Cerebrospinal fluid in the diagnosis of spinal schistosomiasis

Cerebrospinal fluid (CSF) changes in spinal shistosomiasis have been described. Its characteristic features are mild to moderate pleocytosis, presence of eosinophils, slight to moderate protein increase, elevated gamma globulin concentration and a positive immune assay. Nevertheless, these abnormalities are not always present together and therefore difficulties may arise in the assessment of the diagnosis. The purpose of this paper is to evaluate the importance of each CSF alteration concerning the diagnosis in 22 cases of spinal shistosomiasis. According to the results, only 20% of the cases had all the five feature that are considered to be characteristic of spinal shistomiasis. Abnormal cell count was present in 86%, protein increase in 77.3%, immunoglobulin G increase in 60,8%, eosinophils were present in 36.8% and indirect fluorescent antibody test was positive in 68.2%. In three cases all CSF parameters studied were within the normal limits. As the most specific test among those described was the indirect fluorescent antibody test, it should be regarded for the diagnosis.As três espécies de esquistossoma podem comprometer o sistema nervoso. O S. mansoni é responsável pela esquistossomose no Brasil, sendo a mielopatia uma forma grave desta helmintose. O propósito deste trabalho é analisar as alterações do líquido cefalorraquidiano (LCR) para dar mais subsídios para o diagnóstico da esquistossomose raquimedular. Fizeram parte deste estudo 22 amostras de LCR de pacientes com esquistossomose espinal. Os resultados das análises destas amostras mostraram que a associação de alterações do LCR com quadro inflamatório e RIFI-IgM positiva ocorreu em 88% dos pacientes, que o eosinófilo esteve presente em apenas 7 amostras (36,8%), e que 3 dos 22 pacientes estudados apresentaram LCR normal. Conclui-se que o exame de LCR é coadjuvante muito útil para o diagnóstico da neuroesquistossomose.Universidade Estadual de Londrina Centro de Ciências da SaúdeUniversidade Federal de São Paulo (UNIFESP)Universidade de São Paulo Faculdade de Ciências Farmacêuticas Departamento de Análises ClínicasUNIFESPSciEL

Avaliação do desempenho dos testes functional reach e lateral reach em amostra populacional brasileira Assessment of performance in the functional reach and lateral reach tests in a Brazilian population sample

OBJETIVOS: O objetivo deste estudo foi avaliar os padrões de desempenho dos testes Functional Reach e Lateral Reach em uma amostra de indivíduos saudáveis de 20 a 87 anos e verificar a influência do gênero, idade, estatura do indivíduo, peso corporal, comprimentos do braço e do pé. MÉTODO: foi realizado um estudo observacional transversal com 98 pessoas de ambos os gêneros, que residiam na capital e interior de São Paulo. Os voluntários tiveram suas medidas descritivas registradas e posteriormente foram submetidos aos testes Functional Reach e Lateral Reach. RESULTADOS: Para o FR, todas as variáveis tiveram influência, exceto o comprimento do braço (p=0,057), o peso corporal (p=0,746) e a base de suporte usada no momento da avaliação (p=0,384). As variáveis que exerceram maior influência foram o gênero (p=0,001), a idade (p<0,001) e a estatura (p=0,004) do indivíduo. Esta análise mostrou que as mulheres têm um alcance funcional anterior e lateral menor que os homens. Houve uma correlação positiva substancial (r=0,696) entre os valores encontrados no LR à esquerda e à direita. Já o FR teve uma correlação positiva moderada de 0,405 com o LR à esquerda e de 0,614 à direita, sendo então, considerada positiva substancial. Para o LR, as variáveis estatura, peso, comprimentos do braço e do pé não foram significantes na sua determinação. CONCLUSÕES: O padrão de medidas dos testes FR e LR utilizados pela literatura internacional não podem ser os mesmos para os brasileiros. As principais medidas que influenciam os testes são a idade, o gênero e a estatura.<br>OBJECTIVE: To assess the performance in the functional reach test (FR) and lateral reach test (LR) among a sample of healthy individuals aged 20 to 87 years and to verify the influence of gender, age, height, body weight, arm length and foot length. METHOD: A cross-sectional observational study was conducted on 98 people of both genders living in the city of São Paulo and other places in the State of São Paulo. The volunteers were measured and then underwent FR and LR. RESULTS: All the variables had an influence on FR, except arm length (p=0.057), body weight (p=0.746) and the support base used at the time of assessment (p=0.384). The variables exerting greatest influence were the individual's gender (p=0.001), age (p<0.001) and height (p=0.004). This analysis showed that women had less anterior and lateral functional reach than men. There was a substantial positive correlation (r=0.696) between the left and right LR findings. FR had a moderate positive correlation of 0.405 with the left LR and a substantial positive correlation of 0.614 with the right LR. For LR, the height, weight, foot length and arm length variables were not significant determinants. CONCLUSION: The measurement patterns for FR and LR that are used in the international literature may not be the same for Brazilians. The main measurements that influence the tests are age, gender and height

Glycosaminoglycan levels and proteoglycan expression are altered in the hippocampus of patients with mesial temporal lobe epilepsy

Extracellular matrix proteoglycans (PGs) and glycosaminoglycans (GAGs) play a crucial role in cell differentiation and synaptogenesis by modulating neurite outgrowth. the chondroitin sulfate (CS)-rich PG, the receptor protein tyrosine phosphatase zeta/beta (RPTP zeta/beta), has been related to neural morphogenesis and axon guidance. Hippocampal sclerosis is the most frequent pathologic finding in patients with intractable mesial temporal lobe epilepsy (MTLE), which is associated with neuron loss, reactive gliosis, and mossy fiber sprouting. in the present study, we investigated the concentration of CS, heparan sulfate (HS) and hyaluronic acid (HA) in the hippocampus and temporal neocortex as well as RPTPzeta/beta expression in the hippocampus of patients with MTLE. Compared to autopsy control tissue, epileptic hippocampi showed a significantly increased concentration of CS (224%; p=0.0109) and HA (146%; p=0.039). HS was instead similar to control values. No differences were found in the concentration of CS, HS, or HA in the temporal neocortex of epileptic patients when compared to control values. in contrast, RPTPzeta/beta immunoreactivity was induced in astrocytes of the inner molecular layer of the dentate gyrus of the sclerotic hippocampus. Because matrix compounds have been associated with tissue injury and repair, the present findings suggest that changes in PGs and GAGs might be related to damage-induced gliosis and neuronal reorganization in the hippocampus of WILE patients. (C) 2002 Elsevier Science Inc. All rights reserved.UNIFESP, EPM, Dept Neurol, São Paulo, BrazilUNIFESP, EPM, Dept Biochem, São Paulo, BrazilBrigadeiro Hosp, São Paulo, BrazilFMRPUSP, São Paulo, BrazilUNIFESP, EPM, Dept Neurol, São Paulo, BrazilUNIFESP, EPM, Dept Biochem, São Paulo, BrazilWeb of Scienc

Aspectos eletromiográficos preditores da evolução motora de pacientes com neuroesquistossomose Electromyografic patterns predictive of motor evolution in neuroschistosomiasis

A neuroesquistossomose na forma mielorradicular é freqüentemente observada nos pacientes que residem no Nordeste do Brasil. Apesar disso, a evolução dos seus distúrbios neurológicos e padrões eletromiográficos são pouco estudados nesse grupo de pacientes. O objetivo deste estudo foi descrever e comparar a evolução motora com as anormalidades eletromiográficas de pacientes com neuroesquistossomose. Foram realizadas eletromiografias dos membros inferiores em 21 pacientes com diagnóstico presuntivo de radiculomielite esquistossomótica. O padrão eletromiográfico de 95,2% dos casos foi de multirradiculopatia axonal lombo-sacra, havendo extensão variável de desnervação, com predomínio de L2 a S2. Foram identificados graus variáveis de paraparesia, havendo evolução motora mais favorável nos pacientes com envolvimento de menor número de raízes. A eletromiografia poderá fornecer dados prognósticos da evolução motora dos pacientes com radiculomielite esquistossomótica.<br>Neuroschistosomiasis in myeloradicular pattern is frequently observed in patients from Northeast of Brazil. Despite of this, the evolution of neurologic and electromyografic patterns is not well studied in this group of patients. The aims of this study were to describe and compare the clinic and electromyografic abnormalities of patients with neuroschistosomiasis and radicular involvement. We analyzed 21 electromyographic exams of the lower limbs carried out in the initial presentation of the disease. Electromyographic pattern of 95.2% of patients was compatible to axonal lombosacral multirradiculopathy, with variable denervation extension, but predominanthy from levels L2 to S2. There was variable degree of deficit in the lower limbs, and the follow-up of motor disturbances was better more frequently when the roots were involved in smaller number. Electromyography should permit to know the motor prognosis of patients with myeloradiculitis due schistosomiasis