Avaliação vestibular em indivíduos com cinetose

A cinetose tem elevada prevalência mundial, sendo mais frequente na infância e no sexo feminino, mas também pode acometer adultos. Resulta de um conflito vestíbulo-visual que incide durante a locomoção em diversos meios de transporte, como carro, ônibus, avião e barco. A forma mais dramática ocorre no transporte marítimo. Ocasiona náusea, vômito, sudorese, aumento da salivação, redução do apetite, hipotensão e mal-estar. Geralmente é produzida por estímulo vestibular, mas também pode ser induzida por estímulo visual. Tanto as acelerações lineares quanto angulares geram cinetose se persistirem por longo período em indivíduos susceptíveis. Recentemente ocorre maior interesse nessa afecção devido ao crescente uso de tecnologia de simulação de vôo e direção automobilística. O objetivo do estudo foi analisar as alterações vestibulares nos indivíduos adultos com cinetose. Trata-se de um estudo prospectivo, tipo série de casos. Os pacientes do ambulatório do Hospital Universitário Pedro Ernesto-UERJ foram avaliados através de anamnese geral e dirigida e exame fisico geral e otorrinolaringológico. Aqueles com histórico de doença otológica foram excluídos. Posteriormente realizaram audiometria e testes vestibulares com o registro gráfico dos nistagmos através da vectoeletronistagmografia. Nos resultados das provas calóricas encontramos 3,33% de pacientes com alteração de predomínio direcional, 6,67% com alteração de predomínio labiríntico, 3,33% com hiperreflexia esquerda, 3,33% com hiporreflexia direita e 3,33% com hiporreflexia esquerda. Encontrados algumas variações na análise dos movimentos sacádicos, nistagmo optocinético e rastreio pendular. Os resultados foram de encontro aos achados da literatura. Diante dos achados, foi observado que o exame otoneurológico com registro gráfico da cinetose mostrou-se muito importante para a avaliação dos pacientes com essa afecção. O estudo traz benefícios por contribuir para o melhor entendimento da cinetose e estimular novas pesquisas na área.

Attention deficit/hyperactivity disorder children with a 7-repeat allele of the dopamine receptor D4 gene have extreme behavior but normal performance on critical neuropsychological tests of attention

An association of the dopamine receptor D4 (DRD4) gene located on chromosome 11p15.5 and attention deficit/hyperactivity disorder (ADHD) has been demonstrated and replicated by multiple investigators. A specific allele [the 7-repeat of a 48-bp variable number of tandem repeats (VNTR) in exon 3] has been proposed as an etiological factor in attentional deficits manifested in some children diagnosed with this disorder. In the current study, we evaluated ADHD subgroups defined by the presence or absence of the 7-repeat allele of the DRD4 gene, using neuropsychological tests with reaction time measures designed to probe attentional networks with neuroanatomical foci in D4-rich brain regions. Despite the same severity of symptoms on parent and teacher ratings for the ADHD subgroups, the average reaction times of the 7-present subgroup showed normal speed and variability of response whereas the average reaction times of the 7-absent subgroup showed the expected abnormalities (slow and variable responses). This was opposite the primary prediction of the study. The 7-present subgroup seemed to be free of some of the neuropsychological abnormalities thought to characterize ADHD.

Extract of Ginkgo biloba leaves reverses yohimbine-induced spatial working memory deficit in rats

Extract of Ginkgo biloba is used to alleviate age-related decline in cognitive function, which may be associated with the loss of catecholamines in the prefrontal cortex. The purpose of this study was to verify whether alpha-2 adrenergic activity is involved in the facilitative effects of extract of Ginkgo biloba on prefrontal cognitive function. Male Wistar rats were trained to reach criterion in the delayed alternation task (0, 25, and 50-s delay intervals). A pilot study found that 3 or 4 mg/kg of yohimbine (intraperitoneal) reduced the choice accuracy of the delayed alternation task in a dose and delay-dependent manner, without influencing motor ability or perseverative behaviour. Acute oral pre-treatment with doses of 50, 100, or 200 mg/kg (but not 25 mg/kg) of extract of Ginkgo biloba prevented the reduction in choice accuracy induced by 4 mg/kg yohimbine. These data suggest that the prefrontal cognition-enhancing effects of extract of Ginkgo biloba are related to its actions on alpha-2-adrenoceptors.

Postharvest porometer to study transpiration and to measure vapor pressure deficit.

O pôrometro de pós-colheita é um instrumento para medir transpiração, resistência difusiva e déficit de pressão de vapor por manometria a volume constante e por volumetria a pressão constante. É constituído de uma câmara de transpiração com fechamento hermético contendo um suporte de amostras sobre um ventilador e externamente um manômetro de coluna de água com pipeta graduada móvel. Sob temperatura constante, o déficit de pressão de vapor (.P), e o volume de vapor de água (.V) foram proporcionais aos volumes de água vaporizados. Com o uso de um excesso de água este aumento da pressão de vapor iguala-se, em módulo, ao déficit de pressão de vapor do ar na câmara de transpiração. Para amostras do ar atmosférico no laboratório, o déficit de pressão de vapor foi calculado a partir das temperaturas de bulbo seco e úmido em um psicrômetro ventilado e por manometria. A correlação entre estes dois métodos foi de 0,976. A acurácia das medidas de transpiração é tal que o produto do volume morto da câmara (V) pela declividade (.P/ .V) determinada pelo vapor de água liberado no processo iguala-se à pressão barométrica, com erro inferior a 1%. Um exemplo experimental do uso do porômetro de pós-colheita em cenoura é apresentado juntamente e os detalhes para obter a resistência difusiva e espessura da camada laminar. O porômetro de pós-colheita é um porômetro de difusão simples, robusto, que poderá ser usado em estudos de efeito de cêras, na seleção de cultivares e em variados outros estudos de fisiologia de pós-colheita.

Exploring the compassion deficit debate.

Several recent high profile failures in the UK health care system have promoted strong debate on compassion and care in nursing. A number of papers articulating a range of positions within this debate have been published in this journal over the past two and a half years. These articulate a diverse range of theoretical perspectives and have been drawn together here in an attempt to bring some coherence to the debate and provide an overview of the key arguments and positions taken by those involved. In doing this we invite the reader to consider their own position in relation to the issues raised and to consider the impact of this for their own practice. Finally the paper offers some sense of how individual practitioners might use their understanding of the debates to ensure delivery of good nursing care.

Association between attention-deficit/hyperactivity disorder symptoms and obesity and hypertension in early adulthood: a population-based study.

OBJECTIVE: To examine the associations between attention-deficit/hyperactivity disorder (ADHD) symptoms, obesity and hypertension in young adults in a large population-based cohort. DESIGN, SETTING AND PARTICIPANTS: The study population consisted of 15,197 respondents from the National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents followed from 1995 to 2009 in the United States. Multinomial logistic and logistic models examined the odds of overweight, obesity and hypertension in adulthood in relation to retrospectively reported ADHD symptoms. Latent curve modeling was used to assess the association between symptoms and naturally occurring changes in body mass index (BMI) from adolescence to adulthood. RESULTS: Linear association was identified between the number of inattentive (IN) and hyperactive/impulsive (HI) symptoms and waist circumference, BMI, diastolic blood pressure and systolic blood pressure (all P-values for trend <0.05). Controlling for demographic variables, physical activity, alcohol use, smoking and depressive symptoms, those with three or more HI or IN symptoms had the highest odds of obesity (HI 3+, odds ratio (OR)=1.50, 95% confidence interval (CI) = 1.22-2.83; IN 3+, OR = 1.21, 95% CI = 1.02-1.44) compared with those with no HI or IN symptoms. HI symptoms at the 3+ level were significantly associated with a higher OR of hypertension (HI 3+, OR = 1.24, 95% CI = 1.01-1.51; HI continuous, OR = 1.04, 95% CI = 1.00-1.09), but associations were nonsignificant when models were adjusted for BMI. Latent growth modeling results indicated that compared with those reporting no HI or IN symptoms, those reporting 3 or more symptoms had higher initial levels of BMI during adolescence. Only HI symptoms were associated with change in BMI. CONCLUSION: Self-reported ADHD symptoms were associated with adult BMI and change in BMI from adolescence to adulthood, providing further evidence of a link between ADHD symptoms and obesity.

The spacing effect depends on an encoding deficit, retrieval, and time in working memory: evidence from once-presented words.

The spacing effect in list learning occurs because identical massed items suffer encoding deficits and because spaced items benefit from retrieval and increased time in working memory. Requiring the retrieval of identical items produced a spacing effect for recall and recognition, both for intentional and incidental learning. Not requiring retrieval produced spacing only for intentional learning because intentional learning encourages retrieval. Once-presented words provided baselines for these effects. Next, massed and spaced word pairs were judged for matches on their first three letters, forcing retrieval. The words were not identical, so there was no encoding deficit. Retrieval could and did cause spacing only for the first word of each pair; time in working memory, only for the second.

Visual memory-deficit amnesia: a distinct amnesic presentation and etiology.

We describe a form of amnesia, which we have called visual memory-deficit amnesia, that is caused by damage to areas of the visual system that store visual information. Because it is caused by a deficit in access to stored visual material and not by an impaired ability to encode or retrieve new material, it has the otherwise infrequent properties of a more severe retrograde than anterograde amnesia with no temporal gradient in the retrograde amnesia. Of the 11 cases of long-term visual memory loss found in the literature, all had amnesia extending beyond a loss of visual memory, often including a near total loss of pretraumatic episodic memory. Of the 6 cases in which both the severity of retrograde and anterograde amnesia and the temporal gradient of the retrograde amnesia were noted, 4 had a more severe retrograde amnesia with no temporal gradient and 2 had a less severe retrograde amnesia with a temporal gradient.

Response variability in Attention Deficit Hyperactivity Disorder: Evidence for neuropsychological heterogeneity

Response time (RT) variability is a common finding in ADHD research. RT variability may reflect frontal cortex function and may be related to deficits in sustained attention. The existence of a sustained attention deficit in ADHD has been debated, largely because of inconsistent evidence of time-on-task effects. A fixed-sequence Sustained Attention to Response Task (SART) was given to 29 control, 39 unimpaired and 24 impaired-ADHD children (impairment defined by the number of commission errors). The response time data were analysed using the Fast Fourier Transform, to define the fast-frequency and slow-frequency contributions to overall response variability. The impaired-ADHD group progressively slowed in RT over the course of the 5.5 min task, as reflected in this group's greater slow-frequency variability. The fast-frequency trial-to-trial variability was also significantly greater, but did not differentially worsen over the course of the task. The higher error rates of the impaired-ADHD group did not become differentially greater over the length of the task. The progressive slowing in mean RT over the course of the task may relate to a deficit in arousal in the impaired-ADHD group. The consistently poor performance in fast-frequency variability and error rates may be due to difficulties in sustained attention that fluctuate on a trial-to-trial basis. (c) 2006 Elsevier Ltd. All rights reserved.