The aim was to investigate if botulinum toxin type A (BTx-A) associated with physical therapy is superior to physical therapy alone in post stroke spasticity. A randomized, double-blinded controlled trial was performed in a rehabilitation unit on Northeastern, Brazil. Patients with post stroke spasticity were enrolled either to BTx-A injections and a pre-defined program of physical therapy or saline injections plus physical therapy. Primary endpoint was functional performance evaluated through time up and go test, six minutes walking test and Fugl-Meyer scale for upper limb. Secondary endpoint was spasticity improvement. Confidence interval was considered at 95%. Although there was a significant decrease in upper limbs flexor tonus (P<0.05) in the BTx-A group, there was no difference regarding functional performance after 9 months of treatment. When analyzing gait speed and performance, both groups showed a significant improvement in the third month of treatment, however it was not sustained over time. Although BTx-A shows superiority to improve muscle tone, physical therapy is the cornerstone to improve function in the upper limbs of post stroke patients.

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Background & aims Non-alcoholic fatty liver disease (NAFLD) has been associated with small bowel bacterial overgrowth (SIBO) and cardiometabolic dysfunction. This cross-sectional study aimed to evaluate the cardio-metabolic parameters and SIBO in patients with different degrees of hepatic fibrosis estimated by NAFLD fibrosis score (NFS). Methods Subjects (n = 78) were allocated to three groups: Healthy control (n = 30), NAFLD with low risk of advanced fibrosis (NAFLD-LRAF, n = 17) and NAFLD with a high risk of advanced fibrosis (NAFLD-HRAF, n = 31). Anthropometrics, blood pressure, electrocardiogram and heart rate variability (HRV) were evaluated. Only the NAFLD-LRAF and NAFLD-HRAF groups were submitted to blood biochemical analysis and glucose hydrogen breath tests. Results The NAFLD-HRAF group had higher age and body mass index when compared to the control and NAFLD-LRAF groups. The prevalence of SIBO in the NAFLD group was 8.33%. The low frequency/high-frequency ratio (LF/HF ratio) was augmented in NAFLD-LRAF (p < 0.05) when compared with control group. NAFLD-HRAF group had a wide QRS complex (p < 0.05) and reduced LF/HF ratio (p < 0.05) compared to the control and NAFLD-LRAF groups. Serum levels of albumin and platelets were more reduced in the NAFLD-HRAF subjects (p < 0.05) than in the NAFLD-LRAF.

Chronic hepatitis C is a silent evolution disease that can lead to outcomes such as liver cirrhosis and hepatocellular carcinoma (HCC), a public health problem due to high universal morbidity. It is transmitted by single-stranded ribonucleic acid (RNA) virus, discovered in 1989 through studies of contaminated chimpanzees. Unsafe health practices, use of illegal intravenous drugs and tattoos are among the major risk factors for the transmission of this virus. Currently, it is estimated that 71 million people are infected worldwide, in Brazil, the prevalence of 0.7% indicates that 1.032.000 individuals are contaminated. With quick execution and rapid results availability, Rapid Tests (RT) facilitate epidemiological studies and early diagnosis of hepatic impairment, allowing the modification of the natural history of the disease. To evaluate the presence of Anti-HCV antibodies and epidemiological characteristics of hepatitis C in users of health services in Campina Grande-PB. A prospective cross-sectional observational study, from February 2015 to July 2018. Individuals born between 1945 and 1970 who sought health services voluntarily underwent structured questionnaires and the Bioeasy® Rapid Anti-HCV Test. A total of 385 individuals were studied, with a prevalence of Anti-HCV antibodies of 1.84% (n = 7). Of the interviewees, the majority (29.7%) were in the age group between 45 and 50 years and 67.7% were female. Intravenous illicit drug use, tattooing and male sex presented the highest statistical relevance as a risk factor in the study population. A prevalence higher than that estimated for the country was found, which highlights the need to implement strategies aimed at the early detection of virus carriers.