Dados normativos para o teste de fluência verbal categoria animais em nosso meio Normative data: category verbal fluency

OBJETIVOS: Avaliar o desempenho na fluência verbal em nossa população e verificar a influência da idade e escolaridade. MÉTODOS: Foram entrevistados 336 indivíduos sem queixas neurológicas ou psiquiátricas, através do Mini-Exame do Estado Mental (MEM) e geração de animais em um minuto. Para efeito comparativo e para verificação dos níveis de corte, foram examinados 65 indivíduos com quadro de perda cognitiva, acompanhados no ambulatório de Neurologia do Comportamento da EPM. RESULTADOS: Na população "normal" tivemos média de 13,84 animais por minuto. Para os grupos de escolaridade: 11,92, para analfabetos; 12,82, para indivíduos com até 4 anos incompletos; 13,45, para os de 4 a 8 anos incompletos; 15,88 para os com 8 ou mais anos de escolaridade. Houve diferença significante entre eles (p= 0,0001). Para os grupos etários, tivemos médias de: 13,79, para aqueles com idade inferior a 65 anos; 13.92 para os com idade igual ou superior a 65 anos (sem diferença estatística). Determinamos para esses grupos dois níveis de corte: 9 para indivíduos com até 8 anos de escolaridade com sensibilidade de 75 % para analfabetos, 100 % para baixa escolaridade, 87 % para média escolaridade; e especificidade de 79 % para analfabetos, 84 % para baixa escolaridade, 88 % para média escolaridade. Para o grupo de alta escolaridade o escore de corte foi de 13, com sensibilidade de 86 % e especificidade de 67 %. CONCLUSÃO: Devemos utilizar níveis diferenciados de corte no teste de fluência verbal, em nosso meio, considerando os efeitos da escolaridade sobre o desempenho neste teste.<br>OBJECTIVE: Evaluate the performance on verbal fluency (VF) in our population in a Brazilian sample checking the influence of age and literacy. METHODS: 336 people without neurological or psychiatric complaints evaluated through Mini-Mental State Examination and VF (animals). For comparison, and to determine cut-off points, 65 people with cognitive loss followed at our clinic were also evaluated. RESULTS: We found a mean of 13.8 animals in 1 minute, with the following distribution: illiterates, 11.9; up 4 years of education, 12.8; 4 to 7 years, 13.4; 8 years or more, 15.8 (p= 0.0001). In relation to age the means were: up to 64 years, 13.7; 65 years or more, 13.9. There was no difference between the two groups. The cut-off points were 9 for people under 8 years of education with a sensitivity of 75% for illiterates, 100% for low educational level (up 4 years),and 87% for middle level (4 to 7 years). The specificity was respectively 79%, 84%, and 88%. For the high educational level the mean was 13 with a sensitivity of 86% and specificity of 67%. CONCLUSIONS: In the VF (animals) there is a significant influence of schooling and different cut-off points should be used

Vascular Stenosis: An Introduction

International audienceAn arterial stenosis is a narrowing of the lumen that disturbs the local blood flow and precludes the adequate irrigation of perfused organs. A vascular stenosis can be extrinsic, which is caused by external compression (e.g., aneurysms and tumors), or intrinsic, currently related to atherosclerosis.Atherosclerosis is defined by an intramural retention of lipids coupled to inflammation and dyslipidemia. Atherosclerosis scatters throughout large and medium thick-walled systemic arteries, especially near and in branching regions. (Pulmonary arterial stenosis is a congenital defect.)Atherosclerosis is characterized by migration from the media, proliferation, and dedifferentiation of vascular smooth myocytes in the subendothelial layer, in addition to monocyte diapedesis and differentiation into macrophages. Both smooth myocytes and macrophages scavenge accumulated oxidized low-density lipoproteins (oxLDL) and transform into foam cells. Atherosclerosis produces symptoms when the arterial lumen is severely narrowed.Advanced atherosclerotic plaques can be destabilized, thereby being a source of clotting and subsequent emboli. Emboli block tissue perfusion in a smaller downstream artery, thereby causing ischemia and infarction.The treatment of stenotic arterial segments relies on surgical grafting or medical minimally invasive procedures such as stenting. However, both methods often lead to intimal hyperplasia resulting from uncontrolled proliferation of vascular smooth myocytes. Whereas atheroma evolves during a time magnitude order of 10 years, posttherapeutic intimal hyperplasia develops in a period of order 1 month.Successful stenting can be assumed as a procedure without strong endothelial injury. In other words, both delayed thrombosis and intimal hyperplasia result from stent deployment that more or less severely damages the vascular endothelium. To eliminate these complications, drug-eluting stents have been designed and fabricated. However, the antiproliferative drug not only blocks vascular smooth myocyte division but also precludes endothelium healing. In the absence of proper endothelial interface between blood and arterial wall, that is, when the local controller of blood coagulation and cell proliferation is missing, thrombosis and restenosis occur.Arterial stenoses have stimulated biomechanicians and applied mathematicians. They carried out flow visualization and pressure and velocity measurements in experimental models of stenoses with idealized, symmetrical or not, geometry. In parallel to technological improvements of medical imaging techniques, computational fluid dynamics, due to new numerical schemes and high-performance computing, enables to perform numerical tests on subject-specific compartments of the blood circulation, after 3D reconstruction, rather than focusing on more or less short arterial, branched or not, segments. In addition, the drug release from drug-eluting stents is investigated using mathematical models