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Abstract Background During pregnancy, the increase in maternal insulin resistance is compensated by hyperplasia and increased function of maternal pancreatic beta cells; the failure of this compensatory mechanism is associated with gestational diabetes mellitus (GDM). Serotonin participates in beta cell adaptation, acting downstream of the prolactin pathway; the blocking of serotonin receptor B (HTR2B) signaling in pregnant mice impaired beta cell expansion and caused glucose intolerance. Thus, given the importance of the serotoninergic system for the adaptation of beta cells to the increased insulin demand during pregnancy, we hypothesized that genetic variants (single nucleotide polymorphisms [SNPs]) in the gene encoding HTR2B could influence the risk of developing GDM. Methods This was a case–control study. Five SNPs (rs4973377, rs765458, rs10187149, rs10194776, and s17619600) in HTR2B were genotyped by real-time polymerase chain reaction in 453 women with GDM and in 443 pregnant women without GDM. Results Only the minor allele C of SNP rs17619600 conferred an increased risk for GDM in the codominant model (odds ratio [OR] 2.15; 95% confidence interval [CI] 1.53–3.09; P

BACKGROUND: Quality of life has been one of the main issues for patients with a chronic condition.OBJECTIVE: To translate, adapt and validate a Brazilian Portuguese version of the Prosthesis Evaluation Questionnaire (PEQ).METHODS: The questionnaire was translated into Portuguese, back translated into English, and cross-culturally adapted to the Brazilian Population. Sixty-five transtibial unilateral amputees were recruited. The sample comprised 45 men and 20 women with a mean age of 44 years, 47 with traumatic amputations, 14 with vascular dysfunction and 4 with other reasons for amputation, and all of them fitted with prostheses. Patients were interviewed twice, at baseline and again after 15 days. The Brazilian Portuguese version of the SF-36 (a generic Quality of Life outcome measure) and the FIM (a Functional Independence Measure) were also administered.RESULTS: The internal consistency of the nine PEQ scales was tested by computing Cronbach's Alpha coefficients (0.65 - 0.89: high values). Student's t test coefficients were used for interobserver evaluation (0.35 to 084: reliable values with one exception- the Residual Limb Health scale), and Intraclass Correlation Coefficients (ICC), which ranged from 0.65 to 0.92: reliable values. Student's t test coefficients and ICCs were also used for intraobserver evaluation (0.42 to 0.83, except the Residual Limb Health scale and 0.80 to 0.94, respectively: reliable values). Correlations between PEQ, SF-36 and FIM were tested using Pearson's correlation coefficients, which were not statistically significant (p > 0, 01).CONCLUSION: The Brazilian-Portuguese version of the PEQ has high internal consistency and is a reliable quality of life measure for use in amputee patients, but is not associated with the SF-36 or FIM.

Introdução: A doença de Chagas é a maior causa de miocardiopatia e morte súbita em nosso país. Apresenta alta mortalidade quando seus portadores evoluem para classe funcional IV da New York Heart Association (NYHA). Objetivo: O objetivo deste trabalho é analisar a evolução clínica dos pacientes portadores de cardiomiopatia chagásica com insuficiência cardíaca avançada e terapia farmacológica otimizada submetido a terapia de ressincronização cardíaca. Métodos: Entre janeiro de 2004 e fevereiro de 2009, 72 pacientes com cardiomiopatia chagásica em classe funcional III e IV da NYHA foram submetidos à terapia de ressincronização cardíaca e acompanhados para avaliar sua evolução clínica. Para comparar a mesma variável em dois momentos diferentes utilizamos o Teste t pareado ou o Teste de Wilcoxon. Um valor de P

OBJETIVOS: Avaliar o posicionamento estático da escápula no gradil costal em indivíduos saudáveis, por meio da avaliação clínica e radiográfica, avaliar a confiabilidade interavaliador do exame clínico e verificar a confiabilidade do método de avaliação em comparação ao exame radiográfico. MÉTODOS: Foram selecionados 30 indivíduos adultos de ambos os sexos sem diagnóstico de doenças nos ombros. O exame clínico estático, seguindo o protocolo sugerido por Burkhart e cols., foi realizado repetidamente por 2 examinadores independentes; a seguir, foi realizado o exame radiográfico, que posteriormente foi examinado pelo primeiro avaliador. RESULTADOS: 73,3% dos indivíduos apresentaram o posicionamento da escápula considerado dentro da normalidade. A confiabilidade interavaliador e a confiabilidade do exame clínico em relação à radiografia foram considerados baixa e muito baixa respectivamente. CONCLUSÃO: A reprodutibilidade da avaliação realizada por Burkhart foi considerada de satisfatória a boa, enquanto que a reprodutibilidade inter-avaliador do exame clínico estático e a reprodutibilidade do exame clínico com a radiografia foram consideradas de pobres a satisfatórias. Nível de Evidência III, Estudo de Pacientes não Consecutivos.

OBJETIVO: Avaliar a efetividade da crioterapia no pós-operatório imediato de reconstrução do ligamento cruzado anterior (LCA), em relação à redução da dor e melhora da amplitude de movimento (ADM) do joelho. MÉTODOS: Trata-se do estudo piloto de um ensaio clínico prospectivo randomizado. Os pacientes (n=25) foram randomizados em dois grupos: (A) Grupo Intervenção (n=10) que realizou um protocolo fisioterapêutico e fez uso do gelo por 20 minutos, duas vezes ao dia; e o Grupo (B) Controle (n=9), que realizou o mesmo protocolo, duas vezes ao dia. A intensidade da dor foi avaliada pela Escala Análoga Visual e a ADM pela goniometria. RESULTADOS: O Grupo (A) Intervenção obteve melhora absoluta e percentual quando comparado ao (B) Controle, tanto para os parâmetros de dor, ADM de flexão e extensão do joelho. CONCLUSÃO: A crioterapia no pós-operatório imediato de reconstrução do LCA foi efetiva para melhorar a dor e a ADM do joelho. Nível de Evidência I, Estudo Clínico Randomizado.OBJECTIVE: The purpose of this study was to evaluate cryotherapy effectiveness in the immediate postoperative period of ACL reconstruction to improve pain and range of motion (ROM) of the knee. METHODS: This is a pilot study of a prospective and randomized clinical trial. Patients (n=25) were divided into two groups: Intervention (A) group (n=10): patients were submitted to an inpatient physical therapy protocol and received ice compress for 20 minutes, twice a day; Control (B) group (n=9): patients had the same protocol, twice a day. The pain intensity was evaluated with the visual analogic scale (VAS) and range of motion was measured with a goniometer. RESULTS: The Intervention (A) group had important absolute and percentual improvement when compared with the Control (B) group regarding measures of pain and knee flexion/extension ROM. CONCLUSION: Cryotherapy in the immediate postoperative period of ACL reconstruction was effective to improve pain and range of motion of the knee. Level of Evidence I, Randomized Clinical Trial.

OBJETIVO: Avaliar o perfil atual do paciente submetido a revascularização do miocárdio na Disciplina de Cirurgia Cardíaca da Faculdade de Ciências Médicas da Santa Casa de São Paulo, verificar o risco de mortalidade esperada neste grupo, por meio da aplicação do Sistema Europeu de Risco em Operações Cardíacas (EuroSCORE), e confrontá-lo com a mortalidade observada. MÉTODOS: Analisamos 100 pacientes consecutivos submetidos a revascularização do miocárdio, de maio de 2005 a novembro de 2006. Identificamos os fatores predisponentes à coronariopatia e analisamos os critérios de risco de mortalidade pelo EuroSCORE. Comparamos as taxas de mortalidade esperadas com as observadas na amostra. Aplicamos o teste do qui-quadrado para análise univariada e o teste de Hosmer-Lemeshow para ajuste do modelo de regressão logística. RESULTADOS: A mortalidade hospitalar foi 5,0%. Na análise univariada, para escore 0-2 a mortalidade prevista pelo EuroSCORE foi de 0,40% e a encontrada 0%. Para o escore 3-5, a mortalidade prevista foi de 1,45% e a encontrada 0%. Para escore >6, a mortalidade prevista foi de 3,15% e a encontrada 7,94%. As discrepâncias entre as porcentagens observadas e previstas não foram estatisticamente significantes (p = 0,213). O valor-p do teste de Hosmer-Lemeshow foi igual a < 0,001, indicando um ajuste ruim ou má calibração do modelo para o número de indivíduos na amostra atual. CONCLUSÃO: O EuroSCORE é um modelo preditor simples e objetivo de mortalidade operatória. Entretanto, para validação da análise de regressão logística, são necessárias centenas de indivíduos, o que limita a universalização de sua aplicabilidade.OBJECTIVE: The aim of this study was to assess the performance of the European Risk System in Cardiac Operations (EuroSCORE) model to predict mortality in patients undergoing myocardial revascularization at the Division of Cardiovascular Surgery of Santa Casa de São Paulo Medical School. METHODS: From May 2005 to November 2006, 100 consecutive patients undergoing coronary artery bypass surgery were retrospectively analyzed. The records of these patients were reviewed in order to retrieve those variables included in the EuroSCORE risk scoring method. The correlation of predicted and observed mortality was compared. Statistical analysis was performed using chi-square test for univariate analysis and Hosmer-Lemeshow Test for logistic regression model. RESULTS: Hospital mortality was 5%. For EuroSCORE univariate analysis, findings were as follows: score 0-2 predicted mortality 0.40%, observed 0.00%; score 3-5 predicted mortality 1.45%, observed 0.00%; score greater than 6 predicted mortality 3.15%, observed 7.94%. Although these differences, p-value was 0.213 with no statistical significance. The p-value for the Hosmer-Lemeshow Test was < 0.001 indicating poor calibration of the model for this sample. CONCLUSION: The EuroSCORE model is a simple, objective system to estimate hospital mortality. However, to validate the logistic regression analysis, it is necessary hundreds of patients, which limit its widespread application.

Este estudo teve como objetivo principal realizar uma revisão de literatura dos últimos dez anos, sobre os efeitos dos tratamentos fisioterapêuticos realizados nas fraturas de quadril e a observação da descrição e da influência do treinamento proprioceptivo específico nesse processo de reabilitação. Essas fraturas são muito comuns, principalmente entre a população idosa, provocando diversas conseqüências ao indivíduo, entre elas, a alteração das sensações proprioceptivas, podendo predispor o paciente à importante instabilidade articular. Sendo assim, a reabilitação dessas lesões é de grande importância, afim de restaurar as funções do quadril e prevenir contra recidivas. De acordo com o levantamento bibliográfico realizado, os estudos demonstraram protocolos de tratamento fisioterapêuticos nas fraturas do quadril, porém a maioria dos autores não apresenta um treinamento proprioceptivo específico isoladamente; em geral, relacionam o ganho de força muscular, equilíbrio e o treino de marcha e de funcionalidade à melhora indireta da propriocepção articular. Fica evidente a carência teórica sobre o assunto, e espera-se que novas pesquisas possam surgir, para que se tenha maior significância clínica e estatística em relação ao tema abordado.This study was aimed at providing a review of the last ten years in literature addressing the effect of the physical therapeutic treatments carried out in hip fractures and the review of the description and influence of specific proprioceptive drills in rehabilitation processes. These fractures are very common, particularly among the aged population, causing various consequences to the individual, such as proprioceptive sensations changes, which can predispose patients to important joint instability. Therefore, the rehabilitation of these injuries is of great importance in order to restore hip function and to prevent recurrences. According to the literature review, studies describe physical therapeutic treatment protocols in cases of hip fractures, but most authors do not present a specific isolated proprioceptive training; they usually correlate muscular strength gain, balance and gait and functional training to an indirect improvement of joint proprioception. The shortage of theories addressing the subject is clear, and further studies are warranted for providing better clinically and statistically significant data concerning the subject in reference.

OBJETIVOS: Avaliar a função e a qualidade de vida dos pacientes pós-artroplastia de Girdlestone e comparar os resultados entre os grupos Girdlestone unilateral e o grupo com prótese total de quadril contralateral. MÉTODOS: estudo transversal no qual foram avaliados 9 pacientes com Girdlestone unilateral e 3 com Girdlestone em um quadril e prótese total no quadril contralateral. A avaliação constitui-se em aplicar o questionário genérico de qualidade de vida SF-36 e um questionário funcional específico para o quadril, Harris Hip Score (HHS). A comparação dos grupos foi realizada usando-se o teste t- Student e o teste de Fisher. RESULTADOS: Os pacientes do grupo Girdlestone unilateral apresentaram maior quantidade de domínios do SF-36 classificados como elevados, embora 77,8% destes tenham obtido resultados ruins no HHS. Todos os pacientes apresentaram o teste de Trendelenburg positivo e discrepância de membros, o que levou à marcha claudicante em 11 dos 12 pacientes avaliados. Destes, apenas 6 submeteram-se a fisioterapia pós-operatória. CONCLUSÃO: A qualidade de vida e a função pós-operatória de Girdlestone, na população brasileira, ainda necessita ser mais pesquisada, pois estes resultados são indicações do comportamento das variáveis de estudo e não podem ser consideradas encerradas.OBJECTIVES: To evaluate function and quality of life of patients submitted to Girdlestone's arthroplasty, and to compare outcomes between unilateral Girdlestone's group with the group with contralateral total hip prosthesis. METHODS: Cross-sectional study where 9 patients were evaluated with unilateral Girdlestone's and 3 with Girdlestone's in one hip and contralateral total hip prosthesis. The evaluation consisted in filling in a generic questionnaire on quality of life "SF-36" and a specific questionnaire for hip function "Harris Hip Score" (HHS). The comparison between groups was made by using the Student's t-test and the Fisher's test. RESULTS: The patients of the unilateral Girdlestone's group presented a higher number of SF-36 domains classified as high, although 77.8% of these showed poor results on the HHS. All patients had a leg-length discrepancy and positive Trendelenburg's test, which led to limping gait in 11 of 12 patients evaluated. Of these, only 6 underwent physiotherapy after surgery. CONCLUSION: Girdlestone's postoperative quality of life and function in a Brazilian population still requires further studies, because these outcomes are indicative of study variables' behavior and cannot be regarded as definite.

O implante de marcapasso tem sido cada vez mais utilizado, em decorrência de sua segurança e dos baixos índices de complicaçao. No entanto, a infecçao de dispositivos é um quadro grave, que apresenta elevada morbimortalidade e alto custo de tratamento. Algumas vezes essa infecçao evolui com endocardite bacteriana, complicaçao cuja incidência vem aumentando nos últimos anos. É de difícil diagnóstico e tratamento, seja pela inespecificidade dos sintomas clínicos seja pela variaçao dos achados de imagem no ecocardiograma. Descrevemos um caso de febre de origem indeterminada em portador de marcapasso, que investigaçao posterior demonstrou ser decorrente de infecçao dos cabos-eletrodos e de endocardite secundária. O paciente foi tratado com antibioticoterapia prolongada e retirada do sistema por cirurgia aberta.

O texto apresenta uma revisão de trabalhos da área de Educação que fizeram uso das histórias de vida e dos estudos autobiográficos como metodologia de investigação científica no Brasil. Dois recortes foram efetuados, um temporal e outro temático, para focalizar o período compreendido entre 1985 e 2003 e privilegiar dois temas: formação de professores e profissão docente. O objetivo principal foi o de mapear a produção nacional, buscando identificar as temáticas que emergiram com maior força, apontando aspectos lacunares e indicando direções para futuros estudos na área. Várias fontes foram utilizadas: resumos de teses e dissertações (banco de teses da CAPES); textos completos de teses e dissertações defendidas nos programas de pós-graduação da Pontifícia Universidade Católica de São Paulo - PUC-SP - e da Faculdade de Educação da Universidade de São Paulo - FEUSP -; livros; e periódicos científicos. As análises levaram a concluir que o uso dessas abordagens cresceu significativamente no Brasil a partir dos anos de 1990, porém, de modo muito disperso, foram utilizadas muito mais como fonte de dados para o desenvolvimento de um largo espectro de pesquisas e muito timidamente como dispositivos de formação. Todavia, evidenciou-se que a intensificação de tais metodologias contribuiu para renovar as pesquisas sobre os professores, ao mesmo tempo em que fez aflorar o interesse por questões e temáticas novas, tais como as que se configuram, por exemplo, nos estudos sobre profissão, profissionalização e identidades docentes.The text offers a review within the area of Education of the works that make use of life histories and autobiographic studies as a scientific research methodology in Brazil. The period between 1985 and 2003 is focused under two different slants, one temporal, and the other thematic: teacher education and teaching profession. The main purpose here was to map out the national production, seeking to identify the themes that have emerged with greater strength, pointing out deficient aspects, and suggesting directions for future studies in this field. Several sources were utilized: abstracts of theses and dissertations from the CAPES database; complete texts of theses and dissertations presented to the graduate programs of the Pontifical Catholic University of São Paulo - PUC-SP - and of the Faculty of Education of the University of São Paulo - FEUSP; books; and scientific journals. The analyses have shown that the use of these approaches has grown significantly in Brazil since the 1990s but, in a very disperse manner, they have been used more as a source of data for the development of a wide spectrum of studies, and only timidly as formation devices. Nevertheless, it has become apparent that the rise of these methodologies has contributed to a renewal in the studies about teachers, at the same time that it has fostered the interest in new issues and themes, such as those developed, for example, in the researches about profession, professionalization and teacher identity.

A lesão medular (LM) é uma das formas mais graves dentro das síndromes incapacitantes. O paciente com LM sobrecarrega excessivamente os membros superiores, especialmente os ombros, utilizando-os mais freqüentemente e em maior variabilidade de atividades que uma pessoa sem LM. Além disso, a busca da melhoria da qualidade de vida nos últimos anos, levou um número crescente de portadores de LM a procurar a prática de atividade física. Muitos pacientes com LM utilizam cadeira de rodas para locomoção funcional e realização de esportes. Porém, esta demanda funcional na articulação do ombro pode levar a presença de quadro álgico importante interferindo nas atividades de vida diária desses pacientes. Com os adventos da tecnologia e cuidados com a saúde, a expectativa de vida dos pacientes com LM tem aumentado. Desde então, questões relacionadas à qualidade de vida e doenças associadas com o envelhecimento são de grande importância para essa população. Este estudo busca um melhor entendimento da dor no ombro em pacientes com LM através de revisão da literatura.The spinal cord injury (SCI) is one of the most severe forms of disabling syndromes. Patients with SCI usually apply an excessive overload on the upper limbs, especially the shoulders, using them more frequently and in a greater range of activities when compared to healthy subjects. Moreover, the search for the improvement of the quality of life in the last years has led an increasingly number of SCI patients to practice physical activities. Many SCI patients use wheelchairs for functional locomotion and sports practice. However, this functional demand on shoulder's joint may lead to a painful picture, interfering on these patient's daily activities. With the improvements on technology and healthcare life expectancy for SCI patients has been increased. Since then, issues regarding quality of life and age-related diseases are very important for this population. The purpose of this paper was to better understand shoulder pain in SCI patients by reviewing available literature.

O artigo trata de pesquisa realizada com um grupo de professores inovadores da Universidade de São Paulo tendo como objetivo procurar subsídios para a formação do professor universitário. Esses docentes foram entrevistados, solicitando que detalhassem melhor suas experiências inovadoras; explicassem as razões pelas quais haviam introduzido modificações em sua forma de trabalho; explicitassem as relações entre sua atividade de docência e de pesquisa, expressassem o papel que atribuíam ao ensino na universidade, bem como a forma pela qual sua trajetória acadêmica havia se cumprido até então. A diversidade de experiências relatadas e, ao mesmo tempo, a convergência de visões a respeito de suas funções de ensino e de pesquisa na universidade permitem-nos afirmar que, mais do que uma formação pedagógica específica, a sensibilização para as dificuldades do ensino e a valorização institucional dessa atividade consistiriam em grande avanço para a formação do professor.

We localized HCV C-100 protein in liver biopsies of 15 patients with chronic hepatitis C using immunohistochemistry. The results were compared to serum, tissue extract analysis of HCV RNA and in situ RT-PCR described in a previous study. HCV was detected in 80% of the sera tested, in 40% of the tissue extracts and in 80% and 60% of the tissue sections tested by immunohistochemistry and in situ RTPCR respectively. Compared to the serum positive cases, 83% and 67% of the cases were respectively positive with immunohistochemistry and in situ RT-PCR and 41% were positive with tissue extract detection. Compared to the tissue extract positive cases, 25% and 50% of the cases were respectively positive with immunohistochemistry and in situ RT-PCR. Finally, 75% of the cases positive by immunohistochemistry were also positive by in situ RT-PCR. These results underline the complementarity of the different methods for the precise diagnosis of hepatitis C.

Placement of a mediastinal drain is a routine procedure following heart surgery. Postoperative bed rest is often imposed due to the fear of potential risk of drain displacement and cardiac injury. We developed an encapsulating stitch as a feasible, effective and low-cost technique, which does not require advanced surgical skills for placement. This simple, novel approach compartmentalizes the drain allowing for safe early mobilization following cardiac surgery. [ABSTRACT FROM AUTHOR]

Abstract Placement of a mediastinal drain is a routine procedure following heart surgery. Postoperative bed rest is often imposed due to the fear of potential risk of drain displacement and cardiac injury. We developed an encapsulating stitch as a feasible, effective and low-cost technique, which does not require advanced surgical skills for placement. This simple, novel approach compartmentalizes the drain allowing for safe early mobilization following cardiac surgery.

Abstract Objective: To evaluate the sequential changes of hemodynamic and metabolic parameters in patients who underwent aorta no-touch off-pump coronary artery bypass surgery (OPCAB). Methods: Prospective study involving twenty-seven consecutive patients who underwent aorta no-touch OPCAB. The FloTrac/PreSep/Vigileo™ system (Edwards Lifesciences) was used to continuously record heart rate (HR), mean arterial blood pressure (MABP), central venous pressure (CVP), continuous cardiac index (FCI), stroke volume (SV), stroke volume variation (SVV), and central venous oxygen saturation (ScvO2). The parameters were assessed 5 min before, during and 5 min after each anastomosis (left anterior descending [LAD], posterior descending [PD], obtuse marginal [OM] and diagonal [Dg]). Postoperative lactate was also evaluated. Results: There was no significant change in HR and MABP for all anastomoses, except for MABP during PD grafting (-10.1±2.7 mmHg, P=0.03). There was a significant decrease in ScvO2 only during PD and OM anastomoses (-9.4±0.4, P=0.03; -4.4±0.4, P=0.02; respectively). CVP drop after PD manipulation was strongly associated with a higher lactate during the first hours after surgery (r=-0.82; P=0.001). These hemodynamic changes were transient and entirely recovered after the heart was returned to its anatomical position. No significant differences were observed in FCI, SVV, or the systemic vascular resistance index (SVRI) during all anastomoses, except for a drop in SVRI during PD grafting (-8.03±2.3, P=0.007). SV tended to decrease during the procedure in all territories, but with statistically significant drop only in PD and OM grafting (-10.4±1.2, P=0.02; -13.6±5.1, P=0.007; respectively). Conclusion: Heart displacement for performing aorta no-touch OPCAB is well tolerated, with transient and endurable hemodynamic variations.

Objective To evaluate the indication of prosthesis during rehabilitation and the maintenance of their use or abandonment rate after discharge, as well as mortality of lower limb amputees due to peripheral arterial disease.Methods A retrospective and cross-sectional study carried out with lower limb amputee patients, at transfemoral and transtibial levels, due to vascular conditions. The sample was composed of 310 patients (205 men, 105 women, mean age 61.8 years), transfemoral (142) and transtibial (150) levels, unilateral or bilateral (18). A total of 217 were fitted with prosthesis and 93 did not. Nonparametric statistical tests with equality of two proportions, 95% confidence interval and p value

Objective: To evaluate the sequential changes of hemodynamic and metabolic parameters in patients who underwent aorta notouch off-pump coronary artery bypass surgery (OPCAB). Methods: Prospective study involving twenty-seven consecutive patients who underwent aorta no-touch OPCAB. The FloTrac/PreSep/Vigileo™ system (Edwards Lifesciences) was used to continuously record heart rate (HR), mean arterial blood pressure (MABP), central venous pressure (CVP), continuous cardiac index (FCI), stroke volume (SV), stroke volume variation (SVV), and central venous oxygen saturation (ScvO2). The parameters were assessed 5 min before, during and 5 min after each anastomosis (left anterior descending [LAD], posterior descending [PD], obtuse marginal [OM] and diagonal [Dg]). Postoperative lactate was also evaluated. Results: There was no significant change in HR and MABP for all anastomoses, except for MABP during PD grafting (-10.1±2.7 mmHg, P=0.03). There was a significant decrease in ScvO2 only during PD and OM anastomoses (-9.4±0.4, P=0.03; -4.4±0.4, P=0.02; respectively). CVP drop after PD manipulation was strongly associated with a higher lactate during the first hours after surgery (r=-0.82; P=0.001). These hemodynamic changes were transient and entirely recovered after the heart was returned to its anatomical position. No significant differences were observed in FCI, SVV, or the systemic vascular resistance index (SVRI) during all anastomoses, except for a drop in SVRI during PD grafting (-8.03±2.3, P=0.007). SV tended to decrease during the procedure in all territories, but with statistically significant drop only in PD and OM grafting (-10.4±1.2, P=0.02; -13.6±5.1, P=0.007; respectively). Conclusion: Heart displacement for performing aorta notouch OPCAB is well tolerated, with transient and endurable hemodynamic variations. [ABSTRACT FROM AUTHOR]

The article discusses various papers published in this issue including one by Leese on Foucauldian notions of biopolitics, one by Nabers, Wittendorp, Walters and Tazziioli on governmentality and one by Chamlian on secularism.

Research on the Common Security and Defence Policy (CSDP) has been notoriously uncritical of the justification systems that underpin both CSDP practices and the production of academic/“scientific” knowledge. Critique here has widely meant “testing”: exploring (mis)matches either between theory and empirical observation or between political rhetoric and concrete implementation. Drawing on Michel Foucault’s understanding of power and critique, this article seeks to contribute to the problematisation and politicisation of contemporaneous power relations as exercised in and through CSDP. Specifically, it asks how the future is enacted in security practices such as comprehensive crisis management exercises, the knowledge they empower and the subjects they shape. It critically engages how the rationality of preparedness, combining logics of problem solving and speculation, allows constant depoliticised interventions into the present in the name of imagined future events and system failures. [ABSTRACT FROM PUBLISHER]

Objective: Detect the main predictive non-motor factors related to independent community ambulation after stroke. Furthermore, we propose a scale to estimate the probability of a stroke patient achieving independent community ambulation after 6 months of rehabilitation. Design and Settings: Prospective cohort. Subjects treated in a rehabilitation center in a large metropolitan area. Independent community ambulation was evaluated after rehabilitation according to the Hoffer classification. Functional ambulation was assessed at four levels: nonambulatory, nonfunctional ambulation, household ambulation, and community ambulation. Participants: Patients (n=201) with a moderate disability after stroke. Results: The average time of hospitalization was 19.3 days. However, only 32.8% of the patients started the rehabilitation program during the first 6 months after stroke. We found that 121 patients achieved community ambulation (60.2%), 40 achieved household ambulation (19.9%), 12 achieved therapeutic ambulation (5.9%), and 28 were non-ambulatory after 6 months of treatment. Based on our final model, a scoring scale was created in order to evaluate the probability of stroke patients achieving independent community ambulation after 6 months of rehabilitation. Higher scores were associated with better chances of community ambulation within 6 months. Conclusions: The scale that evaluated these factors proved to have acceptable sensitivity and specificity to establish the prognosis of community ambulation after 6 months of rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Quality of life has been one of the main issues for patients with a chronic condition. Objective: To translate, adapt and validate a Brazilian Portuguese version of the Prosthesis Evaluation Questionnaire (PEQ). Methods: The questionnaire was translated into Portuguese, back translated into English, and cross-culturally adapted to the Brazilian Population. Sixty-five transtibial unilateral amputees were recruited. The sample comprised 45 men and 20 women with a mean age of 44 years, 47 with traumatic amputations, 14 with vascular dysfunction and 4 with other reasons for amputation, and all of them fitted with prostheses. Patients were interviewed twice, at baseline and again after 15 days. The Brazilian Portuguese version of the SF-36 (a generic Quality of Life outcome measure) and the FIM (a Functional Independence Measure) were also administered. Results: The internal consistency of the nine PEQ scales was tested by computing Cronbach's Alpha coefficients (0.65 - 0.89: high values). Student's t test coefficients were used for interobserver evaluation (0.35 to 084: reliable values with one exception- the Residual Limb Health scale), and Intraclass Correlation Coefficients (ICC), which ranged from 0.65 to 0.92: reliable values. Student's t test coefficients and ICCs were also used for intraobserver evaluation (0.42 to 0.83, except the Residual Limb Health scale and 0.80 to 0.94, respectively: reliable values). Correlations between PEQ, SF-36 and FIM were tested using Pearson's correlation coefficients, which were not statistically significant (p > 0, 01). Conclusion: The Brazilian-Portuguese version of the PEQ has high internal consistency and is a reliable quality of life measure for use in amputee patients, but is not associated with the SF-36 or FIM. [ABSTRACT FROM AUTHOR]

Controlling the dissemination of malaria requires the development of new drugs against its etiological agent, a protozoan of the Plasmodium genus. Angiotensin II and its analog peptides exhibit activity against the development of immature and mature sporozoites of Plasmodium gallinaceum. In this study, we report the synthesis and characterization of angiotensin II linear and cyclic analogs with anti-plasmodium activity. The peptides were synthesized by a conventional solid-phase method on Merrifield's resin using the t-Boc strategy, purified by RP-HPLC and characterized by liquid chromatography/ESI (+) MS (LC-ESI(+)/MS), amino acid analysis, and capillary electrophoresis. Anti-plasmodium activity was measured in vitro by fluorescence microscopy using propidium iodine uptake as an indicator of cellular damage. The activities of the linear and cyclic peptides are not significantly different ( p < 0.05). Kinetics studies indicate that the effects of these peptides on plasmodium viability overtime exhibit a sigmoidal profile and that the system stabilizes after a period of 1 h for all peptides examined. The results were rationalized by partial least-square analysis, assessing the position-wise contribution of each amino acid. The highest contribution of polar amino acids and a Lys residue proximal to the C-terminus, as well as that of hydrophobic amino acids in the N-terminus, suggests that the mechanism underlying the anti-malarial activity of these peptides is attributed to its amphiphilic character. Copyright © 2013 European Peptide Society and John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Moberg Pick up Test modified by Dellon evaluates the person's hand ability to identify small objects with and without the use of eyesight. Purpose: Developing a standard for its use and establishing the normalcy index for the adult population in order to identify whether there are differences between the runtime of the subtests for variables gender, right and left dominant and non-dominant hand, educational level; and to evaluate the interrater's reliability. Methods: A cross-sectional research was carried out with 100 volunteers from the Federal University of Sao Paulo (UNIFESP-SP) that presented no lesion in the upper limbs. A total of 10 objects known by the participants were placed in front of them and they were instructed to place one at a time inside a box as quickly as possible. This test was performed with open and closed eyes. In order to check the interrater's reliability, the participants were evaluated by two researchers. Results: There were no statistically significant differences between raters and genders. There were statistically significant correlations between left and right hands and the educational level. Conclusion: The overall average runtime in seconds to open eyes with the right hand was 18.23 s and with the left hand, 19.96 s; to closed eyes with the right hand, 37.54 s and with the left hand, 39.42 s. The mean time for primary level was greater than for the other levels. Moberg Pick up Test modified by Dellon is a reproducible test. [ABSTRACT FROM AUTHOR]

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OBJECTIVE: To evaluate the prevalence of asymptomatic transitory myocardial ischemia during scintigraphy among amputees of vascular etiology as well as to ascertain correlation with atherothrombotic events during long-term follow-up. DESIGN: A cohort, mean follow-up of 2.1 yrs study was performed in an outpatient rehabilitation clinic with 58 lower limb vascular amputees who were referred for rehabilitation, asymptomatic for coronary heart disease. Patients were evaluated for myocardial ischemia by dipyridamole scintigraphy, and occurrence of severe cardiovascular events (death, acute myocardial infarction, stroke, and peripheral ischemia with hospitalization) was assessed. RESULTS: Of the 58 patients, 26 (44.8%) had positive dipyridamole myocardial scintigraphy for transitory myocardial ischemia. During follow-up, 12 subjects (20.7%), mainly diabetic patients (83%), registered a serious cardiovascular event, with 9 of 12 events having occurred in those who had tested positive for transitory ischemia on scintigraphy (P < 0.025). There were five deaths (19.2%) in those with a positive scintigraphy and a single death (3.1%) in those with a negative dipyridamole test, although the Kaplan-Meier survival curve and Cox regression were not significant (P = 0.09 and 0.1, respectively). CONCLUSIONS: We found that 44.8% of patients with vascular lower limb amputation, asymptomatic for coronary disease, tested positive on myocardial scintigraphy for transitory myocardial ischemia. In a mean follow-up of 2.1 yrs, there was 10.3% of atherothrombotic events/year, with a higher death toll in those patients with positive scintigraphy. [ABSTRACT FROM AUTHOR]