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In this study we compared the effect of temperature variation (>32ºC to <27ºC) on latency differences median to ulnar (ringdiff), median to radial (thumbdiff), palmar median to ulnar (palmdiff) and the sum of three, the combined sensory index (CSI), in 15 controls and 12 patients with carpal tunnel syndrome (CTS). After cooling, ringdiff was the most reliable technique with little variation in both controls and patients; thumbdiff decreased dramatically in controls and could even come within normal limits in patients; palmdiff increased only in patients; CSI decreased significantly in controls and showed a slight increase in patients with no loss in electrodiagnosis accuracy. The high increase of palmdiff in patients, and the high decrease of thumbdiff in controls, after cooling, could not be explained only for fiber size in the nerve trunks. We concluded that for CTS electrodiagnosis even latency differences in same person/same limb could be significantly modified after cooling not previously emphasized in literature.

SummaryObjective: To verify the possible association between the levels of serum ferritin and the degree of obstructive coronary artery disease.Methods: 115 patients with coronary arteriography and concomitant evaluation of serum ferritin were studied. The adopted cut-off values were 80 ng/ml for women and 120 ng/ml for men.Results: The mean ferritin levels for males and females were 133.9±133.8 ng/ml and 214.6±217.2 ng/ml, respectively (p=0.047). It was observed that 44.1% of the women had normal serum ferritin levels in comparison to 30.9% of the men (p=0.254). In the patients without obstructive coronary artery disease or with less severe obstructions (group A) the serum ferritin level was 222.3±325 ng/ml. On the other hand, for those with moderate (group B) and severe obstructions (group C) the levels were 145.6+-83.7 ng/ml and 188.9±150.6 ng/ml, respectively. There was no correlation between the degree of coronary artery disease and the mean level of serum ferritin. Regarding the cut-off value, the number of women with serum ferritin level > 80 ng/ml in groups B+C or only C was significantly higher than the number of women in group A (ODDS RATIO 9.71 with 95%CI from 1.63 to 57.72). For males there was no significant difference between the number of cases above or below the cut-off values (ODDS RATIO 0.92 with 95%CI from 0.28 to 2.95).Conclusion: It was verified that women with serum ferritin levels > 80 ng/mL presented more severe obstructive coronary artery disease than women with lower levels. In men, the serum ferritin level was not a predictor element of the degree of obstruction.

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Background Risk stratification is paramount for treatment of patients with chronic Chagas disease (CCD). The exercise stress test (EST) may be useful in the risk stratification of patients with this condition, but few studies have been performed in patients with CCD. Methods This was a longitudinal, retrospective cohort study. A total of 339 patients followed at our institution from January 2000 to December 2010 were screened. A total of 76 (22%) patients underwent the EST. The Cox proportional hazards model was used to identify independent predictors of all-cause mortality. Results Sixty-five (85%) patients were alive and 11 (14%) patients died by the study's close. In the univariate analysis, decreased systolic blood pressure (BP) at the peak of exercise and the double product were associated with all-cause mortality. However, in the multivariate analysis, only systolic BP at the peak of exercise was independently associated with all-cause mortality [hazard ratio 0.97 (95% confidence interval 0.94 to 0.99), p=0.02]. Conclusion Systolic BP at the peak of EST is an independent predictor of mortality in patients with CCD.