RESUMO
OBJECTIVE: To ascertain in a cross-sectional study whether substantia nigra (SN) echogenicity, olfaction, and dopamine transporter (DaT)-SPECT are reliable premotor biomarkers in a cohort of asymptomatic carriers of the LRRK2 G2019S mutation (AsG2019S+). METHODS: These biomarkers were evaluated in 49 AsG2019S+ patients, and we also studied olfaction and SN echogenicity in 29 patients with G2019S-associated Parkinson disease (PD-G2019S), 47 relatives who were noncarriers of the LRRK2 G2019S mutation (AsG2019S-), 50 patients with idiopathic Parkinson disease (iPD), and 50 community controls. RESULTS: Eighty-five percent of unaffected mutation carriers (AsG2019S+) showed pathologic SN hyperechogenicity, with a similar proportion observed among both PD-G2019S and iPD cases, and 41% of AsG2019S- also showing increased SN echogenicity. The proportion of hyposmic individuals was not statistically different in patients with PD-G2019S (50%) and iPD (82%), but hyposmia was significantly less common in both AsG2019S+ (26%) and AsG2019S- (28%). In AsG2019S+ cases, reduced striatal uptake in DaT-SPECT was observed in 43.7%. CONCLUSIONS: Independently of age at examination, the most frequently altered premotor biomarker in LRRK2 G2019S-associated PD was SN hyperechogenicity, whereas abnormal DaT-SPECT predominated in older, unaffected mutation carriers.
Assuntos
Predisposição Genética para Doença , Mutação/genética , Transtornos do Olfato/etiologia , Doença de Parkinson/complicações , Doença de Parkinson/genética , Proteínas Serina-Treonina Quinases/genética , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Distribuição de Qui-Quadrado , Estudos de Coortes , Estudos Transversais , Análise Mutacional de DNA , Feminino , Glicina/genética , Humanos , Serina-Treonina Proteína Quinase-2 com Repetições Ricas em Leucina , Masculino , Pessoa de Meia-Idade , Nortropanos/farmacocinética , Transtornos do Olfato/diagnóstico por imagem , Doença de Parkinson/diagnóstico por imagem , Serina/genética , Índice de Gravidade de Doença , Olfato/genética , Substância Negra/diagnóstico por imagem , Substância Negra/patologia , Tomografia Computadorizada de Emissão de Fóton Único , Ultrassonografia Doppler TranscranianaRESUMO
Se realiza un estudio de intervención educativo-terapéutico encaminado a tratar la hipertensión arterial con Tintura de Ajo. El universo de estudio está conformado por los hipertensos no controlados del Consultorio Médico de la Familia No. 1 de La Yaya, municipio Niceto Pérez, Guantánamo, en el período enero - diciembre de 2007, de los cuales se selecciona una muestra de 94 pacientes. Las variables estudiadas fueron: sexo, edad, factores de riesgo, grupo de edades y sexo de hipertensos no controlados después de la intervención, estadio, respuesta y costo del tratamiento. La enfermedad fue más frecuente en el sexo masculino y en el grupo de 45 - 59 años. Se logró reducción de las cifras tensionales en el 97.9 por ciento después de la intervención. Se demostró la efectividad de la Tintura de Ajo con la que se logró controlar al mayor número de enfermos (AU)
A study of educational and therapeutic intervention was done with the aim of treating hypertension with tincture of garlic. The universe is made up of hypertensive patients uncontrolled in the Family Medical Clinic No. 1 from La Yaya municipality Niceto Pérez, Guantánamo, during January to December 2007, 94 patients were selected as example. The variables studied were sex, age, risk factors, age group and sex of hypertensive patients not controlled after surgery, stage, response and cost of treatment. The disease was more common in males in the group of 45 - 59. It was possible to reduce blood pressure in 97.9por ciento after the intervention. Demonstrated the effectiveness of tincture of garlic with was controlled to the greatest number of patients
