Agreement between mechanical and digital skinfold callipers.

Background: Skinfold callipers are often used in clinical practice to estimate subcutaneous adipose tissue thickness. Recently, LipoTool emerged as a potential digital system to measure skinfolds, however comparisons with competing equipment are lacking. Aim: The aim of this study was to test the agreement between two competing skinfold callipers (digital and mechanical). Methods: The sample included 22 healthy male adult participants. A certified observer measured eight skinfolds twice using different skinfold callipers (digital and mechanical). Differences between equipment were tested using Wilcoxon signed rank test The distribution of error was examined using the normality test Results: Differences between skinfold callipers were significantly in five skinfolds: triceps (Z = -3.546; P < 0.001), subscapular (Z = -3.984; P < 0.001), suprailiac (Z = 3.024; P = 0.002), supraspinale (Z = 3.885; P < 0.001), abdominal (Z z = -2.937; P = 0.003), thigh (Z = -2.224; P = 0.026) and calf (Z = -2.052; P = 0.040). Differences between callipers were constant. Conclusions: Mechanical and digital callipers tended to record different values of skinfold thickness. Clinical examination should consider equipment-related variation in fat mass estimation.

Effect of Carrageenans on Vegetable Jelly in Humans with Hypercholesterolemia.

Changes in lipid profile constitute the main risk factor for cardiovascular diseases. Algae extracted carrageenans are long-chain polysaccharides and their ability to form gels provides for the formation of vegetable jelly. The objective was to evaluate the bioactive potential of carrageenan (E407) in the lipid profile, after ingestion of jelly. A total of 30 volunteers of both sexes, aged 20-64 years and with total cholesterol (TC) values ≥200 mg/dL, who ingested 100 mL/day of jelly for 60 days, were studied. All had two venous blood collections: before starting the jelly intake and after 60 days. At both times, TC, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG), were evaluated using commercial kits and spectrophotometer. The statistics were performed using the SPSS 25.0 software and p < 0.05 were considered statistically significant. Serum values after 60 days of jelly intake revealed a statistically significant decrease in TC levels (5.3%; p = 0.001) and LDL-C concentration (5.4%; p = 0.048) in females. The daily intake of vegetable jelly for 60 days showed a reduction in serum TC and LDL-C levels in women, allowing us to conclude that carrageenan has bioactive potential in reducing TC concentration.

Towards the Development of a Low-Cost Device for the Detection of Explosives Vapors by Fluorescence Quenching of Conjugated Polymers in Solid Matrices.

Conjugated polymers (CPs) have proved to be promising chemosensory materials for detecting nitroaromatic explosives vapors, as they quickly convert a chemical interaction into an easily-measured high-sensitivity optical output. The nitroaromatic analytes are strongly electron-deficient, whereas the conjugated polymer sensing materials are electron-rich. As a result, the photoexcitation of the CP is followed by electron transfer to the nitroaromatic analyte, resulting in a quenching of the light-emission from the conjugated polymer. The best CP in our studies was found to be poly[(9,9-dioctylfluorenyl-2,7-diyl)-co-bithiophene] (F8T2). It is photostable, has a good absorption between 400 and 450 nm, and a strong and structured fluorescence around 550 nm. Our studies indicate up to 96% quenching of light-emission, accompanied by a marked decrease in the fluorescence lifetime, upon exposure of the films of F8T2 in ethyl cellulose to nitrobenzene (NB) and 1,3-dinitrobenzene (DNB) vapors at room temperature. The effects of the polymeric matrix, plasticizer, and temperature have been studied, and the morphology of films determined by scanning electron microscopy (SEM) and confocal fluorescence microscopy. We have used ink jet printing to produce sensor films containing both sensor element and a fluorescence reference. In addition, a high dynamic range, intensity-based fluorometer, using a laser diode and a filtered photodiode was developed for use with this system.

The environmental risk as a culture in the Sinos Valley, Brazil.

The proposal of analysis of the social-environmental perception will be developed from the discourse as a constitutive element of reality. The discourse practices and their concretion will be the source of meaning and social-cultural value. Thus, the chosen research method was the qualitative and quantitative case study. In the first part of the text we will recapture a theoretical input by Mary Douglas on risk and culture, as well as on the acceptance of the risks in society. In the second part, we cover a few data of the case of the risks resulting from the tanning industry and on how the society of the "Vale do Rio dos Sinos" relates to these risks. In this article we conclude that risk perception of the population is directly related with past experiences, thus, assigning a meaning to all new events. This meaning is the result of a sociocultural construction. It is worth noting that behind this history, there are basic issues related to population survival, i.e., both the industrialists and workers establish partnerships when the society creates a movement against the leather industry.

Knotted or knotless double-row rotator cuff repair retear rates: a systematic review and meta-analysis.

Background: Arthroscopic rotator cuff tear repair techniques used to rely on knot-tying double row techniques, but the advent of knotless transosseous equivalent procedures introduced a new variable to the debate. The purpose of this study is to determine which technique is associated with lower retear rates. For its' biomechanical advantages, the authors' hypothesis is that knotless techniques would have lower retear rates. Methods: A systematic literature search was performed via PubMed and Google Scholar by two independent reviewers following PRISMA guidelines. Papers reporting retear rates after rotator cuff arthroscopic repair using knotted double-row or knotless transosseous equivalent techniques, evaluated by magnetic resonance imaging at least 6 months after surgery, were retrieved. Studies that do not differentiate between techniques and nonclinical reports were excluded. Eligible data was analyzed with Review Manager 5.4.1 using Mantel-Haenszel statistics with a fixed effect model. Results: The authors' initial literature search retrieved 511 reports. After the selection process, 24 articles were available for this review, and 9 were eligible for meta-analysis. A comparison of 1888 subjects from noncomparative reports and a meta-analysis of reports in which both techniques were studied could not show a statistically significant difference in technique retear rates. Discussion and conclusion: The current report revealed no significant difference in retear rates between the two arthroscopic repair techniques. Studies' quality was a limitation. Only two reported level 1 evidence. This review could not control variables such as cuff tear size, tissue quality, or individual comorbidities. Larger and longer follow-up studies could be helpful to further investigate this topic.

Risk Factors for Breast Cancer in Third-Year Medical Students in NOVA Medical School.

Comprehending the complexities of breast cancer, including its risk factors, methods for early detection, and treatment alternatives, is vital for effectively combating the illness and enhancing both survival rates and the quality of life for patients. The current study, which is observational, descriptive, and cross-sectional in nature, was designed to assess the risk factors and perceptions related to breast cancer within a specific population. This research was carried out among third-year medical students at NOVA Medical School. The survey collected data on sociodemographic aspects and potential risk factors for developing breast cancer. Results indicate that the sample consisted mainly of young females with a relatively low occurrence of known risk factors such as genetic predisposition and exposure to ionizing radiation. Analysis of the participants' answers revealed a comprehensive understanding of recognized risk factors. Nonetheless, there was a divergence in views concerning the impact of body mass index before menopause. This study underscores the importance of ongoing education regarding breast cancer and the factors that increase the risk of developing this disease.

Laboratory Assessment of the Effects of AGA@4life Multidisciplinary Intervention on the Inflammatory Profile, MMPs, and TIMPs in a Geriatric Population.

In recent years, the world's aging population has increased, contributing to the development of age-related pathologies, which have been aggravated by physical inactivity and excessive fat intake. This study aimed to evaluate the effect of implementing a nutritional program (control group-CG) combined with exercise (intervention group-IG) on the inflammatory profile, MMPs, and TIMPs in a group of 34 elderly participants (IG, n = 18; CG, n = 16). Participants underwent a full multidisciplinary diagnostic evaluation (T0), with the gathering of clinical information and biochemical and hematological determinations being re-evaluated eight weeks later (T1). A diet manual was made, which provided a selection of different types of diets resulting from the nutritional needs of the different users at the center. The aerobic exercise consisted of two sessions per week with a total duration of 1 h. The laboratory evaluation was performed by slot blot. Statistical analysis included a paired sample t-test and Spearman's correlation coefficient. We observed that in the IG, there was a significant increase at T1 of TNF-α (p < 0.05) and MMP-2 (p < 0.05), without changes in IL-6 and MMP-9, showing that the intervention did not cause an exacerbated inflammatory response in exercised elderly people. The intervention program implemented showed potential to contribute to better active aging strategies, taking advantage of the known benefits of exercise without inducing a harmful inflammatory response in elderly participants.

Assessing Sarcocornia as a Salt Substitute: Effects on Lipid Profile and Gelatinase Activity.

Sodium, although essential for life, is a key factor in changes in vascular function and cardiovascular disease when consumed in excess. Sarcocornia spp., a halophyte plant with many nutritional benefits, presents itself as a promising substitute for the consumption of purified salt. Matrix metalloproteinases (MMPs) 2 and 9 are widely studied due to their action in physiological processes and as biomarkers at the diagnostic level due to their increased expression in inflammatory processes. This study aimed to evaluate whether replacing salt with Sarcocornia perennis (S. perennis) powder in healthy young people leads to an improvement in biochemical profiles and the attenuation of MMP-2 and MMP-9 activity. In the present study, 30 participants were randomized into a control group that consumed salt and an intervention group that replaced salt with powdered S. perennis. The evaluation of the biochemical parameters was carried out by the spectrophotometry method, and the evaluation of MMP activity was carried out by zymography. A significant decrease was observed in the intervention group in total cholesterol, high-density lipoprotein cholesterol (HDL-c), and creatinine (p-value ≤ 0.05), along with lower but not significantly different mean values of triglycerides. Regarding MMP activity after the intervention, a lower mean value was observed for MMP-9 activity, with there being higher mean values for MMP-2 activity, both with p-values ≥ 0.05. The results confirmed that the consumption of S. perennis is a beneficial choice for health regarding the lipid profile. The evaluation of MMP activity indicated the potential of S. perennis in the regulation of MMP-9 activity in healthy individuals, along with the need for the further study of these proteases in individuals with pathologies.

Dissimilar forests along the Rio Doce watershed call for multiple restoration references to avoid biotic homogenization.

An environmental disaster caused by the rupture of a mining tailings dam has impacted a large area of the Rio Doce watershed in the Brazilian Atlantic Forest, resulting in unprecedented damage at spatial and temporal scales. The Atlantic Forest is one of the world's most important biodiversity hotspots. A long history of land use conversion has resulted in a highly fragmented landscape. Despite numerous restoration initiatives, these efforts have often biased criteria and use limited species assemblages. We conducted a comprehensive synthesis of the plant community in riparian forests along the Rio Doce watershed. Our work detailed vegetation composition (tree and sapling strata) and examined its relationship with edaphic and landscape factors, aiming to inform restoration projects with scientifically robust knowledge. A total of 4906 individuals from the tree strata and 4565 individuals from the sapling strata were recorded, representing a total of 1192 species from 75 families. Only 0.8% of the tree species and 0.5% of the sapling species occurred in all sampled sectors, with over 84% of the species occurring in a single watershed sector for both strata. We observed a high species heterogeneity modulated by turnover (92.3% in the tree, and 92.7% in the sapling strata) among sites. Overall, our research revealed a gradient of soil fertility influencing species composition across different strata. Additionally, we discovered that preserved landscapes had a positive impact on species diversity within both strata. The species exclusivity in the sampled sites and the high turnover rate imply the need to consider multiple reference ecosystems when restoring the watershed to reduce the risk of biotic homogenization. Finally, the reference ecosystems defined here serve as a basis for the selection of locally particular species in the implementation of restoration projects that aim to improve biodiversity, ecosystem services, and water security.

Education and training in radiation protection in Europe: results from the EURAMED Rocc-n-Roll project survey.

PURPOSE: To analyse the existing radiation protection (RP) education and training (E&T) capabilities in the European Union and identify associated needs, problems and challenges. METHOD: An online survey was disseminated via the EURAMED Rocc-n-Roll consortium network and prominent medical societies in the field of radiological research. The survey sections analyse the RP E&T during undergraduate, residency/internship and continuous professional development; RP E&T problems and legal implementation. Differences were analysed by European geographic regions, profession, years of professional experience and main area of practice/research. RESULTS: The majority of the 550 respondents indicated that RP topics are part of undergraduate curricula in all courses for their profession and country (55%); however, hands-on practical training is not included according to 30% of the respondents. The lack of E&T, practical aspects in current E&T, and mandatory continuing E&T were considered the major problems. The legal requirement that obtained higher implementation score was the inclusion of the practical aspects of medical radiological procedures on education (86%), and lower score was obtained for the inclusion of RP E&T on medical and dental school curriculums (61%). CONCLUSIONS: A heterogeneity in RP E&T during undergraduate, residency/internship and continuous professional development is evident across Europe. Differences were noted per area of practice/research, profession, and European geographic region. A large variation in RP E&T problem rating was also obtained.

Impact of Hydrotherapy on Antioxidant Enzyme Activity in an Elderly Population.

Oxidative stress is defined as the imbalance between reactive species and antioxidant agents. One of the effects of oxidative stress is the normal process of cellular aging that stems from the accumulation of tissue damage. Epidemiological studies show that regular physical exercise prevents the injuries caused by aging. The objective was to evaluate whether the practice of hydrotherapy, in an elderly population, positively influenced the activity of the enzymes superoxide dismutase, glutathione peroxidase and reductase that act by reducing reactive species in the body. The study involved 37 participants aged ≥ 60 years, of both sexes, divided into experimental and control groups. The experimental group performed 15 hydrotherapy sessions. Enzyme activity was evaluated in two moments: T0-before the first session, and T1-after the last session, with blood collections conducted in both. In T1, there was a significant increase vs. T0 of glutathione peroxidase activity (57.72 ± 19.99 vs. 48.14 ± 17.22 U/g Hb) and glutathione reductase activity (100.18 ± 30.85 vs. 78.44 ± 21.26 U/L). Both sexes tended to show higher values at T1. We concluded that hydrotherapy proved to be a positive stimulus for the enzymatic antioxidant activity of the elderly, suggesting that a regular and moderate practice of physical exercise induces better and higher quality of life.

Estuarine Aquacultures at the Crossroads of Animal Production and Antibacterial Resistance: A Metagenomic Approach to the Resistome.

It is recognized that the spread of antibiotic resistance (AR) genes among aquatic environments, including aquaculture and the human environment, can have detrimental effects on human and animal health and the ecosystem. Thus, when transmitted to the human microbiome or pathogens, resistance genes risk human health by compromising the eventual treatment of infections with antibiotic therapy. This study aimed to define the resistance profile of aquaculture farms and their potential risk for spreading. Twenty-four sediments from oyster and gilthead sea bream aquaculture farms located in three Portuguese river estuaries (17 sediments from Sado, 4 from Aveiro, and 3 from Lima) were studied by comparative metagenomic analysis. The computation of the diversity of genes conferring resistance per antibiotic class revealed a significant increase in aminoglycosides, beta-lactams, disinfectants, quinolones, and tetracyclines counts. In all geographic locations under study, the most diverse AR genes confer resistance to the macrolides, tetracyclines and oxazolidinones classes, all of which are medically important for human and animal therapies, as well as resistance to disinfectants. The diversity of mobile genetic elements correlated with the number of AR genes such as tetracyclines, suggesting that AR could be easily mobilized among bacterial genomes and microbiomes.

Electroacupuncture and acupuncture in the treatment of anxiety - A double blinded randomized parallel clinical trial.

BACKGROUND: The estimated number of people living with anxiety disorders worldwide is around 264 million and is estimated to have worsened with the recent pandemic of COVID-19. Acupuncture has shown to have excellent therapeutic effects in reducing anxiety. DESIGN: Double-blinded randomized controlled clinical trial with 56 participants (21-82 years) with anxiety diagnosed by 3 different anxiety scales (BAI, GAD-7 and OASIS). A 30-min acupuncture session was applied once a week for 10 weeks. AIMS: Evaluate the effectiveness of acupuncture and electroacupuncture in the treatment of anxiety to verify if: (1) People with high anxiety report reduced scores after 5 and 10 sessions; (2) Salivary cortisol levels accompanied the reduced scores; (3) Electroacupuncture treatment is more effective than acupuncture; (4) the treatments is independent of anxiolytic medication. METHODS: Volunteers were randomized into 3 groups (control, acupuncture, and electroacupuncture). The results were analyzed by anxiety scales and salivary cortisol tests. RESULTS: The findings show an improvement in anxiety, assessed by BAI, GAD-7 and OASIS, after the 5th session of acupuncture (p < 0.05) and electroacupuncture (p < 0.05) and the 10th session for both techniques (p < 0.001). The salivary cortisol values measured in the morning followed this pattern (p < 0.05), although the reduction of the night cortisol values was not statistically significant. Electroacupuncture and acupuncture show similar efficacy. The positive effect after the treatments is independent of anxiolytic medication (p < 0.001). CONCLUSION: Acupuncture and electroacupuncture are effective in treating anxiety on their own or as adjuncts to pharmacological therapy. TRIAL REGISTRATION NUMBER: NºP445-08/2017 (Unidade de Investigação em Ciências da Saúde).

Education and training in radiation protection in Europe: an analysis from the EURAMED rocc-n-roll project.

BACKGROUND: A Strengths, weaknesses, opportunities and threats analysis was performed to understand the status quo of education and training in radiation protection (RP) and to develop a coordinated European approach to RP training needs based on stakeholder consensus and existing activities in the field. Fourteen team members represented six European professional societies, one European voluntary organisation, two international healthcare organisations and five professions, namely: Medical Physicists; Nuclear Medicine Physicians; Radiologists; Radiation Oncologists and Radiographers. Four subgroups analysed the "Strengths", "Weaknesses", "Opportunities" and "Threats" related to E&T in RP developed under previous European Union (EU) programmes and on the Guidelines on Radiation Protection Education and Training of Medical Professionals in the EU. RESULTS: Consensus agreement identified four themes for strengths and opportunities, namely: (1) existing structures and training recommendations; (2) RP training needs assessment and education & training (E&T) model(s) development; (3) E&T dissemination, harmonisation, and accreditation; (4) financial supports. Weaknesses and Threats analysis identified two themes: (1) awareness and prioritisation at a national/global level and (2) awareness and prioritisation by healthcare professional groups and researchers. CONCLUSIONS: A lack of effective implementation of RP principles in daily practice was identified. EuRnR strategic planning needs to consider processes at European, national and local levels. Success is dependent upon efficient governance structures and expert leadership. Financial support is required to allow the stakeholder professional agencies to have sufficient resources to achieve a pan European radiation protection training network which is sustainable and accredited across multiple national domains.

Social cognition and interaction training for recent-onset schizophrenia: A preliminary randomized trial.

Comprehensive social cognition training programs have been effective to improve social cognition in people with chronic schizophrenia, although there is insufficient quality evidence for recent-onset psychosis. The aim of this study was to assess the effects of Social Cognition and Interaction Training (SCIT) in a sample of recent-onset schizophrenia outpatients. Sixteen participants who had their first psychotic episode for less than 2 years were randomly allocated to the SCIT group during 20 weeks (weekly sessions) or to a psychoeducation group and completed baseline and post-training assessment for cognitive biases, social cognition, clinical symptoms and functioning. Permutation-based analysis revealed improvements in overall functioning (P = 0.036) and blame score (P = 0.070) in the SCIT group compared to the psychoeducation intervention, with large effect sizes (d = 1.438 and d = 1.204, respectively). There were also large effect sizes for hostility, emotion recognition, social perception, positive and total symptoms (d = 0.833-1.158). These results suggest that SCIT may be an effective tool to improve attributional biases and functional outcomes in recent-onset schizophrenia outpatients. Future controlled trials with larger sample size and follow-up assessments should be developed to further understand effective intervention outcomes for this population.

Presence of Cryptosporidium spp. and Giardia duodenalis in drinking water samples in the north of Portugal.

Cryptosporidium and Giardia are 2 protozoan parasites responsible for waterborne diseases outbreaks worldwide. In order to assess the prevalence of these protozoans in drinking water samples in the northern part of Portugal and the risk of human infection, we have established a long term program aiming at pinpointing the sources of surface water, drinking water, and environmental contamination, working with the water-supply industry. Total 43 sources of drinking water samples were selected, and a total of 167 samples were analyzed using the Method 1623. Sensitivity assays regarding the genetic characterization by PCR and sequencing of the genes, 18S SSU rRNA, for Cryptosporidium spp. and beta,-giardin for G. duodenalis were set in the laboratory. According to the defined criteria, molecular analysis was performed over 4 samples. Environmental stages of the protozoa were detected in 25.7% (43 out of 167) of the water samples, 8.4% (14 out of 167) with cysts of Giardia, 10.2% (17 out of 167) with oocysts of Cryptosporidium and 7.2% (12 out of 167) for both species. The mean concentrations were 0.1-12.7 oocysts of Cryptosporidium spp. per 10 L and 0.1-108.3 cysts of Giardia duodenalis per 10 L. Our results suggest that the efficiency in drinking water plants must be ameliorated in their efficiency in reducing the levels of contamination. We suggest the implementation of systematic monitoring programs for both protozoa. To authors' knowledge, this is the first report evaluating the concentration of environmental stages of Cryptosporidium and Giardia in drinking water samples in the northern part of Portugal.

Biological and genetic characterization of Cryptosporidium spp. and Giardia duodenalis isolates from five hydrographical basins in northern Portugal.

To understand the situation of water contamination with Cryptosporidium spp. and Giardia spp. in the northern region of Portugal, we have established a long-term program aimed at pinpointing the sources of surface water and environmental contamination, working with the water-supply industry. Here, we describe the results obtained with raw water samples collected in rivers of the 5 hydrographical basins. A total of 283 samples were analyzed using the Method 1623 EPA, USA. Genetic characterization was performed by PCR and sequencing of genes 18S rRNA of Cryptosporidium spp. and beta-giardin of Giardia spp. Infectious stages of the protozoa were detected in 72.8% (206 of 283) of the water samples, with 15.2% (43 of 283) positive for Giardia duodenalis cysts, 9.5% (27 of 283) positive for Cryptosporidium spp. oocysts, and 48.1% (136 of 283) samples positive for both parasites. The most common zoonotic species found were G. duodenalis assemblages A-I, A-II, B, and E genotypes, and Cryptosporidium parvum, Cryptosporidium andersoni, Cryptosporidium hominis, and Cryptosporidium muris. These results suggest that cryptosporidiosis and giardiasis are important public health issues in northern Portugal. To the authors' knowledge, this is the first report evaluating the concentration of environmental stages of Cryptosporidium and Giardia in raw water samples in the northern region of Portugal.

Development of red-light cleavable PEG-PLA nanoparticles as delivery systems for cancer therapy.

The development of targeted delivery systems can improve the selectivity of cancer drugs. Additionally, a system that promotes the controlled delivery of the drug triggered by an external stimulus in the exact target tissue is highly desirable. Regarding the light stimulus, the NIR window (650-950 nm) is the most suitable due to its higher capacity of penetration in human tissues and less harmful effects on normal cells. In this work, new red-light-responsive nanoparticles for doxorubicin delivery were developed. The nanoparticles were based on cleavable di-block copolymers of poly(ethylene glycol) (PEG) and poly(lactic acid) (PLA) linked by a red-light sensitive segment (1,2-bis(2-hydroxyethylthio)ethylene, BHETE). The PEG-BHETE-PLA copolymers were synthesized under mild conditions and exhibited a narrow polydispersity. The nanoparticles presented a size between 53 and 133 nm, with a doxorubicin loading capacity between 1.2 and 4.4 wt%. Release study of the encapsulated doxorubicin confirms the light-triggered nanoparticle disassembly process. In vitro cytotoxicity tests in MCF7 cell line, for the light-triggered nanoparticles, showed a decrease in cancer cells' viability higher than 25% compared to non-irradiated cells. Due to the promising results obtained with the light-sensitive PEG-BHETE-PLA nanoparticles, these materials have great potential to be used in drug delivery systems for cancer therapy.

Hemodynamic Changes During Heart Displacement in Aorta No-Touch Off-Pump Coronary Artery Bypass Surgery: A Pilot Study.

OBJECTIVE: To evaluate the sequential changes of hemodynamic and metabolic parameters in patients who underwent aorta no-touch off-pump coronary artery bypass surgery (OPCAB). METHODS: Prospective study involving twenty-seven consecutive patients who underwent aorta no-touch OPCAB. The FloTrac/PreSep/Vigileo™ system (Edwards Lifesciences) was used to continuously record heart rate (HR), mean arterial blood pressure (MABP), central venous pressure (CVP), continuous cardiac index (FCI), stroke volume (SV), stroke volume variation (SVV), and central venous oxygen saturation (ScvO2). The parameters were assessed 5 min before, during and 5 min after each anastomosis (left anterior descending [LAD], posterior descending [PD], obtuse marginal [OM] and diagonal [Dg]). Postoperative lactate was also evaluated. RESULTS: There was no significant change in HR and MABP for all anastomoses, except for MABP during PD grafting (-10.1±2.7 mmHg, P=0.03). There was a significant decrease in ScvO2 only during PD and OM anastomoses (-9.4±0.4, P=0.03; -4.4±0.4, P=0.02; respectively). CVP drop after PD manipulation was strongly associated with a higher lactate during the first hours after surgery (r=-0.82; P=0.001). These hemodynamic changes were transient and entirely recovered after the heart was returned to its anatomical position. No significant differences were observed in FCI, SVV, or the systemic vascular resistance index (SVRI) during all anastomoses, except for a drop in SVRI during PD grafting (-8.03±2.3, P=0.007). SV tended to decrease during the procedure in all territories, but with statistically significant drop only in PD and OM grafting (-10.4±1.2, P=0.02; -13.6±5.1, P=0.007; respectively). CONCLUSION: Heart displacement for performing aorta no-touch OPCAB is well tolerated, with transient and endurable hemodynamic variations.

[Familial isolated primary hyperparathyroidism--description and analyses of six cases]. / Hiperparatireoidismo primário familiar isolado--análise e descrição de uma família com seis casos índices.

Our objective is to evaluate and describe one family with six cases of familial isolated primary hyperparathyroidism (HFI), a rare hereditable disorder with an autossomal dominant mode of inheritance. It is characterized by a primary hyperparathyroidism without association with other endocrine tumors or diseases. The HFI diagnosis relied on the demonstration of hypercalcemia, inappropriately high levels of parathyroid hormone, and parathyroid adenomas, plus exclusion of NEM 1/2a and HPT/TM syndrome in this family. We analyzed the description of the first diagnosis, surgical approach, postoperative histopathological results and their development process. The first patient, treated in our institute twenty years ago, has recidivated eleven years after the treatment. Her sister had had the same diagnosis, which motivated us to investigate theirs relatives. The analysis of the characteristics that run in these patients' family has contributed to facilitate their diagnosis and therapeutic treatment, including clinical and genetic orientation of this family.