bluuebunny/crossref_metadata_2025 huggingface dataset:
The Developmental Timing Regulatorhbl-1Modulates the Dauer Formation Decision inCaenorhabditis elegans
Authors: Karp Xantha , Ambros Victor
Published: October 2010

Animals developing in the wild encounter a range of environmental conditions, and so developmental mechanisms have evolved that can accommodate different environmental contingencies. Harsh environmental conditions cause Caenorhabditis elegans larvae to arrest as stress-resistant “dauer” larvae after the second larval stage (L2), thereby indefinitely postponing L3 cell fates. HBL-1 is a key transcriptional regulator of L2 vs. L3 cell fate. Through the analysis of genetic interactions between mutations of hbl-1 and of genes encoding regulators of dauer larva formation, we find that hbl-1 can also modulate the dauer formation decision in a complex manner. We propose that dynamic interactions between genes that regulate stage-specific cell fate decisions and those that regulate dauer formation promote the robustness of developmental outcomes to changing environmental conditions.
Acute pancreatitis caused by hypertriglyceridemia
Authors: Baranyai Tamás , Terzin Viktória , Vajda Ágota , Wittmann Tibor , Czakó László
Published: October 2010

Az akut pancreatitist az esetek 1–7%-ában hypertriglyceridaemia okozza.Célkitűzés:A szerzők vizsgálatának célja az volt, hogy meghatározzák a Szegedi Tudományegyetem belgyógyászati klinikáin a hypertriglyceridaemia okozta akut pancreatitis előfordulását, klinikai sajátosságait és kezelését.Módszerek:2007. január 1. és 2009. december 31. között az I. és a II. Sz. Belgyógyászati Klinikán előforduló hypertriglyceridaemia okozta akut pancreatitis miatt kezelt eseteket vizsgálták. Olyan betegeket választottak be, akiknek szérumtriglicerid-szintje a felvételkor 11,3 mmol/l-nél (≈1000 mg/dl) magasabb, vagy a tejszerű szérum miatt meghatározhatatlan volt. Az egyéb etiológiájú akut pancreatitis miatt kezelt betegeket a tanulmányból kizárták.Eredmények:Huszonhat beteg esetében [2 nő, 24 férfi; átlagéletkor: 42 év (22–70)] igazolódott hypertriglyceridaemia okozta akut pancreatitis. Három betegnek voltak recidívái, összesen 7 alkalommal. Az összes akut pancreatitis 4,71%-a volt hypertriglyceridaemia-eredetű. Az esetek 30,3%-ában a hypertriglyceridaemia mellett diétahiba is szerepelt az anamnézisben. A betegek 57,6%-a fogyasztott rendszeresen alkoholt. A betegek 38,1%-ának volt diabetes mellitusa, 9,1%-ának pedig epeköve. Az esetek 27,3%-ában tejszerű volt a betegek széruma felvételkor. Az átlagos trigliceridszint 47,24 mmol/l (≈4181 mg/dl; 12,4–103,8 mmol/l) volt. A szérumamiláz-, illetve -lipázszint csak a betegek 54,5, illetve 58,8%-ában volt magasabb, mint a normálérték háromszorosa. Hét betegben (26,9%) volt nekrotizáló típusú a pancreatitis, 8 betegben (30,7%) pseudocysta alakult ki. Inzulin, heparin, plazmaferézis és fibrát hatására a trigliceridszint az intézeti kezelés alatt 3,71 mmol/l-re (≈328 mg/dl) mérséklődött.Következtetések:A hypertriglyceridaemia okozta akut pancreatitis klinikai lefolyása nem különbözik az egyéb etiológiájú akut pancreatitistől. A szérumamiláz és -lipáz az esetek jelentős részében nem vagy csak minimálisan emelkedett. Heparin, inzulin, fibrát és plazmaferézis alkalmazása sikeresen csökkenti a szérumtriglicerid-szintet, javítja a klinikai képet. A recidíva megelőzéséhez elengedhetetlen a szérumtriglicerid-szint alacsony szinten tartása. Orv. Hetil., 2010,45,1869–1874.
Family planning in Hungary: past and present
Authors: Erős Erika , Hajós Anett
Published: October 2010

A perikoncepcionális gondozás 3 hónappal a tervezett terhességet megelőzően kezdődik és a 3. terhességi hónapig tart. A célja, hogy a veleszületett rendellenességek és a koraszülés kockázatát csökkentse. Jelenleg a fejlett országokban a csecsemőhalandóság 20–25%-áért a veleszületett rendellenességek felelősek és a vezető halálokok közé tartoznak. Jellemző rájuk, hogy defekt állapotot képviselnek, s a teljes gyógyulás ritkán érhető el. Ezért az elsődleges megelőzés jelentheti az egészségügyi ellátás számára az egyetlen optimális megoldást. Az elmúlt 25 évben számos vizsgálat igazolta a perikoncepcionális időszakban alkalmazott folsavszupplementáció hatékonyságát a veleszületett rendellenességek – főleg az idegcső-záródási rendellenesség – terén. A családtervezési szolgáltatás Magyarországon 1984 óta működik. Ez a modell optimális lehetőség a perikoncepcionális folsav/multivitamin szupplementáció bevezetésére, így eredményes eljárást biztosít veleszületett rendellenességek megelőzésére. Orv. Hetil,45,1858–1862.
Mumps meningoencephalitis: an epidemiological approach
Authors: Leboreiro-Fernandez Alfredo , Moura-Ribeiro Maria Valeriana L , Leboreiro Ivone Elisabete Ferreira , Sawan Fahim Miguel , Ventura Alessandra Ribeiro , Barbosa Kellen Cristina Kamimura
Published: October 2010

The aim of this study was to analyse distribution of meningoencefalitis caused by mumps viras in children related to sex, age and seasonal influences. Thirty seven children were evaluated, ages ranging from 2 to 14 years. They were seen at Emergency Unit of Faculdade de Medicina do Triângulo Mineiro and at Hospital da Criança, in Uberaba-MG, Brazil, from March 1st 1991 to February 1st 1993 and they were hospitalized for about 5 days. Through a protocol findings were studied during hospitalization and clinical course stressing epidemiology, symptomatology, cerebrospinal fluid studies, electroencephalogram and cortical function analysis. Only epidemiological data were considered in the present study. Data analysis revealed male predominance, at a range from 5 to 9 years and great number of occurrences at the last quarter of the year.
Middle cerebral artery revascularization: anatomical studies and considerations on the anastomosis site
Authors: Meneses Murilo S. , Ramina Ricardo , Jackowski Andrea P. , Pedrozo Ari A. , Pacheco Robertson B. , Tsubouchi Mário H.
Published: October 2010

In the surgical management of skull base lesions and vascular diseases such as giant aneurysms, involvement of the internal carotid artery may require the resection or the occlusion of the vessel. The anastomosis of the external carotid artery and the middle cerebral artery with venous graft may be indicated to re-establish the blood flow. To determine the best suture site in the middle cerebral artery, an anatomical study was carried out. Fourteen cerebral hemispheres were analysed after the injection of red latex into the internal carotid artery. The superior and inferior trunk of the main division of the middle cerebral artery have more than 2 mm of diameter. They are superficial allowing an anastomosis using a venous graft. The superior trunk has a disadvantage, it gives rise to branches for the precentral and post-central giri. The anastomosis with the inferior trunk presents lower risk of neurological deficit even though the angular artery originates from it.
Alterações clínicas e laboratoriais anteriores ao desenvolvimento do delirium tremens
Authors: Borini Paulo , Silva Cleuza Olivatto da
Published: October 2010

Duzentos e trinta pacientes alcoolistas crônicos do sexo masculino internados em hospital psiquiátrico para tratamento do alcoolismo foram examinados clínica e laboratorialmente dentro das primeiras 24 horas da internação. Treze pacientes que desenvolveram delirium tremens (DT) após a internação (grupo I) constituem a casuística deste estudo que visa avaliar a ocorrência de alterações clínicas, hematológicas, bioquímicas hepáticas e eletrolíticas que antecedem ao aparecimento das manifestações do DT. Para análises comparativas foram estudados dois grupos de 26 pacientes cada um, constituídos de pacientes que não entraram em DT na internação atual mas com história pregressa de DT (grupo II) e pacientes aleatoriamente arrolados - amostra aleatória simples obtida empregando tabela de números aleatórios fornecida por computador - que nunca entraram em DT (grupo III). Os pacientes do grupo I apresentavam média de idade significativamente mais baixa e fisicamente encontravam-se em pior estado geral que os do grupo III. As frequências de taxas elevadas de aminotransferases e de hipomagnesemia foram significativamente maiores nos grupos I e II que no grupo III. Os valores plasmáticos médios das aminotransferases, especialmente da aspartato-aminotransferase, estavam significativamente mais elevados nos grupos I e II que no grupo III.
Normatização de um teste computadorizado de atenção visual: (TAVIS)
Authors: Duchesne Mônica , Mattos Paulo
Published: October 2010

Os autores apresentam os dados normativos de um teste computadorizado de atenção visual (TAVIS) para crianças e adolescentes, que representa o primeiro instrumento neuropsicológico deste tipo projetado e desenvolvido no Brasil. Três tarefas diferentes avaliam os apectos de seletividade, alternância e sustentação da atenção. Erros de omissão e ação, bem como o tempo de reação, são avaliados. São comentadas as vantagens e limitações do teste.
Astrocitomas do cerebelo na infância: experiência em 25 casos
Authors: Cabral Nilton Domingos , Ciquini Jr. Orildo , Matushita Hamilton , Neves Valdir Delmiro , Plese José Píndaro Pereira
Published: October 2010

É relatada a experiência do Serviço de Neurocirurgia do Hospital das Clínicas da FMUSP com o tratamento neurocirurgia) de 25 crianças com astrocytoma do cerebelo no período de 1982 a 1994. São analisados incidência, quadro clínico, localização, forma de apresentação, anatomia patológica, recidivas e tratamento. A série incluiu crianças até 10 anos com pico de incidência (7 casos ) aos 7 anos. Os sintomas iniciais mais frequentes foram: cefaléia, vômitos e distúrbios da marcha. Não houve mortalidade cirúrgica. Os autores concluem que a ressecção cirúrgica radical é a melhor forma de tratamento para estes tumores e que a radioterapia somente está indicada para tumores histologicamente malignos.
Características dos pacientes com traumatismo craniencefálico atendidos no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto
Authors: Colli Benedicto Oscar , Sato Takassu , Oliveira Ricardo Santos de , Sassoli Valéria Paula , Cibantos Filho Jubert Sanches , Manço Amábile Rodrigues Xavier , Carlotti Junior Carlos Gilberto
Published: October 2010

Foram analisados os prontuários de 3468 pacientes com traumatismo craniencefálico (TCE) atendidos no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HC-FMRP) no período de 1990 a 1992, objetivando estabelecer seu perfil. Os pacientes do sexo masculino predominaram. As causas mais frequentes de TCE foram quedas acidentais em crianças e acidentes de trânsito em adultos. A distribuição circadiana do atendimento mostrou um pico entre 20 e 24 horas e a distribuição semanal mostrou um afluxo constante de segunda a quinta-feira e um aumento progressivo no sábado e no domingo. A maioria dos pacientes (74,5%) apresentou TCE leve (escore igual ou superior a 13 na Escala de Coma de Glasgow). Os sinais e sintomas mais comuns foram cefáléia nas crianças e vômitos, cefaléia e alcoolismo agudo nos adultos. Na alta hospitalar 87,2% dos pacientes apresentavam-se assintomáticos. A mortalidade foi de 5,7%. As peculiaridades do TCE na região são discutidas em relação à literatura.
Possível intermediação do sistema imune na polineuropatia periférica plúmbica: relato de caso
Authors: Dias-Tosta Elza , Alves Adriana , Calmon Miriam , Colombo Luiz C.
Published: October 2010

Relata-se o caso de paciente de 25 anos com ferimento por arma de fogo na articulação coxo-femural esquerda que desenvolveu, entre outros sinais de intoxicação plúmbica, polineuropatia periférica axonal predominantemente motora. Tratado inicialmente com corticosteróides em doses imunossupressoras obteve melhora, mas apresentava recidiva a cada tentativa de retirada da medicação. Demonstrados laboratorialmente níveis séricos tóxicos de chumbo, foi submetido à quelação com EDTA e à retirada cirúrgica do projétil, com boa recuperação da polineuropatia, sem necessidade ulterior de corticosteróides. Enfatiza-se: 1) o possível papel do sistema imune na fisiopatogenia da intoxicação por chumbo, podendo ser um dos motivos das diferentes apresentações clínicas das neuropatias plúmbicas na infância e no adulto; 2) a importância da retirada do material plúmbeo quando alojado em articulações.
Aspectos clínicos e Neurorradiológicos do pseudo-hipoparatireoidismo: relato de caso
Authors: Rocha Cristiane , Gonfinetti Nelson Vinícius , Pellucci Loraine Albiero
Published: October 2010

Os autores relatam o caso de um paciente do sexo masculino, de 18 anos, com baixa estatura, epilepsia e deficiência mental, além de calcificações dos gânglios da base. Os achados clínicos e laboratoriais sugeriram pseudo-hipoparatireoidismo. Trata-se de patologia rara, de base genética, secundária a resistência periférica ao hormônio da paratireóide e que evolui com excitabilidade neuromuscular, baixa estatura e calcificações dos gânglios da base, entre outros achados. São discutidas as formas diagnosticas e a terapêutica empregada, seguidas de breve revisão da literatura sobre calcificação dos gânglios da base.
ON the pathogenesis of headache following TIA
Authors: André Charles , Vincent Maurice B.
Published: October 2010

Twelve out of 49 patients with single or multiple transient ischemic attacks (TIAs) had TIA-related headaches, mostly in close temporal relation to the ischemic onset. Headache predominated in patients taking vasodilators when TIA occurred or with orthostatic hypotension at the first clinical examination, but arterial hypertension or a personal history of migraine were not more frequent in patients with headache. The site of the pain did not correlate with the presumed territory of cerebral ischemia. Pain during TIA is conceivably due to an interaction between cerebral vessels and the surrounding nervous system. Blood vessels have a sturdy physiological role corcerning blood flow regulation, with receptors and signaling molecules potentialy involved with pain production. Reflex mechanisms should justify pain in other areas.
The predictive value of cerebrospinal fluid tap-test in normal pressure hydrocephalus
Authors: Damasceno Benito P. , Carelli Edmur F. , Honorato Donizeti C. , Facure Jose J.
Published: October 2010

Eighteen patients (mean age of 66.5 years) with normal pressure hydrocephalus (NPH) underwent a ventriculo-peritoneal shunt surgery. Prior to operation a cerebrospinal fluid tap-test (CSF-TT) was performed with measurements of gait pattern and psychometric functions (memory, visuo-motor speed and visuo-constructive skills) before and after the removal of 50 ml CSFby lumbar puncture (LP). Fifteen patients improved and 3 were unchanged after surgery. Short duration of disease, gait disturbance preceding mental deterioration, wide temporal horns and small sulci on CT-scan were associated with good outcome after shunting. There was a good correlation between the results of CSF-TT and shunt surgery (X² = 4,11 ,phi = 0.48, p < 0.05), with gait test showing highest correlation (r = 0.99, p = 0.01). In conclusion, this version of CSF-TT proved to be an effective test to predict improvement after shunting in patients with NPH.
From the foot-mouth reflex to the hand-mouth reflex a continuum of responses to Appendicular Compression
Authors: Pedroso Fleming S. , Rotta Newra T.
Published: October 2010

We studied the mouth opening response to appendicular compression in two groups of children. This study was performed with the intention of testing the semiologic role of the act of mouth opening following stimulation of various regions, based on the hand mouth reflex of Babkin. Group I was formed by 33 normal children who underwent monthly follow up assessments since birth; and group II consisted of 50 children older than 6 months of age, known to have a neurologic deficit and a neuro-psychomotor development equivalent to that of a child in the first trimester of life. We observed that the normal mouth opening response in group I was more pronounced following compression of the hand and forearm when compared to compression of the arm (p<0.001). This response could persist for as long as the first 6 months of life. We were not able to elicit a mouth opening response following compression of the lower limb in this group. Among children from group II, we observed mouth opening responses to stimulation of all limb segments. Within the upper limb, the response was more pronounced following compression of the hand in comparison to the forearm (p<0.01), and forearm in comparison to the proximal arm (p<0.01). Stimulation of the foot was more effective in eliciting a mouth opening response when compared to equivalent stimulation of the lower leg (p<0.05). However, there was no statistical difference when responses to stimulation of the lower leg and thigh were compared. The presence of the previously unreported foot-mouth response may serve as an indicator of central nervous system compromise and could be associated with a poorer prognosis. We believe that our observations of the specific foot-mouth response patterns may serve as a marker of early neuro-psychomotor development dysfunction during childhood.
Alterations of cell-mediated immune response in children with febrile seizures
Authors: Montelli Terezinha C.B. , Soares Angela M.V.C. , Parise-Fortes Maria R. , Rezkallah-Iwasso Maria T. , Padula Niura M.R. , Peraçoli Maria Terezinha S.
Published: October 2010

The aim of the present investigation was to study the distribution of T-cell subsets in peripheral blood defined by monoclonal antibodies and by the lymphocyte proliferative response to phytohemagglutinin (PH A) in 30 children with febrile seizures and in 14 age-matched control subjects. Frequent respiratory, urinary and dermatologic infections were observed in 22 patients. The immunologic parameters showed that 64% of the patients presented an increased number of CD8+ cells and a low helper/suppressor ratio was observed in 60% of the patients. In addition, the proliferative response of lymphocytes to PHA was impaired in the patients. It was observed the presence of inhibitory activity on lymphocyte function in the plasma of 33% of children with febrile seizures. These results suggest that patients with febrile seizures have an impairment of cellular immunity that may be connected with this epileptic syndrome and explain the infections observed.
Detection of metabolic disorders in high-risk patients: a pilot study in Salvador, Bahia
Authors: Pereira Maria Betânia , Conceição Gildásio Carvalho da , Coelho Janice C. , Wajner Moacir , Giugliani Roberto
Published: October 2010

The purpose of this pilot-study was to evaluate the applicability of a screening protocol for the detection of inborn errors of metabolism (IEM) in high-risk patients. The protocol was applied in 65 patients referred to the Medical Genetics Laboratory of the University Hospital Professor Edgard Santos due to the suspicion of an IEM. Eight of these patients (12.3%) displayed an abnormal result in the screening protocol. These patients, along with 22 who displayed normal results in the screening protocol but who presented clinical symptoms or signs suggestive of an IEM not detectable by the tests applied, were selected for a further diagnostic investigation. In 5 of these 30 patients (7.7% of the total sample) it was possible to establish the diagnosis of an specific IEM. The results indicate that the designed screening protocol was sucessfully applied, allowing the detection of affected patients in a frequency comparable to that observed in larger studies performed elsewhere. The continuation of this study and the enlargement of the sample will help to delineate the profile of IEM in northeast of Brazil and will allow the identification of a significative number of patients and families, who could benefit from the therapeutic and preventive measures available for these diseases.
Atividade fásica do sono rem em recém-nascidos e lactentes e sua relação com episódios de apnéia
Authors: Nunes Magda Lahorgue , Costa Jaderson Costa da , Taufer Letícia
Published: October 2010

A hipótese de que a apnéia pudesse ser o evento final da síndrome da morte súbita da infância (SMSI) deu origem a vários estudos avaliando as características deste evento do ponto de vista polissonográfico. Foi sugerido que a atividade fásica do sono REM estaria associada a ativação dos neurônios respiratórios prevenindo a ocorrência de apnéias prolongadas e protegendo os lactentes de evoluírem para SMSI. Em estudo prévio retrospectivo com recém-nascidos não confirmamos estes achados mas muitos destes bebês apresentavam comprometimento neurológico severo. O objetivo do presente estudo é verificar a relação existente entre períodos de atividade fásica do sono REM (movimentos oculares rápidos e movimentos de sucção) e apnéia. Estudamos do ponto de vista clínico c polissonográfico 86 recém-nascidos c lactentes encaminhados para avaliação por terem apresentado apnéia ou episódios com aparente risco de vida durante o sono. Dividimos os pacientes em 3 grupos: recém-nascidos (idade concepcional inferior a 44 semanas, n=31), lactentes com 1 -6 meses (n=48) e lactentes com >6m<12 meses (n=7). Todos foram submetidos a avaliação clínica e neurológica para detectar possíveis fatores etiológicos das apnéias. As polissonografias constavam de EEG, eletromiograma submentoniano, eletro-oculograma e monitorização cardiorrespiratória, todas com duração de 2 a 3 horas. Durante 5 minutos contínuos de sono REM verificamos a incidência de atividade fásica relacionada a períodos em apnéia e comparamos sua incidência em períodos semelhantes sem apnéia. Nossos resultados mostraram que a atividade fásica do sono REM ocorre com maior freqüência em períodos sem apnéia. No período neonatal os movimentos de sucção (p < 0.05) e nos lactentes com 1-6 meses os movimentos oculares rápidos (p=0,001). Não houve diferença estatisticamente significativa nos lactentes >6<12 meses. Nossos resultados mostram que a atividade fásica do sono REM é mais frequente cm períodos sem apnéia durante os 6 primeiros meses de vida, período que coincide com o maior risco de SMSI. Sugerimos que o "driving" excitatório que determina o aparecimento da atividade fásica possa ter efeito protetor contra apnéias através do bloqueio ou atenuação da inibição tônica do centro respiratório que determinaria a apnéia. Estudos futuros são necessários para avaliar a relação entre perda desse "mecanismo de proteção"e SMSI.
Caracterização etiológica e clínica das neurites ópticas infecciosas
Authors: Lana-Peixoto Marco Aurélio , Pereira Fabiano M. , Veloso Evaldo D.
Published: October 2010

As neurites ópticas infecciosas (NOI) foram estudadas em relação aos aspectos etiológicos, epidemiológicos e clínicos, com o intuito de detectar características que possam diferencia-las das neurites ópticas desmielinizantes (NOD), que apresentam nítida tendência para conversão em esclerose múltipla. Entre 105 casos de NOI, 51 não apresentavam qualquer evidência de envolvimento da coróide ou retina e poderiam ser confundidos com NOD. Envolvimento bilateral foi encontrado em 23 pacientes (45,1%), sendo simultâneo em 18 (78,3%) casos. A relação entre sexos foi 2M: IF. As idades variaram ente 1 a 82 anos, com mediana de 34,8 anos. Um terço dos pacientes tinha idades até 20 anos, e em um terço dos pacientes as idades eram igual ou maior que 50 anos. Sífilis foi encontrada em 19 pacientes sendo a causa mais comum das NOI, enquanto infecções virais diversas foram responsabilizadas em 41,2%. A acuidade visual foi gravemente afetada na maioria dos casos, sendo pior que 20/200 em 57,3% dos olhos acometidos. Distúrbios da visão cromática foram encontrados em 91,8%, enquanto o exame do campo visual revelou anormalidades em 92,6% dos olhos, predominando os defeitos centrais (40,7%). O disco óptico estava anormal em 90,5% dos olhos examinados, sendo atrofia óptica o principal achado fundoscópico. O presente estudo demonstra que a maior tendência a bilateralidade e simultaneidade das NOI, sua maior prevalência no sexo masculino, na infância e em adultos após os 50 anos de idade, assim como a maior severidade do comprometimento das funções visuais diferem substancialmente das características relatadas nas NOD. O conhecimento destas diferenças pode auxiliar na diferente abordagem terapêutica e prognostica das duas distintas condições.
Edema pulmonar neurogênico: relato de dois casos
Authors: Dragosavac Desanka , Falcão Antônio L. E. , Araújo Sebastião , Terzi Renato G. G.
Published: October 2010

O edema pulmonar neurogênico é rara e grave complicação de pacientes com traumatismo craniencefálico (TCE). Pode ocorrer também em outras patologias do sistema nervoso central, tais como acidentes vasculares cerebrais (AVC), tumores ou após crises epilépticas, entre outras. Foram avaliados 36 casos com TCE grave e quatro pacientes com AVC, internados na UTI geral, no período de janeiro a setembro 1995. Nesse intervalo de tempo foram diagnosticados dois casos de edema pulmonar neurogênico, um ocorrendo em paciente com TCE grave e outro em paciente com AVC hemorrágico. O diagnóstico foi estabelecido pelo rápido desenvolvimento de edema pulmonar, com hipoxemia grave, queda da complacência pulmonar e infiltrados difusos bilaterais sem história prévia de aspiração traqueal ou outro fator de risco para o desenvolvimento de síndrome de angústia respiratória aguda. No primeiro paciente com trauma craniencefálico, o edema neurogênico foi diagnosticado na internação, uma hora após o trauma, com concomitante reação inflamatória grave e boa evolução em três dias. O outro caso, com AVC hemorrágico, desenvolveu edema neurogênico no quarto dia após drenagem de hematoma intraparenquimatoso, evoluindo para o óbito.
Síndrome de Angelman: causa frequentemente não reconhecida de deficiência mental e epilepsia. relato de caso
Authors: Fridman Cintia , Kok Fernando , Diament Aron , Koiffmann Célia P.
Published: October 2010

Os autores descrevem um caso típico de síndrome de Angelman. A paciente apresenta atraso de desenvolvimento neuropsicomotor, deficiência mental, macrostomia, dentes espaçados, convulsões, ausência de fala, andar com a base alargada e instável, crises de risos. Os estudos citogenéticos e moleculares revelaram deleção do segmento 15q11ql3 de origem materna, confirmando o diagnóstico clínico de síndrome de Angelman.
Evolução do comportamento auditivo após meningite bacteriana: relato de caso
Authors: Lichtig Ida , Couto Maria Inês Vieira , Monteiro Silvia Roberta Gesteira , Casella Erasmo Barbante , Okay Yassahuko , Navarro Jessy
Published: October 2010

A deficiência auditiva adquirida tem nas meningites bacterianas a sua principal etiologia e pouco tem-se dito a respeito da evolução para melhora ou piora do comportamento auditivo após a alta hospitalar. O presente estudo descreve o caso de um menino que teve meningite por Haemophilus influenzae aos 5 meses de vida e que entre outras complicações apresentou diminuição da acuidade auditiva detectada na evolução imediata, com melhora significativa posteriormente, confirmada por testes qualitativos e quantitativos. Discute-se a importância e a necessidade do seguimento fonoaudiológico de tais indivíduos para estabelecer orientação adequada.
Applying a new version of the Brazilian-Portuguese UPSIT smell test in Brazil
Authors: Silveira-Moriyama Laura , Azevedo Adriana M.S , Ranvaud Ronald , Barbosa Egberto R , Doty Richard L , Lees Andrew J
Published: October 2010

Standardized olfactory tests are now available to quantitatively assess disorders of olfaction. A Brazilian-Portuguese version of the University of Pennsylvania Smell Identification Test (UPSIT) is currently being developed specifically for the Brazilian population. The most recent Brazilian-Portuguese version of the UPSIT (UPSIT-Br2) was administered to 88 Brazilian subjects who had no history of neurological or otorhinolaryngological disease. UPSIT-Br2 scores decreased with age, were lower in men than in women, and were lower in subjects with lower income. The degree to which the poorer performance of subjects with lower socio-economic status reflects lack of familiarity with test items is not known. Although this version of the UPSIT provides a sensitive and useful test of smell function for the Brazilian population, a revision of some test items is needed to achieve comparable norms to those found using the North American UPSIT in the United States.
Association between the SLC6A3 A1343G polymorphism and schizophrenia
Authors: Cordeiro Quirino , Siqueira-Roberto Jacqueline , Vallada Homero
Published: October 2010

Epidemiological studies have demonstrated that the genetic component is an important risk factor for the development of schizophrenia. The genes that codify the different compounds of the dopaminergic system have created interest for molecular investigations in patients with schizophrenia because the antipsychotic drugs, especially those of first generation, act on this cerebral system. Thus the aim of the present study was to investigate the possible association between a new single nucleotide polymorphism (rs6347) located in exon 9 of the protein transporter (SLC6A3) and schizophrenia. The distribution of the alleles and genotypes of the studied polymorphism was investigated in a sample of 235 patients and 834 controls matched by gender and age. There were statistical differences in the allelic (χ2=5.97, 1d.f. , p=0.01, OR=1.33-1.05<OR<1.69) and genotypic (χ2=6.56, 2d.f. , p=0.03) distributions between patients and controls. Thus the SLC6A3 A1343G polymorphism was associated to the SCZ phenotype in the investigated sample.
Prevalence of epilepsy in a case series of multiple sclerosis patients
Authors: Viveiros Cynthia Dumas , Alvarenga Regina Maria Papais
Published: October 2010

OBJECTIVE: The prevalence of epilepsy in multiple sclerosis (MS) patients has been a subject of interest for some years. The objectives of this study were to describe the clinical, radiological and electroencephalographic characteristics of epileptic seizures and to calculate the prevalence of epilepsy in a case series of MS patients. METHOD: Medical charts of MS patients were reviewed and patients who had suffered epileptic seizures were identified. RESULTS: Of 160 cases analyzed, 5 had suffered epileptic seizures and one had comorbid mesial hippocampal sclerosis, confirmed by magnetic resonance imaging in a patient with complex partial seizures that began fifteen years prior to her diagnosis of MS. In the other four patients, seizures occurred both during the acute phase of the disease and in the chronic phase. CONCLUSION: The prevalence of epileptic seizures in MS patients in this study was 2.5%, similar to that found in other studies.
Emotional declarative memory assessment of patients with mesial temporal lobe epilepsy and patients submitted to mesial temporal lobectomy
Authors: Machado Lara De Vecchi , Frank Jean Edith , Tomaz Carlos
Published: October 2010

Epileptic seizures generate cognitive and behavioral impacts in individuals who suffer from epilepsy. Declarative memory is one of the cognitive functions that can be affected by epileptic seizures. The main objective of this work was to investigate neurocognitive function, especially the emotional working memory of patients with unilateral mesial temporal lobe epilepsy, and that of patients submitted to unilateral mesial temporal lobectomy. A face recognition test that can simultaneously recruit the frontal lobe (working memory) and mesial temporal lobe (emotional memory) was used to investigate emotional working memory. Our findings showed that the epilepsy factor significantly compromised the performance in the emotional memory test. On the other hand, surgical removal of the epileptic focus promoted an improvement in the emotional working memory of these patients, in addition to the significantly decrease in the number of seizures.
Bronchopulmonary dysplasia as a predictor factor for motor alteration at 6 months corrected age in premature infants
Authors: Martins Priscila Silveira , Mello Rosane Reis de , Silva Kátia Silveira da
Published: October 2010

OBJECTIVE: The study aimed to assess bronchopulmonary dysplasia (BPD) as a predisposing factor for alteration in the psychomotor development index (PDI) in premature infants and verify the incidence of neuromotor alterations at 6 months corrected age. METHOD: This was a prospective cohort study that followed the neuromotor development of 152 very low birth weight premature infants, with psychomotor development index as the outcome. The study used the Bayley Scale of Infant Development at 6 months corrected age, and neurological examination. RESULTS: Incidence of BPD was 13.2% (n=20). Logistic regression analysis showed an association between BPD and altered psychomotor development index (OR 3.98; 95%CI: 1.04-15.1) after adjusting for confounding variables. Neurological examination was altered in 67.1% of the 152 infants. CONCLUSION: Bronchopulmonary dysplasia acted as an independent predisposing factor for alteration in the psychomotor development index in premature infants at 6 months corrected age.
Prognostic factors predicting a fatal outcome in HIV-negative children with neurotuberculosis
Authors: Rodrigues Murilo Gimenes , Lin Jaime , Masruha Marcelo Rodrigues , Vilanova Luiz Celso Pereira , Minett Thais Soares Cianciarullo
Published: October 2010

OBJECTIVE: To identify prognostic factors predicting a fatal outcome in HIV-negative children with neurotuberculosis based on clinical, epidemiological, and laboratory findings. METHOD: The clinical records of all in-patients diagnosed with neurotuberculosis from 1982 to 2005 were evaluated retrospectively. The following prognostic parameters were examined: gender, age, close contact with a tuberculosis-infected individual, vaccination for bacillus Calmette-Guérin, purified protein derivative (PPD) of tuberculin results, concomitant miliary tuberculosis, seizures, CSF results, and hydrocephalus. RESULTS: One hundred forty-one patients diagnosed with neurotuberculosis were included. Seventeen percent of the cases resulted in death. The factors that were correlated with a negative outcome included lack of contact with a tuberculosis-infected individual, negative PPD reaction, coma, and longer hospitalisation time. A multiple logistic regression analysis was performed to identify which of these factors most often resulted in death. CONCLUSION: Coma at diagnosis, lack of tuberculosis contact, and a non-reactive PPD were the most important predictors of fatality in patients with neurotuberculosis
Endovascular therapy for selected (most non-surgical) intracranial aneurysms in a Brazilian University Hospital
Authors: Abud Daniel G , Nakiri Guilherme S , Abud Thiago G , Carlotti Jr Carlos G , Colli Benedicto O , Santos Antonio C
Published: October 2010

OBJECTIVE: The objective of this study was to evaluate technical, clinical and angiographic results of a nonsurgical series of intracranial aneurysms treated by endovascular approach at Hospital das Clínicas of Medical School of Ribeirão Preto - University of São Paulo. METHOD: Between August 2005 and November 2008, 137 aneurysms in 106 patients were endovascularly treated. Of these, 101 were unruptured in 75 patients and 36 aneurysms in 31 patients were treated during the acute phase. The data were prospectively studied. RESULTS: Sixty three aneurysms (46%) were treated with coils alone, 52 (38%) with balloon remodeling, 15 (10.9%) with stent remodeling, and 7 (5.1%) with therapeutic occlusion of the internal carotid artery. Six clinical complications (5.7%) were related to the procedures, 3 (2.8%) transitory and 3 (2.8%) permanent. Angiographic follow-up was available for 97 aneurysms (70.8%), clinical monitoring for 77 patients (72.6%) and telephone contact for 97 (91.5%). CONCLUSION: The technical, clinical and angiographic results found in this study are similar to those reported in the literature
Microsurgical clipping in forty patients with unruptured anterior cerebral circulation aneurysms: an investigation into cognitive outcome
Authors: Pereira-Filho Arthur A , Pereira Adriana G , Faria Mário B , Lima Leonardo C.S , Portuguez Mirna W , Kraemer Jorge L
Published: October 2010

OBJECTIVE: It is a consensus that most unruptured intracranial aneurysms (UIA) can be treated with acceptably low morbidity. However, some studies recently reported postoperative cognitive impairment, suggesting that it could be attributable to surgical damage. Our goal is to evaluate cognitive function before and after microsurgical clipping in patients with UIA. METHOD: A consecutive series of 40 patients who underwent microsurgical clipping for UIA were studied. The cognitive assessment (Mini Mental State Examination, MMSE) was performed immediately before and at least one month after surgery. Paired Student's "t" test and analysis of variance (ANOVA) were used for statistical purposes. RESULTS: The mean MMSE score in the preoperative analysis was 28.12 (SD, 1.34). In the postoperative period the mean MMSE score was 28.40 (SD, 1.46). Paired Student's "t" test was applied to the scores and no significant difference was found (p=0.315). ANOVA did not find independent associations between MMSE scores and age, hypertension, smoking, dyslipidemia, education, aneurysm location, number, laterality or size. CONCLUSION: The present study suggests that microsurgical clipping for UIA does not result in major cognitive dysfunction as determined by the MMSE
Brain sweet brain: importance of sugars for the cerebral microenvironment and tumor development
Authors: Quirico-Santos Thereza , Fonseca Clovis O , Lagrota-Candido Jussara
Published: October 2010

The extracellular matrix (ECM) in the brain tissue is a complex network of glycoproteins and proteoglycans that fills the intercellular space serving as scaffolding to provide structural framework for the tissue and regulate the behavior of cells via specific receptors - integrins. There is enormous structural diversity among proteoglycans due to variation in the core protein, the number of glycosaminoglycans chains, the extent and position of sulfation. The lectican family of proteoglycans interacts with growth factors, hyaluronan and tenascin forming a complex structure that regulates neuronal plasticity and ion homeostasis around highly active neurons. In this review, we will discuss the latest insights into the roles of brain glycoproteins as modulators of cell adhesion, migration, neurite outgrowth and glial tumor invasion.
Hitler's hysterical blindness: fact or fiction?
Authors: Maranhão-Filho Péricles , Silva Carlos Eduardo da Rocha e
Published: October 2010

This article deals with a little known episode that occurred near the end of the Great War in a military reserve hospital located in the small town of Pasewalk, part of the distant region of Pomerania in northern Poland. The story is centered around the transient visual loss of a 29-year-old Austrian messenger of the 16th Bavarian Infantry Regiment. His name: Adolf Hitler.
Frequency of hepatitis B immunity and occupational exposures to body fluids among brazilian medical students at a public university
Authors: Oliveira Luiz Carlos Marques de , Pontes João Paulo Jordão
Published: October 2010

In the present study the frequencies of immunity against hepatitis B (HB) and of potentially contaminating accidents among medical students of a Brazilian public university were evaluated. Of all the 400 students who should have been immunized, 303 (75.7%), 66.3% of whom were women, answered an anonymous, self-administered questionnaire. Serum anti-HBs were determined in 205 of them and titers > 10 UI/L were considered to be protective. A total of 86.8% of students had received three doses of HB vaccine. The frequency of immunity among women (96.4%) was higher (p = 0.04) than that among men (87.7%). Among those who did not have immunity, 12/13 (92.3%) had been vaccinated before entering medical school. Only 11% of the students with complete vaccination had previously verified serological response to the vaccine. A total of 23.6% reported having been somehow exposed to blood or secretions. Among final-year students, this frequency was 45.0%, being similar among men (47.8%) and women (43.2%). Of all these accidents, 57.7% were due to body fluids coming in contact with mucosa and 42.3% due to cut and puncture accidents. The results from this study show that: 1) the frequency of immunity against HB is high among the evaluated medical students, although verification of response to vaccination is not a concern for them; 2) anti-HBs titers should be verified after complete vaccination and on a regular basis, especially by men; and 3) the frequency of potentially contaminating accidents is high.
Hyponatremia in visceral leishmaniasis
Authors: Verde Frederico A. Lima , Verde Francisco A.A. Lima , Veronese Francisco José V. , S. Neto Augusto , Fuc Galdino , Verde Emir M. Lima
Published: October 2010

There are few reports linking hyponatremia and visceral leishmaniasis (kala-azar). This is a study of 55 consecutive kala-azar patients and 20 normal individuals as a control group. Hyponatremia and serum hypo-osmolality were detected in 100% of kala-azar patients. High first morning urine osmolality (750.0 ± 52.0 vs. 894.5 ± 30.0mOsm/kg H2O, p < 0.05), and high 24-hour urine osmolality (426.0 ± 167.0 vs. 514.6 ± 132.0 mOsm/kg H2O, p < 0.05) demonstrated persistent antidiuretic hormone secretion. Urinary sodium was high (82.3 ± 44.2 vs.110.3 ± 34.7 mEq/L, p < 0.05). Low seric uric acid occurred in 61.8% of patients and increased fractional urinary uric acid excretion was detected in 74.5% of them. Increased glomerular filtration rate was present in 25.4% of patients. There was no evidence of extracellular volume depletion. Normal plasma ADH levels were observed in kala-azar patients. No endocrine or renal dysfunction was detected. It is possible that most hyponatremic kala-azar patients present the syndrome of inappropriate antidiuretic hormone secretion.
Canine visceral leishmaniasis due to Leishmania (L.) infantum chagasi in Amazonian Brazil: comparison of the parasite density from the skin, lymph node and visceral tissues between symptomatic and asymptomatic, seropositive dogs
Authors: Lima Luciana Vieira R. , Carneiro Liliane Almeida , Campos Marliane Batista , Chagas Eujênia Janis , Laurenti Márcia D. , Corbett Carlos E.P. , Lainson Ralph , Silveira Fernando Tobias
Published: October 2010

Canine visceral leishmaniasis (CVL) is recognizable by characteristic signs of disease and is highly lethal. The infection, however, may be quite inapparent in some seropositive dogs, and this has raised the polemic question as to whether or not such animals can be a source of infection for Lutzomyia longipalpis, the vector of American visceral leishmaniasis (AVL). In this study we have examined 51 dogs with acute CVL from an AVL area in Pará State, northern Brazil, and compared the parasite density, amastigotes of Leishmania (L.) infantum chagasi, in the skin, lymph node and viscera of symptomatic with that of nine asymptomatic but seropositive dogs (IFAT-IgG). Post-mortem biopsy fragments of these tissues were processed by immunohistochemistry, using a polyclonal antibody against Leishmania sp. The X² and Mann Whitney tests were used to evaluate the means of infected macrophage density (p < 0.05). There was no difference (p > 0.05) in the skin (10.7/mm² x 15.5/mm²) and lymph node (6.3/mm² x 8.3/mm²), between asymptomatic and symptomatic dogs, respectively. It was higher (p < 0.05), however, in the viscera of symptomatic (5.3/mm²) than it was in asymptomatic (1.4/mm²) dogs. These results strongly suggest that asymptomatic or symptomatic L. (L.) i. chagasi-infected dogs can serve as a source of infection, principally considering the highest (p < 0.05) parasite density from skin (10.7/mm² x 15.5/mm²), the place where the vetor L. longipalpis takes its blood meal, compared with those from lymph node (6.3/mm² x 8.3/mm²) and viscera (1.4/mm²x 5.3/mm²).
Susceptibility and morbidity between male and female Swiss mice infected with Angiostrongylus costaricensis: Susceptibilidade e morbidade entre camundongos Swiss machos e fêmeas infectados com Angiostrongylus costaricensis
Authors: Mentz Márcia B. , Dallegrave Eliane , Graeff-Teixeira Carlos
Published: October 2010

The gender of vertebrate hosts may affect the outcome of parasitic infections. An experimental murine infection with Angiostrongylus costaricensis was followed with determinations of body weight, fecal larval elimination, number and length of adult worms, number of macroscopic intestinal lesions, and mortality. Groups of male and female Swiss mice were infected with 10 3rd-stage A. costaricensis larvae per animal. The results indicate there are no significant differences related to gender of the host, except for higher length of worms developed in male mice.
Epidemiological investigation of an acute case of Chagas disease in an area of active transmission in Peruvian Amazon region
Authors: Cabrera Rufino , Vega Silvia , Cáceres Abraham G. , Ramal A. César , Álvarez Carlos , Ladera Pedro , Pinedo Raul , Chuquipiondo Gladys
Published: October 2010

The study objective was to investigate an acute case of Chagas disease in the San Pedro de Shishita community, Pebas District, in the Peruvian Amazon basin, a non-endemic area. Both parents of the index case (acute case) were thoroughly interviewed, a seroepidemiological survey was carried out in the community, parasitological exams were carried out only in relatives of the index case, and triatomine bugs were searched for inside houses, peridomiciliary, and in wild environments. Seroprevalence for IgG anti-T. cruzi antibodies was 1/104 (0.96%), using an ELISA test and an indirect immunofluorescence assay. Panstrongylus geniculatus and Rhodnius pictipes adults were found. The index case is autochthonous from San Pedro de Shishita, but the source of transmission is unknown.
Rupioid histoplasmosis: first case reported in an AIDS patient in Argentina
Authors: Corti Marcelo , Villafañe María F. , Palmieri Omar , Negroni Ricardo
Published: October 2010

Disseminated histoplasmosis is a relatively common AIDS-defining illness, occurring in almost 4% of patients living in endemic areas and it may be the first clinical expression of the HIV infection. A broad spectrum of clinical skin lesions associated with Histoplasma capsulatum infection have been described in AIDS patients, such as erythematous macules, papules, nodules, and pustules. Herpetic, acneiform, erythema multiforme-like, molluscum contagiosum-like, vasculitic, and exfoliative forms have also been reported. To our knowledge, this is the first case of disseminated histoplasmosis in an AIDS patient presented as a rupioid eruption.
Tuberculose bovina no Estado da Paraíba: estudo retrospectivo
Authors: Figueiredo Salomão M. , Rocha Vivianne C.M. , Higino Severino S.S. , Batista Carolina S.A. , Alves Clebert J. , Clementino Inácio J. , Azevedo Sérgio S.
Published: October 2010

O objetivo do presente trabalho foi determinar a frequência de propriedades positivas (focos) e de animais positivos para a tuberculose bovina no Estado da Paraíba. Foram utilizados dados da Agência de Defesa Agropecuária do Estado, coletados de suas 23 microrregiões, durante o período de janeiro de 2008 a julho de 2009. Durante esse período, foram examinadas 10.963 propriedades e 54.472 bovinos foram submetidos ao teste de tuberculinização. Para o diagnóstico foi utilizada, como prova de triagem, a tuberculinização cervical simples para gado de leite e a tuberculinização na prega caudal para gado de corte; como prova confirmatória foi utilizada a tuberculinização cervical comparativa. Uma propriedade foi considerada foco quando apresentou pelo menos um animal soropositivo. Das propriedades investigadas, 62 (0,57%) apresentaram pelo menos um animal positivo e dos animais analisados, 136 (0,25%) foram positivos. Houve diferença significativa (p<0,001) na proporção de fêmeas (0,32%) e machos (0,04%) positivos. A despeito da baixa freqüência de focos de brucelose e de animais soropositivos, é necessária a condução de medidas que incluem a conscientização dos produtores, fiscalização nas barreiras sanitárias e levantamentos periódicos da situação epidemiológica desta doença, principalmente nas microrregiões com maior frequência da infecção, com o objetivo de evitar, ou pelo menos minimizar, a disseminação do agente.