Que pacientes atende um neurologista? Alicerce de um currículo em neurologia

OBJETIVO: Apresentar os diagnósticos mais freqüentes em pacientes encaminhados a neurologistas e discutir a importância destes achados para a definição de um currículo em neurologia. EMBASAMENTO:O desenvolvimento de subespecialidades em neurologia tem interferido na definição do que deveria ser ensinado no treinamento de um médico ou de um neurologista. O conhecimento de quais são as doenças neurológicas mais comuns pode contribuir para a construção deste currículo. MÉTODO: Os diagnósticos iniciais de 1815 pacientes encaminhados a um ambulatório de neurologia, num hospital público universitário em São Paulo, Brasil, são analisados. RESULTADOS:Os diagnósticos mais comuns, em ordem decrescente de frequência, foram: cefaléia, epilepsia, transtornos mentais, doença encéfalo-vascular, traumatismo craniencefálico, polineuropatia, síndrome vestibular, paraparesia crural espástica, síndrome extrapiramidal, síndrome demencial, hipertensão intracraniana e paralisia facial. CONCLUSÕES: A importância das subespecialidades no currículo deve ser relacionada à frequência da doença neurológica na comunidade.OBJECTIVE: To present the most frequent diagnosis of patients referred to a neurologist and to discuss the importance of this finding for the definition of the curriculum in Neurology. BACKGROUND:The development of subespecialties of Neurology is interfering in the definition of what should be taught to train a physician or a neurologist. The knowledge of which are the most common neurological diseases may contribute to construct these curricula. METHOD:The initial diagnosis in 1815 outpatients referred to the neurologic service of an university-affiliated public hospital in São Paulo, Brazil, were analyzed. RESULTS: The most common diagnosis, in decreasing order of frequency, were: headache, epilepsy, mental disorders, cerebrovascular disease, head injury, polyneuropathy, vestibular syndrome, spastic crural paraparesis, extrapyramidal syndrome, dementia, intracranial hypertension and facial palsy. CONCLUSION:The importance of the subespecialties in the curriculum should be related to the frequency of the neurologic diseases in the community

An overview of the microphysical structure of cirrus clouds observed during EMERALD-1

High-resolution ice microphysical, turbulence, heat and water vapour flux data in cirrus clouds were collected by the Airborne Research Australia’s (ARA) Egret Grob 520T research aircraft during the first EgretMicrophysics with Extended Radiation and Lidar experiment (EMERALD-1). The in situ cirrus measurements were guided by simultaneous airborne lidar measurements collected by the ARA Super King Air research aircraft which flew below the cirrus and whose horizontal position was synchronized with the Egret. This allowed the microphysics and turbulence measurements to be interpreted and evaluated within the context of large-scale cirrus structure and its evolution. A significant feature of the clouds observed was the presence on occasion of active convective columns. Large variations in the cirrus dynamics were observed, with significant variations in the ice crystal habit from cloud top to cloud base and within the evaporating fall-streaks of precipitation. However, on average the picture presented is consistent with that shown by Heymsfield andMiloshevich, and by Kajikawa and Heymsfield, with the upper supersaturated region of the cloud acting as an active particle-generation zone where homogeneous nucleation proceeds apace; ice crystals there are initially dominated by small irregular or spheroidally shaped particles, some of which can be identified as proto or ‘germ’ rosettes. These are then observed to grow into more open bullet rosette and columnar types as they fall into the less supersaturated middle and lower layers of the cloud. The mean recognisable ice particle size fell within a very narrow size band, 70–90 μm, but the actual size distribution is thought to increase in a continuous manner to smaller sizes. However, there are currently instrument limitations that make it difficult to confirm this unambiguously. Unlike most previous studies, however, the cirrus clouds observed here were mostly devoid of pristine plate-like crystals, as nucleation and growth within the planar growth regime was rarely encountered. During some cases bullet rosettes, once formed, did undergo transition to the plate growth regime with complex crystal shapes resulting. The mean size of pristine bullet rosettes was again confined to a relatively narrow range. The likely nucleation processes dominating in cirrus clouds are discussed in the light of the observations. Very high concentrations of small ice crystals were sometimes detected, concentrations reaching a maximum of 10 000 Lcm-1. There is strong evidence supporting these high concentrations which are probably produced by the homogeneous freezing of aerosol

When Their World Falls Apart: Helping Families and Children Manage the Effects of Disasters by Lawerence B. Rosenfeld, and Joanne S. Caye, and Ofra Ayalon, and Mooli Lahad

Reviewed Work: When Their World Falls Apart: Helping Families and Children Manage the Effects of Disasters by Lawerence B. Rosenfeld, and Joanne S. Caye, and Ofra Ayalon, and Mooli Lahad&nbsp