Análisis de los tratamientos en pacientes diagnosticados con polimiositis / Analysis of Treatments in Patients Diagnosed with Polymyositis

Introducción: La polimiositis, la frase conocida como miopatía idiopática inflamatoria, es una enfermedad poco frecuente, considerada rara y heterogénea, que se caracteriza por la debilidad muscular, por lo que puede dificultar la movilidad cotidiana Objetivo: Analizar los tratamientos farmacológicos y no farmacológicos en pacientes diagnosticados con polimiositis. Métodos: Se realizó una búsqueda bibliográfica donde se siguió la recomendación PRISMA. Las fuentes de información consultadas fueron: SciELO, LILACS, PubMed, Elsevier, EBSCO, Medline, Google Académico, en el período de 2018 a 2022. Resultados: Se consultaron un total de 14 268 artículos correspondientes a la búsqueda bibliográfica, de ellos 42 artículos cumplieron con los criterios de selección. Se utilizó el método PRISMA según su recomendación, quedaron un total de cuatro artículos científicos originales de las cuales tres describen tratamientos farmacológicos, que mencionan a los corticoides y a los inmunosupresores; sin embargo, en aquellos pacientes que no responden al tratamiento se le recomienda la intervención clínica con inmunoglobulina G (IgG), que proporciona anticuerpos como moléculas monoméricas policlonales, que son bien tolerada. Por otro lado, dos artículos describen como tratamiento no farmacológico a la rehabilitación física con el objetivo de evitar el deterioro muscular. Conclusiones: El tratamiento en los pacientes diagnosticados con polimiositis debe ser individualizado, a partir de la gravedad de dicho padecimiento. A Una mayor afectación del cuerpo del paciente a nivel muscular, menor será la respuesta al tratamiento. Es importante la rehabilitación física y el uso de fármacos para controlar y aliviar la polimiositis(AU)

Introduction: Polymyositis known as idiopathic inflammatory myopathy is a rare disease. It is heterogeneous disease, characterized by symmetrical muscle weakness, which can make daily mobility difficult. Objective: To analyze pharmacological and non-pharmacological treatments in patients diagnosed with polymyositis. Methods: A bibliographic search was carried out following PRISMA recommendation. The information sources consulted were SciELO, LILACS, PubMed, Elsevier, EBSCO, Medline, Google Scholar from 2018 to 2022. Results: 14,268 articles corresponding to the bibliographic search were consulted, only 42 met the selection criteria. PRISMA method was used according to its recommendation. Four original scientific articles remained, three of them describe pharmacological treatments mentioning corticosteroids and immunosuppressants. However, in those patients who do not respond to treatment, clinical intervention with immunoglobulin G (IgG) is recommended, which provides antibodies as polyclonal monomeric molecules, which are well tolerated. On the other hand, two articles describe physical rehabilitation as a non-pharmacological treatment with the aim of avoiding muscle deterioration. Conclusions: Treatment in patients diagnosed with polymyositis should be individualized, based on the severity of the condition. A greater involvement of the patient's body at the muscular level, the lower the response to treatment. Physical rehabilitation and the use of drugs is important to control and relieve polymyositis(AU)

Gut-microbiota-directed strategies to treat epilepsy: clinical and experimental evidence.

A growing appreciation that the intestinal microbiota might exert changes on the central nervous system via the gut-brain has emerged as a new research frontier in neurological disorders. Moreover, new approaches for studying and manipulating the gut microbiome, including metabolomics and faecal microbiota transplantation, have highlighted the tremendous potential that microbes have on neuroinflammation, metabolic, and neuroendocrine signaling pathways. Despite the large proliferation of studies in animal models examining the linkage between microbial disequilibrium and epilepsy, intestinal profiles at a functional level in humans have remained scarce. We reviewed the scientific evidence on gut microbiota's role in epilepsy, both in clinical and experimental studies, to better understand how targeting the gut microbiota could serve as a diagnostic or prognostic research tool. Likewise, translating microbial molecular mechanisms to medical settings could fill the gaps related to alternative therapies for patients with epilepsy, mainly in cases with refractory phenotypes.

COVID-19: enfoque básico para entender sus tratamientos / COVID-19: a basic approach to understanding potential treatments

Resumen El virus SARS-CoV-2 ha sido identificado como el agente patológico causante de la pandemia de COVID-19. Aun cuando no se cuenta con un tratamiento estándar, se han probado antivirales como remdesivir y otros fármacos como cloroquina e ivermectina, que interfieren con la replicación del virus. También se han intentado algunas estrategias encaminadas a disminuir los mecanismos inmunitarios, como el uso de tocilizumab y antioxidantes naturales. Los fármacos relacionados con el sistema renina-angiotensina han resultado controversiales. Aún se debe estudiar con detalle los mecanismos de patogenicidad, así como los tratamientos controlados para proponer alguna opción terapéutica viable que evite la entrada y replicación del virus o que aumente los sistemas inmunitarios del huésped.

Abstract SARS-CoV-2 virus has been identified as the causative agent of the COVID-19 pandemic. Even when no standard treatment is available, antivirals such as remdesivir and other drugs such as chloroquine and ivermectin, which interfere with viral replication, have been assayed. Some strategies aimed to reduce immune mechanisms, such as the use of tocilizumab and natural antioxidants, have also been tested. The use of drugs related to the renin-angiotensin system has been controversial. Pathogenicity mechanisms, as well as controlled treatments, still have to be studied in detail in order to propose a viable therapeutic option that prevents the entry and replication of the virus or enhances the host immune system.

COVID-19: a basic approach to understanding potential treatments.

SARS-CoV-2 virus has been identified as the causative agent of the COVID-19 pandemic. Even when no standard treatment is available, antivirals such as remdesivir and other drugs such as chloroquine and ivermectin, which interfere with viral replication, have been assayed. Some strategies aimed at reducing immune mechanisms, such as the use of tocilizumab and natural antioxidants, have also been tested. The use of drugs related to the renin-angiotensin system has been controversial. Pathogenicity mechanisms, as well as controlled treatments, still have to be studied in detail in order to propose a viable therapeutic option that prevents the entry and replication of the virus or enhances the host immune system.El virus SARS-CoV-2 ha sido identificado como el agente patológico causante de la pandemia de COVID-19. Aun cuando no se cuenta con un tratamiento estándar, se han probado antivirales como remdesivir y otros fármacos como cloroquina e ivermectina, que interfieren con la replicación del virus. También se han intentado algunas estrategias encaminadas a disminuir los mecanismos inmunitarios, como el uso de tocilizumab y antioxidantes naturales. Los fármacos relacionados con el sistema renina-angiotensina han resultado controversiales. Aún se debe estudiar con detalle los mecanismos de patogenicidad, así como los tratamientos controlados para proponer alguna opción terapéutica viable que evite la entrada y replicación del virus o que aumente los sistemas inmunitarios del huésped.

Neuroprotection in Hypoxic-Ischemic Brain Injury Targeting Glial Cells.

Brain injury constitutes a disabling health condition of several etiologies. One of the major causes of brain injury is hypoxia-ischemia. Until recently, pharmacological treatments were solely focused on neurons. In the last decades, glial cells started to be considered as alternative targets for neuroprotection. Novel treatments for hypoxia-ischemia intend to modulate reactive forms of glial cells, and/or potentiate their recovery response. In this review, we summarize these neuroprotective strategies in hypoxia-ischemia and discuss their mechanisms of action.

Tratamentos não farmacológicos que melhoram a qualidade de vida de idosos com doença de Alzheimer: uma revisão sistemática / Non-pharmacological treatments that improve the quality of life of elderly with Alzheimer’s disease: a systematic review

RESUMO Objetivo Realizar uma revisão sistemática sobre quais são os tratamentos não farmacológicos que ajudam a melhorar a qualidade de vida (QV) de idosos com doença de Alzheimer (DA) mais descritos na literatura nos últimos dez anos (2006-2016). Métodos Revisão sistemática da literatura realizada nas três primeiras semanas de janeiro de 2016, nas bases: Capes, SciELO, Web of Science, PubMed, Lilacs e Scopus. Foram utilizadas duas combinações de termos: (1) predictors AND quality of life AND elderly AND Alzheimer’s disease e (2) non-pharmacological treatment AND quality of life AND Alzheimer’s disease. Foram encontrados 240 artigos e analisados o título e o resumo dos artigos e, quando necessário, o próprio texto. Do total de 240 artigos, apenas quatro trabalhos preencheram os critérios de inclusão e foram selecionados. Resultados Os resultados mostraram que os tratamentos não farmacológicos mais descritos, no referido período, visando melhorar a QV de idosos com DA, foi a reabilitação, tanto cognitiva quanto multidisciplinar. Conclusão As técnicas de reabilitação mostraram-se capazes de melhorar a QV de idosos com doença de Alzheimer leve.

ABSTRACT Objective To carry out a systematic bibliographical review, between 2006 and 2016, about the most cited non-pharmacological treatments that improve the quality of life (QOL) of elderly with Alzheimer’s disease (AD). Methods The study was to realize in Capes, SciELO, Web of Science, PubMed, Lilacs and Scopus databases. The search was to carry out in the three first of January 2016. The following terms combinations were used: (1) predictors AND quality of life AND elderly AND Alzheimer’s disease (in February) and (2) non-pharmacological treatment AND quality of life AND Alzheimer’s disease. The searches resulted in 240 articles. Four articles were selected after title and abstract inspection. Results Multidisciplinary or cognitive rehabilitation was the most cited non-pharmacological treatment that promote the QOL in elderly with AD. Conclusion The rehabilitation techniques presented capable of improving the QOL in elderly with mild Alzheimer’s disease.

Referral to rehabilitation in Parkinson's disease: who, when and to what end? / Criterios de encaminhamento para a reabilitacao na doenca de Parkinson: quem, quando e que finalidade?

The current state of evidence in non-pharmacological treatments amounts to an impending paradigm shift in neurology where physicians should be alerted that some rehabilitation interventions are already supported in current therapeutic guidelines. This manuscript aims to overview the best scientific data supporting referral to rehabilitation services in order to help physicians make the best use of the existing evidence for non-pharmacological treatments in the different stages of Parkinson´s disease.

O atual nível de evidência para tratamentos não farmacológicos sugere uma mudança de paradigma na área da neurologia, a qual passa por alertar os médicos neurologistas de que algumas intervenções na área da reabilitação estão já fundamentadas em linhas de orientação terapêutica. Este trabalho tem o objetivo de rever a melhor evidencia cientifica para a definição de critérios de encaminhamento para serviços de reabilitação, procurando auxiliar os médicos neurologistas a obter o melhor beneficio da evidência cientifica atual para tratamentos não farmacológicos nos diferentes estadios da doença de Parkinson.

Permanência das representações do gênero em sexologia: as inovações científica e médica comprometidas pelos estereótipos de gênero / Permanence of gender stereotypes in sexology: when scientific innovations are challenged by traditional gender stereotypes

Numerosas mudanças surgiram no domínio da pesquisa em sexologia, notadamente no que concerne à função e disfunções sexuais e seus tratamentos. A disfunção erétil foi reconceitualizada como uma disfunção com origem orgânica, uma transformação em relação às abordagens anteriores acerca da impotência psicogênica, desenvolvidas nos anos 1960 e 1970. Essa mudança se baseia em muitas descobertas científicas e no avanço farmacológico realizado sob influência de urologistas norte-americanos. A disponibilização no mercado do sildenafil, em 1998, acionou novos tipos de tratamentos, centrados na atividade peniana. Os mesmos grupos de urologistas passaram recentemente a repensar as "disfunções sexuais femininas" segundo o mesmo modelo orgânico da função sexual. Novos produtos farmacêuticos estão em testagem clínica, tendo em vista a proposta de tratamentos da nova categoria de transtornos sexuais. A colocação no mercado do sildenafil não provocou reações contrárias às novas abordagens dos transtornos sexuais masculinos. Inversamente, o surgimento de novos conceitos da função sexual feminina suscita importantes debates. O British Medical Journal veiculou uma discussão, estabelecendo que a função sexual feminina não possuía origem orgânica, mas fundava-se em fatores psicológicos e relacionais da atividade sexual das mulheres. O debate centrou-se na "simplicidade" da sexualidade masculina, em oposição à "complexidade" da sexualidade feminina. Este artigo apresenta a analisa as novas concepções da função sexual masculina e feminina, e evidencia a permanência de estereótipos tradicionais da sexualidade masculina e feminina, e sua influência sobre as pesquisas científicas mais avançadas nessa esfera1.

Major changes have occurred in male and female sexual function/dysfunction research and treatments. Male erectile dysfunction has been re-conceptualized as an organic dysfunction, which marks a dramatic shift from previous conceptions of psychogenic impotence developed during the 60' and the 70's. This shift is based on major scientific discoveries, and pharmacological advances that took place since the early 80's under the influence of North American urologists. The release of sildenafil in 1998 was the corner stone of a new paradigm of treatments focusing on male penile activity, far remote from any psychological approaches. More recently, the same group of urologists started to reconsider Female Sexual Dysfunction using the same organic/biological model of sexual function. New pharmaceutical products are currently under trial for the treatment of this new category of female sexual disorder. But as opposed to the absence of public adverse reaction to the development of this approach of male function, many voices raised to oppose this new conception of female function. A major discussion took place in the British Medical Journal stating that female sexual function was not organically driven, but rather determined by the social, psychological and interpersonal context of female sexual activity and relations. One of the major dimensions of this discussion opposed the so-called "simplicity" of male sexual function to the "complexity" of female sexual function. This paper demonstrates the permanence of traditional social scripts of male and female sexuality and their influence in the most advanced scientific research in this field.