Objetivo: Verificar a capacidade do reconhecimento dos sinais e sintomas do Acidente Vascular Cerebral (AVC) por usuários do Sistema Único de Saúde (SUS) de Juiz de Fora. Métodos: Conduziu-se um estudo transversal, observacional com amostra caracterizada por usuários do SUS que frequentavam um hospital de ensino. Selecionou-se 215 voluntários, de ambos os sexos e apresentou-se a eles um vídeo de simulação de AVC, com utilização do questionário qAVC para obtenção dos dados. Resultados: A amostra foi de 65,12% de voluntários do sexo feminino, predominantemente com ensino médio (37,21%), majoritariamente, sem planos de saúde (71,63%). Questionados sobre o ocorrido na simulação, 55,35% indicaram que se tratava de um AVC, não sendo observada diferença entre o sexo e os acertos (OR:1,0; IC95%: 0,56-1,8; p>0,05). Observou-se significância estatística entre aqueles que possuíam planos de saúde e seus acertos (OR:2,1; IC95%:1,1-4,0;p=0,03), além da escolaridade e a capacidade de reconhecimento da condição (p=0,006). 42,79% dos entrevistados afirmaram que acionaria o Serviço de Atendimento Móvel de Urgência, entretanto, 8,37% identificaram “192” como telefone correto. Conclusão: Parcela significativa da amostra desconhece os sinais e sintomas tipicamente associados ao AVC, carecendo de informações sobre seu manejo, além de desconhecer os mecanismos de acionamento dos serviços médicos de urgência.

INTRODUCTION: Alzheimer’s disease (AD) is a disorder characterized by cognitive impairment. The brain network in DA can be interrupted by deficiencies in glucose metabolismo. Deep brain stimulation (DBS) is used in Parkinson’s disease (PM), once it modulates motor circuits. Considering this potential, the benefits of this approach in DA must be evaluated1,2. OBJECTIVE: To investigate the potential benefit of stimulating the cerebral fornix (CF) through DBS for patients with AD. METHODS: Controlled and randomized clinical trials (ECCR), in English, performed on humans, in the last 5 years, indexed on PubMed, were selected from the keywords “Deep brain Stimulation” and “Alzheimer Dementia”. This review was registered on PROSPERO by protocol 254506 and the PRISMA recommendation was used to improve its organization. RESULTS: Deeb W et al. (2019) conducted an ECCR on 42 patients with AD receiving DBS in CF, anterior commissure, corpus and sub-corpus callosum, demonstrating that in 48% of them, old experiences were reported. Furthermore, the memories became better as the stimulation increased. Lozano AM et al. (2016), in turn, developed an ECCR on 6 patients receiving DBS in CF, showing increases in glucose metabolism in some cerebral areas after 12 months, contrasting to the expected reduction in AD, especially in > 65 years. It’s noteworthy that the multicenter and double-blind ECCR by Ponce FA (2016) showed the safety of DBS in CF as therapy for AD, similar to that verified in the MP. CONCLUSION: The analyzed evidences suggest a potential cognitive benefit of DBS in the therapeutic management of AD.

Background: Deep brain stimulation (DBS) is a promising adjuvant therapy for Parkinson’s disease (PD) in intermediate and advanced states, improving motor symptoms and life quality. Objectives: To investigate the efficacy of DBS in PD treatment. Design and Setting: Systematic review performed on medical school in Brazil. Methods: A literature review in the MedLine database was conducted using the following descriptors: “Deep Brain Stimulation”, “Parkinson’s Disease” and its variations according to MeSH. Only randomized controlled trials conducted in humans and published in English in the last 10 years were included. The PRISMA statement was used to improve this systematic review’s findings. Results: Three clinical trials that evaluated the effects of DBS in PD’s management were analysed. The main result measurement tools used in the studies were the PDQ-39-SI and UPDRS-III scores. Hacked ML et al. (2018) concluded that drug therapy + DBS was significantly superior to isolated drug therapy (p <0.0002). Schuepbach WMM et al. (2019) found that the experimental group presented significantly better outcomes in comparison to the control group (p <0,05). Birchall EL et al. (2016) suggested that the DBS device implant in the subthalamic nucleus caused significant improvement in depressive symptoms, motor symptoms, quality of sleep (p <0.0001) and quality of life (p=0.0005) in comparison to the control group. Conclusions: DBS has shown to be an efficient therapy for PD, once it promoted better outcomes regarding motor symptoms, depression, quality of life and quality of sleep. However, it is necessary to be aware of eventual side effects in the post-operative period.

Background: Traumatic brain injury(TBI) is an important component of mortality rate(MR) among young adults. Hypothermia(HT) is a treatment with questionable efficacy, given existing discordant views. Objective: investigate the performance of HT in TBI. Methods: Randomized controlled trials(RCT) from PUBMED, over the last five years, were analysed through the descriptors “Traumatic brain injury”; “Therapeutic hypothermia” and its MeSH variations. RCTs in individuals over 19 were included. After criteria were applied, four were selected for this review. This systematic review was submitted for registration on the PROSPERO plataform(ID: 253817). Results: Eurotherm3235 segregated n=387 to a group subjected to HP and another to standard treatment, evaluating them through the Glasgow Scale. The RCT was interrupted due potential damage to the participants, and showed greater MR(p <0.05) in the experimental group (EG). The POST-HOC of the B-HYPO sorted n=129 into a control group on fever management, and another group subjected to HT, separating them according to the injury. The patients with minor severity from the EG showed higher MR(p <0.05). The RCT from Chunhai T et al.(n=60) subjected to decompressive hemicraniectomy, which were divided into those who received HT, and a control group, displaying an inferior MR in the EG (p<0.05). Feng JZ et al. with n=14 subjected the EG to HT, and analysed the participants through the magnetic resonance metabolomics, showing lesser MR and better recovery in the EG(p<0.05). Conclusion: The studies indicated disparate results. However, those with larger samples indicated worse prognosis between patients subjected to HT.