Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 282
Filtrar
1.
Food Res Int ; 179: 114017, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38342539

RESUMO

This study produced pH-sensing carboxymethyl cellulose (CMC) films functionalized with bioactive compounds obtained by pressurized liquid extraction (PLE) of grape peel to monitor the freshness of pork and milk. A semi-continuous PLE was conducted using hydroethanolic solution (70:30, v/v) at a flow rate of 5 mL/min, 15 MPa, and 60 °C. The films were produced by the casting technique using CMC (2.5 %, w/v), glycerol (1 %, v/v), and functionalized with 10, 30, and 50 % (v/v) grape peel extract. From the results obtained, LC-MS/MS revealed that PLE extracted twenty-seven phenolic compounds. The main phenolic compounds were kaempferol-3-glucoside (367.23 ± 25.88 µg/mL), prunin (270.23 ± 3.62 µg/mL), p-coumaric acid (236.43 ± 26.02 µg/mL), and procyanidin B1 (117.17 ± 7.29 µg/mL). The CMC films presented suitable color and mechanical properties for food packaging applications. The addition of grape peel extract promoted the pH-sensing property, showing the sensitivity of anthocyanins to pH changes. The films functionalized with grape peel extract presented good release control of bioactive compounds, making them suitable for food packaging applications. When applied to monitor the freshness of pork and milk, the films exhibited remarkable color changes associated with the pH of the food during storage. In conclusion, PLE is a sustainable approach to obtaining bioactive compounds from the grape peel, which can be applied in the formulation of pH-sensing films as a promising sustainable material to monitor food freshness during storage.


Assuntos
Carne de Porco , Carne Vermelha , Vitis , Animais , Suínos , Carboximetilcelulose Sódica/química , Carne Vermelha/análise , Leite , Antocianinas/química , Cromatografia Líquida , Concentração de Íons de Hidrogênio , Espectrometria de Massas em Tandem , Fenóis
2.
Clin Oral Investig ; 28(3): 169, 2024 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-38396299

RESUMO

OBJECTIVE: Craniofacial and oral manifestations of Osteogenesis Imperfecta (OI) can affect the functioning of the stomatognathic system and impact the patient's quality of life. The objective of the study was to evaluate the relationship between craniofacial and oral manifestations and the Oral Health-related Quality of Life (OHRQoL) of OI children and adolescents. MATERIAL AND METHODS: A total of 30 OI patients aged eight to fourteen years old followed up at the Oral Care Center for Inherited Diseases were enrolled in the research. OHRQoL was assessed using the short form of the Child Perceptions Questionnaire (CPQ) for eight to ten-year-olds (CPQ8-10) and 11 to 14-year-olds (CPQ11-14). The relationship between the OHRQoL index and its assessment domains, OI types, and the presence of dentinogenesis imperfecta (DI), class III malocclusion, and dental agenesis were evaluated. RESULTS: The median CPQ score of patients was 5, and there was no significant difference in OHRQoL between children and adolescents, nor associated with the disease severity or the presence of DI. The oral manifestations evaluated did not directly impact the patients' OHRQoL. CONCLUSIONS: The study demonstrated that the perception of OHRQoL is similar for both adolescents and children. The oral symptom was the most relevant domain for the index among patients aged eight to fourteen years while the emotional well-being was the most impacted. CLINICAL RELEVANCE: this study makes contributions by indicating that addressing dental care for children and adolescents with OI is important in clinical management and better OHRQoL for this population.


Assuntos
Cárie Dentária , Má Oclusão Classe III de Angle , Osteogênese Imperfeita , Criança , Humanos , Adolescente , Saúde Bucal , Osteogênese Imperfeita/complicações , Qualidade de Vida/psicologia , Estudos Transversais , Inquéritos e Questionários , Cárie Dentária/epidemiologia
3.
Epilepsia Open ; 9(2): 626-634, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38217377

RESUMO

OBJECTIVE: To investigate the association between left epileptiform activity and language laterality indices (LI) in patients with right mesial temporal sclerosis (MTS). METHODS: Twenty-two patients with right MTS and 22 healthy subjects underwent fMRI scanning while performing a language task. LI was calculated in multiple regions of interest (ROI). Data on the presence of left epileptiform abnormalities were obtained during prolonged video-EEG monitoring. RESULTS: After correction for multiple comparisons, LI was reduced in the middle temporal gyrus in the left interictal epileptiform discharges (IED+) group, compared with the left IED- group (p < 0.05). SIGNIFICANCE: Using a responsive reading naming fMRI paradigm, right MTS patients who presented left temporal interictal epileptiform abnormalities on video-EEG showed decreased LI in the middle temporal gyrus, indicating decreased left middle temporal gyrus activation, increased right middle temporal gyrus activation or a combination of both, demonstrative of language network reorganization, specially in the MTG, in this patient population. PLAIN LANGUAGE SUMMARY: This research studied 22 patients with right mesial temporal sclerosis (a specific type of epilepsy) comparing them to 22 healthy individuals. Participants were asked to perform a language task while undergoing a special brain imaging technique (fMRI). The findings showed that patients with epilepsy displayed a change in the area of the brain typically responsible for language processing. This suggests that their brains may have adapted due to their condition, altering the way language is processed.


Assuntos
Epilepsia do Lobo Temporal , Epilepsia , Esclerose Hipocampal , Humanos , Encéfalo , Idioma
4.
J Neuroimmunol ; 388: 578295, 2024 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-38280268

RESUMO

Therapeutic plasma exchange (TPE) can improve disability recovery after neuromyelitis optica spectrum disease (NMOSD) attacks, but its effectiveness and safety in Latin-American patients with access barriers and diverse ethnicity is underexplored. We carried out a retrospective cohort study with NMOSD patients that underwent TPE. 84 NMOSD attacks in 68 patients were evaluated. Despite a median 25-day delay from symptom onset to TPE, 65,5% of patients showed significant improvement. Adverse events occurred in 39% of patients, usually transitory and with no fatalities.


Assuntos
Neuromielite Óptica , Humanos , Neuromielite Óptica/diagnóstico , Troca Plasmática , Estudos Retrospectivos , Brasil/epidemiologia , Etnicidade , Aquaporina 4
5.
Food Res Int ; 173(Pt 1): 113332, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37803643

RESUMO

This study evaluated the use of a semi-continuous high-pressure hydrothermal process for the recovery of value-added products from pitaya peel. The process was carried out at 15 MPa, a water flow rate of 2 mL/min, a solvent-to-feed ratio of 60 g water/g pitaya peel, and temperatures ranging from 40 to 210 °C. The results show that extraction temperatures (between 40 and 80 °C) promoted the recovery of betacyanin (1.52 mg/g), malic acid (25.6 mg/g), and citric acid (25.98 mg/g). The major phenolic compounds obtained were p-coumaric acid (144.63 ± 0.42 µg/g), protocatechuic acid (91.43 ± 0.32 µg/g), and piperonylic acid (74.2 ± 0.31 µg/g). The hydrolysis temperatures (between 150 and 210 °C) could produce sugars (18.09 mg/g). However, the hydrolysis process at temperatures above 180 °C generated Maillard reaction products, which increased the total phenolic compounds and antioxidant activity of the hydrolysates. Finally, the use of semi-continuous high-pressure hydrothermal process can be a sustainable and promising approach for the recovery of value-added compounds from pitaya peel, advocating a circular economy approach in the agri-food industry.


Assuntos
Cactaceae , Fenóis , Antioxidantes , Solventes , Extratos Vegetais , Água
6.
Epilepsia Open ; 8(4): 1532-1540, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37750472

RESUMO

OBJECTIVE: To compare memory outcomes after surgery for unilateral hippocampal sclerosis (HS)-associated epilepsy in patients with unilateral and bilateral ictal electrographic involvement. METHODS: We prospectively evaluated HS patients, aged 18-55 years and IQ ≥70. Left (L) and right (R) surgical groups underwent noninvasive video-EEG monitoring and Wada test. We classified patients as Ipsilateral if ictal EEG was restricted to the HS side, or Bilateral, if at least one seizure onset occurred contralaterally to the HS, or if ictal discharge evolved to the opposite temporal region. Patients who declined surgery served as controls. Memory was evaluated on two occasions with Rey Auditory-Verbal Learning Test and Rey Visual-Design Learning Test. Baseline neuropsychological test scores were compared between groups. Pre- and postoperative scores were compared within each group. Reliable change index Z-scores (RCI) were obtained using controls as references, and compared between surgical groups. RESULTS: We evaluated 64 patients. Patients were classified as: L-Ipsilateral (9), L-Bilateral (15), L-Control (9), R-Ipsilateral (10), R-Bilateral (9), and R-Control (12). On preoperative evaluation, memory performance did not differ among surgical groups. Right HS patients did not present postoperative memory decline. L-Ipsilateral group presented postoperative decline on immediate (P = 0.036) and delayed verbal recall (P = 0.011), while L-Bilateral did not decline. L-Ipsilateral had lower RCI Z-scores, indicating delayed verbal memory decline compared to L-Bilateral (P = 0.012). SIGNIFICANCE: Dominant HS patients with bilateral ictal involvement presented less pronounced postoperative verbal memory decline compared to patients with exclusive ipsilateral ictal activity. Surgery was indicated in these patients regardless of memory impairment on neuropsychological testing, since resection of the left sclerotic hippocampus could result in cessation of contralateral epileptiform activity, and, therefore, improved memory function.


Assuntos
Epilepsia do Lobo Temporal , Esclerose Hipocampal , Humanos , Epilepsia do Lobo Temporal/cirurgia , Lobo Temporal/patologia , Lobo Temporal/cirurgia , Transtornos da Memória/etiologia , Transtornos da Memória/patologia , Eletroencefalografia , Esclerose/complicações , Esclerose/patologia
7.
Seizure ; 112: 77-83, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37769548

RESUMO

OBJECTIVE: To evaluate the effectiveness and side-effect profile of the modified Atkins diet (MAD) compared to the usual diet (UD) in reducing seizure frequency among patients with drug-resistant epilepsy (DRE). METHODS: In February 2023, we conducted an extensive search in PubMed, EMBASE, and Cochrane databases to find randomized controlled trials (RCTs) comparing MAD to UD in patients with drug-resistant epilepsy (DRE) on standard anti-seizure medication (ASM). We used random-effects meta-analyses and the Risk of Bias 2 tool to evaluate treatment effects and assess the quality of the included RCTs, respectively. RESULTS: Six studies were evaluated in the meta-analysis, including 575 patients, of whom 288 (50.1 %) were randomized to the MAD. Average follow-up period was 12 weeks. MAD plus standard drug therapy was associated with a higher rate of 50 % or greater reduction in seizure frequency compared to UD plus drug therapy (RR 6.28; 95 % CI 3.52-10.50; p<0.001), both in children (RR 6.28; 95 % CI 3.43-11.49; p<0.001) and adults with DRE (RR 6.14; 95 % CI 1.15-32.66; p = 0.033). MAD was also associated with a higher seizure freedom rate compared to UD (RR 5.94; 95 % CI 1.93-18.31; p = 0.002). Five studies reported adverse events with MAD; constipation was reported in 17 % of patients (95 % CI 5-44 %), lethargy in 11 % (95 % CI 4-25 %), and anorexia in 12 % (95 % CI 8-19 %). Due to limited information about the ASM regimens, we were unable to further analyze the interaction between MAD and ASM. SIGNIFICANCE: This meta-analysis, comprising 575 patients from 6 RCTs, revealed that MAD led to higher rates of seizure freedom and underscored its role in seizure frequency reduction by 50 % or more in both adults and children, with no significant adverse events concerns.


Assuntos
Dieta Rica em Proteínas e Pobre em Carboidratos , Dieta Cetogênica , Epilepsia Resistente a Medicamentos , Adulto , Criança , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Epilepsia Resistente a Medicamentos/tratamento farmacológico , Dieta Cetogênica/efeitos adversos , Convulsões/tratamento farmacológico , Convulsões/induzido quimicamente , Anticonvulsivantes/efeitos adversos
8.
J Neuroimmunol ; 381: 578140, 2023 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-37364518

RESUMO

Optic neuritis (ON) admits diverse differential diagnoses. Petzold proposed diagnostic criteria for ON in 2022, although real-world application of these criteria is missing. We conducted a retrospective review of patients with ON. We classified patients into definite or possible ON, and into groups A (typical neuritis), B (painless), or C (binocular) and estimated the frequency of etiologies for each group. We included 77 patients, with 62% definite and 38% possible ON. CRION and NMOSD-AQP4 negative-ON were less commonly seen in definite ON. Application of the 2022 criteria revealed a lower-than-expected frequency of definite ON, particularly for seronegative non-MS causes.


Assuntos
Neuromielite Óptica , Neurite Óptica , Humanos , Neurite Óptica/diagnóstico , Neurite Óptica/etiologia , Estudos Retrospectivos , Diagnóstico Diferencial , Aquaporina 4 , Neuromielite Óptica/diagnóstico , Autoanticorpos , Glicoproteína Mielina-Oligodendrócito
9.
Front Immunol ; 14: 1176898, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37122732

RESUMO

Introduction: SARS-CoV-2 infection during pregnancy can induce changes in the maternal immune response, with effects on pregnancy outcome and offspring. This is a cross-sectional observational study designed to characterize the immunological status of pregnant women with convalescent COVID-19 at distinct pregnancy trimesters. The study focused on providing a clear snapshot of the interplay among serum soluble mediators. Methods: A sample of 141 pregnant women from all prenatal periods (1st, 2nd and 3rd trimesters) comprised patients with convalescent SARS-CoV-2 infection at 3-20 weeks after symptoms onset (COVID, n=89) and a control group of pre-pandemic non-infected pregnant women (HC, n=52). Chemokine, pro-inflammatory/regulatory cytokine and growth factor levels were quantified by a high-throughput microbeads array. Results: In the HC group, most serum soluble mediators progressively decreased towards the 2nd and 3rd trimesters of pregnancy, while higher chemokine, cytokine and growth factor levels were observed in the COVID patient group. Serum soluble mediator signatures and heatmap analysis pointed out that the major increase observed in the COVID group related to pro-inflammatory cytokines (IL-6, TNF-α, IL-12, IFN-γ and IL-17). A larger set of biomarkers displayed an increased COVID/HC ratio towards the 2nd (3x increase) and the 3rd (3x to 15x increase) trimesters. Integrative network analysis demonstrated that HC pregnancy evolves with decreasing connectivity between pairs of serum soluble mediators towards the 3rd trimester. Although the COVID group exhibited a similar profile, the number of connections was remarkably lower throughout the pregnancy. Meanwhile, IL-1Ra, IL-10 and GM-CSF presented a preserved number of correlations (≥5 strong correlations in HC and COVID), IL-17, FGF-basic and VEGF lost connectivity throughout the pregnancy. IL-6 and CXCL8 were included in a set of acquired attributes, named COVID-selective (≥5 strong correlations in COVID and <5 in HC) observed at the 3rd pregnancy trimester. Discussion and conclusion: From an overall perspective, a pronounced increase in serum levels of soluble mediators with decreased network interplay between them demonstrated an imbalanced immune response in convalescent COVID-19 infection during pregnancy that may contribute to the management of, or indeed recovery from, late complications in the post-symptomatic phase of the SARS-CoV-2 infection in pregnant women.


Assuntos
COVID-19 , Gestantes , Humanos , Gravidez , Feminino , Interleucina-17 , COVID-19/terapia , Interleucina-6 , Estudos Transversais , SARS-CoV-2 , Citocinas , Quimiocinas , Resultado da Gravidez
10.
Mult Scler Relat Disord ; 75: 104737, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37156037

RESUMO

BACKGROUND: Optic neuritis (ON), a major cause of visual impairment in young adults, is generally associated with rapid visual recovery when treated with intravenous methylprednisolone treatment (IVMPT). However, the optimal duration of such treatment is unknown, ranging from three to seven days in clinical practice. We aimed to compare the visual recovery in patients treated with 5-day or 7-day duration IVMPT. METHODS: We performed a retrospective cohort study of consecutive patients with ON in São Paulo, Brazil, from 2016 to 2021. We compared the proportion of participants with visual impairment in 5-day and 7-day treatment schedules at discharge, at 1 month and between 6 and 12 months after the diagnosis of ON. The findings were adjusted to age, severity of the visual impairment, co-intervention with plasma exchange, time from symptom onset to IVMPT and the etiology of the ON to mitigate indication bias. RESULTS: We included 73 patients with ON treated with 5 or 7-day duration of 1 g/d intravenous methylprednisolone therapy. Visual impairment at 6-12 months in the 5-day or the 7-day treatment groups was similar (57% x 59%, p > 0.9, Odds Ratio 1.03 [95% CI 0.59-1.84]). The results were similar after adjusting for prognostic variables and when observed at different time points. CONCLUSION: Visual recovery is similar in patients treated with 5-day and 7-day duration treatments of 1 g/day intravenous methylprednisolone, suggesting a ceiling effect. Limiting the duration of the treatment can reduce hospital stay and costs, without interfering with clinical benefit.


Assuntos
Metilprednisolona , Neurite Óptica , Adulto Jovem , Humanos , Estudos Retrospectivos , Brasil , Corticosteroides/uso terapêutico , Neurite Óptica/tratamento farmacológico , Neurite Óptica/diagnóstico , Transtornos da Visão/tratamento farmacológico , Transtornos da Visão/etiologia , Resultado do Tratamento
11.
Int J Dermatol ; 62(8): 1088-1093, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37118975

RESUMO

BACKGROUND: Pyoderma gangrenosum currently lacks standardized therapy. New safer and more efficacious therapies are welcome. AIMS: To present two new PG cases treated with JAK inhibitors, adding to the small existing experience METHODS & METHODS: Two case reports of PG patients successfully treated with tofacitinib and baricitinib. RESULTS: Both patients were cured and presented no relapse. Patient # 1 used baricitinib 2 mg bid for 39 days while patient # 2 was treated with tofacitinib 5 mg bid for 120 days. No adverse reactions were seen. DISCUSSION: The increasing usage of JAKi to treat inflammatory diseases had a positive reflex on PG therapy. Fifteen PG cases treated with these drugs had been found in literature and the two new cases here described add to the limited existing experience. CONCLUSION: This is a novel use of tofacitinib and baricitinib beyond the approved indications. JAKi are a welcome addition to our options to manage patients with PG.


Assuntos
Azetidinas , Inibidores de Janus Quinases , Pioderma Gangrenoso , Humanos , Inibidores de Janus Quinases/uso terapêutico , Pioderma Gangrenoso/etiologia , Purinas/uso terapêutico , Azetidinas/uso terapêutico
12.
Viruses ; 15(3)2023 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-36992324

RESUMO

During the Zika virus (ZIKV) outbreak and after evidence of its sexual transmission was obtained, concerns arose about the impact of the adverse effects of ZIKV infection on human fertility. In this study, we evaluated the clinical-laboratory aspects and testicular histopathological patterns of pubertal squirrel monkeys (Saimiri collinsi) infected with ZIKV, analyzing the effects at different stages of infection. The susceptibility of S. collinsi to ZIKV infection was confirmed by laboratory tests, which detected viremia (mean 1.63 × 106 RNA copies/µL) and IgM antibody induction. Reduced fecal testosterone levels, severe testicular atrophy and prolonged orchitis were observed throughout the experiment by ultrasound. At 21 dpi, testicular damage associated with ZIKV was confirmed by histopathological and immunohistochemical (IHC) analyses. Tubular retraction, the degeneration and necrosis of somatic and germ cells in the seminiferous tubules, the proliferation of interstitial cells and an inflammatory infiltrate were observed. ZIKV antigen was identified in the same cells where tissue injuries were observed. In conclusion, squirrel monkeys were found to be susceptible to the Asian variant of ZIKV, and this model enabled the identification of multifocal lesions in the seminiferous tubules of the infected group evaluated. These findings may suggest an impact of ZIKV infection on male fertility.


Assuntos
Infecção por Zika virus , Zika virus , Animais , Masculino , Humanos , Zika virus/genética , Testículo , Saimiri
13.
Clin Adv Periodontics ; 13(1): 27-32, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-35582970

RESUMO

BACKGROUND: A gingival display higher than 3 mm is considered a characteristic of a gingival smile (GS). Several etiological factors have been associated to GS and for this reason various treatments have been proposed according to its etiology. The aim of this study is to present a case with an alternative technique to treat GS with minimally invasive vestibular incision subperiosteal tunnel access (VISTA) and polymethyl methacrylate (PMMA) implants for lip repositioning. METHODS AND RESULTS: The patient, a 25-year-old woman diagnosed with excessive gingival exposure, had previously done botulinum toxin (BoNT) injections and did not like the result. She had a major subnasal depression and the upper lip would lodge in there during spontaneous smile. She was informed about all options of treatment and agreed to a lip repositioning installing a customized PMMA implant. CONCLUSION: This is the first study to our knowledge to present a case with use of a PMMA implant associated with the VISTA approach for lip repositioning and gingival smile correction. The results are encouraging, and the patient was satisfied with results accomplished by this technique. KEY POINTS: Why is this case new information? This is a new and innovative surgical approach for gingival smile with PMMA implants through a minimally invasive technique (VISTA). What are the keys to successful management of this case? Well-defined presurgical planning and the presence of the upper lip lodging in the subnasal depression during spontaneous smile. What are the primary limitations to success in this case? Cases with vertical maxillary excess and those in which osteotomy/osteoplasty is indicated. It is a technique-sensitive treatment dependent on the clinician's experience.


Assuntos
Implantes Dentários , Polimetil Metacrilato , Feminino , Humanos , Adulto , Polimetil Metacrilato/uso terapêutico , Gengivectomia/métodos , Estética Dentária , Impressão Tridimensional
15.
Food Res Int ; 160: 111711, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36076407

RESUMO

This study aimed to extract anthocyanins from dried and semi-defatted açaí pulp using green technologies based on the coupling of pressurized liquid extraction (PLE) with in-line purification through solid-phase extraction (SPE) and on-line analysis by high-performance liquid chromatography (HPLC). Critical parameters that affect the extraction efficiency and purification were investigated and optimized by response surface methodology (RSM). PLE was performed with acidified water at different pH (2.0, 4.5, and 7.0) and temperatures (40, 80, and 120 °C) at 15 MPa, 2 mL/min, and solvent-to-feed mass ratio equal to 40. SPE was optimized in a column packed with the adsorbent PoraPak™ Rxn. Different ethanol concentrations (50, 75, and 100 %) and temperatures (30, 40, and 50 °C) were evaluated for the anthocyanin's elution. The optimal conditions of the two experimental designs were determined by the RSM, firstly for PLE: 71 °C and pH 2; then using this PLE condition, the optimization of the SPE was obtained: 30 °C and 50 % ethanol. The developed PLE method provided similar anthocyanin yield to other techniques, and the coupling with SPE in-line produced an extract 5-fold more concentrated than PLE alone. Therefore, the system (PLE-SPE × HPLC-PDA) proved to be a powerful tool for monitoring the extraction process in real-time.


Assuntos
Antocianinas , Euterpe , Dióxido de Carbono , Cromatografia Líquida de Alta Pressão , Etanol , Extração em Fase Sólida
16.
Arq Neuropsiquiatr ; 80(5 Suppl 1): 232-237, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35976301

RESUMO

Vestibular migraine (VM) remains an underdiagnosed condition, often mistaken with brainstem aura. VM is defined by recurrent vestibular symptoms in at least 50% of migraine attacks. Diagnosis is established by clinical criteria based on the International Classification of Headache Disorders (ICHD-3). Estimated prevalence of VM is 1 to 2.7% of the adult population. Vestibular symptoms usually appear after the headache. VM pathophysiology remains poorly understood. Vertigo may occur before, during, after the migraine attack, or even independently, and may last seconds to hours or days. Pathophysiological mechanisms for VM are still poorly understood and are usually extrapolated from migraines. Differential diagnoses include Ménière's disease, benign paroxysmal positional vertigo, brainstem aura, transient ischemic attack, persistent perceptual postural vertigo, and episodic type 2 ataxia. Specific treatment recommendations for vestibular migraine are still scarce.


Assuntos
Transtornos de Enxaqueca , Adulto , Vertigem Posicional Paroxística Benigna/diagnóstico , Diagnóstico Diferencial , Epilepsia/diagnóstico , Humanos , Transtornos de Enxaqueca/diagnóstico
17.
Arq Neuropsiquiatr ; 80(5 Suppl 1): 143-158, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35976312

RESUMO

Autoimmune encephalitis (AE) comprises a group of diseases mediated by antibodies against neuronal cell surface or synaptic antigens, such as ion channels or neurotransmitter receptors. New clinical syndromes and their associated antibodies were and are still being characterized over the last two decades. The fact that their main clinical features are interdisciplinary, - encompassing neuropsychiatric symptoms, cognitive dysfunction, epileptic seizures, movement and sleep disorders - has led to a surge of interest in this field. Some of these diseases present with a well-defined syndrome, being recognizable on clinical grounds. Correct diagnosis is important since AE are potentially treatable diseases, despite their severity. On the other hand, an increasing number of neuronal antibodies being described casts doubt upon the way we should utilize antibody testing and interpret results. In this article we review, summarize and update the current knowledge on antibody mediated encephalitis.


Assuntos
Encefalite , Epilepsia , Doença de Hashimoto , Autoanticorpos , Encefalite/diagnóstico , Encefalite/terapia , Epilepsia/diagnóstico , Doença de Hashimoto/diagnóstico , Doença de Hashimoto/terapia , Humanos , Convulsões/diagnóstico
18.
Arq Neuropsiquiatr ; 80(5 Suppl 1): 307-312, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35976314

RESUMO

Although, insomnia is one of the most common diseases that health professionals face in their practice, it receives little attention in medical training. Diagnosis is based on a careful history taking, and physicians must be aware of the diagnostic criteria. Insomnia should not be considered a symptom, but a comorbid condition. Although cognitive behavioral therapy (CBT) has been the mainstay treatment for insomnia for many years, it is usually regarded as a novel therapeutic strategy, both because of scarcity of qualified psychologists and of limited knowledge about insomnia among physicians. GABA receptor acting drugs are being abandoned in the treatment of insomnia because of abuse and dependence potential and accident risk. Two main current therapeutic options with the best scientific evidence are the tricyclic antidepressant, doxepin, and a new melatoninergic receptor agonist, ramelteon. Newer drugs to treat insomnia are in the pipeline. Hypocretine blocking agents will be marketed in the near future.


Assuntos
Terapia Cognitivo-Comportamental , Distúrbios do Início e da Manutenção do Sono , Humanos , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico
19.
Arq Neuropsiquiatr ; 80(5 Suppl 1): 182-192, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35976327

RESUMO

BACKGROUND: Cannabidiol (CBD) has become a promising therapeutic option in the treatment of epilepsy. Recent studies provide robust evidence that CBD is effective and safe. Limitations in current knowledge and regulatory issues still limit CBD use. CBD use regarding epilepsy types still lacks clear guidelines. OBJECTIVE: To critically review the main current pharmacological features and clinical issues regarding CBD use in epilepsy, to provide current regulatory background regarding CBD use in Brazil, and to suggest a practical CBD therapeutic guide in Brazil. METHODS: Non-systematic literature review (up to February 2022) of current concepts of CBD and epilepsy, including the authors' personal experience. RESULTS: Five pivotal trials have led to CBD approval as an adjunctive treatment for Dravet and Lennox-Gastaut syndromes, and for the tuberous sclerosis complex. Efficacy of CBD in other drug-resistant epilepsies remains not completely understood. CBD adverse event profile and drug interactions are better understood. CBD is well tolerated. In Brazil, CBD is not classified as a medication, but as a product subject to a distinct regulatory legislation. CBD is still not offered by the National Brazilian health system, but can be purchased in authorized pharmacies or imported under prescription and signed informed consent. CONCLUSION: CBD is a recognized novel treatment for epilepsy. Future well-designed studies and public health strategies are needed to offer widespread access to CBD, and to improve the quality of life of people living with epilepsy in Brazil.


Assuntos
Canabidiol , Epilepsias Mioclônicas , Epilepsia , Anticonvulsivantes/efeitos adversos , Brasil , Canabidiol/farmacologia , Canabidiol/uso terapêutico , Epilepsias Mioclônicas/induzido quimicamente , Epilepsias Mioclônicas/tratamento farmacológico , Epilepsia/induzido quimicamente , Epilepsia/tratamento farmacológico , Humanos , Qualidade de Vida
20.
Food Res Int ; 158: 111547, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35840241

RESUMO

The valorization of the by-product of the agro-industrial processing of jabuticaba (Myrciaria cauliflora) was studied by hydrothermal pretreatment. Experiments were carried out in a semi-continuous flow-through process for 45 min, at 15 MPa, a water flow rate of 5 mL min-1, and at different temperatures (60 - 210 °C). The results demonstrate that fructose and glucose were the sugars with the highest concentration in all analyzed treatments. Arabinose and cellobiose were obtained only at higher temperatures (above 130 °C), demonstrating that they were released from the hydrolysis of polysaccharides. The highest cyanidin-3-glucoside yield (1.88 mg g-1) was achieved at 60 °C. The treatments at 135 and 210 °C promoted the degradation of cyanidin-3-glucoside, leading to yields lower than 0.05 mg g-1. At 60 °C, it was possible to recover 74.18 mg g-1 of glucose, 103.77 mg g-1 of fructose, 30.75 mg g-1 of citric acid, and 1.88 mg g-1 of cyanidin-3-glucoside, without the presence of furfural and 5-hydroxymethylfurfural. The results suggest that hydrothermal pretreatment is a promising eco-friendly technology to recover sugars, organic acids, and anthocyanins from jabuticaba by-products in a circular economy framework.


Assuntos
Antocianinas , Myrtaceae , Frutose , Glucose , Açúcares
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...