Medical Express

ISSN (print): 2318-8111

ISSN (online): 2358-0429

Issue: 2(2)2015 - 7 Articles

EDITORIAL

1 - MedicalExpress has been visited, downloaded and cited. Publish with us!

Mauricio Rocha e Silva

MEDICALEXPRESS 2015;2(2):M150201

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ORIGINAL RESEARCH

2 - Isokinetic dynamometry on the internal rotator and adductor muscles of the swimmers’ shoulders: no differences between asymmetrical and symmetrical swimming strokes

Leonardo Luiz Barretti Secchi; Guilherme Carlos Brech; Júlia Maria D’Andréa Greve

MEDICALEXPRESS 2015;2(2):M150202

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OBJECTIVE: In this study, we compare muscular strength of the internal rotators and adductors of the shoulder between asymmetrical (backstroke and freestyle) and symmetrical (breaststroke and butterfly) swimming strokes.
METHOD: We evaluated: shoulders of (a) asymmetrical swimmers (aged 21.8 ± 3.8 years), (b) symmetrical swimmers (aged 20.3 ± 4.5 years), (c) recreational swimmers (aged 24.5 ± 4.5 years), and (d) control individuals (aged 25.8 ± 3.5 years). All evaluations were performed on a Biodex® isokinetic dynamometer at velocities of 608 and 300º/second. Adduction and internal rotation movements were evaluated. The variables studied were peak torque corrected for body weight (PTQ/BW), total work (TW) and the agonist/antagonist relationship.
RESULTS: There were no differences in adductor strength between the symmetrical and asymmetrical swimmers regarding PTQ/BW (symmetrical: 114.4 Newto-meter vs. asymmetrical: 109.4 Newton-meter) and TW (symmetrical: 642.9 Joules; asymmetrical: 641.5 Joules). There was no difference in the abduction/adduction relationship between the symmetrical (67.4%) and asymmetrical (68.3%) swimmers. There was no difference in the internal rotator musculature between the symmetrical and asymmetrical swimmers regarding the variables PTQ/BW (symmetrical = 66.4 Newton-meter and asymmetrical = 63.4 Newton-meterm) and TW (symmetrical = 517.4J and asymmetrical 526.7 J). There was no difference in the ratio of external to internal rotation of the shoulder between the symmetrical (65.7%) and asymmetrical (61.5%) swimmers.
CONCLUSIONS: There were no differences in muscular strength in the adductor and internal rotator muscles of the shoulder between symmetrical and asymmetrical swimming strokes.


Keywords: Shoulder; Swimming; Muscle force; Dynamometry; Physiotherapy; Torque.

3 - Dentists and undergraduate dental students require more information relating to child abuse

Ana Rodrigues Moura; Armanda Amorim; Luís Proença; Virgínia Milagre

MEDICALEXPRESS 2015;2(2):M150203

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OBJECTIVE: To evaluate the preparation for, and the appropriate approach of dentists to the diagnosis of patient mistreatment.
METHOD: This investigation was conducted among sixty randomly selected dentistry students: twenty 1st year students, ten 5th year students at our institution, ten 5th year students at the Faculty of Dentistry, Lisbon University, sixteen dentists at the University Clinic of our institution, and four dentists with private offices. Students and dentists took part voluntarily. The exclusion criteria were (a) prior attendance of another degree, (b) cooperation with social organizations; and, for professionals, less than five years of experience. Data analysis was performed through descriptive and inferential statistics (chi-squared test) for a confidence level of 95%.
RESULTS: Among dentists, 38% do not know which area of the organism is the most affected, 43% know it is proper to officially report the fact; out of these, 48% know that the information may be provided anonymously. There are 47% who state that they received no undergraduate training in this area. However, 60% of the students in the last year declare they did receive training.
CONCLUSIONS: Dentists are not sufficiently familiar with the subject of child abuse. A regular approach to this matter in undergraduate education is important. It will be very useful to create a working tool unifying the criteria for screening, diagnosing, and registering such events.


Keywords: child abuse; dentist knowledge; orofacial manifestations.

4 - Nonalcoholic fatty liver disease: a cohort study focusing on treatment response to nutritional counseling

Tâmara Oliveira Reis; Silvia Marinho Ferolla; Maria Luiza Pereira Lima; Maria Arlene Fausto; Ana Cristina Lopes Albricker; Geyza Nogueira de Almeida Armiliato; Clara Gontijo Camelo; Lucas Paschoal Horta Gomes; Teresa Cristina Abreu Ferrari; Claudia Alves Couto

MEDICALEXPRESS 2015;2(2):M150204

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BACKGROUND: Nonalcoholic fatty liver disease is the leading cause of liver pathology. The mainstay of management is weight loss. Our aim was to evaluate responses to nutritional counseling in long-term patients with this condition.
METHODS: A prospective cohort study with consecutive inclusion of 105 subjects with nonalcoholic fatty liver disease who received individualized low-calories diet counseling (1400 to 1600 kcal/day according to gender) every three months for 24 months. Weight loss of 5% or more was considered as a therapeutic response.
RESULTS: Out of 105 patients, 45 (42.9%) did not return for a second evaluation. Mean age was 55 ± 9 years, 81.6% were women and mean body mass index was 31.9 (23.8 - 44.9) kg/m2. Follow-up time was 6.5 (3.2-26.9) months and median appointment number was 3 (2-11). Metabolic syndrome and hypercholesterolemia were more common in women. The number of subjects who lost more than 5% weight was: 5/20 (25%) at 6-months; 3/15 (33%) at 12 months; 3/18 (17%) at 18 months and 4/13 (31%) at the end of follow up. The median body weight loss at 6, 12, 18 and 24 months decreased significantly.
CONCLUSIONS: Adherence to nutritional counseling is poor in patients with nonalcoholic fatty liver disease. Only a very small proportion of patients reached the targeted body loss of weight on long term.


Keywords: hepatic steatosis; lifestyle; low-calories diet; obesity.

5 - Exposure of pregnant rats to shortwave electromagnetic athermal radiation does not adversely affect their fetuses

Alexandre Buchner de Oliveira; Rosana Alves Lessa; Carlos Alberto dos Santos ; Rodrigo Emmanuel Sabbag da Silva; Angelica Castilho Alonso ; Danielli Souza Speciali ; Julia Maria D'Andréa Greve; Alexandre Sabbag da Silva

MEDICALEXPRESS 2015;2(2):M150205

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BACKGROUND: The aim of this study was to determine whether shortwave electromagnetic radiation in pulsed mode with a frequency of 45 Hz, promotes teratogenic changes, stillbirths and changes in organ weight at birth in the fetuses of pregnant rats exposed to this radiation.
METHOD: Ten black Macole pregnant female rats were studied, 5 in a test group, subjected to electromagnetic radiation with an average power of 4.5W for 15 minutes, on a daily basis, during the entire period of pregnancy and 5 in a control group that was not exposed to radiation. At day 21, the animals were euthanized for analysis of fetuses. To assess the thermal effect of the radiation the abdominal temperature was measured before and after application, together with prevailing ambient temperature. The fetuses were evaluated through the Galant reflex to assess the existence of stillbirths. The fetuses were removed and weighed; through a midline laparotomy their hearts, stomachs, kidneys and livers were excised and weighed, wet and dry. Twenty-nine fetuses were harvested in the control group and 59 in the test group, with no cases of stillbirth, teratogenesis or malformation of internal organs.
RESULTS: The analysis found no differences in birthweight and weight of dehydrated organs when compared to the control group.
CONCLUSION: The results in our findings suggest that exposure to shortwave therapy without significant heat buildup, does not lead to teratogenic changes and did not affect the mass and weight of dehydrated internal organs.


Keywords: radio waves; pregnancy; teratogenesis; adverse effects.

REVIEW

6 - Effects of surfactants on preterm infant lungs

Gian Maria Pacifici

MEDICALEXPRESS 2015;2(2):M150206

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Lack of surfactant is the commonest cause of death in preterm infants. Their lungs may contain as little as 10 mg/kg of surfactant at birth, a tenth of the amount normally found at term. Surfactants (animal origin or synthetic) can reduce mortality by 40% in infants with less than 30 weeks of gestation. Poractant is the surfactant derived from minced porcine lungs, Beractant from minced bovine lungs. Bronchoalveolar lavage with diluted poractant is effective in mechanically ventilated term infants with severe acute respiratory distress syndrome due to meconium aspiration syndrome. Nebulized surfactant and mask airway surfactant do not require intubation. Alternatively, surfactant may be administered via a thin catheter during spontaneous breathing. In conclusion, surfactants reduce the mortality in preterm infants.


Keywords: beractant; poractante; calfactant; neonate; surfactant.

7 - Insights into the role of cervical mucus and vaginal pH in unexplained infertility

Fabiana Y. Nakano; Rogério de Barros F. Leão; Sandro C. Esteves

MEDICALEXPRESS 2015;2(2):M150207

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Unexplained infertility diagnosis is made in the presence of a normal semen analysis when tubal patency and normal ovulatory function are established. Among several potential causes, unexplained infertility could be attributed to vaginal pH and cervical mucus abnormalities. Although the vaginal canal and the cervix generally function as effective barriers to sperm, and although the production of mucus is essential to transport them from the vagina to the uterine cavity, these factors receive little attention in the investigation of couples with unexplained infertility. A substantial reduction in sperm number occurs as they transverse the cervix. From an average of 200 to 300 million sperm deposited in the vagina, only a few hundred achieve proximity to the oocyte. Given this expected high spermatozoa loss, a slight modification in cervical mucus may rapidly transform the cervix into a "hostile" environment, which, together with changes in vaginal environment and cervix structure, may prevent natural conception and be a cause of infertility. In this review, we discuss the physiological role of the vaginal pH and cervical mucus in fertility, and describe several conditions that can render the cervical mucus hostile to sperm and therefore be implicated in the pathophysiology of unexplained infertility.


Keywords: Sperm transport; Cervix mucus; Hydrogen ion concentration; Sperm agglutination; Uterine cervix disease; Vaginal disease; Female infertility; Unexplained infertility.