Medical Express

ISSN (print): 2318-8111

ISSN (online): 2358-0429

Issue: 4 (3) 2017 - 6 Articles


1 - Dental Neglect, one type of child abuse – Narrative review

Ana Sofia Baptista, Elisa Laranjo, Ana Alves Norton, David Casimiro de Andrade, Cristina Areias, Ana Paula Macedo

MEDICALEXPRESS 2017;4(3):M170301

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Dental neglect is defined as an intentional failure of the caretaker in the pursuit and continuity of necessary treatment to achieve an oral health that allows adequate function, free from pain and infection. We intend to clarify, according to the current scientific literature, the clinical indications for the identification of dental neglect in children. After the search in databases and search engines with the keywords “child”, “dental” and “neglect”, between 1996 and 2016, the results revealed that identifying this condition requires not only a detailed clinical history and clinical data that clearly show the lack of oral health care but also investigating the social and parental determinants in which the child is involved. Thus, inserting the dentist in teams of analysis in case of suspicion proves to be indispensable for the detection of this and other situations of abuse.

Keywords: Child Abuse, Oral Health, Negligence.


2 - Higuchi Fractal Analysis of Heart Rate Variability is Sensitive during Recovery from Exercise in Physically Active Men

Rayana L. Gomes; Luiz Carlos M. Vanderlei; David M. Garner; Franciele M. Vanderlei; Vitor E. Valenti

MEDICALEXPRESS 2017;4(3):M170302

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OBJECTIVE: Nonlinear techniques to assess heart rate variability (HRV) have received much recent attention. We aimed to evaluate nonlinear HRV responses during recovery from exercise through the novel algorithm Higuchi Fractal Dimension.
METHOD: We examined 35 healthy male volunteers aged between 18 and 35 years old. For the training of exercise intensity we used 60% of Vmax determined through a progressive test using the Conconi threshold. HRV was analyzed 10 minutes before and 10 minutes after exercise. We analyzed the geometric indices of HRV (SD1, a measure of short-term HRV and SD2, a measure of long-term HRV) and applied the Higuchi Fractal Dimension to RR intervals.
RESULTS: During recovery from exercise the Poincaré plot indices SD1 and SD1/SD2 decreased while SD2 and SD2/SD1 increased (p<0.0001) compared to control at rest. All parameters of Higuchi Fractal Dimension analysis were lowered after exercise compared to control at rest (p<0.0001).
CONCLUSION: Physical exercise acutely decreased the chaotic behavior of HRV as measured through the Higuchi Fractal Dimension analysis. Physiologically, this indicates that we detected complex changes in HRV immediately after exercise.

Keywords: Cardiovascular system; Autonomic Nervous System; Physical Exercise; Nonlinear Dynamics; Higuchi Fractal Dimension.

3 - Evaluation of fecal protein S100A12 in patients with inflammatory bowel disease

Fengming Yi; Long Feng; Jianbing Wu

MEDICALEXPRESS 2017;4(3):M170303

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BACKGROUND AND OBJECTIVE: The diagnosis and evaluation of inflammatory bowel disease is quite complex. An ideal, noninvasive marker for this disease is quite urgently needed. Fecal S100A12 is a member of the S100 protein family and is secreted by activated neutrophils. We aim to evaluate it as a biomarker for inflammatory bowel disease patients in China.
METHODS: Fecal S100A12 was measured in 18 Crohn’s disease, 21 ulcerative colitis, and 17 healthy controls. Diagnostic value was evaluated by receiver operating characteristic (ROC) analysis in comparison with C-reactive protein and erythrocyte sedimentation rate. The correlation between fecal S100A12 and clinical characteristics was also evaluated.
RESULTS: We found significant increases (p<0.01) in the diagnostic value of S100A12 in both Ulcerative Colitis and Crohn’s Disease when compared to healthy controls. In ulcerative colitis, fecal S100A12 correlated with fecal occult blood (p=0.02, r=0.55); in Crohn’s disease, it correlated with disease duration, albumin and platelet levels (p=0.01, r=-0.53; p<0.01, r=-0.65; p=0.04, r=0.45. respectively). No correlation occurred between fecal S100A12 and other clinical conditions.
CONCLUSION: Fecal S100A12 is valuable in distinguishing inflammatory bowel disease patients versus healthy controls. However, the sensitivity and specificity are limited when compared with that described in western countries. The correlation between S100A12 and clinical characteristics is limited as well. More research is need to better explore this interaction in Chinese patients.

Keywords: Crohn’s disease, ulcerative colitis, S100A12.

4 - Vascular and Inflammatory Acute Responses after a Resistance Exercise Session in Young Women with Excessive Adiposity

Luiz Guilherme Kraemer-Aguiar; Belmiro Freitas de Salles; Ingrid Dias; Silvio Rodrigues Marques-Neto; Artur E. C. Guimarães; Maria G. C. de Souza; Braulio Santos; Eliete Bouskela

MEDICALEXPRESS 2017;4(3):M170304

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BACKGROUND: Endothelial dysfunction and low-grade inflammation are both positively associated to states of excessive adiposity but reports on the acute effects of resistance exercise on these variables are still lacking. We evaluated these acute effects of resistance exercise on vascular reactivity and on the inflammatory profile in young women.
METHODS: Participants were divided into two groups: lean Controls (n=16) and Overweight (n=16). The resistance exercise session consisted of unilateral elbow flexions for five sets of 10 repetitions at 70% of one repetition maximum. Blood pressure, heart rate, forearm blood flow, vascular conductance, cytokines, adipopeptides and endothelin-1 were evaluated at rest and during the acute post-exercise period.
RESULTS: The overweight group had higher forearm blood flow at rest (p=0.03) and during post-exercise (p<0.001) while forearm vascular conductance was higher only during post-exercise, at 20 (p=0.02) and 40 min (p<0.001). Endothelial-dependent vasodilation was higher during the post-exercise period in the Overweight group compared to controls (p=0.01). In the Overweight group, the resistance exercise session reduced interleukin-6 (p=0.02) and leptin (p<0.001) but increased endothelin-1 levels (p=0.02).
CONCLUSIONS: We conclude that the single resistance exercise session elicited an acute increment of baseline vascular reactivity and an increased endothelial-dependent vasodilation with concomitant changes in inflammatory profile and endothelin-1 in our tested women with excessive adiposity.

Keywords: metabolic syndrome, exercise , inflammation.

5 - The use of the Gait Deviation Index for the evaluation Post-stroke Hemiparetic Subjects

Carolina C. Alcantara; Angelica Castilho Alonso; Danielli S. Speciali

MEDICALEXPRESS 2017;4(3):M170305

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BACKGROUND: The Gait Deviation Index, initially conceived to evaluate the gait of children with cerebral palsy, has been used as a quantitative parameter of gait pattern changes of individuals with other conditions. However, there are no studies evaluating changes in the gait pattern of chronic hemiparetic post-stroke subjects based on this index.
AIMS: To characterize the changes in gait pattern according to the Gait Deviation Index and gait spatiotemporal parameters of chronic hemiparetic subjects compared to healthy subjects.
METHODS: Retrospective study. Data were obtained from the database of the Gait Laboratory of Hospital Israelita Albert Einstein. Thirty subjects were included in this study, with previous unilateral, ischemic or hemorrhagic chronic stroke (time post-lesion > 6 months) and ability of walking classified as 2, 3, 4 or 5 according to Functional Ambulation Category. Data from 87 healthy subjects were included in control group, obtained from a normality database. Statistical analysis was applied through the Kruskall Wallis test, followed by Mann-Whitney post-hoc test, considering a critical p value <0.05.
RESULTS: The Gait Deviation Index scores were decreased for both paretic (64.69 ± 16.29) and non-paretic limbs (64.88 ± 15.00) compared to control (101.01 ± 10.12; p < 0.001). No differences were observed in Gait Deviation Index scores between paretic and non-paretic limbs (p > 0.99).
CONCLUSION: The findings of the current study demonstrate that the Gait Deviation Index may be a sensitive parameter to identify changes in the gait pattern of chronic hemiparetic post-stroke subjects.

Keywords: stroke, gait, kinematic, hemiparetic.


6 - Acute static muscle stretching improves manual dexterity in young men

César Rafael M Costa; Raoni C Dos-Santos; Welington V de Paula; Wallace MV Ribeiro; Anderson Luiz B Silveira

MEDICALEXPRESS 2017;4(3):M170306

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OBJECTIVE: This study aimed to evaluate the influence of acute muscle stretching on manual function.
METHODS: The sample consisted of 10 untrained men in a randomized, four test session cross-over experimental design. Each session was composed of only one of two protocols: a) control, or b) single series of passive static stretching; followed by either Minnesota Hand dexterity test or hand grip strength test with eletromyographical recording of reaction time. For data comparison, the Student T-test with significance level of p ≤ 0.05 was used.
RESULTS: Manual dexterity increased after stretching for both placing and turning tests, with no changes in hand grip strength or reaction time.
CONCLUSION: The results show that a 30 second static stretch of the hand decreases time to complete the Minnesota Hand Dexterity test without affecting handgrip strength or hand reaction time; thus it improves manual dexterity of young untrained men.

Keywords: Muscle stretching, motor skills, reaction time.