São Paulo medical journal = Revista paulista de medicina
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Randomized Controlled Trial
Non-invasive brain stimulation and computational models in post-stroke aphasic patients: single session of transcranial magnetic stimulation and transcranial direct current stimulation. A randomized clinical trial.
Patients undergoing the same neuromodulation protocol may present different responses. Computational models may help in understanding such differences. The aims of this study were, firstly, to compare the performance of aphasic patients in naming tasks before and after one session of transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS) and sham, and analyze the results between these neuromodulation techniques; and secondly, through computational model on the cortex and surrounding tissues, to assess current flow distribution and responses among patients who received tDCS and presented different levels of results from naming tasks. ⋯ The present study did not show any statistically significant difference between tDCS, TMS and sham stimulation regarding naming tasks. The patients'responses to the computational model showed different patterns of current distribution.
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Review Case Reports
Relapse of congenital thrombotic thrombocytopenic purpura, after spontaneous remission, in a second-trimester primigravida: case report and review of the literature.
Thrombotic microangiopathy syndrome or thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) describes distinct diseases sharing common pathological features: microangiopathic hemolytic anemia and thrombocytopenia, without any other apparent cause. ⋯ To date, this is the only report of congenital TTP with two spontaneous remissions in the literature This report reveals the importance of suspicion of this condition in the presence of microangiopathic hemolytic anemia and thrombocytopenia without any other apparent cause.
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Sarcopenia is an emerging public health issue in Brazil. Because of its high prevalence and the lack of national data, the objective here was to identify cutoff points for appendicular skeletal muscle (ASM) and handgrip strength in relation to fear of falling among Brazilian older adults. ⋯ The values presented can be used as references in clinical practice and research. We recommend use of ASM adjusted for BMI and choosing between absolute and relative handgrip strength for men and women, according to study needs.
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Chronic diseases are the main cause of death among adults and are responsible for most outpatient and hospital care expenses in Brazil. The objective here was to determine the prevalence of hypertension and diabetes and to analyze the associations with risk and protection factors among adults. ⋯ The results indicated that the prevalences of hypertension and diabetes were high and that preventable factors were associated with this situation, thus providing support for public policies aimed towards coping with this.