Os grandes avanços da gerontología nos últimos anos não encontraram na neurocirurgia um éco tão grande quanto nas outras especialidades médicas. Em geral as contribuições encontradas na literatura médica se restringem aos aspectos diagnósticos e terapêuticos especiais dos tumores e insuficiências vasculares cerebrais nessa faixa etária ( Para evitar repetição no texto, usaremos as seguintes siglas para designar os diferentes grupos de casos: TCFL -traumatismos cranianos fechados leves; TCFG = traumatismos cranianos fechados graves; TCA = traumatismos cranianos abertos; HI •= hematomas intracranianos.

Day-to-day we have to make choices. Even simple decisions involve complex cognitive processes that are still not clearly understood. When it comes to critical decisions which may lead to impactful and irreversible consequences, the understanding of the decision-making process is highly relevant. Dysfunctional coping responses may lead to stress and ultimately to trauma. In the present project, we aim to understand decision-making in the context of firefighting and to study how neurocognitive control and stress management strategies affect decision-making. We present here a functional brain imaging paradigm coupled with biosensors while firefighters play a decision-making task. In this computerized task, the firefighter faces the dilemma of entering or not in a burning house, with variable risk of house collapsing, variable number of victims in danger and variable probability of the victims saving themselves. We present here the preliminary results from a cohort of 13 firefighters, of which none presented clinically significant symptoms of post-traumatic stress disorder. We found brain regions, including the ventromedial and dorsolateral prefrontal cortices and angular gyrus, showing a parametric pattern of activation during the decision phase, i.e. the lower the risk of collapsing, the higher the neural activity in these areas. This suggests that these regions are processing that risk information and signalling the chances of being successful in the rescue phase. We also found that the power in high frequencies of the pulse rate variability of this cohort of firefighters is higher when they decide to enter for the rescue. It is suggestive that deciding not to enter for rescue causes an increase in arousal, which may be related to the expectation about the victims’ outcome (whether they survived or not). Concerning coping strategies, we found that active coping used in personal context was significantly correlated with the age and the years of experience in our sample of firefighters. We aim to understand if this pattern of brain activity reflects the coping strategies and if, in turn, it is reflected in the physiological signals we measure. Concurrently, we are recruiting firefighters with post-traumatic stress disorder and non-firefighters to perform the same task. We will investigate whether the decision processes in firefighters are different from non-firefighters, and we will address if post-traumatic stress disorder impairs decision-making in this context. Biosignals will also be used in a second phase of the project to inform training systems about the physiological state of the firefighter during virtual reality simulation. This may help developing optimal neurocognitive control and better coping strategies to deal with stress.

In the 20th century, scientists attempted to limitate the workings of the mind onto the brain by detailing its anatomy and physiology. The task of localizing function, however, has proven to be very difficult than initially presumed, with almoust all regions of the brain subserving a variety of processes and having only loose coupling of structure and function. As we know, the majority of neuropsychological tests and the brain capacities they tap lack brain regional specificity. This is a complex and sophisticated problem, that gets much worse in the brain that is compounded significantly by damage or disease. However, in the past two decades, neuroimaging has rekindled and renewed enthusiasm for unraveling brain function. Recent studies of cerebral image show “in vivo” what had already been proven in the laboratory: there are multiples neuroquimical changes in cortical and subcortical areas of the brain in psychiatric patients.Amongst the many techniques and technologies that have been developed, functional magnetic resonance imaging (fMRI) has proven to be one of the most exciting and perhaps the most used. It has permitted unprecedented access to the living brain. The authors propose to do a brief review on the late descoverys and studys that have been done with neuroimage.

BackgroundWorldwide, about 1.25 million people die each year as a result of road traffic accidents (World Health Organisation’s Global Status Report on Road Safety 2015) and as many as 50 million people are injured. In Portugal, last year we have registered about 480 deaths, 2.098 severely injured. Trauma, after road traffic accidents are a major problem of public health, associated with a substantial impact on psychological, social, economic and labour dimensions, both for the victims and for their families.Description of the problemRoad traffic accidents are frequently associated with an increased risk for psychological problems, particularly acute reaction to stress, phobic anxiety, depression, or even a posttraumatic stress disorder. The consequences involve increased medical costs and longer hospitalizations, decreased productivity, help-seeking behaviour. Most of these patients with somatization complains, conversive symptoms, depression, chronic pain, presents a posttraumatic stress disorder (PTSD) not diagnosed.ResultsIn order to implement appropriate strategies for prevention and treatment and so reducing the risk and impact inherent in the development of psychological disorders, it is essential that the diagnosis is made as soon as possible. The survivors of road traffic accident at risk will be referred to the Centre for Prevention and Treatment of Psychological Trauma before being discharged from the General Hospital: Emergency Room, Surgery, Orthotraumatology or Neurosurgery Wards.They will be subjected to a brief screening for symptoms of PTSD, dissociative symptoms, anxiety, nightmares and phobias, briefly after the accident and 4 weeks later. This is a challenge that requires a networking efforts for effective prevention.ConclusionsEarly identification of people with posttraumatic stress symptoms after a road traffic accident is critical to allow for intervention and prevent greater impairment and restriction.

It is often assumed that sexuality in the classical world was experienced in a free manner, without the censorship imposed during the midle ages. We also know that this culture is characterized by the symbolism and implicit messages, present in the speech, art, literature, always targeting a knowledge that would allow the spirit to achieve a higher level and be more perfect. But how was sexuality actually experienced by these people? What were their interests, what were their fears, and how were they transmitted? How did they related affection and sexuality? Using the metaphor of representations in erotic art, the authors seek to address the issue of sexuality in ancient world and how it may be compared to current affairs. Using for examples the art of ceramics (eg: the author Triptolemus), sculpture (eg: the statue from Herculaneum) and painting (eg: fresh Pompeii), the authors try to make a pictorial journey by the theme of sexuality and their role in society, as an interface between man with himself and with nature.