Evaluation of safety and effectiveness of NAD in different clinical conditions: a systematic review.

Nicotinamide adenine dinucleotide (NAD+) is an essential pyridine nucleotide cofactor that is present in cells and in several important biological processes, including oxidative phosphorylation and production of adenosine triphosphate, DNA repair, calcium-dependent secondary messenger and gene expression. The purpose of this systematic review is to examine whether the coenzyme formulae NAD+ and NADH are safe and effective when acting as a supplement to humans. This systematic review of randomized clinical trials performed a search in six electronic databases: PubMed, MEDLINE (ovid), Embase, Cochrane CENTRAL (clinical trials), Web of Science, and Scopus. Secondary search included the databases (e.g., Clinical trials.gov, Rebec, Google Scholar - advance). Two reviewers assessed and extracted the studies independently. The risk of bias in studies was performed using version 2 of the Cochrane risk of bias tool for randomized trials. This review includes 10 studies, with a total of 489 participants. The studies included different clinical conditions, such as chronic fatigue syndrome (CFS), older adults, Parkinson's disease, overweight, postmenopausal prediabetes, and Alzheimer's disease. Based on studies, the supplementation with NADH and precursors was well tolerated and observed clinical results such as, a decrease in anxiety conditions and maximum heart rate was observed after a stress test, increased muscle insulin sensitivity, insulin signaling. Quality of life, fatigue intensity, and sleep quality among others were evaluated on patients with CFS. All studies showed some side effects, thus, the most common associated with NADs use are muscle pain, nervous disorders, fatigue, sleep disturbance, and headaches. All adverse events cataloged by the studies did not present a serious risk to the health of the participants. Overall, these findings support that the oral administration of NADH can be associated to an increase in general quality of life and improvement on health parameters (e.g., a decrease in anxiety, maximum heart rate, inflammatory cytokines in serum, and cerebrospinal fluid). NADH supplementation is safe and has a low incidence of side effects. Future investigations are needed to evidence the clinical benefits regarding specific diseases and doses administered.

Relação entre rigidez de fixador externo e quantidade de pinos: análise computacional por elementos finitos / Relationship between rigidity of external fixator and number of pins: computer analysis using finite elements

OBJETIVO: Analisar a rigidez da montagem de um fixador externo tipo plataforma, segundo diferentes números de pinos em cada clamp. MÉTODOS: Realizou-se simulação computacional do fixador externo dinâmico modelo Cromus tamanho grande (Baumer S.A.) por elementos finitos, conforme a norma ASTM F1541. Os modelos foram gerados com, aproximadamente, 450.000 elementos tetraédricos quadráticos. Compararam-se as montagens com dois, três e quatro pinos tipo Schanz com 5,5mm de diâmetro em cada clamp. Cada modelo foi submetido à força máxima de 200N, dividida em 10 sub-steps. Para os componentes foi assumido comportamento do material linear, elástico, isotrópico e homogêneo. Para cada modelo, avaliou-se a rigidez da montagem e a distribuição de tensão de Von Mises. RESULTADOS: A rigidez do sistema foi de 307,6N/mm para dois pinos, 369,0N/mm para três e437,9 N/mm para quatro. CONCLUSÃO: Os resultados demonstram que quatro pinos tipo Schanz por clamp promovem aumento de rigidez de 19% em relação à configuração com três e 42% em relação à configuração com dois. Maiores tensões ocorrem para configurações com menor quantidade de pinos. Nos modelos analisados, a tensão máxima ocorre na superfície do pino, próxima à área de fixação.

OBJECTIVE: To analyze the rigidity of a platform-type external fixator assembly, according to different numbers of pins on each clamp. METHODS: Computer simulation on a large-sized Cromus dynamic external fixator (Baumer SA) was performed using a finite element method, in accordance with the standard ASTM F1541. The models were generated with approximately 450,000 quadratic tetrahedral elements. Assemblies with two, three and four Schanz pins of 5.5 mm in diameter in each clamp were compared. Every model was subjected to a maximum force of 200 N, divided into 10 sub-steps. For the components, the behavior of the material was assumed to be linear, elastic, isotropic and homogeneous. For each model, the rigidity of the assembly and the Von Mises stress distribution were evaluated. RESULTS: The rigidity of the system was 307.6 N/mm for two pins, 369.0 N/mm for three and 437.9 N/mm for four. CONCLUSION: The results showed that four Schanz pins in each clamp promoted rigidity that was 19% greater than in the configuration with three pins and 42% greater than with two pins. Higher tension occurred in configurations with fewer pins. In the models analyzed, the maximum tension occurred on the surface of the pin, close to the fixation area.

RELATIONSHIP BETWEEN RIGIDITY OF EXTERNAL FIXATOR AND NUMBER OF PINS: COMPUTER ANALYSIS USING FINITE ELEMENTS.

OBJECTIVE: To analyze the rigidity of a platform-type external fixator assembly, according to different numbers of pins on each clamp. METHODS: Computer simulation on a large-sized Cromus dynamic external fixator (Baumer SA) was performed using a finite element method, in accordance with the standard ASTM F1541. The models were generated with approximately 450,000 quadratic tetrahedral elements. Assemblies with two, three and four Schanz pins of 5.5 mm in diameter in each clamp were compared. Every model was subjected to a maximum force of 200 N, divided into 10 sub-steps. For the components, the behavior of the material was assumed to be linear, elastic, isotropic and homogeneous. For each model, the rigidity of the assembly and the Von Mises stress distribution were evaluated. RESULTS: The rigidity of the system was 307.6 N/mm for two pins, 369.0 N/mm for three and 437.9 N/mm for four. CONCLUSION: The results showed that four Schanz pins in each clamp promoted rigidity that was 19% greater than in the configuration with three pins and 42% greater than with two pins. Higher tension occurred in configurations with fewer pins. In the models analyzed, the maximum tension occurred on the surface of the pin, close to the fixation area.