Efeito da equoterapia no equilíbrio de idosos: uma revisão sistemática com metanálise / Effect of hippotherapy on older balance: a systematic review with methanalysis

A prática regular de exercícios físicos de diferentes naturezas tem sido amplamente recomendada para a população idosa, em virtude dos inúmeros benefícios relacionados à capacidade funcional e cognitiva nesta etapa da vida, aumentando a longevidade com independência funcional. Os efeitos da equoterapia na melhora do equilíbrio postural estão sendo cada vez mais estudados nas diversas populações, contudo, os estudos sobre esses efeitos em idosos são recentes. Dada a importância de melhorar a prática baseada em evidências, surgiu o interesse em realizar uma síntese rigorosa de todas as consultas relacionadas com o efeito da equoterapia no equilíbrio de idosos. Esta revisão seguiu as recomendações do Preferred reporting items for Systematic Reviews and Meta-análise (PRISMA) e registrado em um banco de dados internacional de revisões sistemáticas (PROSPERO). Foram selecionados artigos de bases de dados BIREME, SCIELO, MEDLINE CINAHAL, EBSCHOST e ISI, publicados em português e inglês. As palavras-chaves utilizadas foram: "equoterapia" OR "terapia assistida por animais" AND "equilíbrio postural" AND "idoso", presentes no título ou nos resumos dos artigos. Os artigos foram avaliados com base em seu nível de evidência e conduta. Utilizou-se a escala PEDro, para avaliação metodológica dos artigos incluídos na revisão. Identificou-se 20 estudos; 4 preencheram os critérios de inclusão. Estudos sobre os efeitos de equoterapia em idosos apresentam uma homogeneidade (I2 = 0 %) e uma melhora significativa (p = 0,001) equilíbrio. Embora os estudos apontem que a equoterapia seja benéfica para a melhora do equilíbrio postural, somente 4 estudos foram analisados, havendo necessidade de mais pesquisas que relacionem essas variáveis na população idosa....(AU)

The regular practice of physical exercises of diff erent natures has been widely recommended for the elderly population, due to the innumerable benefi ts related to functional and cognitive capacity in this stage of life, increasing the longevity with functional independence.The eff ects hippotherapy on the improvement of postural balance are being increasingly studied in diff erent populations, however, studies on these eff ects in the elderly are recent. Given the importance of improving evidence-based practice, the interest in performing a rigorous synthesis of all queries related to the eff ect of hippotherapy on balance postural. This review followed the reporting items Preferred recommendations for Systematic Reviews and Meta-analysis (PRISMA) And registered in an international database of systematic reviews (PROSPERO). Were selected articles from databases BIREME, SCIELO, MEDLINE CINAHAL, EBSCHOST e ISI, published Portuguese and English. The key words used were: hippotherapy, therapeutic riding, postural balance and elderly, present in the title or summary of articles. Were used the PEDro scale for methodological evaluation of the articles included in the review. It identifi ed 20 studies; 4 met the inclusion criteria. Studies on the eff ects of hippotherapy in older adults homogeneity (I2 = 0 %) and a signifi cant improvement (p = 0.001) in the functional capacity of the elderly. Although the studies indicate that hippotherapy is benefi cial for the improvement of postural balance, only 4 studies were analyzed, and there is a need for research that relates these variables to the elderly population....(AU)

Breaking down barriers: enabling care-by-parent in neonatal intensive care units in China.

BACKGROUND: Denying parents access to their infant in the Neonatal Intensive Care Unit (NICU) is a standard practice in most hospitals across China. Visitation is not usually permitted or may be strictly limited, and NICU care for most neonates is provided by health-care professionals with little participation of the parents. An exception to this rule is the level 2 "Room-In" ward in Qilu Children's Hospital, Shandong University, where parents have 24-hour access to their infants and participate in providing care. METHODS: This retrospective cohort study compared the outcomes of infants who were admitted to the NICU and remained there throughout their stay (NICU-NICU group, n=428), admitted to the NICU and then transferred to the Room-In ward (NICU-RIn group, n=1018), or admitted straight to the Room-In ward (RIn only group, n=629). RESULTS: There were no significant differences in the rates of nosocomial infection, bronchopulmonary dysplasia, intraventricular hemorrhage, and retinopathy of prematurity between the NICU-NICU and NICU-RIn groups. The rate of necrotizing enterocolitis was significantly lower in the NICU-RIn group (P=0.04), while weight gain and duration of hospital stay were significantly higher (both P<0.001). Rates of adverse outcomes were lower in RIn-only infants due to their low severity of illness on admission. CONCLUSIONS: Allowing parents access to their infant in the NICU is feasible and safe in China, and may result in improvements in infant outcomes. Further studies are required to generate stronger evidence that can inform changes to neonatal care in China.

[Balloon dilatation bronchoplasty in management of bronchial stenosis in children with mycoplasma pneumonia].

OBJECTIVE: To assess the efficacy and safety of balloon dilatation through flexible bronchoscopy in the management of inflammatory stenosis of grade 4-5 bronchus. METHOD: Thirty patients with inflammatory bronchial stenosis caused by mycoplasmal pneumonia complicated with pulmonary atelectasis were treated with balloon dilatation through fiberoptic bronchoscopy. Before the procedure and after the last operation, therapeutic effect on pulmonary atelectasis were evaluated with CT and all of the patients were followed-up for 1 - 6 months. RESULT: One to three operations were required to achieve satisfactory dilatation. After balloon dilatation, the average airway diameter increased obviously and the farther airways were opened after the therapy with irrigation. In 25 of 30 cases satisfactory immediate effects were obtained, a narrow airway diameter above expansion significantly increased as compared with preoperative diameter. In 5 children treated with balloon dilatation, the stenosis could not be improved significantly. In 3 patients with hyperplasia of granulation tissue, cryotherapy had to be applied. The operations were ineffective in the other two patients whose course of disease exceeded 3 months. After follow-up periods of 1 - 6 months, chest CT manifestation of expanded sites was improved in 28 patients and atelectasis disappeared. No severe complication was found in any patients. CONCLUSION: Bronchoplasty by balloon dilatation through flexible fiberoptic bronchoscopy is a simple, effective and safe method to treat childhood tracheobronchial stenosis after pulmonary infections.

[Leber hereditary optic neuropathy and optic neuritis: similarities and differences of clinical characteristics].

OBJECTIVE: To compare the clinical characteristics of Leber hereditary optic neuropathy (LHON) with optic neuritis (ON). METHODS: The information of clinical manifestation and laboratory tests in 55 patients with LHON and 48 patients with ON were reviewed and analyzed. RESULTS: Compared with ON, LHON was more commonly found in male patients (46/55 vs 21/48) and onset at younger age (median 16 years vs 30 years). There were more LHON than ON patients with the decrease of visual acuity lasted more than two weeks (42/49 vs 10/48), severe damage in visual acuity whereas little pain sensation in eye associated with eye movement (3/55 vs 26/48), dominant single-phase course (53/55 vs 30/48), central scotoma (26/39 vs 12/35), and family history of maternal relatives (25/50 vs 2/48). The visual evoked potential, cerebral spinal fluid and brain magnetic resonance scanning revealed the involvement of inflammatory demyelination in the patients with LHON. Most patients with LHON could be confirmed by the mtDNA mutation examination. CONCLUSIONS: Leber hereditary optic neuropathy has distinct clinical characteristics but overlap with optic neuritis in many aspects. mtDNA mutation examination can further confirm LHON in most of patients although a negative result may be seen in a small portion of patients showing typical manifestation of LHON.

[Clinical characteristic of optic neuritis and its relevancy with human leukocyte antigen].

OBJECTIVE: To investigate clinical characteristics of optic neuritis and its association with HLA (human leukocyte antigen). METHOD: The clinical data of 42 patients with optic neuritis were collected and flow polymerase chain reaction-reverse sequence specific oligonucleotide probe (PCR-rSSOP) was used to determine the genotype of HLA-DRB1. RESULTS: Two patients confirmed as Leber hereditary optic neuropathy by gene sequencing were excluded from the study. The complaint of pain was found in the patients (31/40) of optic neuritis. The visual field defect varied with patients and central and pericentral scotoma were demonstrated in 7 patients of 17. Of 40 patients with optic neuritis, 20 (50.0%) showed multifocal brain lesions in white matter by MR scanning. 26 of 38 patients had increased STIR signals. Inflammatory demyelinating changes were found in cerebral spinal fluid in 21 patients (80.8%). Out of demonstrated brain abnormal was revealed in 29 (72.5%) patients using MRI and/or CSF examination. The rate of HLA-DRB1(*)15 in the patients (35.0%) was much higher than control (19.4%), (chi(2) = 4.2328, P = 0.0397). Frequencies of HLA-DRB1(*)15 increased significantly in 26 female patients. The increased frequencies of HLA-DRB1(*)15 were associated with CSF abnormality and no relevancy was found with onset times, brain MR changes and increase of optic nerve signals. Acute optic neuritis responded well to intravenous megadose of methylprednisolone or immunoglobulin. CONCLUSIONS: Most of optic neuritis was characterized as clinical inflammatory demyelinating disease. HLA-DRB1(*)15 might correlated with genetic susceptibility of female patients with optic neuritis.

Primary investigation on variable but nonculturable-state of enterotoxigenic Escherichia coli in vitro / 中华流行病学杂志

<p><b>OBJECTIVE</b>7 variable but nonculturable-state strains of Enterotoxigenic Escherichia coli (ETEC) during the routine bacterial subculture were found in our lab and their morphology and antigen studied. Biological features, antigens and pathogenicity of the revertants were also tested and compared to that of the initial strains in order to detect their variations.</p><p><b>METHODS</b>Biological variations between the variable but nonculturable-state and the revertant of every strain were detected, using the routine gram-staining, reverting the isolates in animal intestinal, reverting their pathogenicity, serological agglutination, biochemical identifications and antibiotic resistance tests.</p><p><b>RESULTS</b>For the 7 variable but nonculturable-state strains of ETEC,other than the trains that had changed into sphero vegetale cells, there were no other obvious variations found. However, high pathogenicity of these strains still remained.</p><p><b>CONCLUSION</b>The presence of variable but nonculturable-state strains suggested that the routine method of bacteria storage should be changed and more attention should be paid to realize the existence of this kind of bacteria during the routine surveillance of the communicable diseases.</p>