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We report experimental differential cross sections (DCSs) for electron impact excitation of bands I to V of benzene at incident energies of 10, 12.5, 15, and 20 eV. They are compared to calculations using the Schwinger multichannel method while accounting for up to 437 open channels. For intermediate scattering angles, the calculations reveal that the most intense band (V) emerges from surprisingly similar contributions from all its underlying states (despite some preference for the dipole-allowed transitions). They further shed light on intricate multichannel couplings between the states of bands I to V and higher-lying Rydberg states. In turn, the measurements support a vibronic coupling mechanism for excitation of bands II and IV and also show an unexpected forward peak in the spin-forbidden transition accounting for band III. Overall, there is decent agreement between theory and experiment at intermediate angles and at lower energies and in terms of the relative DCSs of the five bands. Discrepancies between the present and previous experiment regarding bands IV and V draw attention to the need of additional experimental investigations. We also report measured DCSs for vibrational excitation of combined C-H stretching modes.
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HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic disabling disease. However, there is a lack of an adequate and specific health measurement instrument validated and with good performance to assess their degree of physical disability. This led us to carry out this study and to evaluate the performance of Fiocruz's National Institute of Infectious Diseases (IDS) disability scale, a specific instrument for HAM/TSP. Ninety-two HAM/TSP patients participated in the study. One researcher applied the IDS, IPEC scale, Disability Status Scale (DSS), Expanded DSS (EDSS), Osame scale, Beck Depression Inventory, and the WHOQOL-BREF questionnaire. In parallel, blindly, and separately, other researchers applied the IDS. An inter-rater reliability analysis of the IDS, correlation analysis with the other scales, and depression and quality of life questionnaires were performed. The applicability of the IDS was also evaluated. The IDS showed high reliability in all scores. The inter-rater reliability test for the total IDS score was 0.94 (0.82-0.98) on its four dimensions. The scale adequately indicated the different degrees of disability, presenting a distribution similar to normal. There was a high correlation with the other scales (Spearman coefficients > 0.80, p < 0.001). The scale had good acceptance among users and a short application time. IDS for HAM/TSP was reliable, consistent, easy, and fast to use. It can be used for both prospective evaluations and clinical trials. The present study supports the IDS as a valid instrument to measure disability in patients with HAM/TSP compared to previously used scales.
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Doenças Transmissíveis , Vírus Linfotrópico T Tipo 1 Humano , Paraparesia Espástica Tropical , Humanos , Paraparesia Espástica Tropical/diagnóstico , Reprodutibilidade dos Testes , Qualidade de VidaRESUMO
Meningeal sporotrichosis is rare and occurs predominantly in immunosuppressed individuals. This retrospective study explored clinical and laboratory characteristics, treatment, and prognosis of patients with disseminated sporotrichosis who underwent lumbar puncture (LP) at a Brazilian reference center from 1999 to 2020. Kaplan-Meier and Cox regression models were used to estimate overall survival and hazard ratios. Among 57 enrolled patients, 17 had meningitis. Fifteen (88.2%) had HIV infection, and in 6 of them, neurological manifestations occurred because of the immune reconstitution inflammatory syndrome (IRIS). The most frequent symptom was headache (88.2%). Meningeal symptoms at first LP were absent in 7/17 (41.2%) patients. Sporothrix was diagnosed in cerebrospinal fluid either by culture or by polymerase chain reaction in seven and four patients, respectively. All but one patient received prolonged courses of amphotericin B formulations, and seven received posaconazole, but relapses were frequent. Lethality among patients with meningitis was 64.7%, with a higher chance of death compared to those without meningitis (HR = 3.87; IC95% = 1.23;12.17). Meningeal sporotrichosis occurs mostly in people with HIV and can be associated with IRIS. Screening LP is indicated in patients with disseminated disease despite the absence of neurological complaints. Meningitis is associated with poor prognosis, and better treatment strategies are needed.
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Sporothrix brasiliensis usually causes infection limited to the skin, subcutaneous tissue and regional lymph nodes. Contamination occurs through inhalation or accidental inoculation from animal scratches and bites. Meningitis is rare and mostly occurs in immunosuppressed patients. Here, we describe an immunocompetent person who developed chronic meningitis and discuss the diagnosis, differential diagnosis and treatment of this rare condition.
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Meningite , Sporothrix , Esporotricose , Animais , Humanos , Masculino , Pessoa de Meia-Idade , Pele , Esporotricose/diagnósticoRESUMO
BACKGROUND: Headache is a frequent complaint in COVID-19 patients. However, no detailed information on headache characteristics is provided in these reports. Our objective is to describe the characteristics of headache and the cerebrospinal fluid (CSF) profile in COVID-19 patients, highlighting the cases of isolated intracranial hypertension. METHODS: In this cross-sectional study, we selected COVID-19 patients who underwent lumbar puncture due to neurological complaints from April to May 2020. We reviewed clinical, imaging, and laboratory data of patients with refractory headache in the absence of other encephalitic or meningitic features. CSF opening pressures higher than 250 mmH2O were considered elevated, and from 200 to 250 mmH2O equivocal. RESULTS: Fifty-six COVID-19 patients underwent lumbar puncture for different neurological conditions. A new, persistent headache that prompted a CSF analysis was diagnosed in 13 (23.2%). The pain was throbbing, holocranial or bilateral in the majority of patients. All patients had normal CSF analysis and RT-qPCR for SARS-CoV-2 was negative in all samples. Opening pressure >200 mmH2O was present in 11 patients and, in six of these, > 250 mmH2O. 6/13 patients had complete improvement of the pain, five had partial improvement, and two were left with a daily persistent headache. CONCLUSIONS: In a significant proportion of COVID-19 patients, headache was associated to intracranial hypertension in the absence of meningitic or encephalitic features. Coagulopathy associated with COVID-19 could be an explanation, but further studies including post-mortem analysis of areas of production and CSF absorption (choroid plexuses and arachnoid granulations) are necessary to clarify this issue.
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Infecções por Coronavirus/complicações , Hipertensão Intracraniana/virologia , Pneumonia Viral/complicações , Adulto , Idoso , Betacoronavirus , COVID-19 , Pressão do Líquido Cefalorraquidiano , Infecções por Coronavirus/líquido cefalorraquidiano , Estudos Transversais , Feminino , Cefaleia/líquido cefalorraquidiano , Cefaleia/etiologia , Humanos , Hipertensão Intracraniana/líquido cefalorraquidiano , Hipertensão Intracraniana/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/líquido cefalorraquidiano , Estudos Retrospectivos , SARS-CoV-2 , Punção EspinalRESUMO
COVID-19 pandemic revealed several neurological syndromes related to this infection. We describe the clinical, laboratory, and radiological features of eight patients with COVID-19 who developed peripheral facial palsy during infection. In three patients, facial palsy was the first symptom. Nerve damage resulted in mild dysfunction in five patients and moderate in three. SARS-Cov-2 was not detected in CSF by PCR in any of the samples. Seven out of eight patients were treated with steroids and all patients have complete or partial recovery of the symptoms. Peripheral facial palsy should be added to the spectrum of neurological manifestations associated with COVID-19.
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COVID-19/complicações , Paralisia Facial/virologia , Adulto , Anti-Inflamatórios/uso terapêutico , Nervo Facial/patologia , Paralisia Facial/tratamento farmacológico , Feminino , Humanos , Masculino , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Prednisona/uso terapêutico , SARS-CoV-2RESUMO
Anosmia has been recognized as a prevalent and early symptom by many COVID-19 patients. However, most researchers have recorded smell dysfunction solely as present or absent and based on subjective evaluation by patients. We described the results of 57 consecutive COVID-19 patients seen at FIOCRUZ, Rio de Janeiro, Brazil, from April to May 2020. Data about the presence of smell loss, the onset of smell loss and other COVID-19 symptoms such as ageusia and nasal congestion or rhinorrhea were recorded. All patients at the initial consultation and 34 healthy controls underwent the Q-SIT, which is a quick disposable three-item smell identification test, by a trained physician. We compared three groups: healthy controls, COVID+ patients with reported smell loss (COVID w/ SL) and COVID+ patients without smell loss (COVID+ w/o SL). The mean age of patients was 41.4 years (SD ± 10.4), and 54.4% were women. Smell loss was reported by 40.4% of COVID-19 patients. We observed a gradual effect with higher Q-SIT scores in healthy controls, followed by COVID+ w/o SL and COVID+ w/ SL (medians = 3, 2 and 0; respectively, p < 0.001). Anosmia or severe microsmia (Q-SIT≤1) was present in 11.1% (CI: 3.1%-26.1%) of controls, 32.4% (CI: 17.4%-50.5%) of COVID-19 w/o SL and 87% (CI: 66.4%-97.2%) of COVID+ w/ SL (p < 0.001). This study provides evidence that olfactory dysfunction in COVID-19 is common and more prevalent than what is perceived by patients. Q-SIT is a quick and reliable screening test for the detection of smell dysfunction during the pandemics.
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Anosmia/diagnóstico , Anosmia/fisiopatologia , COVID-19/epidemiologia , COVID-19/fisiopatologia , Olfato/fisiologia , Adulto , Anosmia/epidemiologia , Brasil/epidemiologia , Estudos de Casos e Controles , Comorbidade , Feminino , Humanos , Masculino , Pandemias , Valor Preditivo dos Testes , Prevalência , SARS-CoV-2/patogenicidadeRESUMO
We report computed differential cross sections (DCSs) for electron impact excitation of the lower-lying states of both trans and gauche tautomers of ethanol, as well as total cross sections for the 15 eV-50 eV energy range. The Schwinger multichannel (SMC) method with pseudopotentials has been employed, and in our most sophisticated calculation in terms of multichannel coupling, 431 open target states have been considered. We found an overall good agreement with the available experimental data at intermediate scattering angles and at higher impact energies. Although we have used a Born-closure scheme for the higher partial waves, we have found discrepancies in the forward direction that were assigned to a poor description of the long-range component of the lower partial waves. Meanwhile, the lack of more Rydberg states could be related to the overestimated DCSs at lower energies. Missing open channels are usually evoked to explain the remaining discrepancies to experiment, but here, we argue that other factors should also be involved. Aiming at an improved description of the target states, we have proposed a simple procedure for selecting the pairs of hole and particle orbitals while keeping the single excitation prescription of the current SMC implementation. A quantitative assessment of the collision process should further consider the individual contribution of each tautomer, which presented quite distinct DCSs in some cases. Our computed excitation energies also support that the second absorption band of ethanol is comprised of three singlet states of each tautomer, rather than the previously suggested two or four states.
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Infecções Fúngicas do Sistema Nervoso Central/líquido cefalorraquidiano , Infecções Fúngicas do Sistema Nervoso Central/diagnóstico , Reação em Cadeia da Polimerase , Esporotricose/líquido cefalorraquidiano , Esporotricose/diagnóstico , Adulto , Infecções Fúngicas do Sistema Nervoso Central/microbiologia , Líquido Cefalorraquidiano/microbiologia , Feminino , Humanos , Masculino , Sporothrix , Esporotricose/microbiologiaRESUMO
BACKGROUND: Brain tumors are frequent in clinical practice and associated with high morbidity and mortality. However, many diseases can present as tumefactive lesions and mimic neoplastic lesions. We aimed to determine the frequency of pseudotumoral central nervous system lesions referred to an oncology center and the frequency of the tumor mimickers. METHODS: This was a retrospective study at the National Institute of Cancer, Rio de Janeiro, Brazil. Medical charts of patients admitted to the Neurosurgery and Pediatrics services from 2007 to 2011 were reviewed. Clinical and radiologic features of cases initially diagnosed with primary central nervous system tumors but received a final diagnosis of pseudotumoral disease were recorded. RESULTS: Among 891 patients referred as primary brain tumors, 38 cases had pseudotumoral lesions (4.3%). Most were adults (63%), with mean age of 29.4 years, and women (60.5%). Most frequent symptoms were headache (28.9%), motor signs (23.7%), and seizures (15.8%). Mean time from initial symptoms to diagnosis was 12.2 months. Lesions were single in 84.2% of patients, had contrast enhancement in 45.6%, and surrounding edema in 17.4%. Twenty patients (52,6%) underwent biopsy. Systemic autoimmune diseases were the most frequent etiologies (28.9%), followed by idiopathic inflammatory demyelinating diseases, infections, and vascular abnormalities (15.8% each). Good outcome with no major deficits was observed in 60.5% cases. CONCLUSIONS: The frequency of pseudotumoral lesions in an oncology reference center was low. Young women were most affected, and lesions were associated more frequently with systemic autoimmune diseases. Prompt recognition is important to avoid unnecessary treatment, because most patients had a good outcome.
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Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/epidemiologia , Institutos de Câncer/tendências , Pseudotumor Cerebral/diagnóstico por imagem , Pseudotumor Cerebral/epidemiologia , Adulto , Brasil/epidemiologia , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Masculino , Oncologia/métodos , Oncologia/tendências , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Progressive multifocal leukoencephalopathy (PML) is lytic infection of oligodendrocytes caused by JC virus (JCV). While PML incidence in developing countries has decreased after the introduction of combination antiretroviral therapy (cART), data in developing countries is scarce and limited to few cohorts. We described the epidemiological and clinical profile of a group of Brazilian HIV infected patients with PML in the cART era. A total of 27 patients were included in the study. The median age at PML onset was 42years (range: 27-67years) and 18 (66.7%) were men. The median CD4+ T cell count at the time of diagnosis was 67cells/mm3 and the median HIV viral load was 27,000copies/ml. Motor deficits were the most common early manifestations (44%). Seizures occurred in 37% of the patients and 9 (33.3%) had PML associated with immune reconstitution inflammatory syndrome (IRIS). Mortality was 33% and lower age at PML onset was associated with survival (p: 0.013). Our results are in accordance with previous published series of PML cases. Factors such as genetic background, regional JCV subtype differences, death from other diseases and underdiagnosis may explain the low prevalence of reported PML cases in developing countries.
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Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Leucoencefalopatia Multifocal Progressiva/complicações , Leucoencefalopatia Multifocal Progressiva/epidemiologia , Adulto , Idoso , Brasil , Feminino , Infecções por HIV/complicações , Infecções por HIV/fisiopatologia , Humanos , Leucoencefalopatia Multifocal Progressiva/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosAssuntos
Infecções por HTLV-I/fisiopatologia , Músculo Liso/fisiopatologia , Paraparesia Espástica Tropical/fisiopatologia , Doenças da Bexiga Urinária/fisiopatologia , Adulto , Idoso , Progressão da Doença , Feminino , Seguimentos , Vírus Linfotrópico T Tipo 1 Humano , Humanos , Masculino , Pessoa de Meia-Idade , Paraparesia Espástica Tropical/virologia , Provírus , Doenças da Bexiga Urinária/virologia , Carga ViralRESUMO
We report on integral-, momentum transfer- and differential cross sections for elastic and electronically inelastic electron collisions with furfural (C5H4O2). The calculations were performed with two different theoretical methodologies, the Schwinger multichannel method with pseudopotentials (SMCPP) and the independent atom method with screening corrected additivity rule (IAM-SCAR) that now incorporates a further interference (I) term. The SMCPP with N energetically open electronic states (N(open)) at either the static-exchange (N(open) ch-SE) or the static-exchange-plus-polarisation (N(open) ch-SEP) approximation was employed to calculate the scattering amplitudes at impact energies lying between 5 eV and 50 eV, using a channel coupling scheme that ranges from the 1ch-SEP up to the 63ch-SE level of approximation depending on the energy considered. For elastic scattering, we found very good overall agreement at higher energies among our SMCPP cross sections, our IAM-SCAR+I cross sections and the experimental data for furan (a molecule that differs from furfural only by the substitution of a hydrogen atom in furan with an aldehyde functional group). This is a good indication that our elastic cross sections are converged with respect to the multichannel coupling effect for most of the investigated intermediate energies. However, although the present application represents the most sophisticated calculation performed with the SMCPP method thus far, the inelastic cross sections, even for the low lying energy states, are still not completely converged for intermediate and higher energies. We discuss possible reasons leading to this discrepancy and point out what further steps need to be undertaken in order to improve the agreement between the calculated and measured cross sections.
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INTRODUCTION: The Bothrops sp. venom has proteolytic, hemorrhagic, and coagulant activity. Clinical manifestations range from local ecchymosis to severe hemorrhage in distant organs. However, stroke is rarely reported. CASE REPORT: A 52-year-old man who presented with an intracranial bleeding as the sole manifestation of Bothrops sp. snakebite. CONCLUSIONS: Although uncommon, Bothrops snakebite may present as isolated intracranial bleeding. This case illustrates the importance of the correct identification of the snake as poisonous and the institution of the adequate medical care in a short period of time.
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Bothrops , Hemorragia/complicações , Hemorragias Intracranianas/complicações , Mordeduras de Serpentes/complicações , Acidente Vascular Cerebral/patologia , Animais , Encéfalo/irrigação sanguínea , Encéfalo/patologia , Hemorragia/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Mordeduras de Serpentes/diagnóstico , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnósticoAssuntos
Infecções Fúngicas do Sistema Nervoso Central/tratamento farmacológico , Infecções Fúngicas do Sistema Nervoso Central/epidemiologia , Sporothrix/isolamento & purificação , Esporotricose/tratamento farmacológico , Esporotricose/epidemiologia , Adulto , Antifúngicos/uso terapêutico , Brasil/epidemiologia , Infecções Fúngicas do Sistema Nervoso Central/diagnóstico , Infecções Fúngicas do Sistema Nervoso Central/patologia , Feminino , Humanos , Hospedeiro Imunocomprometido , Masculino , Sporothrix/classificação , Esporotricose/diagnóstico , Esporotricose/patologiaRESUMO
We report theoretical and experimental total cross sections for electron scattering by phenol (C6H5OH). The experimental data were obtained with an apparatus based in Madrid and the calculated cross sections with two different methodologies, the independent atom method with screening corrected additivity rule (IAM-SCAR), and the Schwinger multichannel method with pseudopotentials (SMCPP). The SMCPP method in the Nopen-channel coupling scheme, at the static-exchange-plus-polarization approximation, is employed to calculate the scattering amplitudes at impact energies ranging from 5.0 eV to 50 eV. We discuss the multichannel coupling effects in the calculated cross sections, in particular how the number of excited states included in the open-channel space impacts upon the convergence of the elastic cross sections at higher collision energies. The IAM-SCAR approach was also used to obtain the elastic differential cross sections (DCSs) and for correcting the experimental total cross sections for the so-called forward angle scattering effect. We found a very good agreement between our SMCPP theoretical differential, integral, and momentum transfer cross sections and experimental data for benzene (a molecule differing from phenol by replacing a hydrogen atom in benzene with a hydroxyl group). Although some discrepancies were found for lower energies, the agreement between the SMCPP data and the DCSs obtained with the IAM-SCAR method improves, as expected, as the impact energy increases. We also have a good agreement among the present SMCPP calculated total cross section (which includes elastic, 32 inelastic electronic excitation processes and ionization contributions, the latter estimated with the binary-encounter-Bethe model), the IAM-SCAR total cross section, and the experimental data when the latter is corrected for the forward angle scattering effect [Fuss et al., Phys. Rev. A 88, 042702 (2013)].
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We report on the shape resonance spectra of phenol-water clusters, as obtained from elastic electron scattering calculations. Our results, along with virtual orbital analysis, indicate that the well-known indirect mechanism for hydrogen elimination in the gas phase is significantly impacted on by microsolvation, due to the competition between vibronic couplings on the solute and solvent molecules. This fact suggests how relevant the solvation effects could be for the electron-driven damage of biomolecules and the biomass delignification [E. M. de Oliveira et al., Phys. Rev. A 86, 020701(R) (2012)]. We also discuss microsolvation signatures in the differential cross sections that could help to identify the solvated complexes and access the composition of gaseous admixtures of these species.
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Gases/química , Hidrogênio/química , Modelos Químicos , Modelos Moleculares , Fenol/química , Solventes/química , Água/química , Ânions/química , Sítios de Ligação , Simulação por Computador , Ligação de HidrogênioRESUMO
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the CNS caused by reactivation of JC virus (JCV) in a setting of cellular immunosuppression. Originally, PML was observed in patients with advanced HIV infection, lymphoproliferative disorders and transplant recipients. However, the widespread use of HIV antiretroviral drugs and the new selective immunomodulatory and immunosuppressive medications, such as Rituximab and Natalizumab, has recently modified the epidemiology, clinical presentation and prognosis of PML. Herein, we discuss the new concepts on PML, emphasizing the recent modification in the epidemiology; the impact of new immunomodulatory treatments in the disease, PML-IRIS (Immune reconstitution inflammatory syndrome), new treatment strategies and other JCV related CNS diseases.