Abstract Introduction Neuropsychiatric symptoms are an integral component of the natural history of dementia, occurring from prodromal to advanced stages of the disease process and causing increased burden and morbidity. Clinical presentations are pleomorphic and clinical management often requires combinations of pharmacological and non-pharmacological interventions. However, limited efficacy and a non-negligible incidence of adverse psychotropic drug events emphasize the need for novel therapeutic options. Objectives To review the evidence supporting use of medical cannabinoids for treatment of neuropsychiatric symptoms (NPS) of dementia. Methods We conducted a systematic review of the medical literature to examine scientific publications reporting use of medical cannabinoids for treatment of NPS. Medical Subject Headings (MeSH) were used to search for relevant publications and only papers reporting original clinical information were included. A secondary search was performed within selected publications to capture relevant citations that were not retrieved by the systematic review. The papers selected were categorized according to the level of evidence generated by the studies in relation to this clinical application, i.e. (1) controlled clinical trials; (2) open-label or observational studies; and (3) case reports. Results Fifteen publications with original clinical data were retrieved: five controlled clinical trials, three open-label/observational studies, and seven case reports. Most studies indicated that use of medical cannabinoids engendered favorable outcomes for treatment of NPS related to moderate and advanced stages of dementia, particularly agitation, aggressive behavior, sleep disorder, and sexual disinhibition. Conclusion Medical cannabinoids constitute a promising pharmacological approach to treatment of NPS with preliminary evidence of benefit in at least moderate to severe dementia. Controlled trials with longitudinal designs and larger samples are required to examine the long-term efficacy of these drugs in different types and stages of dementia, in addition to their adverse events and risk of interactions with other drugs. Many pharmacological details are yet to be determined, such as dosing, treatment duration, and concentrations of active compounds (e.g., cannabidiol [CBD]/ Δ9-tetrahydrocannabinol [THC] ratio) in commercial preparations of medical cannabinoids.

ABSTRACT The objective of this study was to evaluate the effects of mineral and protein-energy (MPES), exogenous fibrolytic enzyme supplements (ES), combination of MPES + ES, and straw without supplement (WS) on digestibility, fermentation kinetic parameters, cumulative gas production, methane, CO2 production, and volatile fatty acid concentration of rice straw of low and high nutritional value, estimated by in vitro techniques. The experimental design was randomized and factorial 2 × 4: two straws (low and high nutritional value) incubated with four supplements (MPES, ES, MPES + ES, and WS) and their interactions. Four experimental periods were used, totaling four replications per treatment over time. Data were analyzed by PROC MIXED of SAS. The in vitro dry matter and organic matter digestibilities of the rice straw with high nutritional value was improved by MPES, while the combination of MPES + ES supplements inhibited the digestibility of this straw. Dietary carbohydrate and nitrogen increased through MPES and MPES + ES supplements resulted in an increase in NH3-N concentration and a decrease in CO2 production due to the microbial mass formation. However, this increase was not enough to improve organic matter degradability parameters, cummulative gas production, gas production kinetics, and acetate:propionate ratio and reduce methane emissions. The straw with high nutritional value showed greater content of nitrogen fraction a, effective degradability, cummulative gas production, and methane and CO2 productions comparing with low-nutritional value straw. The use of MPES and MPES + ES supplements can be used as strategy to mitigate CO2 in ruminant production systems that use rice straw.

ABSTRACT The objectives of this study were to evaluate the effects of cultivation and hay making factors on chemical composition, protein fractionation, and digestibility in rice straw, as well as to identify the chemical fractions that contribute to the variation in its nutritional value for ruminants. Statistical procedures were performed in a model that included rice crop cycle, sowing season, baling season, soil classification, fertilizer application, and productivity (kg/ha) as fixed effects and the hay bale as random effect. Chemical composition, protein fractionation, and digestibility data were subjected to multivariate analyses including factor, cluster, and discriminant. Considering the cultivation and haymaking factors, development cycle, baling season, and grain production explained the most variation in the rice straw nutritional value. Straws derived from early maturing cultivars showed the lowest levels of neutral detergent fiber, acid detergent fiber, acid detergent insoluble nitrogen, and C nitrogen fraction in comparison with straw originating from mid cycle cultivars. Rice straw from more productive cultivars had lower levels of lignin and C fraction as well as higher levels of crude protein and B3 fraction compared with straws from less productive cultivars. However, the main variation in the nutritional value between the samples of rice straw was related to the baling season. The bailing seasons were grouped in two clusters. Straws with better nutritional value were those with lower levels of cell wall fractions, from more productive crops, with early development cycle and baled until March. Rice crop cycle, baling season, and grain production effects explain the variation in the nutritional value of rice straws. Straws with better nutritional value have lower levels of fractions related to secondary cell wall and lignification.

Se avaluó pasto de las áreas verdes públicas de la ciudad de Palmira (Colombia) para determinar su potencial para producir energía renovable a través de la digestión anaerobia. Después de realizados los trabajos de poda, se tomaron pequeñas muestras de pasto fresco para formar una muestra final representativa. La muestra se caracterizó y se identificaron las especies de gramíneas contenidas. En un primer experimento, se realizó una prueba del potencial bioquímico de metano a 37°C, durante 60 días. En una siguiente prueba por lotes, se optimizó la producción de metano en términos de la concentración de los sólidos totales. Se identificaron nueve especies de gramíneas representativas en la muestra y se estableció su contenido nutricional. La producción de metano final del pasto fue de 0,327m³CH4/kgSVadicionado, resultado comparable con lo encontrado en la literatura para pasto ensilado. La remoción de sólidos volátiles observada fue de 44%, y se registró una remoción del 45% de celulosa, 12% de hemicelulosa y 4% para la lignina. El mayor rendimiento de producción de metano se produjo con el 4% de sólidos totales. Este valor se puede recomendar en un proceso de digestión anaerobia convencional; sin embargo, se requiere continuar la investigación con el fin de determinar las condiciones de operación a escala real. La digestión anaerobia de pasto junto con otros residuos orgánicos urbanos podría convertirse en una opción sostenible para el manejo ambientalmente seguro de residuos orgánicos y para la producción de energía renovable en un país tropical como Colombia.

Grass from public green spaces of the tropical city of Palmira (Colombia) was analyzed to determine its potential to produce renewable energy trough anaerobic digestion. After pruning labor, grass samples were taken fresh in a representative way to form a big final sample. This sample was characterized and the grass species contained therein were identified. In a first experiment, a standard biochemical methane potential test was carried out at 37°C during 60 days. In a subsequent batch experiment, methane yield was optimized in terms of total solid concentration. Nine representative grass species were identified along with their nutritional content. It was found that the ultimate methane yield of the grass examined is 0.327m³CH4/kgVSadded, which is comparable with that reported for grass silage. A volatile solids removal of 44% was observed, and a removal of 45% cellulose, 12% hemicellulose, 4% lignin was found at the end of the experiment. Maximum methane yield was obtained at 4% of total solids, which may be recommended in a conventional anaerobic digestion process. Although more research is needed, this research showed that an economical and simpler operation can be suggested for the digestion of fresh grass in a tropical country like Colombia.

Grama de áreas verdes da cidade tropical de Palmira (Colômbia) foi analisada para determinar seu potencial para produzir energia renovável através da digestão anaeróbia. Após os trabalhos de poda, foi recolhido material fresco em vários pontos da cidade formando uma amostra final. A amostra foi caracterizada, identificando-se nove espécies de gramíneas representativas cujo conteúdo nutricional foi determinado. Numa primeira experiência, foi realizado um teste de potencial bioquímico de metano a 37°C durante 60 dias. Logo, num teste por lotes, otimizou-se a produção de metano por meio da variação da concentração de sólidos totais. A produção final de metano da grama foi de 0,327m³CH4/kgSVadicionado, o que é comparável com o relatado na literatura para silagem de erva. Uma remoção dos sólidos voláteis de 44% foi observada, em conjunto com uma remoção de 45% de celulose, 12% de hemicelulose e 4% de lignina. O rendimento máximo de metano obteve-se a partir de uma concentração de 4% de sólidos totais, sendo um valor que pode ser recomendado num processo de digestão anaeróbia convencional, embora sejam necessários mais testes. Ao final a digestão anaeróbia apresenta-se como uma operação econômica e simples para o tratamento de resíduos de poda em um país tropical como a Colômbia.

CONTEXTO E OBJETIVO: A qualidade de vida relacionada à saúde (QVRS) pode ser piorada em pacientes com doença falciforme na presença de transtornos psiquiátricos. O objetivo deste estudo é descrever a sintomatologia psiquiátrica presente no paciente brasileiro com doença falciforme e avaliar a relação desses sintomas com o genótipo da doença e a QVRS do sujeito. TIPO DE ESTUDO E LOCAL: Estudo com delineamento transversal, realizado no ambulatório de Hematologia do Hospital São Paulo. MÉTODOS: Adultos com doença falciforme responderam ao Questionário de Qualidade de Vida (SF-36) e ao Questionário sobre a Saúde do Paciente (PHQ). Dados clínicos foram obtidos no prontuário médico. Modelos de regressão linear foram desenvolvidos para estudar a dependência dos domínios de QVRS no genótipo com controle para sintomas psiquiátricos. RESULTADOS: No período do estudo, 110 pacientes foram avaliados. O sintoma psiquiátrico mais frequente foi o depressivo (30%), seguido do ansioso (12,7%) e de abuso de álcool (9,1%). Os pacientes com genótipo mais grave (SS e S βthal0) apresentaram menores médias nos domínios de QVRS de "saúde geral" e de "aspectos físicos", sem interferência dos sintomas psiquiátricos. No domínio "aspectos físicos", o genótipo mais grave funcionou como fator protetor da QVRS (β = 0,255; P = 0,007). CONCLUSÃO: Os genótipos mais graves pioraram a QVRS em dois domínios do componente físico ("aspectos físicos" e "saúde geral"), mas não influenciaram o componente mental, sugerindo que o médico deve estar atento aos aspectos da QVRS relacionados com a funcionalidade do portador da doença falciforme, conhecendo as limitações com as quais o paciente convive.

CONTEXT AND OBJECTIVE: Health-related quality of life (HRQoL) may be worsened in sickle cell patients due to the presence of psychiatric disorders. The aims of this study were to describe the psychiatric symptoms in Brazilian sickle cell patients and to evaluate the relationship of these symptoms to the genotype of the disease and the subject's HRQoL. DESIGN AND SETTING: Cross-sectional study conducted at the hematology outpatient clinic, Hospital São Paulo. METHODS: Adult patients with sickle cell disease completed the Medical Outcome Study - Short Form 36 and the Patients' Health Questionnaire. Clinical data were gathered from their medical files. Linear regression models were developed to study the dependency of HRQoL domains on the genotype controlling for psychiatric symptoms. RESULTS: In the study period, 110 patients were evaluated. The most frequent psychiatric symptom was depression (30%), followed by anxiety (12.7%) and alcohol abuse (9.1%). Patients with the more severe genotype (SS and Sβthal0) showed lower scores for the "general health" and "role-physical" HRQoL domains, without interference from psychiatric symptoms. In the "role-physical" domain, the more severe genotype operated as a protective factor for HRQoL (β = 0.255; P = 0.007). CONCLUSION: The more severe genotypes worsened HRQoL in two domains of physical health (general health and role-physical), but they did not have any influence on mental health, thus suggesting that physicians should be more attentive to aspects of HRQoL relating to the functionality of sickle cell disease patients, so as to be aware of the limitations that these patient live with.

O Brasil dispõe de reservas de rochas silicáticas potássicas de baixa solubilidade, sendo necessário o desenvolvimento de alternativas de beneficiamento capazes de aumentar sua solubilidade, para o suprimento da demanda desse nutriente na agricultura. Este estudo objetivou a obtenção de novas rotas tecnológicas para a produção de fontes alternativas de potássio, a partir do verdete. Prepararam-se misturas de verdete com calcário, para as quais foram realizados testes de calcinação e solubilização alcalina. O processo de calcinação seguido de resfriamento à temperatura ambiente proporcionou maior disponibilidade de potássio que os outros métodos empregados. Porém, o aumento na proporção de calcário, em relação ao verdete, ocasionou diminuição na solubilidade do potássio. O tratamento calcário:verdete, na proporção 0:100, calcinado por uma hora a 800ºC e tratado com NH4OH, e na proporção 25:75, submetida à calcinação, liberam, proporcionalmente, maior quantidade de potássio que as misturas não calcinadas.

Brazil owns reserves of low solubility potassium silicate rocks, being necessary the development of alternative processing methods to increase their solubility, so they can be efficiently used in agriculture. This study aimed to get new technological routes to produce alternative potassium sources from verdete. Calcination and alkaline solubilization tests were performed for verdete and limestone mixtures. The calcination process followed by cooling at room temperature provided a higher potassium availability than other methods used. However, the increase of limestone content, concerning verdete, decreased the potassium solubility. The treatment limestone:verdete, in the proportion of 0:100, after calcination at 800 ºC during one hour and then treated with NH4OH, and in the proportion of 25:75, after calcination, release proportionally higher amounts of K than non-calcinated samples.

O custo atual do cloreto de potássio relacionado à grande dependência de sua importação para suprir a demanda nacional sugere a necessidade de estudos que procurem avaliar a eficiência de fontes alternativas de nutrientes. O objetivo deste trabalho foi avaliar o efeito de rochas silicáticas e de um subproduto de mineração de manganês e suas alterações nos atributos químicos do solo e na produção da braquiária. O experimento foi realizado em casa de vegetação, em vasos com 5 kg de um Latossolo Vermelho-Amarelo distrófico. As fontes alternativas de nutrientes foram: verdete, verdete calcinado e tratado com NH4OH, fonolito, ultramáfica, rejeito e a proporção de 75 % dessas fontes com 25 % de calcário calcítico. As misturas que apresentaram 25 % de calcário foram calcinadas a 800 ºC por 1 h. As fontes foram aplicadas nas doses de 0; 150; 300; 450; e 600 kg ha-1 de K2O e permaneceram incubadas por um período de 45 dias. As misturas de rochas silicáticas calcinadas com calcário que promoveram maior aumento nos valores de pH do solo foram: ultramáfica, verdete, fonolito e rejeito. Com a aplicação da mistura de rejeito, elevaram-se o K+ do solo e o P disponível, quando da incorporação da ultramáfica, Quando foi aplicada ultramáfica, o teor de Ca2+ no solo aumentou significantemente. O rejeito liberou a maior quantidade de Zn2+ e Mn2+ para o solo. As fontes alternativas de K com composição química variada, quando misturadas ao solo, alteraram a disponibilidade de nutrientes e os atributos químicos do solo, melhorando principalmente o desenvolvimento e a absorção de K pelas plantas, sendo importantes fontes de nutrientes para o solo.

The current high price of potassium chloride and the dependence of Brazil on imported materials to supply the domestic demand call for studies evaluating the efficiency of alternative sources of nutrients. The aim of this work was to evaluate the effect of silicate rock powder and a manganese mining by-product, and secondary materials originated from these two materials, on soil chemical properties and on brachiaria production. This greenhouse experiment was conducted in pots with 5 kg of soil (Latossolo Vermelho-Amarelo distrófico - Oxisol). The alternative nutrient sources were: verdete, verdete treated with NH4OH, phonolite, ultramafic rock, mining waste and the proportion of 75 % of these K fertilizers and 25 % lime. Mixtures containing 25 % of lime were heated at 800 ºC for 1 h. These sources were applied at rates of 0, 150, 300, 450 and 600 kg ha-1 K2O, and incubated for 45 days. The mixtures of heated silicate rocks with lime promoted higher increases in soil pH in decreasing order: ultramafic rock>verdete>phonolite>mining waste. Applying the mining waste-lime mixture increased soil exchangeable K, and available P when ultramafic rock was incorporated. When ultramafic rock was applied, the release of Ca2+ increased significantly. Mining subproduct released the highest amount of Zn2+ and Mn2+ to the soil. The application of alternative sources of K, with variable chemical composition, altered the nutrient availability and soil chemical properties, improving mainly plant development and K plant uptake, and are important nutrient sources.

The aim of this study was to investigate the effect of laser phototherapy (LPT) in the prevention and/or treatment of oral mucositis induced by 5-fluorouracil (5-FU; Eurofarma, São Paulo, Brazil) in hamsters. Ninety-six hamsters were divided into four groups (n = 24): Control (no treatment); Preventive [LPT from day (D) D-5 to D+5]; Therapeutic (LPT from D+5 to D+15); and Combined (preventive plus therapeutic LPT from D-5 to D+15). The animals received an intraperitoneal injection of 5-FU on Days 0 and 2. The pouch mucosa was scratched on Days 3 and 4. The irradiation parameters were: indium-gallium-aluminum-phosphide (InGaAlP) diode laser (MM Optics, São Carlos, Brazil) (660 nm), beam area of 0.036 cm2, 40 mW, 1.11 W/cm2, 6.6 J/cm2, power density applied daily of 39.6 J/cm2, in punctual mode (six points and six seconds per point) and contact mode, one application per day. The animals were sacrificed on Days 0, 5, 10 and 15 (n = 6) and weighed, and the pouch mucosa was removed for histopathological analysis. Clinical and corresponding histological scores were compared using ANOVA and Tukey's test (p ≤0.05). Similar weight losses ranging from 5% to 10% occurred in all groups. The therapeutic group had significantly lower clinical and histological scores than the other groups at Day 10. This study showed that positive effects on oral mucositis management were obtained only when LPT was applied in the therapeutic protocol (from D+5 to D+15 after chemotherapy).

CONTEXTUALIZAÇÃO: A Pediatric Balance Scale (PBS) foi desenvolvida a partir de uma modificação da Escala de Equilíbrio de Berg (EEB), visando obter uma escala de equilíbrio mais apropriada para a população infantil. OBJETIVOS: Adaptar para o português-Brasil e avaliar a confiabilidade intra-avaliador e interavaliadores/observadores da versão brasileira da PBS. MÉTODOS: Para a adaptação cultural da versão americana da PBS, foram envolvidos quatro tradutores que realizaram duas traduções e respectivas retrotraduções, uma revisão por um comitê multidisciplinar e uma avaliação subsequente da equivalência de significado entre as retrotraduções e o original (respectivamente três e 30 profissionais da área de saúde). A confiabilidade intra-avaliador da escala final em Português - Escala de Equilíbrio Pediátrica (EEP) - foi avaliada comparando-se duas avaliações repetidas pelo mesmo avaliador com o intervalo de uma semana. A confiabilidade interavaliadores foi testada comparando-se as avaliações de dois avaliadores diferentes que realizaram o teste no mesmo dia. A confiabilidade interobservadores, a partir do vídeo do desempenho dos voluntários, foi avaliada por meio da comparação da pontuação dada independentemente por cinco observadores. A confiabilidade foi avaliada por meio do Coeficiente de Correlação Intraclasse (CCI). Foram avaliados 15 voluntários (11±2,7 anos) com diagnóstico de Paralisia Cerebral (PC), classificados nos níveis I e II do Sistema de Classificação da Função Motora Grossa (GMFCS). RESULTADOS: A confiabilidade para o escore total da EEP foi excelente tanto para o teste intra-avaliador (CCI=0,85) como para o interavaliadores (CCI=0.91). A confiabilidade interobservadores (a partir do vídeo) para o escore total foi excelente (CCI=0,98). CONCLUSÃO: Os resultados mostraram confiabilidade adequada para a EEP para a população pediátrica com diagnóstico de PC classificada nos níveis I e II do GMFCS.

BACKGROUND: The Pediatric Balance Scale (PBS) was developed from a modified version of the Berg Balance Scale aiming to obtain a balance scale more appropriate for the child population. OBJECTIVES: To adapt the PBS into Brazilian-Portuguese and to evaluate the intra and inter-rater reliability of the Brazilian-Portuguese version of PBS. METHODS: To perform the cross-cultural adaptation of the American version of PBS four translators were involved, who have performed two translations and their respective back-translations. Then, a review by a multidisciplinary committee and a subsequent an assessment of the equivalence of meaning between the back-translations and the original English scale were performed by 3 and 30 healthcare professionals respectively. The intra-rater reliability of the final version of the Brazilian-Portuguese PBS was evaluated using a test-retest design with one-week interval. The Brazilian-Portuguese version of the PBS was tested twice on the same day by two different raters to test the inter-rater reliability. The inter-rater reliability, which was measured from a video of the volunteers performance, was evaluated by comparing the score given by five raters independently. Reliability was evaluated by Intraclass Correlation Coefficient (ICC). Fifteen volunteers (11±2.7 years) diagnosed with Cerebral Palsy (CP) classified at level I and II on the Gross Motor Function Classification System (GMFCS) were assessed. RESULTS: The reliability of the PBS total score for both intra-rater (ICC=0.85) and inter-rater (ICC=0.91) was excellent. The inter-rater reliability (measured from the video) for the total score was also classified as excellent (ICC=0.98). CONCLUSION: The results showed adequate reliability for the PBS for pediatric population with CP diagnostic classified at level I and II on the GMFCS.

INTRODUÇÃO: A atividade física proporciona benefícios sobre o sistema neurológico, em particular, sobre as deficiências motoras e de equilíbrio, sendo estes déficits importantes em indivíduos com sequelas após acidente vascular encefálico (AVE). OBJETIVO: Avaliar a relação existente entre o equilíbrio e nível de confiança no equilíbrio com o nível de atividade física e com a qualidade de vida (QV) de indivíduos com hemiparesia após AVE. Método: Participaram 19 indivíduos (57,8 ± 14,1 anos) com hemiparesia crônica (44,1 ± 37,9 meses). Avaliou-se o perfil de atividade humana (PAH), o nível de confiança no equilíbrio (ABC), o equilíbrio funcional (BERG) e a QV (EQVEAVE). Os dados foram submetidos ao teste de coeficiente de correlação de Spearman. RESULTADOS: O PAH ajustado apresentou uma correlação positiva forte para o BERG (ρ = 0,73) e uma correlação positiva moderada para o ABC (ρ = 0,64). A QV (total) e os domínios de papéis familiares e mobilidade da EQVE-AVE apresentaram correlações moderadas para BERG e ABC (ρ entre 0,53 e 0,67). O PAH total e ajustado apresentaram correlação positiva moderada com os domínios mobilidade (respectivamente, ρ = 0,48 e ρ = 0,71), autocuidado (ρ = 0,48 e ρ = 0,65), função do membro superior (ρ = 0,56 para ambos) e visão (ρ = 0,49 e ρ = 0,69). CONCLUSÃO: Sugere-se que quanto mais ativo o indivíduo se apresenta melhor será seu equilíbrio e sua confiança no equilibrar-se, tanto na realização das atividades de vida diária (AVDs) como também nas atividades físicas, com um impacto positivo na sua QV. Diante disto, é de extrema importância o desenvolvimento de programas de atividade física voltados para indivíduos com hemiparesia após AVE.

INTRODUCTION: Physical activity brings benefits to the neurological system, especially to motor and balance impairment, which are important deficits in individuals with sequels after a stroke. OBJECTIVE: To assess the correlation between the level of physical activity and balance in the quality of life of individuals with hemiparesis after a stroke. Method: 19 individuals (57.8 ± 14.1 years old) with chronic hemiparesis (44.1 ± 37.9 months) were involved in this study. The study evaluated the human activity profile (HAP), the balance confidence level (ABC), the functional balance (BERG) and quality of life (SSQOL). Data were submitted to analysis of Spearman's correlation coefficient. RESULTS: HAP presented a positive strong correlation with the scores of functional balance (BERG; ρ = 0.73) and a moderated positive correlation with the scores of balance confidence (ABC; ρ = 0.64). Total HAP and the HAP set showed moderate positive correlation with the mobility (respectively ρ = 0.48 and ρ = 0.71), self-care (ρ = 0.48 and ρ = 0.65), upper limb function (ρ = 0.56 for both) and vision (ρ = 0.49 and ρ = 0.69) domains. Quality of life and the family roles and mobility domains showed moderate correlations with both functional and balance with balance confidence. CONCLUSION: The results of this study suggest that the more active the person is, the greater his/her balance and quality of life will be. Considering this, the development of physical activity programs for individuals with hemiparesis after strokes becomes extremely important.

O objetivo do presente estudo foi comparar as variáveis espaço-temporais entre o andar para frente (AF) e para trás (AT) em indivíduos com hemiparesia. Dez participantes com hemiparesia crônica (30,6±25,1 meses), comprometimento motor leve (20-31 pontos no Fugl-Meyer-membro inferior), bom equilíbrio (escore=50±7 na escala de Berg) e marcha independente (capaz de caminhar 10 metros sem auxilio) foram filmados caminhando em velocidade confortável, com marcadores reflexivos nos maléolos laterais. As variáveis comprimento, duração e velocidade da passada, bem como duração do apoio foram analisadas pela ANOVA com 2 fatores: tarefa e membro inferior. O comprimento da passada foi menor (~44cm) no AT do que no AF (F(1,18)=130,94; p≤0,001), assim como a velocidade da passada (F(1,18)=163,78;p≤0,001) e da marcha (t19=10,99;p≤0,001). A duração da passada e do apoio foram respectivamente maiores, ~0,18s e ~8%, no AT do que no AF, (F(1,18)=11,98; p=0,003; F(1,18)=32,00; p≤0,001, respectivamente). Embora o comprimento da passada do AT seja reduzido, o maior tempo do MI parético suportando o peso do corpo no AT pode ser um indicador relevante na reabilitação motora.

The present study aimed to compare spatial temporal variables between forward (FW) and backward walking (BW) in individuals with hemiparesis. Ten adults with chronic hemiparesis (30.6±25.1 months), mild motor impairment (20-31 points on Fugl-Meyer lower limb test), good balance (score=50±7 in the Berg scale) and independent walking (able to walk 10 meters without aid) were videotaped walking at comfortable speed with reflexive markers placed on lateral malleolus. The variables stride length, duration and speed and stance phase duration were analyzed with a two-way ANOVA: task and lower limb (LL). Stride length was lower (~44cm) in BW than in FW (F(1,18)=130,94; p≤0,001), as well as for stride (F(1,18)=163,78;p≤0,001) and walking speed (t19=10,99;p≤0,001). Stride and stance duration were ~0,18s e ~8%, respectively larger in BW than in FW (F(1,18)=11,98; p=0,003; F(1,18)=32,00; p≤0,001, respectively). Although the stride length in BW was reduced, the fact that the affected LL remained longer in stance in BW compared to FW indicates that the BW might be a relevant parameter in motor rehabilitation.

FUNDAMENTO: Devido à hemiparesia, a avaliação da aptidão cardiorrespiratória de indivíduos após acidente vascular encefálico (AVE), por meio de testes ergométricos com protocolos convencionais, tem se tornado um desafio. OBJETIVO: Realizar teste cardiopulmonar (TCP) em hemiparéticos para uma avaliação pré-participação visando uma criteriosa prescrição de exercício aeróbico. MÉTODOS: Participaram do estudo 8 indivíduos com hemiparesia crônica, que foram submetidos a TCP realizado com protocolo individualizado em rampa, desenvolvido a partir da informação da velocidade de marcha dos indivíduos previamente avaliados em teste de pista. Foi considerada a proposta de inclinação variando entre 0 e 10,0%, velocidade inicial correspondente a 70,0% do ritmo de caminhada confortável e velocidade máxima 40,0% superior à velocidade máxima no teste de pista, na expectativa de que o TCP, com este incremento gradativo e constante da intensidade, durasse entre 6 e 8 minutos. RESULTADOS: Em 100,0% dos avaliados, o motivo para a interrupção do teste foi fadiga periférica. O VO2 de pico alcançado foi de 20,6 ± 5,7 ml/kg.min. O Limiar I foi identificado em todos os exames, situando-se em 82,64 ± 4,78% da FC de pico e 73,31 ± 4,97% do VO2 de pico. O quociente respiratório (R) do grupo foi de 0,96 ± 0,09, e três dos 8 indivíduos (37,5%) atingiram R superior a 1,00, sendo o Limiar II identificado nestes sujeitos. Foram encontradas relações positivas entre variáveis do TCP e escores de equilíbrio, desempenho no teste de caminhada de 6 minutos e velocidade de marcha no solo. CONCLUSÃO: O teste mostrou ser útil para prescrição de atividade física nesses indivíduos.

BACKGROUND: Due to the hemiparesis, the assessment of cardiorespiratory fitness on individuals after cerebrovascular accident (CVA), using exercise tests with conventional protocols, has become a challenge. OBJECTIVE: Perform cardiopulmonary test (CPT) in hemiparetic patients to a pre-participation evaluation aimed at a careful prescription of aerobic exercise. METHODS: The study included eight individuals with chronic hemiparesis who underwent CPT performed with individualized ramp protocol, developed from information on the gait speed of individuals previously evaluated in the track test. We considered the proposal of inclination ranging from 0 to 10.0%, initial speed corresponding to 70.0% of comfortable walking speed rhythm and 40.0% higher than the maximum speed on the track test, expecting that the CPT with this gradual and steady increase in intensity, lasted from 6 to 8 minutes. RESULTS: In 100.0% of the sample, the reason for discontinuation was peripheral fatigue. The peak VO2 achieved was 20.6 ± 5.7 ml/kg.min. The threshold I was identified in all tests, standing at 82.64 ± 4.78% of peak HR and 73.31 ± 4.97% of peak VO2. The respiratory quotient (R) of the group was 0.96 ± 0.09, and three out of eight individuals (37.5%) reached R higher than 1.00, and the Threshold II was identified in these individuals. We found positive relationships between CPT variables and balance scores, performance in the 6-minute walking test and running speed on the ground. CONCLUSION: The test proved to be useful for prescribing physical activity in these individuals.

FUNDAMENTO: Debido a la hemiparesia, la evaluación de la aptitud cardiorrespiratoria de individuos después de accidente vascular encefálico (AVE), por medio de pruebas ergométricas con protocolos convencionales, se ha vuelto en un reto. OBJETIVO: Llevar a cabo prueba cardiopulmonar (PCP) en hemiparéticos para una evaluación pre participación que busca una criteriosa prescripción de ejercicio aeróbico. MÉTODOS: Participaron en el estudio 8 individuos con hemiparesia crónica, que se sometieron a PCP realizado con protocolo individualizado en rampa, desarrollado a partir de la información de la velocidad de marcha de los individuos previamente evaluados en prueba de pista. Se consideró como la propuesta de inclinación variando entre el 0% y el 10%, velocidad inicial correspondiente a un 70% del ritmo de caminata confortable y velocidad máxima el 40% superior a la velocidad máxima en la prueba de pista, en la expectativa de que el PCP, con este incremento gradual y constante de la intensidad, durase entre 6 y 8 minutos RESULTADOS: El 100% de los evaluados, la motivación para la interrupción de la prueba fue fatiga periférica. El VO2 de pico alcanzado fue de 20,6 ± 5,7 ml/kg.min. Se identificó el Umbral I en todos los exámenes, situándose en 82,64 ± 4,78% de la FC de pico y 73,31 ± 4,97% del VO2 de pico. El cociente respiratorio (R) del grupo fue de 0,96 ± 0,09, y tres de los 8 individuos (37,5%) alcanzaron R superior a 1,00, siendo el umbral II identificado en estos sujetos. Se encontraron relaciones positivas entre variables del PCP y scores de equilibrio, desempeño en la prueba de marcha de 6 minutos y velocidad de marcha en el suelo. CONCLUSIÓN: La prueba se reveló útil para prescripción de actividad física en estos individuos.

INTRODUÇÃO: Um número crescente de programas de treinamento com resultados positivos tem sido proposto para a reabilitação de pacientes com sequelas motoras após acidente vascular encefálico (AVE). No entanto, observa-se que muitos não oferecem recomendações no que diz respeito a indicações para técnicas e procedimentos específicos. OBJETIVO: Revisar a literatura pertinente sobre programas de treinamento envolvendo marcha, condicionamento cardiorrespiratório e fortalecimento muscular de membros inferiores em pacientes portadores de hemiparesia por sequela de AVE, e descrever a eficácia, limitações e efeitos desses programas na recuperação cardiovascular, funcional e motora dessa população. MÉTODO: Foi realizada uma busca por ensaios clínicos, trabalhos pré-experimentais, meta-análises e revisões de literatura que abordassem os temas treinamento físico, fortalecimento muscular, treinamento de marcha e programas de exercícios para membros inferiores após AVE. RESULTADOS: Foram encontrados 27 artigos relatando diversos protocolos de treinamento (marcha, treinamento cardiovascular, fortalecimento muscular, entre outros) e seus efeitos no sistema cardiovascular, músculo-esquelético e sobre o status funcional em indivíduos portadores de hemiparesia após AVE. CONCLUSÃO: Praticamente todas as intervenções relatam resultados positivos em termos de ganhos funcionais, além de efeitos específicos de acordo com o tipo de treinamento. No entanto, as diferenças metodológicas, a carência de grupo controle em alguns estudos, a variabilidade da população estudada e os critérios de análise nem sempre permitem a recomendação segura de procedimentos específicos na prática clínica.

INTRODUCTION: An increasing number of training programs with positive results has been proposed for rehabilitation of stroke survivors with motor impairments. However, few studies offer recommendations regarding indications for specific techniques and procedures. OBJECTIVE: To review data from the literature about training and exercise programs in patients with hemiparesis following stroke regarding walking training, lower limb strengthening and cardiorespiratory fitness, and to describe the efficacy, limitations and effect of such programs on cardiovascular, motor recovery and functional status. Method: It was made a search in relevant medical journals for articles of clinical trials, meta-analyses, and literature reviews pertaining to physical training, muscular strengthening, gait training and exercise programs for lower limbs after stroke. RESULTS: It was found 27 articles reporting on various training and exercise techniques (gait training, cardiovascular training, muscle strengthening, and others) and their results on the cardiovascular, musculoskeletal, and neurological systems, as well as functional status in stroke patients. CONCLUSION: Training and exercise programs have value in stroke rehabilitation, and published results are, in general, promising. The differences in the populations tested, methods, and criteria for analysis do not always allow the recommendation of specific procedures in clinical practice.

The Nothofagus genus includes about 35 native tree species of the Southern hemisphere. In Patagonia various natural hybrids among different species of the genus were found. The aim of this work was to describe and determine the presence of putative natural hybrids between N. pumilio and N. antarctica at South Patagonia, through the study of morphological leaf characteristics. Twenty possible hybrids (individuals with both parental species characteristics), 10 pure individuals of each of the two parental species, were studied. Material was collected in transition areas between N. pumilio and N. antarctica in Tierra del Fuego forests. Twenty leaves of each individual were selected through random sampling. Length, width, distance from the largest width to the base, shape, base, apex and petiole length of each leaf were measured. The leaves of the supposed hybrid differ from those of N. pumilio in their size, distance of the largest width to the base and base. Nothofagus antarctica leaves are different from the supposed hybrid in their border, size and distance of the largest width to the base and base. These results prove that the studied species hybridize naturally in transition areas. This hybridization capacity can be used in genetic improvement programs for the development of individuals with the best characteristics of each parental species.

El género Nothofagus comprende alrededor de 35 especies nativas del Hemisferio Sur. En la Patagonia se han citado numerosos ejemplos de híbridos naturales entre varias especies de Nothofagus. El objetivo del presente trabajo fue analizar y describir la evidencia de la existencia de posibles híbridos naturales entre Nothofagus pumilio y N. antarctica en Patagonia Sur, mediante el estudio de caracteres morfológicos foliares. Se trabajó con 20 posibles híbridos recolectados en una zona de transición entre bosques de N. pumilio y N. antarctica de Tierra del Fuego, y con individuos de N. pumilio y N. antarctica obtenidos de poblaciones puras cercanas a las anteriores. Por medio de un muestreo aleatorio se seleccionaron 20 hojas de cada individuo a las que se les midió largo, ancho, distancia del mayor ancho a la base, forma, base, borde, ápice y largo del pecíolo. Las hojas de los posibles híbridos difirieron de N. pumilio en tamaño, distancia del ancho máximo a la base y frecuencia de asimetría en la base, y de N. antarctica en distancia del ancho máximo a la base, tamaño y frecuencias de asimetría en la base y de borde crenado. Los resultados obtenidos sugieren que N. pumilio y N. antarctica hibridizan naturalmente en zonas de condición ecotonal. Dicha capacidad de hibridación podría utilizarse en programas de mejoramiento genético para el desarrollo de individuos con las mejores características de cada especie parental.