Age-Related Changes in Clinical and Analytical Variables in Chronic Hemodialyzed Patients.

Worldwide, the number of elderly individuals receiving chronic hemodialysis is rising. The aim of our study was to evaluate several clinical and analytical biomarkers in chronically dialyzed patients and analyze how they change with age. A cross-sectional study was performed by evaluating 289 end-stage renal disease patients undergoing dialysis. We evaluated the hemogram, adipokines, the lipid profile, and several markers related to inflammation, endothelial function/fibrinolysis, nutrition, iron metabolism, and cardiac and renal fibrosis. Clinical data and dialysis efficacy parameters were obtained from all patients. The relationships between studied biomarkers and age were assessed by a statistical comparison between younger (adults with age < 65 years) and older (age ≥ 65 years) patients and by performing regression analysis. Participants presented a mean age of 68.7 years (±13.6), with 66.8% (n = 193) being classified as older. Compared to younger patients, older patients presented the following: (a) significantly lower values of diastolic blood pressure (DBP) and ultrafiltration volume; (b) lower levels of phosphorus, uric acid, creatinine, and albumin; and (c) higher circulating concentrations of tissue-type plasminogen activator (tPA), D-dimer, interleukin-6, leptin, N-terminal pro B-type natriuretic peptide, and tissue inhibitor of metalloproteinase-1. In the multiple linear regression analysis, DBP values, tPA, phosphorus, and D-dimer levels were independently associated with the age of patients (standardized betas: -0.407, 0.272, -0.230, and 0.197, respectively; p < 0.001 for all), demonstrating relevant changes in biomarkers with increasing age at cardiovascular and nutritional levels. These findings seem to result from crosstalk mechanisms between aging and chronic kidney disease.

Pulmonary valve replacement in tetralogy of Fallot - who and how?

BACKGROUND AND AIM: Pulmonary regurgitation is the most common complication in repaired tetralogy of Fallot patients. Severe chronic pulmonary regurgitation can be tolerated for decades, but if not treated, it can progress to symptomatic, irreversible right ventricular dilatation and dysfunction. We investigated clinical associations with pulmonary valve replacement among patients with significative pulmonary regurgitation and how interventional developments can change their management. METHODS: All adult patients with repaired tetralogy of Fallot who were followed at an adult CHD Clinic at a single centre from 1980 to 2022 were included on their first outpatient visit. Follow-up was estimated from the time of correction surgery until one of the following events occurred first: pulmonary valve replacement, death, loss to follow-up or conclusion of the study. RESULTS: We included 221 patients (116 males) with a median age of 19 (18-25). At a median age of 33 (10) years old, 114 (51%) patients presented significant pulmonary regurgitation. Among patients with significant pulmonary regurgitation, pulmonary valve replacement was associated with male gender, older age at surgical repair, and longer QRS duration in adulthood. Pulmonary valve replacement was performed in 50 patients, including four transcatheter pulmonary valve implantations, at a median age of 34 (14) years. CONCLUSION: Pulmonary regurgitation affects a large percentage of tetralogy of Fallot adult patients, requiring a long-term clinical and imaging follow-up. Sex, age at surgical repair and longer QRS are associated with the need of PVR among patients with significative pulmonary regurgitation. Clinical practice and current literature support TPVI as the future gold standard intervention.

The Association of Leptin with Left Ventricular Hypertrophy in End-Stage Kidney Disease Patients on Dialysis.

Left ventricular hypertrophy (LVH) is a common cardiovascular complication in end-stage kidney disease (ESKD) patients. We aimed at studying the association of LVH with adiponectin and leptin levels, cardiovascular stress/injury biomarkers and nutritional status in these patients. We evaluated the LV mass (LVM) and calculated the LVM index (LVMI) in 196 ESKD patients on dialysis; the levels of hemoglobin, calcium, phosphorus, parathyroid hormone, albumin, adiponectin, leptin, N-terminal pro B-type natriuretic peptide (NT-proBNP) and growth differentiation factor (GDF)-15 were analyzed. ESKD patients with LVH (n = 131) presented higher NT-proBNP and GDF-15, lower hemoglobin and, after adjustment for gender, lower leptin levels compared with non-LVH patients. LVH females also showed lower leptin than the non-LVH female group. In the LVH group, LVMI presented a negative correlation with leptin and a positive correlation with NT-proBNP. Leptin emerged as an independent determinant of LVMI in both groups, and NT-proBNP in the LVH group. Low hemoglobin and leptin and increased calcium, NT-proBNP and dialysis vintage are associated with an increased risk of developing LVH. In ESKD patients on dialysis, LVH is associated with lower leptin values (especially in women), which are negatively correlated with LVMI, and with higher levels of biomarkers of myocardial stress/injury. Leptin and NT-proBNP appear as independent determinants of LVMI; dialysis vintage, hemoglobin, calcium, NT-proBNP and leptin emerged as predicting markers for LVH development. Further studies are needed to better understand the role of leptin in LVH in ESKD patients.

Interleukin 6 (rs1800795) and pentraxin 3 (rs2305619) polymorphisms-association with inflammation and all-cause mortality in end-stage-renal disease patients on dialysis.

Chronic inflammation plays an important role in the progression and outcome of chronic kidney disease (CKD). The circulating levels of the inflammatory biomarkers interleukin 6 (IL6) and pentraxin 3 (PTX3) are enhanced in CKD patients, and are associated with the progression of the disease and with higher risk for cardiovascular events, the major cause of death in CKD patients. Our aim was to study how specific polymorphisms of IL6 and PTX3 encoding genes affect the inflammatory response and outcome of end-stage renal disease (ESRD) patients on dialysis. Methodology included the analysis of two single nucleotide polymorphisms (SNP), namely the IL6 (rs1800795) polymorphism in the promoter region (-174G > C), and the PTX3 (rs2305619) polymorphism in the intron 1 (+ 281A > G), which were analyzed in ESRD patients on dialysis and in a group of heathy individuals. The allelic frequencies, genotype distribution and their association with circulating levels of the inflammatory markers C-reactive protein (CRP), IL6, growth differentiation factor 15 (GDF15) and PTX3, were determined in ESRD patients. Events of death were recorded along one year, to assess the association of the studied SNPs with all-cause mortality and the inflammatory biomarkers, in ESRD patients. Results showed that the allelic frequencies and genotype distribution for IL6 and PTX3 SNPs in the control group and ESRD patients were similar and in agreement with other European reports. For the IL6 polymorphism, we found a trend towards higher levels of high-sensitivity (hs) CRP, IL6 and PTX3 in the homozygous genotypes; the CC genotype also showed the highest levels of GDF15. The mortality rate after the 1-year follow-up was 10.4%. The CC genotype (IL6 SNP) was associated to a higher risk of mortality and deceased patients carrying this genotype also showed the highest levels of hsCRP. Regarding the studied PTX3 SNP, the AA genotype was linked to an enhanced inflammatory response, showing the highest values of hsCRP and IL6. Nevertheless, this genotype had no significant impact on the mortality rate. In conclusion, both studied SNPs seem to modulate the inflammatory response in ESRD and may, therefore, be determinant on disease progression and patients' outcome. Our data also highlights the importance of research on genetic variants that, although less frequent, may have significant biological value.

Cell-free DNA as a marker for the outcome of end-stage renal disease patients on haemodialysis.

BACKGROUND: DNA damage and inflammation are common in end-stage renal disease (ESRD). Our aim was to evaluate the levels of circulating cell-free DNA (cfDNA) and the relationship with inflammation, anaemia, oxidative stress and haemostatic disturbances in ESRD patients on dialysis. By performing a 1-year follow-up study, we also aimed to evaluate the predictive value of cfDNA for the outcome of ESRD patients. METHODS: A total of 289 ESRD patients on dialysis were enrolled in the study: we evaluated cfDNA, haemogram, serum iron, hepcidin, inflammatory and oxidative stress markers, and haemostasis. Events and causes of deaths were recorded throughout the follow-up period. RESULTS: ESRD patients, as compared with controls, presented significantly higher levels of cfDNA, hepcidin, and inflammatory and oxidative stress markers, and significantly lower values of iron and anaemia-related haemogram parameters. The all-cause mortality rate was 9.7%; compared with alive patients, deceased patients (n = 28) were older and presented significantly higher values of inflammatory markers and of cfDNA, which was almost 2-fold higher. Furthermore, cfDNA was the best predictor of all-cause mortality and cardiovascular mortality in ESRD patients, in both unadjusted and adjusted models for basic confounding factors in dialysis. CONCLUSIONS: Our data show cfDNA to be a valuable predictive marker of prognosis in ESRD patients on dialysis treatment; high levels of cfDNA were associated with a poor outcome.

A coreologia de Rudolf Laban e o ensino de artes corporais: uma síntese de conceitos-chave / Laban's choreology and art teaching: a synthesis of key concepts / La coreología de laban y la enseñanza de artes corporales: una síntesis de conceptos clave

Laban lançou a Coreologia em 1928 com o propósito de redi- mensionar o lugar do corpo e do movimento na cultura e na sociedade. A Coreologia, em linhas gerais, estrutura-se através de duas categorias que devem ser estudadas de forma integrada: a Corêutica (harmonia es- pacial) e a Eucinética (qualidades expressivas do movimento). O propósi- to deste artigo de revisão é apresentar uma síntese de conceitos-chave da Coreologia de Laban (Corêutica e Eucinética), além de refletir, com base nos conhecimentos historicamente construídos, sobre o ensino de artes corporais. Espera-se que este trabalho possa contribuir com a di- vulgação, entre estudantes e profissionais de artes, pedagogia e educa - ção física, de uma obra instigante e atual que se contrapõe ao tecnicismo ainda vigente nas aulas de dança, ginástica, circo e artes marciais.

Laban launched Choreology in 1928 with the purpose of re- dimensioning the place of body and movement in culture and society. Choreology is structured through two categories that should be thought of as a unit: Choreutics and Eukinetics. The purpose of this review article is to present a synthesis of the key concepts of Laban's Choreology and reflect, based on this historically constructed knowledge, on the teaching of body movement arts. It is hoped that this synthesis can contribute to the dissemination, among students and professionals of arts, pedagogy and physical education, of an instigating and current work that opposes the technicism still present in dance, gymnastics, circus and martial arts classes.

Labán lanzó Coreología en 1928 con el propósito de redimensionar el lugar del cuerpo y el movimiento en la cultura y la sociedad. La Coreología se estructura a través de dos categorías que deben considerarse como una unidad: Corêutica y Eucinética. El propósito de este artículo de revisión es presentar una síntesis de los conceptos clave de la Coreología de Labán y reflexionar, basándose en este conocimiento históricamente construido, sobre la enseñanza de las artes del cuerpo. Se espera que esta síntesis pueda contribuir a la difusión, entre estudiantes y profesionales de artes, pedagogía y educación física, de un trabajo instigador y actual que se opone al tecnicismo aún vigente en las clases de danza, gimnasia, circo y artes marciales.

Long Pentraxin 3 as a Broader Biomarker for Multiple Risk Factors in End-Stage Renal Disease: Association with All-Cause Mortality.

Persistent inflammation in end-stage renal disease (ESRD) patients is known to underlie the progression of chronic kidney disease and to be associated with multiple risk factors including malnutrition, atherosclerosis, and cardiovascular disease (CVD). The acute-phase protein pentraxin 3 (PTX3) has a proven potential as a local inflammatory biomarker, but its clinical utility in ESRD remains unclear. Circulating levels of PTX3 and classical inflammatory mediators, including the clinical prototypical C-reactive protein (CRP), were assessed in 246 ESRD patients on dialysis and analysed in relation to the lipid profile, adipokine levels, and nutritional, cardiac, and renal fibrosis markers. Occurrence of deaths was recorded for the following year. Contrarily to the classical inflammatory markers, PTX3 levels were negatively correlated with nutritional markers and associated with a less atherogenic lipid profile. Levels of the cardiac and renal fibrosis markers and of the oxidized LDL/LDL-C ratio were found to be independent determinants of PTX3 concentration. When comparing inflammatory mediators, the increase in the PTX3 levels was the only predictor of all-cause mortality in dialysis patients in a survival model adjusted to all markers under study, other than the inflammatory ones, besides common confounding factors in dialysis. Data support the clinical applicability of PTX3 as a broader inflammatory biomarker than the classical ones, presenting a close association with inflammation, malnutrition, CVD, and renal fibrosis and a great potential to predict all-cause mortality in dialysis patients. The pleiotropic character of PTX3 may be of clinical relevance, and it could be targeted to ameliorate the high morbidity and mortality associated with ESRD.

Hepcidin and diabetes are independently related with soluble transferrin receptor levels in chronic dialysis patients.

Background: Soluble transferrin receptor (sTfR) is a biomarker of erythropoiesis, which is often impaired in dialysis patients. The aim of our study was to evaluate sTfR levels in chronically dialyzed patients and assess potential determinants of its levels. Methods: We performed a cross-sectional study by evaluating 246 end-stage renal disease patients undergoing dialysis and 32 healthy controls. Circulating levels of interleukin (IL)-6, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, hepcidin, sTfR, growth differentiation factor 15 (GDF15), and traditional iron metabolism markers were measured, as well as hemogram parameters. Clinical data was obtained from all patients. Results: Compared to controls, patients presented similar values of sTfR, reticulocytes and reticulocyte production index (RPI), and significantly higher levels of IL-6, CRP, ferritin, hepcidin, TNF-α, and GDF15. Iron, transferrin, hemoglobin levels, erythrocyte count, mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC) values were significantly lower in dialysis group. Within patients, sTfR values were higher in diabetic patients and were positively and significantly correlated with reticulocytes and erythrocytes, RPI, and therapeutic doses of erythropoiesis stimulating agents (ESA) and intravenous iron; and inversely and significantly correlated with circulating iron, ferritin, transferrin saturation, hepcidin, MCH, and MCHC. In multiple linear regression analysis, ESA dose, RPI, serum iron, diabetes, and hepcidin levels were independently associated with sTfR levels in dialysis patients and, thus, with erythropoiesis. Conclusion: Our data suggest that, besides RPI and ESA dose, diabetes and hepcidin are closely related to erythropoiesis in dialysis patients. The influence of diabetes on sTfR levels deserves further investigation.

The Protective Role of Adiponectin for Lipoproteins in End-Stage Renal Disease Patients: Relationship with Diabetes and Body Mass Index.

Cardiovascular disease (CVD) events are the main causes of death in end-stage renal disease (ESRD) patients on dialysis. The number and severity of CVD events remain inappropriate and difficult to explain by considering only the classic CVD risk factors. Our aim was to clarify the changes and the relationship of lipoprotein subfractions with other CVD risk factors, namely, body mass index (BMI) and adipokines, inflammation and low-density lipoprotein (LDL) oxidation, and the burden of the most prevalent comorbidities, diabetes mellitus (DM) and hypertension (HT). We studied 194 ESRD patients on dialysis and 22 controls; lipid profile, including lipoprotein subpopulations and oxidized LDL (oxLDL), C-reactive protein (CRP), adiponectin, leptin, and paraoxonase 1 activity were evaluated. Compared to controls, patients presented significantly lower levels of cholesterol, high-density lipoprotein cholesterol (HDLc), LDLc, oxLDL, and intermediate and small HDL and higher triglycerides, CRP, adiponectin, large HDL, very-low-density lipoprotein (VLDL), and intermediate-density lipoprotein- (IDL) B. Adiponectin levels correlated positively with large HDL and negatively with intermediate and small HDL, oxLDL/LDLc, and BMI; patients with DM (n = 17) and with DM+HT (n = 70), as compared to patients without DM or HT (n = 69) or only with HT (n = 38), presented significantly higher oxLDL, oxLDL/LDLc, and leptin and lower adiponectin. Obese patients (n = 45), as compared to normoponderal patients (n = 81), showed lower HDLc, adiponectin, and large HDL and significantly higher leptin, VLDL, and intermediate and small HDL. In ESRD, the higher adiponectin seems to favor atheroprotective HDL modifications and protect LDL particles from oxidative atherogenic changes. However, in diabetic and obese patients, adiponectin presents the lowest values, oxLDL/LDLc present the highest ones, and the HDL profile is the more atherogenic. Our data suggest that the coexistence of DM and adiposity in ESRD patients on dialysis contributes to a higher CVD risk, as showed by their lipid and adipokine profiles.

Rítmica dalcroze e o cancioneiro infantil: reflexões e possibilidades de sensibilização corporal e musical / Dalcroze rhythmic and the children's songbook: reflections and body awareness and musical possibilities / Rítmica dalcroze y el cancionero infantil: reflexiones y posibilidades de sensibilización corporal y musical

O artigo apresenta uma pesquisa bibliográfica sobre os conceitos da Rítmica Dalcroze na Educação Física escolar como contribuinte no processo de formação e desenvolvimento da criança. Com isso, foi desenvolvida uma proposta pedagógica para a educação infantil que consiste no cancioneiro infantil associado ao trabalho da Plástica Animada como uma estraté-gia de musicalização, sensibilização rítmica e desenvolvimento da expressividade do corpo. Foram selecionadas três músicas do cancioneiro infantil e, a partir delas, são apresentadas formas de trabalho para a Educação Infantil.

The article presents a bibliographic research on the concepts of Rhythmic Dalcroze in Physical Education as a contributor in the child's education and development. Thus, we developed an educational proposal for children's education which is the Children's Songbook associated with the work of Plastique Animée as a musicalization strategy, rhythmic awareness and the development of expressiveness of the body. Three songs from the Child's Songbook were selected, and, from them, are presented ways of working for Early Childhood Education.

El artículo presenta una investigación bibliográfica sobre los conceptos de Rítmica Dalcroze en la educación física escolar como colaborador en el proceso de formación y el desarrollo del niño. Por eso, hemos desarrollado una propuesta educativa para la educación infantil, que consiste en el cancionero infantil asociado al trabajo de Plástica Animada, como una estrategia musicalizacion, sensibilización rítmica y el desarrollo de la expresividad corporal. Se seleccionaron 3 músicas del cancionero infantil y, a partir de ellas, se presentan formas de trabajar con ellas en la Educación Infantil.

Risk factors for mortality in end-stage kidney disease patients under online-hemodiafiltration: three-year follow-up study.

The aim of this work was to evaluate the predictors of mortality in a group of end-stage kidney disease (ESRD) patients under dialysis, by performing a three-year follow-up study. From the 236 patients included in this study, 54 patients died during the three-year follow-up period. Our data showed that the risk of death was higher in patients presenting lower levels of mean cell hemoglobin concentration, transferrin, and albumin. Our study showed that poor nutritional status and an inflammatory-induced iron depleted erythropoiesis are important factors for mortality in these patients.

Effect of Aging in the Perception of Health-Related Quality of Life in End-Stage Renal Disease Patients under Online-Hemodiafiltration.

This work aimed to evaluate how aging could influence patients' perception of health quality of life (HRQOL), as well as, the effect of aging on dialysis adequacy and in hematological, iron status, inflammatory and nutritional markers. In this transversal study were enrolled 305 ESRD patients under online-hemodiafiltration (OL-HDF) (59.67% males; 64.9 ± 14.3 years old). Data about comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected from patient's records. Moreover, HRQOL score, by using the Kidney Disease Quality of Life-Short Form (KDQOL-SF), was assessed. Analyzing the results according to quartiles of age, significant differences were found for some parameters evaluated by the KDQOL-SF instrument, namely for work status, physical functioning and role-physical, which decreased with increasing age. We also found a higher proportion of diabetic patients, a decrease in creatinine, iron, albumin serum levels, transferrin saturation and nPCR, with increasing age. Moreover, significant negative correlations were found between age and mean cell hemoglobin concentration, iron, transferrin saturation, albumin, nPCR, work status, physical functioning and role-physical. In conclusion, our results showed that aging is associated with a decreased work status, physical functioning and role-physical, with a decreased dialysis adequacy, iron availability and nutritional status, and with an increased proportion of diabetic patients and of patients using central venous catheter, as the vascular access. The knowledge of these changes associated with aging, which have impact in the quality of life of the patients, could be useful in their management.

Predictors of health-related quality of life perceived by end-stage renal disease patients under online hemodiafiltration.

PURPOSE: Patients' perception of health-related quality of life (HRQOL) is a consistent and powerful predictor of the outcome of end-stage renal disease (ESRD) patients under dialysis. This study aims to identify factors that could affect the HRQOL of ESRD patients under online hemodiafiltration (OL-HDF). METHODS: We evaluated 322 ESRD patients under OL-HDF (59.63% males; 64.9 ± 14.3 years old) from five dialysis units in the north of Portugal. Socio-demographic data, comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected from patients records. Patient's reported HRQOL score was assessed by using the Kidney Disease Quality of Life-Short Form (KDQOL-SF). RESULTS: ESRD patients showed a mean (± SD) of 53.17% (± 15.31%) in SF-36 total score, 50.17% (± 9.51%) in the SF-36 mental component summary (MCS) and 49.75% (± 9.44%) in the SF-36 physical component summary (PCS). Red cell distribution width (RDW), feminine gender and diabetes were found as significant predictors of SF-36 total score of HRQOL, which accounts for 12% of the total explained variance. Patient satisfaction, RDW, body mass index and gender were identified as predictors for the PCS, which accounts for 22% of total explained variance. Furthermore, patient satisfaction and dry weight were found as predictors for MCS. These predictors accounted for 28% of the total explained variance. CONCLUSIONS: Our results showed that the coexistence of diabetes, gender and erythropoietic disturbances are predictors of HRQOL in patients under OL-HDF and suggest that more attention should be given to woman patients, to the improvement of anemia and to diabetic patients, who are more prone to perceive a worst HRQOL.

Type of vascular access and location in online hemodiafiltration and its association with patient's perception of health-related quality of life.

PURPOSE: The aim of this work is to evaluate the patient-reported health-related quality of life (HRQOL), according to the type and location of vascular access used for dialysis procedure. METHODS: In this transversal study, 322 end-stage renal disease (ESRD) patients under online hemodiafiltration (OL-HDF, 59.63% males; 64.9±14.3 years) were enrolled. Arteriovenous fistula (AVF) was used by 252 patients (78.3%), whereas 70 patients (21.7%) had a central venous catheter (CVC). Besides AVF location, data on comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected. Moreover, the patients' reported HRQOL score, using the Kidney Disease Quality of Life-Short Form, was evaluated. RESULTS: ESRD patients using CVC as vascular access presented a decrease in four SF-36 domain scores, namely physical functioning, emotional well-being, role-emotional and energy/fatigue when compared with those using AVF as vascular access. Additionally, these patients also showed significant differences in ESRD target areas, namely decline in cognitive function and quality of social interaction domains. When comparing the variables according to the localization of the AVF, significant differences were found in three SF-36 domain scores, namely physical functioning, pain and general health. Moreover, we also found significant differences in ESRD target areas, namely symptoms/problem list, effects of kidney disease and quality of social interaction domains. CONCLUSIONS: Our results showed that ESRD patients under OL-HDF using AVF as vascular access had higher HRQOL scores in several domains when compared with those using CVC. Additionally, we also found that dialysis patients using AVF in the left forearm presented with higher HRQOL scores.

Efeito das atividades rítmicas nas habilidades motoras de paciente atáxico: um estudo de caso / Effect of rhythmic activities on motor abilities of an ataxic patient: a case report

Pacientes atáxicos apresentam uma disfunção de coordenação sobre a sequência de ativação muscular e disfunção na performance rítmica e movimentos alternados. O objetivo desse estudo foi investigar a influência das atividades rítmicas no desempenho motor e funcional de um paciente atáxico. M.A., sexo feminino, 57 anos participou de 18 sessões de atividades rítmicas, 3 vezes por semana por 40 minutos. A ataxia foi avaliada pela Escala de Avaliação e Classificação de Ataxia (SARA) e para avaliação rítmica foi utilizado o Teste do Padrão Rítmico (TPR), que avalia a execução de algumas habilidades motoras na presença de um ritmo sonoro. A terapia consistiu em atividades de coordenação motora associadas com atividades rítmicas. As atividades eram realizadas com auxilio de um metrônomo utilizando música de andamento lento e, em seguida, andamento rápido. As avaliações foram aplicadas antes e após a intervenção. Antes a após a intervenção a paciente obteve 12 pontos na SARA (0 - ausência de ataxia e 40 - ataxia grave), o que mostra uma manutenção dos sintomas relacionados à ataxia. Antes da intervenção, a paciente foi incapaz de realizar qualquer atividade do TPR de forma adequada, obtendo 0pontos. Após a intervenção, oito das 10 atividades foram realizadas corretamente, pontuando 8. Melhoras nas habilidades motoras após a intervenção puderam ser adquiridas indiretamente, como o equilíbrio estático e dinâmico. Esta habilidade não foi diretamente treinada na terapia, porém a realização com sucesso das atividades salto skip, elevação alternada dos joelhos e deslocamento lateral do TPR, ao final da intervenção, demonstra uma melhora no quesito equilíbrio. A intervenção com as atividades rítmicas melhorou a capacidade de executar atividades relacionadas ao TPR enquanto trouxe uma abordagem lúdica e prazerosa ao tratamento embora não tenha exercido influência sobre as características motoras da ataxia avaliadas pela SARA.

Ataxic patients present a coordination dysfunction on the sequence of muscle activation and dysfunction on performing rhythmic and alternating movements. The objective of this study was to investigate the influence of rhythmic activities on motor and functional performance in an ataxic patient. M.A., female, 57 years old underwent 18 sessions of rhythmic activities, 3 times a week for 40 minutes. Ataxia features were assessed by the Scale for Assessment and Rating of Ataxia (SARA) and rhythmic performance was assessed using the Test of Rhythmic Pattern (TPR), which evaluates the performance of some motor skills in the presence of a rhythm. Rhythmic activities consisted of motor coordination activities associated with rhythmic features. Activities were performed following a metronome, using slow-paced music and then fast-paced music. SARA and TPR have been assessed before and after the intervention. Before and after intervention the patient obtained 12 points at SARA (0-absence of ataxia and 40-severe ataxia), which shows a maintenance of the symptoms related to ataxia. Before intervention, the patient was unable to perform any activity of TPR in the appropriate way, scoring 0 points. After intervention, 8 of the 10 activities have been performed correctly, scoring 8. Improvement on motor abilities post intervention were indirectly acquired, as static and dynamic balance. Balance was not directly trained during therapy sessions, although the correct execution of skip jump (jumping with alternating legs), lifting alternating knees and lateral displacement abilities of TPR post intervention show this improvement on balance... It would be possible that a greater number of sessions associated to a gradually increase on the degree of difficulty of the rhythmic activities can bring benefits to motor performance of an ataxic patient.

A estética aplicada de François Delsarte: entre memórias e esquecimentos / François Delsarte's applied aesthetics: among memories and forgetfulness / La estética aplicada de François Delsarte: entre recuerdos y olvidos

O propósito deste artigo é apresentar a tradução de alguns fragmentos autobiográficos de François Delsarte (1811-1871), reconhecido ela historiografia do espetáculo (ROPA, 1988; PORTE, 1992; RANDI, 1993) como protagonista da refundação teatral novecentista, em especial no campo da dança. Langlade e Langlade (1982) também apontam Delsarte como grande inspirador dos métodos ginásticos modernos, na Europa como nos Estados Unidos. Delsarte desenvolveu uma vasta teoria sobre a expressividade humana - suas fontes e mecanismos psicofísicos - que culminou num sistema de educação do gesto denominado Estética aplicada (esthétique appliquée) inicialmente destinado aos atores líricos e oradores e, algum tempo depois, revisitado pelo dançarino Ted Shawn (1891-1972), responsável pelo desencadeamento de uma nova tradição em dança

The purpose of this paper is to present the translation of some autobiographical fragments by François Delsarte (1811-1871), recognized by the historiography of theather (ROPA, 1988; PORTE, 1992; RANDI, 1993) as protagonist of the twentieth-century theather refoundation, specially in the field of dance. Langlade & Langlade (1982) also consider Delsarte the great inspirator of modern gymnastic methods, in Europe as well as in the United States. Delsarte has developed an extensive theory on human expressivity - its sources and psychophysical mechanisms - which has culminated on a gesture education system named Applied aesthetics (Esthétique appliquée). This system was initially intended for lyric actors and orators, but was later revisited by the dancer Ted Shawn (1891-1972), who was responsible for the beginning of a new tradition in dance

A estética aplicada de François Delsarte: entre memórias e esquecimentos / François Delsarte's applied aesthetics: among memories and forgetfulness / La estética aplicada de François Delsarte: entre recuerdos y olvidos

O propósito deste artigo é apresentar a tradução de alguns fragmentos autobiográficos de François Delsarte (1811-1871), reconhecido ela historiografia do espetáculo (ROPA, 1988; PORTE, 1992; RANDI, 1993) como protagonista da refundação teatral novecentista, em especial no campo da dança. Langlade e Langlade (1982) também apontam Delsarte como grande inspirador dos métodos ginásticos modernos, na Europa como nos Estados Unidos. Delsarte desenvolveu uma vasta teoria sobre a expressividade humana - suas fontes e mecanismos psicofísicos - que culminou num sistema de educação do gesto denominado Estética aplicada (esthétique appliquée) inicialmente destinado aos atores líricos e oradores e, algum tempo depois, revisitado pelo dançarino Ted Shawn (1891-1972), responsável pelo desencadeamento de uma nova tradição em dança

The purpose of this paper is to present the translation of some autobiographical fragments by François Delsarte (1811-1871), recognized by the historiography of theather (ROPA, 1988; PORTE, 1992; RANDI, 1993) as protagonist of the twentieth-century theather refoundation, specially in the field of dance. Langlade & Langlade (1982) also consider Delsarte the great inspirator of modern gymnastic methods, in Europe as well as in the United States. Delsarte has developed an extensive theory on human expressivity - its sources and psychophysical mechanisms - which has culminated on a gesture education system named Applied aesthetics (Esthétique appliquée). This system was initially intended for lyric actors and orators, but was later revisited by the dancer Ted Shawn (1891-1972), who was responsible for the beginning of a new tradition in dance (AU)

Correçäo cirúrgica de fenda esternal total: relato de caso / Surgical correction of the total clefts sternum: case report

A fenda esternal total é uma doença grave, rara e que traz repercussöes clínicas importantes quando näo tratada precocemente. Os autores procuram aqui relatar um caso de fenda esternal total que foi submetido a correçäo cirúrgica no Hospital Infantil Pequeno Príncipe, cuja evoluçäo pós-operatória imediata foi bem sucedida. A raridade da doença demonstra a pouca experiência no tratamento cirúrgico da fenda esternal total na literatura mundial

Biópsia retiniana para esclarecimento de tumor intra-ocular; relato de um caso / Retinal biopsy for diagnosis of intraocular tumor; a case report

Os tumores intra-oculares na infância necessitam de diagnóstico preciso. No presente trabalho relatamos um caso de tumor intra-ocular em uma criança de 33 dias que tinha o diagnóstico prévio de retinoblastoma. A criança foi encaminhada ao serviço de pediatria devido a problemas respiratórios. Os exames clínicos e complementares evidenciaram vários tumores cardíacos. Optou-se entäo pela biópsia retiniana para esclarecimento do quadro. A biópsia foi feita através de vitrectomia pars plana e o exame histopatológico demonstrou tratar-se de hamartoma astrocístico de retina, compatível com esclerose tuberosa