Amyotrophic lateral sclerosis: one or multiple causes?

The Amyotrophic lateral sclerosis (ALS) is the most common form of motor neuron disease in the adulthood, and it is characterized by rapid and progressive compromise of the upper and lower motor neurons. The majority of the cases of ALS are classified as sporadic and, until now, a specific cause for these cases still is unknown. To present the different hypotheses on the etiology of ALS. It was carried out a search in the databases: Bireme, Scielo and Pubmed, in the period of 1987 to 2011, using the following keywords: Amyotrophic lateral sclerosis, motor neuron disease, etiology, causes and epidemiology and its similar in Portuguese and Spanish. It did not have consensus as regards the etiology of ALS. Researches demonstrates evidences as regards intoxication by heavy metals, environmental and occupational causes, genetic mutations (superoxide dismutase 1), certain viral infections and the accomplishment of vigorous physical activity for the development of the disease. There is still no consensus regarding the involved factors in the etiology of ALS. In this way, new research about these etiologies are necessary, for a better approach of the patients, promoting preventive programs for the disease and improving the quality of life of the patients

Uso de AAS em pacientes cardiopatas e ocorrência de Úlcera Perfurada quais as melhores soluções? uma revisão sistemática com metánalise

A administração do ácido acetilsalicílico (AAS) é uma das medidas indicadaspelos médicos em caso de suspeita de infarto agudo do miocárdio. De acordo com os especialistas, o medicamento serve para diminuir a agregação de plaquetas e inibir a formação de coágulos no interior das artérias. O objetivo deste estudo é verificar na literatura o uso do Ácido Acetilsalicílico (AAS) em pessoas cardiopatas e sua possível relação com o aparecimento de úlcera. Trata-se de uma revisão sistemática com base em publicações, dos último cinco anos, que essa temática, extraídas de bases de dados eletrônicas como Scielo, PubMed, Lilacs, BVS, Embase e Medline, em língua inglesa e portuguesa. Dos estudo que se aproximaram do objetivo da pesquisa, muitos não relataram a estreita relação entre o uso AAS e o surgimento de úlcera. Assim, espera-se que este estudo sirva de incentivo para que mais estudos sejam realizados sobre essa temática afim de estabelecer e conhecer se há alguma relação entre o fármaco e a doença

RELATO DE EXPERIÊNCIA: A IMPORTÂNCIA DA ATENÇÃO PRIMÁRIA NO RASTREIO DE FATORES DE RISCO E PROTEINÚRIA NO CONTEXTO DA DRC

A doença renal crônica (DRC) apresenta-se como um relevante problema de saúde pública, já que atinge cerca de 13% dos brasileiros

Functional recovery of upper limb post-stroke : mental practice with motor and non-motor imagery.

Problem statement: Mental Practice (MP) with motor imagery consists of a method of training in which motor imagery is used to improve performance. The aim of this study was to investigate the efficacy of MP with motor imagery on motor recovery of the paretic upper limb of poststroke patients in comparison with MP with non-motor imagery. Approach: Four post-stroke patients were divided into two groups: experimental (the physical practice of motor tasks and MP of the same tasks: n = 2) and control (the physical practice of motor tasks and MP of non-motor tasks: n = 2). We evaluated: Heart Rate (HR) and systolic (SBP) and Diastolic Blood Pressure (DBP), immediately before and after execution and imagination of the tasks; time of execution and imagination of each task; and motor function of the paretic upper limb through the questionnaires “Fugl-Meyer for Upper Extremity” and “quality of movement section of arm motor ability test” before and after the 10 weeks of treatment. Results: The qualitative analysis showed that regardless of training, patients spent less time on imagery motor tasks than to execute them; and have increased in HR, SBP and DBP after execution as well as after imagery of motor tasks. The training caused a reduction in the time of execution of motor tasks in both groups and increment on the motor function of the paretic upper limb only in the experimental group. Conclusion: These results suggest that an MP with motor imagery may be an effective method for the functional recovery of the paretic upper limb of post-stroke patients

Simula??o mental de movimentos : da teoria ? aplica??o na reabilita??o motora.

A imag?tica motora (IM) consiste na evoca??o do plano motor de uma dada a??o sem que haja a execu??o do movimento. Objetivo. Realizar uma revis?o e an?lise cr?tica sobre a IM, discutindo as caracter?sticas neurofisiol?gicas, as diferen?as entre as estrat?gias de simula??o e sua aplica??o cl?nica no contexto da reabilita??o de pacientes p?s-Acidente Vascular Cerebral (AVC). M?todo. Busca de artigos indexados pelas bases ISI e Medline, publicados entre 1980 e 2012, nos idiomas ingl?s, portugu?s e espanhol. Discuss?o. A IM ? capaz de levar a ativa??es cerebrais, fisiol?gicas e comportamentais semelhantes ?s ocorridas durante a execu??o motora. Entretanto, a IM pode ser realizada utilizando duas poss?veis estrat?gias, a cinest?sica e a visual, e cada uma delas provoca distintos padr?es de ativa??o cortical. Observou-se que o treinamento com a IM ? capaz de gerar ganhos funcionais em pacientes p?s-AVC. No entanto, n?o foi poss?vel padronizar a utiliza??o do protocolo mais adequado, visto que ainda n?o h? um consenso quanto ? frequ?ncia, dura??o, a estrat?gia de IM e a fase da doen?a mais apropriada para sua aplica??o. Conclus?o. Apesar dos avan?os, ainda h? necessidade de mais estudos a fim de determinar as diretrizes para a utiliza??o da IM na reabilita??o motora e seus benef?cios a longo prazo.Motor imagery (MI) consists in the evocation of a motor plan of a given action without motor output. Objective. To perform a review and critical analyses about MI, discussing its neurophysiological characteristics, differences between the strategies of simulation and the clinical application in the context of rehabilitation of post-stroke patients. Method. Search of studies indexed by ISI and Medline databases, published between 1980 and 2012, in English, Spanish or Portuguese. Discussion. MI can promote similar brain, physiological and behavioral activations as during the execution of motor actions. However, MI can be performed using two possible strategies, visual and kinesthetic, and each of them causes different patterns of cortical activation. It was also observed that the training with MI can improve performance in post-stroke patients. However, it was not possible to standardize the use of the more appropriate protocol, since there is still no consensus on the frequency, duration, strategy of MI and stage of the disease is most appropriate for its application. Conclusions. Despite the advances, there is still a need of more studies to determine the guidelines for mental simulation in the motor rehabilitation and its long-term benefits

Immobility reactions under threat : a contribution to human defensive cascade and PTSD.

Violence exacts a burden on public health. Gun violence is a major trigger for motor defensive reactions in humans and post-traumatic stress disorder (PTSD) is its main psychiatric sequela. However, studies of the human defensive cascade, especially the motor reactions, are at an early stage. This review focuses on studies that employ stabilometry, a methodology that assesses whole body motor reactions, to address defensive behaviors to violence-related threats. Special attention is given to three reactions: ?attentive immobility?, ?immobility under attack? and ?tonic immobility?, with emphasis on the latter ? a peritraumatic reaction which has been strongly associated with the severity of PTSD. These reactions are characterized by reduced body sway and bradycardia, except tonic immobility that presents robust tachycardia. The advances made by investigations into the immobility reactions of the human defensive cascade contribute to helping to bridge the gap between human and non-human species. Furthermore, progresses in basic research to objectively monitor motor defensive reactions under threat can help to develop a dimensional, trans-diagnostic approach to PTSD

Additional file 1 of Machine learning applied to fMRI patterns of brain activation in response to mutilation pictures predicts PTSD symptoms

Supplementary Material 1: Portugal_202

Prevalence of HIV-1 transmitted drug resistance and viral suppression among recently diagnosed adults in Sao Paulo, Brazil

HIV-1 transmitted drug resistance (TDR) mutations may reduce the efficacy of antiretroviral therapy (ART), but pre-treatment testing to determine the virus genotype can improve the efficacy of ART. Unfortunately, issues related to cost and logistics of pre-treatment testing limit its use in resource-limited settings. We studied 596 ART-naive individuals who were newly diagnosed from 2014 to 2016 in SAo Paulo, Brazil, to evaluate TDR and virological outcome after 48weeks of genotype-guided therapy. One or more TDR (based on the WHO surveillance list) was observed in 10.9% (CI 95%, 8.6-13.6) of the sequences, the most common of which was the K103N mutation, which confers resistance to first-generation drugs of the non-nucleoside reverse transcriptase inhibitor (NNRTI) antiretroviral drug class. Dual-class (1%, 6/596) and triple-class (0.34%, 2/596) resistance were uncommon. After 48weeks of treatment with ART, infection was suppressed to below 200 copies/mL in most patients (95%), with full suppression (RNA target not detected) in 65%. The following characteristics at patient enrollment were independently associated with a lack of full suppression: CD4 T cell counts below 500 cells/mu L, viremia above 100,000 copies/mL, older age, and TDR to NNRTI. The rates of resistance were intermediate, but genotype-guided therapy resulted in high rates of viral suppression. The observed resistance profile should not be an obstacle to the use of the dolutegravir-based regimen now recommended in Brazil, but genotype testing may be warranted before initiating first-generation NNRTI-based regimens1643699706FAPESP – Fundação de Amparo à Pesquisa Do Estado De São Paulo2013/19441-7; 2016/14813-