Cross-cultural adaptation and assessment of the reliability and validity of the Core Outcome Measures Index (COMI) for the Brazilian-Portuguese language

The use of patient-orientated questionnaires is of utmost importance in assessing the outcome of spine surgery. Standardisation, using a common set of outcome measures, is essential to aid comparisons across studies/in registries. The Core Outcome Measures Index (COMI) is a short, multidimensional outcome instrument validated for patients with spinal disorders. This study aimed to produce a Brazilian-Portuguese version of the COMI. A cross-cultural adaptation of the COMI into Brazilian-Portuguese was carried out using established guidelines. 104 outpatients with chronic LBP (> 3 months) were recruited from a Public Health Spine Medical Care Centre. They completed a questionnaire booklet containing the newly translated COMI, and other validated symptom-specific questionnaires: Oswestry Disability Index (ODI) and Roland Morris disability scale (RM), and a pain visual analogue scale. All patients completed a second questionnaire within 7-10 days to assess reproducibility. The COMI summary score displayed minimal floor and ceiling effects. On re-test, the responses for each individual domain of the COMI were within 1 category in 98% patients for the domain 'function', 96% for 'symptom-specific well-being', 97% for 'general quality of life', 99% for 'social disability' and 100% for 'work disability'. The intraclass correlation coefficients (ICC2,1) for COMI pain and COMI summary scores were 0.91-0.96, which compared favourably with the corresponding values for the RM (ICC, 0.99) and ODI (ICC, 0.98). The standard error of measurement for the COMI was 0.6, giving a "minimum detectable change" (MDC95%) of approximately 1.7 points i.e., the minimum change to be considered "real change" beyond measurement error. The COMI scores correlated as hypothesised (Rho, 0.4-0.8) with the other symptom-specific questionnaires. The reproducibility of the Brazilian-Portuguese version of the COMI was comparable to that of other language versions. The COMI scores correlated in the expected manner with existing but longer symptom-specific questionnaires suggesting good convergent validity for the COMI. The Brazilian-Portuguese COMI represents a valuable tool for Brazilian study-centres in future multicentre clinical studies and surgical registries.

Population biology of Stellifer rastrifer, S. brasiliensis and S. stellifer in Caraguatatuba Bay, northern coast of São Paulo, Brazil

Ecosystems may reflect environmental changes in many respects, from the debilitation of individuals to alterations in community composition. Equally, population parameters may provide reliable indications of environmental changes. Members of the sciaenid fish genus Stellifer are usually very abundant where they occur, often with two or more species living in sympatry. Here, the population dynamics of three Stellifer species from southeastern Brazil were assessed. Sampling was carried out in shallow marine areas of Caraguatatuba Bay, from August 2003 to October 2004. The species evaluated were Stellifer rastrifer (n=3183), S. brasiliensis (n=357) and S. stellifer (n=116). The area under greater continental influence tended to support more, but smaller individuals. Size variations over time were similar among species and negatively correlated with Krel, which showed smooth fluctuations. The general length-frequency distribution was concentrated between 6.0 and 9.0 cm, and the great majority of females did not present mature gonads during the sampling period. The findings support the existence of a stratification by size for these species, indicating that the area is essential for the development of younger fish. Failure to consider these characteristics for the management of similar areas may have serious implications for these environments.

Does the neonatal clinical risk for illness severity influence pain reactivity and recovery in preterm infants?

Background: The biobehavioural pain reactivity and recovery of preterm infants in the neonatal period may reflect the capacity of the central nervous system to regulate neurobiological development. Objective: The aim of the present study was to analyse the influence of the neonatal clinical risk for illness severity on biobehavioural pain reactivity in preterm infants. Methods: Fifty-two preterm infants were allocated into two groups according to neonatal severity of illness, as measured by the Clinical Risk Index for Babies (CRIB). The low clinical risk (LCr) group included 30 neonates with CRIB scores <4, and the high clinical risk (HCr) group included 22 neonates with CRIB scores >= 4. Pain reactivity was assessed during a blood collection, which was divided into five phases (baseline, antisepsis, puncture, recovery-dressing and recovery-resting). Behavioral pain reactivity was measured using the scores, and magnitude of responses in Neonatal Facial Coding System (NFCS) and Sleep-Wake States Scale (SWS). The heart rate was continuously recorded. Results: The HCr demonstrated a higher magnitude of response on the SWS score from the baseline to the puncture phase than the LCr. Also, the HCr exhibited a higher mean heart rate and minimum heart rate than the LCr in the recovery-resting phase. In addition, the HCr exhibited a higher minimum heart rate from the baseline to the recovery-resting phase than the LCr. Conclusion: The infants exhibiting a high neonatal clinical risk showed high arousal during the puncture procedure and higher physiological reactivity in the recovery phase.

Population biology of Stellifer rastrifer, S. brasiliensis and S. stellifer in Caraguatatuba Bay, northern coast of São Paulo, Brazil

Ecosystems may reflect environmental changes in many respects, from the debilitation of individuals to alterations in community composition. Equally, population parameters may provide reliable indications of environmental changes. Members of the sciaenid fish genus Stellifer are usually very abundant where they occur, often with two or more species living in sympatry. Here, the population dynamics of three Stellifer species from southeastern Brazil were assessed. Sampling was carried out in shallow marine areas of Caraguatatuba Bay, from August 2003 to October 2004. The species evaluated were Stellifer rastrifer (n=3183), S. brasiliensis (n=357) and S. stellifer (n=116). The area under greater continental influence tended to support more, but smaller individuals. Size variations over time were similar among species and negatively correlated with Krel, which showed smooth fluctuations. The general length-frequency distribution was concentrated between 6.0 and 9.0 cm, and the great majority of females did not present mature gonads during the sampling period. The findings support the existence of a stratification by size for these species, indicating that the area is essential for the development of younger fish. Failure to consider these characteristics for the management of similar areas may have serious implications for these environments.

Connexin and pannexin (hemi) channels in the liver

The liver was among the first organs in which connexin proteins have been identified. Hepatocytes harbor connexin32 and connexin26, while non-parenchymal liver cells typically express connexin43. Connexins give rise to hemichannels, which dock with counterparts on adjacent cells to form gap junctions. Both hemichannels and gap junctions provide pathways for communication, via paracrine signaling or direct intercellular coupling, respectively. Over the years, hepatocellular gap junctions have been shown to regulate a number of liver-specific functions and to drive liver cell growth. In the last few years, it has become clear that connexin hemichannels are involved in liver cell death, particularly in hepatocyte apoptosis. This also holds true for hemichannels composed of pannexin1, a connexin-like protein recently identified in the liver. Moreover, pannexin1 hemichannels are key players in the regulation of hepatic inflammatory processes. The current paper provides a concise overview of the features of connexins, pannexins and their channels in the liver.