Attenuation of neuropsychiatric symptoms and caregiver burden in Alzheimer's disease by motor intervention: a controlled trial

OBJECTIVE: To analyze the effects of motor intervention on the neuropsychiatric symptoms of Alzheimer's disease and on the caregivers' burden. DESIGN: This is a controlled trial evaluating the effects of a motor intervention program on the neuropsychiatric symptoms. SETTING: The intervention was performed on community patients from two university centers specializing in physical exercise for the elderly. SUBJECTS: Patients with Alzheimer's disease were divided into two groups: sixteen received the motor intervention and sixteen controls (five controls were excluded because of clinical intercurrences). INTERVENTIONS: Aerobic exercises (flexibility, strength, and agility) and functional balance exercises were conducted over six months for 60 minutes three times per week. MAIN MEASURES: Psychopathological features of patients were evaluated with the Neuropsychiatric Inventory and Cornell Scale for Depression in Dementia. Caregivers were evaluated using the Neuropsychiatric Inventory-Distress and Burden Interview. A two-way analysis of variance (ANOVA) was applied to observe interactions (pre- vs. post-intervention; participants vs. controls). RESULTS: Patients from the intervention presented a significant reduction in neuropsychiatric conditions when compared to controls (Neuropsychiatric Inventory: F: 11.12; p = 0.01; Cornell Depression scale: F: 11.97; p = 0.01). The burden and stress of caregivers responsible for patients who participated in the intervention significantly decreased when compared to caregivers responsible for controls (Neuropsychiatric Inventory-Distress: F: 9.37; p = 0.01; Burden Interview: F: 11.28; p = 0.01). CONCLUSIONS: Aerobic exercise was associated with a reduction in the neuropsychiatric symptoms and contributed to attenuate the caregivers' burden. However, the researchers were not blinded to the patient's intervention status, which constitutes an important limitation of this study.

Caregiver report versus clinician impression: disagreements in rating neuropsychiatric symptoms in Alzheimer's disease patients

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

Minas e a aclamação de D. João VI no limiar da formação do Estado-Nação brasileiro: memórias, conflitos e sedições

Dans cet article on examinera les cérémonies d'acclamation du roi D. João VI qui ont eu lieu à Tejuco en 1818. Le décodage de la riche variété d'images esthétiques présente dans ces célébrations peut être une stratégie privilégiée pour comprendre la création, à ce moment-là, des mythes qui donneraient soutien et orientation au projet d'affirmation du prestige politique du roi et à la consolidation de sa domination sur la région et sur tout le territoire brésilien. on analysera en particulier le conflit de mémoires entre la signification symbolique de la célébration et la révolte du peuple de Minas contre l'exploitation coloniale portugaise qui avait éclaté dans la région environ trois décennies avant.

Mecanismos de abertura de sulcos, inoculação e adubação nitrogenada em feijoeiro em sistema plantio direto

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

Fontes e épocas de aplicação de nitrogênio em feijoeiro de inverno sob sistema plantio direto

O aproveitamento do nitrogênio pelo feijoeiro é dependende da fonte, dose e época de aplicação. Com o objetivo de se avaliar o efeito de fontes e épocas de aplicação de N sobre feijoeiro cultivado em sistema plantio direto, desenvolveu-se o presente trabalho, no município de Selvíria (MS), em 2006 e 2007, com os tratamentos dispostos em delineamento de blocos casualizados, em esquema fatorial 3x6, com quatro repetições. Foram avaliadas fontes de N (ureia, entec e sulfato de amônio) e épocas de aplicação (testemunha - sem N, semeadura, estádio de desenvolvimento V3, estádio de desenvolvimento V4-5, 1/3 semeadura + 2/3 estádio V3 e 1/3 semeadura + 2/3 estádio V4-5). As fontes de N tiveram influência semelhante sobre a produtividade do feijoeiro, afetando apenas o teor de N foliar, em 2006, sendo que a utilização de entec proporcionou concentrações do nutriente, nas folhas, equivalentes às da ureia. A aplicação de todo o N na semeadura afetou a população inicial e final de plantas, em 2006, sendo que o mesmo não foi observado em 2007. As épocas de aplicação não influenciaram na produtividade de grãos da cultura, em ambos os anos de cultivo, porém, em 2006, a adubação nitrogenada incrementou a produtividade em mais de 100%, em média, independentemente da época de aplicação.

Os convivas da morte no banquete das almas: presença de eguns em um conto de João Antônio

A literatura escrita tem sido um espaço privilegiado para a representação e, consequentemente, para o registro e divulgação dos valores e costumes de variados grupos e segmentos sociais. No conto analisado neste ensaio – Eguns –, o escritor paulistano João Antônio (1937-1996) traz um narrador que descreve com detalhes uma rara festa religiosa ocorrida na Bahia, destinada ao culto dos ancestrais. Contemplativo e respeitoso, limita-se a contar o que a tradição religiosa permite. O contato com a alteridade ganha foros de rito iniciático e a experiência – em sentido forte – é transferida ao leitor.

A importância político-cultural do Levante das Estátuas nas Homilias sobre as Estátuas de João Crisóstomo

A sociedade romana produziu estátuas abundantemente, como argumenta Stewart (2003:118). As suas funções eram diversas e vários os seus propósitos. Neste artigo, buscaremos apresentar a importância político-cultural das estátuas imperiais na sociedade romana do século IV d.C. a partir da compreensão da gravidade dos acontecimentos ocorridos durante a deflagração de um levante que ficou conhecido, na historiografia, como Levante das Estátuas. Neste levante, estátuas imperiais foram destruídas. Para tanto, utilizaremos a documentação legada por um presbítero, João Crisóstomo, que pronunciou, tradicionalmente, 21 homilias que a historiografia vinculou ao Levante das Estátuas.

Clonixinato de lisina no tratamento de enxaquecas

In order to determinate both efficacy and safety of lysine clonixinate in migraine treatment, we have conducted an open, non-comparative study, with fourthy five patients. The analgesic effect was excellent and same patients presenting the maxime effect after five minutes. Lysine clonixinate tolerability deeply describing in many others reports.

Avaliação das condutas de biossegurança em laboratórios de prótese dentária de João Pessoa, PB, Brasil

Objective: To evaluate the biosecurity measures adopted in dental prosthesis laboratories of the city of João Pessoa, PB, Brazil with respect to prosthetic works sent by dentists. Method: Twenty-five dental prosthesis technicians (DPT) of the city of João Pessoa, PB, filled out a questionnaire referring to their knowledge of the biosecurity principles, disinfection of impressions and other prosthetic items, and the use of individual protection equipment (IPE). Results: Although 92% of the interviewees believed in the possible occurrence of cross-infection between dental prosthesis laboratories and dental offices, 64% declared that the prosthetic works received in their laboratories do not undergo any disinfection procedure. It was also observed that, for disinfection of impressions and stone casts, the chemical substances are not used as recommended by the manufacturers or are innocuous to microorganisms. Regarding the use of IPE, 60% of the DPT used mask, but only 4% used gowns. With respect to the measures taken regarding the impressions received from dental offices, 56% of the interviewees only wash them in running tap water, and 56% of the stone casts that arrive at the laboratory are not disinfected in any way. Conclusion: There is a need for more motivation and instructions to DPT regarding the prevention of cross-contamination during sending and receiving of prosthetic works between dental prosthesis laboratories and dental offices because the DPT evaluated in this study were found negligent with respect to disinfection procedures.

Panoramic radiography in the diagnosis of carotid artery atheromas and the associated risk factors

Atherosclerosis is a serious chronic disease, responsible for thousands of deaths worldwide and is characterized by thickening and loss of elasticity of the arterial walls, associated with the presence of atheromatous plaques. Various risk factors act directly on predisposition to the disease, among which the following are pointed out: diabetes mellitus, arterial hypertension and inadequate diet and eating habits. More recent researches have elucidated new risk factors acting in the development of this disease, such as, for example: periodontitis, chronic renal disease and menopause. The panoramic radiograph, commonly used in dental practice, makes it possible to see calcified atherosclerotic plaques that are eventually deposited in the carotid arteries. The aim of this review article was to emphasize the dentist's important role in the detection of carotid artery atheromas in panoramic radiographs and the immediate referral of patients affected by these calcifications to doctors. In addition, the study intended to guide the dentist, especially the dental radiologist, with regard to differential diagnosis, which should be made taking into consideration particularly the triticeal cartilage when it is calcified. © Henriques et al.

Noninvasive aspergillosis as a maxillary antrolith: report of a rare case.

Maxillary antrolithiasis is characterized by masses of tissue of endogenous or exogenous origin that calcify within the maxillary sinuses. Aspergillosis is a fungal disease in which the maxillary sinus is a primary site of infection. Aspergillosis mycetoma, its noninvasive form, is the most prevalent modality of the disease in the maxillary sinuses. In approximately half of the cases reported in the literature, calcification of the fungal mycelia, which later became antroliths, was verified. This article reports a rare case of the accidental discovery of a maxillary antrolith associated with noninvasive aspergillosis in an immunocompetent and asymptomatic 56-year-old woman. The diagnosis and therapeutic procedures used in treating the patient are discussed as well as the probable iatrogenic origin of the fungal pathology.

Planejamento em saúde bucal no município de João Pessoa, Estado da Paraíba: o cirurgiãodentista enquanto protagonista da atenção básica

The aim was to identify the perception of Oral Health Planning (OHP) of basic care (BC) dental surgeons (DSs) in João Pessoa, Paraíba State, Brazil. Seventeen BC DSs from João Pessoa were interviewed. A qualitative analysis was performed using the Discourse of the Collective Subject (DCS) methodology. DCS obtained: Impact - My work is effective when the user's need remains at the BC. Social Control - The population participates in the organization of promotional activities, but I think it doesn't have enough maturity to opine on OHP. OHP Basis and Organization - The OHP has a diverse organization and is based on user needs. It can be concluded that the knowledge of the DSs on OHP is varied. There is limited understanding about problem-solving. Social control is considered incipient and weak. It is understood that the organization of the local OHP assumes a diverse character and should be based on user demands.

Synthesis, characterization and antifungal activity of quaternary derivatives of chitosan on Aspergillus flavus

Two series of new chitosan derivatives were synthesized by reaction of deacetylated chitosan (CH) with propyl (CH-Propyl) and pentyl (CH-Pentyl) trimethylammonium bromides to obtain derivatives with increasing degrees of substitution (DS). The derivatives were characterized by 1H NMR and potentiometric titration techniques and their antifungal activities on the mycelial growth of Aspergillus flavus were investigated in vitro. The antifungal activities increase with DS and the more substituted derivatives of both series, CH-Propyl and CH-Pentyl, exhibited antifungal activities respectively three and six times higher than those obtained with commercial and deacetylated chitosan. The minimum inhibitory concentrations (MIC) were evaluated at 24, 48 and 72h by varying the polymer concentration from 0.5 to 16g/L and the results showed that the quaternary derivatives inhibited the fungus growth at polymer concentrations four times lower than that obtained with deacetylated chitosan (CH). The chitosans modified with pentyltrimethylammonium bromide exhibited higher activity and results are discussed taking into account the degree of substitution (DS). © 2012 Elsevier GmbH.

Correlation between hand/wrist and panoramic radiographs in severe secondary hyperparathyroidism

Objectives: Hand/wrist and dental radiographs are important for osteoporosis analysis in secondary hyperparathyroidism (SHPT). This study evaluated whether a correlation exists between the effects of the disease on the hands and jaws, and investigated the association between osteoporosis progression in the hands and parathyroid hormone (PTH) levels in chronic kidney disease (CKD) patients. Materials and methods: Four panoramic radiographic parameters (mental index, mandibular cortical index, trabecular bone pattern, and calcification/resorption) and four corresponding hand/wrist radiographic parameters (metacarpal cortical thickness, phalangeal cortical index, trabecular bone pattern, and calcification/resorption) were applied to investigate possible correlation between the effects of SHPT on the jaws and hands/wrists, by Spearman's correlation coefficient. PTH levels and the hand/wrist radiographic parameters were also tested by spearman's correlation coefficient (p < 0.05). The presence of brown tumors, vascular calcifications, and acroosteolysis on the hands was also evaluated. Results: Mandibular cortical index was strongly correlated with the phalangeal cortical index (p = 0.000). Phalangeal cortical index and trabecular bone pattern of hand/wrist correlated with PTH levels (0.002 and 0.000, respectively). Brown tumors occurred in four CKD patients, while both vascular calcifications and acroosteolysis were observed in 19 patients. Conclusion: There is a significant correlation between the morphological changes caused by secondary hyperparathyroidism in hand and jaw bones. The morphological status can be assessed using the mandibular cortical index, besides the phalangeal cortical index. The latter correlates well with parathyroid hormone levels of advanced chronic kidney disease. Clinical relevance: Panoramic images reveal morphological changes in the jaw bone, indicating likewise changes in the hand/wrist in severe secondary hyperparathyroidism. The severity of the bone changes may be a reflection of the parathyroid hormone levels in advanced chronic kidney disease. © 2012 Springer-Verlag.

The Brazilian version of the Neuropsychiatric Inventory-Clinician rating scale (NPI-C): Reliability and validity in dementia

ABSTRACT Background: Patients with dementia may be unable to describe their symptoms, and caregivers frequently suffer emotional burden that can interfere with judgment of the patient's behavior. The Neuropsychiatric Inventory-Clinician rating scale (NPI-C) was therefore developed as a comprehensive and versatile instrument to assess and accurately measure neuropsychiatric symptoms (NPS) in dementia, thereby using information from caregiver and patient interviews, and any other relevant available data. The present study is a follow-up to the original, cross-national NPI-C validation, evaluating the reliability and concurrent validity of the NPI-C in quantifying psychopathological symptoms in dementia in a large Brazilian cohort. Methods: Two blinded raters evaluated 312 participants (156 patient-knowledgeable informant dyads) using the NPI-C for a total of 624 observations in five Brazilian centers. Inter-rater reliability was determined through intraclass correlation coefficients for the NPI-C domains and the traditional NPI. Convergent validity included correlations of specific domains of the NPI-C with the Brief Psychiatric Rating Scale (BPRS), the Cohen-Mansfield Agitation Index (CMAI), the Cornell Scale for Depression in Dementia (CSDD), and the Apathy Inventory (AI). Results: Inter-rater reliability was strong for all NPI-C domains. There were high correlations between NPI-C/delusions and BPRS, NPI-C/apathy-indifference with the AI, NPI-C/depression-dysphoria with the CSDD, NPI-C/agitation with the CMAI, and NPI-C/aggression with the CMAI. There was moderate correlation between the NPI-C/aberrant vocalizations and CMAI and the NPI-C/hallucinations with the BPRS. Conclusion: The NPI-C is a comprehensive tool that provides accurate measurement of NPS in dementia with high concurrent validity and inter-rater reliability in the Brazilian setting. In addition to universal assessment, the NPI-C can be completed by individual domains. © International Psychogeriatric Association 2013.