ABSTRACT
Objective: Schizophrenia is one of the most severe psychiatric disorders, and its current treatment relies on antipsychotic medications with only partial effectiveness. Clozapine is an atypical antipsychotic with a specific profile of action indicated for treatment-resistant schizophrenia. Neuroimaging studies assessing the effects of clozapine could help shed light on the neural underpinnings of the effects of this drug in the brain. The objective of this study was to review the available literature on the structural and functional neuroimaging findings associated with use of clozapine. Method: We conducted a systematic review of the indexed literature using the PubMed, BIREME, and ISI Web of Knowledge search engines and the following keywords: clozapine, neuroimaging, computed tomography, MRI, functional magnetic resonance, PET, SPECT, and DTI. Results: A total of 23 articles were included in the review. In structural studies, the use of clozapine was associated with volume reductions in the basal ganglia, especially the caudate nucleus, where functional neuroimaging studies also found decreased perfusion. In the frontal lobe, clozapine treatment was associated with increased gray matter volume and reduced perfusion. Conclusion: The results of the studies reviewed suggest that the use of clozapine is associated with distinctive structural and functional neuroimaging findings that are not shared with other antipsychotics. .
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Cognition Disorders/etiology , Evoked Potentials/physiology , Schizophrenia/complications , Schizophrenic Psychology , Analysis of Variance , Electroencephalography , Neuropsychological Tests , Problem Solving , Reaction Time/physiology , Statistics as TopicABSTRACT
Yerba-mate (Ilex paraguariensis A. St. Hil., Aquifoliaceae) is a South American native species that is widely used for its industrial potential in the preparation of drinks, teas and cosmetics. Its properties are directly related to the presence of its chemical constituents, such as saponins, methylxanthines and phenolic compounds. This study aimed to investigate the influence of leaf age on methylxanthine and total phenolic contents by High Performance Liquid Chromatography and Ultraviolet Spectroscopy, as well as on free radical scavenging capacity, of aqueous extracts of I. paraguariensis leaves. The results showed great variability in all the metabolites measured. Leaf ageing significantly increased the methylxanthine content and total phenolic content of the extracts. Free radical scavenging capacity was also significantly affected (p < 0.05) by leaf age. A positive correlation was observed, between the antioxidant activity and total phenolic content.
ABSTRACT
BRCA1 mutations are known to be responsible for the majority of hereditary breast and ovarian cancers in women with early onset and a family history of the disease. In this paper we present a mutational survey conducted in 47 Brazilian patients with breast/ovarian cancer, selected based on age at diagnosis, family history, tumor laterality, and presence of breast cancer in male patients. All 22 coding exons and intron-exon junctions were sequenced. Constitutional mutations were found in seven families, consisting of one insertion (insC5382) in exon 20 (four patients), one four base-pair deletion (3450-3453delCAAG) in exon 11 resulting in a premature stop codon (one patient), one transition (IVS17+2T> C) in intron 17 affecting a mRNA splicing site (one patient), and a C> T transition resulting in a stop-codon (Q1135X) in exon 11 (one patient). The identification of these mutations which are associated to hereditary breast and ovarian cancers will contribute to the characterization of the mutational spectrum of BRCA1 and to the improvement of genetic counseling for familial breast/ovarian cancer patients in Brazil.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Breast Neoplasms , Mutation , Ovarian Neoplasms , Brazil , Genes, BRCA1 , Genetic Counseling , Germ-Line MutationABSTRACT
Objetivo: a doença de Kawasaki (DK) é uma vasculite sistêmica idiopática, autolimitada, de pequenos e médios vasos. Foram descritos na literaura treze casos de deficiência auditiva neurossensorial, durante a evolução dessa doença. Descreve-se o caso de um lactente com doença de Kawasaki com evolução, durante a fase aguda, para deficiência auditiva neurossensorial. A descrição do caso justifica-se por ilustrar uma complicação grave da DK, pouco mencionada na literatura, que reforça a recomendação de cautela na avaliação global destes pacientes. Descrição: menino hígido de 1 ano e sete meses de idade apresentou-se com febre diária persistente, iniciada havia sete dias, associada à irritabilidade,conjutivite bilateral não-exsudativa, reitema máculo-papular em tronco. Evoluiu com artrite em punhos, cotovelos, joelhos e tornozelos e edema e descamação de mãos e pés, que impossibilitava a deambulação. O diagnóstico de doença de Kawasaki foi estabelecido de acordo com os critérios da American Heart Association (AHA), e a criança foi tratada de forma convencional. Houve regressão das manifestações clínicas três dias após o inicio do tratamento. Contudo, um mês após o início dos sintomas, os familiares notaram resposta insatisfatória a estímulos sonoros. A avaliação da acuidade auditiva através do BERA (Brainstem Evoked Responses Audiometry - Audiometria de Potenciais Evocados de Tronco Cerebral) disgnosticou perda auditiva neurossensorial bilateral, grau severo a profundo. Comentários: é possível que o exame rotineiro de acuidade auditiva em crianças com doença de Kawasaki possa identificar precocemente a deficiência auditiva neurossensorial
Subject(s)
Humans , Male , Infant , Hearing Loss, Sensorineural , Mucocutaneous Lymph Node Syndrome , VasculitisABSTRACT
Esse caso ressalta a importância da osteomielite crônica recorrente multifocal para o diagnóstico diferencial das espondilites infecciosas. Menina, nove anos de idade, com história de febre intermitente, artrite em joelhos e tornozelos e dor na coluna torácica lombar havia seis meses. Ao exame físico observaram-se escoliose e limitação importante da flexão da coluna toracolombar. Os exames laboratoriais revelaram discreta leucocitose, elevação das proteínas de fase aguda ePPD não reator. A radiografia simples e a tomografia de coluna evidenciaram redução de altura do corpo vertebral de L1 e do interespaço do disco L3-L4 com ponte óssea entre estes corpos vertebrais e osteocondensação dos platôs vertebrais. A hipótese inicial foi de mal de Pott e a paciente foi tratada com esquema convencional para tuberculose óssea por seis meses. Houve melhora importante da deformidade de coluna, mas persistiram os episódios de dores articulares e edema em joelhos e tornozelos. A radiografia simples de tornozelo esquerdo revelou lesão osteolítica de contorno geográfico com esclerose marginal em região metafisária da tíbia. A biópsia de fragmento ósseo de tíbia mostrou fibrose medular e cultura negativa. Nova tomografia de coluna revelou aumento das dimensões e da densidade das áreas de osteocondensação sem comprometimento de partes moles adjacentes. Esses achados são sugestivos de osteomielite crônica recorrente multifocal. Embora rara, a osteomielite crônica recorrente multifocal é um dos diagnósticos diferenciais das espondilites infecciosas. Seu reconhecimento pode evitar tratamentos antimicrobianos prolongados e desnecessários