Efeito da crioterapia e da laserterapia na resposta ao dano muscular induzido pelo exercício excêntrico: ensaio clínico e randomizado

Exercise-induced muscle damage mainly affects individuals who returned to physical activity after a time without practicing it or had some kind of exhaustive exercise, particularly eccentric exercise. To evaluate the effect of cryotherapy and laser therapy in response to muscle damage induced by eccentric exercise on the biceps muscle. This was a randomized clinical trial consisting of 60 female subjects. All subjects initially underwent an evaluation consisting of perimetry, measurement of pain sensation (via algometry and visual analogue scale), electromyography and dynamometry. Then the subjects performed an exercise protocol on the isokinetic dynamometer consisting of 2 sets of 10 eccentric elbow flexors contraction at 60 °/s. Completed this protocol, an intervention was held according to a previously random group distribution: control group (no intervention), cryotherapy group and laser therapy group. Finally, subjects were re-evaluated immediately and 48 hours after the intervention protocol, except for Visual Analogue Scale (VAS), which was also evaluated 24 hours after exercise. The circumference of the limb, the pain sensation (VAS and algometry), the muscle activation amplitude (via Root Mean Square - RMS), median frequency, peak torque normalized per body weight, average peak torque, power and work were analyzed. The median frequency immediately after the intervention protocol on the cryotherapy group was the only variable that showed inter and intra-group differences; the remaining variables showed only intragroup differences. The perimetry values did not change immediately after the protocol on the groups which underwent cryotherapy and laser therapy, however, there was an increase after 48 hours; algometry values decreased in all groups for 48 hours and the VAS values increased 24 and 48 hours also for all groups. Regarding RMS no significant change was observed. For dynamometry, peak torque normalized per body weight and average peak torque had a similar behavior, with a reduction in the post protocol that has remained after 48 hours. For the power and work, a decrease was observed immediately after the protocol with a further reduction after 48 hours. Cryotherapy and laser therapy does not alter the muscle damage response, except for the perimetry values immediately after exercise.

Prevalência de talassemia alfa+ (deleção -3.7) na população adulta do estado do Rio Grande do Norte

Alpha thalassemia, the most common monogenic disorder in the world, is characterized by deletions of one (+-thalassemia) or both alpha genes (0-thalassemia) located on human chromosome 16 (16p13.3). The most common case of +-thalassemia is a deletion of 3.7 kb of DNA (-3.7 deletion). It is most prevalent in African and Middle East regions. In the few studies carried out in Brazilian population -3.7 deletion was the most common deletion, mainly in African descendants. This study was conducted to determine the prevalence of +- thalassemia (deletion 3.7kb) in adult population from Rio Grande do Norte. We obtained blood samples from 713 unrelated individuals of both genders, aged between 18 and 59 years old. All individuals were born in Rio Grande do Norte. The hematological indices were obtained in an automatic cell counter (Micros 60, ABX Diagnostics). The hemoglobin measurement (A2 and Fetal hemoglobin) and the profile confirmation were carried out by high performance liquid chromatography (HPLC) methodology. Genomic DNA was obtained from peripheral blood leukocytes using Illustra Blood GenomicPrep Mini Spin kit and -3.7 deletion was investigated by PCR. Among the 713 individuals studied, 80 (11,2%) presented +- thalassemia: 79 (11,1%) were heterozygous and 1 (0,1%) homozygous for the -3.7 deletion. Considering the ethnic group, negroes showed the greatest prevalence of +-thalassemia (12,5%), followed by mulattoes (12,3%) and caucasian (9,6%). Statistical comparison of hematological parameters between normal individuals and heterozygous to +-thalassemia showed significant differences in RBC (p<0,001), MCV (p<0,001), MCH (p<0,001), Hb A2 (p=0,007) as well as female hemoglobin concentration (p=0,003). This is one of the first studies to research +-thalassemia in general population of Rio Grande do Norte state and these results attest the importance of investigation of this condition to define the etiology of microcytosis and hypochromia.

Perfil de memória e ativação de linfócitos T na leishmaniose visceral

Visceral leishmaniasis (VL) in Brazil is a disease caused by Leishmania infantum chagasi (L.i.chagasi). The clinical evolution post-infection depends on the vertebrate host immune response, which is genetically mediated. This study aimed to evaluate the immune response of individuals living in endemic area for VL in the state of the Rio Grande do Norte, considering individuals with VL under treatment (n = 9), recovered VL <1 year post treatment (n = 10), > 10 years posttreatment (n = 9), uninfected individuals living in endemic areas (n = 7), individuals that lost DTH response (n=6) and asymptomatic individuals for VL (n=9). Peripheral blood cells were evaluated in the presence and absence of soluble Leishmania antigens (SLA) and ex vivo, to determine activation, presence of regulatory cells and memory cells. The Leishmania parasitemia and anti-Leishmania antibodies were determined respectively by qPCR and ELISA. Cells from individuals with VL under treatment showed less cell activation after stimulation with SLA for the markers CD4/CD69, CD8/CD69 and CD8/CD25 compared with VL post treatment treatment (p <0.001). Apparently uninfected individuals have a higher cell activation than symptomatic VL (p <0.001), with the exception of CD8/CD25 marker (p = 0.6662). On the other hand, in the ex-vivo group, significant differences were observed for CD4/CD69, CD8/CD69 and CD8/CD25 between the 4 groups due to increased cell activation present in cells of individuals symptomatic LV (p <0.001). VL cells under treatment, ex vivo, have a lower percentage of memory cells (CD4/CD45RO and CD8/CD45RO) than individuals VL post-treatment or control group (p = <0.01). Likewise, individuals with symptomatic VL have fewer regulatory cells when stimulated by SLA [CD4/CD25 (p = 0.0022) and CD4/FOXP3 (p = 0.0016)] and in the ex-vivo group (p = 0.0017). Finally, DNA isolated from recovered VL contained Leishmania DNA, supporting the hypothesis of non-sterile clinical cure for Leishmania infection. Recovered VL, even 10 years after treatment have high levels of memory cells, which may be due to the presence of stimulation, either by reexposure to Leishmania or non-sterile cure

Prevalência de oclusopatias e caracteríticas cefalométricas e dentais de escolares cearense da cidade de Fortaleza

The people of Ceará state are descended from miscegenation between the Portuguese colonizers and the native population, resulting in a different facial pattern from other populations. It is important that this pattern be thoroughly understood, along with its minimum and maximum values so that they can be assessed and respected, allowing professionals who deal with the craniofacial complex to work more efficiently and scientifically. Aim: To characterize the morphological pattern of individuals from Ceará state, whose father and grandfather are also native from Ceará, in the 10-12 year age group, not submitted to previous orthodontic treatment, in order to determine: 1) the prevalence of occlusal pattern; 2) the prevalence of dental anomalies (DA) and, 3) the skeletal and dental cephalometric characteristics of individuals that present with normal occlusion and harmonious facial pattern. Methodology: A list of 10-12 year-olds was obtained from 515 schools containing 162,713 students (Education Secretariat of Ceará State), from which 234 individuals were examined (107 boys and 157 girls). The assessment criteria adopted were: 1) Angle s Classification System to determine occlusal pattern. The occlusal characteristics were measured through overbite, overjet, crowding and interincisal diastema. 2) DA are anomalies of number, shape, size, eruption and structure and, 3) in the group that presented with normal occlusion, we used cephalometric analysis measures proposed by Downs, Steiner, Tweed, Holdaway, Jacobson and McNamara. Results: 1) 25.8% of the schoolchildren had normal occlusion, 47.5% class I malocclusion, 22.3% class II malocclusion and 4.2% class III malocclusion. No statistically significant difference was found between the age group studied and sex. Thirty percent of the individuals had normal overbite, while 36.7% and 19.7% had increased and reduced overbite, respectively. Normal overjet was found in 33.7% of the individuals, increased overjet in 50% and reduced in 16.3%. Dental crowding was observed in 62.5% of the individuals and the presence of interincisal diastema in 14.8%. 2) The prevalence of DA was 56.1%, 6.8% in the number, 10.8% in shape, 4.1% in size, 34.5% in eruption, 26.4% in structure and 17.4% had more than one DA. No association was found between DA and sex, but DA was significantly associated to malocclusion (p<0.05); 3) there was no association between sex or facial type between the measures of nasal-labial angle, position and effective maxillary length, effective mandibular length and the sagittal relationship between the molars, overjet and overbite, position of upper incisors, lower incisors and between the incisors themselves. There was a difference between sex, on the VERT index and in lower anterior facial height, upper incisor inclination and line-H, between facial types for the occlusal plane angles, mandibular plane, facial axis, lower incisor inclination, mandibular position, upper incisor position, lower anterior facial height, ANB and line-H. It was concluded that: 1) the most prevalent occlusal type was class I malocclusion, with no distinction for sex or age group, and the assessment of occlusal characteristics showed that excessive overbite and overjet were the most predominant findings, along with a high occurrence of tooth crowding; 2) a high prevalence of DA was found, particularly eruption anomalies, not influenced by sex but significantly associated to malocclusion and 3) individuals from Ceará are predominantly brachyfacial, exhibiting a number of similarities inherent to their facial pattern, such as a convex profile, retracted jaw, reduced lower third and protruded lower incisors. This study was multidisciplinary, involving researchers from the areas of epidemiology, radiology and dentistry, thereby meeting the multidisciplinarity requirements of the Postgraduate Program in Health Sciences

Valorização do servidor no Programa Nacional de Humanização: estudo em um hospital universitário

It is at the work environment where value of the health professional is realized, according to the National Humanization Policy (PNH) from a Pediatric Hospital connected to an institution of higher education. Among the guiding principles of PNH it is highlighted the commitment to the democratization of labor relations and enhancement of health professionals, stimulating the continuing education process. For this research, a qualitative approach was chosen, using a semistructured interview as a tool to collect data. In a perspective of identifying the appreciation and humanization into interpersonal relations between workers, information from the theory of communicative action of Habermas was analyzed, considering cultural values goes beyond the practice in action, where the prospects of moral arguments in the universal truisms of life pervade original cultural moral, cognitive and expressive, imbued on ethics. This reasearch had the collaboration 29 employees with a regular contract labor to a teaching hospital in Natal, Brazil. The data was obtained through interviews which all participants signed a consent term. After data analysis the results shows the existance of a satisfaction of all workers on performing duties. The workers perceive its role valorization through kudos received as a consequence of a work done, others believe that it occurs when the institution or the group itself is concerned to enhance the work. Thus, in general, they feel valued. Regarding the interpersonal relationship, the most highlighted point was the fact that in the employees versus general directors item, respondents indicated the existence of a distance between these two categories, which can affect a participatory management. Therefore, the results of this study showed the necessity to develop actions that provide a healthy work environment. The joint guidelines of the PNH and the Employee Health Care Policy, represent some directions with some similarities in their purpose to the theory of communicative action, where there is a mutual respect, tolerance and coexistence of differences, considering the constructive conflict among health workers within the perspective of communication and interaction among individuals

Alterações nos genes da E-caderina e β-catenina em adenoma pleomórfico e carcinoma adenóide cístico: estudo molecular e imuno-histoquímico

Pleomorphic adenoma and adenoid cystic carcinoma represent a benign and malignant salivary gland neoplasm, respectively, that shares the same histological origin, however with distinct biological behavior. The aim of the present study was identify the -160 C/A polymorphism in the gene CDH1, mutational analysis of CTNNB1 gene and evaluation the expression of the E-cadherin and β-catenin in pleomorphic adenomas and adenoid cystic carcinomas. Furthermore, it was proposed correlate the immunochemistry staining patterns with the polymorphism and mutations. Twenty-four pleomorphic adenomas and 24 adenoid cystic carcinomas were retrieved. The polymorphism analysis was performed by restriction fragment length polymorphism (RFLP), using the restriction enzymes HphI or AflIII and the mutational screening was performed by PCR-single strand conformational polymorphism (PCR-SSCP). The immunohistochemical analysis was taken by the counting of cells, recorded as the Hscore index, and considering the presence or absence, intensity, distribution and localization of proteins expression. Comparing the two neoplasms, the results demonstrated statistically significant difference for the E-cadherin and β-catenin expression, with pleomorphic adenoma presenting weaker immunostaining. Was observed statistical correlation between E-cadherin and β-catenin expression. CDH1 heterozigotic polymorphism was seen in two cases and 13 cases displayed abnormal mobility electrophoretic shifts, suggesting CTNNB1 gene mutation. The immunohistochemical expression was not statistically correlated with the polymorphism or suggested mutations. In conclusion this study supports that the E-cadherin/β-catenin complex immunohistochemical expression might be related with the myoepithelial component amount and differentiation neither the tumor biological behavior. The cases that showed E-cadherin gene polymorphism presented reduced protein expression and, moreover, CTNNB1 suggested mutations seem not influence in the β-catenin protein expression

Indicadores da resposta ao estresse agudo associados com a familiaridade ao ambiente e aos procedimentos de banho e tosa em cães (Canis familiaris) da raça poodle

The stress responses can be parameters used in order to identify the welfare of animals. Behavior parameters can also be regarded as means to identify their relation to stressing situations. In this study, adult male and female poodle dogs, accustomed (group 1) or not (group 2) to the environment of a bath and grooming salon were analyzed through the plasmatic concentration of cortisol, cell counting of the immune system (total leukocytes and percentage of neutrophils and lymphocytes) and through observation of changes in behavior before and after the bath and grooming service. After arriving at the kennel, the dogs were taken to the bath and grooming facility, where they had their blood samples taken and were observed for ten minutes. The subsequent procedures consisted of the bath and grooming services and the collection of another blood samples. The research results were analyzed through non-parametric statistic tests and p < 0.05. Accustomed and non-accustomed dogs presented different hormonal and behavior responses: accustomed dogs presented an increasing of the cortisol level at the second blood samples collection, thus indicating stress towards the aforementioned procedures and presenting behavior responses which can be described as moderated stress. Non-accustomed dogs presented the same cortisol levels in both first and second samples suggesting that they were already reacting to the new environment. Dogs also shown behavioral responses which can be described as acute stress. Both male and female dogs showed similar immunological changes as well as different endocrine and behavioral profiles. Concerning aggression, this study demonstrates that biting the owner can be a predicting behavior of aggression during the bath and grooming service, male dogs were more aggressive than the female, and that males were more reactive to unknown caretaker. The results of this research propose that the familiarization of the animal with the bath and grooming environment and caretaker is important to the welfare of poodle dogs, especially to that of male dogs

Gravidez tardia: bem-estar subjetivo e percepção da gestação

The subjective well- being (SWB) is formed by global judgments of satisfaction with life, or with peculiar domains the positive and the negative emotional experiences. The perception in turn, is the process of interpretive process of sensory data with cognitive or informative sense, absorbed in function of a context. From this perspective, the research aimed to evaluate SWB and the perception of advanced age pregnant women. Participated in the survey 80 pregnant with 35 years old or older (Group A or older) and 80 pregnant aged between 20 and 34 years old (Group B or young adults). The instruments used were: the scale of subjective well-being and a questionnaire, that included sociodemographic informations, items about pregnancy and a statement based on the Free Association of Words Technique (FAWT) to approach the perception of pregnancy. The data from the questionnaire and scale, in order to compare the data between groups suffered descriptive and inferential statistical analyzes. The analyzes performed with chi-square test among groups, which had values that were statistically significant, with the sociodemographic variables the type of contraceptive and health problems. The indicators of the SWB had further more by means in groups. The results of the Wilcoxon's test that there were no differences between the groups referred above. In the relation indicators of well being with variables age, education and income, some associations were significant. In addition, the words derived from the (FAWT) were analyzed using the software Programmer s Permenttant l´Analyse des Evocation (EVOC2000) and categorized according to content analysis of Bardin in three thematic categories (positive and negative affects, perception of gestation and implications of pregnancy) discussed as a group, since most of words were common. The study highlights shown how similar were the presented data by pregnant women surveyed. It is supposed about this fact the similarity is related to the social context. The relevance of this study for the health care network is to help with proposals aimed at specific improvements to the public and the sector, beside demonstrate that advanced age pregnant women and young adulst in the researched context showed no differences in the most of the studied characteristics

Projeto e implementação de uma plataforma MP-SoC usando SystemC

This work presents the concept, design and implementation of a MP-SoC platform, named STORM (MP-SoC DirecTory-Based PlatfORM). Currently the platform is composed of the following modules: SPARC V8 processor, GPOP processor, Cache module, Memory module, Directory module and two different modles of Network-on-Chip, NoCX4 and Obese Tree. All modules were implemented using SystemC, simulated and validated, individually or in group. The modules description is presented in details. For programming the platform in C it was implemented a SPARC assembler, fully compatible with gcc s generated assembly code. For the parallel programming it was implemented a library for mutex managing, using the due assembler s support. A total of 10 simulations of increasing complexity are presented for the validation of the presented concepts. The simulations include real parallel applications, such as matrix multiplication, Mergesort, KMP, Motion Estimation and DCT 2D

Segmentação Fuzzy de Texturas e Vídeos

The segmentation of an image aims to subdivide it into constituent regions or objects that have some relevant semantic content. This subdivision can also be applied to videos. However, in these cases, the objects appear in various frames that compose the videos. The task of segmenting an image becomes more complex when they are composed of objects that are defined by textural features, where the color information alone is not a good descriptor of the image. Fuzzy Segmentation is a region-growing segmentation algorithm that uses affinity functions in order to assign to each element in an image a grade of membership for each object (between 0 and 1). This work presents a modification of the Fuzzy Segmentation algorithm, for the purpose of improving the temporal and spatial complexity. The algorithm was adapted to segmenting color videos, treating them as 3D volume. In order to perform segmentation in videos, conventional color model or a hybrid model obtained by a method for choosing the best channels were used. The Fuzzy Segmentation algorithm was also applied to texture segmentation by using adaptive affinity functions defined for each object texture. Two types of affinity functions were used, one defined using the normal (or Gaussian) probability distribution and the other using the Skew Divergence. This latter, a Kullback-Leibler Divergence variation, is a measure of the difference between two probability distributions. Finally, the algorithm was tested in somes videos and also in texture mosaic images composed by images of the Brodatz album

Evolução geodinâmica e condicionamento estrutural dos terrenos Piancó-Alto Brígida e Alto Pajeú, domínio da zona transversal, NE do Brasil

This thesis aims to advance in the geological knowledge of the region comprising the Piancó-Alto Brígida (TPAB) and Alto pajeú (TAP) terranes, in the Transversal Zone Domain (Borborema Province, NE Brazil), with the main objective of understanding the geodynamic evolution and the structural framework of these units. To reach this objective, and besides field work and interpretation of traditional aerial photographs, other tools were employed like of remote sensing products (Landsat 7 ETM+, aeroradiometrics, aeromagnetics and topographical images), lithogeochemical (whole rock) analyses and geochronological dating (U-Pb in zircon), besides integration with literature data. In the area, several precambrian geological units outcrop, represented in the TAP by the paleoproterozoic Serra Talhada and Afogados da Ingazeira complexes, Riacho Gravatá Complex (metavolcano-sedimentary sequence of Stenian-Tonian age) and Cariris Velhos orthogneisses (of Tonian age). The TPAB comprises the Santana do Garrote (lower unit) and Serra do Olho d'Água (upper unit) formations of the Cachoeirinha Group (Neoproterozoic III), besides the Piancó orthogneisses and Bom Jesus paragneisses; the latter correspond to an older (basement ?) block and a possible high grade equivalent of the Cachoeirinha Group (or Seridó Group ?), respectively. Several Brasiliano-age plutons occur in both terranes.The aeromagnetic data show the continuity, at depth, of the main shear zones mapped in the region. The Patos, Pernambuco, Boqueirão dos Cochos, Serra do Caboclo, Afogados da Ingazeira/Jabitacá and Congo-Cruzeiro do Nordeste shear zones reach depths greater than to 6-16 km. The aeromagnetic signature of other shear zones, like the Juru one, suggests that these structures correspond to shallower crustal features. The satellite images (Landsat 7 ETM+) and aerogamaspectrometric images discriminate different geological units, contributing to the mapping of the structural framework of the region. The Serra do Caboclo Shear Zone was characterized as the boundary/suture between the TPAB and TAP. This structure is an outstanding, pervasive feature that separates contrasting geological units, such as the Neoproterozoic III Cachoeirinha Group in the TPAB and the Riacho Gravatá Complex and the Cariris Velhos metaplutonics, of Stenian-Tonian age, in the TAP. Occupying different blocks, these units are not found in authoctonous relations, like unconformities and intrusive contacts. Concerning the Cariris Velhos (ca. 1,0 Ga old) event is recorded by radiometric ages of the Riacho Gravatá Complex metavolcanics and intrusive augen and orthogneisses, all of them displaying geochemical affinities of arc or collisional settings. A structural signature of this event was not recorded in the region, possibly due to its low grade/low strain style, obliterated by the overprinting of younger, higher grade/high strain Brasiliano-age fabrics.The first tectonic event (D1) observed in the Cariris Velhos lithotypes presents contractional kinematics with transport to the NW. Neoproterozoic III geochronologic dates, obtained in late-D1 granitoids, imply a Brasiliano age (ca. 610-600 Ma) for this deformation event. The second tectonic event (D2) characterized in the region corresponds to the Brasiliano transcurrent kinematics of the outstanding shear zones and associated granitoid plutons. The geochronological (U-Pb in zircon) data obtained during this thesis also confirms the occurrence of the Cariris Velhos magmatic suite in the TAP, as well as the Neoproterozoic III age to the Cachoeirinha Group in the TPAB. The TAP (Riacho Gravatá Complex, augen and orthogneisses) is interpreted as a continental arc possibly accreted to a microcontinent during the Cariris Velhos (Stenian-Tonian) event. Later on, this terrane collided with the TPAB at the beginning of the Brasiliano orogeny (D1 contractional deformation), and both domins were reworked by the transcurrent shear deformation of the D2 event

Fatores determinantes da near miss materna em uma unidade de terapia intensiva obstétrica: avaliação das competências profissionais da área médica

Objective: Evaluate the determinants of morbidity and mortality in an obstetric intensive care unit and professional medical skills of students/residents at a university hospital. Methods: observational cross - sectional with 492 pregnant/pue rperal women and 261 students/residents. Patients were admitted to the obstetric intensive care unit during a year, being informed about the proposals of the study and a questionnaire was applied. The analysis was performed using Microsoft Excel 2013 and G raphPad6. Chi - square tests were used to evaluate risk factors and student t test evaluates resident/students' skills concerning the cognitive test and the Mini - Cex. Results: the main risk factors to near miss were: non - white race (OR = 2.527; RR = 2.342) ; marital status(married women) (OR = 7.968; RR = 7.113) , schooling (primary) (OR = 3.177 ; RR = 2.829) , from country town (OR = 4.643 ; RR = 4.087), low income (OR = 7014 ; RR = 5.554) , gestational hypertensive disorders (OR = 16.35 ; RR = 13.27) , re alization of pre - natal (OR = 5.023 ; RR = 4.254) and C - section before labor(OR = 39.21 ; RR = 31.25). In cognitive/Mini - cex analysis were noted significant difference in the performance of students on the subject (3.75 ± 0.93, 4.03 ± 0.94 and 4.88 ± 0.35). We still observed the best performance of residents, when compared to graduation students (p < 0.01). Conclusions: the prevalence of near miss was associated with socioeconomic/clinics factors and care issues, revealing the importance of interventions to improve these indicators. In addition, we suggest a better curriculum insertion of this subject in the medical Course disciplines due the importance to avoid the near miss through of adequacy of medical education.

Efeitos do treino de marcha em esteira com adição de carga ao membro inferior não parético de indivíduos com acidente vascular cerebral: ensaio clínico controlado e randomizado

Introduction: Gait after stroke is characterized by a significant asymmetry between the lower limbs, with predominant use of the non-paretic lower limb (NPLL) over using the paretic lower limb. Accordingly, it has been suggested that adding load/weight to the NPLL as a form of restricting the movement of this limb may favor the use of the paretic limb, reducing interlimb asymmetry. However, few studies have been conducted up to this moment, which only investigated the immediate effects of this practice. Objectives: 1) Investigating whether there is an influence of adding load to the NPLL during treadmill training on cardiovascular parameters and on gait performance of individuals with stroke, compared to treadmill training without load addition; 2) Analyzing the effects of treadmill training with and without load added to the NPLL on kinematic parameters of each lower limb during gait; 3) Analyzing the effects of treadmill training with and without load added to the NPLL on measurements of functional mobility and postural balance of these patients. Materials and Methods: This is a randomized single blinded clinical trial involving 38 subjects, with a mean age of 56.5 years, at the subacute post-stroke phase (with mean time since stroke of 4.5 months). Participants were randomly assigned into an experimental group (EG) or control group (CG). EG (n= 19) was submitted to gait training on a treadmill with the addition of load to the NPLL by ankle weights equivalent to 5% of body weight. CG (n= 19) was only submitted to gait training on a treadmill. Behavioral strategies which included home exercises were also applied to both groups. The interventions occurred daily for two consecutive weeks (Day 1 to Day 9), being of 30 minutes duration each. Outcome measures: postural balance (Berg Functional Balance Scale – BBS), functional mobility (Timed Up and Go – TUG; kinematic variables of 180° turning) and kinematic gait variables were assessed at baseline (Day 0), after four training sessions (Day 4), after nine training sessions (Day 9), and 40 days after completion of training (Follow-up). Cardiovascular parameters (mean arterial pressure and heart rate) were evaluated at four moments within each training session. Analysis of variance (ANOVA) was used to compare outcomes between EG and CG in the course of the study (Day 0, Day 4, Day 9 and Follow-up). Unpaired t-tests allowed for intergroup comparison at each training session. 5% significance was used for all tests. Results: 1) Cardiovascular parameters (systemic arterial pressure, heart rate and derivated variables) did not change after the interventions and there were no differences between groups within each training session. There was an improvement in gait performance, with increased speed and distance covered, with no statistically significant difference between groups. 2) After the interventions, patients had increased paretic and non-paretic step lengths, in addition to exhibiting greater hip and knee joint excursion on both lower limbs. The gains were observed in the EG and CG, with no statistical difference between the groups and (mostly) maintained at follow-up. 3) After the interventions, patients showed better postural balance (higher scores on BBS) and functional mobility (reduced time spent on the TUG test and better performance on the 180° turning). All gains were observed in the EG and CG, with no statistically significant difference between groups and were maintained at follow-up. Conclusions: The addition of load to the NPLL did not affect cardiovascular parameters in patients with subacute stroke, similar to treadmill training without load, thus seemingly a safe training to be applied to these patients. However, the use of the load did not bring any additional benefits to gait training. The gait training program (nine training sessions on a treadmill + strategies and exercises for paretic limb stimulation) was useful for improving gait performance and kinematics, functional mobility and postural balance, and its use is suggested to promote the optimization of these outcomes in the subacute phase after stroke.

Perfil de memória e ativação de linfócitos T na leishmaniose visceral

Visceral leishmaniasis (VL) in Brazil is a disease caused by Leishmania infantum chagasi (L.i.chagasi). The clinical evolution post-infection depends on the vertebrate host immune response, which is genetically mediated. This study aimed to evaluate the immune response of individuals living in endemic area for VL in the state of the Rio Grande do Norte, considering individuals with VL under treatment (n = 9), recovered VL <1 year post treatment (n = 10), > 10 years posttreatment (n = 9), uninfected individuals living in endemic areas (n = 7), individuals that lost DTH response (n=6) and asymptomatic individuals for VL (n=9). Peripheral blood cells were evaluated in the presence and absence of soluble Leishmania antigens (SLA) and ex vivo, to determine activation, presence of regulatory cells and memory cells. The Leishmania parasitemia and anti-Leishmania antibodies were determined respectively by qPCR and ELISA. Cells from individuals with VL under treatment showed less cell activation after stimulation with SLA for the markers CD4/CD69, CD8/CD69 and CD8/CD25 compared with VL post treatment treatment (p <0.001). Apparently uninfected individuals have a higher cell activation than symptomatic VL (p <0.001), with the exception of CD8/CD25 marker (p = 0.6662). On the other hand, in the ex-vivo group, significant differences were observed for CD4/CD69, CD8/CD69 and CD8/CD25 between the 4 groups due to increased cell activation present in cells of individuals symptomatic LV (p <0.001). VL cells under treatment, ex vivo, have a lower percentage of memory cells (CD4/CD45RO and CD8/CD45RO) than individuals VL post-treatment or control group (p = <0.01). Likewise, individuals with symptomatic VL have fewer regulatory cells when stimulated by SLA [CD4/CD25 (p = 0.0022) and CD4/FOXP3 (p = 0.0016)] and in the ex-vivo group (p = 0.0017). Finally, DNA isolated from recovered VL contained Leishmania DNA, supporting the hypothesis of non-sterile clinical cure for Leishmania infection. Recovered VL, even 10 years after treatment have high levels of memory cells, which may be due to the presence of stimulation, either by reexposure to Leishmania or non-sterile cure