Walking-induced muscle fatigue impairs postural control in adolescents with unilateral spastic cerebral palsy.

BACKGROUND: Fatigue is likely to be an important limiting factor in adolescents with spastic cerebral palsy (CP). AIMS: To determine the effects of walking-induced fatigue on postural control adjustments in adolescents with unilateral CP and their typically developing (TD) peers. METHODS: Ten adolescents with CP (14.2±1.7yr) and 10 age-, weight- and height-matched TD adolescents (14.1±1.9yr) walked for 15min on a treadmill at their preferred walking speed. Before and after this task, voluntary strength capacity of knee extensors (MVC) and postural control were evaluated in 3 conditions: eyes open (EO), eyes closed (EC) and with dual cognitive task (EODT). RESULTS: After walking, MVC decreased significantly in CP (-11%, P<0.05) but not in TD. The CoP area was only significantly increased in CP (90%, 34% and 60% for EO, EC and EODT conditions, respectively). The CoP length was significantly increased in the EO condition in CP and TD (20% and 21%) and was significantly increased in the EODT condition by 18% in CP only. CONCLUSIONS: Unlike TD adolescents, treadmill walking for 15min at their preferred speed lead to significant knee extensor strength losses and impairments in postural control in adolescents with unilateral spastic CP.

Tireoidectomia unilateral no carcinoma diferenciado da tireóide de baixo risco: uma cirurgia inadequada

OBJETIVO: Caracterizar os doentes operados de carcinoma diferenciado da tireóide no Hospital Universitário Clementino Fraga Filho (HUCFF); avaliar a divisão destes doentes em alto e baixo riscos e a validade da cirurgia conservadora nos pacientes com carcinoma diferenciado de baixo risco. MÉTODO: Foram analisados 169 pacientes operados no HUCFF por carcinoma diferenciado da tireóide. Cento e cinqüenta e dois (90%) eram mulheres e 17 (10%) homens. A idade variou entre 13 e 85 anos com mediana de 39 anos. Cento e onze tumores (65,7%) eram papilíferos e 58 (34,3%) foliculares. RESULTADOS: Vinte e um por cento apresentaram metástases linfonodais cervicais quando vistos pela primeira vez e 1,7% metástases a distância. Houve 75 cirurgias unilaterais (lobectomia subtotal ou total) e 94 bilaterais (tireoidectomia subtotal, lobectomia total + lobectomia subtotal ou tireoidectomia total). 127 casos (75,2%) foram considerados pacientes de baixo risco e 42 casos (24,8%) de alto risco. O seguimento pós-operatório foi conseguido em 155 pacientes: 116 entre os de baixo risco, com seguimento médio de 8,4 anos (extremos: um ano a 21 anos) e 39 entre os de alto risco (seguimento médio cinco anos, extremos um ano e 17 anos). Foram encontrados 13 recidivas tumorais (8,3%) e cinco óbitos pelo tumor (3,2%) em toda a série: 10 (8,6% recidivas e nenhum óbito nos pacientes de baixo risco e três recidivas (7,5%) e cinco óbitos (12,5%) nos de alto risco. Nos pacientes de baixo risco submetidos à tireoidectomia parcial houve 7,5% de recidivas e nos pacientes com tireoidectomia total a ocorrência de recidivas foi de 10%. Não houve óbitos pelo tumor em nenhum dos grupos. CONCLUSÕES: Os pacientes com tumores de baixo risco apresentam evolução mais favorável: número igual de recidivas (relativamente aos tumores de alto risco), porém menos graves, e nenhum faleceu pelo tumor. Nos pacientes de baixo risco a cirurgia unilateral mostrou resultados idênticos aos da bilateral.

Dermatan sulfate reduces monocyte chemoattractant protein 1 and TGF-β production, as well as macrophage recruitment and myofibroblast accumulation in mice with unilateral ureteral obstruction

Selectins play an essential role in most inflammatory reactions, mediating the initial leukocyte-rolling event on activated endothelium. Heparin and dermatan sulfate (DS) bind and block P- and L-selectin function in vitro. Recently, we reported that subcutaneous administration of DS inhibits colon inflammation in rats by reducing macrophage and T-cell recruitment and macrophage activation. In the present study, we examined the effect of porcine intestinal mucosa DS on renal inflammation and fibrosis in mice after unilateral ureteral obstruction (UUO). Twenty-four adult male Swiss mice weighing 20-25 g were divided into 4 groups: group C (N = 6) was not subjected to any surgical manipulation; group SH (N = 6) was subjected to surgical manipulation but without ureter ligation; group UUO (N = 6) was subjected to unilateral ureteral obstruction and received no treatment; group UUO plus DS (N = 6) was subjected to UUO and received DS (4 mg/kg) subcutaneously daily for 14 days. An immunoblot study was also performed for TGF-β. Collagen (stained area ~3700 µm²), MCP-1 (stained area ~1700 µm²), TGF-β (stained area ~13% of total area), macrophage (number of cells ~40), and myofibroblast (stained area ~1900 µm²) levels were significantly (P < 0.05) higher in the UUO group compared to control. DS treatment significantly (P < 0.05) reduced the content of collagen (stained area ~700 µm²), MCP-1 (stained area ~160 µm²) and TGF-β (stained area ~5% of total area), in addition to myofibroblast (stained area ~190 µm²) and macrophage (number of cells ~32) accumulation in the obstructed kidney. Overall, these results indicate that DS attenuates kidney inflammation by reducing macrophage recruitment, myofibroblast population and fibrosis in mice submitted to UUO.

Dopamine Receptor Subtypes,IP3, cAMP and cGMP Functional Regulation in Parkinsonism Induced by Unilateral Infusion of Rotenone in Rats: Recovery with Bone Marrow Cells,Serotonin and GABA Supplementation

In the present study, the effects of 5-HT, GABA and Bone Marrow Cells infused intranigrally to substantia nigra individually and in combinations on unilateral rotenone infused Parkinsonism induced rats. Scatchard analysis of DA, DA D1 and D2 receptors in the corpus striatum, cerebral cortex, cerebellum, brain stem and hippocampus showed a significant increase in the Brain regions of rotenone infused rat compared to control. Real Time PCR amplification of DA D1, D2, Bax and ubiquitin carboxy-terminal hydrolase were up regulated in the brain regions of rotenone infused rats compared to control. Gene expression studies of -Synuclien, cGMP and Cyclic AMP response element-binding protein showed a significant down regulation in Rotenone infused rats compared to control. Behavioural studies were carried out to confirm the biochemical and molecular studies.Our study demonstrated that BMC administration alone cannot reverse the above said molecular changes occurring in PD rat. 5-HT and GABA acting through their specific receptors in combination with bone marrow cells play a crucial role in the functional recovery of PD rats. 5-HT, GABA and Bone marrow cells treated PD rats showed significant reversal to control in DA receptor binding and gene expression. 5-HT and GABA have co-mitogenic property. Proliferation and differentiation of cells re-establishing the connections in Parkinson's disease facilitates the functional recovery. Thus, it is evident that 5-HT and GABA along with BMC to rotenone infused rats renders protection against oxidative, related motor and cognitive deficits which makes them clinically significant for cellbased therapy. The BMC transformed to neurons when co-transplanted with 5-HT and GABA which was confirmed with PKH2GL and nestin. These newly formed neurons have functional significance in the therapeutic recovery of Parkinson’s disease.

Bone marrow cells differentiation to neurons in the rat brain using Serotonin and GABA:Their role on glutamate receptors, IP3, cAMP and cGMP functional regulation in unilateral Parkinsonism induced by 6-hydroxydopamine

Parkinson's disease is a chronic progressive neurodegenerative movement disorder characterized by a profound and selective loss of nigrostriatal dopaminergic neurons. Our findings demonstrated that glutamatergic system is impaired during PD. The evaluations of these damages have important implications in understanding the molecular mechanism underlying motor, cognitive and memory deficits in PD. Our results showed a significant increase of glutamate content in the brain regions of 6- OHDA infused rat compared to control. This increased glutamate content caused an increase in glutamatergic and NMDA receptors function. Glutamate receptor subtypes- NMDAR1, NMDA2B and mGluR5 have differential regulatory role in different brain regions during PD. The second messenger studies confirmed that the changes in the receptor levels alter the IP3, cAMP and cGMP content. The alteration in the second messengers level increased the expression of pro-apoptotic factors - Bax and TNF-α, intercellular protein - α-synuclein and reduced the expression of transcription factor - CREB. These neurofunctional variations are the key contributors to motor and cognitive abnormalities associated with PD. Nestin and GFAP expression study confirmed that 5-HT and GABA induced the differentiation and proliferation of the BMC to neurons and glial cells in the SNpc of rats. We also observed that activated astrocytes are playing a crucial role in the proliferation of transplanted BMC which makes them significant for stem cell-based therapy. Our molecular and behavioural results showed that 5-HT and GABA along with BMC potentiates a restorative effect by reversing the alterations in glutamate receptor binding, gene expression and behaviour abnormality that occur during PD. The therapeutic significance in Parkinson’s disease is of prominence.

La facultad de modificación unilateral en los contratos de distribución de acuerdo con la jurisprudencia arbitral

Las partes pueden pactar cláusulas de modificación unilateral en los contratos de distribución, puesto que dicha facultad se encuentra fundamentada en el ejercicio de la autonomía de la voluntad, por medio del cual las partes pueden elegir la manera y la figura mediante la cual van a desarrollar sus relaciones. Sin embargo, dicha facultad no es absoluta y tiene un límite en el orden público y las buenas costumbres. Particularmente en el contrato de distribución, por ser atípico, esta facultad presenta mayor relevancia pues al analizar sus elementos esenciales, no se puede acudir a la ley, sino que se debe acudir a la costumbre y a la práctica mercantil. Para analizar e interpretar la facultad de modificación unilateral, los tribunales arbitrales parten del principio de buena fe, a través del cual se analiza si el ejercicio de dicha facultad es abusivo, pues se ha establecido que este tipo de cláusulas no son en sí mismas abusivas. El análisis trazado se realiza de acuerdo con el del principio de la buena fe en las diferentes etapas de la negociación, debiendo estar presente a su vez durante toda la negociación y posteriormente durante su ejecución. Así, entonces, los árbitros analizan si la cláusula de modificación unilateral fue pactada, es decir que se revisa la validez de la misma y, en segundo lugar, se analiza si el ejercicio de la cláusula fue abusivo, es decir si conllevó a un abuso del derecho o a un abuso de la posición dominante en el contrato.

Características biomecánicas de la técnica en estilo crol de natación en personas con amputación unilateral de miembro inferior

Este documento abordará inicialmente una descripción general de la técnica en estilo crol, posteriormente se centrará en la revisión de las modificaciones que surgen en la persona con amputación unilateral de miembro inferior; por último, se realizará la descripción de la importancia del análisis biomecánico en el desempeño del deportista en la técnica deportiva. De igual forma, se abordan algunas de las características biomecánicas generales en miembros superiores (MMSS) y miembros inferiores (MMII) para el estilo seleccionado en la persona con amputación unilateral del miembro inferior. El estudio está dirigido a estudiantes y profesionales de fisioterapia y de otras disciplinas relacionadas con el deporte y el área de la salud, y que trabajen con población amputada.

Opinión consultiva de la Corte Internacional de Justicia sobre la conformidad con el derecho internacional de la declaración unilateral de independencia relativa a Kosovo

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The Interpretation and Revocation of Unilateral Acts in the Strict Sense

It is with increasing frequency that States undertake unilateral acts. For that reason this article undertakes to demonstrate the development of unilateral acts of States in the heart of the International Law Commission of the United Nations - ILC. It analyzes unilateral and autonomous acts which can by themselves have juridical effects. In this sense, silence acquiescence and acceptance may have an influence in these acts.The ILC has studied this issue for ten years, analyzing its interpretation, the specific rules which are applicable, their modification, termination and the revocation of unilateral acts.

Análisis computarizado de la marcha de amputados transfemoral unilateral con prótesis endoesquelética y exoesquelética

El propósito de este estudio es realizar un análisis computarizado de la marcha en sujetos con amputación transfemoral unilateral, con prótesis endoesquelética y exoesquelética. Método: los participantes fueron dos soldados del Ejercito Nacional Colombiano en edad (25+/-10 años), con amputación transfemoral (AK) unilateral en fase protésica, con un tiempo de amputación mayor de 3 años, por causa traumática, en extremidadizquierda. Se empleó un software de análisis de movimiento denominado Ariel Performance Analysis System (APAS), donde se determinaron variables cinemáticas de la marcha como: el desplazamiento angular de las articulaciones de los miembros inferiores en los diferentes planos y la cadencia de los movimientos; parámetros de marcha como: la longitud del paso, la longitud de la zancada y el ancho del paso; el consumo de energía en el desplazamiento y el tiempo de duración del ciclo de marcha. Los datos arrojados fueron comparados entre sí frente a los parámetros de una marcha normal según la literatura universal. Resultados: Los resultados se presentan en forma de gráficos interactivos, en los cuales se puede apreciar el comportamiento de cada variable medida comparando los resultados frente a una marcha normal. En los amputados AK que usan prótesis por encima de rodilla el patrón de marcha se asocia a pasos cortos bilaterales. El fisioterapeuta debe hacer énfasis en la habilitación de los parámetros de la marcha, con el fin de que estos se asemejen a una marcha normal. Conclusiones: El uso de esta tecnología en la intervención fisioterapéutica con personas amputadas arroja datos exactos en todas las variables del estudio, lo que puede mejorar la habilitación de estas personas en la fase protésica y proporcionarles una reeducación efectiva del patrón de marcha.

Efectos en las cualidades de la voz posteriores a la intervención con fonoterapia y lipoinyección en parálisis de pliegue vocal unilateral paramediana. Comparación de dos casos.

La temática del presente proyecto de investigación se centra en la descripción de los efectos en las cualidades de la voz, analizadas por el Multidimensional Voice Program (MDVP) de Kay - Elemetrics Corp. y el análisis de la estructura y dinámica de las cuerdas vocales a partir de la Videoestroboscopia Laríngea Computarizada (VELC), luego de la intervención en la Parálisis de Pliegue Vocal Unilateral en posición Paramediana (PPVUP), realizada a dos usuarios que consultaron la unidad de Laringe y Voz de la Clínica Avellaneda entre los años 2000 y 2003. En uno de los casos se utilizó la infiltración paracordal de grasa o lipoinyección y en el otro la fonoterapia o terapia vocal.

Investigation and literature review of unilateral hearing loss

Literature and research were gathered and analyzed to determine the impact UHL has on a child’s education, speech and language development. The effects of early intervention and amplification were also analyzed.

Quality of life in children with unilateral hearing loss: a pilot study

The purpose of this investigation was to determine the impact of unilateral hearing loss on the quality of life of children. Focus group sessions were held for parents and children or adolescents with unilateral hearing loss to discuss their perceptions. Parents and children or adolescents completed the Pediatric Quality of Life Inventory. Findings were presented depicting which domains of quality of life are most affected.

Comparative study of the Gaze Stabilization Test (GST) and the Dynamic Visual Acuity Test (DVAT) for detecting patients with unilateral vestibular dysfunction

This paper compares the use of two diagnostic tests, Gaze Stabilization Test (GST) and the Dynamic Visual Acuity Test (DVAT) to detect unilateral vestibular dysfunction.