bluuebunny/crossref_metadata_2025 huggingface dataset:
Molar incisor hypomineralization: an aesthetic conservative restorative approach
Authors: SILVA-JUNIOR Manoelito Ferreira , ASSIS Rahyza Inácio Freire de , PAZINATTO Flávia Bittencourt
Published: July 2016

ABSTRACT The aim this study is to present a clinical case of conservative aesthetic restorative treatment of teeth 11 and 21 in a patient diagnosed with molar incisor hypomineralization. An 18-year-old female patient came to the Outpatient Restorative Dentistry Clinic at the Federal University of Espírito Santo, complaining mainly of not feeling comfortable with a color change in her anterior teeth. Molar incisor hypomineralization was diagnosed in molars and incisors and the negative psychosocial implications for the aesthetics involved were noticed. Due to factors such as age, financial viability, technical facility and low degree of severity, we opted for maximum preservation of the healthy tooth structure, through minimal surgical intervention to remove the irregular enamel only and subsequently restore the teeth involved (11 and 21) with resin composite. For the patient, this conservative procedure restored function and aesthetics, and thereby improved her emotional and social behavior. Conservative restorations can provide real solutions, especially in cases of molar incisor hypomineralization in anterior teeth where the patient's psychological state should always be considered. An appropriate assessment of the dental substrate and a careful restorative technique are necessary for success in terms of aesthetics and function and can quickly promote the patient's well-being.
Odontoma associated with impacted mandibular canine: surgically guided eruption
Authors: NASCIMENTO Murilo Maia , ALMEIDA Carolina Medeiros de , NONAKA Cassiano Francisco Weege , PEIXOTO Tony Santos , GRANVILLE-GARCIA Ana Flávia , COSTA Edja Maria Melo de Brito
Published: July 2016

ABSTRACT Odontoma is the most common type of odontogenic tumor and is most often diagnosed in the second decade of life. This benign tumor has a slow growth and is asymptomatic, which favors its persistence in the bone until some clinical sign emerges or the tumor or be detected in a routine radiograph. The aim of this case report was to present a clinic case of a 13-year-old male, who presented delayed exfoliation of the mandibular right primary canine. The radiographic exam revealed a radiopaque image in the anterior region of the mandible produced by structures that resembled the formation of teeth surrounded by a radiolucent area. Adjacent to the tumor, the impacted mandibular right canine was identified with deviation of its eruption axis. The clinical diagnosis was compound odontoma. Treatment consisted of the removal of the tumor and the surgically-assisted eruption of the tooth without orthodontic traction. After three years of follow up, the patient has exhibited positive results. It is possible to surgically assist the eruption of an impacted tooth, with a deviated axis, associated with an odontoma through the removal of the tumor and of the physical barrier (ostectomy) without orthodontic traction.
Osteoblastoma in the retromolar region: a case report
Authors: TENÓRIO Jefferson da Rocha , SILVA FILHO Tiago João da , OLIVEIRA Denise Hélen Imaculada Pereira de , QUEIROZ Lélia Maria Guedes
Published: July 2016

ABSTRACT Osteoblastoma is a rare benign tumor that accounts for less than 1% of all bone tumors. About 10% of osteoblastomas are found in the skull bones and almost half of these cases involve the mandible, especially the posterior segments. This report describes the case of a 27-year-old female patient with a unilocular radiopaque expansive lesion in the left mandible, which had well-delimited margins and caused mild bone expansion. Microscopic analysis revealed the presence of mineralized material in the form of irregularly arranged vital trabeculae at different stages of mineralization. Osteocytes were trapped inside these trabeculae, which contained osteoclast-like multinucleated cells and voluminous pavement cells with hyperchromatic nuclei, sometimes interpreted as osteoblasts. Many bone-producing lesions have clinical, radiologic and histopathologic features that resemble osteoblastoma. The understanding and correlation of these findings are extremely important since they contribute to the correct diagnosis and appropriate treatment of this rare entity, improving its prognosis.
Successful in a conservative treatment of osteoradionecrosis of the jaw: a case report and review of literature
Authors: MORAES Paulo de Camargo , THOMAZ Luiz Alexandre , SILVA Milena Bortolotto Felippe , JUNQUEIRA José Luiz Cintra , TEIXEIRA Rubens Gonçalves
Published: July 2016

ABSTRACT Osteoradionecrosis of jaws is one of the most serious complications of radiation therapy for head and neck malignancies. The management of osteoradionecrosis continues to be debated and there are few cases which can be resolved with conservative management. This paper presents a case of osteoradionecrosis after a dental extraction affecting the mandible of a 58-year-old man and highlights the conservative therapeutic management and 3-year follow-up period. We combined a conservative nonoperative therapy, including long-term antibiotic therapy and daily irrigation with chlorhexidine mouthrinses in a case of osteoradionecrosis after a dental extraction affecting the mandible of a 58-year-old man. At the follow-up, clinical aspect was resolved. A CBCT scan image and a three-dimensional (3D) reconstructed image revealed bone remodeling in a 3-year follow-up period .No sign of exposed bone could be seen. Follow-up 3 years later revealed that the conservative management posed was successful for osteoradionecrosis and the patient is currently under regular review.
Comparação entre duas metodologias para a realização do teste de redução do tetrazólio nitroazul (NBT) em caprinos
Authors: Fonteque Joandes H. , Saito Mere E. , Rizelo Priscila A. , Teixeira William T. , Kohayagawa Aguemi
Published: July 2016

Resumo: O teste de redução do tetrazólio nitroazul (NBT) é um dos métodos mais utilizados para a avaliação do metabolismo oxidativo dos neutrófilos. Porém, o custo por amostra e o tempo de utilização do corante são desvantagens do método. O objetivo deste trabalho foi comparar duas metodologias para realização do teste do NBT a fim de maximizar a sua utilização e diminuir o custo por amostra processada. Foram utilizadas 10 cabras, adultas clinicamente sadias e colhidas amostras de sangue por meio de venipunção jugular em tubos de 10mL sendo retirada uma alíquota de 500μL em tubo "eppendorff" contendo 2μL de heparina. Através desta alíquota foram realizadas três metodologias para o teste do NBT: A) técnica original Park & Good (1970); B) redução de 50% do volume do corante; C) redução de 50% e armazenamento do corante a -20°C por 180 dias. Foram confeccionados e corados esfregaços sanguíneos (May Grünwald-Giemsa) das amostras com as metodologias propostas e realizada contagem de 100 neutrófilos em microscopia óptica para determinar o percentual de neutrófilos reativos ao NBT. A análise estatística pelo método de Análise de Medidas Repetida (ANOVA) demonstrou diferenças significativas (P<0,05) entre os dois métodos e o original (A=14,4±4,6; B=1,9±1,4; C=1,1±0,9), porém apresentou alta correlação pelo teste de Spearman entre os métodos (rs=0,82 (AxB), rs=0,75 (BxC) e rs=0,93 (AxC)). Conclui-se que o teste de Redução do Tetrazólio Nitroazul (NBT) segundo a metodologia descrita por Park & Good (1970) e a redução do corante em 50% do seu volume e a sua redução associada ao congelamento por 180 dias a -20ºC podem ser realizadas em caprinos, porém os valores devem ser comparados com as respectivas metodologias utilizadas.
Perfil metabólico de ovinos em crescimento alimentados com dietas constituídas de feno ou silagem de maniçoba e palma forrageira
Authors: Gouveia Luciana N.F. de , Maciel Michel V. , Soares Pierre C. , F.S. Neto Izíldo , Gonçalves Daniel N.A. , Batista Ângela M.V. , Carvalho Francisco F.R. de
Published: July 2016

Resumo: Objetivando-se avaliar o efeito da adição de palma forrageira associado à maniçoba na dieta de ovinos sobre o perfil de indicadores bioquímicos do metabolismo energético e proteico, foi realizado um delineamento em blocos casualizados onde foram utilizados 24 ovinos machos, sem padrão racial definido, com peso corporal médio de 19,77±1,95 kg e idade média de seis meses, divididos igualmente em três tratamentos: concentrado + feno Tifton 85, concentrado + feno de maniçoba e concentrado + silagem de maniçoba, e semelhantes partes de palma forrageira. Realizaram-se quatro coletas de sangue, que constituíram as repetições, com intervalos de 15 dias (0d, 15d, 3d0 e 45d). Em seguida, procederam-se as análises dos seguintes indicadores bioquímicos: creatinina sérica, ureia, proteína total, albumina, globulina, glicose, frutosamina, aspartato aminotransferase, fosfatase alcalina, gama glutamiltransferase, sódio, potássio, cloro, cálcio e fósforo. Maior consumo de matéria seca foi observado no grupo com feno de maniçoba. O tratamento com silagem de maniçoba apresentou diferença (P<0,05) no consumo de fibra em detergente neutro. Houve variações significativas na concentração de ureia nos animais que receberam a dieta composta de feno de maniçoba. Tanto o feno como a silagem de maniçoba, em até 30%, pode substituir o feno de Tifton 85 na alimentação de ovinos em terminação, mantendo efetivamente o consumo de matéria seca, rendimento de carcaça, os metabolismos proteico, energético e mineral, além de ser uma boa alternativa para a alimentação de ovinos.
Influência da altitude sobre parâmetros eletrocardiográficos, obtidos por meio do uso do "Holter" em cavalos de enduro em diferentes níveis de condicionamento físico
Authors: Griska Paulo R. , Michima Lílian E.S. , Oliveira Tiago M. , Fernandes Wilson R.
Published: July 2016

Resumo: O presente trabalho teve por objetivo o estudo da influência da altitude sobre os parâmetros eletrocardiográficos obtidos por meio do uso do Holter em 40 cavalos das raças Árabe e Cruza Árabe, em diferentes níveis de condicionamento físico, realizando treinamento em trilhas de 15 km de extensão com velocidade média de 15km/h e variando entre o nível do mar até 1700m de altitude. O monitoramento eletrocardiográfico foi obtido por eletrocardiografia padrão em repouso antes do exercício e por eletrocardiografia dinâmica, com o uso do Holter, durante o exercício e na recuperação pós-exercício. Os animais apresentaram ritmo sinusal com período médio gravado para taquicardia sinusal (32%) e bradicardia sinusal (14%). Entre as arritmias observadas estão o bloqueio atrioventricular de primeiro grau (20%) e o bloqueio atrioventricular de segundo grau (5%). As arritmias ectópicas supraventriculares foram observadas em dois animais e somente um animal apresentou arritmia ventricular. O número de assistolias foi maior em animais menos condicionados. As frequências cardíacas médias e máximas sofreram efeito da altitude com valores maiores em altitude elevada.
Toxicity and oxidative stress of canine mesenchymal stromal cells from adipose tissue in different culture passages
Authors: Sprada Arícia Gomes , Rosa Matheus Pippi da , Machado Alencar Kolinski , Pippi Ney Luis , Bayard Paulo , Cruz Ivana Beatrice Mânica da
Published: July 2016

Abstract: Stem cells in regenerative therapy have received attention from researchers in recent decades. The culture of these cells allows studies about their behavior and metabolism. Thus, cell culture is the basis for cell therapy and tissue engineering researches. A major concern regarding the use of cultivated stem cell in human or veterinary clinical routine is the risk of carcinogenesis. Cellular activities require a balanced redox state. However, when there is an imbalance in this state, oxidative stress occurs. Oxidative stress contributes to cytotoxicity, which may result in cell death or genomic alterations, favoring the development of cancer cells. The aim of this study was to determine whether there are differences in the behavior of cultured mesenchymal stem cells from canine adipose tissue according to its site of collection (omentum and subcutaneous) evaluating the rate of proliferation, viability, level of oxidative stress and cytotoxicity over six passages. For this experiment, two samples of adipose tissue from subcutaneous and omentum where taken from a female dog corpse, 13 years old, Pitbull. The results showed greater levels of oxidative stress in the first and last passages of both groups, favoring cytotoxicity and cell death.
Miologia do membro pélvico da paca (Cuniculus paca Linnaeus, 1766)
Authors: Leal Leonardo M. , Sá Rafaela M. de , Oliveira Fabricio S. de , Sasahara Tais H.C. , Minto Bruno W. , Machado Marcia R.F.
Published: July 2016

Resumo: Objetivam-se descrever os músculos do membro pélvico da paca (Cuniculus paca Linnaeus, 1766), mediante dissecção anatômica dessa região. Foram utilizadas dez Cuniculus paca adultas, machos e fêmeas, pesando entre cinco e 10 kg do plantel de pacas do setor de Animais Silvestres da FCAV, Unesp, Jaboticabal/SP. Os animais foram fixados em formaldeído 10% e conservados em solução salina a 30% para dissecação anatômica da musculatura da pelve, coxa e perna, identificando-se a origem e inserção de cada músculo. Os resultados foram fotodocumentados e discutidos com base na literatura sobre animais domésticos, ratos e cobaias. Salvo algumas variâncias na origem e inserção de cada músculo e na fusão dos ventres de alguns grupos musculares, de forma geral, a musculatura da paca assemelha-se a dos animais domésticos e a de outros roedores.
Perfil bioquímico sérico de bezerros de origem leiteira aleitados com dietas líquidas alternativas
Authors: Lopes Kátia T. de L. , Lima Renata N. de , Assis Ana P.P. de , Miranda Maria V.F.G. de , Ferreira Jamile M. , Leite Hélia M. de S. , Lima Júnior Dorgival M. de , Lima Patrícia de O.
Published: July 2016

Resumo: O perfil metabólico é utilizado como monitoramento rotineiro para o diagnóstico de transtornos metabólicos, deficiências nutricionais e como preventivo de transtornos subclínicos, além da pesquisa de problemas de saúde e de desempenho de um rebanho. Neste contexto, o objetivo do presente trabalho foi avaliar a influência de diferentes dietas líquidas contendo soro de queijo e colostro sobre os perfis dos metabólitos séricos de bezerros durante a fase de aleitamento. Foram utilizados 24 bezerros mestiços provenientes de rebanhos leiteiros da região, distribuídos em delineamento inteiramente casualizado com três tratamentos e oito repetições: LI = Leite integral (controle); LS = 50% Leite integral + 50% de Soro de queijo in natura; SC = 70% de Soro de queijo in natura + 30% Colostro. Semanalmente foram coletadas amostras de sangue por punção jugular externa, no período da manhã, antes do fornecimento da dieta líquida e duas horas após a ingestão desta. As concentrações dos parâmetros séricos avaliados diferiram entre os tratamentos, porém sem comprometer o desempenho dos animais. Desse modo, a utilização de soro de queijo associado ao colostro apresenta-se como forma viável de redução de custos com aleitamento de bezerros, visto que possíveis déficits causados pelas diferenças nutricionais das dietas líquidas são supridos pelos alimentos sólidos, não afetando os perfis dos metabólitos séricos relacionados ao status protéico e energético.
Concentrações bioquímicas séricas de jacaré-açú (Melanosuchus niger) machos, adultos de vida livre
Authors: Caixeta Bruno Tolentino , Monteiro Eva Mendes , Rocha Paulo Vinícius Pereira , Santos André Luiz Quagliatto
Published: July 2016

Resumo: O jacaré-açu (Melanosuchus niger), pertencendo à família Aligatoridae, é considerado o maior predador aquático da América Continental. Como todos os répteis, possui particularidades para o uso de energia, controlando sua temperatura corporal nas variações climáticas. Essas variações podem revelar a situação metabólica atual desse animal, justificando o estudo de tais parâmetros. A importância desse trabalho se justifica pela escassez de estudos disponíveis na literatura. Nesse sentido, determinamos o perfil bioquímico de compostos sanguíneos de 12 jacarés açu, com peso de 77,66±8,92 kg, os quais foram: uréia (3,41±0,66), albumina (24,85±0,63), proteína total (63,83±16,97), ácido úrico (0,25±0,09), glicose (6,99±0,77), colesterol total (2,20±0,27), triglicérides (0,58±0,07), TGO (138,83±9,16) e TGP (12,47±2,82).
Arquitetura comparativa dos pulmões de camundongos normais e afetados pela Distrofia Muscular de Duchenne
Authors: Lessa Thais B. , Abreu Dilayla K. , Bertassoli Bruno M. , Ambrósio Carlos E.
Published: July 2016

Resumo: A Distrofia Muscular de Duchenne (DMD) é uma doença genética de caráter recessivo que caracterizada por fraqueza muscular progressiva de cintura pélvica e escapular evoluindo para insuficiência respiratória e, ou cardíaca. O camundongo mdx é um modelo amplamente utilizado para estudos da DMD. Apesar do fenótipo destes animais serem mais suave, estes apresentam o principal músculo respiratório, o diafragma com morfologia e bioquímica semelhante à DMD humana, fato este que pode comprometer a função respiratória e consequentemente os pulmões. Foi realizado um estudo anatômico descritivo do parênquima pulmonar dos pulmões de 5 animais modelo mdx comparando estes com os pulmões de 5 camundongos BALB/C57 (Mus musculus). Os pulmões foram analisados macroscopicamente e através de microscopia de luz e eletrônica de varredura. Os achados sugerem que o modelo mdx apresenta morfologia pulmonar semelhante aos camundongos BALB/C57 e que seu uso deve ser cauteloso e criterioso em ensaios clínicos que aborde este órgão.
Caracterização morfológica do trato gastrointestinal de frangos de corte da linhagem Cobb 500®
Authors: Sousa Denise C. , Oliveira Nadja L.A. , Santos Edna T. , Guzzi Anderson , Dourado Leilane R.B. , Ferreira Guilherme J.B.C.
Published: July 2016

Resumo: Caracterizou-se morfologicamente o tubo digestório de frangos de corte da linhagem Cobb 500®. O experimento foi conduzido no setor de avicultura do Colégio Técnico de Bom Jesus, Piauí, em galpão experimental. Foram utilizados oito animais aos quarenta e seis dias de idade, e avaliou-se as características morfológicas macroscópica a partir da mensuração dos órgãos do tubo digestório, essas foram avaliadas através de análise estatística descritiva e análise correlação de Pearson. A avaliação microscópica foi realizada pela análise das lâminas histológicas. Conclui-se que a linhagem Cobb 500® demonstrou estratigrafia tecidual do tubo digestório, composta por quatro túnicas: mucosa, submucosa, muscular e serosa, com exceção do esôfago e inglúvio que ao invés de possuir túnica serosa possui a adventícia. No esôfago há presença de glândulas mucosas, e no inglúvio são ausentes. O proventrículo é estruturado por várias glândulas mucosas localizadas na túnica mucosa, que drenam suas secreções em ductos secundários e primários e ao um ducto excretor em direção ao lúmen do órgão. O ventrículo possui um conteúdo queratinóide na túnica mucosa, glândulas gástricas na lâmina própria. No intestino delgado é mais visível a presença de células caliciformes no íleo, porém também estão presentes no duodeno e no jejuno. Em ambos os intestinos delgado e grosso é visível à presença de vilos, que se tornam mais curtos e largos caudalmente ao tubo digestório, apresentam em seus segmentos a presença de tecido linfático difuso e nodular, sendo estes mais evidenciados no intestino grosso.
Morfologia do escroto, do testículo e das vias espermáticas de Metachirus nudicaudatus (Geoffroy, 1803), Didelphidae-Marsupialia
Authors: Costa Suely F. , Nogueira José C. , Soares Bruno A. , Ambrósio Natália A. , Chaves Amália S. , Melo Leandra Q. de , Zangeronimo Márcio G.
Published: July 2016

Resumo: Foram utilizadas as gônadas e vias espermáticas de cinco animais machos, adultos em fase reprodutiva, da espécie Metachirus nudicaudatus Geoffroy 1803, única espécie do gênero, para descrever a morfologia do escroto, do testículo e das vias espermáticas. O Metachirus possui escroto pré-peniano e que contém os testículos permanentemente. A pele escrotal é não pigmentada e com poucos pelos e glândulas. A lâmina parietal da túnica vaginal apresenta-se pouco pigmentada. Os testículos são ovais e ligados ao epidídimo através do pedículo testículo-epididimário. Eles são envolvidos, externamente, pela cápsula testicular e sustentados por um estroma de natureza conjuntiva. As células intersticiais são os elementos predominantes no abundante tecido intertubular. Os túbulos seminíferos são largos, enovelados e envolvidos por uma túnica própria fibroelástica, contendo células mióides. O epitélio seminífero é formado pelas células espermatogênicas e de Sertoli intercaladas. Os túbulos seminíferos convergem em direção à extremidade capitata do testículo, ficando revestidos por apenas células de sustentação, caracterizando uma região de transição entre túbulos seminíferos e túbulos retos, ocupada por uma estrutura tipo "válvula" que obstrui parcialmente o lume tubular. Os túbulos retos reúnem-se para formar um único dúctulo eferente, que percorre uma pequena extensão intratesticular, atravessa a albugínea e penetra no pedículo testículo-epididimário. A parte flexuosa do dúctulo eferente forma um lóbulo separado na parte medial do corpo do epidídimo. O epidídimo é envolvido pela cápsula epididimária e constituído pelo ducto epididimário, que se encontra bastante enovelado. O ducto epididimário é revestido por epitélio simples colunar pseudoestratificado apresentando células principais, basais, apicais e de "halo claro". As células principais são predominantes e apresentam características morfológicas e histoquímicas que diferem ao longo do ducto, possibilitando a caracterização de nove diferentes zonas epididimárias. É no lume da zona sete (início da cauda) que começa o pareamento de espermatozoides. Esse fenômeno coincide com alterações morfológicas bem evidentes e uma maior quantidade de mucossubstâncias neutras é secretada nessa zona.O ducto deferente apresenta-se dividido em três partes: justa-epididimária, funicular e abdominal, baseando nas variações histológicas e histoquímicas de seu epitélio e componentes envolventes. O ducto deferente não apresenta ampola e nem cruza o ureter antes de desembocar na uretra. O funículo espermático contém o ducto deferente, artéria e veias testiculares, vasos linfáticos, nervos e um desenvolvido músculo cremáster. Seus componentes apresentam modificações estruturais nas regiões proximal, média e distal, sendo notável a peculiar rede admirável.
Argyrophilic grain disease: An update on a frequent cause of dementia
Authors: Grinberg Lea T. , Heinsen Helmut
Published: July 2016

Abstract Argyrophilic grain disease (AGD) is a sporadic, very late-onset tauopathy, accounting for approximately 4-13% of neurodegenerative dementias. AGD may manifest with a range of symptoms such as cognitive decline and behavioral abnormalities. To date, no study has been able to demonstrate a distinct clinical syndrome associated with AGD. The diagnosis is exclusively based on postmortem findings, the significance of which remains controversial because up to 30% of AGD cases are diagnosed in subjects without any cognitive impairment, while AGD findings often overlap with those of other neurodegenerative processes. Nevertheless, the presence of AGD is likely to have a significant effect on cognitive decline. The neuropathological hallmarks of AGD are argyrophilic grains, pre-neurofibrillary tangles in neurons and coiled bodies in oligodendrocytes found mainly in the entorhinal cortex and hippocampus. This review aims to provide an up-to-date overview of AGD, emphasizing pathological aspects. Additionally, the findings of a Brazilian case series are described.
Normal pressure hydrocephalus: Diagnostic and predictive evaluation
Authors: Damasceno Benito Pereira
Published: July 2016

Abstract In typical cases, normal pressure hydrocephalus (NPH) manifests itself with the triad of gait disturbance, which begins first, followed by mental deterioration and urinary incontinence associated with ventriculomegaly (on CT or MRI) and normal cerebrospinal fluid (CSF) pressure. These cases present minor diagnostic difficulties and are the most likely to improve after shunting. Problems arise when NPH shows atypical or incomplete clinical manifestations (25-50% of cases) or is mimicked by other diseases. In this scenario, other complementary tests have to be used, preferentially those that can best predict surgical outcome. Radionuclide cisternography, intracranial pressure monitoring (ICP) and lumbar infusion tests can show CSF dynamics malfunction, but none are able to confirm whether the patient will benefit from surgery. The CSF tap test (CSF-TT) is the only procedure that can temporarily simulate the effect of definitive shunt. Since the one tap CSF-TT has low sensitivity, it cannot be used to exclude patients from surgery. In such cases, we have to resort to a repeated CSF-TT (RTT) or continuous lumbar external drainage (LED). The most reliable prediction would be achieved if RTT or LED proved positive, in addition to the occurrence of B-waves during more than 50% of ICP recording time. This review was based on a PubMed literature search from 1966 to date. It focuses on clinical presentation, neuroimaging, complementary prognostic tests, and differential diagnosis of NPH, particularly on the problem of selecting appropriate candidates for shunt.
Cognitive impairment in Wilson's disease
Authors: Frota Norberto Anizio Ferreira , Caramelli Paulo , Barbosa Egberto Reis
Published: July 2016

Abstract Wilson's disease (WD) or hepatolenticular degeneration is a rare, genetic and systemic disease, caused by a deficit in the metabolism of copper, leading to its accumulation in different organs, mainly the liver, followed by the central nervous system, especially the basal ganglia. When symptoms begin between the second and third decades of life, approximately 50% of the patients show neurological symptoms. Although dystonia and dysarthria are the most common neurological signs, cognitive changes have been reported since the first cases were described in 1912. Memory change is one of the most common impairments, but other cognitive changes have been reported, including dementia in untreated cases. In this article we review the cognitive changes in WD patients and the occurrence of dementia.
Stroke and brain atrophy in chronic Chagas disease patients: A new theory proposition
Authors: Oliveira-Filho Jamary
Published: July 2016

Abstract Chagas disease (CD) remains a major cause of cardiomyopathy and stroke in developing countries. Brain damage in CD has been attributed exclusively to the effects of structural heart disease on the brain, including cardioembolism and low cardiac output symptoms. However, CD patients also develop stroke and brain atrophy independently of cardiac disease severity. Chronic inflammation directed against T. cruzi may act as a trigger for endothelial damage, platelet activation, acceleration of atherosclerosis and apoptosis, all of which lead to stroke and brain atrophy. In the present article, evidence supporting this new theory is presented, along with considerations towards mechanistically-based targeted treatment.
Cognitive dysfunction in chronic Chagas disease cardiomyopathy
Authors: Dias Jesângeli Sousa , Lacerda Amanda M. , Vieira-de-Melo Rodrigo M. , Viana Leila C. , Jesus Pedro A.P. , Reis Francisco J.F.B. , Nitrini Ricardo , Charchat-Fichman Helenice , Lopes Antônio A. , Oliveira-Filho Jamary
Published: July 2016

Abstract Chagas disease (CD) remains a major cause of stroke in developing countries, but cognitive repercussion of CD has not been well studied. Objective: To compare the frequency and pattern of cognitive dysfunction in patients with CD cardiomyopathy (CDC) and other cardiomyopathies (OC). Methods: We studied 37 patients with CDC and 42 patients with OC with similar age, educational level and cardiac systolic function. Cognitive tests were applied to both groups by a single examiner blinded to CD status. Logistic regression multivariable models were constructed to ascertain predictors of cognitive dysfunction for each test. Results: Cognitive dysfunction was detected in 9 (24%) CDC patients and 6 (14%) OC patients by Mini Mental State Exam (MMSE) corrected for educational level. Independent predictors of abnormal MMSE (p <0.05) included stroke history (OR=5.51; 95% CI=1.27-24.01) and digoxin use (OR=0.23, 95% CI=0.06-0.89), while CD showed a trend toward statistical significance (OR=4.63; 95% CI=0.87-24.73, p =0.07). Delayed recall of Rey's Complex Figure Test was significantly worse in CD patients, where this remained a significant predictor in the multivariable analysis (OR=4.67; 95% CI=1.23-17.68). Conclusions: Cognitive dysfunction is frequent in Chagas disease and should be considered as an outcome measure in Chagas disease studies.
Lack of executive function deficits among adult ADHD individuals from a Brazilian clinical sample
Authors: Saboya Eloisa , Coutinho Gabriel , Segenreich Daniel , Ayrão Vanessa , Mattos Paulo
Published: July 2016

Abstract Executive function deficits have been previously documented in individuals with Attention Deficit Hyperactivity Disorder (ADHD). Objective: The current study aimed to compare measures of executive functions among a clinical sample of adults with ADHD and normal control subjects, matched for age, gender and education. Methods: Twenty-three self-referred adults diagnosed with ADHD according to DSM-IV criteria, and twenty-five control subjects were assessed using a neuropsychological battery which included the Wisconsin Card Sorting Test, Tower of Hanoi, Digit Span, Trail Making Test (A and B), Stroop Test and Raven's Progressive Matrices. Results: The ADHD group did not differ significantly from the control subjects on any of the measures assessed. Conclusion: Measures of executive functions using this test battery were unable to discriminate between adults with ADHD and control subjects in this clinical sample.
Do attention deficit/hyperactivity disorder symptoms exist among Brazilian indigenous children?
Authors: Azevêdo Paulo Verlaine Borges e , Caixeta Leonardo Ferreira
Published: July 2016

Abstract The validity of the clinical constructs of attention deficit hyperactivity disorder (ADHD) has been generalized for all human populations of different cultures worldwide. Yet important population groups have yet to be adequately studied so as to definitively confirm this generalization. Objective: To investigate the presence of symptoms of ADHD in children living within an indigenous community. Methods: We performed interviews in a bid to screen for symptoms of ADHD among settlement-dwelling indigenous children of the Karajá ethnic group in the Brazilian Amazonian Region. Results: Three narratives are presented highlighting the classical symptomatological triad of ADHD: inattentiveness, hyperactivity and impulsiveness. Conclusions: Some of ADHD's major characteristics, described in the most common disease classification worldwide, are clearly described by children of this population. We concluded that ADHD symptoms are present in this population which diverges greatly in cultural issues compared to the Western world
Age and educational level effects on the performance of normal elderly on category verbal fluency tasks
Authors: Fichman Helenice Charchat , Fernandes Conceição Santos , Nitrini Ricardo , Lourenço Roberto Alves , Paradela Emylucy Martins de Paiva , Carthery-Goulart Maria Teresa , Caramelli Paulo
Published: July 2016

Abstract Cognitive decline, particularly executive dysfunction, is observed in normal aging. In Brazil, the elderly population presents broad educational diversity. Category verbal fluency tests are frequently used to detect cognitive impairment, assessing executive function, language and semantic memory. Objective: To investigate the effects of age and education on category animal fluency task (CAF) in healthy elderly. Methods: We evaluated 319 healthy elderly from outpatient care units of two university reference centers of Rio de Janeiro and São Paulo. The sample was divided into two age, and five schooling subgroups. To be included participants had to demonstrate preservation of global cognitive functioning, independence for activities of daily living and not fulfill diagnostic criteria for dementia. All participants were submitted to neurological and neuropsychological evaluations. Results: There was a correlation between age and CAF performance (r= -0.26, p<0.01), which was not confirmed when years of education were included as a covariant in univariate ANCOVA. Significant differences were found in CAF performance among the different educational level groups on correlation analysis (r=0.42, p<0.01) and ANCOVA analysis (F=18.8, p<0.05). Illiteracy was associated with worst CAF performance, while university level was associated with best performance. Conclusion: The best CAF performance was found in the first years of schooling (literacy learning process) compared to illiteracy, and when finishing high school and starting university courses compared to all other educational levels. These stages are associated with significant gains in semantic memory and executive function which are critical for verbal fluency performance.
Normative data for healthy elderly on the phonemic verbal fluency task - FAS
Authors: Machado Thais Helena , Fichman Helenice Charchat , Santos Etelvina Lucas , Carvalho Viviane Amaral , Fialho Patrícia Paes , Koenig Anne Marise , Fernandes Conceição Santos , Lourenço Roberto Alves , Paradela Emylucy Martins de Paiva , Caramelli Paulo
Published: July 2016

Abstract Phonemic verbal fluency tests assess the production of words beginning with specific letters. Of these letters, the most frequently used are F, A and S. It is a sensitive test for assessing frontal lobe functions. Objective: To provide normative data for the elderly Brazilian population on the FAS test and to investigate the effects of age and schooling on test performance. Methods: The individuals were divided into three age groups (60-69, 70-79 and ³80 years), and into four groups according to education (1-3, 4-7, 8-11 and ³12 years). All subjects were assessed by the Mini Mental State Examination and the FAS. Data were analyzed with Student's t test, ANOVA, simple linear regression and Spearman's correlation. Results: We evaluated 345 cognitively healthy volunteers, 66.66% being female, aged 60 to 93 years, with an educational level ranging from one to 24 years. The average (number of items) ±SD for the whole sample was 28.28±11.53. No significant effect of gender was observed (p=0.5). Performance on the MMSE and education exerted a direct influence on FAS scores (p<0.001), with education being the most significant factor. A positive correlation was found between FAS and the MMSE (r=0.404; p<0.001). Conclusion: The performance of Brazilian elderly on the phonemic verbal fluency tests-FAS is significantly influenced by education, where individuals with higher educational level present better performance than those with fewer years of schooling. Age and gender did not prove significant with the FAS.
Charles Bonnet Syndrome: Case series
Authors: Brucki Sonia Maria Dozzi , Takada Leonel Tadao , Nitrini Ricardo
Published: July 2016

Abstract Since its first description in 1760, Charles Bonnet syndrome (CBS) has been reported in many studies. The main characteristics are visual hallucinations, preserved awareness of unreal visions, and absence of psychotic symptoms. CBS can occur with lesions located anywhere along the central visual pathway, from the eye to the calcarine fissure. Objective: To describe patients with CBS and carry out a review of the literature. Methods: Six patients with visual hallucinations were evaluated in an outpatient memory clinic between 2001 and 2008, and their clinical characteristics recorded. Results: Four patients were female, and the mean age was 74.5±16.9 years. Three patients had visual loss secondary to eye disease and three due to cerebral lesions. The visions consisted of animals, persons, moving objects, bizarre creatures or colored forms, and were considered disturbing by five patients. Five patients received treatment, and only three reported partial benefit from the therapy. Complete recovery was not seen in any of the subjects. Conclusions: CBS is relatively rare and its recognition is important to avoid misdiagnoses with psychiatric or dementing illnesses.
Dementia post-radiotherapy: improvement with acetylcholinesterase inhibitor A case report
Authors: Damin Antonio Eduardo , Morillo Lílian S. , Perroco Tíbor Rilho , Jacob Filho Wilson , Bottino Cássio Machado de Campos
Published: July 2016

Abstract Cognitive decline associated with radiotherapy is a progressive complication that affects many patients submitted to this form of treatment. The lack of an effective treatment drives research for new treatment options to improve the quality of life of patients with this disorder. We report the case of a 64 year-old man who developed a severe dementia of the frontal subcortical type, which was associated with subcortical frontal lesions and appeared as a late complication of radiotherapy used to treat a pituitary tumor. After many pharmacological attempts to improve his cognitive and behavioral problems, the patient showed a significant improvement in the cognitive, functional and behavioral impairments after treatment with an acetylcholinesterase inhibitor. This report discusses hypotheses for the positive effect of this treatment.
The Clock Drawing Test A review of its accuracy in screening for dementia
Authors: Aprahamian Ivan , Martinelli José Eduardo , Neri Anita Liberalesso , Yassuda Mônica Sanches
Published: July 2016

Abstract The Clock Drawing Test (CDT) is a simple neuropsychometric instrument that can be easily applied to assess several cognitive functions. Over the past 20 years, the CDT has aroused considerable interest in its role for the early screening of cognitive impairment, especially in dementia. Although the CDT is considered an accurate test for dementia screening, recent studies including comparisons with structured batteries such as the CAMCOG have shown mixed results. Objectives: To investigate the importance of the CDT compared to other commonly used tests, in the diagnosis of dementia in the elderly; (2) to evaluate the reliability and correlation between available CDT scoring scales from recent studies. Methods: A systematic search in the literature was conducted in September 2008 for studies comparing CDT scoring systems and comparing the CDT with neuropsychiatric batteries. Results: Twelve studies were selected for analyses. Seven of these studies compared CDT scoring scales while five compared the CDT against the CAMCOG and the MMSE. Eight studies found good correlation and reliability between the scales and the other tests. Conclusion: Despite the mixed results in these studies, the CDT appears to be a good screening test for dementia.
The performance of the Mini-Cog in a sample of low educational level elderly
Authors: Ribeiro Filho Sergio Telles , Lourenço Roberto Alves
Published: July 2016

Abstract Objectives: To study the criterion validity of the Mini-Cog in low educational level elderly. Design: Cross-sectional and validation design. Setting: Policlínica Piquet Carneiro, an outpatient unit of Rio de Janeiro State University Hospital, in Brazil. Participants: A convenient sample consisting of 306 individuals, 65 yrs or older, selected from April 8th to July 15th, 2002. Methods: All participants underwent comprehensive geriatric evaluations which included the Mini-Mental State Examination (MMSE) and the cognitive part of the Cambridge Examination for Mental Disorders of the Elderly - Revised (CAMCOG-R). They were classified as demented or non-demented (DSM-IV). A post-hoc analysis was performed on the data from the 3 word recall test of the MMSE, and the Clock Drawing Test from the CAMCOG-R, and respective scores were added and interpreted in accordance with the Mini-Cog protocol. Results: 293 individuals completed all the study steps; 211 had 4 or less years of schooling and were included in the data analysis. 32% had dementia. Mini-Cog sensitivity and specificity was consistently low independently of the different cut-off points considered. The best performance was found at the cut-off point of 2/3 which yielded sensitivity and specificity of 60% and 65%, respectively. Conclusion: The Mini-Cog is not a good cognitive screening tool for individuals with less than five years of formal education.
Evaluation of Mini-Mental State Examination scores according to different age and education strata, and sex, in a large Brazilian healthy sample
Authors: Kochhann Renata , Cerveira Maria Otília , Godinho Cláudia , Camozzato Analuiza , Chaves Márcia Lorena F.
Published: July 2016

Abstract Until better measures have been accepted for wider use, the Mini-Mental State Examination (MMSE) will continue to be utilized. In this context, knowledge on characteristics and determinants of its distribution for the Brazilian population are particularly valuable. The present study aimed to evaluate, based on multivariate analysis, the independent effect of age, educational level and sex, and their interactions, on MMSE scores in a healthy sample. Methods: Demographic data and scores on the MMSE of 1,553 healthy individuals were analyzed. The sample was grouped according to age and education. Results: The sample was composed of 963 females (62%), mean age ±SD was 49.6±20.7 yrs (range 20 to 92 yrs). The mean years of education ±SD was 8.9±5.5 yrs (range 0 to 28 yrs). The mean score ±SD on the MMSE was 27.3±2.7 (range 15 to 30). A significant effect of the interaction between education and sex (p=0.011), and also between education and age was observed (p=0.003). An independent effect of education (p<0.001) and age (p<0.001) was found. Participants from the higher educated group presented higher MMSE scores than the other groups. Younger adults presented higher MMSE scores than the other age groups. Conclusions: We observed an effect of education and age on MMSE scores. Younger individuals and higher educated participants presented higher scores.
Comprehension and storage of sequentially presented radio news items by healthy elderly
Authors: Bonini Milena Vaz , Mansur Letícia Lessa
Published: July 2016

Abstract In the normal aging processes, complaints of memory loss and auditory comprehension are not uncommon, principally in complex and cognitively demanding situations. Objective: The objective of this study was to investigate skills of discourse comprehension and retention in a natural situation, by healthy aged in relation to variables such as age, schooling and cognitive screening measurement. Methods: Thirty healthy elderly participated in the study (mean age=73.56 yrs; SD=6.26 and mean schooling=8.6 yrs; SD=4.41). Twelve news items were recorded and presented in three sequences of four news-groups. Participants were instructed to listen to the four news items, and upon completion were questioned about one of them. Results: We found no age or schooling effect on the performance of the subjects. The participants achieved almost full scores on all answers (ceiling effect). Discussion: The heterogeneity of elderly and cognitive compensation in natural situations could explain these results of elderly behavior.
Cognitive training in older adults with Mild Cognitive Impairment: Impact on cognitive and functional performance
Authors: Brum Paula Schimidt , Forlenza Orestes Vicente , Yassuda Mônica Sanches
Published: July 2016

Abstract Aging is associated with cognitive decline, yet this does not prevent older adults from finding ways to compensate for age-related deficits. Earlier studies have shown that cognitively unimpaired older adults can benefit from training programs. The efficacy of cognitive interventions among older adults without dementia but with cognitive decline (mild cognitive impairment, MCI) has not yet been widely tested. Objectives: To evaluate the impact of 8-session cognitive training on the cognitive and functional performance of older adults with MCI. Methods: 16 older adults diagnosed with MCI received cognitive training (18 participated as controls). All participants were assessed pre and post intervention using the Short Cognitive Test (SKT), Direct Assessment of Functional Scale Revised (DAFS-R), Geriatric Depression Scale (GDS), and Clock Drawing Test (CDT). Results: A significant improvement was observed in the study group between pre and post-test in attention (SKT), time orientation, shopping skills and dealing with finances (DAFS-R) along with reduced depressive symptoms (GDS). Conclusion: These results indicate the importance of non-pharmacological interventions for older adults with MCI to help compensate for cognitive decline.
Cognitive dysfunction in spinocerebellar ataxias
Authors: Teive Helio Afonso Ghizoni , Arruda Walter Oleschko
Published: July 2016

Abstract Spinocerebellar ataxias (SCAs) comprise a heterogeneous group of complex neurodegenerative diseases, characterized by the presence of progressive cerebellar ataxia, associated or otherwise with ophthalmoplegia, pyramidal signs, extrapyramidal features, pigmentary retinopathy, peripheral neuropathy, cognitive dysfunction and dementia. Objective: To verify the presence of cognitive dysfunction among the main types of SCA described in the literature. Methods: the review was conducted using the search system of the PUBMED and OMIM databases. Results: Cognitive dysfunction occurs in a considerable proportion of SCA, particularly in SCA 3, which is the most frequent form of SCA worldwide. Dementia has been described in several other types of SCA such as SCA 2, SCA 17 and DRPLA. Mental retardation is a specific clinical feature of SCA 13. Conclusions: The role of the cerebellum in cognitive functions has been observed in different types of SCAs which can manifest varying degrees of cognitive dysfunction, dementia and mental retardation.
Neurobiological pathways to Alzheimer's disease: Amyloid-beta, TAU protein or both?
Authors: Paula Vanessa de Jesus R. de , Guimarães Fabiana Meira , Diniz Breno Satler , Forlenza Orestes Vicente
Published: July 2016

Abstract Alzheimer's disease (AD) is a neurodegenerative disease characterized by progressive cognitive decline, including memory loss, behavioral and psychological symptoms and personality changes. The neuropathological hallmarks of AD are the presence of neuritic (senile) plaques (NP) and neurofibrillary tangles (NFT), along with neuronal loss, dystrophic neurites, and gliosis. Neuritic plaques are extracellular lesions and their main constituent is the amyloid-b42 peptide (Ab42). Neurofibrillary tangles are intracellular lesions that are mainly composed of hyperphosphorylated TAU protein. In this article, we review the major hypotheses concerning the physiopathology of AD, focusing on the b-amyloid cascade as primary events (supported by the "baptists") and cytoskeletal abnormalities secondary to the hyperphosphorylation of protein TAU (as advocated by the "Tauists"). We further provide an integrative view of the physiopathology of AD.
Physical activity and cognition in the elderly: A review
Authors: Busse Alexandre Leopold , Gil Gislaine , Santarém José Maria , Jacob Filho Wilson
Published: July 2016

Abstract Physical activity has been indicated as a strategy to promote health in the elderly, as well as to encourage the maintenance of functional capacity, and acts in the prevention and control of various diseases. In recent years, there has been great interest in studying the benefits of physical activity in the preservation or even improvement of cognitive performance in both the elderly without cognitive impairment and in elderly patients with some degree of cognitive impairment or dementia. The majority of epidemiological studies and clinical trials have evaluated aerobic exercises while few have assessed resistance exercise programs. The objective of this review was to examine the effects of different types of physical activity on cognitive function of elderly individuals with or without prior impairment.