Subject(s)
Humans , Awards and Prizes , Neurology/education , Neurology/history , Schools , Congresses as Topic , Education, MedicalABSTRACT
OBJECTIVE: To test the ability of a 5HT2a/c (trazodone) antagonist, to improve depression and motor function in Parkinson' disease (PD). METHOD: Twenty PD patients with and without depression were randomly assigned to receive trazodone (group 1) or not (group 2). They were evaluated through UPDRS and Hamilton Depression Rating Scale (HAM-D). RESULTS: For the UPDRS the mean score of group 2 was 33.1 ± 19.7 and 37.1 ± 18.0 at the end. For the group 1, the corresponding scores were 31.4 ± 11.3 and 25.9 ± 13.7. The variations in the Mann-Whitney test were 0.734 at the initial moment and 0.208 at the final moment. The variation in the comparison of the initial moment with the final moment was 0.005 providing statistical significance. For the HAM-D, the mean score went up 4 points in group 2, contrary to a 5.5 points decrease in group 1. CONCLUSION: Data analysis shows that this agent significantly improves depression, but the motor function improved only in the depressed patients. Because of the known anti-dopaminergic property of the 5-HT2c receptors, a possible approach for depression in PD could be the use of 5-HT2c antagonists, similarly to the use of atypical neuroleptics in case of psychotic symptoms.
OBJETIVO: Avaliar a eficácia de um antagonista 5-HT2a/c (trazodona) na depressão e na função motora de pacientes com doença de Parkinson (DP). MÉTODO: Vinte pacientes com DP com e sem depressão foram randomizados e divididos em 2 grupos com e sem a trazodona (grupos 1 e 2). Foram avaliados pela escala UPDRS e a de depressão de Hamilton (EDH). RESULTADOS: A média inicial do grupo 2 na UPDRS foi 33,1 ± 19,7 no momento inicial e 37,1 ± 18,0 no final. Para o grupo 1 as médias correspondentes foram 31,4 ± 11,3 e 25,9 ± 13,7. As variações no teste de Mann-Whitney foram 0,734 no momento inicial e de 0,208 no final. A variação na comparação entre o momento inicial e o final foi 0,005, caracterizando significância estatística. Para a EDH a média subiu 4 pontos no grupo 2, e desceu 5,5 pontos no grupo 1. CONCLUSÃO: A análise estatística revelou melhora da depressão, porém o benefício na função motora foi obtido apenas entre os deprimidos. Do mesmo modo que os neurolépticos atípicos atuam nos sintomas psicóticos, a ação secundária dopaminérgica do antagonista 5-HT2c pode ser útil no tratamento da depressão na DP.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Depression/drug therapy , Parkinson Disease/drug therapy , /antagonists & inhibitors , Selective Serotonin Reuptake Inhibitors/therapeutic use , Trazodone/therapeutic use , Depression/etiology , Psychiatric Status Rating Scales , Parkinson Disease/complications , Treatment OutcomeABSTRACT
Sudden sensorineural hearing loss (SSNHL) is one of the autoimmune diseases of the inner ear (AIED), which is characterized by a hearing loss of above 30 decibels in at least three contiguous audiometric frequencies over a time course of 72 hours or shorter. Its cause can be found in only 10 percent to 15 percent of patients. Histopathologic findings have reported retrograde neuronal degeneration and atrophy of Corti's organ and of the vascular stria. This paper describes a case of a middle-aged female patient undergoing a treatment for hyperthyroidism who developed bilateral SSNHL. The patient was treated with methylprednilisone (1mg/kg/day) for three days with considerable hearing improvement. This treatment was followed by lung and kidney tuberculosis. The immune mechanism of this entity and the possibility of interconnected participation of the antigen type, of an autoimmune disease and of bacterial infection are discussed
Subject(s)
Humans , Female , Middle Aged , Autoimmune Diseases/immunology , Hearing Loss, Sensorineural/immunology , Anti-Inflammatory Agents/therapeutic use , Antithyroid Agents/adverse effects , Autoimmune Diseases/drug therapy , Cross Reactions , Hearing Loss, Sensorineural/drug therapy , Hyperthyroidism/drug therapy , Methylprednisolone/therapeutic use , Propylthiouracil/adverse effectsABSTRACT
A case-control study of Parkinsonïs disease (PD) was conducted in the city of Rio de Janeiro based on the asumption that neurotoxins with secondary parkinsonian action may be related to the development of Parkinsonïs disease. Ninety-two subjects with PD and 110 controls were queried through a questionnaire in order to investigate possible risk factors for the disease. The following factors were studied: herbicides/pesticides, exposure to chemicals, ingestion of drugs with secondary PD effects, rural life, water well source, family history, cranial trauma and cigarette smoking. Study of mentioned factors was archieved through univariate, stratified and multivariate analyses. Univariate and multivariate analyses demonstrated that PD was positively associated with family history (OR=14.5; CI-2,98 - 91.38), with the use of drugs with secondary PD action (OR=11.01; CI=3.41 - 39.41) and with exposure to chemical agents (OR= 5.87; CI=1.48 - 27.23). PD was found to be inversely associated with cigarette smoking (OR=0.39; IC=0.16 - 0.95). Stratified analysis only confirmed family history and drug use, besides demonstrating that cigarette consumption could be a protection factor, when aforementioned factors were involved. This study might be a warning as to the cares that need to be taken regarding drug use and occupational exposure to chemical agents, as both types of substances present secondary PD action.
Subject(s)
Humans , Male , Female , Middle Aged , Parkinson Disease/etiology , Case-Control Studies , Environmental Exposure , Multivariate Analysis , Parkinson Disease, Secondary/chemically induced , Parkinson Disease/genetics , Random Allocation , Risk FactorsABSTRACT
Säo demonstradas alteraçöes transitórias bipalidais caracterizadas por hiperintensidade na sequência T1 da ressonância nuclear magnética, que ocorreram em um paciente com degeneraçäo hepatocerebral adquirida provocada por hemocromatose. Em funçäo de acrescentar-se a este sinal a visibilizaçäo de imagem de hiperintensidade bitalâmica na sequência T2, discute-se a hipótese destes sinais serem unicamente secundários â degeneraçäo hepatocerebral ou, ainda, se teriam sido também originados pela própria hemocromatose.
Subject(s)
Middle Aged , Humans , Male , Hemochromatosis/complications , Hepatic Encephalopathy/etiology , Nerve Degeneration/etiology , Hepatic Encephalopathy/diagnosis , Magnetic Resonance Spectroscopy , Nerve Degeneration/diagnosisABSTRACT
Cem pacientes com neurocisticerose, nascidos e residentes no Estado do Rio de Janeiro, foram estudados no período de setembro-1981 a dezembro-1989. A incidência aproximada de um caso por mês mostra que a doença näo é rara neste Estado brasileiro
Subject(s)
Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Cysticercosis/epidemiology , Central Nervous System Diseases/epidemiology , Aged, 80 and over , Brazil/epidemiology , Central Nervous System Diseases/cerebrospinal fluid , Central Nervous System Diseases/diagnosis , Complement Fixation Tests , Cysticercosis/cerebrospinal fluid , Cysticercosis/diagnosis , Retrospective StudiesABSTRACT
Apresentamos um caso de paralisia bilateral do abducente como achado inicial em carcinoma de nasofaringe. Discute-se o modo de envolvimento. Somente um caso semelhante foi registrado anteriormente na literatura
Subject(s)
Middle Aged , Humans , Male , Abducens Nerve , Carcinoma, Squamous Cell/complications , Nasopharyngeal Neoplasms/complications , Paralysis/etiology , Carcinoma, Squamous Cell/pathology , Cranial Nerve Diseases/complications , Cranial Nerve Diseases/diagnosis , Nasopharyngeal Neoplasms/diagnosis , Nasopharyngeal Neoplasms/pathology , Paralysis/diagnosisABSTRACT
Säo estudados 21 pacientes internados no Hospital dos Servidores do Estado do Rio de Janeiro com diagnóstico clínico e laboratorial de síndrome de Guillain-Barré, no período de maio de 1966 a dezembro de 1983. Dos casos, 14 eram do sexo masculino e 7 do feminino, com maior incidência nas segunda e quarta décadas. Doze casos foram tratados com corticoesteróides e 9 näo foram. A média do tempo de internaçäo dos pacientes que näo usaram corticoesteróides foi 52,6 dias, enquanto nos casos tratados foi 63,6 dias. É discutido o aspecto terapêutico do uso de corticosteróide com a constataçäo de melhor resposta nos pacientes em que näo foram utilizados e, também, a presença de complicaçöes quando do uso de corticoesteróides e o menor tempo de internaçäo dos casos näo tratados