¿Podría ser útil la puntuación Apgar quirúrgica para predecir las complicaciones postoperatorias tras la cirugía de fractura femoral proximal? Un estudio retrospectivo de cohorte / Would surgical Apgar score be useful to predict postoperative complications after proximal femoral fracture surgery? A retrospective cohort study

Antecedentes: El Apgar quirúrgico (AQ) es una puntuación evaluadora del riesgo perioperatorio, que evalúa intraoperatoriamente la frecuencia cardiaca mínima, la presión arterial media mínima y la pérdida de sangre estimada. Aunque ha sido validado en múltiples campos quirúrgicos, el AQ sigue siendo controvertido en el campo traumatológico. El objetivo principal de este estudio fue investigar si AQ guarda relación con la incidencia de complicaciones durante los primeros 30 días tras la cirugía de fractura femoral proximal. Métodos: Estudio retrospectivo que incluyó todos los pacientes consecutivos sometidos a cirugía de fractura femoral proximal entre enero y julio de 2019. Se excluyó a los pacientes que carecieran de información sobre el AQ. Se dividió a los pacientes en dos grupos, sobre la base de la incidencia de complicaciones durante los primeros 30 días postoperatorios y el cálculo de su AQ. Se utilizaron curvas ROC (característica operativa del receptor) para evaluar el modelo predictivo de complicaciones. Resultados: El 44% (n = 76) de los 181 pacientes incluidos en el estudio desarrollaron complicaciones durante los primeros 30 días postoperatorios. Ocho pacientes (4,4%) fallecieron durante dicho periodo. La edad media de los pacientes fue de 79 años, y el 30,9% (n = 56) fueron varones. La insuficiencia cardiaca (IC), el uso de marcapasos, la enfermedad renal crónica, la enfermedad pulmonar obstructiva crónica y la demencia estuvieron significativamente asociadas a la morbilidad postoperatoria. No existió correlación significativa entre AQ y la incidencia de complicaciones durante los primeros 30 días postoperatorios. El ABC de AQ como modelo predictivo de complicaciones postoperatorias tras la cirugía de fractura femoral proximal fue de 0,522, lo cual es insuficiente para poder considerarse un modelo predictivo aceptado. Conclusión: Sobre la base de este estudio, concluimos que AQ no es predictivo del desarrollo de complicaciones en los primeros...(AU)

Background: The surgical Apgar score (SAS) is a perioperative risk evaluation score, which considers intraoperative minimum heart rate, minimum mean arterial pressure and estimated blood loss. Although validated in multiple surgical fields, SAS remains quite controversial in the orthopedic one. The main purpose of this study was to investigate if SAS relates with the occurrence of complications during the first 30-days after proximal femoral fracture surgery. Methods: Retrospective study including all consecutive patients submitted to proximal femoral fracture surgery between January and July 2019. Patients with no information about SAS were excluded. Patients were divided in two groups, based on the occurrence of complications during the first 30 post-operative days and their SAS calculated. Receiver operating characteristic (ROC) curves were used to assess SAS power as a predictive model of complications. Results: Forty-two percent (n = 76) of the 181 patients included in the study developed complications during the first 30 postoperative days. Eight patients (4,4%) died during that period. The patient's mean age was 79 years and 30,9% (n = 56) were men. Heart failure, pacemaker use, chronic kidney disease, chronic obstructive pulmonary disease and dementia were significantly associated with post-operative morbidity. There was no significant correlation between SAS and the occurrence of complications during the first 30 postoperative days. The AUC of SAS as a predictive model for postoperative complications after proximal femoral fracture surgery was 0,522, being insufficient to be considered an accepted model of prediction. Conclusion: Based on this study, we conclude that SAS is not predictive of the development of complications in the first 30 post-operative days in patients submitted to proximal femoral fracture surgery. However, other clinical factors have been identified as associated with postoperative morbidity...(AU)

Would surgical Apgar score be useful to predict postoperative complications after proximal femoral fracture surgery? - A retrospective cohort study.

BACKGROUND: The surgical Apgar score (SAS) is a perioperative risk evaluation score, which considers intraoperative minimum heart rate, minimum mean arterial pressure and estimated blood loss. Although validated in multiple surgical fields, SAS remains quite controversial in the orthopedic one. The main purpose of this study was to investigate if SAS relates with the occurrence of complications during the first 30-days after proximal femoral fracture surgery. METHODS: Retrospective study including all consecutive patients submitted to proximal femoral fracture surgery between January and July 2019. Patients with no information about SAS were excluded. Patients were divided in two groups, based on the occurrence of complications during the first 30 post-operative days and their SAS calculated. Receiver operating characteristic (ROC) curves were used to assess SAS power as a predictive model of complications. RESULTS: Forty-two percent (n = 76) of the 181 patients included in the study developed complications during the first 30 postoperative days. Eight patients (4,4%) died during that period. The patient's mean age was 79 years and 30,9% (n = 56) were men. Heart failure, pacemaker use, chronic kidney disease, chronic obstructive pulmonary disease and dementia were significantly associated with post-operative morbidity. There was no significant correlation between SAS and the occurrence of complications during the first 30 postoperative days. The AUC of SAS as a predictive model for postoperative complications after proximal femoral fracture surgery was 0,522, being insufficient to be considered an accepted model of prediction. CONCLUSION: Based on this study, we conclude that SAS is not predictive of the development of complications in the first 30 post-operative days in patients submitted to proximal femoral fracture surgery. However, other clinical factors have been identified as associated with postoperative morbidity. In the future, prospective-based studies with higher samples may better clarify the role of SAS in this context.

The effect of aging on the (mis)perception of intentionality - an ERP study.

Despite the accumulated knowledge on moral decision-making in the early stages of development, empirical evidence is still limited in the old-aged adults. The current study contributes to unveil the neural correlates of judgments of moral transgressions as a function of aging, by examining the temporal dynamics of neural activation elicited by intentional and accidental harmful actions in three groups of healthy participants: young adults (18-35), adults (40-55), and older adults (60-75). Older adults were slower and less accurate in rating intentionality, compared to the younger groups. In ERP analysis, the older group showed increased P2 amplitude, which was predicted by poorer performance on neuropsychological tests. Reduced amplitudes were found on critical ERP components to moral cognition (N2 and LPP), namely while processing intentional harmful scenarios. Older adults seem to allocate more attentional resources (P2) to the task, probably to compensate the age-related decline in executive functioning, while younger groups show a pronounced negativity while detecting harm (N2) and increased neural activation to encode the intentions behind the acts (LPP).

Age-related decline in emotional perspective-taking: Its effect on the late positive potential.

Aging is associated with changes in cognitive and affective functioning, which likely shape older adults' social cognition. As the neural and psychological mechanisms underlying age differences in social abilities remain poorly understood, the present study aims to extend the research in this field. To this purpose, younger (n = 30; Mage = 26.6), middle-aged (n = 30; Mage = 48.4), and older adults (n = 29; Mage = 64.5) performed a task designed to assess affective perspective-taking, during an EEG recording. In this task, participants decided whether a target facial expression of emotion (FEE) was congruent or incongruent with that of a masked intervener of a previous scenario, which portrayed a neutral or an emotional scene. Older adults showed worse performance in comparison to the other groups. Regarding electrophysiological results, while younger and middle-aged adults showed higher late positive potentials (LPPs) after FEEs congruent with previous scenarios than after incongruent FEEs, older adults had similar amplitudes after both. This insensitivity of older adults' LPPs in differentiating congruent from incongruent emotional context-target FEE may be related to their difficulty in generating information about others' inner states and using that information in social interactions.

Age-related changes in social decision-making: An electrophysiological analysis of unfairness evaluation in the Ultimatum Game.

This study examines age-related differences in behavioral and neural responses to unfairness. Our sample was composed of younger, middle-aged, and older adults, who performed the Ultimatum Game in the proposer role, and in the respondent role during an EEG recording. We administered neurocognitive tests to identify whether patterns in decision-making are associated with age-related changes in cognition. Despite the worse performance in measures of executive functioning, older adults had the best economic strategy by accepting more unfair offers than younger and middle-aged adults. Regarding electrophysiological results, while younger adults showed higher medial frontal negativity (MFN) amplitudes after unfair than after fair offers, middle-aged and older adults had similar amplitudes after both conditions. Our results suggest that aging may be accompanied by an insensitivity to unfairness, which may underlie their higher rates of unfair offers acceptance.

Comparative analysis of viral shedding in pediatric and adult subjects with central nervous system-associated enterovirus infections from 2013 to 2015 in Switzerland.

BACKGROUND: Several enterovirus (EV) genotypes can result in aseptic meningitis, but their routes of access to the central nervous system remain to be elucidated and may differ between the pediatric and adult populations. OBJECTIVE: To assess the pattern of viral shedding in pediatric and adult subjects with acute EV meningitis and to generate EV surveillance data for Switzerland. STUDY DESIGN: All pediatric and adult subjects admitted to the University Hospitals of Geneva with a diagnosis of EV meningitis between 2013 and 2015 were enrolled. A quantitative EV real-time reverse transcriptase (rRT)-PCR was performed on the cerebrospinal fluid (CSF), blood, stool, urine and respiratory specimens to assess viral shedding and provide a comparative analysis of pediatric and adult populations. EV genotyping was systematically performed. RESULTS: EV positivity rates differed significantly between pediatric and adult subjects; 62.5% of pediatric cases (no adult case) were EV-positive in stool and blood for subjects for whom these samples were all collected. Similarly, the EV viral load in blood was significantly higher in pediatric subjects. Blood C-reactive protein levels were lower and the number of leucocytes/mm3 in the CSF were higher in non-viremic than in viremic pediatric subjects, respectively. A greater diversity of EV genotypes was observed in pediatric cases, with a predominance of echovirus 30 in children ≥3 years old and adults. CONCLUSION: In contrast to adults, EV-disseminated infections are predominant in pediatric subjects and show different patterns of EV viral shedding. This observation may be useful for clinicians and contribute to modify current practices of patient care.

Synthesis of cellulose acetate and carboxymethylcellulose from sugarcane straw.

Sugarcane straw (SCS) is a raw material with high potential for production of cellulose derivatives due to its morphology and structure. The proposal of this work was to synthesize cellulose acetate (CA) and carboxymethylcellulose (CMC) from sugarcane straw cellulose, and applied the CA in the preparation of a membrane. The cellulose extraction was carried out in four steps. Firstly, SCS was treated with H2SO4 (10% v/v) followed by NaOH (5% w/v) treatment. Subsequently, a chelating process was performed before ending the extraction process with chemical bleaching using H2O2 (5% v/v). The extracted cellulose was employed in the obtainment of CA and CMC. The CA presented a degree of substitution (DS) of 2.72. Its FTIR spectrum showed that practically all hydroxyl groups were replaced by acetate groups. The membrane synthesized from CA was dense and homogeneous. The presence of small particles on the top and bottom surfaces decreased the mechanical resistance of the membrane. The CMC presented a low DS (0.4) demonstrating the carboxymethylation reaction was not very effective due to the presence of lignin. These results proved that SCS can be utilized in the synthesis of CA and CMC.

Proactive therapeutic drug monitoring of infliximab: a comparative study of a new point-of-care quantitative test with two established ELISA assays.

BACKGROUND: Therapeutic drug monitoring is a powerful strategy known to improve the clinical outcomes and to optimise the healthcare resources in the treatment of autoimmune diseases. Currently, most of the methods commercially available for the quantification of infliximab (IFX) are ELISA-based, with a turnaround time of approximately 8 h, and delaying the target dosage adjustment to the following infusion. AIM: To validate the first point-of-care IFX quantification device available in the market - the Quantum Blue Infliximab assay (Buhlmann, Schonenbuch, Switzerland) - by comparing it with two well-established methods. METHODS: The three methods were used to assay the IFX concentration of spiked samples and of the serum of 299 inflammatory bowel diseases (IBD) patients undergoing IFX therapy. RESULTS: The point-of-care assay had an average IFX recovery of 92%, being the most precise among the tested methods. The Intraclass Correlation Coefficients of the point-of-care IFX assay vs. the two ELISA-based established methods were 0.889 and 0.939. Moreover, the accuracy of the point-of-care IFX compared with each of the two reference methods was 77% and 83%, and the kappa statistics revealed a substantial agreement (0.648 and 0.738). CONCLUSIONS: The Quantum Blue IFX assay can successfully replace the commonly used ELISA-based IFX quantification kits. This point-of-care IFX assay is able to deliver the results within 15 min makes it ideal for an immediate target concentration adjusted dosing. Moreover, it is a user-friendly desktop device that does not require specific laboratory facilities or highly specialised personnel.

Photophysics and ex vivo biodistribution of ß-cyclodextrin-meso-tetra(m-hydroxyphenyl)porphyrin conjugate for biomedical applications.

Low aqueous solubility of porphyrin-based photosensitizers hampers their clinical use in photodynamic therapy because of complex delivery. In this study, we explore meso-tetra(m-hydroxyphenyl)-21,23H-porphyrin (mTHPP), a potent photosensitizer, covalently attached to ß-cyclodextrin (CD-mTHPP) with a focus on topical delivery and cellular uptake. The photophysical properties of CD-mTHPP were examined using steady-state fluorescence and lifetime measurements verifying increased aqueous solubility. Confocal and fluorescence lifetime imaging microscopy on human squamous carcinoma cells (A431) evidenced a cytoplasmic uptake of CD-mTHPP in predominantly monomeric form. CD-mTHPP was also delivered to human skin ex vivo and the skin penetration was assessed using two-photon fluorescence microscopy. The results indicated that CD-mTHPP exhibits improved skin distribution compared to mTHPP alone using aqueous vehicles. Thus the CD-mTHPP conjugate demonstrates improved biodistribution ex vivo compared to mTHPP and is a promising multimodal system for photodynamic therapy.

Homing in rocky intertidal fish. Are Lipophrys pholis L. able to perform true navigation?

Although navigation is common in many animals, only a few perform true navigation, meaning that they have the ability to return to a given place by relying on indirect cues obtained at the release site (i.e., by relying on information from a "map and compass" mechanism). The common intertidal fish, Lipophrys pholis, is thought to have homing abilities through a mechanism that primarily makes use of familiar landmarks (i.e., piloting). Anecdotal reports that individuals return to their home pools after release at unfamiliar sites suggest that L. pholis might use cues collected at the release site to find their way back (i.e., they might use map and compass information). Using a completely artificial setup, we tested the homing abilities of L. pholis as a function of age, sex, and familiarity with the release site. The findings showed that motivation for homing is present only in the adult phase and is independent of sex and/or familiarity with the release site. Moreover, adults released at a completely unfamiliar place oriented themselves in a direction roughly similar to that of their home pools. The fact that L. pholis were tested in a complete artificial environment means that hydrodynamic cues can be excluded as playing a role in this process and restricts the candidate options (e.g., magnetic cues). The ability to perform navigation based on a "map and compass" mechanism raises many interesting questions about the learning process, once these individuals have restricted home ranges during their lives. In vertebrate navigation, the cues used during the navigation process are a question of debate, and L. pholis offers an outstanding model to test hypotheses and ultimately provide answers.

Association between albuminuria, glomerular filtration rate and mortality or recurrence in stroke patients.

BACKGROUND/AIMS: In an attempt to find new predictors of stroke prognosis, we evaluated the association of albuminuria (AUr) and the estimated glomerular filtration rate (eGFR) with the recurrence of stroke and mortality. METHODS: We evaluated and followed for at least 7 months patients with first-ever stroke or transient ischemic attack admitted to a prospective cohort from March 2005 to December 2007. We analyzed traditional CV risk factors, albumin-to-creatinine ratio and eGFR (ml/min/1.73 m(2)) as predictors of mortality or recurrence. RESULTS: From a total of 185 patients included [57% (104/185) men, 64 ± 13 years], 38 patients suffered from a recurrent stroke or died, with a mean follow-up of 25.1 ± 8.7 months. AUr (≥30 mg/g) was found in 50.2% (93/185), and 38.9% (72/185) presented an eGFR <60. In univariate analysis, age >65 years, eGFR ≤50, atrial fibrillation (AF), no alcohol intake and AUr >17 mg/g were associated with the composite endpoint. In a multivariate analysis, AF and AUr >17 mg/g were independent predictors of the composite endpoints, but eGFR ≤50 was not. CONCLUSION: The presence of AUr >17 mg/g is independently associated with death or recurrence after stroke. Further studies should consider the AUr as a predictor for a worse prognosis in these patients.

Detection of bacterial DNA in acute and chronic cholecystitis.

BACKGROUND: The incidence of bacterbilia in cholelithiasis remains controversial. The positivity of cultures ranges from 0 to 73 per cent. The aim of this study was to employ the polymerase chain reaction (PCR) to detect bacterial DNA in gallbladder bile extracted during elective laparoscopic cholecystectomy, and to compare PCR findings with those of bile culture. METHODS: Bile samples from 84 laparoscopic cholecystectomies were collected for culture and PCR analysis. RESULTS: Positive results for bacterbilia were found in 42 (50 per cent) of 84 patients by PCR but in only 16 patients (19 per cent) by culture (P < 0.001). Agreement between the two methods was seen in 44 samples (52 per cent), which were negative in 35 cases. Pathological examination showed chronic cholecystitis in 69 cases (82 per cent) and acute cholecystitis in 15 (18 per cent). Thirty-three (48 per cent) of the patients with chronic cholecystitis were PCR positive but only ten (14 per cent) were culture positive (P < 0.001). Only culture results correlated with findings on pathological examination (P = 0.033). CONCLUSION: PCR is more sensitive in detecting bacterial contamination of gallbladder bile in cholecystitis than conventional culture. The clinical relevance of this high sensitivity remains unclear.

Incidence of stroke subtypes, prognosis and prevalence of risk factors in Joinville, Brazil: a 2 year community based study.

BACKGROUND: There have been few population based studies on stroke risk factors and prognosis conducted in Brazil. The objective of this study was to evaluate, over a 2 year period, the incidence of the subtypes of first ever stroke, the prevalence of cardiovascular risk factors and functional prognosis in a city located in the south of Brazil. METHODS: The period from January 2005 to December 2006 was evaluated prospectively by compiling data on first ever stroke cases, medications used prior to the morbidity and the incidence of traditional risk factors. The annual incidence was adjusted for age using the direct method. Patients were monitored for at least 6 months following the event. RESULTS: Of 1323 stroke cases, 759 were first ever stroke cases. Of these, 610 were classified as infarctions, 94 as intracerebral haemorrhage and 55 as subarachnoid haemorrhage. The crude incidence rate per 100 000 inhabitants was 61.8 for infarction (95% CI 57.0 to 66.9), 9.5 for intracerebral haemorrhage (95% CI 7.7 to 11.6) and 5.6 for subarachnoid haemorrhage (95% CI 4.2 to 7.3). The 30 day case fatality was 19.1%. The most prevalent cardiovascular risk factor was arterial hypertension. By post-stroke month 6, 25% had died (95% CI 21.4 to 29.1) whereas 61.5% had regained their independence (95% CI 56.2 to 68.3). CONCLUSIONS: Case fatality rate, prognosis and incidence adjusted for stroke subtypes were similar to those found in other population based studies. The prevalence rates of ischaemic heart disease, dyslipidaemia, arterial hypertension and diabetes suggest that Joinville presents a mixed pattern of cardiovascular risk, a pattern seen in developed and developing countries alike.

Inibição e inativação in vitro de Salmonella spp. com extratos de plantas com indicativo etnográfico medicinal ou condimentar / In vitro inhibition and inactivation activity of Salmonella spp. by plant extracts with spicy or medicinal ethnographic indicative

Determinou-se in vitro a intensidade de atividade de inibição bacteriana e a intensidade de atividade de inativação bacteriana, por meio de testes de diluição e suspensão em sistema de tubos múltiplos, de diferentes extratos, aquosos ou alcoólicos/hidroalcoólicos, de 86 plantas com indicativo etnográfico medicinal ou condimentar acessadas na região metropolitana de Porto Alegre, Rio Grande do Sul, frente a Salmonella spp., ou S. enteritidis ATCC nº 13076, ou S. cholera-suis ATCC nº10708, ou S. gallinarum CPVDF-SAA/RS/BR, em doses-desafio de <10(7)UFC.mL-1. Cinquenta plantas apresentaram alguma atividade seletiva antissalmonela, e 37 nenhuma atividade. Discute-se a validade da ferramenta etnográfica na prospecção de fatores de proteção antibacteriana em plantas, bem como a influência da inibição/inativação na preditividade do diagnóstico bacteriológico.

The in vitro intensity of bacterial inhibition activity of diverse extracts (aquous, alcoholic, or hydroalcoholic) from 86 plants with medicinal and spicy ethnographic indicative, from Porto Alegre City, Rio Grande do Sul State, Brazil, were determinated in Salmonella spp. (S. enteritidis ATCC n.13076, S. cholera-suis ATCC n. 10708, or S. gallinarum CPVDF-SAA/RS/BR) in challenge dose <10(7)CFU.mL-1. Extracts of fifty plants presented some anti-Salmonella selective activity, while the other 36 extracts presented no activity. It is discussed the validity of ethnographic search instruments in the prospection of anti-bacterial protection factors in plants, as well the influence of inhibition/inactivation results in the predictivity of bacteriological diagnostic.

Trends in stroke incidence, mortality and case fatality rates in Joinville, Brazil: 1995-2006.

BACKGROUND: Studying stroke rates in a whole community is a rational way to assess the quality of patient care and primary prevention. However, there are few studies of trends in stroke rates worldwide and none in Brazil. OBJECTIVE: Established study methods were used to define the rates for first ever stroke in a defined population in Brazil compared with similar data obtained and published in 1995. METHODS: All stroke cases occurring in the city of Joinville during 2005-2006 were prospectively ascertained. Crude incidence and mortality rates were determined, and age adjusted rates and 30 day case fatality were calculated and compared with the 1995 data. RESULTS: Of the 1323 stroke cases registered, 759 were first ever strokes. The incidence rate per 100 000 was 105.4 (95% CI 98.0 to 113.2), mortality rate was 23.9 (95% CI 20.4 to 27.8) and the 30 day case fatality was 19.1%. Compared with the 1995 data, we found that the incidence had decreased by 27%, mortality decreased by 37% and the 30 day case fatality decreased by 28%. CONCLUSIONS: Using defined criteria we showed that in an industrial southern Brazilian city, stroke rates are similar to those from developed countries. A significant decrease in stroke rates over the past decade was also found, suggesting an improvement in primary prevention and inpatient care of stroke patients in Joinville.

Atividade anti-estafilócica em extratos de plantas com indicativo medicinal ou condimentar / Anti-staphylococci activity in extracts from plants presenting medicinal and spice indicative

O gênero Staphylococcus permanece em evidência no contexto das doenças transmissíveis considerando-se os portadores humanos e animais como a sua principal fonte de infecção. Por sua vez, a pesquisa de fatores de proteção antibacteriana em recursos naturais como plantas com indicativo medicinal ou condimentar vem sendo recomendado como prioridade pelas Conferências Mundiais de Saúde. A presente revisão descreve a triagem in vitro, através de testes de diluição em sistema de tubos múltiplos, de atividade anti-estafilococo de diferentes extratos de 80 plantas com indicativo etnográfico medicinal, condimentar ou aromático, acessadas na região metropolitana de Porto Alegre, RS. Demonstrou-se atividade seletiva em 39 espécies, enquanto as demais 41 não apresentaram atividade.

The genus Staphylococcus remains in evidence regarding transmissible diseases since human and animal carriers are its main infection source. Studies on antibacterial protection factors in natural resources, such as plants presenting medicinal or spice indicative, have been recommended by World Health Conferences as a priority. Dilution tests in multiple tube system were used in this review to describe the in vitro sorting of anti-staphylococci activity of different extracts from 80 plants presenting medicinal, spice or aromatic ethnographic indicatives at the metropolitan region of Porto Alegre, Rio Grande do Sul State, Brazil. Selective activity was observed for 39 species, whereas the remaining 41 species did not show activity.

Características cinemáticas, cinéticas e eletromiográficas do andar de adultos jovens com e sem suporte parcial de peso corporal / Kinematic, kinetic and electromyographic characteristics of young adults walking with and without partial body weight support

OBJETIVO: O objetivo deste estudo foi analisar as características cinemáticas, cinéticas e eletromiográficas do andar de adultos jovens em piso fixo sem colete e com suporte parcial de peso (SPP) de 0, 10, 20 e 30 por cento do peso corporal. MÉTODO: Oito jovens com idade média de 22,2 anos foram filmados andando sobre uma passarela que continha uma plataforma de força na região central para registro das componentes da força de reação do solo. Marcadores refletivos foram posicionados nos principais pontos anatômicos dos membros inferiores para registro dos dados cinemáticos, e eletrodos de superfície foram afixados nos músculos tibial anterior e gastrocnêmio medial para registro da atividade elétrica muscular. RESULTADOS: Diferenças significantes entre as cinco condições experimentais foram constatadas nas variáveis espaço-temporal, nos ângulos máximos e mínimos da coxa, joelho e tornozelo e nas amplitudes das componentes horizontal ântero-posterior e vertical da força de reação do solo. De forma geral, as maiores mudanças ocorreram na condição de SPP de 30 por cento do peso corporal. CONCLUSÃO: É importante considerar as compensações que ocorrem no padrão do andar com SPP no planejamento das intervenções terapêuticas. Ainda, para melhor definir a utilização dos sistemas de suspensão de peso na reabilitação, estudos futuros precisam ser realizados para verificar o comportamento do andar em populações com alteração de movimento em piso fixo.

OBJECTIVE: The aim of this study was to analyze the kinematic, kinetic and electromyographic characteristics of young adults walking on a fixed platform without a vest and with partial body weight support (PBWS) of 0, 10, 20 and 30 percent. METHOD: Eight young adults (mean age: 22.2 years) were videotaped walking on a walkway that contained a force plate embedded in its middle portion, to record the ground reaction force (GRF) components. Reflective markers were placed on the main anatomical points of the lower limbs in order to acquire kinematic data, and surface electrodes were attached to the tibialis anterior and gastrocnemius medialis muscles in order to record electromyographic muscle activity. RESULTS: Significant differences among the five experimental conditions were observed with regard to spatial-temporal variables, the maximum and minimum angles for the thigh, knee, and ankle, and the amplitudes of the anteroposterior horizontal and vertical GRF components. Generally, the greatest changes occurred with PBWS of 30 percent. CONCLUSION: It is important to take into consideration the compensations to walking patterns that occur with PBWS, in planning therapeutic interventions. Moreover, to better define the use of suspended weight systems in rehabilitation programs, further investigations should be conducted in order to verify the walking patterns on fixed platforms among populations with movement disorders.

Splenic haemangioma and Kasabach-Merritt Syndrome as differential diagnosis for abdominal mass in a newborn: case report

Apresentamos um caso raro de hemangioma esplênico em um recém-nascido do sexo feminino, apresentando-se como massa abdominal, coagulopatia e trombocitopenia. No ato operatório observou-se uma massa tumoral vascular do pólo inferior do baço. A paciente encontra-se em acompanhamento ambulatorial. O diagnóstico e as opções de tratamento foram revistas e discutidas. Os autores revisaram a literatura sobre hemangioma esplênico em recém-nascidos e observaram ser este o terceiro caso de associação entre hemangioma esplênico e Síndrome de Kasabach-Merritt. O hemangioma esplênico é uma doença rara no diagnóstico diferencial das massas abdominais em recém-nascidos. O hemangioma é a neoplasia benigna mais freqüente do baço. A anemia, a trombocitopenia e a coagulopatia são vistos com freqüência em hemangiomas cavernosos grandes associados à Síndrome de Kasabach-Merritt (KMS). O hemangioma cavernoso esplênico associado com esta síndrome é extremamente raro.

Hydroxymethylation and oxidation of Organosolv lignins and utilization of the products.

Organosolv lignins obtained from Eucalyptus grandis, sugarcane bagasse and Picea abies by Acetosolv, Formacell and Organocell processes were characterized, fractionated and converted to hydroxymethylated and oxidized products. The reactivity of lignins with formaldehyde did not improve significantly with the fractionation. Both eucalyptus Acetosolv (EAc) and eucalyptus Formacell (EFo) lignins retained high heterogeneity in relation to the molecular weight distribution but not in relation to structural units. The temperatures of the exothermic peaks and the apparent activation energies for the cross-linking are different for hydroxymethylated lignins and phenol, with similar cure temperatures of the resols. Chemical oxidation using cobalt(II) and manganese(II) salts furnished oxidized lignins with improved chelating properties. These chelating agents can remove up to 14% of Mn present in pulps, decreasing the peroxide consumption in the bleaching process. The products obtained can be also used as oxidized phenols and controlled-release matrices. Oxidation of Acetosolv bagasse lignin with polyphenol oxidase furnishes lignins with chelating capacity 110% higher than that of original lignin.