Application and outcomes of therapy combining transcranial direct current stimulation and virtual reality: a systematic review

Purpose: To evaluate the methods and major outcomes of transcranial direct current stimulation (tDCS) combined with virtual reality (VR) therapy in randomized controlled trials.

Method: A systematic review was performed following PRISMA guidelines using PubMed, PubMed Central, Web of Science and CAPES periodic databases, with no time restriction. The studies were screened for the following inclusion criteria: human subjects, combination of VR and tDCS methods, and randomized controlled study design. All potentially relevant articles were independently reviewed by two researchers, who reached a consensus on which articles met the inclusion criteria. The PEDro scale was used to evaluate the studies.

Results: Eleven studies were included, all of which utilized a variety of tDCS and VR application methods. The main outcomes were found to be beneficial in intervention groups of different populations, including improvements in body sway, gait, stroke recovery, pain management and vegetative reactions.

Conclusions: The use of tDCS combined with VR showed positive results in both healthy and impaired patients. Future studies with larger sample sizes and homogeneous participants are required to confirm the benefits of tDCS and VR.

• Implications for Rehabilitation

• tDCS with VR intervention can be an alternative to traditional rehabilitation programs.

• tDCS with VR is a promising type of intervention with a variety of positive effects.

• Application of tDCS with VR is appropriated to both healthy and impaired patients.

• There is no consensus of tDCS with VR application.

     

Bactericide effect of methylene blue associated with low-level laser therapy in <Emphasis Type="Italic">Escherichia coli</Emphasis> bacteria isolated from pressure ulcers

The present study analyzed the bactericidal effect of methylene blue associated with low-level lasers on Escherichia coli isolated from a pressure ulcer. Microbiological material from a pressure ulcer was isolated using an aseptic swab, and antimicrobial activity was verified using the diffusion disc method. Methylene blue was used at concentrations of 0.001 and 0.005%, and low-level lasers of 670, 830, and 904 nm, with the energy densities of 4, 8, 10, and 14 J/cm², were tested on three plates each and combined with methylene blue of each concentration. In addition, three control plates were used, with each concentration and energy density separated without any interventions. The results were analyzed using the paired sample t test to determine the bactericidal effect of the methylene blue and using the ANOVA test to compare the effects of the energy densities and wavelengths among the low-level laser treatment protocols. The results showed bacterial reduction at wavelengths of 830 and 904 nm and more proliferation in wavelengths of 670 nm. In wavelength of 830 nm, a bacterial reduction was observed in the conditions with 0.001% methylene blue in all energy density utilized, with 0.005% methylene blue in energy density of 10 J/cm², and without methylene blue in energy density at 10 J/cm². And in a wavelength of 904 nm, all condition showed bacterial reduction with or without methylene blue. We concluded that the low-level lasers of 904 and 830 nm have bactericidal effects and at better energy densities (10 and 14 J/cm²).     

Effect of acute swimming exercise at different intensities but equal total load over metabolic and molecular responses in swimming rats

Journal of Muscle Research and Cell Motility - Acute metabolic and molecular response to exercise may vary according to exercise’s intensity and duration. However, there is a lack regarding...     

SIRT1 Transcription Is Decreased in Visceral Adipose Tissue of Morbidly Obese Patients with Severe Hepatic Steatosis

Background  

Visceral adipose tissue is known to release greater amounts of adipokines and free fatty acids into the portal vein, being one of the most predictive factors of nonalcoholic fatty liver disease (NAFLD). Our study has the purpose to evaluate sirtuin 1 (SIRT1), adiponectin, Forkhead/winged helix (FOXO1), peroxisome proliferator-activated receptor (PPAR)γ1–3, and PPARβ/δ mRNA expression in morbidly obese patients in three different lipid depots: visceral (VAT), subcutaneous (SAT), and retroperitoneal (RAT). Recent studies suggest that SIRT1, a NAD⁺-dependent deacetylase, protects rats from NAFLD.     

Reinforcing a medical hypothesis with a new question: is there a subgroup of shrinking lungs syndrome that is induced by pleurisy in systemic lupus erythematosus and is this subgroup marked by anti-Ro/SSA?

Shrinking lungs syndrome (SLS) is a rare entity associated with autoimmune diseases and its underlying pathogenesis is still unclear. We describe a series of seven consecutive cases of SLS in systemic lupus erythematosus, all of them with serositis and six (85.7%) with anti-Ro/SSA antibodies. Our findings reinforce the hypothesis that SLS may be, in some cases, a consequence of diaphragmatic restriction due to pleuritic pain, and we suggest anti-Ro/SSA as a marker of this subgroup of SLS.     

4th Global CRO Council for Bioanalysis: coadministered drugs stability, EMA/US FDA guidelines, 483s and carryover

The Global CRO Council for Bioanalysis (GCC) was formed in September 2010. Since then, the representatives of the member companies come together periodically to openly discuss bioanalysis and the regulatory challenges unique to the outsourcing industry. The 4th GCC Closed Forum brought together experts from bioanalytical CROs to share and discuss recent issues in regulated bioanalysis, such as the impact of coadministered drugs on stability, some differences between European Medicines Agency and US FDA bioanalytical guidance documents and lessons learned following recent Untitled Letters. Recent 483s and agency findings, as well as issues on method carryover, were also part of the topics discussed.     

Leptospiral pneumonias

PURPOSE OF REVIEW: Pulmonary involvement in leptospirosis has been reported to be increasing in the last few years and is emerging as a serious life threat and the main cause of death due to leptospirosis in some countries. In this review, we present the main clinical and pathological manifestations of pulmonary involvement in leptospirosis, and recent data on the pathophysiology of lung damage and therapeutic implications. RECENT FINDINGS: Although previous reports have emphasized the increasing incidence of pulmonary manifestations in patients with leptospirosis worldwide, pulmonary involvement in leptospirosis is still under-recognized. Experimental models have been used to address new aspects of the pathogenesis of the disease, including determination of novel outer membrane proteins, characterization of dysregulation of sodium transporters of alveolar epithelial cells, and provision of new data on the role of innate immunity in the development of severe disease, thereby making major progress in understanding the mechanisms underlying lung injury. SUMMARY: Pulmonary hemorrhage represents the main cause of death in severe forms of leptospirosis. Although the mechanism of pulmonary impairment is still poorly understood, recent experimental studies have brought new insights to the pathogenesis of lung injury and provide new perspectives on treatment of critically ill patients.