Detecção de IgE total em amostras pareadas de líquido cefalorraquiano e soro de pacientes com neurocisticercose

Neurocysticercosis (NC), the presence of Taenia solium metacestodes in tissues, is the most frequent and severe parasitic infection of the central nervous system. We investigated the presence of total IgE by an automated chemiluminescence assay in 53 paired cerebrospinal fluid (CSF) and serum samples from patients with NC (P) and in 40 CSF samples from individuals with other neurological disorders as the control group (C). Total IgE concentration ranged from 1.2 to 6.6 IU/ml (mean = 1.4 IU/ml, standard deviation-sd = 1.1 IU/ml) in 28.3% of CSF samples from the P group, a value significantly higher than for the C group (£1.0 IU/ml). The serum samples from the P group showed concentrations ranging from 1.0 to 2330.0 IU/ml (mean = 224.1 IU/ml, sd = 452.1 IU/ml), which were higher than the normal value cited by the manufacturer (<100.0 IU/ml) in 32.1% of the samples. A significant difference was observed in CSF samples from the P and C groups (p = 0.005) and in serum samples from the P group compared to the normal value (p = 0.005), with sera showing more frequent abnormal results.Neurocisticercose (NC), causada pela presença da forma larvária de Taenia solium em tecidos, é a mais frequente e grave infecção parasitária que acomete o sistema nervoso central. Nós investigamos a presença de IgE total por quimiluminescência em 53 amostras pareadas de líquido cefalorraquiano (LCR) e soro de pacientes com NC (P) e 40 amostras de LCR de indivíduos portadores de outras desordens neurológicas como grupo controle (C). A detecção de IgE total mostrou 28,3% das amostras de LCR do grupo P com concentrações entre 1,2 UI/ml e 6,6 UI/ml (média = 1,4 UI/ml, desvio padrão-sd = 1,1 UI/ml), maiores que o grupo C (£1,0 UI/ml). As amostras de soro do grupo P mostraram concentrações entre 1,0 UI/ml e 2330,0 UI/ml (média = 224.1 UI/ml, sd = 452,1 UI/ml), e 32,1% das amostras apresentaram valores maiores que o valor normal citado pelo fabricante (<100,0 UI/ml). Diferença significativa foi encontrada entre as amostras de LCR dos grupos P e C (p = 0,005) e entre as amostras de soro do grupo P e valor de referência (p = 0,005), sendo os resultados dos soros mais frequentemente alterados

Neuroprogression in post-traumatic stress disorder : a systematic review

Introduction: Neuroprogression has been proposed as the pathological rewiring of the brain that takes place in parallel with clinical and neurocognitive deterioration in the course of psychiatric disorders. This study aims to review the biological underpinnings and clinical outcomes related to neuroprogression in post-traumatic stress disorder (PTSD). Methods: We performed a systematic review by searching PubMed, Embase, and Web of Science for articles published between January 1, 1960, and January 6, 2020. Inclusion criteria were met when articles assessed brain changes, neurocognition, functioning, inflammation, oxidative stress, and neurotrophins in patients with PTSD. Narrative review articles, case reports, and preclinical studies were excluded. Results: A total of 965 abstracts were identified and 15 articles were included in our systematic review. It seems that for a subset of patients whose symptoms worsen or are maintained at a high intensity there is a progressive change in the frontal lobe, especially the prefrontal cortex, and worsening of both neurocognition (verbal memory and facial recognition) and functioning (physical, psychological, social and environmental). Conclusion: Although current findings associate progressive reduction in frontal lobe size with neurocognitive impairment, further research is needed to characterize PTSD as a neuroprogressive disorder

ESCORPIONISMO NO MUNICÍPIO DE CRUZ DAS ALMAS- BAHIA: : ESTRATÉGIAS E AÇÕES NA FORMAÇÃO DE AGENTES MULTIPLICADORES

O ser humano tem provocado impactos irreversíveis ao meio ambiente, pois a produção de lixo e seu descarte inadequado resultam no surgimento de locais ideais para a proliferação de animais sinantrópicos peçonhentos, como os escorpiões. O Estado da Bahia tem registrado o maior índice de escorpionismo da Região Nordeste do Brasil, sendo este um problema de saúde pública ainda negligenciado. Diante desse cenário, a Educação Ambiental (EA) se mostra como ferramenta transformadora. O presente estudo busca divulgar as estratégias e ações de EA na relação homem-lixo-escorpiões como determinante do processo saúde-doença, desenvolvidas no âmbito do projeto de extensão “Bicho e o Lixo” no município de Cruz das Almas-BA, de modo a transformar agentes comunitários de saúde em agentes multiplicadores de conhecimento sobre escorpionismo. Os resultados das atividades desenvolvidas revelam a necessidade de articulação das ações formativas/educativas sobre a prevenção de acidentes escorpiônicos, a importante sensibilização para a convivência harmoniosa entre o ambiente e as demais espécies, e que o diálogo entre a Universidade, o poder público local e a população resultem em um maior e mais efetivo impacto social sobre este tema

Estudo de bandas oligoclonais restritas ao líquido cefalorraquidiano em pacientes com esclerose múltipla na cidade de São Paulo

The frequency of oligoclonal bands (OCB) restricted to the cerebrospinal fluid (CSF) from patients with multiple sclerosis (MS) varies widely in different populations. The objective of this study was to determine the frequency of these OCB in a group of MS patients in the city of São Paulo. Techniques used to detect OCB consisted of isoelectric focusing followed by immunoblotting. Oligoclonal bands were found in 49 (54.4%) out of 90 patients with clinically definite MS; in (31.2%) of the 16 patients with clinically isolated syndrome; in 7 (17.9%) of 39 patients with inflammatory disorders of the central nervous system (IDCNS), and in none of the individuals with no neurological condition (control group). The specificity of the method was 100% when compared to the control group and 82.1% when compared to the IDCNS group. These results suggest that the frequency of CSF OCB is much lower in Brazilian MS patients from São Paulo city than that reported in MS series from Caucasian populations.A frequência da detecção de bandas oligoclonais (BOC) restritas ao líquido cerebrorraquidiano (LCR) em pacientes com esclerose múltipla (EM) varia amplamente em diferentes populações. O objetivo deste estudo foi determinar a frequência destas BOC em pacientes com EM em amostra de população da cidade de São Paulo. A técnica utilizada para a detecção das BOC foi a focalização isoelétrica, seguida do immunoblotting. BOC foram detectadas: em 49 (54,4%) de 90 pacientes com EM clinicamente definida; em 5 (31,2%) de 16 pacientes com síndrome clínica isolada; em 7 (17,9%) de 30 pacientes com doenças inflamatórias do sistema nervoso central (DISNC); e em nenhum indivíduo sem doença neurológica. A especificidade do método foi 100% quando comparada ao grupo controle e 82,1% quando comparada ao grupo de DISNC. Estes resultados sugerem que a freqüência de BOC no LCR é mais baixa em pacientes da cidade de São Paulo portadores de EM do que aquelas descritas em populações caucasianas

Nationwide access to endovascular treatment for acute ischemic stroke in portugal

Publisher Copyright: Copyright Ordem dos M dicos 2021.Introduction: Since the publication of endovascular treatment trials and European Stroke Guidelines, Portugal has re-organized stroke healthcare. The nine centers performing endovascular treatment are not equally distributed within the country, which may lead to differential access to endovascular treatment. Our main aim was to perform a descriptive analysis of the main treatment metrics regarding endovascular treatment in mainland Portugal and its administrative districts. Material and Methods: A retrospective national multicentric cohort study was conducted, including all ischemic stroke patients treated with endovascular treatment in mainland Portugal over two years (July 2015 to June 2017). All endovascular treatment centers contributed to an anonymized database. Demographic, stroke-related and procedure-related variables were collected. Crude endovascular treatment rates were calculated per 100 000 inhabitants for mainland Portugal, and each district and endovascular treatment standardized ratios (indirect age-sex standardization) were also calculated. Patient time metrics were computed as the median time between stroke onset, first-door, and puncture. Results: A total of 1625 endovascular treatment procedures were registered. The endovascular treatment rate was 8.27/100 000 inhabitants/year. We found regional heterogeneity in endovascular treatment rates (1.58 to 16.53/100 000/year), with higher rates in districts closer to endovascular treatment centers. When analyzed by district, the median time from stroke onset to puncture ranged from 212 to 432 minutes, reflecting regional heterogeneity. Discussion: Overall endovascular treatment rates and procedural times in Portugal are comparable to other international registries. We found geographic heterogeneity, with lower endovascular treatment rates and longer onset-to-puncture time in southern and inner regions. Conclusion: The overall national rate of EVT in the first two years after the organization of EVT-capable centers is one of the highest among European countries, however, significant regional disparities were documented. Moreover, stroke-onset-to-first-door times and in-hospital procedural times in the EVT centers were comparable to those reported in the randomized controlled trials performed in high-volume tertiary hospitalspublishersversionpublishe