Most students interviewed consider that participation in preparatory courses is important to be approved in the residency programs' admission exams and that this participation does not hinder the activities of the internship.

Background: Huntington's disease (HD) is a progressive disorder characterized by motor, cognitive and psychiatric features. Cerebellar ataxia is classically considered as uncommon in HD clinical spectrum. Objective: To determine the prevalence of cerebellar ataxia in patients with HD, both in the early and in the late stages of HD. Methods: Seventy-two individuals considered eligible were assessed by two trained doctors, applying the Scale for Assessment and Rating of Ataxia (SARA) and Brief Ataxia Rating Scale (BARS) for ataxia, the Unified Huntington's Disease Rating Scale (UHDRS) and also, Barthel Index (BI), in order to evaluate functional capacity. Results: Fifty-one patients (70.8%) presented with clinical ataxia at the time of examination (mean time of disease was 9.1 years). Six (8.33%) patients presented with cerebellar ataxia as first symptom. When stratified according to time of disease, a decline in the presence of chorea ( p = 0.032) and an increase in cognitive deficit ( p = 0.023) were observed in the patients as the disease progressed. The presence of ataxia was associated with longer duration of illness and severity of illness (UHDRS) ( p < 0.0001), and shorter Barthel (less functionality) ( p = 0.001). Conclusions: Cerebellar involvement may play an important role in natural history of brain degeneration in HD. The presence of cerebellar ataxia in HD is relevant and it may occur even in early stages, and should be included as part of the motor features of the disease.

Qualitative evaluation of menus offered in primary schools in the metropolitan area of São Paulo Resumo Objetivos: Avaliar qualitativamente as preparações do cardápio de escolas municipais da Grande São Paulo. Método: Avaliaramse qualitativamente pelo método de Avaliação Qualitativa das Preparações do Cardápio (AQPC) os cardápios mensais de escolas municipais das seguintes cidades: Barueri, Guarulhos, São Bernardo do Campo e São Paulo-SP. Resultados: Foi satisfatória a oferta de hortaliças. Embora a oferta de frutas tenha sido adequada, é constante a presença de doces. Dos cinco cardápios analisados, em três houve monotonia de cores em pelo menos uma das grandes refeições. Houve adequação com relação às técnicas de cocção de pratos proteicos. A carne bovina é a mais presente nos cardápios e há limitação da oferta de peixe. Conclusão: Conclui-se que o método AQPC é um bom instrumento de avaliação da qualidade das refeições, pois os alimentos não são ingeridos apenas por sua qualidade nutricional, mas em conjunto com suas características sensoriais. De modo geral, os cardápios avaliados estão adequados em relação à oferta de frutas, hortaliças e laticínios e às técnicas de cocção empregadas. No entanto, sugere-se a revisão da frequência do emprego de alimentos sulfurados e doces no cardápio.

OBJECTIVE: To identify and evaluate the effects of community-based interventions on the sedentary behavior (SB) of Latin American children and adolescents. METHODS: A systematic review on community-based trials to reduce and/or control SB in Latin American countries (Prospero: CRD42017072157). Five databases (PubMed, Web of Science, Scopus, SciELO and Lilacs) and a reference lists were searched. RESULTS: Ten intervention studies met the eligibility criteria and composed the descriptive synthesis. These studies were conducted in Brazil (n=5), Mexico (n=3), Ecuador (n=1) and Colombia (n=1). Most interventions were implemented in schools (n=8) by educational components, such as meetings, lessons, and seminars, on health-related subjects (n=6). Only two studies adopted specific strategies to reduce/control SB; others focused on increasing physical activity and/or improving diet. Only one study used an accelerometer to measure SB. Seven studies investigated recreational screen time. Eight studies showed statistically significant effects on SB reduction (80%). CONCLUSIONS: Latin America community-based interventions reduced children and adolescents’ SB. Further studies should: define SB as a primary outcome and implement strategies to reduce such behaviour; focus in different SBs and settings, other than recreational screen time or at-home sitting time; and use objective tools together with questionnaires to measure sedentary behaviour in.

Conflito de interesses: NãoContribuição dos autores: TBB concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. YCVA concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. ACO concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. ICAS concepção e planejamento do projeto de pesquisa, obtenção ou análise/ interpretação dos dados, redação e revisão crítica. VBP concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. FDM concepção e planejamento do projeto de pesquisa, obtenção ou análise/interpretação dos dados, redação e revisão crítica. p=0,3258). Conclusão: A prevalência de hipotireoidismo clínico na população estudada foi maior que a determinada na população geral. Pacientes com sinais e sintomas similares tanto ao hipotireoidismo como a síndrome da apneia obstrutiva do sono podem se beneficiar da dosagem hormonal tireoidiana.Descritores: Síndromes da Apneia do Sono; Hipotireoidismo; Identidade de Gênero. Abstract Introduction:The obstructive sleep apnea syndrome is one of the most complex sleep disorders. The association between hypothyroidism and obstructive sleep apnea syndrome has been the focus of research due to the similarity of symptoms of both disorders. Objective: Determine the prevalence of hypothyroidism in patients complaining of sleep-related breathing disorders. Material and Methods: Two hundred reports from patients of both genders who were referred to first appointment at the Sleep Apnea Clinic of a tertiary center between 2013 and 2014, were revised. The following data were collected: age at time of polysomnography, serum concentration of free thyroxine (T4) and thyroid-stimulating hormone (TSH), body mass index (BMI) and apnea/hypopnea index (AHI). A retrospective cross-sectional case study. Results: A prevalence of 16.2% (21/130) of hypothyroidism in patients with obstructive sleep apnea syndrome was found and most of them were male, and 10% (7/70) of hypothyroidism in patients without obstructive sleep apnea syndrome and all of them (100%) were female (OR-1.734; CI95%-0.6979-4.308; χ 2 -0.96565; p=0.3258). Conclusion:The prevalence of clinical hypothyroidism in this population was higher than that determined in the general population. Patients with similar signs and symptoms of both hypothyroidism and obstructive sleep apnea syndrome might benefit from thyroid hormone tests.