Case Report: Anomalous Experience in a Dissociative Identity and Borderline Personality Disorder.

Introduction: Dissociative identity disorder, formerly called multiple personality disorder, is a rupture of identity characterized by the presence of two or more distinct personality states, described in some cultures as an experience of possession. Objective: The case of a 30-year-old woman with dissociative identity disorder and borderline personality disorder associated with a previous history of anomalous experience was reported. Case Report: A 30-year-old woman who fulfilled the DSM-5 criteria for dissociative identity disorder and borderline personality disorder reported the presence of unusual sensory experiences (clairvoyance, premonitory dreams, clairaudience) since she was 5 years old. The patient told that for 12 months she presented episodes in which a "second self" took charge of her actions: she would then speak with a male voice, become aggressive, and require several people to contain her desire for destruction. After 3 months of religious follow-up, and accepting her unusual experiences and trance possessions as normal and natural, she had significant improvement. Conclusion: When approaching DID and BPD patients, it is necessary to observe the anomalous phenomena (in the light of) closer to their cultural and religious contexts, to promote better results in the treatment of their disorders, which has not been explored in the treatment guide.

Nerves transfers for functional hand recovery in traumatic lower brachial plexopathy.

BACKGROUND: Distal nerve transfers are an innovative modality for the treatment of C8-T1 brachial plexus lesions. The purpose of this case series is to report the authors' results with hand restoration function by nerve transfer in patients with lower brachial plexus injury. METHODS: Three consecutive nerve transfers were performed in a series of 11 patients to restore hand function after injury to the lower brachial plexus: brachialis motor branch to anterior interosseous nerve (AIN) and supinator branch to the posterior interosseous nerve (PIN) in a first surgical procedure, and AIN to pronator quadratus branch of ulnar nerve between 4 and 6 months later. RESULTS: In all, 11 male patients underwent 33 surgical procedures. Time between brachial plexus injury and surgery was a mean of 11 months (range 4-13 months). Postoperative follow-up ranged from 12 to 24 months. We observed recovery of M3 or better finger flexion strength (AIN) and wrist extension (PIN) in 8 of the 11 surgically treated upper limbs. These patients recovered full thumb and finger extension between 6 and 12 months of surgery, without significant loss of donor function. CONCLUSION: Nerve transfers represent a way of restoring volitional control of upper extremity function in patients with C8-T1 brachial plexus injury.

Pattern of anxiety, insecurity, fear, panic and/or phobia observed by quantitative electroencephalography (QEEG).

Stress is a response in which an individual wants to have more control over a situation. A constant state of stress is called anxiety. Some patients deny symptoms. An instrument can help arrive at a diagnosis. OBJECTIVE: Using TQ-7 QEEG, this study aimed to evaluate the association of symptoms of anxiety, insecurity, fear, panic and phobia with hot temporals defined as Beta (15-23 Hz) >17% and High-Beta waves (23-38 Hz) >10% at T3 and T4. METHODS: Five hundred and forty-three patients of both genders with ages ranging from 16-59 years were evaluated, divided into two groups: Control (without hot temporals: n=274) and Case Group (with hot temporals: n=269). The Chi-square test was used (p-values ≤0.05). RESULTS: There was a significant association (p-value <0.001) between the symptoms related to amygdala activation, expressed in the temporals (Beta >17% and High-Beta >10%). (Anxiety, T3=89.6% - T4=88.8%; T3=92.6% - T4=93.3%), (Fear, T3=80.7% - T4=84.4%; T3=82.9% - T4=95.9%), (Insecurity, T3=82.2% - T4=81.4%; T3=69.5% - T4=97.8%), (Panic, T3=52.4 - T4=72.5%; T3=90.3% - T4=74.0%), (Phobia, T3=17.5% - T4=22.7%; T3=19.7% - T4=27.1%), when compared to the respective controls (Beta control, T3=8.4%, 10.2%, 21.2%, 1.1%, 0.4% and T4=11.3%, 4.4%, 23.0%, 2.6%, 1.1%) (High-Beta control, T3=4.0%, 6.9%, 6.2%, 0.4%, 0.0% and T4=17.5%, 6.2%, 3.3%, 4.0%, 0.7%). CONCLUSION: Anxiety, insecurity, fear, panic and phobia are observed by QEEG when the levels of total Beta >17% and High-Beta waves >10% at T3 and T4.

O estresse é uma resposta a uma situação na qual, um indivíduo quer ter mais controle. Um estado de estresse constante é chamado de ansiedade. Alguns pacientes negam sintomas. Um instrumento pode auxiliar um diagnóstico. OBJETIVO: Utilizando o QEEG TQ-7, este estudo objetivou avaliar a associação dos sintomas de ansiedade, insegurança, medo, pânico e/ou fobia com a categoria de temporais quentes definidos como Beta (15-23 Hz) >17% e Beta-Alta (23-38 Hz) >10% em T3 e T4. MÉTODOS: Foram avaliados 543 pacientes de ambos os gêneros na faixa etária de 16-59 anos, divididos: Controle (sem temporais quentes: n=274) Grupo estudado (com temporais quentes: n=269). Foi utilizado o teste qui-quadrado (p-valor ≤0.05). RESULTADOS: Houve associação significativa (p-valor <0.001) entre os sintomas relacionados à ativação da amigdala, expressos nos temporais (Beta >17% e Beta-Alta >10%). (Ansiedade, T3=89,6% - T4=88,8%; T3=92,6% - T4=93,3%), (Medo, T3=80,7% - T4=84,4%; T3=82,9% - T4=95,9%), (Insegurança, T3=82,2% - T4=81,4%; T3=69,5% - T4=97,8%), (Pânico, T3=52.4% - T4=72.5%; T3=90.3% - T4=74.0%), (Fobia, T3=17,5% - T4=22,7%; T3=19,7% - T4=27,1%), quando comparados aos respectivos controles (Beta controle, T3=8,4%, 10,2%, 21,2%, 1,1%, 0,4% e T4=11,3%, 4,4%, 23,0%, 2,6%, 1,1%) e (Beta-Alta Controle, T3=4,0%, 6,9%, 6,2%, 0,4%, 0,0%; T4=17,5%, 6,2%, 3,3%, 4,0%, 0,7%). CONCLUSÃO: Ansiedade, insegurança, medo, pânico e fobia são observados no QEEG, quando Beta >17% e Beta-Alta >10% em T3 e T4.

Pattern of anxiety, insecurity, fear, panic and/or phobia observed by quantitative electroencephalography (QEEG) / Padrão de ansiedade, insegurança, medo, pânico e/ou fobia observado no exame de eletroencefalografia quantitativa (QEEG)

ABSTRACT: Stress is a response in which an individual wants to have more control over a situation. A constant state of stress is called anxiety. Some patients deny symptoms. An instrument can help arrive at a diagnosis. Objective: Using TQ-7 QEEG, this study aimed to evaluate the association of symptoms of anxiety, insecurity, fear, panic and phobia with hot temporals defined as Beta (15-23 Hz) >17% and High-Beta waves (23-38 Hz) >10% at T3 and T4. Methods: Five hundred and forty-three patients of both genders with ages ranging from 16-59 years were evaluated, divided into two groups: Control (without hot temporals: n=274) and Case Group (with hot temporals: n=269). The Chi-square test was used (p-values ≤0.05). Results: There was a significant association (p-value <0.001) between the symptoms related to amygdala activation, expressed in the temporals (Beta >17% and High-Beta >10%). (Anxiety, T3=89.6% - T4=88.8%; T3=92.6% - T4=93.3%), (Fear, T3=80.7% - T4=84.4%; T3=82.9% - T4=95.9%), (Insecurity, T3=82.2% - T4=81.4%; T3=69.5% - T4=97.8%), (Panic, T3=52.4 - T4=72.5%; T3=90.3% - T4=74.0%), (Phobia, T3=17.5% - T4=22.7%; T3=19.7% - T4=27.1%), when compared to the respective controls (Beta control, T3=8.4%, 10.2%, 21.2%, 1.1%, 0.4% and T4=11.3%, 4.4%, 23.0%, 2.6%, 1.1%) (High-Beta control, T3=4.0%, 6.9%, 6.2%, 0.4%, 0.0% and T4=17.5%, 6.2%, 3.3%, 4.0%, 0.7%). Conclusion: Anxiety, insecurity, fear, panic and phobia are observed by QEEG when the levels of total Beta >17% and High-Beta waves >10% at T3 and T4.

RESUMO: O estresse é uma resposta a uma situação na qual, um indivíduo quer ter mais controle. Um estado de estresse constante é chamado de ansiedade. Alguns pacientes negam sintomas. Um instrumento pode auxiliar um diagnóstico. Objetivo: Utilizando o QEEG TQ-7, este estudo objetivou avaliar a associação dos sintomas de ansiedade, insegurança, medo, pânico e/ou fobia com a categoria de temporais quentes definidos como Beta (15-23 Hz) >17% e Beta-Alta (23-38 Hz) >10% em T3 e T4. Métodos: Foram avaliados 543 pacientes de ambos os gêneros na faixa etária de 16-59 anos, divididos: Controle (sem temporais quentes: n=274) Grupo estudado (com temporais quentes: n=269). Foi utilizado o teste qui-quadrado (p-valor ≤0.05). Resultados: Houve associação significativa (p-valor <0.001) entre os sintomas relacionados à ativação da amigdala, expressos nos temporais (Beta >17% e Beta-Alta >10%). (Ansiedade, T3=89,6% - T4=88,8%; T3=92,6% - T4=93,3%), (Medo, T3=80,7% - T4=84,4%; T3=82,9% - T4=95,9%), (Insegurança, T3=82,2% - T4=81,4%; T3=69,5% - T4=97,8%), (Pânico, T3=52.4% - T4=72.5%; T3=90.3% - T4=74.0%), (Fobia, T3=17,5% - T4=22,7%; T3=19,7% - T4=27,1%), quando comparados aos respectivos controles (Beta controle, T3=8,4%, 10,2%, 21,2%, 1,1%, 0,4% e T4=11,3%, 4,4%, 23,0%, 2,6%, 1,1%) e (Beta-Alta Controle, T3=4,0%, 6,9%, 6,2%, 0,4%, 0,0%; T4=17,5%, 6,2%, 3,3%, 4,0%, 0,7%). Conclusão: Ansiedade, insegurança, medo, pânico e fobia são observados no QEEG, quando Beta >17% e Beta-Alta >10% em T3 e T4.

The participation of Early Maladaptive Schemas (EMSs) in the perception of pain in patients with migraine: A psychological profile.

Young's early maladaptive schemas questionnaire (YSQ-S3) is used to understand psychological aspects. OBJECTIVE: EMSs were evaluated in patients with migraine. METHODS: Sixty-five subjects were evaluated using the YSQ-S3 under standard conditions in a room with air conditioning at 22 ± 2°C. The subjects were stratified by morbidity (migraine), gender (male/female) and age (18-29 / 30-39 / 40-55). Controls (without migraine), n = 27 and patients (with migraine), n = 38, men (n = 19) and women (n = 46); participants aged 18-29 years, n = 34, aged 30-39 years, n = 14 and aged 40-55 years, n = 17. Data were analyzed using the Chi-square test, with p-values <0.05. Results were expressed as percentages in contingency tables. RESULTS: There was a significant association between migraine and female gender (84.21%; p-value <0.05, Table 1), between hypervigilance and inhibition, and unrelenting standards (56.52%; p-value <0.0.014, Table 2) and female gender with migraine. Moreover, there was a significant association between hypervigilance and inhibition, and unrelenting standards (73.68%; p-value <0.0001) and self-punishment (84.21%; p-value <0.0001) in patients with migraine of both genders (Table 3). CONCLUSION: The individuals with migraine had a psychological profile of being overly demanding with themselves and others and self-punishing, where this was more frequent in women.

O questionário de esquemas iniciais desadaptativos de Young (YSQ-S3) é usado para se entender aspectos psicológicos. OBJETIVO: Os EIDs foram avaliados em pacientes com migrânea. MÉTODOS: Sessenta e cinco indivíduos foram avaliados utilizando YSQ-S3 sob condições padrão em uma sala com ar condicionado a 22 ± 2°C. Os sujeitos foram estratificados pela morbidade (migrânea), por gênero (masculino/feminino) e por idade (18-29 / 30-39 / 40-55). Controle (sem migrânea), n = 27 e com migrânea, n = 38, homens (n ​​= 19) e mulheres (n = 46); indivíduos com idade entre 18 a 29 anos, n = 34, entre 30-39 anos, n = 14 e entre 40-55 anos, n = 17. Os dados foram analisados ​​usando o teste do qui-quadrado, com valores p <0,05. Os resultados foram expressos em porcentagens em tabelas de contingência. RESULTADOS: Houve associação significativa entre migrânea e gênero feminino (84,21%; p-valor <0,05, Tabela 1), entre hipervigilância e inibição, e padrões excessivamente rígidos ​​(56,52%; p-valor <0,0,014, Tabela 2) e gênero feminino com migrânea. Além disso, houve associação significativa entre hipervigilância e inibição, e padrões excessivamente rígidos ​​(73,68%; p-valor <0,0001) e autopunição (84,21%; p-valor <0,0001) em pacientes com migrânea de ambos os gêneros (Tabela 3). CONCLUSÃO: Os indivíduos com migrânea têm um perfil psicológico de serem excessivamente exigentes consigo e com os outros e de se autopunirem, sendo isso mais frequente em mulheres.

The participation of Early Maladaptive Schemas (EMSs) in the perception of pain in patients with migraine: A psychological profile / A participação dos esquemas iniciais desadaptativos (eids) na percepção da dor em pacientes com migrânea: um perfil psicológico

ABSTRACT. Young's early maladaptive schemas questionnaire (YSQ-S3) is used to understand psychological aspects. Objective: EMSs were evaluated in patients with migraine. Methods: Sixty-five subjects were evaluated using the YSQ-S3 under standard conditions in a room with air conditioning at 22 ± 2°C. The subjects were stratified by morbidity (migraine), gender (male/female) and age (18-29 / 30-39 / 40-55). Controls (without migraine), n = 27 and patients (with migraine), n = 38, men (n = 19) and women (n = 46); participants aged 18-29 years, n = 34, aged 30-39 years, n = 14 and aged 40-55 years, n = 17. Data were analyzed using the Chi-square test, with p-values <0.05. Results were expressed as percentages in contingency tables. Results: There was a significant association between migraine and female gender (84.21%; p-value <0.05, Table 1), between hypervigilance and inhibition, and unrelenting standards (56.52%; p-value <0.0.014, Table 2) and female gender with migraine. Moreover, there was a significant association between hypervigilance and inhibition, and unrelenting standards (73.68%; p-value <0.0001) and self-punishment (84.21%; p-value <0.0001) in patients with migraine of both genders (Table 3). Conclusion: The individuals with migraine had a psychological profile of being overly demanding with themselves and others and self-punishing, where this was more frequent in women.

RESUMO. O questionário de esquemas iniciais desadaptativos de Young (YSQ-S3) é usado para se entender aspectos psicológicos. Objetivo: Os EIDs foram avaliados em pacientes com migrânea. Métodos: Sessenta e cinco indivíduos foram avaliados utilizando YSQ-S3 sob condições padrão em uma sala com ar condicionado a 22 ± 2°C. Os sujeitos foram estratificados pela morbidade (migrânea), por gênero (masculino/feminino) e por idade (18-29 / 30-39 / 40-55). Controle (sem migrânea), n = 27 e com migrânea, n = 38, homens (n ​​= 19) e mulheres (n = 46); indivíduos com idade entre 18 a 29 anos, n = 34, entre 30-39 anos, n = 14 e entre 40-55 anos, n = 17. Os dados foram analisados ​​usando o teste do qui-quadrado, com valores p <0,05. Os resultados foram expressos em porcentagens em tabelas de contingência. Resultados: Houve associação significativa entre migrânea e gênero feminino (84,21%; p-valor <0,05, Tabela 1), entre hipervigilância e inibição, e padrões excessivamente rígidos ​​(56,52%; p-valor <0,0,014, Tabela 2) e gênero feminino com migrânea. Além disso, houve associação significativa entre hipervigilância e inibição, e padrões excessivamente rígidos ​​(73,68%; p-valor <0,0001) e autopunição (84,21%; p-valor <0,0001) em pacientes com migrânea de ambos os gêneros (Tabela 3). Conclusão: Os indivíduos com migrânea têm um perfil psicológico de serem excessivamente exigentes consigo e com os outros e de se autopunirem, sendo isso mais frequente em mulheres.

The Learning Curve in neurofeedback of Peter Van Deusen: A review article / A curva da aprendizagem de Peter Van Deusen em neurofeedback: artigo de revisão

ABSTRACT The Learning Curve (TLC) in neurofeedback concept emerged after Peter Van Deusen compiled the results of articles on the expected electrical activity of the brain. This concept was subsequently tested on patients at four clinics in Atlanta between 1994 and 2001. The aim of this paper was to report the historical aspects of TLC. Articles published on the electronic databases MEDLINE/PubMed and Web of Science were reviewed. During patient evaluation, TLC investigates categories called disconnected, hot temporal lobes, reversal of alpha and beta waves, blocking, locking, and filtering or processing. This enables neuroscientists to use their training designs and, by means of behavioral psychology, to work on neuroregulation, as self-regulation for patients. TLC shows the relationships between electrical, mental and behavioral activity in patients. It also identifies details of patterns that can assist physicians in their choice of treatment.

RESUMO A TLC em neurofeedback surgiu após uma reunião de periódicos organizada por Peter Van Deusen sobre as atividades elétricas cerebrais esperadas e depois testadas em diversos pacientes em quatro consultórios, em Atlanta, de 1994 a 2001. O objetivo deste artigo é relatar o aspecto histórico da TLC. Realizou-se uma revisão na base eletrônica MEDLINE/PubMed e Web of Science. A TLC investiga as categorias denominadas desconectados, temporais quentes, inversões de alpha e beta, bloqueando, trancando, filtrando e processando e, em seguida, possibilita, em seus designs de treinamento, que o (a) neurocientista trabalhe, por meio da psicologia comportamentalista, a autoneuroregulação do paciente. A TLC mostra as relações entre as atividades elétricas, mentais e comportamentais nos pacientes e também fornece uma identificação detalhada dos padrões que podem ajudar os médicos na escolha dos tratamentos.

The Learning Curve in neurofeedback of Peter Van Deusen: A review article.

The Learning Curve (TLC) in neurofeedback concept emerged after Peter Van Deusen compiled the results of articles on the expected electrical activity of the brain. This concept was subsequently tested on patients at four clinics in Atlanta between 1994 and 2001. The aim of this paper was to report the historical aspects of TLC. Articles published on the electronic databases MEDLINE/PubMed and Web of Science were reviewed. During patient evaluation, TLC investigates categories called disconnected, hot temporal lobes, reversal of alpha and beta waves, blocking, locking, and filtering or processing. This enables neuroscientists to use their training designs and, by means of behavioral psychology, to work on neuroregulation, as self-regulation for patients. TLC shows the relationships between electrical, mental and behavioral activity in patients. It also identifies details of patterns that can assist physicians in their choice of treatment.

A TLC em neurofeedback surgiu após uma reunião de periódicos organizada por Peter Van Deusen sobre as atividades elétricas cerebrais esperadas e depois testadas em diversos pacientes em quatro consultórios, em Atlanta, de 1994 a 2001. O objetivo deste artigo é relatar o aspecto histórico da TLC. Realizou-se uma revisão na base eletrônica MEDLINE/PubMed e Web of Science. A TLC investiga as categorias denominadas desconectados, temporais quentes, inversões de alpha e beta, bloqueando, trancando, filtrando e processando e, em seguida, possibilita, em seus designs de treinamento, que o (a) neurocientista trabalhe, por meio da psicologia comportamentalista, a autoneuroregulação do paciente. A TLC mostra as relações entre as atividades elétricas, mentais e comportamentais nos pacientes e também fornece uma identificação detalhada dos padrões que podem ajudar os médicos na escolha dos tratamentos.

Participation in night time activities in the genesis of depression in public school teachers from the State of Pernambuco, Brazil / Participação eventual de atividdes noturnas na gênese da depressão em professoores da rede pública do Estado de Pernambuco, Brasil

Teachers often undertake nighttime work involving exam corrections, projects and devising lesson plans in theirhomes. Many present excessive daytime sleepiness (EDS) and depression. Objective: The objective of this study was toevaluate EDS and depression in teachers from public schools. Methods: 201 female teachers were evaluated in the districtof Quipapá/PE, Brazil. Among the study sample, 38 working 1 shift (CONTROL 1), 40 working 2 shifts (CONTROL 2) and123 working 3 shifts (WTeachers-3T). The subjects were submitted to evaluation by the Epworth Sleepiness Scale and Beck Depression Inventory (BDI).The EDS data were analyzed by the Kruskal-Wallis test with Dunns multiple comparison, p<0.05and expressed in MEDIAN (MINIMUM - MAXIMUM) whereas the depression data were analyzed by the Chi-square test,with p<0.05, expressed in percentage. Results: WTeachers-3T presented excessive daytime sleepiness and higher ratesof mild (24%) and moderate (37%) depression compared to controls - Control 1: mild (8%) and moderate (11%) - Control2: mild (5%) and moderate (15%). Conclusion: This study found that teachers in the Quipapá municipality of Penambucostate working three shifts showed excessive daytime sleepiness and a higher percentage of mild and moderate depression compared to teachers working only one (1) or two (2) shifts.

Professores têm trabalhado muito no período noturno com correções de provas, trabalhos e elaborando planejamento de ensino em suas casas. Muitos estão apresentando sonolência excessiva diurna (SED) e depressão.Objetivo: O objetivo deste trabalho foi avaliar sonolência excessiva diurna e depressão em professoras da rede pública. Métodos: Foram avaliadas 201 professoras do município de Quipapá/PE, Brasil, sendo 38 que trabalham em 1 turno(CONTROLE 1), 40 que trabalham em 2 turnos (CONTROLE 2) e 123 que trabalham em 3 turnos (PROFas-3T). Os sujeitos foram avaliados pela Escala de Sonolência de Epworth e pelo Inventário de Depressão de Beck. Os dados referentes à SE foram analisados pelo teste Kruskal-Wallis com comparação múltipla em Dunn, p<0,05 e expressos em MEDIANA(MÍNIMO - MÁXIMO) e os dados referentes à depressão foram analisados pelo teste qui-quadrado, com p<0,05, expressos em percentuais. Resultados: PROFas-3T apresentam sonolência excessiva e apresentam maior percentual de depressão leve (24%) e moderada (37%) comparadas a seus controles - CONTROLE 1: leve (8%) e moderada (11%) -CONTROLE2: leve (5%) e moderada (15%). Conclusão: Este estudo observou que professoras da rede municipal de Quipapá/PE que trabalham em 3 turnos apresentam sonolência excessiva e maior percentual de depressão leve e moderada comparadasàs professoras que trabalham em 1 (um) ou em 2 (dois) turnos.

Life quality, depression and anxietysymptoms in chronic post-traumaticheadache after mild brain injury / Qualidade de vida, sintomas de depressão e ansiedade em cefaléia pós-traumática crônica após lesão cerebral leve

ABSTRACT. Post-traumatic headache (PTH) is the most common symptom found in the post-traumatic syndrome, whose onset occurs within seven days of the trauma. The condition is characterized as acute when it persists for up to 3 months. PTH beyond this period is considered chronic. Objectives: The objective of this study was to determine the clinical features of chronic post-traumatic headache (cPTH) and its association with depression, anxiety and quality of life. Methods: A total of 73 female subjects were evaluated. Patients were divided into three groups: (a) group without headache, CONTROL, n=25; (b) cPTH group, n=19; and (c) MIGRAINE, n=29, with all subjects in the 11-84 year age group. Symptoms of anxiety and depression were evaluated by the Beck inventories of anxiety and depression, and quality of life assessed by the Lipp and Rocha quality of life inventory. Qualitative variables were analyzed using the Chi-square or Fisher's exact tests and expressed as percentages whereas quantitative variables were analyzed by ANOVA, Mann-Whitney or Kruskal-Wallis tests with data expressed as mean±standard deviation, p<0.05. Results: Subjects with cPTH presented with headache manifesting similar features to those found in migraine. The cPTH group was associated with similar levels of anxiety and depression to the migraine group and higher than the CONTROL (p<0.001). Quality of life of individuals with cPTH was similar to that of subjects with migraine and lower than CONTROL subjects (p<0.05). Conclusions: cPTH presents similar clinical characteristics to migraine. Subjects with cPTH had high levels of anxiety and depression symptoms and reduced quality of life.

RESUMO. A cefaleia é o sintoma mais encontrado na síndrome pós-traumática, iniciando-se dentro de sete dias após o trauma. Sua a forma aguda dura até três meses e a crônica persiste após este período. Objetivos: O objetivo deste estudo foi determinar as características clínicas da cefaleia pós-traumática crônica (CPTc) e sua associação com a depressão, ansiedade e com nível de qualidade de vida. Métodos: Foram avaliados 73 sujeitos do gênero feminino, divididos em três grupos: (a) grupo sem cefaleia (CONTROLE, n=25), (b) grupo com CPTc (n=19) e (c) migrânea (MIGRÂNEA, n=29), com idades variando entre 11 e 84 anos. Os sintomas de ansiedade e depressão foram avaliados pelos inventários de ansiedade e depressão de Beck e a qualidade de vida pelo inventário de qualidade de vida de Lipp e Rocha. As variáveis qualitativas foram analisadas pelos testes qui-quadrado ou exato de Fisher e expressas em percentuais e as quantitativas por ANOVA, Mann-Whitney ou Kruskal-Wallis com os dados apresentados em média±desvio padrão, p<0,05. Resultados: Os sujeitos com CPTc apresentaram cefaleia com características semelhantes as encontradas na migrânea. A CPTc esteve associada aos níveis de sintomas de ansiedade e depressão similares ao grupo com migrânea e superior ao CONTROLE (p<0,001). Os níveis de qualidade de vida dos sujeitos com CPTc mostraram-se semelhantes aos dos sujeitos com migrânea e inferior ao CONTROLE (p<0,05). Conclusões: A CPTc apresenta características clínicas semelhantes a migrânea. Os sujeitos com CPTc apresentam elevado nível de sintomas de ansiedade e depressão e nível de qualidade de vida reduzida.

Life quality, depression and anxiety symptoms in chronic post-traumatic headache after mild brain injury.

Post-traumatic headache (PTH) is the most common symptom found in the post-traumatic syndrome, whose onset occurs within seven days of the trauma. The condition is characterized as acute when it persists for up to 3 months. PTH beyond this period is considered chronic. OBJECTIVES: The objective of this study was to determine the clinical features of chronic post-traumatic headache (cPTH) and its association with depression, anxiety and quality of life. METHODS: A total of 73 female subjects were evaluated. Patients were divided into three groups: (a) group without headache, CONTROL, n=25; (b) cPTH group, n=19; and (c) MIGRAINE, n=29, with all subjects in the 11-84 year age group. Symptoms of anxiety and depression were evaluated by the Beck inventories of anxiety and depression, and quality of life assessed by the Lipp and Rocha quality of life inventory. Qualitative variables were analyzed using the Chi-square or Fisher's exact tests and expressed as percentages whereas quantitative variables were analyzed by ANOVA, Mann-Whitney or Kruskal-Wallis tests with data expressed as mean±standard deviation, p<0.05. RESULTS: Subjects with cPTH presented with headache manifesting similar features to those found in migraine. The cPTH group was associated with similar levels of anxiety and depression to the migraine group and higher than the CONTROL (p<0.001). Quality of life of individuals with cPTH was similar to that of subjects with migraine and lower than CONTROL subjects (p<0.05). CONCLUSIONS: cPTH presents similar clinical characteristics to migraine. Subjects with cPTH had high levels of anxiety and depression symptoms and reduced quality of life.

A cefaleia é o sintoma mais encontrado na síndrome pós-traumática, iniciando-se dentro de sete dias após o trauma. Sua a forma aguda dura até três meses e a crônica persiste após este período. OBJETIVOS: O objetivo deste estudo foi determinar as características clínicas da cefaleia pós-traumática crônica (CPTc) e sua associação com a depressão, ansiedade e com nível de qualidade de vida. MÉTODOS: Foram avaliados 73 sujeitos do gênero feminino, divididos em três grupos: (a) grupo sem cefaleia (CONTROLE, n=25), (b) grupo com CPTc (n=19) e (c) migrânea (MIGRÂNEA, n=29), com idades variando entre 11 e 84 anos. Os sintomas de ansiedade e depressão foram avaliados pelos inventários de ansiedade e depressão de Beck e a qualidade de vida pelo inventário de qualidade de vida de Lipp e Rocha. As variáveis qualitativas foram analisadas pelos testes qui-quadrado ou exato de Fisher e expressas em percentuais e as quantitativas por ANOVA, Mann-Whitney ou Kruskal-Wallis com os dados apresentados em média±desvio padrão, p<0,05. RESULTADOS: Os sujeitos com CPTc apresentaram cefaleia com características semelhantes as encontradas na migrânea. A CPTc esteve associada aos níveis de sintomas de ansiedade e depressão similares ao grupo com migrânea e superior ao CONTROLE (p<0,001). Os níveis de qualidade de vida dos sujeitos com CPTc mostraram-se semelhantes aos dos sujeitos com migrânea e inferior ao CONTROLE (p<0,05). CONCLUSÕES: A CPTc apresenta características clínicas semelhantes a migrânea. Os sujeitos com CPTc apresentam elevado nível de sintomas de ansiedade e depressão e nível de qualidade de vida reduzida.

Participation in nighttime activities in the genesis of depression in public school teachers from the State of Pernambuco, Brazil.

Teachers often undertake nighttime work involving exam corrections, projects and devising lesson plans in their homes. Many present excessive daytime sleepiness (EDS) and depression. OBJECTIVE: The objective of this study was to evaluate EDS and depression in teachers from public schools. METHODS: 201 female teachers were evaluated in the district of Quipapá/PE, Brazil. Among the study sample, 38 working 1 shift (CONTROL 1), 40 working 2 shifts (CONTROL 2) and 123 working 3 shifts (WTeachers-3T). The subjects were submitted to evaluation by the Epworth Sleepiness Scale and Beck Depression Inventory (BDI).The EDS data were analyzed by the Kruskal-Wallis test with Dunn's multiple comparison, p<0.05and expressed in MEDIAN (MINIMUM - MAXIMUM) whereas the depression data were analyzed by the Chi-square test, with p<0.05, expressed in percentage. RESULTS: WTeachers-3T presented excessive daytime sleepiness and higher rates of mild (24%) and moderate (37%) depression compared to controls - Control 1: mild (8%) and moderate (11%) - Control 2: mild (5%) and moderate (15%). CONCLUSION: This study found that teachers in the Quipapá municipality of Penambuco state working three shifts showed excessive daytime sleepiness and a higher percentage of mild and moderate depression compared to teachers working only one (1) or two (2) shifts.

Professores têm trabalhado muito no período noturno com correções de provas, trabalhos e elaborando planejamento de ensino em suas casas. Muitos estão apresentando sonolência excessiva diurna (SED) e depressão. OBJETIVO: O objetivo deste trabalho foi avaliar sonolência excessiva diurna e depressão em professoras da rede pública. MÉTODOS: Foram avaliadas 201 professoras do município de Quipapá/PE, Brasil, sendo 38 que trabalham em 1 turno (CONTROLE 1), 40 que trabalham em 2 turnos (CONTROLE 2) e 123 que trabalham em 3 turnos (PROFas-3T). Os sujeitos foram avaliados pela Escala de Sonolência de Epworth e pelo Inventário de Depressão de Beck. Os dados referentes à SE foram analisados pelo teste Kruskal-Wallis com comparação múltipla em Dunn, p<0,05 e expressos em MEDIANA (MÍNIMO - MÁXIMO) e os dados referentes à depressão foram analisados pelo teste qui-quadrado, com p<0,05, expressos em percentuais. RESULTADOS: PROFas-3T apresentam sonolência excessiva e apresentam maior percentual de depressão leve (24%) e moderada (37%) comparadas a seus controles - CONTROLE 1: leve (8%) e moderada (11%) - CONTROLE 2: leve (5%) e moderada (15%). CONCLUSÃO: Este estudo observou que professoras da rede municipal de Quipapá/PE que trabalham em 3 turnos apresentam sonolência excessiva e maior percentual de depressão leve e moderada comparadas às professoras que trabalham em 1 (um) ou em 2 (dois) turnos.

Hematological and immunological effects of stress of air traffic controllers in northeastern Brazil

BACKGROUND: Several studies have shown that stress and emotional reactions can affect immune responses in animals and humans. OBJECTIVE: The aim of this study was to evaluate hematological and immunological effects of stress on air traffic controllers. METHODS: Thirty air traffic controllers and 15 aeronautical information service operators were evaluated. The groups were divided as information service operators with 10 years or more of experience (AIS>10) and with less than 10 years in the profession (AIS<10) and air traffic controllers with 10 years or more of experience (ATCo>10) and with less than 10 years in the profession (ATCo<10). Blood samples were drawn at 8:00 a.m. and 2:00 p.m. The paired t-test was used to compare monocyte and nitric oxide concentrations and ANOVA was used for the other parameters. RESULTS: The ATCo>10 group presented a significantly lower phagocytosis rate of monocytes at 2:00 p.m. compared to 8:00 a.m. Moreover, the ATCo>10 group presented lower hemoglobin, mean corpuscular hemoglobin concentration, platelet and leukocyte levels, and increased cortisol concentrations at 8:00 a.m. compared to the other groups. Additionally, this group had lower phagocytosis rate of monocytes, and hemoglobin, platelet, leukocyte, basophils and nitric oxide levels at 2:00 p.m. compared to the other groups. CONCLUSION: Stress seems to greatly affect immune responses of air traffic controllers with more than ten years of experience.

Hematological and immunological effects of stress of air traffic controllers in northeastern Brazil.

BACKGROUND: Several studies have shown that stress and emotional reactions can affect immune responses in animals and humans. OBJECTIVE: The aim of this study was to evaluate hematological and immunological effects of stress on air traffic controllers. METHODS: Thirty air traffic controllers and 15 aeronautical information service operators were evaluated. The groups were divided as information service operators with 10 years or more of experience (AIS≥10) and with less than 10 years in the profession (AIS<10) and air traffic controllers with 10 years or more of experience (ATCo≥10) and with less than 10 years in the profession (ATCo<10). Blood samples were drawn at 8:00 a.m. and 2:00 p.m. The paired t-test was used to compare monocyte and nitric oxide concentrations and ANOVA was used for the other parameters. RESULTS: The ATCo≥10 group presented a significantly lower phagocytosis rate of monocytes at 2:00 p.m. compared to 8:00 a.m. Moreover, the ATCo≥10 group presented lower hemoglobin, mean corpuscular hemoglobin concentration, platelet and leukocyte levels, and increased cortisol concentrations at 8:00 a.m. compared to the other groups. Additionally, this group had lower phagocytosis rate of monocytes, and hemoglobin, platelet, leukocyte, basophils and nitric oxide levels at 2:00 p.m. compared to the other groups. CONCLUSION: Stress seems to greatly affect immune responses of air traffic controllers with more than ten years of experience.

Brazilian air traffic controllers exhibit excessive sleepiness.

Excessive sleepiness (ES) is an increased tendency to initiate involuntary sleep for naps at inappropriate times. OBJECTIVE: The objective of this study was to assess ES in air traffic controllers (ATCo). METHODS: 45 flight protection professionals were evaluated, comprising 30 ATCo, subdivided into ATCo with ten or more years in the profession (ATCo≥10, n=15) and ATCo with less than ten years in the profession (ATCo<10, n=15) and 15 aeronautical information services operators (AIS), subdivided into AIS with ten years or more in the profession (AIS≥10, n=8) and AIS with less than ten years in the profession (AIS<10, n=7), who were included as the control group. The Epworth Sleepiness Scale and Maintenance of Wakefulness Test were used for evaluating subjective and objective excessive sleepiness. Kruskal-Wallis was used for ES and Mann-Whitney for sleep latency (SL), collection time in minutes (mins), and expressed as Median (Minimum-Maximum), p<0.05. RESULTS: ATCo≥10 12 (6-14) mins and ATCo<10 10 (1-15) mins showed greater sleepiness compared to CONTROL1 7 (3-8) mins and CONTROL2 6 (4-6) mins, p=0.001*. A total of 77.27% of the ATCo and 16.67% of the AIS had an SL of less than 20 minutes. The ATCo presented an SL of 16.59 (3.25-40), lower than that of the AIS of 31.71 (10.63-40) mins, p<0.05*. CONCLUSION: Brazilian air traffic controllers exhibit excessive sleepiness.

A sonolência excessiva (SE) é a uma tendência aumentada de se iniciar o sono por cochilos involuntários em momentos inapropriados. OBJETIVO: O objetivo deste trabalho foi avaliar SE em controladores de trafego aéreo (CTA). MÉTODOS: Foram avaliados 45 profissionais de proteção ao voo, sendo 30 CTA, subdivididos em CTA com dez ou mais anos na profissão (CTA≥10, n=15) e CTA com menos de dez anos na profissão (CTA<10, n=15) e 15 operadores de serviços de informações aeronáuticas (AIS), subdivididos em AIS com dez anos ou mais na profissão (AIS≥10, n=8) e AIS com menos de dez anos na profissão (AIS<10, n=7). A Escala de Sonolência de Epworth e o Teste de Manutenção da Vigília foram empregados para avaliação subjetiva e objetiva de sonolência excessiva. Utilizou-se: Kruskal-Wallis para os dados de SE e Mann-Whitney para a latência de sono. Tempo coletado em minutos (mins). Todos os dados foram expressos em mediana (mínimo-máximo), p<0,05). RESULTADOS: CTA≥10 12 (6-14) mins e CTA<10 10 (1-15) mins apresentaram um aumento de sonolência, quando comparados ao CONTROLE1 7 (3-8) mins e ao CONTROLE2 6 (4-6) mins, p=0,001*. 77,27% dos CTA e 16,67% dos AIS apresentaram latência de sono abaixo de 20 minutos. Os CTA apresentaram uma latência de sono de 16,59 (3,25-40) mins abaixo dos AIS 31,71(10,63-40), p<0,05*. CONCLUSÃO: Controladores de tráfego aéreo apresentam sonolência excessiva.

Efeito do estresse na atenção de manipuladores de alimentos de um hospital público em Recife-PE, Brasil / Stress effects on food handler attention in a public hospital in Recife-PE, Brazil

Production of meals in Food and Nutrition Units (FNU) requires human labor performance in order to attend demand. Stress is one of the factors responsible for alterations in the health of these professionals. Reduced attention is one of the negative effects caused by stress. Objective: The objective of this study was to evaluate attention in Food Handlers (FH). Methods: 67 professionals were evaluated, subdivided into FH with less than 5 years in the profession, who were included as the control group (Control, n=29), and FH with more than 5 years in the profession (FH>5, n=38). Lipp?s Inventory of Stress Symptoms for adults (LISS), the digit symbol, d2, forward digit span, backward digit span and paced auditory serial addition tests were applied. The data found on the LISS were analysed by Fisher?s Exact and Chi-Square tests and individual attention tests were analyzed by the Mann-Whitney test, with data expressed as Median (Minimum and Maximum) with p<0.05. A total of 73.68% of FH>5 presented stress versus 13.79% of Control. Also, 57.89% of FH>5 with stress presented physical symptoms and 15.79% psychological symptoms. In the Control, 9.68% presented physical symptoms. Results: 73.68% of FH>5 with stress and 17.24% of the Control were in the resistance phase. Regarding attention, the FH>5 presented reduced focused attention (32.5±2.9), auditory attention (7.25±0.4) and resistance to interference (4.67±1.1), compared to their respective controls (43.88±1.39), (8.63±0.38), (9.25±1.16), p<0.05. Discussion and Conclusions: The activity of food handling can cause stress and attention level reduction after 5 years.

A produção de refeições em Unidades de Alimentação e Nutrição (UAN) dispõe de apoio do desempenho humano. O estresse é um dos fatores responsáveis por alterações na saúde desses profissionais. Redução da atenção é um dos prejuízos causados pelo estresse. Objetivo: O objetivo deste trabalho foi avaliar a atenção em manipuladores de alimentos (MA). Métodos: Foram avaliados 67 profissionais subdivididos em MA com menos de cinco anos na profissão que foram considerados grupo de controle (Controle, n=29) e MA com mais de 5 anos na profissão (MA>5, n=38). Foram utilizados o Inventário de Sintomas de Stress em Adultos de Lipp (ISSL), os testes de atenção digit symbol, d2, span de dígitos em ordem direta e inversa e teste de dependência auditiva para adição em série. Utilizou-se o Exato de Fisher, Qui-quadrado e Mann-Whitney, dados expressos em percentuais e mediana (mínimo-máximo), p<0,05. Resultados: Verificou-se que 73,68% dos MA>5, enquanto 13,79% do controle apresentam estresse. 57,89% dos MA>5 com estresse apresentaram sintomas físicos e 15,79% sintomas psicológicos. No controle, 9,68% apresentaram sintomas físicos. 73,68% dos MA>5 com estresse e 17,24% do controle estão na fase de resistência. Em relação à atenção, Os MA>5 apresentaram redução do foco de atenção (32,5±2,9), da atenção auditiva (7,25±0,4) e da resistência à interferência (4,67±1,1), comparados aos seus respectivos controles (43,88±1,39), (8,63±0,38), (9,25±1,16), p<0,05. Discussão e Conclusões: A atividade de manipulação de alimentos pode causar estresse e redução da atenção após 5 anos.

Air traffic control activity increases attention capacity in air traffic controllers / Atividade de controle de tráfego aéreo aumenta a capacidade de atenção em controladores de vôo

Abstract. Air traffic controllers simultaneously develop complex and multiple tasks in the course of their activities. In this context, concern is raised over the high level of attention needed by these professionals which can ultimately be affected by stress and fatigue. Objectives: The objective of this study was to assess attention level in air traffic controllers (ATCo). Methods: 45 flight protection professionals were evaluated, comprising 30 ATCo, subdivided into ATCo with ten or more years in the profession (ATCo³10, n=15) and ATCo with less than ten years in the profession (ATCo <10, n=15) and 15 aeronautical information services operators (AIS), subdivided into AIS with ten years or more in the profession (AIS³10, n=8) and AIS with less than ten years in the profession (AIS <10, n=7), who were included as the control group. The digit symbol, d2 (the individual marks the letter d on a specific form containing 14 lines with 47 letters in each, maintaining focus on letter d followed by two dashes), forward digit span, backward digit span and PASAT (paced auditory serial addition test) attention tests were used. Kruskal-Wallis was used and data expressed as Median (Minimum and Maximum) with p<0.05. Results: The ATCo³10 presented greater focus of attention, sustained attention, mental manipulation and resistance to interference capacity compared to the AIS³10. Comparison of ATCo³10 to the AIS<10 showed they presented only greater resistance to interference, and when compared to the ATCo<10 presented lower focus. Conclusions: The air traffic control activity after ten years may be associated with a high level of attention.

Resumo. Os controladores de tráfego aéreo (CTA) desenvolvem em suas atividades tarefas complexas e múltiplas simultaneamente. Nesse contexto, surge a preocupação com a necessidade de um maior nível de atenção desses profissionais que pode ser afetada pelo estresse e fadiga. Objetivos: O objetivo deste trabalho foi avaliar o nível de atenção em controladores de tráfego aéreo (CTA). Métodos: Foram avaliados 45 profissionais de proteção ao vôo, sendo 30 CTA, subdivididos em CTA com dez ou mais anos na profissão (CTA³10, n=15) e CTA com menos de dez anos na profissão (CTA<10, n=15) e 15 operadores de serviços de informações aeronáuticas (AIS), subdivididos em AIS com dez anos ou mais na profissão (AIS³10, n=8) e AIS com menos de dez anos na profissão (AIS<10, n=7). Foram utilizados os testes de atenção digit symbol, d2 (o indivíduo deve marcar a letra d em um formulário específico, contendo 14 linhas com 47 letras cada, mantendo sempre o foco na letra d que aparece acompanhada de dois traços), span de dígitos em ordem direta e inversa e teste de dependência auditiva para adição em série (PASAT). Foi utilizado o Kruskal-Wallis e os dados expressos em mediana (mínimo e máximo), p<0,05. Resultados: Os CTA³10 apresentaram maior foco de atenção, manutenção do foco, capacidade de manipulação mental e resistência à interferência, quando comparados aos AIS³10, mas quando comparados aos AIS<10 apresentaram somente maior resistência à interferência e quando comparados aos CTA<10, menor foco. Conclusões: A atividade de controle de tráfego aéreo após dez anos pode apresentar um alto nível de atenção.

Headache precipitated by Valsalva maneuvers in patients with congenital Chiari I malformation.

The objective of this study was to characterize the headache precipitated by Valsalva maneuvers associated with Chiari type I malformation (CM-1). Nineteen patients were evaluated, with ages ranging from 30 to 75 years. Ten of them presented headache. Pain was more prevalent in the occipital (80%) and frontal region (60%). The headaches were of significantly shorter duration in the women compared with the men. The frequency of headache crises was relatively high. All patients with Valsalva-related headache suffered from at least one episode per month. The most prevalent precipitating factors were coughing, which is well described in the literature, and sexual activity, which only now is recognized as an event associated with CM-1.