Botulinum Toxin Type A in the Spasticity of Cerebral Palsy Related to Congenital Zika Syndrome: An Observational Study.

PURPOSE: Investigate the effect of botulinum toxin type-A (BoNT-A) on spasticity and motor performance in children with Cerebral Palsy (CP) related to Congenital Zika Syndrome (CZS). METHODS: Prospective longitudinal observational study of 34 children with CP referred for BoNT-A treatment. Outcomes were evaluated with a muscle tone assessment scale (Modified Ashworth Scale - MAS) and the Patients' Global Impression of Improvement (PGI-I) scale. RESULTS: Mean age was 32.06 ± 3.07 months and 85% were classified as Gross Motor Function Classification System (GMFCS) V. Primitive reflexes were present in 56% of the sample. The majority of the parents (97.9%) reported improvement in range of motion or reduction in spasticity after treatment with botulinum toxin. No side effects were recorded. When compared to the baseline, median reduction in the MAS was 0.5 (IQR = 0). CONCLUSIONS: The findings of this study suggest that BoNT-A may effectively promote functional improvements and reduce muscle tone, improving the child's and family's quality of life.

The impact of botulinum toxin type A in the treatment of drooling in children with cerebral palsy secondary to Congenital Zika Syndrome: an observational study.

OBJECTIVE: The main aim of this study was to determine the impact of botulinum toxin A (BTX-A) on severity and frequency of drooling in children with Cerebral Palsy (CP) secondary to Congenital Zika Syndrome (CZS). METHODS: This is a prospective longitudinal observational study including 23 children who received bilateral injections of BTX in the parotid and submandibular glands. The Thomas-Stonell & Greenberg Drooling Severity and Frequency Scale was applied by a multidisciplinary team including Speech, Language and Hearing professionals. The Global Impression of Improvement (GII) Scale was also applied to assess parents' subjective perceptions of therapeutic response. Swallowing was assessed using Doppler ultrasonography. Univariate logistic regression was used to analyse differences between responders and non-responders. RESULTS: Participant age varied from 27 to 38 months (mean 31.78, SD = 2.61) all presented with Gross Motor Function Classification System (GMFCS) V. Drooling Severity and Frequency Scale scores ranged from 7 to 9 points (median = 9) prior to BTX administration and from 4 to 6 (median = 6) after. Pre- and post-treatment reduction in drooling severity occurred (Z = -3.746; p < 0.001). No cases of drooling worsening were reported. Only two subjects presented adverse effects attributed to BTX administration. Correlation was only confirmed with GII. DISCUSSION: This article presents the safe and positive impact of BTX-A administration guided by anatomical references described in the literature, even on children with microcephaly. Further studies are needed to facilitate the use of Doppler ultrasonography as a tool to characterize changes in sensory processing and motor response following intraoral input in children with CP.

Avaliação da sinergia abdomino-pélvica durante atividades funcionais em mulheres nulíparas: série de caso / Evaluation of abdomino-pelvic synergy during functional activities in nulphary women: case series

Introdução: É relevante compreender que as disfunções do assoalho pélvico (DAP) feminino são condições clínicas que acometem um número crescente de mulheres a cada ano, constituindo um problema de saúde pública. DAP podem ter relação com o desequilíbrio entre a sobrecarga tensional dessa musculatura e a diminuição da capacidade desses músculos em suportar o aumento da pressão nessa região, uma vez que essa musculatura deve se contrair durante qualquer atividade que promova o aumento da pressão intra-abdominal favorecendo a manutenção da continência. Objetivo: analisar a presença desta sinergia em três voluntárias descrevendo o comportamento da atividade eletromiográfica de músculos localizados no assoalho pélvico e no abdome durante as atividades funcionais: andar, sentar/levantar, segurar peso, agachar, pular e tossir. Materiais e Métodos: Série de três casos, envolvendo voluntárias jovens universitárias nulíparas, sem queixas miccionais. Foi mensurado o registro da atividade eletromiográfica dos músculos do assoalho pélvico e o grupo muscular formado pelo transverso abdominal e oblíquo interno durante as atividades funcionais, utilizando a eletromiografia de superfície. Resultados: O sinal eletromiográfico aumentou em relação ao repouso durante as atividades funcionais de tossir, pular, agachar, sentar/levantar, segurar peso e andar em ambas as musculaturas analisadas. As maiores atividades eletromiográficas foram observadas durante as atividades de pular e agachar, e as menores ao segurar peso, andar e sentar/levantar. Conclusões: A partir da coleta eletromiográfica dos músculos transverso abdominal/ oblíquo interno e esfíncter anal externo em três voluntárias nulíparas foi possível observar sinergia destas musculaturas durante as atividades funcionais propostas. Estudos que envolvam grupos maiores de voluntárias, são necessários para podermos afirmar as respostas sobre a sinergia entre esses grupos musculares durante as atividades funcionais. [AU]

Introduction: It is relevant to understand that female pelvic floor dysfunctions (PFD) are clinical conditions that affect an increasing number of women each year, constituting a public health problem. PFD may be related to the imbalance between the tensional overload of this musculature and the decreased ability of these muscles to withstand increased pressure in this region, since this musculature must contract during any activity that promotes an increase in intra-abdominal pressure favoring the maintenance of continence. The present study aims to analyze the presence of this synergy in three volunteers describing the behavior of electromyographic activity of muscles located in the pelvic floor and abdomen during functional activities: walking, sitting rising, holding weight, crouching, jumping and coughing. Materials and Methods: A series of three cases, involving volunteer nulliparous university students, with no voiding complaints. The recording of electromyographic activity of pelvic floor muscles and muscular group formed by the transverse abdominal and oblique internal muscles during functional activities was measured using surface electromyography. Results: The electromyographic signal increased in relation to rest during functional activities of coughing, jumping, squatting, sitting rising, holding weight and walking in both musculature analyzed. The largest electromyographic activities were observed during jumping and crouching activities, and the lowest ones when holding weight, walking and sitting rising. Conclusion: From the electromyographic data collection of the transverse abdominal/internal oblique muscles and external anal sphincter in three nulliparous volunteers, it was possible to observe synergy of these muscles during the proposed functional activities. Studies involving larger groups of volunteers are needed to be able to state important details about the synergy between these muscle groups. [AU]

Chromium distribution in an Amazonian river exposed to tannery effluent.

This study aims to evaluate the Cr concentrations in surface water, suspended particles, and bottom sediments exposed to tannery effluent releases in the Candeias River. Cr concentrations were compared in relation to environmental thresholds imposed by United States Environmental Protection Agency (USEPA) and the Brazilian Environmental Council (CONAMA), and the geoaccumulation index (Igeo) was calculated in bottom sediment. Samples were collected in flood and dry seasons. Cr extraction was done by an acid extraction and quantified by flame atomic absorption spectrometry. Most samples were found to be below the environmental thresholds imposed by CONAMA and USEPA, except in the one from the discharge zone sampled during the dry season, showing values 1.5 and 6.1 higher than CONAMA in water and bottom sediment, respectively. Cr concentrations were significantly higher (P < 0.001) in suspended particles during dry season than flood season. Surface water and bottom sediment did not show significant differences between the seasons. The Igeo revealed an enrichment of Cr in bottom sediments after discharge zone, indicating that the effluent may be contributing to metal accumulation in the sediment. Apparently, the Candeias River shows a wash behavior on the river bottom, leaching the accumulated metal deposited on the riverbed to other areas during the flood pulses, which decreases Cr concentration in the discharge zone during dry seasons. Thus, this behavior can promote Cr dispersion to unpolluted areas.

Lipemia Pós-Prandial e Inflamação Subclínica em Mulheres Ativas queUtilizam Contraceptivo Oral / Postprandial Lipemia and Subclinical Inflammation on Active Women Taking Oral Contraceptive

Fundamentos: Mulheres em uso de contraceptivo oral combinado (COC) apresentam perfil lipídico de jejum, lipemia pós-prandial (LPP) e proteína C-reativa (PCR) maiores do que mulheres que não utilizam COC. O exercíciofísico apresenta bons resultados no controle lipídico e inflamatório.Objetivo: Comparar os valores do perfil lipídico de jejum, da LPP e da PCR entre mulheres ativas e irregularmenteativas em uso de COC.Métodos: Avaliadas 44 mulheres em uso de COC, da cidade de Salvador, BA, estratificadas em dois grupos:grupo ativo (GA; n=22) formado por mulheres fisicamente ativas e grupo irregularmente ativo (GIA; n=22) formadopor mulheres irregularmente ativas. Nos dois grupos, após jejum de 12 horas, realizada a dosagem do perfil lipídicode jejum e da PCR. A seguir, as voluntárias ingeriram um composto contendo 25g de gordura e foram dosados ostriglicerídeos para verificar a LPP. Utilizado o teste de Mann-Whitney para comparação da LPP e PCR. Resultados: Os valores dos deltas dos triglicerídeos que representam a LPP respectivamente para o GA e GIAforam: 93±38,4 mg/dL vs. 163±49,6 mg/dL e 89±50,9 mg/dL vs. 156±47,6 mg/dL (p˂0,01). Os valores da PCR respectivamente para GA e GIA foram: 1,1 mg/L (0,4-2,1 mg/L) e 2,1 mg/L (0,8-3,4 mg/L) (p=0,04).Conclusão: Neste estudo, mulheres ativas em uso de COC apresentaram triglicerídeos e LDL de jejum, LPP ePCR significativamente menores que mulheres irregularmente ativas em uso de COC.

Background: Women taking oral contraceptives (OC) have higher fasting lipid profile, postprandial lipemia (PPL) and C-reactiveprotein (CRP) than women not taking OC. Exercise has shown good results in controlling lipid and inflammatory levels.Objective: To compare fasting lipid, PPL and CRP levels among regularly active and irregularly active women taking OC.Methods: The study evaluated forty-four women taking OC, from the city of Salvador, BA, stratified into two groups: active group (AG; n=22), composed of physically active women and irregularly active group (IAG; n=22) composed of irregularly active women. In both groups, after 12-hour fasting, fasting lipid profile and CRP were assessed. Then, the volunteers took a compound containing 25g fat and triglycerides were measured to check PPL. Mann-Whitney’s test was used to compare PPL and CRP. Results: The delta values of triglycerides representing PPL respectively for the AG and the IAG were: 93±38.4 mg/dLvs. 163±49.6mg/dL and 89±50.9mg/dL vs. 156±47.6mg/dL (p˂0.01). The CRP values respectively for the AG and the IAG were:1.1mg/L (0.4-2.1mg/L) and 2.1mg/L (0.8-3.4mg/L) (p=0.04). Conclusion: In this study, physically active women taking OC presented triglycerides and fasting LDL, PPL and CRP significantlylower than irregularly active women taking OC.

Estudo químico de duas plantas medicinais da amazônia: Philodendron scabrum k. Krause (araceae) e Vatairea guianensis aubl. (fabaceae) / Chemical study of two Amazonian medicinal plants: Philodendron scabrum K. Krause (Araceae) and Vatairea guianensis Aubl. (Fabaceae)

Este trabalho relata o estudo químico de duas plantas medicinais da Amazônia: Philodendron scabrum K. krause (Araceae) e Vatairea guianensis Aubl. (Fabaceae). As composições dos óleos essenciais dos cipós de P. scabrum e dos frutos de V. guianensis, respectivamente, foram analisadas em CG-DIC e CG-EM. Os constituintes majoritários dos cipós de P. scabrum foram óxido de cariofileno (19,42%), α-copaeno (16,08%) e ß-bisaboleno (10,01%); e nos frutos de V. guianensis foram o ácido (9Z)-octadecenoico (24,95%) e o ácido docosahexaenoico (24,17%). ß-sitosterol e o alquilresorcinol 1-hexadecanoil-2,6-dihidroxibenzeno foram isolados do extrato etanólico dos cipós de P. scabrum; e do extrato etanólico dos frutos de V. guianensis, foram isoladas as antraquinonas crisofanol e fisciona. As determinações estruturais foram baseadas em dados de RMN de ¹H e 13C. RMN, uni e bidimensional e comparação com dados da literatura.

This work describes the chemical study of two medicinal plants of the Amazon Philodendron scabrum K. Krause (Araceae) and Vatairea guianensis Aubl. (Fabaceae). Essential oils composition from stems of Philodendron scabrum K. Krause (Araceae) and fruits of Vatairea guianensis Aubl. (Fabaceae), respectively were analyzed in GC-FID and GC-MS. The major constituents from stems of P. scarabum were caryophyllene oxide (22.42%), α-copaene (16.08%) and ß-bisabolene (12.01%) and from fruits of V. guianensis were (9Z)-octadecenoic acid (24.95%) and docosahexenoic acid (24.17%). ß-sitosterol and alkylresorcinol 1-hexadecanoyl-2,6-dihydroxybenzene were isolated from ethanolic extracts from stems of P. scabrum and from ethanolic extracts from fruits of V. guianensis, the athraquinones chrysophanol and physcion were isolated. The structure of isolated compounds we determinate wered based on data from ¹H and 13C NMR, including two dimensional analyses and comparison with literature data.