Hydrotherapy in the evaluation of enzymatic antioxidants in an elderly population

Introduction Oxidative stress is the imbalance between reactive species produced in the body during metabolic reactions and antioxidant agents that have the ability to neutralize or prevent the formation of these species. One of the effects of oxidative stress is the normal and physiological process of cell aging that arises from the accumulation of tissue damage caused by free radicals.

Objectives To assess whether the activity of enzymes superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione reductase (GR) are influenced by the hydrotherapy sessions.

Methodology 37 subjects aged 60 years old and above, of both genders, were divided into two groups (experimental and control). The experimental group underwent 15 hydrotherapy sessions supervised by a physical therapist. Two peripheral venous blood samples were collected at two different times: T0, instant before the intervention and T1, instant after the last session. The activity of SOD, GPx and GR enzymes were determined, respectively, with the Ransod superoxide dismutase, Ransel glutathione peroxidase and glutathione reductase commercial kits, from Randox Laboratories Limited, United Kingdom. The assay was performed as described in the kits and the sample results were obtained by spectrophotometric reading.

Results SOD activity at T1 tended to decrease slightly compared to T0 (1437.64 ± 593.46 vs 1421.41 ± 705.39 U/g Hb). At T1, there was a statistically significant increase in GPx activity (48.14 ± 17.22 vs 57.72 ± 19.99 U/g Hb) and in GR activity (78.44 ± 21.26 vs 100.18 ± 30.85 U/L). Regarding gender, both genders tended to have higher values of GPx and GR at T1.

Conclusion According to the obtained results, we conclude that the practice of hydrotherapy presents as a positive stimulus in the antioxidant activity of aged individuals suggesting that a regular and moderate practice of exercise induces a higher quality of life.

Proposed new diagnoses of anxious depression and bodily stress syndrome in ICD-11-PHC: an international focus group study

BACKGROUND

The World Health Organization is revising the primary care classification of mental and behavioural disorders for the International Classification of Diseases (ICD-11-Primary Health Care (PHC)) aiming to reduce the disease burden associated with mental disorders among member countries.

OBJECTIVE

To explore the opinions of primary care professionals on proposed new diagnostic entities in draft ICD-11-PHC, namely anxious depression and bodily stress syndrome (BSS).

METHODS

Qualitative study with focus groups of primary health-care workers, using standard interview schedule after draft ICD-11-PHC criteria for each proposed entity was introduced to the participants.

RESULTS

Nine focus groups with 4-15 participants each were held at seven locations: Austria, Brazil, Hong Kong, New Zealand, Pakistan, Tanzania and United Kingdom. There was overwhelming support for the inclusion of anxious depression, which was considered to be very common in primary care settings. However, there were concerns about the 2-week duration of symptoms being too short to make a reliable diagnosis. BSS was considered to be a better term than medically unexplained symptoms but there were disagreements about the diagnostic criteria in the number of symptoms required.

CONCLUSION

Anxious depression is well received by primary care professionals, but BSS requires further modification. International field trials will be held to further test these new diagnoses in draft ICD-11-PHC.

Medically unexplained symptoms in family medicine: defining a research agenda. Proceedings from WONCA 2007

BACKGROUND

Medically unexplained symptoms (MUSs) are frequently presented in primary care. Unfortunately, knowledge of these patients and/or symptoms in primary care is still limited. Available research comes mainly from Europe and North America, while the perspectives of cultures such as Africa, Asia and South America are relatively unknown. To bring cultural perspectives together, a symposium and workshop on MUS in primary care was held at the WONCA World Conference 2007 in Singapore.

OBJECTIVE

Main goals of this symposium and workshop-apart from presenting ongoing research and bringing together experts in MUS-were to detect knowledge gaps in MUS and to establish priorities in MUS research. This publication focuses on the proposed research agenda.

METHODS

Using a nominal group technique, we generated research topics and set priorities. Research topics were grouped into research themes.

RESULTS

Participants' (66 researchers and GPs from 29 nationalities) most important research topics were 'formulating a broadly accepted definition of MUS', 'finding a strategy to recognize MUS better and at an earlier stage', 'studying the value of self-management and empowerment in patients with MUS' and 'finding predictors to decide which strategy will best help the individual patient with MUS'. Priorities in research themes of MUS are as follows: (i) therapeutic options for patients with MUS and (ii) problems in consultations with these patients.

CONCLUSIONS

More research on MUS in primary care is needed to improve the consultations with and management of these patients. Internationally primary care conferences are excellent for exchanging ideas and formulating central issues of research.