Adaptação transcultural da escala de distonia cervical de Toronto (TWSTRS) para o português

Cervical dystonia (CD) is a prevalent and incapacitating movement disorder which needs a thorough clinical evaluation of every patient to better tailor treatment strategies. In Brazil, there are no validated CD scales that measure the burden of dystonia. The aim of our study was to translate and adapt the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) to Brazilian Portuguese. After translation and back-translation according to international methods, a pre-test was carried out with 30 patients. Patients under 8 years of formal schooling had severe difficulty in understanding the whole scale. The scale went through a remodeling process, without loss of its conceptual and semantic properties. The new scale was tested in 15 patients, with good understanding scores. We are now in the process of validation of the adapted scale.Distonia cervical (DC) é um transtorno de movimento prevalente e incapacitante, sendo uma avaliação global e consistente de cada paciente necessária para a melhor intervenção diagnóstica e terapêutica. No Brasil, não há escalas validadas para avaliar o impacto da DC. O objetivo deste trabalho foi traduzir e adaptar uma escala mundialmente conhecida e usada, a Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) para o português. Após a tradução e retro-tradução da escala segundo as normas e critérios internacionais, realizamos o pré-teste com 30 pacientes, sendo que o completo entendimento da escala ficou prejudicado nos pacientes com escolaridade abaixo de 8 anos. Tornou-se necessária a re-adaptação da escala, com modificação de alguns elementos, tentando manter-se sua integridade conceitual e semântica. Após pré-teste adicional com 15 pacientes, verificou-se que a escala foi completamente entendida por praticamente todos os pacientes. A validação da escala está em andamento

cardiovascular manifestations in patients infected with the human immunodeficiency virus

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Practising pastoralism in an agricultural environment: An isotopic analysis of the impact of the Hunnic incursions on Pannonian populations

We conducted a multi-isotope study of five fifth-century AD cemeteries in modern-day Hungary to determine relationships between nomadic-pastoralist incomers—the historically documented Huns and other nomadic groups—and the sedentary agricultural population of the late Roman province of Pannonia. Contemporary historical sources describe this relationship as adversarial and destructive for the late Roman population, but archaeological evidence indicates high levels of hybridity between different groups. We undertook carbon, nitrogen, strontium and oxygen isotope analyses of bone collagen, dentine and tooth enamel at Keszthely-Fenékpuszta, Hács-Béndekpuszta, Győr-Széchenyi Square, Mözs and Szolnok-Szanda to examine these relationships through past subsistence practices. The patterns at all sites indicate medium to high animal protein consumption with little evidence for a significant contribution of aquatic resources. All populations relied to a great extent on C4 plants, most likely millet. Within each population, diet was heterogeneous, with significant variations in terms of animal protein and C3 and C4 plant consumption. High levels of intra-population and individual variability suggest that populations made use of a range of subsistence strategies, with many individuals exhibiting significant changes over their lifetimes. Rather than being characterised only by violence, the historically-documented influx of nomadic populations appears to have led to widespread changes in subsistence strategies of populations in the Carpathian basin. Nomadic-pastoralist groups may have switched to smaller herds and more farming, and, conversely, local populations may have integrated with a new economic system based on animal herding.The analytical costs were funded by a research grant from the McDonald Institute for Archaeological Research, University of Cambridge. A study visit to Hungary was supported by a SYNTHESYS travel grant

Combined carriership of TLR9-1237C and CD14-260T alleles enhances the risk of developing chronic relapsing pouchitis

AIM: To investigate the single nucleotide polymorphisms (SNPs) in genes involved in bacterial recognition and the susceptibility to pouchitis or pouchitis severity. METHODS: Analyses of CD14 -260C>T, CARD15/NOD2 3020insC, Toll-like receptor (TLR)4 +896A>G, TLR9 -1237T>C, TLR9+2848G>A, and IRAKM + 22148G>A SNPs were performed in 157 ileal-pouch anal anastomosis (IPAA) patients (79 patients who did not develop pouchitis, 43 infrequent pouchitis patients, 35 chronic relapsing pouchitis patients) and 224 Italian Caucasian healthy controls. RESULTS: No significant differences were found in SNP frequencies between controls and IPAA patients. However, a significant difference in carriership frequency of the TLR9-1237C allele was found between the infrequent pouchitis and chronic relapsing pouchitis groups [P = 0.028, oddos ratio (OR) = 3.2, 95%CI = 1.2-8.6]. This allele uniquely represented a 4-locus TLR9 haplotype comprising both studied TLR9 SNPs in Caucasians. Carrier trait analysis revealed an enhanced combined carriership of the alleles TLR9 -1237C and CD14 -260T in the chronic relapsing pouchitis and infrequent pouchitis group (P = 0.018, OR = 4.1, 95%CI = 1.4 -12.3). CONCLUSION: There is no evidence that the SNPs predispose to the need for IPAA surgery. The significant increase of the combined carriership of the CD14 -260T and TLR9 -1237C alleles in the chronic relapsing pouchitis group suggests that these markers identify a subgroup of IPAA patients with a risk of developing chronic or refractory pouchitis

Complete mitochondrial sequences from Mesolithic Sardinia

Little is known about the genetic prehistory of Sardinia because of the scarcity of pre-Neolithic human remains. From a genetic perspective, modern Sardinians are known as genetic outliers in Europe, showing unusually high levels of internal diversity and a close relationship to early European Neolithic farmers. However, how far this peculiar genetic structure extends and how it originated was to date impossible to test. Here we present the first and oldest complete mitochondrial sequences from Sardinia, dated back to 10,000 yBP. These two individuals, while confirming a Mesolithic occupation of the island, belong to rare mtDNA lineages, which have never been found before in Mesolithic samples and that are currently present at low frequencies not only in Sardinia, but in the whole Europe. Preliminary Approximate Bayesian Computations, restricted by biased reference samples for Mesolithic Sardinia (the two typed samples) and Neolithic Europe (limited to central and north European sequences), suggest that the first inhabitants of the island have had a small or negligible contribution to the present-day Sardinian population, which mainly derives its genetic diversity from continental migration into the island by Neolithic times