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Efeitos da estimulação transcraniana combinada com o treinamento cognitivo-linguístico de memória e atenção em crianças com transtorno fonológico: um estudo piloto cruzado, controlado, randomizado e triplo cego

Fri, 24 Jul 2026 00:00:00 GMT

Título: Efeitos da estimulação transcraniana combinada com o treinamento cognitivo-linguístico de memória e atenção em crianças com transtorno fonológico: um estudo piloto cruzado, controlado, randomizado e triplo cego Autor(es): Alves, Maria Vanessa Martins Abstract: Introduction: Transcranial Direct Current Stimulation (tDCS), a non-invasive neuromodulation technique with the potential to induce neuroplastic effects, has shown promising results in modulating cognitive and language functions. However, the application of tDCS in children with specific language disorders remains underrepresented in the current literature, particularly in cases without the presence of other associated medical conditions. Objective: To investigate the effects of tDCS combined with a paired intervention on the cognitive abilities of memory and attention in children with Phonological Disorder (PD). Methods: This pilot, randomized, placebo-controlled, triple-blind, crossover clinical trial was conducted with 16 children aged 7 to 12 years diagnosed with PD. Participants underwent three consecutive weekly sessions of tDCS over four weeks, totaling 12 sessions. Anodal stimulation was applied over the left dorsolateral prefrontal cortex (F3), combined with a standardized cognitive-linguistic training program focused on memory and attention skills. Participants were assessed for cognitive and language functions using the Attention, Oral Language, Executive Functions, and Memory (working, verbal, visual, and semantic) subtests of the NEUPSILIN-Inf – Brief Neuropsychological Assessment Instrument for Children and were evaluated at three time points (T0, T1, and T2). Statistical analyses were performed using R software version 4.5.1, following the intention-to-treat principle. Missing data were handled using Multiple Imputation by Chained Equations (MICE). Considering the crossover design, two analytical approaches were conducted: (1) comparison of changes between T0 and T1 across groups and (2) within-subject analysis comparing the effects of active and sham stimulation. The domains of attention, memory, language, and executive functions were evaluated, in addition to exploratory analyses of individual subtests. Estimates were combined according to Rubin's Rules, and multiple comparisons were adjusted using the False Discovery Rate (FDR) method, adopting a significance level of 5%. Results: The study sample consisted of 16 children, including eight boys and eight girls, aged 7 to 12 years, with a mean age of 8.81 years (SD ± 1.8). Between-group comparison during the first intervention period (T0–T1) demonstrated significantly greater improvement in the attention domain among participants who received active tDCS compared with those who received sham stimulation (p = 0.0085). This finding was corroborated by the within-subject crossover analysis, which also demonstrated superior attentional performance following active stimulation (p = 0.039). Exploratory analyses revealed improvements in auditory attention (p = 0.032) and total attention score (p = 0.033) after active stimulation. Favorable trends were also observed for language and memory, although these findings did not reach statistical significance. Conclusion: The findings suggest that tDCS may primarily enhance attentional processes in children with PD, with potential positive effects on related cognitive functions, including memory and language. These results support the potential of non-invasive neuromodulation as an adjunctive strategy for cognitive rehabilitation, although studies with larger samples are needed to confirm these effects.

Impacto dos aspectos socioeconômicos e ambientais na incidência da leishmaniose visceral humana em Aracaju: um estudo ecológico uma revisão sistemática

Thu, 26 Feb 2026 00:00:00 GMT

Título: Impacto dos aspectos socioeconômicos e ambientais na incidência da leishmaniose visceral humana em Aracaju: um estudo ecológico uma revisão sistemática Autor(es): Melo, Náira Alice Vieira Abstract: Visceral leishmaniasis (VL) is a disease caused by parasites of the genus Leishmania and transmitted by vectors called phlebotomine sand flies. Classified as a zoonosis, this disease is considered a serious public health problem in the country, given that Brazil is endemic, accounting for 90% of cases found in the Americas. In Sergipe, a Brazilian state in the Northeast region, this zoonosis has a high incidence and lethality rate. Therefore, due to the epidemiological situation, it was hypothesized that in Aracaju, the city where cases predominate, socioeconomic factors and environmental changes such as deforestation and disordered urbanization are important risk factors, since there is already scientific evidence that proves these correlations in other regions of the country. In this sense, the present project aims to investigate the impact of socioeconomic indicators and changes in vegetation cover on the incidence of human visceral leishmaniasis in Aracaju between 2019 and 2024. To this end, an ecological study was conducted using the Generalized Additive Model (GAM) and Principal Component Analysis (PCA). These methods complement each other, as GAM is predictive and inferential, aiming to determine the influence of variables individually, while PCA is exploratory and descriptive, aiming to explore multivariate patterns and determine the weight of variables in the occurrence of the disease. The databases used were: reports and official documents from the Brazilian Ministry of Health and the Sergipe State Health Secretariat, MapBiomas, DATASUS, and the Brazilian Institute of Geography and Statistics (IBGE). Evidence suggests that visceral leishmaniasis is concentrated in impoverished populations in Africa, Asia, and Latin America, particularly in Brazil, Ethiopia, India, Kenya, Sudan, and Yemen. This is similar to the findings of this research, as the GAM results indicated that the predictive variables for visceral leishmaniasis in Aracaju are: illiteracy, irregular water supply, irregular garbage collection, irregular sanitation, and population density. In the PCA, the variables with the greatest weight were: illiteracy, poverty, inaccessibility to electricity, irregular water supply, irregular garbage collection, and irregular sanitation. These findings revealed that socioeconomic and demographic determinants had the greatest influence on the incidence of the disease during the study period. Therefore, the need for the implementation of integrated public policies that consider social, economic, and environmental factors is evident in order to effectively control the incidence of the disease and enable health promotion for the municipality as a whole.

Fatores associados a nefropatia falciforme

Mon, 01 Jan 2024 00:00:00 GMT

Título: Fatores associados a nefropatia falciforme Autor(es): Valverde, Thaísa Leite Abstract: Nephropathy is one of the main complications related to sickle cell anemia. Among the pathophysiological mechanisms, hemolysis and vascular occlusion stand out. In its initial predictions, it manifests with glomerular hyperfiltration and reduced urinary concentration capacity. In addition, proteinuria and hematuria, which can progress to chronic kidney disease and, finally, end-stage kidney disease The objectives of the present study were to estimate the prevalence and determine the factors associated with the emergence of sickle cell nephropaty in patients diagnosed with AF who are regularly monitored at the benign hematology outpatient clinic of the University Hospital of the Federal University of Sergipe. Data were collected using information contained in the medical record, with approval by the local Ethics Committee. Among the 134 eligible patients, 38 were excluded due to lack of data on potential predictors of nephropathy, resulting in 96 patients. Of these, half were provided by women and the median age was 23 years. Sixty patients (62.5%) were diagnosed with nephropathy. Age over 20 years and hydroxyurea use over 5 years were associated with nephropathy in patients with sickle cell anemia. Although there are limitations related to the retrospective analysis and to the fact that there is no systematization in the approach to nephropathy, the importance of the present study was due to highlighting the high prevalence of renal involvement in this subgroup of patients, confirming the need to create an institutional screening and follow-up protocol, in order to better control the morbidity and mortality attributed to this complication.

Avaliação da sensibilidade à dor nos membros inferiores de mulheres corredoras de curta distância e sua relação com as variáveis de treinamento da corrida: estudo transversal comparativo

Mon, 01 Jan 2024 00:00:00 GMT

Título: Avaliação da sensibilidade à dor nos membros inferiores de mulheres corredoras de curta distância e sua relação com as variáveis de treinamento da corrida: estudo transversal comparativo Autor(es): Mota, Riziane Ferreira da Abstract: Introduction: Running is one of the most practiced sports in the world and women are increasingly taking part in the sport. Despite this, pain and injuries are common among practitioners, therefore, advance risk monitoring strategies are necessary. Objectives: to evaluate, primarily, the relationship between the volume, pace and time of running practice and pressure pain threshold (LDP) measurements in the lower limbs (LL) of short-distance runners and, secondarily, to understand the differences or similarities of LDPs in relation to male short- distance runners and female non-runners. Methods: This is a comparative cross-sectional observational study whose main population was female short-distance runners and the comparison populations: 1. male short-distance runners; 2. non-runner women. 82 individuals between 20 and 54 years old, of both sexes, were included, 33 women and 23 men short-distance runners (≤ 10 km), with at least 3 months of practice and 15 km of weekly training volume; and 26 non-runners (time ≥ 3 months without physical exercise). Anthropometric data and LDPs were collected on the greater trochanter of the femur, piriformis muscle, quadriceps tendon and anterior tibialis muscle of all participants using a portable pressure algometer (Impac®, Paulínia, SP, Brazil). Additionally, the runners completed the training/race routine monitoring form. Statistical analyzes were performed in SPSS Statistics V25.0 and considered p <0.05. Normality and homogeneity were tested by Shapiro-Wilk and Levene, respectively. For comparisons, the Mann-Whitney and Kruskal-Wallis tests were applied, followed by the Wilcoxon post-hoc test. For correlations, the Spearman test was used, followed by regression analyses. Results: The regressions showed that when increasing weekly volume by 1 km, the LDP of the left trochanter (B = 0.094, 95% [CI = 0.004 – 0.185]) increases by 0.094 kgf/cm2. Furthermore, when increasing running pace, the LDP of the left trochanter increases by 0.90 kgf/cm2, and with an increase of one year in practice time, the LDP of the right and left tibialis anterior muscle increases by 0.30 and 0.37 kgf/cm2, respectively. Male runners had a higher running pace than women (U = 128.500; z = -4.187; p = 0.000; r = -0.56), whereas women had a longer training duration (U = 225.500; z = - 2.572; p= 0.010; r =-0.34). The LDPs of the trochanter and piriformis region were significantly higher in men than in women runners and non-runners, although between them (runners and non-runners) there was no significant difference in any of the variables. Conclusion: The practice of running appears to be unrelated to mechanical hyperalgesia in the lower limbs of female runners; on the contrary, there is an increase in LDPs with increasing volume, pace and running time, especially in the hip region. Men demonstrated higher LDPs in the hip region, however, they had a higher running pace.