The influence of hemodialysis on intracranial pressure waveform in patients with chronic kidney disease: an observational study

ABSTRACT BACKGROUND: Among the complications related to chronic kidney disease (CKD), those of a neurological nature stand out, and for a better quality of life for patients, the diagnosis and treatment of these complications is fundamental. OBJECTIVES: This study aimed to assess the effect of hemodialysis on intracranial pressure waveform (ICPw) in patients with chronic kidney disease undergoing hemodialysis and those who are not yet undergoing substitutive therapy. DESIGN AND SETTING: An observational study was conducted in two stages at a kidney replacement therapy center in Brazil. The first was a longitudinal study and the second was a cross-sectional study. METHODS: Forty-two patients on hemodialysis were included in the first stage of the study. In the second stage, 226 participants were included. Of these, 186 were individuals with chronic kidney disease (who were not undergoing substitutive therapy), and 40 did not have the disease (control group). The participants' intracranial compliance was assessed using the non-invasive Brain4care method, and the results were compared between the groups. RESULTS: There was a significant difference between the hemodialysis and non-hemodialysis groups, with the former having better ICPw conditions. CONCLUSIONS: Hemodialysis influenced the improvement in ICPw, probably due to the decrease in the patients' extra-and intracellular volumes. Furthermore, ICPw monitoring can be a new parameter to consider when defining the moment to start substitutive therapy.

Neuromuscular Alterations Associated with COVID-19. A Scientific Literature Review

Introduction: The COVID-19 pandemic has brought short, medium, and long-term consequences on the quality of life of those affected. Among the complications are those related to the involvement of the nervous system and the structures involved in body movement, with sequelae that may be transitory and/or definitive, and require rehabilitation. Objective: Identify the neuromuscular alterations that affect body movement, associated with COVID-19. Material and methods: A search was made for observational works published in the SCOPUS, PubMed, EBSCO, and Nature databases between January 2020 and June 2022 under the PRISMA methodology, to answer the PICO question: what are the neuromuscular alterations that can potentially affect movement, associated with COVID-19? The established filters were type of study, language, age, availability, publication dates. The MeSH terms were SARS-Cov-2, COVID-19, Long Covid, Motor Activity Neuromuscular Diseases, Neurological Disorders, Guillain-Barré Syndrome, Myelitis Transverse, Stroke, Patient, Peripheral Nervous System Diseases. The methodological quality was evaluated according to STROBE and the level of evidence was established according to CEBM. Results: In the first search, 645 articles were identified. 637 were discarded by filters, titles, duplicate abstracts, methodological quality, and level of evidence. There were 8 articles selected for the present review in which neuromuscular alterations of central and peripheral origin were identified, such as myalgias, fatigue, polyneuroradiculopathies, CNS inflammation, among others, with clinical manifestations that affect movement. Conclusion: COVID-19 is a multisystemic disease that can affect the nervous system with symptoms of neuromuscular alterations that compromise body movement.

Introducción: La pandemia por la COVID-19 ha traído consecuencias a corto, mediano y largo plazo sobre la calidad de vida de los afectados. Entre las complicaciones se encuentran aquellas relacionadas con la afectación del sistema nervioso y las estructuras involucradas en el movimiento corporal, con secuelas que pueden ser transitorias y/o definitivas, y requieren rehabilitación Objetivo: Identificar las alteraciones neuromusculares que afectan el movimiento corporal, asociadas a la COVID-19. Material y métodos: Se hizo una búsqueda de trabajos observacionales publicados en las bases de datos SCOPUS, PubMed, EBSCO y Nature entre enero de 2020 y junio de 2022 bajo metodología PRISMA, para dar respuesta a la pregunta PICO: ¿cuáles son las alteraciones neuromusculares que potencialmente pueden afectar el movimiento, asociadas a la COVID-19? Los filtros establecidos fueron tipo de estudio, idioma, edad, disponibilidad y fechas de publicación. Los términos MesH fueron SARS-Cov-2, COVID-19, Long Covid, Motor Activity Neuromuscular Diseases, Neurological Disorders, Guillain-Barré Syndrome, Myelitis Transverse, Stroke, Patient, Peripheral Nervous System Diseases. La calidad metodológica se evaluó según STROBE y el nivel de evidencia se estableció según CEBM. Resultados: En la primera búsqueda se identificaron 645 artículos. Posteriormente se descartaron 637 por filtros, títulos, resúmenes duplicados, calidad metodológica y nivel de evidencia. Así, quedaron seleccionados 8 para la presente revisión, en los cuales se identificaron alteraciones neuromusculares de origen central y periférico, como mialgias, fatiga, polineuroradiculopatías, inflamación del SNC, entre otras, con manifestaciones clínicas que afectan el movimiento. Conclusión: La COVID-19 es una enfermedad multisistémica que puede afectar el sistema nervioso con síntomas de alteraciones neuromusculares que comprometen el movimiento corporal.

Structure-activity relationship of pyrazol-4-yl-pyridine derivatives and identification of a radiofluorinated probe for imaging the muscarinic acetylcholine receptor M4

There is an accumulating body of evidence implicating the muscarinic acetylcholine receptor 4 (M4) in schizophrenia and dementia with Lewy bodies, however, a clinically validated M4 positron emission tomography (PET) radioligand is currently lacking. As such, the aim of this study was to develop a suitable M4 PET ligand that allows the non-invasive visualization of M4 in the brain. Structure-activity relationship studies of pyrazol-4-yl-pyridine derivates led to the discovery of target compound 12 - a subtype-selective positive allosteric modulator (PAM). The radiofluorinated analogue, [18F] 12, was synthesized in 28 ± 10% radiochemical yield, >37 GBq/μmol and an excellent radiochemical purity >99%. Initial in vitro autoradiograms on rodent brain sections were performed in the absence of carbachol and showed moderate specificity as well as a low selectivity of [18F] 12 for the M4-rich striatum. However, in the presence of carbachol, a significant increase in tracer binding was observed in the rat striatum, which was reduced by >60% under blocking conditions, thus indicating that orthosteric ligand interaction is required for efficient binding of [18F] 12 to the allosteric site. Remarkably, however, the presence of carbachol was not required for high specific binding in the non-human primate (NHP) and human striatum, and did not further improve the specificity and selectivity of [18F] 12 in higher species. These results pointed towards significant species-differences and paved the way for a preliminary PET study in NHP, where peak brain uptake of [18F] 12 was found in the putamen and temporal cortex. In conclusion, we report on the identification and preclinical development of the first radiofluorinated M4 PET radioligand with promising attributes. The availability of a clinically validated M4 PET radioligand harbors potential to facilitate drug development and provide a useful diagnostic tool for non-invasive imaging.

Therapeutic effects of Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction on post-stroke depression in 31 patients / 中国基层医药

Objective:To investigate the clinical effects of Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction on post-stroke depression in patients. Methods:Sixty-two patients with post-stroke depression who received treatment in Zhongda Hospital of Southeast University from October 2020 to April 2022 were included in this study. They were randomly treated either with traditional Chinese medicine decoction (control group, n = 31) or Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction (combined group, n = 31) based on routine medication. All patients were treated for 4 weeks. Depressive state, neurological function, and activities of daily living were compared between the two groups. Results:Before treatment, there were no significant differences in the Hamilton Depression Scale (HAMD) score, National Institutes of Health Stroke Scale (NIHSS) score, and Barthel index between the two groups (all P > 0.05). After 4 weeks of treatment, the HAMD and NIHSS scores in the control group were (13.88 ± 3.92) points and (8.56 ± 1.82) points, respectively, and they were (8.72 ± 2.48) points and (6.67 ± 1.14) points in the combined group. There were significant differences in HAMD and NIHSS scores between the two groups ( t = 2.14, 2.43, both P < 0.05). The Barthel index in the combined group was (69.53 ± 13.29) points, which was significantly higher than (62.34 ± 15.67) points in the control group ( t = 2.23, P < 0.05). Conclusion:Tongdu Qishen acupuncture combined with traditional Chinese medicine decoction can reduce depressive symptoms and improve neurological function and activities of daily living in patients with post-stroke depression. The combined therapy has obvious efficacy in the treatment of post-stroke depression.

Anxiety, depression, and memory loss in Chagas disease: a puzzle far beyond neuroinflammation to be unpicked and solved*

Mental disorders such as anxiety, depression, and memory loss have been described in patients with chronic Chagas disease (CD), a neglected tropical disease caused by the protozoan parasite Trypanosoma cruzi. Social, psychological, and biological stressors may take part in these processes. There is a consensus on the recognition of an acute nervous form of CD. In chronic CD patients, a neurological form is associated with immunosuppression and neurobehavioural changes as sequelae of stroke. The chronic nervous form of CD has been refuted, based on the absence of histopathological lesions and neuroinflammation; however, computed tomography shows brain atrophy. Overall, in preclinical models of chronic T. cruzi infection in the absence of neuroinflammation, behavioural disorders such as anxiety and depression, and memory loss are related to brain atrophy, parasite persistence, oxidative stress, and cytokine production in the central nervous system. Interferon-gamma (IFNγ)-bearing microglial cells are colocalised with astrocytes carrying T. cruzi amastigote forms. In vitro studies suggest that IFNγ fuels astrocyte infection by T. cruzi and implicate IFNγ-stimulated infected astrocytes as sources of TNF and nitric oxide, which may also contribute to parasite persistence in the brain tissue and promote behavioural and neurocognitive changes. Preclinical trials in chronically infected mice targeting the TNF pathway or the parasite opened paths for therapeutic approaches with a beneficial impact on depression and memory loss. Despite the path taken, replicating aspects of the chronic CD and testing therapeutic schemes in preclinical models, these findings may get lost in translation as the chronic nervous form of CD does not fulfil biomedical model requirements, as the presence of neuroinflammation, to be recognised. It is hoped that brain atrophy and behavioural and neurocognitive changes are sufficient traits to bring the attention of researchers to study the biological and molecular basis of the central nervous system commitment in chronic CD.

Pattern of neurological disorders managed in neurology clinics in Kano, Nigeria

To determine the pattern of neurological disorders managed in some neurology clinics in Kano, Nigeria. Materials and Methods: A five-year retrospective descriptive survey (2016-2020) of patients with neurological disorders attending neurology out-patient clinics at three selected hospitals in Kano metropolis. A research proforma was used to collect information on socio-demographic and health characteristics of the participants. Case folders and outpatient registers were used as a source of information about the patients. Data obtained was analyzed using IBM Statistical package for social science (SPSS) version 20 and results presented using descriptive statistics of frequency and percentage. Results: Out of the 433 cases with neurological disorders surveyed, 58% were adult and 42% were pediatric. Males (54.3%) were found to be more affected. Majority (83.4%) of the participants were from an urban area, with married (79.7%) individuals mostly affected. Stroke was the most prevalent (33.7%) neurological disorder. Hypokinesia (5.1%) and hyperkinesia(3%) as a primary and secondary movement disorder respectively were the most prevalent forms of movement disorder. Psychotic symptoms, weakness, paresthesia, fever, vomiting and convulsion were the most common manifestations that comes with the neurological disorders. Of the common neurological disorders, stroke was most associated with motor (56.2%), sensory (36.4%) and psychiatric (43.5%) manifestations. Conclusion: Paediatric age group contributed close to half of neurological disorders. Stroke was the most prevalent form of neurological disorder and most associated with motor, sensory and psychiatric manifestations. Hypokinesia and hyperkinesia had close prevalence and were the most common primary and secondary movement disorders respectively.

Niños con alteraciones neurológicas provocadas por Plasmodium falciparum en Guinea Ecuatorial

RESUMEN Introducción: Más del 40 % de la población corre un riesgo variable de contraer paludismo en los países en donde persiste su transmisión, lo que constituye un importante problema de salud mundial. Objetivo: Identificar las características clínicas, evolución y tratamiento de niños con alteraciones neurológicas provocadas por Plasmodium falciparum como formas de presentación del paludismo. Método: Se hizo un estudio observacional, descriptivo, de serie de casos en una muestra aleatoria de 30 pacientes, que ingresaron en el Policlínico "Dr. Loeri Comba", Guinea Ecuatorial, con diagnóstico de paludismo por este protozoo y alteraciones neurológicas asociadas, durante el período comprendido desde junio de 2017 hasta septiembre de 2019. Resultados: La convulsión (33,3 %) y el estado de coma (30 %) fueron las formas clínicas más frecuentes, sobre todo en los menores de cuatro años de edad. La alta parasitemia no estuvo presente en todos ellos, aunque fue la que predominó (63,3 %). La respuesta al tratamiento con artesunato intravenoso como medicamento de elección fue favorable (90 %), incorporándose además vitaminas a altas dosis en forma de complejo, sulfato de zinc, anticonvulsivantes, dexametasona y manitol, creando un protocolo de tratamiento propio en el servicio de Pediatría. Hubo tres fallecidos por infección respiratoria del tipo de neumonía asociado al paludismo. Conclusiones: Los niños con alteraciones neurológicas provocadas por el Plasmodium falciparum en el paludismo, como formas de presentación del mismo, no solo se evidencia en el estado de coma que provoca la enfermedad, sino también en otras formas de presentación con afectación de la conciencia y presencia de convulsiones.

ABSTRACT Introduction: More than 40% of the population has a variable risk of contracting malaria in countries where its transmission persists, which constitutes a major global health problem. Objective: To identify the clinical characteristics, evolution and treatment of children with neurological disorders caused by Plasmodium falciparum as forms of malaria. Method: An observational, descriptive study of a series of cases was carried out in a random sample of 30 patients, who were admitted to the Clinic "Dr. Loeri Comba", in Equatorial Guinea, with a diagnosis of malaria caused by this protozoan, and with associated neurological alterations, during the period from June 2017 to September 2019. Results: Seizure (33.3%) and coma (30%) were the most frequent clinical forms, especially in those under four years of age. High parasitaemia was not present in all of them, although it predominated in the 63.3%. The response to treatment with intravenous artesunate as the drug of choice was favorable (90%), also incorporating vitamins at high doses in complex form, zinc sulfate, anticonvulsants, dexamethasone and mannitol, creating a treatment protocol of its own in the Pediatric service. There were three deaths from respiratory infection, caused by the type of pneumonia associated with malaria. Conclusions: Children with neurological alterations caused by Plasmodium falciparum in malaria are not only evidenced in the coma state that causes the disease, but also in other forms of presentation with impaired consciousness and presence of seizures.

RESUMO Introdução: Mais de 40% da população corre um risco variável de contrair malária em países onde a sua transmissão persiste, o que constitui um grande problema de saúde global. Objetivo: Identificar as características clínicas, evolução e tratamento de crianças com distúrbios neurológicos causados pelo Plasmodium falciparum como formas de apresentação da malária. Método: Foi realizado um estudo observacional descritivo de uma série de casos em uma amostra aleatória de 30 pacientes internados no "Dr. Loeri Comba", Guiné Equatorial, com diagnóstico de malária por este protozoário e alterações neurológicas associadas, no período de junho de 2017 a setembro de 2019. Resultados: Convulsão (33,3%) e coma (30%) foram as formas clínicas mais frequentes, especialmente em menores de quatro anos. Parasitemia elevada não esteve presente em todos eles, embora tenha sido o que predominou (63,3%). A resposta ao tratamento com artesunato intravenoso como medicamento de escolha foi favorável (90%), incorporando também vitaminas em altas doses na forma complexa, sulfato de zinco, anticonvulsivantes, dexametasona e manitol, criando um protocolo de tratamento próprio no serviço de Pediatria. Houve três mortes por infecção respiratória do tipo de pneumonia associada à malária. Conclusões: Crianças com alterações neurológicas causadas pelo Plasmodium falciparum na malária, como formas de apresentação do mesmo, não são evidenciadas apenas no estado de coma que causa a doença, mas também em outras formas de apresentação com comprometimento da consciência e presença de convulsões.

Efecto a largo plazo de la infección por SARS-CoV-2: Síndrome neurológico post-Covid-19 / Long-term effect of SARS-CoV-2 infection: Post-Covid-19 neurological syndrome

RESUMEN La pandemia de la COVID-19 ha provocado aproximadamente 182 millones de casos y cerca de cuatro millones de muertes en todo el mundo, comprometiendo con mayor frecuencia a personas de 25 y 64 años de edad. Esta infección afecta principalmente al sistema respiratorio, pero otros órganos y sistemas pueden verse afectados a corto plazo como el neurológico. Una gran población de pacientes ha logrado superar la infección por el SARS-CoV-2, sin embargo, han comenzado a reportarse una serie de manifestaciones clínicas tardías, básicamente neuropsiquiátricas, dentro de ellas se ha referido a la ansiedad, depresión, deterioro del sueño, dolor muscular, mareos, cefaleas, fatiga, anosmia, entre otros; a este conjunto de manifestaciones tardías se le ha denominado síndrome neurológico post-Covid-19 y requiere por un lado, la atención de la comunidad médica para investigar las manifestaciones tardías o secuelas de esta enfermedad y por otro lado, una vigilancia médica ante la consulta de pacientes con estas manifestaciones.

ABSTRACT The COVID-19 pandemic has caused approximately 182 million cases and nearly four million deaths worldwide, most frequently involving people between 25 and 64 years of age. This infection primarily affects the respiratory system, but other organs and systems can be affected in the short term, such as the neurological system. A large population of patients has managed to overcome the SARS-CoV-2 infection, however, a serie of late clinical manifestations have begun to be reported, basically neuropsychiatric, including anxiety, depression, disorder of sleep, muscle pain, dizziness, headaches, fatigue, anosmia, among others; this set of late manifestations has been called post-Covid-19 neurological syndrome and requires, on the one hand, the attention of the medical community to investigate the late manifestations or sequel of this disease and, on the other hand, medical vigilance when consulting patients with these manifestations.

Spina bifida, diplomyelia and multiple malformations in a Texel lamb / Espinha bífida, diplomielia e múltiplas malformações em um cordeiro Texel

ABSTRACT: This report described the clinical and pathological aspects of open spina bifida and diplomyelia along with multiple congenital malformations in a Texel lamb. Clinically, paresis of the thoracic limbs, paralysis of the pelvic limbs and a cutaneous opening in the lumbosacral region were observed. At necropsy, there was a focally extensive disruption of the skin associated with an absence of the dorsal portions of the lumbosacral vertebrae. Additionally, diplomyelia of the lumbar segment, mild hydromyelia of thoracic segment, and moderate communicating hydrocephalus of the lateral and third ventricles were noted. Possible viral etiologies (bovine viral diarrhea virus, bluetongue virus, and Schmallemberg virus) were not detected by RT-PCR, and toxic plants were not identified. Therefore, a possible genetic cause may not be discarded.

RESUMO: Este trabalho descreve os aspectos clínicos e patológicos de um caso de espinha bífida aberta e diplomielia, além de múltiplas malformações, em um cordeiro Texel. Clinicamente, este apresentava paresia de membros torácicos, paralisia dos membros pélvicos e uma abertura cutânea na região lombossacral desde o nascimento. À necropsia, visualizou-se solução de continuidade na pele e ausência das porções dorsais das vértebras lombossacrais. Além disso, observou-se diplomielia em segmento lombar, hidromielia discreta de segmento torácico e hidrocefalia comunicante moderada de ventrículos laterais e terceiro ventrículo. Possíveis etiologias virais (vírus da diarreia viral bovina, vírus da língua azul e Schmallemberg virus) não foram detectadas através de RT-PCR, e possíveis plantas tóxicas não foram identificadas. Portanto, uma causa genética não pode ser descartada.

Effects of cerebroprotein hydrolysate for injection (II) on neuritogenesis and its underlying mechanisms / 中国药科大学学报

@#In most mammalian central nervous system diseases, axons are damaged.Due to the limited ability of damaged neurons to promote axonal regeneration, the formation of glial scar and the release of inhibitory nutrients, it is difficult to regenerate axons of damaged neurons. The purpose of this study was to investigate the effect of cerebroprotein hydrolysate for injection (II) (CBL) on neuritogenesis and its underlying mechanism. Immunofluorescence staining was used to detect the axon length of mouse neuroma cells (Neuro-2a) and mouse primary cortical neuronal cells. Western blotting was used to detect the expression of phosphorylated TrkB protein in Neuro-2a cells and mouse primary cortical neuronal cells. The results showed that CBL could increase the axon length of Neuro-2a cells or mouse primary cortical neuronal cells, and that the phosphorylation level of TrkB in neuronal cells was significantly increased when 5 μg/mL CBL was applied to neuronal cells for 1 h. In conclusion, CBL can promote neuritogenesis, and increase the expression of phosphorylated TrkB, which may be related to the activation of TrkB signaling pathway.

Microbe-gut-brain axis and neurological disorders: a review / 生物工程学报

Intestinal microbes have an adjuvant therapeutic effect on neurological disorders (such as Parkinson's, depression, and Alzheimer's disease). It affects brain function and host behavior through the neural pathways, the immune pathways and the microbial metabolites, the so-called gut-brain axis. This article summarizes the recent advances in the role of the microbe-gut-brain axis in neurological disorders, in order to provide new ideas for the treatment of neurodegenerative diseases.

Trastornos neurológicos asociados a la infección por virus dengue / Neurological disorders associated with dengue virus infection

Introducción: Los trastornos neurológicos asociados al dengue es un tema que cobra vital importancia en estos tiempos debido a que el espectro clínico del dengue ha cambiado y las manifestaciones atípicas están reportándose con mayor frecuencia. Los serotipos 2 y 3 son los más frecuentemente relacionados a manifestaciones neurológicas como la encefalitis, mielitis y síndrome de Guillain-Barré. Objetivo: Reportar una serie de casos con trastornos neurológicos asociados a la infección por DENV y sus variables clínicas, humorales e imagenológicas. Casos clínicos: Todos los pacientes cursaron en primera instancia con un cuadro clínico de dengue no complicado dado por fiebre de 38,5º C y escalofríos de aparición brusca, exantema maculo-papuloso céfalo-caudal que respeta palmas y plantas, artralgias, mialgias, cefalea frontal y retro-ocular, esta última a la contracción del músculo recto superior del globo ocular. Todos confirmados con anticuerpos específicos anti-virus del dengue. Un paciente desarrolló síndrome de Guillain-Barré, otro curso con encefalitis, bicitopenia y compromiso del nivel de conciencia. El resto cursó con mielitis transversa, meningoencefalitis y encefalitis autoinmune. Conclusiones: Los trastornos neurológicos asociados al virus del dengue deben ser sospechados en todo paciente que ingrese con esta infección y manifieste cualquiera de las alteraciones aquí descritas(AU)

Introduction: Neurological disorders associated with dengue is an issue of vital importance in these times because the clinical spectrum of dengue has changed and atypical manifestations are being reported much frequently. Serotypes 2 and 3 are the most frequently related to neurological manifestations such as encephalitis, myelitis and Guillain-Barré syndrome. Objective: To report a series of cases with neurological disorders associated with DENV infection and its clinical, humoral and imaging variables. Clinical case report: All patients had, in the first instance, uncomplicated dengue clinical status due to 38.5º C fever and chills of sudden appearance, Cephalo-caudal maculo-papular rash that spares palms and soles, arthralgias, myalgias, frontal and retro-ocular headache, the latter due to the contraction of the superior rectus muscle of the eyeball. All confirmed with specific anti-dengue virus antibodies. One patient developed Guillain-Barré syndrome, another had encephalitis, bicytopenia, and compromised level of consciousness. The rest had transverse myelitis, meningoencephalitis and autoimmune encephalitis. Conclusions: Neurological disorders associated with dengue virus should be suspected in every patient who is admitted with this infection and manifests any of the alterations described here(AU)

Repercussão da microbiota intestinal na modulação do sistema nervoso central e sua relação com doenças neurológicas / Repercussion of the intestinal microbiota in modulation of the central nervous system and its relation with neurological diseases

Introdução: a microbiota intestinal representa agrupamentos de micro-organismos encarregados de exercerem várias atividades indispensáveis para a regulação da homeostase. Esta, além da manutenção funcional do trato gastrointestinal (TGI), faz interferência na regulação do eixo de conexão entre o sistema nervoso entérico (SNE) com sistema nervoso central (SNC), denominado eixo intestino-cérebro, sendo uma comunicação bidirecional. Objetivo: identificar o papel da microbiota intestinal no processo de saúde e doença do hospedeiro humano, indispensável ao estudo de infecções e desordens do sistema nervoso entérico e sua relação com patologias neurológicas. Metodologia: foi realizado revisão integrativa da literatura nas bases de dados Scientific Eletronic Library Online (SciELO) e Literatura Latino Americana e do Caribe de Informação em Ciências da Saúde (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE), além da Medical Publisher (PubMed). Resultados: constatou-se que a microbiota intestinal exerce influência sobre a cognição, o comportamento e também sobre o desenvolvimento neural. Além disso, a perda da homeostase do eixo intestino-cérebro pode contribuir para o surgimento de doenças mentais. Conclusão: através do estudo do eixo intestinocérebro, fica evidente a atuação da microbiota intestinal na manutenção da homeostase do SNC, bem como o seu envolvimento em várias disfunções, afetando o sistema nervoso e os intestinos, evidenciando uma via de comunicação bidirecional. Esse mecanismo é efetuado através de um sistema complexo de vias envolvendo os diversos componentes do sistema nervoso, endócrino e imunológico.

Introduction: the intestinal microbiota represents clusters of microorganisms that perform various activities that are essential for regulating homeostasis. This, in addition to the functional maintenance of the gastrointestinal tract (GIT), interferes in the regulation of the connection axis between the enteric nervous system (SNE) with the central nervous system (CNS), called the gut-brain axis, being a bidirectional communication. Objective: to identify the role of the intestinal microbiota in the health and disease process of the human host, indispensable for the study of infections and disorders of the enteric nervous system and its relation with neurological pathologies. Methodology: an integrative review of the literature was carried out in the Scientific Electronic Library Online (SciELO) and Latin American and Caribbean Literature on Health Sciences Information (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE), as well as Medical Publisher (PubMed). Results: it was verified that the intestinal microbiota influences cognition, behavior and also neural development. In addition, the loss of intestinal-brain axis homeostasis may contribute to the onset of mental illness. Conclusion: through the study of the intestine-brain axis, the intestinal microbiota performance in the maintenance of CNS homeostasis is evident, as well as its involvement in various dysfunctions, affecting the nervous system and the intestines, evidencing a bidirectional communication pathway. This mechanism is effected through a complex system of pathways involving the various components of the nervous, endocrine and immune systems.

Cerebrospinal fluid analysis in 58 ruminants showing neurological disorders / Análise do líquido cefalorraquidiano em 58 ruminantes com distúrbios neurológicos

Ruminants may be affected by a wide variety of central nervous system (CNS) diseases. Cerebrospinal fluid (CSF) analysis forms the basis for ante mortem diagnostic evaluation of ruminants with clinical signs involving the CNS. Despite its importance as a tool to aid diagnosis, data regarding CSF examinations in spontaneous cases of CNS diseases in ruminants from Brazil are limited, and most reports involve experimental studies. Therefore, this study aimed to report the results of CSF analysis in 58 ruminants showing signs of neurological disorders. CSF samples for analysis were obtained from 32 cattle, 20 sheep, and 6 goats by cerebello-medullary cistern (n=54) or lumbosacral space (n=4) puncture. These ruminants showed neurological signs related to viral (n=13), mycotic (n=3), or bacterial (n=15) infections, and toxic (n=21), traumatic (n=4), or congenital disorders (n=2). CSF analysis from ruminants with viral infections presented lymphocytic pleocytosis, even though CSF showed no changes in several cases of rabies. Neutrophilic pleocytosis, cloudiness, presence of fibrin clots, and abnormal coloration were evident in the CSF of most cases of CNS bacterial infection, such as meningoencephalitis, meningitis, abscesses, myelitis, and a case of conidiobolomycosis. On the other hand, CSF was unchanged in most cases of toxic disorders, as botulism and hepatic encephalopathy. Elevated CSF density was observed in 60% of ruminants diagnosed with polioencephalomalacia. Our findings show that evaluation of CSF is a valuable diagnostic tool when used in association with epidemiological, clinical and pathological findings for diagnosis of CNS diseases in ruminants.(AU)

Os ruminantes podem ser afetados por uma grande variedade de doenças do sistema nervoso central (SNC). A análise do líquido cefalorraquidiano (LCR) constitui a base da avaliação diagnóstica ante mortem de ruminantes com sinais clínicos envolvendo o SNC. Apesar de sua importância como ferramenta para auxiliar no diagnóstico, os dados referentes aos exames do LCR em casos espontâneos de doenças do SNC em ruminantes no Brasil são limitados, e, a maioria dos relatos envolve estudos experimentais. Portanto, este trabalho teve como objetivo relatar os resultados da análise do LCR em 58 ruminantes com distúrbios neurológicos. Amostras do LCR foram obtidas de 32 bovinos, 20 ovinos e 6 caprinos por punção da cisterna cerebelo-medular (n=54) ou espaço lombossacro (n=4) para posterior análise. Esses ruminantes apresentaram sinais neurológicos relacionados a infecções virais (n=13), micóticas (n=3) ou bacterianas (n=15), e desordens tóxicas (n=21), traumáticas (n=4) ou congênitas (n=2) A análise do LCR de ruminantes com infecções virais apresentou pleocitose linfocítica, embora, em vários casos de raiva, o LCR não tenha apresentado alterações. Pleocitose neutrofílica, turbidez, presença de coágulos de fibrina e coloração anormal foram evidentes no LCR da maioria dos casos de infecções bacterianas do SNC, como meningoencefalites, meningites, abscessos, mielite e um caso de conidiobolomicose. Por outro lado, o LCR não foi alterado na maioria dos casos dos distúrbios tóxicos, como botulismo e encefalopatia hepática. A densidade elevada no LCR foi observada em 60% dos ruminantes diagnosticados com polioencefalomalácia. Nossos resultados mostram que a avaliação do LCR é uma valiosa ferramenta de diagnóstico, quando usada em associação com os achados epidemiológicos, clínicos e patológicos para o diagnóstico de doenças do SNC em ruminantes.(AU)

Circulating nucleic acids in the plasma and serum as potential biomarkers in neurological disorders

Neurological diseases are responsible for approximately 6.8 million deaths every year. They affect up to 1 billion people worldwide and cause significant disability and reduced quality of life. In most neurological disorders, the diagnosis can be challenging; it frequently requires long-term investigation. Thus, the discovery of better diagnostic methods to help in the accurate and fast diagnosis of neurological disorders is crucial. Circulating nucleic acids (CNAs) are defined as any type of DNA or RNA that is present in body biofluids. They can be found within extracellular vesicles or as cell-free DNA and RNA. Currently, CNAs are being explored as potential biomarkers for diseases because they can be obtained using non-invasive methods and may reflect unique characteristics of the biological processes involved in several diseases. CNAs can be especially useful as biomarkers for conditions that involve organs or structures that are difficult to assess, such as the central nervous system. This review presents a critical assessment of the most current literature about the use of plasma and serum CNAs as biomarkers for several aspects of neurological disorders: defining a diagnosis, establishing a prognosis, and monitoring the disease progression and response to therapy. We explored the biological origin, types, and general mechanisms involved in the generation of CNAs in physiological and pathological processes, with specific attention to neurological disorders. In addition, we present some of the future applications of CNAs as non-invasive biomarkers for these diseases.

Compromiso neurológico grave por déficit de vitamina B12 en lactantes hijos de madres veganas y vegetarianas / Serious neurological compromise due to vitamin B12 deficiency in infants of vegan and vegetarian mothers

La deficiencia de vitamina B12 es una de las complicaciones más graves del vegetarianismo. Los lactantes hijos de madres veganas tienen mayor riesgo de deficiencia grave y son más lábiles ante sus efectos. La deficiencia de B12 no es, por lo general, sospechada por el pediatra en lactantes previamente sanos con síntomas neurológicos, ya que las manifestaciones iniciales son inespecíficas: apatía, rechazo del alimento y pérdida de pautas madurativas. La anamnesis nutricional es fundamental para detectar riesgo de déficit de esta vitamina en lactantes. El objetivo de este trabajo es describir a un grupo de lactantes, hijos de madres veganas, con déficit de B12 y compromiso neurológico grave: apneas centrales, convulsiones, hipotonía, pérdida de conexión con el medio y de pautas madurativas. Nuestro propósito es alertar sobre la importancia de suplir B12 a las madres veganas desde antes de la concepción hasta el fin de la lactancia.

Vitamin B12 deficiency is one of the most serious complications of vegetarianism and its variants. Infants born to vegan mothers are at greater risk of serious deficiency, being more vulnerable to their effects. B12 deficiency is not usually suspected by the pediatrician in healthy infants with neurological symptoms. The manifestations are nonspecific: apathy, rejection of food and loss of maturational patterns. A nutritional history of the mother, mainly if she is vegetarian, to estimate her reserves is fundamental to detect risk of deficiency of this vitamin in the small child. The objective of this work is to describe a group of infants, children of vegan mothers, with B12 deficiency and serious neurological compromise: central apneas, seizures, hypotonia, loss of connection with the environment and maturational patterns. Our purpose is to alert about the importance of supplying vegan mothers with B12 before conception until the end of breastfeeding.

Prescribing pattern in outpatient department of neurosurgery in a tertiary care hospital of North India

Background: The neurosurgical disorders are amongst the leading cause of global mortality and morbidity. Though surgical intervention is thought to be the main management protocol in the neurosurgical setup but drugs are being equally used especially in the outpatient setting. The present study was carried out in view of the sparse data available on prescribing pattern in neurosurgery.Methods: The present study was conducted by the department of pharmacology in outpatient department of neurosurgery in a tertiary care centre to look into the prescription pattern among these patients.Results: In 268 patients analyzed, mean age was 43.02±15.93 years and 52.23% were females. Majority of our participants (44%) were found to be of young to middle age group (21-40 years). The diagnosis among the study population was spread over large number of diseases. Lumbar Disc Prolapse (LDP) was found to be the leading cause of neurosurgical morbidity, amounting to 32%. As far as the prescription of various drugs in the outpatient of neurosurgery is concerned, Analgesics were the most common drugs prescribed constituting about 48% of the total drugs prescribed followed by GABA analogues and multivitamins which equally formed 41% of the total prescribed drugs.Conclusions: Although the prescription pattern studies among the outpatient neurosurgery patients are very scant, the analysis of prescription studies will be helpful to encourage the rational drug prescribing pattern.

Advance of Botulinum Toxin A in Neurological Disorders (review) / 中国康复理论与实践

The studies of Botulinum toxin A (BoNT/A) are progressing in many fields. BoNT/A has been used in neurological disorders, such as pains, spasticity, dystonias and autonomic disorders, etc. The pharmacological interaction among BoNT/A, neuronal transport and protein has been explored, and promoted basic science studies.

Role of gap junction protein connexin43 in pathogenesis of neuro-disorders / 中国药理学通报

Gap junction (GJ), which mainly consists of connexins, is a linking method between neighboring cells. Neighboring cells exchange substances, energy and information by gap junction intercellular communication mediated by GJ. Particularly, Cx43 protein is one of the most important members of Cx family. The study in recent years demonstrated the features of Cx43 protein and its important roles in the pathogenesis of neurological disorders, tumors, cardiovascular risks. This article summarizes the structure, functions, coding gene, structure analysis, synthesis, membrane localization, regulation of Cx43. Furthermore, this article explains the physiological functions of Cx43 in human bodies and its important roles in the pathogenesis of related neurological disorders.

Niños con trastornos neurológicos y salud bucal: percepción familiar de la necesidad de atención / Children with neurological disorders and oral health: family perception of need for care

La discapacidad o trastornos del desarrollo es una patología que se presenta con cierta frecuencia en la población infantil .En algunos casos varias funciones están severamente afectadas: la interacción social, el lenguaje, el comportamiento, funciones cognitivas o de motricidad. Estas características son consideradas factores de riesgo para su salud bucal. Con el objeto de mejorar su calidad de vida en el futuro a través de la salud oral , de analizar la percepción familiar de la necesidad de atención odontológica en niños con trastornos neurológicos e identificar los motivos de realizar una consulta, como así también los fundamentos de no realizarla, y conocer los hábitos de alimentación y de higiene, se realizó un estudio observacional mediante una encuesta de elaboración propia en diferentes centros de estimulación temprana y rehabilitación de la ciudad de La Plata. Se realizó un total de 120 encuestas, a niños y niñas, entre 3 y 12 años.El 66% presento un diagnóstico de Trastorno general del desarrollo, en cuanto a la consulta odontológica el 56,6 % no la había realizado hasta el momento. Con respecto al motivo de la consulta odontológica el 34% la hizo por prevención, el 31% por dolor. No realizaron la consulta odontológica el 53 % por falta de tiempo, el 24 % por temor y el 23% por falta de información. El 44% de los encuestados manifestó cepillarles a veces los dientes a sus hijos, el 37% lo realiza todos los días, el 13% no higieniza los dientes, mientras que el 6% se higienizan solos. En cuanto al conocimiento de las bebidas y alimentos que dañan los dientes el 86 % manifestó saber, y el 13% no; esta información el 33 % la obtuvo del odontólogo. Gran parte de la población infantil con trastornos neurológicos concurren por primera vez a la consulta odontológica por dolor, en muchas ocasiones demoran la primer visita al odontólogo por falta de tiempo, ya que estos niños están en tratamiento de rehabilitación y estimulación desde edades muy tempranas, y en muchos casos no reciben la derivación en el momento oportuno. La promoción y prevención de la salud bucal en niños con discapacidad es de vital importancia para todo el grupo familiar por lo cual es importante instruir a los padres acerca de la importancia de la prevención y enfatizar en el cuidado de la salud en el hogar (AU)

Disability or developmental disorder is a pathology that frequently appears in child population. In some cases, several functions are severely affected: social interaction, language, behaviour, cognitive and motor function. These characteristics are taken as a risk factors for their oral health. An observational study was performed by means of a self-made survey in different early stimulation and rehabilitation centers from the city of La Plata. The survey was conducted with the purpose of improving children's future life through their oral health and to analyze family perception as regards the need of dental care in children with neurological disorders; to identify the reasons for seeking dental care as well as the reasons for not doing so and to acknowledge feeding and hygiene habits. A total of 120 surveys were carried out, for boys and girls, between 3 and 12 years. 66% presented a diagnosis of General Developmental Disorder, regarding the dental consultation 56,6% had not done so far. Regarding the reason for the dental consultation, 34% did it for prevention, 31% for pain. They did not perform the dental consultation 53% for lack of time, 24% for fear and 23% for lack of information. 44% of the respondents stated that they sometimes brush their children's teeth, 37% do it every day, 13% do not sanitize their teeth, and 6% sanitize themselves. As far as the knowledge of the drinks and foods that damage the teeth are concerned, 86% reported knowing, and 13% did not; This information 33% obtained it from the dentist. A large proportion of the children with neurological disorders are for the first time in the dental consultation due to pain, often delay the first visit to the dentist due to lack of time, since these children are in rehabilitation and stimulation treatment from very early ages, And in many cases do not receive the referral in a timely manner. The promotion and prevention of oral health in children with disabilities is of vital importance for the whole family group. Therefore, it is important to educate parents about the importance of prevention and to emphasize the health care at home (AU)