflammatory response. The calculated mean ID(50) for Hoe140 and SSR240612 were 23.83 (9.14-62.14) nmol/kg and 0.23 (0.15-0.36) mg/ear, respectively. The I(max) observed for Hoe140, SSR240612, R-715, FR173657, and FR plus SSR were 61+/-5%, 56+/-3%, 65+/-10%, 48+/-8%, and 52+/-4%, respectively. Supporting these results, double B(1) and B(2) kinin receptors knockout mice showed a significant inhibition of capsaicin-induced ear oedema (42+/-7%). However, mice with a single deletion of either B(1) or B(2) receptors exhibited no change in their capsaicin responses. In contrast, all of the examined kinin receptor antagonists were unable to inhibit the oedema induced by TPA and the results from knockout mice confirmed the lack of kinin receptor signaling in this model. These findings show that kinin receptors are present in the skin and that both kinin receptors seem to be important in the neurogenic inflammatory response. Moreover, non-peptide antagonists were very effective in reducing skin inflammation when topically applied, thereby suggesting that they could be useful tools in the treatment of some skin inflammatory diseases.

Topical anti-inflammatory activity of Serjania erecta Radlk (Sapindaceae) extracts.

Serjania erecta Radlk (Sapindaceae), commonly called cinco-folhas or cipó-cinco-folhas in Brazil, is thought to be effective for treating several inflammatory diseases. In order to verify the topical anti-inflammatory effect of Serjania erecta, hydroalcoholic extract and fractions were obtained by extraction in solvents of increasing polarity and were tested in mouse models using croton-oil-induced inflammation. Our findings showed that topical application of Serjania erecta hydroalcoholic extract (0.01-3.0 mg/ear), and the dichloromethane (0.03-1.0 mg/ear), ethyl acetate (0.03-1.0 mg/ear), and hexane (0.003-1.0 mg/ear) fractions revealed significant activity, causing a dose-dependent reduction of croton-oil ear edema (ID(50)=0.14 mg/ear, 0.23 mg/ear, 0.14 mg/ear, 0.04 mg/ear, respectively). The extract and all tested fractions also decreased tissue myeloperoxidase activity (indicative of polymorphonuclear leukocytes influx) in mouse-ears treated with croton oil with a maximum inhibition of 72% at 3.0 mg/ear for the hydroalcoholic extract and 81%, 78%, and 83% at 1.0mg/ear for dichloromethane, ethyl acetate and hexane fractions, respectively. As expected, dexamethasone (0.05 mg/ear) was effective in inhibiting both edema and myeloperoxidase activity (99% and 82%, respectively). In conclusion, our results indicate a topical anti-inflammatory effect for the species of Serjania studied.

Topical anti-inflammatory activity of Eugenia brasiliensis Lam. (Myrtaceae) leaves.

Eugenia brasiliensis Lam., a plant from the south of Brazil, is used in the popular medicine for rheumatism treatment. This study reports that topical application of hydroalcoholic extract, fractions and isolated compounds from E. brasiliensis caused an inhibition of ear oedema in response to topical application of croton oil on the mouse ear. For oedema inhibition, the estimated ID50 values (dose reducing the inflammatory response by 50% relative to the control value) for hydroalcoholic extract and fractions (hexane, ethyl acetate and dichloromethane) were 0.17, 0.29, 0.13 and 0.14 mg/ear, respectively, with inhibition of 79+/-7%, 87+/-6%, 88+/-5% and 96+/-2%, respectively. Isolated phenolic compounds (quercetin, catechin and gallocatechin) were also effective in inhibiting the oedema (inhibition of 61+/-5%, 66+/-2% and 37+/-9%, respectively). Moreover, both extract and isolated compounds caused inhibition of polymorphonuclear cells influx (inhibition of 85+/-6%, 81+/-5%, 73+/-6% and 76+/-6%, respectively). The histological analysis of the ear tissue clearly confirmed that the extract and compounds of E. brasiliensis inhibited the influx of polymorphonuclear cells to mouse ear skin after application of croton oil. Furthermore, hydroalcoholic extract was also effective in inhibiting the arachidonic acid-mediated mouse ear oedema (ID50 value was 1.94 mg/ear and inhibition of 60+/-7%). Therefore, these results consistently support the notion that E. brasiliensis possesses topical anti-inflammatory activity.