Subtle Cognitive Deficits in Adults With a Previous History of Sydenham's Chorea During Childhood

Objective. To evaluate the neuropsychological profile and health-related quality of life (HRQOL) of adults who had rheumatic fever (RF) during childhood with and without Sydenham's chorea (SC).Methods. Three groups of patients were assessed: adults who had RF with SC during childhood (SC group), adults who had RF without SC during childhood (RF group), and controls (CT group). A range of neuropsychological tests looked at several cognitive domains. HRQOL was measured through a Brazilian version of the Short Form 36 (SF-36) health survey.Results. Twenty patients were included in the SC group, 23 patients in the RF group, and 19 patients in the CT group. The 3 groups were homogeneous regarding sex (P = 0.078), age (P = 0.799), schooling (P = 0.600), socioeconomic status (P = 0.138), intelligence quotient (P = 0.329), and scores for anxiety (P = 0.156) and depression (P = 0.076). The SC group demonstrated inferior performance in tests that assessed attention (Digit Span Forward [ P = 0.005], Corsi Block Forward [ P = 0.014]), speeded information processing (Trail Making A [ P = 0.009], Symbol Search [ P = 0.042]), and executive functions and working memory (Corsi Block Backward [ P = 0.028]), and higher scores for attention deficit scale (P = 0.030) when compared with the RF and CT groups. They also showed a tendency toward lower scores in the physical aspects, vitality, emotional aspects, and mental health domains of the SF-36. The RF group had a lower score for the general health domain than the CT group (P = 0.030).Conclusion. Patients who had SC during childhood can exhibit inferior performance in tasks that evaluate attention, speeded information processing, executive functions, and working memory in adult life. Therefore, there is indirect evidence of the persistence of dysfunction in cerebral circuits involved with the basal ganglia. They also presented a worse self-evaluation in HRQOL that was not related to cognitive impairments.

Referral letters in oral medicine: an approach for the general dental practitioner

The aim of this study was to analyze the contents of referral letters related to clinical history and reason for consultation. A total of 236 consecutive referral letters were evaluated. Analysis of the referral letters was based on key items concerning patient identification. chief complaint, previous consultation. laboratory investigation and use of drugs for the chief complaint. A database was organized (Epinfo 6.04) and the chi (2) test (a = 0.05) was applied to the results. of the 800 files examined. only 30%, (236) had a referral letter. of the 236 referral letters. 67% were from dentists, 22% from physicians and 11% from unidentified professionals. Patient age did not appear in 70%, of the letters and the chief complaint was mentioned only in 55%. The letters had no details such as description of the oral lesion (80%), anatomical site (34%), size (99%), symptoms (83%), or period of evolution (92%). Clinical diagnosis was not included in 84% of the letters. Less than 5% of the referral letters contained information about previous consultation and laboratory investigation. The chi (2) test showed significant differences for ail items of the referral letter. Referral letters did not satisfy minimal requirements about clinical history or reason for consultation. leading to failed communication among professionals. Based on this study, we suggest that standard letters are important to improve the quality of the letters, reducing the rate of omission of relevant items.

The Phylogeographic History of the New World Screwworm Fly, Inferred by Approximate Bayesian Computation Analysis

Insect pest phylogeography might be shaped both by biogeographic events and by human influence. Here, we conducted an approximate Bayesian computation (ABC) analysis to investigate the phylogeography of the New World screwworm fly, Cochliomyia hominivorax, with the aim of understanding its population history and its order and time of divergence. Our ABC analysis supports that populations spread from North to South in the Americas, in at least two different moments. The first split occurred between the North/Central American and South American populations in the end of the Last Glacial Maximum (15,300-19,000 YBP). The second split occurred between the North and South Amazonian populations in the transition between the Pleistocene and the Holocene eras (9,100-11,000 YBP). The species also experienced population expansion. Phylogenetic analysis likewise suggests this north to south colonization and Maxent models suggest an increase in the number of suitable areas in South America from the past to present. We found that the phylogeographic patterns observed in C. hominivorax cannot be explained only by climatic oscillations and can be connected to host population histories. Interestingly we found these patterns are very coincident with general patterns of ancient human movements in the Americas, suggesting that humans might have played a crucial role in shaping the distribution and population structure of this insect pest. This work presents the first hypothesis test regarding the processes that shaped the current phylogeographic structure of C. hominivorax and represents an alternate perspective on investigating the problem of insect pests. © 2013 Fresia et al.

Releituras da história franquista nos romances Galíndez e Autobiografía del general Franco de Manuel Vázquez Montalbán

Pós-graduação em Letras - FCLAS

Trends in Brazilian academic production in the History of Mathematics Education: directions from EBRAPEM

The number of papers on History of Mathematics Education presented at EBRAPEM (Brazilian Meeting of Graduate Students in Mathematics Education) has increased significantly between 2003 and 2008. This article presents a study with the aim of identifying themes, periods in focus, and sources and theoretical and methodological references used by the authors of the papers on History of Mathematics Education published in the proceedings of VII, VIII, IX, X, XI and XII EBRAPEM. The study indicates that the approach of ongoing research in History of Mathematics Education in Brazil has been similar to the approach of research in History of Education in general. However, the institutional separation between these two areas of investigation is noted as a factor rendering communication between both groups of researchers difficult.

A survey of the management of patients with temporomandibular disorders by general dental practitioners in southern Brazil

Purpose: Temporomandibular disorders (TMD) are recognized as one of the mostcontroversial topics in dentistry, despite the fact that both basic science and clinicalresearchers have currently reached some degree of consensus. This study aimed toconduct a questionnaire-based survey about the management of TMD patients bygeneral dental practitioners (GDPs).Materials and Methods: One hundred fifty-one GDPs with a private practice in a cityof southern Brazil were included, independent of school of origin, gender, graduationyear, and curriculum content. All participants were administered a questionnaire aboutthe management of patients with TMD, and the responses were analyzed by binomialand chi-square tests (α = 0.05).Results: Of the GDPs, 88.7% received TMD patients, who were primarily diagnosedon the basis of medical history (36.6%) or physical examination (30.4%). Of these,65.4% referred the patients elsewhere, primarily to specialists in occlusion (36.1%) ororthodontics (29.7%). Occlusal splinting was the most commonly used managementmodality (20.8%), followed by occlusal adjustment (18.1%) and pharmacotherapy(16.6%). Splints were fabricated in maximum habitual intercuspation or centric re-lation depending on individual patient (54.8%). The hard stabilization form was themost common type of appliance used (35.0%). Moreover, 73.8% of the GDPs didnot employ semi-adjustable articulators, and 69.5% adjusted the appliances at thetime of fixing. The duration of splint use and the frequency of follow-up were con-sidered patient dependent by 62.1% and 72.8%, respectively. GDPs considered thetwo major TMD etiologic categories as multifactorial (20.8%) and occlusion (19.9%).Multidisciplinary medical and dental treatment was considered necessary by 97.9%.Conclusions: The evaluated general dental practitioners manage TMD patients ac-cording to international guidelines.

Higher education in evening courses in Brazil: history, growth and public policies at the beginning of the XXI Century

There are three distinct and complementary objectives in this article in order to clarify the higher education outline in Brazil, specifically evening courses (classes are held on weekdays, generally from 7:00 pm to 10:30 pm) and thesecurrent sector policies. The first objective is to present a short historical overview on the establishment of evening courses in Brazil, including those in the higher education level, occurred on the middle of last century. The second objective is to demonstrate the growth of evening higher education in Brazil, considering that in 1998, of the 2.1 million college enrollments, 55.3% were enrolled in evening courses; in 2010, twelve years later, of the 5.4 million students enrolled, there were 63.5% enrolled in evening courses. This expansion is due to the growing need of many students who must work while attending college, to defray costs of the study as well as personal and family costs. The reality of the working student is hostile considering external factors, such as transport problems, public security and lack of legislation for flexible working hours. The third objective is to discuss current public policies to expand eveningopenings in public institutions which represent nowadays only 16.1% of the 3.4 million enrollments for evening classes, including federal (6.8%), state (7.0%) and municipal (2.3%) institutions. In the third objective it is included the discussion of programs for scholarships and tuition loans. The methodology applied was to rescue historical information on the establishment and the expansion of evening courses in Brazil, analyzing the current general Brazilian policies and the specific ones from the State of São Paulo. The research results pointed to the importance of federal programs for scholarships and tuition loans for students from private institutions such as the 1,382,484 scholarships since 2004 (PROUNI Program) and the 847,000 tuition loans since 1999 (FIES Program). Important steps have been made by the Brazilian government. Considering that there are 3,987,424 enrollments in private institutions, the effectiveness of the programs for scholarships and tuition loans is still insufficient to meet the universal benefits for the student’s needs. Evening courses became the real instrument of social inclusion for many Brazilian youths and must be expanded quantitatively and qualitatively, with aggressive public policies, including also, scholarships and tuition loans.