bluuebunny/crossref_metadata_2025 huggingface dataset:
A articulação entre a avaliação somativa e a formativa, na prática pedagógica: uma impossibilidade ou um desafio?
Authors: Santos Leonor
Published: July 2016

Resumo A avaliação somativa das aprendizagens dos alunos é, em muitos países, um imperativo. A avaliação formativa, embora recomendada pelos documentos curriculares e pela investigação, acontece de forma esporádica na sala de aula. A articulação entre estas duas modalidades de avaliação é, nos dias de hoje, ainda pouco estudada. O propósito deste artigo é o de problematizar e discutir respostas conducentes a uma possível articulação. Recorrerei à educação matemática para ilustrar certas situações de prática. A partir destas e da reflexão sobre os aportes teóricos usados, proporei um conjunto de princípios orientadores que nortearão a articulação entre a avaliação somativa e formativa, aqui entendida como um processo em complementaridade, em relação, e não em simultaneidade.
Educação Profissional e Tecnológica: análises e perspectivas da LDB/1996 à CONAE 2014
Authors: Afonso Anthone Mateus Magalhães , Gonzalez Wania Regina Coutinho
Published: July 2016

Resumo Esse artigo tem como objetivo analisar a concepção de Educação Profissional e Tecnológica no Brasil em documentos recentes de grande importância nas definições das políticas públicas de ensino. É realizada uma análise documental compreendendo a Lei de Diretrizes e Bases da Educação – Lei no 9.394/1996, os decretos no 2.208/1997 e no 5.154/2004, a Lei no 13.005/2014, que trata do Plano Nacional de Educação no decênio 2014-2024, e os documentos final e referência das Conferências Nacionais de Educação de 2010 e 2014. Nesses documentos, foram encontrados e destacados alguns indícios de defesa de diferentes concepções de Educação Profissional e Tecnológica, e identificada uma grande importância conferida às Conferências Nacionais de Educação na articulação e construção das políticas educacionais e do Plano Nacional de Educação vigente.
Impact of respiratory therapy in vital capacity and functionality of patients undergoing abdominal surgery
Authors: Fernandes Shanlley Cristina da Silva , Santos Rafaella Souza dos , Giovanetti Erica Albanez , Taniguchi Corinne , Silva Cilene Saghabi de Medeiros , Eid Raquel Afonso Caserta , Timenetsky Karina Tavares , Carnieli-Cazati Denise
Published: July 2016

ABSTRACT Objective To evaluate the vital capacity after two chest therapy techniques in patients undergoing abdominal surgical. Methods A prospective randomized study carried out with patients admitted to the Intensive Care Unit after abdominal surgery. We checked vital capacity, muscular strength using the Medical Research Council scale, and functionality with the Functional Independence Measure the first time the patient was breathing spontaneously (D1), and also upon discharge from the Intensive Care Unit (Ddis). Between D1 and Ddis, respiratory therapy was carried out according to the randomized group. Results We included 38 patients, 20 randomized to Positive Intermittent Pressure Group and 18 to Volumetric Incentive Spirometer Group. There was no significant gain related to vital capacity of D1 and Ddis of Positive Intermittent Pressure Group (mean 1,410mL±547.2 versus 1,809mL±692.3; p=0.979), as in the Volumetric Incentive Spirometer Group (1,408.3mL±419.1 versus 1,838.8mL±621.3; p=0.889). We observed a significant improvement in vital capacity in D1 (p<0.001) and Ddis (p<0.001) and in the Functional Independence Measure (p<0.001) after respiratory therapy. The vital capacity improvement was not associated with gain of muscle strength. Conclusion Chest therapy, with positive pressure and volumetric incentive spirometer, was effective in improving vital capacity of patients submitted to abdominal surgery.
Auditory evoked potential P300 in adults: reference values
Authors: Didoné Dayane Domeneghini , Garcia Michele Vargas , Oppitz Sheila Jacques , Silva Thalisson Francisco Finamôr da , Santos Sinéia Neujahr dos , Bruno Rúbia Soares , Filha Valdete Alves Valentins dos Santos , Cóser Pedro Luis
Published: July 2016

ABSTRACT Objective To establish reference intervals for cognitive potential P300 latency using tone burst stimuli. Methods This study involved 28 participants aged between 18 and 59 years. P300 recordings were performed using a two-channel device (Masbe, Contronic). Electrode placement was as follows: Fpz (ground electrode), Cz (active electrode), M1 and M2 (reference electrodes). Intensity corresponded to 80 dB HL and frequent and rare stimulus frequencies to 1,000Hz and 2,000Hz, respectively. Stimuli were delivered binaurally. Results Mean age of participants was 35 years. Average P300 latency was 305ms. Conclusion Maximum acceptable P300 latency values of 362.5ms (305 + 2SD 28.75) were determined for adults aged 18 to 59 years using the protocol described.
Impact of dental orientation given to mothers during pregnancy on oral health of their children
Authors: Rigo Lilian , Dalazen Jaqueline , Garbin Raíssa Rigo
Published: July 2016

ABSTRACT Objective To analyze the perception of mothers about oral health of their children, as well as to check the influence of demographic variables, perception and preventive practice in oral health of mothers regarding guidance received during pregnancy. Methods Quantitative and cross-sectional field study, with a non-probability sample formed by all mothers who attended the primary healthcare unit of Ijuí (RS), Brazil, from January to July 2014, comprising a sample of 79 women. Self-applied questionnaires were given to these mothers. Data analysis was carried out using descriptive and inferential statistics, the χ2 test at a significance level of 5%. Results The mothers who received dental orientation during pregnancy had greater perception of oral health of their children. The mean age of mothers was 26 years, most of them attended high school education (32.9%) and worked outside the home (60.8%). There was a statistically significant relation between the outcome variable, dental orientation during pregnancy, and the independent variables: schooling level of mothers, occupation, baby’s first visit to the dentist, duration of breastfeeding, beginning of baby’s tooth brushing and knowledge about dental decay (p<0.005). Conclusion Mothers with higher schooling levels and who worked outside the home had more knowledge about oral care, because they received dental orientation during pregnancy. The dental guidance during pregnancy influences the mother in the procedures adopted with their children, as to early oral hygiene, first dentist appointment, duration of breastfeeding, knowledge about the factors that lead to dental decay.
Assessment of nurse’s knowledge about Glasgow coma scale at a university hospital
Authors: Santos Wesley Cajaíba , Vancini-Campanharo Cássia Regina , Lopes Maria Carolina Barbosa Teixeira , Okuno Meiry Fernanda Pinto , Batista Ruth Ester Assayag
Published: July 2016

ABSTRACT Objective To assess knowledge of nurses of emergency services and intensive care units about Glasgow Coma Scale. Methods This cross-sectional analytical study included 127 nurses of critical units of an university hospital. We used structured interview with 12 questions to evaluate their knowledge about the scale. Association of Knowledge with professionals’ sociodemographic variables were verified by the Fisher-test, χ2 and likelihood ratio. Results Most of participants were women mean aged 31.1 years, they had graduated more than 5 years previously, and had 1 to 3 years of work experience. In the assessment of best score possible for Glasgow scale (question 3) nurses who had graduate more than 5 years ago presented a lower percentage success rate (p=0.0476). However, in the question 7, which evaluated what interval of the scale indicated moderate severity of brain trauma injury, those with more years of experience had higher percentage of correct answers (p=0.0251). In addition, nurses from emergency service had more correct answers than nurses from intensive care unit (p=0.0143) in the same question. Nurses graduated for more than 5 years ago had a lower percentage of correct answers in question 7 (p=0.0161). Nurses with more work experience had a better score (p=0.0119) to identify how assessment of motor response should be started. Conclusion Number of year since graduation, experience, and work at critical care units interfered in nurses’ knowledge about the scale, which indicates the need of training.
Pain assessment in elderly with dementia: Brazilian validation of the PACSLAC scale
Authors: Thé Karol Bezerra , Gazoni Fernanda Martins , Cherpak Guilherme Liausu , Lorenzet Isabel Clasen , Santos Luciana Alves dos , Nardes Edlene Maria , Santos Fânia Cristina dos
Published: July 2016

ABSTRACT Objective To validate the Pain Assessment Checklist for Seniors with Limited Ability to Communicate – Portuguese in demented elderly and to analyze its measurement properties. Methods We evaluated 50 elderly with dementia, residing in a nursing home and with limited communication ability, when exposed to potentially painful situations. The tool was applied at two different moments. First, two interviewers applied it simultaneously, and the intensity of pain was asked based on the caregiver’s opinion. After 14 days, with no analgesic intervention, one of the interviewers applied it again. Results The sample comprised more females, aged over 80 years, with dementia due to Alzheimer, presenting musculoskeletal pain of moderate to severe intensity. The psychometric properties of the tool demonstrated appropriate internal consistency (Cronbach’s alpha coefficient of 0.827). The scale had excellent reproducibility, according to the intraclass correlation coefficient, and the tool has been duly validated. Conclusion The Pain Assessment Checklist for Seniors with Limited Ability to Communicate – Portuguese had adequate measuring properties for use with elderly presenting limited communication.
Endovascular revascularization of TASC C and D femoropopliteal occlusive disease using carbon dioxide as contrast
Authors: Mendes Cynthia de Almeida , Teivelis Marcelo Passos , Kuzniec Sergio , Fukuda Juliana Maria , Wolosker Nelson
Published: July 2016

ABSTRACT Objective To analyze the results of ten angioplasties of TASC C and D femoropopliteal lesions using CO2 as primary contrast in patients with no formal contraindication to iodine, aiming to decrease allergic reactions and potential nephrotoxicity in high-risk patients. Methods We describe the results of ten angioplasties of TASC C and D femoropopliteal lesions using CO2 as primary contrast in patients with high risk for open revascularization and no formal contraindication to iodine. We analyzed feasibility of the procedures, complications, quality of the angiographic images, clinical and surgical outcomes, and costs of C and D lesions treated using CO2 as contrast medium. Results The use of CO2 in C and D lesions needed iodine complementation in most of the cases (nine cases) but decreased the potential nephrotoxicity of iodine contrast medium by the reduction of its volume in this group of high-risk patients. The extension of the arterial lesions was the factor that most contributed to the need for iodine supplementation due to the difficulty to visualize the refill after a long arterial occlusion. Conclusion The use of CO2 as contrast in patients with C and D lesions with no restriction for iodine contrast medium was an alternative that did not dismiss the need of iodine supplementation in most of the cases, but could decrease the potential nephrotoxicity of iodine constrast medium.
The destruction complex of beta-catenin in colorectal carcinoma and colonic adenoma
Authors: Bourroul Guilherme Muniz , Fragoso Hélio José , Gomes José Walter Feitosa , Bourroul Vivian Sati Oba , Oshima Celina Tizuko Fujiyama , Gomes Thiago Simão , Saba Gabriela Tognini , Palma Rogério Tadeu , Waisberg Jaques
Published: July 2016

ABSTRACT Objective To evaluate the destruction complex of beta-catenin by the expression of the proteins beta-catetenin, adenomatous polyposis coli, GSK3β, axin and ubiquitin in colorectal carcinoma and colonic adenoma. Methods Tissue samples from 64 patients with colorectal carcinoma and 53 patients with colonic adenoma were analyzed. Tissue microarray blocks and slides were prepared and subjected to immunohistochemistry with polyclonal antibodies in carcinoma, adjacent non-neoplastic mucosa, and adenoma tissues. The immunoreactivity was evaluated by the percentage of positive stained cells and by the intensity assessed through of the stained grade of proteins in the cytoplasm and nucleus of cells. In the statistical analysis, the Spearman correlation coefficient, Student’s t, χ2, Mann-Whitney, and McNemar tests, and univariate logistic regression analysis were used. Results In colorectal carcinoma, the expressions of beta-catenin and adenomatous polyposis coli proteins were significantly higher than in colonic adenomas (p<0.001 and p<0.0001, respectively). The immunoreactivity of GSK3β, axin 1 and ubiquitin proteins was significantly higher (p=0.03, p=0.039 and p=0.03, respectively) in colorectal carcinoma than in the colonic adenoma and adjacent non-neoplastic mucosa. The immunohistochemistry staining of these proteins did not show significant differences with the clinical and pathological characteristics of colorectal cancer and colonic adenoma. Conclusions These results suggest that, in adenomas, the lower expression of the beta-catenin, axin 1 and GSK3β proteins indicated that the destruction complex of beta-catenin was maintained, while in colorectal carcinoma, the increased expression of beta-catenin, GSK3β, axin 1, and ubiquitin proteins indicated that the destruction complex of beta-catenin was disrupted.
Is the algorithm used to process heart rate variability data clinically relevant? Analysis in male adolescents
Authors: Soares Antonio Henrique Germano , Farah Breno Quintella , Cucato Gabriel Grizzo , Bastos-Filho Carmelo José Albanez , Christofaro Diego Giulliano Destro , Vanderlei Luiz Carlos Marques , Lima Aluísio Henrique Rodrigues de Andrade , Ritti-Dias Raphael Mendes
Published: July 2016

ABSTRACT Objective To analyze whether the algorithm used for the heart rate variability assessment (fast Fourier transform versus autoregressive methods) influenced its association with cardiovascular risk factors in male adolescents. Methods This cross-sectional study included 1,152 male adolescents (aged 14 to 19 years). The low frequency, high frequency components (absolute numbers and normalized units), low frequency/high frequency ratio, and total power of heart rate variability parameters were obtained using the fast Fourier transform and autoregressive methods, while the adolescents were resting in a supine position. Results All heart rate variability parameters calculated from both methods were different (p<0.05). However, a low effect size (<0.1) was found for all parameters. The intra-class correlation between methods ranged from 0.96 to 0.99, whereas the variation coefficient ranged from 7.4 to 14.8%. Furthermore, waist circumference was negatively associated with high frequency, and positively associated with low frequency and sympatovagal balance (p<0.001 for both fast Fourier transform and autoregressive methods in all associations). Systolic blood pressure was negatively associated with total power and high frequency, whereas it was positively associated with low frequency and sympatovagal balance (p<0.001 for both fast Fourier transform and autoregressive methods in all associations). Body mass index was negatively associated with high frequency, while it was positively associated with low frequency and sympatovagal balance (p values ranged from <0.001 to 0.007). Conclusion There are significant differences in heart rate variability parameters obtained with the fast Fourier transform and autoregressive methods in male adolescent; however, these differences are not clinically significant.
Initial experience with hysteroscopic tubal occlusion (Essure®)
Authors: Depes Daniella De Batista , Pereira Ana Maria Gomes , Lippi Umberto Gazi , Martins João Alfredo , Lopes Reginaldo Guedes Coelho
Published: July 2016

ABSTRACT Objective To evaluate results of early tubal occlusions performed by hysteroscopy (Essure®). Methods This prospective study included 38 patients, 73.7% of them were white, mean age 34.5 years, they have had on average 3 pregnancies and 2.7 of deliveries. A total of 86.8% of patients previously prepared the endometrium. All procedures were carried out at outpatient unit without anesthesia. Results Insertion rate of the device was 100% at a mean time of 4 minutes and 50 seconds. Based on the analogical visual scale, average pain reported was three, and 55.3% of women did not report pain after the procedure. After 3 months, 89.5% of patients were very satisfied with the method. Simple radiographs of the pelvis showed 92.1% of topical devices, and one case of unilateral expulsion had occurred. A four years follow-up did not show failure in the method. Conclusions Tubal occlusion through hysteroscopy at outpatient unit and without anesthesia was a quickly and well-tolerated procedure. No serious complications were seen, the success rate was high, and patients were satisfied.
An update on clinical oncology for the non-oncologist
Authors: Kaliks Rafael Aliosha
Published: July 2016

ABSTRACT Recent advances in the understanding of tumor driver mutations, signaling pathways that lead to tumor progression, and the better understanding of the interaction between tumor cells and the immune system are revolutionizing cancer treatment. The pace at which new treatments are approved and the prices at which they are set have made it even more difficult to offer these treatments in countries like Brazil. In this review we present for the non-oncologist these new treatments and compare their availability in Brazilian public health system and private health system with that of developed countries.
The advances and new technologies for the study of mitochondrial diseases
Authors: Bianco Bianca , Montagna Erik
Published: July 2016

ABSTRACT Genetic mitochondrial disorders are responsible for the most common inborn errors of metabolism, caused by mutations in either nuclear genes or in mitochondrial DNA. This article presents the prokaryotic origin of the organelle and the relation between nuclear and mitochondrial genomes, as well as current evolutionary models for such mechanisms. It also addresses the structure of mitochondrial genes, their expression pattern, clinical features of gene defects, risk of transmission and current techniques to avoid these events in assisted human reproduction. Finally, it discusses the ethical implications of these possibilities.
Group A rotavirus gastroenteritis: post-vaccine era, genotypes and zoonotic transmission
Authors: Luchs Adriana , Timenetsky Maria do Carmo Sampaio Tavares
Published: July 2016

ABSTRACT This article provides a review of immunity, diagnosis, and clinical aspects of rotavirus disease. It also informs about the changes in epidemiology of diarrheal disease and genetic diversity of circulating group A rotavirus strains following the introduction of vaccines. Group A rotavirus is the major pathogen causing gastroenteritis in animals. Its segmented RNA genome can lead to the emergence of new or unusual strains in human populations via interspecies transmission and/or reassortment events.
Prospective memory in Alzheimer's disease and Mild Cognitive Impairment
Authors: Spíndola Lívia , Brucki Sonia Maria Dozzi
Published: July 2016

Abstract Prospective memory (PM) is defined as remembering to carry out intended actions at an appropriate point in the future, and can be categorized into three types of situation: time-, event-, and activity-based tasks. PM involves brain structures such as frontal and medial temporal cortices. The aim of this study was to review the currently available literature on PM in Alzheimer's disease and Mild Cognitive Impairment patients. We performed a search on Pubmed, Medline, ScieLO, LILACS and the Cochrane Library electronic databases from January 1990 to December 2010. The key terms used were: prospective memory, memory for intentions, delayed memory and memory for future actions, separately and also combined with the search terms dementia, Alzheimer's disease and Mild Cognitive Impairment. Both patient groups showed significant impairment in PM. Further studies are needed to verify the accuracy of PM tasks as an early marker of mild cognitive impairment, and initial dementia.
Performance of Brazilian children on phonemic and semantic verbal fluency tasks
Authors: Charchat-Fichman Helenice , Oliveira Rosinda Martins , Silva Andreza Morais da
Published: July 2016

Abstract The most used verbal fluency paradigms are semantic and letter fluency tasks. Studies suggest that these paradigms access semantic memory and executive function and are sensitive to frontal lobe disturbances. There are few studies in Brazilian samples on these paradigms. Objective: The present study investigated performance, and the effects of age, on verbal fluency tasks in Brazilian children. The results were compared with those of other studies, and the consistency of the scoring criteria data is presented. Methods: A sample of 119 children (7 to 10 years old) was submitted to the three phonemic fluency (F, A, M) tasks and three semantic fluency (animals, clothes, fruits) tasks. The results of thirty subjects were scored by two independent examiners. Results: A significant positive correlation was found between the scores calculated by the two independent examiners. Significant positive correlations were found between performance on the semantic fluency task and the phonemic fluency task. The effect of age was significant for both tasks, and a significant difference was found between the 7- and 9-year-old subjects and between the 7- and 10-year-old subjects. The 8-year-old group did not differ to any of the other age groups. Conclusion: The pattern of results was similar to that observed in previous Brazilian and international studies.
Depressive symptoms in elderly participants of an open university for elderly
Authors: Batistoni Samila Sathler Tavares , Ordonez Tiago Nascimento , Silva Thaís Bento Lima da , Nascimento Priscila Pascarelli Pedrico do , Kissaki Priscilla Tiemi , Cachioni Meire
Published: July 2016

Abstract Although the prevalence of depressive disorders among the elderly is lower than among the younger population, the presence of significant symptoms of depression is common in this group. Studies report that participation in social, educational and leisure activities is related to fewer depressive symptoms in this population. Objective: The aim of this study was to examine the prevalence of depression among elderly participants of an Open University for the Third Age, in terms of the time studying. Methods: The study had a cross-sectional design and the participation of 95.2% (n=184) of total enrollers in the first half of 2010 on the activities of the Third Age Open University's School of Arts, Sciences and Humanities of the University of São Paulo. All participants answered a socio-demographic questionnaire and the Geriatric Depression Scale (GDS-15). Results: An association between studying time of over one semester at the University of the Third Age and a lower rate of depressive symptoms, was observed. Conclusion: Study time of over one semester was associated with less depressive symptoms, acting as a possible protective factor against depression.
Use of memory strategies among younger and older adults: Results from objective and subjective measures
Authors: Fabricio Aline Teixeira , Yassuda Mônica Sanches
Published: July 2016

Abstract Memory plays a fundamental role in the identity of people and in human life, as it enables us to interpret our surroundings and make decisions. It is known that the aging process can be accompanied by cognitive decline in some memory sub systems. However, the use of memory strategies can help encoding and retrieval of new information. Objective: The aim of this study was to identify and compare, using objective and subjective measures, which recall strategies are used spontaneously by young and older adults. Methods: Twenty-six first-year college students, and thirty-three seniors enrolled at the Third Age University of the same campus, completed a visual memory test including 18 black and white pictures, memorized a short story, and completed an open question about memory strategies, a memory check list to indicate strategies used, and a memory self-efficacy scale. The Bousfield categorization measure was also calculated from the recall protocol. Results: Young adults demonstrated better performance than the older adults on the memory tasks, and were also more confident. Both groups reported using similar strategies. Conclusion: Young and older adults seem to tackle memory tasks in similar ways but young adults outperform seniors.
Verbal fluency: Effect of time on item generation
Authors: Venegas Mayra Jacuviske , Mansur Leticia Lessa
Published: July 2016

Abstract The distribution of item generation/time in the performance of elderly on verbal fluency (VF) remains unknown. Objective: To analyze the number of items, their distribution and impact of the first quartile on the final test result. Methods: 31 individuals performed the tests (average age=74 years; schooling=8.16 years). Results: The number of items produced in the first quartile differed from the other quartiles for both semantic and phonologic VF where 40% of items were produced in the first quartile. No effect of age was found and schooling influenced performance on the first and second quartiles of semantic VF and on the 1st, 2nd and 3rd quartiles of phonemic VF. Discussion: This study contributes with the finding that asymptotic levels are attained prior to the 30 seconds observed in other studies, being reached at the 15-second mark. Furthermore, schooling was found to be associated to the number of items produced in both the first and 2nd quartiles for semantic VF, and in 1st, 2nd and 3rd quartiles for phonemic fluency. Conclusion: The schooling effect was noted both in semantic and executive aspects of VF. The brief form of the VF test may represent a promising tool for clinical evaluation.
Elderly patients with Alzheimer's disease and their family relationships: Caregiver perspectives
Authors: Cachioni Meire , Lima-Silva Thaís Bento , Ordonez Tiago Nascimento , Galo-Tiago Juliana , Alves Ana Regina , Suzuki Milena Yuri , Falcão Deusivania Vieira da Silva
Published: July 2016

Abstract Objective: The present study was to investigate the status of the family relationships of elderly patients with Alzheimer's disease from a caregiver's perspective. Methods: A total of sixteen relatives/caregivers of AD patients were assessed by applying a semi-structured questionnaire about family relationships. Frequency tables containing categorical variables (gender, schooling, personal income and current occupation) were compiled. Descriptive statistics were calculated of continuous variables such as age. Answers to open questions were submitted to Bardin's content analysis. The data were held on the Epidata program and statistical analysis was performed using the SPSS v.17.0 software package. Results: In line with the literature, the family was the main source of caregivers and the typical caregiver profile was female. In contrast to other studies, emotional burnout was not a major complaint in the sample studied. The ties created among family members and the life experience of each individual influences how interviewees cope with AD. Conclusion: The family relationships of caregivers of AD patients represent a constant challenge, due to changes in roles within the family structure as well as to disease progression. However, participation in psychological and socio-educational activities run by pioneering institutions in Brazil, act as a mediator of stress in the lives of both caregivers and patients.
Memory span measured by the spatial span tests of the Cambridge Neuropsychological Test Automated Battery in a group of Brazilian children and adolescents
Authors: Teixeira Rosani Aparecida Antunes , Zachi Elaine Cristina , Roque Daniela Tsubota , Taub Anita , Ventura Dora Fix
Published: July 2016

Abstract The neuropsychological tests of spatial span are designed to measure attention and working memory. The version of the spatial span test in the Cambridge Neuropsychological Test Automated Battery (CANTAB) evaluates these functions through the recall of sequences of spatial locations presented to the subject. Objective: The present study investigated how age, gender and educational level might affect the performance of the non-verbal system. Methods: A total of 60 children and adolescents aged 6 to 18 years were assessed (25 males and 35 females). Results: The results showed no gender differences in test performance. Children with six or more years of education showed better performance than children with less than three years of education. Older children had more schooling and thus were able to recall a greater number of items. Span length values proved similar to a previous large normative study which also employed the CANTAB Spatial Span (De Luca et al., 2003). Conclusion: The similarity in performance of the Brazilian children and adolescents studied and the group of Australian participants examined by the cited authors, despite the socio-cultural and economical differences, points to the suitability of the task for the assessment of attention and working memory in Brazilian children.
Clinicopathologic analysis of progressive non-fluent aphasia and corticobasal degeneration:Case report and review
Authors: Brito-Marques Paulo Roberto de , Vieira-Mello Roberto José , Montenegro Luciano , Aragão Maria de Fátima Vasco
Published: July 2016

Abstract Objective: To investigate progressive non-fluent aphasia and histopathologically-proven corticobasal degeneration. Methods: We evaluated symptoms, signs, neuropsychological deficits, and radiology data longitudinally, in a patient with autopsy-proven corticobasal degeneration and correlated these observations directly to the neuroanatomic distribution of the disease. Results: At presentation, a specific pattern of cognitive impairment was evident with an extreme extrapyramidal motor abnormality. Follow-up examination revealed persistent impairment of praxis and executive functioning, progressive worsening of language performance, and moderately preserved memory. The motor disorder manifested and worsened as the condition progressed. Many of the residual nerve cells were ballooned and achromatic with eccentric nuclei. Tau-immunoreactive pathology was significantly more prominent in neurons in the frontal and parietal cortices and dentate nuclei than in temporal neocortex, hippocampi and brainstem. Conclusion: The clinical diagnosis of progressive non-fluent aphasia secondary to corticobasal degeneration hinged on a specific pattern of impaired cognition as well as an extrapyramidal motor disorder, reflecting the neuroanatomic distribution of the disease in frontal and anterior temporal cortices and the dentate nuclei.
Criteria for the diagnosis of Alzheimer's disease: Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology
Authors: Frota Norberto Anízio Ferreira , Nitrini Ricardo , Damasceno Benito Pereira , Forlenza Orestes V. , Dias-Tosta Elza , Silva Amauri B. da , Herrera Junior Emílio , Magaldi Regina Miksian
Published: July 2016

Abstract This consensus prepared by the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology is aimed at recommending new criteria for the diagnosis of dementia and Alzheimer's disease (AD) in Brazil. A revision was performed of the proposals of clinical and of research criteria suggested by other institutions and international consensuses. The new proposal for the diagnosis of dementia does not necessarily require memory impairment if the cognitive or behavioral compromise affects at least two of the following domains: memory, executive function, speech, visual-spatial ability and change in personality. For the purpose of diagnosis, AD is divided into three phases: dementia, mild cognitive impairment and pre-clinical phase, where the latter only applies to clinical research. In the dementia picture, other initial forms were accepted which do not involve amnesia and require a neuroimaging examination. Cerebrospinal fluid biomarkers are recommended for study, but can be utilized as optional instruments, when deemed appropriate by the clinician.
Treatment of Alzheimer's disease in Brazil: I. Cognitive disorders
Authors: Vale Francisco de Assis Carvalho do , Corrêa Neto Ylmar , Bertolucci Paulo Henrique Ferreira , Machado João Carlos Barbosa , Silva Delson José da , Allam Nasser , Balthazar Márcio Luiz Figueredo
Published: July 2016

Abstract This article reports the recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology for the treatment of Alzheimer's disease (AD) in Brazil, with special focus on cognitive disorders. It constitutes a revision and broadening of the 2005 guidelines based on a consensus involving researchers (physicians and non-physicians) in the field. The authors carried out a search of articles published since 2005 on the MEDLINE, LILACS and Cochrane Library databases. The search criteria were pharmacological and non-pharmacological treatment of cognitive disorders in AD. Studies retrieved were categorized into four classes, and evidence into four levels, based on the 2008 recommendations of the American Academy of Neurology. The recommendations on therapy are pertinent to the dementia phase of AD. Recommendations are proposed for the treatment of cognitive disorders encompassing both pharmacological (including acetyl-cholinesterase inhibitors, memantine and other drugs and substances) and non-pharmacological (including cognitive rehabilitation, physical activity, occupational therapy, and music therapy) approaches. Recommendations for the treatment of behavioral and psychological symptoms of dementia due to Alzheimer's disease are included in a separate article of this edition.
Treatment of Alzheimer's disease in Brazil: II. Behavioral and psychological symptoms of dementia
Authors: Vale Francisco de Assis Carvalho do , Corrêa Neto Ylmar , Bertolucci Paulo Henrique Ferreira , Machado João Carlos Barbosa , Silva Delson José da , Allam Nasser , Balthazar Márcio Luiz Figueredo
Published: July 2016

Abstract This article reports the recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology for the treatment of Alzheimer's disease (AD) in Brazil, with special focus on behavioral and psychological symptoms of dementia (BPSD). It constitutes a revision and broadening of the 2005 guidelines based on a consensus involving researchers (physicians and non-physicians) in the field. The authors carried out a search of articles published since 2005 on the MEDLINE, LILACS and Cochrane Library databases. The search criteria were pharmacological and non-pharmacological treatment of the behavioral and psychological symptoms of AD. Studies retrieved were categorized into four classes, and evidence into four levels, based on the 2008 recommendations of the American Academy of Neurology. The recommendations on therapy are pertinent to the dementia phase of AD. Recommendations are proposed for the treatment of BPSD encompassing both pharmacological (including acetyl-cholinesterase inhibitors, memantine, neuroleptics, anti-depressives, benzodiazepines, anti-convulsants plus other drugs and substances) and non-pharmacological (including education-based interventions, physiotherapy, occupational therapy, music therapy, therapy using light, massage and art therapy) approaches. Recommendations for the treatment of cognitive disorders of AD symptoms are included in a separate article of this edition.
Vascular dementia: Diagnostic criteria and supplementary exams: Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Part I.
Authors: Engelhardt Eliasz , Tocquer Carla , André Charles , Moreira Denise Madeira , Okamoto Ivan Hideyo , Cavalcanti José Luiz de Sá
Published: July 2016

Abstract Vascular dementia (VaD) is the most prevalent form of secondary dementia and the second most common of all dementias. The present paper aims to define guidelines on the basic principles for treating patients with suspected VaD (and vascular cognitive impairment - no dementia) using an evidence-based, systematized approach. The knowledge used to define these guidelines was retrieved from searches of several databases (Medline, Scielo, Lilacs) containing scientific articles, systematic reviews, meta-analyses, largely published within the last 15 years or earlier when pertinent. Information retrieved and selected for relevance was used to analyze diagnostic criteria and to propose a diagnostic system encompassing diagnostic criteria, anamnesis, as well as supplementary and clinical exams (neuroimaging and laboratory). Wherever possible, instruments were selected that had versions previously adapted and validated for use in Brazil that take into account both schooling and age. This task led to proposed protocols for supplementary exams based on degree of priority, for application in clinical practice and research settings.
Treatment of vascular dementia Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology
Authors: Brucki Sonia Maria Dozzi , Ferraz Ana Cláudia , Freitas Gabriel R. de , Massaro Ayrton Roberto , Radanovic Márcia , Schultz Rodrigo Rizek
Published: July 2016

Abstract Scientific Department of Cognitive Neurology and Aging of ABN had a consensus meeting to write recommendations on treatment of vascular dementia, there was no previous issue. This disease has numerous particularities and can be considered a preventable dementia. Prevention treatment is primary care of vascular risk factors or a secondary prevention of factors that could cause recurrence of ischemic or hemorrhagic brain modifications. In these guidelines we suggested only symptomatic treatment, pharmacologic or non-pharmacologic. We have reviewed current publications on MEDLINE (PubMed), LILACS e Cochrane Library databases. Recommendations are concern to the following factors and their prevention evidences, association, or treatment of vascular dementia: physical activity, tobacco use, diet and food supplements, arterial hypertension, diabetes mellitus, obesity, statins, cardiac failure, atrial fibrillation, antithrombotics, sleep apnea, carotid revascularization, symptomatic pharmacological treatment.
Differential diagnosis between dementia and psychiatric disorders: Diagnostic criteria and supplementary exams Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology
Authors: Bottino Cássio M.C. , Pádua Analuiza Camozzato de , Smid Jerusa , Areza-Fegyveres Renata , Novaretti Tânia , Bahia Valeria S.
Published: July 2016

Abstract In 2005, the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology published recommendations for the diagnosis of Alzheimer's disease These recommendations were updated following a review of evidence retrieved from national and international studies held on PUBMED, SCIELO and LILACS medical databases. The main aims of this review article are as follows: 1) to present the evidence found on Brazilian (LILACS, SCIELO) and International (MEDLINE) databases from articles published up to May 2011, on the differential diagnosis of these psychiatric disorders and dementia, with special focus on Dementia due to Alzheimer's and vascular dementia, including a review of supplementary exams which may facilitate the diagnostic process; and 2) to propose recommendations for use by clinicians and researchers involved in diagnosing patients with dementia. Differential diagnosis between dementia and other neuropsychiatric disorders should always include assessments for depression, delirium, and use of psychoactive substances, as well as investigate the use of benzodiazepines, anti-epileptics and pattern of alcohol consumption.
Judgment in Mild Cognitive Impairment and Alzheimer's disease
Authors: Capucho Patrícia Helena Figueirêdo Vale , Brucki Sonia Maria Dozzi
Published: July 2016

Abstract Judgment is the capacity to make decisions after considering available information, contextual factors, possible solutions and probable outcomes. Our aim was to investigate previous research studies regarding assessment of judgment in older adults with different degrees of cognitive impairment. To this end, a search of Pubmed and Lilacs electronic databases for studies published from January 1990 until August 2011 in English, Spanish and Portuguese was carried out. The terms used were "judgment" combined with the terms "dementia" or "Mild Cognitive Impairment" (MCI) or "Alzheimer's disease" (AD). Some studies showed that MCI and AD patients had impaired judgment. There is a lack of specific methods to measure judgment capacity, and data on judgment abilities in older adults with MCI and dementia are scarce. No studies with specific measures of judgment capacity in other dementias were found.
Cognitive impairment in multiple system atrophy: Changing concepts
Authors: Abrahão Agessandro , Dutra Livia Almeida , Braga Neto Pedro , Pedroso José Luiz , Oliveira Ricardo Araújo de , Barsottini Orlando Graziani Povoas
Published: July 2016

Abstract Multiple system atrophy (MSA) is characterized by a variable combination of cerebellar ataxia, parkinsonism and pyramidal signs associated with autonomic failure. Classically, cognitive impairment was not considered a clinical feature of MSA and dementia was pointed out as an exclusion diagnostic criteria. Based on comprehensive neuropsychological assessment, cognitive impairment was found to be a frequent feature in MSA, and clinically-defined dementia is now reported in 14-16% of cases. This article reviews the current data on cognitive impairment in MSA along with its neuropsychological profile and pathophysiology.
A systematic review of the neurobiological aspects of memory in the aging process
Authors: Oliveira Eduardo Moreira de , Kissaki Priscilla Tiemi , Ordonez Tiago Nascimento , Lima-Silva Thaís Bento
Published: July 2016

Abstract A systematic review of the neuroanatomical literature was performed to determine the neuropharmacological aspects most relevant to the study of memory processes. Articles were retrieved using the search terms "biology of memory", "memory and aging", "memory impairment", "elderly and memory," and their equivalents in Portuguese. Of the studies surveyed, five studies dealt with epidemiological and demographic issues, 12 were clinical trials i.e. were based on testing and implementation of instruments in human subjects, 33 studies were basic research involving studies of mice, rats and non-human primates, and biochemical and in vitro trials and finally, 52 studies were literature reviews or book chapters which in our view, fell into this category. Conclusions: The work sought to highlight which neural networks are most involved in processing information, as well as their location within brain regions and the way in which neurotransmitters interact with each other for the formation of these memories. Moreover, it was shown how memory changes during the normal human aging process, both positively and negatively, by analyzing the morphological alterations that occur in the brain of aging individuals.
Cross-cultural Adaptation of the "Functional Activities Questionnaire - FAQ" for use in Brazil
Authors: Sanchez Maria Angélica dos Santos , Correa Pricila Cristina Ribeiro , Lourenço Roberto Alves
Published: July 2016

Abstract Objective: The aim of this paper was to present the results of the first stage of cross-cultural adaptation of the Functional Activities Questionnaire (FAQ). Methods: The tool was subjected to translation and re-translation, and the test-retest reliability of a proposed version for use in Brazil was analyzed. Results: Of the 548 questionnaire respondents, a convenience sample of 68 informants was selected for retesting. Internal consistency was measured by Cronbach's alpha (0.95) while test-retest reliability was assessed using intra-class correlation (0.97). The findings have shown that FAQ is brief - averaging seven minutes to apply, easily understood and has good intra-rater test-retest reliability. Conclusion: Our results suggest this adapted version of the FAQ is a reliable and stable tool which may be useful for assessing function in Brazilian elderly. Notwithstanding, the version should be subjected to further analysis with the aim of reaching functional equivalence.
Factors influencing possible delay in the diagnosis of Alzheimer's disease Findings from a tertiary Public University Hospital
Authors: Miranda Luís Felipe José Ravic de , Matoso Rafael de Oliveira , Rodrigues Márlon Vieira , Lima Thiago Oliveira Lemos de , Nascimento Adriano Fiorini , Carvalho Fernando Castro , Moreira Débora Regina de Melo , Fernandes Jeferson Cruz , Paula Jonas Jardim de , Magno Luiz Alexandre V. , Caramelli Paulo , Moraes Edgar Nunes de
Published: July 2016

Abstract Alzheimer's disease (AD) is characterized by impairment in memory and autonomy, causing excessive pressure on family and an overburdened health care system. Early diagnosis, with the appropriate treatment, is important to reduce the pattern of disease progression. Objective: The study sought to identify the most probable causes of delay in diagnosis. Methods: A cross-sectional study involving AD patients followed at an Outpatient Geriatric Clinic from a tertiary public university hospital was conducted between June 2009 and February 2011. Results: Ninety-four patients were evaluated (66% women), aged 77.76±6.8 years and with median educational level of 3 years (95% CI 2.7-3.80). Regarding severity of dementia, 51.8% of patients were classified as having mild dementia (CDR 1), 40% moderate dementia (CDR 2) and 8.2% severe dementia (CDR 3). Mean educational level of caregivers was 8.3±3.9 years. Among those who believed there was a delay, 36% stated that the "family thought that the changes were normal for the age of the patient" reporting average delay of 1.8 years (95% CI: 1.3-2.5) while 45.3% stated that the "doctor did not reach a diagnosis" reporting a median delay of 1.5 years (95% CI: 1.4-2.3). Conclusion: Based on these results, it can be concluded the time between onset of symptoms and diagnosis was excessive. This study may be useful to help increase awareness of issues not sufficiently discussed in the literature, such as diagnostic delay and influence of caregivers' educational level on treatment.
Cognitive assessment instruments in Parkinson's disease patients undergoing deep brain stimulation
Authors: Romann Aline Juliane , Dornelles Silvia , Maineri Nicole de Liz , Rieder Carlos Roberto de Mello , Olchik Maira Rozenfeld
Published: July 2016

ABSTRACT Deep Brain Stimulation (DBS) is a widely used surgical technique in individuals with Parkinson's disease (PD) that can lead to significant reductions in motor symptoms. Objectives: To determine, from publications, the most commonly used instruments for cognitive evaluation of individuals with PD undergoing DBS. Methods: A systematic review of the databases: PubMed, Medline, EBECS, Scielo and LILACS was conducted, using the descriptors "Deep Brain Stimulation", "Verbal Fluency", "Parkinson Disease", "Executive Function", "Cognition" and "Cognitive Assessment" in combination. Results: The Verbal Fluency test was found to be the most used instrument for this investigation in the studies, followed by the Boston Naming Test. References to the Stroop Test, Trail Making Test, and Rey's Auditory Verbal Learning Test were also found. Conclusions: The validation of instruments for this population is needed as is the use of batteries offering greater specificity and sensitivity for the detection of cognitive impairment.