Background. Orthostatic hypotension (OH) is an important nonmotor manifestation of Parkinson's disease (PD). Changes in cerebrovascular reactivity may contribute to this manifestation and can be monitored using transcranial Doppler. Objective. To identify possible changes in cerebrovascular reactivity in patients with OH. Methods. Twenty-two individuals were selected and divided into three groups: with and without OH and controls. Transcranial Doppler was used to assess basal mean blood flow velocity, postapnea mean blood flow velocity, percentage increase in mean blood flow velocity, and cerebrovascular reactivity as measured by the breath-holding index. Results. PD patients had lower values of basal velocity (p = 0.019), postapnea velocity (p = 0.0015), percentage increase in velocity (p = 0.039), and breath-holding index (p = 0.04) than the controls. Patients with OH had higher values of basal velocity (p = 0.09) and postapnea velocity (p = 0.19) but lower values of percentage increase in velocity (p = 0.22) and breath-holding index (p = 0.32) than patients without OH. Conclusions. PD patients present with abnormalities in a compensatory mechanism that regulates cerebral blood flow. OH could be an indicator of these abnormalities.

Attention deficit hyperactivity disorder (ADHD) manifests as a behavioral pattern that leads to significant social, educational and occupational impairment. The main characteristics of the disorder are inattention, hyperactivity and impulsivity 1. The diagnosis of ADHD is clinical and is based on a persistent, early-onset clinical picture that manifests in different settings and leads to functional loss 2 . A failure in behavioral inhibition is believed to lead to the predominant symptoms of ADHD: hyperactivity, inattention, distraction and impulsivity 3 . The changes in the catecholaminergic pathways are believed also to involve the nucleus accumbens, with impairment of selective attention and the reward system 4 , which may be associated with a greater risk of substance use and dependence 5. The risk of dependence on alcohol or other substances is significantly higher in adolescents with attention-related difficulties than in healthy adolescents 6. Hence, because of the impulsivity and inattention associated with the condition, ADHD may be a risk factor for substance use disorder 5 , a set of cognitive, behavioral and physiological symptoms that cause occupational impairment as a result of the use of a particular substance. Substance dependence is a clinical condition at the more severe end of the substance use disorder spectrum. Even when occupationally incapacitated, dependent individuals continue to use substances. Drugs described as potentially causing dependence include nicotine, alcohol, cannabis, and cocaine and its derivatives ABSTRACTObjective: Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of inattention or hyperactivity. This study aimed to investigate the relationship between ADHD and drug dependence. Methods: The presence and severity of ADHD and substance use were evaluated through questionnaires in 80 adult patients in therapeutic communities. Results: No difference in drug use or dependence prevalence between ADHD and non-ADHD patients was found. However, ADHD patients had lower ages on admission (p = 0.004) and at first contact with cocaine (p = 0.033). In ADHD patients, there was a negative correlation between the age at first use of cannabis and the subsequent severity of cannabis use (p = 0.017) and cocaine use (p = 0.033). Conclusions: Though there was no difference in prevalence of drug use among groups, results show that ADHD in patients in therapeutic communities may cause different addiction patterns, such as earlier use of cocaine and admission, and a more severe use of cocaine correlated to earlier contact with cannabis.Keywords: attention deficit disorder with hyperactivity; substance-related disorders; cocaine. RESUMOObjetivo: O Transtorno de Déficit de Atenção e Hiperatividade (TDAH) é caracterizado por um padrão de desatenção ou hiperatividade. Este estudo investigou relações entre TDAH e dependência de substância. Métodos: Prevalência e gravidade de TDAH e de uso de substância foram avaliadas em oitenta pacientes adultos de comunidades ...

Extracorporeal lithotripsy (ESWL) is one of the most common urological procedures. Among its possible complications, renal parenchymal lesions are rare (approximately 7%). This is a case report of a renocolic fistula after ESWL. It is a very rare complication and without descriptions in the literature of association with ESWL. Because it is a rare lesion, there is no standardized treatment or data that makes it possible to determine the best conduct. The present case required a surgical approach to correct the fistula. It was possible to preserve the affected kidney, which is even rarer in the medical literature.

A Liga Acadêmica de Neurociências é um projeto extensionista composto por um grupo de estudantes, coordenado por professores da UEPG – Universidade Estadual de Ponta Grossa, dedicados a se aprofundarem nas ciências neurológicas, ampliarem o conhecimento nas principais doenças da área das neurociências e atenderem as demandas da população sobre o tema. Os membros são designados por meio de um processo seletivo que ocorre anualmente. A liga abrange as três modalidades clássicas de aprendizado: Ensino, Pesquisa e Extensão. Na área de Ensino, há reuniões semanais sobre um assunto preestabelecido nas áreas de neurologia clínica, psiquiatria e neurocirurgia. Na Pesquisa, os alunos que apresentam interesse realizam projeto em iniciação científica sob a coordenação dos professores responsáveis pela liga. Por fim, na Extensão, os acadêmicos acompanham atendimentos nos ambulatórios de Neurologia do HURCG – Hospital Universitário Regional dos Campos Gerais – e praticam atividades direcionadas para a população, como palestras sobre AVC (Acidente Vascular Cerebral). A cada ano, novas ideias têm sido implantadas para enriquecer o conhecimento dos acadêmicos. Palavras-chave: Instituições Acadêmicas, Neurociências, Educação Superior, Educação de Graduação em Medicina, Relações Comunidade-Instituição. The Neuroscience League: the academic complementation at neurological studies based on actions of education, research and extension Abstract: The Neuroscience Academic League is a university extension project composed of students supervised by professors from UEPG (Universidade Estadual de Ponta Grossa, Paraná, Brazil). This group is dedicated to delving into neurosciences, expanding their knowledge in the fields of major neuroscience-related diseases, as well as meeting the demands of the population on the subject. The members of the project are appointed through a selection process which takes place annually. The league covers the three classical learning methods: Teaching, Research and Extension. In the teaching, there are weekly meetings on predetermined subject fields of clinical neurology, psychiatry and neurosurgery. In the research, students who show interest can take part in undergraduate projects under the supervision of the professors in charge of the league. And finally, in the university extension the students can provide assistance in the Neurology ambulatories at HURCG (Hospital Universitário Regional dos Campos Gerais) and develop other activities such as lectures to the general public on the topic of cerebrovascular accidents (CVA). Every year, new ideas have been implemented to enrich the knowledge of the participants involved. Keywords: Academic Institutions, Neurosciences, Higher Education, Undergraduate Medical Education, Community-Institutional Relations. La Liga de Neurociencia: los estudios de complementación académica en neurologia basados en acciones de docencia, investigación y extensión Resumen: La Liga Académica de Neurociencias es un proyecto de extensión que comprende un grupo de alumnos, coordinados por profesores de la UEPG - Universidade Estadual de Ponta Grossa, Paraná, Brasil, dedicado a profundizar en las neurociencias, ampliar los conocimientos en el área de las enfermedades principales relacionadas con las neurociencias y satisfacer las demandas de la población sobre el tema. Los miembros son nombrados a través de un proceso de selección que se lleva a cabo anualmente. La liga cubre los tres métodos clásicos de aprendizaje: Enseñanza, Investigación y Extensión. En la Enseñanza, hay reuniones semanales en áreas predeterminadas de clínica de neurología, psiquiatría y neurocirugía. En la Investigación, los estudiantes que tienen interés realizan proyectos de investigación, bajo la supervisión de los profesores de la liga. Por último, en la extensión, académicos acompañan asistencias en las consultas externas de Neurología en HURCG - Hospital de Campos Gerais de la Universidade Regional - y participan en actividades dirigidas a la población como conferencias sobre accidentes cerebrovasculares. Cada año, nuevas ideas se han aplicado para enriquecer el conocimiento de los académicos. Palabras-clave: Instituciones Académicas, Neurociencias, Educación Superior, Educación Médica de Pregrado, Relaciones comunitario-institucionales.

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