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Objective: Hydration can favor cognitive functions during childhood and adolescence, helping with daily and school activities. This study aimed to identify possible interactions between hydration and memory in children and adolescents. Methods: This is a systematic review with meta-analysis. The bibliographic search was conducted in the MEDLINE/PubMed, SciELO, LILACS, Web of Science, Embase, and Cochrane Library databases, through a combination of the descriptors: “hydration” AND “memory”; “hydration” AND “memory” AND “child”; “hydration” AND “memory” AND “children”; “organism hydration status” AND “memory”; “organism hydration status” AND “memory” AND “child”. Results: The search resulted in 816 articles, of which ten were selected for qualitative synthesis and two for the meta-analysis. The results indicated that hydration could not enhance working, visual and visuomotor memories, or visual attention (Line Tracing Task, MD 0.67, 95% CI -0.87 to 2.22; Indirect Image Difference, MD 0.32, 95% CI -0.75 to 1.40; Letter Cancellation, MD 1.68, 95% CI -0.81 to 4.17). Conclusion: From the obtained results, hydration per se does not reinforce working, visual and visuomotor memories, or visual attention. However, there are still gaps regarding other types of memory and cognitive, motor, nutritional and environmental integration. Objetivo: A hidratação pode favorecer as funções cognitivas durante a infância e adolescência, auxiliando as atividades cotidianas e escolares. Portanto, objetivou-se identificar as possíveis interações entre a hidratação e memória em crianças e adolescentes. Métodos: Trata-se de uma revisão sistemática com meta-análise. A busca foi realizada nas bases de dados MEDLINE/PubMed, SciELO, LILACS, Web of Science, Embase e Cochrane Library, por meio da combinação dos descritores: “hydration” AND “memory”; “hydration” AND “memory” AND “child”; “hydration” AND “memory” AND “children”; “organism hydration status” AND “memory”; “organism hydration status” AND “memory” AND “child”. Resultados: A estratégia de busca resultou inicialmente em 816 artigos, dos quais 10 foram selecionados para a síntese qualitativa e dois para a meta-análise. Os resultados indicaram que apenas hidratação não foi capaz de potencializar as memórias de trabalho, visual, visuomotora e atenção visual (Line Tracing Task, MD 0.67, 95% CI -0.87 to 2.22; Indirect Image Difference, MD 0.32, 95% CI -0.75 to 1.40; Letter Cancellation, MD 1.68, 95% CI -0.81 to 4.17). Conclusão: A partir dos resultados obtidos, apenas a hidratação per si não fortalece as memórias de trabalho, visual e visuomotora e a atenção visual. Entretanto, ainda há lacunas sobre outros tipos de memória e a integração cognitiva, motora, nutricional e ambiental.

Background: Individuals with migraine usually complain about lower memory performance. Diagnostic methods such as neuroimaging may help in the understanding of possible morphologic and functional changes related to the memory of those individuals. Therefore, the aim of this review is to analyze the available literature on neuroimaging changes related to memory processing in migraine. Methods: We searched the following databases: Pubmed/Medline, Psycinfo, Science Direct, Cochrane and Web of Science. We used articles without restriction of year of publication. The combination of descriptors used for this systematic review of literature were Neuroimaging OR Imaging OR Brain AND Migraine OR Chronic Migraine AND Memory. Results: Of the 306 articles found, nine were selected and all used magnetic resonance imaging (MRI). The studies used structural and functional MRI techniques with a predominance of 3 Tesla equipment and T1-weighted images. According to the results obtained reported by these studies, migraine would alter the activity of memory-related structures, such as the hippocampus, insula and frontal, parietal and temporal cortices, thereby suggesting a possible mechanism by which migraine would influence memory, especially in relation to the memory of pain. Conclusions: Migraine is associated to global dysfunction of multisensory integration and memory processing. This condition changes the activity of structures in various regions related to memory of pain, prospective memory, as well as in short- and long-term verbal and visuospatial memories. However, it is necessary to perform studies with larger samples in association with cognitive tests, and without the interference of medications to verify possible alterations and to draw more concrete conclusions. RESUMO Introdução: Indivíduos com enxaqueca geralmente se queixam de menor desempenho de memória. Métodos de diagnóstico como a neuroimagem podem auxiliar no entendimento de possíveis alterações morfológicas e funcionais relacionadas à memória desses indivíduos. Portanto, o objetivo desta revisão é analisar a literatura disponível sobre alterações de neuroimagem relacionadas a alterações de memória na enxaqueca. Métodos: Pesquisou-se nas seguintes bases de dados: PubMed/MEDLINE, Psycinfo, Science Direct, Cochrane e Web of Science. Foram utilizados artigos sem restrição de ano de publicação. A combinação dos descritores utilizados para esta revisão sistemática da literatura foram Neuroimaging OR Imaging OR Brain AND Migraine OR Chronic Migraine AND Memory. Resultados: Dos 306 artigos encontrados, nove foram selecionados e todos utilizaram ressonância magnética (RM). Os estudos utilizaram as técnicas de RM estrutural e funcional com predomínio de equipamentos de 3 Tesla e imagens ponderadas em T1. De acordo com os resultados obtidos nos estudos, a enxaqueca alteraria a atividade de estruturas relacionadas à memória, como o hipocampo, a ínsula e os córtices frontal, parietal e temporal, sugerindo um possível mecanismo pelo qual a enxaqueca influenciaria a memória, especialmente em relação à memória da dor. Conclusões: A enxaqueca está associada à disfunção global da integração multissensorial e processamento de memória. Essa condição altera a atividade de estruturas em várias regiões relacionadas à memória da dor, à memória prospectiva, bem como às memórias verbais e visuais-espaciais de curto e longo prazo. No entanto, é necessário realizar estudos com amostras maiores em associação com testes cognitivos, e sem a interferência de medicamentos para verificar possíveis alterações e tecer conclusões mais concretas.

Key Points Question Can common genetic variants associated with essential tremor (ET) be identified? Findings In this genome-wide association study and meta-analysis including genetic data on 483 054 individuals, 5 genome-wide significant loci were associated with risk of ET and common variants were associated with approximately 18% of ET heritability. Meaning Findings of this study may help identify new genes and inform ET biology., This genome-wide association study identifies common variants associated with risk of essential tremor., Importance Essential tremor (ET) is one of the most common movement disorders, affecting 5% of the general population older than 65 years. Common variants are thought to contribute toward susceptibility to ET, but no variants have been robustly identified. Objective To identify common genetic factors associated with risk of ET. Design, Setting, and Participants Case-control genome-wide association study. Inverse-variance meta-analysis was used to combine cohorts. Multicenter samples collected from European populations were collected from January 2010 to September 2019 as part of an ongoing study. Included patients were clinically diagnosed with or reported having ET. Control individuals were not diagnosed with or reported to have ET. Of 485 250 individuals, data for 483 054 passed data quality control and were used. Main Outcomes and Measures Genotypes of common variants associated with risk of ET. Results Of the 483 054 individuals included, there were 7177 with ET (3693 [51.46%] female; mean [SD] age, 62.66 [15.12] years), and 475 877 control individuals (253 785 [53.33%] female; mean [SD] age, 56.40 [17.6] years). Five independent genome-wide significant loci and were identified and were associated with approximately 18% of ET heritability. Functional analyses found significant enrichment in the cerebellar hemisphere, cerebellum, and axonogenesis pathways. Genetic correlation (r), which measures the degree of genetic overlap, revealed significant common variant overlap with Parkinson disease (r, 0.28; P = 2.38 × 10−8) and depression (r, 0.12; P = 9.78 × 10−4). A separate fine-mapping of transcriptome-wide association hits identified genes such as BACE2, LRRN2, DHRS13, and LINC00323 in disease-relevant brain regions, such as the cerebellum. Conclusions and Relevance The results of this genome-wide association study suggest that a portion of ET heritability can be explained by common genetic variation and can help identify new common genetic risk factors for ET.

Daytime sleepiness could reduce the memorization of children who are in school. Thus, the aim of this study was to study the effect of daytime sleepiness on the visual memory of schoolchildren at different times during the school semester. Individuals of both genders (n = 88) aged 9 to 11 years and regularly enrolled at the Mariana Amália Municipal School were selected. Data collection occurred in two moments: at the beginning and end of the academic semester. A semi-structured questionnaire was used to collect sociodemographic information, the Epworth Sleepiness Scale to assess sleepiness and the Rey-Osterrieth complex figure, object recall, scrambling figures and addition of dictated numbers for memory analysis tests. The data revealed that there is no direct relationship between sleepiness and impaired memory by the tests used in any of the analyzed moments. However, children showed lower visuospatial memory efficiency at the beginning of the school semester, indicating that they may have greater difficulty in memory retention. Lastly, there was an abnormality in the degree of sleepiness at the end of the school semester and the female gender showed efficiency in immediate and late memory. La somnolencia diurna puede reducir la memorización de informaciones en los niños que están en el ambiente escolar. Así, se propuso estudiar el efecto de la somnolencia diurna en la memoria visual de escolares. Se seleccionaron individuos de ambos sexos (n=88), regularmente matriculados en la Escuela Municipal Mariana Amália, con edades comprendidas entre 9 y 11 años. La recogida de datos se produjo en dos momentos: al principio y al final el semestre escolar. Se utilizó un cuestionario semiestructurado para recoger información sociodemográfica, la Escala de Somnolencia de Epworth para evaluar la somnolencia y las pruebas de la figura compleja de Rey, recuerdo de objetos, figuras barajadas y suma de números dictados para el análisis de la memoria. Los datos revelaron que no existe una relación directa entre somnolencia y el deterioro de la memoria por las pruebas utilizadas en cualquiera de los momentos analizados. Sin embargo, al principio del semestre escolar, los niños mostraron una menor eficiencia en la memoria visoespacial, lo que indica que pueden tener una mayor dificultad en la retención de la memoria. Al final del semestre, hubo una anormalidad en el grado de somnolencia al final del semestre escolar y el sexo femenino mostró eficiencia en la memoria inmediata y tardía. A sonolência diurna pode reduzir a memorização de informações de crianças que estão no ambinte escolar. Assim, objetivou-se estudar o efeito da sonolência diurna sobre a memória visual de escolares. Foram selecionados indivíduos de ambos os sexos (n=88), regularmente matriculados na Escola Municipal Mariana Amália, com idade entre 9 a 11 anos. A coleta de dados ocorreu em dois momentos: início e final do semestre letivo. Utilizou-se um questionário semiestruturado para coleta de informações sociodemográficas, a Escala de Sonolência de Epworth para avaliar a sonolência e os testes da figura Complexa de Rey, Recordação de objetos, figuras embaralhas e adição de números ditados para análise da memória. Os dados revelaram que não há relação direta entre sonolência e comprometimento da memória pelos testes utilizados em nenhum dos momentos analisados. Entretanto, no início do semestre letivo, as crianças apresentaram menor eficiência da memória visuoespacial, indicando que podem ter maior dificuldade na retenção da memória. No final do semestre, houve anormalidade no grau de sonolência e o sexo feminino apresentou eficiência na memória imediata e tardia.

Childhood sleep-related problems can predict later emotional and behavioral disturbances, such as anxiety. Thus, this study aimed to investigate the relationship between sleepiness and anxiety symptoms throughout the semester in schoolchildren aged 9 to 11 years old. Children enrolled in a public school, located in Vitória de Santo Antão, Pernambuco, Brazil, of both genders, without sleep disorders, physical disabilities or cognitive disorders (n = 88) were evaluated. The State-Trait Anxiety Inventory was used to analyze mood. Subjective sleep assessment was performed using the Epworth Sleepiness Scale and the Horne & Ostberg Morningness and Eveningness Questionnaire (MEQ-HO). The questionnaires were applied in the morning at the beginning (P1) and at the end (P2) of the school semester, with the exception of the MEQ-HO. The correlation between sleepiness and state of anxiety in period 1 (r=0.16; p=0.21) was insufficient, as well as in period 2 (r=0.34; p=0.01). There was a low correlation between sleepiness and anxiety traits in period 1, while the correlation was moderate in period 2 (r=0.48; p

Introduction: Migraine has a neurological origin and is characterized by failure of central modulation leading to neuronal hyperexcitability. Among the factors related to such excitability is the mitochondrial dysfunction that has been considered since the 1980s. Objective: To investigate changes in the cerebral energetic metabolism of individuals with migraine through phosphorus magnetic resonance spectroscopy (31P-MRS). Methods: It was searched articles on Pubmed, Web of Science and Science Direct betweenof June, 2018 and February, 2019. There was no restriction regarding the year of publication and language. The combination of the descriptors used for this systematic review was: Migraine AND Magnetic resonance spectroscopy [MESH]. The inclusion criteria chosen were: original articles using 31P-MRS in individuals diagnosed with migraine (with and/or without aura); studies with adults between 18 and 60 years of age diagnosed with episodic or chronic migraine; with control group of individuals without migraine and without pathologies or conditions that would interfere in the results. Excluded were articles: incomplete or unpublished; animal studies; and research protocol articles. Results: Of the 319 articles found, nine were selected. The sample totaled 216 individuals with migraine (53.7% without aura) and 233 healthy individuals in the control group. It was verified a reduction of phosphocreatine, phosphorylation potential, Mg2+ and ATP, whereas it was observed increase of inorganic phosphate and ADP. Conclusion: There are alterations in cerebral energetic metabolism in individuals with migraine, revealing mitochondrial dysfunction. However, it is needed more studies with higher quality and analysis of the relationships with the socio-demographic and clinical variables.

Objective: To investigate the effects of cognitive training associated with physical exercise on cognitive performance of elderly people with Alzheimer's Disease (AD). Methodology: A systematic review was carried out with a meta-analysis of controlled and cross-over clinical trials. The literature search was carried out in databases Pubmed / MEDLINE, LILACS, SciELO, PEDro, Scopus, CINAHL and Web of Science, using terms MeSH / DeCS. The risk of bias was assessed according to recommendations of Cochrane Handbook for Systematic Reviews of Interventions and RevMan 5.3 software was used for the meta-analysis. . Results: Initially, 1126 articles were found, nine were chosen for qualitative synthesis and two for meta-analysis. The meta-analysis data showed significant differences in effect size for executive functions and attention, evaluated by Clock Drawing Test (Z = 3.05; p = 0.002) and frontal cognitive functions evaluated by Frontal Assessment Battery (Z = 3.56; p = 0.0004). For qualitative analysis, seven studies demonstrated positive effects of cognitive training associated with physical exercise to improve/maintain cognitive functions of elderly with AD. Conclusion: Despite the limitations found in analyzed studies, it can be suggested that cognitive training associated with physical exercise can benefit the cognitive performance of elderly with AD. However, the dearth of studies developed with greater discerning methodology limits generalizations of these results. Objetivo: Investigar los efectos del entrenamiento cognitivo asociado al ejercicio físico sobre el desempeño cognitivo de ancianos con Enfermedad de Alzheimer (EA). Metodología: Se realizó una revisión sistemática con metanálisis de ensayos clínicos controlados e de tipo cross-over. La búsqueda de la literatura fue realizada a través de las bases de datos de Pubmed / MEDLINE, LILACS, SciELO, PEDro, Scopus, CINAHL y Web of Science, utilizando los descriptores de términos MeSH / DeCS. El riesgo de sesgo se evaluó de acuerdo a las recomendaciones de Cochrane Handbook for Systematic Reviews of Interventions y el metanálisis fue realizado con el software RevMan 5.3. Resultados: De los 1126 artículos obtenidos de la búsqueda, fueron escogidos nueve para la síntesis cualitativa y dos para el metanálisis. Los datos del metanálisis mostraron diferencias significativas en el tamaño del efecto para las funciones ejecutivas y atención evaluadas por el Test del Dibujo del Reloj (Z= 3,05; p= 0,002) y funciones cognitivas frontales evaluadas por la Batería de Evaluación Frontal (Z= 3,56; p = 0,0004). En el análisis cualitativo, siete estudios demostraron efectos positivos del entrenamiento cognitivo asociado al ejercicio físico en la mejora/mantenimiento de las funciones cognitivas de ancianos con EA. Conclusión: Apesar de las limitaciones encontradas en los estudios disponibles sobre este tema, se puede sugerir que el entrenamiento cognitivo asociado al ejercicio físico presenta beneficios sobre el desempeño cognitivo en ancianos con EA. Sin embargo, se requieren más estudios de mayor calidad metodológica para corroborar los efectos de esta terapia combinada. Objetivo: Investigar os efeitos do treinamento cognitivo associado ao exercício físico no desempenho cognitivo de idosos com Doença de Alzheimer (Dos Santos Picanco et al.). Metodologia: Foi realizada uma revisão sistemática com metanálise de ensaios clínicos controlados e cross-over. A busca na literatura foi realizada nas bases de dados Pubmed / MEDLINE, LILACS, SciELO, PEDro, Scopus, CINAHL e Web of Science, utilizando os descritores MeSH / DeCS. O risco de viés foi avaliado de acordo com as recomendações do Cochrane Handbook for Systematic Reviews of Interventions e a metanálise foi realizada com o software RevMan 5.3. Resultados: Dos 1126 artigos obtidos na busca, nove foram escolhidos para a síntese qualitativa e dois para a metanálise. Os dados da metanálise mostraram diferenças significativas no tamanho do efeito para as funções executivas e atenção avaliadas pelo Teste do Desenho do Relógio (Z = 3,05; p = 0,002) e funções cognitivas frontais avaliadas pela Bateria de Avaliação Frontal (Z = 3,56; p = 0,0004). Na análise qualitativa, sete estudos demonstraram efeitos positivos do treinamento cognitivo associado ao exercício físico na manutenção e melhora das funções cognitivas de idosos com DA. Conclusão: Apesar das limitações encontradas nos estudos disponíveis sobre o tema, pode-se sugerir que o treinamento cognitivo associado ao exercício físico apresenta benefícios no desempenho cognitivo de idosos com DA. No entanto, a escassez de estudos desenvolvidos com melhor rigor metodológico limita generalizações desses resultados.

CNPq Alterações no ciclo sono-vigília poderiam exacerbar a intensidade e frequência de crises de migrânea, bem como, gerar prejuízos na memória e sintomas de ansiedade ou depressão em portadores de migrânea crônica (MC). Assim, objetivou-se investigar a interação do ritmo de atividade-repouso sobre a dor, memória e sintomas de ansiedade e depressão de portadores de MC. Tratou-se de estudo transversal composto por indivíduos com MC (n=23) e indivíduos saudáveis no grupo controle (n=23). Avaliou-se o ritmo de atividade por actimetria durante 15 dias, diários de cefaleia e de sono por 30 dias. Os demais instrumentos da pesquisa utilizados foram: Ficha de Avaliação Sociodemográfica, Clínica e de Hábitos de Vida; Questionário Internacional de Atividade Física - Versão Curta; Escala Visual Analógica; Headache Impact Test - 6; Questionário de Matutinidade e Vespertinidade de Horne & Ostberg; Índice de Qualidade do Sono de Pittsburgh; Escala de Sonolência de Epworth; Inventário de Depressão de Beck; Inventário da Ansiedade Traço-Estado; e Teste da Figura Complexa de Rey-Osterrieth. Realizou-se o teste de normalidade Shapiro-Wilk, comparações foram realizadas através do teste de Mann-Whitney e, correlações pelo coeficiente de correlação de Spearman. Além disso, foram conduzidos modelos de regressão linear múltipla com efeito de interação, considerando-se o nível de significância de 5%. Os indivíduos com MC apresentaram 27,8 ± 6,4 anos e sexo feminino (96%). Crises de migrânea com intensidade da dor de moderada à severa e frequência de 17,4 ± 7,8 dias/mês. Os indivíduos com MC apresentaram maior dificuldade para iniciar o sono (p

Background : Amebiasis is a parasitic infection caused by obligate or facultative amoeboid protozoans, as well as free-living forms. The genus Entamoeba includes both pathogenic and commensal species that can affect humans and animals. E ntamoeba histolytica is the most important species associated with intestinal and extraintestinal infections in humans, while E ntamoeba invadens is considered the most common and serious pathogen to many reptile species, including lizards, snakes and crocodilians. The aim of this manuscript is to report a case of amebiasis in a backyard red-foot tortoise in northeastern Brazil. Case : A 10-month-old male red-foot tortoise ( Chelonoidis carbonaria ) was presented at the Animal Pathology Laboratory of the Veterinary Hospital of Federal University of Campina Grande for necropsy with a 1-week history of anorexia, apathy, and reluctance to move. According to the owner, the animal suffered from heat stress in the backyard, where it was housed with another male red-foot tortoise. At post-mortem examination, there were approximately 1 mL of yellowish viscous transudate in the coelomic cavity. The liver was large, with rounded edges and multifocal to coalescing yellowish areas in the subcapsular surface. When cut, the parenchyma was more friable and yellowish. At the opening of the small intestine, the mucosa was thickened, reddened, and contained many variably sized, dark red ulcers with depressed and hemorrhagic centers. Histopathology of the liver reveals diffuse macro and microvacuolar degeneration of the hepatocyte cytoplasm, often displacing the nucleus peripherally (fatty degeneration). There were extensive and multifocal areas of necrosis characterized by shrunken, hypereosinophilic and pyknotic hepatocytes. Amebic trophozoites were seen through the areas of necrosis and degeneration and the morphological features were suggestive of the genus Entamoeba . In the portal triads and slightly extending to the sinusoidal spaces, there is a moderate inflammatory infiltrate of macrophages, lymphocytes, plasma cells and rare heterophils. There were amebic trophozoites and thrombi in hepatic vessels, and mild intracanalicular cholestasis. The small intestine contained areas of transmural necrosis and ulceration associated with inflammatory infiltrate of macrophages, lymphocytes and plasma cells. The ulcers were covered by a thick fibrinonecrotic exudate mixed with a varying number of heterophils and macrophages. The submucosa contained hemorrhage and edema. Similar amebic trophozoites were found within the mucosa and submucosa, and also detected in the lumens of blood vessels at the submucosa. The amebic trophozoites, seen in the liver and intestine, were intensely Periodic acid–Schiff positive. Discussion : The diagnosis of amebiasis was based on the epidemiological, clinical and anatomopathological findings. Amebiasis is a well-recognized disease that usually is diagnosed post-mortem in numerous species of reptiles. Unfortunately, there are no scientific articles describing these cases in Brazil. In reptiles, the major pathogenic specie is Entamoeba invadens , while several other species are considered non-pathogenic, such as E. barreti, E. insolita, E. terrapinae, E. ctenosaurae, and E. knowlesi , among others. Although cultivation of E. invadens was not undertaken, the anatomopathological findings and the morphological appearance of the agent is highly suggestive of infection with this organism. In conclusion, amebiasis is a severe infectious disease that can affect young red-footed tortoises under adverse environmental conditions. Clinical signs are nonspecific and may be difficult to identify. The diagnosis is usually made post-mortem by anatomopathological findings and the morphological appearance of the agent.

Problemas relacionados ao sono na infância podem predizer distúrbios emocionais e comportamentais posteriores, como ansiedade. Sendo assim, objetivou-se investigar a relação da sonolência sobre os sintomas de ansiedade ao longo do semestre em escolares de 9 a 11 anos de idade. Foram avaliadas crianças matriculadas em uma escola pública, localizada no município de Vitória de Santo Antão - Pernambuco, de ambos os sexos, sem distúrbios do sono, deficiência física e distúrbios cognitivos (n = 88). Para a análise do humor, foi utilizado o Inventário de Ansiedade Traço- Estado. A avaliação subjetiva do sono foi realizada por meio da Escala de Sonolência de Epworth e o Questionário de Matutinidade e Vespertinidade de Horne & Ostberg (QMV-HO). Os questionários foram aplicados no período da manhã, no início (P1) e no final (P2) do semestre letivo, com exceção do QMV-HO. A correlação entre sonolência e estado de ansiedade no período 1 (r=0,16; p=0,21), foi insuficiente, bem como no período 2 (r=0,34; p=0,01). Houve baixa correlação entre sonolência e os traços de ansiedade no período 1, contanto a correlação foi moderada no período 2 (r=0,48; p

Os dutos são altamente utilizados na indústria petrolífera para o transporte de óleo, gás natural e produtos provenientes de refinarias. Uma das principais áreas de estudo na engenharia de dutos é a garantia de escoamento, além da otimização deste escoamento ao longo da tubulação. É de extrema importância o estudo no modo transiente na tubulação, a fim de determinar e analisar possíveis mudanças nos dutos com o decorrer do tempo. O presente estudo apresenta a modelagem matemática e numérica de um escoamento monofásico em uma tubulação soterrada. Foram feitas análises no modo transiente sobre o efeito de bombas e válvulas na pressão e vazão ao longo da tubulação, além de um estudo do surgimento de vazamento nos dutos com o tempo. As simulações e análises foram feitas utilizando o software PipelineStudio®. Os resultados mostram que a pressão e vazão ao longo de uma tubulação sofrem uma grande influência de equipamentos como bombas e válvulas, os quais devem ser monitorados constantemente a fim de serem utilizados em prol do aumento da eficiência do escoamento.

Objetivo: Investigar os efeitos do treinamento cognitivo associado ao exercício físico no desempenho cognitivo de idosos com Doença de Alzheimer (Dos Santos Picanco et al.). Metodologia: Foi realizada uma revisão sistemática com metanálise de ensaios clínicos controlados e cross-over. A busca na literatura foi realizada nas bases de dados Pubmed / MEDLINE, LILACS, SciELO, PEDro, Scopus, CINAHL e Web of Science, utilizando os descritores MeSH / DeCS. O risco de viés foi avaliado de acordo com as recomendações do Cochrane Handbook for Systematic Reviews of Interventions e a metanálise foi realizada com o software RevMan 5.3. Resultados: Dos 1126 artigos obtidos na busca, nove foram escolhidos para a síntese qualitativa e dois para a metanálise. Os dados da metanálise mostraram diferenças significativas no tamanho do efeito para as funções executivas e atenção avaliadas pelo Teste do Desenho do Relógio (Z = 3,05; p = 0,002) e funções cognitivas frontais avaliadas pela Bateria de Avaliação Frontal (Z = 3,56; p = 0,0004). Na análise qualitativa, sete estudos demonstraram efeitos positivos do treinamento cognitivo associado ao exercício físico na manutenção e melhora das funções cognitivas de idosos com DA. Conclusão: Apesar das limitações encontradas nos estudos disponíveis sobre o tema, pode-se sugerir que o treinamento cognitivo associado ao exercício físico apresenta benefícios no desempenho cognitivo de idosos com DA. No entanto, a escassez de estudos desenvolvidos com melhor rigor metodológico limita generalizações desses resultados.

Introduction: Cancer is now the third leading cause of death in the world, surpassed only by accidents and cardiovascular deaths by external causes, among them stands mammary carcinoma. Mastectomy is in a procedure consisting of invasive breast removal due to some anatomical and functional changes previously diagnosed. With the growth of the disease and its high content in increasingly young women, Manual Therapy has been used as a new form of treatment. Objective: To show the effects of manual therapy in patients after mastectomy surgery. Method: This was a systematic review study in which secondary and tertiary sources were used, using the databases PubMed, Medline, Lilacs and SciELO. It was adopted as inclusion criteria studies classified as: a randomized controlled trial, with publication period between 2009 and 2013. Were used as search terms: "Mastectomy", "Neck", "Shoulder Pain", "Musculoskeletal Manipulations" and "Functionality". Results: Among the 37 initially selected by electronic search in the databases of articles, 25 were excluded for the title did not meet the inclusion criteria. Of the 12 retained studies, 5 were excluded for duplicity. 7 studies were selected for a more thorough analysis through summary, 2 of them being excluded. The remaining 5 articles were evaluated from reading the text. It can be seen that the manual therapy techniques have significant results in the alleviation of muscle pain in patients submitted to surgery mastectomia. Conclusion: It can be seen that the manual therapy techniques have significant results in the alleviation of muscle pain in patients undergoing the mastectomy surgery. However, there is still a lack of studies of type randomized controlled trial on the effects of manual therapy in patients in the postoperative period of mastectomy