Adverse Drug Reactions during COVID-19 Treatment: A Comprehensive Analysis Focused on Hospitalized Patients, with the Use of a Survey in Cuba in 2020.

Aims: To evaluate the prevalence and type of adverse drug reactions (ADRs), together with associated risk factors, among Cuban COVID-19 patients treated with chloroquine (CQ), lopinavir/ritonavir (LPV/r), or interferon α2b (IFN α2b), according to the Cuban protocol. Materials and Methods: A prospective descriptive analysis of ADRs was performed on 200 COVID-19 patients who were admitted consecutively to three hospitals in Havana and Pinar del Río from April to July 2020. Information on demographics, ADRs, outcomes, behavioral, and health-related factors was collected using a validated questionnaire and clinical records. Each potential ADR case was assessed for causality based on the WHO-UMC algorithm, concomitant drug influences, and the presence of any drug-drug interactions (DDI). Results: The total frequency of ADRs was 55%, with predominantly gastrointestinal disorders and general symptoms (23% vs 20%). 95.1% of ADRs occurred within 10 days after treatment and 42 potential DDI in 55.5% of patients (61/110) were observed. The prevalence of ADRs was: 44%, 30.4%, and 26.4% for IFN α2b, LPV/r, and CQ, respectively. Sex (odds ratio (OR): 0.40 (95% confidence interval (CI): 0.211-0.742), age (OR: 2.36 (95% CI: 1.02-5.44)), and underlying diseases (OR: 0.12 (95% CI: 0.06-0.23)) were independently associated factors for ADRs (P < 0.05). Conclusions: The frequency of ADRs and potential DDI was high compared to their use during nonpandemic times (e.g., for malaria, HIV, or inflammatory diseases). The safety profile of these drugs when used for COVID-19 treatment showed similar characteristics. Comorbidities, age >37 years old, and female sex were associated with ADRs.

Proteína precursora del beta-amiloide (ß-App) y daño axonal difuso tras un traumatismo craneoencefálico: un punto de vista forense / Beta-amiloid precursos protein (ß-App) and diffuse axonal damage after head injuries: a forensic point of view

Resumen La proteína precursora del β- Amiloide (β-APP) es una glicoproteína de membrana y un componente habitual de las neuronas. Tiene funciones en el crecimiento y la adhesión celular tras un traumatismo. Es transportada mediante transporte rápido axonal anterógrado y se acumula dentro de las neuronas cuando se daña citoesqueleto. Este proceso es activo, es decir consume energía. El β-APP no es específico de los traumatismos. Se acumula en cualquier circunstancia en la que se dañen los axones, tal como la hipoxia, alteraciones metabólicas, y cualquier otra causa de edema cerebral y aumento de la presión intracraneal que puedan conducir a un daño axonal difuso (DAI) En el presente estudio estudiamos la expresión de esta proteína en casos de traumatismo cráneo-encefálico con diferente evolución cronológica El daño del citoesqueleto producido por la proteólisis, junto con la alteración de las quinasas y las fosfatasas, aumentan la permeabilidad de la membrana, lo que provoca la entrada de calcio en la célula que, a su vez, activa la calmodulina que hace que los neurofilamentos se compacten, los microtúbulos desaparezcan y se rompa la espectrina. Esta disrupción del citoesqueleto tiene como consecuencia que las sustancias que se transportan a su través, se acumulen, sobre todo en las zonas afectadas por el DAI. Al final de todo este proceso, los axones se rompen, lo que se conoce como axotomía secundaria. El estudio de la acumulación del β-APP es útil para valorar la extensión del DAI y para determinar el tiempo de supervivencia tras el traumatismo o cualquier otro daño cerebral.

Abstract β-Amyloid Precursor Protein (β-APP) is a membrane glycoprotein and a common component of neurons. It is involved in adhesion and cell growth processes after traumatic events. It is carried by anterograde fast axonal transport, and it accumulates inside neurons when the cytoskeleton is damaged. This is a vital biochemical process that consumes energy. β-APP is not specific of traumatic events. It accumulates in any case of axonal damage, whatever its cause may be, like hypoxia, metabolic disorders, and any other circumstances that lead to brain swelling and intracranial pressure rising and in consequence to Diffuse Axonal Injury (DAI). In this study we review the expression of this protein in cases of traumatic brain injury with different chronological evolution. The damage of cytoskeleton due to proteolysis in addition to the disturbance of kinases and phosphatases increase the permeability of the membrane. Calcium gets into the cell and activates calmodulin, thus neurofilaments compact, microtubules disappear and spectrin breaks. This disruption of the cytoskeleton has as consequence that the transported substances accumulate in the most affected areas by DAI. At the end of this process axon breaks, which is known as secondary axotomy. The study of the accumulation of β-APP is useful to assess the extent of DAI and to determine the time elapsed after trauma or another insult to CNS.

Hydroxyapatite extraction from fish scales of Tilapia.

Hydroxyapatite is the inorganic component of human bones. To be used for bone replacements, hydroxyapatite can be synthesized or extracted from natural components. In this work we present the hydroxyapatite extraction from fish scales of the same Orechromis family (Tilapia) but from two different species usually consumed in Mexico and in Spain. Our results indicate, for both species, that it is possible to obtain hydroxyapatite, and moreover, that this biomaterial is enriched with magnesium for the Mexican Oreochromis hunteri, and with aluminum for the Spanish Oreochromis niloticus.

Biomateriales para Regeneración de Tejido Óseo Extraídos de Desechos de Pescado / Biomaterials for Bone Tissue Regeneration Extracted from Fish Wastes

Resumen Los biomateriales para regeneración ósea comúnmente se basan en el diseño natural del hueso, el cual mezcla la dureza de un material cerámico como la hidroxiapatita con la flexibilidad de un polímero como el colágeno. Ambos materiales pueden extraerse de los desechos del pescado consumido en la dieta humana, tales como escamas, piel e incluso huesos. Esta extracción tiene la ventaja de aportar biomateriales naturales, de baja toxicidad y como añadido, que evitan la transmisión de enfermedades que se ha reportado para colágenos provenientes de animales mamíferos. En este trabajo se hace una revisión de bibliografía referente a la extracción de colágeno tipo I, precursores de hidroxiapatita y síntesis de compósitos de ambos, para proponer la recuperación de estos biomateriales como una alternativa amigable con el ambiente y útil para usos médicos.

Abstract Biomaterials for bone tissue regeneration are commonly based in the natural design of bone where the stiffness of a ceramic material as hydroxyapatite is combined with the flexibility of a polymer such as collagen. Both materials can be extracted from human consumed fish waste, such as scales, bones and skin. The recovery of these biomaterials from fish waste has the advantage of yielding natural materials of low toxicity, avoiding the possible disease transmission found for the collagen coming from mammalians. In this article, we review several reports about collagen type I and hydroxyapatite precursors extraction, and composite synthesis, from fish waste in order to propose these methods as a green alternative for biomaterials useful for medical purposes.

The shell effect on the room temperature photoluminescence from ZnO/MgO core/shell nanowires: exciton-phonon coupling and strain.

The room temperature photoluminescence from ZnO/MgO core/shell nanowires (NWs) grown by a simple two-step vapor transport method was studied for various MgO shell widths (w). Two distinct effects induced by the MgO shell were clearly identified. The first one, related to the ZnO/MgO interface formation, is evidenced by strong enhancements of the zero-phonon and first phonon replica of the excitonic emission, which are accompanied by a total suppression of its second phonon replica. This effect can be explained by the reduction of the band bending within the ZnO NW core that follows the removal of atmospheric adsorbates and associated surface traps during the MgO growth process on one hand, and a reduced exciton-phonon coupling as a result of the mechanical stabilization of the outermost ZnO NW monolayers by the MgO shell on the other hand. The second effect is the gradual increase of the excitonic emission and decrease in the defect related emission by up to two and one orders of magnitude, respectively, when w is increased in the ∼3-17 nm range. Uniaxial strain build-up within the ZnO NW core with increasing w, as detected by x-ray diffraction measurements, and photocarrier tunneling escape from the ZnO core through the MgO shell enabled by defect-states are proposed as possible mechanisms involved in this effect. These findings are expected to be of key significance for the efficient design and fabrication of ZnO/MgO NW heterostructures and devices.

Glucose biosensor based on functionalized ZnO nanowire/graphite films dispersed on a Pt electrode.

We present a glucose biosensor based on ZnO nanowire self-sustained films grown on compacted graphite flakes by the vapor transport method. Nanowire/graphite films were fragmented in water, filtered to form a colloidal suspension, subsequently functionalized with glucose oxidase and finally transferred to a metal electrode (Pt). The obtained devices were evaluated using scanning electron microscopy, energy-dispersive x-ray spectroscopy, cyclic voltammetry and chronoamperometry. The electrochemical responses of the devices were determined in buffer solutions with successive glucose aggregates using a tripolar electrode system. The nanostructured biosensors showed excellent analytical performance, with linear response to glucose concentrations, high sensitivity of up to ≈17 µA cm(-2) mM(-1) in the 0.03-1.52 mM glucose concentration range, relatively low Michaelis-Menten constant, excellent reproducibility and a fast response. The detection limits are more than an order of magnitude lower than those achievable in commercial biosensors for glucose control, which is promising for the development of glucose monitoring methods that do not require blood extraction from potentially diabetic patients. The strong detection enhancements provided by the functionalized nanostructures are much larger than the electrode surface-area increase and are discussed in terms of the physical and chemical mechanisms involved in the detection and transduction processes.

ZnO nanowire co-growth on SiO2 and C by carbothermal reduction and vapour advection.

Vertically aligned ZnO nanowires (NWs) were grown on Au-nanocluster-seeded amorphous SiO(2) films by the advective transport and deposition of Zn vapours obtained from the carbothermal reaction of graphite and ZnO powders. Both the NW volume and visible-to-UV photoluminescence ratio were found to be strong functions of, and hence could be tailored by, the (ZnO+C) source-SiO(2) substrate distance. We observe C flakes on the ZnO NWs/SiO(2) substrates which exhibit short NWs that developed on both sides. The SiO(2) and C substrates/NW interfaces were studied in detail to determine growth mechanisms. NWs on Au-seeded SiO(2) were promoted by a rough ZnO seed layer whose formation was catalysed by the Au clusters. In contrast, NWs grew without any seed on C. A correlation comprising three orders of magnitude between the visible-to-UV photoluminescence intensity ratio and the NW volume is found, which results from a characteristic Zn partial pressure profile that fixes both O deficiency defect concentration and growth rate.

From amorphous to crystalline silicon nanoclusters: structural effects on exciton properties.

Synchrotron x-ray absorption spectroscopy (XAS) and electron spin resonance (ESR) experiments were performed to determine, in combination with Raman spectroscopy and x-ray diffraction (XRD) data from previous reports, the structure and paramagnetic defect status of Si-nanoclusters (ncls) at various intermediate formation stages in Si-rich Si oxide films having different Si concentrations (y = 0.36-0.42 in Si(y)O(1-y)), fabricated by electron cyclotron resonance plasma-enhanced chemical vapor deposition and isochronally (2 h) annealed at various temperatures (T(a) = 900-1100 °C) under either Ar or (Ar + 5%H(2)) atmospheres. The corresponding emission properties were studied by stationary and time dependent photoluminescence (PL) spectroscopy in correlation with the structural and defect properties. To explain the experimental data, we propose crystallization by nucleation within already existing amorphous Si-ncls as the mechanism for the formation of the Si nanocrystals in the oxide matrix. The cluster-size dependent partial crystallization of Si-ncls at intermediate T(a) can be qualitatively understood in terms of a 'crystalline core-amorphous shell' Si-ncl model. The amorphous shell, which is invisible in most diffraction and electron microscopy experiments, is found to have an important impact on light emission. As the crystalline core grows at the expense of a thinning amorphous shell with increasing T(a), the PL undergoes a transition from a regime dominated by disorder-induced effects to a situation where quantum confinement of excitons prevails.

Influence of socio-demographic, clinical and functional factors on the severity of dementia.

Dementia is one of the most relevant illnesses due to its functional impact on the elderly. The aim of the present study was to determine the influence of socio-demographic, clinical, cognitive and functional factors on the severity of dementia in elderly individuals. One hundred six elderly individuals with a diagnosis of dementia as determined by the DSM-IV/APA participated in the study. Cognition was assessed by the mini-mental state examination (MMSE); functional performance of basic and instrumental activities of daily living (BADLs and IADLs) was assessed by the Katz index (KI), Lawton-Brody index (LBI) and Pfeffer index (PI). The severity of dementia was established through the clinical dementia rating (CDR). In order to determine the influence of factors on the degree of dementia, ordinal regression analysis was performed. Age, MMSE, KI, LBI and PI scores had statistically significant associations to the severity of dementia. However, only the age (odds ratio (OR) = 0.197; confidence interval (CI) = 0.060-0.643) and performance in IADLs (LBI: OR = 1.237, CI = 1.077-1.422; PI: OR = 0.641, CI = 0.548-0.750) were maintained in the final ordinal regression model, R(2) = 0.818. The results show that elderly individuals over 80 years of age and those with a more compromised performance in IADLs have a greater chance of exhibiting more severe degrees of dementia. These findings suggest that the ability to perform IADLs may be an important variable in differentiating degrees of the severity of dementia.

Electrical characteristics of core-shell p-n GaAs nanowire structures with Te as the n-dopant.

GaAs nanowire (NW)-based p-n photovoltaic devices, with two distinct p and n spatial distributions and where Te was the n-dopant, have been studied by impedance spectroscopy in the 10(3)-10(7) Hz frequency range and the - 1.5-1.5 V bias range. For a large n-core/p-shell overlap region within NWs in a coaxial geometry, the p-n junction properties (DC rectification and p-n depletion capacitance) are found to prevail. The impedance data at low bias for both NW devices show large frequency dispersions with relaxation frequencies that are compatible with carrier re-emission times from traps due to GaAs surface states. An increasing conductance with increasing frequency for low bias is observed, suggesting hopping transport through localized states. For large bias the conductance increases exponentially with bias and is frequency independent, indicating conduction through extended states in this regime.

Predicting mobility gains among children with cerebral palsy after application of botulinum toxin A / Predizendo ganhos de mobilidade em crianças com paralisia cerebral após aplicação de toxina botulínica A

BACKGROUND: Botulinum toxin A (BTA) is commonly used to treat children with cerebral palsy (CP). However, the variables measured before BTA application and associated with motor function and independent mobility, known as predictors of functional outcomes, have not been well defined. OBJECTIVE: To identify clinical predictors of gains in functional motor skills and independence of mobility among children with CP, three and six months after BTA application. METHODS: This was a convenience sample of children with spastic CP (n=35). Measurements of quantitative gains in motor skills and independence of mobility were taken three and six months after BTA application. These outcomes were observed through repeated applications of two functional tests: GMFM (Gross Motor Function Measure) and PEDI (Pediatric Evaluation of Disability Inventory). These tests evaluated gross motor function while sitting or standing and during transitions between these postures, and also during dynamic activities such as walking, running and jumping, along with the children's independence in mobility tasks. The independent variables included the children's characteristics such as age, severity, topographic diagnosis, neuromuscular-skeletal parameters (range of motion and spasticity), gait quality and performance in the functional tests before BTA. RESULTS: Four predictive models were developed (R² between 0.58 and 0.83; p<0.05) through the use of CART analysis: two at three months and two at six months after BTA application. The results indicated that children with better gait quality, smaller repertoire of functional motor skills, less independence of locomotion and age below four years and six months before BTA presented greater gains in motor skills and independence in mobility. CONCLUSION: The results identified significant clinical parameters that can predict functional outcomes of BTA applications among children with CP.

CONTEXTUALIZAÇÃO: A toxina botulínica A (TBA) é comumente utilizada em crianças com paralisia cerebral (PC), entretanto preditores de desfechos funcionais, ou seja, variáveis mensuradas pré-aplicação da TBA e associadas a ganho na função motora e independência na mobilidade não são bem definidos. OBJETIVO: Identificar preditores clínicos de ganho em habilidades motoras funcionais e independência em mobilidade em crianças com PC, aos três e seis meses pós-aplicação de TBA. MÉTODOS: Amostra de conveniência de crianças com PC espástica (n=35). As medidas incluíram: melhora quantitativa nas habilidades motoras e na independência em mobilidade aos três e seis meses após a aplicação da TBA. Esses desfechos foram observados por meio de aplicações repetidas dos testes funcionais GMFM (Gross Motor Function Measure) e PEDI (Pediatric Evaluation of Disability Inventory). Esses testes avaliaram a função motora grossa durante a manutenção e transições entre as posturas sentada e de pé, além de atividades dinâmicas como andar, correr e pular, e a independência da criança em tarefas de mobilidade. As variáveis independentes incluíram características das crianças como idade, severidade e diagnóstico topográfico, parâmetros neuromusculoesquelético (amplitude de movimento, espasticidade), qualidade da marcha e desempenho nos testes funcionais antes da TBA. RESULTADOS: Foram gerados quatro modelos preditivos (R² entre 0,58 e 0,83; p<0,05), dois aos três e dois aos seis meses após a aplicação da TBA, a partir da análise CART. Os resultados indicaram que crianças com melhor qualidade da marcha, menor repertório de habilidades da função motora, menor independência na locomoção e idade menor que quatro anos e seis meses pré TBA apresentaram maior ganho de habilidades motoras e de independência em mobilidade. CONCLUSÃO: Os resultados identificaram parâmetros clínicos importantes de serem documentados em crianças com PC submetidas à aplicação da TBA para predizer...

[Evaluation of two immunochromatography kits for rapid diagnosis of rotavirus infections]. / Evaluación de dos equipos inmunocromatográficos comerciales para el diagnóstico rápido de la infección por rotavirus.

A prospective study was conducted to evaluate two immunochromatography (ICG) commercial kits for diagnosis of rotavirus infection, VIKIA Rota-Adeno (bioMérieux) and Simple Rota-Adeno (Operon). Reverse transcriptase and polymerase chain reaction (RT-PCR) with specific primers for the VP7 gene of group A rotavirus was used as the reference method. The sensitivity and specificity of the ICG tests compared with those of the reference method were 98.4% and 84.8%, respectively, for Simple Rota-Adeno (Operon), and 100% and 24.2% for VlKIA Rota-Adeno (bioMérieux). It is remarkable the low specificity of the latter method, which yields a high number of false positive results. The predictive value of a positive result by this method was only 71.6%. Most of the detected rotavirus strains corresponded to genotype G9P[8] (65%), followed by G1P[8] (25.4%) and G2P[8] (3.2%).

Evaluación de dos equipos inmunocromatográficos comerciales para el diagnóstico rápido de la infección por rotavirus / Evaluation of two immunochromatography kits for rapid diagnosis of rotavirus infections

Se realizó un estudio prospectivo para evaluar dos equipos comerciales inmunocromatográficos para el diagnóstico rápido de infección por rotavirus a partir de muestras fecales: VIKIA® Rota-Adeno, de bioMérieux, y Simple Rota- Adeno, de Operon. Como método de referencia se utilizó la transcripción reversa y reacción en cadena de la polimerasa (RT-PCR) con cebadores específicos del gen de la proteína VP7 de rotavirus del grupo A. La sensibilidad y la especificidad respecto de la RT-PCR fueron del 98,4% y 84,8% para el Simple Rota-Adeno, y del 100% y 24,2% para el VIKIA® Rota-Adeno. Es de destacar la baja especificidad de este último equipo diagnóstico, que presentó un elevado número de falsos positivos, por lo que el valor predictivo de un resultado positivo es sólo del 71,6%. Asimismo, se identificaron los genotipos de las cepas de rotavirus detectadas; la mayoría de ellas correspondieron al genotipo G9P(8) (65%), seguido de los genotipos G1P(8) (25,4%) y G2P(8) (3,2%).

A prospective study was conducted to evaluate two immunochromatography (ICG) commercial kits for diagnosis of rotavirus infection, VIKIA® Rota-Adeno (bioMérieux) and Simple Rota-Adeno (Operon). Reverse transcriptase and polymerase chain reaction (RT-PCR) with specific primers for the VP7 gene of group A rotavirus was used as the reference method. The sensitivity and specificity of the ICG tests compared with those of the reference method were 98.4% and 84.8%, respectively, for Simple Rota-Adeno (Operon), and 100% and 24.2% for VIKIA® Rota-Adeno (bioMérieux). It is remarkable the low specificity of the latter method, which yields a high number of false positive results. The predictive value of a positive result by this method was only 71.6%. Most of the detected rotavirus strains corresponded to genotype G9P(8) (65%), followed by G1P(8) (25.4%) and G2P(8) (3.2%).

Um olhar sobre as LER/DORT no contexto clínico do fisioterapeuta / A look into Repetitive Strain Injury/Work-Related Musculoskeletal Disorders within physical therapists' clinical context

OBJETIVO: Conhecer as representações do fisioterapeuta a respeito das Lesões por Esforços Repetitivos/Distúrbios Osteomusculares Relacionados ao Trabalho (LER/DORT) e analisar como essas representações interferem na prática clínica desses profissionais. MÉTODOS: O estudo foi realizado numa abordagem qualitativa, e os recursos metodológicos foram entrevista semi-estruturada e observação não-participante. A teoria das representações sociais e a epistemologia comparativa serviram como referenciais teóricos. Participaram do estudo 14 fisioterapeutas da cidade de Divinópolis, Minas Gerais. RESULTADOS: a representação dos fisioterapeutas sobre LER/DORT e o doente foi elaborada coletivamente, com base na realidade cotidiana, e configurou-se entre os entrevistados um estilo de pensamento reducionista, com uma concepção mecanicista do organismo humano. CONCLUSÕES: não basta concentrar esforços na tentativa de restaurar o funcionamento normal do corpo se as demandas do paciente são desconsideradas. O conhecimento técnico-científico do fisioterapeuta deve ser conciliado com a expressão subjetiva do paciente na busca de estratégias de intervenção mais eficazes.

OBJECTIVE: To understand physical therapists' representations regarding Repetitive Strain Injury/Work-Related Musculoskeletal Disorders (RSI/WRMSD) and to analyze how these representations interfere with the clinical practice of these professionals. METHODS: The study took a qualitative approach, and the methodological tools were semi-structured interviews and non-participatory observation. The theory of social representations and comparative epistemology served as the theoretical foundations for the study. Fourteen physical therapists from the city of Divinópolis, Minas Gerais, took part in this study. RESULTS: The physical therapists' representations about RSI/WRMSD and patients were collectively elaborated on the basis of the therapists daily practice. A reductionistic thinking style with a mechanistic conceptualization of the human organism was perceived among the interviewees. CONCLUSIONS: It is insufficient to direct efforts towards restoring the normal functioning of the body if the patient's needs are ignored. Physical therapists' scientific and technical knowledge should be reconciled with patients' subjective expression, in order to seek more effective intervention strategies.

Qualidade de vida na perspectiva de idosas com incontinência urinária / Quality of life from the perspective of elderly women with urinary incontinence

CONTEXTUALIZAÇÃO: A incontinência urinária (IU), condição clínica comum entre idosos, pode comprometer a qualidade de vida (QV) e, por esta razão, avaliar as repercussões sobre a mesma torna-se relevante. OBJETIVO: Desvendar como idosas submetidas a tratamento fisioterapêutico para IU percebem sua QV atual. METODOLOGIA: Este foi um estudo qualitativo que, por meio de entrevistas individuais semi-estruturadas, pesquisou a QV na perspectiva de doze idosas com 60 anos e mais. O tamanho da amostra foi determinado por meio de saturação. As entrevistas foram gravadas, transcritas e posteriormente analisadas pela técnica da análise de conteúdo. RESULTADOS: A QV vinculou-se à saúde, autonomia, relacionamentos pessoais, estabilidade financeira e vida ativa. O comprometimento psicológico vinculou-se à preocupação e desagrado diante das perdas urinárias e receio de elas ocorrerem em locais não apropriados. O constrangimento de outras pessoas perceberem o odor de urina e a vivência prévia de situações também constrangedoras vincularam-se ao comprometimento social. CONCLUSÕES: A análise do conteúdo das entrevistas permitiu concluir que, apesar de a IU estar presente na vida das idosas, trazendo prejuízos psicológicos e sociais, a QV foi positivamente percebida.

BACKGROUND: Urinary incontinence (UI) is a common clinical condition among elderly people and may interfere with quality of life (QOL). For this reason, assessing its repercussions becomes important. OBJECTIVE: To ascertain how elderly women undergoing physical therapy for UI perceived their current QOL. METHOD: This was a qualitative study that investigated QOL from the perspective of twelve elderly women aged 60 years and over, by means of individual semistructured interviews. The sample size was determined by saturation. The interviews were recorded, transcribed and then analyzed using the content analysis technique. RESULTS: QOL was correlated with health, autonomy, personal relationships, financial stability and active life. Psychological impairment was associated with concern and disgust regarding urine loss and fear that this might occur in inappropriate places. Embarrassment because other people had noticed the smell of urine, and previous experience of similar embarrassing situations, was associated with social impairment. CONCLUSION: Content analysis on the interviews allowed the conclusion that, even though UI was present in these elderly women's lives and caused psychological and social harm, they had a positive perception of their QOL.

Avaliação das atividades de vida diária de idosos com diferentes níveis de demência / Evaluation of the activities of daily living of elderly people with different levels of dementia

OBJETIVOS: Comparar o desempenho de idosos com diferentes níveis de gravidade de demência em questionários de atividades básicas de vida diária (ABVDs) e atividades instrumentais de vida diária (AIVDs). Verificar se existe correlação entre os questionários de AIVDs aplicados. METODOLOGIA: Foram aleatorizados 90 idosos (75,46 ± 7,66 anos) atendidos no Centro de Referência do Idoso-MG, com diagnóstico clínico de demência (DSM-IV/APA) e classificados quanto ao nível de gravidade da demência (Clinical Dementia Rating). As ABVDs foram avaliadas pelo índice de Katz, e as AIVDs, pelo índice de Lawton-Brody e de Pfeffer. Os testes de Kruskal-Wallis e de Mann-Whitney foram utilizados para verificar o desempenho dos idosos nas ABVDs, e a correlação de Spearman, para investigar a relação entre os instrumentos de AIVDs (alfa< 0,05). RESULTADOS: Foram encontradas diferenças estatisticamente significativas entre o desempenho dos idosos com diferentes níveis de gravidade de demência avaliados pelos instrumentos de ABVDs e AIVDs (p< 0,001). Os questionários de AIVDs apresentaram correlação significativa na amostra total (p< 0,0001; r= -0,818), nos grupos com demência leve (p= 0,007; r= -0,530) e grave (p< 0,0001; r= -0,723). CONCLUSÃO: A gravidade do processo demencial interferiu no desempenho dos idosos nas atividades básicas e instrumentais de vida diária. As AIVDs foram mais comprometidas nos estágios iniciais das demências, e as ABVDs, nos estágios mais avançados. Os questionários de AIVDs utilizados, apesar de sua particularidade estrutural, parecem medir um construto comum. A variabilidade do quadro clínico nos indivíduos com demência moderada pode explicar a ausência de correlação dos questionários usados nesse grupo específico.

OBJECTIVE: To compare the performance of elderly people with different levels of severity of dementia using questionnaires on basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). Also, to verify whether there were any association between the IADL questionnaires applied. METHOD: Ninety elderly people, aged 75.46 ± 7.66 years with a clinical diagnosis of dementia (DSM-IV/APA) who were seen at the Minas Gerais Reference Center for the Elderly, were randomized selected and classified according to the level of severity of their dementia (Clinical Dementia Rating). Their BADLs were assessed using the Katz Index and their IADLs by the Lawton-Brody and Pfeffer indexes. The Kruskal-Wallis and Mann-Whitney tests were used in order to investigate the elderly people's performance regarding BADLs, while the Spearman correlation was used to investigate the relationships among the IADL (alpha< 0.05). RESULTS: Statistically significant differences in performance were found between the elderly people with different levels of severity of dementia, as assessed by the BADL and IADL questionnaires (p< 0.001). The IADL questionnaires presented significant correlation for the total sample (p< 0.0001; r = -0.818) as well as for the groups with mild dementia (p= 0.007; r = -0.530) and severe dementia (p< 0.0001; r = -0.723). CONCLUSION: The severity of the dementia process interfered with the elderly people's performance of the elderly in BADLs and IADLs. The IADLs were more affected in the early stages of dementia whereas the BADLs were more affected in the more advanced stages. Despite structural particularities, the IADL questionnaires utilized seemed to be measuring a common construct. The variability in the clinical condition of the individuals with moderate dementia may be an explanation for the lack of correlation between the questionnaires in this specific group.

Efeitos do uso de ortese na mobilidade funcional de criancas com paralisia cerebral / The effects of the use of orthoses on the functional mobility of children with cerebral palsy

Comparar o desempenho de criancas com paralisia cerebral (PC) em duas condicoes: com ortese e sem ortese. Metodos: vinte criancas PC foram avaliadas utilizando-se o teste Gross Motor Function Measure (GMFM), a versao modificada da avaliacao da marcha Physicians Rating Scale (PRS) e entrevista com os pais para avalair o uso de oreteses na rotina diaria. Resultados: o teste ANOVA que foi utilizado para avaliar o efeito do uso ortese na mobilidade das criancas revelou medias significativamente superiores na condicao com ortese durante o desempenho motor grosso e na marcha. entrevistas informaram que o uso de orteses estava inserido na rotina diaria e os pais demonstraram percepcao positiva com relacao ao uso desse dispositivo. Conclusao: as orteses promoveram o desempenho de tarefas motoras da rotina diaria de criancas com PC, podendo orientar os processos de avaliacao e de intervencao dos profissionais que trbalaham com essa clientela

Gravidade da paralisia cerebral e desempenho funcional / Severity of cerebral palsy and functional performance

A paralisia cerebral (PC) e um disturbio do movimento e da postura que resulta de lesao cerebral nao-progressiva ocorrida no periodo inicial do desenvolvimento infantil, podendo apresentar sintomatologia variada, que caracteriza a gravidade do comprometimento neuromotor. Embora a literaturae disponibilize evidencias sobre a gravidade do comprometimento neuromotor desse grupo clinico, informacoes msobre a manifestcao sobre as diferentes categorias de gravidade na capacidade e na independencia da crianca para realizar atividades do seu cotidiano nao estao bem documentadas. O objetivo deste estudo foi comparar o impacto da gravidade neuromotora ao perfil funcional das criancas portadoras de PC. Trinta e seis criancas portadoras de paralisia cerebral com niveis de compxrometimento neuromotor leve, moderado ou grave classificados pelo GMFCS foram avaliadas pelo teste PEDI, que informa sobre as habilidades funcionais e a independencia da crianca nas areas de autocuidado, mobilidade e funcao social

[Monoclonal antibodies to dengue virus 4: the spectrum of the reactivity to 4 serotypes of dengue]. / Anticuerpos monoclonales al virus dengue 4: espectro de reactividad a los 4 serotipos del dengue.

These types of monoclonal antibodies 8E8, 3F7 and 1E9 to dengue 4 virus H-241 strain. These monoclonal antibodies show various patterns of reactivity to the four dengue serotypes and different antigen preparations of serotype 4 when they were tested in various serological methods. The monoclonal antibody 8E8 exhibited a specificity of serotype (D-2; by hemagglutination inhibition); subcomplex (D-2 and D-4 by immunofluorescence) and complex (by immunoperoxidase technique). It was able to neutralize by 80% homologous virus and it turned out to be the only reactive monoclonal antibody in the complement fixation test. The monoclonal 3F7 did not react to by hemagglutination inhibition, recognized serotypes D-1, D-2, D-3 and D-4 by immunofluorescence and only serotypes D1 and D4 by immunoperoxidase technique but it was unable to neutralize the homologous virus. The 1E9 antibody was reactive to serotypes D1, D-2, D-3 and D-4 only by hemagglutination inhibition and neutralized serotype D-4. All the monoclonal antibodies were able to react to various dengue antigens through an ELISA of double antibody and showed fluorescent activity against 38th pass in Beagle dog kidney culture; however, they could not react to a D-4 recombinant antigen.

Cistitis por garnerella vaginalis: reporte de caso y revisión / Vaginalis gardnerella cystitis: a case report and review

Se reporta el caso de una paciente con cistitis en donde se aisló Gardnerella vaginalis. Se trata de paciente femenino de 71 años de edad que presentó disuria, poliaquiuria, micción imperiosa y dolor suprapúbico, sin otra sintomatología. Refirió orina turbia a simple vista, además de mal olor de la misma. Al examen físico no se evidenció ningún signo sugestivo, por ejemplo de vaginosis bacteriana, según los criterios clínicos. Una hematología reveló leve linfopenia. Al examen de orina ésta fue aspecto turbio, con signos sugestivos de infección urinaria. Al realizar el urocultivo, en este creció y se identificó Gardnerella vaginalis. Se indicó Metronizadol. Se evidenció adecuada respuesta al tratamiento y resolución del cuadro clínico. El papel de G. vaginalis en las infecciones urinarias se discute, ya que es raro encontrale en infecciones extra-vaginales