Effects of amino acid supplementation on muscle mass, muscle performance and functional capacity in subjects undergoing total knee arthroplasty: a systematic review of randomized clinical trials.

The aim of the present study was to summarize the effectiveness of amino acid supplementation on muscle strength, muscle volume, and functional capacity in patients undergoing total knee arthroplasty. For this, in November 2022, a search was carried out in the PubMed, Cochrane Library, and EMBASE databases, identifying a total of 2182 documents, of which only 4 were included in the present review. The included studies had 148 participants (47 men and 101 women), with a minimum age of 53 and a maximum of 92 years, and supplementation times of 13 to 30 days (1 to 3 times a day). For the results, in relation to muscle performance, when comparing the control and experimental groups, greater muscle atrophy was observed in the pre- and post-moments of the control group, in relation to the experimental group. In addition, studies suggest a good tendency for muscle mass gain, and improvement in the functional capacities of patients who used supplementation. Therefore, the use of amino acids after TKA surgery reduces muscle atrophy, which preserves muscle mass and leads to better performance in tests of strength and functional capacity, when compared to the use of a placebo.

Associação entre saúde bucal, variáveis sociais, culturais e de acesso em indivíduos de uma população quilombola / Association between oral health, social, cultural and access variables in individuals from a quilombola population

Avaliar as condições de saúde bucal e sua relação com os aspectos socioculturais e de acesso a serviços odontológicos em quilombolas do Município de Cachoeira (BA). Realizou-se um estudo transversal, examinando 128 indiíduos. A análise estatística foi conduzida através da distribuição das frequências das variáveis demográficas e socioeconômicas. O cálculo de associação entre as variáveis e os desfechos foi obtido pelas Razões de Prevalências e respectivos intervalos de confiança. Constatou-se que há significância estatística (IC 95%) entre a doença periodontal e dieta cariogênica, plantas medicinais e bochecho com chá ou enxaguante bucal, assim como existiu associação entre a cárie dentária e a dificuldade de acesso a serviços odontológicos, odontalgia e o edentulismo. A maior prevalência dos agravos bucais investigados foi em indivíduos adultos e predominantemente em mulheres, sendo que a maior parte dos indivíduos possuía apenas o ensino fundamental e renda inferior a um salário-mínimo.

To evaluate oral health conditions and their relationship with sociocultural aspects and access to dental services in quilombolas in the municipality of Cachoeira, Bahia. A cross-sectional study was carried out, examining 128 individuals. Statistical analysis was conducted through the frequency distribution of demographic and socioeconomic variables. The calculation of the association between variables and outcomes was obtained using Prevalence Ratios and respective confidence intervals. It was found that there is statistical significance (CI 95%) between periodontal disease and cariogenic diet, medicinal plants and mouthwash with tea or mouthwash, as well as an association between dental caries and difficulty in accessing dental services, toothache and edentulism. The highest prevalence of oral diseases investigated was in adult individuals and predominantly in women, and most individuals had only elementary education and income below the minimum wage.

Effects of nutrients on immunomodulation in patients with severe COVID-19: Current knowledge.

Recent research has demonstrated that critically ill patients with coronavirus disease 2019 (COVID-19) show significant immune system dysregulation. Due to that, some nutrients that influence immunomodulation have been suggested as a form of treatment against the infection. This review collected the information on the impact of vitamins on the prognosis of COVID-19, with the intention of facilitating treatment and prevention of the disease risk status in patients. The collected information was obtained using the PubMed electronic database by searching for articles that relate COVID-19 and the mechanisms/effects of the nutrients: Proteins, glucose, lipids, vitamin B12, vitamin D, calcium, iron, copper, zinc, and magnesium, including prospective, retrospective, and support articles. The findings reveal an optimal response related mainly to omega-3, eicosapentaenoic acid, docosahexaenoic acid, calcium, and iron that might represent benefits in the treatment of critically ill patients. However, nutrient supplementation should be done with caution due to the limited availability of randomized controlled studies.

Non-pharmacological management of pediatric functional abdominal pain disorders: Current evidence and future perspectives.

Functional abdominal pain disorders (FAPDs) are an important and prevalent cause of functional gastrointestinal disorders among children, encompassing the diagnoses of functional dyspepsia, irritable bowel syndrome, abdominal migraine, and the one not previously present in Rome III, functional abdominal pain not otherwise specified. In the absence of sufficiently effective and safe pharmacological treatments for this public problem, non-pharmacological therapies emerge as a viable means of treating these patients, avoiding not only possible side effects, but also unnecessary prescription, since many of the pharmacological treatments prescribed do not have good efficacy when compared to placebo. Thus, the present study provides a review of current and relevant evidence on non-pharmacological management of FAPDs, covering the most commonly indicated treatments, from cognitive behavioral therapy to meditation, acupuncture, yoga, massage, spinal manipulation, moxibustion, and physical activities. In addition, this article also analyzes the quality of publications in the area, assessing whether it is possible to state if non-pharmacological therapies are viable, safe, and sufficiently well-based for an appropriate and effective prescription of these treatments. Finally, it is possible to observe an increase not only in the number of publications on the non-pharmacological treatments for FAPDs in recent years, but also an increase in the quality of these publications. Finally, the sample selection of satisfactory age groups in these studies enables the formulation of specific guidelines for this age group, thus avoiding the need for adaptation of prescriptions initially made for adults, but for children use.

Acute effect of core stability and sensory-motor exercises on postural control during sitting and standing positions in young adults.

Core stability exercises and exercises that stimulate sensory-motor information are recommended for the prevention of injuries and the maintenance and rehabilitation of deficits related to postural control (PC). However, the comparison of results between core stability and sensory-motor exercises in the literature is limited to sitting and standing positions. OBJECTIVE: To determine the acute effect of core stability and sensory-motor exercises on PC during sitting and standing in young adults. METHODS: A total of 39 participants, with a mean age of 23 years, were randomly divided into three groups (1) Core stability exercises; (2) Sensory-motor exercises; (3) Control. Each group performed a sequence of five specific exercises of core stability and sensory-motor exercises (except controls). PC was evaluated before and after exercise in the seated and the one-legged stance conditions using a force platform. RESULTS: No significant difference was found for any variables of postural oscillation (P > 0.05) among the three groups studied. The magnitude of the effect of interventions in general was a small to moderate effect (d = 0.02/-0.48). CONCLUSION: The findings show that acute intervention with core stability and sensory-motor exercises did not produce any significant effects (reduction of postural oscillation) on PC during sitting and standing positions in young adults.

Potential prescribing omissions according to START criteria at the time of hospital discharge

The purpose of this study is to describe the frequency of potential drug prescribing omissions (PPOs) for elderly patients at the time of hospital discharge and to compare the frequency PPOs among different medical specialities. This cross-sectional study examined data from elderly patients when they were admitted for >24 h to a northeastern Brazil teaching hospital during June-December 2016. Were included in the study 227 patients, of whom 36.9% had at least one PPO. The highest number of PPOs was identified among those with at least 5 prescribed drugs. In total, 153 PPOs were identified at hospital discharge. In most cases (78.4%), patients were not evaluated by the specialist physician.The most commonly identified PPOs on discharge were: the omission of statin therapy in cases of diabetes mellitus plus one or more cardiovascular-associated factor; calcium and vitamin D supplements in patients with known osteoporosis; and angiotensin converting enzyme inhibitors in cases of chronic heart failure. The results of this study suggest that the frequency of prescribing omissions PPOs during patient discharge was high. This can be avoided by the careful evaluation by prescribers with experience in certain specialties where several prescribed omissions would be common.

Avaliação do conhecimento dos cirurgiões-dentistas e do perfil da assistência bucal prestada na atenção primária à saúde das fissuras orofaciais / Evaluation of the knowledge of dental surgeons and the profile of oral care provided in the primary health care of orofacial fissures

Introdução: a fissura orofacial pode ser definida como uma falta de fusão de determinadas estruturas da face, durante o desenvolvimento embrionário, sendo descritas como um dos defeitos de nascimento mais comuns encontrados nas populações do mundo. Sua etiologia é multifatorial, envolvendo alterações genéticas e fatores ambientais de risco no primeiro trimestre da gestação. Objetivos: analisar o conhecimento dos cirurgiões-dentistas sobre as fissuras e o perfil da assistência bucal prestada na atenção primária em saúde para a ocorrência de fissuras orofaciais. Metodologia: estudo descritivo censitário, aplicado por meio de um questionário, que envolveu 70 cirurgiões-dentistas que atuam na atenção primária de uma cidade do interior da Bahia, Brasil, e investigou a experiência clínica e profissional, conhecimentos básicos sobre fissuras, experiência no atendimento aos portadores de necessidades especiais com ênfase nos portadores de fissuras e o perfil da assistência à saúde bucal prestada a esses indivíduos no município. Resultados: o estudo mostrou que 50% dos participantes (n=35) possuíam pós-graduação, que 81,5% (n=57) tem mais de 05 anos de formados e que 60% (n=42) tem pelo menos 10 anos de serviço público. Observou-se reduzido conhecimento específico sobre o tema e desinformação sobre a existência de centros multidisciplinares para atendimento especializado desse público no país e no estado. Conclusões: observou-se reduzido conhecimento sobre as FO entre os CD, principalmente no tocante a orientação quanto à prevenção e aos cuidados bucais necessários com o portador, além da desinformação quanto à existência de instituições multidisciplinares que prestam assistência especializada de média e alta complexidade. Dessa forma, sugere-se a necessidade de adequar o serviço de saúde para facilitar e garantir o acesso desses portadores ao atendimento integral, além de contribuir para a prevenção de novos casos.

Introduction: the orofacial fissure can be defined as a lack of fusion of certain structures of the face, during embryonic development, being described as one of the most common birth defects found in the populations of the world. Its etiology is multifactorial, involving genetic changes and environmental risk factors in the first trimester of pregnancy. Objectives: to analyze the knowledge of dentists about clefts and the profile of oral care provided in primary health care for the occurrence of orofacial clefts. Methodology: a descriptive census study, applied through a questionnaire, involving 70 dentists who work in primary care in a city in the interior of Bahia, Brazil, and investigated the clinical and professional experience, basic knowledge about cracks, experience in assisting people with special needs with an emphasis on patients with clefts and the profile of oral health care provided to these individuals in the municipality. Results: the study showed that 50% (n = 35) had postgraduate degrees, that 81.5% (n = 57) graduated and that 60% (n = 42) had at least 10 years of public service. There was little specific knowledge on the subject and lack of information on the existence of multidisciplinary centers for specialized care of this public in the country and in the state. Conclusions: it was observed that knowledge about FO was reduced among the DC, especially with regard to guidance on prevention and the necessary oral care for the patient, in addition to the lack of information regarding the existence of multidisciplinary institutions that provide specialized assistance of medium and high complexity. Thus, it is suggested the need to adapt the health service to facilitate and guarantee the access of these patients to comprehensive care, in addition to contributing to the prevention of new cases.

How many balance task trials are needed to accurately assess postural control measures in older women?

Taking the average of different trials is recommended for better balance assessment, but few studies have really proven this point under different balance conditions. OBJECTIVE: To assess the effects of averaging trials of five different balance tasks on postural control measures in older women. METHODS: A total of 90 older women (means: Age: 68 years; Weight: 67 kg; Height: 1.56 m; Body mass index, 27 kg/m2) participated in this study. The participants completed five balance tasks with three performance trials for each task on a force platform in random order. The participants completed a total of three 30-s trials of tasks with 30 s of rest between trials. Repeated measure ANOVA and coefficient of variation were computed to compare differences for one trial vs. averaging across two or three trials on center of pressure (COP) sway values. RESULTS: There were no significant differences (P > 0.05) in COP sway values when comparing one vs. the average of two or three trials for all balance tasks. However, the coefficient of variation was higher for three trials (10-40%) than two (6-37%) or one trial (3-23%) for COP parameters. CONCLUSIONS: Based on reduction of variability, the present study recommends the averaging of a minimum of two trials for balance assessment in older women. The results of the current study have implications for balance assessment in older people in fall prevention programs.

Anti-inflammatory activity of ß-caryophyllene combined with docosahexaenoic acid in a model of sepsis induced by Staphylococcus aureus in mice.

BACKGROUND: Sepsis is a set of serious organic manifestations caused by an infection, whose progression culminates in exacerbated inflammation and oxidative stress, poor prognosis, and high hospital costs. Antioxidants used against sepsis have been evaluated, including essential oils such as ß-caryophyllene (BCP), and polyunsaturated fatty acids, such as docosahexaenoic acid (DHA). The aim of this study was to evaluate the anti-inflammatory activity of the association of these two compounds. RESULTS: Treatment with BCP-DHA, at a dose of 200 µL/animal, significantly inhibited the migration of neutrophils in a Cg-induced peritonitis model. After Staphylococcus aureus infection, in the groups treated with BCP-DHA there was a significant decrease in the total and differential count of leukocytes, increased expression of cytokines TNF-α and IFN-γ in treated groups, an increase of IL-4 and IL-5 in B/D and B/D + SA groups, and an augmentation of IL-6 and IL-12 groups in B/D + SA groups. Histological and bacterial analysis revealed lower neutrophil migration and lower bacterial load in the infected and treated groups. CONCLUSION: In general, the BCP-DHA association presented anti-inflammatory activity against two different models of acute inflammation and infection, showing promising potential as a therapeutic adjuvant in sepsis. © 2019 Society of Chemical Industry.

Biochemical changes in injured sciatic nerve of rats after low-level laser therapy (660 nm and 808 nm) evaluated by Raman spectroscopy.

The aim of this study was to identify biochemical changes in sciatic nerve (SN) after crush injury and low-level laser therapy (LLLT) with 660 nm and 808 nm by Raman spectroscopy (RS) analysis. A number of 32 Wistar rats were used, divided into four groups (control 1, control 2, LASER 660 nm, and LASER 808 nm). All animals underwent surgical procedure of the SN and groups control 2, LASER 660 nm, and LASER 808 nm were submitted to SN crush damage (axonotmesis). The LLLT in the groups LASER 660 nm and LASER 808 nm was applied daily for 21 consecutive days (100 mW, 30 s, 133 J/cm2 fluence). The hind paw was removed and the SN was dissected and positioned on an aluminum support to collect dispersive Raman spectra (830 nm excitation, 30 s accumulation). To estimate the biochemical changes in the SN associated with LLLT, the principal component analysis (PCA) was applied. The Raman spectra of the sciatic nerve fragments showed peaks of the major biochemical components of the nerve, especially sphingolipids, phospholipids, glycoproteins, and collagen. The spectral features identified in some of the principal component loading vectors are referred to the biochemical elements present on the SN and were increased in the groups treated with LLLT, mainly lipids (sphingo and phospholipids) and proteins (collagen)-constituents of the myelin sheath. The RS was effective in identifying the biochemical differences in the SN after the crush injury, and LASER 660 nm was more efficient than the LASER 808 nm in cell proliferation and repair of the injured SN.

Antimicrobial Activity and Biocompatibility of the Psidium cattleianum Extracts for Endodontic Purposes

Abstract Psidium cattleianum (PC) has been displaying inhibitory effect against a variety of microorganisms, but this effect has not yet been tested against endodontic pathogens. The aim of this study was to evaluate the antimicrobial activity and biocompatibility of the aqueous (PCAE) and hydroethanolic (PCHE) extracts from Psidium cattleianum (PC) leaves. Minimum inhibitory concentration (MIC) and minimum lethal concentration (MLC) were determined using the microdilution broth method in order to analyze the antimicrobial effect against Enterococcus faecalis, Pseudomonas aeruginosa, Actinomyces israelii and Candida albicans in planktonic conditions. Biofilm assays were conducted only with the extracts that were able to determine the MLC for microorganisms in planktonic conditions. Immediate and late tissue reactions against PC extracts were evaluated using edemogenic test and histological analysis of subcutaneous implants in Wistar rats. The results showed that the MIC and MLC values ranged between 0.25 and 4 mg/mL. The MLC obtained for PCHE inhibited 100% growth of all the tested strains, except for C. albicans. PCAE had the same effect for E. faecalis and P. aeruginosa. Both PC extracts were able to eliminate E. faecalis biofilms and only the PCHE eliminated P. aeruginosa biofilms. The positive controls inhibited the growth of all tested strains in MIC and MLC essays, but no CHX tested concentrations were able to eliminate A. israelii biofilm. PCAE caused a discrete increase in the edema over time, while PCHE caused a higher initial edema, which decreased progressively. Both PCAE and PCHE extracts were biocompatible, but PCHE showed better results with slight levels of inflammation at 28 days. In conclusion, PCHE was biocompatible and presented better antimicrobial effect against important pathogens associated with persistent endodontic infections

Resumo Psidium cattleianum (PC) tem apresentado atividade inibitória frente diversos microrganismos, entretanto esse efeito ainda não foi testado contra microrganismos de interesse endodôntico. O objetivo desse estudo foi avaliar a atividade antimicrobiana e a biocompatibilidade dos extratos aquoso (EAPC) e hidroetanólico (EHPC) das folhas de Psidium cattleianum. As concentrações inibitória mínima (CIM) e letal mínima (CLM) foram determinadas pelo método de microdiluição em caldo, com o objetivo de analisar o efeito antimicrobiano frente Enterococcus faecalis, Pseudomonas aeruginosa, Actinomyces israelii e Candida albicans em condições planctônicas. Os ensaios de biofilme foram realizados somente com os extratos em que se determinou a CLM frente os microrganismos em condições planctônicas. Respostas teciduais imediata e tardia frente aos extratos de Psidium cattleianum foram avaliadas por teste edemogênico e análise histológica de implantes subcutâneos em ratos Wistar. Os resultados mostraram que CIM e CLM variaram entre 0,25 e 4 mg/mL. As CLMs determinadas pelo EHPC inibiram 100% do crescimento de todas as cepas testadas, exceto Candida albicans. EAPC apresentou o mesmo efeito para E. faecalis e P. aeruginosa. Ambos os extratos de PC conseguiram eliminar o biofilme de E. faecalis, e somente o EHPC eliminou o biofilme de P. aeruginosa. Os controles positivos inibiram o crescimento de todos os microrganismos testados nos ensaios de CIM e CLM, mas nenhuma das concentrações de clorexidina testadas foi capaz de eliminar o biofilme de A. israelii. O EAPC provocou um discreto aumento de edema com o tempo, enquanto EHPC provocou um edema inicial severo, que diminuiu progressivamente. Ambos os extratos EAPC e EHPC foram biocompatíveis, entretanto, EHPC apresentou melhores resultados com baixos níveis de inflamação em 28 dias. Pode-se concluir que EHPC foi biocompatível e apresentou melhor efeito antimicrobiano frente importantes patógenos associados a infecções endodônticas persistentes.

Effects of Holding an External Load on the Standing Balance of Older and Younger Adults With and Without Chronic Low Back Pain.

OBJECTIVE: The purpose of this study was to assess the effect of holding an external load on the standing balance of younger and older adults with and without chronic low back pain (CLBP). METHODS: Twenty participants with and 20 without CLBP participated in the study. Each group contained 10 younger (50% men) and 10 older adults (50% men). Participants were instructed to look straight ahead while standing on a force platform during two 120-second trials with and without holding an external load (10% of body mass). The center of pressure area, mean velocity, and mean frequency in the anteroposterior and mediolateral directions were measured. RESULTS: Older adults had worse standing balance than younger adults did (P < .001, d = 0.20). There were no significant balance differences between participants with and without CLBP within age groups during standing balance condition. However, holding the external load significantly increased postural instability for both age groups and CLBP status, with mean effect size across center of pressure variables of d = 0.82 for older participants without CLBP and d = 2.65 for younger participants without CLBP. These effects for people with CLBP were d = 1.65 for subgroup of older and d = 1.60 for subgroup of younger participants. CONCLUSION: Holding an external load of 10% of body mass increased postural instability of both younger and older adults with and without CLBP.

Anti-Inflammatory Activity of the Essential Oil Citral in Experimental Infection with Staphylococcus aureus in a Model Air Pouch.

This study proposes to implement an alternative and effective strategy for local treatment of disease provoked by S. aureus. For the analysis of possible anti-inflammatory activity of essential oil, after establishing an air pouch model, 48 male mice of Balb/c were treated, infected, and euthanized at 4 and 8 h. Thus, the total and differential white blood cells were counted in the animal's blood, and cytokines IL-1ß, IL-6, and TNF-α were titrated using ELISA in the air pouch lavage. Moreover, TNF-α, IL-1ß, and IL-6 gene expression was analyzed through an RT-qPCR array, and S. aureus was quantified using qPCR. Our results, p < 0.05, showed that EOC reduced the quantity of microorganisms. The group of mice treated with essential oil citral showed a significant decrease in TNF-α levels in tests demonstrating anti-inflammatory activity. There is no data about the mutual influence of the air pouch model, essential oil citral, and S. aureus. Thus, considering the interaction of these variables and the anti-inflammatory activity of the essential oil citral, we demonstrated, by alternative local treatment, a new antimicrobial agent that is not an antibiotic.

Antimicrobial Activity and Biocompatibility of the Psidium cattleianum Extracts for Endodontic Purposes.

Psidium cattleianum (PC) has been displaying inhibitory effect against a variety of microorganisms, but this effect has not yet been tested against endodontic pathogens. The aim of this study was to evaluate the antimicrobial activity and biocompatibility of the aqueous (PCAE) and hydroethanolic (PCHE) extracts from Psidium cattleianum (PC) leaves. Minimum inhibitory concentration (MIC) and minimum lethal concentration (MLC) were determined using the microdilution broth method in order to analyze the antimicrobial effect against Enterococcus faecalis, Pseudomonas aeruginosa, Actinomyces israelii and Candida albicans in planktonic conditions. Biofilm assays were conducted only with the extracts that were able to determine the MLC for microorganisms in planktonic conditions. Immediate and late tissue reactions against PC extracts were evaluated using edemogenic test and histological analysis of subcutaneous implants in Wistar rats. The results showed that the MIC and MLC values ranged between 0.25 and 4 mg/mL. The MLC obtained for PCHE inhibited 100% growth of all the tested strains, except for C. albicans. PCAE had the same effect for E. faecalis and P. aeruginosa. Both PC extracts were able to eliminate E. faecalis biofilms and only the PCHE eliminated P. aeruginosa biofilms. The positive controls inhibited the growth of all tested strains in MIC and MLC essays, but no CHX tested concentrations were able to eliminate A. israelii biofilm. PCAE caused a discrete increase in the edema over time, while PCHE caused a higher initial edema, which decreased progressively. Both PCAE and PCHE extracts were biocompatible, but PCHE showed better results with slight levels of inflammation at 28 days. In conclusion, PCHE was biocompatible and presented better antimicrobial effect against important pathogens associated with persistent endodontic infections.

Efeito da clorexidina e do laser de baixa potência na prevenção e no tratamento da mucosite oral / Effect of chlorhexidine and low power laser in the prevention and treatment of oral mucositis

Introdução: A mucosite oral é um dos efeitos colaterais mais frequentes do tratamento oncológico, sendo responsável pelo maior declínio na qualidade de vida dos pacientes e causando importante morbidade. Objetivo: Este estudo tem como objetivo avaliar o efeito preventivo da clorexidina e o efeito terapêutico do laser de baixa potência em pacientes sob terapia antineoplásica, nos centros de oncologia da cidade de Feira de Santana, Estado da Bahia. Material e método: Foram avaliados 74 pacientes em tratamento quimio e/ou radioterápico, divididos em quatro grupos: grupo experimental I (n = 37), pacientes submetidos a bochechos com digluconato de clorexidina; grupo experimental II (n = 07), pacientes com mucosite oral submetidos a bochechos com digluconato de clorexidina e ao laser de baixa potência; grupo controle I (n = 37), pacientes submetidos ao protocolo dos centros de oncologia, e grupo controle II (n  =  15), pacientes com mucosite submetidos ao protocolo dos centros de oncologia. Cada paciente foi avaliado ao final do tratamento, por meio de exame local, para detecção de mucosite. Resultado: Dos 74 pacientes, 22 desenvolveram mucosite, sendo 07 dos grupos controles (I e II) e 15 dos grupos experimentais (I e II). Dos pacientes que desenvolveram mucosite, 07 foram tratados com o laser. Conclusão: A solução de clorexidina não preveniu a instalação da mucosite oral, apesar de ter diminuído a gravidade das lesões. Com relação ao tempo de permanência das lesões, observou-se a importância do uso do laser no manejo da mucosite (p = 0,0106).

Background: The oral mucositis is one of the most frequent side effects of oncology treatment and is responsible for the largest decline in quality of life of patients and causing significant morbidity. Objective: This study aimed to evaluate the preventive effect of chlorhexidine and treatment of low-energy laser in patients under antineoplastic therapy in three oncology centers in the city of Feira de Santana, Bahia. Material and method: 74 patients were evaluated on chemotherapy or radiotherapy treatment, divided into four groups: experimental group I (n = 37), patients undergoing mouthwash with chlorhexidine digluconate; experimental group II (n = 07), patients with oral mucositis undergoing mouthwashes with chlorhexidine digluconate and low laser power, control group I (n = 37), submitted to the protocol of the centers of oncology and control group II (n = 15) patients with mucositis protocol submitted to the centers of oncology. Each patient was evaluated at the end of treatment by local examination for the detection of oral mucositis. Result: From 74 patients, 22 developed mucositis, where 07 of the control groups and 15 of experimental groups. From patients who developed mucositis, 07 were treated by laser. Conclusion: The chlorhexidine did not prevent the installation of oral mucositis, although it decreased the severity of injuries. Regarding the time of permanence of the injuries, the value found (p = 0.0106) demonstrated the importance of laser using in the management of oral mucositis.

Methods for increasing upper airway muscle tonus in treating obstructive sleep apnea: systematic review.

OBJECTIVE: Treatment of obstructive sleep apnea (OSA) using methods for increasing upper airway muscle tonus has been controversial and poorly reported. Thus, a review of the evidence is needed to evaluate the effectiveness of these methods. DESIGN: The design used was a systematic review of randomized controlled trials. DATA SOURCES: Data sources are from the Cochrane Library, Medline, Embase and Scielo, registries of ongoing trials, theses indexed at Biblioteca Regional de Medicina/Pan-American Health Organization of the World Health Organization and the reference lists of all the trials retrieved. REVIEW METHODS: This was a review of randomized or quasi-randomized double-blind trials on OSA. Two reviewers independently applied eligibility criteria. One reviewer assessed study quality and extracted data, and these processes were checked by a second reviewer. The primary outcome was a decrease in the apnea/hypopnea index (AHI) of below five episodes per hour. Other outcomes were subjective sleep quality, sleep quality measured by night polysomnography, quality of life measured subjectively and adverse events associated with the treatments. DATA SYNTHESIS: Three eligible trials were included. Two studies showed improvements through the objective and subjective analyses, and one study showed improvement of snoring, but not of AHI while the subjective analyses showed no improvement. The adverse events were reported and they were not significant. CONCLUSIONS: There is no accepted scientific evidence that methods aiming to increase muscle tonus of the stomatognathic system are effective in reducing AHI to below five events per hour. Well-designed randomized controlled trials are needed to assess the efficacy of such methods.

Methods to increase muscle tonus of upper airway to treat snoring: systematic review.

BACKGROUND: Snoring is the noise caused by vibration during the in-breath; and which structure actually vibrates depends on many factors. OBJECTIVE: The treatment of snoring with methods to increase muscle tonus of upper airway has been controversial, and poorly reported, thus a review of evidence is necessary to evaluate the effectiveness of these methods. METHOD: A review of randomized or quasi-randomized, double blind trials on snoring treatment that have employed any method to increase muscle tonus of upper airway like phonotherapy or physical therapy among others. OUTCOMES: decrease or completely stop of snoring, sleep quality, quality of life, and adverse events. RESULTS: Three eligible trials were potentially analyzed, but none of them could provide good scientific evidence favoring the intervention. The objective analyses of one study showed improvement of snoring, although the objective sub-analyses and subjective analyses showed controversial results. The adverse events were not reported. CONCLUSION: There is no enough evidence to support the recommendation of methods to increase muscle tonus of upper airways in treatment of snoring. Well designed randomized clinical trials are needed to asses the efficacy of such methods, and a standard and worldwide accepted method for snoring assessment would be useful for future researches.

Age-related changes in multi-finger interactions in adults during maximum voluntary finger force production tasks.

This study aimed to continue our characterization of finger strength and multi-finger interactions across the lifespan to include those in their 60s and older. Building on our previous study of children, we examined young and elderly adults during isometric finger flexion and extension tasks. Sixteen young and 16 elderly, gender-matched participants produced maximum force using either a single finger or all four fingers in flexion and extension. The maximum voluntary finger force (MVF), the percentage contributions of individual finger forces to the sum of individual finger forces during four-finger MVF task (force sharing), and the non-task finger forces during a task finger MVF task (force enslaving), were computed as dependent variables. Force enslaving during finger extension was greater than during flexion in both young and elderly groups. The flexion-extension difference was greater in the elderly than the young adult group. The greater independency in flexion may result from more frequent use of finger flexion in everyday manipulation tasks. The non-task fingers closer to a task finger produced greater enslaving force than non-task fingers farther from the task finger. The force sharing pattern was not different between age groups. Our findings suggest that finger strength decreases over the aging process, finger independency for flexion increases throughout development, and force sharing pattern remains constant across the lifespan.

Methods to increase muscle tonus of upper airway to treat snoring: systematic review / Métodos para aumentar o tônus muscular da via aérea superior no tratamento do ronco: revisão sistemática

BACKGROUND: Snoring is the noise caused by vibration during the in-breath; and which structure actually vibrates depends on many factors. OBJECTIVE: The treatment of snoring with methods to increase muscle tonus of upper airway has been controversial, and poorly reported, thus a review of evidence is necessary to evaluate the effectiveness of these methods. METHOD: A review of randomized or quasi-randomized, double blind trials on snoring treatment that have employed any method to increase muscle tonus of upper airway like phonotherapy or physical therapy among others. Outcomes: decrease or completely stop of snoring, sleep quality, quality of life, and adverse events. RESULTS: Three eligible trials were potentially analyzed, but none of them could provide good scientific evidence favoring the intervention. The objective analyses of one study showed improvement of snoring, although the objective sub-analyses and subjective analyses showed controversial results. The adverse events were not reported. CONCLUSION: There is no enough evidence to support the recommendation of methods to increase muscle tonus of upper airways in treatment of snoring. Well designed randomized clinical trials are needed to asses the efficacy of such methods, and a standard and worldwide accepted method for snoring assessment would be useful for future researches.

CONTEXTO: O ronco é o ruído causado pela vibração durante a inspiração, cujas estruturas vibratórias, dependem atualmente de vários fatores. OBJETIVO: O tratamento do ronco com métodos para aumentar o tônus muscular da via aérea superior tem sido controverso e pouco relatado, portanto uma revisão de evidências é necessária para avaliar a efetividade destes métodos. MÉTODO: Revisão sistemática de ensaios clínicos randomizados ou quasi-randomizados, duplo-cegos para o tratamento do ronco, com métodos visando o aumento do tônus da via aérea superior, tais como fonoterapia e fisioterapia. Desfechos: diminuição ou cura do ronco, qualidade do sono, qualidade de vida e efeitos adversos. RESULTADOS: Três estudos elegíveis foram potencialmente analisados, porém nenhum deles demonstrou evidência científica de qualidade favorecendo a intervenção. As análises subjetivas em um estudo mostrou melhora do ronco, entretanto as sub-análises objetivas demonstraram resultados controversos. Os efeitos adversos não foram relatados. CONCLUSÃO: Não existe evidência científica suficiente para sustentar a recomendação de métodos para aumentar o tônus muscular da via aérea superior no tratamento do ronco. Ensaios clínicos randomizados bem elaborados são necessários para avaliarmos a eficácia de tais métodos e uma padronização de métodos para intervir no ronco mundialmente aceitos se tornariam úteis em pesquisas futuras.

Avaliação da força de preensão palmar em atletas de jiu-jitsu de nível competitivo / Evaluation of the palmar grip strength in jiu-jitsu athletes in competitive level

Trata-se de um estudo de caráter analítico transversal, cujo objetivo foi avaliar a força de preensão palmar em atletas de jiu-jitsu de nível competitivo, no intuito de estabelecer uma escala de funcionalidade para esta população, visto que há um aumento crescente do número de praticantes. Os sujeitos da pesquisa foram 100 indivíduos do sexo masculino com idade compreendida entre 20 e 30 anos, dos quais 50 formaram o grupo de atletas (GA) e 50 o grupo controle (GC). O instrumento utilizado no estudo foi dinamômetro JAMAR. Com relação à média da força de preensão obtida nos grupos estudados, observou-se que houve predomínio significativo (p<0,05) no GA em relação ao GC apenas para a mão esquerda, e que no primeiro houve uma tendência ao aumento da força ao longo das medidas, enquanto que no segundo esta tendência se inverteu. Concluiu-se que atletas de jiu-jitsu não apresentam valores elevados de força de preensão palmar, sendo que a prática do esporte sugere que ocorrem alterações fisiológicas que se caracterizam pelo aumento da capacidade de resistência nesse movimento. Os resultados obtidos devem ser considerados como indicativo de força para a reabilitação da função manual do atleta de jiu-jitsu.

It is a transversal and analytical study, whose objective was to evaluate the palmar grip strength in jiu-jitsu athletes in competitive level, with the purpose of establishing a functionality range for this population, considering that the number of athletes has been increasing. The subjects of the research were 100 individuals from the masculine gender divided in two groups (CG and GA) with age between 20 and 30 years. The group of athletes (GA) had 50 subjects and the control group (CG) had 50 subjects. The instrumental used in the study was the dynamometer JAMAR. Regarding the average of the prehension strength recorded in the study groups, there was a significant predominance (p<0,05) in the GA in comparison to the GC only for the left hand. In the first group, there was a trend of a increasing the strength as the measurement were taken, while in the second one, this trend was reverted. We concluded that jiu-jitsu athletes do not present high values of palmar grip strength, being that the jiu-jitsu practice suggests that occur physiological causes alterations characterized by the increase of the ability of resistance in the movement of prehension. The results obtained must be considered as an indication of strength for rehabilitating the manual function of the Jiu-Jitsu athlete.Keywords – Leadership, soccer, coaching.