QUALITY OF LIFE AND EPIDEMIOLOGICAL PROFILE OF PATIENTS UNDERGOING BOTULINUM TOXIN TREATMENT

The botulinum toxin (BTX) is a therapeutic modality used in diverse range of diseases in neurology such as dystonia, tics and tremors and spasticity. The literature about the relation between the use of BTX and its impact in quality of life scales are conflicting, our study proposes to aid answering this question. We selected 110 patients between April 2014 and January 2015, from two tertiary hospitals (movement disorder outpatient clinic), which have been evaluated for age, gender, type of BTX applied, technic of application, adverse events, clinical syndrome and etiology. To evaluate quality of life we used the SF-36® scale. The most prevalent clinical syndromes were dystonia, spasticity and daytime bruxism. We applied the scale in 55 patients pre and post treatment to trace a clinical and epidemiological profile of patients treated with botulinum toxin, evaluating its impact on quality of life. Main etiologies were: idiopathic, stroke and peripheral facial palsy. SF-36® scale applied to 55 patients showed that 35 of them improved, with higher impact upon the mental health, vitality, physical functioning and body pain subsections. Incidence of adverse events (21,8%) was similar to the literature. Botulinum toxin application was associated with higher scores on SF-36®, therefore representing a good therapeutic option dystonia and spasticity.

Avaliação do efeito da força de aperto de parafusos de retenção na desadaptação marginal de próteses sobre implantes

OBJECTIVES: The present in vitro study was designed to compare the differences in the vertical misfit of implant-supported frameworks using three different forces for tightening the bridge locking screws: fastening by hand until first resistance, and using torque drivers with 10 and 20Ncm. METHODS: The investigation was conducted based on the results given by 9 six-unit nickel-chromium (2 abutments/ 4 pontics) screw-retained implant-supported frameworks. The structures were exposed to simulated porcelain firings. The marginal misfit measurements were made using a traveling measuring microscope at selected screw tightening forces: fastening by hand until first resistance, and using torque drivers with 10 and 20Ncm. The results were submitted to one-way ANOVA with repeated measures on one factor, and post hoc pairwise comparisons using Tukey test (5%). RESULTS: The mean marginal misfit of the frameworks, fastening the screws by hand until first resistance, was 41.56µm (SD±12.45µm). The use of torque driver devices caused a significant reduction in marginal opening (pO presente estudo avaliou o efeito da força de aperto de parafusos de retenção na desadaptação marginal de próteses sobre implantes. A investigação foi conduzida baseada em resultados fornecidos por nove estruturas metálicas implanto-suportadas de seis elementos (02 retentores e 04 pônticos), retidas por parafusos. A mensuração da desadaptação marginal foi realizada com auxílio de microscópio óptico, nos seguintes momentos: M1: aperto com chave manual até a primeira resistência do parafuso; M2: aperto utilizando torquímetro mecânico com 10Ncm e M3: aperto utilizando torquímetro mecânico com 20Ncm. As médias de desadaptação foram submetidas à análise estatística (ANOVA e Tukey). O emprego de torquímetros mecânicos, independente do valor de torque, determinou redução significativa na abertura marginal (

Neuroimaging in Hereditary Spastic Paraplegias: Current Use and Future Perspectives

Hereditary spastic paraplegias (HSP) are a large group of genetic diseases characterized by progressive degeneration of the long tracts of the spinal cord, namely the corticospinal tracts and dorsal columns. Genotypic and phenotypic heterogeneity is a hallmark of this group of diseases, which makes proper diagnosis and management often challenging. In this scenario, magnetic resonance imaging (MRI) emerges as a valuable tool to assist in the exclusion of mimicking disorders and in the detailed phenotypic characterization. Some neuroradiological signs have been reported in specific subtypes of HSP and are therefore helpful to guide genetic testing/interpretation. In addition, advanced MRI techniques enable detection of subtle structural abnormalities not visible on routine scans in the spinal cord and brain of subjects with HSP. In particular, quantitative spinal cord morphometry and diffusion tensor imaging look promising tools to uncover the pathophysiology and to track progression of these diseases. In the current review article, we discuss the current use and future perspectives of MRI in the context of HSP

SCHWANOMA GIGANTE DO VIII NERVO CRANIANO DE EVOLUÇÃO SUBAGUDA: RELATO DE CASO.

O schwanoma vestibular é uma neoplasia que se origina das células de Schwann da porção vestibular do VIII nervo craniano e que corres- ponde a cerca de 10% dos tumores intracranianos e a 80% a 90% da- queles localizados no ângulo pontocerebelar. Apesar do crescimento lento e evolução em geral benigna, estes tumores podem evoluir de maneira desfavorável devido à localização em compartimento anatô- mico relativamente reduzido no crânio (fossa posterior), o que pode levar a compressão de estruturas nobres (como o tronco encefálico) e a desenvolvimento de hidrocefalia obstrutiva, especialmente nos raros casos de schawanomas gigantes ( 40 mm). Apresentamos relato de caso de paciente com quadro de tinnitus e hipoacusia à esquerda que evoluiu de forma subaguda com alterações do humor, da cognição e da marcha cujo diagnóstico final foi de schwanoma gigante do VIII nervo craniano

Evaluation Of The Taxonomic Status Of Populations Assigned To Phyllomedusa Hypochondrialis (anura, Hylidae, Phyllomedusinae) Based On Molecular, Chromosomal, And Morphological Approach.

The taxonomic and phylogenetic relationships of the genus Phyllomedusa have been amply discussed. The marked morphological similarities among some species hamper the reliable identification of specimens and may often lead to their incorrect taxonomic classification on the sole basis of morphological traits. Phenotypic variation was observed among populations assigned to either P. azurea or P. hypochondrialis. In order to evaluate whether the variation observed in populations assigned to P. hypochondrialis is related to that in genotypes, a cytogenetic analysis was combined with phylogenetic inferences based on mitochondrial and nuclear sequences. The inter- and intra-population variation in the external morphology observed among the specimens analyzed in the present study do not reflect the phylogenetic relationships among populations. A monophyletic clade was recovered, grouping all the specimens identified as P. hypochondrialis and specimens assigned P. azurea from Minas Gerais state. This clade is characterized by conserved chromosomal morphology and a common C-banding pattern. Extensive variation in the nucleolar organizing region (NOR) was observed among populations, with four distinct NOR positions being recognized in the karyotypes. Intra-population polymorphism of the additional rDNA clusters observed in specimens from Barreiras, Bahia state, also highlights the marked genomic instability of the rDNA in the genome of this group. Based on the topology obtained in the phylogenetic analyses, the re-evaluation of the taxonomic status of the specimens from the southernmost population known in Brazil is recommended. The results of this study support the need for a thorough revision of the phenotypic features used to discriminate P. azurea and P. hypochondrialis. The phylogenetic data presented here also contribute to an extension of the geographic range of P. hypochondrialis, which is known to occur in the Amazon basin and neighboring areas of the Cerrado savanna, where it may be sympatric with P. azurea, within contact zones. The misidentification of specimens may have led to inconsistencies in the original definition of the geographic range of P. azurea. The variability observed in the NOR of P. hypochondrialis reinforces the conclusion that these sites represent hotspots of rearrangement. Intraspecific variation in the location of these sites is the result of constant rearrangements that are not detected by classical cytogenetic methods or are traits of an ancestral, polymorphic karyotype, which would not be phylogenetically informative for this group.147

Violência doméstica em gestantes na atenção primária: Atuação do enfermeiro.

Resumo. A violência doméstica contra a gestante é reconhecida como um grave problema de saúde pública do país. Independentemente das relações humanas e no contexto sociocultural, as gestantes não estão livres de serem vítimas da violência. Este estudo tem como objetivo apresentar a atuação do enfermeiro na identificação de casos de violência doméstica em gestantes na atenção primária. Trata-se de uma revisão integrativa de literatura utilizando os descritores: Domestic violence, Pregnant women, nurse, Primary health care. O recrutamento dos artigos completos ocorreu no mês de julho de 2022, na Biblioteca Virtual em Saúde, nos idiomas inglês e português do período de 2017 até 2022. Resultado: nenhum artigo recrutado retratava a assistência de enfermagem prestada pelo profissional às mulheres vítimas de violência na gestação na atenção primária. Conclusão: A falta de literatura sobre a temática impõe reflexões sobre a atuação do enfermeiro na atenção primária, uma vez que essa assistência existe e não está registrada nas literaturas, bem como a garantia dos princípios da atenção primária em relação aos cuidados das gestantes usuárias do Sistema Único de Saúde