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1.  Double-lumen catheter in the right jugular vein induces two sub-endothelial abscesses in an unusual place, the transition between the superior vena cava and the right atrium: a case report 
Endocarditis is a type of infection that is common in internal medicine wards and in haemodialysis clinics. The location that is most affected are the heart valves. Herein, we report a case of an uncommon abscess, a sub-endothelial abscess between the transition of the superior vena cava and the right atrium. There were several emboli to the lung and foot, and the agent was related to Staphylococcus aureus and a double-lumen catheter. Usually, this type of abscess is located in valves, either the tricuspid valve if related to catheters or injection drug use or the mitral valve if related to other causes. An exhaustive review was made, but we found no information about the location of this abscess and the rarity of the event motivating the report of infection.
doi:10.1186/1755-7682-7-37
PMCID: PMC4125593  PMID: 25110520
Endocarditis; Central venous catheters; Renal dialysis; Hospitalisation
2.  Gait profile score and movement analysis profile in patients with Parkinson's disease during concurrent cognitive load 
Background:
Gait disorders are common in individuals with Parkinson's Disease (PD) and the concurrent performance of motor and cognitive tasks can have marked effects on gait. The Gait Profile Score (GPS) and the Movement Analysis Profile (MAP) were developed in order to summarize the data of kinematics and facilitate understanding of the results of gait analysis.
Objective:
To investigate the effectiveness of the GPS and MAP in the quantification of changes in gait during a concurrent cognitive load while walking in adults with and without PD.
Method:
Fourteen patients with idiopathic PD and nine healthy subjects participated in the study. All subjects performed single and dual walking tasks. The GPS/MAP was computed from three-dimensional gait analysis data.
Results:
Differences were found between tasks for GPS (P<0.05) and Gait Variable Score (GVS) (pelvic rotation, knee flexion-extension and ankle dorsiflexion-plantarflexion) (P<0.05) in the PD group. An interaction between task and group was observed for GPS (P<0.01) for the right side (Cohen's ¯d=0.99), left side (Cohen's ¯d=0.91), and overall (Cohen's ¯d=0.88). No interaction was observed only for hip internal-external rotation and foot internal-external progression GVS variables in the PD group.
Conclusions:
The results showed gait impairment during the dual task and suggest that GPS/MAP may be used to evaluate the effects of concurrent cognitive load while walking in patients with PD.
doi:10.1590/bjpt-rbf.2014.0049
PMCID: PMC4183263  PMID: 25054382
Parkinson's disease; gait; kinematics; attention; rehabilitation
3.  Propulsion Phase of the Single Leg Triple Hop Test in Women with Patellofemoral Pain Syndrome: A Biomechanical Study 
PLoS ONE  2014;9(5):e97606.
Asymmetry in the alignment of the lower limbs during weight-bearing activities is associated with patellofemoral pain syndrome (PFPS), caused by an increase in patellofemoral (PF) joint stress. High neuromuscular demands are placed on the lower limb during the propulsion phase of the single leg triple hop test (SLTHT), which may influence biomechanical behavior. The aim of the present cross-sectional study was to compare kinematic, kinetic and muscle activity in the trunk and lower limb during propulsion in the SLTHT using women with PFPS and pain free controls. The following measurements were made using 20 women with PFPS and 20 controls during propulsion in the SLTHT: kinematics of the trunk, pelvis, hip, and knee; kinetics of the hip, knee and ankle; and muscle activation of the gluteus maximus (GM), gluteus medius (GMed), biceps femoris (BF) and vastus lateralis (VL). Differences between groups were calculated using three separate sets of multivariate analysis of variance for kinematics, kinetics, and electromyographic data. Women with PFPS exhibited ipsilateral trunk lean; greater trunk flexion; greater contralateral pelvic drop; greater hip adduction and internal rotation; greater ankle pronation; greater internal hip abductor and ankle supinator moments; lower internal hip, knee and ankle extensor moments; and greater GM, GMed, BL, and VL muscle activity. The results of the present study are related to abnormal movement patterns in women with PFPS. We speculated that these findings constitute strategies to control a deficient dynamic alignment of the trunk and lower limb and to avoid PF pain. However, the greater BF and VL activity and the extensor pattern found for the hip, knee, and ankle of women with PFPS may contribute to increased PF stress.
doi:10.1371/journal.pone.0097606
PMCID: PMC4022617  PMID: 24830289
4.  Analysis of the Applicability of an Ankle-Foot Orthosis during Gait in Poststroke Patients 
Journal of Physical Therapy Science  2013;25(8):1001-1005.
[Purpose] The aim of this study was to develop and assess the applicability of an experimental ankle-foot orthosis during gait in patients with hemiparesis. [Subjects and Methods] This was a noncontrolled cross-sectional study. Ten adult patients with hemiparesis but who were capable of independent gait were included in the study. Gait assessment was performed using two platforms (EMG System do Brasil), an electromyograph (EMG System do Brasil), and a video camera. The experimental orthosis consisted of a single piece that fit over the foot and 1/3 of the distal tibia and had a steel spring. [Results] There was greater activation of the rectus femoris and vastus lateralis muscles in the stance and mid-stance phases with the use of the experimental ankle-foot orthosis in comparison with the use of a polypropylene ankle-foot orthosis and no orthosis. Regarding spatial and temporal gait parameters, the individuals achieved an increase in stride length with the use of the experimental ankle-foot orthosis in comparison with the use of a polypropylene ankle-foot orthosis. [Conclusion] The results of the present study demonstrate that individuals with hemiparesis achieved an improvement in the stance and mid-stance phases of gait with the use of the experimental ankle-foot orthosis.
doi:10.1589/jpts.25.1001
PMCID: PMC3820236  PMID: 24259903
Orthosis; Hemiparesis; Gait
5.  Bovine pericardium retail preserved in glutaraldehyde and used as a vascular patch 
BMC Surgery  2011;11:37.
Background
In this study we evaluated the performance of bovine pericardium preserved in glutaraldehyde used as a vascular patch.
Methods
Fourteen young pigs, six females and eight males, weighting 10.3 - 18.4 kg were used in our study. We implanted three remnants in each pig, two in the abdominal aorta and one was juxtaposed to the peritoneum. The smooth face (SF) and rough face (RF) of each remnant were implanted turned to the vessel inner portion and one remnant was juxtaposed to the peritoneum. The animals were sacrificed in 4.5 - 8 months after surgery (75 - 109 kg). The remnants were assessed for aorta wall, fibroses formation in inner apposition and calcification related to the face turned to the vessel inner portion.
Results
The rough face showed a lower dilatation level compared to the face implanted in adjacent aorta. There was no difference between intensity and/or incidence of graft calcification when the superficies were compared. The bovine pericardium preserved in glutaraldehyde did not show alterations in its structure when implanted with different faces turned to the inner portion of vessel.
Conclusion
When turned to the inner portion of the vessel, the rough face of the remnant presented a lower dilatation in relation to the adjacent aorta and a better quality of endothelium layer and did not show a difference between intensity and/or incidence of graft calcification.
doi:10.1186/1471-2482-11-37
PMCID: PMC3258210  PMID: 22192162
6.  An experience of vascular access for hemodialysis in Brazil 
Background
The analysis of hemodialysis services is relevant for the quality of life of patient. In this study we investigated the profile of vascular access used for hemodialysis patients in our Unit.
Methods
We evaluated 219 patients of both genders aged over 18 years old who have undergone implant or manufacture of vascular hemodialysis access. We excluded patients on renal replacement therapy by peritoneal dialysis.
Results
Associated diseases were hypertension and diabetes mellitus. 161 had arteriovenous fistula, with 153 held by the same dialysis and nine of them were still maturing. 27 patients on dialysis used central venous catheter. 148 were indigenous and five were made using polytetrafluoroethylene prosthesis (PTFE). Among the 27 patients with central venous catheters, ten used short-term catheter and 17 used long-term catheter. The most frequent type of fistula use was on the radio distal cephalic, in 85 patients (52.5%), followed by radio cephalic proximal in 26 patients (16%). The number of fistulas in dialysis patients conducted by this kind of therapy ranged from one to ten and in 64 patients (41.83%) fistula was the first and only to be made. Among the fistula for dialysis patients, the highest prevalence was radio cephalic fistula in 111 patients (72.5%) and mean duration of use was 48.1 months, ranging from two months to 17 years.
Conclusion
Our Unit of hemodialysis is above the limits established by international norms.
doi:10.1186/1755-7682-4-16
PMCID: PMC3117692  PMID: 21569616
8.  Memantine effects on liver and adrenal gland of rats exposed to cold stress 
Background
Memantine attenuates heart stress due cold stress, however, no study focused its effects on liver and adrenal gland. We evaluated its effects on lipid depletion in adrenal gland and glycogen depletion in liver of rats exposed to cold stress.
Methods
Male rats divided into 4 groups: 1)Control (CON); 2)Memantine (MEM); 3)Induced cold stress (IH) and; 4)Induced cold stress memantine (IHF). Memantine were administrated by gavage (20 mg/kg/day) during eight days. Cold stress were performed during 4 hours once at - 8°C. Lipid and glycogen depletion were presented as its intensity levels.
Results
Rats exposed to cold stress presented the highest glycogen (p < 0.001) and lipid depletion (p < 0.001) in liver and adrenal gland, respectively. We noted that memantine significantly reduced lipid depletion in adrenal gland and glycogen depletion in liver.
Conclusion
Memantine prevented glycogen depletion in liver and lipid depletion in adrenal gland of rats under a cold stress condition.
doi:10.1186/1755-7682-4-5
PMCID: PMC3033327  PMID: 21255456
9.  Saphenofemoral arteriovenous fistula as hemodialysis access 
BMC Surgery  2010;10:28.
Background
An upper limb arteriovenous (AV) fistula is the access of choice for haemodialysis (HD). There have been few reports of saphenofemoral AV fistulas (SFAVF) over the last 10-20 years because of previous suggestions of poor patencies and needling difficulties. Here, we describe our clinical experience with SFAVF.
Methods
SFAVFs were evaluated using the following variables: immediate results, early and late complications, intraoperative and postoperative complications (up to day 30), efficiency of the fistula after the onset of needling and complications associated to its use.
Results
Fifty-six SFAVF fistulas were created in 48 patients. Eight patients had two fistulas: 8 patent (16%), 10 transplanted (20%), 12 deaths (24%), 1 low flow (2%) and 20 thrombosis (39%) (first two months of preparation). One patient had severe hypotension during surgery, which caused thrombosis of the fistula, which was successfully thrombectomised, four thrombosed fistulae were successfully thrombectomised and revised on the first postoperative day. After 59 months of follow-up, primary patency was 44%.
Conclusion
SFAVF is an adequate alternative for patients without the possibility for other access in the upper limbs, allowing efficient dialysis with good long-term patency with a low complication rate.
doi:10.1186/1471-2482-10-28
PMCID: PMC2965703  PMID: 20955561
10.  Assessment of plantar pressure and balance in patients with diabetes 
Introduction
Patients with diabetes for more than 10 years may have an increase in peak plantar pressure, considerable postural oscillation, balance deficit, alterations in gait pattern and an increased risk of falls. The aim of the present study was to assess the correlation between plantar pressure distribution and balance in patients with diabetes using a pressure platform (Footwork).
Material and methods
The study was carried out at the Human Movement Clinic of the Centro Universitário de Belo Horizonte (Brazil). The sample was made up of 18 right-handed individuals with type 2 diabetes – 14 females and 4 males – with an average age of 58.72 ±9.54 and an average of 18.56 ±6.61 years since diagnosis.
Result
Data analysis revealed that greater peak plantar pressure on the right hindfoot led to greater radial displacement (Rd) (r = 0.2022) and greater displacement velocity (r = 0.2240). Greater peak plantar pressure on the left hindfoot also led to greater displacement velocity (P) (r = 0.5728) and radial displacement (RD) (r = 0.1972). A positive correlation was found between time elapsed since diagnosis and peak midfoot pressure (r = 0.3752) on the right and left side as well as between BMI and plantar pressure on all regions of the foot.
Conclusions
The data reveal a correlation between postural oscillation and peak plantar pressure on the hindfoot.
doi:10.5114/aoms.2010.13506
PMCID: PMC3278942  PMID: 22371719
diabetes; baropodometry; balance; stabilometry; diabetic neuropathy; plantar pressure

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