Talassoterapia para pacientes com fibromialgia: ensaio clínico radômico

Fibromyalgia (FM) is a chronic rheumatic syndrome characterized by diffuse muscle-skeletal pain, and aerobic exercises represent a fundamental portion in therapeutic approach. Objective of this study was to evaluate the effectiveness of aerobic exercises accomplished in the water of the sea (thalassotherapy) for women with FM and to compare with exercises accomplished in the swimming pool, involving a multidisciplinary team, composed by rheumatologists, physical therapists, students of physical therapy and students of physical education. Forty six (46) women with age between 18 and 60 years with FM were randomized in 2 groups: a swimming pool group (23 patients) and a sea group (23 patients). 80th groups trained a week with the same program of aerobic conditioning 3 times (60 minutes each) for 12 weeks. Ali the patients were evaluated, before and immediately after treatment, with Visual Analogical Scale (VAS) for pain and fatigue, number of tending points, Fibromyalgia Impact Ouestionnaire (FIO), Short Form 36 Health Survey (SF-36), Pittsburgh Sleep Ouality Index (PSOI) and Beck Oepression Inventory (BOI). For statistical analysis, it was used paired-t test for analysis intra-group and non-paired test for inter-groups analysis, significance levei of p <0,05. Four patients, of each group, didn't complete the training programo Groups were homogeneous and they were compared in initial evaluation, except for BOI (p <0,05). Both groups presented statistically significant improvement for ali appraised parameters in the post-treatment compared with initial evaluation, there were reduction of intensity of pain and fatigue, number of tending points, better functional capacity (FIO), life quality (SF-36), quality of sleep (PSQI) and depression indexes (BOI). However, in comparison among the groups, group of sea (thalassotherapy) presented better results for ali parameters, however with statistically significant difference just only for depression indexes (BOI). At the end, it was observed that accomplishment of aerobic exercises in sea water or swimming pool was effective as part of treatment for patients with FM. However, exercise programs with thalassotherapy seems to bring more benefits, mainly related to emotional aspects, could be a therapeutic option of low cost for patients with FM in our area

Sono e síndrome da fragilidade em idosos residentes em instituições de longa permanência

Introduction: The aging process causes quantitative and qualitative changes in sleeping. Such changes affects more than half of the adults above 65 years old, that live in the community and 70% of the institutionalized, a great negative impact in their quality of life. One of the pathological displays of aging, that share some characteristics with sleeping disorders and predict similar results, is the Frailty Syndrome, that characterize the most weakened and vulnerable elderly. The way sleeping disorders play a role in the frailty pathogeneses remains uncertain. Objective: Evaluate the relation between the sleeping and the frailty syndrome on institutionalized elderly. Methodology: A transversal study was performed with 69 elderly in institutions in the city of João Pessoa PB. Were used the Pittsburgh Sleeping Quality Index and actigraphy to subjective and objective variables, respectively, and questionnaires and specific tests to frailty phenotype variant (Fried Frailty Criteria). In the statistic analysis were used the Pearson correlation test, Chi Square and One-way ANOVA test, with Tukey-Krammer posttest. Subsequently, a Simple Linear Regression model was built. On every statistical analysis were considered a confidence interval of 95% and a p < 0,05. Results: The sample was characterized by the prevalence of the frail (49,3%), women (62,3%), single (50,7%) and 77,52 (±7,82).The frail elderly obtained the worst sleeping quality 10,37 (±4,31) (f = 4,15, p = 0,02), when compared with the non-frail. The sleep latency influenced more the frailty (R2 = 0,13, β standard = 1,76, β = 0,41, p = 0,001). Weren t found differences between the standard resting-activity variable and the frailty phenotype categories. Conclusion: Sleeping alterations, including bad sleeping quality, prolonged sleep latency, low sleep efficiency and day drowsiness, influenced the frailty in institutionalized elderly

An investigation of Hebbian phase sequences as assembly graphs

Hebb proposed that synapses between neurons that fire synchronously are strengthened, forming cell assemblies and phase sequences. The former, on a shorter scale, are ensembles of synchronized cells that function transiently as a closed processing system; the latter, on a larger scale, correspond to the sequential activation of cell assemblies able to represent percepts and behaviors. Nowadays, the recording of large neuronal populations allows for the detection of multiple cell assemblies. Within Hebb's theory, the next logical step is the analysis of phase sequences. Here we detected phase sequences as consecutive assembly activation patterns, and then analyzed their graph attributes in relation to behavior. We investigated action potentials recorded from the adult rat hippocampus and neocortex before, during and after novel object exploration (experimental periods). Within assembly graphs, each assembly corresponded to a node, and each edge corresponded to the temporal sequence of consecutive node activations. The sum of all assembly activations was proportional to firing rates, but the activity of individual assemblies was not. Assembly repertoire was stable across experimental periods, suggesting that novel experience does not create new assemblies in the adult rat. Assembly graph attributes, on the other hand, varied significantly across behavioral states and experimental periods, and were separable enough to correctly classify experimental periods (Naïve Bayes classifier; maximum AUROCs ranging from 0.55 to 0.99) and behavioral states (waking, slow wave sleep, and rapid eye movement sleep; maximum AUROCs ranging from 0.64 to 0.98). Our findings agree with Hebb's view that assemblies correspond to primitive building blocks of representation, nearly unchanged in the adult, while phase sequences are labile across behavioral states and change after novel experience. The results are compatible with a role for phase sequences in behavior and cognition.

Naps in school can enhance the duration of declarative memories learned by adolescents

Sleep helps the consolidation of declarative memories in the laboratory, but the pro-mnemonic effect of daytime naps in schools is yet to be fully characterized. While a few studies indicate that sleep can indeed benefit school learning, it remains unclear how best to use it. Here we set out to evaluate the influence of daytime naps on the duration of declarative memories learned in school by students of 10–15 years old. A total of 584 students from 6th grade were investigated. Students within a regular classroom were exposed to a 15-min lecture on new declarative contents, absent from the standard curriculum for this age group. The students were then randomly sorted into nap and non-nap groups. Students in the nap group were conducted to a quiet room with mats, received sleep masks and were invited to sleep. At the same time, students in the non-nap group attended regular school classes given by their usual teacher (Experiment I), or English classes given by another experimenter (Experiment II). These 2 versions of the study differed in a number of ways. In Experiment I (n = 371), students were pre-tested on lecture-related contents before the lecture, were invited to nap for up to 2 h, and after 1, 2, or 5 days received surprise tests with similar content but different wording and question order. In Experiment II (n = 213), students were invited to nap for up to 50 min (duration of a regular class); surprise tests were applied immediately after the lecture, and repeated after 5, 30, or 110 days. Experiment I showed a significant ∼10% gain in test scores for both nap and non-nap groups 1 day after learning, in comparison with pre-test scores. This gain was sustained in the nap group after 2 and 5 days, but in the non-nap group it decayed completely after 5 days. In Experiment II, the nap group showed significantly higher scores than the non-nap group at all times tested, thus precluding specific conclusions. The results suggest that sleep can be used to enhance the duration of memory contents learned in school.

Genes candidatos de suscetibilidade a pré-eclampsia: estudo de associação

Preeclampsia is a multifactorial disease of unknown etiology that features with wide clinical symptoms, ranging from mild preeclampsia to severe forms, as eclampsia and HELLP syndrome. As a complex disease, preeclampsia is also influenced by genetic and environmental factors. Aiming to identify preeclampsia susceptibility genes, we genotyped a total of 22 genetic markers (single nucleotides polymorphisms SNPs) distributed in six candidates genes (ACVR2A, FLT1, ERAP1, ERAP2, LNPEP e CRHBP). By a case-control approach, the genotypic frequencies were compared between normotensive (control group) and preeclamptic women. The case s group was classified according to the disease clinical form in: preeclampsia, eclampsia and HELLP syndrome. As results we found the following genetic association: 1) ACVR2A and preeclampsia; 2) FLT1 and severe preeclampsia; 3) ERAP1 and eclampsia; 4) FLT1 and HELLP syndrome. When stratifying preeclampsia group according to symptoms severity (mild and severe preeclampsia) or according to the time of onset (early and late preeclampsia), it was detected that early preeclampsia is strongly associated to risk preeclampsia, eclampsia and HELLP syndrome have different genetic bases, although FLT1 gene seems to be involved in preeclampsia and HELLP syndrome pathophisiology

Papel da proteína de reparo XPC na regulação das proteínas de reparo APE1, OGG1 e PARP-1 em células humanas e de camundongos

studies using UV as a source of DNA damage. However, even though unrepaired UV-induced DNA damages are related to mutagenesis, cell death and tumorigenesis, they do not explain phenotypes such as neurodegeneration and internal tumors observed in patients with syndromes like Xeroderma Pigmentosum (XP) and Cockayne Syndrome (CS) that are associated with NER deficiency. Recent evidences point to a role of NER in the repair of 8-oxodG, a typical substrate of Base Excision Repair (BER). Since deficiencies in BER result in genomic instability, neurodegenerative diseases and cancer, it was investigated in this research the impact of XPC deficiency on BER functions in human cells. It was analyzed both the expression and the cellular localization of APE1, OGG1 e PARP-1, the mainly BER enzymes, in different NER-deficient human fibroblasts. The endogenous levels of these enzymes are reduced in XPC deficient cells. Surprisingly, XP-C fibroblasts were more resistant to oxidative agents than the other NER deficient fibroblasts, despite presenting the highest of 8-oxodG. Furthermore, subtle changes in the nuclear and mitochondrial localization of APE1 were detected in XP-C fibroblasts. To confirm the impact of XPC deficiency in the regulation of APE1 and OGG1 expression and activity, we constructed a XPC-complemented cell line. Although the XPC complementation was only partial, we found that XPC-complemented cells presented increased levels of OGG1 than XPC-deficient cells. The extracts from XPC-complemented cells also presented an elevated OGG1 enzimatic activity. However, it was not observed changes in APE1 expression and activity in the XPCcomplemented cells. In addition, we found that full-length APE1 (37 kDa) and OGG1- α are in the mitochondria of XPC-deficient fibroblasts and XPC-complemented fibroblasts before and after induction of oxidative stress. On the other hand, the expression of APE1 and PARP-1 are not altered in brain and liver of XPC knockout mice. However, XPC deficiency changed the APE1 localization in hypoccampus and hypothalamus. We also observed a physical interaction between XPC and APE1 proteins in human cells. In conclusion, the data suggest that XPC protein has a role in the regulation of OGG1 expression and activity in human cells and is involved mainly in the regulation of APE1 localization in mice. Aditionally, the response of NER deficient cells under oxidative stress may not be only associated to the NER deficiency per se, but it may include the new functions of NER enzymes in regulation of expression and cell localization of BER proteins

Distúrbios do sono em pacientes com transtorno depressivo

To evaluate sleep disorder complaints in outpatients with depressive disorder from a general hospital. Methods: An observational, cross-sectional study was carried out with a study sample composed of 70 patients (44 women and 26 men) with diagnosis of depressive disorder, according to the DSM-IV criteria. The patients were interviewed and evaluated by the Identification Questionnaire, the Sleep Habits Questionnaire and the Beck Depression Inventory (BDI). Results: In this study, 50 (71.3%) patients had recurrence of sleep disorder complaints. Mean BDI score was 35.83+8.85, with significant differences between patients with (38.50+8.70) and without (29.60+7.80) recurrence (p<0.05) and among patients with 1, 2, 3 and >3 episodes (p<0.05). In this study, 49 (70%) patients had insomnia and 21 (30%) had subjective excessive sleepiness. Significant differences were observed between the mean duration in months of the sleep disorders (7.16+2.10) and the depressive disorder (6.12+1.90) (p<0.05). Discussion: In the study sample, recurrence of sleep disorder complaints was high and significantly associated with severe depression. Insomnia was prevalent and the mean duration of sleep disorders was higher in relation to depressive disorder

Diferenças de gênero na produção de associações livres de palavras através do ciclo sono-vigília

Although several studies, have shown differences in cognitive performance between men and women, it not yet known whether these differences occur in tasks involving free association of words (WA). Studies across the sleep-wake cycle (SWC) suggest that rapid eye movement sleep (REM) favors semantic flexibility, in comparison with pre-sleep waking (Pre-WK), slow-wave sleep (SWS) and post-sleep waking (Post-WK). The present work has two aims: (1) to evaluate the semantic distances of word pairs produced by AP, comparing men and women, (2) to evaluate semantic distance in word pairs produced by free association across the SWC in young adults of both sexes. To achieve aim (1), we applied a task of WA in 68 adult volunteers during waking (52 women and 16 men). The WA task consisted of writing the first word that came to mind after viewing another word offered as a stimulus (root Word). To achieve aim (2), we performed polysomnography to identify specific stages of the SWC. The experimental subjects were then awakened (if they were asleep) and were immediately given a WA task. The task was administered to 2 groups of 10 subjects each (G1 and G2). G1 subjects were stimulated with the same set of root words after waking from various states of SWC, while G2 subjects received sets of different root words at each state of the SWC. In the absence of a Portuguese corpus suitable for the measurement of semantic distances, the words collected in our experiments were translated to English, and semantically quantified within a systematic and representative corpus of that language (Wordnet). This procedure removed the polysemies typical of Portuguese, but preserved the semantic macrostructure common to both languages. During waking, we found that semantic distances are significantly lower in WA produced by women, in comparison with the distances observed in men. Through the SWC, there were no statistically significant differences in G1. In G2 women, we detected a significant increase of semantic distances upon being awakened from SWS. In contrast, G2 men showed a significant increase in semantic distances upon being awakened from REM. The results of the first experiment are consistent with the notion that women have a more concrete reasoning than men. The results of the second experiment indicate that men awakened from REM present more flexibility in word association than when being awakened from other states. In contrast, women showed more flexible word association after being awakened from SWS, in compared with other states. The results indicate that the cognitive flexibility attributed to different states of the SWC shows gender dependency

Custo-efetividade da terapia compressiva no processo de cicatrização de úlceras venosas

Analytical study of therapeutic nonrandomized intervention type, intra-group controlled, with the aim of analyzing the cost-effectiveness of compression therapy with manipulated Unna boot in relation to conventional therapy in the healing of venous ulcers (VU) of patients treated in ambulatory clinic. The study population was composed by patients with VU treated by angiologists in Surgical Clinic Ambulatory of the Onofre Lopes University Hospital (HUOL) with a sample of 18 patients. It obtained the assent of the HUOL Ethics in Research Committee (Protocol 276/09). Data collection was performed over a period of four months by the own master's student and 34 nursing students, through the application of the research instrument in the admission of patients to the study and in the ten subsequent evaluations, performed at the time of changing Unna boot, weekly, for a maximum period of 10 weeks. The data were analyzed with SPSS 15.0 software, using descriptive and inferential statistics, and presented as tables, charts and graphs. Among those surveyed, prevailed: females, mean age 57.6 years, low education and income levels, most retired, unemployed or off work, with the standing position more than six hours per day and up to eight hours daily of domestic or occupational activities. In health status profile of respondents there were predominantly sleep, rest and inadequate elevation of the lower limbs, no smoking and/or alcohol use, presence of hypertension and no use of drugs. Most presented the first VU for over 10 years, recurrences, present VU for more than five years, involvement of left leg, in malleolar and / or distal leg region, mild edema, hyperpigmentation, lipodermatosclerosis, telangiectasies, reticular and varicose veins, mild pain, serous exudate in moderate quantity, small lesions (up to 50cm2), with predominance of granulation tissue and / or epithelialization and demarcated, elevated and irregular borders, with crusts and macerated. Most patients reported that in the 10 weeks prior to admission, made bandages at home and / or Basic Health Unit and / or ambulatory, with nursing aides or technicians, daily, and on weekends or holidays, performed by patients themselves, using healing ointment on the lesion, being observed granulation / epithelialization and increase in VU prevalent in the 10 weeks of traditional treatment. After follow up with manipulated Unna boot, was observed a decrease of lesions in all study patients, with complete healing in 27.8% of those between 1 and 5 weeks of treatment, with satisfactory evolution of the lesions, pain and ankle and calf circumferences, and unsatisfactory development of the borders of ulcers, edema, sleep, rest and elevation of the lower limbs, especially in more chronic patients. Furthermore, patients who achieved total healing and exhibited the greatest percentage reduction of lesions had a higher number of wound healing factors (ρ = 0.01 and ρ = 0.027, respectively). The manipulated Unna boot showed better results in those patients with shorter duration of injury, leading them to a satisfactory outcome within a short period of treatment. After the cost-effectiveness analysis, we conclude that the manipulated Unna boot is more effective than conventional therapy in the healing process of VU and is more cost-effective in patients with shorter lesions (ρ = 0.001), shorter treatment (ρ = 0.000) and greater number of wound healing factors (ρ = 0.005).