bluuebunny/crossref_metadata_2025 huggingface dataset:
Fahr’s Syndrome: A Case Report
Authors: Monteiro Ana Karoline da Costa , Marcelino Paulo Filho Soares , Andrade Marcello Holanda de , Nascimento Rairis Barbosa , Araújo Marx Lincoln Lima de Barros , Silva Samuel Pinheiro da
Published: December 2021

Context: Fahr’s syndrome is a clinical entity of primary or secondary causes characterized by neurological and/or psychiatric symptoms associated with abnormal calcifications in basal ganglia, cerebellum and cerebral cortex. Case report: G.M.A, female, 49 years-old, presented athetosis in the distal extremity of the right upper limb (RUL) in December 2020, without seeking for medical help. Known to be diabetic, hypertensive and with diastolic heart failure (HF), in February 2021 she presented decompensated HF associated with worsening of involuntary movements in the RUL. During investigation, abnormalities in serum levels of parathormone (PTH) and calcium were observed, in addition to bilateral calcifications in basal ganglia and thalamus in brain computed tomography (CT) without contrast. In March 2021, she was admitted to the University Hospital of the Federal University of Piauí, with maintenance of athetosis at the distal extremity of the RUL, in addition to oromandibular dyskinesia. Laboratory profile compatible with primary hypoparathyroidism and new brain CT without contrast with calcifications in basal ganglia and pulvinar of the thalamus, bilaterally, were confirmed. Intravenous calcium replacement and use of calcitriol were performed, with partial clinical improvement. Conclusions: Fahr’s syndrome is characterized by the presence of movement disorders (with highlights for parkinsonism and athetosis) and psychiatric symptoms (depression most commonly). Possible etiologies are primary (genetic) and secondary (mainly idiopathic or secondary hypoparathyroidism). Classic finding of symmetrical calcifications in base nuclei is seen on brain CT. Treatment is symptomatic and control of the underlying disease.
L-dopa: main drug induced dyskinesia
Authors: Farah Pedro Felisberto Nogueira Viana , Souza Felipe dos Santos , Costa Felipe Oliveira , Santos Mariana Bastos Rodrigues dos , Barbosa Yasmim Evelyn Lisboa
Published: December 2021

Introduction: 3,4-dihydroxy-L-phenylalanine (L-dopa) is the gold standard drug for the treatment of Parkinson’s disease (PD). This disease causes degeneration of dopaminergic cells, L-dopa supplies the lack of dopamine, being effective in its treatment. The average time for the onset of this hyperkinetic disorder is usually 6.5 years and the young age at the beginning of the disease. This pathology may present with chorea, dystonia, myoclonus and stereotypes. Diskinesia-inducing L-dopa (LID) remains one of the most challenging unmet needs in the treatment of PD and other neurodegenerative diseases. Methodology: This is an integrative review, using the MedLine, Cochrane and PubMed databases with the descriptors “drug induced”, “dyskinesia” and “L- dopa”. Articles published in the last 10 years; in English; clinical trial articles and original articles were included. Results: The prevalence for the development of LID was 50% for those who started PD at 40-59 years of age, compared to 16% at 70 years of age. The incidence of LID is about 90% after 9 years, but the main cause is related to the dose of levodopa and the duration of the disease. The risk factors for the development of LID are modifiable (levoodopa dose and body weight) and non- modifiable (age, sex, duration, progress and severity of the disease). Conclusion: With this, it can be concluded that doctors who deal with PD need to be aware of the risk factors for LID and know how to manage it.
Hospitalization and deaths from ischemic and hemorrhagic stroke in adults in Brazil in the last 10 years
Authors: Raskin Ana Pudles , Faccio Carolina Bohn
Published: December 2021

Background: The cerebrovascular accident (CVA) is an obstruction or rupture of brain irrigating vessels, causing reduction of the tecidual oxigenation, which may result in after-effects and death. Objectives: To analyze the number of hospitalizations and deaths from ischemic and hemorrhagic CVA in Brazil in the last decade. Design and setting: Transversal descriptive epidemiological study based in Brazil. Methods: Study based on DATASUS data, from February 2011 to February 2021. Results: Brazil registered 417.950 hospitalizations, of which 19.493 occurred in the North region, 86.626 in the North East, 205.356 in the Southeast, 85.201 in the South and 21.274 in the Midwest. The 60 to 79 age registered 213.255 hospitalizations; the 40 to 59, 99.993; the 80 or more, 88.184; and the 20 to 39, 16.518. The male gender registered 216.454 hospitalizations; the female, 201.496. The deaths registered 64.552, of which 3.111 happened in the North region, 13.483 in the North East, 33.455 in the Southeast, 11.119 in the South and 3.384 in the Midwest. The 80 above age range represented 19.803 deaths; the 60 to 79, 18.339; the 40 to 59, 11.867; and the 20 to 39, 1.543. The male gender registered 32.336 cases; the female, 32.216. Conclusions: Brazil had an anual average of 41.795 hospitalizations and 6.455,2 deaths due to stroke in last decade. The South region showed the highest incidence of hospitalizations (0,28%), while the North had the lowest (0,10%). The lethality of the disease was similar in all regions (15%), except for the South, with a 13% lethality.
Evaluation of procedures for treating polyneuropathy in the state of São Paulo for 13 years
Authors: Hernandes Júnior Paulo Roberto , Rosa Juliana de Souza , Lopes Patrick de Abreu Cunha , Silva Bárbara Tisse da , Silva Heloá Santos Faria da , Gomes Tiago Veiga , Innocencio Giovanna de Camargo , Feitosa Jhoney Francieis
Published: December 2021

Background: Polyneuropathy is the simultaneous dysfunction of several peripheral nerves that normally occurs as a result of diabetes. Objectives: To analyze the current panorama of treatment of polyneuropathies performed in the State of São Paulo and to correlate with the epidemiology. Methods: literature review and observational, descriptive and transversal data collect on treatment of polyneuropathies, available at DATASUS from January 2008 to December 2020, assessing the number of hospitalizations, the amount of public spending, complexity, mortality rate, deaths, permanence and character of service, and articles available in Scielo, Lilacs and PubMed. Results: There were 19,099 hospitalizations for polyneuropathy treatment procedures with a total expense of R$ 21,870,767.84, with 2014 being the year with the highest number of hospitalizations (1,740) and with the highest amount spent (R$ 2,034,880.25) . Of the total procedures, 3,732 were carried out on an elective basis and 15,362 in urgency, with 5,774 in the public sector and 6,396 in the private sector. All 19,099 considered to be of medium complexity. The total mortality rate was 1.63, corresponding to 312 deaths, with 2020 being the year with the highest mortality rate, 2.42, while 2014 had the lowest rate, 1.26. The mortality rate for elective procedures was 0.38 compared to 1.94 for urgent procedures, whereas in the public sector it was 1.25 compared to 1.77 for the private sector. The average total hospital stay was 9.3 days, with an average cost of R$ 1,145.13. Conclusion: Polyneuropathy is a disease that has a low mortality rate.
Use of metoclopramide associated with the risk of developing extrapyramidal symptoms: a literature review
Authors: Botton Daniela Videira , Moraes Daisi Sanches , Mendes Rafaela Tavares , Mourão Letícia Pereira , Malfará Wilson Roberto
Published: December 2021

Background: Parkinsonism is an extrapyramidal syndrome characterized by the presence of tremor, akinesia and stiffness. Metoclopramide is a substance with antiemetic properties, and the mechanism of action is an antagonism of the dopamine D2 receptor. Thus, it presents adverse effects, such as dyskinesia, dystonia, hypertonia and tremor. Accordingly, studies associate the use of metoclopramide with an increased risk of developing extrapyramidal effects. Objectives: The aimed is describe the association between the use of metoclopramide and the risk of developing extrapyramidal symptoms. Methods: A literature review was carried out based on articles from the PubMed database, totaling 10 articles. The keywords used for the selection of articles were: metoclopramide, extrapyramidal and parkinsonism. Results: A case study noted that the use of metoclopramide leads to a dopamine deficiency, which may be involved in the etiology of parkinsonism, as a patient already diagnosed with Parkinson’s disease developed an exacerbation after using metoclopramide. Another study showed that the use of metoclopramide in the elderly population was considered a risk factor for adverse effects such as involuntary movements. A cohort study described a positive association between the use of oral metoclopramide and an increased risk of developing parkinsonism, considered as an important side effect in high-exposure, older users and with other morbidities. Conclusions: Therefore, it was evident that an association between metoclopramide and the development of extrapyramidal symptoms is strongly indicated by the studies analyzed, which suggests caution in the prescription of this pharmacological class.
Serological screening for syphilis in non-compressive spinal injuries
Authors: Pires Bianca Frigo , Hamamoto Osmi
Published: December 2021

Background: Syphilis is an infectious disease that can present systemic symptoms during its progression, reaching the central nervous system, causing neurosyphilis, combined include involvement of the meninges and spinal cord. Objectives: to review information on meningomyelitis in patients with positive syphilis serology, assessing the need for serological screening for syphilis knowledge and the importance of the clinician for an accurate diagnosis, preventing major sequelae or fatalities Methods: We analyzed 14 clinical cases of syphilitic myelitis from January 2000 to January 2021. Documents were resolved to determine clinical issues, apparent symptoms, radiological findings, penal treatment and complications. Results: 85.7% suffered from chronic myelopathy and 14.3% revealed subacute transverse myelitis. The most common clinical condition of chronic myelopathy was tabes dorsalis, present in 50%, afterwards it was syphilitic meningomyelite, present in 33.3%. Conclusion: Syphilitic myelitis is a rare condition, but there are studies that prove an increase in cases of myelopathy in patients with positive syphilis serology. The condition manifests itself with weakness of the lower limbs, sensory disturbance and urinary and fecal incontinence, in addition to long spinal cord injuries and abnormal enhancement, predominantly in the superficial parts of the spinal cord, in imaging exams. There is a differential diagnosis with multiple pathologies, such as intramedullary tumors, herniated intervertebral disc, myelopathy caused by HIV, among others. Therefore, it is important to know the signs and symptoms and an approach to serological screening for syphilis in patients with neurological disorders and non-compressive medical injuries.
Conservative treatment of rachimedular trauma: a state epidemiological analysis
Authors: Hernandes Júnior Paulo Roberto , Rosa Juliana de Souza , Lopes Patrick de Abreu Cunha , Silva Bárbara Tisse da , Silva Heloá Santos Faria da , Gomes Tiago Veiga , Hautequestt Gabriella Ferreira
Published: December 2021

Background: Spinal cord injury is a major cause of mortality worldwide and is highly relevant in the context of neurological emergencies. Objectives: To analyze the current panorama of conservative treatment procedures for spinal trauma performed in the State of São Paulo and to correlate the current epidemiology with the results obtained. Methods: Literature review and observational, descriptive and transversal data collect on treatment for spinal trauma, available at DATASUS from January 2008 to December 2020 and articles available in Scielo, Lilacs and PubMed. Results: There were 11,402 hospitalizations for the performance of conservative treatment procedures for spinal trauma with a total expenditure of R$ 13,422,685.10, with 2013 being the year with the highest number of hospitalizations (1,031) and the highest amount spent during the period (R$ 1,216. 410.34). 234 procedures were performed on an elective basis and 8,129 on an urgent basis, with 2,921 occurring in the public sector and 4,215 in the private sector. All 11,402 considered highly complex. The total mortality rate was 4.99 (569 deaths), with 2017 being the year with the highest mortality rate, 5.95, while 2011 had the lowest rate, 3.51. The mortality rate for elective procedures was 6.84 compared to 5.19 for urgent procedures, whereas in the public sector it was 5.31 compared to 4.34 for the private sector. The average total hospital stay was 8.8 days, with an average cost of R$ 1,177.22. Conclusion: The conservative treatment of spinal trauma presents a predominance of emergency care, with a low average cost of hospitalization.
Mortality and hospital stay due to stroke in elderly people in Brazil (2008-2019): a time series study
Authors: Leal Thiago Cavalcanti , Souza Carlos Dornels Freire de , Silva Leonardo Feitosa da , Paiva João Paulo Silva de , Santos Lucas Gomes , Santana Gibson Barros de Almeida , Rocha Carlos Alberto de Oliveira , Carmo Rodrigo Feliciano do , Baggio Jussara Almeida de Oliveira , Rodrigues Amanda Karine Barros Ferreira , Matos Thais Silva
Published: December 2021

Background: Stroke is the second leading cause of mortality worldwide, being preceded only by ischemic heart diseases, 85% of these deaths occur in developing countries. Objective: To analyze the temporal behavior of elderly mortality due to stroke in Brazil, regions and federation units from 2008 to 2019. Methods: Ecological study of time series using Brazil, its regions and federation units as units of analysis. The following categories were collected on the DATASUS online platform :, :, i) length of stay, ii) average length of stay (days), iii) number of deaths, and hospital mortality rate from 2008 to 2019 for Brazil, regions and federative units. In the analyzes, the inflection point regression model was used, the 95% confidence interval and the significance level of 5% (joinpoint regression model) were adopted and the annual percentage change (Annual Percent Change - APC) was calculated. and the entire period (Average Annual Percent Change - AAPC). Results: As for Brazil, there was an average of 7.5 days per hospital stay and a hospital mortality rate corresponding to 16.6%. Among the regions, the highest gross numbers were evidenced in the Southeast with 4427093 days of stay, 7.73 days on average of stay and 99753 deaths. A decrease was observed only in the hospital mortality rate in the South (AAPC: -1.3 CI: -1.9 to -0.7), Southeast (AAPC: -1.3 CI: -1.7 to -0.9) and Northeast (AAPC: -0.7 CI: -1.4 to -0.0) and the average hospital stay for the Southeast (AAPC: -0.7 CI: -1.3 to -0.1). Conclusion: There was a heterogeneous behavior of the variables related to the mortality of elderly people due to stroke in Brazil, in parallel to the stationary behavior of the average hospitalization observed in the regions and units of the federation with the exception of the Southeast, which showed a decrease in the average days spent in study period.
Red Ear Syndrome: um relato de caso sobre uma síndrome rara associada a cefaleia
Authors: Borri Juliana Baleki , Silva Junior Hilton Mariano da
Published: December 2021

Context: The Red Ear Syndrome” (RES) is a rare condition characterized by ear hyperemia associated with burning pain. This syndrome is classified into secondary and idiopathic forms, which pathophysiological mechanisms are still unclear. Idiopathic forms occur isolated or associated with primary headaches and secondary forms are associated to cervical disorders. The aim of this study is to report a case of RES related to migraine, the new published cases make this syndrome earn more attention and investigation. Case report: A 31-year-old woman presented with acute pain, edema and marked erythema, occasionally accompanied by hyperhidrosis and local burning. These episodes occurred spontaneously or were induced by triggers. During attacks, cooling was the only means of relief. The patient reported a clear association between RES and some migraine attacks. Extensive laboratory and radiological investigation showed no abnormalities. Conclusions: RES is mainly determined by sudden or induced attacks of burning pain and redness in the ear. Attacks can last from minutes to hours in conjunction with primary headaches. The uncertainty about the etiology of this syndrome is an obstacle to treatment.
Neurocognitive impairment postCOVID-19: a review
Authors: Silva Luciana Maria Campos e , Vieira Suelen Darlane , Baltazar Ana Catarini Lopes , Almeida Ana Luiza Soares Henriques de , Rodrigues Rafael Felipe Silva , Guedes Isabela , Rosa Amanda Mansur , Diniz Maíssa Ferreira
Published: December 2021

Background: COVID-19 is an infectious disease caused by SARS-CoV-2, a neurotropic virus. Although its main manifestations are respiratory, neurological complaints associated with COVID-19 are growing. Important cognitive impairments have been shown during and after the acute illness. Objectives: To review post-COVID-19’s neurocognitive deficits. Design and Setting: Review of the literature. Methods: The PubMed database was used with the descriptors “COVID-19” and “neurocognition”, finding 94 articles. Only articles with participants without previous cognitive or psychiatric disorders were included, 7 review articles and 5 cohort studies being selected. Results: All of the reviewed articles demonstrated cognitive impairment in post-COVID-19 patients, including patients without cognitive complaints. Headache, dysgeusia, diarrhea and use of oxygen during acute COVID were related to lower scores on global cognition tests. Severe Acute Respiratory Syndrome (SARS) was associated with a higher risk of cognitive impairment both at hospital discharge and 1 year after, mainly in working memory, processing speed, executive functions and attention. Post-SARS imaging exams showed atrophy and loss of brain volume. The mechanisms of CNS injury in COVID-19 are not completely understood, but systemic hypoxia, associated with important viremia and the massive release of cytokines, has an important role in a picture of toxic encephalopathy and destruction of nervous tissue. Conclusion: There is evidence of neurocognitive impairments as a result of COVID-19, however studies on the mechanisms of occurrence and severity of deficits are scarce. Further studies are needed to identify predictors and develop prevention strategies.
Creutzfeldt-Jakob Disease - a literature review
Authors: Guelli Mariana Sandoval Terra Campos , Zampier Daniela Bastos de Almeida , Dias Lorena Araújo Silva , Ibrahim Marina de Oliveira Nunes
Published: December 2021

Background: Creutzfeldt-Jakob disease (CJD) is a progressive, rare, fatal and rapid human neurodegenerative disease that occurs in the etiologies: sporadic (CJD), familial, iatrogenic (CJD) and CJD variant (CJV) in which cell prion protein (PrP) can be transmitted through animals. Objectives: Literature review about Creutzfeldt-Jakob diseaseDesign and setting: Literature review development in the Centro Universitário de Volta Redonda, Rio de Janeiro, Brazil. Methods: The Creutzfeldt-Jakob disease, infectious diseases and neuroinfection indexes were used in the PUBMED and Scielo databases. Results:CJD has different etiologies with different clinical and pathological phenotypes. CJDV shows psychiatric behaviors and symptoms followed by abnormalities, ataxia and dementia. The sporadic form is the most common, with a progressive clinical course with generalized brain deposition of abnormal prion protein aggregates (PrPTSE) that leads to spongiform change, gliosis and neuronal loss. CJD progresses to dementia and two or more symptoms: cerebellar or visual impairments; pyramidal or extrapyramidal signs; myoclonus; and akinetic mutism. Complex periods of acute wave in the electroencephalogram (EEG) are strongly suggestive of prionic diseases. Rapidly evolving field neuroimmune disorders have shown an increasing in autoantibody testing; attempt to diagnose a range of immune-mediated conditions. Evidence indicates that diffusion-weighted magnetic resonance imaging (DWI) is more sensitive for detecting signal abnormalities. Conclusion: The disease progresses to dementia, accompanied by myoclonus, pyramidal signs and characteristic EEG. It is a complex pathology, which has only symptomatic treatment and requires strict control of reservoirs and risk of contamination.
Impact of the Covid-19 pandemic on compulsory notifications of meningitis in Brazil
Authors: Rocha Carlos Alberto de Oliveira , Souza Carlos Dornels Freire de , Leal Thiago Cavalcanti , Silva Leonardo Feitosa da , Santos Lucas Gomes , Armstrong Anderson da Costa , Carmo Rodrigo Feliciano do , Paiva João Paulo Silva de , Santana Gibson Barros de Almeida
Published: December 2021

Background: Meningitis is a disease considered endemic in Brazil and is included in the national list of compulsory notification diseases. The presentstudy analyzed the impacts of the pandemic triggered by COVID-19 on compulsory notification of meningitis in Brazil in 2020. Methods: This is an ecological, quantitative and descriptive study. The data were collected from the DATASUS Diseases and Notification Information System (SINAN), referring to the period from 2015 to 2020, from January to August of each year. The variables analyzed were the region / unit of the notification federation and the month of notification, with the information divided into two groups: general population and children under 15 years old. The values were subjected to statisticals analysis of the P-score. Results: In Brazil 10,634 notifications of meningitis were expected in 2020. However, only 4,712 cases were reported. With the exception of Roraima, all states had a negative P- score in the two groups investigated: Rondônia had a greater discrepancy between the observed and expected values (-100%), as no notification records for the year 2020 were found; the P-score of Roraima was positive, with an increase of 22.8% in addition to the predicted notifications. Regarding the regions, the Southeast presented -56.8% of the predicted notifications, the South -55.9%, the Midwest -50.3%, the North -52.5% and the Northeast -54.2 %. Conclusion: The study showed a negative impact on meningitis notifications in Brazil, in all regions and in all states, except in Roraima.
Hemifacial spasm caused by posterior fossa arachnoid cyst: Case Report
Authors: Cordeiro Júlia Coutinho , Henriques José Gilberto de Brito
Published: December 2021

Context: Hemifacial spasm (HFS) is characterized by continuous or intermittent spasmodic movements at the facial nerve motor territory.1,2,3 It mainly affects middle- aged adults and usually occurs by compression of the facial nerve by anomalous vascular loops of the anteroinferior and vertebral cerebellar artery.2,3,4,5 The arachnoid cyst at the cerebellopontine angle (CPA) is an rare cause of HFS, especially in children. Case report: A six-year-old female patient started presenting at 18 months HFS on the right side. She was initially treated with anticonvulsant without improvement. The patient came to our care at the age of six presenting 2-3 HFS per day and remissions lasting 3-4 weeks. Image exams reveled a CPA arachnoid cyst compressing the VII and VIII nerves complex. Surgical drainage of the cyst was performed as the treatment of choice. In postoperative period, the patient presented remission of HFS, and cranial tomography showed a decrease in cyst volume. In three months, there was remission of the signs without use of any medications. Conclusions: There was no report of arachnoid cyst in CPA as a cause of HFS in children. HFS occurs probably by chronic irritation, since birth, because of the contact of arachnoid cyst in the emergence of the VII and VIII nerves complex in the PCA. Therefore, treatment was chosen according to the cause of HFS. Movement disorder as a clinical manifestation of the cyst is rare, especially in pediatric population, and should be considered as one of the diagnostic hypotheses.
The impact of Covid-19 on hospitalizations and deaths due to stroke: a comparison between the regions of Brazil
Authors: Guglielmi Vanessa Saling , Ferrari Gabriela Kreutz , Falcetta Julia Estrazulas , Roehrig Júlia Bortolini , Ribeiro Ana Luiza Savioli , Oliveira René Ochagavia Chagas de , Busin Isabella Montemaggiore , Toffoli Laura , Affonso Ana Laura Terra , Paglioli Victoria Bento Alves , Fassina Vitória , Bernich Natali Rocha , Soares Bruna Martins de , Silva Bianca Brinques da , Redmann Lucas Henrique Skalei , Amorim Antônio Helder Loiola
Published: December 2021

Background: Stroke is the second leading cause of death in the world and in Brazil. During the Corona Virus pandemic, patients may have been neglecting stroke symptoms, inducing a drop in the search for medical assistance. Objectives: Analyze the prevalence of hospitalizations and deaths due to stroke in Brazil during the COVID-19 pandemic compared to the previous year. Design and setting: Transversal, descriptive Epidemiologic study between the years of 2019 and 2020 in Brazil. Methods: Study realized using data from the Department of Information of the Brazilian Health System (DATASUS). Results: There were 163.120 hospitalizations for stroke in the year of 2019, and in the year of 2020 this number had a decrease of approximately 6%. In 2019, Household deaths due to unspecified Cardiovascular Diseases had 85 records. In 2020, there was an increase of 7% in home deaths due to unspecified Cardiovascular Diseases. Conclusion: There is a decrease in notifications of hospitalizations and deaths in Brazil due to unspecified stroke during the year of the pandemic. It is also noticed, during this period, an increase in home deaths due to unspecified Cardiovascular Diseases, of which stroke is a prominent cause. This fact suggests interference of the pandemic in the search for medical care.
Nefroneural syndrome as a result of poisoning by diethylene glycol
Authors: Aleixo Andre Goncalves , Fasciani Julia Silva , Lazaroni Thiago Luiz do Nascimento
Published: December 2021

Introduction: Diethylene glycol is a clear, hygroscopic, odorless and toxic liquid for humans. It is widely available in the industry, being widely used in the production of antifreeze, lubricants, cosmetics and plasticizers. Poisoning by ingesting this substance leads patients to an early neurological syndrome consisting of drunkenness, ataxia and, if severe, seizures and coma. Objectives: To review the central aspects of diethylene glycol intoxication, its toxic dynamics and the development of nephroneural syndrome. Methods: A literature review compiled from searches for articles in the PubMed and Medline databases was performed using the descriptors Dietilenoglicol; Ácido 2-hidroxietoxiacético; Toxicidade Renal; Álcoois tóxicos. Results: After ingestion, diethylene glycol is rapidly absorbed and distributed in the body. Metabolism occurs in the liver and the excretion of both the substance and its metabolite 2-hydroxyethoxyacetic acid (HEAA) is renal. HEAA is primarily responsible for kidney and neurological damage, which result in severe nephroneural syndrome, initially characterized by gastrointestinal changes, such as nausea, vomiting and abdominal pain, followed by metabolic acidosis and emerging kidney injury. After 72 hours of intoxication, damage to the optic nerve, functional deficit of cranial nerves, tetraparesis and peripheral neuropathy can occur, which can lead the patient to death or permanent disability. HEAA causes damage to renal and nerve cells to varying degrees depending on the amount of substance ingested or the susceptibility of the intoxicated patient. Conclusion: Early diagnosis and proper patient management, in addition to good industry practices, are essential for the eradication of this intoxication.
Guillain-barré syndrome (GBS): acute motor axonal neuropathy (AMAN) - case report
Authors: Parca Leonardo Martins , Nasser Ahmad Abdallah Hilal , Fonseca Gabriel Rodrigues Gomes da , Vasconcelos Gabriel Nogueira Noleto , Marques Grazielle de Oliveira , Proença Renato Sarnaglia , Silva Pablo Henrique da Costa
Published: December 2021

Background: GBS is an acute inflammatory polyneuropathy resulting from an immune response after infection. Characterized as an ascetic, progressive, selflimiting flaccid tetraparesis. It has several phenotypic presentations, which one is AMAN. The treatment’s based on use of intravenous immunoglobulin (IGIV) and plasmapheresis (PLEX). Methods: A literature review of the PubMed and UpToDate databases using descriptors “GBS” and “AMAN” between 2014-2020. Objectives: Report a case of GBS, addressing AMAN variant; a literature review with therapeutic and diagnostic possibilities. Case report: DTS, 32y, male, admitted with a picture of flaccid, limp asymmetrical tetraparesis, with an asymmetrical pattern, predominant in lower limbs, without sensory symptoms. Progressive evolution, onset of motor symptoms on the 8th day after self-limited diarrhea. CSF on 3rd day of onset of motor symptoms without dissociation cytological protein - CN: 62 / Ptn: 80.1mg / dl. Repeated CSF on the 10th day with CN: 27 / Ptn: 215 mg / dl. electroneuromyography 16/04: electrophysiological examination shows motor neuropathy of axonal pattern with signs of denervation in activity, findings compatible with axonal neuropathy. IGIV was performed for 5 days, without complications. Results: The diagnosis of GBS is based on CSF clinical criteria and findings on electroneuromyography. AMAN is a phenotypic variant characterized by purely motor and axonal impairment. The therapeutic options proven effectiveness are PLEX, and IGIV. Conclusion: Studies demonstrates that there’s no difference in effectiveness between PLEX and IGIV, the choice of treatment being dependent on socioeconomic and patient-related factors.
The autistic spectrum disorder and its relation to intestinal dysbiosis
Authors: Nogueira Fábio Dias , Alves Ana Klara Rodrigues , Silva Barbara Beatriz Lira da , Alves Ana Kamila Rodrigues , Sousa Marlilia Moura Coelho , Alves Ana Karla Rodrigues , Nery Wanderson da Silva , Almeida Breno Carvalho de , Nogueira Flávia Dias , Véras Leiz Maria Costa
Published: December 2021

Introduction: Autistic Spectrum Disorder (ASD) is characterized by a neurodevelopmental disorder, in which the child has persistent deficits in verbal and / or non-verbal communication, social interaction and behavior. One of the factors related to the cause of ASD are nutritional aspects, such as intestinal dysbiosis. Objective: To analyze the relationship between imbalance in the intestinal microbiota and the pathophysiological characteristics of ASD. Methodology: This is a systematic review, carried out in the Pubmed, SciELO databases, in order to answer the question: what is the relationship between intestinal microbiota imbalance and ASD? 139 articles were found, of which 12 were selected, through the simultaneous crossing between the descriptors “Autistic Disorder”, “Dysbiosis”. Articles written in Portuguese and English published from 2016 to 2021 were inserted. Results/Discussion: Most children with ASD exhibit gastrointestinal symptoms, such as constipation and diarrhea, and greater intestinal permeability, with major differences in the composition of microorganisms in the gastrointestinal tract (GIT). Patients with ASD have a lower microbiota diversity in the GIT. However, it is not possible to identify the origin of this change, since children with ASD often have changes in diet and eating behavior, which could alter the microbiota. Conclusion: It is still complex to understand what are the main causes of ASD. The gut-brain axis is an important associated factor both in the etiology and in the clinical manifestations of ASD. The use of diets, together with the modulation of the microbiota, by the use of probiotics and specific antibiotics, are possibilities for promising therapy.
Rhinocerebral Murcomycosis: Reflection of the World Diabetes Epidemic
Authors: Castro Ruan Matheus Freitas de , Macedo Messias de Lima , Castro Rwanielly Freitas de , Souza Cássia Rozária da Silva , Pereira Leidy Nara Andrade Soares , Melo Willams Costa
Published: December 2021

Introduction: The human body is a structure composed of billions of specialized cells, each activity goes through the control of the Central Nervous System (CNS). Neuroinfections are pathologies that affect the CNS, for example, we have Murcomycosis, a progressive infection caused by opportunistic fungi of the order Mucorales, with high frequency in Immunodepressed patients, Diabetes Mellitus (DM) is the main underlying pathology associated with the development of Rhinocerebral Murcomycosis, which represents 50% of the cases, with a mortality rate of 70% (Sidrim, 2012, p.168). Objective: To highlight the main symptoms associated with Murcomycosis and Diabetes Mellitus. Methodology: Literary review of the Scielo, Shola.google PubMed and library collections, from 2012 to 2021, with the descriptors: Mycosis, Diabetes mellitus and Central Nervous System. Results: It was evidenced that 90% of the diagnosed cases refer to patients with a high degree of immunodepression, mainly due to DM, the main symptoms include unilateral facial pain, headache and fever, frequently resulting in necrosis of the paranasal sinuses. Conclusion: Considering the findings of Murcumicosis associated with DM, it becomes essential to apply informative strategies regarding healthy eating and physical habits, protected by an efficient policy aimed at reducing the incidence of the disease as a basis, the diagnosis of Murcomycosis can be reduced.
Analysis of the epidemiological profile of hospitalizations for Epilepsy in Brazilian regions between 2015 and 2019
Authors: Cruz Davi Santos , Almeida Gabriella Ribeiro de , Vidal Sávio Miranda , Melo Maria Clara Passos , Cruz Mirela de Souza Santa , França Enmilly Oliveira
Published: December 2021

Background: Epilepsy is a chronic neurological disease with the highest incidence in the world, affecting 1.3% of the Brazilian inhabitants. On average, 10% of the world population can be affected by an epileptic seizure. Thus, knowledge of the epidemiology of hospitalizations for epilepsy enables better health planning. Objective: To analyze epidemiology of hospitalizations in Brazil’s regions in 2015-2019. Methods: It is an observational and retrospective study of the descriptive epidemiological profile, using data from the Hospital Information System (SIH/ DATASUS). Variables: year, region, age group, sex and color/race. Results: There were 263,881 hospitalizations from 2015 to 2019 in Brazil. The Southeast region has the highest hospitalization rates between 2015 and 2019, reaching 42.32% of the cases, while the North region has the smallest, adding 5.5% (n = 14,530). In the epidemiological profile of hospitalizations prevails: the male gender, with 57.65% (n = 152,134), surpassing in 36.14% the female gender, with 111,747; the age group of 1-4 years (n = 45,702), exceeding in 378,9% the age group greater than or equal to 80 years (n = 9,543); the brown race, with 36% (n = 94,091), followed by white (34.4%), black (3.8%), yellow (1.2%) and indigenous (0.14%). Conclusion:There was a higher prevalence of hospitalizations for male epilepsy, aged 1-4 years, brown race and in the Southeast region. Therefore, through this study, resolutive actions can be taken in the face of such problems.
Factors associated with activity limitation in new leprosy cases in a hyperendemic municipality in the Northeast, Brazil: a cross-sectional study
Authors: Santana Gibson Barros de Almeida , Leal Thiago Cavalcanti , Silva Leonardo Feitosa da , Santos Lucas Gomes , Armstrong Anderson da Costa , Carmo Rodrigo Feliciano do , Paiva João Paulo Silva de , Matos Thais Silva , Rocha Carlos Alberto de Oliveira , Rodrigues Amanda Karine Barros Ferreira , Souza Carlos Dornels Freire de
Published: December 2021

Background: Leprosy is a neglected, chronic and infectious tropical disease, caused by Mycobacterium leprae. It presents with skin and peripheral nerves alterations, responsible for irreversible physical disabilities. Brazil is one of the main countries endemic for the disease, persisting as a public health problem; its position is the first in the world in terms of prevalence coefficient. Objectives: To analyze the magnitude and factors associated with activity limitation in new leprosy cases diagnosed in the reference center in northeastern Brazil. Methods: This is a cross-sectional study, carried out in a reference center located in the municipality of Juazeiro - Bahia, between January and June 2018, involving 50 people diagnosed with leprosy. Clinical and sociodemographic variables were collected in addition to the application of the SALSA scale (Screening of Activity Limitation and Safety Awareness) for the analysis of functional limitation. The data were structured using Microsoft Excel software and, for analysis, IBM SPSS Statistics for Windows was used. Logistic regression was used with the calculation of the Odds Ratio to identify the factors associated with functional limitation. A 95% confidence interval and a 5% significance level were adopted. Results: The presence of functional limitations was registered in 32% (n = 16) of the cases analyzed, especially female (56.3%), elderly (37.5%), low education (87.6%), dimorphic form (62.5%), multibacillary classification (75.0%) and degree 2 of physical disability (50.0%). Functional limitation was associated with: age group ≥ 45 years (OR 3.80; p = 0.047), multibacillary age (OR 4.28; p = 0.021) and OMP score ≥ 6 (OR 4.69; p = 0.041). 75% of individuals with limitations were aged ≥ 45 years and were multibacillary. Conclusions: The factors associated with functional limitation were age equal to or greater than 45 years, multibacillary classification and OMP score greater than or equal to six. Early diagnosis and timely treatment in the routine of health services can contribute to the prevention of physical disability and functional limitations.
Association of genetic markers with ischemic stroke in pediatric patients with sickle cell anemia
Authors: Machado Vitor Pereira , Bellini Júnior Edis , Gazarini Lucas , Lobo Clarisse , Bonini-Domingos Claudia
Published: December 2021

Introduction: Sickle cell anemia (SCA) is characterized by complex clinical heterogeneity. Amongst them, ischemic stroke (IS) stands out because it affects 8% to 12% of patients up to the age of 20, with a mortality rate of 20% in untreated cases. Objectives: To evaluate the association of SNPs -786T/C NOS3 and C667T MTHFR in the occurrence of IS in SCA pediatric patients undergoing regular blood transfusion. Methods: Ninety SCA pediatric patients 12.1±3.3 years old being followed-up at HEMORIO/RJ, divided into Patients with IS in hypertransfusion (n=20) and Patients without IS not transfused (n=70). Results: IS Group: genotypic frequencies: -786T/C NOS3, 4 (20%) CC, 4 (20%) CT and 22 (60%) TT; C667T MTHFR, 3 (15%) TT, 2 (10%) CT and 15 (75%) CC. Group without IS: genotypic frequencies: -786T/C NOS3, 1 (1.4%) CC, 25 (35.7%) CT and 44 (62.8%) TT; C667T MTHFR, 1 (1.4%) TT, 18 (25.7%) CT and 51 (72.8%) CC. Chisquare test revealed association of SNPs -786T/C NOS3 (p = 0,017) and C667T MTHFR (p = 0,004) with the occurrence of stroke in SCA patients, in which the frequency of homozygous mutants is higher in the IS group than in the control group (-786T/C NOS3 20% vs. 1.4% and C667T MTHFR 15% vs. 1.4%). Conclusions: The polymorphisms evaluated influenced the occurrence of IS in SCA pediatric patients especially when carrying recessive alleles. Studies with larger sample sizes and similar inclusion/exclusion criteria is needed.
Most common arrhytmias in patients with spinal cord injury
Authors: Brandão Gabriel Andreata , Brandão Vinícius Andreata , Rezende Lucas Dalvi Armond , Silva Kelly Eduarda de Jesus , Fiorin Bruno Henrique
Published: December 2021

Introduction: The spinal cord injury is a public heatlh problem, and it can have three different origens: traumatic, compressive and congenital. The consequences are partial or total insufficiency of the spinal cord due to the interruption of motor and sensory nervous tracts. This injury results in clinical manifestations such as: autonomic dysreflexia, conduction disorders and loss of pain and touch sensitivity. Objectives: To describe the main cardiac conduction disorders on patients with spinal cord injury trough the guiding question: “What are the most common arrhytmic disorders in patients with spinal cord injury?” Methods: A integrative review was made in the MEDLINE and LILACS databases combining the MeSH descriptors: ‘Arrhytmias, cardiac” and “Spinal cord injuries”. Furthermore, the inclusion criteria was articles produced in the past ten years that answer the guiding question. Results: After na analysis, 6 out of 15 articles were selected to compound this review. The main disorders founded were tachycardia, sinus node dysfunction, atrial and ventricular fibrillation and bradychardia, the most founded disorder. There was also descripted the possibility for these patients to envolve into a distributive choque. Conclusion: Bradycardia was the main arrhythmic impairment found in patients with spinal cord injury, followed by ventricular and atrial fibrillation and tachycardia, with the severity of bradyarrhythmias being associated with the level and severity of the spinal cord injury
Ramsay Hunt syndrome - a case report
Authors: Gauza Mateus de Miranda , Canello Andréia , Genero Henrique Muller , Mendes Rafael Marques , Longo Maria Francisca Moro , Lino Jordana Dolores Villar
Published: December 2021

Context: Ramsay Hunt syndrome is uncommon, with an incidence of 5 / 100,000 people (1), characterized by the triad of ipsilateral peripheral facial paralysis, otalgia and vesicles in the ear canal and / or auricular pavilion (1,2,3). It results from the reactivation of the Varicella Zoster virus in the geniculate ganglion and may extend to other cranial pairs, causing inflammation, edema and nerve dysfunction (1,3). As the second leading cause of peripheral facial palsy (1), its importance lies in a lower likelihood of recovery with a worse prognosis compared to Bell’s palsy (4). Case report: M.R.S, female, 54 years old, went to the emergency room due to ophthalmological complaints (blurred vision, diplopia, floaters, photophobia), nausea and vomiting, associated with vertigo, headache and facial hypoesthesia on the left. With the worsening of the condition, she was referred to the neurology service of the municipal hospital São José, presenting dysarthria, vesicular lesions in the left external auditory canal, preserved tactile sensitivity, MRC grade V and facial paralysis on the left (House Brackmann grade IV). Lumbar puncture and cerebrospinal fluid analysis were performed to discard other pathologies of the central nervous system. The diagnosis of Ramsay Hunt syndrome was established and treatment with Acyclovir and prednisone was started. After worsening renal function, drug therapy was suspended and venous hydration increased. She continued with improved renal function and was discharged with valacyclovir and corticosteroids. Conclusions: The importance of early diagnosis and treatment is emphasized in order to avoid permanent sequelae of the disease (1,3).
Benefits of using cannabidiol in the treatment of dyskinesias in patients with Parkinson’s
Authors: Silva Thais Ellen de Ramos , Castelhano Diego Rodrigues , Anchieta Cintia , Silva Bruna Kuhn de Freitas
Published: December 2021

Introduction: Parkinson’s disease (PD) is a neurological, chronic, and progressive disease that causes the death of brain cells, especially in the area responsible for the production of dopamine, which, among other functions, controls body movements. The first signs of PD are usually hand tremors, muscle stiffness, pain, dizziness, sleep disturbances, respiratory and urinary systems. In this context, cannabidiol (CBD) has been a source of research to improve institutional motor disorders. Objectives: Compile scientific evidence on the use of cannabidiol to improve dyskinesias in patients with Parkinson’s. Methodology: This is an integrative literature review, through the selection of scientific articles, available in the virtual databases: PubMed, Scielo, and Google academic, published between the years 2018 to 2021. Results: CBD has a positive effect, bradykinesia, tremors, stiffness and psychotic, mood and sleep disorders, quality of life, its adverse effects are observed with low frequency. In addition, there seems to be a beneficial drug interaction between CBD and levodopa (l-DOPA), the drug of choice for the treatment of this disease. The prolonged use of this drug causes a type of dyskinesia, known as DOPA- induced dyskinesias (LIDs). Thus, modulation of the endocannabinoid system through CBD presents itself as a possible promising therapy for the control of PD and LIDs. Conclusion: Studies induced expressive results regarding the use of CBD to treat PD. However, as there is still no consensus, specific studies are carried out to assess the safety of using CBD in patients with long-term PD and its possible beneficial interaction with antiparkinsonian drugs.
Rhodopsin stimulation in neural circuits by neuromodulation in optogenetics: current findings on the use of Deep Brain Stimulation (DBS)
Authors: Souza Felipe dos Santos , Chaves Matheus Furlan , Santos Guilherme da Cunha Messias dos
Published: December 2021

Introduction: Optogenetic neuromodulation describes a contemporary technique of brain modulation that has been increasingly studied, both in the field of genetic engineering and in neuroscience, for the treatment of diseases such as epilepsy, schizophrenia, parkinson and essential tremor. Through it, we seek to alter neurons, making them sensitive to light stimulation. For this, viral vectors are used to insert opsin genes into neural tissue. Objective: to describe the most recent scientific findings related to the use of DBS using Optogenetics techniques. Methodology: use of databases, SCIELO, PUBMED, LILACS and American Association of Neurological Surgeons using the following descriptors: Genetic Engineering. Deep Brain Stimulation. Optogenetics. Rhodopsins. Results: The use and Deep Brain Stimulantion (DBS) or Pronfunda Cerebral Stimulation (ECP) for therapeutic intervention in patients with movement disorders is performed through the insertion of a tungsten wire in specific areas of the central nervous system with the passage of electric current from microampers for milliseconds. However, over time, this causes plasticity, associated with gliosis and loss of DBS effectiveness. In addition, scientific evidence shows that cerebral neuromodulation by optogenetics in patients with dystonia, depression and obsessive compulsive disorder (OCD) is also already a reality with significant and approved results. Conclusions: Optognetics can replace classic DBS for the treatment of several neurological comorbidities with safety and space-time precision, with minimal side effects, when compared with that technique.