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The concept of aphasia designates impairment in the symbolic domains of language (vocabulary, semantics, phonology, syntax and morphology) by one or more lesions in the dominant cerebral hemisphere, which may be manifest through spoken and written comprehension and production, but can not be explained by motor or sensory deficits in view of the preservation of phono-articulatory structures, and neither by generalized cognitive deficits (consciousness must be preserved)1. Stroke is the leading cause of aphasia, which may be identified in more [...]

Estudos neurossonológicos, especialmente o Doppler transcraniano (DTC) e o duplex transcraniano codificado a cores (DTCC), apresentam elevados níveis de especificidade e sensibilidade quando utilizados como exames complementares no diagnóstico de morte encefálica (ME). Um grupo de peritos do Departamento Científico de Doppler transcraniano da Academia Brasileira de Neurologia criou uma força-tarefa de forma a determinar os critérios neurossonológicos para os seguintes aspectos no diagnóstico de ME no Brasil: metodologia do DTC; metodologia do DTCC; treinamento e habilidades em Neurossonologia; diagnóstico de parada circulatória encefálica e documentação do exame para a ME. Os resultados deste encontro foram apresentados neste artigo. Neurosonological studies, specifically transcranial Doppler (TCD) and transcranial color-coded duplex (TCCD), have high level of specificity and sensitivity and they are used as complementary tests for the diagnosis of brain death (BD). A group of experts, from the Neurosonology Department of the Brazilian Academy of Neurology, created a task force to determine the criteria for the following aspects of diagnosing BD in Brazil: the reliability of TCD methodology; the reliability of TCCD methodology; neurosonology training and skills; the diagnosis of encephalic circulatory arrest; and exam documentation for BD. The results of this meeting are presented in the current paper. Universidade Federal do Paraná Hospital de Clínicas Universidade Federal de São Paulo (UNIFESP) Hospital São Luiz Universidade da Região de Joinville Hospital Municipal São José UNIFESP Universidade Federal da Bahia Secretaria Estadual de Saúde Hospital Geral de Goiânia Universidade de São Paulo Faculdade de Medicina de Ribeirão Preto Hospital das Clínicas Universidade Estadual de Campinas Hospital das Clínicas Laboratório de Neurossonologia Instituto D'Or de Pesquisa e Ensino (IDOR) UNIFESP, Hospital São Luiz UNIFESP SciELO

We read with interest the article by Li and Johnson in which they demonstrated that improvement initiatives were able to reduce alarm-to-needle time in acute stroke care by applying the Lean Six Sigma approach. In Brazil, the Unified Health System is challenged to improve efficiency with limited budgets by ensuring that the right things are done by the right people at the right time. Successful implementations in the National Health System (United Kingdom) have shown that Lean thinking contributes to [...]