Identification of Potential Multitarget Compounds against Alzheimer's Disease through Pharmacophore-Based Virtual Screening.

Alzheimer's disease (AD) is a neurodegenerative disease characterized by progressive loss of cognitive functions, and it is the most prevalent type of dementia worldwide, accounting for 60 to 70% of cases. The pathogenesis of AD seems to involve three main factors: deficiency in cholinergic transmission, formation of extracellular deposits of ß-amyloid peptide, and accumulation of deposits of a phosphorylated form of the TAU protein. The currently available drugs are prescribed for symptomatic treatment and present adverse effects such as hepatotoxicity, hypertension, and weight loss. There is urgency in finding new drugs capable of preventing the progress of the disease, controlling the symptoms, and increasing the survival of patients with AD. This study aims to present new multipurpose compounds capable of simultaneously inhibiting acetylcholinesterase (AChE), butyrylcholinesterase (BChE)-responsible for recycling acetylcholine in the synaptic cleft-and beta-secretase 1 (BACE-1)-responsible for the generation of amyloid-ß plaques. AChE, BChE, and BACE-1 are currently considered the best targets for the treatment of patients with AD. Virtual hierarchical screening based on a pharmacophoric model for BACE-1 inhibitors and a dual pharmacophoric model for AChE and BChE inhibitors were used to filter 214,446 molecules by QFITBACE > 0 and QFITDUAL > 56.34. The molecules selected in this first round were subjected to molecular docking studies with the three targets and further evaluated for their physicochemical and toxicological properties. Three structures: ZINC45068352, ZINC03873986, and ZINC71787288 were selected as good fits for the pharmacophore models, with ZINC03873986 being ultimately prioritized for validation through activity testing and synthesis of derivatives for SAR studies.

PREVALENCE OF POSTURAL CHANGES IN SCHOOL CHILDREN AND ADOLESCENTS.

Objective: Investigate the prevalence of postural changes and correlate them with body weight and the weight of schoolchildren's backpacks in a school in the city of São João del-Rei-MG. Material and. Methods: The study is an original type, with a cross-sectional design, where 109 schoolchildren of both sexes and mean age of 13 years were evaluated. The New York scale was used for posture analysis, measuring body weight, height, backpack weight, and Body Mass Index (BMI). The ANOVA statistical test and Pearson's correlation test were used, considering a significance level of 0.05. Results: According to the results, the general average of the scores of postural problems was 68.7 points, with a predominance in the head, spine, hips, trunk, and abdomen. The regions of shoulder, feet, and neck presented mean scores below seven. The mean height was 1.61 m, body weight 56.03 kg, backpack weight 4.49 kg and BMI was 21.51 kg/m. Conclusion: Postural alterations are highly prevalent among the evaluated students. The most affected body segments are the head, spine, hips, trunk, and abdomen. However, this finding was not related to the weight of the backpacks or the students' body weight. However, different parameters must be used to analyze the factors that may be related to such findings, such as ergonomic changes, inadequate habits, growth spurt, among others. Evidence Level III,Cross-sectional Observational Study.

Objetivo: Investigar a prevalência de alterações posturais e correlacionar com o peso corporal e o peso das mochilas dos escolares em uma escola no município de São João del-Rei-MG. Métodos: O estudo é do tipo original, com delineamento transversal onde foram avaliados 109 escolares, com média de idade de 13 anos, de ambos os sexos. A escala de Nova Iorque foi utilizada para análise de postura, medição do peso corporal, altura, peso da mochila e Índice de Massa Corporal (IMC). Foi utilizado o teste estatístico ANOVA e o teste de correlação de Pearson, considerando o nível de significância de 0,05. Resultados: De acordo com os resultados, a média geral dos escores dos problemas posturais foi de 68,7 pontos, com predomínio na região da cabeça, coluna, nos quadris, no tronco, e no abdômen. As regiões dos ombros, pés e pescoço apresentaram médias de escores menores que 7. A média da altura foi de 1,61m, do peso corporal de 56,03kg, do peso das mochilas de 4,49 kg e 21,51 kg/m do IMC. Conclusão: Conclui-se que existe uma alta prevalência de alterações posturais entre os escolares avaliados. Sendo que, os segmentos corporais mais comprometidos são, a cabeça, a coluna vertebral, os quadris, o tronco e o abdômen. No entanto, esse achado não foi relacionado ao peso das mochilas ou ao peso corporal dos escolares. Assim, diferentes parâmetros devem ser utilizados para analisar os fatores que podem estar relacionados a tais achados, como alterações ergonômicas, hábitos inadequados, estirão de crescimento, entre outros. Nível de Evidência III, Estudo Transversal Observacional.

Fatores de risco intrínsecos para quedas entre idosos institucionalizados / Intrinsic risk factors for falls among institutionalized older adults

Objetivo: Investigar os fatores de risco intrínsecos para queda entre idosos de duas Instituições de Longa Permanência (ILP) no interior de Minas Gerais/Brasil. Métodos: Foram avaliados 20 idosos com idade média de 79 anos (entre 60-100 anos). Foram aplicadas as escalas de Tinetti e Barthel para avaliação do equilíbrio corporal e independência funcional, respectivamente. A escala de Downton para análise do risco de quedas; a estesiometria, a dinamometria e o teste manual de força muscular para estimar respectivamente, a sensibilidade das mãos e pés, a força de preensão palmar e a força dos músculos de membros inferiores. A análise estatística utilizada foi o teste t-student, o teste de correlação de Pearson, a análise de variância (ANOVA-one way), considerando nível de significância de 5%. Resultados: A média geral do escore da escala de Dowton foi de 4,68 (p<0,05); a do equilíbrio corporal foi de 14,57 pontos (p<0,05), a escala de Barthel foi de 72,36 pontos (p<0,05); a força de preensão palmar foi de 2,73 kg/m² (±3,64) e a média de força em membros inferiores foi de 3,7 kg/m2 (p<0,05). Conclusão: Conclui-se que os idosos avaliados apresentam alto risco de quedas sendo os parâmetros mais comprometidos e responsáveis por este risco, a polifarmácia, desequilíbrio, fraqueza muscular, perda de sensibilidade e dependência funcional.

Objective: The objective of the study is to investigate the intrinsic risk factors for falls among elderly people from two Long Stay Institutions (ILP) in the countryside of Minas Gerais/Brazil. Methods: Twenty elderly people with a mean age of 79 years (between 60-100 years) were evaluated. Tinetti and Barthel scales were applied to assess body balance and functional independence, respectively. The Downton scale for the analysis of the risk of falls; esthesiometry, dynamometry and manual muscle strength test to estimate, respectively, the sensitivity of the hands and feet, the hand grip strength and the strength of the muscles of the lower limbs. The statistical analysis used was the t-student test, Pearson's correlation test, analysis of variance (ANOVA-one way), considering a significance level of 5%. Results: The general mean score on the Dowton scale was 4.68 (p<0.05); that of body balance was 14.57 points (p<0.05), the Barthel scale was 72.36 points (p<0.05); the handgrip strength was 2.73 kg/m² (±3.64) and the mean strength in the lower limbs was 3.7 kg/m2 (p<0.05). Conclusion: It is concluded that the evaluated elderly have a high risk of falls and the parameters most compromised and responsible for this risk are polypharmacy, imbalance, muscle weakness, loss of sensitivity and functional dependence.

The Effects of Resistance Exercise on the Cardiorespiratory Tissue of Rats with Parkinson's Disease.

Parkinson's Disease (PD) affects the cardiorespiratory system, causing an increase in the left ventricular mass in the heart and respiratory muscle weakness in relation to healthy individuals. The objective of this study was to investigate the effects of progressive resistive physical exercise on the vertical ladder on the histomorphometry of cardiac tissue and respiratory muscles in rats with PD. Seventy male Wistar rats, aged 40 days old, were divided into Parkinson's (PD) and Sham (SH) groups; they were also subdivided into groups that performed progressive resistive physical exercise on the vertical ladder Before Surgery (ExBS), After Surgery (ExAS), and Before and After Surgery (ExBAS). The physical training was carried out before and/or after PD induction. Exercise was performed five times a week for 25 min/day for four or eight weeks. PD induction was conducted via electrolytic stimulation of the Substantia nigra of the animals' brains, adopting the following stereotaxic table coordinates: -4.9; lateral medium equal to 1.7, and dorsoventral equal to 8.1. For the morphometric analysis of the heart, the following variables were calculated: relative weight and diameter and thickness of the left ventricle. The diaphragm and the myocardial, intercostal, and abdominal muscles were stained with Hematoxylin and Eosin (HE). The histomorphometric analysis was performed using the ImageJ software to assess the cross-sectional area of muscles and the number of muscle fibers. Progressive resistance exercise promoted the hypertrophy of respiratory muscles and the left ventricle in animals with PD.

Prevalence of postural changes in school children and adolescents / Prevalência de alterações posturais em crianças e adolescentes escolares

ABSTRACT Objective Investigate the prevalence of postural changes and correlate them with body weight and the weight of schoolchildren's backpacks in a school in the city of São João del-Rei-MG. Material and Methods The study is an original type, with a cross-sectional design, where 109 schoolchildren of both sexes and mean age of 13 years were evaluated. The New York scale was used for posture analysis, measuring body weight, height, backpack weight, and Body Mass Index (BMI). The ANOVA statistical test and Pearson's correlation test were used, considering a significance level of 0.05. Results According to the results, the general average of the scores of postural problems was 68.7 points, with a predominance in the head, spine, hips, trunk, and abdomen. The regions of shoulder, feet, and neck presented mean scores below seven. The mean height was 1.61 m, body weight 56.03 kg, backpack weight 4.49 kg and BMI was 21.51 kg/m. Conclusion Postural alterations are highly prevalent among the evaluated students. The most affected body segments are the head, spine, hips, trunk, and abdomen. However, this finding was not related to the weight of the backpacks or the students' body weight. However, different parameters must be used to analyze the factors that may be related to such findings, such as ergonomic changes, inadequate habits, growth spurt, among others. Evidence Level III,Cross-sectional Observational Study.

RESUMO Objetivo Investigar a prevalência de alterações posturais e correlacionar com o peso corporal e o peso das mochilas dos escolares em uma escola no município de São João del-Rei-MG. Métodos O estudo é do tipo original, com delineamento transversal onde foram avaliados 109 escolares, com média de idade de 13 anos, de ambos os sexos. A escala de Nova Iorque foi utilizada para análise de postura, medição do peso corporal, altura, peso da mochila e Índice de Massa Corporal (IMC). Foi utilizado o teste estatístico ANOVA e o teste de correlação de Pearson, considerando o nível de significância de 0,05. Resultados De acordo com os resultados, a média geral dos escores dos problemas posturais foi de 68,7 pontos, com predomínio na região da cabeça, coluna, nos quadris, no tronco, e no abdômen. As regiões dos ombros, pés e pescoço apresentaram médias de escores menores que 7. A média da altura foi de 1,61m, do peso corporal de 56,03kg, do peso das mochilas de 4,49 kg e 21,51 kg/m do IMC. Conclusão Conclui-se que existe uma alta prevalência de alterações posturais entre os escolares avaliados. Sendo que, os segmentos corporais mais comprometidos são, a cabeça, a coluna vertebral, os quadris, o tronco e o abdômen. No entanto, esse achado não foi relacionado ao peso das mochilas ou ao peso corporal dos escolares. Assim, diferentes parâmetros devem ser utilizados para analisar os fatores que podem estar relacionados a tais achados, como alterações ergonômicas, hábitos inadequados, estirão de crescimento, entre outros. Nível de Evidência III, Estudo Transversal Observacional.

Benefits of progressive resistance training on motor performance and muscular hypertrophy in rats with Parkinson's disease / Beneficios del entrenamiento con ejercicios de resistencia progresiva sobre el rendimiento motor y la hipertrofia muscular en ratas con enfermedad de Parkinson / Benefícios do treinamento com exercícios resistidos progressivos no desempenho motor e na hipertrofia muscular de ratos com doença de Parkinson

ABSTRACT Parkinson's disease (PD) is a progressive neurodegenerative condition defined by the presence of primary debilitating motor symptoms. This study aims to investigate the benefits of high-intensity progressive resistance training on muscle tissue and motor performance before and after the induction of PD in rats. A total of 80 male Wistar rats (Rattus norvegicus, var. albinus) aged 40 days and weighing between 250 and 450g were used. A total of 40 animals were subjected to PD surgery to induce electrolytic injury and were randomly assigned to the following subgroups: animals trained before PD induction (PA-Exa); animals trained after PD induction (PA-Exd); animals trained before and after PD induction (PA-Exad); and sedentary animals with PD induction (PA-Sed). The other 40 animals (control) were subjected to surgical access but not to PD electrolytic injury (Sham) and distributed in the same subgroups described above. For the PD induction surgery, electrolytic stimulation was used at the following coordinates: anteroposterior (AP) −4.9, mid-lateral (ML) 1.7,and dorsoventral (DV) 8.1. High-intensity progressive resistance training was performed on a vertical ladder five days/week from 30 to 45 minutes for four weeks. For our functional evaluation, the parallel bars and the misstep tests were used at the beginning (after surgery) and at the end of the experiment. After euthanasia, the forelimb biceps and hindlimb flexor hallucis longus muscles were removed. Processing, coloration, and histomorphometry analysis of muscle tissue were performed for all groups. To analyze the data, GraphPad Prism 9.4 was used with one-way analysis of variance (ANOVA) and a p<0.05. Data on muscle fiber count and area in forelimb biceps showed no significant differences, with a 0.853 and 0.4122 p-value, respectively. Flexor hallucis longus muscle fiber count showed a significant difference (p=0.0356), and PA-Exa and PA-Exd averaged the highest means. Hindlimb flexor hallucis longus muscle fiber area also evinced a significant difference (p=0.0306), in which PA-Exd, PA-Exad, and Sham-Exad showed the largest areas. Analysis of hindlegs in the parallel bars test showed that PA-Exad evinced the best functional performance. In the misstep test, we observed an increase in the number of errors animals made for almost all the groups, evincing a significant difference in the number of errors before and after the test only for PA-Exa, PA-Exd, and PA-Sed. We concluded that the animals that underwent high-intensity progressive training showed better performance in their hindlegs than in their fore ones and that animals that exercised before and after surgery benefited more from training.

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RESUMO A doença de Parkinson (DP) é uma doença neurodegenerativa progressiva definida pela presença de sintomas motores debilitantes primários. O objetivo deste estudo é investigar os benefícios do treinamento com exercícios físicos progressivos de alta intensidade no tecido muscular e no desempenho motor antes e depois da indução da DP em ratos. Para tanto, foram utilizados 80 ratos Wistar machos (Rattus norvegicus var. albinus) com 40 dias de vida e peso corporal entre 250 e 450g. Quarenta animais foram submetidos à cirurgia de indução da DP por lesão eletrolítica e distribuídos aleatoriamente nos seguintes subgrupos: animais treinados antes da indução da DP (PA-Exa), animais treinados depois da indução da DP (PA-Exd), animais treinados antes e depois da indução da DP (PA-Exad) e animais sedentários com indução da DP (PA-Sed). Os outros 40 animais (controle) foram submetidos ao acesso cirúrgico, mas não à lesão eletrolítica (sham) da DP, e distribuídos nos mesmos subgrupos descritos anteriormente. Para cirurgia de indução da DP, foi utilizada estimulação eletrolítica nas coordenadas: anteroposterior (AP) igual a −4,9, médio-lateral (ML) igual a 1,7 e dorsoventral (DV) igual a 8,1. O treinamento com exercícios físicos progressivos de alta intensidade foi realizado na escada vertical, cinco dias/semana, de 30 a 45 minutos, por quatro semanas. Para avaliação funcional, foi utilizado o teste das barras paralelas e do passo em falso no início, depois da cirurgia e no final do experimento. Após a eutanásia dos animais, foram retirados os músculos bíceps da pata dianteira e flexor longo do hálux da pata traseira. Foi realizado processamento, coloração e análise histomorfométrica do tecido muscular dos grupos de animais. Para análise dos dados, foi utilizado o programa GraphPad Prism 9.4, com a análise de variância (Anova) one-way e p<0,05. Os dados sobre contagem e área das fibras musculares no bíceps da pata dianteira do animal não demonstraram diferenças significativas com valor de p igual a 0,853 e 0,4122, respectivamente. Os resultados da contagem de fibras musculares no flexor longo do hálux demonstraram diferença significativa (p=0,0356), e os grupos que apresentaram maior média de fibras foram PA-Exa e PA-Exd. Sobre a área das fibras do músculo flexor longo do hálux da pata traseira, também foi evidenciada diferença significativa (p=0,0306), e os grupos que apresentaram maiores áreas foram PA-Exd, PA-Exad e o grupo de animais treinados antes e depois da falsa cirurgia (SHAM-Exad). A análise das patas traseiras no teste das barras paralelas demonstrou que os animais do grupo PA-Exad apresentaram melhora do desempenho funcional nesse teste. No teste do passo em falso, foi observado aumento do número de erros cometidos pelos animais em quase todos os grupos, evidenciando diferença significativa no número de erros antes e depois do teste apenas nos grupos PA-Exa, PA-Exd e PA-Sed. Conclui-se que os animais que realizaram o treinamento com exercícios físicos progressivos de alta intensidade apresentaram melhor desempenho nas patas traseiras em comparação com as dianteiras e que os animais que se exercitaram antes e depois da cirurgia foram mais beneficiados com o treinamento.

High Intensity Physical Exercise before the Brain Ischemia Promotes Increase in Brain Injury.

Studies have demonstrated the beneficial effects of light- and moderate-intensity physical exercise on the nervous system of animals with cerebral ischemia. To investigate the effects of two high-intensity physical exercise protocols, standardized for resistance and strength gain, in rats trained before cerebral ischemia induced by Bilateral Common Carotid Artery Occlusion (BCCAO). Forty-eight male Wistar rats were divided into two groups: with ischemia and without ischemia (sham). Both groups were subdivided into animals that performed high-intensity exercises in the muscle strength modality (I+Ex2; Sham+Ex2; n=16); animals submitted to high-intensity exercises in the aerobic modality (I+Ex1; Sham+Ex1; n=16), and animals that did not practice physical exercises - sedentary (I+Sed; Sham+Sed, n=16). Cerebral ischemia was induced using the BCCAO model. The physical training program used before the procedure was of high intensity, in the aerobic and muscular strength modalities, and was performed using a vertical ladder, for 4 weeks, 5 days per week. In order to process and stain the brain tissue, the Nissl method was used for neuron labeling and quantification in the cortex, striatum, and hippocampus. As for the animals' body weight and the heart weight differences were found between the groups I+Ex2 and Sham+Ex2 (p<0.05). Data on neuron quantification in the cerebral cortex, dentate gyrus, and right and left striatum revealed significant differences between groups. High-intensity physical training in the strength gain modality promotes significant damage to the animal's brain when performed prior to BCCAO-induced cerebral ischemia.

Nonperiodic stimulation for the treatment of refractory epilepsy: Applications, mechanisms, and novel insights.

Electrical stimulation of the central nervous system is a promising alternative for the treatment of pharmacoresistant epilepsy. Successful clinical and experimental stimulation is most usually carried out as continuous trains of current or voltage pulses fired at rates of 100 Hz or above, since lower frequencies yield controversial results. On the other hand, stimulation frequency should be as low as possible, in order to maximize implant safety and battery efficiency. Moreover, the development of stimulation approaches has been largely empirical in general, while they should be engineered with the neurobiology of epilepsy in mind if a more robust, efficient, efficacious, and safe application is intended. In an attempt to reconcile evidence of therapeutic effect with the understanding of the underpinnings of epilepsy, our group has developed a nonstandard form of low-frequency stimulation with randomized interpulse intervals termed nonperiodic stimulation (NPS). The rationale was that an irregular temporal pattern would impair neural hypersynchronization, which is a hallmark of epilepsy. In this review, we start by briefly revisiting the literature on the molecular, cellular, and network level mechanisms of epileptic phenomena in order to highlight this often-overlooked emergent property of cardinal importance in the pathophysiology of the disease. We then review our own studies on the efficacy of NPS against acute and chronic experimental seizures and also on the anatomical and physiological mechanism of the method, paying special attention to the hypothesis that the lack of temporal regularity induces desynchronization. We also put forward a novel insight regarding the temporal structure of NPS that may better encompass the set of findings published by the group: the fact that intervals between stimulation pulses have a distribution that follows a power law and thus may induce natural-like activity that would compete with epileptiform discharge for the recruitment of networks. We end our discussion by mentioning ongoing research and future projects of our lab.

Analysis of motor performance and histomorphometry of skeletal muscles of rats exercised after cerebral ischemia.

INTRODUCTION: Cerebral ischemia causes muscle atrophy and motor incoordination in animals, impairing motor performance. OBJECTIVE: Thus, the objective of the present study was to analyze the motor performance and histomorphometry of the biceps brachii, soleus, and anterior tibialis muscles of rats submitted to a treadmill training program after induction of cerebral ischemia by the transient occlusion of the middle cerebral artery (MCAO). MATERIALS AND METHODS: To do so, twenty-four 30-day-old Wistar rats were utilized. The exercises were performed for 6 weeks on a leveled treadmill, for 30 min/day, 5 days a week, at a controlled speed of 8 m/min, and the MCAO surgery took place for 60 min. The animals were divided into the following experimental groups: SC (n = 6): control animals that underwent false surgery (operation without the induction of cerebral ischemia) and did not exercise (sedentary); CEA (n = 6): control animals exercised on the treadmill after the false surgery; SI (n = 6): sedentary ischemic animals; IEA (n = 6): animals exercised on the treadmill after the induction of cerebral ischemia. RESULTS: The type-II fibers atrophy in muscle soleo was observed in groups CEA (5125.63 ± 158.83) and SI (4982.38 ± 248.16) when compared to the SC (5927.98 ± 106.17) and IEA (6526.73 ± 195.08) groups. CONCLUSION: It is concluded that the low intensity physical exercise performed on the treadmill for six weeks after the induction of cerebral ischemia by OMCA, promoted a decrease in the atrophy of muscles important of the ischemic animals, benefiting their motor performance.

INCIDENCE OF POSTURAL CHANGES AND TEMPOROMANDIBULAR DISORDERS IN STUDENTS.

OBJECTIVE: The aim of this study was to identify the incidence of postural changes and temporomandibular disorders (TMD) in children and adolescents . METHODS: We selected 117 individuals aged 10-18 years from a state school in the Zona da Mata region of Minas Gerais. The students were evaluated in four stages: assessment of body weight and height and calculation of body mass index; posture evaluation using a questionnaire developed by the researchers; application of a questionnaire recommended by the American Academy of Orofacial Pain to assess TMD; and, finally, application of the Fonseca anamnesis questionnaire . RESULTS: Of our sample, 26.36% had no TMD, 50.9% had mild TMD, 21.8% moderate TMD, and 0.9% severe TMD. Of the participants with moderate or severe TMD (30.8%), about 56% had some kind of change in head positioning. We found that 88% of the children with moderate or severe TMD had changes in the shoulders . CONCLUSION: The postural changes found in the head and shoulders are related to the biomechanical adaptation of the muscles of mastication and consequent changes in the TMJ. Level Of Evidence Iii, Non-Consecutive Patient Study Without Gold Reference Standard Applied Uniformly.

OBJETIVO: O objetivo deste estudo foi identificar a incidência de alterações posturais e transtornos temporomandibulares (TTM) em crianças e adolescentes. MÉTODOS: Foram selecionados 117 indivíduos com idade entre 10 e 18 anos, de uma escola estadual na Zona da Mata de Minas Gerais. A avaliação dos escolares foi feita em quatro etapas: avaliação do peso corporal, da estatura e cálculo do índice de massa corporal; avaliação postural, utilizando um questionário elaborado pelos pesquisadores; aplicação do questionário para avaliação de TTM recomendado pela American Academy of Orofacial Pain; e, por fim, aplicação do questionário anamnésico de Fonseca. RESULTADOS: Em nossa amostra, 26,36% não tinham TTM, 50,9% apresentavam TTM leve, 21,8% TTM moderado e 0,9% TTM severo. Dos participantes com TTM moderado ou severo (30,8%), cerca de 56% apresentaram algum tipo de alteração de posicionamento da cabeça. Constatou-se que 88% das crianças com TTM moderado ou severo tinham alterações nos ombros. CONCLUSÃO: As alterações posturais verificadas na cabeça e nos ombros estão relacionadas com a adaptação biomecânica dos músculos da mastigação e a consequente alteração na ATM. Nível De Evidência Iii, Estudo De Paciente Não Consecutivo Sem Padrão De Referência Ouro Aplicado Uniformemente.

Incidence of postural changes and temporomandibular disorders in students / Incidência das alterações posturais e transtornos temporomandibulares em estudantes

ABSTRACT Objective: The aim of this study was to identify the incidence of postural changes and temporomandibular disorders (TMD) in children and adolescents . Methods: We selected 117 individuals aged 10-18 years from a state school in the Zona da Mata region of Minas Gerais. The students were evaluated in four stages: assessment of body weight and height and calculation of body mass index; posture evaluation using a questionnaire developed by the researchers; application of a questionnaire recommended by the American Academy of Orofacial Pain to assess TMD; and, finally, application of the Fonseca anamnesis questionnaire . Results: Of our sample, 26.36% had no TMD, 50.9% had mild TMD, 21.8% moderate TMD, and 0.9% severe TMD. Of the participants with moderate or severe TMD (30.8%), about 56% had some kind of change in head positioning. We found that 88% of the children with moderate or severe TMD had changes in the shoulders . Conclusion: The postural changes found in the head and shoulders are related to the biomechanical adaptation of the muscles of mastication and consequent changes in the TMJ. Level Of Evidence Iii, Non-Consecutive Patient Study Without Gold Reference Standard Applied Uniformly.

RESUMO Objetivo: O objetivo deste estudo foi identificar a incidência de alterações posturais e transtornos temporomandibulares (TTM) em crianças e adolescentes. Métodos: Foram selecionados 117 indivíduos com idade entre 10 e 18 anos, de uma escola estadual na Zona da Mata de Minas Gerais. A avaliação dos escolares foi feita em quatro etapas: avaliação do peso corporal, da estatura e cálculo do índice de massa corporal; avaliação postural, utilizando um questionário elaborado pelos pesquisadores; aplicação do questionário para avaliação de TTM recomendado pela American Academy of Orofacial Pain; e, por fim, aplicação do questionário anamnésico de Fonseca. Resultados: Em nossa amostra, 26,36% não tinham TTM, 50,9% apresentavam TTM leve, 21,8% TTM moderado e 0,9% TTM severo. Dos participantes com TTM moderado ou severo (30,8%), cerca de 56% apresentaram algum tipo de alteração de posicionamento da cabeça. Constatou-se que 88% das crianças com TTM moderado ou severo tinham alterações nos ombros. Conclusão: As alterações posturais verificadas na cabeça e nos ombros estão relacionadas com a adaptação biomecânica dos músculos da mastigação e a consequente alteração na ATM. Nível De Evidência Iii, Estudo De Paciente Não Consecutivo Sem Padrão De Referência Ouro Aplicado Uniformemente.

Os efeitos da capacitação de enfermeiros sobre avaliação de pacientes com acidente vascular cerebral / The effects of nursing training on the evaluation of patients with cerebrovascular accident

Objetivo: avaliar os efeitos da capacitação dos enfermeiros do serviço de emergência no reconhecimento dos sinais e sintomas do acidente vascular cerebral e aplicação da escala National Institutes of Health Stroke Scale (NIHSS). Método: estudo descritivo, transversal, com abordagem quantitativa. Foram capacitados e avaliados 20 enfermeiros do serviço de emergência de uma unidade de pronto atendimento sobre o reconhecimento dos sinais e sintomas dos pacientes com acidente vascular cerebral. Utilizaram-se para avaliação do conhecimento dos enfermeiros um pré-teste e um pós-teste, que foram aplicados antes e após a capacitação. Resultados: houve uma melhora do conhecimento sobre acidente vascular cerebral de 68,5% a85,26% após a capacitação. Conclusão: a capacitação dos enfermeiros responsáveis pela triagem dos pacientes com suspeita de acidente vascular cerebral deve ser estimulada para otimizar o atendimento e o tratamento desses pacientes.

Avaliação clínica e topográfica dos pacientes diagnosticados com acidente vascular cerebral no serviço de emergência / Clinical and topographic evaluation of patients diagnosed with stroke in an emergency uinit

Introdução: O Acidente Vascular Cerebral (AVC), conhecido como derrame, é considerado a primeira causa de mortes no mundo e de incapacidade permanentes em adultos, o que demanda que seja identificado e tratado o mais precocemente possível. Existem estudos que descrevem os fatores de risco no AVC, mas não está claro como esses fatores de risco interferem no prognóstico dos pacientes. Objetivo: O presente estudo objetivou traçar o perfil epidemiológico dos pacientes admitidos na unidade de pronto atendimento (UPA) de uma cidade do Centro Oeste de Minas Gerais, com diagnóstico de AVC. Materiais e Métodos: Foi avaliado o prognóstico clínico desses pacientes relacionando esses dados com as lesões nas imagens de tomografia computadorizada (TC), quando existentes, através das escalas NIHSS e ASPECTS. Resultados: Foram examinados 59 pacientes, sendo observada uma alta incidência de hipertensão arterial (89,8%) e sedentarismo (40,3%). A TC foi realizada em 27,6% dos pacientes admitidos na UPA com AVC e o predomínio da lesão no cérebro foi o hemisfério cerebral direito (44%). A avaliação do prognóstico dos pacientes pela escala NIHSS demonstrou que 33,9% dos pacientes apresentaram escore entre 0 a 7 (bom prognóstico). Os pacientes que apresentaram AVC/AIT prévio como fator de risco tiveram o pior prognóstico na escala NIHSS. Cerca de 20,3% dos pacientes chegaram na UPA com menos de 4 horas e 30 minutos do ictus. Conclusão: Conclui-se que existe uma alta prevalência de pacientes hipertensos, sedentários, dislipidêmicos, diabéticos, tabagistas, etilistas e com AVC/AIT prévio, na cidade em estudo, indicando a necessidade de intervenções na atenção primária local, além do acompanhamento dos pacientes após a alta hospitalar. (AU) Introduction: Stroke is considered the first cause of death worldwide and of permanent incapacity in adults, which demands it to be detected and treated as soon as possible. There are studies describing risk factors for stroke, but it is not clear how these risk factors interfere with the patients' outcomes. Objective: To characterize the epidemiological profile of patients admitted to an emergency unit of a city on the Central-West region of Minas Gerais (Brazil) and diagnosed with stroke. Material and Methods: The clinical prognosis of these patients was evaluated and correlated with the lesions shown (if present) by computed tomography (CT) images through the ASPECT score and NIH Stroke Scale. Results: A total of 59 patients were examined, being observed a high incidence of arterial hypertension (89,8%) and sedentarism (40,3%). CT was undertaken in 27.6% of the admitted patients and the most frequent damaged area was the right brain hemisphere (44%). Patient prognosis evaluated through NIHSS demonstrated that 33.9% of the patients had a score between 0 and 7 (good prognosis). Patients who had a previous history of stroke showed a worse prognosis based on the NIHSS. About 20.3% of the patients were admitted to the emergency unit less than 4 hours and 30 minutes after the ictus. Conclusion: There is a high prevalence of hypertensive, sedentary, dyslipidemic, diabetic, smoker, and alcoholic patients, with previous history of stroke, in the city under study. This profile indicates the need for interventions in the local primary care, in addition to patient follow-up after discharge. (AU)

Os efeitos da estimulação elétrica funcional na marcha de crianças com paralisia cerebral hemiparética após estimulação dos músculos tibial anterior e tríceps sural / The effects of functional electrical stimulation on gait of children with hemiparetic cerebral palsy after stimulation of the anterior tibial and triceps surae muscles

A paralisia cerebral (PC) interfere na execução dos movimentosdevido aos padrões anormais da coordenação, postura e tônus muscular.Estima-se que no Brasil existam 17 mil novos casos por ano,sendo considerado problema social e de saúde pública. A hemiparesiase caracteriza por espasticidade no hemicorpo contralateral aohemisfério cerebral afetado. A marcha hemiparética não apresentao toque do calcâneo no início do apoio bipodal pela incapacidadedo músculo tibial anterior em produzir tensão sufi ciente para realizaro movimento de dorsifl exão. A fase de impulsão também fi cacomprometida em decorrência da fraqueza do músculo tríceps sural,constituindo fator limitante para a marcha. Estudos morfológicossugerem que a fraqueza do músculo parético é mais incapacitanteque a espasticidade, ela ocorre devido ao desuso, perda de unidadesmotoras, alteração na ordem do recrutamento, tornando-se necessárioo fortalecimento desta musculatura para melhorar a capacidadede geração de força e habilidade motora. A estimulação elétricafuncional (FES) promove fortalecimento com possibilidade deredução da assimetria cortical, pois envolve processos relacionadosà movimentação voluntária. O objetivo do presente estudo é compararos efeitos da FES na funcionalidade da marcha em pacientescom PC após sua aplicação nos músculos tibial anterior e trícepssural. Os resultados obtidos pela escala GMFM constataram maiorevolução no paciente que recebeu a FES no músculo tríceps sural,assim como melhora da ADM passiva e aumento de força muscularde dorsifl exores e plantifl exores, redução do grau de espasticidade eevolução nas variáveis da marcha. Desta forma a FES demonstrouresultados positivos no tratamento de musculatura espástica comevolução na funcionalidade da marcha...

Th e cerebral palsy (CP) acts in the implementation of the movementsdue to abnormal patterns of coordination, posture and muscletone. It is estimated that in Brazil there are 17,000 new cases peryear, which is considered a social and public health problem. Th ehemiparesis is characterized by spastic paralysis in the contralateralhalf part of the body of the aff ected cerebral hemisphere. Th e hemipareticgait does not show the touch of the calcaneus at the beginningof the bipedal support because the tibialis anterior muscle does notproduce enough strength to perform dorsifl exion movements. Th epush to walk is also damaged as result of the weakness of the suraetriceps muscle, which is a limiting factor for gait. Morphologicalstudies suggest that the weakness of the paretic muscle is moredisabling than the spasticity, and occurs due to disuse, motor unitloss and changes in recruitment order. In order to improve strengthand motor skill, the muscles should be strengthened. Th e FunctionalElectrical Stimulation (FES) promotes improvement on strengthand may reduce cortical asymmetry, as it involves voluntary bodymovement processes. Th e objective of this study was to compare theeff ects of FES on gait function in patients with CP after using it inthe tibialis anterior and triceps surae muscles. Th e results obtainedby the GMFM score showed a great improvement of patients whoreceived FES in the surae triceps muscle, as well as improvementin the passive range of motion of muscle strength in dorsifl exorsand plantifl exors, reducing the degree of spasticity and changes ingait variables. Th e FES showed positive results in treating spasticmuscles and improvements in gait function...