1000 resultados para Distúrbios do início e da manutenção do sono


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O AVC é uma grande causa de mortalidade e uma das principais causas de incapacidade entre adultos. O presente estudo visa analisar o estado do sono e da utilização de cartilhas educativas em pacientes com AVC. No primeiro estudo foram abordados os fatores associados com os horários de dormir/acordar e no segundo estudo foi analisado o conhecimento e prática quanto às orientações sobre os hábitos de sono e estimulação cognitiva. No estudo 1 foram avaliados 50 pacientes sendo 28 homens, de faixa etária entre 25 e 90 anos que durante uma semana completaram um diário do sono e o registro de atividades através do Social Rhythm Metric (SRM) e do Indice de Nível de Atividades (ALI) e aplicação do questionário de cronotipo (MEQ). Utilizado o teste de correlação de Spearman verificou-se correlação significativa entre os horários de dormir/acordar com cronotipo e entre os horários de dormir/acordar com SRM e o ALI. No segundo estudo foram abordados 40 pacientes com idade média 56,1 ± 11,9 anos, sendo 15 homens e 25 mulheres; como instrumentos foram utilizados National Institute Health Stroke Scale (NIHSS) e em seguida os pacientes observaram cartilhas educativas sobre hábitos de sono e estimulação cognitiva respondendo se conheciam e se praticavam as orientações apresentadas. A análise estatística realizada através do teste de Fisher obteve como resultado, que das 10 orientações apresentadas sobre os hábitos de sono, 6 foram citadas como conhecidas e apenas 4 foram praticadas. Das 6 orientações cognitivas, não houve diferença significativa entre os que conheciam e não conheciam, mas em 5 delas a maior frequência foi dos pacientes que não praticaram. Os resultados dos estudos indicam a importância de avaliar o cronotipo antes do planejamento de reabilitação, e a necessidade de se estimular o ritmo social a fim de contribuir para a melhoria dos padrões de sono de pacientes. Verificou-se também que em relação ao conhecimento e prática de orientações apresentadas muitos pacientes não conheceram ou não praticaram orientações importantes a respeito de hábitos de sono e de estimulação cognitiva, mesmo na fase crônica da patologia, sugerindo que mais políticas de educação em saúde devem ser implementadas com intuito de causar mudança nos hábitos de vida dos pacientes com AVC

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Analyses the presence of new standards of habitation detected in the construction of the region called Cidade Nova, in the first s years of the XX century. Associates the presence of these new patterns with the historical moment lived by the capital, marked by the urban modernization and by the changes of local life. Map voices that, introduced by the republican groups since 1889, pronounced the overcome of the old city of the XIX century asseverated a new model of town. Make use, as fundamental fonts of research, of the urban chronicles produced by the local intellectuals and the newspapers, like A República. Dialog with chronics that includes since propositions about the colonial past until the preoccupations about the acting of the State on how to order the public space. Identifies on those texts the political motivations and the elements whose where inherent to capitalism that accelerated the changes occurred in the urban space. Demonstrates the gradual occupation of Cidade Nova as an important modification happened in the city from that time on. That neighborhood adopted a new model on how to construct the houses of their citizens and helped to promote the urban life as a whole. From now on, Natal has a space meant for the home of their richest families. Recognizes, from many ways, many discourses, manners of living that was legitimized by the changing of the XIX to the XX century and has his highest point in the 1920´s. And it was representative of the strong attachment about the habits of refinery and order in the essence of the private life of the local urban elites

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

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Conselho Nacional de Desenvolvimento Científico e Tecnológico

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Autism comprises a heterogeneous group of neurodevelopmental disorders that affects the brain maturation and produces sensorial, motor, language and social interaction deficits in early childhood. Several studies have shown a major involvement of genetic factors leading to a predisposition to autism, which are possibly affected by environmental modulators during embryonic and post-natal life. Recent studies in animal models indicate that alterations in epigenetic control during development can generate neuronal maturation disturbances and produce a hyper-excitable circuit, resulting in typical symptoms of autism. In the animal model of autism induced by valproic acid (VPA) during rat pregnancy, behavioral, electrophysiological and cellular alterations have been reported which can also be observed in patients with autism. However, only a few studies have correlated behavioral alterations with the supposed neuronal hyper-excitability in this model. The aim of this project was to generate an animal model of autism by pre-natal exposure to VPA and evaluate the early post-natal development and pre-puberal (PND30) behavior in the offspring. Furthermore, we quantified the parvalbumin-positive neuronal distribution in the medial prefrontal cortex and Purkinje cells in the cerebellum of VPA animals. Our results show that VPA treatment induced developmental alterations, which were observed in behavioral changes as compared to vehicle-treated controls. VPA animals showed clear behavioral abnormalities such as hyperlocomotion, prolonged stereotipies and reduced social interaction with an unfamiliar mate. Cellular quantification revealed a decrease in the number of parvalbumin-positive interneurons in the anterior cingulate cortex and in the prelimbic cortex of the mPFC, suggesting an excitatory/inhibitory unbalance in this animal model of autism. Moreover, we also observed that the neuronal reduction occurred mainly in the cortical layers II/III and V/VI. We did not detect any change in the density of Purkinje neurons in the Crus I region of the cerebellar cortex. Together, our results strengthens the face validity of the VPA model in rats and shed light on specific changes in the inhibitory circuitry of the prefrontal cortex in this autism model. Further studies should address the challenges to clarify particular electrophysiological correlates of the cellular alterations in order to better understand the behavioral dysfunctions

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Epilepsies are neurological disorders characterized by recurrent and spontaneous seizures due to an abnormal electric activity in a brain network. The mesial temporal lobe epilepsy (MTLE) is the most prevalent type of epilepsy in adulthood, and it occurs frequently in association with hippocampal sclerosis. Unfortunately, not all patients benefit from pharmacological treatment (drug-resistant patients), and therefore become candidates for surgery, a procedure of high complexity and cost. Nowadays, the most common surgery is the anterior temporal lobectomy with selective amygdalohippocampectomy, a procedure standardized by anatomical markers. However, part of patients still present seizure after the procedure. Then, to increase the efficiency of this kind of procedure, it is fundamental to know the epileptic human brain in order to create new tools for auxiliary an individualized surgery procedure. The aim of this work was to identify and quantify the occurrence of epilepticform activity -such as interictal spikes (IS) and high frequency oscillations (HFO) - in electrocorticographic (ECoG) signals acutely recorded during the surgery procedure in drug-resistant patients with MTLE. The ECoG recording (32 channels at sample rate of 1 kHz) was performed in the surface of temporal lobe in three moments: without any cortical resection, after anterior temporal lobectomy and after amygdalohippocampectomy (mean duration of each record: 10 min; N = 17 patients; ethic approval #1038/03 in Research Ethic Committee of Federal University of São Paulo). The occurrence of IS and HFO was quantified automatically by MATLAB routines and validated manually. The events rate (number of events/channels) in each recording time was correlated with seizure control outcome. In 8 hours and 40 minutes of record, we identified 36,858 IS and 1.756 HFO. We observed that seizure-free outcome patients had more HFO rate before the resection than non-seizure free, however do not differentiate in relation of frequency, morphology and distribution of IS. The HFO rate in the first record was better than IS rate on prediction of seizure-free patients (IS: AUC = 57%, Sens = 70%, Spec = 71% vs HFO: AUC = 77%, Sens = 100%, Spec = 70%). We observed the same for the difference of the rate of pre and post-resection (IS: AUC = 54%, Sens = 60%, Spec = 71%; vs HFO: AUC = 84%, Sens = 100%, Spec = 80%). In this case, the algorithm identifies all seizure-free patients (N = 7) with two false positives. To conclude, we observed that the IS and HFO can be found in intra-operative ECoG record, despite the anesthesia and the short time of record. The possibility to classify the patients before any cortical resection suggest that ECoG can be important to decide the use of adjuvant pharmacological treatment or to change for tailored resection procedure. The mechanism responsible for this effect is still unknown, thus more studies are necessary to clarify the processes related to it

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The presence of fixed orthodontics appliances interfere on sanitation, allowing periodontal diseases to appear, despite the fact patients keep on visiting the dentist every month. This research aims to determine a protocol for the mechanical control of the dental biofilm performed by the professional. A protocol that was able to maintain the periodontal health of the patients under orthodontic treatment with fixed appliances, and in order to do so, it used a non-controlled, randomized and blind clinical essay. The sample involved 40 adolescents who were under the installation of fixed orthodontics appliances and it was divided in three groups, as follows: monthly controlled group (group 1) composed of 11 patients, the quarterly controlled group (group 2) with 16 patients and the semestrial controlled group (group 3) with 13 patients. For data collection, an interview and clinical exams with probing depth measurement, quantity of keratinized mucosa, Gingival Index and the Plaque Index were used. On the initial exam all patients received brushing guidelines as well as the professional control of dental biofilm, with periodontal scaler, Robinson s brush and prophylactic paste. However, Group 1 returned every month for control procedures; Group 2 every three months and Group 3 after six months. The intervention had a six-month duration (for all the three groups), when all the exams were repeated by another examiner who did not know which group each patient was inserted in. Finally, the research concluded that despite the fact there is no statistically significant difference among the three groups, clinically the patients from the monthly group presented a better response to professional control, with less accumulation of dental biofilm and less rate of gingival inflammation. Thus, the mechanical control of the dental biofilm performed by the professional could not avoid gingival increase, characterized by the raise of probing depth measurement, neither the quantity of keratinized mucosa

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This study clinically evaluated the relationship of gingival recessions with the periodontal index of gingival and plaque, dental alignment, keratinized mocous, type of periodontal, and occlusal disorders. Study participants were individuals aged between 19 and 33 years. The evaluations were performed by using questionnaires and clinical examinations. In subjects examined, the teeth were assessed and divided into groups (Molars, premolars, canines and incisors). The gingival recession were measured in the central region of the teeth and individuals were subject to disclosure to the plate and observing the poll of plaque and gingival index, respectively. 558 teeth were examined, with 24.1%, 135 had gingival recession greater than or equal to 1mm. Through the combination of tests used to evaluate the average of the recession and its relationship with the variables studied, we observed that the degree of recession of the elements assessed dental showed, almost for the most part, when higher values associated with the index plaque (p = 0.101), Gingival Index (p = 0.053), dental alignment (p = 0.962), width of keratinized mocous (p = 0.004) and type of periodontium (p = 0.033), however statistically significant difference could only be considered when related the recessions in the keratinized mocous and the type of the periodontium. Although we identify, when we evaluate the whole set of teeth that occlusal disturbances (p = 0.002) were more strongly associated with cases of gum recession that the gingival index (p = 0.006), however, these two conditions were correlated with the cases of recession, contributing to its occurrence

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One of the largest problems of the present time resulting from the economic globalization and the modern technology, of the point of view of the biological rhytms of our organism, it is offering services and production of goods available in 24 o'clock, that it demands organized workers in several work schedules besides the hours of the day. Those schedules cause a series of biopsychosocial consequences in the worker's health, in function of circadian, homeostatic and psychosocial alterations. Accordingly, the aim of this study was to accomplish an evaluation of the effects of several works schedules in the pattern of the sleep wake cycle, anxiety, stress and in the health. We counted with a sample of 274 workers subdivided in 49 daytime worker groups and 225 workers in different shift work schedules with different speeds (rotating shift group, slower day shift group, faster day shift group). From the results analysis it is verified irregularities of the daily activities, stress and alterations in the workers' health in all schedules. It was also verified thata the workers thata presented irregularities in the daily activities were the mroe stressed. On the other hand, the shift works were considered more ansious and associated with bad sleep quality. It was verified that the workers with bad sleep quality were those presented larger levels of dispocional anxiety. There was no statistically significant correlation between bad sleep quality and irregular daily lifestyle. However, it can be affirmed thata shift work schendules doesn't are the main determinant for the circadian alterations, but the answers of the individuals to the shifts work; and that the inadequate behavioural strategies to work with the effects of the shift schedules. In conclusion, individual strategies related to the coping of the work in shift (adaptation and tolerance) should be extolled as indispensable tool in the ergonomic evaluation of the work

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The use of animal models in biomedical research is ever increasing. Models that use primates might also have advantages in terms of low maintenance costs and availability of biological knowledge, thereby favoring their use in different experimental protocols. Many current stress studies use animal models at different developmental stages since biological response differs during ontogeny. The aims of this study were to perform a detailed characterization of the developmental stages of common marmosets (Callithrix jacchus), a very important animal model used in biomedical research. Ten subjects, 6 females and 4 males, were followed from birth to initial adult age (16 months). Behavioral and fecal collection for measurement of adrenal (cortisol) and sex (progesterone, estradiol and androgens) hormones took place twice a week during the first month of life and once a week for the remainder of the study. Behavior was observed for 30 minutes in the morning (0700-09:00h) and afternoon (12:00-14:00h). Behavioral profile showed changes during ontogeny, characterizing the 4 developmental stages and the respective phases proposed by Leão et al (2009).. Differentiation of developmental stages was considered using the onset, end, change and stabilization of the behavioral profile parental care (weaning and carrying), ingestion (solid food), affiliation (social grooming) and autogrooming, agonism (scent marking and piloerection) and play behavior and endocrine profile. Infant weaning and carrying terminated within the infantile stage and the peak of solid food ingestion was recorded in the infantile III phase. Receiving grooming was recorded earlier than grooming performed by the infant and autogrooming. The first episode of scent marking was recorded in the 4th week and it was the least variable behavior, in terms of its onset, which, in almost all animals, was between the 5th and 7th week of life. Solitary play and play with the twin started around the 7th week and play with other members of the group started 8 weeks later. Sex hormone secretion started to differ from basal levels between the 21st and 23rd week of life, in males and females, suggesting that puberty occurs simultaneously in both sexes. Basal cortisol, even at an early age, was higher in females than in males. However, cortisol was not correlated with the juvenile stage, as expected, since this stage corresponds to the transition between infancy and adult age and most behaviors are intensified by this time. The behavioral and endocrine profile of subadult animals did not differ from that of the adults. These results provide more detailed parameters for the developmental process of C. jacchus and open new perspectives for the use of experimental approaches focused on the intermediate ontogenetic phases of this species

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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

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Fibromyalgia (FM) is a non-inflammatory rheumatic syndrome of unknown etiology, with symptoms of diffuse musculoskeletal pain and presence of specific anatomic sites called tender points. The symptoms are often associated with fatigue, sleep disturbances, morning stiffness, alterations in pain perception, anxiety and depression. Fibromyalgia exhibits a correlation between physical and behavioral symptoms, which have a negative influence on the quality of life of patients. Emotional skills are important factors since they are related to subjective well-being, personal productivity, social interaction and interpersonal relationships. We aim to describe the physical and psychosocial interactions in women with FM, showing the association between perceived social support and affect with symptoms of pain, functionality and mood. We will also describe a body representation of pain in women with FM. Data were collected over 3 years and the sample size ranged between studies. This is an exploratory cross-sectional study conducted with a convenience sample of 63 women with FM and 42 healthy women as a control group (CT), aged 20-76 years, recruited through spontaneous demand at Onofre Lopes University Hospital (HUOL) and the Clinical School of Physiotherapy of Universidade Potiguar (UNP). The Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), Social Support Scale (MOS), Hamilton Anxiety Scale and Scale of Positive and Negative Affect Schedule (PANAS), in addition to pressure algometry were used. For data analysis, we used parametric and non-parametric tests and a general linear model with adjustment variables and analysis of variance. A significant difference was found between pain threshold and tolerance, functionality, depression, anxiety, social support, and positive and negative affect between the groups. Affective states and social support were associated with anxiety, depression and functionality. A body was drawn representing pain with higher incidences in trapeze, supraspinatus and second ribs. The reason for studying sensory aspects, affective behavior and social support in FM patients opens perspectives for scientific and clinical research of this syndrome. Women with chronic pain such as FM appear to have altered mood states, less social support and affective dysfunctions, influencing the other symptoms of the syndrome

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Most of ontogenetic studies on circadian timing system have been developed on infants, adults and elderly. The puberty has not been a stage of life few studied, except for researches in human adolescents, that presents phase delay in sleep-wake cycle. However, few studies have focused on the basis of this circadian change due to methodological difficulties. Thus, an animal model to study the sleep-wake cycle at puberty is essential. In the common marmoset, a social primate, the circadian activity periodicity stabilizes around 4 months (juvenile stage) and the 8h period component has a seasonal variation. Puberty stage of this species begins near the 8th month of age in males and near the 7th month in females with 7 months of duration. With the aim to characterize the circadian motor activity rhythm during puberty in marmosets (Callithrix jacchus) the motor activity was continuous registered by actiwatches in 6 animals between 5-12 months. Since the social factor influence the behavior of this specie, behavioral observations were realized in 30 minutes windows twice/week to a general evaluation of the influence social interactions dynamic across experiment. Determination of puberty onset was done by fecal progesterone and estrogens in females, and androgens in males. From the analysis of the multiple regression test was selected a model that evaluate age and seasonal variables effect on the activity rhythm according to the higher explanation coefficient. The total activity was the only parameter influenced by age. Moreover, the activity onset was the parameter more explained by the model, and the sunrise was the factor that most influenced it. After the puberty onset, 2 dyads advanced the activity onset. The activity total decreased in 1 dyad and increased in 2 dyads. This increase may be related to the birth of infants in these families. The motor activity circadian component stabilized later in 1 dyad, coinciding with the puberty onset of these animals, while bimodality, caused by the 8 h component, was modulated by seasonality. The agonistic behavior was not evaluated due to reduced number of events. There were changes across ages in affiliative behavior of contact in 1 dyad, grooming done in 1 animal and grooming received in 2 animals. Although there is evidence of puberty effect on the activity motor rhythm, the photoperiodic fluctuations influenced the rhythm. Therefore is not possible to affirm if the puberty modulate the activity rhythm in marmosets

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The sleep onset and offset delay at adolescence in relation to childhood. Besides biological causes, some external factors as academic obligations and socialization contributes, increasing the burden of school and socialization. However, morning school schedules reduce sleep duration. Besides light strong effect, studies in humans have indicated that exercise influence circadian synchronization. To evaluate the effect of the morning exercise under sunlight on sleep-wake cycle (SWC) of adolescents, 160 high school students (11th year) were exposed to the following conditions: lesson in usual classroom (Group C), lesson in swimming pool exposed to sunlight (Group E), half of them carrying through physical activity (EE) and the other resting (EL). Each experimental group met two stages: assessment of SWC 1 week before and 1 week during the intervention, which was held in Monday and Wednesday between 7:45 and 8:30 am. In the baseline, there were applied the questionnaires "Health and Sleep" and cronotype evaluation (H & O). In addition, students were evaluated before and during the intervention by "Sleep Diary", "Karolinska Sleepiness Scale" (KSS), Psychomotor Vigilance Test (PVT) and actimetry. During the intervention, there was a delay in wake-up time on the weekend and a trend to greater sleep duration on week for the three groups. At the weekend, only the groups EE and EL increased sleep duration. There was no difference in bedtime, irregularity of sleep schedules and nap variables. The sleepiness showed a circadian pattern characterized by higher alertness levels at 11:30 am and sleepiness levels at bedtime and wake-up time on week. On weekends there were higher levels of alertness in these times. In the days of intervention, there was an increase of sleepiness at 11:30 am for groups EL and EE, which may have been caused by a relaxing effect of contact with the water of the pool. In addition, the group EE showed higher alert levels at 14:30 pm on Monday and at 8:30 am in the Wednesday, possibly caused by exercise arousal effect. The reaction time assessed through the TPV did not vary between the stages. The sleep quality improved in the three groups in the second stage, making impossible the evaluation of intervention effect. However, the sleep quality increased on Monday and Tuesday only on the group EE. From the results, it is suggested that the intervention promoted effects on the sleepiness at some day hours. In other SWC variables there were no effects, possibly due to a large SWC irregularity on weekends. Thus, the evaluation of higher weekly frequency EF is necessary, since only two days were insufficient to promote greater effect on adolescents SWC

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The ability to predict future rewards or threats is crucial for survival. Recent studies have addressed future event prediction by the hippocampus. Hippocampal neurons exhibit robust selectivity for spatial location. Thus, the activity of hippocampal neurons represents a cognitive map of space during navigation as well as during planning and recall. Spatial selectivity allows the hippocampus to be involved in the formation of spatial and episodic memories, including the sequential ordering of events. On the other hand, the discovery of reverberatory activity in multiple forebrain areas during slow wave and REM sleep underscored the role of sleep on the consolidation of recently acquired memory traces. To this date, there are no studies addressing whether neuronal activity in the hippocampus during sleep can predict regular environmental shifts. The aim of the present study was to investigate the activity of neuronal populations in the hippocampus during sleep sessions intercalated by spatial exploration periods, in which the location of reward changed in a predictable way. To this end, we performed the chronic implantation of 32-channel multielectrode arrays in the CA1 regions of the hippocampus in three male rats of the Wistar strain. In order to activate different neuronal subgroups at each cycle of the task, we exposed the animals to four spatial exploration sessions in a 4-arm elevated maze in which reward was delivered in a single arm per session. Reward location changed regularly at every session in a clockwise manner, traversing all the arms at the end of the daily recordings. Animals were recorded from 2-12 consecutive days. During spatial exploration of the 4-arm elevated maze, 67,5% of the recorded neurons showed firing rate differences across the maze arms. Furthermore, an average of 42% of the neurons showed increased correlation (R>0.3) between neuronal pairs in each arm. This allowed us to sort representative neuronal subgroups for each maze arm, and to analyze the activity of these subgroups across sleep sessions. We found that neuronal subgroups sorted by firing rate differences during spatial exploration sustained these differences across sleep sessions. This was not the case with neuronal subgroups sorted according to synchrony (correlation). In addition, the correlation levels between sleep sessions and waking patterns sampled in each arm were larger for the entire population of neurons than for the rate or synchrony subgroups. Neuronal activity during sleep of the entire neuronal population or subgroups did not show different correlations among the four arm mazes. On the other hand, we verified that neuronal activity during pre-exploration sleep sessions was significantly more similar to the activity patterns of the target arm than neuronal activity during pre-exploration sleep sessions. In other words, neuronal activity during sleep that precedes the task reflects more strongly the location of reward than neuronal activity during sleep that follows the task. Our results suggest that neuronal activity during sleep can predict regular environmental changes