Metamemory training for memory disorders in adults with a closed head injury

The purpose of the present study was to investigate the efficacy of a memory and metamemory training program on memory performance and metamemory judgement accuracy in adults with a closed head injury. A multiple baseline across subjects design was used with six subjects. All subjects were seen at least two years post-injury. Training included general metamemory information about the nature of memory, use of a specific memory strategy to assist verbal recall (to Preview, Question, Read, State and Test- PQRST), specific metamemory information about the strategy, and a self instruction procedure (WTSC- What is the task, Select a strategy to use, Try out strategy, Check to evaluate strategy effectiveness). During the training period all subjects recalled greater than fifty percent of paragraph ideas while using PQRST. Follow-up tests showed that five of the six subjects maintained recall levels but a gradual decrease in slope was observed over eight weeks post-training. Tests of recall, recognition and metamemory judgements on Sentence and Action Tasks were used to evaluate generalisation of training. Two subjects showed improved recall and two subjects showed improved recognition performance. In addition, four subjects demonstrated greater metamemory judgement accuracy about recognition performance following training. Improved performance post-training was also observed for three subjects on the Rivermead Behavioral Memory Test and the Logical Memory subtest of the Wechsler Memory Scale-Revised, greater than that expected for repeated testing. Several factors were identified as having a role in subjects’ ability to benefit from training.

Outcome after traumatic injury

The thesis' aim was to explore outcome after traumatic injury. Poorer physical health prior to injury and receipt of compensation explained variance in physical health 12 months after injury. Poorer mental health 3 and 12 months after injury was partly explained by stronger emotional reactions immediately after the injury, receipt of compensation, and lower perceived social support. The portfolio focuses on symptoms of depression and anxiety in those suffering chronic pain. Through four case studies who attended a pain management service, it is argued that psychological symptoms are able to be addressed concurrently with pain management strategies.

The extra resource burden of in-hospital falls: a cost of falls study

OBJECTIVE: To quantify the additional hospital length of stay (LOS) and costs associated with in-hospital falls and fall injuries in acute hospitals in Australia. DESIGN, SETTING AND PARTICIPANTS: A multisite prospective cohort study conducted during 2011-2013 in the control wards of a falls prevention trial (6-PACK). The trial included all admissions to 12 acute medical and surgical wards of six Australian hospitals. In-hospital falls data were collected from medical record reviews, daily verbal reports by ward nurse unit managers, and hospital incident reporting and administrative databases. Clinical costing data were linked for three of the six participating hospitals to calculate patient-level costs. OUTCOME MEASURES: Hospital LOS and costs associated with in-hospital falls and fall injuries for each patient admission. RESULTS: We found that 966 of a total of 27 026 hospital admissions (3.6%) involved at least one fall, and 313 (1.2%) at least one fall injury, a total of 1330 falls and 418 fall injuries. After adjustment for age, sex, cognitive impairment, admission type, comorbidity and clustering by hospital, patients who had an in-hospital fall had a mean increase in LOS of 8 days (95% CI, 5.8-10.4; P < 0.001) compared with non-fallers, and incurred mean additional hospital costs of $6669 (95% CI, $3888-$9450; P < 0.001). Patients with a fall-related injury had a mean increase in LOS of 4 days (95% CI, 1.8-6.6; P = 0.001) compared with those who fell without injury, and there was also a tendency to additional hospital costs (mean, $4727; 95% CI, -$568 to $10 022; P = 0.080). CONCLUSION: Patients who experience an in-hospital fall have significantly longer hospital stays and higher costs. Programs need to target the prevention of all falls, not just the reduction of fall-related injuries.

Os acidentes humanos e suas implicações fonoaudiológicas: opiniões de docentes e discentes sobre a formação superior

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Infecções cutâneas e acidentes por animais traumatizantes e venenosos ocorridos em aquários comerciais e domésticos no Brasil: descrição de 18 casos e revisão do tema

FUNDAMENTOS: O aquarismo a cada dia ganha novos adeptos no Brasil. Impulsionado por belos peixes e objetos de decoração, o hábito pode trazer problemas como infecções e envenenamentos por diversos animais. OBJETIVOS: Demonstração dos animais causadores e dos quadros clínicos envolvidos com estes acidentes, das infecções cutâneas encontradas após traumas e das medidas terapêuticas e preventivas para controle do problema, pouco conhecido pela população em geral. MÉTODOS: Utilizou-se um estudo prospectivo para a detecção de acidentes por animais e infecções ocorridas após traumas em aquários. Estes dados serviram de base para um estudo epidemiológico, clínico e terapêutico sobre o problema. RESULTADOS: em cerca de 300 acidentes por animais aquáticos, 12 ou 4% do total foram causados por animais venenosos em aquários. Cinco infecções bacterianas e uma fúngica foram identificadas após traumas em aquários. CONCLUSÕES: Os acidentes em aquários domésticos e comerciais são relativamente comuns e podem acarretar infecções cutâneas e ferimentos por animais venenosos ou traumatizantes. Os proprietários de aquários na maioria das vezes não têm informações sobre estes acidentes. Os autores fornecem as espécies de microorganismos e animais mais freqüentemente envolvidas com ferimentos e as medidas terapêuticas e preventivas adequadas ao manejo do problema.

HIPERTERMIA EM RATOS INDUZIDA PELA LESAO ELETROLITICA DO MESENCEFALO: PARTICIPACAO DAS PROSTAGLANDINAS

The present studies were conducted to determine the role of prostaglandins in the etiology of a rise of body temperature observed in rats after electrolytic lesion made on the dorsal mesencephalic areas. This hyperthermia was abolished by intraperitoneal administration of indomethacin, an inhibitor of prostaglandins synthesis. These results strengthen the suggestion of a similar mechanism for both neurogenic hyperthermia and the fevers produced by pyrogens. However, until further experiments are carried out, the possibility of lesion in producing hyperthermia by different mechanisms cannot be ruled out.

Attack upon a bather by a swordfish: A case report

We report a case of a bather injured by a swordfish in shallow water off the coast of southern Brazil. The victim suffered multiple injuries from the fish's bill, including a puncture wound of his left knee and the tip of the bill remaining as a foreign body. The victim made a full recovery after field management and conservative care. The potential factors leading to this most unusual attack are discussed. © 2009 Wilderness Medical Society.

Occurrence of traumatic dental injury in cases of domestic violence

The purpose of this study was to investigate the prevalence and types of traumatic dental injuries in situations of domestic violence. A coross-sectional study was conducted and data were collected from the police occurrence records to domestic physical aggression between 2001 and 2005. Of the 1,844 subjects who underwent medical evaluation, 15 had information pertaining to traumatic dental injuries. From the medical records, the forensic medical reports completed by the forensic medical experts who examined the victims after the aggression were reviewed and data of individuals with dental injuries (e.g., fractures, luxation and avulsion) were collected. In the selected sample, there was a predominance of individuals with injuries to the head and neck region (38.7%), and the frequency of traumatic dental injuries among all injuries to the head and neck region was 2.0%. The most frequently injured teeth were the maxillary incisors (31.8%), followed by the mandibular incisors (27.3%) and the maxillary canines (9.1%). In 31.8% of the injured teeth, the forensic experts did not specify the nomenclature. Of the dental trauma cases, 59.1% were fractures, 27.2% were luxations and 13.7% were avulsions. In conclusion, domestic violence was an important etiologic factor of traumatic dental injury. The aggression in all cases occurred in the form of punches and slaps. Fracture was the most common type of traumatic dental injury, and the most frequently injured teeth were the incisors.

Eletroforetograma das proteínas do soro de equinos submetidos a diferentes protocolos de exercícios

Pós-graduação em Medicina Veterinária - FMVZ

Avaliação dos parâmetros gasométricos dos traumatizados durante o atendimento pré-hospitalar móvel

OBJECTIVE: To evaluate gasometric differences of severe trauma patients requiring intubation in prehospital care. METHODS: Patients requiring airway management were submitted to collection of arterial blood samples at the beginning of pre-hospital care and at arrival at the Emergency Room. We analyzed: Glasgow Coma Scale, respiratory rate, arterial pH, arterial partial pressure of CO2 (PaCO2), arterial partial pressure of O2 (PaO2), base excess (BE), hemoglobin O2 saturation (SpO2) and the relation of PaO2 and inspired O2 (PaO2/FiO2). RESULTS: There was statistical significance of the mean differences between the data collected at the site of the accident and at the entrance of the ER as for respiratory rate (p = 0.0181), Glasgow Coma Scale (p = 0.0084), PaO2 (p <0.0001) and SpO2 (p = 0.0018). CONCLUSION: tracheal intubation changes the parameters PaO2 and SpO2. There was no difference in metabolic parameters (pH, bicarbonate and base excess). In the analysis of blood gas parameters between survivors and non-survivors there was statistical difference between PaO2, hemoglobin oxygen saturation and base excess.

Orientações de alta: cartões padronizados ajudam na compreensão dos pacientes do pronto socorro?

OBJECTIVE: To determine whether the addition of discharge standard illustrated cards improves understanding of patients in the emergency room. METHODS: We conducted a prospective, randomized, interventional study with 228 patients discharged from the emergency department. All patients were interviewed and tested for the level of understanding of discharge instructions. Some of them received the intervention, with the standard cards, and another did not, constituting the control group. RESULTS: The average of followed discharge guidelines of the group that received the cards was higher than the control group, with statistical significance (p=0.009). When segregated by age, the group between 16 and 35 years of both sexes had the best average of followed guidelines, statistically, than the average of the control group (p=0.01). The difference between the mean orientations between the control group and the card for patients undergoing procedures was statistically significant (p=0.02); as for the stratification according to the number of procedures, the significance increases when that is equal to 1 (p=0.001) and decreased the more procedures were carried out. CONCLUSION: The introduction of discharge standard orientation cards was associated with improvement in the understanding of patients. Without replacing the verbal directions, which establishes dialogue and doctor-patient bonding, cards appear as auxiliary elements, facilitating understanding and care guidelines.

A lei seca cumpriu sua meta em reduzir acidentes relacionados à ingestão excessiva de álcool?

OBJECTIVE: To assess whether the Brazilian Driving Dry Law reached its goal after the three years following its enactment. METHODS: We onnducted a retrospective study of patients with craniofacial fractures who underwent surgery at a university hospital in two periods: before the Law (2005 to 2008) and after the Law (2008 to 2011). RESULTS: 265 patients (220 men and 45 women) were operated on during this period, 149 (56%) before and 116 (44%) after the Law, which indicates a reduction in the number of traumatisms (p=0.04). The age range between 19 and 40 years predominated in both periods. The main causes of traumas were car accidents, physical aggression and falls. Alcohol abuse was identified in 15.4% patients before and 19% patients after the enactment. The jaw and the maxillo-zygomatic complex were the most affected bones. CONCLUSION: The drop in the number of polytraumatized patients operated on at this institution in the three years following the Driving Dry Law was 22%, which is below the expected and desired percentage. These results must be compared to those of different services offering the same attendance type in order to compile data and enlarge statistics. The low index of reduction in the number of traumatisms and the report of alcohol abuse by several patients at the moment of trauma, even after the law, evidence the need of adopting stricter measures to control and punish violators.

Platelet-Rich Plasma, Low-Level Laser Therapy, or Their Combination Promotes Periodontal Regeneration in Fenestration Defects: A Preliminary In Vivo Study

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

Efeitos da suplementação da quercetina sobre o rendimento físico em esteira ergométrica e indicadores metabólicos do exercício exaustivo em atletas de futebol

Pós-graduação em Patologia - FMB

Efeito do consumo agudo de erva mate sobre o rendimento fisíco em esteira ergométrica e indicadores metabólicos da exaustão em jogadores profissionais de futebol

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)