Screening of cognitive impairment in patients with Parkinson's disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination-Revised

ABSTRACTObjective The aim of the present study is to examine the accuracy of the Brazilian versions of the Montreal Cognitive Assessment (MoCA) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) to screen for mild cognitive impairment (PDMCI) and dementia (PDD) in patients with Parkinson's disease (PD).Method Both scales were administered to a final convenience sample of 79 patients with PD. Patients were evaluated by a neurologist, a psychiatrist and a neuropsychologist using UPDRS, Hoehn and Yahr and Schwab and England scales, global deterioration scale, a psychiatric structured interview, Mattis Dementia Rating Scale and other cognitive tests.Results There were 32 patients with PDMCI and 17 patients with PDD. The MoCA and the ACE-R were able to discriminate patients with PDD from the others.Conclusion Both scales showed to be useful to screen for dementia but not for mild cognitive impairment in patients with PD

Prognostic value of cytokines and chemokines in addition to the GRACE Score in non-ST-elevation acute coronary syndromes

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-02-27T19:28:23Z No. of bitstreams: 1 Correia L C L Prognostic value of....pdf: 193215 bytes, checksum: 3e62c8dbdc443b23fee18ac01ea9bfbd (MD5)Made available in DSpace on 2014-02-27T19:28:23Z (GMT). No. of bitstreams: 1 Correia L C L Prognostic value of....pdf: 193215 bytes, checksum: 3e62c8dbdc443b23fee18ac01ea9bfbd (MD5) Previous issue date: 2010Portuguese Hospital. Cardiology Division. Salvador, BA, Brasil / Medical School of Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilPortuguese Hospital. Cardiology Division. Salvador, BA, BrasilPortuguese Hospital. Cardiology Division. Salvador, BA, BrasilPortuguese Hospital. Cardiology Division. Salvador, BA, BrasilPortuguese Hospital. Cardiology Division. Salvador, BA, BrasilPortuguese Hospital. Cardiology Division. Salvador, BA, BrasilMedical School of Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Institute of Investigation in Immunology (iii). Science and Technology National Institute (INCT). Bahia, BA, BraSilIncreased cytokine and chemokine levels are associated with cardiovascular events in patients with non-ST-elevation acute coronary syndromes (ACS), but the incremental prognostic value of these inflammatory markers is not known. We determined if cytokine and chemokine assessment adds prognostic information to the GRACE Score in patients with ACS. METHODS: Five cytokines (interleukin (IL)-1beta, IL-6, IL-10, IL-12p70, and tumor necrosis factor (TNF)-alpha soluble receptor I), five chemokines (IL-8, CCL5, CXCL9, CCL2, and CXCL10) and C-reactive protein (CRP) were measured at admission of 87 patients admitted with ACS. RESULTS: During hospitalization, the incidence of cardiovascular events was 13% (7 deaths, 1 nonfatal acute myocardial infarction, and 3 refractory unstable angina). Individuals who developed events had significantly greater levels of CRP, IL-1beta, IL-12, TNF-alpha, IL-8, CXCL9 and CCL2, compared with those free of events. Thus, these markers were used to build an Inflammatory Score, by the input of one point for each of these variables above the 75th percentile. After adjustment for the GRACE Score, the Inflammatory Score independently predicted events (OR=1.80; 95% CI=1.12-1.88). Incorporation of the Inflammatory Score into the GRACE Score promoted a C-statistics improvement from 0.77 (95% CI=0.58-0.96) to 0.85 (95% CI=0.71-1.0). Net reclassification improvement obtained with GRACE-Inflammatory Score was 13% (P=0.007), indicating a significant reclassification. When only CRP was incorporated into GRACE, the increase on C-statistics was not relevant (from 0.77 to 0.80). CONCLUSION: Cytokines and chemokines measured at admission add prognostic information to the GRACE Score in patients admitted with ACS

Ferrovias, doenças e medicina tropical no Brasil da Primeira República Railroads, disease, and tropical medicine in Brazil under the First Republic

Aborda o impacto da malária no âmbito da modernização republicana, basicamente nas ferrovias, que asssumiram então o papel de integrar o território e operar a expansão simbólica e material da nação brasileira. Os cientistas destacados para debelar os surtos epidêmicos não se limitaram a realizar as campanhas. Fizeram observações sobre aspectos da doença, inclusive suas relações com hospedeiros e ambientes, contribuindo com novos conhecimentos e com a institucionalização, no Brasil, de novo campo que então se estabelecia nas potências coloniais européias: a medicina tropical. O artigo articula essas inovações - especialmente a teoria da infecção domiciliária - com as campanhas em prol de ferrovias e com estágio subseqüente no enfrentamento da malária no Brasil, nos anos 1920.<br>The article explores the impact of malaria on infrastructure works - above all, railroads - under the republican drive towards modernization. Railways helped tie the territory together and foster the symbolic and material expansion of the Brazilian nation. The scientists entrusted with vanquishing such epidemic outbreaks did not just conduct campaigns; they also undertook painstaking observations of aspects of the disease, including its relations to hosts and the environment, thus contributing to the production of new knowledge of malaria and to the institutionalization of a new field in Brazil, then taking root in Europe's colonies: "tropical medicine." The article shows the ties between these innovations (especially the theory of domiciliary infection) and the sanitary campaigns that helped the railways, which in the 1920s were followed by a new phase in Brazil's anti-malaria efforts