A importância das informações aferentes podais para o controle postural

Introduction. The postural control involves a complex mechanism for connecting the afferent and efferent pathways and their integration into the central nervous system (CNS). Three systems are responsible to obtain outside information: visual, vestibular and sensory. Recent studies have shown that among such systems, the CNS shows a greater predilection for sensory information to postural control. Objective. Given this, the review proposes to discuss the feet sensory information importance and its reflection in postural control mechanisms. Method. For this reason, a literature search was carried out by PubMed and Bireme libraries, and papers of the last five years were selected. Specific books were also used. Discussion. Studies were separated into topics on sensory information integration to neuro-motor answer, postural feed-forward adjustments recruitment mechanisms; neuro-muscular coordination and synergy responses and the musculoskeletal tissues role. Conclusion. Despite has been found a large number of studies, the real mechanism that the CNS uses to filter, integrate and process the sensory information and select the appropriate motor response, be it for the movement or posture for the stabilization remains obscure.

O papel dos sistemas visual, vestibular, somatosensorial e auditivo para o controle postural

The maintenance of a given body orientation is obtained by the complex relation between sensory information and muscle activity. Therefore, this study purpose was to review the role of visual, somatosensory, vestibular and auditory information in the maintenance and control of the posture. Method. a search by papers for the last 24 years was done in the PubMed and CAPES databases. The following keywords were used: postural control, sensory information, vestibular system, visual system, somatosensory system, auditory system and haptic system. Results. the influence of each sensory system and its integration were analyzed for the maintenance and control of the posture. Conclusion. the literature showed that there is information redundancy provided by sensory channels. Thus, the central nervous system chooses the main source for the posture control.

Estimulação elétrica neuromuscular na reabilitação da disfagia orofaríngea neurogênica

Objective. To present an overview of the literature about the efficacy of neuromuscular electrical stimulation (NMES) in the rehabilitation of neurogenic oropharyngeal dysphagia and to compare methods of therapy in stroke. Method. An extensive bibliographic survey of several databases (Medline, Scielo Brazil, Chile and Spain and Lilacs) was performed using the following keywords: deglutition disorders, therapy, electrical stimulation, pharynx and stroke between 1990 and 2011. Results. The articles reported the use of NMES in heterogeneous population; there is no consensus thus far about the method used during the NMES and about its rehabilitation efficacy in neurogenic oropharyngeal dysphagia. Conclusions. After this study, we concluded that further investigations are necessary with homogeneous groups of patients with neurogenic dysphagia, discussing the proposition of a specific NMES protocol for the rehabilitation of neurogenic oropharyngeal dysphagia.

Atuação fisioterapêutica na lesão medular em unidade de terapia intensiva: Atualização de literatura

Objective. Collate and update knowledge in relation to physical therapy in spinal cord injury (SCI) in the intensive care unit (ICU). Method. We performed a literature update in the databases Lilacs, PubMed and Scielo, crossing the descriptors spinal cord injury, cinesiotherapy, physiotherapy, mobilization, rehabilitation, intensive care unit, respiratory therapy and electrotherapy in the period of 2005 to 2010. Results. We found 21 studies, however, only five articles met the inclusion criteria. Kinesiotherapy is essential since the phase of spinal shock, since it favors the maintenance of joint range of motion and flexibility, and to prevent circulatory complications caused/ resulted from prolonged immobilization in bed. Respiratory therapy promotes bronchial hygiene, correction of abnormal respiratory patterns and respiratory diseases. The electrotherapy is a feature still little used by physiotherapists in the intensive care units. Conclusions. The physical therapy in SCI in ICU is focused on motor rehabilitation through kinesiotherapy and intervention through the respiratory bronchial hygiene and training of respiratory muscles. New treatment modalities such as electrotherapy, there have been in intensive environment, there is a need for more studies to confirm benefits and risks of this feature in the spinal cord.

Fisioterapia Aquática na Transferência do Sentado para Ortostatismo no Paciente com AVC: Relato de Caso

Introduction. Studies show that 70% of body weight in patients with stroke during the transfer from sitting to standing position is transferred to the uninvolved limb. Significantly interfering with activities of daily living. Objective. The influence of aquatic therapy on eight in the affected hemisphere during the transition from sitting to standing. Method. Participated in this study a patient with right hemiparesis, the protocol lasted eight sessions in a liquid medium. The data of activation of the gluteus muscle were collected from surface electromyography and data as the weight transfer was examined by baropodometry platform. Results. Initial electromyography (151.1uv right gluteus maximus and left gluteus maximus 229.1uv) and Final electromyography (113.6 uv right gluteus maximus and left gluteus maximus113.3uv). Evolution was 19% in weight transferin paretic hemibody compared the pre and post intervention. Conclusion. The results showed that treatment was favorable to the patient, because at the end of application of the observed activation of the gluteus maximus and improved weight-bearing, and consequently these factors interfered positively in the security and independe in transferring from sitting to standing position.

Espectros Clínicos da Trombose Venosa Cerebral

Introduction. Cerebral Venous Thrombosis has a highly variable clinical presentation. Four major syndromes had been described in patients with cerebral venous thrombosis: isolated intracranial hypertension, focal neurological deficits, focal or generalized seizures and disturbances of consciousness and cognitive dysfunction. Method. We describe five consecutive patients admitted to our service with a diagnosis of cerebral venous thrombosis, highlighting the different possibilities of clinical presentation and prognosis. Discussion. The diagnosis of cerebral venous thrombosis should be considered in patients with acute, subacute or chronic headache, with or without signs of intracranial hypertension or focal deficits, even in the absence of cerebrovascular risk factors. Treatment should be started as soon as the diagnosis is confirmed and consists of reversal of the underlying cause when known, control of seizures and intracranial hypertension, and antithrombotic therapy.

Descrição de outras doenças sexualmente transmissíveis em pessoas infectadas pelo vírus da imunodeficiência humana do tipo 1

Noventa pacientes soropositivos para o HIV-1 foram estudados, visando-se a descrição de manifestações clínicas e de marcadores de outras doenças sexualmente transmissíveis, assim como de fatores demográficos e comportamentais que possam estar relacionados com a infecção pelo HIV-1 e em pacientes com SIDA/AIDS. A maioria dos entrevistados (83,3%) foi do sexo masculino, apresentou a média de idade 31,4 anos (variando entre 18 e 60 anos) e a distribuição da renda familiar mensal mostrou que 79,5% tinham um ganho inferior a cinco salários mínimos. Pelos menos um tipo de droga, foi consumido por 51,1%, sendo que 20.7% usaram droga não medicamentosa de uso injetável. Destes, 94,4% referiram antecedentes de doenças sexualmente transmissíveis. A observação dos hábitos sexuais revelou que 41,6% eram bissexuais, 38,2% heterossexuais e 20,2% eram homossexuais. Cerca de 51,1% dos bissexuais usaram drogas injetáveis e todos referiram a prática de sexo anal e foram positivos para a presença de anticorpos para Chlamydia. A média de idade da primeira relação sexual com penetração foi de 14.7 anos, enquanto que a média de idade em que ocorreu a primeira doença sexualmente transmissível foi de 20.6 anos. A quase totalidade (95,5%) dos entrevistados tiveram múltiplos parceiros sexuais, antes do conhecimento da soropositividade para o HIV-1. Dentre os 90 soropositivos, 73,3% referiram antecedentes de doenças sexualmente transmissíveis. Destes, 82,2% referiram a presença de secreção uretraI, de sífilis e de herpes simples. No momento da avaliação, 36,6% (33/90) apresentaram secreção uretral, anal e/ou vaginal, lesão genital, anal, perianal e/ou adenopatia inguinal, assim discriminado: Secreção (51,1%), vesículas (18,1%), lesão verrucosa (18,1%), Adenopatias iguinais ( 18,1% ), úlceras ( 12,1 %) e pápulas (6% ). A reação do VDRL foi positiva em 13,7% (11/80), sendo que neste grupo, 90,9% referiram a prática do sexo anal e 81,8% revelaram antecedentes de DST. Cerca de 96,4% (81/84) apresentaram anticorpos para Chlamydia, sendo que 81,8% revelaram a prática do sexo anal e 72,8% relataram antecedentes de DST .

Ingestão Oral e Grau de Comprometimento da Disfagia Orofaríngea Neurogênica Pré e Pós-Fonoterapia

Objective. To compare, pre- and post-swallowing therapy, the level of oral intake scale, and the degree of severity of neurogenic oropharyngeal dysphagia. Method. 19 patients with oropharyngeal dysphagia: 10 Post-Stroke adults, aged from 44 years to 76 years (group 1 – G1), and nine children with Cerebral Palsy, aged from two years and five months to 15 years (group 2 – G2). We excluded individuals in the process of spontaneous recovery. We held retrospective analysis of clinical protocols for clinical speech therapy evaluation with classification of the degree of dysphagia severity, applied before and after swallowing therapy. We used the Functional Oral Intake Scale - FOIS to assess the level of oral ingestion, pre and post-swallowing therapy. Results. The degree of commitment of dysphagia was favorable change only in adults, and in FOIS these changes occurred in both groups. Conclusion. There were favorable changes in the degree of impairment of oropharyngeal dysphagia and levels of FOIS, pre and post - speech therapy in stroke, but in ECINP markers used showed no favorable changes should even be reviewed for application in this population. Future studies are needed to investigate the variables in this sample.

Redescription of the larva of Amblyomma oblongoguttatum Koch, 1844 (Acari: Ixodidae) by light and scanning electron microscopy

The larval stage of Amblyomma oblongoguttatum Koch is redescribed using optical and scanning electron microscopy. Unfed larvae were obtained from a colony of A. oblongoguttatum originated from engorged females collected on domestic pigs from Monte Negro municipally (10 degrees 29'S, 63 degrees 32'W), State of Rondonia, Western Amazon, Brazil. Several characters are presented including the chaetotaxy of the idiosoma, palpi and Haller's organ, as well as morphological features of the idiosoma, gnathosoma and legs. In addition, the porotaxy (topographical and numerical patterns of integumentary structures) were presented by using a new nomenclature recently proposed. The chaetotaxy of the larvae of A. oblongoguttatum, in general, is similar to other Neotropical Amblyomma species. Three types of integumentary structures were observed on the idiosoma: lyrifissures, small glands, and large wax glands. Topographic and numerical patterns of the integumentary structures consisted of 5 pairs of large wax glands (1 dorsal/4 ventral), 24 pairs of lyrifissures (11 dorsal/13 ventral), and 49 pairs of small glands (28 dorsal/21 ventral). These topographic and numerical patterns found for A. oblongoguttatum show only minor differences when compared with patterns of other Amblyomma larvae, however, a few key features can be used for identification of these species.

TRANSITIVITY AND ROTATION SETS WITH NONEMPTY INTERIOR FOR HOMEOMORPHISMS OF THE 2-TORUS

We show that if f is a homeomorphism of the 2-torus isotopic to the identity and its lift (f) over tilde is transitive, or even if it is transitive outside the lift of the elliptic islands, then (0,0) is in the interior of the rotation set of (f) over tilde. This proves a particular case of Boyland's conjecture.

Revision of Nanophareus, a mysterious harvestman genus from Chile, with descriptions of three new species (Opiliones: Laniatores: Gonyleptidae)

The Chilean genus Nanophareus Roewer, 1929 is revised and three new species are described: N. araucanus sp. nov. (type locality: Parque Nacional La Campana, Valparaiso, Chile); N. bipartitus sp. nov. (type locality: Parque Nacional La Campana, Valparaiso, Chile); N. bosqenublado sp. nov. (type locality: Parque Nacional Fray Jorge, Coquimbo, Chile). The type species, N. palpalis Roewer, 1929, is redescribed and a lectotype is designated. A cladistic analysis was performed using these three new species plus N. palpalis and 14 more laniatorid species, and a data matrix of 72 characters: Seven from the ocularium, 22 from the dorsal scutum, one from the venter, one from the chelicera, eight from the pedipalp, 24 from male legs, and nine from male genitalia. Two equally most parsimonious trees were found (L = 210; C.I. = 0.41; R.I. = 0.51). Nanophareus was recovered as nested within a paraphyletic subfamily Pachylinae. The genus Nanophareus was found to be monophyletic based on the following exclusive synapomorphies: An external row of enlarged tubercles inserted among small ones on lateral margin of the dorsal scutum (innapplicable in N. bosqenublado); the ventro-basal margin of pedipalpal tibia curved 90 degrees in lateral view; and retrolateral seta of the pedipalpal tibia with a socket apically bifid (socket and seta longer than pedipalpal tibia length).