Desempenho funcional de crianças com paralisiacerebral diparéticas e hemiparéicas

The definition ideal of cerebral palsy (PC) is to associate the functional performance with topographical characteristics and alterations of tonus. However, most of the bibliography describes this pathology and its consequences, when they evaluate the functional performance and doesn´t consider the existing differences in these types or uses only one type of PC. In literature, only one bibliography was differentiate the self-care between diplegic and hemiplegic. Evaluating the relation of the functional performance of children with diplegic and hemiplegic P.C. Transversal study with children of three to seven years old who have diplegic and hemiplegic spastics P.C., in both the sexes, and did under physitherapy. Children who didn’t walk and/or had any cognitive deficit were excluded from the research. Guardians were interviewed using part I (functional performance in the areas of self-care and mobility) of the Pediatric Evaluation of Disability Inventory (PEDI), as well as questionnaire with personal datas of the children. The program BioEstat 4,0 was used, statistical test Mann-Whitney, to verification of the association purpose. α 0,05 was used as statistics inference. The sample was composed for 40 children, 22 diplegic and 18 hemiplegic. The feminine sex participation (53%) was the biggest and carried through treatment associated with the physitherapy (88%). The self-care area (p=0,16) didn´t present difference between the groups, however, mobility, (p=0,02) suggests that the hemiplegic group had a better functional performance. The hemiplegic had better mobility that the diplegic, while in the self-care it was not observed statistic difference between the groups.Na Paralisia Cerebral (PC), o ideal é associar o desempenho funcional com características topográficas e alterações de tônus. Entretanto, grande parte da bibliografia descreve apenas a doença e suas conseqüências, e, quando se avalia o desempenho funcional, não se consideram as diferenças existentes nos tipos de PC ou se utiliza apenas um tipo. Na literatura, foi encontrada apenas uma referência bibliográfica que diferencia diparéticos e hemiparéticos quanto ao seu autocuidado, e nenhuma que compare a mobilidade entre eles. Este trabalho teve por objetivo avaliar a relação do desempenho funcional de crianças com PC diparéticas e hemiparéticas. Para tanto, fez-se um estudo transversal com portadores de PC diparéticos e hemiparéticos espásticos, de ambos os sexos, de três a sete anos, que estavam realizando fisioterapia. Excluíram-se crianças que não andavam e (ou) com déficit cognitivo. Foram realizadas entrevistas com cuidadores, utilizando-se a parte 1 (desempenho funcional nas áreas de autocuidado e mobilidade) do Inventário de Avaliação Pediátrica de Incapacidade (PEDI), assim como um questionário com dados pessoais das crianças. Utilizou-se programa BioEstat 4.0, e o teste estatístico Mann-Whitney, para verificação da associação proposta. Aceitou-se α 0,05 como inferência estatística. A amostra foi composta de 40 crianças, 22 diparéticas e 18 hemiparéticas. A maioria era do sexo feminino (53%) e realizava tratamento associado à fisioterapia (88%). A área de autocuidado (p=0,16) não apresentou diferença entre os grupos. Todavia mobilidade, (p=0,02) sugere que o grupo hemiparético possui melhor desempenho funcional. Concluiu-se que os hemiparéticos possuem melhor mobilidade que os diparéticos, enquanto que, no autocuidado, não se observou diferença estatística entre os grupos

Luminescent PhotoCORMs : Enabling/Disabling CO Delivery upon Blue Light Irradiation

The new luminescent carbonyl compounds [Mn(Oxa-H)(CO)3Br] (1) and [Mn(Oxa-NMe2)(CO)3Br] (2) were synthesized and fully characterized. Complexes 1 and 2 showed CO release under blue light (λ453). Spectroscopic techniques and TD-DFT and SOC-TD-DFT calculations indicated that 1 and 2 release the Oxa-H and Oxa-NMe2 coligands in addition to the carbonyl ligands, increasing the luminescence during photoinduction

HLA-G genetic diversity and evolutive aspects in worldwide populations.

HLA-G is a promiscuous immune checkpoint molecule. The HLA-G gene presents substantial nucleotide variability in its regulatory regions. However, it encodes a limited number of proteins compared to classical HLA class I genes. We characterized the HLA-G genetic variability in 4640 individuals from 88 different population samples across the globe by using a state-of-the-art method to characterize polymorphisms and haplotypes from high-coverage next-generation sequencing data. We also provide insights regarding the HLA-G genetic diversity and a resource for future studies evaluating HLA-G polymorphisms in different populations and association studies. Despite the great haplotype variability, we demonstrated that: (1) most of the HLA-G polymorphisms are in introns and regulatory sequences, and these are the sites with evidence of balancing selection, (2) linkage disequilibrium is high throughout the gene, extending up to HLA-A, (3) there are few proteins frequently observed in worldwide populations, with lack of variation in residues associated with major HLA-G biological properties (dimer formation, interaction with leukocyte receptors). These observations corroborate the role of HLA-G as an immune checkpoint molecule rather than as an antigen-presenting molecule. Understanding HLA-G variability across populations is relevant for disease association and functional studies

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline