bluuebunny/crossref_metadata_2025 huggingface dataset:
Adverse Effects of Anti-Interleukin-23 Agents Employed in Patients with Psoriasis: A Systematic Review
Authors: Naik Piyu Parth
Published: June 2022

Background: Psoriasis is an immune-mediated protracted ailment that perturbs about 100 million people globally. Anti-interleukin (IL)-23 agents have a distinctive status of safety and clinical efficacy. Anti-IL-23 operatives have demonstrated therapeutic prominences in cases of psoriasis in preceding global research. However, arrays of adverse events have been associated with the anti-IL-23 agents in the remedies of psoriasis. This systematic review aimed to assess the adverse developments of anti-IL-23 operatives for patients with psoriasis determined in phase III trials. Methodology: The PRISMA guidelines were wielded for this systematic review. The author systematically searched Google Scholar, PubMed, Scopus, and Cochrane databases to diagnosticate appropriate articles on adverse effects of anti-IL-23 agents in patients with psoriasis including the appropriate key terms (Medical Subject Headings). Results: A total of 18 studies were encompassed in this cutting-edge systematic review that met the selection criteria. In this review, the most prevailing adverse effect caused by anti-IL-23 agents was nasopharyngitis followed by headache, upper respiratory tract infection, and back pain, which are observed during the treatment with anti-IL-23 agents. The anti-IL-23 operatives, including ustekinumab and guselkumab, were significantly involved in the grade 3 stage of adverse effects for the treatment of psoriasis, whereas the anti-IL-23 agents including briakinumab, tildrakizumab, and risankizumab were significantly involved in the grade 4 stage of adverse effects. Conclusion: Targeted IL-23 therapy has expeditiously upsurged to the forefront as the importance of the IL-23 axis has been progressively identified, setting a new benchmark for psoriasis outcomes. Over the last 3 years, ustekinumab, guselkumab, tildrakizumab, and risankizumab have successively come to the market. However, these drugs caused several immunological and nonimmunological side effects, but they are customarily well-tolerated and have orderly safety vignettes.
Severe Inflammatory Colitis Related to Encorafenib and Binimetinib following Immune Checkpoint Inhibitor Therapy
Authors: Issac Aaron G. , Szafron David , Wei Dongguang , McQuade Jennifer L. , Wang Yinghong
Published: June 2022

Encorafenib, a BRAF kinase inhibitor, in combination with binimetinib, a selective MEK inhibitor have known gastrointestinal adverse events; however, adverse colitis events have not been well studied. We report a case series of 4 patients with melanoma who developed inflammatory colitis after BRAF and MEK inhibition with encorafenib and binimetinib, respectively. In the setting of immune checkpoint inhibitor use, BRAF and MEK inhibitors can cause significant inflammatory colitis with endoscopic patterns of predominant right colon ulcerations. It can lead to significant morbidity and frequent interruption of cancer treatment. Early recognition and prompt intervention are critical to improving patient outcomes.
Antioxidants for Treatment of Duchenne Muscular Dystrophy: A Systematic Review and Meta-Analysis
Authors: Ren Shouchen , Yao Chunmei , Liu Yali , Feng Guoshuang , Dong Xiaohuan , Gao Baoqin , Qian Suyun
Published: June 2022

Introduction: Increasing evidence has shown that oxidative stress is involved in the pathogenesis of Duchenne muscular dystrophy (DMD). Oxidative stress impairs muscle function, reduces regenerative capacity, and leads to atrophy and muscle weakness. The present study aimed to evaluate the effectiveness and safety of antioxidants in treatment of DMD patients. Methods: Medline, Embase, EBSCOhost, and Cochrane Library databases were searched using relevant keywords regarding DMD and antioxidants. The risk of bias for all included studies was assessed using the Cochrane risk of bias tool. The effectiveness of antioxidants in improving pulmonary function and muscle strength in DMD patients and their rate of adverse events was evaluated by meta-analysis. Results: A total of nine eligible studies were identified. Among these, two studies involving 85 patients compared idebenone with placebo. Pooled data showed a significant improvement in pulmonary function after idebenone treatment. Flavonoids- and omega 3-based compounds (FLAVOMEGA) significantly improved muscle strength. Two studies evaluated coenzyme Q10 (CoQ10) and reported clinical improvement in physical activity. The remaining four studies evaluated pentoxifylline, superoxide dismutase, vitamin E combination with penicillamine and penicillamine alone, respectively, and found no significant differences between the intervention and placebo groups, measured by pulmonary function, muscle strength, movement function, or quality of life. Most adverse events were mild, while the rates of dropout and serious adverse events were low with respect to antioxidants. Conclusions: Idebenone appeared to be safe and effective in improving pulmonary function in DMD patients, while pentoxifylline, superoxide dismutase, penicillamine, or a combination of vitamin E with penicillamine did not show a significant therapeutic effect. CoQ10 and FLAVOMEGA might be beneficial in improving muscle strength or physical activity in DMD patients. However, additional trials with more participants are warranted in the future.
Use of Intraoperative Neuronavigation to Identify Transdural Collaterals in Moyamoya Vasculopathy: A Simple Way to Make It Safer
Authors: Costa Matias L. , Kozyrev Danil A. , Lalgudi Srinivasan Harishchandra , Hausman-Kedem Moran , Jonas Kimchi Tali , Roth Jonathan
Published: June 2022

Introduction: Transdural collaterals (TC) from the external carotid artery must be preserved when operating on patients with moyamoya vasculopathy. Several techniques have been used to identify the superficial temporal artery (STA) and middle meningeal artery (MMA) during surgery and prevent their damage. However, the use of neuronavigation for this specific purpose has never been described in the literature. We describe an operative case in which neuronavigation was used to preserve the TC (originating from the MMA), detailing our technique step by step and reviewing alternative methods previously reported. Case Presentation: A 6-year-old girl with moyamoya disease, who had developed marked bilateral TC from the MMA sparing the middle cerebral artery territory, underwent staged bilateral indirect revascularization surgery. Intraoperative neuronavigation was used to identify the STA and MMA with their main branches during skin incision, craniotomy, and dural opening. The neuronavigation matched the intraoperative findings exactly, and the target structures remained undamaged. The patient was discharged home after both surgeries with no neurological deficits. One year following surgery, the patient has excellent collateralization from both STAs and is asymptomatic and neurologically intact. Conclusion: With the use of intraoperative neuronavigation, the STA, MMA, and their main branches, as well as their relationship to the bone, can be identified and preserved. This approach can help in preventing undesirable injury to TC during surgery and may potentially prevent perioperative stroke in patients with moyamoya vasculopathy undergoing revascularization surgery.
Whole-Cell and Acellular Pertussis Vaccine: Reflections on Efficacy
Authors: Alghounaim Mohammad , Alsaffar Zainab , Alfraij Abdulla , Bin-Hasan Saadoun , Hussain Entesar
Published: June 2022

Pertussis is a common respiratory infection caused by the bacterium Bordetella pertussis. Although most cases occur in developing countries, it is considered endemic globally. The World Health Organization estimates there are 20–40 million cases of pertussis annually. Pertussis vaccines played a pivotal role in reducing the burden of pertussis disease as well as infant morbidity and mortality. Although the two forms of pertussis vaccine are effective, each has its advantages and drawbacks. This review aims to review the current knowledge on pertussis vaccines, emphasizing vaccine effectiveness in different populations within a community. Clinical trials have shown favorable vaccine efficacy with acellular pertussis (aP)vaccine. However, observational and population-level studies showed that introducing at least a single dose of whole-cell pertussis (wP) vaccine within the routine immunization schedule is associated with better disease protection and a longer duration of immunity. On the other hand, wP vaccine is more reactogenic and associated with higher adverse events. Therefore, the selection of vaccine should be weighed against the effectiveness, reactogenicity, and cost-effectiveness. Due to its safety profile, aP vaccine can be offered to wider population groups. Booster adolescent and pregnant immunization programs have been implemented globally to control outbreaks and protect vulnerable infants. Due to the variable effectiveness performance of both vaccines, different countries adopted distinctive immunization programs. Determining the right vaccination approach depends on financial consideration, immunization program infrastructure, adverse event monitoring, and pertussis surveillance in the community.
The foundations of a political anthropology
Authors: Cardoso Sérgio
Published: June 2022

This article examines and comments upon the methodological innovation proposed in political anthropology by the work of J.-W. Lapierre in the late 1960s. The text seeks to show the origin ality and interest of the proposal- as well as its problems - in the midst of the various critical reviews which were then reevaluating the direction of the discipline (Balandier, Gluckman , Beatti e, M. Fried etc .). The article also und ertakes to evaluate, in historical perspective, teh territory and horizons of the debate of which his solution is a part - the difficulties of the diverse configurations assumed by comparativism in the practice of the discipline.
A brief history of the quilombos of Trombetas River basin
Authors: Andrade Lúcia M. M. de
Published: June 2022

The author recovers oral tradition and reconstructs the history of communities that come from "quilombos" (villages founded by fugitive slaves). This is dane from a work developed with the population from Trombetas river, in the state of Pará
A dialogue among indigenous groups: the experience of two encounters mediated by the video
Authors: Gallois Dominique T. , Carelli Vicent
Published: June 2022

The article analyses the role of video in intercultural communication from the interaction that is established among indigenous groups which met each other by vídeo images, afterwards, they ended up meeting personally, "in real life". The description of two of these encouters, between Waiãpi (AP) and Zo'e (PA), and between Gavião/Parkatêjê (PA) and Krahô (TO), provides context to the documentaries produced by the project Vídeo nas Aldeias/CTI about these experiences.
Comparação de picos de pressão em assento flexível em portadores de lesão medular e indivíduos normais: uma avaliação por interface de pressão
Authors: Kochhann Ana Raquel da Silva , Canali Nívea , Serafim Marcos Antônio Pineda
Published: June 2022

As úlceras por pressão (UP) são complicações freqüentes em pacientes com lesão medular (LM). Estratégias de prevenção objetivam reduzir a magnitude ou duração da pressão, fricção e cisalhamento entre a pele e superfície de suporte. Para medir a eficácia destas superfícies utilizam-se medidas de interface de pressão. O objetivo deste estudo é determinar os índices de interface de pressão em assento flexível em pacientes lesados medulares. Um estudo transversal com 103 indivíduos com LM e 101 pessoas sadias foi realizado com o mapeamento dos picos de pressão por meio de um sistema de interface sensível em cadeira de rodas padrão, com almofada flexível. Dados antropométricos foram obtidos pelo exame físico para o cálculo do índice de massa corpórea (IMC). Os resultados confirmam os elevados índices de interface de pressão na amostra de pacientes com LM. Com o aumento do IMC em indivíduos não lesados medulares há uma diminuição dos picos de pressão, ou seja, melhor distribuição da força. Na amostra de pacientes com LM, observou-se que apesar do aumento do IMC, a maioria dos indivíduos mantém elevados índices de pressão na posição sentada. Não é possível contestar os estudos que relacionam picos de pressão, lesão medular e peso, pois na amostra estudada, indivíduos obesos ou com sobrepeso apresentam pequena representação.
Avaliação da dor e função de pacientes com lombalgia tratados com um programa de Escola de Coluna
Authors: Caraviello Eliana Zeraib , Wasserstein Sílvia , Chamlian Therezinha Rosane , Masiero Danilo
Published: June 2022

As dores lombares incidem em cerca de 80% da população em algum momento de sua vida, sendo, portanto, um grande problema de saúde pública. O diagnóstico diferencial das doenças da coluna vertebral é bastante amplo, mas sabe-se que boa parte das afecções está relacionada a posturas e movimentos corporais inadequados. Criou-se, portanto, a Escola de Coluna como opção de tratamento a estes pacientes. Neste trabalho avaliamos a dor e a incapacidade funcional dos pacientes, antes e após freqüentarem a Escola de Coluna, através do questionário de Roland-Morris e da Escala Visual Analógica de Dor. Estudamos 30 pacientes no período de maio a novembro de 2004, sendo 86,7% do sexo feminino, com idade média de 48,1 anos, de baixa escolaridade e com excesso de peso (70%). A maioria dos pacientes apresentou melhora da dor (56,7%) e da função (60%) após o término do programa de reabilitação.
Medicina e arte: observações para um diálogo interdisciplinar
Authors: Cherem Alfredo Jorge
Published: June 2022

Partindo de métodos não invasivos, algumas especialidades médicas encontram-se envolvidas com a questão do diagnóstico e avaliação da incapacidade provocada pelos distúrbios osteomusculares relacionados ao trabalho. O que se espera das mesmas é que desenvolvam conhecimentos próprios e singulares, mas em interlocução com outras áreas, devendo-se salientar o fato de que, a partir de concepções exclusivamente técnicas, os especialistas nem sempre reconhecem que a medicina é uma ciência que durante um longo período foi também uma arte. Daí que atentar para esse elo pode resultar num alargamento do próprio horizonte interdisciplinar. Relacionando medicina e arte, o presente texto pretende contribuir para que o entendimento do especialista seja enriquecido através da história dos sinais e sintomas que insidem sobre o corpo. Tais conhecimentos, vindos desde o renascimento e legados pelos artistas como Leonardo Da Vinci, Miguelangelo e Vesálio permitem reconhecer, ainda que por via aparentemente distante e indireta, um meio para que nos tornemos mais atentos e criteriosos na observação de detalhes. Transitando do histórico para o exame físico do paciente, até chegar a uma diagnóstico preciso, o médico poderá reduzir ao mínimo necessário a solicitação de exames complementares e a recomendação de práticas invasivas.
Impacto da hospitalização na independência funcional do idoso em tratamento clínico
Authors: Kawasaki Kozue , Diogo Maria José D’Elboux
Published: June 2022

O objetivo geral deste trabalho foi avaliar a independência funcional de idosos hospitalizados em unidades de clínica médica. O estudo foi realizado em um hospital universitário do município de Campinas, SP, com 28 idosos de ambos os sexos, internados para tratamento clínico, com idade média de 68 anos. Foi utilizado o instrumento de Medida da Independência Funcional (MIF) no momento da internaçao, durante o período de hospitalizaçao, no momento da alta e um mês após a alta hospitalar. Foi possível observar uma diminuiçao nos valores da MIF total e seus domínios durante a hospitalizaçao, quando comparado a admissao (média: 109,2±14,0), a alta (média: 97,8±19,4) e um mês após o retorno ao domicílio (média: 114,4±14,1), com diferença significativa (p<0,05)nos valores da MIF da alta hospitalar ao domicílio, e da admissao a alta hospitalar, na MIF total e nos seus domínios. Durante a internaçao, houve declínio dos escores das tarefas da MIF de autocuidado, de controle da urina, de transferência, de locomoçao e de resoluçao de problemas. Conclusão: os resultados mostraram a ocorrência de declínio da independência funcional durante o período de hospitalizaçao e recuperaçao funcional após retorno ao domicílio.
Confiabilidade de dois métodos de avaliação da amplitude de movimento ativa de dorsiflexão do tornozelo em indivíduos saudáveis
Authors: Venturini Claudia , André Alex , Aguilar Bruna Prates , Giacomelli Bruno
Published: June 2022

A medida da amplitude do movimento é um importante parâmetro utilizado na avaliação e no acompanhamento fisioterápico. Portanto, a confiabilidade destas medidas e dos instrumentos utilizados para esta finalidade deve ser avaliada. Objetivo: Avaliar e comparar a confiabilidade intra-examinador e interexaminador da medida de amplitude do movimento (ADM) de dorsiflexão ativa do tornozelo utilizando um goniômetro universal e um inclinômetro digital. Métodos: Dois estudantes avaliaram a amplitude de dorsiflexão de 28 voluntários com idade entre 18 e 30 anos utilizando um inclinômetro digital e um goniômetro universal. Resultados: Os resultados demonstram média e desvio padrão da amplitude do movimento de 18,1±3,1 e 18,6±3,8 graus para as medidas obtidas pelo goniômetro e inclinômetro, respectivamente. O coeficiente de correlação intraclasse (CCI) encontrado para a condição na mesma sessão para as medidas obtidas com o inclinômetro foi de 0.91 e 0.83, para os examinadores A e B, respectivamente. Já o CCI obtido pelo goniômetro foi de 0.91 e 0.97 para os examinadores A e B, respectivamente. Os resultados da confiabilidade entre as sessões de teste demonstraram confiabilidade moderada para as medidas de goniometria e alta confiabilidade para a inclinometria. Já a confiabilidade interexaminador foi moderada para as medidas obtidas pelo goniômetro e alta para as medidas obtidas pelo inclinômetro. Conclusão: Os resultados do presente estudo demonstraram uma maior confiabilidade para as medidas de amplitude de movimento obtidas pelo inclinômetro digital quando comparado com o goniômetro universal, principalmente quando a confiabilidade interexaminador foi avaliada.
O processo de metamorfose na identidade da pessoa com amputação
Authors: Pacheco Kátia Monteiro De Benedetto , Ciampa Antonio da Costa
Published: June 2022

O presente artigo refere-se a uma pesquisa cujo objetivo foi compreender o processo de metamorfose da identidade da pessoa com amputação. Utilizou-se a metodologia qualitativa do estudo de caso, mediante a análise da narrativa da história de vida do sujeito considerado emblemático, que foi selecionado na Divisão de Medicina de Reabilitação do Hospital das Clínicas da FMUSP. Verificou-se que, quando o sujeito consegue atribuir um sentido emancipatório ao conflito gerado pela sua amputação, ele pode rever seus valores preconceituosos e estigmatizantes acerca do significado social de ser uma pessoa com deficiência e com isso re-significar tais valores, o que propicia uma postura mais reflexiva e autodeterminada, bem como a reconstrução de seu projeto de vida com um novo sentido emancipatório.
Documentation of myofascial pain syndrome with infrared imaging Marcos
Authors: Brioschi Marcos Leal , Yeng Lin Tchia , Pastor Elda Matilde Hirose , Colman Daniel , Silva Francisco Miguel Roberto Moraes , Teixeira Manoel Jacobsen
Published: June 2022

The myofascial trigger points (TP) are involved as much pathologies of hyperextension/hyperflexion cervical injuries, disc injuries, and overuse injuries. One of the basic indications and clinical uses of infrared (IR) imaging is documentation of soft tissue pathology, particularly in conditions which cannot be demonstrated on radiologic tests, electroneuromyography or laboratory workup. The authors review the literature regarding IR imaging in the documentation of myofascial pain syndrome. The IR imaging is a diagnostic test which objectively documents TP in the form of hyperradiant hot spots. These hyperradiant spots corresponding to areas of pain usually represent active TP in clinical examination. They can be corroborated by local tenderness in the region, thus confirming the patient’s complaint. The areas of pain are presented as thermal asymmetry between corresponding areas of opposite sides of the body. Latent TP, not subject to patient complaints at the time of IR imaging examination, are detected in the form of hyperradiant spots. The presence of these latent TP can be documented by abnormal pressure threshold measurement in these areas. There was an alteration of the skin thermal profile after TP local anesthesia/dry needling demonstrating an immediate neurovegetative sympathetic response. The IR imaging findings represent an objective mean to document TP, thus corroborating with the subjective patient’s complaints. The documentation of TP by IR imaging is important to introduce the most adequate treatment directed the pain cause as well as to evaluate its response.
Methods of assessment of scapular movements during upper limb elevations: literature review
Authors: Faria Cristina Danielli Coelho de Morais , Penido Helen Cristina , Teixeira-Salmela Luci Fuscaldi
Published: June 2022

Objective: To carry out a literature review on methods to assess scapular movements during upper limb elevation and point out their advantages, disadvantages, and limitations. Methods: The search was performed assessing MEDLINE, SCIELO, LILACS e PEDro databases with key words related to the subject. To be included, the studies would have to be published in Portuguese/English/Spanish/ French until the last day of 2005 and have assessed scapular movement during upper limb elevation. The exclusion criterion included assessments in the decubitus position. Results: one hundred eighty-one different studies were found and after the verification of the established criteria, 29 were selected for the analysis, which were divided into four groups: bidimensional static, bidimensional dynamic, three-dimensional static and three-dimensional dynamic assessment methods. Despite the variety of assessment techniques, a method that shows clinical applicability and is able to carry out measurements related to the functional movements of the scapula is yet to be developed. Another problem found was the lack of standardization of the terminology regarding movements, planes and axes. Furthermore, the three-dimensional methods applicable to scientific studies showed important limitations, such as high cost, need for specialized human resources, and measurement errors, which could be significant when determining changes in scapular kinematics. Conclusion: It is essential to standardize the terminology used to describe scapular movements, planes and axes and to develop complete functional assessment methods with clinical applicability, reliability and validity.
Ambulation follow-up in patients with myelomeningocele treated at the Associação de Assistência à Criança Deficiente (AACD) in São Paulo, Brazil
Authors: Rocco Fernanda Moraes , Saito Elizabete Tsubomi , Fernandes Antonio Carlos
Published: June 2022

Myelomeningocele (MMC) is a congenital malformation of the vertebral column and spinal cord, characterized by flaccid paraplegia and sensitive alteration below the lesion level, accompanied by neurological, urological and orthopedic impairment. The patients can be classified as thoracic (T), high lumbar (HL), low lumbar (LL) and sacral (S) or asymmetric. Objective: to describe the profile of the patients treated at the MMC Clinic of the Assistance Association to the Defective Child - AACD – SP, considering variables related to the gait pattern. Methods: review of files of the patients seen at the initial assessment during the year 2000, aged younger than one year and their follow-up until their last visit to clinic in the year 2004. Results: A total of 230 patients were seen at the initial assessment at the MMC Clinic of AACD - SP in the year 2000. Of these, 64 (27%) were younger than 1 year at the first assessment. Of these, 11% did not return to the Clinic after the initial assessment and two patients died. Mean age at the last visit to the Clinic was 3.5 years. When the neurological level at the return assessment was analyzed, we found: 43% of Thoracic level, 20% of High Lumbar level, 28% of Low Lumbar level, 2% Sacral level and 6% Asymmetric. When the gait pattern was analyzed, we observed that 57% of them were not ambulators, 7% were non-functional ambulators, 25% were home ambulators and 11% were community ambulators. Among the ambulating patients, the average age at the start of gait was 3 years. It is known that patients with lower neurological levels tend to maintain the gait for longer periods. As these patients tend to become less active and lose gait ability with the passing years (mainly due to obesity and orthopedic deformities), it is essential to study the age at acquisition of gait ability. When we analyzed the presence of orthopedic deformities in the column, we observed that 57% of the patients did not present deformities, 9% presented thoracolumbar scoliosis, 32% presented kyphosis and 1% presented hyperlordosis. Tethered spinal cord syndrome occurred in 36% of the patients. Conclusion: The higher functional levels are associated to a later acquisition of gait, as well as more orthopedic deformities and higher need for auxiliary means.
Profile of the Patients with Myelomeningocele from the Associação de Assistência à Criança Deficiente (AACD) in São Paulo – SP, Brazil
Authors: Rocco Fernanda Moraes , Saito Elizabete Tsubomi , Fernandes Antonio Carlos
Published: June 2022

Myelomeningocele (MMC) is the most frequent of the Neural Tube Defects, with 85% of the cases. The etiology is unknown, but it has genetic and environmental characteristics. The diagnosis can be achieved in the prenatal period through the morphological ultrasonography. The closing of the defect within the first hours after birth is recommended as well as the early control of hydrocephalus. Objective: To describe the profile of the patients treated at the Myelomeningocele Clinic of the Assistance Association to the Defective Child - AACD – SP and assess their clinical condition upon admission at the Institution, aiming at verifying whether the early diagnosis has been attained and improving treatment procedures. Methods: To review the files of patients seen at the initial assessment of the MMC Clinic of AACD – SP during the year of 2000, aged younger than one year. The information was obtained from patients’ files through a research protocol and consisted of personal data, neurological level at the first assessment, prenatal diagnosis, age at the closing of the defect and presence or absence of ventriculoperitoneal shunt (VPS). Results: A total of 230 patients were assessed in the year 2000. Of these, 64 (27%) were younger than 1 year at the initial assessment. Mean age at the initial evaluation was 5 months and 44% of the patients were females, whereas 56% were males. Diagnosis at the prenatal period had not been achieved in 37% of the patients. The closing of the defect was performed within the 24 hours after birth in 51% of the patients. Only 17% of the patients had not undergone VPS at the time of the initial assessment. The neurological assessment at the initial evaluation disclosed 35% thoracic, 29% high lumbar, 24% low lumbar, 11% asymmetric and no patient at the sacral level. Conclusion: The AACD - SP is a Reference Center in the treatment of MMC and this might account for the fact that the center receives a large number of children with higher functional levels. It is important to try to stimulate not only the prevention, but also the diagnosis and early treatment of this pathology, aiming at decreasing its impact on society. The lack of or late diagnosis of MMC was an expected finding in the present study, as the morphological ultrasound is not routinely performed in Basic Health Units in our country during the prenatal follow-up. The survival of patients with MMC has increased due to the early closing of the defect and hydrocephalus control through VPS, associated with posterior control of the neurogenic bladder.
Variation in functional independence in hospitalized elderly related to social and health variables
Authors: Kawasaki Kozue , Diogo Maria José D’Elboux
Published: June 2022

The aging process, non-transmissible chronic diseases and hospitalizations can cause functional decline in the elderly. Objective: to identify the variation in functional capacity in elderly during hospitalization and correlate it with social and health variables. Method: The study was developed at a University Hospital in Campinas, SP, with 28 elderly inpatients of both sexes, admitted for clinical treatment, with a mean age of 68 years. The Functional Independence Measure (FIM) was used at the admission, during the hospitalization, at the discharge and one month after the discharge. The variation in FIM scores was calculated at different moments of evaluation, expressed by deltas and correlated with the variables: gender, previous hospitalization, presence of caregiver and use of medications. Results: There was a significant difference in the deltas of FIM between the discharge-home return periods (p=0.0010) and the admission-discharge periods (p<0.0001), in total FIM and its domains, showing decreased functional independence during hospitalization and recovery after the return home. The gender, previous hospitalization and presence of caregiver did not significantly influence the functional capacity of the elderly inpatients; however the increased number of prescribed medications between the admission and the discharge periods presented a moderate (r=0.5059) and a very significant correlation (p=0.0071) with functional decline in this period. Conclusion: There was a functional decrease in elderly inpatients during the hospitalization, being more significant among inpatients that had an increased number of prescribed medications during hospitalization.
Design, application and assessment of an educational pool-therapy adaptation program for the elderly
Authors: Candeloro Juliana Monteiro , Caromano Fátima Aparecida
Published: June 2022

The present report presents an educational pool-therapy adaptation program, especially designed for this study, consisting of four sessions, aiming at learning skills that warrant motor independence (adaptation to the aquatic environment) during immersion, for elderly people. The adaptation to the aquatic environment is a prerequisite for the development of hydrotherapy intervention, due to the natural fear presented by these people to perform aquatic environment activities, common in this population, when they start hydrotherapy activities. The subjects of the present study consisted of 18 women, aged 65 to 70 years. Their performance during ten trained motor activities based on a previously designed plan was assessed as well as blood pressure and heart rate, as indicative factors of stress caused by performing activities in the aquatic environment. The assessment was carried out by the researcher and by an independent observer and the scores 1, 2 and 3 were assigned to each motor activity. The results showed that the group presented 89.7% of the expected learning outcomes when performing the motor activities at the end of the program, associated with decreased blood pressure when the first session is compared with the fourth. We conclude that the educational pool-therapy adaptation program for the elderly was enough to produce alterations in the motor responses of the participants, who presented independence in the aquatic environment, as well as establishing blood pressure and heart rate levels.
Effects of early rehabilitation on the outcome of cerebro-vascular insult rehabilitation in women over 65 in correlation with initial neurological deficit gravity
Authors: Nikcevic Ljubica , Savic Milan , Zaric Nevenka , Nikolic Dejan , Plavsic Aleksandra , Mujovic Natasa
Published: June 2022

This study aims at verifying the effects of short- and long-term rehabilitation on the outcome of encephalic vascular accident (EVA) in women older than 65 years; establishing the correlation between the impact of the neurological deficit severity on the prediction of the rehabilitation treatment outcome as well as investigating the possibility of the follow-up of individual parameters at the Functional Independence Measure (FIM) when predicting the EVA rehabilitation outcome. The EVA is currently the third major cause of death in the world’s population, as well as the main cause of permanent disability. In the present scenario, cardiovascular and cerebrovascular diseases, which used to be observed almost exclusively in the male population, now affect the female population as well. On the other hand, we observe a linear correlation between aging and the occurrence of these diseases. We conclude that the implementation of early rehabilitation leads to a significant acceleration in the treatment and recovery process post-EVA in women older than 65 years. We also conclude that certain FIM parameters can be used to predict the patient’s overall recovery, as they present the same evolution pattern.
The physical therapy background in the field of the orthopedics: a critical view under the optics of functioning
Authors: Silva Ana Clarissa Lopes , Neves Robson da Fonseca , Riberto Marcelo
Published: June 2022

The World Health Organization published the International Classification of Functioning, Disability and Health (ICF) in 2001. This reflected the change from a disease-centered approach to an emphasis on functioning as a component of health. Objective: this study discusses the challenges faced by the physical therapy education regarding the implementation and application of the concept of functioning in the rehabilitation of orthopedic outpatients. Methods: a total of 93 physical therapy patient records with musculoskeletal disorders were analyzed and information was obtained based on a form that had predefined ICF categories. The data analysis was carried out with the statistical package EPIINFO 6.04. Results: the records, filled out by physical therapy students, reported and described disorders of body functions at a higher frequency when compared to the activities and participation or the influence of the environmental factors on the patients’ functioning. Conclusion: the results showed that the physical therapy students focused their attention mainly on body functions and structures, based on their biomedical background. The lack of information about other components of functioning indicate that there is still a disconnection between the more modern concepts of functioning and the physical therapy background in the field of orthopedics.
Trunk control scales as functional predictors for stroke patients
Authors: Aguiar Paula Teixeira de , Rocha Talitha Nery , Oliveira Elisandra Silva de
Published: June 2022

According to the World Health Organization (WHO), stroke is considered a syndrome with a rapid development of clinical signs of focal or global disturbance of cerebral function, of which origin is possibly vascular and lasting more than 24 hours. In addition to deficits in limb movement, gait, and language, the stroke may also cause impaired control of trunk mobility, which is an important issue. Therefore, the aim of this literature review was to identify, through the use of scales, the association between trunk control impairment and functional disability in hemiparetic patients after a stroke. A literature review was carried out and eight clinical, longitudinal and descriptive articles were selected. All the studies showed a prognostic association between trunk control and functional abilities. Trunk Control Test (TCT), Trunk control items of the Postural Assessment Scale for Stroke Patients (PASS-TC) and Trunk Impairment Scale (TIS) (Fujiwara and Verheyden) were used in the assessments. It was concluded that the clinical evaluation of trunk control, through the use of scales, is an important tool for the prognosis of the functional capacity of hemiparetic patients after a stroke and for the planning of a specific and differentiated treatment of these patients. However, there few studies proved this association, as different scales were used and there was no consensus among authors. Additionally, there is no agreement on the data regarding the evaluation of balance and gait.
Phenol block for spasticity management
Authors: Trevisol-Bittencourt Paulo Cesar , Tournier Marcelo Benedet
Published: June 2022

Peripheral blocks with botulinum toxin (BoTN) and phenol are the treatment of first choice in the management of focal spasticity. This review will focus on phenol blocks, presenting some historical aspects, principles of action, main indications and the clinical applicability of this substance. The purpose of this review is to remind that, when its indications are respected, phenol has shown a good balance between efficacy and safety. Since it is an extremely low-cost drug, phenol should be considered as the ideal agent for large-scale use in resource-poor rehabilitation centres.
Atualização de conhecimentos sobre a prática de exercícios resistidos por indivíduos idosos
Authors: Câmara Lucas Caseri , Santarém José Maria , Jacob Filho Wilson
Published: June 2022

A associação da piora da condição funcional e aumento de comorbidades em idades mais avançadas, faz do atual envelhecimento populacional um quadro que merece atenção crescente por parte do profissional médico. Este profissional está certamente entre os mais questionados sobre recomendações de atividades físicas adequadas para pessoas idosas ou debilitadas. No entanto, a formação generalista não têm abrangido aspectos atuais relacionados à fisiologia do exercício e prescrição de atividades físicas adequadas para estas populações. Exercícios resistidos têm ganhado crescente importância na comunidade científica como forma de exercícios seguros e eficazes, trazendo benefícios de caráter preventivo e terapêutico para pessoas idosas ou debilitadas. Assim, objetivando que mais indivíduos possam se beneficiar da recomendação de exercícios resistidos, fez se necessária uma atualização destes conhecimentos para o profissional médico.
Estudo comparativo entre a Escala de Equilíbrio de Berg, o Teste Timed Up & Go e o Índice de Marcha Dinâmico quando aplicadas em idosos hígidos
Authors: Rodini Carolina , Ferreira Luana Talita Diniz , Pirré Gemal Emanuel , Hino Marisa , Alfieri Fabio Marcon , Riberto Marcelo , Moreira Maria Cecília dos Santos
Published: June 2022

Os distúrbios do equilíbrio compõem um dos fatores etiológicos centrais das quedas e da instabilidade em idosos, podendo levar a incapacidade funcional e dependência e, por isso vêm sendo utilizados como marcadores de fragilidade. Considerando que a prevenção e a reabilitação do declínio do equilíbrio em idosos requerem o desenvolvimento de protocolos de pesquisa adequados para se medir a função do equilíbrio, este trabalho teve como objetivo analisar e comparar a eficácia de três instrumentos de avaliação utilizados para identificar o risco de queda em idosos. Para isso, a Escala de equilíbrio de Berg (EEB), o Teste Timed Up & Go (TUG) e o Índice de Marcha Dinâmico (IMD) foram aplicados em sete idosos hígidos. A análise dos resultados revelou que as escalas utilizadas são de fácil aplicação e entendimento, não havendo necessidade de treinamento do avaliador. No entanto, como as três escalas avaliam aspectos distintos, foi possível identificar, na população avaliada, risco de queda aumentado em quatro idosos apenas por meio do IMD.
Activity limitation and social participation of patients with diabetes
Authors: Fenley Juliana de Camargo , Santiago Ludmilla Nadir , Nardi Susilene Maria Tonelli , Zanetta Dirce Maria Trevisan
Published: June 2022

Objectives: to evaluate the activity limitation and the social participation in individuals with type 2 diabetes mellitus. Method: 79 diabetic patients were evaluated through SALSA scale (Screening of Activity Limitation and Safety Awareness) and Social Participation scale of the International Classification of Functioning, Disability and Health (ICF). Results: the average age of the participants was 61.6±9.8 years, 55.7% were female, 68.4% had a marital status, 32.9% had a low income (up to three minimum wages) and 13.9% had left work due to health reasons. The average time of illness was 10.3±8.9 years. 39.3% of the participants were treated with insulin, 70.9% with oral medication, 51.9% with diet and 45.6% with physical exercises. 48.1% presented some disease complication. The average in SALSA score was 26.5±11.6 and higher scores were associated with more than 10 years of disease. With diabetes evolution there may be a need for insulin therapy and diabetes complications can appear and interfere with the individual’s occupations. These factors can contribute to activity limitation. The average in Social Participation scale was 9.8±10.9, with higher scores when the patients considered their physical health impaired in the last year and when they were under insulin therapy. Conclusion: the activity limitation in type 2 diabetes mellitus was associated to the duration of the disease with possible contribution of factors related to the disease’s evolution. The auto-evaluation of impaired physical health and insulin therapy seem to interfere with social participation.
Prevalência de úlcera por pressão em indivíduos com lesão de medula espinhal e a relação com a capacidade funcional pós-trauma
Authors: Rabeh Soraia Assad Nasbine , Caliri Maria Helena Larcher , Haas Vanderlei José
Published: June 2022

O estudo observacional, transversal, teve por objetivos caracterizar indivíduos adultos que sofreram Lesão de Medula Espinhal (LME) entre janeiro de 2003 a Julho 2006 em hospitais credenciados ao SUS no município de Ribeirão Preto, avaliar a capacidade funcional utilizando a escala Medida de Independência Funcional (MIF), considerando o nível de lesão e identificar a prevalência de úlcera por pressão (UP). Após a aprovação do Comitê de Ética em Pesquisa o estudo foi realizado, mediante consentimento dos participantes. As entrevistas e avaliações foram realizadas nos domicílios. Dos 22 individuos, 91% eram do sexo masculino, com predominância na faixa etária de 30 a 39 anos. Acidente de trânsito foi a etiologia principal (50%) da LME, seguida de queda (27,3%). Onze (50%), tiveram lesão cervical, dez (45,5%) lesão torácica e um lesão lombar. Indivíduos com lesão cervical apresentaram escores menores na MIF total e motora, entretanto, a MIF cognitiva atingiu o valor máximo independente do nível da lesão. Nenhum dos indivíduos apresentou grau de dependência completa. Onze (50,0%), apresentaram dependência mínima, 6 (27,3%) dependência máxima e 5 (22,7%) independência moderada ou completa. Os 7 (31,8%) participantes com UP tinham maior dependência funcional. O trauma causou maior impacto no domínio motor com diminuição da capacidade funcional nas diferentes atividades para os indivíduos com lesão cervical. Houve aumento dos escores da MIF com o aumento do tempo pós-lesão, independente da participação em programa de reabilitação. Os resultados apontaram aspectos essenciais para a proposição de programa de reabilitação para esta população no contexto estudado.
Avaliação isocinética em nadador amputado de membro superior: relato de caso
Authors: Secchi Leonardo Luiz Barretti , Muratt Mavi Diehl , Saccol Michele Forgiarini , Greve Julia Maria D'Andrea
Published: June 2022

A natação é um dos principais esportes de estudo, mas a natação em atletas com deficiência física abre um ramo de pesquisa. Objetivo: Analisar através da dinamometria isocinética os grupos musculares: abdutores e adutores, flexores e extensores de ombro de um nadador da elite brasileira com amputação do terço proximal do rádio. Métodos: Paciente do gênero masculino com 18 anos de idade, sendo, nove deles competindo. Foi avaliado clinicamente e através do questionário funcional DASH e pelo questionário EROE quanto à atividade esportiva. Na avaliação no dinamômetro isocinético Biodex System 3 com o protocolo de 5 repetições a 60º/segundo e 20 repetições a 180º e 240º/segundo quanto aos movimentos abdução/adução e flexão/extensão. Resultados: Nos questionários não se observou dor ou outra alteração da avaliação clínica. No questionário DASH, o atleta referiu dificuldade grau médio. Seu desempenho na escala EROE foi excelente. Na avaliação isocinética o atleta apresentou diferenças no lado amputado comparado em relação ao sadio. Conclusão: A avaliação isocinética é um bom parâmetro para estudo da força mesmo em nadadores com deficiência física, mostrando que estes atletas necessitam de um treinamento específico.
Correlation among tools for the assessment of functional independence and physical activity levels in infants
Authors: Freitas Tatiana Beline de , Sá Cristina dos Santos Cardoso de , Martins Emerson Fachin
Published: June 2022

Assessment tools to quantify functional independence and physical activity levels are particularly useful for making decisions and monitoring rehabilitation programs. There are many tools available to assess independence in children. However, such tools can be more or less responsive to independence conditions. The aim of this study was to verify the correlation between functional independence parameters and physical activity levels quantified by different assessment tools in 4 and 5 year-old children. For this, 20 children whose motor development was appropriate for their age were assessed by the following tools: (1) Pediatric Evaluation Disability Inventory (PEDI), (2) Evaluation Questionnaire of Independence Level for Daily Life Activities in 4 to 8 year-old children (Questionnaire), and (3) Physical Activity Questionnaire for Children (PAQ-C). Delineation of a Cross-sectional study was utilized, with the measurements taken at just one moment describing the variables and their distribution and association patterns. For that age group, only for the self-care functional skills assessed by PEDI, significant correlation was observed with the age indicating higher independence values for the older children. For all other PEDI categories and for the other tools utilized in this study, that independence-age correlation was not significant. Despite the independence-age correlation having not been found in infants assessed by the Questionnaire, other significant correlations were observed between the Questionnaire values obtained and some PEDI values. No significant correlations were observed between the PAQ-C values obtained and the other tools. In conclusion, some categories quantified by PEDI are not correlated with functional independence changes detected by other categories by the same tool. Still, the correlation between Questionnaire values and PEDI values was observed in just some categories assessed by PEDI. Finally, PAQ-C did not correlate with the other two tools, suggesting the need for a better investigation into the responsiveness of the measurements from psychometric studies.