Light is the major synchronizer of circadian rhythms. In the absence of light, as for totally blind people, some variables, such as body temperature, have an endogenous period that is longer than 24 h and tend to be free running. However, the circadian rhythm of muscle strength and reaction time in totally blind people has not been defined in the literature. The objective of this study was to determine the period of the endogenous circadian rhythm of the isometric and isokinetic contraction strength and simple reaction time of totally blind people. The study included six totally blind people with free-running circadian rhythms and four sighted people (control group). Although the control group required only a single session to determine the circadian rhythm, the blind people required three sessions to determine the endogenous period. In each session, isometric strength, isokinetic strength, reaction time, and body temperature were collected six different times a day with an interval of at least 8 h. The control group had better performance for strength and reaction time in the afternoon. For the blind, this performance became delayed throughout the day. Therefore, we conclude that the circadian rhythms of strength and simple reaction time of totally blind people are within their free-running periods. For some professionals, like the blind paralympic athletes, activities that require large physiological capacities in which the maximum stimulus should match the ideal time of competition may result in the blind athletes falling short of their expected performance under this free-running condition.
Osteogenesis imperfecta is an inherited disorder of the connective tissue characterized primarily by fractures with no or small causal antecedents and extremely variable clinical presentation. The disorder requires a global and, therefore, multidisciplinary therapeutic approach that should aim, among other aspects, at the prevention and treatment of deformities resulting from osteogenesis imperfecta. Due to limitations related to bony deformities, it can be difficult to place these infants in a variety of positions that would help remediate skull deformities, so a cranial orthosis becomes the therapy of choice. The aim of this study was to demonstrate the results obtained during treatment with a cranial remolding orthosis (helmet) in babies with osteogenesis imperfecta. Case Description and Methods: For the first time in the scientific literature, this study describes the use of a cranial orthosis for the treatment of infants with osteogenesis imperfecta. Both children had severe asymmetrical brachycephaly documented by laser digital scanning and were submitted to treatment with a cranial remolding orthosis. Outcomes and Conclusion: The study showed that there was a significant improvement in cranial proportion and symmetry, with a reduction in the cephalic index at reevaluation. It is concluded that the orthotic therapy is an effective therapeutic modality to improve the proportion and minimize the asymmetry in children with osteogenesis imperfecta. Clinical relevance The clinical relevance of such a description is that children with osteogenesis imperfecta may have numerous deformities and minimizing them can be an important factor. This report showed a beneficial result as the orthotic therapy modality improved the proportions and minimized the asymmetry. This treatment offers too high levels of satisfaction to parents and brings these children closer to normal indices.
The number of cranial deformities has increased considerably since international efforts of pediatricians to recommend parents putting their babies to sleep in the supine position as a strategy to reduce sudden death syndrome of the newborn. On the one hand, this program has demonstrated very efficient results at reducing deaths and, on the other hand, such recommendation has increased the incidence of cranial asymmetries. In addition, infants are kept too long in one position, much of this due to abusive use of strollers, baby carriers, car seats, swings and other devices. Among resulting asymmetries, the most frequently found are plagiocephaly (parallelogram shaped skull, with posterior unilateral flattening with the opposite frontal area also flattened) and brachycephaly (occipital bilateral flattening). The present study is a case report of a patient with brachycephaly associated with deformational plagiocephaly treated with cranial orthosis. The same physician clinically evaluated the patient before and after treatment using photographic recording and a laser scanning device, which allows the accurate measurement of variables determining asymmetries. It became clear during treatment that there was significant improvement in cranial symmetry documented by decrease in the cephalic index, diagonal difference and volume gain in the quadrant that was flattened. The authors conclude that orthotic therapy is a safe and effective therapeutic modality for position cranial asymmetries.
RESUMOAs assimetrias cranianas podem ser de origem deformacional ou sinostótica e esse deve ser o foco no diagnóstico diferencial quando o pediatra recebe o bebê com a deformidade em seu consultório. O objetivo desse estudo é apresentar uma revisão de literatura sobre as assimetrias cranianas permitindo uma diferenciação diagnóstica e possibilitando, com isso, a melhor conduta terapêutica. Os resultados obtidos para ambos os tratamentos são melhores quando o diagnóstico é precoce e permite o direcionamento adequado para cada necessidade de intervenção. Por isso é importante que o pediatra, que é o médico de referencia de todo bebê, consiga desenvolver uma visão ampla sobre o tema a fim de possibilitar intervenção preventiva e o manejo dos sinais precoces que permitirão o desenvolvimento dos cuidados primários com uma visão multidisciplinar baseada nas necessidades e nos objetivos das famílias.Palavras Chave:Plagiocefalia; Plagiocefalia não sinostotica,craniossinostoses, suturas. ___________________________________________________________________Pinto, Fernando Campos Gomes; Matarazzo, Carolina Gomes. "Assimetria craniana: Cranioestenose ou Plagiocefalia Posicional?", in Anais do 2º. Congresso Internacional Sabará de Especialidades Pediátricas 1.INTRODUÇÃOÉ muito importante considerar que as questões estéticas não são questões de menos valia para nossa sociedade e que a estética se insere, em nosso cotidiano, como fator de grande importância para a grande maioria das pessoas. Um dos componentes da mesma é a questão da simetria que se conecta á aparência. Alguns estudos literários tem demonstrado a associação entre a atratividade física e muitas atribuições de características positivas 3,8 .Pensando sobre esses fatores, muitas mães tem considerado relevante a aparência de seus bebês e dessa forma o tratamento das assimetrias cranianas tem se
The Western Ontario and McMaster Universities Osteoarthritis Index questionnaire detected changes in outcome following hip replacement surgery among patients with primary diagnoses of hip osteoarthritis and hip fracture, with differences in the pattern of changes between the two groups.
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