ABSTRACT
A hemorragia subaracnóidea (HAS) é uma doença grave na qual 10% dos pacientes podem apresentar morte súbita antes mesmode chegar ao hospital. Os pacientes apresentam um risco elevado de complicações secundárias, incluindo o vasoespasmo . Paravasoespasmo o refratário e, essencialmente, para o controle de PIC, a hipotermia pode ser utilizada de forma terapêutica.Nosso objetivo foi avaliar a influência da hipotermia terapêutica nas taxas de mortalidade de pacientes com HSA grave ecom pressão intracraniana elevada, apesar de melhor tratamento clínico implementado previamente. As temperaturas foramreduzidas utilizando colchão térmico para uma temperatura alvo de 33 -35o C.Cinco pacientes foram incluídos. Dois pacientes foram admitidos com um Hunt- Hess de 2, dois com Hunt Hess de 3 e um comHunt Hess de 4. O tempo médio de hipotermia terapêutica foi de 7,2 dias. Dois pacientes sobreviveram com uma escala de Rankinde 0, e três faleceram.Em nosso estudo observacional foi observada uma taxa de mortalidade de 180 dias de 40% , que aumentou para 60% emanálise de seis meses. Estudos recentes descrevem uma taxa de mortalidade de 90% em pacientes com HSA com Hipertensãointracraniana refratária. Acreditamos que a hipotermia pode seja o melhor método para ser utilizado na presente situação clínica.
Subject(s)
Coma , Hypothermia, Induced , Intracranial Aneurysm , Intracranial Hypertension , Subarachnoid Hemorrhage , Vasospasm, IntracranialABSTRACT
Este estudo experimental visa comparar os efeitos do meloxicam e da laserterapia sobre a inibição da permeabilidade vascular, induzida por histamina, na região dorsal dos animais. Foram utilizados 25 ratos wistar divididos em 5 grupos, contendo 5 animais cada e classificados da seguinte maneira: 1) grupo controle (solução fisiológica, i.p.); 2) Meloxicam 10 mg/kg, i.p.; 3) laser 30J/50mW; 4) laser 60J/50mW e 5) laser 120J/150mW. As aplicações do laser foram, em modo de varredura, distribuídas em quatro pontos no dorso dos animais. Estes foram tratados 20 minutos antes da injeção do corante por via i.v. Dez minutos após a última injeção do mesmo, o mediador foi aplicado por via intradérmica no dorso dos ratos. A quantidade de corante extravasado foi mensurada por medida espectrofotométrica, utilizando comprimento de onda de 620 nm. Os resultados foram submetidos aos testes T de student e ANOVA com p < 0,05. A inibição do processo inflamatório pelo meloxicam e Laser 30J apresentou valor percentual semelhante.
This experimental study aims to compare meloxicams effects and laserterapy on the inhibition of the vasculary permeable, induced by histamine, in the dorsal region of the animals. The sample was composed by 25 mice wistar divided into 5 groups, contained 5 animals and classified as following: 1) control group (physiologic solution, intraperitoneal); 2) meloxicam 10 mg/kg, intraperitoneal; 3) laser 30J/50mW; 4) laser 60J/50mW and 5) laser 120J/150mW. The application of the laser was distributed in four points in the back of the animals. They were treated 20 minutes before the injection of intravenous ink. Ten minutes after the last injection, the mediator was applied by intradermic in the back of the mice. The quantity of overflowed ink was measured by spectrophotometry using wavelength of 620 nm. The results were submitted to Student T test and ANOVA with p < 0.05. The inhibition of the inflammatory process by meloxicam and laser 30J presented similar percentile value.
Subject(s)
Anti-Inflammatory Agents , Capillary Permeability , Histamine , Lasers , Low-Level Light TherapyABSTRACT
The idiopathic facial paralysis or Bell's palsy installs abruptly or within a few hours, without any apparent cause. It corresponds to approximately 75 percent of all peripheral facial palsies. Three theories try to explaim its pathogenecity: vascular-ischemic, viral and auto-immune. We reviewed the records of the EMG Sector, Hospital do Servidor Público Estadual (Säo Paulo, Brazil), from 1985 to 1995 and found 239 cases of Bell's palsy. Data were analysed according to age, gender, seasonal distribution of cases. There was a predominance of cases in the 31-60 age bracket (40.59 percent). The female gender was responsible to 70.71 percent of cases. There was a predominance of cases in winter (31.38 percent) and autumn (30.13 percent), which was statiscally significant. These findings let us to suppose that Bell's palsy predominates in females, in 41-60 years age bracket, and occurs predominantly in cold months. There are groups of clusters throughout temporal distribution of cases and cases are dependent on one each other or on factors affecting them all, which reinforces the infectious hypothesis (there is a rise in the incidence of viral upper respiratory tract infection during cold months).
Subject(s)
Humans , Male , Female , Aged , Middle Aged , Child , Child, Preschool , Adult , Infant , Infant, Newborn , Facial Paralysis , Age Factors , Disease Outbreaks , Incidence , Seasons , Sex FactorsABSTRACT
Neurocysticercosis is the central nervous system infestation by Cysticercus cellulosae, the larval form of Taenia solium. It is related to poor hygiene habits and sanitation; although Northeast is poorest Region of Brazil, it has been always stated as a non-endemic area. After the installation of computed tomography (CT) service, the incidence of neurocysticercosis began to raise in neurology services in Campina Grande PB, a city where people from the interior Paraíba can find specialized medical facilities. We analyse 5,883 CT record of the TomoHPI Computed Tomography Service from August 1993 to December 1995, observing 1.02 per cent suggestive neurocysticercosis cases and classified them according to sex and age, procedence and socioeconomic condition. Distribution of cases according to age is homogeneous until the age of 50 (mean: 28.36 years old). Men and women are equally affected. Urban areas inhabitants represented 83.33 per cent. Residents of Campina Grande represented 48.33 per cent and 48.34 per cent were residents of cities around Campina Grande (until 50 Km around) and other cities of Paraíba State. Fifty-eight patients were dependent to public health care system. We conclude that neurocysticercosis seems to be endemic in Paraíba State, demanding a more detailed study to determine its incidence/prevalence.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Central Nervous System Diseases/epidemiology , Cysticercosis/epidemiology , Endemic Diseases , Age Factors , Brazil , Central Nervous System Diseases , Cysticercosis , Socioeconomic Factors , Tomography, X-Ray ComputedABSTRACT
Neurocysticercosis is the infection of the central nervous system by the larval form of Taenia Solium, the Cysticercus cellulosae. We studied 4011 computerized tomographies perfomed in TomoHPI Radioimaging Service, Hospital Pedro I, Campina Grande PB, Northern Brazil, since its installation on August 1993 to July 1995. 41 patients were diagnosed as having Cysticercus cerebral infestation, corresponding to an incidence of 1.02 per cent. No cases were related in Campina Grande PB during 1991 according to hospitalizations under prospective payment rates. After this radioimaging service installation, we observed 1.86 cases per month. We conclude that Campina Grande has to be included as an endemic area of neurocysticercosis, needing health service measures to cease the cycle Taenia-Cysticercus, the only way to get rid of such a serious problem.
Subject(s)
Humans , Cysticercosis , Central Nervous System Diseases , Tomography, X-Ray Computed , Brazil , Cysticercosis/diagnosisABSTRACT
O nervo supraescapular se origina do tronco superior do plexo braquial ou, menos frequentemente, da raiz de C5. Percorre curto caminho e cruza a incisura supraescapular. Daí, o nervo supraescapular dá ramos para o músculo supraespinhoso e para as articulaçöes acromioclavicular e glenomeral. Entäo, cruza a borda lateral da espinha da escápula, passando através da chanfradura espinoglenóide e inervando o músculo infraespinhoso. Esses säo locais potenciais para lesäo do nervo supraescapular. Foram estudados três casos de compressäo do nervo supraescapular causando atrofia isolada do músculo infraespinhoso em jogadores de voleibol. É sugerida a hipótese de que a natureza do ataque, na qual o atleta usa o braço violentamente, mais do que no saque ou na recepçäo, seja a chave da patogênese da lesäo em jogadas de voleibol
Subject(s)
Humans , Male , Adolescent , Adult , Muscular Atrophy , Shoulder/innervation , Nerve Compression Syndromes/diagnosisABSTRACT
Neste artigo é mostrada a incidência das doenças do cérebro em Campina Grande utilizando como fontes os registros das internaçöes na rede hospitalar conveniada ao INAMPS. As afecçöes neurológicas foram classificadas de acordo com CID-9§ Revisäo DE 1975. Foi demostrado que 3,09 por cento das internaçöes tiveram como causa as doenças do cérebro, principalemtne as doenças cerebrovasculares. Evidenciou-se que Campina Grande está incluída na média nordestina da incidência das afecçöes do cérebro, que por diferença regionais, contrasta os resultados nacionais. Os distúrbios mentais näo puderam ser incluídos neste estudo por causa das dificuldades na obtençäo de dados. Foram eles classificados no grupo das demais doenças