Muscle strength assessment among children and adolescents with growing pains and joint hypermobility

OBJETIVO: Avaliar, por meio de teste quantitativo, a força muscular em crianças e adolescentes com dores de crescimento, associada ou não com hipermobilidade articular e comparadas com controles saudáveis. MÉTODO: Quarenta e sete casos de crianças e adolescentes acompanhados por dores de crescimento, sendo 24 com hipermobilidade articular (DC-HA), 23 sem hipermobilidade articular (DC) e 47 controles saudáveis pareados por idade e gênero foram submetidos a dois testes quantitativos para a avaliação da força muscular, o Childhood Myositis Assessment Scale (CMAS) e o Manual Muscle Strength Test (MMT). Os dados antropométricos como altura, peso, índice de massa corporal, prega cutânea tricipital, circunferência média do braço e a área muscular do braço foram comparados entre os três grupos. RESULTADOS: Os três grupos não apresentaram diferença estatística entre as medidas antropométricas. Houve diferença significante entre a mediana da pontuação do CMAS, sendo menores no grupo DC (47, mínimo e máximo 39-52) e DC-HA (46, mínimo e máximo 40-51), comparados com controles (50, mínimo e máximo 45-52; p<0,0001). Dois dos exercícios cronometrados do CMAS, a elevação da cabeça e a duração da elevação das pernas, tiveram menor pontuação nos pacientes comparados aos controles (p<0.0001). A pontuação mediana do MMT no grupo DC (79, mínimo e máximo 73-80) e DC-HA (78, mínimo e máximo 32-80) também apresentou diferença significante, sendo menor nos pacientes que nos controles (80, mínimo e máximo 78-80; p<0,0001). A melhor correlação entre a pontuação do CMAS e MMT foi no grupo DC-HA (Spearman r=0,65; p=0,0007). A aplicação do CMAS e MMT em duas ocasiões apresentou boa concordância e coeficiente de correlação intraclasse de 0,87 (IC 95% 0,64-0,96; p<0,0001) e 0,92 (IC 95% 0,76-0,97; p<0,0001), respectivamente. CONCLUSÃO: Os pacientes com dores de crescimento com ou sem hipermobilidade articular apresentaram fraqueza muscular de leve a moderada quando comparados com controles saudáveis.

Replacement of dicalcium phosphate by rock phosphate in cattle diets: nutrients digestibility, plasma parameters, ruminal fermentation and microbial synthesis efficiency

Este estudo foi conduzido para avaliar os efeitos da substituição do fosfato bicálcico pelo fosfato de rocha na dieta de bovinos em crescimento. Foram determinados a digestibilidade aparente das dietas, a absorção aparente do fósforo, cálcio e flúor, o pH ruminal, a concentração de amônia ruminal, a eficiência microbiana e o fósforo no plasma utilizando-se cinco bovinos da raça Holandesa Preto-e-Branco, fistulados, pesando entre 275 e 283 kg. O delineamento estatístico foi um quadrado latino 5 × 5 e as dietas consistiram de 0, 25, 50, 75 e 100% de substituição do fosfato bicálcico pelo fosfato de rocha no suplemento mineral. A adição de fosfato de rocha nas dietas ocasionou aumento linear na ingestão, no fluxo omasal, no fluxo fecal e no desaparecimento total do flúor. As dietas não diferiram quanto à absorção aparente do cálcio, assim como em relação à ingestão, excreção, digestão e digestibilidades aparentes parcial e total da matéria seca, matéria orgânica, proteína bruta, fibra em detergente neutro e carboidratos não-fibrosos. O fósforo no plasma não foi influenciado pelos tratamentos e a média foi de 5,93 mg/dL. Não houve diferença para o pH ruminal e concentração de amônia ruminal. A substituição do fosfato bicálcico não afetou a síntese microbiana aparente e verdadeira de proteína. A total substituição do fosfato bicálcico pelo fosfato de rocha em suplementos minerais em bovinos em crescimento não afetou o ambiente ruminal e a síntese de proteína no rúmen. Assim, a substituição do fosfato bicálcico em dietas para bovinos em crescimento diminui a absorção de fósforo e deveria ser vista com cuidado dependendo dos requerimentos.

Joint (X)over-bar and R charts with variable sample sizes and sampling intervals

Recent studies have shown that the (X) over bar chart with variable sampling intervals (VSI) and/or with variable sample sizes (VSS) detects process shifts faster than the traditional (X) over bar chart. This article extends these studies for processes that are monitored by both the (X) over bar and R charts. A Markov chain model is used to determine the properties of the joint (X) over bar and R charts with variable sample sizes and sampling intervals (VSSI). The VSSI scheme improves the joint (X) over bar and R control chart performance in terms of the speed with which shifts in the process mean and/or variance are detected.

Gluconeogenesis and glucose replacement rate during long-term fasting of Japanese quails

Gluconeogenic activity and kinetic parameters of glucose metabolism were estimated during the different phases of prolonged food deprivation in quails. Gluconeogenic activity, estimated from the rate of increase of incorporation of (HCO3-)-C-14 into circulating glucose, was significantly higher in fasted quails than in fed birds, whatever the period of food deprivation. However, gluconeogenic activity during phase II, although higher than in the fed state, was significantly lower than in quails fasted for 2 days (phase I) or in those on the final (phase III) period of starvation. Gluconeogenic activity did not differ significantly in birds from phases I and III. Rates of glucose replacement, estimated with [6-H-3]-glucose, were very high (20.5 mg . kg(-1). min(-1)) in fed quails and were markedly reduced (to about 42% of fed values) by fasting, no difference being observed between quails fasted for 2 and 5 days. Because of the poor condition of the birds, glucose replacement rates could not be measured during phase III. The present data are the first to provide direct evidence for the changes in gluconeogenesis which occur during prolonged food deprivation.

Intra-articular pressure profiles of the cadaveric equine fetlock joint in motion

The study of the influence of motion and initial intra-articular pressure (IAP) on intra-articular pressure profiles in equine cadaver metatarsophalangeal (MTP) joints was undertaken as a prelude to in vivo studies, Eleven equine cadaver MTP joints were submitted to 2 motion frequencies of 5 and 10 cycles/min of flexion and extension, simulating the condition of lower and higher (double) rates of passive motion. These frequencies were applied and pressure profiles generated with initial normal intra-articular pressure (-5 mmHg) and subsequently 30 mmHg intra-articular pressure obtained by injection of previously harvested synovial fluid.The 4 trials performed were 1) normal IAP; 5 cyles/min; 2) normal IAP; 10 cycles/min; 3) IAP at 30 mmHg; 5 cycles/min and 4) IAP at 30 mmHg; 10 cycles/min. The range of joint motion applied (mean +/- s.e.) was 67.6 +/- 1.61 degrees with an excursion from 12.2 +/- 1.2 degrees in extension to 56.2 +/- 2.6 degrees in flexion, Mean pressure recorded in mmHg for the first and last min of each trial, respectively, were 1) -5.7 +/- 0.9 and -6.3 +/- 1.1; 2) -5.3 +/- 1.1 and -6.2 +/- 1.1; 3) 58.8 +/- 8.0 and 42.3 +/- 7.2; 4) 56.6 +/- 3.7 and 40.3 +/- 4.6. Statistical analyses showed a trend for difference between the values for the first and last minute in trial 3 (0.05>P<0.1) with P = 0.1 and significant difference (P = 0.02) between the mean IAP of the first and last min in trial 4. The loss of intra-articular pressure associated with time and motion was 10.5, 16.9, 28.1 and 28.9% for trials 1-4, respectively. As initial intraarticular pressure and motion increased, the percent loss of intra-articular pressure increased.The angle of lowest pressure was 12.2 +/- 1.2 (mean +/- s.e.) in extension in trials 1 and 2, In trials 3 and 4, the lowest pressures were obtained in flexion with the joints at 18.5 +/- 2.0 degrees (mean +/- s.e.). This demonstrated that the joint angle of least pressure changed as the initial intra-articular pressure changed and there would not be a single angle of least pressure for a given joint.The volume of synovial fluid recovered from the MTP joints in trial 3 compared to 4 (trials in which fluid was injected to attain IAP of 30 mmHg) was not significantly different, supporting a soft tissue compliance change as a cause for the significant loss of intra-articular pressure during the 15 min of trial 4.The pressure profiles generated correlate well with in vivo values and demonstrated consistent pressure profiles. Our conclusions are summarised as follows:1. Clinically normal equine MTP joints which were frozen and then later thawed were found to have mostly negative baseline intra-articular pressures, as would be expected in living subjects,2. Alternate pressure profiles of the dorsal and plantar pouch at baseline intra-articular pressure document the presence of pressure forces that would support 'back and forth' fluid movement between joint compartments. This should result in movement of joint fluid during motion, assisting in lubrication and nutrition of articular cartilage,3. If joint pressure was initially greater than normal (30 mmHg), as occurs in diseased equine MTP joints, joint motion further increased joint capsule relaxation (compliance) and, therefore, reduced intra-articular pressure.4. Peak intra-articular pressures reached extremely high values (often >100 mmHg) in flexion when initial pressure was 30 mmHg. Joint effusion pressures recorded for clinical MCP joints are frequently 30 mmHg. These IAP values are expected to produce intermittent synovial ischaemia in clinical cases during joint flexion.5, Additional in vivo studies are necessary to confirm our conclusions from this study and to identify the contributions of fluid absorption and the presence of ischaemia in a vascularised joint.

Design of a fuzzy Takagi-Sugeno controller to vary the joint knee angle of paraplegic patients

The papers shows, through theoretical studies and simulations, that using the description of the plant by Takagi-Sugeno (T-S), it is possible to design a nonlinear controller to control the position of the leg of a paraplegic patient. The control system was designed to change the angle of the joint knee of 60 degrees. This is the first study that describes the application of Takagi-Sugeno (T-S) models in this kind of problem.

Joint conomic design of (x)over-bar and R charts under Weibull shock models

This paper deals with the joint economic design of (x) over bar and R charts when the occurrence times of assignable causes follow Weibull distributions with increasing failure rates. The variable quality characteristic is assumed to be normally distributed and the process is subject to two independent assignable causes (such as tool wear-out, overheating, or vibration). One cause changes the process mean and the other changes the process variance. However, the occurrence of one kind of assignable cause does not preclude the occurrence of the other. A cost model is developed and a non-uniform sampling interval scheme is adopted. A two-step search procedure is employed to determine the optimum design parameters. Finally, a sensitivity analysis of the model is conducted, and the cost savings associated with the use of non-uniform sampling intervals instead of constant sampling intervals are evaluated.

Chromotropic acid-formaldehyde reaction in strongly acidic media. The role of dissolved oxygen and replacement of concentrated sulphuric acid

The procedure for formaldehyde analysis recommended by the National Institute for Occupational Safety and Health (NIOSH) is the Chromotropic acid spectrophotometric method, which is the one that uses concentrated sulphuric acid. In the present study the oxidation step associated with the aforementioned method for formaldehyde determination was investigated. Experimental evidence has been obtained indicating that when concentrated H2SO4 (18 mol l(-1)) is used (as in the NIOSH procedure) that acid is the oxidizing agent. on the other hand, oxidation through dissolved oxygen takes place when concentrated H2SO4 is replaced by concentrated hydrochloric (12 mol l(-1)) and phosphoric (14.7 mol l(-1)) acids as well as by diluted H2SO4 (9.4 mol l(-1)). Based on investigations concerning the oxidation step, a modified procedure was devised, in which the use of the potentially hazardous and corrosive concentrated H2SO4 was eliminated and advantageously replaced by a less harmful mixture of HCl and H2O2. (C) 2003 Elsevier B.V. B.V. All rights reserved.

Joint rolling-horizon scheduling of materials processing and lot-sizing with sequence-dependent setups

A lot sizing and scheduling problem from a foundry is considered in which key materials are produced and then transformed into many products on a single machine. A mixed integer programming (MIP) model is developed, taking into account sequence-dependent setup costs and times, and then adapted for rolling horizon use. A relax-and-fix (RF) solution heuristic is proposed and computationally tested against a high-performance MIP solver. Three variants of local search are also developed to improve the RF method and tested. Finally the solutions are compared with those currently practiced at the foundry.

MASSETERIC ELECTROMYOGRAPHIC SILENT PERIOD DURATION IN PATIENTS WITH TEMPOROMANDIBULAR-JOINT DYSFUNCTION

1. The present study compared the duration of the electromyographic silent period (SP) of the masseter muscles elicited by chin-tapping in normal asymptomatic adults (N = 39) and in a group with symptoms of temporomandibular joint dysfunction (TMJD) (N = 31).2. EMG activity was recorded from right (RM) and left (LM) masseter muscles using bipolar surface electrodes coupled to a DISA 1500 EMG-System. During maximal clenching, ten taps were applied downwards to the chin with a reflex hammer.3. The mean SP durations obtained for the normal group were 25.45 +/- 4.20 ms (RM) and 25.33 +/- 4.18 ms (LM), whereas the TMJD group presented significantly greater values (P < 0.01, Student t-test) of 41.89 +/- 12.94 ms (RM) and 42.40 +/- 12.99 ms (LM). The upper limits of normality calculated for RM and LM were 32.36 ms and 31.21 ms, respectively. Eighty-four percent of patients with TMJD showed SP durations above these limits.4. The results indicate that the measurement of masseteric SP duration may be used as an objective diagnostic method of TMJ disorders, provided that borderline values are interpreted with caution along with clinical impressions.

Clinical evaluation of tinnitus in patients with sleep bruxism: prevalence and characteristics

Evaluation of the prevalence and characteristics of tinnitus in a Brazilian series of sleep bruxism patients. In this descriptive study, 100 patients (80 women and 20 men) were selected through the self-report of grinding teeth during sleep, confirmed by room mate or family member. They were evaluated according to a systematized approach: a questionnaire for orofacial pain and the Portuguese version of the Research Diagnostic Criteria for Temporomandibular Disorders. The patients were divided into two groups: group A, 54 patients with complaint of tinnitus and group B, 46 patients without tinnitus complaint. The mean age was 37.85 (13-66 years) and 34.02 years (20-59 years), respectively, for groups A and B (P = 0.1164). There was statistically significant difference between the two groups, with higher prevalence for the group A, in relation to: presence of chronic facial pain (P = 0.0007); number of areas painful to palpation in the masticatory and cervical muscles (P = 0.0032); myofascial pain in the masticatory muscles (P = 0.0003); absence of teeth without prosthetic replacement (P = 0.0145) and indices of depression (P = 0.0234). Structural alterations of the TMJ, like disc displacement and vertical dimension loss did not differ for the two groups. Tinnitus frequency was higher in patients with sleep bruxism and chronic facial pain. Myofascial pain, number of areas painful to palpation in the masticatory and cervical muscles, higher levels of depression and tooth absence without prosthetic replacement were more frequent in the group with tinnitus.