A two-mass expanding exact space-time solution

In order to understand how locally static configurations around gravitationally bound bodies can be embedded in an expanding universe, we investigate the solutions of general relativity describing a space-time whose spatial sections have the topology of a 3-sphere with two identical masses at the poles. We show that Israel junction conditions imply that two spherically symmetric static regions around the masses cannot be glued together. If one is interested in an exterior solution, this prevents the geometry around the masses to be of the Schwarzschild type and leads to the introduction of a cosmological constant. The study of the extension of the Kottler space-time shows that there exists a non-static solution consisting of two static regions surrounding the masses that match a Kantowski-Sachs expanding region on the cosmological horizon. The comparison with a Swiss-Cheese construction is also discussed.Comment: 15 pages, 5 figures. Replaced to match the published versio

Reabilitação de pacientes portadores da doença de Kienböck submetidos a ressecção da fileira proximal do carpo Rehabilitation of patients with Kienböck disease underwent proximal row carpectomy

A proposta deste estudo foi a aplicação de um protocolo de avaliação e tratamento desenvolvido no Serviço de Terapia da Mão do Setor de Terapia Ocupacional da Disciplina de Fisiatria do Departamento de Ortopedia e Traumatologia da Universidade Federal de São Paulo, destinado a pacientes portadores da Doença de Kienböck e submetidos a técnica cirúrgica de ressecção da fileira proximal do carpo. O protocolo de avaliação foi aplicado em 16 pacientes que foram avaliados no pré e pós-tratamento, considerando-se a dor, perímetro do punho, força muscular, amplitude articular do antebraço e punho e a capacidade funcional. Considerou-se também alguns referenciais subjetivos, no que se refere à satisfação pessoal do paciente quanto ao tratamento. Os resultados mostraram que o protocolo de tratamento aplicado foi eficaz na redução da dor, no aumento do arco de movimento da pronação e supinação do antebraço, abdução e adução do punho e favoreceu a melhora da capacidade funcional da mão afetada. Na avaliação subjetiva 90% dos pacientes tratados em nosso protocolo estavam satisfeitos com a sua recuperação.<br>The aim of this study was to apply an evaluation and treatment protocol developed by the Hand Therapy Department of the Occupational Therapy Group of Physiatrics Medicine, Department of Orthopedics and Traumatology, University of São Paulo, to patients with Kienböck disease underwent proximal row carpectomy. The protocol was applied to 16 patients who were assessed in the pretreatment and post-treatment periods concerning some objective parameters, such as pain, wrist circumference, muscular strength, forearm / wrist articular range of motion and functional capacity. Patients' satisfaction with their evolution was evaluated through a questionnaire according to the treatment. Results have shown that the group underwent a rehabilitation approach showed better outcomes concerning pain, muscle strength, supination, abduction and adduction range of motion and an improved hand functional efficacy. Subjective evaluation showed 90% satisfaction in the rehabilitation group