Freshwater-Derived Streptomyces: Prospective Polyvinyl Chloride (PVC) Biodegraders.

Polyvinyl chloride (PVC) is widely used in industrial applications, such as construction and clothing, owing to its chemical, physical, and environmental resistance. Owing to the previous characteristics, PVC is the third most consumed plastic worldwide and, consequently, an increasing waste accumulation-related problem. The current study evaluated an in-house collection of 61 Actinobacteria strains for PVC resin biodegradation. Weight loss percentage was measured after the completion of incubation. Thermo-gravimetric analysis was subsequently performed using the PVC incubated with the three strains exhibiting the highest weight loss. GC-MS and ionic exchange chromatography analyses were also performed using the culture media supernatant of these three strains. After incubation, 14 strains had a PVC weight loss percentage higher than 50% in ISP-2 broth. These 14 strains were identified as Streptomyces strains. Strains 208, 250, and 290 showed the highest weight loss percentages (57.6-61.5% range). The thermal stability of PVC after bacterial exposure using these three strains was evaluated, and a modification of the representative degradation stages of nonincubated PVC was observed. Additionally, GC-MS analysis revealed the presence of aromatic compounds in the inoculated culture media, and ionic exchange chromatography showed chloride release in the supernatant. A mathematical relation between culture conditions and PVC weight loss was also found for strains 208 and 290, showing an accuracy up to 97.99%. These results highlight the potential of the freshwater-derived Streptomyces strains as candidates for the PVC biodegradation strategy and constitute the first approach to a waste management control scale-up process.

Technical performance of a lateral flow immunoassay for detection of anti-SARS-CoV-2 IgG in the outpatient follow-up of non-severe cases and at different times after vaccination: comparison with enzyme and chemiluminescent immunoassays.

This study assessed the technical performance of a rapid lateral flow immunochromatographic assay (LFIA) for the detection of anti-SARS-CoV-2 IgG and compared LFIA results with chemiluminescent immunoassay (CLIA) results and an in-house enzyme immunoassay (EIA). To this end, a total of 216 whole blood or serum samples from three groups were analyzed: the first group was composed of 68 true negative cases corresponding to blood bank donors, healthy young volunteers, and eight pediatric patients diagnosed with other coronavirus infections. The serum samples from these participants were obtained and stored in a pre-COVID-19 period, thus they were not expected to have COVID-19. In the second group of true positive cases, we chose to replace natural cases of COVID-19 by 96 participants who were expected to have produced anti-SARS-CoV-2 IgG antibodies 30-60 days after the vaccine booster dose. The serum samples were collected on the same day that LFIA were tested either by EIA or CLIA. The third study group was composed of 52 participants (12 adults and 40 children) who did or did not have anti-SARS-CoV-2 IgG antibodies due to specific clinical scenarios. The 12 adults had been vaccinated more than seven months before LFIA testing, and the 40 children had non-severe COVID-19 diagnosed using RT-PCR during the acute phase of infection. They were referred for outpatient follow-up and during this period the serum samples were collected and tested by CLIA and LFIA. All tests were performed by the same healthcare operator and there was no variation of LFIA results when tests were performed on finger prick whole blood or serum samples, so that results were grouped for analysis. LFIA's sensitivity in detecting anti-SARS-CoV-2 IgG antibodies was 90%, specificity 97.6%, efficiency 93%, PPV 98.3%, NPV 86.6%, and likelihood ratio for a positive or a negative result were 37.5 and 0.01 respectively. There was a good agreement (Kappa index of 0.677) between LFIA results and serological (EIA or CLIA) results. In conclusion, LFIA analyzed in this study showed a good technical performance and agreement with reference serological assays (EIA or CLIA), therefore it can be recommended for use in the outpatient follow-up of non-severe cases of COVID-19 and to assess anti-SARS-CoV-2 IgG antibody production induced by vaccination and the antibodies decrease over time. However, LFIAs should be confirmed by using reference serological assays whenever possible.

Perfil e desafios da produção e da comercialização de alimentos orgânicos processados no estado do Rio de Janeiro / Profile and challenges of the production and commercialization of processed organic foods in the state of Rio de Janeiro

Introdução: O processamento de alimentos orgânicos por pequenos produtores contribui para um sistema alimentar economicamente, socialmente e ambientalmente sustentável. É importante conhecer o perfil e as potenciais dificuldades dos processadores de alimentos orgânicos, organizados sob a modalidade do Sistema Participativo de Garantia da qualidade orgânica, devido ao seu crescimento e relevância social, para direcionamento de ações e políticas públicas com consequente fortalecimento da agricultura de bases agroecológica. Objetivo: Descrever o perfil dos processadores de alimentos orgânicos do estado do Rio de Janeiro e identificar os principais desafios nas redes de produção e comercialização. Método: Estudo exploratório e descritivo com delineamento transversal realizado por pesquisa documental aos planos de manejos, manual de boas práticas, atas do Sistema Participativo de Garantia, certificados  emitidos pela Associação de Agricultores Biológicos do Estado do Rio de Janeiro, assim como outros documentos de atualização de Organismos Participativos de Avaliação da Conformidade Orgânica em relação aos produtores credenciados. Resultados: Observou-se que 60% dos processadores orgânicos no estado do Rio de Janeiro são vinculados ao Sistema Participativo de Garantia da qualidade orgânica. A unidade de processamento mais utilizada é a anexa ao domicílio. A maioria são agricultores ou microempreendedores familiares que recebem ajuda da família no processo produtivo e a atividade mais desenvolvida é a fabricação de conservas, geleias, molhos e doces. Menos de 70% possuíam alvará de funcionamento e licença sanitária, 97% tinham plano de manejo orgânico; 79% possuíam manual de boas práticas e 78%, plano de rastreabilidade. Das principais dificuldades, destacam-se: aquisição de matéria-prima, adequação às normas sanitárias e logística de distribuição. Conclusões: O estudo desvelou a potencialidade do processamento de produtos orgânicos para o desenvolvimento socioeconômico regional e a necessidade de mais incentivos para viabilizar a inclusão produtiva de pequenos empreendimentos.

Introduction: Smallholder organic food processing contributes to an economically, socially and environmentally sustainable food system. It is important to know the profile and potential difficulties of organic food processors, organized under the modality of the Participatory Organic Quality Assurance System, due to its growth and social relevance for targeting actions and public policies with the consequent strengthening of agriculture with an agroecological basis. Objective: Describe the profile of organic food processors in Rio de Janeiro state and identify the main challenges in the production and commercialization schemes. Method: This is an exploratory and descriptive study with transversal design developed by documental research of different documents: handling plans, good practices manual, minutes of the Participatory Organic Quality Assurance System, certificates issued by the Association of Biological Farmers of the State of Rio de Janeiro, and other updated documents of the Participative Organism of Organic Conformity Assessment related to the accredited producers. Results: Sixty per cent of the organic processors in the Rio de Janeiro state were linked to the Participatory Organic Quality Assurance System. The processing unit mostly used is the one attached to their homes. Most of them are farmers or family micro-entrepreneurs that have assistance of family members in the production process and the main activity carried out is the production of canned foods, jams, sauces, and homemade desserts. Less than 70% of the producers had an operation permit and sanitary license, 97% had an Organic Handling Plan; 79% had a Good Practices Manual and 78% had a Traceability Plan. Among the main difficulties, there were: raw resource acquisition, sanitary rules adequacy and logistics in supplies. Conclusions: The study demonstrated the potentiality of organic products processing for the local social and economic development, and the need of greater inducements to make an inclusive production of small enterprises feasible.

Disinfectant effects of Brazilian green propolis alcohol solutions on the Staphylococcus aureus biofilm of maxillofacial prosthesis polymers.

STATEMENT OF PROBLEM: Brazilian green propolis may be an alternative product that reduces the development of a microbial biofilm on the polymers used for maxillofacial prostheses. However, its effects as a disinfectant have not been fully established. PURPOSE: The purpose of this in vitro study was to investigate the effects of Brazilian green propolis alcohol solutions against the Staphylococcus aureus biofilm on polymers used in maxillofacial prostheses, the maxillofacial silicone elastomer (MDX4-4210), and specific acrylic resins for ocular prostheses. MATERIAL AND METHODS: A total of 324 disk-shaped specimens (3×10 mm) of each material were fabricated. All specimens were contaminated with S. aureus (108 cells/mL) to assess the antibiofilm activity of immersion solutions and protocols. Thus, 162 specimens of each material were randomly distributed and equally divided into 5 groups of disinfectants and 1 control group: 3 separate groups of 2.5%, 5%, and 10% propolis alcohol solutions, 1 group of 5% propolis alcohol gel, a positive control group of 2% chlorhexidine gluconate, and a negative control group of distilled water. Specimens (n=9) were disinfected by immersion for 5, 10, and 15 minutes and immersed in culture medium for 24 hours. Any notable turgescence in the final medium was considered indicative of a biofilm. The effects of disinfectants were analyzed by a turbidity assay and by scanning electron microscopy. Data were analyzed descriptively. RESULTS: The final medium with specimens disinfected with 10% propolis alcohol solution showed no turbidity, indicating constant efficacy against the S. aureus biofilm. Similarly, these findings were observed in the 2% chlorhexidine gluconate group. Scanning electron microscopy images demonstrated that the surface of the polymers treated with 10% propolis alcohol solution did not show bacterial colonies. CONCLUSIONS: Disinfection with 10% green propolis alcohol solution was effective in eliminating the S. aureus biofilm from specimens of maxillofacial elastomer and N1 acrylic resin specific to ocular prostheses by immersion for 5 minutes.

Streptomyces as Potential Synthetic Polymer Degraders: A Systematic Review.

The inherent resistance of synthetic plastics to degradation has led to an increasing challenge of waste accumulation problem and created a pollution issue that can only be addressed with novel complementary methods such as biodegradation. Since biocontrol is a promising eco-friendly option to address this challenge, the identification of suitable biological agents is a crucial requirement. Among the existing options, organisms of the Streptomyces genus have been reported to biodegrade several complex polymeric macromolecules such as chitin, lignin, and cellulose. Therefore, this systematic review aimed to evaluate the potential of Streptomyces strains for the biodegradation of synthetic plastics. The results showed that although Streptomyces strains are widely distributed in different ecosystems in nature, few studies have explored their capacity as degraders of synthetic polymers. Moreover, most of the research in this field has focused on Streptomyces strains with promising biotransforming potential against polyethylene-like polymers. Our findings suggest that this field of study is still in the early stages of development. Moreover, considering the diverse ecological niches associated with Streptomyces, these actinobacteria could serve as complementary agents for plastic waste management and thereby enhance carbon cycle dynamics.

Differences in children and adolescents with SARS-CoV-2 infection: a cohort study in a Brazilian tertiary referral hospital

OBJECTIVES: To compare demographic/clinical/laboratory/treatments and outcomes among children and adolescents with laboratory-confirmed coronavirus disease 2019 (COVID-19). METHODS: This was a cross-sectional study that included patients diagnosed with pediatric COVID-19 (aged <18 years) between April 11, 2020 and April 22, 2021. During this period, 102/5,951 (1.7%) of all admissions occurred in neonates, children, and adolescents. Furthermore, 3,962 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection samples were processed in patients aged <18 years, and laboratory-confirmed COVID-19 occurred in 155 (4%) inpatients and outpatients. Six/155 pediatric patients were excluded from the study. Therefore, the final group included 149 children and adolescents (n=97 inpatients and 52 outpatients) with positive SARS-CoV-2 results. RESULTS: The frequencies of sore throat, anosmia, dysgeusia, headache, myalgia, nausea, lymphopenia, pre-existing chronic conditions, immunosuppressive conditions, and autoimmune diseases were significantly reduced in children and adolescents (p<0.05). Likewise, the frequencies of enoxaparin use (p=0.037), current immunosuppressant use (p=0.008), vasoactive agents (p=0.045), arterial hypotension (p<0.001), and shock (p=0.024) were significantly lower in children than in adolescents. Logistic regression analysis showed that adolescents with laboratory-confirmed COVID-19 had increased odds ratios (ORs) for sore throat (OR 13.054; 95% confidence interval [CI] 2.750-61.977; p=0.001), nausea (OR 8.875; 95% CI 1.660-47.446; p=0.011), and lymphopenia (OR 3.575; 95% CI 1.355-9.430; p=0.010), but also had less hospitalizations (OR 0.355; 95% CI 0.138-0.916; p=0.032). The additional logistic regression analysis on patients with preexisting chronic conditions (n=108) showed that death as an outcome was significantly associated with pediatric severe acute respiratory syndrome (SARS) (OR 22.300; 95% CI 2.341-212.421; p=0.007) and multisystem inflammatory syndrome in children (MIS-C) (OR 11.261; 95% CI 1.189-106. 581; p=0.035). CONCLUSIONS: Half of the laboratory-confirmed COVID-19 cases occurred in adolescents. Individuals belonging to this age group had an acute systemic involvement of SARS-CoV-2 infection. Pediatric SARS and MIS-C were the most important factors associated with the mortality rate in pediatric chronic conditions with COVID-19.

Severe clinical spectrum with high mortality in pediatric patients with COVID-19 and multisystem inflammatory syndrome.

OBJECTIVES: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C). METHODS: This cross-sectional study included 471 samples collected from 371 patients (age<18 years) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study group comprised 66/371 (18%) laboratory-confirmed pediatric COVID-19 patients: 61 (92.5%) patients tested positive on real-time reverse transcription-polymerase chain reaction tests for SARS-CoV-2, and 5 (7.5%) patients tested positive on serological tests. MIS-C was diagnosed according to the criteria of the Center for Disease Control. RESULTS: MIS-C was diagnosed in 6/66 (9%) patients. The frequencies of diarrhea, vomiting, and/or abdominal pain (67% vs. 22%, p=0.034); pediatric SARS (67% vs. 13%, p=0.008); hypoxemia (83% vs. 23%, p=0.006); and arterial hypotension (50% vs. 3%, p=0.004) were significantly higher in patients with MIS-C than in those without MIS-C. The frequencies of C-reactive protein levels >50 mg/L (83% vs. 25%, p=0.008) and D-dimer levels >1000 ng/mL (100% vs. 40%, p=0.007) and the median D-dimer, troponin T, and ferritin levels (p<0.05) were significantly higher in patients with MIS-C. The frequencies of pediatric intensive care unit admission (100% vs. 60%, p=0.003), mechanical ventilation (83% vs. 7%, p<0.001), vasoactive agent use (83% vs. 3%, p<0.001), shock (83% vs. 5%, p<0.001), cardiac abnormalities (100% vs. 2%, p<0.001), and death (67% vs. 3%, p<0.001) were also significantly higher in patients with MIS-C. Similarly, the frequencies of oxygen therapy (100% vs. 33%, p=0.003), intravenous immunoglobulin therapy (67% vs. 2%, p<0.001), aspirin therapy (50% vs. 0%, p<0.001), and current acute renal replacement therapy (50% vs. 2%, p=0.002) were also significantly higher in patients with MIS-C. Logistic regression analysis showed that the presence of MIS-C was significantly associated with gastrointestinal manifestations [odds ratio (OR)=10.98; 95%CI (95% confidence interval)=1.20-100.86; p=0.034] and hypoxemia [OR=16.85; 95%CI=1.34-211.80; p=0.029]. Further univariate analysis showed a positive association between MIS-C and death [OR=58.00; 95%CI=6.39-526.79; p<0.0001]. CONCLUSIONS: Pediatric patients with laboratory-confirmed COVID-19 with MIS-C had a severe clinical spectrum with a high mortality rate. Our study emphasizes the importance of investigating MIS-C in pediatric patients with COVID-19 presenting with gastrointestinal involvement and hypoxemia.

Severe clinical spectrum with high mortality in pediatric patients with COVID-19 and multisystem inflammatory syndrome

OBJECTIVES: To assess the outcomes of pediatric patients with laboratory-confirmed coronavirus disease (COVID-19) with or without multisystem inflammatory syndrome in children (MIS-C). METHODS: This cross-sectional study included 471 samples collected from 371 patients (age<18 years) suspected of having severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The study group comprised 66/371 (18%) laboratory-confirmed pediatric COVID-19 patients: 61 (92.5%) patients tested positive on real-time reverse transcription-polymerase chain reaction tests for SARS-CoV-2, and 5 (7.5%) patients tested positive on serological tests. MIS-C was diagnosed according to the criteria of the Center for Disease Control. RESULTS: MIS-C was diagnosed in 6/66 (9%) patients. The frequencies of diarrhea, vomiting, and/or abdominal pain (67% vs. 22%, p=0.034); pediatric SARS (67% vs. 13%, p=0.008); hypoxemia (83% vs. 23%, p=0.006); and arterial hypotension (50% vs. 3%, p=0.004) were significantly higher in patients with MIS-C than in those without MIS-C. The frequencies of C-reactive protein levels >50 mg/L (83% vs. 25%, p=0.008) and D-dimer levels >1000 ng/mL (100% vs. 40%, p=0.007) and the median D-dimer, troponin T, and ferritin levels (p<0.05) were significantly higher in patients with MIS-C. The frequencies of pediatric intensive care unit admission (100% vs. 60%, p=0.003), mechanical ventilation (83% vs. 7%, p<0.001), vasoactive agent use (83% vs. 3%, p<0.001), shock (83% vs. 5%, p<0.001), cardiac abnormalities (100% vs. 2%, p<0.001), and death (67% vs. 3%, p<0.001) were also significantly higher in patients with MIS-C. Similarly, the frequencies of oxygen therapy (100% vs. 33%, p=0.003), intravenous immunoglobulin therapy (67% vs. 2%, p<0.001), aspirin therapy (50% vs. 0%, p<0.001), and current acute renal replacement therapy (50% vs. 2%, p=0.002) were also significantly higher in patients with MIS-C. Logistic regression analysis showed that the presence of MIS-C was significantly associated with gastrointestinal manifestations [odds ratio (OR)=10.98; 95%CI (95% confidence interval)=1.20-100.86; p=0.034] and hypoxemia [OR=16.85; 95%CI=1.34-211.80; p=0.029]. Further univariate analysis showed a positive association between MIS-C and death [OR=58.00; 95%CI=6.39-526.79; p<0.0001]. CONCLUSIONS: Pediatric patients with laboratory-confirmed COVID-19 with MIS-C had a severe clinical spectrum with a high mortality rate. Our study emphasizes the importance of investigating MIS-C in pediatric patients with COVID-19 presenting with gastrointestinal involvement and hypoxemia.

A Painting Technique Using Ceramic Pigments for the Artificial Iris of an Ocular Prosthesis Guided by Applying Newton's Color Wheel.

This article describes a simple method for painting an artificial iris for the manufacturing of an ocular prosthesis with dark and light tones, both with excellent esthetic results. The challenge of choosing colors around the pupil and medium zone during painting is aided by the application of Newton's color wheel theory. This technique provides a safer choice of color during the painting procedure by using a mixture of ceramic pigments.

Relação entre índice de motivação escolar e desempenho acadêmico de crianças com transtorno de déficit de atenção/hiperatividade e grupo controle / Relation between the academic motivation index and the academic performance of children with attention deficit hyperactivity disorder and control group

INTRODUÇÃO: Transtorno do Déficit de Atenção e Hiperatividade (TDAH) é um transtorno do neurodesenvolvimento caracterizado por padrões persistentes de desatenção e/ou hiperatividade e impulsividade, que causam prejuízos no funcionamento e no desenvolvimento do indivíduo. Um dos prejuízos marcantes nessa população está relacionado à habilidade de motivação. OBJETIVO: Neste sentido, o presente estudo teve como objetivo analisar a relação entre índices de motivação escolar e desempenho acadêmico em crianças com TDAH comparadas com grupo de desenvolvimento típico. MÉTODO: Participaram 60 crianças com idade entre 6 e 12 anos, de ambos os sexos, pertencentes a escolas da rede pública e privada, sendo 30 com TDAH e 30 com desenvolvimento típico. Para avaliação da motivação escolar, foi utilizada a Escala para Avaliação da Motivação Escolar Infantojuvenil (EAME-IJ) e para avaliação do desempenho acadêmico utilizou-se o Teste de Desempenho Escolar (TDE). RESULTADOS: Nos resultados referentes ao desempenho acadêmico, as crianças com TDAH apresentaram desempenho significativamente inferior em todas as tarefas em relação às crianças do grupo com desenvolvimento típico. Na motivação escolar o grupo com TDAH apresentou menor índice de motivação intrínseca. Os resultados revelaram também correlação negativa de magnitude moderada entre motivação extrínseca e desempenho escolar. CONCLUSÃO: Os achados sugerem que as crianças com TDAH têm dificuldades para modular e autorregular seus níveis de motivação, especialmente o de motivação intrínseca, o que pode implicar em maior necessidade de recompensas externas, principalmente durante a execução de tarefas que demandam maior esforço cognitivo, como é o caso das tarefas escolares.

INTRODUCTION: Attention-Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that consists of persistent patterns of inattention and/or hyperactivity and impulsiveness, which impair an individual's behavior and development. A major impairment undergone by this population has to do with motivation. OBJECTIVE: Thus, this study had the objective of analyzing the relation between academic motivation and performance indexes in children with ADHD as compared to results from a control group that exhibits typical development patterns. METHODS: A total of 60 children of both sexes, aged 6-12 years and studying in both private and public schools participated in this study. Half of the participants (30 children) has ADHD and the other half (30 children) exhibits typical development. In order to evaluate their academic motivation, we used the Rating Scale of School Motivation (EAME - IJ) and also academic performance was tested with the Academic Achievement Test (TDE). RESULTS: Regarding academic performance, children with ADHD showed significantly lower performance in all tasks when contrasted with the typical development group. As for academic motivation, the ADHD group also showed a lower level of intrinsic motivation. Results also had shown negative correlation with low magnitude between extrinsic motivation and scholar performance. CONCLUSION: The findings suggest that children with ADHD have difficulty modulating and self-regulating their motivation levels, especially intrinsically, which may suggest a greater need for external rewards, mainly during the execution of tasks that demand greater cognitive effort, such as schoolwork.

Lesões orais e maxilofaciais em pacientes idosos: um estudo comparativo em dois serviços ­ clínico e laboratorial / Oral and maxillofacial lesions in older individuals and associated factors: a retrospective analysis of cases retrieved in two different services

O perfil demográfico brasileiro passa por um processo de transição em que a taxa de sobrevida vem crescendo e, consequentemente, há aumento da população idosa. Os serviços de saúde pública precisarão se adequar para atender as necessidades e demandas dessa população. Este estudo teve como objetivo descrever a frequência de lesões orais e maxilofaciais em idosos (pacientes ≥60 anos) comparando dois serviços distintos, um clínico e outro laboratorial, e investigar a associação entre a ocorrência das três lesões mais frequentes e as variáveis independentes. Um estudo retrospectivo e comparativo foi realizado. Os dados foram coletados dos prontuários de dois tipos de serviços de referência em Patologia Oral e Maxilo Facial. As variáveis independentes analisadas foram: sexo, faixa etária (idoso jovem: 60-79 anos e mais idoso: ≥80 anos), cor da pele, tabagismo, uso de álcool e uso de próteses removíveis. Quanto à lesão foi considerada a sintomatologia e a localização anatômica. Uma análise descritiva de frequência das lesões para os dois serviços e o teste Qui-quadrado foram realizados. A análise univariada verificou a associação entre a ocorrência das três lesões mais frequentes e as variáveis independentes. O intervalo de confiança foi estabelecido em 95% e o nível de significância foi de p <0,05. Inicialmente foram analisados 32.842 registros de um banco de dados, dos quais 5.148 eram de indivíduos com 60 anos ou mais. Desses, 1.695 (37.3%) eram de origem clínica e 2.848 (62,7%) laboratorial. Considerando os dois serviços, a maioria foi do sexo feminino (62,3%), idoso jovem (90,1%) e não brancos (48,2%). Em 18,3% dos prontuários, os indivíduos relataram fumar e 12,1% faziam uso de álcool. O uso de próteses removíveis foi identificado em 32,4% dos registros. Lesões assintomáticas (54,3%) foram mais frequentes e a mucosa alveolar foi o sítio anatômico mais acometido (18,2%). A hiperplasia fibrosa inflamatória (HFI) foi a lesão mais comum nos dois serviços. A candidíase e as varizes foram a segunda e terceira lesões mais frequentes no serviço clínico, enquanto o carcinoma de células escamosas (CCE) e a displasia epitelial (DE) foram mais frequentes no serviço laboratorial. Encontramos diferenças na frequência quando comparamos os grupos de lesões (p <0,05), exceto nos grupos de lesões pigmentadas (p = 0,054) e infecciosas (p = 0,054) que não houve diferença significativa. Pacientes do sexo feminino (OR: 2,08; IC: 1,81-2,39) e indivíduos que usavam prótese removível (OR: 3,99; IC: 2,83-5,62) tiveram uma frequência maior de diagnóstico para hiperplasia fibrosa inflamatória. Também houve diferença de frequência no diagnóstico de carcinoma de células escamosas no grupo dos mais idosos (OR: 1,70; IC: 1,30-2,21), nos indivíduos do sexo masculino (OR: 3,63; IC: 3,00­4,39), tabagistas (OR: 6,05; IC: 4,84­7,56) e aos que faziam uso de álcool (OR: 3,95; IC: 3,12­5,01). Os resultados mostraram diferentes frequências de OMLs em idosos, de acordo com as fontes de dados e grupos pela idade. Os resultados são importantes para direcionar políticas públicas mais eficazes para essa faixa etária.

The Brazilian demographic profile is in transition, which the survival rate is increasing and, consequently, there is an increase in the older population. Public health services will have to adapt to attend needs and demands of this population. The aim of this study was to describe the frequency of oral and maxillofacial lesions among older individuals (≥60 years) as reported by two different services: clinical and laboratory services and to investigate the association between the occurrence of the three most frequent lesions and the independent variables. A retrospective study was performed using data obtained from the oral and maxillofacial pathology services. Data on the frequency of oral and maxillofacial lesions from the clinical and laboratory services were collected. Data on the sex, age group (young­old: 60­79 years and old­old: 80 years or older), and skin color of the individuals, as well as their habits, such as smoking, alcohol use, and the wearing of prosthesis, were also retrieved. Regarding the lesion, the symptoms and the anatomical location were considered. Descriptive analyses of the frequencies of oral and maxillofacial lesions reported by both services were performed. Univariate analysis was used to test the association between the occurrence of the three most frequent oral and maxillofacial lesions and the independent variables. The confidence interval was set at 95% and the level of significance was p < 0.05. From 32,842 records in the two services, 5,148 were individuals aged 60 years or older, theses 1,685 (32.7%) were from the clinical service and 3,463 (67.3%) were from the laboratory service. Considering the two services, the majority were female (62.3%), young-old (90.0%) and non-white individuals (48.7%). In 17.7% and 12.1% of the records, smoking and alcohol use was reported, respectively, while 29.3% of the records indicated that the individual wore a removable prosthesis. Painful symptoms were reported in 1,345 (26.1%) of the cases. The most affected anatomical site was the alveolar mucosa (943 cases; 18.3%). The inflammatory fibrous hyperplasia (IFH) was the most commom lesion in both services, while the candidiasis and varices were the second and third most frequent lesions in the clinical service, and squamous cell carcinoma (SCC) and epithelial dysplasia (ED) were more frequent in the laboratory service. Young-old individuals were likely to present with IFH: odds ratio (OR): 1.38 and confidence interval (CI): 1.11-1.71. However, females (OR: 2.01; CI: 1.77-2.29) and individuals who wore a removable prosthesis (OR: 4.21; CI: 2.99-5.93) were also likely to present with IFH. Old-old individuals who were 80 years or older (OR: 1.64; CI: 1.28- 2.11), male (OR: 3.66; CI: 3.07-4.36), or who had reported smoking (OR: 5.83; CI: 4.74-7.18) or alcohol use (OR: 3.69; CI: 2.96-4.60) were likely to present with SCC. Males (OR: 1.59; CI: 1.30-1.95) and individuals who had reported smoking (OR: 1.86; CI: 1.44-2.42) were likely to present with ED. The frequency of oral and maxillofacial lesions diagnosed in both services was different. The data source and the study design used in retrospective analyzes can direct the results found.

Management of Peri-Implant Hypertrophic Scarring for an Ear Prosthesis.

The clinical report describes a case of a 14-year-old patient with a traumatic amputation of the left auricle and severe hypertrophic scarring. The management of peri-implant soft tissue was challenging, but successful in the rehabilitation of a patient with auricular prosthesis retained by implants. The prosthesis restored the patient's facial aesthetics and contributed not only to function, but also to psychosocial well-being.

Internal displacement in Colombia: Fifteen distinguishing features.

This commentary aims to delineate the distinguishing features of conflict-induced internal displacement in the nation of Colombia, South America. Even as Colombia is currently implementing a spectrum of legal, social, economic, and health programs for "victims of armed conflict," with particular focus on internally displaced persons (IDPs), the dynamics of forced migration on a mass scale within this country are little known beyond national borders.   The authors of this commentary are embarking on a global mental health research program in Bogota, Colombia to define best practices for reaching the displaced population and implementing sustainable, evidence-based screening and intervention for common mental disorders. Presenting the defining characteristics of internal displacement in Colombia provides the context for our work and, more importantly, conveys the compelling and complex nature of this humanitarian crisis. We attempt to demonstrate Colombia's unique position within the global patterning of internal displacement.

Transtorno do déficit de atenção e hiperatividade na escola: mediação psicopedagógica / Attention deficit/hyperactivity disorder at school: mediation psychopedagogical

O estudo apresenta um caso de mediação psicopedagógica para diagnóstico de Transtorno do Déficit de Atenção/Hiperatividade (TDAH), tratamento, orientação na escola, família, e com a criança. A criança foi encaminhada pela psicopedagoga para avaliação interdisciplinar dos aspectos psicopedagógicos, neuropsicológico, neuropediátrico, psiquiátrico e familiar. A queixa da escola e da mãe era de que a criança estava agressiva, opositora, recusava-se a fazer as atividades, provocava confusões em casa e na sala de aula, era desorganizada, sem cuidado com seus pertences pessoais, não conseguia manter amizades e não demonstrava interesse pelas lições. Foi tratada com medicação metilfenidato, com melhora imediata da impulsividade e desatenção. Foram aplicados testes neuropsicológicos, psicopedagógicos, escalas de comportamento, antes e após o tratamento medicamentoso. Após o tratamento e as intervenções, foi verificada grande melhora no comportamento, na aprendizagem e nas relações pessoais. Os resultados nos testes foram para melhor; em relação à aprendizagem, foi possível verificar uma dificuldade fonológica do processo de alfabetização, que antes não foi constatado devido a sua recusa. A psicopedagoga fez orientação na escola e soube na ocasião que a criança frequentava o reforço escolar na escola, com conteúdo mais relacionado à matéria atual, assim foi realizada orientação para que fosse trabalhado o processo de alfabetização com ênfase nos aspectos fonológicos devido às dificuldades apresentadas na escrita e na leitura. A relação Saúde e Educação trouxe perspectivas e intervenções importantes na vida escolar, demonstrando que é possível mudar o comportamento e a qualidade da aprendizagem de crianças com diagnóstico de TDAH.(AU)

The study presents a case of psycho-pedagogical mediation to the Attention Deficit/Hyperactivity Disorder diagnoses, treatment, and school/family/child guidance. The child was referred by the psycho-pedagogue to the interdisciplinary evaluation of the psycho-pedagogical, neuropsychological, neuropediatrician, psychiatric and familiar aspects. The school and mother's complain was that the child was aggressive, objector, declining to do the activities, troublemaker at home and at school, disorganized, careless with his/her personal belongs, difficulty in keeping friends and not interested in classes. The child was treated with methylphenidate, with a prompt impulsivity and neglect improvement. Neuropsychological and psychiatric tests have been applied, behavior scales, before and after the drug treatment. After the treatment and the interventions, a great behavior improvement was verified, as in the learning process and in the social relations. The tests results were for better, concerning to the learning process, it was possible to realize a phonologic difficulty, which was not identified previously due to the refusal. During the scholar guidance, the psycho-pedagogue noted that the child was taking tutoring classes at school, with a content related to the current subject, and so it was advised that the literacy ability should be worked with a focus on the phonologic aspects due to the difficulties showed in the writing and reading skills. The Health-Education relation brought out important prospects and interventions in the scholar life, showing that it is possible to change the behavior and the quality of learning in children with ADHD.(AU)

Transtorno do déficit de atenção e hiperatividade na escola: mediação psicopedagógica / Attention deficit/hyperactivity disorder at school: mediation psychopedagogical

O estudo apresenta um caso de mediação psicopedagógica para diagnóstico de Transtorno do Déficit de Atenção/Hiperatividade (TDAH), tratamento, orientação na escola, família, e com a criança. A criança foi encaminhada pela psicopedagoga para avaliação interdisciplinar dos aspectos psicopedagógicos, neuropsicológico, neuropediátrico, psiquiátrico e familiar. A queixa da escola e da mãe era de que a criança estava agressiva, opositora, recusava-se a fazer as atividades, provocava confusões em casa e na sala de aula, era desorganizada, sem cuidado com seus pertences pessoais, não conseguia manter amizades e não demonstrava interesse pelas lições. Foi tratada com medicação metilfenidato, com melhora imediata da impulsividade e desatenção. Foram aplicados testes neuropsicológicos, psicopedagógicos, escalas de comportamento, antes e após o tratamento medicamentoso. Após o tratamento e as intervenções, foi verificada grande melhora no comportamento, na aprendizagem e nas relações pessoais. Os resultados nos testes foram para melhor; em relação à aprendizagem, foi possível verificar uma dificuldade fonológica do processo de alfabetização, que antes não foi constatado devido a sua recusa. A psicopedagoga fez orientação na escola e soube na ocasião que a criança frequentava o reforço escolar na escola, com conteúdo mais relacionado à matéria atual, assim foi realizada orientação para que fosse trabalhado o processo de alfabetização com ênfase nos aspectos fonológicos devido às dificuldades apresentadas na escrita e na leitura. A relação Saúde e Educação trouxe perspectivas e intervenções importantes na vida escolar, demonstrando que é possível mudar o comportamento e a qualidade da aprendizagem de crianças com diagnóstico de TDAH.(AU)

The study presents a case of psycho-pedagogical mediation to the Attention Deficit/Hyperactivity Disorder diagnoses, treatment, and school/family/child guidance. The child was referred by the psycho-pedagogue to the interdisciplinary evaluation of the psycho-pedagogical, neuropsychological, neuropediatrician, psychiatric and familiar aspects. The school and mother's complain was that the child was aggressive, objector, declining to do the activities, troublemaker at home and at school, disorganized, careless with his/her personal belongs, difficulty in keeping friends and not interested in classes. The child was treated with methylphenidate, with a prompt impulsivity and neglect improvement. Neuropsychological and psychiatric tests have been applied, behavior scales, before and after the drug treatment. After the treatment and the interventions, a great behavior improvement was verified, as in the learning process and in the social relations. The tests results were for better, concerning to the learning process, it was possible to realize a phonologic difficulty, which was not identified previously due to the refusal. During the scholar guidance, the psycho-pedagogue noted that the child was taking tutoring classes at school, with a content related to the current subject, and so it was advised that the literacy ability should be worked with a focus on the phonologic aspects due to the difficulties showed in the writing and reading skills. The Health-Education relation brought out important prospects and interventions in the scholar life, showing that it is possible to change the behavior and the quality of learning in children with ADHD.(AU)

Transtorno do déficit de atenção e hiperatividade na escola: mediação psicopedagógica / Attention deficit/hyperactivity disorder at school: mediation psychopedagogical

O estudo apresenta um caso de mediação psicopedagógica para diagnóstico de Transtorno do Déficit de Atenção/Hiperatividade (TDAH), tratamento, orientação na escola, família, e com a criança. A criança foi encaminhada pela psicopedagoga para avaliação interdisciplinar dos aspectos psicopedagógicos, neuropsicológico, neuropediátrico, psiquiátrico e familiar. A queixa da escola e da mãe era de que a criança estava agressiva, opositora, recusava-se a fazer as atividades, provocava confusões em casa e na sala de aula, era desorganizada, sem cuidado com seus pertences pessoais, não conseguia manter amizades e não demonstrava interesse pelas lições. Foi tratada com medicação metilfenidato, com melhora imediata da impulsividade e desatenção. Foram aplicados testes neuropsicológicos, psicopedagógicos, escalas de comportamento, antes e após o tratamento medicamentoso. Após o tratamento e as intervenções, foi verificada grande melhora no comportamento, na aprendizagem e nas relações pessoais. Os resultados nos testes foram para melhor; em relação à aprendizagem, foi possível verificar uma dificuldade fonológica do processo de alfabetização, que antes não foi constatado devido a sua recusa. A psicopedagoga fez orientação na escola e soube na ocasião que a criança frequentava o reforço escolar na escola, com conteúdo mais relacionado à matéria atual, assim foi realizada orientação para que fosse trabalhado o processo de alfabetização com ênfase nos aspectos fonológicos devido às dificuldades apresentadas na escrita e na leitura. A relação Saúde e Educação trouxe perspectivas e intervenções importantes na vida escolar, demonstrando que é possível mudar o comportamento e a qualidade da aprendizagem de crianças com diagnóstico de TDAH...

The study presents a case of psycho-pedagogical mediation to the Attention Deficit/Hyperactivity Disorder diagnoses, treatment, and school/family/child guidance. The child was referred by the psycho-pedagogue to the interdisciplinary evaluation of the psycho-pedagogical, neuropsychological, neuropediatrician, psychiatric and familiar aspects. The school and mother's complain was that the child was aggressive, objector, declining to do the activities, troublemaker at home and at school, disorganized, careless with his/her personal belongs, difficulty in keeping friends and not interested in classes. The child was treated with methylphenidate, with a prompt impulsivity and neglect improvement. Neuropsychological and psychiatric tests have been applied, behavior scales, before and after the drug treatment. After the treatment and the interventions, a great behavior improvement was verified, as in the learning process and in the social relations. The tests results were for better, concerning to the learning process, it was possible to realize a phonologic difficulty, which was not identified previously due to the refusal. During the scholar guidance, the psycho-pedagogue noted that the child was taking tutoring classes at school, with a content related to the current subject, and so it was advised that the literacy ability should be worked with a focus on the phonologic aspects due to the difficulties showed in the writing and reading skills. The Health-Education relation brought out important prospects and interventions in the scholar life, showing that it is possible to change the behavior and the quality of learning in children with ADHD...

Análise da associação entre o desempenho acadêmico, a velocidade de execução das tarefas e o comportamento da criança a partir da EACI-P / Analysis of association between the academic performance, the speed of execution of tasks and behavior of children from EACI-P

OBJETIVO: Esse trabalho busca analisar a associação entre o desempenho acadêmico, a velocidade de execução das tarefas, e os problemas de comportamento infantil, avaliados pela EACI-P, bem como as inter-relações entre esses problemas de comportamento, desempenho e a inteligência estimada das crianças. MÉTODO: Trata-se de um estudo transversal com a avaliação do comportamento por meio de escala padronizada, comparação entre as idades e análise de associação entre as variáveis do instrumento (EACI-P) segundo classificação do professor. RESULTADOS: Os resultados da avaliação dos professores quanto à presença ou não de problemas de comportamento nas 84 crianças avaliadas revelam que 7,9 por cento (7) crianças apresentam Hiperatividade/Problema de Conduta, 2,2 por cento (2) crianças apresentam um nível abaixo do esperado para sua idade e nível de escolarização no que se refere ao Funcionamento Independente/Socialização Positiva, 13,5 por cento (12) apresentam Inatenção, 5,6 por cento (5) têm sintomas de Neurotismo/Ansiedade e 1,1 por cento (1) vivencia um processo de Socialização Negativa. O desempenho foi associado aos escores de desatenção e hiperatividade. A velocidade de execução foi associada à socialização negativa e o escore de QI foi negativamente correlacionado com todas as variáveis comportamentais, exceto funcionamento independente. CONCLUSÃO: É possível por meio da aplicação da EACI-P obter dados para compreender o comportamento e a aprendizagem da criança, fundamentando intervenções precoces. Comportamento, desempenho acadêmico, velocidade de execução e inteligência foram fatores de risco ou proteção para aprendizagem, caso estejam preservados ou prejudicados. A relação professor-aluno-escola é fundamental para o desenvolvimento psicossocial da criança, a partir da mediação dessa tríade podem-se evitar problemas de aprendizagem, comportamentos e relacionamentos interpessoais.(AU)

OBJECTIVE: The aim of this study was to analyze the association between academic achievement, assessed by Child Behavior Scale for Teacher (EACI-P), as well as to correlate it to behavioral problems, speed of performance and IQ score. METHODS: This is a cross-sectional study analysing EACIP Inventory answers through standardized comparison to neuropsychological variables in 84 children. RESULTS: Hyperactivity and conduct problems prevailed in 7.9 percent (7 cases) children, 2.2 percent of cases showed difficulties in Independent Functioning / Positive Socialization, 13.5 percent revealed inattention, 5.6 percent (5 cases) showed symptoms of neuroticism / anxiety and 1.1 percent (1 case) of cases experiences a negative socialization. Global performance was associated with inattention scores and positive socialization, whereas hyperactivity symptoms were correlated to inattention. Speed of performance was associated with negative socialization and IQ score was negatively correlated to all behavioral variables except independent functioning. CONCLUSION: It is possible through the application of EACI-P to obtain data to understand behavior and learning correlations, supporting early intervention. Behavior, speed of performance and intelligence could be either risk or protective factors for learning if they are preserved or impaired. Such data suggest that teacher-student interface is crucial to understand psychosocial development of children and could give support to positive approaches to face learning, behavior and interpersonal problems.(AU)

Análise da associação entre o desempenho acadêmico, a velocidade de execução das tarefas e o comportamento da criança a partir da EACI-P / Analysis of association between the academic performance, the speed of execution of tasks and behavior of children from EACI-P

Esse trabalho busca analisar a associação entre o desempenho acadêmico, a velocidade de execução das tarefas, e os problemas de comportamento infantil, avaliados pela EACI-P, bem como as inter-relações entre esses problemas de comportamento, desempenho e a inteligência estimada das crianças. MÉTODO: Trata-se de um estudo transversal com a avaliação do comportamento por meio de escala padronizada, comparação entre as idades e análise de associação entre as variáveis do instrumento (EACI-P) segundo classificação do professor. RESULTADOS: Os resultados da avaliação dos professores quanto à presença ou não de problemas de comportamento nas 84 crianças avaliadas revelam que 7,9 por cento (7) crianças apresentam Hiperatividade/Problema de Conduta, 2,2 por cento (2) crianças apresentam um nível abaixo do esperado para sua idade e nível de escolarização no que se refere ao Funcionamento Independente/Socialização Positiva, 13,5 por cento (12) apresentam Inatenção, 5,6 por cento (5) têm sintomas de Neurotismo/Ansiedade e 1,1 por cento (1) vivencia um processo de Socialização Negativa. O desempenho foi associado aos escores de desatenção e hiperatividade. A velocidade de execução foi associada à socialização negativa e o escore de QI foi negativamente correlacionado com todas as variáveis comportamentais, exceto funcionamento independente. CONCLUSÃO: É possível por meio da aplicação da EACI-P obter dados para compreender o comportamento e a aprendizagem da criança, fundamentando intervenções precoces. Comportamento, desempenho acadêmico, velocidade de execução e inteligência foram fatores de risco ou proteção para aprendizagem, caso estejam preservados ou prejudicados. A relação professor-aluno-escola é fundamental para o desenvolvimento psicossocial da criança, a partir da mediação dessa tríade podem-se evitar problemas de aprendizagem, comportamentos e relacionamentos interpessoais...

The aim of this study was to analyze the association between academic achievement, assessed by Child Behavior Scale for Teacher (EACI-P), as well as to correlate it to behavioral problems, speed of performance and IQ score. METHODS: This is a cross-sectional study analysing EACIP Inventory answers through standardized comparison to neuropsychological variables in 84 children. RESULTS: Hyperactivity and conduct problems prevailed in 7.9 percent (7 cases) children, 2.2 percent of cases showed difficulties in Independent Functioning / Positive Socialization, 13.5 percent revealed inattention, 5.6 percent (5 cases) showed symptoms of neuroticism / anxiety and 1.1 percent (1 case) of cases experiences a negative socialization. Global performance was associated with inattention scores and positive socialization, whereas hyperactivity symptoms were correlated to inattention. Speed of performance was associated with negative socialization and IQ score was negatively correlated to all behavioral variables except independent functioning. CONCLUSION: It is possible through the application of EACI-P to obtain data to understand behavior and learning correlations, supporting early intervention. Behavior, speed of performance and intelligence could be either risk or protective factors for learning if they are preserved or impaired. Such data suggest that teacher-student interface is crucial to understand psychosocial development of children and could give support to positive approaches to face learning, behavior and interpersonal problems...

Análise da associação entre o desempenho acadêmico, a velocidade de execução das tarefas e o comportamento da criança a partir da EACI-P / Analysis of association between the academic performance, the speed of execution of tasks and behavior of children from EACI-P

OBJETIVO: Esse trabalho busca analisar a associação entre o desempenho acadêmico, a velocidade de execução das tarefas, e os problemas de comportamento infantil, avaliados pela EACI-P, bem como as inter-relações entre esses problemas de comportamento, desempenho e a inteligência estimada das crianças. MÉTODO: Trata-se de um estudo transversal com a avaliação do comportamento por meio de escala padronizada, comparação entre as idades e análise de associação entre as variáveis do instrumento (EACI-P) segundo classificação do professor. RESULTADOS: Os resultados da avaliação dos professores quanto à presença ou não de problemas de comportamento nas 84 crianças avaliadas revelam que 7,9 por cento (7) crianças apresentam Hiperatividade/Problema de Conduta, 2,2 por cento (2) crianças apresentam um nível abaixo do esperado para sua idade e nível de escolarização no que se refere ao Funcionamento Independente/Socialização Positiva, 13,5 por cento (12) apresentam Inatenção, 5,6 por cento (5) têm sintomas de Neurotismo/Ansiedade e 1,1 por cento (1) vivencia um processo de Socialização Negativa. O desempenho foi associado aos escores de desatenção e hiperatividade. A velocidade de execução foi associada à socialização negativa e o escore de QI foi negativamente correlacionado com todas as variáveis comportamentais, exceto funcionamento independente. CONCLUSÃO: É possível por meio da aplicação da EACI-P obter dados para compreender o comportamento e a aprendizagem da criança, fundamentando intervenções precoces. Comportamento, desempenho acadêmico, velocidade de execução e inteligência foram fatores de risco ou proteção para aprendizagem, caso estejam preservados ou prejudicados. A relação professor-aluno-escola é fundamental para o desenvolvimento psicossocial da criança, a partir da mediação dessa tríade podem-se evitar problemas de aprendizagem, comportamentos e relacionamentos interpessoais.(AU)

OBJECTIVE: The aim of this study was to analyze the association between academic achievement, assessed by Child Behavior Scale for Teacher (EACI-P), as well as to correlate it to behavioral problems, speed of performance and IQ score. METHODS: This is a cross-sectional study analysing EACIP Inventory answers through standardized comparison to neuropsychological variables in 84 children. RESULTS: Hyperactivity and conduct problems prevailed in 7.9 percent (7 cases) children, 2.2 percent of cases showed difficulties in Independent Functioning / Positive Socialization, 13.5 percent revealed inattention, 5.6 percent (5 cases) showed symptoms of neuroticism / anxiety and 1.1 percent (1 case) of cases experiences a negative socialization. Global performance was associated with inattention scores and positive socialization, whereas hyperactivity symptoms were correlated to inattention. Speed of performance was associated with negative socialization and IQ score was negatively correlated to all behavioral variables except independent functioning. CONCLUSION: It is possible through the application of EACI-P to obtain data to understand behavior and learning correlations, supporting early intervention. Behavior, speed of performance and intelligence could be either risk or protective factors for learning if they are preserved or impaired. Such data suggest that teacher-student interface is crucial to understand psychosocial development of children and could give support to positive approaches to face learning, behavior and interpersonal problems.(AU)

Triagem diagnóstica no processo de avaliação neuropsicológica interdisciplinar

O presente artigo apresenta o modelo de triagem diagnóstica interdisciplinar de um núcleo assistencial neuropsicológico infantil. O modelo de triagem está fundamentado numa perspectiva bio-psico-social, que consiste na entrevista inicial com as crianças em grupo realizado uma equipe interdisciplinar. O modelo se justifica pelo fato de que essa percepção inicial do neuropsicólogo, através do modelo tradicional, é demorado, caro, e às vezes ineficiente para determinados pacientes neurológicos. A proposta de que possa direcionar o processo, gerando um ponto de partida para a avaliação neuropsicológica da criança. A implementação deste procedimento em serviços ambulatoriais propicia benefícios amplos que envolvem não só a redução de custos, como também a humanização do atendimento ao paciente.(AU)

This article aims at presenting a model of interdisciplinary diagnosis screening in a child care neuropsychological group. The biopsychosocial perspective is the base of the diagnosis screening, which consists of an initial interview with the children in groups carried by an interdisciplinary staff. The model is justified for the fact that this initial perception of the neuropsychologist, through the traditional model, is time-consuming, costly and, inefficient for most neurology patients. The proposal is that this can direct the assessment, generating a starting point for the neuropsychology evaluation. Considering the patient's decrease of emotional loses, the integrated diagnosis, and the financial aspect, we conclude that the implementation of this procedure in clinic services promotes benefits which involve not only the reduction of costs, but also the humanization of the patient's care.(AU)