Plantar Pressure Distribution Patterns During Gait in Diabetic Neuropathy Patients with a History of Foot Ulcers

OBJECTIVE: To investigate and compare the influence of a previous history of foot ulcers on plantar pressure variables during gait of patients with diabetic neuropathy. INTRODUCTION: Foot ulcers may be an indicator of worsening diabetic neuropathy. However, the behavior of plantar pressure patterns over time and during the progression of neuropathy, especially in patients who have a clinical history of foot ulcers, is still unclear. METHODS: Subjects were divided into the following groups: control group, 20 subjects; diabetic neuropathy patients without foot ulcers, 17 subjects; and diabetic neuropathy patients with at least one healed foot ulcer within the last year, 10 subjects. Plantar pressure distribution was recorded during barefoot gait using the Pedar-X system. RESULTS: Neuropathic subjects from both the diabetic neuropathy and DNU groups showed higher plantar pressure than control subjects. At midfoot, the peak pressure was significantly different among all groups: control group (139.4±76.4 kPa), diabetic neuropathy (205.3±118.6 kPa) and DNU (290.7±151.5 kPa) (p=0.008). The pressure-time integral was significantly higher in the ulcerated neuropathic groups at midfoot (CG: 37.3±11.4 kPa.s; DN: 43.3±9.1 kPa.s; DNU: 68.7±36.5 kPa.s; p=0.002) and rearfoot (CG: 83.3±21.2 kPa.s; DN: 94.9±29.4 kPa.s; DNU: 102.5±37.9 kPa.s; p=0.048). CONCLUSION: A history of foot ulcers in the clinical history of diabetic neuropathy subjects influenced plantar pressure distribution, resulting in an increased load under the midfoot and rearfoot and an increase in the variability of plantar pressure during barefoot gait. The progression of diabetic neuropathy was not found to influence plantar pressure distribution

Evaluación Multidimensional de la Superdotación: Criterios de validez de la Batería de Inteligencia y Creatividad para predecirlos talentos artísticos y académicos

We test the utility of the Battery for Giftedness Assessment (BaAH/S) in identifying differences in two groups of already known gifted students in the areas of academic and artistic talents. Four latent factors were assessed (a) fluid intelligence, (b) metaphor production (verbal crea-tivity), (c) figural fluency (figural creativity), and (d) divergent thinking figu-ral task quality (figural creativity). A sample of 987 children and adoles-cents, 464 boys and 523 girls, of ages ranging from 8 to 17 of two groups: regular students (N=866) and gifted students (N= 67 academic abilities, N=34 artistic abilities and N=20 no domain identified). Academic gifted-ness group of have higher reasoning, can produce more remote/original metaphors, high figural fluency and drawings rated as more original. Chil-dren in the group of artistic giftedness have higher reasoning, high figural fluency and drawings rated as more original. Reasoning abilities are relative-ly higher in academic giftedness group than artistic (r = .39 vs r =.14). Within artistic group figural fluency and ratings of originality are relatively more important than reasoning (r = .25 and r = .21 vs .14). We emphasizes the importance of assessing creativity in different domains in addition to intelligence to improve the understanding of giftedness and talent.Este trabajo tiene por objeto probar la utilidad de la Batería para la Evaluación de la Superdotación (BaSH/S, por sus siglas en portugués) para identificar diferentes grupos de alumnos superdotados en las aéreas de talento académico y artístico. La batería valora cuatro factores latentes: (a) inteligencia fluida, (b) producción de metáforas (creatividad verbal), (c) fluidez figurativa (creatividad figurativa), y (d) calidad del pensamiento divergente figurativo (creatividad figurativa). Se tomó una muestra de 987 alumnos adolescentes, 464 chicos y 523 chicas de edades de 8 a 17 años, que pertenecían a dos grupos: alumnos no superdotados (N=866) y alumnos superdotados (N= 67 habilidades académicas, N=34 habilidades artísticas y N=20 no identificados en un dominio especifico). El grupo de superdotados académicos presento las puntuaciones más altas en razonamiento y podían producir metáforas más originales y remotas, eran figurativamente más fluidos y sus dibujos eran más originales. Las habilidades académicas eran relativamente mayores en los superdotados académicos que en los artísticos (r = .39 vs r =.14). En el grupo de superdotados artísticos la fluidez figurativa y sus puntuaciones en originalidad eran relativamente más importantes que el razonamiento (r = .25 y r = .21 vs .14). El trabajo enfatiza la importancia de evaluar la creatividad en distintos dominios además de la inteligencia para mejorar el entendimiento de la superdotación y el talento.This article is part of a research project financed by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Coordenação de Aperfeiçoamento de Pessoal do Ensino Superior (CAPES)

Tegumentary manifestations of Noonan and Noonan-related syndromes

OBJECTIVES: Noonan and Noonan-related syndromes are common autosomal dominant disorders with neuro-cardio-facial-cutaneous and developmental involvement. The objective of this article is to describe the most relevant tegumentary findings in a cohort of 41 patients with Noonan or Noonan-related syndromes and to detail certain aspects of the molecular mechanisms underlying ectodermal involvement. METHODS: A standard questionnaire was administered. A focused physical examination and a systematic review of clinical records was performed on all patients to verify the presence of tegumentary alterations. The molecular analysis of this cohort included sequencing of the following genes in all patients: PTPN1, SOS1, RAF1, KRAS, SHOC2 and BRAF. RESULTS: The most frequent tegumentary alterations were xeroderma (46%), photosensitivity (29%), excessive hair loss (24%), recurrent oral ulcers (22%), curly hair (20%), nevi (17%), markedly increased palmar and plantar creases (12%), follicular hyperkeratosis (12%), palmoplantar hyperkeratosis (10%), café-au-lait spots (10%) and sparse eyebrows (7%). Patients with mutations in PTPN11 had lower frequencies of palmar and plantar creases and palmar/plantar hyperkeratosis compared with the other patients. CONCLUSIONS: We observed that patients with mutations in genes directly involved in cell proliferation kinase cascades (SOS1, BRAF, KRAS and RAF1) had a higher frequency of hyperkeratotic lesions compared with patients with mutations in genes that have a more complex interaction with and modulation of cell proliferation kinase cascades (PTPN11)

1-Hydr­oxy-1,1,3,3,3-penta­phenyl­disiloxane, [Si2O(OH)(Ph)5], at 150 K

In the crystal structure of the title compound, C30H26O2Si2, one Si(Ph)3 residue is bound to another Si(OH)(Ph)2 residue via a nonlinear Si—O—Si bridge. The asymmetric unit is composed of four [Si2O(OH)(Ph)5] molecules. Each pair of adjacent molecules inter­acts via strong and highly directional O—H⋯O hydrogen bonds connecting neighbouring Si—OH units, and via inter-unit O—H⋯π contacts connecting the second hydroxyl groups with adjacent phenyl groups

Differentiation Among Brazilian Wine Regions Based on Lead Isotopic Data

For the first time, the isotope ratio of lead is reported in Brazilian red wines. The lead concentration and the ratios of Pb ratio data demonstrated that the wines of the Southern region have radiogenic features, whereas the wines of the Northeastern region ranged from slightly to very radiogenic. These results indicated that the lead concentrations in the wines from these Brazilian regions are influenced both by agricultural practices and by natural occurrences. Isotope ratios allowed for differentiation among the wines produced in these two important wine producing areas in Brazil and are emerging as a promising tool in the study of the geographical origin of Brazilian wines

Chromosomal painting and ZW sex chromosomes differentiation in Characidium (Characiformes, Crenuchidae)

<p>Abstract</p> <p>Background</p> <p>The <it>Characidium </it>(a Neotropical fish group) have a conserved diploid number (2n = 50), but show remarkable differences among species and populations in relation to sex chromosome systems and location of nucleolus organizer regions (NOR). In this study, we isolated a W-specific probe for the <it>Characidium </it>and characterized six <it>Characidium </it>species/populations using cytogenetic procedures. We analyzed the origin and differentiation of sex and NOR-bearing chromosomes by chromosome painting in populations of <it>Characidium </it>to reveal their evolution, phylogeny, and biogeography.</p> <p>Results</p> <p>A W-specific probe for efficient chromosome painting was isolated by microdissection and degenerate oligonucleotide primed-polymerase chain reaction (DOP-PCR) amplification of W chromosomes from <it>C. gomesi</it>. The W probe generated weak signals dispersed on the proto sex chromosomes in <it>C. zebra</it>, dispersed signals in both W and Z chromosomes in <it>C. lauroi </it>and, in <it>C. gomesi </it>populations revealed a proximal site on the long arms of the Z chromosome and the entire W chromosome. All populations showed small terminal W probe sites in some autosomes. The 18S rDNA revealed distinctive patterns for each analyzed species/population with regard to proto sex chromosome, sex chromosome pair, and autosome location.</p> <p>Conclusions</p> <p>The results from dual-color fluorescence <it>in situ </it>hybridization (dual-color FISH) using W and 18S rDNA probes allowed us to infer the putative evolutionary pathways for the differentiation of sex chromosomes and NORs, from structural rearrangements in a sex proto-chromosome, followed by gene erosion and heterochromatin amplification, morphological differentiation of the sex chromosomal pair, and NOR transposition, giving rise to the distinctive patterns observed among species/populations of <it>Characidium</it>. Biogeographic isolation and differentiation of sex chromosomes seem to have played a major role in the speciation process in this group of fish.</p

Propriocepção na artroplastia total de joelho em idosos: uma revisão da literatura

Proprioception is the conscious or unconscious ability to perceive the motion and joint position through the articular mechanoreceptors. Proprioception is extremely important in geriatric patients, because such deficits may increase the risk of falls. Patients with total knee arthroplasty usually lose some proprioceptives afferents, and the consequences of this impairment are still contradictory among researchers. The posterior cruciate ligament is one of the primary stabilizers of the knee joint, andit may or may not be removed in total knee arthroplasty. The present paper reviewed the literature in order to discuss proprioception in patients with replaced knees. We also highlighted the importance of keeping the posterior cruciate ligament after surgery. Our conclusion raised controversial issues. However, most of the past studies agree that jointproprioception decreases after total knee arthroplasty and also agree on the importance to preserve posterior cruciate ligament.Propriocepção é a capacidade de perceber, de modo consciente ou inconsciente, o movimento e o posicionamento articular através dosmecanorreceptores articulares. Na população geriátrica, a propriocepção é extremamente importante, pois deficits aumentam os riscos para a queda. Em pacientes com artroplastia total de joelho, algumas aferênciasproprioceptivas são perdidas na cirurgia e suas conseqüências ainda geram controvérsias entre pesquisadores. O ligamento cruzado posterior é um elemento estabilizador primário do joelho que pode ser ou não preservado nas artroplastias totais. O presente trabalho buscou realizar uma revisão da literatura com o objetivo de rever a propriocepção em pacientes com artroplastia total de joelho, a partir do levantamento atual da literatura, e especificamente a importância da preservação do ligamento cruzado posterior nas próteses. A conclusão traz controvérsias, no entanto, a maioria dos autores defendem a idéia de que a artroplastia total de joelho diminui a propriocepção da articulação e que o ligamento cruzado posterior deve ser preservado sempre que possível

Is the expansion of sugarcane over pasturelands a sustainable strategy for Brazil's bioenergy industry?

The authors gratefully thank the São Paulo Research Foundation (FAPESP) (grants # 2014/08632-9 # 2015/14122-6, # 2013/17581-6, # 2014/16612-8 and 2018/09845-7) for the scholarship granted while this research was carried out, and CNPq (grants # 402992/2013-0 and # 311661/2014-9) for the financial support of the present research. Anonymous reviewers are also thanked for their valuable criticisms and comments, which led to substantial improvements of this manuscript.Peer reviewedPostprintPostprin

Órteses para o paciente com osteoartrite do polegar: o que os terapeutas ocupacionais no Brasil indicam?

Órteses são consideradas a primeira linha de atuação para o tratamento de disfunções causadas pela osteoartrite (OA) da articulação carpometacárpica do polegar. Entretanto, não existem estudos que investiguem as preferências e indicações de órteses por profissionais brasileiros. Objetivo: Identificar os modelos de órteses indicados por terapeutas ocupacionais para pacientes com OA do polegar, bem como as barreiras encontradas para o uso deste recurso. Métodos: Estudo exploratório transversal, realizado através de questionário eletrônico com terapeutas ocupacionais brasileiros. Os dados obtidos foram analisados por meio da distribuição, frequência e porcentagem das respostas. Resultados: Participaram da pesquisa 52 terapeutas ocupacionais de todo o Brasil, atuando junto a pacientes reumáticos. A maioria das indicações foi de órteses sob medida (81%), envolvendo mais de uma articulação (83,7%). Políticas institucionais e ausência de materiais foram as principais dificuldades para 48,1% dos participantes. Conclusão: A indicação de órteses para pacientes com OA se faz presente na prática clínica de terapeutas ocupacionais e torna-se importante o incentivo a estratégias que permitam o aperfeiçoamento e difusão de ações de reabilitação junto a esta população.Orthoses are the first line of action for the treatment of dysfunctions caused by osteoarthritis (OA) of the carpometacarpal joint of the thumb. However, there are no studies that investigate the preferences and orthotics prescriptions made by Brazilian health professionals. Objective: To identify orthotic designs indicated by occupational therapists for patients with thumb OA and the barriers encountered to use these devices. Methods: Cross-sectional, exploratory study conducted by electronic questionnaire with Brazilian occupational therapists. Data were analyzed using the distribution, frequency and percentage of responses. Results: 52 Brazilian occupational therapists who treated patients with rheumatic diseases participated in this study. Most of the participants indicated custom-made models (81%), involving more than one joint (83.7%). Institutional policies and lack of materials were the main barriers for 48.1% of the participants. Conclusion: The prescription of orthoses for patients with OA is present in the clinical practice of occupational therapists, and it is important to encourage strategies to the development and dissemination of rehabilitation actions for this population