Bakgrund: Idag lever personer med Downs syndrom längre än vad de tidigare har gjort. De tenderar att ha ett stillasittande liv vilket genererar olika komplikationer och följdsjukdomar. Fysisk aktivitet förebygger och behandlar folksjukdomar hos den generella populationen. För att främja hälsa ska sjuksköterskan utföra hälsofrämjande omvårdnad. Syfte: Syftet var att belysa betydelsen av hälsofrämjande fysisk aktivitet hos personer med Downs syndrom. Metod: Studien är utformad som en allmän litteraturstudie. Resultat: Datamaterialet analyserades och tre huvudteman framkom: Hälsofrämjande fysisk aktivitet ger positiva fysiska effekter, Hälsofrämjande fysisk aktivitet ger ökat välbefinnande samt Hälsofrämjande fysisk aktivitet främjar socialt samspel. Fysisk aktivitet förebygger många av de sjukdomar som personer med Downs syndrom riskerar att drabbas av. Fysisk aktivitet förbättrade hälsan hos personer med Downs syndrom. Resultaten som kunde läsas ur litteraturen var minskat kroppsfett, lägre blodtryck, ökad muskelstyrka samt bättre rörlighet och balans. Fysisk aktivitet genererade dessutom ett ökat socialt samspel vilket gav ökad glädje och ökat välbefinnande. Konklusion: Fysisk aktivitet var hälsofrämjande för personer med Downs syndrom. Vid regelbunden fysisk aktivitet skapades bättre förutsättningar för ett hälsosamt liv. / Background: People with Down ́s Syndrome live longer today than they have done previously. But they tend to have a sedentary life which causes different complications and secondary diseases. Physical activity prevents and treats national diseases in the general population. To promote health, nurses should give health- promoting care. Purpose: The aim was to illustrate the importance of health-promoting physical activity in persons with Down’s Syndrome. Method: The study is constructed as a general literature study. Results: The data was analysed and three main themes emerged: Health-promoting physical activity produces positive physical effects, Health-promoting physical activity produces improved well-being and Health- promoting physical activity encourages social interactions. Physical activity preventsmany of the diseases that people with Down’s Syndrome are at risk of contracting. Physical activity improved the health of persons with Down’s Syndrome. Conclusion: Physical activity promoted better health for persons with Down’sSyndrome. Regular physical activity improved the prerequisites needed for increased quality of life.

A terapia fotodinâmica antimicrobiana (aPDT) tem sido amplamente utilizada em Periodontia por permitir redução de periodontopatógenos, com ausência de efeitos sistêmicos colaterais e mínimas possibilidades de resistência bacteriana. Surge assim uma boa alternativa adjuvante para o tratamento da doença periodontal (DP), como para os pacientes com Síndrome de Down (SD) que possuem maior severidade e alta prevalência dessa doença. O objetivo desse estudo foi avaliar a efetividade da aPDT como adjuvante da raspagem e alisamento corono-radicular (RACR) em pacientes com SD. Foram realizadas avaliações dos parâmetros clínicos como: índice de placa (IP), índice gengival (IG), nível clínico de inserção (NCI), profundidade (PS) e sangramento à sondagem (SS) no período inicial e após 1 e 3 meses do tratamento. Para a aPDT, foi utilizado laser vermelho (658nm; 0,1W; 2229J/cm2; 10s por ponto), com o corante azul de metileno (AM) como agente fotossensibilizador na concentração de 100&#x3BC;g/ml, com tempo de pré-irradiação de 3 minutos, com repetidas sessões após 3,7 e 14 dias. As análises estatísticas foram realizadas com testes paramétricos e não paramétricos (p<0,05). Participaram desse estudo 33 pacientes com SD, randomizados aleatoriamente em dois grupos: C (RACR), composto por 6 mulheres e 11 homens (27±9,16 anos) e aPDT (realizadas associação da aPDT com a RACR), composta por 9 homens e 7 mulheres (27,12±9,74anos). Os pacientes são os principais responsáveis pela sua escovação (100%) com baixíssima ajuda pelos pais e/ou responsáveis na supervisão ou reforço da escovação (12,12%). Houve melhora de todos os índices periodontontais nos tempos inicias (baseline), como após 1 e 3 meses tanto para o grupo C (redução da PS de 0,97mm do baseline para 3 meses; redução do SS de 16,13% do baseline para 3 meses; redução do IP de 11,29% do baseline para 3 meses, redução do NCI de 0,09mm do baseline para 3 meses) e para o grupo aPDT (redução da PS de 1,56mm do baseline para 3 meses, redução do SS de 16,77% do baseline para 3 meses, redução do IP de 13,81% do baseline para 3 meses, redução do NCI de 0,13mm do baseline para 3 meses). Conclui-se que ambos os tratamentos resultaram em melhoras clínicas (PS, SS, IP, NCI) significantes no tratamento da doença periodontal em pacientes com SD. / Antimicrobial photodynamic therapy (aPDT) has been widely used in Periodontics to obtain reduction of periodontopathogenic bacteria with absence of systemic side effects and minimal bacterial resistance. Therefore, a good adjuvant alternative for periodontal disease (PD) treatment arises, especially for patients with Down syndrome (DS) who present greater severity and high prevalence of PD. The aim of this study was to evaluate the effectiveness of aPDT as an adjuvant of scaling and root planning (SRP) for treatment of PD in patients with DS. Periodontal clinical exam was evaluated by: plaque index (PI), gingival index (GI), clinical attachment loss (CAL), probing depth (PD) and bleeding on probing (BOP) in baseline, one and three-month treatment periods. The aPDT protocol was red laser (658nm; 0.1W; 2229J/cm2, 10s per point), methylene blue dye (MB), 100&#x3BC;g/ml, with a 3-minute preirradiation. aPDT sessions were repeated after 3, 7 and 14 days. Statistical analysis was performed using parametric and non-parametric tests (p<0.05). 33 patients with DS participated in this study, randomly assigned into two groups: C (SRP), composed of 6 women and 11 men (27 ± 9.16 years old) and aPDT (SRP + aPDT), composed of 9 men and 7 women (27.12 ± 9,74 years old). Patients were the main contributors to the brushing (100%) with very low support by parents and/or guardians in monitoring or enhancing brushing (12.12%). There was improvement of clinical parameters in baseline (B), and after 1 and 3 months for group C (reduction on PB of 0.97mm from baseline to 3 months; reduction on BOP of 16.13% from baseline to 3 months; reduction on PI of 11.29% from baseline to 3 months, reduction on CAL of 0.09mm from baseline to 3 months) and for the aPDT group (reduction on PB of 1.56mm from baseline to 3 months, reduction on BOP of 16.77% from baseline to 3 months, reduction on PI of 13.81% from baseline to 3 months, reduction on CAL of 0.13mm from baseline to 3 months). In conclusion, besides an improvement in periodontal condition, aPDT as an adjuvant of SRP did not enhance the clinical periodontal parameters in relation to SRP alone.

Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is characterised by repeated cycles of upper airway obstruction during sleep, leading to diurnal symptoms. Individuals with Down syndrome (DS) are predisposed to this as the DS phenotype overlaps with OSAHS risk factors. Around 2-4% of the general adult population and 55% of children with DS have OSAHS but, to date, no large-scale study has assessed OSAHS prevalence or efficacy of treatment in DS adults. This study aimed to: 1) Systematically assess subjective and objective OSAHS prevalence; 2) Assess the effectiveness of continuous positive airway pressure (CPAP) in an adult DS population. Standard questionnaires including pictorial Epworth Sleepiness Scale (pESS) and Developmental Behaviour Checklist for Adults (DBC-A) were sent to UK adults aged ≥16yr with DS and their caregivers. All questionnaire responders were invited to undergo home polygraphy. Symptomatic adults with DS with ≥10 apnoeas/hypopnoeas per hour in bed (AH) on home polygraphy were invited to participate in a prospective randomised controlled trial (RCT) of CPAP v. lifestyle advice, with review at 1, 3, 6 and 12m. Participants in the lifestyle arm were offered CPAP at 1m. Standard measurements of sleepiness, behaviour, cognitive function and general health were undertaken. Standard statistical analyses were conducted, with significance set at p < 0.001 to control for multiple testing. Of 5270 questionnaires sent, 1105 responses were valid (21%). Responders (55% males) were overweight/obese young adults: mean BMI 29.0±6.8kg/m2; mean age 28±9 years. Women had a higher BMI (p < 0.0001), but collar size was greater in men (p < 0.0001). Mean pESS scores were broadly within the normal range (7±5/24). No significant gender differences in OSAHS symptoms were noted. Individuals with probable OSAHS had higher pESS and DBC-A scores, and significantly more symptoms of OSAHS. Subjective OSAHS prevalence was estimated at 35%. Of the 790 individuals invited, 149 underwent polygraphy, with 134 valid studies obtained: mean AH 21.8(10.9-42.7); mean oximetry desaturation index (ODI) 6.6(2.3-20.0). No significant gender differences were observed. Forty-two percent of participants met standard clinical diagnostic criteria for OSAHS. Twenty-eight eligible adults with DS (19 male) were randomised: age 28±9yr; BMI 31.5±7.9kg/m2; AH 28.6(14.8-47.9); ODI 7.3(1.8-21.9); pESS 11±6/24. Groups did not differ significantly at baseline. By 12m, 4 participants had withdrawn (all remaining participants on CPAP). The pESS (p=0.001), DBC-A Disruptive (p < 0.0001) and Kaufmann Brief Intelligence Test verbal subscale (p=0.001) scores improved significantly. This first large study of OSAHS prevalence in the adult DS population estimates a prevalence of 35-42% - around 10 times higher than in the general adult population. Sustained, significant improvements in sleepiness, cognitive function and behavioural/emotional outcomes with CPAP use over a 12m period were demonstrated during this first RCT of CPAP in adults with DS. A larger trial of CPAP in this population is warranted.