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Da Cruz Junior ATV, Vasconcelos BHB, Barroso TGCP, Souza GS, Monteiro LCP, Xavier MB, Callegari B. Plantar pressure distribution and altered postural control in multibacillary leprosy patients. BMC Infect Dis 2024; 24:130. [PMID: 38267905 PMCID: PMC10809460 DOI: 10.1186/s12879-023-08749-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 10/25/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Leprosy is a chronic infectious disease caused by Mycobacterium leprae, predominantly affecting the peripheral nerves, resulting in sensory and motor deficits in the feet. Foot ulcers and imbalances are frequent manifestations in leprosy, often correlating with diminished sensitivity. While clinical scales and monofilament esthesiometers are conventionally utilized to evaluate foot sensitivity and balance in these patients, their discriminatory power is limited and their effectiveness is greatly dependent on the examiner's proficiency. In contrast, baropodometry and posturography offer a more comprehensive evaluation, aiming to preempt potential damage events. This study aimed was to assess the correlation between baropodometry and force plate measurements in leprosy patients and control participants, to improve the prevention and treatment of foot ulcers and complications associated with leprosy. METHODOLOGY This cross-sectional study was conducted during 2022 and enrolled 39 participants (22 patients with multibacillary leprosy and 17 non-leprosy controls). Demographic data were collected, and a monofilament esthesiometer was used to assess sensory deficits. In addition, physical examinations and balance and plantar pressure tests were conducted. The Student's t-test was used to compare mean and maximum plantar pressures between groups. For most COP variables, a Mann-Whitney Wilcoxon test was used, except for AP amplitude which was analyzed with the Student's t-test due to its normal distribution. The relationship between foot pressure and balance control was assessed using Spearman's correlation, focusing on areas with significant pressure differences between groups. PRINCIPAL FINDINGS Leprosy patients showed increased pressure in forefoot areas (T1, M1, T2-T5, and M2) and decreased pressure in hindfoot regions (MH and LH) compared to controls. These patients also displayed higher AP and ML amplitudes, suggesting poorer COP control. Correlation analyses between the two groups revealed that foot plantar pressures significantly impact balance control. Specifically, increased T1 region pressures correlated with greater sway in balance tasks, while decreased MH region pressures were linked to reduced COP control. CONCLUSIONS/SIGNIFICANCE The findings suggest a joint disturbance of plantar pressure distribution and static balance control in leprosy patients. These alterations may increase the risk of tissue injuries, including calluses and deformities, as well as falls.
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Affiliation(s)
- Alex Tadeu Viana Da Cruz Junior
- Laboratory of Human Motricity Studies, Health Science Institute, Federal University of Para, Belém, Brazil
- Nucleous of Tropical Medicine, Federal University of Para, Belém, Brazil
| | | | | | - Givago Silva Souza
- Nucleous of Tropical Medicine, Federal University of Para, Belém, Brazil
- Biological Science Institute, Federal University of Para, Belém, Brazil
| | | | - Marília Brasil Xavier
- Nucleous of Tropical Medicine, Federal University of Para, Belém, Brazil
- Biological and Health Sciences Center, State University of Pará (UEPA), Belém, Pará, Brazil
| | - Bianca Callegari
- Laboratory of Human Motricity Studies, Health Science Institute, Federal University of Para, Belém, Brazil.
- Nucleous of Tropical Medicine, Federal University of Para, Belém, Brazil.
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Costa KHA, Santos PSA, da Silva Almeida GC, Caires AS, Vasconcelos BHB, Lima RC, Domingues MM, da Conceição Nascimento Pinheiro M, Sousa RCM, de Athayde Costa e Silva A, Souza GS, Callegari B. Comparison of Static Balance Control in Infected Htlv-1 Subjects with Different Tsp/Ham Diagnosis. Viruses 2022; 14:v14112334. [PMID: 36366437 PMCID: PMC9693226 DOI: 10.3390/v14112334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: Tropical spastic paraparesis (TSP/HAM) associated with the T cell lymphotropic virus in type I humans (HTLV-1) is a slow, chronic, and progressive disease that causes balance changes. TSP/HAM diagnosis can be classified as probable, possible, and definite. We compared the static balance control of HTLV-1-infected patients with different TSP/HAM diagnosis. (2) Methods: Our sample consisted of 13 participants infected with HTLV-1 and 16 healthy participants. The center of pressure was recorded using a force platform with open and closed eyes. We divided the recordings into three intervals, period T1 (corresponds to the first 10 s); period T2 (from 10 to 45 s); period T3 (from 45 to 55 s). (3) Results: Eight participants infected with HTLV-1 were classified as probable TSP/HAM and five participants infected with HTLV-1 were classified as definite TSP/HAM. There was a significant increase in postural instability in patients with definite PET/MAH considering the structural and global variables of body sway compared to the control and the probable TSP/HAM. (4) Conclusions: We concluded that the severity of balance is directly related to the degree of signs and symptoms of TSP/HAM.
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Affiliation(s)
| | | | | | - Andrew Sousa Caires
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | | | - Ramon Costa Lima
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | | | | | | | | | - Givago Silva Souza
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém 66005240, Brazil
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
- Correspondence: ; Tel.:+55-919-8265-3131
| | - Bianca Callegari
- Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém 66005240, Brazil
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de Sousa JR, Azevedo RDSDS, Martins Filho AJ, de Araujo MTF, Cruz EDRM, Vasconcelos BCB, Cruz ACR, de Oliveira CS, Martins LC, Vasconcelos BHB, Casseb LMN, Chiang JO, Quaresma JAS, Vasconcelos PFDC. In situ inflammasome activation results in severe damage to the central nervous system in fatal Zika virus microcephaly cases. Cytokine 2018; 111:255-264. [PMID: 30199767 DOI: 10.1016/j.cyto.2018.08.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 12/11/2022]
Abstract
Zika virus (ZIKV) has caused substantial concern worldwide owing to its association with severe birth defects, such as microcephaly and other congenital malformations. Inflammasomes, i.e., multi-protein complexes that induce inflammation and pyroptosis, are predicted to contribute to the immune response to this flavivirus. Accordingly, in this study, the in situ inflammasome response was evaluated in fatal cases of ZIKV-linked microcephaly. Brain tissue samples were collected from eight babies, including four ZIKV-positive microcephalic neonates who died after birth and four flavivirus-negative neonatal controls who died of other causes and whose central nervous system (CNS) architecture was preserved. In the ZIKV-positive newborn/stillbirth babies, the major histopathological alterations included atrophy of the cortical layer, a predominance of mononuclear cell infiltration in the Virchow-Robin space, neuronal necrosis, vacuolization and neuronal degeneration, neuronophagy, and gliosis. An immunohistochemical analysis of tissues in the neural parenchyma showed significantly higher expression of the receptors NLRP1, NLRP3, and AIM2, cytokines IL-1β, IL-18, and IL-33, and enzymes caspase 1, iNOS, and arginase 1 in ZIKV-positive microcephaly cases than in flavivirus-negative controls. These results suggest that inflammasome activation can aggravate the neuroinflammatory response and consequently increase CNS damage in neonates with fetal neural ZIKV infection and microcephaly.
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Affiliation(s)
- Jorge Rodrigues de Sousa
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Pará State, Brazil
| | | | | | | | | | | | - Ana Cecilia Ribeiro Cruz
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Pará State, Brazil; Center of Biological and Health Sciences, State University of Pará, Belém, Brazil
| | - Consuelo Silva de Oliveira
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Pará State, Brazil
| | - Livia Caricio Martins
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Pará State, Brazil
| | | | - Livia Medeiros Neves Casseb
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Pará State, Brazil
| | - Jannifer Oliveira Chiang
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Pará State, Brazil
| | - Juarez Antonio Simões Quaresma
- Department of Pathology, Evandro Chagas Institute, Ministry of Health, Ananindeua, Pará State, Brazil; Center of Biological and Health Sciences, State University of Pará, Belém, Brazil; Tropical Medicine Center, Federal University of Pará, Belém, Brazil
| | - Pedro Fernando da Costa Vasconcelos
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ministry of Health, Ananindeua, Pará State, Brazil; Center of Biological and Health Sciences, State University of Pará, Belém, Brazil.
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