RELATIONSHIP BETWEEN RESIDUAL DIURESIS AND SARCOPENIA IN PATIENTS ON HEMODIALYSIS.

OBJECTIVE: To assess the association of residual diuresis with sarcopenia in patients with Chronic Kidney Disease (CKD) on hemodialysis. METHODS: Through a cross-sectional study, patients on hemodialysis were subjected to a Dual Energy Radiologic Absorption (DEXA) exam to record muscle mass. Based on the volume of urine collected in 24 hours, patients were classified as anuric (diuresis ≤ 100 mL/day) or non-anuric (diuresis > 100 mL/day). Functional performance was evaluated by Short Physical Performance Battery (SPPB) and muscle strength by handgrip strength and 5-repetition sit-to-stand test. The association between the absence of residual urine and the presence of sarcopenia, low SPPB, and low muscle strength was analyzed using a binary logistic regression model. RESULTS: Ninety-two patients, with a mean age of 54.4 years (95% CI 51.3 - 57.4) and with a mean diuresis volume of 476.3 mL/day (95% CI 320.4 - 632.2) were evaluated (48 anuric and 44 non-anuric). Anuric patients had a 2.77 (95% CI 1.14 - 6.73) times greater probability of sarcopenia and had a 3.55 (1.14 - 11.0) times greater probability of low SPPB, regardless of gender, age, and time on dialysis. Gender was the other associated variable for the presence of sarcopenia, with males having a 3.30 (95% CI 1.34 - 8.13) times higher risk. There were no associations with muscle strength. CONCLUSION: The absence of residual diuresis in patients on hemodialysis is associated with a higher risk of sarcopenia and low functional performance.

Is vitamin D receptor (VDR) polymorphism associated with head and neck cancer risk? A systematic review and meta-analysis.

BACKGROUND: Head and neck cancer encompasses neoplasms affecting the oral cavity, pharynx, larynx, and thyroid. Identifying factors that modulate the carcinogenesis process can aid in identifying subgroups at higher risk of developing the disease, enabling implementation of prevention programs. Vitamin D receptor polymorphisms can affect the carcinogenesis of various tumors by altering vitamin D metabolism and cellular response. METHODS: To elucidate the role of vitamin D receptor polymorphisms in head and neck cancer, a systematic review was performed, searching the Embase, PubMed, Scopus, and Lilacs databases. A total of 19 articles met the inclusion criteria. The frequency of vitamin D receptors polymorphism alleles (FokI, ApaI, BsmI, TaqI, Cdx2, rs2107301, rs2238135) was recorded and pooled to calculate the odds ratio in a meta-analysis using the Review Manager software. RESULTS: Subgroup analysis demonstrated significant associations in the anatomical site of cancer (oral cancer in ApaI and BsmI, and unspecified subsites of head and neck cancer in TaqI), genotyping method (FokI and BsmI), and continent of the study (ApaI, FokI, and BsmI). CONCLUSION: Our findings were heterogeneous, as with other evidence available in the literature. Therefore, more clinical studies with larger sample sizes are needed to obtain more accurate results on the relationship between vitamin D receptor polymorphism and head and neck cancer.

Mechanisms of action of anti-inflammatory proteins and peptides with anti-TNF-alpha activity and their effects on the intestinal barrier: A systematic review.

Several studies in animal models of intestinal inflammation have been performed with the aim of understanding the mechanisms of action of anti-inflammatory proteins and peptides that reduce TNF-α. In order to present the best targets, effects and strategies for the treatment of intestinal inflammation in experimental models, this systematic review (SR) aimed to answer the following question: what are the mechanisms of action of molecules with anti-TNF-α activity on the intestinal barrier? The SR protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, number CRD42019131862) and guided by the methodological procedures used for the elaboration of the SR. Articles that were part of the SR were selected considering the eligibility criteria according to the PICO (Population, Intervention, Comparison/Control and Outcomes) and were searched in the PubMed, Scopus, Web of Science, Excerpta Medica Database (EMBASE) and ScienceDirect databases. Twenty-five articles reporting studies in rats and mice were selected and the risk of bias was assessed using the tool from the SYstematic Review Center for Laboratory Animal Experimentation (SYRCLE). A descriptive synthesis of the results obtained was carried out. Based on the results, the anti-inflammatory molecules that reduced TNF-α acted mainly on the TNF-TNFR1/TNFR2 and TLR4/MD2 complex signaling pathways, and consequently on the NF-κB pathway. This improved the aspects of the inflammatory diseases studied. In addition, these mechanisms also improved the macroscopic, histological and permeability aspects in the intestine of the animals. These findings point to the potential of protein and peptide molecules that act on inflammatory pathways for medical applications with specific and promising strategic targets, aiming to improve inflammatory diseases that affect the intestine. This systematic review also highlights the need for more details during the methodological description of preclinical studies, since this was a limitation found.

The influence of weaning age and biocholine supplementation to post-weaning growth and puberty in Brangus heifers.

This experiment was conducted to determine the effect of earlier weaning in addition to biocholine supplementation on age at puberty of Brangus heifers. Brangus calves were randomized and divided into three weaning ages groups, at 30 (Hyper-early weaning; HW), 75 (Early weaning; EW) and 180 days (Conventional weaning; CW). Then, calves were supplemented using the additive Biocholine (BIO) or not (CON). Animals were subjected to puberty induction and the presence of estrus was observed for 7 days. In addition, transrectal ultrasonography was performed to assess the ovarian activity and the presence of corpus luteum to determine heifer puberty. We also evaluated the body weight (BW; Kg), hip height (HH; cm), thoracic perimeter (TP; cm) and BW:HH ratio during the experimental period. BIO group showed higher ADG (>226 g/day) when the animals were exposed to ryegrass pasture compared to CON (P < 0.05). We observed an interaction between weaning x biocholine and CW-BIO heifers showed greater HH more compared to CW-CON (P < 0.05). Overall, animals that have reached puberty at day 8 after puberty induction showed 331.0 ± 5.04 kg BW, 122.0 ± 0.56 cm HH and 165.4 ± 0.75 cm TP and 2.7 ± 0.03 BW:HH. At the time of ovulation detection, the heifers from the HW group had 32.1 kg BW, 3.93 cm HH and 0.18 cm BW:HH greater compared to CW (P < 0.05). The BIO supplementation together with ryegrass pasture, led to an increase in ADG weight throughout the evaluated period. We concluded that HW heifers showed an adequate body development throughout the experimental period until puberty appearance at the same age as others weaned groups.

Can high-flow nasal cannula reduce the risk of bronchopulmonary dysplasia compared with CPAP in preterm infants? A systematic review and meta-analysis.

BACKGROUND: Bronchopulmonary dysplasia (BPD) is a chronic lung disease that affects the premature lung, and to reduce its incidence has been used non-invasive ventilatory support, such as continuous positive airway (CPAP) and high-flow nasal cannula (HFNC). Thus, the objective of this review was to assess whether the use of high flow nasal cannula (HFNC) compared to continuous positive airway pressure (CPAP) decreases the risk of bronchopulmonary dysplasia (BPD) in premature newborns. METHODS: The protocol was registered (Prospero: CRD42019136631) and the search was conducted in the MEDLINE, PEDro, Cochrane Library, CINAHL, Embase, and LILACS databases, and in the clinical trials registries, until July 2020. We included randomized clinical trials comparing HFNC versus CPAP use in premature infants born at less than 37 weeks of gestational age. The main outcome measures were the development of BPD, air leak syndrome, and nasal injury. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool and the GRADE system was used to summarize the evidence recommendations. Meta-analyses were performed using software R. RESULTS: No difference was found between HFNC or CPAP for the risk of BPD (RR: 1.10; 95% CI: 0.90-1.34), air leak syndrome (RR: 1.06; 95% CI: 0.52-2.14), and nasal trauma (RR: 2.00; 95% CI: 0.64-6.25), with a very low level of evidence. CONCLUSION(S): The HFNC showed similar results when compared to CPAP in relation to the risk of BPD, air leak syndrome, and nasal injury. In the literature, no randomized clinical trial has been found with BPD as the primary outcome to support possible outcomes.

Social network changes during the development of immature capuchin monkeys (Sapajus spp.).

Immature indivuduals influence the formation and maintenance of social relationships within groups in diverse ways. Because of the increased interest of group members toward newborns, lactating females may use infants as social tools to temporally gain rank positions in matrilineal societies, and differential support received by the mothers may bias the network of immatures born to females of different ranks. In this study, we investigated the changes in proximity, grooming, play, and agonism networks of lactating females and immatures of different developmental periods, sex, and mothers' dominance rank. A semi-free-ranging group of 22 capuchin monkeys (Sapajus spp) was monitored for 12 months, totaling over 300 hours of observation. During this period, the age changes of 13 immatures were monitored and recorded. Best regression models showed that an increased number of grooming partners while lactating did not translate into changes in the proximity or agonistic network positions for females. Age was the main predictor of social network changes, while sex had a minor influence on the play network and no influence on the grooming or agonistic networks. Finally, mothers' rank predicted differences in the affiliative but not the agonistic social network. This pattern points to a more affiliative and individual-based rather than agonistic and nepotism-based strategy for social network insertion, which can be explained by the decreased competition faced by the focal group and by the behavioral flexibility of the clade.

Photobiomodulation: systematic review and meta-analysis of the most used parameters in the resolution diabetic foot ulcers.

The most common photobiomodulation parameters used to aid in the treatment of diabetic foot ulcers were investigated in this paper. The databases MEDLINE, LILACS, MEDCARIB, PAHO-IRIS, and WHOLIS were searched with the following descriptors: diabetic foot ulcers AND low-level laser therapy OR low-level therapy AND wound healing; this search was conducted from January of 2014 to December of 2019. Inclusion criteria were randomized clinical trials on humans. Exclusion criteria were systematic reviews, literature reviews, studies with animals, studies lacking photobiomodulation parameters, and studies with non-diabetic individuals. The Jadad scale was used in order to analyze the methodological quality of the matching papers. There were seventeen studies found on PubMed and four on LILACS. Among these, seven were selected, according to the inclusion and exclusion criteria. Two out of the seven matching studies obtained a high score, and five obtained a low score, on the Jadad scale. The studies settled on the use of 600-nm and 800-nm wavelength spectrum. Most of the analyzed papers on photobiomodulation on diabetic foot ulcers did not describe the detailed parameters in their methodology. None of the studies featured the maximum score with regard to the Jadad scale for methodological quality. The relations of energy versus wavelength and power versus wavelength were divergent among the parameters on the papers. Therefore, it is necessary to analyze the parameters for an optimized power value in order to improve the results of the treatment.

Comparison of pelvic floor muscle training isolated and associated with weight loss: a randomized controlled trial.

PURPOSE: To analyze whether pelvic floor muscle training (PFMT) associated with weight loss (WL) is better than isolated PFMT to provide additional beneficial effects to urinary symptoms in women with MUI. METHODS: A randomized, simple-blind parallel controlled trial was performed and included women with MUI aged between 40 and 65 years and body mass index between 25 and 40 kg/m2. The sample was randomized into two groups: 11 PFMT + WL and 11 PFMT. Data collection was performed in baseline and after interventions. The primary outcome was to investigate the loss of urine. Secondary aim includes PFM pressure and quality of life. PFMT was performed with two sets of eight repetitions in the first 4 weeks, and with three sets of eight repetitions in the final 4 weeks. The weight loss program was based on the calculation of total energy value needs. Data analysis was performed by SPSS 20.0 software and one-way ANCOVA. RESULTS: 22 volunteers participated in the study. There was no intergroup significant difference in post-intervention ICIQ-SF F(1, 19) = 7.115, p = 0.87, partial η2 = 0.001; manometry F(1, 19) = 0.608, p = 0.44, partial η2 = 0.003; pad test 1 h F(1, 19) = 0.185, p = 0.67, partial η2 = 0.01; QoL F(1, 19) = 1.018, p = 0.32, partial η2 = 0.05; and weight F(1, 19) = 0.251, p = 0.62, partial η2 = 0.01. CONCLUSIONS: Weight loss did not provide additional beneficial effects to PFMT in women with overweight or obesity grade I with MUI symptoms.

Trypsin inhibitors: promising candidate satietogenic proteins as complementary treatment for obesity and metabolic disorders?

The increase in non-communicable chronic diseases has aroused interest in the research of adjuvants to the classic forms of treatments. Obesity and metabolic syndrome are the main targets of confrontation because they relate directly to other chronic diseases. In this context, trypsin inhibitors, molecules with wide heterologous application, appear as possibilities in the treatment of overweight and obesity due to the action on satiety related mechanisms, mainly in the modulation of satiety hormones, such as cholecystokinin. In addition, trypsin inhibitors have the ability to also act on some biochemical parameters related to these diseases, thus, emerging as potential candidates and promising molecules in the treatment of the obesity and metabolic syndrome. Thus, the present article proposes to approach, through a systematic literature review, the advantages, disadvantages and viabilities for the use of trypsin inhibitors directed to the treatment of overweight and obesity.

Increased risk of death and readmission after hospital discharge of critically ill patients in a developing country: a retrospective multicenter cohort study.

PURPOSE: To describe long-term mortality and hospital readmissions of patients admitted to Brazilian intensive care units (ICU). METHODS: Retrospective cohort study of adult patients admitted to Brazilian hospitals affiliated to the Public Healthcare System from 10 state capitals. ICU patients were paired to non-ICU patients by frequency matching (ratio 1:2), according to postal code and admission semester. Hospitalization records were linked through deterministic linkage to national mortality data. Primary outcome was mortality up to 1 year. Other outcomes were mortality and readmissions at 30 and 90 days and 3 years. Multiple Cox regressions were used adjusting for age, sex, cancer diagnosis, type of hospital, and surgical status. RESULTS: We included 324,594 patients (108,302 ICU and 216,292 non-ICU). ICU patients had increased hospital length of stay [9 (5-17) vs. 3 (1-6) days, p < 0.001] and mortality (18.5 vs. 3.6%, p < 0.001) versus non-ICU patients. One year after discharge, ICU patients were more frequently readmitted to hospital (25.4 vs. 17.4%, p < 0.001) and to ICU (31.4 vs. 7.3%, p < 0.001) than controls. Mortality up to 1 year was also higher for ICU patients (14.3 vs. 3.9%, p < 0.001). A significant interaction between surgical status and mortality was found, with adjusted hazard ratios (HRs) up to 1 year of 2.7 [95% confidence interval (CI) 2.5-2.9] for surgical patients, and 3.4 (95%CI 3.3-3.5) for medical patients. The risk for death and readmission diminished over time up to 3 years. CONCLUSIONS: In a public healthcare system of a developing country, ICU patients have excessive long-term mortality and frequent readmissions. The ICU burden tended to reduce over time after hospital discharge.

Preparation of cashew gum-based flocculants by microwave- and ultrasound-assisted methods.

In this work, copolymers based on cashew gum (CG) grafted with polyacrylamide (PAM) were synthesized by microwave- and ultrasound-assisted methods, using potassium persulfate as an initiator in aqueous medium. The graft copolymers were characterized by Fourier-transform infrared spectroscopy, nuclear magnetic resonance spectroscopy, and thermogravimetric analysis. The efficiency of the graft copolymers (CG-g-PAM) in flocculation of a kaolin suspension was studied. Results indicated that the graft copolymers synthesized by ultrasound energy had better flocculation properties than the ones synthesized by the microwave-assisted method. The biodegradability of the graft copolymers was tested by inoculation with the basidiomycete Trametes villosa in liquid medium. The higher formation of biomass than that observed with the commercial flocculant Flonex-9045 indicated that the graft copolymer was accessible to enzymatic attack.

Suporte on-line às crianças e adolescentes doentes crônicos: uma revisão integrativa / Online support for chronically ill children and adolescents: an integrative review

Objetivo: Caracterizar a produção científica relacionada com o suporte on-line direcionado a crianças e adolescentes com doença crônica. Síntese do conteúdo: Trata-se de uma revisão integrativa. Realizou-se uma busca no período de 2008 a 2017 nas bases de dados PubMed, Biblioteca Virtual em Saúde, Cumulative Index to Nursing and Allied Health Literature (CINAHL) e ScienceDirect. Foram encontrados 30 artigos, organizados e caracterizados por título, autores, ano de publicação, país de proveniência, base de dados, tipo de estudo e objetivos. A temática reportou maior produção de conhecimento no período de 2012 a 2014. A tendência de pesquisa orientase em duas categorias: Avaliação das ferramentas de suporte on-line direcionadas a crianças e adolescentes com doença crônica e Percepção das famílias e profissionais de saúde sobre a usabilidade das ferramentas de suporte on-line direcionadas a crianças e adolescentes com doenças crônicas. Conclusão: O suporte on-line é um complemento importante às atividades de promoção à saúde para as famílias. É disponibilizado por meio de sites e programas on-line; apresenta potencialidades e fragilidades na usabilidade e constitui-se em um novo desafio para os profissionais de saúde.

Objetivo: Caracterizar la producción científica relacionada con el soporte en línea dirigido a niños y adolescentes con enfermedad crónica. Síntesis del contenido: Se trata de una revisión integrativa. Se realizó una búsqueda que abarcó el período 2008-2017 en las bases de datos PubMed, Biblioteca Virtual em Saúde, Cumulative Index to Nursing and Allied Health Literature y ScienceDirect. Se encontraron 30 artículos, organizados y clasificados por título, autor, año de publicación, país de origen, base de datos, tipo de estudio y objetivos. Los hallazgos informaron sobre una mayor producción de conocimiento en el período 2012-2014. La tendencia de investigación se orientó de acuerdo a dos categorías: Evaluación de las herramientas de soporte en línea dirigidas a niños y adolescentes con enfermedad crónica y La percepción de las familias y los profesionales de la salud sobre el uso de las herramientas de soporte en línea dirigidas a niños y adolescentes con enfermedad crónica. Conclusión: El soporte en línea es un complemento importante de las actividades de promoción de la salud para las familias. Está disponible en sitios web y en programas en línea; tiene fortalezas y debilidades en cuanto al uso y constituye un nuevo desafío para los profesionales de la salud.

Objective: To characterize scientific production related to online support targeted at chronically ill children, and adolescents. Content synthesis: This is an integrative review. A literature search was performed, from 2008 to 2017, using databases PubMed, Biblioteca Virtual em Saúde, Cumulative Index to Nursing and Allied Health Literature, and ScienceDirect. Thirty articles were found, arranged and sorted by title, author, year of publication, country of origin, database, type of study, and objectives. Findings reported a greater knowledge generation during the period from 2012 to 2014. Trend in research was focused in accordance with two categories: Online support tools assessment aimed at chronically ill children and adolescents and Perception of families and health professionals about usability of online support tools aimed at chronically ill children, and adolescents. Conclusion: Online support is a vital complement to health promotion activities for families. It is available on websites and online programs; moreover, it has strengths and weaknesses in usability, and represents a new challenge for health professionals.

Gastroprotective and antielastase effects of protein inhibitors from Erythrina velutina seeds in an experimental ulcer model.

Trypsin and chymotrypsin inhibitors from Erythrina velutina seeds have been previously isolated by our group. In previous studies using a sepsis model, we demonstrated the antitumor and anti-inflammatory action of these compounds. This study aimed to evaluate the gastroprotective and antielastase effects of protein inhibitors from E. velutina seeds in an experimental stress-induced ulcer model. Two protein isolates from E. velutina seeds, with antitrypsin (PIAT) and antichymotrypsin (PIAQ) activities, were tested. Both protein isolates showed a high affinity and inhibitory effect against human neutrophil elastase, with 84% and 85% inhibition, respectively. Gastric ulcer was induced using ethanol (99%) in 6 groups of animals (female Wistar rats, n = 6). Before ulcer induction, these animals were treated for 5 days with one of the following: (1) PIAT (0.2 mg·kg-1), (2) PIAT (0.4 mg·kg-1), (3) PIAQ (0.035 mg·kg-1), (4) ranitidine hydrochloride (50 mg·kg-1), (5) saline solution (0.9%), or (6) no intervention (sham). Both PIAT and PIAQ protected gastric mucosa, preventing hemorrhagic lesions, edema, and mucus loss. No histologic toxic effects of PIAT or PIAQ were seen in liver and pancreatic cells. Our results show that protein isolates from E. velutina seeds have potential gastroprotective effects, placing these compounds as natural candidates for gastric ulcer prevention.

Abandonment to therapeutic diet on patients at risk cardiovascular in a health care clinic.

BACKGROUND: Cardiovascular diseases are the leading cause of death among adults and measures to reverse this situation go through changes in lifestyle, among them adopt healthy eating through professional counseling. To do this we need to keep the patient engaged in treatment, and the abandonment of treatment is an important risk factor in this population. OBJECTIVES: To assess abandonment to dietary treatment of patients with cardiovascular risk treated on an outpatient basis, and identify the reasons for the abandonment of treatment. METHODS: Participants were patients between 18 and 70 years, of both sexes, who held their first nutritional consultation and had two or more cardiovascular risk factors. A telephone contact was made by applying a questionnaire on the withdrawal of reasons for treatment and encouraging them to return to the health service by checking the return after three months of telephone contact. RESULTS: Of the 142 patients with cardiovascular risk, 61.26% did not return to the service after the first visit, a percentage similar to that found in other studies, and contacted by telephone 64.37% of them. Regarding the main reasons for the withdrawal, difficulty following the diet and individual/behavioral characteristics of the patient were the aspects that contributed to the abandonment (57.14%), corroborating the findings that show the influence of cultural and socioeconomic factors on the therapeutic adherence. Although 92.86% of patients have been satisfied with the service and 75% have reported interest in resuming treatment, only 5.36% patients returned to service after the phone contact. CONCLUSION: There was a high drop-out from nutritional treatment, mainly because of the difficulty of organization required to follow the diet. The motivational intervention was not enough to motivate a return to treatment.

Effect of Pilates on sleep quality and quality of life of sedentary population.

The purpose of this study was to investigate the effects of an exercise program based on the Pilates Matwork method on sedentary volunteers who self-reported changes in their sleep quality and quality of life. This was a prospective clinical study, in which the variables (level of sleepiness and quality of life) were compared before and after applying a protocol of 12 weeks of an exercise program (2 sessions per week). The level of sleepiness showed significant improvement between before and after the intervention (p: 0.04). Quality of life improved based on all of the emotional components and the physical components (p < 0.05) with the exception of the physical domain (p: 0.09). The results of this study indicate that the sedentary population who participated in this 12 week Pilates program experienced improvements in sleep quality and quality of life.

Chlamydophila psittaci and Toxoplasma gondii infection in pigeons (Columba livia) from São Paulo State, Brazil.

Pigeons (Columba livia) cohabit with humans in urban and rural areas, representing a public health problem since microorganisms are transmitted through the inhalation of dust from their dry feces (chlamydiosis) and through ingestion of their undercooked or poorly refrigerated meat (toxoplasmosis). This study aimed to evaluate the presence of Chlamydophila psittaci and Toxoplasma gondii in pigeons from four cities in São Paulo State, Brazil. C. psittaci was evaluated through hemi-nested polymerase chain reaction (hnPCR) using cloacal and tracheal swabs, whereas T. gondii specific antibodies were assessed by means of modified agglutination test (MAT), mouse brain and muscle bioassay, and polymerase chain reaction (PCR). To confirm the infection in mice, T. gondii antibodies were assayed by using indirect fluorescent antibody test (IFAT). Considering C. psittaci, 40/238 (16.8%; 95%CI 12.6-22.1%) samples were positive according to hnPCR, especially for the cities of São Paulo (42.5%) and Bauru (35%). As regards T. gondii, 12/238 (5%; 95%CI 2.9-8.6%) serum samples were positive according to MAT. Of these, five samples had titer equal to 1:8; six samples, 1:16; and one sample, 1:32. Bioassay, IFAT and PCR were negative for mouse toxoplasmosis. The absence of T. gondii antibodies suggests that pigeons may be infected with a low concentration of the agent, not detected by the antigen test. Thus, C. psittaci represents an actual problem concerning bird health.

Repercussion of physiotherapy intradialytic protocol for respiratory muscle function, grip strength and quality of life of patients with chronic renal diseases.

INTRODUCTION: Chronic kidney disease consists in the slow, progressive and irreversible loss in renal function and it is considered a social and economic problem worldwide, since it is linked to numerous diseases, as well as to higher public health spending. It is known that dialysis patients undergo a long period of restricted physical activity reflects in dysfunctions in various organical systems and in the quality of their lives. OBJECTIVE: To verify the results of physical therapy intervention in patients on hemodialysis, for respiratory muscle function, grip strength and quality of life. METHODOLOGY: Experimental, nonrandomized, quantitative and qualitative of a sample of 13 patients, 43.69 ± 9.28 years, on hemodialysis in the hospital Santa Casa de Diamantina/MG, selected by convenience. All patients were evaluated for maximal respiratory pressures (PI(max) e PE(max) ) and peak expiratory flow (PFE), before and after physiotherapy, which consisted of 3 sessions per week for a period of 2 months weeks: exercises for upper limbs, with technique PNF and breathing diaphragmatic; strengthening exercises for lower limbs and use of exerciser ball. Statistical analysis was performed using the student-t test and significance value at p < 0.05. RESULTS: Respective means for the variables before and after intervention were: PImáx (97.69 ± 28.3 cmH2O e 98.46 ± 23.39 cmH2O) p = 0.93; PEmáx (83.07 ± 31.19 cmH(2)O e 88.46 ± 14.0 cmH(2)O) p = 0.46 e PF (375.38 ± 75.23 L/min e 416.15 ± 57.37 L/min) p = 0.02. The dynamometer average pre intervention was: 57.23 ± 17.39 kgf and post intervention: 56.61 ± 16.09 kgf. In the SF-36, which evaluates the quality of life, improvement was observed in the eight domains, except the item 'vitality'. Of all the variables measured only the PFE was statistically significant. CONCLUSION: The proposed physical therapy protocol did not promote significant improvements in those variables, the statistical point, explaining in part the small sample size, time of protocol and proposed interventions.

Effects of zinc supplementation in patients with type 1 diabetes.

The purpose of this study was to identify the effect of oral zinc supplementation in patients with type 1 diabetes (T1DM) on metabolic control and zinc blood concentrations. The sample consisted of 20 patients with T1DM and a control group (n=17). Metabolic control was evaluated by glycemia at fast, 24 h glycosuria, and HbA1c. Zinc concentrations were measured in plasma and erythrocytes. After the first collection of biological material, oral zinc supplementation was initiated and continued for 4 mo in T1MD patients (T1). Daily dosages were established based on Dietary Recommended Intakes (DRIs), considering zinc intake based on data from other studies previously performed with this population. All analyses were repeated after supplementation (T2). Metabolic control was unsatisfactory, with an HbA1c increase at T2. There was no difference in zinc concentrations in plasma and erythrocytes between patients with T1DM and control. Zinc concentrations in plasma were within the normal range in T1MD before and after supplementation and the control. Zinc concentrations in erythrocyte presented lower than normal values for all groups. A zinc increase in erythrocyte after supplementation was observed in T1DM patients, although without statistical significance. More studies are needed to confirm oral zinc supplementation as nutritional management in diabetes.

Genotyping of Toxoplasma gondii strains isolated from dogs with neurological signs.

From 111 dogs with neurological signs admitted in this research in a 22-month period, brain samples of 34 animals were inoculated in mice in order to isolate Toxoplasma gondii. From these 34 dogs, 9 strains of T. gondii were isolated and the genetic characterization performed by restriction analysis (RFLP) of the SAG-2 gene. RFLP analysis showed that four of them were classified as Type I, and five as Type III. The present report is the first description of genotyping of T. gondii isolated from brain samples of naturally infected dogs, in Brazil.