Inhibitors of tumor necrosis factor synthesis as a new approach for the treatment of rheumatoid arthritis

Objective: The treatment of rheumatoid arthritis (RA) is based on the inhibition of TNF. Here we evaluated whether drugs that might inhibit TNF, such as pentoxifylline (PTX), rupatadine (RUP), rolipram (ROL) and thalidomide (THA), could be an alternative for RA treatment. Methods: In wistar male rats the changes in paw thickness, plasma TNF and by the activity of basic aminopeptidase (APB) in soluble fraction of synovial tissue and peripheral blood mononuclear cells (PBMC) evaluated after daily injection for 30 days were taken as anti-inflammatory outputs, while hepatotoxicity was assessed by measuring plasma alanine transaminase (ALT) and aspartate transaminase (AST) activity. The content of IL1-β, IL-6 in serum and synovial fluid and the histology of the injured tissue were determined only for ROL, THA and ROL+THA. Prednisolone was used as a standard drug. Results: Collagen treatment induced paw thickness, histological changes in the tibiotarsal joint, increase in synovial fluid of both cytokines and synovial tissue of APB activity. Furthermore, the APB activity in PBMC was reduced and ALT and AST activity were enhanced. The most effective drug schedule in reducing arthritis induced changes described above, as well as recovering from control levels TNF, IL1-β, APB in synovial tissue and AST activities were THA and the association of ROL and THA. However, only THA alone reduced the levels of ALT. Conclusion: The synthesis of TNF in RA models can be blocked by drugs acting at different targets. We show that THA and THA+ROL emerges as simple and effective therapeutic alternatives for RA.

Efficacy of different interaction devices using non-immersive virtual tasks in individuals with Amyotrophic Lateral Sclerosis: a cross-sectional randomized trial.

BACKGROUND: Amyotrophic Lateral Sclerosis (ALS) is a rapid progressive neurodegenerative disease, characterized by a selective loss of motor neurons, brain stem and spinal cord which leads to deterioration of motor abilities. Devices that promote interaction with tasks on computers can enhance performance and lead to greater independence and utilization of technology. OBJECTIVE: To evaluate performance on a computer task in individuals with ALS using three different commonly used non-immersive devices. METHOD: Thirty individuals with ALS (18 men and 12 women, mean age 59 years, range 44-74 years) with a mean score of 26, (minimum score of 14 and maximum 41) on the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) and 30 healthy controls matched for age and gender, participated. All participants were randomly divided into three groups, each using a different device system (motion tracking, finger motion control or touchscreen) to perform three task phases (acquisition, retention and transfer). RESULTS: Both the ALS and control group (CG) showed better performance on the computer task when using the touchscreen device, but there was limited transfer of performance onto the task performed on the Finger Motion control or motion tracking. However, we found that using the motion tracking device led to transfer of performance to the touchscreen. CONCLUSION: This study presents novel and important findings when selecting interaction devices for individuals with ALS to access technology by demonstrating immediate performance benefits of using a touchscreen device, such as improvement of motor skills. There were possible transferable skills obtained when using virtual systems which may allow flexibility and enable individuals to maintain performance overtime. TRIAL REGISTRATION: Registration name: Virtual Task in Amyotrophic Lateral Sclerosis; Registration number: NCT03113630 ; retrospectively registered on 04/13/2017. Date of enrolment of the first participant to the trial: 02/02/2016.

Application and outcomes of therapy combining transcranial direct current stimulation and virtual reality: a systematic review.

PURPOSE: To evaluate the methods and major outcomes of transcranial direct current stimulation (tDCS) combined with virtual reality (VR) therapy in randomized controlled trials. METHOD: A systematic review was performed following PRISMA guidelines using PubMed, PubMed Central, Web of Science and CAPES periodic databases, with no time restriction. The studies were screened for the following inclusion criteria: human subjects, combination of VR and tDCS methods, and randomized controlled study design. All potentially relevant articles were independently reviewed by two researchers, who reached a consensus on which articles met the inclusion criteria. The PEDro scale was used to evaluate the studies. RESULTS: Eleven studies were included, all of which utilized a variety of tDCS and VR application methods. The main outcomes were found to be beneficial in intervention groups of different populations, including improvements in body sway, gait, stroke recovery, pain management and vegetative reactions. CONCLUSIONS: The use of tDCS combined with VR showed positive results in both healthy and impaired patients. Future studies with larger sample sizes and homogeneous participants are required to confirm the benefits of tDCS and VR. Implications for Rehabilitation tDCS with VR intervention can be an alternative to traditional rehabilitation programs. tDCS with VR is a promising type of intervention with a variety of positive effects. Application of tDCS with VR is appropriated to both healthy and impaired patients. There is no consensus of tDCS with VR application.

Pain characterization in Duchenne muscular dystrophy.

OBJECTIVE: To investigate the relationship between DMD and pain. METHODS: We conducted a systematic review in Medline/PubMed and BVS (virtual library in health) databases. We searched for articles that showed the terms "Muscular Dystrophy, Duchenne" and "Pain" in all fields. All studies included boys diagnosed with DMD and the occurrence/amount of pain on this population. RESULTS: Initially, there were 175 studies. 167 articles were excluded for not meeting the inclusion criteria. The remaining eight eligible studies, involving pain assessment in DMD, were analyzed. CONCLUSION: Pain is a frequent problem in this population and this symptom is potentially tractable. Studies conclude that pain can directly influence the quality of life of this population.

Pain characterization in Duchenne muscular dystrophy / Caracterização da dor na distrofia muscular de Duchenne

ABSTRACT Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder, characterized by progressive muscle weakness. Historically, pain has not been considered to be a major symptom in DMD. Objective To investigate the relationship between DMD and pain. Methods We conducted a systematic review in Medline/PubMed and BVS (virtual library in health) databases. We searched for articles that showed the terms “Muscular Dystrophy, Duchenne” and “Pain” in all fields. All studies included boys diagnosed with DMD and the occurrence/amount of pain on this population. Results Initially, there were 175 studies. 167 articles were excluded for not meeting the inclusion criteria. The remaining eight eligible studies, involving pain assessment in DMD, were analyzed. Conclusion Pain is a frequent problem in this population and this symptom is potentially tractable. Studies conclude that pain can directly influence the quality of life of this population.

RESUMO Distrofia muscular de Duchenne (DMD) é uma doença recessiva ligada ao X, caracterizada por fraqueza muscular progressiva. Historicamente a dor não foi considerada como um dos principais sintomas em DMD. Objetivo Investigar a relação entre DMD e dor. Métodos Foi realizada uma revisão sistemática nas bases de dados Medline/PubMed e BVS (Biblioteca Virtual em Saúde). Foram incluídos na busca artigos que mostravam os termos “Distrofia Muscular de Duchenne” e “Dor” em todos os campos. Todos os estudos incluíram meninos diagnosticados com DMD e a ocorrência/intensidade da dor nesta população. Resultados Inicialmente, havia 175 estudos. 167 artigos foram excluídos por não preencherem os critérios de inclusão. Então, 8 estudos elegíveis, envolvendo a avaliação da dor em DMD, foram analisados. Conclusão A dor é um problema frequente nesta população e esse sintoma é potencialmente tratável. Estudos concluíram que a dor pode influenciar diretamente a qualidade de vida dessa população.

Virtual reality in multiple sclerosis - A systematic review.

INTRODUCTION: Multiple sclerosis (MS) is an inflammatory disease in which the insulating cover of nerve cells in the brain and spinal cord are damaged. The methods used for motor rehabilitation of patients with neurological problems require the performance of several rehabilitation exercises. Recently, studies related to the use of video game consoles have proliferated in the field of motor rehabilitation. Virtual reality (VR) has been proposed as a potentially useful tool for motoring assessment and rehabilitation. OBJECTIVE: The purpose of this study was to investigate the results shown in previous studies on "Multiple Sclerosis" and "Virtual Reality". METHOD: A bibliographic review was performed without time limitations. The research was carried out using PubMed and BVS databases. Considering keywords, we included articles that showed the terms "Multiple Sclerosis" and "Virtual Reality". The review was according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines RESULTS: The initial search yielded 41 articles. After the duplicates were removed, two authors independently evaluated the title and abstract of each of the articles with the study inclusion criteria. From these, 31 articles were excluded based on the title and abstract. Finally, 10 articles were isolated that met the inclusion criteria. CONCLUSION: VR represents a motivational and effective alternative to traditional motor rehabilitation for MS patients. The results showed that VR programs could be an effective method of patients with MS rehabilitation in multiple cognitive and / or motor deficits. Additional research is needed to support the rehabilitation protocols with VR and increase the effects of treatment.

Avaliação da relação velocidade-precisão em função do nível de dificuldade no transtorno de asperger / Speed-precision assessment in difficulty level function in asperger's disorder

INTRODUÇÃO: O Transtorno de Asperger (TA) é considerado um distúrbio do neurodesenvolvimento, caracterizado por deficiências sociais, dificuldade de comunicação, padrões restritos e repetitivos de comportamento. OBJETIVO: Comparar o desempenho motor na realização de tarefa computacional com base na relação velocidade e precisão, entre pessoas com desenvolvimento típico e com TA, por meio do tempo de movimento. MÉTODOS: Participaram deste estudo oito meninos com diagnóstico de TA e oito meninos com desenvolvimento típico, pareados por idade e sexo, para compor o grupo controle. A tarefa que utilizamos avalia a relação velocidade e precisão de movimento, que consiste na realização de movimentos manuais direcionados a um alvo, em três índices de dificuldade (ID). O tempo de movimento foi obtido por meio da divisão entre segundos pré-estabelecidos para a tarefa (10) e o número de toques realizados no alvo. A ANOVA para medidas repetidas foi utilizada para a comparação entre os ID e entre os grupos. RESULTADOS: Observamos que o tempo de movimento aumentou conforme o progresso dos ID. CONCLUSÃO: Os indivíduos com TA apresentaram um tempo de movimento significativamente maior quando comparados ao grupo controle, em todos os ID. Supõe-se que há dificuldades inerentes à doença, e condições motoras dos indivíduos com TA limitam o desempenho durante a tarefa.

INTRODUCTION: Asperger's Disorder (AD) is one of the neurodevelopmental disorders characterized by social impairments, difficulty in communication and restricted and repetitive patterns of behavior. OBJECTIVE: To compare the motor performance in performing computational tasks with base on the relation speed and accuracy among people with typical development and AD, through the time of movement. METHODS: The study included eight boys diagnosed with AD and eight children with typical development, matched for age and sex, to compose the control group. The task used to assesses the relative movement speed and accuracy, consisting in making hand movements directed at a target in three levels of difficulty (DI). Movement time was obtained by dividing the seconds to preestablished between the task (10) and the number of rings made on the target. ANOVA for repeated measures was used to compare the DI and between groups. RESULTS: We observed that the movement time increased with the progress of DI. CONCLUSION: Individuals with AD had a significantly increased movement time compared to the control group in all DI. It is assumed that the difficulties are inherent in motor pathology and conditions of the patients with MT limit performance during task.