Efeitos da eletroestimulação percutânea na incontinência urinária e qualidade de vida pós-prostatectomia: registro de seis casos

Introduction: Radical prostatectomy surgery is the best treatment currently adopted by detecting prostate cancer. The urinary incontinence is one more common and difficult to treat postoperative complications, which causes a negative impact on quality of life of the individual prostatectomy . The surface electrical nerve stimulation involves the transmission of electrical impulses from an external stimulator for peripheral nerve through surface electrodes attached to skin. It is an easy and efficient technique, widely used for pain relief, rehabilitation and muscle strengthening. Objective: To analyze the effect of T10-L2 percutaneous electrical stimulation, in individuals with urinary incontinence who underwent radical prostatectomy by the laparoscopic technique. Methods: Six patients had previously undergone radical prostatectomy were submitted to 20 sections of surface electrical stimulation with frequency of 4 Hz, pulse width of 1ms during 20 minutes. All subjects fillid a quality of life - International Consultation on Incontinence Questionnaire- Short FormI - ICIQ-SF questionnaire evaluating. Results: Results showed reduction in the use of the number of pads, number of leaks before and after treatment, and reduced voiding frequency and consequent improvement in quality of life. No side effects were reported. Conclusion: Percutanous electrical stimulation in T10-L2 may be an effective technique to treat urinary incontinence (UI) after radical prostatectomy video laparoscopy

Variáveis relacionadas ao processo de adesão a um programa de prevenção de quedas em idosos cadastrados na Estratégia de Saúde da Família

Introduction: Falls among older adults is a public health problem, therefore it is necessary preventive actions, however the adherence is the major problem faced by practitioners and researchers working on falls prevention programs. Objective: To evaluate the variables related to the adherence to falls prevention programs among the elderly enrolled in a Basic Health Unit (BHU). Methods: Was performed an observational cross-sectional analytical study. All elderly registered in a BHU and able to ambulate independently were invited to participate in a falls prevent program. The Elderly who Adhered to the Program (EAP) were evaluated at BHU; and the Elderly Not Adhered to the Program (ENAP) were identified and assessed at home. The assessment for both groups was performed using an evaluation form containing personal data, measures and clinical scales to assess cognitive status, balance, mobility, fear of falling, handgrip strength. Data were analyzed with SPSS 20.0. In addition to this assessment, the ENAP underwent a semi structured interview, in which we used the qualitative approach based on the figure of the Collective Subject Discourse. Results: The study included 222 elderly, 111 EAP and 111ENAP, most aged between 70 and 79 years (48.2%), female (68.5%), married (52.3%) and illiterate (47.7%). Consolidated as protective factors for adherence, worst rates of physical activity (p = 0.001), balance (p = 0.010) and cognition (p = 0.007). The interview of ENAP identified two themes: "Local implementation of programs for the prevention of falls" and "Relationship between BHU and the elderly health care," and found that the elderly who did not adhere were unable to displace and did not mention that primary care programs are related to health care in elderly. Conclusions: Elderly who do not adhere to the program differ from elderly who adhere as worst indices of cognition, balance and physical activity which implies greater risk of falling; and they were unable to participate in falls prevention program and by to be caregiver and showed displacement difficult

Custos e benefícios de um programa de exercício aeróbios na doença pulmonar obstrutica crônica: ensaio cliníco aleatório controlado

Pulmonary Rehabilitation, especially due to aerobic exercise, positive impact in reducing morbidity/mortality of patients with COPD, however the economic impact with costs of implementing simple programs of aerobic exercise are scarce. This is a blind randomized clinical trials, which aimed to evaluate the costs and benefits of a simple program of aerobic exercise in individuals with COPD, considering the financial costs of the Public Health System and its secondary endpoints. We evaluated lung function, the distance walked during six minutes of walking, the respiratory and peripheral muscle strength, quality of life related to health (QLRH), body composition and level of activity of daily living (ADL) before and after eight weeks of an aerobic exercise program consisting of educational guidance for both groups, control and intervention and supervised walks to the intervention group. The health costs generated in both groups were calculated following table Brazilian Public Health System. The sample consisted of forty patients, two being excluded in the initial phase of desaturation during the walk test six minutes. Were randomized into control and intervention group thirty-eight patients, three were excluded from the control group and one was excluded from the intervention group. At the end, thirty-four COPD comprised the sample, 16 in the control group and 18 in the intervention group (FEV1: 50.9 ± 14% pred and FEV1: 56 ± 0.5% pred, respectively). After for intervention, the intervention group showed improvement in meters walked, the sensation of dyspnea and fatigue at work, BODE index (p <0.01) in QLRH, ADL level (p <0.001) as well as increased strength lower limbs (p <0.05). The final cost of the program for the intervention group was R $ 148.75, including: assessments, hiking supervised by a physiotherapist and reassessments. No patient had exacerbation of IG, while 2 patients in the CG exacerbated, generating an average individual cost of R $ 689.15. The aerobic exercises in the form of walking showed significant clinical benefits and economic feasibility of its implementation, due to low cost and easy accessibility for patients, allowing them to add their daily practice of aerobic exercises

Evolução do reparo por excisão de nucleotídeo

The phylogeny is one of the main activities of the modern taxonomists and a way to reconstruct the history of the life through comparative analysis of these sequences stored in their genomes aimed find any justification for the origin or evolution of them. Among the sequences with a high level of conservation are the genes of repair because it is important for the conservation and maintenance of genetic stability. Hence, variations in repair genes, as the genes of the nucleotide excision repair (NER), may indicate a possible gene transfer between species. This study aimed to examine the evolutionary history of the components of the NER. For this, sequences of UVRA, UVRB, UVRC and XPB were obtained from GenBank by Blast-p, considering 10-15 as cutoff to create a database. Phylogenetic studies were done using algorithms in PAUP programs, BAYES and PHYLIP package. Phylogenetic trees were build with protein sequences and with sequences of 16S ribosomal RNA for comparative analysis by the methods of parsimony, likelihood and Bayesian. The XPB tree shows that archaeal´s XPB helicases are similar to eukaryotic helicases. According to this data, we infer that the eukaryote nucleotide excision repair system had appeared in Archaea. At UVRA, UVRB and UVRC trees was found a monophyletic group formed by three species of epsilonproteobacterias class, three species of mollicutes class and archaeabacterias of Methanobacteria and Methanococci classes. This information is supported by a tree obtained with the proteins, UVRA, UVRB and UVRC concatenated. Thus, although there are arguments in the literature defending the horizontal transfer of the system uvrABC of bacteria to archaeabacterias, the analysis made in this study suggests that occurred a vertical transfer, from archaeabacteria, of both the NER genes: uvrABC and XPs. According the parsimony, this is the best way because of the occurrence of monophyletic groups, the time of divergence of classes and number of archaeabacterias species with uvrABC system

Estrutura genética de populações de Amphobotrys ricini, agente causal do mofo cinzento da mamoneira

The gray mold, causal organism Amphobotrys ricini, is one of the major diseases of castor bean. Difficulties in managing plant disease arises form the limited understanding of the genetic structure of A. ricini, their complexity and variability make it difficult to control. Genetic structure can be used to infer the relative impact of different forces that influence the evolution of pathogen populations, that allow to predict the potencial for pathogen populations to envolve in agricultural ecosystems. Growers protect their crop by applying fungicides, but there aren t fungicides to provide significant control of gray mold of castor bean. The objectives of this work were use RAPD to determine the genetic structure of A. ricini subpopulations in Paraíba and assay the sensitivity of A. ricini isolates to azoxystrobin and carbendazim. To determine the genetic structure of A. ricini subpopulations in Paraíba, 23 isolates were colleted from two different geographic location (subpopulation). These isolates were analysed by RAPD using 22 random decamer primers, purchased from OPERON, produced a total of 80 markers polimorphics. The resulting matrixes were analysed using PopGene version 1.32. Sensitivity to azoxystrobin and carbendazim of 30 isolates, colleted form Paraíba and Alagoas, was estimated based on spore germination and colony growth inhibition. The stock solutions were added toV8 medium after sterilization to produce final concentrations of 0, 0.01, 0.1, 1, 10, and 100 µg/ml of carbendazim and 0, 0.001, 0.01, 0.1, 1, and 10 µg/ml of azoxystrobin. All statistical analyses were performed using SAS to estimate the dose that inhibited fungal growth by 50% (ED50 values). The genetic diversity within subpopulations (Hs=0,271) accounted for 92% of the total genetic diversity (Ht=0,293), while genetic diversity between subpopulations (Gst = 0,075) represented only 7,5%. The estimated number of migrants per generation (NM ) was 6,15. Nei s average gene identity across 80 RAPD loci was 0,9468. Individual ED50 values, for the 30 isolates screened for their sensitivity to azoxystrobin, ranged From a maximum of 0,168 µg/ml to a minimum of 0,0036 µg/ml. The ED50 values for carbendazim varied within the range of 0,026 to 0,316 µg/ml

Sitios geologicos e geomorfologicos dos municipios de Acari, Carnaúba dos Dantas e Currais Novos, região saridó do Rio Grande do Norte

Geological and Geomorphological Sites of the Towns of Acari, Carnaúba dos Dantas and Currais Novos, Seridó Region of the Rio Grande do Norte, northeastern Brazil, consist s of a study about geological, geomorphological, mineralogical, palaeontological and archaeological features of the study area, aiming the identification of sites that presents scientific, historical, cultural, economic and ecological excellent importance, and that they deserve to receive special protection for its maintenance for the gifts and future generations. It was developed according with methods adopted for the Brazilian Commitee of Geological and Paleontological Sites SIGEP/UNESCO and by Initiati ve of Sofia for the Preservation of the Mineral Diversity of the Planet, objectifying the description of the main sites, the its environmental problematic and proposal of protectionistic measures. Seven sites with features and typical structures had been identified that they deserve to be aim of protection. In the Acari town, three sites had been identified: geological -geomorphologicalarchaeological site Barra of the Carnaúba; geological-geomorphological site of the Gargalheiras; and geological-geomorphological site Bico of Arara. In Carnaúba of the Dantas, the geomorphological complex river of the Bojo that possesss canyons and deep throats, with rocky-arts registers of the three great rocky-arts traditions of northeast: Northeast Seridó Sub-tradition, Wasteland and Itaquatiara. In the Currais Novos town, 3 sites had been also identified: geomorphological site Canyon of the Apertados; geomorphological-archaeological-palaeontological complex of the Totoró; e, geologicalmineralogical site Brejuí. Because to the environmental problematic that it involves each one of the identified sites, it is proposed, as a guarantee of protection to these sites, its economic exploitation with the ecogeotouristic activity, that it aims at to the integration of the community in programs of environmental education and others, besides providing to the generation of job and income for the towns. Finally, a series of measures is suggested that they aim at to the efectivation of the activity and to the protection of the sites that they can be classified as natural heritage, in accordance with the denomination of UNESCO, in its program World Natural Heritage

Avaliação de implementação da Educação Superior a Distância: o caso da Secretaria de Educação a Distância da Universidade Federal do Rio Grande do Norte SEDIS/UFRN

The considerable expansion of Distance Education registered in recent years in Brazil raises the importance of debate about how the implementation of this policy has been happening so that formulators and implementers make better informed decisions, maximizing results, identifying successes and overcoming bottlenecks. This study aims to evaluate the implementation process of Distance Education policy by Secretary of Distance Education of the Federal University of Rio Grande do Norte. For this, we sought to use an evaluation proposal consistent with this policy, and came to the one developed by Sonia Draibe (2001), which suggests an analysis called anatomy of evaluation general process. To achieve the objectives, we made a qualitative research, case study type, using documentary research and semi-structured interviews with three groups of subjects who belong to the policy: managers, technicians and beneficiaries. It was concluded that: the implementation process needs a open contact channel between the management and technicians and beneficiaries; the lack of clarity in the dissemination of information between technicians produces noises that affects the outcomes; the absence of dissemination of internal and external actions contributes to the perpetuation of prejudice in relation to Distance Education; using selection criteria based on competence and merit contributes to form a team of skilled technicians to perform their function within the policy; an institution that do not enable technicians generates gaps that possibly will turn into policy implementation failures; all subjects involved in politics need internal evaluations to contribute to improvements in the implementation process, however, a gap is opened between the subjects if there is no socialization of results; the existence of an internal structure that manipulates financial resources and balances the budget from different maintainer programs is essencial; the consortium between IES and municipalities in presential support poles are bottlenecks in the process, since beneficiaries are exposed to inconsistency and lack of commitment of these local municipalities

Avaliação clínica do efeito da irradiação pós-opratória do laser de baixa intensidade na cicatrização de gengivoplastias em humanos

Many studies have been made to understand the process of tissular cicatrization, as well as the possible effects of laser therapy in the wound healing. However, the influence of low frequency laser irradiation in the repairing process is not completely understood. Our study has the purpose to assess clinically the effect of postoperative irradiation of the low frequency laser in humans, and the gingival repairing process postgingivoplasty performed with the extern bevel technique. Twenty-four patients with inflammatory gingival hyperplasia were enrolled in this study, which did not reduce with basic periodontal procedures, and patients with melanin pigmentation, with esthetic indications. After surgery the test group, randomly selected by a drawing, received laser application with energy density of 4 J/cm2, immediately after surgery and each 48 hours, during a week, with a total of 4 sections. The control group did not receive irradiation. The visual clinical analyses were performed by a single blind examiner, in the 2nd, 4th, 6th, 8th, 15th and 21st days post surgery. For statistic analyses of the data was used a Q-square test. Concerning the color, the results showed a better wound healing during days 6 to 8. when assessed the degree of progress of surgical wound, the results showed that the test group had a better cicatrization compared with the control group in the 2nd, 6th, 8th and 15th days post surgery, and at the 21st day both groups had the same results. Our results confirm that the laser had clinical influence in the repairing process after gingivoplasty surgery during days 2 to 15 post surgery

Perspectivados cirurgiões-dentistas sobre a inserção da fisioterapia na atenção básica de saúde

This work aims at investigating the surgeons-dentists acceptability in the field of public health in the city of Natal, State of Rio Grande do Norte, about the possibility of medicinal plants insertion in basic attencion of health. Moreover, it searchs to know if during their professinal formation it had some theoretician-pratical basement on this subject, as well as investigating their confidence on the medicinal plants. The basic motivation for developing this study is the possibility of contributing to the insertion of a tradicional health pratical at public assistance scope, endorsed by popular use, but now scientifically proven. For in a such way, the medicinal plants use is emphasized as a way to be followed to increase basic pharmaceutical assistance, improving the acess to the medicine and diminish expenses. Following this logic, family health program constitutes the way through which this pratical will be available to the users of health services. The research was done over thirty surgeonsdentists, all ofthem pertaining to public service ofNatal, state ofRio Grande do Norte. It was used, as research instrument, semi-estructured interview associated with methodological analysis user s speeches. On this form, this work is inserted in a trend observed nowadays not only in Brazil, where the use of the medicinal plants has been stimulated and defended to be inserted at programs ofprimary attenction of health

Avaliação longitudinal do impacto da saúde bucal na estratégia saúde da família em Natal

As a result of the financial incentive provided by the GM / MS 1.444, since 2000, Brazil has experienced a substantial increase in the number of oral health services at the Family Health Strategy. There is, however, evidence that these teams have produced qualitatively different experiences which do not translate necessarily into improved quality of life and health. Thus, evaluative research of great importance. This study aims to assess the impact of the Family Health Strategy in oral health in a longitudinal perspective natalense the years 2006 and 2009. This is an intervention study whose design is a community trial in parallel, nearly randomized. The sample consisted of census tracts covered by oral health teams in the Family Health and the Traditional Model (Basic Health Units and non-FHS Program of Community Health Agents and areas not covered.) The sample was determined by drawing ten census tracts to form the experimental group and ten other sectors for the control group by pairing intentional based on socio-economic and geographic. To check the net effect of the intervention was performed multivariate analysis by Poisson regression. As a result of cross-sectional analysis of year 2009, it was found that the effects of the ESF in Natal were satisfactory only for the variables of injuries and for other purposes without and with negative impact on stock coverage reclaimers. However, the longitudinal analysis revealed that the ESB / ESF improved their performance in dealing with grievances, access and coverage of the type of actions and this fact is independent of age, sex and social and economic conditions. In other employees' words are related to the presence of the Family Health Strategy in the region. However it does not say that both models under study (the Family Health Strategy Model and Traditional) are different in terms of performance and it is pertinent to reflect on the need for further development of evaluation studies that use other approaches able to clarify the dynamics of the process whose results can come to the knowledge of the actors responsible for leading the ESF and encourage them to incorporate the assessment in their routine

Os significados do tabagismo construídos na dinâmica social

The present study has the purpose of catching the significances of smoking in the social dinamics based on the Theory of Social Representations. It was developed among adults with ages from 20 to 59 years, low social and economic conditions, at Natal RN, Brazil. The Free-words Association Test was applied as the instrument of data collection and a semi-structured interview with the smokers and non-smokers, besides a structured interview with smokers, non-smokers and ex-smokers. All data was analyzed by the descriptive statistics using the Analysis of Content Technique of the thematic kind and by the softwares ALCESTE and EVOC 2000. Elaborations about smoking were marked by social, cultural and historical dimension, however they showed sensibility to changes and revealed positive and negative aspects of the habit. The analysis of the semi-structured interviews showed the following categories and under-categories respectively: Initiation of the habit (Friends and Family and Appreciation and Beauty); Psychosocial Implications of smoking (Personal relationship, Work and Financial); Behavior when facing smoking (Positive, Negative and Neutral); Smoking Effects (Smokers´ health and the other people health); Description about oral diseases ( Bad breath, Oral cancer and Dental problems); Smoking treatment (Physician and psychological, Supernatural and Difficulties). ALCESTE analysis presented 4 classes: Ambivalence between pleasure and get ill, Smoking as a trouble and danger to society, Social discrimination of smokers and Mouth as a place of reaffirmation of the discrimination. Those helped us to understand the psychosocial repercussion of the habit. On the social representation structure we identified as a probable central nucleus of the smoker group the categories Pleasure and Bad to the health and as peripheral elements Alcoholic Drink, Financial damage and Nervousness. For the non-smoker group the category Bad to the health comes first and Stop Smoking comes as a peripheral element. Finally, we hope that the knowledge of these representations can contribute to plan and/or to rethink over the professional practices and public policies related to smoking. Besides that, for an amplified comprehension of the study object the discussions over the identified representations should be deepen and amplified to other population and social groups

Impacto do Programa de Saúde da Família sobre indicadores de saúde bucal na população de Natal -RN

The aim of this study was to assess the impact of the Family Health Program (FHP) on a number of oral health indicators in the population of Natal, Brazil. The study is characterized as a quasi-random community intervention trial. The intervention is represented by the implementation of an Oral Health Team (OHT) in the FHP prior to the study. A total of 15 sectors covered by the FHP with OHT were randomly drawn and paired with another 15 sectors, based on socioeconomic criteria, not covered by the teams. A few sectors were lost over the course of the study, resulting in a final number of 22 sectors, 11 covered and 11 not covered. We divided the non-covered areas into two conditions, one in which we considered areas that had some type of assistance program such as the Community Agents Program (CAP), FHP without OHT, BHU (Basic Health Unit) or no assistance, and the other, in which we considered areas that had only BHU or no assistance. Community Health Agents (CHAs) and Dental Office Assistants (DOAs) applied a questionnaire-interview to the most qualified individual of the household and the data obtained per household were transformed into the individual data of 7186 persons. The results show no statistical difference between the oral health outcomes analyzed in the areas covered by OHT in the FHP and in non-covered areas that have some type of assistance program, with a number of indicators showing better conditions in the non-covered areas. When we considered the association between covered and non-covered areas under the second condition, we found a statistical difference in the coverage indicators. Better conditions were found in covered areas for indicators such as I have not been to the dentist in the last year with p < 0.001 and OR of 1.64 and I had no access to dental care with p < 0.001 and OR of 2.22. However, the results show no impact of FHP with OHT on preventive action indicators under both non-covered conditions. This can be clearly seen when we analyze the toothache variable, which showed no significant difference between covered and non-covered areas. This variable is one of the most sensitive when assessing oral health programs, with p of 0.430 under condition 1 and p of 0.038 under condition 2, with CI = 0.70-0.90. In the analysis of health indicators in children where the proportion of deaths in children under age 1, the rate of hospitalization for ARI (Acute Respiratory Infections) in those under age 5 and the proportion of individuals born underweight were considered, a better condition was found in all the outcomes for areas with FHP. Therefore, we can conclude that oral health in the FHP has little effect on oral health indicators, even though the strategy improves the general health conditions of the population, as, for example child health

Estimação de parâmetros genéticos para resistência à infecção por IMNV em camarões Litopenaeus vannamei por meio de análise de sobrevivência

The main specie of marine shrimp raised at Brazil and in the world is Litopenaeus vannamei, which had arrived in Brazil in the `80s. However, the entry of infectious myonecrosis virus (IMNV), causing the infectious myonecrosis disease in marine shrimps, brought economic losses to the national shrimp farming, with up to 70% of mortality in the shrimp production. In this way, the objective was to evaluate the survival of shrimps Litopenaeus vannamei infected with IMNV using the non parametric estimator of Kaplan-Meier and a model of frailty for grouped data. It were conducted three tests of viral challenges lasting 20 days each, at different periods of the year, keeping the parameters of pH, temperature, oxygen and ammonia monitored daily. It was evaluated 60 full-sib families of L. vannamei infected by IMNV in each viral challenge. The confirmation of the infection by IMNV was performed using the technique of PCR in real time through Sybr Green dye. Using the Kaplan-Meier estimator it was possible to detect significant differences (p <0.0001) between the survival curves of families and tanks and also in the joint analysis between viral challenges. It were estimated in each challenge, genetic parameters such as genetic value of family, it`s respective rate risk (frailty), and heritability in the logarithmic scale through the frailty model for grouped data. The heritability estimates were respectively 0.59; 0.36; and 0.59 in the viral challenges 1; 2; and 3, and it was also possible to identify families that have lower and higher rates of risk for the disease. These results can be used for selecting families more resistant to the IMNV infection and to include characteristic of disease resistance in L. vannamei into the genetic improvement programs

Distribuição diária do comportamento da mosca da fruta Anastrepha zenildae Zucchi, (Diptera: Tephritidae) em laboratório.

The knowledge of Anastrepha zenildae behavioral aspects combined with the biology of Tephritidae may contribute to monitoring and control programs of this fruit fly that is considered as economically important to the Rio Grande do Norte state. In order to characterize the daily activity profile of this species, we studied the behaviors of resting, locomotion, feeding, cleaning, courtship, copulation and oviposition of animals submitted to an artificial 12:12h light-dark cycle (750:1lux) with controlled temperature (26±2 °C). The observations were made with groups of 16 males and 16 females during 3 consecutive days each generation from parental to F5. Resting, locomotion, feeding and cleaning data were recorded as frequency and time of occurrence by scanning technique in 15 minutes windows per hour, with a record each minute. Courtship, copulation and oviposition were recorded as frequency, time of occurrence and duration by al occurrences technique. Resting was the most frequent behavior with males resting more than females. Locomotion was more evident in the first half of the ligh phase with higher values in females. Cleaning and feeding behaviors were more frequent in the second half of the light phase for both sexes with females eating more frequently than males. During the courtship, males were grouped in lek formations showing wings vibration and pheromone liberation. Courtship occurred more frequently 4 to 7 h after lights on (81,9%) with copulations being more frequent 6 h after lights on with a mean duration of 58,1±40,4 min. Copulation attempts were observed in males inside and outside the lek with aggressive behavior being observed only between males in the lek. Oviposition behavior was similar to that described for other species of the genus with a peak of this activity 2-3 h after the lights on, mean duration of 43, 7±34, 8 sec and 2 to 5 eggs by event. According to the results, sexual behavior of A. zenildae is temporally different of other sympatric species of the genus, being favorable to the reproductive isolation as well as the use of resources as oviposition substrate.

Características sociodemográficas, hábitos de sono, estado cognitivo e funcional após acidente vascular cerebral

ABSTRACT Introduction: The cerebrovascular accident (CVA) is an important cause of neurological impairment. Few data about the factors associated with morbidity of cerebrovascular accident are found in Brazil. Objectives: Evaluate sociodemographic characteristics, sleep habits, cognitive and functional status of patients with cerebrovascular accident. Methods: The patients evaluated through questionnaire Step 1 to survey the sociodemographic characteristics and Modified Rankin Scale for functional assessment. The neurological degree was evaluated by the National Institutes of Health Stroke Scale (NIHSS), the sleep Habits questionnaire for sleep and cognitive status by the Mini-Examination of the Mental State (MEMS). The data were analyzed using the chi-square test to determine differences in proportions of variables and linear regression analysis. Results: 305 patients were evaluated and the larger number of subjects was between 50 and 69 years (40%), most patients had no formal education (40.3%) and had ischemic type of cerebrovascular accident (72.5%). In the analysis of the functionality it was found that most patients had moderate impairment (55.1%). The results of the sleep habits showed that 63,6% of patients had one more person in the bedroom,12,3% complained about too much noise in the 11 room and 35% of too much light. From these patients 5,8% were smokers, 7,8% and 70,1% drank coffee drinkers, 28,6% had difficulty in initiate to sleep and woke up 37,6% in the middle of the night. Were showed complaints about nightmares (11%), feeling of suffocation (37,7%) and 35% felt very sleepy during the day. In addition, 95% were unemployed, 80,5% did not perform physical activities and 95,4% did not perform mental activities. The cognitive screening conducted a determined association of cognitive status with age and education level and neurological status. Conclusion: The study showed a high frequency of cases of cerebrovascular accident with functional dependence in a moderate degree, identified that many patients do not follow hygienic measures of sleep and found that the assessment of cognitive deficits must take into consideration the age, educational level and degree of neurological patients. We suggest the need for programs of assistance to victims of cerebrovascular accident patients, with a multidimensional approach including the rehabilitation team, the role of sleep medicine and Neuropsychology, so that patients have access to a more appropriate functional rehabilitation, develop a lifestyle that ensures a good sleep quality and are evaluated and rehabilitated with regard to cognitive impairment