Dupla artéria torácica esqueletizada versus convencional na revascularização do miocárdio sem CEC em diabéticosDouble skeletonized internal thoracic artery vs. double conventional internal thoracic artery in diabetic patients submitted to OPCAB Abstract Objective: To evaluate the influence of the technique used in the dissection of thoracic arteries in the evolution of diabetic patients submitted to OPCAB.Methods: Seventy diabetic patients submitted to OPCAB using bilateral thoracic arteries were evaluated. In Group A, thoracic arteries were dissected as a pedicle, while in Group B they were skeletonized.Results: The mean age of patients in Group A was 52.14 ± 7.35 years old versus 55.71 ± 8.1 years for Group B (p=0.057). In Group A, six patients (17.1%) were insulin dependent against nine (25.7%) in Group B (p = 0.561). The EUROSCORE was 3.97 ± 2.49 for Group A opposed to 4.14 ± 3.06 for Group B (p = 0.879). The number of distal anastomoses in Group A was 3 ± 0.77 versus 3.03 ± 0.89 in Group B (p = 0.981). Three patients (8.57%) from Group A presented with mediastinitis. Insulin dependence was the only significant risk factor (p=0.008) for mediastinitis. In this group the use of skeletonized ITAs significantly decreased the incidence of mediastinitis (p = 0.044).Conclusion: The incidence of mediastinitis was lower in the group for which thoracic arteries were dissected using skeletonization. Among insulin-dependent diabetics, 50% of the patients from the group in which the pedicled internal thoracic artery was utilized presented with mediastinitis; the utilization of skeletonized ITAs significantly decreases the incidence of mediastinitis. Rev Bras Cir Cardiovasc 2008; 23(3): 351-357 Descriptors

This paper examines variation in the noun phrase gender agreement rule in the Afro-Brazilian Portuguese dialect of Helvétia. The analysis of the variation proceeds within a quantitative framework; it considers structural implications, in generative terms, and sociolinguistic aspects, yielding evidence relevant to the definition of the postcreole nature of the dialect. Structural parallels are found with Portuguese L1 acquisition and with varieties of creole Portuguese, and the relationship of the Helvétia dialect to more standard varieties of Brazilian Portuguese is clarified. An evaluation of structural variables reveals how the gender agreement rule is being incorporated into the grammar of the dialect at different rates along different structural paths and in different pragmatic functions, reflecting intricacies of the grammar associated with the noun. Finally, a scrutiny of the effect of extralinguistic variables on gender agreement clearly reveals the acquisitional nature of the variation.

ObjectiveTo assess the immediate results of myocardial revascularization surgery without extracorporeal circulation in a group of patients over 75 years of age. December 2003, 193 (121 men and 72 women) Methods From January 2001 to ConclusionThe surgery adopted for myocardial revascularization was associated with a low mortality rate, a low complication index, and a short length of stay at the hospital. Keywords elderly, myocardial revascularization surgery, extracorporeal circulationThe increase in the elderly population in Brazil in recent years has led to a greater number of patients over the age of 70 years requiring myocardial revascularization surgery. However, over the years, advanced age has been considered a risk factor for morbidity and mortality in coronary artery surgeries 1,2 . The recent advances in myocardial revascularization surgeries without extracorporeal circulation, the technique recommended by Buffolo et al 3 and Benetti 4 at the beginning of the 1980s, has aroused interest in this type of surgery, especially in high-risk patients [5][6][7] .We retrospectively analyzed the immediate results of the myocardial revascularization surgery without extracorporeal circulation in patients over the age of 75 years.

In this paper, we demonstrate that Brazilian Portuguese phonemic nasal vowels are, as Mattoso Camara (1953, 1970) suggested, derived from an underlying sequence of oral vowel plus nasal consonant... or almost that. Two types of transformational language games reveal that Mattoso was 80% right: four of the nasal vowels are indeed derived from such a sequence, while nasal   (strictly speaking,  ) is the result of an underlying, inherently nasal vowel. We also propose a further revision to Mattoso's disegmental hypothesis for nasal vowels: rather than being a sequence of oral vowel plus nasal archiphoneme, we propose that they are specifi cally the result of a combination of oral vowel plus homorganic nasal glide (i.e.   or  ). Th is nasal glide, however, is incompatible with  , and moreover would disrupt the contrast between   ,   , and   . As a result,    must be inherently underlyingly nasal, a result confi rmed through a variety of external evidence.