Cervical spondylotic myelopathy: what the neurologist should know

Cervical spondylotic myelopathy is a wellknown cause of disability among older people. A significant amount of these patients is asymptomatic. Once the symptoms start the worsening may follow a progressive manner. We should suspect of spondylotic myelopathy in any individual over 55 years presenting progressive changes in gait or losing fine motor control of the upper limbs. Despite its frequent prevalence, this condition is still neglected and many times confused with other supratentorial lesions regarding diagnostic. Here we address some of most important aspects of this disease, calling attention to pathophysiology, the natural history. presentation, differential diagnosis, clinical assessment and treatment.Natl Inst Traumatol & Orthoped, Rio de Janeiro, BrazilUniv Severino Sombra, Div Neurol, Grad Program Neurol Neurosci, Tavares Macedo St 95-902, BR-24220215 Vassouras, RJ, BrazilUniv Severino Sombra, Masters Program Urgencia & Emergencia Med, Vassouras, RJ, BrazilUniv Fed Estado Rio de Janeiro, Sch Med, Rio de Janeiro, RJ, BrazilNeurology Division, Universidade Federal de São Paulo - UNIFESP , São Paulo, SP. BrazilUniv Fed Fluminense, Div Neurosurg, Niteroi, RJ, BrazilNeurology Division, Universidade Federal de São Paulo - UNIFESP , São Paulo, SP. BrazilWeb of Scienc

Triceps surae muscle architecture adaptations to eccentric training

Eccentric exercises have been used in physical training, injury prevention, and rehabilitation programs. The systematic use of eccentric training promotes specific morphological adaptations on skeletal muscles. However, synergistic muscles, such as the triceps surae components, might display different structural adaptations due to differences in architecture, function, and load sharing. Therefore, the purpose of this study was to determine the effects of an eccentric training program on the triceps surae (GM, gastrocnemius medialis; GL, gastrocnemius lateralis; and SO, soleus) muscle architecture. Methods: Twenty healthy male subjects (26 ± 4 years) underwent a 4-week control period followed by a 12-week eccentric training program. Muscle architecture [fascicle length (FL), pennation angle (PA), and muscle thickness (MT)] of GM, GL, and SO was evaluated every 4 weeks by ultrasonography. Results: Fascicle lengths (GM: 13.2%; GL: 8.8%; SO: 21%) and MT (GM: 14.9%; GL: 15.3%; SO: 19.1%) increased from pre- to post-training, whereas PAs remained similar. GM and SO FL and MT increased up to the 8th training week, whereas GL FL increased up to the 4th week. SO displayed the highest, and GL the smallest gains in FL post-training. Conclusion: All three synergistic plantar flexor muscles increased FL and MT with eccentric training. MT increased similarly among the synergistic muscles, while the muscle with the shortest FL at baseline (SO) showed the greatest increase in FL

Clinical and epidemiological differences between septic arthritis of the knee and hip caused by oxacillin-sensitive and -resistant s. aureus

OBJECTIVE: To establish the risk factors for joint infection by oxacillin-resistant Staphylococcus aureus (MRSA) using clinical and epidemiological data. METHODS: All septic arthritis cases of the knee and hip diagnosed and treated in our institution from 2006 to 2012 were evaluated retrospectively. Only patients with cultures identified as microbial agents were included in the study. The clinical and epidemiological characteristics of the patients were analyzed, seeking the differences between populations affected by MRSA and oxacillin-sensitive Staphylococcus aureus (MSSA). RESULTS: S. aureus was isolated in thirty-five patients (46.0%) in our total sample, 25 in the knee and 10 in the hip. Of these 35 patients, 22 presented with MSSA and 13 presented with MRSA. Provenance from a health service-related environment, as described by the Centers for Disease Control and Prevention, was the only variable associated with oxacillin-resistant strains of this bacterium (p = 0.001). CONCLUSION: Provenance from a health service-related environment was associated with a higher incidence of MRSA-related septic arthritis, suggesting that this agent should be considered in the initial choice of antibiotic treatment. Previous surgeries of the knee or affected limb and the absence of leukocytes might also be related to infection with this agent

Trichlorfon for Treatment of Cutaneous Habronemosis - Evaluation of Intravenous Regional Perfusion in the Distal Equine Limbs

Background: Equine cutaneous habronemiasis is common in the distal regions of the limbs. Organophosphates, applied systemically, one previously used treatment, which is highly effective, but currently in disuse, due to the risks of intoxica-tion. Regional perfusion is a potential technique for distal limb wounds, since, in addition to being used in low doses, it prevents systemic circulation of the drug and possible intoxication, and has a lower treatment cost. The current work aimed to perform clinical, laboratory, and venography evaluations of the use of trichlorfon in regional intravenous perfusion, as a possible form of treatment for cutaneous habronemosis in the distal region of equine limbs.Materials, Methods & Results: Twelve horses were used, divided into two groups, with the left thoracic limb (LTL) being the test limb, and the right thoracic limb (RTL) the control limb. At moment zero (M0), distal radiography and venography were performed. The tourniquet was then loosened and after five minutes, at moment one (M1), the tourniquet was repositioned for 1.25 mg/kg (G1) and 5.5mg/kg (G2) trichlorfon injections into the left thoracic limb, diluted in 20 mL of Ringer's lactate solution, and 20 mL of Ringer's lactate solution was applied to the right thoracic limb. The tourniquet was maintained for 30 minutes after infusion in both groups. At moment two (M2), four days later, blood tests, radiography, and venography were repeated. Every day between M0 and M2, physical examinations were performed, including measurement of the pastern, fetlock, and coronet band, and a lameness examination. There were no significant alterations in clinical parameters, behavior, and appetite. In the blood cell count, there was an increase in leukocytes on D4 in G2, although remaining within the reference values for the species. The biochemical tests showed no alterations. There were no changes in the circumferences evaluated and 4 horses from G2 presented lameness in the LTL and one in the RTL. In the venograms, one G2 animal was noticed to be hypoperfused in all LTL plexuses. Discussion: The use of trichlorfon in regional perfusion at a dose of 1.25 mg/kg demonstrated safety, with no clinical, laboratory, and lameness changes in any of the animals. At the highest dose (5.5 mg/kg), individual reactions were observed, such as different degrees of lameness, swelling, and heat in foot. Serial venographies document the response to treatment used, it was decided to perform the second venography 4 days after the trichlorfon perfusion and the first initial venography evaluation, following the recommendations for the repetition time of the examination and evaluation of the use of the drug. The evaluation of radiographic images of venography, in a grading system created considering the range of contrast in five regions by the three examiners experienced in podiatry and the analysis of radiographic images of limbs of horses, without having participated in the previous procedures was important for the reliability of the assessment. The areas of hypoperfusion observed in the venography were not related to trichlorfon perfusion. It is essential that the application of trichlorfon be performed correctly, intravenously, to avoid reactions such as necrosis, pain, edema, erythema, lameness, and even more severe inflammatory reactions, such as phlegmon and thrombophlebitis. Although a small number of animals were used in this study, trichlorfon regional perfusion of equine limbs, at a dose of 1.25 mg/kg may be a technique appears to be inert to hoof vascularization

Sydney Melancholia Prototype Index (SMPI) : translation and cross-cultural adaptation to Brazilian Portuguese

Introduction: Depression is possibly not a single syndrome but rather comprises several subtypes. DSM-5 proposes a melancholia specifier with phenotypic characteristics that could be associated with clinical progression, biological markers or therapeutic response. The Sydney Melancholia Prototype Index (SMPI) is a prototypic scale aimed to improve the diagnosis of melancholia. So far, there is only an English version of the instrument available. The aim of this study is to describe the translation and adaptation of the English version of the SMPI into Brazilian Portuguese. Methods: Translation and cross-cultural adaptation of the self-report (SMPI-SR) and clinician-rated (SMPICR) versions into Brazilian Portuguese were done following recommendations of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). This guideline includes the following steps: preparation, forward translation, reconciliation, back translation, back translation review, harmonization, cognitive debriefing, debriefing results review, proofreading and final report. Results: The Brazilian Portuguese versions of the SMPI were well-accepted by respondents. Changes in about two-thirds of the items were considered necessary to obtain the final Brazilian Portuguese version of the SMPI. Conclusions: Both versions of the SMPI are now available in Brazilian Portuguese. The instrument could become an important option to enhance studies on melancholia in Portuguese-speaking samples

First-time administration of the Sydney Melancholia Prototype Index (SMPI) to non-English-speaking patients : a study from Brazil

Objective: The Sydney Melancholia Prototype Index (SMPI) is a scale that uses a non-conventional strategy to assess melancholia status based on prototypic symptoms and illness course variables. This study aimed to evaluate the performance of the first translation of this instrument in a non-Englishspeaking population. Methods: A sample comprising 106 Brazilian outpatients with depression was evaluated simultaneously with the Brazilian version of the self-rated SMPI (SMPI-SR) and clinician-rated SMPI (SMPICR). The kappa coefficient and t test were used to evaluate concurrent validity vs. DSM-IV, CORE system, Hamilton Depression Rating Scale-6 item (HAM-D6), and HAM-D17 assignments to a melancholic or non-melancholic class. The prevalence of melancholia as well as sensitivity and specificity were calculated across instruments. Results: The prevalence of melancholia was highest using DSM-IV criteria (56.6%). The kappa agreement between SMPI-CR and DSM-IV melancholia assignment was moderate (kappa 0.44, p <= 0.001). SMPI-CR-assigned melancholic patients had significantly higher CORE, HAM-D17, and HAM-D6 scores. The test-retest consistency values for the SMPI were modest at best, and somewhat superior for the CR version. Conclusion: The Brazilian SMPI-CR presented satisfactory psychometric properties (which were superior to those of the SMPI-SR), and therefore appears to be a useful option for identifying melancholia and studying its causes and optimal treatments

Modeling Deforestation and CO2 Emissions in Tropical Forests (Western South Amazon)

Spatial modeling is a tool to represent deforestation and predict future scenarios according to different landscape change. Establishing 80% Legal Reserve Area (LR) in the Amazon since 90th, the Brazilian forestry code has made clear the biodiversity conservation profile of the largest tropical forest in the world. However, this mechanism did not prevent the advance of deforestation, which in recent years has increased again. This remote tool aims to monitor the deforestation, simulating its possible future trajectories, and thus generate information that can be used to assist in the management of deforestation reduction. The spatial modeling in the prediction of different deforestation scenarios based on public policies and their changes to the state of Acre (north of Brazil). Using the methodological processes of the Dinamica EGO software, three scenarios were projected up to the year 2050: (1) deforestation “Business as usual”, (2) deforestation with 50% LR and (3) deforestation with 80% LR provided by law. Based on these results it was evident that maintaining and respect 80% LR, it’s possible reduce the CO2 emissions more than 76%, avoiding around 119,534,836 t of CO2 and influences positively on reducing deforestation. Dinamica EGO proved to be an effective to represent the deforestation

Assessment of SNPs for linkage mapping in Eucalyptus: construction of a consensus SNP/microsatellite map from two unrelated pedigrees

Financial support. Brazilian Ministry of Science and Technology (CNPq Grant 577047-2008-6), FAP-DF NEXTREE Grant 193.000.570/2009 and EMBRAPA Macroprogram 2 project grant 02.07.01.004

Revisiting the term neuroprotection in chronic and degenerative diseases

Thanks to the development of several new researches, the lifetime presented a significant increase, even so, we still have many obstacles to overcome - among them, manage and get responses regarding neurodegenerative diseases. Where we are in the understanding of neuroprotection? Do we really have protective therapies for diseases considered degeneratives such as amyotrophic lateral sclerosis and its variants, Parkinson's disease, Alzheimer's disease and many others? Neuroprotection is defined by many researches as interactions and interventions that can slow down or even inhibit the progression of neuronal degeneration process. We make some considerations on this neuroprotective effect.Department of Neurology, Antonio Pedro University Hospital, Fluminense Federal University , NiteróiNeurology Service, Nova Iguaçu Hospital , PosseBrain Mapping Laboratory and Electroencephalogram, Federal University of Rio de JaneiroBrain Mapping and Functionality Laboratory, Federal University of PiauíSeverino Sombra University Center, School of Medicine , VassourasDepartment of Neurology, Federal University of São Paulo , BrazilDepartment of Neurology, Federal University of São Paulo , BrazilWeb of Scienc