10 Annotation This diploma thesis deals with relations between developmental coordination disorder (or developmental dyspraxia) and laterality and handedness. In the theoretical part this work summarizes actual knowledge about the origin and the development of laterality and handedness and describes possibilities how to examine it. It also deals with knowledge about developmental coordination disorder, its characteristic, etiology, prevalence and diagnostic possibilities. The aim of the practical part was to evaluate motor difficulties in children with right and left handedness and to compare differencies. The Movement Assessment Battery for Children 2 was used for that evaluation. Motor skills in 64 children (30 left-handed and 34 right-handed) were evaluated. We haven't found any difference between those groups of children, their results were very balanced. We have also tested the motor skills in children with crossed eye-hand laterality, any significant difference hasn't been found in comparison with standard population. The group of children with learning disabilities has been also evaluated, we have found statisticaly significant difference between their motor skills and motor skills of standard population.

The aim of this study is to investigate influence of physical activity on postural balance of children (12 - 15 years old). Method is measurment of postural balance on stabilometric desc in differently challenging positions. Three groups are tested (biathletes, oarsmen and control group), each in count 15 - 20 probands. We expect, young biathletes will have better postural stability than oarsmen and control group thanks to specific training. Keywords Postural balance, static balance, biathlon, rowing, sport, children, laterality, bipedal stance, unipedal stance

This diploma thesis focuses on the important knowledge related to education and bringing up left-handed children. The theoretical part focuses on the explanation of the term laterality and its diagnostics and also on the methodology of left-handed writing and the preparatory exercises for writing. Furthermore this part points to some various causes and effects suppression of left- handedness, and a brief insight into a former approach and an actual approach. This part offers information to the new trend in writing - Czech school font called Comenia Script. The practical part concentrates on the development of writing for left-handed in the commonly used writing alphabet, and in the font Comenia Script. There is also included a tentative questionnaire for primary school teachers and an observation and teaching of left- handed pupils in four different grades at primary schools. Keywords: laterality, left-handedness, upbringing, education, the commonly used writing alphabet, the font Comenia Script

L'examen des asymétries oro-faciales fournit un indice indirect et fiable pour déterminer la spécialisation hémisphérique des processus liés à la communication socio-émotionnelle chez les primates non humains. Cependant, à ce jour, peu d'études ont été réalisées et les théories formulées chez l'homme sont peu consensuelles. Afin de contribuer à la question de la latéralisation cérébrale des processus cognitivo-émotionnels chez le primate, quatre études expérimentales ont été réalisées au cours de cette thèse. Tout d'abord, deux méthodes ont été utilisées pour mesurer les asymétries oro-faciales dans une population de babouins adultes (une méthode morphométrique et une méthode dite des « chimères »). Une spécialisation hémisphérique droite dominante pour le traitement des émotions négatives a été notée. Une troisième étude a démontré, pour la première fois, une asymétrie oro-faciale au niveau populationnel chez des jeunes macaques et babouins. Enfin, une dernière étude a été réalisée chez des chimpanzés afin de tester la robustesse d'une recherche qui avait mis en évidence une différence d'asymétrie selon la fonction communicative intentionnelle (hémisphère gauche) vs. émotionnelle (hémisphère droit) des vocalisations. Les résultats ont confirmé ceux de la première étude et permettent de discuter des hypothèses concernant l'origine de l'évolution du langage. Ces travaux sont discutés à la lumière des recherches récentes concernant de nombreuses espèces animales. Ils apportent des connaissances nouvelles pour appréhender la phylogénèse de la spécialisation hémisphérique des processus associés à la communication verbale et non verbale chez l'homme. / The study of oro-facial asymmetries offers an indirect and suitable index to determine the hemispheric specialization of the processes associated to socio-emotional communication in non-human primates. However, few studies have been made in this domain and the available theories in humans are in part contradictory. In order to contribute to this field, i.e., hemispheric specialization of cognitive and emotional processing in primates, four experimental studies have been carried out during this doctorate. Firstly, two methods have been used to assess oro-facial asymmetries in adult baboons (a morphometric one and a free viewing of chimeric faces). A right hemispheric specialization for negative emotions was noticed. A third study demonstrated for the first time a population-level hemispheric specialization for the production of emotions in infant macaques and baboons. A last study tested the robustness of previous findings in chimpanzees concerning differences of hemispheric lateralization patterns depending on the communicative function of the vocalizations: intentional (left hemisphere) vs emotional (right hemisphere). Results confirmed the previous conclusions and allowed to discuss hypotheses about the origin of the evolution of language (speech). These collective findings are discussed within the context of the phylogeny of hemispheric specialization mechanisms underlying verbal and nonverbal communication in humans.

Kann durch ein zusätzliches Kraftausdauertraining bei Hochleistungsschwimmern eine vorhandene Lateralität bei den oberen Extremitäten verringert werden? Ein positiver Effekt des Trainings am Armkraftzuggerät (AKZ), welches mit unterschiedlichen Belastungseinstellungen für die beiden Seiten durchgeführt wurde, konnte nur bei zwei von den sieben Probanden (Pb.) der Testgruppe (TG) nachgewiesen werden. Die anderen Pb. der TG zeigten bei den gemessenen Parametern keine eindeutige Verringerung der absoluten bzw. prozentualen Differenzen, teilweise waren sogar Differenzvergrößerungen zu finden. Die Pb. der Kontrollgruppe (KG), die mit denselben Belastungseinstellungen für die beiden Seiten trainierten, zeigten ein sehr heterogenes Bild bei den erreichten Ergebnissen. Während bei sechs Pb. die erreichten Ergebnisse relativ stabil blieben, stiegen die Differenzen bei den anderen vier Pb. in unterschiedlichen Messungen an. Insgesamt kann keine signifikante Verringerung des anfangs vorhandenen Seitenunterschiedes bei der TG im Vergleich zur KG nachgewiesen werden. Bei einer nachträglichen Trainingsdatenanalyse des Schwimmers Pb. 18 konnte festgestellt werden, dass über den Zugstil Schmetterling (S) auf der linken Seite, wo höhere Belastungen eingestellt waren, auch höhere Leistungswerte provoziert wurden als bei der Zugart Kraul (K). Ferner waren die Leistungswerte beim S links größer als rechts, was bei K nicht der Fall war. Dort zeigte die rechte Extremität höhere Werte. Ob nun solch ein Training am AKZ mit dem Zugstil K oder S zu besseren Ergebnissen führt, konnte noch nicht geklärt werden. Aus diesem Grund wird ein Training in der Zugart der Hauptlage empfohlen. Außerdem sollte versucht werden, im allgemeinen Training spezielle Übungen zur Verringerung von Seitigkeitsunterschieden zu integrieren. / Introduction: The results of published studies on laterality (related to sport) as well as results of evaluations from IAT (Institute for Applied Sports Training) data and findings of own investigations indicate the existence of laterality in athletes, not only in acyclic but also in cyclical sports such as swimming. Is it possible to reduce existing laterality in upper extremities by additional strength endurance training in high performance swimmers? Results and discussion: A positive effect of swimming machine ergometer training, with different load settings for both sides, could be proven by only two out of seven subjects, whose side difference decreased demonstrably. The measured parameters didn’t show any significant decrease of the absolute and/or percentage differences for the other subjects, in fact an increase of side differences were to be found partially. The subjects of the control group, undergoing the same training, showed heterogeneous results. While the results of the six subjects remained stable, the side differences of the other four subjects increased during different measurements. Overall, there was no significant decrease of the existing laterality in the test group compared to the control group. In an additional training data evaluation of subject 18 it was found that the athlete’s left-hand side, where higher loads were set, was able to gain a higher performance in butterfly style than in crawl. In contrast to crawl style, the left side performance values during butterfly strokes were higher then right-hand side values. During crawls strikes the right-hand side displayed higher values. Whether a „crawl" or „butterfly" training at the swimming machine ergometer leads to better results, could not be clarified yet. For that reason, training in the athlete’s favored swimming position is recommended. Moreover, the general training program should imply certain exercises to decrease laterality.

O objetivo do estudo foi descrever e comparar a força de preensão palmar em recém-nascidos de termo (RNT) e pré-termo tardios (RNPT) nas primeiras 72 horas de vida. A força de preensão palmar foi avaliada com o equipamento M-Flex®, sendo realizadas três medidas para cada mão em cada neonato entre 12-24h, 25-48h e 49-72 h de vida. Foi utilizado os testes t-Student e Anova two-way, considerando-se significante p<0,05. Foram estudados 306 recém-nascidos (219 RNT e 87 RNPT),divididos em três grupos. Os RNT apresentaram maior força de preensão quando comparados aos RNPT em cada idade:12-24h (t=4,64, p=0,00); 25-48h (t= 2,54, p=0,01, t=8,02, p=0,00); 49-72h (t=0,95, p=0,01, t= 1,84, p=0,06). O mesmo comportamento foi observado na comparação entre as três idades (força: F=2,67, p=0,00; tempo F=2,18, p=0,02). Na análise de cada grupo os RNT apresentaram maior força de preensão entre 49-72 h de vida, em relação à idade entre 12-24h (t=0,22, p=0,01) e 25-48h (t=0,06, p=0,001), enquanto os RNPT apresentaram diminuição da força (F=3,55, p=0,02) e do tempo (F=23,10, p=0,00) de preensão palmar entre 12 e 72 h. Os autores concluíram que houve aumento significativo da força de preensão palmar nas primeiras 72 horas de vida nos RNT. No entanto, os recém-nascidos pré-termo tardios apresentaram diminuição da força de preensão palmar. A variabilidade da força de preensão palmar observada na comparação entre os gêneros indica similaridade nesta faixa etária. Na comparação entre as mãos, direita e esquerda, não foi identificada preferência manual / The objective of this study was to describe and compare the palmar grasping strength of full-term (FT) and late preterm (LPT) infants in the first 72 hours of life. The palmar grasping strength was assessed with the M-Flex ® equipment, where three measures were performed for each hand of each infant at ages 12-24 h 25-48 h and 49-72 h of life. The t-Student and two-way ANOVA was used, being considered significant at p <0.05. Overall, 306 infants (219 FT and 87 LPT) were studied, being divided into three groups. FT infants had higher grasping strength and time when compared to LPT infants at the following ages: 12-24h (t = 4.64, p = 0.00), 25-48h (t = 2.54, p = 0.01, t = 8.02, p = 0.00), 49-72h (t = 0.95, p = 0.01, t = 1.84, p = 0.06). The same behavior was observed in the comparison between the three ages (strength: t = 2.67, p = 0.00; time t = 2.18, p = 0.02). In the analysis of each group, FT infants had higher grasping strength between 49 and 72 hours of life when compared to the age between 12 and 24h (t = 0.22, p = 0.01) and between 25 and 48 h (t = 0.06, p = 0.001), while LPT infants showed reduced palmar grasping strength (F = 3.55, p = 0.02) and time (F = 23.10, p = 0.00) between 12 and 72 h. The authors concluded that there was significant increase in the palmar grasping strength in the first 72 hours of life for FT infants. However, late preterm infants showed lower palmar grasping strength. The variability in the palmar grasping strength observed in the comparison between genders indicates similarity in this age group. In the comparison between right and left hands, no manual preference was identified

INTRODUÇÃO: Acidente vascular cerebral (AVC), depressão e prejuízo cognitivo são comorbidades associadas à alta carga mundial de incapacidade. Depressão e prejuízo cognitivo são condições que ocorrem mais frequentemente em pacientes pós-AVC e estão associadas a um aumento da morbimortalidade. OBJETIVO: Investigar potenciais fatores de risco cerebrovasculares associados ao desenvolvimento de depressão pós-AVC (DPA) e prejuízo cognitivo pós-AVC (PC) com base na neuroimagem por ressonância magnética cerebral (RM) e biomarcadores (serotonina, BDNF, IL-6, IL-18) na fase subaguda (1-3 meses) e na fase crônica (até 2 anos de seguimento) após o AVC em sobreviventes do Estudo de Mortalidade e Morbidade do AVC (EMMA), São Paulo, Brasil. MÉTODOS: Amostra de participantes admitidos por AVC no Departamento de Emergências do HU-USP, de abril de 2006 a novembro de 2014, foi submetida a avaliações clínicas e neurológicas. Os principais instrumentos para avaliação de depressão foram: Entrevista Clínica Estruturada para DSM-4 eixo 1 (SCID-I) e Questionário de Saúde do Paciente - versão 9 itens (PHQ-9); e para comprometimento cognitivo: Entrevista Telefônica Modificada para Estado Cognitivo (TICS-M), aplicados em 1-3 meses, 6 meses e anualmente até 2 anos. Além da quantificaçao da DPA e PC e fatores associados em 1-3 meses (fase subaguda), na fase crônica foram realizadas análises de sobrevida pelas curvas de Kaplan-Meier e modelos de regressão logística de Cox (Razão de Risco - RR, interval de confiança- IC95%) para investigar a progressão de DPA ou PC aos 6 meses e 2 anos, de acordo com lateralidade do AVC. RESULTADOS: Dos 103 pacientes elegíveis, 85,4% apresentaram AVC isquêmico e 73,7% foram diagnosticados como primeiro evento. Na fase subaguda, 27,2% apresentaram PC e 13,6% apresentaram DPA (5,8% com \"primeiro episódio\" e 7,8% com depressão \"recorrente\"). DPA e/ou PC foram associados com baixa escolaridade, gênero feminino e idade entre 55 e 74 anos. Em 1-3 meses pós-AVC, a lesão cerebral do hemisfério esquerdo foi mais frequentemente associada ao aumento do PC do que à lesão à direita (71,4% vs. 28,4%, p = 0,005). A DPA não esteve associada à lateralidade do AVC. No geral, os níveis de biomarcadores não apresentaram alterações nos pacientes XX com DPA e PC. No seguimento até 2 anos, foi encontrada uma frequência de 19% de DPA e 38% de PC. A maioria dos participantes (53%) apresentou AVC no hemisfério direito, entretanto o AVC neste hemisfério não esteve associado com DPA ou PC. Confirmando os dados observados em 1-3 meses pós-evento, o AVC do lado esquerdo foi um preditor independente de PC em longo prazo, mas não de DPA. O AVC esquerdo foi associado a uma alta probabilidade de PC (42,6% e 53,2%, respectivamente, aos 6 meses e 2 anos, p-log-rank: 0,002). A RR de PC por AVC à esquerda foi de 3,38 (IC95%, 1,35-8,50) aos 6 meses e foi mantida aos 2 anos (RR 3,38; IC95%, 1,50-7,59). CONCLUSÕES: PC associou-se a uma menor escolaridade, sexo feminino e faixa etária entre 55 a 74 anos. O AVC no hemisfério esquerdo esteve associado a uma maior frequência de PC, apresentando um risco 3 vezes maior para o desenvolvimento de PC ao longo de 2 anos após o AVC / INTRODUCTION: Stroke, depression and cognitive impaiment are comorbidities associated with the high burden of disability worldwide. Depression and cognitive impairment are responsible for increased post-stroke morbidity and mortality. OBJECTIVE: To investigate the cerebrovascular risk factors associated with the development of post-stroke depression (PSD) and post-stroke cognitive impairment (PCI) based on brain magnetic resonance imaging (MRI) and biomarkers (serotonin, BDNF, IL-6, IL-18) in the subacute phase (1-3 months) and in the chronic phase (up to 2 years of follow-up) after stroke in survivors of the Stroke Mortality and Morbidity Study (EMMA), São Paulo, Brazil. METHODS: Stroke participants prospectively admitted at HU-USP Emergency Department from April 2006 to November 2014 underwent clinical and neurological evaluations. The main instruments for evaluation of depression were: Structured Clinical Interview for DSM-4 axis 1 (SCID-I) and Patient Health Questionnaire version 9 items (PHQ-9); and cognitive impairment: Modified Telephone Interview for Cognitive Status (TICS-M), applied in 1-3 months, 6 months and annually up to 2 years. In addition of the quantification of PSD and PCI and associated factors in 1-3 months (subacute phase), survival analyzes were performed on Kaplan-Meier curves and Cox logistic regression models (Hazard Ratio-HR, confidence interval-95% CI) to investigate the progression of PSD or PCI at 6 months and 2 years, according to laterality of the stroke. RESULTS: Of the 103 eligible patients, 85.4% had ischemic stroke and 73.7% had a stroke for the first time. In the subacute phase, 27.2% had PCI and 13.6% had current PSD (5.8% with \"first episode\" and 7.8% with \"recurrent\" depression). PSD and / or PCI were associated with low educational level, female gender and 55-74 years old. In 1-3 months, left-sided stroke was more frequently associated with an increase in PCI than right lesion (71.4% vs. 28.4%, p = 0.005). PSD was not associated with laterality of the stroke. Overall, biomarkers levels did not show changes in patients with PSD and PCI. Up to 2 years follow-up, it was found a frequency of 19% of DPA and 38% of PCI. Most participants (53%) presented right-sided stroke, however, it was not associated with PSD or PCI. Confirming the observed data at 1-3 months post-event, left-sided stroke XXI I was an independent predictor of long-term PCI but not PSD. Left-sided stroke was associated with a high probability of PCI (42.6% and 53.2%, respectively at 6 months and 2 years, p-log rank: 0.002). The risk ratio (RR) of PCI due to left-sided stroke was 3.38 (95% CI, 1.35-8.50) at 6 months and maintained at 2 years (RR 3.38, 95% CI, 1, 50-7.59). CONCLUSIONS: PCI was associated with lower educational level, female gender and age group between 55 and 74 years. Stroke in the left hemisphere was associated with a higher frequency of PCI and the risk of developing cognitive impairment over 2 years after stroke was 3

Introdução: alguns pacientes com zumbido podem apresentar pontosgatilho miofasciais, principalmente na musculatura mastigatória e cervical. No entanto, este tema é pouco abordado na literatura. Os objetivos deste estudo foram investigar a associação entre (1) zumbido e pontos-gatilho, (2) a orelha com pior zumbido e o lado do corpo com maior número de pontosgatilho, além de (3) verificar a capacidade de o ponto-gatilho modular o zumbido. Métodos: neste estudo caso-controle foram avaliados 94 pacientes com zumbido e 94 assintomáticos, pareados por sexo e idade, sem queixa de dor generalizada ou mioclonia. Todos foram submetidos, pelo mesmo investigador, a um protocolo de avaliação e à pressão digital para pesquisa de pontos-gatilho em 9 músculos bilateralmente: infra-espinal, levantador da escápula, trapézio, esplênio da cabeça, escaleno, esternocleidomastóideo, digástrico, masseter e temporal. A intensidade do zumbido foi avaliada por uma escala numérica de 0 a 10, considerando-se como modulação o aumento ou diminuição imediata de pelo menos um ponto na escala e/ou mudança no tipo de som. Os exames foram executados em local silencioso para facilitar a percepção da modulação do zumbido. Resultados: os pontos-gatilho estavam presentes em 72,3% dos pacientes com zumbido (OR= 4,87; p< 0,001) e 55,9% deles relataram modulação do sintoma durante a pressão digital nos pontos-gatilho ativos e latentes, em pelo menos um músculo, principalmente no masseter, esplênio da cabeça, esternocleidomastóideo e temporal. A modulação do zumbido pelo ponto-gatilho examinado foi predominantemente ipsilateral em 6 dos 9 músculos avaliados. Houve correlação de lateralidade entre a orelha com pior zumbido e o lado do corpo com maior número de pontos-gatilho em 56,5% dos casos (Kappa= 0,29; p< 0,001). Houve diferença significante quanto à presença de queixa prévia de dor na comparação dos pacientes com zumbido que modularam com aqueles que não modularam (p< 0,008). Conclusões: a presença significante dos pontos-gatilho em pacientes com zumbido associada à freqüente modulação do sintoma durante sua palpação, além da sua presença em maior número no lado da orelha com pior zumbido, sugere que os pontos-gatilho sejam um fator etiológico ou coadjuvante do zumbido. / Introduction: some patients suffering from tinnitus may present myofascial trigger points, mainly in head and neck muscles. However, this issue is poorly explored in the literature. The objectives of this study were to investigate an association between (1) tinnitus and trigger points, (2) the ear with the worst tinnitus and the side of the body with more trigger points, (3) presence of trigger points and their capacity of modulating tinnitus. Methods: in this case control study 94 subjects with tinnitus, and 94 without such symptom were analyzed, matched by age and gender, excluding those with widespread musculoskeletal pain or myoclonus. All of them underwent an evaluation protocol and digital pressure in order to search for trigger points in 9 bilateral muscles: infraspinatus, levator scapulae, trapezius, splenius capitis, scalenus, sternocleidomastoid, digastric, masseter and temporalis. The intensity of tinnitus was evaluated with a scale ranging from 0 to 10, and modulation was considered present in cases of immediate increase or decrease of at least one point in the scale and/or changes in the type of sound. The exams took place in a silent environment, so as to make it easier for tinnitus\' modulation to be perceived. Results: the presence of trigger points was observed in 72.3% of tinnitus patients (OR= 4.87; p< 0,001). Among them, 55.9% reported tinnitus modulation during digital pressure in both active and latent trigger points, in at least one muscle, mainly in masseter, splenius capitis, sternocleidomastoid and temporalis muscles. The rate of tinnitus modulation was significantly higher at the same side of the trigger point subject to examination in 6 out of 9 muscles. There was an association of laterality between the ear with worst tinnitus and the side of the body with more trigger points in 56.5% of the cases (Kappa value = 0.29; p< 0.001). There was a significant difference related to the presence of previous pain complaint when patients with tinnitus that modulated were compared to patients with tinnitus that did not modulate (p< 0.008). Conclusions: significant presence of trigger points in tinnitus patients, associated to frequent modulation of this symptom during palpation, besides the presence of more trigger points in the side of the ear with the worst tinnitus, suggests that trigger points are an etiologic factor or adjuvant in tinnitus onset.

INTRODUÇÃO: Acidente vascular cerebral (AVC), depressão e prejuízo cognitivo são comorbidades associadas à alta carga mundial de incapacidade. Depressão e prejuízo cognitivo são condições que ocorrem mais frequentemente em pacientes pós-AVC e estão associadas a um aumento da morbimortalidade. OBJETIVO: Investigar potenciais fatores de risco cerebrovasculares associados ao desenvolvimento de depressão pós-AVC (DPA) e prejuízo cognitivo pós-AVC (PC) com base na neuroimagem por ressonância magnética cerebral (RM) e biomarcadores (serotonina, BDNF, IL-6, IL-18) na fase subaguda (1-3 meses) e na fase crônica (até 2 anos de seguimento) após o AVC em sobreviventes do Estudo de Mortalidade e Morbidade do AVC (EMMA), São Paulo, Brasil. MÉTODOS: Amostra de participantes admitidos por AVC no Departamento de Emergências do HU-USP, de abril de 2006 a novembro de 2014, foi submetida a avaliações clínicas e neurológicas. Os principais instrumentos para avaliação de depressão foram: Entrevista Clínica Estruturada para DSM-4 eixo 1 (SCID-I) e Questionário de Saúde do Paciente - versão 9 itens (PHQ-9); e para comprometimento cognitivo: Entrevista Telefônica Modificada para Estado Cognitivo (TICS-M), aplicados em 1-3 meses, 6 meses e anualmente até 2 anos. Além da quantificaçao da DPA e PC e fatores associados em 1-3 meses (fase subaguda), na fase crônica foram realizadas análises de sobrevida pelas curvas de Kaplan-Meier e modelos de regressão logística de Cox (Razão de Risco - RR, interval de confiança- IC95%) para investigar a progressão de DPA ou PC aos 6 meses e 2 anos, de acordo com lateralidade do AVC. RESULTADOS: Dos 103 pacientes elegíveis, 85,4% apresentaram AVC isquêmico e 73,7% foram diagnosticados como primeiro evento. Na fase subaguda, 27,2% apresentaram PC e 13,6% apresentaram DPA (5,8% com \"primeiro episódio\" e 7,8% com depressão \"recorrente\"). DPA e/ou PC foram associados com baixa escolaridade, gênero feminino e idade entre 55 e 74 anos. Em 1-3 meses pós-AVC, a lesão cerebral do hemisfério esquerdo foi mais frequentemente associada ao aumento do PC do que à lesão à direita (71,4% vs. 28,4%, p = 0,005). A DPA não esteve associada à lateralidade do AVC. No geral, os níveis de biomarcadores não apresentaram alterações nos pacientes XX com DPA e PC. No seguimento até 2 anos, foi encontrada uma frequência de 19% de DPA e 38% de PC. A maioria dos participantes (53%) apresentou AVC no hemisfério direito, entretanto o AVC neste hemisfério não esteve associado com DPA ou PC. Confirmando os dados observados em 1-3 meses pós-evento, o AVC do lado esquerdo foi um preditor independente de PC em longo prazo, mas não de DPA. O AVC esquerdo foi associado a uma alta probabilidade de PC (42,6% e 53,2%, respectivamente, aos 6 meses e 2 anos, p-log-rank: 0,002). A RR de PC por AVC à esquerda foi de 3,38 (IC95%, 1,35-8,50) aos 6 meses e foi mantida aos 2 anos (RR 3,38; IC95%, 1,50-7,59). CONCLUSÕES: PC associou-se a uma menor escolaridade, sexo feminino e faixa etária entre 55 a 74 anos. O AVC no hemisfério esquerdo esteve associado a uma maior frequência de PC, apresentando um risco 3 vezes maior para o desenvolvimento de PC ao longo de 2 anos após o AVC / INTRODUCTION: Stroke, depression and cognitive impaiment are comorbidities associated with the high burden of disability worldwide. Depression and cognitive impairment are responsible for increased post-stroke morbidity and mortality. OBJECTIVE: To investigate the cerebrovascular risk factors associated with the development of post-stroke depression (PSD) and post-stroke cognitive impairment (PCI) based on brain magnetic resonance imaging (MRI) and biomarkers (serotonin, BDNF, IL-6, IL-18) in the subacute phase (1-3 months) and in the chronic phase (up to 2 years of follow-up) after stroke in survivors of the Stroke Mortality and Morbidity Study (EMMA), São Paulo, Brazil. METHODS: Stroke participants prospectively admitted at HU-USP Emergency Department from April 2006 to November 2014 underwent clinical and neurological evaluations. The main instruments for evaluation of depression were: Structured Clinical Interview for DSM-4 axis 1 (SCID-I) and Patient Health Questionnaire version 9 items (PHQ-9); and cognitive impairment: Modified Telephone Interview for Cognitive Status (TICS-M), applied in 1-3 months, 6 months and annually up to 2 years. In addition of the quantification of PSD and PCI and associated factors in 1-3 months (subacute phase), survival analyzes were performed on Kaplan-Meier curves and Cox logistic regression models (Hazard Ratio-HR, confidence interval-95% CI) to investigate the progression of PSD or PCI at 6 months and 2 years, according to laterality of the stroke. RESULTS: Of the 103 eligible patients, 85.4% had ischemic stroke and 73.7% had a stroke for the first time. In the subacute phase, 27.2% had PCI and 13.6% had current PSD (5.8% with \"first episode\" and 7.8% with \"recurrent\" depression). PSD and / or PCI were associated with low educational level, female gender and 55-74 years old. In 1-3 months, left-sided stroke was more frequently associated with an increase in PCI than right lesion (71.4% vs. 28.4%, p = 0.005). PSD was not associated with laterality of the stroke. Overall, biomarkers levels did not show changes in patients with PSD and PCI. Up to 2 years follow-up, it was found a frequency of 19% of DPA and 38% of PCI. Most participants (53%) presented right-sided stroke, however, it was not associated with PSD or PCI. Confirming the observed data at 1-3 months post-event, left-sided stroke XXI I was an independent predictor of long-term PCI but not PSD. Left-sided stroke was associated with a high probability of PCI (42.6% and 53.2%, respectively at 6 months and 2 years, p-log rank: 0.002). The risk ratio (RR) of PCI due to left-sided stroke was 3.38 (95% CI, 1.35-8.50) at 6 months and maintained at 2 years (RR 3.38, 95% CI, 1, 50-7.59). CONCLUSIONS: PCI was associated with lower educational level, female gender and age group between 55 and 74 years. Stroke in the left hemisphere was associated with a higher frequency of PCI and the risk of developing cognitive impairment over 2 years after stroke was 3

The diploma thesis deals with laterality, the research presents analysis of laterality of six adult people with forced changes in laterality. Then it describes the development of laterality and its types, degrees, types and diagnostics. There is also a historical approach to the left-hand side from the Stone Age to the present. The work focuses on forced changes in laterality in childhood and their influence on the overall development of personality. Six adult respondents, three men and three women aged thirty- eight to seventy-two years were tested for qualitative research. The effects of laterality change were observed in speech, psyche, state of laterality, reading and written speech. The aim of the work was to describe the difficulties that may arise as a result of a forced change in laterality, to find out whether the respondents have to face and to discover their possible survival to adulthood. For all respondents, the laterality and type determined by the test was tested, which was a partial goal. For all respondents, during the interviews, problems related to forced changes in laterality in childhood were manifested or discussed.