The sleep as an activator on epileptic patient's electroencephalogram

In order to study the influence of sleep on the electroencephalograms of epileptic patients the tracings obtained of 1.868 such patients were analised (572 generalized seizures; 121 non-psychomotor temporal; 118 psychomotor; 410 non-temporal focal; 314 noctural seizures; 165 febrile seizures; 168 convulsive seizures associated with psychomotor retard). The electroencephalograms were made with the patients awake (rest and hyperpnea) and sleeping (slow phase), the findings being compared. There was not found any significant difference between the EEG tracings obtained during spontaneous sleep and medically induced sleep. In the majority of the cases the records obtained while the patients were asleep merely confirmed the ones made while the patients were awake. The activator action of sleep appeared only in small number of the cases, having it's peak on the group with psychomotor seizures (26%). In the generalized non-psychomotor temporal, non-temporal focal and noctural seizures the sleep acted as an antiactivator instead of an activator of the abnormalities recorded while the patients were awake.Visando ao estudo da ação do sono como ativador do eletrencefalograma em pacientes epilépticos, foram estudados 1.868 pacientes com síndromes convulsivas (572 com crises generalizadas, 121 com crises temporais não psicomostras, 118 com crises psicomotoras, 410 com crises focais não temporais, 314 com crises noturnas, 165 com crises febris, 168 com crises convulsivas associadas a retardo psicomotor). Em todos os pacientes foram feitos eletrencefalogramas em vigília (repouso e hiperpnéia) e durante o sono (fase lenta) sendo os achados comparados. Em nosso material não encontramos diferença significativa de resposta entre o sono espontâneo e o medicamentoso. Na maioria de nossos pacientes o traçado realizado durante o sono confirmou os achados registrados em vigília. A ação ativadora do sono foi evidenciada em um número relativamente pequeno de casos, tendo atingido o seu máximo no grupo de pacientes com crises psicomotoras (26%). Nas crises generalizadas, temporais não psicomotoras, focais não temporais e noturnas o sono funcionou mais como desativador do que como ativador das anormalidades registradas em vigília.Escola Paulista de Medicina Departamento de Neurologia e NeurocirurgiaUNIFESP, EPM, Depto. de Neurologia e NeurocirurgiaSciEL

Failure Evaluation of Reinforced Concrete Beams Using Damage Mechanics and Classical Laminate Theory

The prediction of the behavior of reinforced concrete beams under bending is essential for the perfect design of these elements. Usually, the classical models do not incorporate the physical nonlinear behavior of concrete under tension and compression, which can underestimate the deformations in the structural element under short and long-term loads. In the present work, a variational formulation based on the Finite Element Method is presented to predict the flexural behavior of reinforced concrete beams. The physical nonlinearity due cracking of concrete is considered by utilization of damage concept in the definition of constitutive models, and the lamination theory it is used in discretization of section cross of beams. In the layered approach, the reinforced concrete element is formulated as a laminated composite that consists of thin layers, of concrete or steel that has been modeled as elasticperfectly plastic material. The comparison of numerical load-displacement results with experimental results found in the literature demonstrates a good approximation of the model and validates the application of the damage model in the Classical Laminate Theory to predict mechanical failure of reinforced concrete beam. The results obtained by the numerical model indicated a variation in the stress–strain behavior of each beam, while for under-reinforced beams, the compressive stresses did not reach the peak stress but the stress–strain behavior was observed in the nonlinear regime at failure, for the other beams, the concrete had reached its ultimate strain, and the beam’s neutral axis was close to the centroid of the cross-section

Reversão de dipolo: um achado crítico em um paciente com epilepsia parcial benigna da infância com ponta centrotemporal

We describe the case of a 15-year-old boy who had the diagnosis of benign partial epilepsy of childhood with centrotemporal spike. During the EEG a subclinical electrographic seizure was recorded. The discharges were clearly electropositive in T4 with positive phase reversal between derivations F8-T4 and T4-T6. The whole episode lasted less than one minute (45 sec). The interictal right medio-temporal spikes reemerged after 60 sec and were electronegative in the same location after the end of the electrographic seizures. The mechanisms underlying this uncommon pattern on EEG is not well stablished.Relatamos o caso de um menino de 15 anos com o diagnóstico de epilepsia parcial benigna da infância com ponta centrotemporal. Durante o EEG uma crise eletrográfica subclínica foi gravada. As descargas estavam eletropositivas em T4 com reversão de fase positiva entre as derivações F8-T4 e T4-T6. O episódio durou menos que um minuto (45 seg). As espículas inter-ictais, na região temporal média direita, reapareceram 60 seg após e estavam eletronegativas na mesma região depois do término da crise eletrográfica. O mecanismo subjacente a este padrão incomum no EEG não está bem estabelecido.Escola Paulista de Medicina EEG SectorEPMUNIFESP, EPM, EEG SectorEPMSciEL

Estado de mal epiléptico por crise parcial complexa em uma criança

Complex partial status epilepticus (SE) has been reported rarely in children. We describe the clinical case of a 14 year-old girl with complex partial seizures (CPS) since age 10 who developed a complex partial SE probably because she was not adherent to treatment. The neurologic examination and computed tomography scan were normal. During the SE she received diazepam and phenytoin and became free of the seizures after 5 minutes. The ictal EEG showed spikes and slow waves over the right temporal region.Estado de mal epiléptico por crise parcial complexa tem sido raramente referido em crianças. Relatamos o quadro clínico de uma menina com 14 anos de idade, com crises parciais complexas desde os 10 anos e que desenvolveu estado de mal epiléptico por crises parciais complexas, provavelmente por não ser aderente ao tratamento. O exame neurológico e a tomografia computadorizada de crânio foram normais. Durante o estado de mal epiléptico ela recebeu fenitoína e diazepam e ficou livre das crises após 5 minutos. O EEG ictal mostrou espículas e ondas lentas na região temporal direita.Escola Paulista de Medicina EEG SectorEPMUNIFESP, EPM, EEG SectorEPMSciEL

Descarga eletrográfica rítmica subclínica do adulto: uma evolução atípica

The subclinical rhythmic electrographic discharge in adults (SREDA) has been rarely reported. We describe the case of a 71 year-old man with transient ischemic attack, whose EEG showed an atypical evolution of this uncommon pattern. The computed tomography scan and cerebrospinal fluid were normal. We are not aware of any other report in the literature with this atypical evolution of SREDA.A descarga eletrográfica rítmica subclínica do adulto tem sido raramente referida na literatura. Relatamos o caso de um homem de 71 anos com ataque isquêmico transitório, cujo EEG mostrou evolução atípica deste padrão incomum. A tomografia computadorizada de crânio e o liquido cefalorraquidiano foram normais. Na literatura por nós pesquisada, não achamos outra publicação com evolução atípica do SREDA.Escola Paulista de Medicina EEG SectorUNIFESP, EPM, EEG SectorSciEL

Padrão atípico no EEG de crianças com crises de ausência

We studied four children with diagnosis of absence seizures (generalized primary epilepsy), and with a generalized delta activity on the EEG during clinical attacks provoked by hyperventilation. The lack of ictal generalized spike-and-wave discharges with a frequency of 3 Hz in our patients, makes this an atypical pattern. All children had complete control of their seizures and disappearance of the EEG changes with valproate. We concluded that generalized delta activity observed on EEG during the hyperventilation in children should not always be considered as a normal finding for age, since it could be an ictal event of an absence seizure.Estudamos quatro crianças com o diagnóstico de crises de ausência (epilepsia generalizada primária) e com atividade delta generalizada no EEG, durante crises provocadas pela hiperpnéia. A ausência de descargas generalizadas por complexos ponta-onda a 3 Hz, durante as crises de nossos pacientes, é achado incomum. Todas as crianças tiveram completo controle de suas crises com o valproato, assim como o desaparecimento das alterações no EEG. Concluimos que a atividade delta generalizada observada no EEG de crianças durante a hiperpnéia nem sempre deve ser vista como achado normal, podendo ser um evento crítico da crise generalizada ausência.Escola Paulista de Medicina Head of the EEG SectorUNIFESP, EPM, Head of the EEG SectorSciEL

EEG focal abnormalities in P.M. epilepsy

Thirty one patients with P.M. epileptic crisis whose EEG showed centrencephalic disrythmia secondary to focal irritating activity where thoroughly observed. 19% of the cases showed centroencephalic disrythmia secondary to deeply situated focus and 8% to focus of cortical situation; in these cases the temporal projection was predominant. The clinical type of the crisis was analysed with emphasis on the fact that 8 patients did not show a sheer P.M. type crisis (absence): 4 showed mioclonic P.M. and 4 akynetic P.M. The high incidency of personal antecedents (33%) is emphasized.Foram estudados 31 pacientes com crises clínicas tipo P.M. cujos eletrencefalogramas revelaram disritmia centrencefálica secundária a atividade irritativa focal. A sua freqüência entre as disritmias centrencefálicas foi de 27% (19% secundárias a foco de localização profunda e 8% secundárias a foco de localização cortical). O tipo clínico das crises foi analizado, sendo ressaltado o fato de que 8 pacientes não apresentaram crise tipo P.M. puro (ausência): 4 apresentaram P.M. mioclônico e 4 P.M. acinético. A alta incidência de antecedentes pessoais de valor (33%) foi enfatizada.Escola Paulista de Medicina Departamento de Neurologia e NeurocirurgiaEscola Paulista de Medicina Departamento de NeurologiaUNIFESP, EPM, Depto. de Neurologia e NeurocirurgiaEscola Paulista de Medicina Depto. de NeurologiaSciEL

Contribuição para o conhecimento da flora do Estado de Alagoas

Esta contribuição é o início de uma série de estudos multidisciplinares sobre a Flora do Estado de Alagoas, questionando problemas ecológicos, taxinômicos e fito-econômicos. Sessenta e nove espécies componentes de Matas Orientais (Atlânticas), Dunas e Restingas, são aqui consideradas. _________________________________________________________________________________ ABSTRACTA series of studies was undertaker in cooperation with the Department of Phytochemistry of Universidade Federal de Alagoas (Brazil). These studies deal with the flora of Estado de Alagoas an 69 species from the "matas Atlânticas" sand dunes and "restingas" are treated here. Ecological, taxonomic an phyto-economic problems are discussed

Padrão atípico associado às pontas positivas 14 Hz

We studied two children with a history of headache and a normal physical and neurological examination whose EEG showed an electroencephalographic pattern recently published, the N-shape potential associated with the 14 Hz positive spikes. This graphoelement was observed only during the asleep state.Estudamos duas crianças com história de cefaléia, exame físico e neurológico normais, cujos EEG mostraram padrão eletrencefalográfico recentemente publicado, o potencial N associado às pontas positivas 14 Hz. Este novo grafoelemento foi observado somente durante o estado de sonolência.Escola Paulista de Medicina EEG SectorEPMUNIFESP, EPM, EEG SectorEPMSciEL

Educational paradigms and mobilization of interactive methodologies with a focus on learning: the use of TIDC for learning to learn / Paradigmas educacionais e mobilização de metodologias interativas com foco na aprendizagem: o uso do TIDC para aprender a aprender

The present work portrays a research on learning styles, with emphasis on what is in fact "concentrating" and "paying attention. "The objective is to show that clear, contextualized and diversified classes, based on the use of TIDCs (Digital Information and Communication Technologies) attract attention and addresses the five most important secrets for students to learn, considering the break with various educational paradigms and mobilization of more interactive methodologies. The study seeks to encourage the use of technologies based on four foundations: awakening curiosity, learning styles, study techniques and the use of TIDCs in the classroom. The discussion and results are based on Law 9394/96 that instructs the teacher to ensure student learning by creating a student / teacher relationship, capable of making the teacher take care of the student in its fullness and equity. The teacher should accept the student as he is, however, develop his / her abilities, be it kinesthetic, auditory or visual. Being the determinant role of the teacher under the students' learning, this one has the task of identifying how each student learns, valuing the identity of each individual as to their way of seeing the world. Only in this way, curiosity will arouse students' interest and learning. When doing a diagnostic evaluation, this result is an indicator, which demonstrates the need to diversify the way of teaching to reach in the student audience: attention and concentration.