Comparison of pre- and postoperative functional dependence in older adults submitted to hip arthroplasty Jefferson Carlos Araujo Silva, Gabriela Martins Sousa, Natália Barrel Cota, Thalita Cristinny Araujo Silva, Murilo Rezende Oliveira, et al. Fisioterapia Em Movimento, 2024 Introduction Femur fractures and hip osteoarthritis affect the functional independence of older adults. Hip arthroplasty (HA) is a surgery to treat these conditions and physiotherapy can reduce functional dependence levels. Objective Compare pre- and postoperative functional dependence in older adults submitted to HA, assess the association between functional dependence and independence, and whether age is associated with greater functional dependence in these patients. Methods A quantitative cross-sectional descriptive comparative study with older adult volunteers submitted to HA evaluated before and after surgery using the Katz index and Functional Independence Measure (FIM). Comparative analysis was performed via Wilcoxon’s matched pairs test and Spearman’s correlation. Linear regression was applied to assess the influence of functional dependence on postoperative independence (p < 0.05). Results Forty-eight patients were evaluated in the pre- and postoperative stages using the Katz index, which demonstrated reduced functional dependence after HA. The FIM assessment indicated greater post-operative functional dependence, demonstrating the surgical procedure combined with early physiotherapy while patients were hospitalized promoted functional independence in older adults. Additionally, there was a directly proportional relationship between dependence level and age. Conclusion Functional dependence declined after HA, which improved independence in older adults. Functional dependence affected postoperative independence and age influenced functional dependence.
Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Nondialysis Chronic Kidney Patients Gysllene M. C. Brito, Andrea M. M. Fontenele, Erika Cristina R. L. Carneiro, Iara Antonia L. Nogueira, Tamires B. Cavalcante, et al. International Journal of Inflammation, 2021 Background. The Neutrophil-to-Lymphocyte Ratio (NLR) and the Platelet-to-Lymphocyte Ratio (PLR) are inflammatory biomarkers for several diseases, such as cancer and cardiovascular morbidities; however, there are currently few studies on kidney diseases. We aimed to evaluate nondialysis patients and determine the association of NLR and PLR with inflammation in these patients. Methods. A prospective cross-sectional study was conducted with 85 patients at different stages of chronic kidney disease (CKD), treated at the Kidney Disease Prevention Center of the University Hospital of the Federal University of Maranhão. This study included adult nondialysis patients diagnosed with CKD. The participants’ blood samples were collected for a high-sensitivity C-reactive protein (hs-CRP) test and blood count. They were divided into two groups according to the presence or absence of inflammation based on the hs-CRP value (<0.5 mg/dL). NLR and PLR were calculated based on the absolute number of neutrophils, lymphocytes, and platelets and were compared between them and with hs-CRP. Statistical analysis was performed using the Stata software, with the Shapiro–Wilk, Mann–Whitney, Spearman’s Correlation, and receiver operating characteristic curve tests. This study was approved by the local ethics committee. Results. The participants were categorized into two groups: with inflammation (n = 64) and without inflammation (n = 21). The mean age was 61.43 ± 14.63 y. The NLR and PLR values were significantly different between the groups with and without inflammation ( p = 0.045 and p = 0.004 , respectively). However, only PLR showed a significant positive correlation with hs-CRP ( p = 0.015 ). The best cutoff point for NLR to detect inflammation was 1.98, with 76.19% sensitivity and 48.44% specificity. For PLR, it was 116.07, with 85.71% sensitivity and 51.56% specificity. There was no significant difference between the area under the NLR and PLR curve (0.71 vs. 0.64; p = 0.186 ) for this population. Conclusions. This study showed that PLR was positively correlated with hs-CRP in nondialysis CKD patients and can be used to identify inflammation in this population.
Plaque reduction neutralization test (PRNT) in the congenital zika syndrome: Positivity and associations with laboratory, clinical, and imaging characteristics Marizélia R. C. Ribeiro, Ricardo Khouri, Patrícia S. Sousa, Maria R. F. C. Branco, Rosângela F. L. Batista, et al. Viruses, 2020 The short duration of viremia, low blood viral load, inaccessibility to timely specific diagnostic tests, and cross-reactions with other flaviviruses have hindered laboratory confirmation of Congenital Zika Syndrome (CZS). This study analyzes the positivity of the plaque reduction neutralization test (PRNT) in children with clinical or imaging characteristics of CZS and its association with laboratory, clinical, and imaging characteristics. The 94 clinical cases of CZS submitted to the ZIKV PRNT90 test were followed from 2016 to 2018. The mean age of children at PRNT90 collection was 22 ± 6 months Standard Deviation. The ZIKV PRNT90 was positive (titer ≥ 10) in 40 (42.5%) children. ZIKV PRNT90 positivity was associated with severe microcephaly in newborns (p = 0.016), lower head circumference z-score at birth (p = 0.043) and 24 months of age (p = 0.031), and severe reduction of the cerebral parenchyma volume (p = 0.021), expressing greater disease severity. Negative PRNT90 in children with characteristic signs of CZS may be due to false-negative results, indicating that the diagnosis of CZS should be primarily syndromic.
Profile of fracture victim patients interned in a university hospital: A cross-sectional study Ana Letícia Santos Do Nascimento, Jefferson Carlos Araujo Silva, Ana Carolina Sá Mendonça, Lívia Christina do Prado Lui, Érika Thalita Nunes Costa, et al. Revista Pesquisa Em Fisioterapia, 2020 OBJETIVO: Descrever o perfil clínico epidemiológico dose pacientes vítimas de fraturas internados em um hospital universitário do Maranhão. MÉTODOS: Trata-se de um E estudo descritivo transversal, retrospectivo e de abordagem quantitativa, realizado a partir da análise de prontuários destes pacientes no Hospital Universitário da Universidade Federal do Maranhão (HU-UFMA) no setor de traumato-ortopedia. RESULTADOS: Foram analisados 251 prontuários, em que no qual houve predomínio do sexo masculino (52,59%), cor parda (64,1%), residentes em São Luís (57%), solteiros (51%), baixa escolaridade, apresentando maior índice de ensino fundamental incompleto (35,3%) e a média de idade foi de 45,4 anos. O tipo de trauma que mais causou fraturas foram as quedas, com 127 vítimas (50,6%), seguido dos acidentes de trânsito com (27,8%) de acidentes motociclísticos, (3,98%) de acidentes automobilísticos, (3,98%) de atropelamentos. Quanto às regiões corpóreas mais acometidas, observou-se com maior frequência as lesões nos membros inferiores (MMII), sendo 33,47% fraturas de fêmur, 23,11% de tíbia e 11,95% de tornozelo. O tipo de cirurgia mais realizado foi a osteossíntese, para a estabilização do seguimento, com 82,87% de prevalência. Desses pacientes 98,8% obtiveram alta hospitalar após procedimento cirúrgico com mediana de 3 dias de internação e 1,2% evoluíram para óbito. CONCLUSÃO: Houve maior prevalência de fraturas entre os indivíduos do sexo masculino, solteiros, compreendidos na faixa etária de 13 a 38 anos, o mecanismo de trauma com maiores números de casos foram quedas e acidentes de trânsito, com maior acometimento dose membros inferiores.
Congenital zika syndrome: Association between the gestational trimester of maternal infection, severity of brain computed tomography findings and microcephaly at birth Ana Karolina Torres Mendes, Marizélia Rodrigues Costa Ribeiro, Fernando Lamy-Filho, Gláucio Andrade Amaral, Marcella Costa Ribeiro Borges, et al. Revista do Instituto De Medicina Tropical De Sao Paulo, 2020 This study analyzed possible associations between the trimester of maternal Zika virus infection (ZIKV) in pregnancy, severity of brain computed tomography (CT) findings and the presence of microcephaly at birth in children with Congenital Zika Syndrome (CZS). It was an analytical study in a cohort of children with CZS. Symptoms of maternal infection were dichotomized into the 1st trimester of pregnancy and other trimesters. Head circumference (HC) at birth was used to calculate the z-score. Mild microcephaly was defined as HC between 2 and ≥3 standard deviations (SD) below the mean for each gestational age and sex, and severe microcephaly when HC <3 SD below average. Brain CT images were evaluated by two radiologists and classified, according to the severity, into mild, moderate and severe. Fisher’s exact, Mann-Whitney and Kruskal-Wallis tests were used to verify the associations between variables. In 108 children, maternal infection in the 1st trimester of pregnancy was associated with more severe brain CT abnormalities (p=0.038), greater severity of microcephaly at birth (p=0.013) and lower HC z-scores at birth (p=0.021). The severity of brain CT lesions was also associated with lower HC z-scores at birth (p<0.001). Maternal ZIKV infection during the first trimester of pregnancy proved to be an important risk factor for a more severe spectrum of CZS, as it is associated with more severe brain CT abnormalities and, consequently, with lower HC z-scores at birth.
Music therapy in patients with disorders of consciousness: An integrative review Thanires Rafaele Menezes Soares dos Santos, Tamires Barradas Cavalcante, João Ferreira Silva Brazilian Journal of Occupational Therapy, 2019 Introducao: A terapia com musica e amplamente utilizada para tratamento e assistencia em varias doencas, incluindo disturbios da consciencia, demencia, acidente vascular cerebral, disturbios psiquiatricos, Parkinson, dor de origens diversas, entre outros. Sabe-se que ouvir musica influencia o humor e a excitacao, o que pode melhorar o desempenho em uma variedade de tarefas cognitivas. Objetivo: Analisar as informacoes disponiveis na literatura sobre as evidencias cientificas do uso da musica como recurso terapeutico. Metodo: Trata-se de uma revisao integrativa com buscas de artigos publicados em periodicos nacionais e internacionais indexados nas bases de dados e banco de revistas: Pubmed, Cinahl, Web of Science e SciELO, entre dezembro/2017 e janeiro/2018. Utilizou-se os descritores “musica” e “disturbios da consciencia” de forma associada em portugues, ingles e espanhol. Resultados: Foram selecionados 14 estudos heterogeneos, porem com boa qualidade metodologica, dentre os quais se destacam estudos intervencionais e observacionais com grau de recomendacao A. Conclusao: O estudo concluiu haver na literatura cientifica algumas evidencias da efetividade e da eficacia da terapia musical no tratamento e avaliacao de pessoas em coma, estados minimamente conscientes e estado vegetativo persistente.
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