Aerobic exercise is safe and effective in systemic sclerosis

Several studies have established that systemic sclerosis patients have a reduced exercise capacity when compared to healthy individuals. It is relevant to evaluate whether aerobic exercise in systemic sclerosis patients is a safe and effective intervention to improve aerobic capacity. Seven patients without pulmonary impairment and seven healthy controls were enrolled in an 8-week program consisting of moderate intensity aerobic exercise. Patients and controls had a significant improvement in peak oxygen consumption (19.72 +/- 3.51 vs. 22.27 +/- 2.53 and 22.94 +/- 4.70 vs. 24.55 +/- 3.00, respectively, p = 0.006), but difference between groups was not statistically significant (p = 0.149). This finding was reinforced by the fact that at the end of the study both groups were able to perform a significantly higher exercise intensity when compared to baseline, as measured by peak blood lactate (1.43 +/- 0.51 vs. 1.84 +/- 0.33 and 1.11 +/- 0.45 vs. 1.59 +/- 0.25, respectively, p = 0.01). Patients improved the peak exercise oxygen saturation comparing to the baseline (84.14 +/- 9.86 vs. 90.29 +/- 5.09, p = 0.048). Rodnan score was similar before and after the intervention(15.84 +/- 7.84 vs. 12.71 +/- 4.31, p = 0.0855). Digital ulcers and Raynaud`s phenomenon remained stable. Our data support the notion that improving aerobic capacity is a feasible goal in systemic sclerosis management. The long term benefit of this intervention needs to be determined in large prospective studies.

Political Parties and Governors as Determinants of Legislative Behavior in Brazil`s Chamber of Deputies, 1988-2006

This article examines the relative importance of regional and national forces in shaping the behavior of Brazilian legislators at the national level. A widely held view is that national legislators respond to state pressures in making decisions, rather than pressures from the national government. Governors not only can influence national debates but also can determine outcomes by exerting control over their states` legislative delegations. This article examines a dataset of all roll-call votes in the Chamber of Deputies between 1989 and 2006 to isolate and evaluate the impact of local pressures on legislative voting. Spanning the terms of five presidents and five different congresses, the data show that the local influence is weaker than the national on the voting decisions of individual legislators and the voting cohesion of state delegations. Alternative institutional resources allow the central government to counteract the centrifugal pressures of federalism and other institutional influences.