A Brazilian Original Pedagogical Approach To The Teaching Of Neurology.

The two-arm Clinical Decisions/Diagnostic Workshop (CD/DW) approach to undergraduate medical education has been successfully used in Brazil. Present the CD/DW approach to the teaching of stroke, with the results of its pre-experimental application and of a comparative study with the traditional lecture-case discussion approach. Application of two questionnaires (opinion and Knowledge-Attitudes-Perceptions-KAP) to investigate the non-inferiority of the CD/DW approach. The method was well accepted by teachers and students alike, the main drawback being the necessarily long time for its completion by the students, a feature that may better cater for different educational needs. The comparative test showed the CD/DW approach to lead to slightly higher cognitive acquisition as opposed to the traditional method, clearly showing its non-inferiority status. The CD/DW approach seems to be another option for teaching neurology in undergraduate medical education, with the bonus of respecting each learner`s time.72747-5

O movimento funcional de alcance em uma abordagem ecológica

Teorias de controle motor tradicionais assumiam um modelo de representação interna responsável pela organização e regulação do alcance, tendo por controlador o sistema nervoso central (SNC). Perspectivas contemporâneas questionam a habilidade de somente o SNC controlar e regular os movimentos. Ações podem não ser guiadas apenas pelo SNC, mas também por informações presentes no ambiente, estando o controle no sistema indivíduo-ambiente. A detecção da informação é um processo ativo: o indivíduo explora o ambiente, percebe possibilidades de ação fornecidas por ele e age em reposta ao que é oferecido. O objetivo deste estudo foi descrever o desenvolvimento e a coordenação do alcance em uma perspectiva teórica fundamentada na abordagem ecológica à percepção-ação, para promover melhor compreensão do movimento humano. Discutem-se nesta revisão de literatura o desenvolvimento do alcance desde a infância até a idade adulta, formas de operacionalização, fatores extrínsecos e intrínsecos relacionados, relações invariantes entre indivíduo e objeto a ser alcançado. Esse referencial teórico pode permitir a compreensão de como intervenções alteram a estabilidade vigente no sistema, levando à emergência de novas soluções funcionais. Em uma visão ecológica, o alcance é entendido de forma ampla: para explicar a ocorrência do movimento, devem considerar-se as informações do ambiente, além das características intrínsecas do indivíduo.Traditional motor control theories rely on a model of internal representation responsible for the organization and regulation of reaching movements, controlled by the central nervous system (CNS). Contemporary perspectives argue the ability of the CNS alone to control and regulate voluntary movements, since actions may also be guided by environmental information, wherein control would be exerted by the individual-environment system. The detection of information is an active process: subjects explore the environment, perceive possibilities of action, and act in response to the environment. The purpose of this study is to describe development and coordination of reaching movements from a theoretical perspective based on an ecological approach to perception-action, in order to provide better understanding of human movement. This literature review discusses the development of reaching movements from infants to adults, operational functions, related extrinsic and intrinsic factors, and invariant relations between the subject and the target object. This theoretical framework allows for a better understanding on how interventions may alter system stability, leading to the emergency of new functional solutions. In an ecological approach, reaching is understood in a broad way: in order to explain movement, environment information is considered, besides subjects' intrinsic characteristics

Effects of exercise in reducing the risk of falls in elderly women with osteoporosis

OBJECTIVE: This study aims to evaluate the effect of progressive muscular strength and proprioception training program on the balance and decrease in the risk of falls in women with osteoporosis. METHOD: 82 sedentary women aged 60-75 years with osteoporosis were selected and randomized in two groups: the intervention group comprised 41 patients submitted to an 18-week progressive muscular strength and proprioception training of quadriceps associated to drug therapy for osteoporosis; and control group, formed by 41 patients submitted to drug therapy only. The balance and fall risk were evaluated using the Balance Berg Scale (BBS) and calculating the Fall Index (FI). The number of fall was assessed six months before the research and the following six months. RESULTS: 69 patients completed the research. The program improved the functional balance (p<0.001) shown by BBS, decreased the risk of falls evidenced by the general score of FI (p<0.004) and also a decrease in the total number of falls. The experimental group showed significant lower number of falls when compared to the control group (p<0.001). CONCLUSION: The association of progressive strength of quadriceps and proprioceptive training is effective to prevent falls and reduce risk factors. The quantitative model to predict risk of falls might be useful to identify the risk of falls in the elderly. Trial registration: 082213-ANZCTR.OBJETIVO: Avaliar o efeito de um programa de treinamento de força muscular progressiva e sensório-motor, no equilíbrio e na redução do risco de quedas em mulheres com osteoporose. MÉTODO: Foram selecionadas 82 mulheres sedentárias com idade entre 60 e 75 anos com osteoporose, randomizadas em dois grupos: grupo intervenção, composto por 41 pacientes submetidas a 18 semanas de treinamento de força muscular progressiva do quadríceps (a 50%, 60%, 70% até 80% de 1-RM - uma repetição máxima), e de propriocepção, associado ao tratamento clínico medicamentoso para osteoporose; e grupo controle, também composto por 41 pacientes que receberam apenas o tratamento clínico medicamentoso. O equilíbrio e o risco de quedas foram avaliados por meio da Escala de Equilíbrio de Berg (BBS) e do cálculo do Índice de Quedas (IQ). O número de quedas foi avaliado seis meses antes do início da pesquisa e nos seis meses seguintes. RESULTADOS: 69 pacientes concluíram a pesquisa. O programa promoveu melhora no equilíbrio funcional (p<0,001) demonstrado pela BBS, redução do risco de quedas calculado pelo escore geral do IQ (p<0,004) e ainda uma redução do número total de quedas, que no grupo experimental foram significativamente menores que no grupo controle (p<0,001). CONCLUSÃO: A associação do treinamento de força progressiva para quadríceps e propriocepção é eficaz na prevenção de quedas e redução de seus fatores de risco, e o modelo para previsão quantitativa do risco de quedas pode ser útil na identificação do risco de quedas em pessoas idosas. Registro ensaio clínico: 082213- ANZCTR.Universidade Federal do Amazonas Departamento de FisioterapiaUniversidade Federal de São Paulo (UNIFESP) Departamento de Ciências do Movimento HumanoUniversidade Federal de São Paulo (UNIFESP) Programa de Pós-graduação em Medicina Interna e TerapêuticaHospital das Forças Armadas Serviço de FisioterapiaUniversidade Santo Amaro Residência em ReumatologiaCentro Universitário do Norte Departamento de FisioterapiaUNIFESP, Depto. de Ciências do Movimento HumanoUNIFESP, Programa de Pós-graduação em Medicina Interna e TerapêuticaSciEL

Risk factors associated with breast cancer patients in Teresina, Piauí, Brazil

Objective: To characterize the risk factors for breast cancer in patients seen in a referral center in the city of Teresina, Piaui (2010-2012). Method: A descriptive exploratory study with 197 patient records. A personal health questionnaire was administered to 20 patients and 20 women without breast cancer. The data were submitted to SPSS 13.0 for analysis of percentages, means and Spearman correlations. Results: The average age (55 years) was positively correlated with ductal carcinoma (83%) and 10% of metastases. The occupation of domestic, family history, medications, and exposure to ionizing radiation have been demonstrated as risk factors. Significant (p <0.001) positive correlation (r = 0.6642, p = 0.002) were observed between breast cancer family history and occupation. Conclusion: Prevention strategies related to environmental, occupational and hereditary factors are necessary to minimize the risk of mutagenicity and carcinogenicity

High-affinity transport, cyanide-resistant respiration, and ethanol production under aerobiosis underlying efficient high glycerol consumption by Wickerhamomyces anomalus

Wickerhamomyces anomalus strain LBCM1105 was originally isolated from the wort of cachaça (the Brazilian fermented sugarcane juice-derived Brazilian spirit) and has been shown to grow exceptionally well at high amounts of glycerol. This paramount residue from the biodiesel industry is a promising cheap carbon source for yeast biotechnology. The assessment of the physiological traits underlying the W. anomalus glycerol consumption ability in opposition to Saccharomyces cerevisiae is presented. A new WaStl1 concentrative glycerol-H+ symporter with twice the affinity of S. cerevisiae was identified. As in this yeast, WaSTL1 is repressed by glucose and derepressed/induced by glycerol but much more highly expressed. Moreover, LBCM1105 aerobically growing on glycerol was found to produce ethanol, providing a redox escape to compensate the redox imbalance at the level of cyanide-resistant respiration (CRR) and glycerol 3P shuttle. This work is critical for understanding the utilization of glycerol by non-Saccharomyces yeasts being indispensable to consider their industrial application feeding on biodiesel residue.This work was supported by grants from Fundacao de Capacitacao de Pessoal de Nivel Superior from the Ministry of Education-CAPES/Brazil (PNPD 2755/2011; PCF-PVE 021/2012), from FEDER through POFC-COMPETE and by FCT through strategic funding (UID/BIA/04050/2013), from Universidade Federal de Ouro Preto, and a research fellowship from Conselho Nacional de Desenvolvimento Cientifico e Tecnologico-CNPq (Brazil) Process 304815/2012 (research grant) and Process 305135/2015-5 (research fellowship to R.L.B.). C.L. is supported by the strategic program UID/BIA/04050/2013 [POCI-01-0145-FEDER-007569] funded by national funds through the FCT I. P. and by the ERDF through the COMPETE2020-Programa Operacional Competitividade e (POCI). The AUXPE-PVES 1801/2012 (Process 23038.015294/2016-18) from Brazilian Government supported a grant of Visiting Professor to C.L. and a research fellowships to A.C.C. and to F.F.O

Trastornos Mentales derivados del uso de drogas en un Hospital Psiquiátrico

In this study, the objective was to describe the profile of patients hospitalized at a psychiatric hospital who had been diagnosed with mental and behavioral disorders due to psychoactive substance use. Documentary study with a retrospective design, obtained from the admission records in the service register. In total, 10.4% of the records of patients hospitalized in the year under study were evaluated. The data were organized in tables. The results showed that most patients were male, young adults, unemployed, with simultaneous drugs use. Alcohol was the most consumed substance. The rehospitalization rate in the year in question was 29.6%. Interdisciplinary interventions facilitate the quality of health, so that the professionals can act in the users’ welcoming and their health needs.El presente estudio tuve por objetivo describir el perfil de los pacientes ingresados en un hospital psiquiátrico con diagnóstico de "Trastornos Mentales y del Comportamiento Debido al consumo de sustancias psicoactivas". Estudio documental y retrospectivo, obtenido del registro de admisiónes en el libro del servicio. Un total de 10,4% de pacientes en internación en el año de estúdio fue valorada. Los datos fueron organizados en tablas. De los resultados, la mayoría era hombre, adulto/jóven, desempleado, con el uso simultâneo de drogas, el álcool siendo lo más consumida. Los reingresos en aquel año fueron 29,6%. La practica de intervenciones interdisciplinares facilita la calidad en salud, aún los profesionales puedan actuar en la acojida, incluso en sus necessidades de salud.No presente estudo, teve-se por objetivo descrever o perfil de pacientes, internados em um hospital psiquiátrico, diagnosticados com transtornos mentais e comportamentais devidos ao uso de substâncias psicoativas. Estudo documental do tipo restrospectivo, obtido por meio do registro de admissões no livro do serviço. No total, 10,4% dos registros de pacientes internados no ano estudado foram avaliados. Os dados foram organizados em tabelas. Dos resultados, a maioria era homem, adulto jovem, desempregada, com uso simultâneo de drogas, sendo o álcool a substância mais consumida. A taxa de reinternações no ano em questão foi de 29,6%. A prática de intervenções interdisciplinares facilita a qualidade em saúde, de modo que os profissionais possam atuar no acolhimento ao usuário, bem como em suas necessidades de saúde

Fatores de risco para a ocorrência de acidentes em laboratórios de ensino e pesquisa em uma universidade brasileira (2012)

O estudo teve o objetivo de analisar os principais fatores associados à ocorrência de acidentes envolvendo agentes biológicos, materiais perfurocortantes ou compostos químicos em laboratórios de ensino e pesquisa de uma universidade brasileira. Trata-se de estudo transversal e analítico, com aplicação de questionário a 271 indivíduos que desenvolviam atividades laboratoriais em três unidades acadêmicas da Universidade Federal de Minas Gerais em 2012. A triagem de características potencialmente associadas à ocorrência de acidentes foi realizada por testes estatísticos univariados. A verificação dos principais fatores de risco ou proteção para a ocorrência de acidentes foi feita por modelos de análise multivariada (

COMPARATIVE ANALYSIS OF THE INFLUENCE OF HANDGRIP STRENGTH AND MOBILITY ON THE QUALITY OF LIFE OF INSTITUTIONALIZED ELDERLY

The objective of this study was to carry out a comparative analysis between handgrip strength and mobility in the quality of life (QOL) of older adults living in long-term care facilities. Methods: This was a cross sectional study conducted in Belo Horizonte, Brazil, comprised of a sample population of 127 older adults. Measurements included the World Health Organization Quality of Life-OLD (WHOQOL-BREF) questionnaire, assessment of the handgrip strength by hand dynamometer and mobility by Timed Up and Go (TUG). An analysis of variance (ANOVA) was performed to compare the mean values of the WHOQOL-BREF, global and domains, in each stratum of the handgrip strength and mobility values. Our results showed that handgrip dynamometer strength was associated with higher perception of the global WHOQOL-BREF score and two WHOQOL-BREF domains environment (p&lt;0.028) and physical health (p&lt;0.002), that is, the highest QOL values were seen in those older adults with greater handgrip strength. However, no significant association between TUG score and any quality of life domains was found. It can be inferred that handgrip strength seems to influence the quality of life of institutionalized older adults and healthcare providers in LTCs should account for when designing interventions