Predictors of Poststroke Depression: a Retrospective Study in a Rehabilitation Unit

INTRODUÇÃO/OBJECTIVOS: O Acidente Vascular Cerebral (AVC) pode limitar de forma importante a funcionalidade. As complicações psiquiátricas têm sido identificadas como factores determinantes na reabilitação pós-AVC, sendo a Depressão a complicação psiquiátrica mais frequente e a que está associada a pior prognóstico. Subsiste ainda incerteza quanto à sua etiologia e factores de risco. Na revisão sistemática mais recente, reconhecem-se como factores preditivos a gravidade do AVC, o grau de incapacidade do doente e o défice cognitivo. Questões metodológicas impediram a determinação de outros factores. Assim, urge definir novos factores que facilitem um diagnóstico atempado, que possa diminuir os efeitos negativos sobre o processo de reabilitação. Objectivos: determinação da incidência da Depressão de novo pós-AVC (DPA) e o estudo das variáveis descritas na literatura como possíveis factores preditivos de DPA: sexo, idade, tipo de AVC, lateralidade, território vascular e presença de afasia. Foi definido como endpoint secundário o estudo do tipo de afasia. MATERIAIS E MÉTODOS: Estudo longitudinal retrospectivo, envolvendo todos os doentes admitidos no internamento de um Serviço de MFR com o diagnóstico de AVC de novo, entre 1-1-2009 e 31-12-2009. Foram colhidos elementos demográficos e clínicos dos processos clínicos, num total de 74 doentes. Critérios de exclusão: ‘AVC prévio’, ‘Doença psiquiátrica com perturbação do humor prévia’ e ‘Medicação antidepressiva à data do AVC’. Para o tratamento estatístico usou-se o SPSS 11.5. RESULTADOS: A incidência da DPA observada foi de 44,6%. Dos possíveis factores preditivos testados, apenas a presença de afasia apresentou uma relação estatisticamente significativa com a depressão (p=0.02). Não se encontrou relação com o tipo de afasia. Os restantes factores preditivos testados não mostraram correlação estatística significativa. Parece existir uma relação entre o sexo masculino e a DPA (p=0.07), que não atingiu significância no tamanho da amostra conseguido (n). CONCLUSÕES: Este estudo estabelece a afasia como factor preditivo da DPA. A elevada incidência de DPA nesta população particular concorda com os estudos existentes, sendo necessário outro tipo de estudo que permita justificar o valor encontrado. São necessários mais estudos não só para aumentar o conhecimento dos factores de risco para a DPA, como para melhorar os resultados dos programas de reabilitação

A3 receptor agonist modulates IL-1β hippocampus levels in a rat model of neuropathic pain

Introduction: Considering the lack of specific treatments to neuropathic pain, this study aimed to evaluate the effect of a single dose adenosine A3 receptor IB-MECA in the inflammatory and neurotrophic parameters of rats submitted to a neuropathic pain model. Methods: 64 adults male Wistar rats were used.  Neuropathic pain was induced by the chronic constriction injury (CCI) of sciatic nerve and the treatment consisted in one dose of 0.5 μmol/kg of a selective agonist of adenosine A3 receptor IB-MECA dissolved in 3% DMSO; vehicle groups received DMSO 3% in saline; morphine groups received 5mg/kg Cerebral cortex and hippocampus IL-1β, BDNF and NGF levels were determined by ELISA assay. Results: The key finding was that a single dose of IB-MECA was able to modulate the IL-1β hippocampus levels CCI and the DMSO increased IL-1β and NGF hippocampus levels in sham animals; however, when the DMSO as an IB-MECA vehicle, this effect was not observed, indicating that IB-MECA was able to prevent the effect of DMSO. Conclusions: Considering that the IL-1β role in neuropathic pain is quite explored, as well as the hippocampus contributions, our result corroborates the relationship of A3 receptor and the chronic pain maintenance process. @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-536870145 1107305727 0 0 415 0;}p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0in; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman",serif; mso-fareast-font-family:"Times New Roman";}.MsoChpDefault {mso-style-type:export-only; mso-default-props:yes;}div.WordSection1 {page:WordSection1;

Effects of restraint stress on the daily rhythm of hydrolysis of adenine nucleotides in rat serum

<p>Abstract</p> <p>Background</p> <p>Adenosine 5-triphosphate (ATP) and its breakdown products ADP and adenosine can act as extracellular messengers in a range of biological processes. Extracellular adenine nucleotides are metabolized by a number of enzymes including NTPDases and 5'-nucleotidase, which are considered to be the major regulators of purinergic signaling in the blood. Previous work by our group demonstrated that ATPase and ADPase activities in rat serum exhibit a 24-h temporal pattern, with higher enzyme activity during the dark (activity) phase. It was found that stress can cause disruptions in biological circadian rhythms and in the cardiovascular system. Therefore, the aim of the present study was to examine the influence of acute stress exposure upon temporal patterns of NTPDase and 5-nucleotidase enzyme activities in rat blood serum.</p> <p>Methods</p> <p>Adult male Wistar rats were divided into 4 groups: ZT0, ZT6, ZT12 and ZT18. Each group was subdivided in 4 groups: control, immediately, 6 h and 24 h after one hour of restraint stress. ATP, ADP and AMP hydrolysis were assayed in the serum.</p> <p>Results</p> <p>All stressed groups showed significant decreases in all enzyme activities at ZT 12 and ZT 18 when compared with control.</p> <p>Conclusion</p> <p>Acute stress provokes a decrease in nucleotidase activities dependent on the time that this stress occurs and this effect appears to persist for at least 24 hours. Stress can change levels of nucleotides, related to increased frequency of cardiovascular events during the activity phase. Altered levels of nucleotides in serum may be involved in cardiovascular events more frequent during the activity phase in mammals, and with their etiology linked to stress.</p

Association of anxiety with intracortical inhibition and descending pain modulation in chronic myofascial pain syndrome

Background: This study aimed to answer three questions related to chronic myofascial pain syndrome (MPS): 1) Is the motor cortex excitability, as assessed by transcranial magnetic stimulation parameters (TMS), related to state-trait anxiety? 2) Does anxiety modulate corticospinal excitability changes after evoked pain by Quantitative Sensory Testing (QST)? 3) Does the state-trait anxiety predict the response to pain evoked by QST if simultaneously receiving a heterotopic stimulus [Conditional Pain Modulation (CPM)]? We included females with chronic MPS (n = 47) and healthy controls (n = 11), aged 19 to 65 years. Motor cortex excitability was assessed by TMS, and anxiety was assessed based on the State-Trait Anxiety Inventory. The disability related to pain (DRP) was assessed by the Profile of Chronic Pain scale for the Brazilian population (B:PCP:S), and the psychophysical pain measurements were measured by the QST and CPM. Results: In patients, trait-anxiety was positively correlated to intracortical facilitation (ICF) at baseline and after QST evoked pain (β = 0.05 and β = 0.04, respectively) and negatively correlated to the cortical silent period (CSP) (β = -1.17 and β = -1.23, respectively) (P <0.05 for all comparisons). After QST evoked pain, the DRP was positively correlated to ICF (β = 0.02) (P < 0.05). Pain scores during CPM were positively correlated with trait-anxiety when it was concurrently with high DRP (β = 0.39; P = 0.02). Controls’ cortical excitability remained unchanged after QST. Conclusions: These findings suggest that, in chronic MPS, the imbalance between excitatory and inhibitory descending systems of the corticospinal tract is associated with higher trait-anxiety concurrent with higher DRP

Importance of TP53 codon 72 and intron 3 duplication 16bp polymorphisms in prediction of susceptibility on breast cancer

<p>Abstract</p> <p>Background</p> <p><it>TP53 </it>is one of major tumour suppressor genes being essential in preservation of genome integrity. Two very common polymorphisms have been demonstrated to contribute to cancer susceptibility and tumour behaviour. The purpose of this study was to evaluate the role of <it>Arg72Pro </it>and <it>PIN3 Ins16bp </it>polymorphisms in <it>TP53 </it>gene as genetic susceptibility and predictive markers to breast cancer.</p> <p>Methods</p> <p>We analysed DNA samples from 264 breast cancer patients and 440 controls, for <it>TP53 Arg72Pro </it>and <it>PIN3 Ins16bp </it>polymorphisms using PCR-RFLP.</p> <p>Results</p> <p>We observed that women with <it>A2A2 </it>genotype have increased risk for developing breast cancer, either in women with or without familial history (FH) of the disease (OR = 4.40, 95% CI 1.60–12.0; p = 0.004; OR = 3.88, 95% CI 1.18–12.8; p = 0.026, respectively). In haplotype analysis, statistically significant differences were found between <it>TP53 Arg-A2 </it>haplotype frequencies and familial breast cancer cases and the respective control group (OR = 2.10, 95% CI 1.08–4.06; p = 0.028). Furthermore, both <it>TP53 </it>polymorphisms are associated with higher incidence of lymph node metastases.</p> <p>Conclusion</p> <p>Our findings suggest <it>TP53 PIN3 Ins16bp </it>polymorphism as a real risk modifier in breast cancer disease, either in sporadic and familial breast cancer. Furthermore, both TP53 polymorphisms are associated with higher incidence of lymph node metastases.</p

Designation processes and semantic substitutions used by european portuguese children in a vocabulary test

This research study focus on the designation processes and semantic substitutions of each word on the vocabulary sub-task from the language test for children – ABFW, standardized in Brazil and adapted to European Portuguese, as well as the comparison of the results obtained in the two countries, to analyze the relevance of their extensibility to the Portuguese population. Methods: The test was applied to 150 children from 5 to 6 years old, of typical development. The test consists of 9 conceptual categories. Each category consists of different words, which were always assessed in the same sequential order. Results: The sample of this study showed a lower performance only in clothes, places and food semantic categories. All the other categories have outperformed the standard. The categories of vocabulary with higher percentage in the right designation of the words were colors and shapes, animals and toys and music instruments. The categories with a higher percentage of substitution processes, from the reference results, were: food and locations. The most recurrent substitution processes were the co-hyponym, words that designate semantic attributes, valorization of the visual stimulus, hypernym and parasynonyms Conclusion: Given the homogeneity of the results of this study with the results obtained with other studies in Brazil, this test reveal potentiality as an instrument for vocabulary assessment in Portugal.Objetivo: Este estudo teve por objetivo a análise e quantificação dos processos de designação e substituição semântica apresentados na prova do vocabulário do Teste de Linguagem Infantil ABFW, padronizado no Brasil e adaptado para Português Europeu (PE), assim como a comparação dos resultados obtidos nos dois países, de forma a analisar a pertinência da sua extensibilidade à população portuguesa. Métodos: A prova foi aplicada a 150 crianças de 5 e 6 anos de idade, de desenvolvimento típico, na Região Norte de Portugal. A prova é constituída por nove categorias conceituais e cada categoria formada por diferentes vocábulos, que foram avaliados sempre pela mesma ordem sequencial. Resultados: A amostra mostrou desempenho inferior, em relação à norma, apenas nas categorias semânticas vestuário, locais e alimentos. Todas as outras categorias revelaram desempenho superior. As categorias do vocabulário que apresentaram maior percentagem de respostas corretas foram: animais, formas e cores e brinquedos e instrumentos musicais. As categorias que apresentaram percentagem superior de processos de substituição, em relação à norma, foram alimentos e locais. Os processos de substituição mais utilizados foram: substituição por co-hipônimo, vocábulos que designam atributos semânticos, valorização do estímulo visual, hiperônimos e parassinônimos. Conclusão: Dada a homogeneidade dos resultados deste estudo com os resultados obtidos em outros estudos no Brasil, esta prova revela potencialidades como instrumento de avaliação do vocabulário em Portugal.This work is funded by CIEd – Research Centre on Education, projects UID/CED/1661/2013 and UID/CED/1661/2016, Institute of Education, University of Minho, through national funds of FCT/MCTESPT.info:eu-repo/semantics/publishedVersio

Adrenocortical oncocytic carcinoma with recurrent metastases: a case report and review of the literature

<p>Abstract</p> <p>Background</p> <p>Adrenal cortex oncocytic carcinoma (AOC) represents an exceptional pathological entity, since only 22 cases have been documented in the literature so far.</p> <p>Case presentation</p> <p>Our case concerns a 54-year-old man with past medical history of right adrenal excision with partial hepatectomy, due to an adrenocortical carcinoma. The patient was admitted in our hospital to undergo surgical resection of a left lung mass newly detected on chest Computed Tomography scan. The histological and immunohistochemical study revealed a metastatic AOC. Although the patient was given mitotane orally in adjuvant basis, he experienced relapse with multiple metastases in the thorax twice in the next year and was treated with consecutive resections. Two and a half years later, a right hip joint metastasis was found and concurrent chemoradiation was given. Finally, approximately five years post disease onset, the patient died due to massive metastatic disease. A thorough review of AOC and particularly all diagnostic difficulties are extensively stated.</p> <p>Conclusion</p> <p>Histological classification of adrenocortical oncocytic tumours has been so far a matter of debate. There is no officially established histological scoring system regarding these rare neoplasms and therefore many diagnostic difficulties occur for pathologists.</p