Influence of education and depressive symptoms on cognitive function in the elderly

Objective: The purpose of the present study was to investigate the influence that education and depression have on the performance of elderly people in neuropsychological tests. Methods: The study was conducted at the Institute of Psychiatry, University of Sao Paulo School of Medicine, Hospital das Clinicas. All of the individuals evaluated were aged 60 or older. The study sample consisted of 59 outpatients with depressive disorders and 51 healthy controls. We stratified the sample by level of education: low = 1-4 years of schooling; high = 5 or more years of schooling. Evaluations consisted of psychiatric assessment, cognitive assessment, laboratory tests and cerebral magnetic resonance imaging. Results: We found that level of education influenced all the measures of cognitive domains investigated (intellectual efficiency, processing speed, attention, executive function and memory) except the Digit Span Forward and Fuld Object Memory Evaluation (immediate and delayed recall), whereas depressive symptoms influenced some measures of memory, attention, executive function and processing speed. Although the combination of a low level of education and depression had a significant negative influence on Stroop Test part B, Trail Making Test part B and Logical Memory (immediate recall), we found no other significant effects of the interaction between level of education and depression. Conclusion: The results of this study underscore the importance of considering the level of education in the analysis of cognitive performance in depressed elderly patients, as well as the relevance of developing new cognitive function tests in which level of education has a reduced impact on the results.

Mobile systems for monitoring Parkinson's disease

A challenge for the clinical management of Parkinson's disease (PD) is the large within- and between-patient variability in symptom profiles as well as the emergence of motor complications which represent a significant source of disability in patients. This thesis deals with the development and evaluation of methods and systems for supporting the management of PD by using repeated measures, consisting of subjective assessments of symptoms and objective assessments of motor function through fine motor tests (spirography and tapping), collected by means of a telemetry touch screen device. One aim of the thesis was to develop methods for objective quantification and analysis of the severity of motor impairments being represented in spiral drawings and tapping results. This was accomplished by first quantifying the digitized movement data with time series analysis and then using them in data-driven modelling for automating the process of assessment of symptom severity. The objective measures were then analysed with respect to subjective assessments of motor conditions. Another aim was to develop a method for providing comparable information content as clinical rating scales by combining subjective and objective measures into composite scores, using time series analysis and data-driven methods. The scores represent six symptom dimensions and an overall test score for reflecting the global health condition of the patient. In addition, the thesis presents the development of a web-based system for providing a visual representation of symptoms over time allowing clinicians to remotely monitor the symptom profiles of their patients. The quality of the methods was assessed by reporting different metrics of validity, reliability and sensitivity to treatment interventions and natural PD progression over time. Results from two studies demonstrated that the methods developed for the fine motor tests had good metrics indicating that they are appropriate to quantitatively and objectively assess the severity of motor impairments of PD patients. The fine motor tests captured different symptoms; spiral drawing impairment and tapping accuracy related to dyskinesias (involuntary movements) whereas tapping speed related to bradykinesia (slowness of movements). A longitudinal data analysis indicated that the six symptom dimensions and the overall test score contained important elements of information of the clinical scales and can be used to measure effects of PD treatment interventions and disease progression. A usability evaluation of the web-based system showed that the information presented in the system was comparable to qualitative clinical observations and the system was recognized as a tool that will assist in the management of patients.

Increased hippocampal excitability and impaired spatial memory function in mice lacking VGLUT2 selectively in neurons defined by tyrosine hydroxylase promoter activity

Three populations of neurons expressing the vesicular glutamate transporter 2 (Vglut2) were recently described in the A10 area of the mouse midbrain, of which two populations were shown to express the gene encoding, the rate-limiting enzyme for catecholamine synthesis, tyrosine hydroxylase (TH).One of these populations (‘‘TH– Vglut2 Class1’’) also expressed the dopamine transporter (DAT) gene while one did not ("TH–Vglut2 Class2"), and the remaining population did not express TH at all ("TH-Vglut2-only"). TH is known to be expressed by a promoter which shows two phases of activation, a transient one early during embryonal development, and a later one which gives rise to stable endogenous expression of the TH gene. The transient phase is, however, not specific to catecholaminergic neurons, a feature taken to advantage here as it enabled Vglut2 gene targeting within all three A10 populations expressing this gene, thus creating a new conditional knockout. These knockout mice showed impairment in spatial memory function. Electrophysiological analyses revealed a profound alteration of oscillatory activity in the CA3 region of the hippocampus. In addition to identifying a novel role for Vglut2 in hippocampus function, this study points to the need for improved genetic tools for targeting of the diversity of subpopulations of the A10 area

Abordagem da ergonomia para análise da acessibilidade a hóspedes com deficiência visual em hotéis: soluções de inclusão de pessoas cegas e com baixa visão

This study evaluates the level of accessibility for people with visual impairment (blindness and low vision) hotels in the city of Natal-RN, Brazil, and provides principles, guidelines and means of projective make hotels accessible, to promote comfort, autonomy and security of these people. We used a qualitative research methodology and quantitative trait descriptive, analytical and interpretive. Was taken as a base for field studies Ergonomic Analysis of Work, beginning with a study of the demands of accessibility of hotels and analyzing the modeling activity in these establishments through the application of interactional and observational techniques, such as film, photographic records, conversational actions and observation protocols. A protocol was developed and applied to evaluate the compliance of accessibility of hotels in the face of Brazilian technical standard NBR 9050 (2004). We used methods of Cognitive Task Analysis (CTA) associated with simulated activities to identify the processes of decision making and analyzing the observables of the activities performed by people with visual impairment (POS). Interviews were conducted with people who are blind and low vision in various cities in order to meet accessibility difficulties they faced in hotels and recommendations for improvement that they indicate. The mapping results showed that of 16 hotels 4 and 5 star studied in Natal-RN, reached only 7% of the 50 items of the protocol, while none of them reached 70% of the items. About the results obtained in simulated activities and analyzed from the ATC, we saw that the hotel where it was performed this step shows a need to adequately address the guests with visual impairments

Effect of the Single or Combined Administration of Cocaine and Testosterone on Cardiovascular Function and Baroreflex Activity in Unanesthetized Rats

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

Influence of visual information on optimal obstacle crossing

Human motion seems to be guided by some optimal principles. In general, it is assumed that human walking is generated with minimal energy consumption. However, in the presence of disturbances during gait, there is a trade-off between stability (avoiding a fall) and energy-consumption. This work analyses the obstacle-crossing with the leading foot. It was hypothesized that energy-saving mechanisms during obstacle-crossing are modulated by the requirement to avoid a fall using the available sensory information, particularly, by vision. A total of fourteen subjects, seven with no visual impairment and seven blind, walked along a 5 meter flat pathway with an obstacle of 0.26 m height located at 3 m from the starting point. The seven subjects with normal vision crossed the obstacle successfully 30 times in two conditions: blindfolded and with normal vision. The seven blind subjects did the same 30 times. The motion of the leading limb was recorded by video at 60 Hz. There were markers placed on the subject's hip, knee, ankle, rear foot, and forefoot. The motion data were filtered with a fourth order Butterworth filter with a cut-off frequency of 4 Hz. The following variables were calculated: horizontal distance between the leading foot and the obstacle at toe-off prior to (DHPO) and after (DHOP) crossing, minimal vertical height from the foot to the obstacle (DVPO), average step velocity (VELOm). The segmental energies were also calculated and the work consumed by the leading limb during the crossing obstacle was computed for each trial. A statistical analysis repeated-measures ANOVA was conducted on these dependent variables revealing significant differences between the vision and non-vision conditions in healthy subjects. In addition, there were no significant differences between the blind and people with vision blindfolded. These results indicate that vision is crucial to determine the optimal trade-off between energy consumption and avoiding a trip during obstacle crossing.

Eficácia do aconselhamento no tratamento das disfunções temporomandibulares

The aim of this controlled trial was to evaluate the effectiveness of counseling in pain, function and well-fare outcomes on the management of patients with temporomandibular disorder (TMD). Therefore, 51 consecutive patients were allocated to one of the research groups. In Group I, was instituted counseling therapy for Group II was conducted treatment as usual with occlusal splint. Patients were followed for returns at 7, 15, 30 and 60 days after baseline. At baseline, all patients were examined and assessed RDC/TMD form, which was administered by a single trained and calibrated examiner, in addition, the patients were referred for specific treatment according to the group to which belonged. The clinical and functional impairment was assessed at each visit through the Temporomandibular Index (TMI). In each session, the patients were also surveyed about pain intensity using a Visual Analogue Scale (VAS). To analyze the impact of pain on quality of life, OHIP-14 questionnaire was used. The results showed 26 patients in Group I with a mean age of 35.15 ± 10.79 years. 25 patients were allocated to Group II. The mean age was 27.36 ± 10.34 years. The counseling was effective in reducing the intensity of pain (VAS), with significant improvement observed at 7 day follow-up (p <0.001). The functional impairment (TMI) showed significant results at 15 days follow-up (p = 0.002). Counseling was also responsible for significant improvement in the impact of TMD on quality of life (OHIP-14) at all times of the analysis (p <0.001). When comparing research groups, no significant difference was observed for any of the analyzed indices (p> 0.05) nor in the short term (7 days) neither in long term (60 days). It was concluded therefore that, for the studied sample, counseling consisted in an effective treatment option for the control of signs and symptoms of TMD, with results in the short and long term similar to the usual treatment group.

Food restriction induces in vivo ventricular dysfunction in spontaneously hypertensive rats without impairment of in vitro myocardial contractility

Cardiac structures, function, and myocardial contractility are affected by food restriction (FR). There are few experiments associating undernutrition with hypertension. The aim of the present study was to analyze the effects of FR on the cardiac response to hypertension in a genetic model of hypertension, the spontaneously hypertensive rat (SHR). Five-month-old SHR were fed a control or a calorie-restricted diet for 90 days. Global left ventricle (LV) systolic function was evaluated in vivo by transthoracic echocardiogram and myocardial contractility and diastolic function were assessed in vitro in an isovolumetrically beating isolated heart (Langendorff preparation). FR reduced LV systolic function (control (mean ± SD): 58.9 ± 8.2; FR: 50.8 ± 4.8%, N = 14, P < 0.05). Myocardial contractility was preserved when assessed by the +dP/dt (control: 3493 ± 379; FR: 3555 ± 211 mmHg/s, P > 0.05), and developed pressure (in vitro) at diastolic pressure of zero (control: 152 ± 16; FR: 149 ± 15 mmHg, N = 9, P > 0.05) and 25 mmHg (control: 155 ± 9; FR: 150 ± 10 mmHg, N = 9, P > 0.05). FR also induced eccentric ventricular remodeling, and reduced myocardial elasticity (control: 10.9 ± 1.6; FR: 9.2 ± 0.9%, N = 9, P < 0.05) and LV compliance (control: 82.6 ± 16.5; FR: 68.2 ± 9.1%, N = 9, P < 0.05). We conclude that FR causes systolic ventricular dysfunction without in vitro change in myocardial contractility and diastolic dysfunction probably due to a reduction in myocardial elasticity.

Erros de refração como causas de baixa visual em crianças da rede de escolas públicas da regional de Botucatu - SP

OBJETIVO: Estudar a ocorrência dos erros refracionais em escolares de nosso meio. MÉTODOS: Estudo transversal avaliando crianças da pré-escola e do ensino básico, quanto ao sexo, tipo de erro refracional, acuidade visual e tratamento realizado. RESULTADOS: Quatro mil seiscentos e vinte e três crianças foram submetidas a exame de acuidade visual, das quais 8,1% apresentaram necessidade de exame oftalmológico completo. Houve 63,2% de portadores de astigmatismo hipermetrópico, 15,7% de astigmatismo miópico, 12,5% de astigmatismo misto, 4,9% de hipermetropia e 3,7% de miopia. Foi indicada a prescrição de lentes corretoras para 48,7% da amostra estudada. A frequência de erros refracionais na população foi de 3,9%. CONCLUSÃO: O astigmatismo hipermetrópico foi o erro de refracional mais frequente, havendo necessidade de tratamento em cerca de 50% das crianças triadas com frequência de 3,9% de erro refracional passível de correção na população de estudo.

Inclusão social do deficiente visual: experiência e resultados de Assis

OBJETIVOS: Traçar o perfil do usuário da Sala de Recursos para Deficiente Visual na cidade de Assis - SP, avaliar a porcentagem de deficientes visuais empregados e comparar o emprego com idade, gênero, tipo de deficiência e doença causadora da deficiência, entre dois períodos: de 1984 a 1996 e de 1997 a 2009. MÉTODOS: Foi realizado estudo retrospectivo dos prontuários médicos e da ficha escolar dos portadores de deficiência visual que frequentaram a Sala de Recursos para Deficiente Visual, no período de 1984 a 2009 na cidade de Assis - SP, divididos em dois períodos de 1984 a 1996 (G1) e de 1997 a 2009 (G2). Analisaram-se dados demográficos, a doença que provocou a baixa visão, o tipo de deficiência visual (cegueira ou baixa visão), escolaridade, recursos ópticos, frequência à Sala de Recursos para Deficiente Visual e taxa de emprego. Foi feita associação da taxa de emprego com: idade, gênero, raça/cor, tipo de deficiência e doença nos dois diferentes períodos. RESULTADOS: Foram encontrados 149 deficientes visuais sendo: 61,07% homens, 38,9% mulheres, 82,5% brancos e 17,4% não brancos e a mediana da idade foi de 18 anos. Dos 149 deficientes visuais, 63,75% eram portadores de baixa visão e 36,24% portadores de cegueira. As principais doenças que levaram à deficiência visual dos 149 pacientes foram em ordem decrescente: retinocoroidite por toxoplasmose (17,40%), atrofia óptica congênita (12,10%), alta hipermetropia (8,72%), retinose pigmentar e alta miopia (6,71% cada uma) e glaucoma congênito e catarata congênita (6,04% cada uma). A frequência à Sala de Recursos para Deficiente Visual foi boa em mais de 50% dos pacientes. Estavam trabalhando regularmente 44,7% e 12,3% dos maiores de 14 anos respectivamente nos períodos de 1984 - 1996 e de 1997 - 2009. Não houve diferença entre os dois períodos quanto às características demográficas, tipo de deficiência e doenças, havendo correlação da taxa de emprego apenas com a idade (pacientes com média de idade maior apresentavam maior porcentagem de emprego). CONCLUSÕES: Os deficientes visuais eram na maioria homens, brancos, portadores de baixa visão e portadores de toxoplasmose ocular. Quase metade (44,7%) dos pacientes com mais de 14 anos encontrava-se trabalhando regularmente até 1996 sugerindo que esforços conjuntos de oftalmologistas e educadores auxilia na inclusão social destes pacientes. A taxa de emprego caiu no período de 1997 a 2009 e a de aposentados aumentou.

Ovarian function in cows submitted to acute stress during proestrus

Studies in which ACTH was administrated in heifers after the occurrence of luteolysis showed a delay in the onset of estrus and the estrus duration was shortened. This study evaluated the effect of acute stress by road transportation on estrous behavior and ovulation, monitored by serum progesterone and cortisol concentrations in cows at the periovulatory period, using a crossover design. Eleven crossbred cows, divided into Control and Transport groups had their estrus cycle synchronized with GnRH, an intravaginal progesterone device, and cloprostenol. Thirty hours after withdrawal of the device, the animals of the Transport group were transported for 60 min by truck and those from the Control group remained at pasture. Ovarian ultrasound examination was performed every 12 h from device withdrawal until ovulation in every cow. From the day after removal of the device until ovulation estrous behavior was monitored 24 h a day. Blood samples for serum cortisol and progesterone concentrations were taken at -90, -60, 0, 30, 60 and 180 min in relation to the end of transportation. Transportation during the estrous period induced stress in cows as reflected by changes in serum concentrations of progesterone and cortisol. However, we did not detect impairment in estrus expression, estrus duration or ovulation (P>0.05). (C) 2010 Elsevier B.V. All rights reserved.

In utero and lactational exposure to fenvalerate disrupts reproductive function in female rats

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

Impairment on sperm quality and fertility of adult rats after antiandrogen exposure during prepuberty

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