Hugo André de Lima Martins

Post-traumatic headache

The onset of post-traumatic headache (PTC) occurs in the first seven days after trauma, according to the International Headache Society (IHS) classification. The objective of this study was to evaluate the several forms of headache that appear after mild head injury (HI) and time interval between the HI and the onset of pain. We evaluated 41 patients with diagnosis of mild HI following the IHS criteria. Migraine without aura and the chronic tension-type headache were the most prevalent groups, occurring in 16 (39%) and 14 (34.1%) patients respectively. The time interval between HI and the onset of headache was less than seven days in 20 patients (48.7%) and longer than 30 days in 10 (24.3%) patients. The results suggest that PTC may arise after a period longer than is accepted at the present by the IHS.

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.

Outbreak of Neuro-Chikungunya in Northeastern Brazil

Chikungunya virus, an alphavirus often associated with large epidemic outbreaks, has a serious social impact. The main symptoms are fever, rash and arthralgia, but recently neurologic complications have been described as an important cause of morbidity. During a large outbreak in at least five towns in poor states of the Brazilian northeast over recent months, 22 patients with chikungunya confirmed by serologic tests who presented some degree of neurologic involvement were assessed in our department. Changes in consciousness were present in almost half of the patients and epileptic seizures and persecutory delusions were present in three and four patients, respectively. As in Brazil there are insufficient serologic tests for patients with a clinical picture of neuro-chikungunya, this is probably a very underdiagnosed disease. The outcomes of the neurologic symptoms were good in all patients of the current series, in contrast with the permanent sequelae reported by other authors.

Neonatal administration of fluoxetine did not alter the anxiety indicators, but decreased the locomotor activity in adult rats in the elevated plus-maze

The objective of this study was evaluate the anxiety and locomotor activity (LA) in 52 Wistar adult male rats, being 26 treated with fluoxetine (10 mg/Kg - sc) in the neonatal period. These same rats received foot shock (FS) (1.6-mA - 2-s) in the 90th day. The anxiety and LA were appraised by plus-maze. The time spent in the open arms was used as anxiety index and the LA was measured by number of entries in closed arms (NECA) and the total of entries (TE). T-test was used with p<0.05 and expresses data in mean+/-SEM. There were reductions with the fluoxetine group in the NECA (2.35+/-0.33) and in the TE (3.96+/-0.61) compared to the controls (4.65+/-0.52) and (6.96+/-0.94). The neonatal administration of fluoxetine did not alter the anxiety, but reduced the LA in the animals that received FS.

Air traffic control activity increases attention capacity in air traffic controllers

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 (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 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 ATCo≥10 presented greater focus of attention, sustained attention, mental manipulation and resistance to interference capacity compared to the AIS≥10. Comparison of ATCo≥10 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.

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.

Alice in Wonderland Syndrome, Burning Mouth Syndrome, Cold Stimulus Headache, and HaNDL: Narrative Review

Unusual headache syndromes are not as infrequent in clinical practice as was generally believed. About three fourths of the classified headache disorders found in the ICHD‐II can be considered rare.

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.

Depression, Anxiety, and Hopelessness in Patients with Chikungunya Fever in Brazil

Chikungunya virus (CHIKV) is an alphavirus found worldwide that is now, with a very large outbreak mostly in the northeast of the country, an emerging disease in Brazil. This study consisted of a series of 18 females and two male patients, with ages ranging from 31 to 87 years and a mean age of 54. The patients presented anxiety or depressive symptoms that emerged during the acute phase of CHIKV infection and remained for at least one year. For the purpose of statistical comparisons, a control group was formed of 15 females and five male individuals without CHIKV infection and aged from 29 to 72 and a mean age of 48. Anxiety, depression, and hopelessness symptoms were prevalent in patients one year after CHIKV infection.

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

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.