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Rio de Janeiro, Brazil

Ferreira A.D.S.,Centro Universitario Augusto Motta | Ferreira A.D.S.,Salgado de Oliveira University
Biomedical Signal Processing and Control | Year: 2013

This study analyzed the 'pressing with one finger' technique for wrist pulse-taking and explored the identification of internal organs according to the resonance theory in the circulatory system. A five-section discretized- transmission-line model of the distal upper limb was proposed considering the radial artery, the distal positions chi-guan-cun, and the hand vasculature. The transfer function of the model was parameterized in terms of its resonance frequency and respective amplification factor. Rheological and geometrical parameters of the modeled arterial system were used to simulate a sample of 1000 healthy volunteers subjected to wrist pulse-taking examination. The 'pressing with one finger' technique was simulated individually at each position by varying the vertical (minor) diameter of the elliptical cross-sectional radial artery from 0% to 99%. The pulse waveform harmonics were calculated in the frequency domain and had their internal organs assigned according to the resonance theory. Compressions in range 0-70% resulted in resonance frequencies around 3-6 Hz (related to the spleen) and amplification factors > 1. Compression in range 70-85% shifted up the resonance frequency of the majority of cases up to 6-8 Hz (related to the heart) and a minority of cases was shifted down to 0-2 Hz. A large decrease in the amplification factor occurred with module values <1. Compressions in range 85-99% increased the resonance frequency to 7-10 Hz (related to the gallbladder) with an even decent amplification factor. These effects were more pronounced in the proximal to distal sequence of positions. Therefore, pressing with one finger amplified specific pulse wave harmonics as a function of depth in all three positions, but it did not explore all harmonics described by the resonance theory. © 2012 Elsevier Ltd. All rights reserved.

de Sa Ferreira A.,Centro Universitario Augusto Motta | de Sa Ferreira A.,Salgado de Oliveira University
Chinese Journal of Integrative Medicine | Year: 2013

Chinese medicine is among other traditional medical systems practiced either as a coadjutant intervention to Greek medicine or as the unique therapeutic intervention for illness prevention, treatment or rehabilitation. The complete spectrum from that traditional system includes acupuncture and moxibustion, herbal and food therapy, massage therapy (tuina), physical exercises (taijiquan), and breathing exercises (qigong). In this article, it is presented several randomized controlled trials and systematic reviews on the application of all therapeutic modalities from Chinese medicine in the physical rehabilitation scenario. The discussed studies encompasses both "positive" and "negative" results of Chinese medicine intervention for disabilities due to illnesses of the nervous, musculoskeletal or cardiovascular systems. Additionally, the importance of the personalized approach for Chinese medicine and rehabilitation is emphasized together with the need for reproducible methods for pattern differentiation and intervention selection. Chinese medicine resources are recognized as promising methods for therapeutic rehabilitation and can be incorporated into the rehabilitation science. The wide variety of therapeutic resources explains why Chinese medicine is currently a multidisciplinary practice for health protection and promotion, early diagnosis and treatment as well as rehabilitation with roles in the public health care system. © 2013 Chinese Association of the Integration of Traditional and Western Medicine and Springer-Verlag Berlin Heidelberg.

Mansur H.N.,Salgado de Oliveira University
Jornal brasileiro de nefrologia : 'orgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia | Year: 2012

Frailty is a physiological vulnerability status of the patient which is associated with the increased number of hospitalization and death. To evaluate the prevalence of frailty and its associated factors in patients with chronic kidney disease (CKD) on conservative treatment (CT), hemodialysis (HD) and peritoneal dialysis (PD). Frailty was assessed in 146 patients (86 CT, 37 HD and 23 PD) and characterized as muscle weakness and exhaustion--by the physical aspect and vitality domains, respectively, evaluated in the SF-36 quality of life instrument; physical inactivity--if he or she answered "never" or "hardly ever" when asked about physical activity; and as unintentional weight loss (> 4.5 kg per year). Patients were divided into three groups: non-fragile (NF), pre-fragile (PF) and fragile (F). The demographic, clinical and laboratory data were extracted from patient charts. Frailty was diagnosed in 36% of patients on CT, 37.8% in HD and 47.8% in PD. It was characterized in 36.8% of patients aged between 20 and 40 years and 40.3% of those between 41 and 60 years. Frailty was significantly associated with the use of vitamin D (r = 0.16; p = 0.03), hemoglobin (r = -0.14; p = - 0.02) and intact parathyroid hormone (r = 0.16; p = 0.03). Frailty is common among patients with CKD on conservative treatment and dialysis, even in those who are not elderly. In the patients studied, the phenotype of frailty was associated with no usage of vitamin D, lower serum levels of hemoglobin and higher levels of parathyroid hormone.

BACKGROUND: Stroke is a morbid entity in Chinese medicine recognized for over 2 000 years with sensory-motor impairments reported by several classical authors. However, the majority of controlled clinical trials of acupuncture in the treatment of poststroke recovery failed to obtain significant long-term results on functional recovery. Moreover, contradictory results have been obtained regarding the immediate effects of acupuncture stimulation on the electrical activity of human skeletal muscles as observed using surface electromyography. These results raise the question of whether acupuncture has any effect on the neuromuscular level. This study aims to evaluate the immediate effects of manual acupoint stimulation on the electrical activity and strength of the biceps brachii of healthy individuals and patients with chronic hypertonic hemiparesis. METHODS AND DESIGN: The study proposes a single-blinded randomized clinical trial with four parallel groups. Healthy subjects and poststroke patients with chronic spastic hemiparesis will be submitted to a single acupuncture intervention puncturing either Quchi (Llll) or Tianquan (PC2). The immediate effects on muscle function will be assessed by surface electromyography and isometric force of the biceps brachii muscle as the primary outcome. Secondary outcomes comprise the frequency of patterns in each group, as well as the frequency distribution of manifestations. DISCUSSION: The proposed study design includes some improvements on common methodological issues on clinical trials with an integrative design. This study design is expected to provide new insights on the neuromuscular effects of acupuncture stimulation in healthy subjects and poststroke patients. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (www.ensaiosclinicos. gov. br) in English and Portuguese in October 2011. Registration number: RBR-5g7xqh.

Araujo A.T.C.,Salgado de Oliveira University | Eickmann S.H.,Federal University of Pernambuco | Coutinho S.B.,Federal University of Pernambuco
Revista Brasileira de Saude Materno Infantil | Year: 2013

Objectives: to assess the frequency of late motor development in premature children admitted to a neonatal unit and to identify associated factors. Methods: a descriptive analytical study carried out at the Neonatal Unit of a high-risk maternity hospital in Recife, Brazil. Motor development was assessed using the Test of Infant Motor Performance, in 98 preterm children with a minimal post-conception age of 34 weeks, during admission to hospital, between January and June 2009. Associations were examined between variables relating to the mother, the newborn, the care provided and motor development. Results: the mean post-conception age on evaluation was 37 weeks and 39.8% of the children had some kind of impaired motor development (atypical or suspected to be atypical). Factors significantly associated with changes in motor development were: lower birth weight; higher age on evaluation; greater number of prenatal sessions; occurrence of hypoxia and bronco-pulmonary dysplasia; longer stay in ICU and neonatal unit. There was a significant trend for motor development to worsen with prolonged use of oxygen-therapy and mechanical ventilation. Conclusions: premature children admitted to hospital may show early signs of delayed motor development of a severe or borderline nature. Birth weight, neonatal morbidities and care received at the neonatal unit were the factors that most strongly influenced the outcome. These results justify initiation of preventive strategies and stimulation while the child is still in hospital.

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