Efeitos da terapia laser de baixa intensidade associada ao exercício aeróbio no reparo de tenotomia do tendão de aquiles de ratos diabéticos

Diabetes Mellitus (DM ) is a complex disease that requires continuous medical care for the reduction of risk factors in addition to glycemic control. The typical hyperglycemia of this disease produces glycosylation of proteins and so the consequence is the accumulation of glycosylation final products in various human tissues, among them, the tendon. The aerobic exercise (AE) and the low level laser therapy (LLLT) have been used to treat tendinopathies in individuals with or without DM. Objective: The aim of this study was to watch the effect of the LLLT and the AE, in association, in partial tenotomy of the tissue repair of the Achilles tendon (AT) of diabetic rats. Methods: 91 animals were utilized and divided in to the following groups: control group (GC), injured control group (GCL), diabetic group (GD), diabetic group LLLT (GD – TLBI), diabetic group trained (GD - EX) and diabetic group trained laser (GD-EX+TLBI). The animals were submitted to intervention with AE, using a protocol with a progressive increase of time (12 to 60 min) and speed of (4 to 9 m/min), and the LLLT (660 nm laser, 10mW, 4 J/cm², single point for 16 seconds, three times for week). It was analyzed morphological, biomechanical and molecular characteristics. For data showing normal distribution was used one-way ANOVA test and post hoc Tukey and data without normal distribution was used Mann Whitney test and post hoc Dunn's. It was accepted p <0.05 for statistical significance Results: The biomechanical tests indicated major improvement in the GC and GD-EX+TLBI groups when compared with the diabetic groups in the following variables: maximum load, strain, absorbed energy, stress, cross section area, elastic modulus and energy density (p<0.05). The analysis through molecular biology indicated that the association of aerobic exercise and LLLT generated an increase of the collagen I gene expression and modulated the expression of the MMP2 and MMP9 (p<0.05). No observed any major improvement in the morphological variable studied. Conclusion: the LLLT associated with aerobic exercise promotes and increase of the mechanical properties, in the control of collagen I gene expression and of the MMP2 and MMP9 of the diabetic rats.

Efeitos da terapia fotodinâmica com aluminio – cloro ftalocianina sobre a peroxidação lipídica e produtos antioxidantes em tecidos inflamados animais

Photodynamic therapy (PDT) consists of a non-toxic photosensitizing agent (FS) administration followed by a laser source resulting in a sequence of photochemical and photobiological processes that generate reactive oxygen species (ROS) that damaging cells. The present work evaluated the effects of PDT nanoemulsion-aluminum chloride phthalocyanine (AlClFc) mediated on malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD) and glutathione peroxidase (GPx) levels, which represent indicators involved in oxidative stress and antioxidant defenses. For this purpose, this study used 120 female rats of the Rattus norvegicus species, Wistar race, divided into 5 groups: Healthy (H), with periodontal disease (PD), with periodontal disease and treatment with FS (F), with periodontal disease and treatment with the laser (L); and periodontal disease and treatment with PDT (FL). An experimental model for represent periodontal disease (PD) was induced by ligature (split-mouth). Seven days later the induction of PD, the treatments were instituted according to the groups. In the group treated with PDT was applied 40μl FS (5μM) followed by laser irradiation diode InGaAlP (660nm, 100J / cm2). The rats were sacrificed on the 7th and 28th day after treatment and tissue specimens were removed and subjected to histological, immunohistochemical methods and enzymatic colorimetric measurements with detection by UV / VIS spectroscopy. Inflammatory changes, connective tissue disorganization and alveolar bone loss were displaying in groups with PD induced. The enzyme dosages showed that MDA levels were higher in PD induced groups, with no statistically significant differences (p> 0.05). High levels of GSH were found in groups L (p = 0.028) and FL (p = 0.028) compared with PD group, with statistically significant differences. Immunohistochemistry for SOD showed higher immunostaining in L and FL groups, compared to the PD group without statistically significant differences (p> 0.05). GPx showed lower immunoreactivity in the DP group when compared to the other groups and statistically significant differences were observed between the DPxL groups (p <0.05). TFD administered in this experiment did not induce elevation of MDA levels significantly increased the GSH levels and showed intense immunostaining pada SOD and GPx, showing that this therapy does not accentuated lipid peroxidation, however, it was able to induce effects on the antioxidant defenses processes. The LBI therapy appeared to show photomodulatory promoting effects reduction of the MDA levels, increasing GSH levels and with intense immunostaining for SOD and GPx, demonstrating that laser therapy induced antioxidant effects.

ELEMENTOS DA OBRA FREIREANA E DA TEOLOGIA DA LIBERTAÇÃO NAS DÉCADAS DE 1950 A 1970: UMA ANÁLISE COMBINADA DE SUA GÊNESE E IDENTIDADE

A presente pesquisa se propõe a analisar o contexto histórico, político, social, econômico e ideológico em que surge a pedagogia crítica de Paulo Freire e posteriormente a Teologia da Libertação, visando encontrar influências deste peculiar contexto na gênese do pensamento freireano e nas concepções dos teólogos Rubem Alves e Gustavo Gutiérrez, que foram os primeiros publicar obras sobre Teologia da Libertação, corrente teológica considerada genuinamente latino-americana. Ainda procura observar em que medida as concepções pedagógicas de Freire podem ter sido acolhidas pelos teólogos Alves e Gutiérrez em suas obras aqui analisadas. Em ambos os pensamentos encontramos a visão de valorização do ser humano e de uma práxis que busca sua libertação de sistemas opressores. Tanto em Paulo Freire como nos fundamentos desta corrente teológica se apresentam princípios humanistas e elementos da tradição cristã. A partir da ferramenta metodológica de análise do materialismo histórico dialético marxista, procura identificar temas comuns que são abordados pelos autores em suas obras surgidas entre as décadas de 1950 a 1970, detendo-se ao estudo de alguns temas subjacentes a esse contexto histórico, a saber: práxis, história, humanismo e libertação.

Efectos de la terapia asistida con animales en dominios cognitivos en pacientes con esquizofrenia

Esta investigación tiene como objetivo determinar la efectividad de incorporar un programa de terapia asistida con animales (TAA) al tratamiento farmacológico y programa individualizado de rehabilitación psicosociolaboral en pacientes con esquizofrenia que acuden a recursos de atención social de la red de atención pública de la Comunidad de Madrid. Hay dos momentos, un primer estudio en el que la investigación se centra en evaluar la mejora de dominios clínicos, psicosociales y cognitivos y un segundo estudio en el que la evaluación se centra en comprobar la mejora en dominios cognitivos utilizando una prueba específica de evaluación de procesos cognitivos en pacientes con esquizofrenia (MATRICS). Se plantean dos hipótesis en la medida en que se han realizado dos estudios. En un primer estudio se plantea que los cambios en las puntuaciones de variables clínicas, psicosociales y cognitivas del grupo con TAA serán mayores y significativas entre evaluaciones pre y post y frente a las del grupo sin TAA. El segundo estudio se centra, casi exclusivamente, en que la mejora de los dominios cognitivos del grupo con TAA será mayor y significativa entre evaluaciones pre y post y frente a las del grupo sin TAA...

Terapia cognitivo-conductual centrada en el trauma para las víctimas de atentados terroristas: un estudio de efectividad con trastornos mentales a muy largo plazo

El terrorismo es un grave problema mundial que cada año afecta a un número muy elevado de personas. Solamente en el año 2014 se produjeron en el mundo 13.463 atentados terroristas que provocaron 32.727 muertos, 34.791 heridos y 9.428 secuestrados (National Consortium for the Study of Terrorism and Responses to Terrorism [START], 2015). En España el número de personas fallecidas por atentados terroristas en los últimos 45 años es de 1.220, a las que habría que sumar los miles de heridos y de familiares y allegados de personas fallecidas y heridas. Aunque la mayoría de las víctimas no desarrollarán trastornos mentales a causa de los atentados terroristas y conseguirán recuperarse sin secuelas psicopatológicas significativas, un porcentaje importante sufrirán un trastorno por estrés postraumático (TEPT), depresivo o de ansiedad (García-Vera y Sanz, 2010, 2015). Entre las víctimas directas, la prevalencia del TEPT se ha estimado entre un 10% y un 30% (DiMaggio y Galea, 2006; García-Vera y Sanz, 2015), la del trastorno depresivo mayor entre un 13,3% y un 47,7% y la de los trastornos de ansiedad entre un 6,1% y un 19,8% (García-Vera y Sanz, 2010; Salguero, Fernández-Berrocal, Iruarrizaga, Cano-Vindel, y Galea, 2011). Además, en muchos casos, tales trastornos no parecen remitir con el tiempo y parecen crónicos (García-Vera y Sanz, 2010; Morina, Wicherts, Lobbrecht y Priebe, 2014)...

Friedl Dicker-Brandeis: arte, dolor y terapia

Esta tesis recrea extensamente y por vez primera en lengua castellana –o español– la vida y obra de Friedl Dicker-Brandeis (1898-1944), artista cuya valía plástica y pedagógica merece ser divulgada en el ámbito hispanohablante tanto para el reconocimiento de su figura en el mundo del arte, como para aplicar su metodología en la enseñanza artística reglada e incluirla en la historia del arteterapia como una de sus pioneras, –toda vez que nos remite a la actividad artística como raíz de dicha disciplina–. Su historia revela a un ser humano pasional y comprometido con la existencia y el arte, cuyas acciones procuraron mejorar la calidad de vida de los seres humanos a través de intervenciones relacionadas con él; la creación, transmisión y acompañamiento artísticos fueron su vehículo para actuar positivamente en un mundo dominado por el totalitarismo nazi. Se expone lo que de valioso para las personas posee el arte y se considera lo provechoso que ofrece la enseñanza de la vida de Friedl Dicker-Brandeis y sus métodos pedagógicos en las clases de Educación Plástica y Visual del sistema reglado. Se presentan actividades realizadas en diversos institutos públicos de la Comunidad de Madrid desde la perspectiva de la creación en el taller/estudio y se propone su inclusión en la programación del área, toda vez que la nueva Ley Orgánica de la Mejora de la Calidad de la Enseñanza (LOMCE) ha incluido la obligatoriedad de introducir la enseñanza del Holocausto en los centros de educación de primaria y secundaria españoles. Por último, la historia de Friedl Dicker-Brandeis nos interpela y cuestiona sobre el languidecimiento de las artes en nuestros entornos educativos, de su falta de entusiasmo hacia lo artístico, hacia la transmisión del valor de la belleza y la empatía estética, el alcance de la creatividad en el desarrollo de las personas o la trascendencia del arte; todos aquellos valores necesarios en el progreso personal y humano que los que nos dedicamos a la enseñanza anhelamos para nuestros estudiantes...

Avaliação da eficácia da implementação de um pacote de medidas na prevenção de pneumonia associada à ventilação mecânica em unidade de terapia intensiva adulta

Background: Ventilator-associated pneumonia (VAP) is a health care related infection and the second leading cause of nosocomial infections linked to morbidity and mortality rates. Therefore, the implementation of care guideline protocols has become necessary for critically ill patients in ICUs in order to provide adequate treatment. Objective: To assess the impact of a package called FAST HUG in PAV ; analyze the risk factors for occurrence of VAP in adult patients at an ICU of a private hospital ; analyze the clinical characteristics of patients who were or were not submitted to the FAST HUG ; analyze the etiology of microorganisms related to EPI ; determine the cost of hospitalization in patients with pneumonia and in patients who received the FAST HUG.Methods: The study was performed in a private hospital that has an 8-bed ICU. It was divided into two phases: before implementing FAST HUG, from August 2011 to August 2012 and after the implementation of FAST HUG, from September 2012 to December 2013. An individual form for each patient in the study was filled out by using information taken electronically from the hospital medical records. The following data for each patient was obtained: age, gender, reason for hospitalization, the use of three or more types of antibiotics, length of stay, intubation time and progress. Findings: After the implementation of FAST HUG, there was an observable decrease in the occurrence of VAP (p <0.01), as well as a reduction in mortality rates (p <0.01). It also shows that the intervention performed in the study resulted in a significant reduction in ICU hospital costs (p <0.05).Conclusion: The implementation of FAST HUG reduced the cases of VAP. Thus, decreasing costs, reducing mortality rates and length of stay, which therefore resulted in an improvement to the overall quality of care.

Terapia de aceptación y compromiso en un caso de tras¬torno mixto de ansiedad y depresión en una paciente con cáncer

This paper introduces the case of a woman with breast cancer who had developed a mixed depressive-anxiety disorder with avoidance behaviors. The patient presented depressive symptoms like listlessness, insomnia, weeping, food disorders and hopelessness though. Also, she exhibited physiological arousal and restlessness feelings. Additionally, the patient had an avoidance patron behavior in relation with all stimulus she believed could hurt her. Based on the Acceptance and Commitment Therapy (ACT) the intervention planted the following objectives: the patient will learn to accept her illness and the emotional distress that she was experiencing, also, the patient will recover the other areas of her life that she had abandoned. The treatment was developed in 14 sessions. The therapist used these techniques: creative hopelessness, disabling verbal functions, values clarification and loss of control over private events. In the results, it was observed a positive change in the behavior of the patient as well as a decrease in emotional distress that was his reason for initial consultation