ESUR prostate MR guidelines 2012

The aim was to develop clinical guidelines for multi-parametric MRI of the prostate by a group of prostate MRI experts from the European Society of Urogenital Radiology (ESUR), based on literature evidence and consensus expert opinion. True evidence-based guidelines could not be formulated, but a compromise, reflected by “minimal” and “optimal” requirements has been made. The scope of these ESUR guidelines is to promulgate high quality MRI in acquisition and evaluation with the correct indications for prostate cancer across the whole of Europe and eventually outside Europe. The guidelines for the optimal technique and three protocols for “detection”, “staging” and “node and bone” are presented. The use of endorectal coil vs. pelvic phased array coil and 1.5 vs. 3 T is discussed. Clinical indications and a PI-RADS classification for structured reporting are presented

Prevention of depression and sleep disturbances in elderly with memory-problems by activation of the biological clock with light - a randomized clinical trial

<p>Abstract</p> <p>Background</p> <p>Depression frequently occurs in the elderly and in patients suffering from dementia. Its cause is largely unknown, but several studies point to a possible contribution of circadian rhythm disturbances. Post-mortem studies on aging, dementia and depression show impaired functioning of the suprachiasmatic nucleus (SCN) which is thought to be involved in the increased prevalence of day-night rhythm perturbations in these conditions. Bright light enhances neuronal activity in the SCN. Bright light therapy has beneficial effects on rhythms and mood in institutionalized moderate to advanced demented elderly. In spite of the fact that this is a potentially safe and inexpensive treatment option, no previous clinical trial evaluated the use of long-term daily light therapy to prevent worsening of sleep-wake rhythms and depressive symptoms in early to moderately demented home-dwelling elderly.</p> <p>Methods/Design</p> <p>This study investigates whether long-term daily bright light prevents worsening of sleep-wake rhythms and depressive symptoms in elderly people with memory complaints. Patients with early Alzheimer's Disease (AD), Mild Cognitive Impairment (MCI) and Subjective Memory Complaints (SMC), between the ages of 50 and 75, are included in a randomized double-blind placebo-controlled trial. For the duration of two years, patients are exposed to ~10,000 lux in the active condition or ~300 lux in the placebo condition, daily, for two half-hour sessions at fixed times in the morning and evening. Neuropsychological, behavioral, physiological and endocrine measures are assessed at baseline and follow-up every five to six months.</p> <p>Discussion</p> <p>If bright light therapy attenuates the worsening of sleep-wake rhythms and depressive symptoms, it will provide a measure that is easy to implement in the homes of elderly people with memory complaints, to complement treatments with cholinesterase inhibitors, sleep medication or anti-depressants or as a stand-alone treatment.</p> <p>Trial registration</p> <p>ISRCTN29863753</p

Desvios fonológicos na educação infantil Phonological deviations in elementary school

TEMA: desvio fonológico na Educação Infantil. PROCEDIMENTOS: analisar a intervenção fonoaudiológica baseada na hierarquia dos traços distintivos e na consciência fonológica em uma população de crianças com desvios fonológicos, estudantes da Educação Infantil. RESULTADOS: com a análise dos dados, verificou-se maior predominância de processos de simplificação de líquidas, simplificação de encontros consonantais e simplificação da consoante final. Ocorreu a intervenção fonoaudiológica, na qual apenas uma criança não conseguiu superar as dificuldades encontradas anteriormente no processo de organização fonológica, apresentando ainda ausência de traço distintivo no sistema. CONCLUSÃO: a intervenção fonoaudiológica fundamentada na hierarquia dos traços distintivos e na consciência fonológica ampliou o inventário fonético e o sistema fonológico dessas crianças, melhorando o contraste entre os fonemas e o desempenho das habilidades de manipulação dos sons da fala, consequentemente, proporcionando a inteligibilidade de fala.<br>BACKGROUND: phonological deviations in elementary school. PROCEDURES: analyzing the phonetic approach based on the ranking of distinctive features and on phonological awareness in a population of children with phonological deviations, students of elementary school. RESULTS: with the analysis of the information, we noted a great predominance simplification of liquids process, simplification of consonant cluster and simplification of final coda. Speech therapy took place, in which a child did not just get to overcome the difficulties found previously in the process of phonological organization, still presenting absence of distinctive trace in the system. CONCLUSION: the phonetic approach to phonological deviation based the ranking of distinctive features and on phonological awareness expanded the phonetic inventory and those children's phonological system, improving the recruiting between the phonemes and the performance of the abilities concerning manipulation speech sounds, consequently providing speech intelligibility