Diego de Sousa Dantas

Quantum molecular modelling of ibuprofen bound to human serum albumin

The binding of the nonsteroidal anti-inflammatory drug ibuprofen (IBU) to human serum albumin (HSA) is investigated using density functional theory (DFT) calculations within a fragmentation strategy. Crystallographic data for the IBU–HSA supramolecular complex shows that the ligand is confined to a large cavity at the subdomain IIIA and at the interface between the subdomains IIA and IIB, whose binding sites are FA3/FA4 and FA6, respectively. The interaction energy between the IBU molecule and each amino acid residue of these HSA binding pockets was calculated using the Molecular Fractionation with Conjugate Caps (MFCC) approach employing a dispersion corrected exchange–correlation functional. Our investigation shows that the total interaction energy of IBU bound to HSA at binding sites of the fatty acids FA3/FA4 (FA6) converges only for a pocket radius of at least 8.5 A, mainly due to the action of residues Arg410, Lys414 and Ser489 (Lys351, Ser480 and Leu481) and residues in non-hydrophobic domains, namely Ile388, Phe395, Phe403, Leu407, Leu430, Val433, and Leu453 (Phe206, Ala210, Ala213, and Leu327), which is unusual. Our simulations are valuable for a better understanding of the binding mechanism of IBU to albumin and can lead to the rational design and the development of novel IBU-derived drugs with improved potency.

Klapp method effect on idiopathic scoliosis in adolescents: blind randomized controlled clinical trial

[Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured by biophotogrammetry. Data were obtained by Generalized Estimated Equation, with 5% significance level. Clinical impact for dependent variables was estimated by “d” Cohen. [Results] There was no change in intragroup analysis and intergroup for all postural symmetry variables. However, it was detected intergroup difference in extensor muscle strength and intergroup difference with marginal significance of gibbosity angles. Regarding extensor muscle strength, intervention group produced average improvement of 7.0 kgf compared to control group. Gibbosity angles progressed less in intervention group, with 5.71° average delay compared to control group. [Conclusion] Klapp method was effective for gibbosity stabilization and it improves spine extensor muscle strength.

CONTRIBUIÇÕES DE UM GRUPO DA TERCEIRA IDADE PARA A SAÚDE DAS IDOSAS PARTICIPANTES

Objective: Aging leads to significant losses in the elderly, whether physical, psychological or social. In this context, social support programs and welcoming environments are highlighted by being prosecutor elements of security and well-being, stimulating and enhancing the autonomy of the elderly. Given this, we aimed to identify the social benefits of a support group for older participants under their own perspective. Material and Methods: A cross-sectional study was conducted consisting of 20 women with a mean age of 69.1 ± 6.29 years, participants of Group Renascer (“Reborn”), inland of Paraiba state. Results: It was verified a good ability to perform functional activities that require flexibility, in contrast with a deficit for activities requiring strength. Regarding contributions to the self-image, 65% reported having greater satisfaction in living upon participation of the group, and 35% felt more socially valued. In the social relationships, 57% reported “ease of living”; 24% greater emotional expressiveness; while 19% said nothing had changed. Conclusion: the Group “Reborn” provided improvements in the personal dimension concerning individual skills, making the elderly more confident, with more self-esteem, better functional capacity and quality of life. In the social dimension, there was an improvement in the relationships among the elderlies themselves and in their social relationships, in addition to an encouragement for collective constructions. DESCRIPTORS Public Health. Social Assistance. Elderly.

Linking of assessment scales for women with urinary incontinence and the International Classification of Functioning, Disability and Health

Abstract Purpose: This study aimed to link the content of four most used questionnaires to assess the quality of life of women with urinary incontinence (International Consultation on Incontinence Questionnaire; Kings Health Questionnaire; Incontinence Quality of Life Questionnaire and Bristol Female Urinary Tract Symptoms Questionnaire) with the International Classification of Functioning, Disability and Health (ICF). Methods: Linking the questionnaires content and the ICF was performed by two independent reviewers, with an excellent concordance level (k = 0.941), using the method described by Cieza et al. Results: A total of 94 items were analyzed, in which 154 meaningful concepts were identified and linked to 48 ICF categories, of which 49% were from activities and participation component (d) and 36.8% from body functions (b). Conclusions: The scales are linked with the classification at different levels. The International Consultation on Incontinence Questionnaire was the most limited instrument. Bristol Female Urinary Tract Symptoms Questionnaire and Incontinence Quality of Life Questionnaire presented greater agreement with the ICF, but the concepts in their items are mostly linked to body functions, denoting a biomedical vision. King’s Health Questionnaire demonstrated greater affinity with the ICF, and most concepts were related to the activities and participation categories, approaching more effectively the biopsychosocial model. Implications for Rehabilitation Choosing the right instrument to assess the quality of life of women with urinary incontinence can be a difficult task, since the instruments have different approaches. The use of International Classification of Functioning, Disability and Health as a reference among health professionals involved in rehabilitation of women with urinary incontinence will promote unification of the language about this group functioning. The comparison among instruments presented here will help the professional to choose the one that provides the greatest amount of information in a consistent way, aiding the clinical decision-making process.

Avaliação do nível de conhecimento e aplicabilidade da Classificação Internacional de Funcionalidade, Incapacidade e Saúde

RESUMO A pesquisa foi conduzida com o objetivo de avaliar o nivel de conhecimento e aplicabilidade da Classificacao Internacional de Funcionalidade, Incapacidade e Saude por profissionais de saude do municipio de Natal (RN). Trata-se de um estudo transversal, que avaliou 186 profissionais de saude, mediante questionario eletronico semiestruturado, composto de questoes sobre o nivel de conhecimento em relacao a classificacao e sua aplicabilidade. Concluiu-se que os profissionais de saude possuem pouco conhecimento sobre a ferramenta. Alem disso, os que relataram conhece-la, dela fazem pouco uso devido as dificuldades para seu entendimento e aplicacao.

Associação entre função sexual, independência funcional e qualidade de vida em pacientes após acidente vascular encefálico

Este estudio de tipo observacional, cuantitativo, transversal tiene el objetivo de analizar la funcion sexual y comparar la calidad de vida y la independencia funcional entre los sujetos sexualmente activos e inactivos, acometidos por accidente cerebrovascular. Se contactaron a los sujetos por telefono y se agendo una cita con ellos segun la disponibilidad. Se les aplico a los participantes una encuesta de evaluacion para conocer sus datos sociodemograficos, habitos de vida, salud y funcion sexual, ademas del cuestionario abreviado de la evaluacion de la calidad de vida Whoqol-Bref y la escala de la medida de independencia funcional. De los 29 sujetos evaluados un 48,3% eran sexualmente activos. De estos, un 64,3% son hombres y un 35,7% mujeres. La mayoria de los participantes informaron que hubo una disminucion de la actividad sexual tras la enfermedad (64,3%), un 60% de las mujeres presentaron disfuncion sexual por el coeficiente sexual -version femenina, y un 77,7% de los hombres presentaron disfuncion erectil, evaluada por el Indice internacional de funcion erectil. Los sujetos sexualmente activos presentaron una mejor calidad de vida referente al dominio fisico (p=0,035), una mayor independencia funcional motora (p=0,005) y cognitiva (p=0,006) en comparacion a los que no tenian actividad sexual. Se concluye que gran parte de estos sujetos mantienen una vida sexual activa y que hay asociacion entre la practica de la actividad sexual a la independencia cognitiva y motora.

Carta ao editor

O artigo esta bem escrito e e muito claro. No en-tanto, chamou-nos a atencao o fato de que a ap-neia obstrutiva do sono, uma patologia extrema-mente prevalente e que esta fortemente associadaa DRGE, foi praticamente esquecida. No sentidode fundamentar a nossa observacao, fizemos umlevantamento de quantos artigos sobre a associa-cao da DRGE com as patologias destacadas narevisao sao citados no banco de dados MEDLINE.A primeira patologia associada a DRGE destacadano artigo de revisao e a asma, que nao por acasoe tambem a associacao mais citada no MEDLINE,com 791 artigos. O segundo item e tosse (510artigos), seguido de fibrose pulmonar (35) e la-ringite (209). Outras doencas, que foram desta-cadas na Tabela 1 da referida revisao, foram ate-lectasia (30 artigos), bronquite cronica (40 arti-gos), bronquiectasia (45), doenca pulmonar obs-trutiva cronica (41) e pneumonias (499). A ap-neia obstrutiva do sono (59 artigos) foi citada naintroducao, lado a lado com a erosao dentaria(100 artigos). O fato de os autores nao desenvol-verem o tema relacionado a erosao dentaria estajustificado pois, apesar de ser este um tema apa-rentemente importante (a se julgar pelo numerode citacoes no MEDLINE), a revisao nao foi direcio-nada para a Odontologia. Triste foi a constatacaode que a apneia obstrutiva do sono, que e umaarea de atuacao da Pneumologia, recebeu o mesmodestaque que a ja citada erosao dentaria, ou seja:nenhum. Nao devemos perder de vista que quemassina esta carta sao pneumologistas que militam

Fragility in the elderly participants of coexistence and health promotion groups in the aging

INTRODUCTION: The frailty syndrome is a complex condition that permeates the life of the elderly, with the decrease of the homeostatic reserve of the organism and loss of resistance to the stressors, caused as results of many factors, but mainly by sarcopenia. Such syndrome makes the elderly vulnerable to illness and may lead to terminal stages of life if there is no adequate treatment. OBJECTIVE: To evaluate the influence of the factors related to the frailty phenotype in the occurrence of this in participants of groups of coexistence and health promotion of the city of Santa Cruz/RN. METHOD: This is a descriptive, associative and transversal of quantitative approach study with 60 elderly. The socioeconomic condition and the fragility phenotype was evaluated. RESULTS: the mean age of the sample was 66.1 years (SD=5.08). Most of them (53.3%) are in the age group of 60-69 years, does not have a partner (63.4%) and are illiterate (58.3%). In the mentioned morbidity, 42 (70%) reported some morbidity and hypertension was more prevalent in the sample (53.3%), followed by diabetes (20%) and osteoporosis (18.3%). Four elderly were fragile, forty-nine were pre-fragile and seven were non-fragile. There was a significant correlation in unintentional loss of weight (0.017), exhaustion (<0.001) and slowness in gait (<0.001) in the occurrence of pre-frailty. CONCLUSION: the prevalence of pre-frailty indicators in the investigated groups indicates warning signs so that actions more strongly linked to the prevention of this aggravation become a priority in the planning of the undertaken interventions in groups. Participation in social groups has a protective effect in the prevention of frailty in the elderly.

VENTILAÇÃO NÃO INVASIVA NA INSUFICIÊNCIA CARDÍACA ASSOCIADA À APNEIA DO SONO

Objective: This study aimed to review the literature on the use of Noninvasive Ventilation (NIV) as a non-pharmacological treatment in respiratory care to patients with sleep apnea syndrome in cases associated with severe heart failure (HF). Material and Methods: This is an integrative literature review comprising a sample 19 articles from journals in the field of health, available from the databases Scientific Electronic Library Online (SciELO), PubMED and Science Direct, published between 1999 and 2012. A combination of the following descriptors was used: heart failure, noninvasive ventilation and sleep apnea syndromes. Results: Data were analyzed through the technique of content analysis. Studies have shown that NIV reduces premature ventricular beats; improves the ejection fraction of the left ventricle (LV), saturation of oxygen in arterial blood (SO2), as well as central and obstructive sleep apnea. Moreover, it contributes to improved quality of life and reduced mortality in these patients. Conclusion: Various studies indicate that the effects of NIV in patients with HF seem to be promising in the treatment of stable cardiac disease, especially in cases with concomitant sleep disturbance. DESCRIPTORS Noninvasive Ventilation. Heart Failure. Sleep Apnea.