Chronic administration of methionine and/or methionine sulfoxide alters oxidative stress parameters and ALA-D activity in liver and kidney of young rats.

High levels of methionine (Met) and methionine sulfoxide (MetO) are found in several genetic abnormalities. Oxidative stress is involved in the pathophysiology of many inborn errors of metabolism. However, little is known about the role of oxidative damage in hepatic and renal changes in hypermethioninemia. We investigated the effect of chronic treatment with Met and/or MetO on oxidative stress parameters in liver and kidney, as lipid peroxidation (TBARS), total sulfhydryl content (SH), reactive oxygen species (ROS) and enzymes activities superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and delta aminolevulinic dehydratase (ALA-D). Serum biochemical parameters were evaluated. Wistar rats were treated daily with two subcutaneous injections of saline (control), Met (0.2-0.4 g/kg), MetO (0.05-0.1 g/kg) and the association between these (Met plus MetO) from the 6th to the 28th day of life. Our data demonstrated an increase of glucose and urea levels in all experimental groups. Cholesterol (MetO and Met plus MetO) were decreased and triglycerides (MetO) were increased. SOD (MetO and Met plus MetO) and CAT (Met, MetO and Met plus MetO) activities were decreased, while GPx was enhanced by MetO and Met plus MetO treatment in liver. In kidney, we observed a reduction of SH levels, SOD and CAT activities and an increase of TBARS levels in all experimental groups. ROS levels in kidney were increased in MetO and Met plus MetO groups. ALA-D activity was enhanced in liver (MetO and Met plus MetO) and kidney (Met plus MetO). These findings help to understand the pathophysiology of hepatic and renal alterations present in hypermethioninemia.

Cholinergic and purinergic systems: A key to multiple sclerosis?

Multiple sclerosis (MS) commonly affects young adults and leads to a decreased quality of life due to different signs and symptoms that induce physical, cognitive, social, and psychological challenges. This disease, an autoimmune neurological disorder, is characterized by chronic inflammatory demyelination and axonal degeneration of the central nervous system (CNS). To date, its etiology is unknown. A large number of physiological functions are regulated by the cholinergic system because the acetylcholine (ACh) is released from cholinergic neurons and acts on other neurons, most of them not cholinergic in the brain, as well as in various nonneuronal cells, such as those of the immune system and blood; thus, it is considered an important modulatory pathway of both the central and peripheral nervous systems. Furthermore, the purinergic system has a significant role in neurotransmission as well as immune and inflammatory responses. Accumulating evidence has suggested the presence of a strong association between these systems and MS. Therefore, this review aims to present and discuss the main mechanisms that potentially explain the influence of the cholinergic and purinergic systems in multiple sclerosis. These mechanisms are discussed in light of available scientific evidence in humans and animal experimental models of MS. We hope that this review provides a better understanding of this subject, helping to guide future research and potential novel therapeutic strategies for patients with MS.

Evaluation of Delta-Aminolevulinic Dehydratase Activity, Oxidative Stress Biomarkers, and Vitamin D Levels in Patients with Multiple Sclerosis.

Multiple sclerosis (MS) is an autoimmune neurological disorder of unknown etiology. Oxidative stress and alterations in vitamin D levels have been implicated in the pathophysiology of MS. The aim of this study was to investigate δ-aminolevulinate dehydratase (δ-ALA-D) activity as well as the levels of vitamin D, lipid peroxidation levels, carbonyl protein content, DNA damage, superoxide dismutase (SOD) and catalase (CAT) activities, and the vitamin C, vitamin E, and non-protein thiol (NPSH) content in samples from patients with the relapsing-remitting form of MS (RRMS). The study population consisted of 29 RRMS patients and 29 healthy subjects. Twelve milliliters of blood was obtained from each individual and used for biochemical determinations. The results showed that δ-ALA-D and CAT activities were significantly increased, while SOD activity was decreased in the whole blood of RRMS patients compared to the control group (P < 0.05). In addition, we observed a significant increase in lipid peroxidation, carbonyl protein levels in serum and damaged DNA in leucocytes in RRMS patients compared with the control group (P < 0.05). Nonetheless, the levels of vitamin C, vitamin E, NPSH, and vitamin D were significantly decreased in RRMS patients in relation to the healthy individuals (P < 0.05). In conclusion, our results suggested that the increase in δ-ALA-D activity may be related to the inflammatory and immune process in MS in an attempt to maintain the cellular metabolism and reduce oxidative stress. Moreover, the alterations in the oxidant/antioxidant balance and lower vitamin D levels may contribute to the pathophysiology of MS.

Assessment of patients with multiple sclerosis according to tests of the Multiple Sclerosis Functional Composite / Avaliação de pacientes com esclerose múltipla segundo testes da Multiple Sclerosis Functional Composite

Abstract Introduction: The Multiple Sclerosis Functional Composite (MSFC) is a scale that evaluates the functional and cognitive aspects of patients with multiple sclerosis (MS). Objective: To compare the performance of individuals with the relapsing-remitting form of MS (RRMS) with a group of healthy subjects using the MSFC. Methods: Twenty subjects were investigated in this study, consisting of 10 patients with clinical diagnosis of RRMS and 10 controls with similar gender and age to the group with the disease. The three tests that comprise the MSFC were used for the evaluation of gait, upper limb motor function and cognition (memory and processing speed). Student's t-test was used to assess data with normal distribution and data with skewed distribution were evaluated using the Mann-Whitney test. Results: The results showed that the patients with RRMS took longer to perform the locomotion test (6.91 ± 2.35) compared to the control group (5.16 ± 1.28). The MS group (22.06 ± 5.44) also showed greater difficulty in performing a task with the dominant upper limb compared to the healthy subjects (17.79 ± 2.96). No statistically significant difference was found between the groups in the performance of cognitive tasks (p = .65). Conclusion: The use of the MSFC tests proved valuable for measuring possible motor and cognitive impairments in patients with RRMS. Thus, it is suggested that this scale is adopted in clinical practice, improving therapies for the treatment of MS patients and thereby providing them a better quality of life.

Resumo Introdução: A Multiple Sclerosis Functional Composite (MSFC) é uma escala que avalia aspectos funcionais e cognitivos em pacientes com esclerose múltipla (EM). Objetivo: Comparar o desempenho de indivíduos com a forma surto-remissão de EM (SREM) com um grupo de sujeitos saudáveis utilizando a MSFC. Métodos: Vinte sujeitos foram investigados no presente estudo, desses 10 eram pacientes com diagnóstico clínico SREM e 10 controles com sexo e idade semelhantes ao grupo com a doença. Foram utilizados os três testes que compõem a MSFC para avaliação da marcha, função motora de membros superiores e cognição (memória e velocidade de processamento). Para aferir os dados com distribuição normal utilizou-se o teste t de Student e os dados com distribuição assimétrica foram avaliados pelo Teste de Mann-Whitney. Resultados: Os pacientes com SREM apresentaram um tempo maior para realizar o teste de locomoção (6,91 ± 2,35) quando comparado ao grupo controle (5,16 ± 1,28). Além disso, o grupo com EM (22,06 ± 5,44) também demonstrou maior dificuldade em realizar uma tarefa com o membro superior dominante em relação aos indivíduos saudáveis (17,79 ± 2,96). Entretanto, não foi encontrada diferença estatisticamente significativa entre os grupos na execução das atividades cognitivas (P = 0,65). Conclusão: A aplicação dos testes da MSFC mostrou-se de grande valia para mensurar possíveis comprometimentos motores e cognitivos de pacientes com SREM. Assim, sugere-se que esta escala seja adotada na prática clínica, aprimorando terapias de tratamento dos portadores de EM e desse modo, proporcionando-lhes uma melhor qualidade de vida.

Efeitos agudos da eletroestimulação no membro superior espástico e associação com variáveis respiratórias / Acute effects of electrostimulation on upper limb spasticity and association with respiratory variables

Introdução: Eletroestimulação funcional (EEF) é um recurso valioso no tratamento de padrões espásticos. Objetivos: Avaliar o efeito agudo da EEF sobre variáveis físico-funcionais do membro superior espástico e a associação destas com variáveis respiratórias. Métodos: Dezenove pacientes receberam intervenção placebo (no limiar sensitivo) e EEF (f=30 Hz, largura de pulso= 0,3 ms, 30 min) no membro espástico (secundário a AVE) em dias diferentes. Antes das intervenções, foram avaliadas as atividades de vida diária pelo Índice de Barthel (IB), função pulmonar e força muscular respiratória. Antes e após as intervenções foram avaliadas função sensório-motora pela Escala de Fugl-Meyer (EFM) e amplitude de movimento. Resultados: A EEF aumentou a abdução e rotação interna de ombro, extensão de cotovelo e EFM. A pressão expiratória máxima se correlacionou com IB e flexão de ombro. Conclusões: A aplicação de EEF melhorou variáveis físico-funcionais do membro espástico, que estiveram associadas com a força muscular expiratória.

Introduction: Functional electrical stimulation (FES) is a valuable resource in the treatment of spastic patterns. Objectives: Evaluate the acute effect of FES on physical and functional variables of the spastic upper limb and its association with respiratory variables. Methods: Nineteen patients received placebo intervention (on the sensory threshold) and FES (f=30 Hz, pulse width=0.3 ms, 30 min) in the spastic limb (secondary to stroke) on different days. Before the interventions, activities of daily living by the Barthel Index (BI), pulmonary function and respiratory muscle strength were evaluated. Before and after the interventions, sensory motor function by Fugl-Meyer Scale (FMS) and movement amplitude were evaluated. Results: FES increased shoulder abduction and internal rotation, elbow extension and FMS. The maximum expiratory pressure was related to BI and shoulder flexion. Conclusions: The application of FES improved physical and functional variables of the spastic limb, which were associated with expiratory muscle strength.

Efeito da terapia por radiofrequência monopolar sobre a dor e capacidade funcional de mulheres com fibromialgia / Effect of monopolar radiofrequency on pain and functional capacity of women with fibromyalgia

Introdução: O tratamento através da eletroterapia está cada vezmais utilizado como um recurso terapêutico para redução de quadrosálgicos na Fisioterapia. No entanto, são escassos os estudos analisandoos efeitos da radiofrequência de modo contínuo não ablativo empacientes com fibromialgia. Objetivo: Este estudo objetivou avaliaros efeitos da terapia por radiofrequência monopolar (RFM) na dore no cotidiano de mulheres com fibromialgia. Método: Participaramdeste estudo mulheres com diagnóstico clínico de fibromialgia, queforam submetidas a 8 sessões de RFM. Os atendimentos ocorreram 2vezes por semana. Os resultados do tratamento foram avaliados pelaEscala Visual Analógica (EVA) e pelo Fibromyalgia Impact Questionary(FIQ). Para comparar os resultados pré e pós tratamentoutilizou-se o teste T Pareado do software Statistica 7.1. Resultados:Participaram deste estudo 9 mulheres com idade média de 53,25 (±8,48) anos. Verificou-se alívio da dor imediatamente após as sessõesde RFM (p < 0,01). Houve repercussão positiva do tratamento nocotidiano dessas pacientes, visto que ocorreu significativa reduçãodo escore do FIQ após as 8 sessões (p = 0,03). Conclusão: A partirdos resultados deste estudo, sugere-se que a terapia por RFM podeser mais um aliado do fisioterapeuta para o tratamento de pacientescom fibromialgia. Contudo, os resultados desta pesquisa devem seranalisados com cautela, pois não houve um grupo controle paragarantir que os resultados positivos deveram-se unicamente ao tratamentoe não a outros fatores desconsiderados pelos pesquisadores.

Introduction: The treatment by electrotherapy is increasinglyused as a therapeutic resource for reducing painful picture in PhysicalTherapy. However, there are few studies analyzing the effectsof continuous and non-ablative radiofrequency in patients with fibromyalgia.Objective: This study evaluated the effects of monopolarradiofrequency on pain and daily life of women with fibromyalgia.Methods: The study included women diagnosed with fibromyalgia,who underwent eight sessions of RFM monopolar radiofrequency.The sessions occurred twice a week. The treatment results wereevaluated by Visual Analogue Scale (VAS) and the FibromyalgiaImpact Questionnaire (FIQ). To compare the results before and aftertreatment, we used paired t-test from software Statistica 7.1. Results:The study included 9 women with mean age of 53.25 ± 8.48 years.Pain decreased immediately after the sessions of RFM (p < 0.01).There was positive impact in the daily treatment of these patients,with a significant reduction in the FIQ score after 8 sessions (p =0.03). Conclusion: The results suggest that RFM therapy can be aphysiotherapist help for the treatment of patients with fibromyalgia.However, this study should be analyzed with caution, becausethere was no control group to ensure that positive results were duesolely to the treatment and not to other factors not considered bythe researchers.

Efeito da terapia por radiofrequência monopolar sobre a dor e capacidade funcional de mulheres com fibromialgia / Effect of monopolar radiofrequency on pain and functional capacity of women with fibromyalgia

Introdução: O tratamento através de eletroterapia é um recurso fisioterapêutico cada vez mais utilizado para a redução de quadros álgicos. No entanto, são escassos os estudos analisando os efeito da radiofrequência de modo contínuo não ablativo em pacientes com fibromialgia. Objetivo: Este estudo objetivou avaliar os efeitosda terapia por radiofrequência monopolar (RFM) na dor e no cotidiano de mulheres com fibromialgia. Método: Participaram deste estudo mulheres com diagnóstico clínico de fibromialgia, que foram submetidas a 8 sessões de RFM. Os atendimentos ocorreram 2 vezes por semana. Os resultados do tratamento foram avaliados pela Escala Visual Analógica (EVA) e pelo Fibromyalgia Impact Questionary (FIQ). Para comparar os resultados pré e pós tratamento utilizou-se o teste T Pareado do software Statistica 7.1. Resultados: Participaram deste estudo 9 mulheres com idade média de 53,25 (± 8,48) anos.Verificou-se alívio da dor imediatamente após as sessões de RFM (p <0,01). Houve repercussão positiva do tratamento no cotidiano dessas pacientes, visto que ocorreu significativa redução do escore do FIQ após as 8 sessões (p = 0,03). Conclusão: A partir dos resultados deste estudo, sugere-se que a terapia por RFM pode ser mais um aliado do fisioterapeuta para o tratamento de pacientes com fibromialgia. Contudo, os resultados desta pesquisa devem ser analisados com cautela, pois não houve um grupo controle para garantir que os resultados positivos deveram-se unicamente ao tratamento e não a outros fatores desconsiderados pelos pesquisadores.

Introduction: The treatment by electrotherapy is increasingly used as a therapeutic resource for reducing painful picture in Physical Therapy. However, there are few studies analyzing the effects of continuous and non-ablative radiofrequency in patients with fibromyalgia. Objective: This study evaluated the effects of monopolar radiofrequency on pain and daily life of women with fibromyalgia. Methods: The study included women diagnosed with fibromyalgia, who underwent eight sessions of RFM monopolar radiofrequency. The sessions occurred twice a week. The treatment results were evaluated by Visual Analogue Scale (VAS) and the Fibromyalgia Impact Questionnaire (FIQ). To compare the results before and after treatment, we used paired t-test from software Statistica 7.1. Results: The study included 9 women with mean age of 53.25 ± 8.48 years. Pain decreased immediately after the sessions of RFM (p < 0.01).There was positive impact in the daily treatment of these patients, with a significant reduction in the FIQ score after 8 sessions (p =0.03). Conclusion: The results suggest that RFM therapy can be an physiotherapist’s help for the treatment of patients with fibromyalgia. However, this study should be analyzed with caution, because there was no control group to ensure that positive results were due solely to the treatment and not to other factors not considered by the researchers.