Feasibility and effect of high-intensity training on the progression of motor symptoms in adult individuals with Parkinson's disease: A systematic review and meta-analysis.

BACKGROUND: To determine the feasibility and effect of high-intensity interval training (HIIT) in individuals with Parkinson's and their effect on symptom modification and progression. METHODS: We conducted this systematic review following the Preferred Reporting Items for systematic review and meta-analysis (PRISMA). All studies were searched in seven databases: MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, SPORTDiscus, Virtual Health Library (VHL) and SCOPUS in September 2020 and updated in June 2023. The risk of bias was assessed by the Cochrane Collaboration tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. We used standardized mean difference (SMD) with a 95% confidence interval (CI) and random effects models, as well as the non-parametric Cochran's Q test and I2 inconsistency test to assess heterogeneity. RESULTS: A total of 15 randomized clinical trials with 654 participants (mean age, 65.4 years). The majority of studies included high intensity training interventions versus moderate intensity, usual care, or control group. The meta-analysis comparing high-intensity exercise versus control group showed an improvement in the disease severity (MD = -4.80 [95%CI, -6.38; -3.21 high evidence certainty); maximum oxygen consumption (MD = 1.81 [95%CI, 0.36; 3.27] very low evidence certainty) and quality of life (MD = -0.54 [95%CI, -0.94; -0.13] moderate evidence certainty). The results showed that high-intensity exercise compared with moderate intensity exercise group showed a improve motor function and functional mobility measured by the TUG test (MD = -0.38 [95%CI, -0.91; 0.16] moderate evidence certainty) with moderate heterogeneity between studies. CONCLUSION: High-intensity exercise performed in both continuous and interval modes when compared with control groups may provide motor function benefits for individuals with Parkinson's disease. HIIT may be feasible, but the intensity of the exercise may influence individuals with Parkinson's disease. However, there was a lack of evidence comparing high intensity and moderate intensity for this population, as the results showed heterogeneity.

The Role of Extracellular Traps in HIV Infection.

Human immunodeficiency virus (HIV) infection is still an important public health problem, which justifies the research of new therapies to combat it. Recent studies show that Extracellular Traps (ETs) are cellular mechanisms useful in the capture and destruction of some viruses, such as the HIV. Here, we show that neutrophils from peripheral blood, genital tissues, and placenta are activated when exposed to human immunodeficiency virus type 1 (HIV-1) and release Neutrophil Extracellular Traps (NETs). The NETs can capture, neutralize, and inactivate the virus and, also, protect other target cells from HIV infection, as long as the DNA and other constituents of the NETs remain intact. Further, the review indicates that the immunoprotective role of NETs in the context of HIV-1 infection is a promising finding for the development of new antiviral therapies. It is necessary, however, the development of studies that evaluate the tissue injury that NETs can cause and the biological relationships with other cells to improve them as therapeutic targets.

Teaching-Learning Process of Medical Students with Real Anatomical Parts: A Practical Intervention Strategy / Proceso de Enseñanza-Aprendizaje de los Estudiantes de Medicina con Piezas Anatómicas Reales: Una Estrategia de Intervención Práctica

SUMMARY: The COVID-19 pandemic caused several changes in the teaching of human anatomy, among them the use of different teaching methodologies based on E-learning. However, studies evaluating electronic tools have not provided clear evidence of effective student learning. Thus, this was the first study to evaluate medical students after completing human anatomy courses in the E- learning modality. We recruited first term (Group A, n=25) and second term (Group B, n=13) medical students. We applied a practical assessment based on 50 human anatomy markingson real anatomical specimens and cadavers, to be completed in Questionnaire 01 (Phase I). After detecting low scores on Questionnaire 01 by both groups, we applied a practical and face-to-face tutoring system for 14 days (Phase II). Afterwards, we re-evaluated both groups by repeating the same scores (Questionnaire 02, Phase III). According to the paired analysis of questionnaires 01 and 02 by Student's T-test, both groups showed significant increase in the final scores obtained in questionnaire 02 (Phase III). The evidence showed that the remote format lecture system weakened the learning and retention process of basic anatomical knowledge by medical students. On the other hand, in-person practical teaching proved to be efficient in the formative process of the students, a fact proven by the significant increase in the scores of the students in the 02 questionnaire, for both groups.

La pandemia por COVID-19 provocó varios cambios en la enseñanza de la anatomía humana, entre ellos el uso de diferentes metodologías de enseñanza basadas en E-learning. Sin embargo, los estudios que evalúan las herramientas electrónicas no han proporcionado evidencia clara de un aprendizaje efectivo de los estudiantes. Este fue el primer estudio que evaluó a estudiantes de medicina luego de cursar cursos de anatomía humana en la modalidad E-learning. Reclutamos estudiantes de medicina de primer término (Grupo A, n=25) y segundo término (Grupo B, n=13). Se aplicó una evaluación práctica basada en 50 marcas de anatomía humana sobre especímenes anatómicos reales y cadáveres, para ser completado en el Cuestionario 01 (Fase I). Tras detectar puntuaciones bajas en el Cuestionario 01 por parte de ambos grupos, se aplicó un sistema de tutorías prácticas y presenciales durante 14 días (Fase II). Posteriormente, reevaluamos ambos grupos repitiendo las mismas puntuaciones (Cuestionario 02, Fase III). Según el análisis apareado de los cuestionarios 01 y 02 por la prueba T de Student, ambos grupos mostraron aumento significativo en los puntajes finales obtenidos en el cuestionario 02 (Fase III). La evidencia mostró que el sistema de conferencias en formato remoto debilitó el proceso de aprendizaje y retención de conocimientos anatómicos básicos por parte de los estudiantes de medicina. Por otro lado, la docencia práctica presencial demostró ser eficiente en el proceso formativo de los alumnos, hecho que demuestra el aumento significativo de las puntuaciones de los alumnos en el cuestionario 02, para ambos grupos.

Compartment syndrome in the first dorsal interosseous compartment: case report.

In areas that are not commonly affected by compartment syndrome because they have a good content/container ratio, diagnosis of the condition can be a challenge, since surgeons will find it difficult to make a diagnosis on the basis of an isolated sign or symptom. As a result, the correct treatment can very often be delayed, causing harm to the patient. In this case, the patient was a 29-year-old woman who was seen for a painful left hand secondary to a large burn injury to the area anterior of the anatomical snuffbox. She had already undergone surgery in her home town 30 days previously, with debridement of skin and subcutaneous tissue, but the pain had not improved. She was on antibiotic therapy (ceftriaxone, 1g every 12 hours) and analgesia, with therapeutic morphine doses every 8 hours.

Síndrome compartimental no primeiro interósseo dorsal: relato de caso / Compartment syndrome in the first dorsal interosseous compartment: case report

Resumo O diagnóstico da síndrome compartimental em regiões que não são frequentemente afetadas, por possuírem uma boa relação continente-conteúdo, pode se tornar difícil, uma vez que o cirurgião terá dificuldades em alcançar um diagnóstico apenas por um sinal ou sintoma isolado. Assim, muitas vezes, pode-se protelar a conduta adequada, desencadeando danos ao paciente. A paciente era uma mulher, de 29 anos, que foi atendida com dor em mão esquerda por queimadura, com lesão em região anterior à tabaqueira anatômica de tamanho significativo. A paciente já havia sido submetida a cirurgia na sua cidade de origem com desbridamento de pele e tecido subcutâneo há 30 dias, com evolução sem melhora do quadro doloroso. Estava em uso de antibioticoterapia (ceftriaxona 1 g de 12 em 12 horas) e analgesia com dose terapêutica de morfina de 8 em 8 horas.

Abstract In areas that are not commonly affected by compartment syndrome because they have a good content/container ratio, diagnosis of the condition can be a challenge, since surgeons will find it difficult to make a diagnosis on the basis of an isolated sign or symptom. As a result, the correct treatment can very often be delayed, causing harm to the patient. In this case, the patient was a 29-year-old woman who was seen for a painful left hand secondary to a large burn injury to the area anterior of the anatomical snuffbox. She had already undergone surgery in her home town 30 days previously, with debridement of skin and subcutaneous tissue, but the pain had not improved. She was on antibiotic therapy (ceftriaxone, 1g every 12 hours) and analgesia, with therapeutic morphine doses every 8 hours.

Evaluation of upper limb superficial venous percussion as a sign of anatomical location and venous permeability. A comparative study of superficial venous percussion to ultrasound findings on non-renal patients and on chronic kidney disease patients.

METHODS: An analytical cross-sectional study with 70 individuals divided into two groups. Group A consisted of 35 volunteers who were being preoperatively prepared for the construction of arteriovenous fistula. Group B consisted of 35 non-renal patients selected by convenience. Each participant underwent physical examination, including venous percussion, of the dominant upper limb and then ultrasound. Interobserver agreement was assessed between a trained vascular surgeon performing percussion and fourth-year medical student. Accuracy, sensitivity, specificity, positive predictive value and negative predictive value of percussion were determined in relation to ultrasound. The agreement between the methods, venous percussion and venous duplex ultrasound was also evaluated by the Kappa index. RESULTS: The overall interobserver agreement for the percussion was 0.74 (95% CI 0.632 to 0.851). It was observed that the results were more favorable in the cephalic vein than in the basilic vein, emphasizing that the cephalic is more used in venous punctures, because of its anatomical location and visibility, and in fistula construction. The 35 percussions of the cephalic forearm vein in Group A resulted in a sensitivity of 1.0 (95% CI 0.63 to 1.00), specificity of 0.96 (95% CI 0.81 to 1.00), a positive predictive value of 0.89(95% CI 0.52 to 1.00) and a negative predictive value of 1.00 (95% CI 0.87 to 1.00), with an accuracy of 0.97 (95% CI 0.85 to 1.00) and Kappa index of 0.92 (95% CI 0.77 to 1.00) in relation to ultrasound. Overall, when all venous segments were analyzed in group A, the Kappa index of agreement between the percussion and the ultrasonography reached 0.56 (95% CI 0.401 to 0.72). All venous segments in Group A had a sensitivity of 0.54 (95% CI 0.37 to 0.70) and a specificity of 0.96 (95% CI 0.90 to 0.99). When all venous segments were analyzed in group B, the Kappa index of agreement between the percussion and the ultrasonography reached 0.48 (95% CI 0.34 to 0.62). All venous segments in Group B had a sensitivity of 0.70 (95% CI 0.59 to 0.79) and a specificity of 0.82 (95% CI 0.69 to 0.91). CONCLUSION: Venous percussion of the upper limbs has a high positive predictive value and high specificity, when compared to ultrasound as a way to evaluate the patency and adequacy of the cephalic vein. Although there is not enough evidence to preclude ultrasound, percussion should definitely be included in the traditional physical exam evaluation of upper limbs superficial veins.

Haloperidol-Induced Preclinical Tardive Dyskinesia Model in Rats.

Haloperidol is a first-generation antipsychotic used in the treatment of psychoses, especially schizophrenia. This drug acts by blocking dopamine D2 receptors, reducing psychotic symptoms. Notwithstanding its benefits, haloperidol also produces undesirable impacts, in particular extrapyramidal effects such as tardive dyskinesia (TD), which limit the use of this and related drugs. TD is characterized by repetitive involuntary movements occurring after chronic exposure therapy with haloperidol. Symptoms most commonly manifest in the orofacial area and include involuntary movements, tongue protrusion, pouting lips, chewing in the absence of any object to chew, and facial grimacing. The most serious aspect of TD is that it may persist for months or years after drug withdrawal and is irreversible in some patients. This unit, aimed at facilitating the study of TD, describes methods to induce TD in rats using haloperidol, as well as procedures for evaluating the animals's TD-related symptoms. © 2019 by John Wiley & Sons, Inc.

Expansion and phenotypic changes of mouse bone marrow mesenchymal cells cultured with FGF-2 and facial nerve-conditioned medium / Expansión y cambios fenotípicos de células mesenquimales de médula ósea de ratón cultivadas con FGF-2 y medio condicionado por el nervio facial

Mesenchymal cells (MCs) exhibit great regenerative potential due to their intrinsic properties and ability to restore tissue function, either directly through transdifferentiation or indirectly through paracrine effects. This study aimed to evaluate morphometric and phenotypic changes in MCs grown with facial nerve-conditioned medium in the presence or absence of fibroblast growth factor 2 (FGF-2). For quantitative phenotypic analysis, the expression of GFAP, OX-42, MAP-2, β-tubulin III, NeuN, and NF-200 was analyzed by immunocytochemistry. Cells cultured with facial nerve-conditioned medium in the presence of FGF-2 expressed GFAP, OX-42, MAP-2, β-tubulin III, NeuN, and NF-200. On average, the area and perimeter of GFAP-positive cells were higher in the group cultured with facial nerve-conditioned medium compared to the group cultured with conditioned medium and FGF-2 (p=0.0001). This study demonstrated the plasticity of MCs for neuronal and glial lineages and opens up new research perspectives in cell therapy and trans.differentiation.

Las células mesenquimales (CM) exhiben un gran potencial regenerativo debido a sus propiedades intrínsecas y la capacidad de restaurar la función del tejido, ya sea directamente, a través de la transdiferenciación, o indirectamente, a través de efectos parácrinos. Este estudio tuvo como objetivo evaluar los cambios morfométricos y fenotípicos en CM cultivadas con medio condicionado por nervio facial en presencia o ausencia de factor de crecimiento de fibroblastos 2 (FGF-2). Para el análisis fenotípico cuantitativo, se analizó la expresión de GFAP, OX-42, MAP-2, β-tubulina III, NeuN y NF-200 mediante inmunocitoquímica. Las células cultivadas con medio condicionado por el nervio facial en presencia de FGF-2 expresaban GFAP, OX-42, MAP-2, β-tubulina III, NeuN y NF-200. En promedio, el área y el perímetro de las células positivas para GFAP fueron mayores en el grupo cultivado con medio condicionado por el nervio facial en comparación con el grupo cultivado con medio acondicionado y FGF-2 (p = 0,0001). Este estudio demostró la plasticidad de CM para linajes neuronales y gliales y abre nuevas perspectivas de investigación en terapia celular y transdiferenciación.

State of the art in the treatment of mandibular fractures caused by firearms: case report / Estado da arte no tratamento de fraturas mandibulares por armas de fogo: relato de caso

ABSTRACT Injuries to the face represent a significant risk to the health of the individual, mainly because of its significance, both functional, because it houses sensory organs and part of the respiratory and digestive systems, as well as esthetic. In this scenario, gunshot wounds in this location cause great concern on account of the magnitude of the damage, and the Oral and Maxillofacial Surgery and Traumatology team must act so that the treatment enables the rehabilitation of the patient in the shortest possible time, with a minimum of complications and sequelae. The objective of this study is to report a clinical case of a 19-year-old female patient with a comminuted fracture of the mandible body caused by a firearm projectile, treated immediately with stable internal fixation using the 2.00 mm plate-screw system for simplification of the fracture and a 2.4 mm reconstruction locking-plate on the bone gap. Relevant aspects of the surgical technique and tactics are reviewed and long-term follow-up of the patient is presented.

RESUMO As lesões em face representam um grande agravo à saúde do indivíduo, principalmente pela sua significância, tanto funcional, por abrigar órgãos sensitivos e parte dos sistemas respiratório e digestório, quanto estético. Neste cenário, ferimentos por arma de fogo neste local, geram grande preocupação pela magnitude de seus danos, devendo a equipe de Cirurgia e Traumatologia Bucomaxilofacial agir para que o tratamento possibilite a reabilitação do paciente no menor tempo possível, com o mínimo de complicações e sequelas. O objetivo desse trabalho é relatar um caso clínico de uma paciente de 19 anos de idade, apresentando uma fratura cominutiva, com perda de substância, em corpo de mandíbula por projétil de arma de fogo, tratada de forma imediata, com fixação interna estável, utilizando o sistema placa-parafuso 2,0 mm para a simplificação da fratura e placa de reconstrução 2,4 mm locking sobre a lacuna óssea. Aspectos relevantes da técnica e tática cirúrgica são revistos e o acompanhamento da paciente em longo prazo é apresentado.

Topographic specializations of catecholaminergic cells and ganglion cells and distribution of calcium binding proteins in the crepuscular rock cavy (Kerodon rupestris) retina.

The rock cavy (Kerodon rupestris) is a crepuscular Hystricomorpha rodent that has been used in comparative analysis of retinal targets, but its retinal organization remains to be investigated. In order to better characterize its visual system, the present study analyzed neurochemical features related to the topographic organization of catecholaminergic cells and ganglion cells, as well the distribution of calcium-binding proteins in the outer and inner retina. Retinal sections and/or wholemounts were processed using tyrosine hydroxylase (TH), GABA, calbindin, parvalbumin and calretinin immunohistochemistry or Nissl staining. Two types of TH-immunoreactive (TH-IR) cells were found which differ in soma size, dendritic arborization, intensity of TH immunoreactivity and stratification pattern in the inner plexiform layer. The topographic distribution of all TH-IR cells defines a visual streak along the horizontal meridian in the superior retina. The ganglion cells are also distributed in a visual streak and the visual acuity estimated considering their peak density is 4.13 cycles/degree. A subset of TH-IR cells express GABA or calbindin. Calretinin is abundant in most of retinal layers and coexists with calbindin in horizontal cells. Parvalbumin is less abundant and expressed by presumed amacrine cells in the INL and some ganglion cells in the GCL. The topographic distribution of TH-IR cells and ganglion cells in the rock cavy retina indicate a suitable adaptation for using a broad extension of its inferior visual field in aspects that involve resolution, adjustment to ambient light intensity and movement detection without specialized eye movements.

Supplementation with Herbal Extracts to Promote Behavioral and Neuroprotective Effects in Experimental Models of Parkinson's Disease: A Systematic Review.

Parkinson's disease (PD) consists of a neurodegenerative pathology that has received a considerable amount of attention because of its clinical manifestations. The most common treatment consists of administering the drugs levodopa and biperiden, which reduce the effectiveness of the disease and the progress of its symptoms. However, phytotherapy treatment of PD has shown great potential in retarding the loss of dopaminergic neurons and minimizing the behavioral abnormalities. The aim of this study is to systematically review the use of supplemental herbal plants with cellular protective effect and behavioral activity in in vivo and in vitro experimental models. A total of 20 studies were summarized, where the effectiveness of herbal extracts and their isolated bioactive compounds was observed in animal models for PD. The main neurochemical mechanisms found in these studies are schematically represented. The herbal extracts and their biocompounds have antioxidant, anti-apoptotic, and antiinflammatory properties, which contribute to avoiding neuronal loss. Reports show that besides acting on the biosynthesis of dopamine and its metabolites, these compounds prevent D2 receptors' hypersensitivity. It is suggested that further studies need be conducted to better understand the mechanisms of action of the bioactive compounds distributed in these plants. Copyright © 2017 John Wiley & Sons, Ltd.

Behavioral and neurochemical effects of alpha lipoic acid associated with omega-3 in tardive dyskinesia induced by chronic haloperidol in rats.

Tardive dyskinesia (TD) is characterized by involuntary movements of the lower portion of the face being related to typical antipsychotic therapy. TD is associated with the oxidative imbalance in the basal ganglia. Lipoic acid (LA) and omega-3 (ω-3) are antioxidants acting as enzyme cofactors, regenerating antioxidant enzymes. This study aimed to investigate behavioral and neurochemical effects of supplementation with LA (100 mg/kg) and ω-3 (1 g/kg) in the treatment of TD induced by chronic use of haloperidol (HAL) (1 mg/kg) in rats. Wistar male rats were used, weighing between 180-200 g. The animals were treated chronically (31 days) with LA alone or associated with HAL or ω-3. Motor behavior was assessed by open-field test, the catalepsy test, and evaluation of orofacial dyskinesia. Oxidative stress was accessed by determination of lipid peroxidation and concentration of nitrite. LA and ω-3 alone or associated caused an improvement in motor performance by increasing locomotor activity in the open-field test and decreased the permanence time on the bar in the catalepsy test and decreased the orofacial dyskinesia. LA and ω-3 showed antioxidant effects, decreasing lipid peroxidation and nitrite levels. Thus, the use of LA associated with ω-3 reduced the extrapyramidal effects produced by chronic use of HAL.

Effect of FGF-2 and sciatic nerve grafting on ChAT expression in dorsal root ganglia neurons of spinal cord transected rats.

Neurotrophic factors and peripheral nerves are known to be good substrates for bridging CNS trauma. The involvement of fibroblast growth factor-2 (FGF-2) activation in the dorsal root ganglion (DRG) was examined following spinal cord injury in the rat. We evaluated whether FGF-2 increases the ability of a sciatic nerve graft to enhance neuronal plasticity, in a gap promoted by complete transection of the spinal cord. The rats were subjected to a 4mm-long gap at low thoracic level and were repaired with saline (Saline or control group, n=10), or fragment of the sciatic nerve (Nerve group, n=10), or fragment of the sciatic nerve to which FGF-2 (Nerve+FGF-2 group, n=10) had been added immediately after lesion. The effects of the FGF-2 and fragment of the sciatic nerve grafts on neuronal plasticity were investigated using choline acetyl transferase (ChAT)-immunoreactivity of neurons in the dorsal root ganglion after 8 weeks. Preservation of the area and diameter of neuronal cell bodies in dorsal root ganglion (DRG) was seen in animals treated with the sciatic nerve, an effect enhanced by the addition of FGF-2. Thus, the addition of exogenous FGF-2 to a sciatic nerve fragment grafted in a gap of the rat spinal cord submitted to complete transection was able to improve neuroprotection in the DRG. The results emphasized that the manipulation of the microenvironment in the wound might amplify the regenerative capacity of peripheral neurons.

Plasticity of mesenchymal stem cells from mouse bone marrow in the presence of conditioned medium of the facial nerve and fibroblast growth factor-2.

A number of evidences show the influence of the growth of injured nerve fibers in peripheral nervous system as well as potential implant stem cells (SCs). The SCs implementation in the clinical field is promising and the understanding of proliferation and differentiation is essential. This study aimed to evaluate the plasticity of mesenchymal SCs from bone marrow of mice in the presence of culture medium conditioned with facial nerve explants and fibroblast growth factor-2 (FGF-2). The growth and morphology were assessed for over 72 hours. Quantitative phenotypic analysis was taken from the immunocytochemistry for glial fibrillary acidic protein (GFAP), protein OX-42 (OX-42), protein associated with microtubule MAP-2 (MAP-2), protein ß-tubulin III (ß-tubulin III), neuronal nuclear protein (NeuN), and neurofilament 200 (NF-200). Cells cultured with conditioned medium alone or combined with FGF-2 showed morphological features apparently similar at certain times to neurons and glia and a significant proliferative activity in groups 2 and 4. Cells cultivated only with conditioned medium acquired a glial phenotype. Cells cultured with FGF-2 and conditioned medium expressed GFAP, OX-42, MAP-2, ß-tubulin III, NeuN, and NF-200. This study improves our understanding of the plasticity of mesenchymal cells and allows the search for better techniques with SCs.

Sciatic nerve grafting and inoculation of FGF-2 promotes improvement of motor behavior and fiber regrowth in rats with spinal cord transection.

PURPOSE: Failure of severed adult central nervous system (CNS) axons to regenerate could be attributed with a reduced intrinsic growing capacity. Severe spinal cord injury is frequently associated with a permanent loss of function because the surviving neurons are impaired to regrow their fibers and to reestablish functional contacts. Peripheral nerves are known as good substrate for bridging CNS trauma with neurotrophic factor addition. We evaluated whether fibroblastic growth factor 2 (FGF-2) placed in a gap promoted by complete transection of the spinal cord may increase the ability of sciatic nerve graft to enhance motor recovery and fibers regrow. METHODS: We used a complete spinal cord transection model. Rats received a 4 mm-long gap at low thoracic level and were repaired with saline (control) or fragment of the sciatic nerve (Nerve) or FGF-2 was added to nerve fragment (Nerve+FGF-2) to the grafts immediately after complete transection. The hind limbs performance was evaluated weekly for 8 weeks by using motor behavior score (BBB) and sensorimotor tests-linked to the combined behavior score (CBS), which indicate the degree of the motor improvement and the percentage of functional deficit, respectively. Neuronal plasticity were evaluated at the epicenter of the injury using MAP-2 and GAP-43 expression. RESULTS: Spinal cord treatment with sciatic nerve and sciatic nerve plus FGF-2 allowed recovery of hind limb movements compared to control, manifested by significantly higher behavioral scores. Higher amounts of MAP-2 and GAP-43 immunoreactive fibers were found in the epicenter of the graft when FGF-2 was added. CONCLUSIONS: FGF-2 added to the nerve graft favored the motor recovery and fiber regrowth. Thus, these results encourage us to explore autologous transplantation as a novel and promising cell therapy for treatment of spinal cord lesion.

A assistência de enfermagem às vítimas com traumatismo cranioencefálico: (re)discutindo as práticas emergenciais / Nursing assistance to the victims with traumatic brain injury: (re)discussing the emergency practices / La asistencia de enfermería a las víctimas con traumatismo craneoencefálico: (re)discutendo las prácticas de emergencia

Objetivo: discutir o atendimento às vítimas com traumatismo cranioencefálico (TCE) por parte dos enfermeiros do Pronto Socorro de um hospital público no interior do Rio Grande do Norte. Metodologia: estudo descritivo e exploratório com abordagem qualitativa realizado com oito enfermeiros do pronto-socorro do Hospital Regional Tarcísio Maia (HRTM) em Mossoró-RN. Para a coleta de dados foram utilizadas entrevistas semi-estruturadas gravadas em aparelho MP4 e depois transcritas para facilitar a estratificação dos resultados. Os dados foram discutidos a partir da técnica de análise de conteúdo proposta por Bardin. A pesquisa só teve início após aprovação pelo Comitê de Ética institucional mediante o Protocolo n. 095/2010 e CAAE n. 2983.0.000.351-10. Resultados: percebeu-se que, em grande parte dos casos, as intervenções de enfermagem restringem-se ao cumprimento das prescrições médicas e rotinas do serviço. Entretanto, há casos em que o enfermeiro já esboça um adequado dimensionamento da equipe, assim como desempenha procedimentos com relativa autonomia. Quanto à efetivação da sistematização da assistência de enfermagem (SAE), por unanimidade ficou constatado que esta não é empregada por uma série de motivos que vão da baixa qualificação profissional à falta de estrutura proporcionada pelo hospital. Conclusões: portanto, torna-se desafiador pensar a SAE voltada para o paciente vítima de TCE no âmbito do pronto-socorro. Isso porque uma série de circunstâncias favorece a perpetuação da situação crítica atual. Todavia, é preciso buscar uma enfermagem mais crítica que desempenhe seus procedimentos com maior autonomia.(AU)

Objective: to discuss the assistance to the victims with traumatic brain injuries (TBI) provide by the nurses of the emergency room of a public hospital in the interior of Rio Grande do Norte, Brazil. Methodology: this is a descriptive and exploratory with a qualitative approach carried out eight nurses of the emergency room of the Hospital Regional Tarcísio Maia in Mossoro, Rio Grande do Norte, Brazil. For the data collection semi-structured interviews recorded to a MP4 container and subsequently transcribed to make the presentation of results easier were used. The data were discussed having the content analysis technique proposed by Bardin as a basis. The research started only after the approval by the institutional Ethics Committee under the Protocol number 095/2010 and CAAE 2983.0.000.351-10. Results: it was realized that, in a large proportion of the cases, the nursing interventions are restricted to follow medical prescriptions and routines of the health service. However, there are cases in which the nurse already sketches an adequate team size, besides performing procedures with a relative autonomy. With regard to the implementation of the systematization of nursing assistance (SNA), it was unanimously found that this is not employed due to a number of reasons, come from the low professional traning to the lack of structure provided by the hospital. Conclusions: therefore, it becomes challenging to think the SNA driven to the patients who is a TBI victim within the emergency room. This is so because a series of circumstances favour the perpetuation of the current critical situation. However, there's a need to search for a more critical nursing which performs procedures with a larger autonomy.(AU)

Objetivo: discutir el atendimiento a las víctimas con traumatismo craneoencefálico (TCE) por parte de los enfermeros de la sala de emergencias de un hospital público de Rio Grande do Norte, Brazil. Metodología: esto es un estudio descriptivo y exploratorio con abordaje cualitativo realizado con ocho enfermeros de la sala de emergencia del Hospital Regional Tarcísio Maia (HRTM) en Mossoró, Rio Grande do Norte, Brazil. Para la recogida dos datos fueron utilizadas entrevistas semi-estructuradas grabadas en aparato de MP4 y después transcritas para facilitar la estratificación de los resultados. Los datos fueron discutidos desde la técnica del análisis de contenido propuesta por Bardin. La investigación se inició somente después de la aprobación por el Comité de Ética bajo el Protocolo 095/2010 y CAAE: 2983.0.000.351-10. Resultados: se percebió que, en grande parte de los casos, las intervenciones de enfermería se limitan al cumplimiento de las prescripciones médicas y rutinas del servicio. Pero hay casos en que lo enfermero ya esboza una adecuada distribución del equipo así como desempeña procedimientos con relativa autonomía. En cuanto a la implementación de la sistematización de la atención de enfermería (SAE), por unanimidad fue constatado que esta no es empleada por una serie de razones que van desde la baja calificación profesional a la falta de estructura proporcionada por el hospital. Conclusiones: por lo tanto, torna desafiador pensar la SAE a el paciente victima de TCE en el ámbito de la sala de emergencia. Esto se debe a una serie de circunstancias que favorece la perpetuación de la situación crítica actual. Sin embargo, se debe buscar una enfermería más crítica que desempeñe sus procedimientos con una mayor autonomía.(AU)

A enfermagem e o traumatismo cranioencefálico: estudo de revisão sistemática de literatura / Nursing and head injury: literature systematic review study / Enfermería y traumatismo craneoencefálico: estúdio de revisión sistemática de literatura

Objetivo: analisar a produção científica sobre a assistência de Enfermagem às vítimas de Traumatismo Cranioencefálico -TCE, tendo como perspectiva o advento de melhorias no tocante à planificação de estratégias de cuidado em âmbito hospitalar. Metodologia: trata-se de um estudo descritivo, do tipo revisão sistemática da literatura. Foi realizada uma busca nas bases de dados LILACS, BDENF e MEDLINE, pelos descritores Enfermagem, Traumatismos Encefálicos e Traumatismos Craniocerebrais. Para refinamento da busca, foi realizado o cruzamento dos unitermos nos idiomas inglês,espanhol e português. Os critérios de inclusão dos artigos eram que os mesmos estivessem publicados em periódicos nacionais e internacionais independente do qualis, durante o período de Janeiro de 2000 a Janeiro de 2010 e disponíveis no idioma inglês, espanhol ou português. Resultados: foram encontrados 19 artigos, sendo cinco em espanhol, sete em inglês e sete em português. A grande maioria dos trabalhos restringe-se a caracterizar a demanda das vítimas de TCE e/ou a validar estratégias de cuidados que vislumbrem uma melhor recuperação no âmbito hospitalar. Conclusões: O número reduzido de trabalhos publicados expressa a carência que a enfermagem tem de conhecimentos no âmbito da neurologia.Além disso, é preciso (re)discutir o rumo tomado por essas pesquisas, pois elas têm demonstrado uma supervalorização das práticas clínicas intra-hospitalares em detrimento a uma assistência integral.(AU)

Objective: to analyze the scientific research about the nursing care for Traumatic Brain Injury ­ TBI, with the perspective of the advent of the improvements in upon the guide of strategic canes in the hospital. Methodology: this is about a descriptive study of systematic review a literature it was performed as a search in the information platform databases LILACS, BDENF and MEDLINE, for descriptors Nursing Brain Injuries and Craniocerebral Trauma. To refine the search was conducted the intersection of keywords in English, Spanish and Portuguese. The inclusion criteria for articles were that they were published in national and international independent of which the journal during the period January 2000 to January 2010 and available in English, Spanish or Portuguese. Results: there were nineteen articles five in Spanish, seven in English and seven in Portuguese. The biggest majority of work was restrict the collected facts characterize the quantity of victims from TBI and the efficiency of the strategic cares that was considered as a more efficient recovery in the hospital. Conclusions: The small number of published articles express the nursing shortage has knowledge in neurology. Moreover, it's necessary check the chosen way to the neurological nursing. That's not frequent and has given wrong information about the clinical practice inside of the hospital rather than a comprehensive health care.(AU)

Objetivo: analizar la literatura científica sobre los cuidados de enfermería para la lesión cerebral traumática - TEC, con la perspectiva de la llegada de mejoras en relación con la planificación de estrategias de atención en el hospital. Metodología: este estudio es una revisión descriptiva y sistemática de la literatura. Se realizó una búsqueda en la bases de datos LILACS, BDENF y MEDLINE, los descriptores para la Enfermería, y Lesiones Cerebrales Craneocerebrales Trauma. Para refinar la búsqueda se llevó a cabo el cruce de palabras clave en Inglés, español y portugués. Los criterios de inclusión para que los artículos fueron publicados en nacionales e internacionales independientes de la que la revista durante el período comprendido desde enero 2000 hasta enero 2010 y disponibles en Inglés, español y portugués.Resultados: se encontraron diecinueve artículos, cinco en español, siete en Inglés y siete en portugués. La gran mayoría del trabajo se limita a caracterizar la demanda de víctimas de TCE y / o validar las estrategias de atención que contemplen una mejor recuperación en el hospital. Conclusiones: el pequeño número de trabajos publicados que expresan la escasez de enfermeras tiene conocimiento de la neurología. También, es necesario (re)examinar el camino recorrido por la investigación en enfermería neurológica. Además no son frecuentes, han mostrado una sobreestimación en el hospital de la práctica clínica en vez de una atención integral de salud.(AU)

The contributions of antioxidant activity of lipoic acid in reducing neurogenerative progression of Parkinson's disease: a review.

ABSTRACT This work reviews the evidence of the mechanism of neuronal degeneration in Parkinson's disease (PD) and the neuroprotective effect of lipoic acid and its use in the treatment of PD. PD is characterized by slow and progressive degeneration of dopaminergic neurons of the substantia nigra pars compacta, leading to reduction of the striatal dopaminergic terminals. It is known that several factors influence neuronal damage. Among these factors, oxidative stress, immune system activity, microglial cells, and apoptotic mechanisms are of major importance. Currently, several antioxidants have been studied with the aim of reducing/slowing the progression of neurodegenerative processes. Lipoic acid is considered a universal antioxidant because it is an amphipathic substance. Lipoic acid and its reduced form, dihidrolipoic acid, act against reactive oxygen species, reducing oxidative stress. Therefore, this antioxidant has been used in the treatment of many diseases, including a new perspective for the treatment of Parkinson's disease.

A organização tecnológica na produção de serviços de saúde: (re)conhecendo limites, abraçando perspectivas / The technology organization of production in health services: recognizing boundaries and embracing perspective / La organización tecnológica en la producción de servicios de salud: (re)conociendo límites y abarcando perspectivas

Objetivo: refletir sobre a atual dinâmica dos serviços de saúde evidenciando a importância das tecnologias leves como proposta de ruptura com o modelo médico curativista hegemônico. Metodologia: foi realizado um levantamento bibliográfico de autores considerados referência básica para o tema. A partir disso, foi desenvolvida uma reflexão teórica dos textos consultados, na perspectiva de subsidiar a discussão sobre as tecnologias leves e a produção do cuidado em saúde. Resultados: percebeu-se que os serviços de saúde apontam para uma prática fragmentadora, curativista e que valoriza os procedimentos de alta complexidade, a especialização e as tecnologias duras e leve-duras como garantia da qualidade da assistência. Conclusão: torna-se imprescindível que a organização tecnológica do trabalho em saúde resgate a priorização do uso das tecnologias leves para que se possa avançar no processo de consolidação de um sistema de saúde de qualidade. Nesse sentido, Universidades e os serviços precisam atuar mutuamente objetivando a transformação da realidade.(AU)

Objective: to reflect on the current dynamics of health services focusing on the importance of soft technologies such proposal to break with the curative hegemonic medical model. Methodology: it was performed a literature review of author considered a basic reference for the theme. From this, was developed a theoretical discussion of the texts consulted with a view to support the discussion of soft technologies and production of health care. Results: we perceived that health services point to a fragmented practice, curative and appreciate the highly complex procedures, expertise and hard technologies and soft-hard to guarantee the quality of care. Conclusion: it is essential that the technological organization of work in health rescue the prioritization of the use of soft technologies to that can move forward in the consolidation of the quality of a health system. In this sense, universities and health institutions must act mutually pointing to the reality transformation.(AU)

Objetivo: reflexionar sobre la dinámica actual de los servicios de salud se destaca la importancia de las tecnologías blandas propuesta de este tipo para romper con el modelo médico hegemónico de la curativa. Metodología: se realizó una revisión de la literatura de autores considera como una referencia básica para el tema. De esto, hemos desarrollado un análisis teórico de los textos consultados con el fin de apoyar la discusión de las tecnologías blandas y la producción de atención de la salud. Resultados: se observó que los servicios sanitarios apuntan a una práctica trituradora, curativos y de apreciar los procedimientos de alta complejidad, la experiencia y las tecnologías de duro y blando-duro para garantizar la calidad de la atención. Conclusión: es esencial que la organización tecnológica de los trabajos de rescate en la priorización de la salud de la utilización de tecnologías blandas para avanzar en la consolidación de un sistema de atención sanitaria de calidad. En este sentido, las universidades y otros servicios deben actuar encaminadas a cambiar la realidad.(AU)