Sensores inerciais na avaliação motora da Doença de Parkinson em pacientes submetidos à Palidotomia - um estudo piloto

A Doença de Parkinson é um distúrbio neurodegenerativo de grande impacto global, apesar dos avanços recentes ainda necessita de aprimoramento nos métodos de avaliação das alterações motoras. Este trabalho teve como objetivo avaliar um sistema (hardware e software) capaz de quantificar de forma precisa o tremor em pacientes com a doença de Parkinson submetidos à Palidotomia. Foi avaliado o Valor Absoluto Médio (MAV - Mean Absolute Value) da atividade involuntária de três pacientes submetidos à cirurgia de palidotomia nos cenários pré e pós-operatório. O Valor Absoluto Médio da atividade involuntária obtido por meio do dispositivo proposto (TREMSEN) apresentou boa correlação com os achados clínicos, bem como os achados já descritos em estudos anteriores. O presente estudo mostrou que as alterações da MAV estavam sempre relacionadas positivamente com tremor ou negativamente com bradicinesia e rigidez, ou eventualmente em ambos. Também se observou a tendência à maior influência do tremor sobre a MAV do que bradicinesia e rigidez. A correlação positiva entre os valores aferidos pelo dispositivo TREMSEN e o resultado clínico dos pacientes abre portas para aplicação futura da tecnologia, tais como avaliação precisa e objetiva dos distúrbios motores, monitoramento contínuo e monitoramento à distânciaParkinson's Disease is a neurodegenerative disorder and an important source of disability worldwide. Despite recent advances, it remains necessary improvements in the assessment of motor changes. The objective of this study was to evaluate a system (hardware and software) capable of precisely quantifying tremor in patients with Parkinson's Disease undergoing ablative surgery. The Mean Absolute Value (MAV) of involuntary activity of three patients undergoing pallidotomy was evaluated in the pre and postoperative scenarios. The Mean Absolute Value of involuntary activity (obtained through the proposed device - TREMSEN) presents a good clinical correlation, as observed in previous studies. The present study revealed that MAV changes were always positively related to tremor or negatively related to bradykinesia and rigidity, possibly both. In addition, there was a trend towards greater influence of tremor on the MAV than bradykinesia and rigidity. The positive correlation between TREMSEN device and the clinical outcome of patients brings possibility to future application of the technology, such as accurate and objective assessment of motor disorders, continuous monitoring, and remote monitoring39 f

Implementing an epilepsy surgery center. Initial experience at a university hospital in Brazil

ABSTRACT Epilepsy is a serious neurological condition, often without a full and effective treatment. In some cases, surgery is beneficial, despite being underused. Our aim herein is to describe the implementation of an epilepsy surgery center in a federal university hospital, sharing the initial experience gained, as well as describing the main challenges and first results. Methods: Experience report of an epilepsy surgery center implementation. Retrospective review of 13 drug-resistant patients who underwent surgical treatment. Results: Thirteen patients underwent surgical epilepsy treatment, five patients categorized as the International League Against Epilepsy class 1, two in class 2, three in class 3, zero in class 4, and two in class 5; with a 30.76% complication rate. Conclusion: Despite the challenges, it was possible to implement an epilepsy surgery center with favorable results and acceptable incidence of complications, which were not higher than the incidences found in more experienced centers

Implementing an epilepsy surgery center. Initial experience at a university hospital in Brazil

<div><p>ABSTRACT Epilepsy is a serious neurological condition, often without a full and effective treatment. In some cases, surgery is beneficial, despite being underused. Our aim herein is to describe the implementation of an epilepsy surgery center in a federal university hospital, sharing the initial experience gained, as well as describing the main challenges and first results. Methods: Experience report of an epilepsy surgery center implementation. Retrospective review of 13 drug-resistant patients who underwent surgical treatment. Results: Thirteen patients underwent surgical epilepsy treatment, five patients categorized as the International League Against Epilepsy class 1, two in class 2, three in class 3, zero in class 4, and two in class 5; with a 30.76% complication rate. Conclusion: Despite the challenges, it was possible to implement an epilepsy surgery center with favorable results and acceptable incidence of complications, which were not higher than the incidences found in more experienced centers.</p></div