Correlação entre a autopercepção de competência com o desempenho na tarefa de levantar-se do solo de sujeitos idosos saudáveis / Correlation between the self-perception of competence with performance in the task to rise from the floor of healthy elderly subjects / Correlación entre la auto percepción de competencia con rendimiento en la tarea de levantarse del suelo de los sujetos saludables a los ancianos

O objetivo deste estudo foi examinar a correlação entre a au- topercepção de competência (facilidade, dificuldade e esforço subjetivo) com o desempenho na tarefa de levantar-se do solo de idosos saudá- veis. Participaram deste estudo transversal 56 idosos voluntários sau- dáveis. A autopercepção de competência foi avaliada por meio de uma escala likert em categorias (dificuldade/facilidade) e desempenho na tarefa de levantar-se do solo foi medido por meio do número de tentativas realizadas e pelo tempo de execução da tarefa. Verificou-se correlação entre a autopercepção de competência (rho= ,807; p< 0,000) com o número de tentativas na tarefa e com o tempo (rho= -,541; p< 0,000) para levantar-se do solo. Pode-se concluir que, para esta amostra de idosos saudáveis, os aspectos da percepção de competência estão correlacionados com o desempenho para levantar-se do solo.

The objective of this study was to examine the correlation between the perception of competence with the performance on the task to get up from the soil of healthy seniors. 56 volunteers participated in this cross-sectional study. The perception of competence was assessed through a scale in seven categories and performance on the task to get up from the ground was measured through the number of retries performed and through time to run the task. It was found correlation between the perception of competence (rho =, 807; p < 0.000) with the number of attempts the task and with time (rho=-, 541; p < 0.000) to rise from the ground for this sample of healthy seniors. It can be concluded that, for this sample of healthy seniors, aspects of perception of competence are correlated with the performance to rise from the ground

El objetivo de este estudio fue examinar la correlación entre la percepción de competencia con el rendimiento en la tarea de levantarse del suelo de la tercera edad sana. 56 voluntarios participaron en este estudio transversal. La percepción de competencia se evaluó mediante una escala en siete categorías y rendimiento en la tarea de levantarse del suelo se midió a través del número de intentos realizados y a través del tiempo para ejecutar la tarea. Se encontró correlación entre la percepción de competencia (rho=, 807; p < 0.000) con el número de intentos de la tarea y con el tiempo (rho=-, 541; p < 0.000) para elevarse de la tierra para esta muestra de adultos mayores sanas. Se puede concluir que, para esta muestra de adultos mayores sanas, aspectos de la percepción de competencia están correlacionados con el rendimiento que se elevan desde el suelo.

Tradução e adaptação do examen géronto-psychomoteur para o português do Brasil / Translation and adaptation of the examen géronto-psychomoteur to brazilian portuguese

O objetivo do presente estudo foi traduzir o original francês do Examen Géronto-Psychomoteur (EGP) para o português do Brasil e adaptar para uso com idosos brasileiros. A proposta busca suprir a ausência de um instrumento multidisciplinar para avaliação funcional do idoso brasileiro. O EGP é um teste que avalia funções motoras e cognitivas, que são habilidades fundamentais para a manutenção da saúde no envelhecimento. Parâmetros internacionalmente aceitos foram adotados em três etapas: Tradução - duas traduções independentes, síntese, tradução reversa; Comitê de especialistas - cinco juízes avaliaram a equivalência conceitual, semântica e cultural, assim como a clareza da tradução; Pré-teste - foram avaliados 35 voluntários com idade média de 68,66 ± 6,22 anos. O processo de tradução apresentou um documento único na língua portuguesa utilizada no Brasil, que obteve índices de validade de conteúdo quase perfeitos para equivalência e clareza entre 0,86 e 1. Também foi calculado o coeficiente de concordância kappa de Cohen, que apontou uma forte concordância entre as avaliações dos juízes, com valores entre 0,85 e 0,96. O tempo médio de aplicação foi de 52,36 ± 7,48 minutos e a média dos escores dos participantes foi de 91,35 ± 9,85. Os parâmetros obtidos da versão brasileira do EGP mostraramse satisfatórios, indicando que o processo de adaptação do instrumento foi adequado e robusto, o que possibilita a continuidade dos estudos das propriedades psicométricas para validação do Exame Geronto Psicomotor para população idosa brasileira. (AU)

The objective of the present study was to translate the French original of the GérontoPsychomoteur Exam (EGP) into Brazilian Portuguese and adapt it for use with Brazilian elderly. It is a test that assesses motor and cognitive functions, which are fundamental skills for maintaining health in aging. International parameters were adopted in three stages, Translation: two independent translations, synthesis, reverse translation; Expert Committee: Five judges evaluated the conceptual, semantic and cultural equivalence, as well as the clarity of the translation; Pre-test: 35 volunteers with a mean age of 68.66 ± 6.22 years were evaluated. The translation process presented a unique instrument in the Portuguese language used in Brazil, which obtained almost perfect content validity indexes for equivalence and clarity between 0.86 and 1. Cohen's kappa coefficient of agreement was also calculated, which pointed to a strong agreement between the judges' evaluations, with values between 0.85 and 0.96. The mean time of application was 52.36 ± 7.48 minutes and the mean of the participants' scores was 91.35 ± 9.85. The parameters obtained from the Brazilian version of the EGP were satisfactory, indicating that the adaptation process of the instrument was adequate and robust, which allows the continuity of the psychometric properties studies to validate the Geronto Psychomotor Examination for the Brazilian elderly people. (AU)

Associação da aptidão física de idosos saudáveis com o desempenho na tarefa de levantar-se do solo / Association of physical fitness of healthy elderly with performance in the task of getting up from the floor

O objetivo deste estudo transversal foi examinar a associação da aptidão física com o desempenho na tarefa de levantar-se do solo em indivíduos idosos saudáveis. Cinquenta e seis voluntários (71,8 ± 6,96 anos; 68,8 ± 14,02 kg; 1,60 ± 0,97 cm) foram classificados de acordo com o índice de massa corporal. A avaliação da aptidão física foi feita por meio dos seguintes testes funcionais: Timed Up and Go; Teste de apoio unipodal; Teste de sentar e alcançar e o Teste de sentar e levantar. O tempo e o número de tentativas para a tarefa de levantar-se do solo foram verificados utilizando-se o Software Kinovea. Para verificar a associação entre as variáveis, foi utilizado o teste de correlação de Spearman. O nível de significância adotado foi de p < 0,05. Os resultados mostraram que houve associação entre o desempenho na tarefa de levantar-se do solo com o IMC (p < 0,009), equilíbrio dinâmico/mobilidade (p < 0,001) e força muscular de membros inferiores (p < 0,001). Dessa maneira, é plausível admitir que a tarefa de levantar-se do solo mostrou ser uma medida resumo da saúde física na amostra estudada.

The objective of this cross-sectional study was to examine the association of physical fitness with performance in the task of getting up from the floor in healthy elderly individuals. Fifty-six volunteers (71.8 ± 6.96 years, 68.8 ± 14.02 kg, 1.60 ± 0.97 cm) were classified according to the body mass index. Physical fitness assessment was performed using the following functional tests: Timed Up and Go; Unipodal support test; Sit and reach test and Sit and stand test. The time and number of attempts for the task of getting off the ground were checked using the Kinovea Software. To verify the association between the variables, the Spearman correlation test was used. The level of significance was set at p <0.05. The results showed that there was an association between the performance in the task of getting up from the ground with BMI (p <0.009), dynamic balance / mobility (p <0.001) and lower limb muscle strength (p <0.001). Thus, it is plausible to admit that the task of getting up from the floor proved to be a summary measure of physical health in the sample studied.

Postnatal Risk of Acquiring Kawasaki Disease: A Nationwide Birth Cohort Database Study.

OBJECTIVE: To investigate the postnatal risk of Kawasaki disease and coronary complications from a nationwide birth cohort in Taiwan, a country with the third-highest incidence of Kawasaki disease worldwide. STUDY DESIGN: We enrolled children born between 2000 and 2009 with complete postnatal medical care records for 2000-2014 in the Taiwan national database. RESULTS: Out of a total of 2 150 590 live births, we identified 6690 (62.6% boys) patients with Kawasaki disease. The onset was mostly (93.9%) within the first 5 years of life (median, 16 months; 38% during infancy), but was rare within the first 3 months of life. The overall cumulative incidence of Kawasaki disease by age 5 years was 2.78‰ (3.33‰ for boys and 2.17‰ for girls; P < .001) and exhibited an increasing trend with birth year (from 2.28‰ for 2000 to 3.67‰ for 2009). The incidence ratio was 1.535 in boys and 1.055 in each increasing year. Kawasaki disease recurred more often in younger patients (cumulative incidence, 2.3% in infants vs 1.7% in children aged 1-4 years). Coronary complications occurred in 16.2% of the patients, including 4 cases of acute myocardial infarction (3 occuring during the acute stage and 1 occurring 5 years later). The probability of a major cardiac event (infarction, undergoing percutaneous coronary intervention or coronary artery bypass grafting, or death) by adolescence was 1.9%. CONCLUSIONS: The postnatal risk of Kawasaki disease was 3‰-4‰ and increased with every birth year. Patients with Kawasaki disease are at substantial risk for a major cardiac events during childhood.

Risk of Respiratory Syncytial Virus Infection in Cyanotic Congenital Heart Disease in a Subtropical Area.

OBJECTIVE: To compare the risk of respiratory syncytial virus (RSV)-associated hospitalization and analyze the epidemiology of RSV infection in patients with cyanotic and acyanotic congenital heart disease (CHD), we analyzed the nationwide health insurance database from 2005-2010. STUDY DESIGN: This study included 1050 patients with cyanotic CHD and 7077 patients with acyanotic CHD. Patients with acyanotic CHD were further classified into hemodynamically significant (hs)-acyanotic and non-hs-acyanotic groups according to whether they underwent surgery or took at least 2 anticongestive medications. RESULTS: RSV-associated hospitalization was higher in the cyanotic group than in hs-acyanotic and non-hs-acyanotic groups both before 1 year of age (4.8% vs 2.1% vs 1.5%, P < .001) and between 1 and 2 years of age (0.9% vs 0.56% vs 0.14%, P = .003). The hospitalization duration, intensive care, ventilator support prevalence, hospitalization cost, and mortality rate were significantly higher in the cyanotic group than in the other 2 groups. Logistic regression revealed that cyanotic CHD was the most significant risk factor for the ventilator support and RSV-associated mortality. In both patients with cyanotic and acyanotic CHD, RSV-associated hospitalization rate was higher in patients aged younger than 1 year and in spring and autumn in Taiwan, a subtropical country. CONCLUSIONS: The results show that patients with cyanotic CHD have a higher risk of severe RSV infection than do those with acyanotic CHD. RSV prophylaxis is more important and may reduce costs more for patients with cyanotic CHD.

Brazilein from Caesalpinia sappan L. Antioxidant Inhibits Adipocyte Differentiation and Induces Apoptosis through Caspase-3 Activity and Anthelmintic Activities against Hymenolepis nana and Anisakis simplex.

Brazilein, a natural, biologically active compound from Caesalpinia sappan L., has been shown to exhibit anti-inflammatory and antioxidant properties and to inhibit the growth of several cancer cells. This study verifies the antioxidant and antitumor characteristics of brazilein in skin cancer cells and is the first time to elucidate the inhibition mechanism of adipocyte differentiation, cestocidal activities against Hymenolepis nana, and reduction of spontaneous movement in Anisakis simplex. Brazilein exhibits an antioxidant capacity as well as the ability to scavenge DPPH(•) and ABTS(•+) free radicals and to inhibit lipid peroxidation. Brazilein inhibited intracellular lipid accumulation during adipocyte differentiation in 3T3-L1 cells and suppressed the induction of peroxisome proliferator-activated receptor γ (PPAR γ ), the master regulator of adipogenesis, suggesting that brazilein presents the antiobesity effects. The toxic effects of brazilein were evaluated in terms of cell viability, induction of apoptosis, and the activity of caspase-3 in BCC cells. The inhibition of the growth of skin cancer cells (A431, BCC, and SCC25) by brazilein is greater than that of human skin malignant melanoma (A375) cells, mouse leukemic monocyte macrophage (RAW 264.7 cells), and noncancerous cells (HaCaT and BNLCL2 cells). The anthelmintic activities of brazilein against Hymenolepis nana are better than those of Anisakis simplex.

The evolution of increased competitive ability, innate competitive advantages, and novel biochemical weapons act in concert for a tropical invader.

There are many non-mutually exclusive mechanisms for exotic invasions but few studies have concurrently tested more than one hypothesis for the same species. Here, we tested the evolution of increased competitive ability (EICA) hypothesis in two common garden experiments in which Chromolaena odorata plants originating from native and nonnative ranges were grown in competition with natives from each range, and the novel weapons hypothesis in laboratory experiments with leachates from C. odorata. Compared with conspecifics originating from the native range, C. odorata plants from the nonnative range were stronger competitors at high nutrient concentrations in the nonnative range in China and experienced far more herbivore damage in the native range in Mexico. In both China and Mexico, C. odorata was more suppressed by species native to Mexico than by species native to China. Species native to China were much more inhibited by leaf extracts from C. odorata than species from Mexico, and this difference in allelopathic effects may provide a possible explanation for the biogeographic differences in competitive ability. Our results indicate that EICA, innate competitive advantages, and novel biochemical weapons may act in concert to promote invasion by C. odorata, and emphasize the importance of exploring multiple, non-mutually exclusive mechanisms for invasions.

Transtorno de déficit de atenção e hiperatividade em adultos: reconhecimento do distúrbio e proposta de intervenção com terapia cognitiva / Attention-deficit hyperactivity disorder in adults: recognizing the disturbance and a cognitive therapy intervention

O transtorno de déficit de atenção e hiperatividade é o distúrbio neurocomportamental mais comum na infância. Sabe-se, atualmente, que não ocorre remissão de sintomas nem na adolescência nem na idade adulta, mas há sua modificação em função do desenvolvimento de estratégia de enfrentamento do indivíduo, que pode ou não ser adequada.Na vida adulta, causa impacto nas áreas familiar e conjugal, ocupacional e com repercussão na financeira. O portador do transtorno apresenta disfunção executiva. As funções executivas gerenciam comportamentos, tais como produzir intenções, iniciar e terminar ações, selecionar alvos, planejar, antecipar consequências, mudar estratégias, monitorar o comportamento entre outras. Portanto, associada à farmacoterapia, a proposta de intervenção da terapia cognitiva é a construção de comportamentos saudáveis e funcionais para buscar a melhora no desempenho de funções globais, incluindo-se as acadêmicas e as laborais. A abordagem utiliza no tratamento técnicas para areestruturação cognitiva em nível de crença condicional ? cognição que corresponde a uma suposição, ou seja, um pensamento ?Se -, então?. O objetivo de corrigir as distorções cognitivas é a consolidação do novo padrão de funcionamento, facilitada pelo registro diário de comportamentos funcionais, pelo monitoramento de atividades semanaise pelos cartões de enfrentamento. Eles são utilizados nos momentos em que as dificuldades possam comprometer a motivação pela mudança. Neles são escritos os objetivos determinados na terapia, as suposições reestruturadas, as desvantagens de manter os sintomas e as vantagens em tratar a doença. A emoção negativa é identificada para que a tomada de decisão pelo tratamento seja mantida.

Attention-deficit hyperactivity disorder is the most common neurocomportamental disorder in the infancy. The symptomsdo not remit nor in adolescence or in adulthood, but individual developmental cause the modifications that are observed. In adulthood it causes a significant impact in familiar, occupational and financial areas. Executive disfunction is a characteristic of patients with the disease. Executive functions manage behaviors, such as to build intentions, beginning and finishing actions, selecting targets, planning anticipating consequences, building better strategies, monitoring behavior, and so on. For treatment, besides medication, cognitive therapy works with tecniques to underlying assumption reestructuring ? the cognition represented by ?If..., then...? statements. The goal of correcting cognitive distortions is to build up healthier and functional behaviors, for the patient to get better in global functions performance, including academic and working ones. Writing down daily functional behaviors, monitoring weekly activities and building coping cards help consolidate the new functional pattern. Coping cards are written to be used when facing difficult situations, which can disturb the motivation for changing. Therapy goals, the underlying assumption restructured, the disadvantages of keeping thesymptoms, the advantages of treating the disease are some examples of coping cards. The negative emotion is identified for the patient to keep with the decision for the adequate treatment.

Association of SLITRK1 to Gilles de la Tourette Syndrome.

Previously the Slit and Trk-like family member 1 (SLITRK1) gene was identified as a candidate gene for Gilles de la Tourette Syndrome (GTS) based on a patient that carried a chromosomal inversion on 13q, as well as the identification of two rare DNA variants in the SLITRK1 gene. Since that report, studies have tested for the two rare variants in GTS and either did not find them, or when found, they did not segregate with the disorder in families, casting doubt on the relationship of this gene to GTS. We tested for these two rare variants and genotyped three polymorphisms that tag the currently identified major haplotypes of this gene in a sample of 154 nuclear families with GTS. In addition, the entire coding region was screened for novel DNA variants. We did not find the two reported rare variants in any of the probands or siblings in these families. We did however find significant evidence for association of a single polymorphism and of haplotypes of the three tagging polymorphisms. These findings provide the first support for the original finding indicating SLITRK1 as a susceptibility gene for GTS and indicate that further study of this gene in GTS is warranted.

Transtorno de déficit de atenção e hiperatividade: por que é preciso compreender esse diagnóstico? / Attention-deficit/hyperactivity disorder: Why is there a need to understand this diagnosis?

O déficit de atenção e hiperatividade é um transtorno psiquiátrico, mais frequentemente observado na infância, com alterações comportamentais características. Este artigo tem por objetivo chamar a atenção de profissionais da assistência básica de saúde para um quadro clínico frequente, que não sendo diagnosticado e não tratado precoce e adequadamente pode trazer consequências devastadoras à vida do indivíduo e de sua família. O adequado diagnóstico do distúrbio possibilita correta intervenção em todos os níveis de atenção à saúde da criança, permite adequado desenvolvimento e diminui os riscos a que suas manifestações podem expor esse grupo populacional.

Attention deficit/hyperactivity disorder is a psychiatric disease, most frequently observed in infancy and presents characteristic behavioral alterations. The purpose of this study is to call the attention of primary care physicians to a frequent condition that when not soon and correctly diagnosed and treated may bring devastating consequences to the patient’s individual life and also to his family. The adequate diagnosis of this disorder enables the correct intervention at all levels of attention to the child’s health, allowing adequate development and reducing the riscs that its manifestations expose to these population.

Transtorno de humor bipolar: diversas apresentações de uma mesma doença / Bipolar mood disorder: different occurrences of the same disease

O presente relato tem por objetivo acompanhar a evolução de um caso que se apresentou como mutismo seletivo e evoluiu para transtorno de humor bipolar e chamar atenção para a diversidade de sintomas possíveis no transtorno de humor. Em geral, o mutismo seletivo tem início na idade pré-escolar, porém os sintomas chamam mais atenção na idade escolar. A importância do diagnóstico e tratamento precoces reside na prevenção das complicações, tais como distúrbios no desenvolvimento social e acadêmico e na auto-estima, além da possibilidade de evolução para outros transtornos de ansiedade. O transtorno de humor bipolar é uma doença mental caracterizada por variações extremas no humor. Na criança, prejudica o crescimento emocional e seu desenvolvimento. É confundido com transtorno de déficit de atenção/hiperatividade e transtornos de comportamento, tais como transtorno de conduta e desafiador opositivo. A paciente do sexo feminino, quando avaliada, estava com 5 anos e 9 meses de idade. Concluiu-se o diagnóstico como mutismo seletivo. Foi indicada psicoterapia, com orientações aos pais e à escola, e iniciado o uso de inibidores seletivos de recaptação da serotonina, com boa resposta aos sintomas de ansiedade, mas passou a apresentar piora significativa do comportamento. Foi levantada a hipótese diagnóstica de transtorno de humor bipolar de início precoce. Medicada com estabilizador, apresentou adequação na terceira medicação e evolução satisfatória. O mutismo seletivo, considerado um transtorno de ansiedade na infância, pode ser pródromo para outros quadros psiquiátricos na infância. Há necessidade que os pediatras, médicos que primeiro acessam essas crianças, assim como os psiquiatras da infância, estejam atentos à riqueza de sintomas que pode dar seguimento ao quadro.

The purpose of the present case report is to follow the evolution of a child who presented selective mutism and evolved into bipolar mood disorder, and also to draw attention to the diversity of possible symptoms of mood disorders. In general, selective mutism starts at preschool age, although the symptoms are more evident at school age. The importance of an early diagnosis and treatment lies in the prevention of some complications, such as social and academic development and self-esteem, besides the possibility of the development of other anxiety disorders. Bipolar mood disorder is a mental disease characterized by extreme mood variations. In childhood, it hinders the child's emotional growth and development. Selective mutism is mistaken by attention deficit hyperactivity disorder, and behavioral disorders, such as conduct disorder and oppositional defiance disorder. The present case report is about a female patient evaluated at 5 years and 9 months of age. We concluded the case as being a selective mutism disorder. Not only psychotherapy, with parent and school orientation, but also medication was prescribed. The first prescribed medication was use of selective serotonin reuptake inhibitors with good results regarding anxiety symptoms, although the patient started to present significant deterioration in behavior. Because of that, the diagnostic hypothesis came to be bipolar mood disorder with an early start. The patient presented satisfactory evolution only after given a third option of mood stabilizer medication. Selective mutism, which is an anxiety disorder in childhood, can be prodromus to other psychiatric conditions at the same age. It is necessary for pediatricians, who are the doctors that first assess these children, and also child psychiatrists, to be aware of the wealth of symptoms that can give continuation to the condition.