Five-year mortality and related prognostic factors after inpatient stroke rehabilitation : A European multi-centre study

Objective: To determine 5-year mortality and its association with baseline characteristics and functional status 6 months post-stroke for patients who received inpatient rehabilitation. Design: A prospective rehabilitation-based cohort study. Subjects: A total of 532 consecutive stroke patients from 4 European rehabilitation centres. Methods: Predictors were recorded on admission. Barthel Index was assessed at 6 months (BI6mths) and patients were followed for 5 years post-stroke. Survival probability was computed using Kaplan-Meier analysis and compared across 3 BI6mths-classes (0-60, 65-90, 95-100) (log-rank test). Significant independent predictors were determined using multivariate Cox regression analysis (hazard ratio (HR)). Results: Five-year cumulative risk of death was 29.12% (95% confidence interval (CI): 22.86-35.38). Age (HR = 1.06, 95% CI: 1.04-1.09), cognitive impairment (HR = 1.77, 95% CI: 1.21-2.57), diabetes mellitus (HR = 1.68, 95% CI: 1.16- 2.41) and atrial fibrillation (HR = 1.52, 95% CI: 1.08-2.14) were independent predictors of increased mortality. Hyperlipidaemia (HR = 0.66, 95% CI: 0.46-0.94), and higher BI6mths (HR = 0.98, 95% CI: 0.97-0.99) were independent predictors of decreased mortality. Five-year survival probability was 0.85 (95% CI: 0.80-0.89) for patients in BI6mthsclass: 95-100, 0.72 (95% CI: 0.63-0.79) in BI6mths-class: 65-90 and 0.50 (95% CI: 0.40-0.60) in BI6mths-class: 0-60 (p < 0.0001). Conclusion: Nearly one-third of rehabilitation patients died during the first 5 years following stroke. Functional status at 6 months was a powerful predictor of long-term mortality. Maximum functional independence at 6 months post-stroke should be promoted through medical interventions and rehabilitation. Future studies are recommended to evaluate the direct effect of rehabilitation on long-term survival

Cristandade Oriental : a Igreja Etíope na Idade Média

O objetivo da presente comunicação é apresentar um estudo sobre a Igreja Copta da Etiópia, que segundo a tradição, teria nascido já nos tempos apostólicos, com influência judaizante e monofisita. Ainda segundo as tradições nacionais etíopes, esse cristianismo já teria encontrado um povo monoteista, devido à conversão da Rainha de Sabá à fé mosaica, depois de seu bíblico encontro com o rei Salomão. Os descendentes de Salomão e da Rainha de Sabá teriam dado origem à dinastia Salomônica. O soberano dessa dinastia foi, no século XVI, identificado como o lendário Preste João das ÍndiasThe goal of the present communication is to present a study about the Copt Church of Ethiopia, that according to tradition, was born on apostolic times, with Jewish and monophisist influences. Still according to Ethiopic national traditions, this Christian's would already have found a monotheist people, due to the conversion of the Queen of Sabbath to the mosaic faith, after its biblical meeting with King Solomon. The descendants of Solomon and the Queen of Sabbath would have given origin to the Solomon dynasty. The sovereign of this dynasty was, in the sixteenth century, identified as the legendary Priest John of India

Oriental Christianity: the Ethiopian Church in the Middle Ages

The goal of the present communication is to present a study about the Copt Church of Ethiopia, that according to tradition, was born on apostolic times, with Jewish and monophisist influences. Still according to Ethiopic national traditions, this Christian’s would already have found a monotheist people, due to the conversion of the Queen of Sabbath to the mosaic faith, after its biblical meeting with King Solomon. The descendants of Solomon and the Queen of Sabbath would have given origin to the Solomon dynasty. The sovereign of this dynasty was, in the sixteenth century, identified as the legendary Priest John of India

Peixes ornamentais exóticos introduzidos em corpos d’água na Mata Atlântica, Brasil

Specimens of Puntius arulius, P. ticto, P. titteya, P. oligolepis, Nannostomus beckfordi, Poecilia latipinna, P. velifera, Trichogaster pectoralis, and Betta splendens were recorded in the largest ornamental aquaculture center in Brazil. These fishes were introduced in the study sites by accidental escape and intentional release. There is evidence that six species are reproducing. Measures are proposed to prevent further spread of ornamental exotic fishes in the region. Key words: Brazil, species introduction, exotic fishes, ornamental aquaculture.Exemplares de Puntius arulius, P. ticto, P. titteya, P. oligolepis, Nannostomus beckfordi, Poecilia latipinna, P. velifera, Trichogaster pectoralis e Betta splendens foram registrados no maior centro de piscicultura ornamental do Brasil. Estes peixes alcançaram os locais de estudo devido a fugas acidentais e liberação intencional. Há evidências de que seis espécies estejam se reproduzindo. Medidas são propostas para se prevenir futuras introduções de peixes ornamentais exóticos na região. Palavras-chave: Brasil, fugas, peixes exóticos, piscicultura ornamental

Illegal trade on non-native amphibians and reptiles in southeast Brazil: the status of e-commerce

Illegal trade on non-native amphibians and reptiles in southeast Brazil: the status of e-commerc

Variations in follow-up services after inpatient stroke rehabilitation: A multicentre study

Background: Care after discharge from inpatient stroke rehabilitation units varies across Europe. The aim of this study was to compare service delivery after discharge. Methods: A total of 532 consecutive patients after stroke were recruited from 4 European rehabilitation centres in Germany, Switzerland, Belgium and the UK. At 2-month intervals, clinical assessments and structured interviews were carried out to document functional status and delivery of services after discharge. Significant factors for receiving follow-up services were analysed using a logistic generalized estimating equation model. Results: After controlling for case-mix, the results showed that Belgian patients were most likely to receive physical therapy but least likely to receive occupational therapy. German patients were least likely to receive nursing care. UK patients were less likely to receive medical care from their general practitioner compared with the other patient groups. Conclusion: Clinical characteristics did not explain the variations in service delivery after discharge from inpatient stroke rehabilitation. The decision-making processes involved in the provision of follow-up services need to be better documented. To improve our understanding of events post-discharge, the influence of non-clinical factors, such as healthcare regulations, should be explored further

Cost of phacoemulsification in the national campaing of elective cataract surgery in Itápolis, SP, Brazil

PURPOSE: To determine the average cost of cataract surgery using the phacoemulsification technique with intraocular lens implant (IOL). This study was conducted during a national campaign to treat patients with cataracts promoted by the Brazilian Council of Ophthalmology (CBO) and the Health Ministry in the city of Itápolis - SP from March to December, 2000. METHODS: All expenses related to the surgery were collected (pre-, intra-, and postoperative data) and analyzed. Fifty-eight patients with senile cataracts and without any other ocular findings were submitted to the procedure in a prospective study. RESULTS: The average cost of the surgery in this study was R$485.03 or US$ 248.05. This value represents the average cost of the surgery itself; in which some materials, equipment, taxes and other services were previously determined and used for this project. CONCLUSION: The phacoemulsification technique for cataract surgery has been used more and more, due to its effectiveness, being an excellent method to treat cataracts. Although this is an excellent technique, the economical aspect does not allow it to be used for part of the populationOBJETIVO: Determinar o custo médio do ato operatório da cirurgia de catarata, pela técnica de facoemulsificação com implante de lente intra-ocular (LIO), realizado durante a Campanha Nacional de Cirurgias Eletivas de Catarata, promovido pelo Conselho Brasileiro de Oftalmologia (CBO) e Ministério da Saúde na cidade de Itápolis - SP, no hospital local, entre os meses de março a dezembro do ano de 2000. MÉTODOS: Análise de custos pré e pós-operatórios a partir de coleta de dados e cálculos inserido no trabalho que visam quantificar os resultados financeiros obtidos na cirurgia de catarata. Para isto realizou-se estudo prospectivo de caso em série. Um grupo com catarata senil submeteu-se à intervenção cirúrgica. Foram verificados neste estudo 58 cirurgias de catarata. RESULTADOS: O custo médio do ato operatório foi de R$485,03 ou US$ 248,05. Este valor representa o custo médio da intervenção cirúrgica propriamente dita; em que determinadas insumos, equipamentos, taxas e/ou outros serviços foram previamente determinados e utilizados para este projeto. CONCLUSÃO: A técnica de facoemulsificação na cirurgia de catarata, tem-se tornado procedimento cada vez mais utilizado devido à sua comprovada eficácia, sendo método de excelência no tratamento da catarata. Apesar desta técnica encontrar-se solidificada, deparamo-nos com um problema de ordem econômica, pois o seu custo ainda a faz inacessível a uma parcela da população.Universidade Federal de São Paulo (UNIFESP)Santa Casa de Misericórdia e Maternidade Dona Julieta LyraUNIFESPSciEL