RESUMEN
Peripheral nerve injury (PNI) is associated with considerable functional impairment. Photobiomodulation (PBM) has demonstrated positive effects regarding neuromuscular repair after PNI when applied locally to the nerve or injured muscle. However, the effects of systemic PBM with transcutaneous application over an important artery, which is also denominated vascular PBM (VPBM), remain unclear. The aim of the study was to compare the effects of VPBM with low-level laser (LLL) and light-emitting diode (LED) on gait, sensitivity and muscle morphology following a PNI. PNI was induced on Wistar rats using the sciatic nerve crushing technique. VPBM was performed over the rat's artery tail region with LED (850 nm, 40 mW, 3.2 J) and LLL (780 nm, 40 mW, 3.2 J). Gait functionality, mechanical (nociceptive) sensitivity, and morphology of the tibialis anterior muscle were evaluated at 7, 14, and 21 days after injury. An improvement in functional gait was shown in the VPBM-LLL group in all periods. Motor sensitivity was found after 14 days in the VPBM-LLL group. The left/right (L/R) muscle mass ratio revealed a reduction in muscle atrophy in the VPBM-LLL group at 7 days. Muscle fiber diameter increased in the VPBM-LED group at 14 days and increases in the cross-section area were found in the VPBM-LED and VPBM-LLL groups at 7 days. VPBM with both light sources (LED and LLL) positively modulated functioning and neuromuscular recovery following sciatic nerve injury in rats, with more pronounced results when using LLL.
Asunto(s)
Terapia por Luz de Baja Intensidad , Traumatismos de los Nervios Periféricos , Ratas , Animales , Ratas Wistar , Traumatismos de los Nervios Periféricos/radioterapia , Terapia por Luz de Baja Intensidad/métodos , Nervio Ciático , Rayos LáserRESUMEN
This systematic review investigated the repercussions of photobiomodulation using low-level laser therapy (LLLT) for the treatment of spinal cord injury (SCI) in experimental models. Studies were identified from relevant databases published between January 2009 and December 2021. Nineteen original articles were selected and 68.4% used light at an infrared wavelength. There was a considerable variation of the power used (from 25 to 200 mW), total application time (8-3000 s) and total energy (0.3-450 J). In 79% of the studies, irradiation was initiated immediately after or within 2 h of the SCI, and treatment time ranged continuously from 5 to 21 days. In conclusion, LLLT can be an auxiliary therapy in the treatment of SCI, playing a neuroprotective role, enabling functional recovery, increasing the concentration of nerve connections around the injury site and reducing pro-inflammatory cytokines. However, there is a need for standardization in the dosimetric parameters.
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Terapia por Luz de Baja Intensidad , Traumatismos de la Médula Espinal , Atención , Humanos , Radiometría , Recuperación de la Función/efectos de la radiación , Médula Espinal , Traumatismos de la Médula Espinal/radioterapiaRESUMEN
INTRODUCTION: Myelomeningocele is a severe type of spina bifida, resulting from improper closure of the neural tube. This condition drastically affects the structures of the spinal cord resulting in deficiencies. The combination of these deficiencies results in an overall decrease in mobility and functional participation amongst this population. Physiotherapy plays an essential role in rehabilitating people with MMC. The current literature shows that resources such as photobiomodulation (PBM) may support the rehabilitation of neurological conditions. The aim of the proposed study is to evaluate the effects of photobiomodulation (PBM) combined with physical therapy on functional performance in children with low lumbosacral myelomeningocele. MATERIALS AND METHODS: This is a protocol randomized clinical blind study, that will include 30 individuals of both sexes, aged between 5 to 8 years, diagnosed with low and sacral lumbar myelomeningocele and capable of performing the sit-to-stand task. The participants will be randomly assigned into two treatment groups: PBM + physiotherapeutic exercises and sham PBM + physiotherapeutic exercises. Irradiation will be carried out with light emitting diode (LED) at a wavelength of 850 nm, energy of 25 J per point, 50 seconds per point and a power of 200 mW. The same device will be used in the placebo group but will not emit light. Muscle activity will be assessed using a portable electromyograph (BTS Engineering) and the sit-to-stand task will be performed as a measure of functioning. Electrodes will be positioned on the lateral gastrocnemius, tibialis anterior and rectus femoris muscles. The Pediatric Evaluation of Disability Inventory will be used to assess functional independence. Quality of life will be assessed using the Child Health Questionnaire-Parent Form 50. Changes in participation will be assessed using the Participation and Environment Measure for Children and Youth. The data will be analyzed with the aid of GraphPad PRISM. DISCUSSION: The results of this study can contribute to a better understanding of the effectiveness of PBM on functioning and quality of life in children with myelomeningocele. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04425330.
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Meningomielocele/fisiopatología , Meningomielocele/terapia , Niño , Preescolar , Evaluación de la Discapacidad , Ejercicio Físico/fisiología , Terapia por Ejercicio/métodos , Femenino , Humanos , Terapia por Luz de Baja Intensidad/métodos , Masculino , Rendimiento Físico Funcional , Modalidades de Fisioterapia , Músculo Cuádriceps/fisiopatología , Calidad de VidaRESUMEN
A maioria dos pacientes com obesidade apresenta resistência à insulina e hiperatividade do sistema renina-angiotensina-aldosterona, o que pode estar relacionado aos piores resultados perante infecção pelo SARS-CoV 2. Além disso, a enzima conversora de angiotensina 2 tem maior expressão no tecido adiposo quando comparado com o pulmão, sendo suscetível a invasão do vírus nos adipócitos tornando-o um importante reservatório viral permitindo propagação para demais órgãos. OBJETIVO: Identificar se a obesidade pode ser preditor de maior gravidade e pior prognóstico da Doença do Coronavírus 2019 (COVID-19). MATERIAIS E MÉTODOS: Revisão sistemática sob o código PROSPERO CRD42020200617 com estudos observacionais através das bases de dados PubMed, Portal Regional da BVS, SciELO, Science Direct e Cochrane, e buscas manuais por meio do cruzamento "Prognosis" OR "Patient Acuity" AND "Coronavirus Infections" AND "Obesity". Foram incluídos estudos observacionais que avaliaram o impacto da COVID-19 em indivíduos com obesidade de ambos os sexos que apresentaram pontuação ≥7 na escala Newcastle-Ottawa. RESULTADOS: Foram incluídos 9 estudos totalizando uma amostra de 179.047 pacientes adultos com idade entre 18 a 80 anos, com IMC mínimo <24 kg/m2 e máximo >35 kg/m2. Verificou-se que indivíduos com obesidade apresentam aumento das taxas de admissão de cuidados agudos e críticos, necessidade ventilação mecânica invasiva (VMI), pneumonia e desenvolvem COVID-19 grave, aumentando assim seu tempo de permanência hospitalar. CONCLUSÃO: Indivíduos com obesidade desenvolvem maior gravidade e pior prognóstico da COVID-19, visto que apresentam aumento das taxas de admissão de cuidados agudos e críticos, necessidade de VMI, tempo de permanência hospitalar, gravidade e letalidade.
A marked proportion of patients with obesity has insulin resistance and hyperactivity of the reninangiotensin-aldosterone system, which may be related to the worse results caused by SARS-CoV 2. In addition, the angiotensin 2-converting enzyme has greater expression in adipose tissue when compared to the lung, being susceptible to the entry of the virus in the adipocytes making it an important viral reservoir allowing the spread to too many organs. OBJECTIVE: To identify whether obesity can be a more serious predictor and worse prognosis for Coronavirus Disease 2019 (COVID-19). MATERIALS AND METHODS: Systematic review under the code CRD42020200617 with observational studies through the PubMed databases, the VHL Regional Portal, SciELO, Science Direct and Cochrane, and manual searches using the "Prognosis" OR "Patient Acuity" AND " Coronavirus Infections " AND " Obesity ". Observational studies that assess the impact of COVID-19 in common with obesity of both sexes that assess a score ≥7 on the Newcastle-Ottawa scale were included. RESULTS: 9 studies were included, totaling a sample of 179,047 adult patients aged 18 to 80 years, with a minimum BMI <24 kg / m2 and a maximum> 35 kg / m2. It was found that with obesity, he wishes to present an increase in the admission rates for acute and mandatory care, invasive mechanical necessity IMV), pneumonia and develop severe COVID-19, thus increasing their hospital stay. CONCLUSION: Individuals with obesity develop greater severity and worse prognosis for COVID-19, since there is an increase in admission rates for acute and mandatory care, need for IMV, length of hospital stay, severity and lethality.
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COVID-19 , Pronóstico , ObesidadRESUMEN
Objetivo: Descrever a experiência vivenciada por acadêmicas na assistência de Enfermagem ao parto humanizado em uma maternidade na região norte do Ceará. Método: Trata-se de um relato de experiência, de caráter descritivo e análise qualitativa, realizado em uma Maternidade do Interior do Ceará. Participaram do estudo os profissionais que estavam inseridos no serviço que prestam os cuidados e assistência à parturiente durante o trabalho de parto. Resultados: Verificou-se que alguns artifícios como o cavalinho, a penumbra e a música, fortalecem o desenvolvimento de um parto seguro e sem intercorrências, contando com a assistência da equipe de enfermagem que tem papel fundamental no cuidado à paciente gestante. Conclusão: Torna-se fundamental humanizar o trabalho de parto, no qual requer substituições de paradigmas meramente intervencionistas e mecânicos, destacando-se a necessidade de conduzir a assistência ao parto de forma humanizada e implementar o aperfeiçoamento da qualidade do apoio que será prestado.
Objective: To describe the experience of students in nursing care for humanized delivery in a maternity hospital in the northern region of the state of Ceará. Method: This is an experience report of descriptive and qualitative approach, carried out in a maternity hospital in the state of Ceará. This study was based on the experience of nursing students with parturient women during labor. Results: It was found that some devices such as rocking chair, low light, and music, strengthen the development of a safe and uneventful delivery, with the assistance of the nursing team that plays a fundamental role in the care of pregnant women. Conclusion: It is essential to humanize labor, which requires replacements of merely interventionist and mechanical paradigms, highlighting the need to conduct childbirth care in a humane way, and implement the improvement of the quality of support that will be provided.
RESUMEN
Introduction: Ameloblastic fibrodentinoma (AFD) is a rare, asymptomatic, slow-growing mixed odontogenic tumor, usually affecting children and young peoplein their first or second decade of life. This lesion usually causes bone expansion ofthe involved region and makes tooth eruption difficult. Objective: the aim of thisstudy is to report a case of AFD in the anterior maxilla of a 3-year-old baby and itstreatment, highlighting the importance of early dental care and treatment forthis type of injury. Casereport: A 3-year-old female patient attended the dentalcare clinic at Cesmac University Center (Maceió- AL, Brazil), accompanied by hermother, reporting a swollen gum for approximately 6 months. Clinical examinationrevealed an increase in volume in the right central and lateral incisor region,discreetly reddish in color, smooth surface, spherical shape, sessile insertion, nomobility and firm consistency. Radiographic examination revealed a mixed lesionwith radiolucent area compatible with bone resorption and radiopaque areascompatible with calcified material within the lesion. An incisional biopsy wasperformed, confirming the diagnosis of Ameloblastic Fibrodentinoma. Conclusion:Treating this anomaly requires an early approach to improve the quality of life ofthese patients. Parents or guardians should be advised of the need for periodicfollow-up after treatment.
Introdução: O Fibrodentinoma Ameloblástico (FDA) é um tumor odontogênicomisto, raro, assintomático e de crescimento lento, acometendo normalmentecrianças e jovens em sua primeira ou segunda década de vida. Essa lesãogeralmente provoca expansão óssea da região envolvida e dificulta a erupçãodentária. Objetivo: O objetivo deste trabalho é relatar um caso de FDA em maxilaanterior de bebê de 3 anos de idade e seu tratamento, ressaltando a importânciado atendimento odontológico precoce e o tratamento para este tipo de lesão.Relatodecaso: Paciente do gênero feminino, 3 anos, compareceu à clínicaodontológica de atendimento a bebês do Centro Universitário Cesmac (Maceió AL, Brasil), acompanhada de sua mãe, relatando uma gengiva inchada háaproximadamente 6 meses. Ao exame clínico, observou-se um aumento de volumena região do incisivo central e lateral direito, com coloração discretamenteavermelhada, superfície lisa, formato esférico, com inserção séssil, sem mobilidadee de consistência firme. Ao exame radiográfico constatou-se uma lesão mistacom área radiolúcida compatível com reabsorção óssea e áreas radiopacascompatíveis com material calcificado no interior da lesão. Foi realizado umabiopsia incisional, confirmando o diagnóstico de Fibrodentinoma Ameloblástico.Conclusão: O tratamento desta anomalia requer uma abordagem precoce como objetivo de melhorar a qualidade de vida desses pacientes, devendo-se aconselharos pais ou responsáveis quanto à necessidade do acompanhamento periódicoapós a realização do tratamento.
Asunto(s)
Odontología Pediátrica , Tumores Odontogénicos , Maxilar , Mucosa BucalRESUMEN
Thirteen natural products derivatives of hydroxyl amide class, three described for the first time, were synthesized by reaction of three indole acids and 3,4,5-trimethoxybenzoic acid with six different amino alcohols in the presence of triphenylphosphine and N-bromosuccinimide. The derivatives were tested against the Gram (+) bacteria Staphylococcus aureus and Bacillus cereus, Gram (-) Pseudomonas aeruginosa and Escherichia coli, besides the yeast Candida albicans. One of the compounds (7) was selectively active against C. albicans (91.3 ± 0.49% inhibition) showing a great potential as a new drug lead, since it was more active than the positive control, miconazole (88.7 ± 2.41% inhibition). Regarding bacterial inhibition, compounds demonstrated mild activity, but inhibition of compounds 9, 10 and 13 towards E. coli is of interest since it is difficult to find drugs selectively active against Gram (-) bacteria. Most of the compounds were very active in the acetylcholinesterase inhibition assay. Compound 7 was again the most active (93.2 ± 4.47%), being more potent than the control galantamine (90.3 ± 0.45%). The most active gallic acid derivatives, compounds 3, 7 and 8 have in common, besides gallic acid skeleton, a (CH2)2OH group, which may be one of the structural requirements for AChE inhibition.