RESUMO
OBJETIVO: Descrever o perfil de mobilidade articular e das forças de garra e de pinça de indivíduos com MPS VI, além de sua correlação com a excreção urinária de glicosaminoglicanos, atividade da ARSB e distância percorrida no teste de caminhada de 6 minutos. MÉTODOS: Estudo observacional de 28 pacientes com MPS VI, não submetidos a tratamento específico. Todos os pacientes foram avaliados em relação à amplitude da mobilidade articular, forças de garra e de pinça, excreção urinária de glicosaminoglicanos, atividade da ARSB e teste de caminhada de 6 minutos. RESULTADOS: Demonstrou-se maior comprometimento de flexão de ombro, sem correlação com a idade, e da extensão de joelho e flexão de cotovelo, estas últimas correlacionadas negativamente com a idade. A força de garra mostrou-se comprometida em todos os pacientes, e a força de pinça apresentou correlação positiva com idade. CONCLUSÕES: A restrição da flexão de ombro, sem correlação com a idade, sugere que este achado esteja presente precocemente na MPS VI e se constitua em sinal clínico importante para suspeita diagnóstica desta doença. A amplitude da extensão de joelho e da flexão de cotovelo, por sua vez, por apresentarem correlação negativa com a idade, são possíveis marcadores da evolução da doença. Estudos adicionais são necessários para confirmação dessas hipóteses.
OBJECTIVE: To describe the profile of joint mobility and grip and pinch strength of MPS VI patients and to correlate this with urinary excretion of glycosaminoglycans (GAGs), ARSB activity, and the distance covered in a 6-minute walking test (6MWT). METHODS: This was an observational study of 28 patients with MPS VI, who had not undergone specific treatment. All patients were assessed for amplitude of joint mobility (shoulder, elbow, and knee), grip and pinch strength and urinary GAG excretion and also performed the 6MWT. RESULTS: Shoulder flexion exhibited the greatest limitation, with no correlation with age, followed by knee extension and elbow flexion, both of which were correlated inversely with age. Hand grip strength was compromised in all patients, and pinch strength exhibited a positive correlation with age. CONCLUSIONS: The fact that restricted shoulder flexion was not correlated with age suggests that this finding is present early on in MPS VI and that it constitutes an important clinical sign that should arouse diagnostic suspicion of this disease. The amplitude of knee extension and elbow flexion, in turn, are possible markers of disease progression since they have a negative correlation with age. Further studies are needed to confirm these hypotheses.
Assuntos
Criança , Feminino , Humanos , Masculino , Força da Mão/fisiologia , Instabilidade Articular/fisiopatologia , Mucopolissacaridose VI/fisiopatologia , Articulação do Cotovelo/fisiopatologia , Glicosaminoglicanos/urina , Instabilidade Articular/diagnóstico , Instabilidade Articular/etiologia , Articulação do Joelho/fisiopatologia , Mucopolissacaridose VI/complicações , Mucopolissacaridose VI/metabolismo , /sangue , Valores de Referência , Articulação do Ombro/fisiopatologiaRESUMO
OBJECTIVE: To describe the profile of joint mobility and grip and pinch strength of MPS VI patients and to correlate this with urinary excretion of glycosaminoglycans (GAGs), ARSB activity, and the distance covered in a 6-minute walking test (6MWT). METHODS: This was an observational study of 28 patients with MPS VI, who had not undergone specific treatment. All patients were assessed for amplitude of joint mobility (shoulder, elbow, and knee), grip and pinch strength and urinary GAG excretion and also performed the 6MWT. RESULTS: Shoulder flexion exhibited the greatest limitation, with no correlation with age, followed by knee extension and elbow flexion, both of which were correlated inversely with age. Hand grip strength was compromised in all patients, and pinch strength exhibited a positive correlation with age. CONCLUSIONS: The fact that restricted shoulder flexion was not correlated with age suggests that this finding is present early on in MPS VI and that it constitutes an important clinical sign that should arouse diagnostic suspicion of this disease. The amplitude of knee extension and elbow flexion, in turn, are possible markers of disease progression since they have a negative correlation with age. Further studies are needed to confirm these hypotheses.
Assuntos
Força da Mão/fisiologia , Instabilidade Articular/fisiopatologia , Mucopolissacaridose VI/fisiopatologia , Criança , Articulação do Cotovelo/fisiopatologia , Feminino , Glicosaminoglicanos/urina , Humanos , Instabilidade Articular/diagnóstico , Instabilidade Articular/etiologia , Articulação do Joelho/fisiopatologia , Masculino , Mucopolissacaridose VI/complicações , Mucopolissacaridose VI/metabolismo , N-Acetilgalactosamina-4-Sulfatase/sangue , Valores de Referência , Articulação do Ombro/fisiopatologiaRESUMO
Periodontal disease in the domestic cat may assume debilitating and serious consequences; however, little is known of the biochemical composition or metabolism of feline gingiva in health or disease. In this report the chemical composition and metabolism of gingival lipids from inflamed an non-inflamed sites is presented and compared to other species with naturally occurring periodontitis. The neutral and phospholipid composition of feline gingiva was found to be distinct from that of porcine and human. As a measure of de novo lipid synthesis, the total incorporation of 14C-acetate into fractionated lipid components was determined and revealed an approximate 2 to 3 fold decrease in inflamed versus non-inflamed gingiva. The decrease in 14C-acetate incorporation appeared to result from a 2-fold increase in free acetate pools in inflamed compared to non-inflamed gingival samples, since total lipase and phospholipase activity were comparable in inflamed and non-inflamed gingiva and total lipid composition was not changed between inflamed and non-inflamed sites. These data are similar to those reported for periodontally involved human gingival tissue and suggest a common effect of periodontal inflammation on lipid metabolism in both species.