RESUMO
OBJECTIVE: Intrathecal measles(M)- rubella(R)- and varicella zoster(Z)-antibody synthesis in German and Cuban multiple sclerosis (MS) patients are compared considering the different rubella epidemiology in the tropics. PATIENTS AND METHODS: Twenty-three Cuban MS patients with a representative age distribution and gender ratio like the group of 177 German MS patients were analysed for albumin, IgG, IgA IgM, oligoclonal IgG and MRZ- antibodies in cerebrospinal fluid (CSF) and serum. RESULTS: Cuban MS patients show similar CSF data patterns like German patients and high frequencies of intrathecal measles- (78/78%) and varicella zoster- (59/55%) antibody synthesis correspondingly. A lower frequency of intrathecal rubella antibody synthesis (rubella-AI >or= 1.5) in Cuban patients (30%, gender ratio of increased rubella - AI m:f = 1:6) compared with German patients (60%, m:f = 1:1.8) is explained by low incidence of rubella infections in Cuba. Only about 10% of the male population (not immunized before 1986, in contrast to females) had rubella antibodies compared to at least 60% in a European male population, representing the relation of increased rubella-AI in male MS patients. CONCLUSION: In MS the frequency of intrathecal antibody synthesis is limited by the fraction of seropositives in the population. Natural infection or vaccination are a necessary and equivalent precondition contributing to the arguments against microorganisms as a cause of MS.
Assuntos
Anticorpos Antivirais/líquido cefalorraquidiano , Imunização/estatística & dados numéricos , Vírus do Sarampo/imunologia , Sarampo/imunologia , Esclerose Múltipla , Adulto , Distribuição por Idade , Anticorpos Antivirais/sangue , Cuba/etnologia , Encefalite por Varicela Zoster/imunologia , Feminino , Alemanha/epidemiologia , Herpesvirus Humano 3/imunologia , Humanos , Imunoglobulina A/sangue , Imunoglobulina A/líquido cefalorraquidiano , Imunoglobulina G/sangue , Imunoglobulina G/líquido cefalorraquidiano , Imunoglobulina M/sangue , Imunoglobulina M/líquido cefalorraquidiano , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/epidemiologia , Esclerose Múltipla/imunologia , Esclerose Múltipla/virologia , Rubéola (Sarampo Alemão)/imunologia , Vírus da Rubéola/imunologia , Estudos Soroepidemiológicos , Distribuição por SexoRESUMO
INTRODUCTION: Early stimulation is known to be useful, necessary treatment aimed at developing as much as possible the social psychophysical potential of any child at high environmental and/or biological risk. This group includes children with cerebral palsy, a disorder of the nervous system which may cause retardation in the processes of maturation of the central nervous system and be expressed from the earliest months of the child's life as retardation of psychomotor development. OBJECTIVE: To show the efficiency of early stimulation in children diagnosed as having cerebral palsy and retardation of psychomotor development. PATIENTS AND METHODS: A retrospective study was made of 20 children aged between 9 and 41 months with this diagnosis, in the hospital of CIREN (Cuba). They were treated for a period of 1 to 3 months by a multi-disciplinary team and participated in the programme for Early Stimulation. Assessment was made by the Neuropsychology Department at the start and end of the treatment period, using the first part of the Brunet-Lezine scale for the measurement of psychomotor development in early childhood. RESULTS: In all patients there was a favorable course and new abilities were acquired. There was better performance than before the treatment was started and accelerated rate of development during the period of treatment. CONCLUSION: Patients with cerebral palsy and psychomotor retardation benefit from application of a programme of Early Stimulation.
Assuntos
Paralisia Cerebral/reabilitação , Deficiências do Desenvolvimento/reabilitação , Transtornos das Habilidades Motoras/reabilitação , Paralisia Cerebral/complicações , Desenvolvimento Infantil , Pré-Escolar , Deficiências do Desenvolvimento/etiologia , Feminino , Humanos , Lactente , Masculino , Transtornos das Habilidades Motoras/etiologia , Testes Neuropsicológicos , Estudos RetrospectivosRESUMO
Introducción. La estimulación temprana se conoce como la intervención terapeútica necesaria y útil, encaminada a desarrollar al máximo el potencial psicofísico social de cualquier niño con alto riesgo ambiental y/o biológico. Es a este último grupo al cual pertenecen los niños portadores de par lisis cerebral (PC), afección del nervioso central que puede causar retraso en los procesos de maduración de dicho sistema y expresarse, desde los primeros meses de vida del niño, como un retraso del desarrollo psicomotor. Objetivos. Demostrar la eficacia de la estimulación temprana en los niños diagnosticados con PC y retraso en su desarrollo psicomotor. Pacientes y métodos. Se realizó un estudio restrospectivo de una muestra de 20 niños con ese diagnóstico, hospitalizados en el Centro Internacional de Restauración Neurológica de la Habana (Cuba) con edades comprendidas entre los 9 y 41 meses, a los que se les brindó tratamiento por parte de un equipo multidisciplinario, mediante la aplicación de un Programa de Estimulación Temprana en un período de 1-3 meses. Se tomaron las evaluaciones realizadas por el Departamento de Neuropsicología, al inicio y al final de la etapa de tratamiento, utilizando la escala para medir el desarrollo psicomotor de la primera infancia Brunet-Lezine (primera parte). Resultados. En todos los pacientes se constató una evolución favorable con incorporación de nuevas adquisiciones, un rendimiento superior a lo observado al iniciar la estimulación y una aceleración en su ritmo de desarrollo durante el período de tratamiento. Conclusiones. Los pacientes con PC y retraso en su desarrollo psicomotor se benefician con la aplicación de un programa de estimulación temprana(AU)