Efeitos imediatos da técnica de desrotação do atlas de Rocabado e do SNAG C1/2 de Mulligan na amplitude do teste de flexão-rotação em indíviduos com cefaleia cervicogénica : um ensaio clínico aleatório

RESUMO: A cefaleia cervicogénica é uma forma comum de dor de cabeça, que tem sido associada à existência de uma disfunção das estruturas da coluna cervical superior. Estudos recentes mostram uma grande incidência dessa disfunção a nível de C1-C2, avaliada pelo teste de flexão-rotação. Vários terapeutas manuais, como Brian Mulligan e Mariano Rocabado, têm sido sugerido técnicas de tratamento para este tipo de disfunção. Contudo, a evidência acerca da efectividade dessas técnicas é escassa. Desenho do estudo: Foi efectuado um ensaio clínico aleatório, duplamente cego, composto por três fases: pré-intervenção, intervenção e pós-intervenção. Objectivos: Avaliar e comparar os efeitos imediatos de duas técnicas de Terapia Manual Ortopédica (SNAG C1/2 de Mulligan e técnica de desrotação do atlas de Rocabado), na amplitude de movimento de rotação do segmento vertebral C1-C2, em indivíduos com história de cefaleia cervicogénica e com limitação no teste de flexão-rotação. As técnicas de tratamento foram usadas de forma isolada, em comparação a um grupo placebo. Métodos: Uma amostra de 60 indivíduos, com cefaleia cervicogénica e limitação do teste de flexão-rotação, foram aleatoriamente distribuídos por três grupos: SNAG C1/2 de Mulligan, técnica de desrotação do atlas de Rocabado e grupo placebo. O outcome primário foi a amplitude de movimento obtida no teste de flexão-rotação, que foi medido antes e imediatamente após a intervenção. Resultados: Imediatamente após a intervenção, a amplitude verificada no teste de flexão-rotação aumentou 21.8º (DP, 4.68) no grupo submetido ao SNAG C1/2 de Mulligan, 15º (DP, 5.07) no grupo em que foi aplicada a técnica de desrotação do atlas de Rocabado e 0.65º (DP, 0.67) no grupo placebo. Uma ANOVA modelo misto, 2 por 3, revelou efeito principal significativo do tempo (p<.001) e grupo (p<.001), assim como uma interacção significativa entre grupo e tempo (p<.001), relativamente à variável amplitude do teste de flexão-rotação. Estes resultados indicam que as diferenças verificadas entre os grupos eram dependentes do momento de avaliação. Uma comparação múltipla post hoc revelou que quer as técnicas de Mulligan, quer de Rocabado, produziram efeitos significativamente maiores que a intervenção placebo na amplitude de movimento do teste de flexão-rotação (p<.001 e p=.001, respectivamente). No entanto,não se verificou uma diferença significativa no que diz respeito à efectividade de ambas as técnicas de Terapia Manual Ortopédica aplicadas (p=.42). Conclusão: Esta investigação sugere que as duas técnicas de Terapia Manual Ortopédica avaliadas produziram efeito clínica e estatisticamente significativo na amplitude do teste de flexão-rotação. No entanto, não se verificaram diferenças entre as duas técnicas, no que diz respeito ao seu efeito no ganho de amplitude de movimento. Os resultados obtidos fornecem evidência preliminar sobre a efectividade de ambas as intervenções no tratamento da redução de amplitude de movimento em indivíduos com história de cefaleia cervicogénica.-------------------------------ABSTRACT:Background: Cervicogenic headache is a common form of headache arising from dysfunction in structures of the upper cervical spine. Recent studies have shown a high incidence of C1/2 dysfunction, evaluated by the flexion-rotation test (FRT). Several manual therapists have suggested different approaches to manage that dysfunction, such as Brian Mulligan and Mariano Rocabado. However, the evidence of the effectiveness of those manual techniques is anedoctal. Design: Randomized double blinded controlled trial with three phases: pre-intervention, intervention and post-intervention. Objectives: To determine and compare the immediate effects of two manual therapy techniques (Mulligan’s SNAG C1/2 and Rocabado’s atlas’ derotation technique) in the range of motion of C1-C2 vertebral segments, in cervicogenic headache patients and with limitation on the flexion-rotatoin test. The treatment techniques were used as single treatments against a placebo group. Methods: A sample of 60 subjects with cervicogenic headache and FRT limitation were randomly allocated into one of three groups: Mulligan’s C1/2 SNAG, Rocabado’s atlas derotation technique or placebo group. The primary outcome was the flexion rotation test range, which was measured before and immediately after the intervention. Results: Immediately after the application of the interventions, FRT range increased by 21.8º (SD, 4.68) for the Mulligan’s C1-2 SNAG group, 15º (SD, 5.07) for the Rocabado’s atlas derotation technique and 0.65º (SD, 0.67) for the placebo group. A 2-by-3 mixedmodel ANOVA a significant main effect of time (p<.001) and group (p<.001), as well as a significant interaction between group and time (p<.001) for the variable FRT range. These results indicate that group differences were dependent on time. A pairwise post hoc comparison revelad that both the Mulligan and Rocabado techniques produced significantly more effect on FRT range of motion than the placebo intervention (p<.001 and p=.001, respectively). However, there was not a significant difference between the effectiveness of the two manual therapy techniques (p=.42).Conclusion: This investigation’s findings suggest that both Mulligan’s C1/2 SNAG and Rocabado’s atlas derotation techniques produced a clinically and statistically significant effect on FRT range, but there were no changes between the two techniques in their effectiveness. These results provide preliminary evidence for the efficacy of both manual therapy techniques in the management of individuals with cervicogenic headache and FRT limitation.

Serologic survey for hantavirus infections among wild animals in rural areas of São Paulo State, Brazil

A serosurvey was conducted in wild animals captured close to two areas where hantavirus cardiopulmonary syndrome (HCPS) occurred in São Paulo State, Brazil. Serum samples from a total of 43 mammals were tested for antibodies reactive with Sin Nombre (SN) hantavirus using a strip immunoblot assay. RNAs from the blood clots of the positive samples were submitted to reverse transcriptase-polymerase chain reaction (RT-PCR). Two rodents of the genus Oligoryzomys were positive for hantavirus antibodies. These animals were captured in the Iguape region and represented 16.7% (2/12) of the sera from rodents and 100.0% (2/2) of the Oligoryzomys captured in that area. RT-PCR failed to amplify any viral cDNA. These results are in agreement with other data that suggest that members of this genus are important reservoirs of hantaviruses in Brazil.

An NMR structural study of nickel-substituted rubredoxin

J Biol Inorg Chem (2010) 15:409–420 DOI 10.1007/s00775-009-0613-6

Desulfovibrio gigas ferredoxin II: redox structural modulation of the [3Fe–4S] cluster

J Biol Inorg Chem (2006) 11: 307–315 DOI 10.1007/s00775-005-0077-2

Integrated study by NMR and X-ray Crystallography on the analysis of the molecular interactions in heme-binding proteins

Dissertação para obtenção do Grau de Doutor em Bioquímica, Especialidade Bioquímica Estrutural

Haemoglobin and red cell counts in leptospirosis patients infected with different serovars

IntroductionThe aim of the study was to compare haemoglobin and red cell counts between patients known to be infected with a range of leptospiral serovars.MethodsThe study retrospectively compared the haemoglobin and red cell count results from the first blood samples taken from 207 patients at presentation to a Queensland Health hospital.ResultsSignificant differences were observed in haemoglobin and red cell counts in those infected with Leptospira interrogans serovars Szwajizak and Canicola when compared with most of the other serovars.ConclusionsThese findings suggest that haemoglobin and red cell counts may be useful in differentiating leptospiral serovars in leptospirosis patients.

Development of a fundus camera for analysis of photoreceptor directionality in the healthy retina

The Stiles-Crawford effect (SCE) is the well-known phenomenon in which the brightness of light perceived by the human eye depends upon its entrance point in the pupil. This physiological characteristic is due to the directional sensitivity of the cone photoreceptors in the retina and it displays an approximately Gaussian dependency which is altered in a number of pathologies. Retinal imaging, a widely spread clinical practice, may be used to evaluate the SCE and thus serve as diagnostic tool. Nonetheless, its use for such a purpose is still underdeveloped and far from the clinical reality. In this project a fundus camera was built and used to assess the cone photoreceptor directionality by reflective imaging of the retina in healthy individuals. The physical and physiological implications of its development are addressed in detail in the text: the optical properties of the human eye, illumination issues, acquiring a retinal image formed by the eye, among others. A full description of the developmental process that led to the final measuring method and results is also given. The developed setup was successfully used to obtain high quality images of the eye fundus and in particular the parafoveal cone photoreceptors. The SCE was successfully observed and characterized. Even though considerable improvements could be done to the measurement method, the project showed the feasibility of using retinal imaging to evaluate the SCE thus motivating its usage in a clinical environment.

A genetic perspective on African prehistory

The various genetic systems (mitochondrial DNA, the Y-chromosome and the genome-wide autosomes) indicate that Africa is the most genetically diverse continent in the world and the most likely place of origin for anatomically modern humans. However, where in Africa modern humans arose and how the current genetic makeup within the continent was shaped is still open to debate. Here, we summarize the debate and focus especially on the maternally inherited mitochondrial DNA (mtDNA) and a recently revised chronology for the African mtDNA tree. We discuss the possible origin of modern humans in southern, eastern or Central Africa; the possibility of a migration from southern to eastern Africa more than 100 ka, carrying lineages within mtDNA haplogroup L0; the evidence for a climate-change-mediated population expansion in eastern Africa involving mtDNA haplogroup L3, leading to the “out-of-Africa” migration around 70–60 ka; the re-population of North Africa from the Near East around 40–30 ka suggested by mtDNA haplogroups U6 and M1; the evidence for population expansions and dispersals across the continent at the onset of the Holocene ; and the impact of the Bantu dispersals in Central, eastern and southern Africa within the last few millennia.

The effects of detergent loading on rotating biological contactor (RBC) wastewater treatment efficiency

There are presently over 182 RBC plants, treating domestic wastewater, in the Republic of Ireland, 136 of which have been installed since 1986. The use of this treatment plant technology, although not new, is becoming increasingly popular. The aim of this research was to assess the effects that a household detergent has on rotating biological contractor treatment plant efficiency. Household detergents contribute phosphorus to the surrounding environment and can also remove beneficial biomass from the disc media. A simple modification was made to a conventional flat disc unit to increase the oxygen transfer of the process. The treatment efficiency of the modified RBC (with aeration cups attached) was assessed against a parallel conventional system, with and without degergent loading. The parameters monitored were chemical oxygen demand (COD), bio-chemical oxygen demand (BOD), nitrates, phosphates, dissolved oxygen, the motors power consumption, pH, and temperature. Some microscopic analysis of the biofilm was also to be carried out. The treatment efficiency of both units was compared, based on COD/BOD removal. The degree of nitrification achievable by both units was also assessed with any fluctuations in pH noted. Monitoring of the phosphorus removal capabilities of both units was undertaken. Relationships between detergent concentrations and COD removal efficiencies were also analysed.

Sôbre dois novos parasitos de peixe da costa do Peru (Cestoda, Tetraphyllidea)

Na presente nota estudamos alguns cestódeos coletados de Sarda chilensis (Cuv.) peixe comum da costa do pacífico, enviado por um de nós (N.I.H); o material era constituído por vários espécimes de Phyllobothriidae e paenas trêss de Onchobothriidae, infelizmente todos comprimidos; não obstante aqui fazemos o seu estudo por ser tratar de material de interêsse.

Helmintos parasitos das espécies Scomberomorus cavalla (Cuvier) e Scomberomorus maculatus (Mitchill) do litoral cearense: Contracaecum fortalezae sp. n. (Nematoda, Ascaridoidea)

De nematódeos encontrados parasitando estômago, intestinos delgado e grosso de Scomberomorus cavalla (Cuv.) e Scomberomorus maculatus (Mitch.) o autor propões para o gênero Contracaecum Railliet et Henry, 1912 uma nova espécie, C. fortalezae sp. n., que mais se aproxima de C. clavatum (Rud., 1809) Baylis, 1920 dela se diferenciando por possuir espículos desiguais, um curto ovejetor, útero opistodelfo, ovos menores e por apresentar em todos exemplares estudados ceco intestinal curto e ceco esofagiano longo.

Estudos de cestóides de peixes do Brasil

Os autores iniciam com este trabalho um estudo sistemático de determinação dos cestóides de peixes depositados na Coleção helmintológica do Instituto Oswaldo Cruz. São referidas ou descritas as seguintes espécies e seus hospedeiros: Schizochoerus liguloideus (Diesing, 1850) e Nesolecithus janicki Posche, 1922, ambas de Arapaima gigas (Cuvier), (piracuru); Gyrocotyle meandrica Herrera, 1946, de Callorhynchus callorhynchus (L.), (quimera); Acanthobothrium dasybati Yamaguti, 1934 e Pterobothriidae não identificado, de uma arraia não determinada; três tipos larvares de trypanorrhyncha e um de Proteocephalidea, de Cynoscion striatus (Cuv.) e C. leiarchus (pescadinha); Proteocephalus jandia Woodland, 1934, de um bagre não determinado. Monticellia siluri (Fuhrmann, 1916) e Amphoteromorphus praeputialis sp. n. de Cetopsis caecutiens e Nomimoscolex magna sp. n. de Pimelodus clarias (mandi).

Misael Acosta Solís y el conservacionismo en el Ecuador (1936-1953)

Entre las décadas de 1930 y 1950 Misael Acosta Solís, miembro de la elite económica serrana y destacado geobotánico y forestal, lideró un proceso de institucionalización del conservacionismo en el Ecuador. Instituciones privadas y gubernamentales de corte conservacionista, exposiciones, libros y artículos, revistas científicas, estaciones de investigación forestal y agroecológica, leyes y políticas, congresos y encuentros, fueron algunos de sus legados. En este trabajo se revisan esos hechos en el contexto de la historia económica, social y ambiental del Ecuador. Asimismo, se sientan algunas premisas sobre las cuales continuar la construcción de la historia ambiental de esa nación.

Opinions and attitudes of a sample of Swiss physicians about physical activity promotion in a primary care setting

Little is known about the opinions, beliefs and behavior of Swiss physicians regarding physical activity (PA) promotion in a primary care setting. A qualitative study was performed with semi-structured interviews. We purposively recruited and interviewed 16 physicians in the French speaking part of Switzerland. Their statements and ideas regarding the promotion of PA in a primary care setting were transcribed and synthesized from the tape recorded interviews. Les opinions, les représentations et les comportements des médecins suisses en matière de promotion de l'activité physique au cabinet médical restent largement méconnus en Suisse. Une étude qualitative a été réalisée au moyen d'entretiens semi-structurés. Nous avons intentionnellement recruté et interviewé 16 médecins en Suisse romande. Leurs opinions et attitudes concernant la promotion de l'activité physique au cabinet médical ont été transcrites et synthétisées à partir de l'enregistrement de ces entretiens.