Can you hear me now? The quest for better guidance on omega-3 fatty acid consumption to combat hearing loss

Pontifícia Universidade Católica de São Paulo (PUC-SP), Programa de Estudos Pós-Graduado em Fonoaudiologia, São Paulo/SP, BrazilEscola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), Departamento de Fonoaudiologia, São Paulo/SP, BrazilUniversidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Fonoaudiologia, Bauru/SP, BrazilEscola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), Disciplina de Neurociência, São Paulo/SP, BrazilEscola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), Departamento de Fonoaudiologia, São Paulo/SP, BrazilEscola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), Disciplina de Neurociência, São Paulo/SP, BrazilWeb of Scienc

Extrapulmonary onset manifestations of COVID-19

Coronavirus disease (COVID-19) usually starts with pulmonary signs and symptoms. However, in some cases, the initial clinical presentations are extrapulmonary. This literature review aimed at summarizing and discussing the extrapulmonary onset manifestations of COVID-19. The most frequent initial extrapulmonary manifestations include hypogeusia, hyposmia, non-specific abdominal symptoms, corneal congestion, and deep venous thrombosis. Several rarer extrapulmonary manifestations in locations such as the brain, peripheral nerves, muscles, eyes, ears, myocardium, intestines, skin, or vessels have been additionally reported as onset presentations of COVID-19. In conclusion, it is crucial for clinicians and health care providers to consider extrapulmonary presentations at the onset of COVID-19 to avoid overlooking the infection and contributing to the spread of the disease

Dystonia is a Common Phenotypic Feature of MEGDEL Syndrome

This letter was written in response to an article called "Adult-onset generalized dystonia as the main manifestation of MEGDEL syndrome", about a 31-year-old male with 3-methylglutaconic aciduria with deafness, encephalopathy, and Leigh-like (MEGDEL) syndrome due to a compound heterozygote variant in the SERAC1 gene. The article raised a number of comments and concerns, which the authors outline in this lette

Sudden unexpected death in Parkinson’s disease (SUDPAR): a review of publications since the decade of the brain

FAPESP (Fundacao de Amparo a Pesquisa do Estado de Sao Paulo)CNPq (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico)CAPES (Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior)FAPESP/CNPq/MCT (Instituto Nacional de Neurociencia Translacional)Univ Fed Sao Paulo EPM UNIFESP, Escola Paulista Med, Disciplina Neurociencia, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Biblioteca Campus Sao Paulo, Sao Paulo, SP, BrazilPUC SP, Programa Estudos Posgrad Fonoaudiol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo EPM UNIFESP, Escola Paulista Med, Dept Fonoaudiol, Sao Paulo, SP, BrazilKrankenanstalt Rudolfstiftung Wien, Dept Neurol, Vienna, AustriaUniv Fed Sao Paulo EPM UNIFESP, Escola Paulista Med, Dept Neurol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo EPM UNIFESP, Escola Paulista Med, Disciplina Neurociencia, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Biblioteca Campus Sao Paulo, Sao Paulo, SP, BrazilUniv Fed Sao Paulo EPM UNIFESP, Escola Paulista Med, Dept Fonoaudiol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo EPM UNIFESP, Escola Paulista Med, Dept Neurol, Sao Paulo, SP, BrazilWeb of Scienc

Sudden unexpected death in Parkinson's disease: Insights from clinical practice

Classified as the second most common neurodegenerative disorder associated with aging after Alzheimer's disease, Parkinson's disease (PD) is the most common movement disorder. In the last decade, despite advances in treatment, mortality rates linked with PD continued to reach significant figures. Available studies have shown that compared with healthy controls, patients with PD are accompanied by high rates of premature death. This is usually caused by factors such as pneumonia and cerebrovascular and cardiovascular diseases. Recently, it has been demonstrated that a significant proportion of patients with PD die suddenly. This is referred to as a sudden and unexpected death in PD (SUDPAR). Here, we focus on the magnitude of SUDPAR. Finally, it is important to learn more about SUDPAR for the implementation of effective prevention strategies

Sudden unexpected death in Parkinson's disease (SUDPAR): a review of publications since the decade of the brain

FAPESP (Fundacao de Amparo a Pesquisa do Estado de Sao Paulo)CNPq (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico)CAPES (Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior)FAPESP/CNPq/MCT (Instituto Nacional de Neurociencia Translacional)Univ Fed Sao Paulo EPM UNIFESP, Escola Paulista Med, Disciplina Neurociencia, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Biblioteca Campus Sao Paulo, Sao Paulo, SP, BrazilPUC SP, Programa Estudos Posgrad Fonoaudiol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo EPM UNIFESP, Escola Paulista Med, Dept Fonoaudiol, Sao Paulo, SP, BrazilKrankenanstalt Rudolfstiftung Wien, Dept Neurol, Vienna, AustriaUniv Fed Sao Paulo EPM UNIFESP, Escola Paulista Med, Dept Neurol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo EPM UNIFESP, Escola Paulista Med, Disciplina Neurociencia, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Biblioteca Campus Sao Paulo, Sao Paulo, SP, BrazilUniv Fed Sao Paulo EPM UNIFESP, Escola Paulista Med, Dept Fonoaudiol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo EPM UNIFESP, Escola Paulista Med, Dept Neurol, Sao Paulo, SP, BrazilWeb of Scienc

Azathioprine in refractory sprue: results from a prospective, open-label study

OBJECTIVE: Refractory sprue is a rare and severe malabsorptive disorder that mimics celiac disease but is refractory to a gluten-free diet and is without initial evidence of overt lymphoma. Treatment is largely empiric and often ineffective, with steroids and immunosuppression being the mainstream therapeutic options. The aim of this study was to evaluate prospectively the effect of azathioprine on a group of patients diagnosed with refractory sprue. METHODS: We studied seven consecutive patients (five women and two men) with a well-defined diagnosis of refractory sprue and a lack of response to oral or parenteral steroids. At diagnosis, five patients had endoscopic evidence of ulcerative jejunitis, and five underwent exploratory laparotomy for exclusion of malignancies. The characteristic monoclonal TCR gene rearrangement was shown in five of six patients studied. Patients were treated for a mean of 11 months (range 8–12 months), and clinical, biochemical, molecular, and histological parameters were reassessed at the end of the trial. The study was a prospective, open-label, non–placebo-controlled study using azathioprine (2 mg/kg/ day) plus oral prednisone (1 mg/kg/day). A gluten-free diet (n 7) as well as enteral (n 6) and parenteral nutrition (n 5) were administered during the trial. RESULTS: After treatment, five patients had a complete clinical remission, and biochemical and nutritional parameters were significantly improved. Steroids were tapered after the onset of azathioprine, and no patient was on steroids at the end of the trial. Intestinal histology improved significantly in all cases (normal histology in three cases and minor infiltration in the lamina propria in two). Two patients did not respond to treatment at any time and died in months 10 and 9, of an irreversible ventricular fibrillation and sepsis, respectively. No overt lymphoma was demonstrated during the follow-up. CONCLUSIONS: The present study confirms earlier anecdotal reports on the efficacy of azathioprine in refractory sprue, with clear clinical and histological improvement shown in most patients. However, monoclonality persisted after treatment. We consider that a larger number of patients should be evaluated before a definitive recommendation is adopted for use of this drug in refractory sprue.Fil: Maurino, Eduardo. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología "Dr. Carlos B. Udaondo"; Argentina. Universidad del Salvador; ArgentinaFil: Niveloni, Sonia Isabel. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología "Dr. Carlos B. Udaondo"; ArgentinaFil: Cherñavsky, Alejandra Claudia. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín. Laboratorio de Inmunogenética; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; ArgentinaFil: Pedreira, Silvia. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología "Dr. Carlos B. Udaondo"; ArgentinaFil: Mazure, Roberto. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología "Dr. Carlos B. Udaondo"; ArgentinaFil: Vazquez, Daniel Horacio. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología "Dr. Carlos B. Udaondo"; ArgentinaFil: Reyes, Hugo. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología "Dr. Carlos B. Udaondo"; ArgentinaFil: Fiorini, Alcira. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología "Dr. Carlos B. Udaondo"; ArgentinaFil: Smecuol, Edgardo. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología "Dr. Carlos B. Udaondo"; ArgentinaFil: Cabanne, Ana. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología "Dr. Carlos B. Udaondo"; ArgentinaFil: Capucchio, Monica. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín. Laboratorio de Inmunogenética; ArgentinaFil: Kogan, Zulema. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología "Dr. Carlos B. Udaondo"; ArgentinaFil: Bai, Julio C.. Gobierno de la Ciudad de Buenos Aires. Hospital de Gastroenterología "Dr. Carlos B. Udaondo"; Argentina. Universidad del Salvador; Argentin