Effect of Transcranial Pulse Stimulation for the Treatment of Alzheimer´s Disease and its Related Symptoms.

Alzheimer's disease (AD) is the most common cause of neurodegenerative cognitive impairment. Brain stimulation techniques based on the delivery of transcranial shockwaves are currently being studied for their increasing popularity as an approach to modulate the human brain in a focal and targeted manner making this therapy a promising line of action against AD. In the present manuscript, we review for further understanding whether transcranial pulse stimulation (TPS) is a beneficial treatment for AD patients. PubMed, Google Scholar, and Cochrane databases were accessed with the search criteria set from year 2001 to 2022 and the following keywords were used: "transcranial pulse stimulation", "focused ultrasound", "noninvasive treatment and Alzheimer" and "TPS". The search was focused on papers that provide evidence on the biological bases of the method, as well as its safety and tolerability. Even though more studies are needed with greater scientific rigor, such as a doubleblind and randomized study versus a placebo, TPS is an excellent and safe therapeutic option for AD. This novel approach accompanies currently available treatments and complements them, helping to maintain greater stability of the disease and slowing its progression. The biological effects and potential mechanisms of action of TPS for the improvement of cognitive function are further discussed.

Shoulder Injury Related to Vaccine Administration Following Misplaced SARS-CoV-2 Vaccination: A Case Report and Review of Literature.

Introduction: To confront the SARS-CoV-2 pandemic, a large share of the population must be immunized. Intramuscular vaccination of the shoulder is the preferred technique as it is easily exposed and guarantees a good immune reaction. Local side effects, such as pain and swelling, are common after deltoid inoculation. They usually resolve within 3 days. Shoulder injury related to vaccine administration (SIRVA) should be considered if the symptoms persist. The aim of this presentation is to describe a typical case of SIRVA after SARS-CoV-2 vaccination and provide information to the general orthopedic surgeon to properly diagnose, report, and treat these cases. Case Report: A 69-year-old female health-care professional without history of shoulder pain consulted the senior author for persistent severe left shoulder pain 3 months following the second dose of Sputnik V COVID-19 vaccination. She claimed an improper application technique that caused immediate pain and loss of active range of motion (ROM). She underwent medical treatment with several doctors during 3 months with poor results. A magnetic resonance imaging (MRI) of the left shoulder done 5 days after vaccination showed mild subacromial-subdeltoid bursitis. A follow-up MRI at 2 months after application revealed synovial hypertrophy and distention of the subacromial-subdeltoid bursa. We prescribed a dose of depot betamethasone and home-based program of gentle exercises. Although initial response was quick, the patient required shoulder arthroscopy the following months, due to persistence in pain and functional limitations. Conclusion: SIRVA cases may occur and should be suspected in all individuals without a history of shoulder symptoms or dysfunction who experience sudden pain and reduced ROM following deltoid muscle vaccination. Treatment must be initiated early with corticosteroids and rehabilitation. The low probability of this complication does not outweigh the advantages of vaccination.

Effects of an Extract of Salmon Milt on Symptoms and Serum TNF and Substance P in Patients With Fibromyalgia Syndrome.

PURPOSE: The aim of this study was to evaluate the effects of a dietary supplement containing primarily an extract of salmon's milt (semen) on symptoms and blood levels of proinflammatory molecules in patients with fibromyalgia syndrome (FMS), a chronic, painful musculoskeletal disease without a distinct pathogenesis or treatment. We recently reported increased serum levels of the proinflammatory molecules substance P (SP) and tumor necrosis factor (TNF) in patients with FMS as compared to those in normal controls. METHODS: This prospective, open-label study was conducted in patients with FMS (n = 87; 80 women, 7 men; age range, 18-80 years) selected from 2 clinical centers in Spain. Patients were administered the supplement and were evaluated at weeks 1 (before treatment), 4, 8, and 12 (end of treatment) for clinical parameters of functioning, fatigue, and pain, as well as overall impression. Patients were directed to take 1 capsule per day in the morning for the first 4 weeks, followed by 1 capsule in the morning and 1 capsule in the evening for the remaining 8 weeks. Differences in symptom scores in patients with FMS between weeks 1 and weeks 4, 8, and 12 were evaluated using ANOVA. Blood was obtained and serum separated in patients with FMS at 1 and 12 weeks and in a separate population of healthy controls (n = 20; 15 women, 5 men; age range, 25-65 years). Serum levels of SP and TNF were measured in patients with FMS at 1 and 12 weeks and in healthy controls by ELISA. TNF and SP levels in patients with FMS were compared between weeks 1 and 12, as well as between patients with FMS and untreated controls, using the Mann-Whitney U test. FINDINGS: Clinical parameters of functioning, fatigue, and pain, as well as overall impression, were improved significantly at 4 weeks as compared to 1 week and remained unchanged for the duration of the study (all, P < 0.0001). Serum TNF and SP levels were significantly elevated at 1 week in patients with FMS compared to controls and were decreased significantly at 12 weeks as compared to 1 week (all, P < 0.0001). IMPLICATIONS: Our findings indicate that this dietary supplement may significantly improve symptoms in patients with FMS. This is the first time to our knowledge that any molecule has been reported to be associated with a reduction in serum SP level. Consequently, the supplement or its hypothesized main active ingredient, spermine, may be developed as a novel treatment approach to FMS or other neuroinflammatory conditions. ClinicalTrials.gov identifier: NCT03911882.

Composição nutricional de duas opções de refeição oferecidas em UAN e sua comparação com o recomendado pelo PAT / Nutritional composition of two meal options offered in UAN and its comparison with the recommendations of the PAT

A alta incidência de sobrepeso e doenças crônicas na população mundial estabelece uma relação com os hábitos alimentares cotidiano dos trabalhadores. Sendo assim, o objetivo do estudo é analisar a composição nutricional de duas opções de cardápio de uma UAN (Unidade de Alimentação e Nutrição) e realizar a comparação destes com os critérios estabelecidos pelo PAT (Programa de Alimentação do Trabalhador). Um estudo do tipo transversal, através do qual foi analisado o cardápio de cinco dias entre as duas opções oferecidas aos comensais, Buffet e Alternativo. Os cálculos referentes à composição nutricional foram realizados através de programa Diet Win profissional 2008. Para a análise estatística foi realizado teste t-student para amostras pareadas com nível de significância de 5% (p<0,05), utilizando software Bioestat 5.0. Através da análise dos dados observa-se que não houve diferença significativa (p=0,3720) do valor energético total com o recomendado pelo PAT, entre os dois cardápios. Já para os valores de macronutrientes, houve um percentual protéico significativamente (p

The high incidence of overweight and chronic diseases in the world population establishes a relation with the food habits daily life of the workers. Being so, the objective of the study is to analyse the composition nutricional of two options of menu of one Unity and to carry out the comparison you gave with the criteria established by PAT. A study of the trasnverse, through which the menu of five days was analysed between two options offered to the people, Buffet and Alternatively. The calculations referring to the composition nutricional were carried out through program professional Diet Win 2008. For the statistical analysis test was carried out t-student for paired samples with level of signification of 5 % (p <0,05), using software Bioestat 5.0. Through the analysis of the data it is noticed that there was no significant difference (p=0,3720) of the energetic total value with the recommended for PAT between two menus. Already for the values of macronutritious ones, there was a protein percentage significantly (p <0,0001) above the recommended one; the results of carbohydrates and lipids presented values inside the established one. Regarding fibers and sodium, two menus presented different values between you. Concludes what the energetic values and of macronutritious ones are fitted in the standards stipulated by PAT, being proteinic values singularly above the recommended one and analysis of fibers and sodium observed divergent results between two menus. (AU)