Mild cognitive impairment (part 1): Clinical characteristics and predictors of dementia

Objective: To critically review and evaluate existing knowledge on the conceptual limits and clinical usefulness of the diagnosis of mild cognitive impairment (MCI) and the neuropsychological assessment and short- and long-term prognosis thereof. Methods: We conducted a systematic search of the PubMed and Web of Science electronic databases, limited to articles published in English between 1999 and 2012. Based on the search terms mild cognitive impairment or MCI and epidemiology or diagnosis, we retrieved 1,698 articles, of which 248 were critically eligible (cross-sectional and longitudinal studies); the abstracts of the remaining 1,450 articles were also reviewed. Results: A critical review on the MCI construct is provided, including conceptual and diagnostic aspects; epidemiological relevance; clinical assessment; prognosis; and outcome. The distinct definitions of cognitive impairment, MCI included, yield clinically heterogeneous groups of individuals. Those who will eventually progress to dementia may present with symptoms consistent with the definition of MCI; conversely, individuals with MCI may remain stable or return to normal cognitive function. Conclusion: On clinical grounds, the cross-sectional diagnosis of MCI has limited prognostic relevance. The characterization of persistent and/or progressive cognitive deficits over time is a better approach for identification of cases at the pre-dementia stages, particularly if these cognitive abnormalities are consistent with the natural history of incipient Alzheimer's disease. © 2013 Associação Brasileira de Psiquiatria.

Rate of cognitive decline in relation to sex after 60 years-of-age: A systematic review

Some studies have shown differences in specific cognitive ability domains between the sexes at 60 years-of-age. However is important to analyze whether the rate of cognitive decline is also similar between the sexes after this age. The present study examined previously published literature to investigate whether cognitive decline is distinct between men and women after the age of 60 years. A systematic review was carried out with the PubMed, LILACS and PsycINFO databases (2001-2011) using the following search terms: aging, aged, cognitive function, mild cognitive impairment, mental health and cognition. We analyzed longitudinal research that used neuropsychological tests for evaluating cognitive function, showed results separated by sex and that excluded participants with dementia. Elderly women showed better performance in tests of episodic memory, whereas elderly men had a better visuospatial ability. Only one study detected distinct rates of cognitive decline in specific tests between the sexes. Despite differences observed in some domains, most of the studies showed that this rate is similar between the sexes until the age of 80 years. It is unclear whether sex influences the rate of cognitive decline after the age of 80 years. The present review observed that sex does not determine the rate of cognitive decline between 60 and 80 years-of-age. The contextual and cultural factors that involve men and women might determine a distinct decline between them, rather than sex alone. © 2013 Japan Geriatrics Society.

Endaural access to remove the projectile from a firearm

Background: Surgical approaches to temporomandibular region have been the subject of numerous controversies in the literature. Pre-auricular approaches have been used with the observance of high success rate, and during surgery history, various modifications of this approach were conducted in order to reduce irreversible sequelae. Thus, given the relevance of the study, this article proposes to alert the professionals that carry out these surgical approaches in relation to the anatomical structures involved and to describe and emphasise the benefits of endaural approach. Case report: A Caucasian male patient, victim of a firearm injury, sustained a wound on the right pre-auricular region, and at the time of assessment, he complained of pain, mouth opening difficulty and dysphagia. On physical examination, there was oedema and ecchymosis in the right periorbital region. In the radiological examination, a foreign body compatible with a firearm projectile was observed in the right pre-auricular region, being in accordance with the information collected. The endaural incision and divulsion by plans was then made until the projectile. Discussion: For proper exposure of the region, several studies were designed to evaluate the patterns of branching and anastomosis of the facial nerve. As for the best cosmetic result with the different pre-auricular approaches, the endaural approach was described as an approach that offers great cosmetic results because the incision design guides the surgeon in the wound closure and causes a decrease in the tension of flap, unlike that observed by some authors. © 2012 Springer-Verlag Berlin Heidelberg.

Management of pure medial orbital wall fracture with autogenous bone graft

The orbit is an irregular conical cavity formed from 7 bones including the frontal, sphenoid, zygomatic, maxillary, ethmoid, lacrimal, and palatine bones. Fractures of the internal orbit can cause a number of problems, including diplopia, ocular muscle entrapment, and enophthalmos. Although muscle entrapment is relatively rare, diplopia and enophthalmos are relatively common sequelae of internal orbital fractures. Medial orbital wall fracture is relatively uncommon and represents a challenge for its anatomical reconstruction. In this context, autogenous bone graft has been the criterion standard to provide framework for facial skeleton and orbital walls. Therefore, it is possible to harvest grafts of varying size and contour, and the operation is performed through the bicoronal incision, which is the usual approach to major orbital reconstruction. Thus, this article aimed to describe a patient with a pure medial orbital wall fracture, and it was causing diplopia and enophthalmos. The orbital fracture was treated using autogenous bone graft from calvarial bone. The authors show a follow-up of 12 months, with facial symmetry and without diplopia and enophthalmos. In addition, a computed tomography scan shows excellent bone healing at the anterior and posterior parts of the medial orbital wall reconstruction. Copyright © 2013 by Mutaz B. Habal, MD.

Quantificação de fibrose e enfisema em pacientes com paracoccidioidomicose (PCM) pulmonar, através de imagens de tomografia computadorizada de alta resolução (TCAR)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da força mastigatória e da atividade eletromiográfica dos músculos masseter e temporal em função de diferentes tratamentos reabilitadores

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Oxigenoterapia domiciliar prolongada: estudo das características dos pacientes atendidos, das indicações, do fornecimento e uso de oxigênio realizado no HC-UNESP-Botucatu

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Avaliação do traumatismo em dente decíduo e da seqüela no dente permanente sucessor

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação neuropsicológica atencional de crianças com distúrbios do sono

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Funções neuropsicológicas executivas pós acidente vascular encefálico hemorrágico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Achados clínicos e radiográficos das doenças endócrinas de interesse estomatológico

Pós-graduação em Biopatologia Bucal - ICT

Qualidade de vida, avaliação cognitiva e comportamental de prematuros de muito baixo peso com idade entre cinco e oito anos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Terapia celular no tratamento de feridas crônicas

Pós-graduação em Pesquisa e Desenvolvimento (Biotecnologia Médica) - FMB

Aquisição dos marcos motores até a marcha em prematuros de muito baixo peso: influência da pré-elampsia, da adequação do peso ao nascer e do sexo do recém-nascido

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Gerenciamento do risco sanitário hospitalar na área de tecnovigilância: análise retrospectiva e prospectiva das notificações de queixas técnicas, incidentes e eventos adversos relacionados ao uso de equipamentos, materiais médico-hospitalares e kits diagnósticos no Hospital das Clínicas da Faculdade de Medicina de Botucatu-UNESP

Pós-graduação em Bases Gerais da Cirurgia - FMB