Eletroestimulação, exercícios dos músculos do assoalho pélvico e incontinência urinária

A incontinência urinária além de ser multifatorial com enorme complexidade terapêutica é um problema de ordem de saúde pública e que merece maior atenção, pois causa um imenso impacto negativo sobre a qualidade de vida das pessoas. São diversas as opções de tratamento da incontinência urinária, como os exercícios dos músculos do assoalho pélvico, tratamento com fármacos, injeção transuretral, e o esfíncter urinário artificial. A Sociedade Internacional de Continência recomenda como tratamento inicial os exercícios dos músculos do assoalho pélvico supervisionado, orientações de estilo de vida adequado, regimes urinários regulares, terapias comportamentais e medicação. A Revisão Sistemática desta Dissertação mostrou a necessidade de mais estudos com melhor qualidade metodológica para evidenciar o uso da eletroestimulação como intervenção eficaz no tratamento da incontinência urinária; O Estudo Transversal Retrospectivo, após a análise de 128 prontuários do Ambulatório de Fisioterapia Pélvica do Hospital Federal dos Servidores do Rio de Janeiro mostrou resultados significativos da Fisioterapia Pélvica para a redução da incontinência urinária e do impacto da incontinência urinária na vida diária destes pacientes. Por fim, o Experimento Controlado Randomizado, duplo cego, mostrou resultados significativos do uso da eletroestimulação associada aos exercícios dos músculos do assoalho pélvico como uma opção de tratamento conservador capaz de potencializar a continência urinária após a prostatectomia radical.

Efeito da estimulação transcraniana por corrente contínua sobre o desempenho físico: análise das respostas cerebrais, metabólicas e perceptivas durante e após exercícios aeróbio e de força

Estimulação transcraniana por corrente contínua (ETCC) sobre áreas corticais pré-selecionadas, tem aumentado o desempenho físico de diferentes populações. Porém, lacunas persistem no tocante aos mecanismos subjacentes à estes efeitos. Assim, a presente tese objetivou: a) investigar os efeitos da ETCC anódica (aETCC) e placebo (Sham) no córtex motor (CM) de indivíduos saudáveis sobre o desempenho de força máxima; b) comparar os efeitos da ETCC sobre a produção de força máxima e estabilidadade da força durante exercícios máximo e submáximo em sujeitos hemiparéticos e saudáveis; c) investigar o efeito da ETCC sobre a conectividade funcional inter-hemisférica (coerência eletroencefalográfica cEEG) do córtex pré-frontal (CPF), desempenho aeróbio e dispêndio energético (EE) durante e após exercício máximo e submáximo. No 1 estudo, 14 adultos saudáveis executaram 2 sessões de exercício máximo de força (EMF) dos músculos flexores e extensores do joelho dominante (3 séries de 10 rep máximas), precedidos por aETCC ou Sham (2mA; 20 mim). aETCC não foi capaz de aumentar o trabalho total e pico de torque (PT), resistência à fadiga ou atividade eletromiográfica durante o EMF. No 2 estudo, 10 hemiparéticos e 9 sujeitos saudáveis receberam aETCC e Sham no CM. O PT e a estabilidade da força (coeficiente de variação - CV) foram avaliados durante protocolo máximo e submáximo de extensão e flexão unilateral do joelho (1 série de 3 reps a 100% do PT e 2 séries de 10 reps a 50% do PT). Nenhuma diferença no PT foi observada nos dois grupos. Diminuições no CV foram obervadas durante a extensão (~25-35%, P<0.001) e flexão de joelho (~22-33%, P<0.001) após a aETCC comparada com Sham nos hemiparéticos, entretanto, somente o CV na extensão de joelhos diminuiu (~13-27%, P<0.001) nos saudáveis, o que sugere que aETCC pode melhorar o CV, mas não o PT em sujeitos hemiparéticos. No 3 estudo, 9 adultos saudáveis realizaram 2 testes incrementais máximos precedidos por aETCC ou Sham sobre o CPF com as respostas cardiorrespiratórias, percepção de esforço (PSE) e cEEG do CPF sendo monitoradas. O VO2 de pico (42.64.2 vs. 38.23.3 mL.kg.min-1; P=0,02), potência total (252.776.5 vs. 23773.3 W; P=0,05) e tempo de exaustão (531.1140 vs. 486.7115.3 seg; P=0,04) foram maiores após aETCC do que a Sham. Nenhuma diferença foi encontrada para FC e PSE em função da carga de trabalho (P>0,05). A cEEG do CPF aumentou após aETCC vs. repouso (0.700.40 vs. 0.380.05; P=0,001), mas não após Sham vs. repouso (0.360.49 vs. 0.330.50; P=0,06), sugerindo que a aETCC pode retardar a fadiga aumentando a conectividade funcional entre os hemisférios do CPF e desempenho aeróbio durante exercício exaustivo. No 4 estudo, o VO2 e EE foram avaliados em 11 adultos saudáveis antes, durante a aETCC ou Sham no CPF e 30 min após exercício aeróbio submáximo isocalórico (~200kcal). Diferenças não foram observadas no VO2 vs. repouso durante aETCC e Sham (P=0.95 e P=0.85). Porém, a associação entre exercício e aETCC aumentou em ~19% o EE após ao menos, 30 min de recuperação após exercício quando comparada a Sham (P<0,05).

Human muscle spindles act as forward sensory models.

Modern theories of motor control incorporate forward models that combine sensory information and motor commands to predict future sensory states. Such models circumvent unavoidable neural delays associated with on-line feedback control. Here we show that signals in human muscle spindle afferents during unconstrained wrist and finger movements predict future kinematic states of their parent muscle. Specifically, we show that the discharges of type Ia afferents are best correlated with the velocity of length changes in their parent muscles approximately 100-160 ms in the future and that their discharges vary depending on motor sequences in a way that cannot be explained by the state of their parent muscle alone. We therefore conclude that muscle spindles can act as "forward sensory models": they are affected both by the current state of their parent muscle and by efferent (fusimotor) control, and their discharges represent future kinematic states. If this conjecture is correct, then sensorimotor learning implies learning how to control not only the skeletal muscles but also the fusimotor system.

Rhythm generation in monkey motor cortex explored using pyramidal tract stimulation.

We investigated whether stimulation of the pyramidal tract (PT) could reset the phase of 15-30 Hz beta oscillations observed in the macaque motor cortex. We recorded local field potentials (LFPs) and multiple single-unit activity from two conscious macaque monkeys performing a precision grip task. EMG activity was also recorded from the second animal. Single PT stimuli were delivered during the hold period of the task, when oscillations in the LFP were most prominent. Stimulus-triggered averaging of the LFP showed a phase-locked oscillatory response to PT stimulation. Frequency domain analysis revealed two components within the response: a 15-30 Hz component, which represented resetting of on-going beta rhythms, and a lower frequency 10 Hz response. Only the higher frequency could be observed in the EMG activity, at stronger stimulus intensities than were required for resetting the cortical rhythm. Stimulation of the PT during movement elicited a greatly reduced oscillatory response. Analysis of single-unit discharge confirmed that PT stimulation was capable of resetting periodic activity in motor cortex. The firing patterns of pyramidal tract neurones (PTNs) and unidentified neurones exhibited successive cycles of suppression and facilitation, time locked to the stimulus. We conclude that PTN activity directly influences the generation of the 15-30 Hz rhythm. These PTNs facilitate EMG activity in upper limb muscles, contributing to corticomuscular coherence at this same frequency. Since the earliest oscillatory effect observed following stimulation was a suppression of firing, we speculate that inhibitory feedback may be the key mechanism generating such oscillations in the motor cortex.

Studies on fish epidemics from Assam

Investigations conducted since July 1988 on ulcerative fish epidemics in Assam, India, indicated that mainly four species of fishes belonging to the genera Puntius, Channa, Macrognathus and Mystus were widely affected by the disease. Results indicated that outbreak of the disease may not be due to organic pollution of water or radioactive and heavy-metallic contamination. Bacterial culture revealed colonies of Escherichia coli and Pseudomonas aeruginosa in the surface muscular lesions and gill tissues while preliminary electron microscopic studies indicated the presence of viruses in the muscles and gills of diseased fishes.

Postmortem changes in hilsa fish. Pt. 2. Studies on physical and bacteriological changes in iced and frozen stored hilsa fish (Tenualosa ilisha Ham.)

Studies were conducted to evaluate the quality of hilsa fish during icing and freezing storage at -20°C by determining organoleptic and bacteriological aspects. The fishes stored in ice were organoleptically in acceptable condition 2 for 20 days. The bacterial load in muscles of 4 days ice stored fish was 2.5x10² CFU/g which gradually increased up to 1.8x10⁵ CFU/g after 20 days when the fishes were organoleptically in acceptable condition. The keeping qualities of different days of ice stored fishes were also evaluated during their subsequent frozen storage at -20°C. Both 4 and 7 days of ice stored fishes were organoleptically in acceptable condition up to 48 weeks but the highest degree of freshness was found for fish stored in ice for 4 days before freezing at -20°C. The result indicates that the longer is the duration of ice storage before freezing, the shorter is the shelf life of the fish. The initial bacterial load prior to freezing of the 4 and 7 days of ice stored samples were 2.5x10³ CFU/g and 3.8x10⁴ CFU/g, respectively which reduced to 2.21x10² CFU/g and 2.38x10² CFU/g, respectively at the end of the 24 weeks of frozen storage. However, after 40 weeks the bacterial load in the frozen stored sample fell below the detection level.

Studies on the post-mortem changes in shrimp and prawn during ice storage. Pt. 1. Organoleptic and physical changes

The organoleptic characteristics such as appearance, textural condition, colour and odour indicated that the M. rosenbergii stored in ice for 5-6 days was acceptable for processing in the industry while P. monodon under similar ice storage condition was acceptable for 8-9 days. In both species, samples stored in headless condition in ice had longer shelf life than that of stored in head-on condition. Physical changes were evaluated by determining expressible moisture and breaking strength of sample of muscles. The expressible moisture increased continuously in both samples with the lapse of storage period. The expressible moisture increased up to around 44% in 4-5 days of ice stored M. rosenbergii muscle while it was around 40% in 8-9 days ice stored P. monodon. At the end of 9 days of ice storage, the expressible moisture content in M. rosenbergii increased up to 60%, while it was up to 47% in P. monodon after 11 days of ice storage. The breaking strength declined from 0. 78 kg/cm² to 0.53 kg/cm² in tiger shrimp after 8 days of ice storage, while in case of immediately killed prawn, the breaking strength of muscle was 0.8 kg/cm² which declined to 0.43 to 0.35 kg/cm².

Microbiological quality of some iced fishes of Imphal market, Manipur

Imphal is the main marketing centre of fish in Manipur. As fish production of the state is not sufficient to meet the demands, about 120 metric tons of iced fishes are annually brought from other states and sold in this market. Microbiological quality of iced Wallago attu, Labeo rohita, L. gonius and Aorichthy aor in respect of total fungal count (TFC), total plate count of bacteria (TPC), Most Probable Number (MPN) of coliforms, Streptococci, Staphylococcus, Salmonella and Escherichia coli in four tissues (skin, muscle, gill and intestine) were analysed. In all cases, the counts were highest in the gills and lowest in the muscles. The values of TFC, TPC, coliforms, Streptococci and Staphylococci were 0-10³/g 10(sup)6-10⁸/g, 2-α/g, 10-10⁵/g, 10-10⁵/g respectively. E. coli and Salmonella were not detected in any of the samples while the ice used in the preservation contained 10⁵-10⁷ of TPC per gram. The microbiological qualities of the iced fishes of Imphal market were adjudged poor. The extremely high counts of bacteria might be due to (1) poor quality and left over fishes being packed, (2) contact with contaminated ice and (3) repeated thawing and freezing during the process of marketing and transportation.

Selective biochemical studies in a freshwater prawn, Macrobrachium nobilli(Crustecea: Palaemodinae)

Calcium and phosphorous contents of abdomen and cheliped muscles of juvenile, male and female Macrobrchium nobilii were determined from field collected samples. In all the three groups calcium concentration was higher in chelipeds while the phosphorous content was more in abdomen muscles than in the chelipeds. However between three groups the calcium content varied significantly both in the abdomen and cheliped muscles (Pmuscles.

Estimation of micro-flora associated with different stages of Macrobrachium rosenbergii (de Man)

The bacterial flora occurring in muscle, haemolymph, hepatopancreas and gill of brood, juveniles, water, eggs, larvae and rearing water were estimated by selective plate count technique for Entrobacteriaceae, Streptococaceae and Vibrionaceae members. The total viable bacterial count was estimated by total plate count technique on nutrient agar. The total viable counts of bacteria were lowest in water from 6.10x10² CFU/mL) and highest in egg (6.06x10super(8) CFU/g). In brood the total counts were varying from 1.62x10² CFU/g in muscle to 2.20x10super(5) CFU/g in gills. In juveniles, the total plate counts were varying from 2.8x10super(4) CFU/g in muscles to 3.67x10 super(8) CFU/g in hepatopancreas. Selective plate counts show that Enterobacteriaceae members dominate in egg and gills of brood and hepatopancreas of juveniles. Vibrios were found to be dominant in water and larvae of rearing tank. Haemolymph of brood was sterile and did not contain any bacteria while muscle of juvenile was having very low count of total viable bacteria.

Quality assessment of rotating and solar tunnel dried marine fish product

Studies were conducted to evaluate the quality aspects of marine dried fish i.e. silver jew fish (Johnius argentatus), Bombay duck (Harpodon nehereus) and ribbon fish (Trichiums haumela) products produced in rotating and solar tunnel dryers. On the basis of organoleptic characteristics such as colour, odour, texture, broken pieces, insect infestation and overall quality, four member panels of experts evaluated the quality of the dried products obtained from both rotating and solar tunnel dryers and all the products were found in acceptable quality. Reconstitutions properties of samples were in the range of 51.05 to 98.75% for the dried fish produced in rotating dryer, while 24.64 to 76.76% for dried fish produced in solar tunnel dryer. The highest reconstitution rate was found in dried silver jew fish and lowest in ribbon fish produced in rotating dryer. On the other hand, the highest reconstitution was observed in dried silver jew fish and lowest in dried Bombay duck produced in solar tunnel dryer. Proximate composition such as moisture, crude protein, lipid and ash content of the dried fish muscles produced in rotating dryer ranged from 16.36% to 19.1%, 62.35% to 67.37%, 6.37% to 10.75% and 7.00% to 8.05%, respectively and in solar tunnel dried fish products, they were in the range of 14.05% to 19.71%,57.64% to 69. 21%,6.92% to 15.40%and 7.69% to 8.80 %, respectively. The TVBN values of dried fish products obtained from rotating dryer were in the range of 15.02 to 19.05 mg/100g, while in solar tunnel dried fish products, the values were in the range of 15.46 to 19.21 mg/100g. The results of the studies indicated that dried fish produced from both rotating and solar tunnel drier were acceptable quality in terms of organoleptic and food quality aspects.

Seasonal changes in the biochemical composition of liver in Garra mullya (Sykes)

Seasonal changes taking place in the biochemical constituents of liver of G. mullya are reported. An inverse relationship was noticed in the variation of fat and water. Maximum fat contents were observed during june-july. Reserve fat was utilized through gluconeogenesis during the spawning months. Protein and glycogen percentages were comparatively higher in liver than in the muscles and gonads. Decline in the glycogen content was associated with spawning during July to November. Nutritive values have shown more energy contents in the liver during pre-spawning months.

Fat and water contents of the muscle and gonad of Otolithus argenteus in relation to gonad growth

Fat and water contents of the muscles and gonads in relation to gonad growth in Otolithus argentes from Karwar are reported. Water content showed an inverse relationship to lipid in both the sexes. Variation in somatic body weight was found associated with the fluctuations in lipid contents.

Heavy metal concentrations in some organs of African catfish (Clarias gariepinus) from Eko-Ende Dam, Ikirun, Nigeria

The contents of the heavy metals Fe, Zn, Cu, Mn, Pb, Cd and As were examined in the liver, heart, gills, kidney and muscles of the fish Clarias gariepinus from Eko-Ende dam in Ikirun, the capital of Ifelodun Local Government of Osun State, Nigeria. C. gariepinus is the fish of choice and the most demanded in the southwest of Nigeria. The highest metal concentrations were in the liver and the gills while the lowest was in the muscles. The general deceasing order of metal accumulation in the organs was Fe > Zn > Cu > Mn > Cd. Lead and arsenic were not detected in any organ. The values were of lower concentrations than found in many other dams and rivers in Nigeria and some other countries. The values were also lower than the FAO/WHO recommended maximum limits in fish samples, making the fish to be safe and not of any hazards for the consumers.

Distribution of 5'-nucleotidase activity in the tissues of a freshwater teleost, Ophicephalus striatus Bloch

Homogenates of tissues have been analysed for the presence of 5'-nucleotidase activity. Sexes are not treated individually since no significant differences were observed. All organs showed marked activity, the highest being in the cardiac tissues, then the kidney, spleen, brain, and low values in the liver and muscles. Comparison with data from other fish studied shows a marked difference between O. striatus and O. punctatus.