Objetivo: Identificar dentre acadêmicos de uma Faculdade de Medicina no Sul de Minas Gerais, usuários do metilfenidato, os principais motivos de utilização deste fármaco, as formas de aquisição e os possíveis efeitos colaterais.  Materiais e Métodos: O estudo é descritivo e transversal e para a coleta de dados foi utilizado um questionário fechado, de caráter anônimo e de autopreenchimento, aplicado entre os meses de agosto e dezembro de 2015. Foram incluídos ao acaso 120 alunos dos 6 anos do curso médico. Resultados: Entre os participantes, 70 (58,33%) eram do sexo feminino e 50 (41,67%) eram do sexo masculino e a média de idade foi de 22,27 anos. Foi encontrada uma prevalência de 25% para o uso não prescrito de metilfenidato, com maior proporção de uso no sexo masculino. O aumento da concentração em época de provas foi citado como propósito de uso por 76,67% do total de pessoas que fazem uso indiscriminado. Além disso, 66,67% afirmaram ter tido o primeiro contato com a substância na faculdade e 60% obtiveram a droga por meio de doação de amigos. Os principais efeitos colaterais citados foram: ansiedade, insônia, euforia, taquicardia, redução de apetite, irritabilidade, cefaleia e tremores. Conclusão: O presente estudo evidencia uma elevada prevalência do uso não prescrito de metilfenidato, por acadêmicos de Medicina.Palavras-chave: Metilfenidato, Prevalência, Estudantes de MedicinaABSTRACTObjective: Identify among the academic students, users of methylphenidate in a medical school in the southern Minas Gerais, the main reasons for the use, the access and the possible side effects. Materials and Methods: The study is a cross-sectional, quantitative and descriptive study among 120 students of six series of the medical school. The instrument used for gathering data was an anonymous self-filling questionnaire, applied between August and December 2015. Results: Among the participants, 70 (58.33%) were female and 50 (41.67%) were male and the average age was 22, 27 years. A prevalence of 25% for non-prescribed use of methylphenidate was found, with a higher proportion of use in males. Among those, 76.67% used it in order to increase their concentration in exam time. In addition, 66.67% reported having their first contact with the substance in college and 60% obtained the drug through donation of friends.  The main side effects reported were: anxiety, insomnia, euphoria, tachycardia, decreased appetite, irritability, headaches and tremors. Conclusion: This study shows a high prevalence of non-prescribed use of methylphenidate  by medical students.Keywords: Methylphenidate, Prevalence, Medical Students

Introdução: A Arterite de Takayasu (AT) é uma vasculite crônica de médios e grandes vasos cuja etiologia é desconhecida. A incidência anual de AT, segundo estatísticas americanas, é de cerca de 2,6 casos por milhão de pessoas, acometendo principalmente mulheres jovens na idade reprodutiva. Essa doença possui sintomas característicos, como claudicação de membros, dor torácica, ausência de pulsos braquiais, sopro carotídeo e ausência de pressão arterial nos membros superiores. Síndromes neurológicas, como Acidente Vascular Cerebral (AVC) e Ataque Isquêmico Transitório (AIT) são apresentadas por aproximadamente 10 a 20% dos pacientes com AT. Relato de Caso: Relatou-se o caso de paciente do sexo feminino, de 42 anos, branca, que apesar de apresentar os sintomas de AT com 15 anos, como dor em região torácica e hipertensão arterial, foi diagnosticada com AT somente após 25 anos. A paciente foi admitida no Pronto Socorro do Hospital Escola de Itajubá com sintomas que sugeriam um AVC, confirmado com Tomografia computadorizada (TC) de crânio e, posteriormente, AngioTC cerebral e de artérias carótidas e vertebrais que, juntamente com os sinais clínicos observados, como pulsos radiais não palpáveis bilateralmente e sopro carotídeo diagnosticaram a AT. Discussão: A AT costuma apresentar intervalo entre início de sintomas e diagnóstico entre dois e onze anos e pode estar associada a várias manifestações características. O diagnóstico de AT tardio tendo o AVC como primeira manifestação clínica é raro. Conclusão: A importância de se conhecer a AT está no fato do diagnóstico, bem como tratamento precoce poderem evitar complicações ou retardar o seu aparecimento.Palavras-chave: Arterite de Takayasu, Acidente Vascular Cerebral, Diagnóstico.ABSTRACTIntroduction: The Takayasu arteritis (TA) is a chronic vasculitis of medium and large vessel, whose etiology is unknown. The annual incidence of TA, according to American statistics, is about 2.6 cases per one million people, mainly affects young women in reproductive age. This disease shows typical symptoms such as limb lameness, chest pain, and absence of brachial pulses, carotid bruit and no blood pressure in the upper limbs. Neurological syndromes, such as cerebral vascular accident (CVA) and transient ischemic attack (TIA) are presented in approximately 10-20% of patients with TA. Case Report: It is reported a case of a female patient, 42 years old, white who, despite having the symptoms of TA, as pain in the thoracic region and hypertension when she was 15 years old, was diagnosed with the disease only after 25 years of age. The patient was admitted to the Emergency Room of Itajubá Teaching Hospital with symptoms suggesting a stroke, which was confirmed by computed tomography (CT) and later brain and carotid and vertebral arteries CT angiography which, together with the observed clinical signs , as the intangible radial pulses bilaterally and carotid bruit, made it possible to diagnose TA. Discussion: The AT usually presents interval between the beginning of the symptoms and diagnosis between two and eleven years and it may be associated with multiple specifics manifestations. The late diagnosis of AT that has AVC, as a first clinical manifestation is rare. Conclusion: The importance of knowing the AT is in the fact that the diagnosis and early treatment can prevent complications or at least delay its appearance.Keywords: Takayasu’s Arteritis, Cerebrovascular Accidents, Diagnosis.

Context: Stroke is a considerable cause of morbidity and mortality nowadays. It is known the incidence, risk factors and etiology in mid-adults differ notably from older patients. When are young stroke patients, should investigate, besides traditional risk factors, a congenital heart disease, inflammatory and infectious causes, and the use of drugs to prevent new events. Case report: A 29-year-old woman, white, with hypothyroidism and history of surgical resection of retinoblastoma at 3 years of age, with sequelae of bilateral amaurosis, admitted with a history of neurological deficit in the left hemibody, with progression in 14 days until complete left hemiparesis provided. The cranial tomography showed infarction in the territory of the right middle cerebral artery and arteriography showed occlusion of the right internal carotid and dissection of the supraclinoid portion of this artery. Conclusions: While much is known about risk factors, pathophysiology and prognosis of extracranial arterial dissection, data are rare when it comes to the dissection of the intracranial portion of the internal carotid, no case was found that evidenced internal carotid artery occlusion of one side and contralateral dissection. The importance of knowing about the internal carotid dissection is the fact that this etiology is suspected when diagnosis young stroke patients.

Introduction: Vertebral artery dissections are responsible for 2% of all ischemic strokes and correspond to more than 25% of events in young adults. Its main etiologies, such as spontaneous and traumatic, which compromise the structural integrity of the arterial wall, allowing blood to accumulate between the layers of the vessel as an intramural hematoma, which can progress to stenosis or luminal occlusion in stroke. Case report: We attended a woman, 29 years old, who suffered a mild trauma in the cervical region during weight training in the gym presenting symptoms hours after the accident, a sudden headache of strong intensity irradiated to cervical, which evolves to a picture of cerebral ischemia characterized by changes in balance and coordination. The diagnosis was confirmed through complementary examinations of cranial tomography and angiotomography and treatment was composed by a combination of aspirin and clopidogrel with favorable evolution of the condition. Conclusion: The report illustrates that the change in cerebral circulation due to ischemia can occur either suddenly or even days after the injury, and it is likely that many cases classified as “spontaneous” without identifying the cause, may have been caused by minor trauma. In general, there is a good prognosis if early recognition and correct management.