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1.
BMC Neurol ; 21(1): 314, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34388988

RESUMO

BACKGROUND: Peripheral neuropathy (PN) is a neurological complication of untreated Human Immunodeficiency Virus (HIV) infection or exposure to certain antiretroviral drugs. In Tanzania where HIV is a major public health problem, the burden of HIV associated peripheral neuropathy has not yet been well defined in children.Thisstudy investigated the prevalence and associated factors for peripheral neuropathy among children living with HIV, attending Care and Treatment Clinic (CTC) at Muhimbili National Hospital (MNH). MATERIALS AND METHODS: A cross-sectional study was conducted among 383 HIV positive children aged 5 to 18 years at MNH, CTC in Dar es Salaam between October to December 2019. All participants provided written assent/consent. Structured questionnaires designed for this study was used to collect data and screening for peripheral neuropathy was done on each participant using the Pediatric modified Total Neuropathy Score (Ped m TNS) that includes subjective and objective assessment. A score of 5 or greater on the Ped m TNS was used to define peripheral neuropathy. Data analysis was done using SPSS Version 23. RESULTS: The prevalence of peripheral neuropathy among HIV infected children was 14.1 % (95 % CI (10.8 - 18 %). Common neuropathic symptoms were numbness, tingling sensation, reduced ankle reflexes and reduced sensation to light touch and pain that was limited to the toes. Low CD4 cell count (OR = 12.21; 95 % CI3.75-39.66; p = 0.0001), high viral load (OR = 10.54; 95 % CI 3.19-34.77; p = 0.0001), ART regime containing NRTI plus PI (OR = 3.93; 95 % CI 1.43- 10.74; p = 0.01) and the last exposure to isoniazid more than 6 months ago (OR = 3.71; 95 % CI 1.57-8.77; p = 0.003) were independent predictors for peripheral neuropathy. CONCLUSION: Peripheral neuropathy is common among HIV infected children attending CTC at MNH and its frequency increases with advanced disease. The choice of ART regimen and other drugs for treating comorbid conditions should carefully be evaluated.


Assuntos
Infecções por HIV , Doenças do Sistema Nervoso Periférico , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Hospitais , Humanos , Masculino , Doenças do Sistema Nervoso Periférico/epidemiologia , Tanzânia/epidemiologia
2.
J Med Case Rep ; 13(1): 370, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31839004

RESUMO

INTRODUCTION: De Morsier syndrome, or septo-optic dysplasia, is a rare, heterogeneous, complex condition with a highly variable phenotype. It is characterized by optic nerve hypoplasia, pituitary gland hypoplasia, and midline brain abnormalities, including absence of septum pellucidum and corpus callosum dysgenesis. Diagnosis is made clinically by the presence of any two or more features from the clinical triad. CASE PRESENTATION: We report a case of a premature African newborn male baby born to nonconsanguineous parents who presented to our institution with agenesis of the septum pellucidum, unilateral optic nerve hypoplasia, and pituitary stalk hypoplasia. However, he had intact central endocrine function. He also presented with limb defects due to constricting amniotic band syndrome. Other dysmorphic features were low-set ears, microcephaly, and bilateral talipes equinovarus. He otherwise had a normal neurological examination result. Over time, he had an adequate weight gain and was managed by a multidisciplinary team. CONCLUSION: De Morsier syndrome still represents a diagnostic challenge, despite advances in neuroimaging and genetic studies, due to the heterogeneous nature of the disorder. This case adds to existing knowledge on the vascular pathogenesis of septo-optic dysplasia.


Assuntos
Síndrome de Bandas Amnióticas/diagnóstico por imagem , Deformidades Congênitas da Mão/patologia , Hipopituitarismo/congênito , Displasia Septo-Óptica/diagnóstico por imagem , Síndrome de Bandas Amnióticas/complicações , Síndrome de Bandas Amnióticas/patologia , Síndrome de Bandas Amnióticas/cirurgia , Deformidades Congênitas da Mão/cirurgia , Humanos , Recém-Nascido , Masculino , Prognóstico , Displasia Septo-Óptica/etiologia , Displasia Septo-Óptica/patologia , Displasia Septo-Óptica/cirurgia , Cirurgia Plástica , Tomografia Computadorizada por Raios X , Resultado do Tratamento
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