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Introducción: La automedicación es un fenómeno creciente y ha sido considerado un problema de salud pública en la actualidad. Objetivo: Estimar el nivel de automedicación relacionado con el retraso diagnóstico de pacientes con enfermedades neurológicas y los factores asociados a esta táctica de autocuidado. Métodos: Se proyectó un estudio observacional de corte transversal, en el que se incluyeron 102 pacientes y 100 familiares pertenecientes al municipio Plaza de la Revolución, atendidos en consulta de Neurología del Instituto de Neurología y Neurocirugía, con diagnóstico de enfermedades neurológicas, durante el período de un año (junio 2018-junio2019). Resultados: Del total de pacientes, 45,1 por ciento manifestó automedicarse, fue más frecuente en mujeres (63,1 por ciento), con predominio en pacientes no universitarios (90 por ciento) y amas de casa (54,3 por ciento). El síntoma principal que motivó la automedicación fue la cefalea (30,4 por ciento), y los analgésicos no opioides fue el grupo de mayor consumo (23,9 por ciento). La latencia al diagnóstico de enfermedades neurológicas en el grupo de automedicados fue entre 10 a 19 meses mayor que en los no automedicados. Conclusiones: La automedicación constituye una práctica muy frecuente, lo cual produjo el retraso diagnóstico y terapéutico de diversas enfermedades neurológicas de baja incidencia, dando al traste con una evolución adecuada de ellas(AU)

Introduction: Self-medication is a growing phenomenon and, today, has been considered a public health concern. Objective: To estimate the level of self-medication related to the diagnostic delay of patients with neurological diseases and the factors associated with this self-care tactic. Methods: An observational and cross-sectional study was designed, in including 102 patients and one hundred relatives from Plaza de la Revolución Municipality, who received attention, during a one-year period (June 2018-June 2019), in the neurology consultation of the Institute of Neurology and Neurosurgery, and had a diagnosis of neurological diseases. Results: Of the total number of patients, 45.1 percent manifested to medicate themselves; it was more frequent in women (63.1 percent), with a predominance in non-university patients (90 percent) and housewives (54.3 percent). The main symptom that motivated self-medication was headache (30.4 percent), while nonopioid analgesics made up the group with the highest consumption (23.9 percent). Latency regarding the diagnosis of neurological diseases in the self-medicated group was between ten and nineteen months higher than in the non-self-medicated group. Conclusions: Self-medication is a very frequent practice, which caused the diagnostic and therapeutic delay of various neurological diseases of low incidence, ruining their adequate evolution(AU)

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The present report describes the clinical, macroscopic and histologic findings associated with Halicephalobus gingivalis infection in a male Arab horse, in the state of Minas Gerais, Brazil. The animal presented with acute neurologic signs that quickly progressed to a comatose status. Due to the lack of response to therapy, rapid progression of signs and poor prognosis, the horse was euthanized. Post-mortem examination revealed large granulomatous nodules in the kidneys. Renal and internal iliac lymph nodes were enlarged and with loss of corticomedullary distinction. Histopathology revealed granulomatous encephalitis, nephritis, lymphadenitis and focal granulomatous pneumonia associated with marked and chronic infection caused by H. gingivalis. This is the first report of H. gingivalis infection in horses in Minas Gerais. H. gingivalis infection should be included in the list of differential diagnosis of equine neurologic diseases in the state of Minas Gerais.(AU)

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The present report describes the clinical, macroscopic and histologic findings associated with Halicephalobus gingivalis infection in a male Arab horse, in the state of Minas Gerais, Brazil. The animal presented with acute neurologic signs that quickly progressed to a comatose status. Due to the lack of response to therapy, rapid progression of signs and poor prognosis, the horse was euthanized. Post-mortem examination revealed large granulomatous nodules in the kidneys. Renal and internal iliac lymph nodes were enlarged and with loss of corticomedullary distinction. Histopathology revealed granulomatous encephalitis, nephritis, lymphadenitis and focal granulomatous pneumonia associated with marked and chronic infection caused by H. gingivalis. This is the first report of H. gingivalis infection in horses in Minas Gerais. H. gingivalis infection should be included in the list of differential diagnosis of equine neurologic diseases in the state of Minas Gerais.

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Cases of compressive myelopathy syndrome associated with post vaccinal pyogranulomas were diagnosed post mortem in three cows from a farm in Minas Gerais state, Brazil. These cows presented ataxia and bilateral paresis of the pelvic limbs, which evolved to paralysis, and sternal recumbence. On necropsy, locally extensive areas of the longissimus dorsi muscle were replaced by pyogranulomas supported by moderate amounts of fibrous connective tissue. On the cut surface, some nodules contained yellowish and viscous fluid (purulent exudate) or whitish fluid (interpreted as the oily adjuvant of a vaccine). In the spinal canal of the subjacent vertebrae, compressing the spinal cord, were pyogranulomas identical to those described in the skeletal muscle. Histologically, the pyogranulomas were composed of a central clear vacuole (consistent with the space left by the oil adjuvant droplets), surrounded by neutrophils and, more externally, by large numbers of epithelioid macrophages and fewer multinucleated giant cells. In the white matter of the spinal cord were numerous well-defined, clear vacuoles (Wallerian degeneration). The association of the clinical history and pathological findings allowed the diagnosis of compressive myelopathy associated with pyogranulomatous reaction to the oily adjuvant of the foot-and-mouth disease vaccine, in this case, due to its inadequate application.(AU)

São descritos casos de síndrome de compressão medular, associada a granulomas pós-vacinais, em bovinos Nelore, provenientes de uma propriedade em Minas Gerais. Esses bovinos apresentavam ataxia e paresia bilateral dos membros pélvicos, que evoluiu para paralisia e decúbito esternal. Na necropsia, áreas focalmente extensas da musculatura na região torácica dorsal (músculo longissimus dorsi) eram substituídas por numerosos piogranulomas, separados por tecido brancacento e firme (tecido conjuntivo fibroso). Ao corte, alguns nódulos continham material amarelado e viscoso (exsudato purulento) ou material esbranquiçado e fluido (sugestivo de adjuvante de vacina). No canal medular das vértebras subjacentes, havia granulomas idênticos aos observados no tecido muscular. Histologicamente, os piogranulomas continham, no centro, vacúolo, bem delimitado e arredondado (consistente com o espaço deixado pela gotícula de lipídio do adjuvante), circundado por variável quantidade de neutrófilos degenerados e íntegros e, mais externamente, por numerosos macrófagos epitelioides e algumas células gigantes multinucleadas. Nas áreas da medula espinhal, circundadas pelos granulomas, numerosos vacúolos, bem definidos, eram observados na substância branca (degeneração walleriana). A associação do histórico clínico e de achados patológicos permitiu o diagnóstico de mielopatia compressiva associada à reação granulomatosa ao adjuvante oleoso da vacina contra febre aftosa, no caso, induzida pela aplicação inadequada da vacina.(AU)

Assuntos

RESUMO

Cases of compressive myelopathy syndrome associated with post vaccinal pyogranulomas were diagnosed post mortem in three cows from a farm in Minas Gerais state, Brazil. These cows presented ataxia and bilateral paresis of the pelvic limbs, which evolved to paralysis, and sternal recumbence. On necropsy, locally extensive areas of the longissimus dorsi muscle were replaced by pyogranulomas supported by moderate amounts of fibrous connective tissue. On the cut surface, some nodules contained yellowish and viscous fluid (purulent exudate) or whitish fluid (interpreted as the oily adjuvant of a vaccine). In the spinal canal of the subjacent vertebrae, compressing the spinal cord, were pyogranulomas identical to those described in the skeletal muscle. Histologically, the pyogranulomas were composed of a central clear vacuole (consistent with the space left by the oil adjuvant droplets), surrounded by neutrophils and, more externally, by large numbers of epithelioid macrophages and fewer multinucleated giant cells. In the white matter of the spinal cord were numerous well-defined, clear vacuoles (Wallerian degeneration). The association of the clinical history and pathological findings allowed the diagnosis of compressive myelopathy associated with pyogranulomatous reaction to the oily adjuvant of the foot-and-mouth disease vaccine, in this case, due to its inadequate application.(AU)

São descritos casos de síndrome de compressão medular, associada a granulomas pós-vacinais, em bovinos Nelore, provenientes de uma propriedade em Minas Gerais. Esses bovinos apresentavam ataxia e paresia bilateral dos membros pélvicos, que evoluiu para paralisia e decúbito esternal. Na necropsia, áreas focalmente extensas da musculatura na região torácica dorsal (músculo longissimus dorsi) eram substituídas por numerosos piogranulomas, separados por tecido brancacento e firme (tecido conjuntivo fibroso). Ao corte, alguns nódulos continham material amarelado e viscoso (exsudato purulento) ou material esbranquiçado e fluido (sugestivo de adjuvante de vacina). No canal medular das vértebras subjacentes, havia granulomas idênticos aos observados no tecido muscular. Histologicamente, os piogranulomas continham, no centro, vacúolo, bem delimitado e arredondado (consistente com o espaço deixado pela gotícula de lipídio do adjuvante), circundado por variável quantidade de neutrófilos degenerados e íntegros e, mais externamente, por numerosos macrófagos epitelioides e algumas células gigantes multinucleadas. Nas áreas da medula espinhal, circundadas pelos granulomas, numerosos vacúolos, bem definidos, eram observados na substância branca (degeneração walleriana). A associação do histórico clínico e de achados patológicos permitiu o diagnóstico de mielopatia compressiva associada à reação granulomatosa ao adjuvante oleoso da vacina contra febre aftosa, no caso, induzida pela aplicação inadequada da vacina.(AU)

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There is enough evidence that, nowadays, the sedentary lifestyle is one of the major health problems worldwide, linked to many chronic diseases, including mental comorbidities, systemic hypertension, metabolic dysregulation, and cancer. Although health societies recommend engagement to physical activities, there is an overwhelming number of people remaining sedentary, even knowing the health benefits of regular exercises. One of the main factors that justifies this scenario is the lack of motivation, which is a barrier to people intended to start new habits for health. Considering this previous information, new alternatives for exercises may help people engage in a healthier lifestyle. Technology has contributed to this with devices that allow movements based on virtual reality approaches, including the exergames. These are games available even in commercial devices, as video-games, that allow people to work with different physical components. Furthermore, exergames add cognitive gain through its dual-task characteristic. Moreover, due to the combination of these benefits, they are feasible to acquire, and easy to use. Exergames are not only a potential strategy to reduce sedentary lifestyle but also a good method to improve health gains and rehabilitation in different populations and pathological conditions: older adults, stroke survivors, and Parkinson's disease. In this review, we aim to demonstrate some conditions that literature supports the intervention with exergames due to its physical and cognitive benefits. Furthermore, at the end of this review, we also explore the neurobiological mechanisms behind virtual-reality based exercises.

RESUMO

The present study reports two outbreaks of salt poisoning in goats on a property in the state of Pará, Brazil. The outbreaks occurred in July and August 2011 when young and adult goats received a mineral mixture after approximately three days of restriction from the supplement. The animals were kept in barns with a high stocking density and had an inadequate supply of water. In the second outbreak, the goats were supplemented too with brewery residue added to 3.3% of the mixture mineral. From a flock of 191 goats, 12 animals (nine crossbreeds, two Anglo-Nubians and one Boer) showed nervous symptomatology, and the morbidity rate was 6.28%. The most frequent clinical signs were head lowering, head tilt, muscle weakness, mydriasis and ataxia. Three goats died, four recovered spontaneously from the first outbreak, and five recovered from the second outbreak over three days after treatment with dexamethasone, thiamine and gradual water supply. The lethality rate was 25%. In two animals, necropsy was performed, and no macro- or microscopic alterations in the nervous system or other organs were observed. These negative pathological findings indicate that the neurological clinical signs were initiated by functional disturbances in the central nervous system. In the brain, a high sodium concentration (3703 and 3675 ppm), compared with the reference values for cattle was detected...(AU)

Este trabalho relata dois surtos de intoxicação por sal em caprinos em uma propriedade no estado do Pará, Brasil. Os surtos ocorreram em julho e agosto de 2011 quando caprinos jovens e adultos receberam mistura mineral, após cerca de três dias de restrição do suplemento. Os animais estavam estabulados em baias com lotação acima do recomendado e os bebedouros não atendiam um adequado fornecimento de água. No segundo surto, os caprinos foram suplementados adicionalmente com resíduos de cervejaria acrescido de 3,3% de mistura mineral. De um total de 191 caprinos, nove mestiços, dois Anglonubianos e um Boer, apresentaram sintomatologia nervosa observando-se taxa de morbidade de 6,28%. Os sinais clínicos mais frequentes foram fraqueza muscular, relutância ao movimento, rotação lateral da cabeça com o pescoço estendido e cabeça baixa. Três caprinos morreram, quatro do primeiro surto recuperaram-se espontaneamente, e cinco recuperarm-se após três dias de tratamento com dexametasona, tiamina e fornecimento gradual de água. A taxa de letalidade foi de 25%. Em dois animais necropsiados, não foram observadas alterações macro e microscópicas no sistema nervoso e em outros órgãos. Estes resultados negativos apontaram que os sinais clínicos neurológicos foram desencadeados por distúrbios funcionais no sistema nervoso central. No cérebro destes dois, havia altas concentrações de sódio...(AU)

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The present study reports two outbreaks of salt poisoning in goats on a property in the state of Pará, Brazil. The outbreaks occurred in July and August 2011 when young and adult goats received a mineral mixture after approximately three days of restriction from the supplement. The animals were kept in barns with a high stocking density and had an inadequate supply of water. In the second outbreak, the goats were supplemented too with brewery residue added to 3.3% of the mixture mineral. From a flock of 191 goats, 12 animals (nine crossbreeds, two Anglo-Nubians and one Boer) showed nervous symptomatology, and the morbidity rate was 6.28%. The most frequent clinical signs were head lowering, head tilt, muscle weakness, mydriasis and ataxia. Three goats died, four recovered spontaneously from the first outbreak, and five recovered from the second outbreak over three days after treatment with dexamethasone, thiamine and gradual water supply. The lethality rate was 25%. In two animals, necropsy was performed, and no macro- or microscopic alterations in the nervous system or other organs were observed. These negative pathological findings indicate that the neurological clinical signs were initiated by functional disturbances in the central nervous system. In the brain, a high sodium concentration (3703 and 3675 ppm), compared with the reference values for cattle was detected...

Este trabalho relata dois surtos de intoxicação por sal em caprinos em uma propriedade no estado do Pará, Brasil. Os surtos ocorreram em julho e agosto de 2011 quando caprinos jovens e adultos receberam mistura mineral, após cerca de três dias de restrição do suplemento. Os animais estavam estabulados em baias com lotação acima do recomendado e os bebedouros não atendiam um adequado fornecimento de água. No segundo surto, os caprinos foram suplementados adicionalmente com resíduos de cervejaria acrescido de 3,3% de mistura mineral. De um total de 191 caprinos, nove mestiços, dois Anglonubianos e um Boer, apresentaram sintomatologia nervosa observando-se taxa de morbidade de 6,28%. Os sinais clínicos mais frequentes foram fraqueza muscular, relutância ao movimento, rotação lateral da cabeça com o pescoço estendido e cabeça baixa. Três caprinos morreram, quatro do primeiro surto recuperaram-se espontaneamente, e cinco recuperarm-se após três dias de tratamento com dexametasona, tiamina e fornecimento gradual de água. A taxa de letalidade foi de 25%. Em dois animais necropsiados, não foram observadas alterações macro e microscópicas no sistema nervoso e em outros órgãos. Estes resultados negativos apontaram que os sinais clínicos neurológicos foram desencadeados por distúrbios funcionais no sistema nervoso central. No cérebro destes dois, havia altas concentrações de sódio...

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Background: One of the greatest challenges for medicine is to find a safe and effective treatment for immune-related diseases. However, due to the low efficacy of the treatment available and the occurrence of serious adverse effects, many groups are currently searching for alternatives to the traditional therapy. In this regard, the use of human mesenchymal stem cells (hMSCs) represents a great promise for the treatment of a variety of immune-related diseases due to their potent immunomodulatory properties. The main objective of this study is, therefore, to present and summarize, through a systematic review of the literature, in vivo studies in which the efficacy of the administration of hMSCs for the treatment of immune-related diseases was evaluated. Methods: The article search was conducted in PubMed/MEDLINE, Scopus and Web of Science databases. Original research articles assessing the therapeutic potential of hMSCs administration for the in vivo treatment immune-related diseases, published from 1984 to December 2017, were selected and evaluated. Results: A total of 132 manuscripts formed the basis of this systematic review. Most of the studies analyzed reported positive results after hMSCs administration. Clinical effects commonly observed include an increase in the survival rates and a reduction in the severity and incidence of the immune-related diseases studied. In addition, hMSCs administration resulted in an inhibition in the proliferation and activation of CD19+ B cells, CD4+ Th1 and Th17 cells, CD8+ T cells, NK cells, macrophages, monocytes, and neutrophils. The clonal expansion of both Bregs and Tregs cells, however, was stimulated. Administration of hMSCs also resulted in a reduction in the levels of pro-inflammatory cytokines such as IFN-γ, TNF-α, IL-1, IL-2, IL-12, and IL-17 and in an increase in the levels of immunoregulatory cytokines such as IL-4, IL-10, and IL-13. Conclusions: The results obtained in this study open new avenues for the treatment of immune-related diseases through the administration of hMSCs and emphasize the importance of the conduction of further studies in this area.

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O objetivo deste trabalho foi identificar as doenças neurológicas que acometeram bovinos no estado do Paraná entre os anos de 2009 e 2015. A investigação aconteceu, preferencialmente, nas propriedades rurais onde os casos ocorreram. Foram registradas as informações sobre a evolução das doenças nos bovinos afetados do rebanho, e os prováveis fatores de risco foram identificados. Todos os procedimentos de exame físico geral e neurológico foram realizados sistematicamente para a caracterização da síndrome neurológica presente. Amostras de sangue e de líquor foram colhidas para a realização de exames laboratoriais. De acordo com o tempo de evolução e com a gravidade dos sinais clínicos observados, os bovinos doentes eram mantidos vivos para acompanhamento da evolução ou da resposta ao tratamento, ou eram submetidos à eutanásia seguida de necropsia. Fragmentos do sistema nervoso e dos demais órgãos foram colhidos para exame histopatológico. O exame de imunofluorescência direta e a prova biológica em camundongos foram realizados em todos os bovinos que morreram, com a finalidade de confirmar ou descartar o diagnóstico de raiva. Métodos laboratoriais específicos das rotinas de virologia, bacteriologia e toxicologia foram empregados, como complementares, para o estabelecimento do diagnóstico diferencial. Foram investigados 236 bovinos com doença neurológica, sendo 85 casos de ocorrência individual e 151 casos distribuídos por surtos que ocorreram em 79 rebanhos. As encefalopatias (180/236; 76,2%) predominaram sobre as mielopatias (27/236; 11,4%). As doenças inflamatórias determinadas por infecções (98/236; 41,5%) e as doenças tóxicas (91/236; 38,6%) foram as principais, enquanto as causas degenerativas (10/236; 4,2%), metabólicas (9/236; 3,8%), físicas (9/236; 3,8%), neoplásicas (4/236; 1,7%), e os defeitos congênitos (1/236; 0,4%) ocorreram menos frequentemente. Os casos inconclusivos somaram 5,9% (14/236). A meningoencefalite por BoHV-5 e a raiva foram as doenças de frequência maior e podem ser consideradas as mais importantes. Dentre as causas tóxicas, as intoxicações por plantas se destacaram (63/91; 69,2%) e foram responsáveis por 26,6% de todos os casos. Destacaram-se ainda a polioencefalomalácia, a meningoencefalite trombótica por Histophilus somni e o botulismo. Essas informações contribuem para que os médicos veterinários adotem condutas mais efetivas de diagnóstico e de prevenção, e são valiosas para o sistema oficial de vigilância epidemiológica do estado.(AU)

The aim of this study was to identify the neurological diseases that affected cattle in Paraná state between the years 2009 and 2015. The investigation took place, preferably, in the farms where cases occurred. Information on the evolution of the diseases in the affected cattle of the herd was recorded, and the probable risk factors were identified. All general and neurological examination procedures were performed systematically for the characterization of the neurological syndrome in each case. Samples of blood and CSF for laboratory exams were also collected. According to the evolution features and the severity of the observed clinical signs, the diseased cattle were kept alive to follow the progress of the disease, or were submitted to euthanasia followed by necropsy. Fragments of tissues from nervous system and other organs were collected for histopathological examination. Direct immunofluorescence test and biological test were performed on all the cattle that died, in order to confirm or rule out the diagnosis of rabies. Specific virology, bacteriology and toxicology laboratory methods were used as complementary exams in order to establish differential diagnosis. A total of 236 cattle with neurological disease were investigated, 85 cases of individual occurrence and 151 cases distributed by outbreaks that occurred in 79 herds. Encephalopathies (180/236, 76.2%) predominated over mielopathies (27/236, 11.4%). Inflammatory diseases caused by infections (98/236, 41.5%) and the toxic diseases (91/236, 38.6%) were the main causes, while degenerative (10/236, 4.2%), metabolic (9/236; 3.8%), physical (9/236, 3.8%), neoplastic (4/236, 1.7%), and congenital defects (1/236, 0.4%) occurred less often. The inconclusive cases were 5.9% (14/236). BoHV-5 meningoencephalitis and rabies were diseases of higher frequency and may be considered the most important. Among the toxic causes, plant poisonings were highlighted (63/91, 69.2%) and were responsible for 26.6% of all cases. Polioencephalomalacia, thrombotic meningoencephalitis caused by Histophilus somni and botulism were also highlighted. This information helps veterinarians to adopt more effective diagnostic and preventive approaches and is valuable to the state's official epidemiological surveillance system.(AU)

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O objetivo deste trabalho foi identificar as doenças neurológicas que acometeram bovinos no estado do Paraná entre os anos de 2009 e 2015. A investigação aconteceu, preferencialmente, nas propriedades rurais onde os casos ocorreram. Foram registradas as informações sobre a evolução das doenças nos bovinos afetados do rebanho, e os prováveis fatores de risco foram identificados. Todos os procedimentos de exame físico geral e neurológico foram realizados sistematicamente para a caracterização da síndrome neurológica presente. Amostras de sangue e de líquor foram colhidas para a realização de exames laboratoriais. De acordo com o tempo de evolução e com a gravidade dos sinais clínicos observados, os bovinos doentes eram mantidos vivos para acompanhamento da evolução ou da resposta ao tratamento, ou eram submetidos à eutanásia seguida de necropsia. Fragmentos do sistema nervoso e dos demais órgãos foram colhidos para exame histopatológico. O exame de imunofluorescência direta e a prova biológica em camundongos foram realizados em todos os bovinos que morreram, com a finalidade de confirmar ou descartar o diagnóstico de raiva. Métodos laboratoriais específicos das rotinas de virologia, bacteriologia e toxicologia foram empregados, como complementares, para o estabelecimento do diagnóstico diferencial. Foram investigados 236 bovinos com doença neurológica, sendo 85 casos de ocorrência individual e 151 casos distribuídos por surtos que ocorreram em 79 rebanhos. As encefalopatias (180/236; 76,2%) predominaram sobre as mielopatias (27/236; 11,4%). As doenças inflamatórias determinadas por infecções (98/236; 41,5%) e as doenças tóxicas (91/236; 38,6%) foram as principais, enquanto as causas degenerativas (10/236; 4,2%), metabólicas (9/236; 3,8%), físicas (9/236; 3,8%), neoplásicas (4/236; 1,7%), e os defeitos congênitos (1/236; 0,4%) ocorreram menos frequentemente. Os casos inconclusivos somaram 5,9% (14/236). A meningoencefalite por BoHV-5 e a raiva foram as doenças de frequência maior e podem ser consideradas as mais importantes. Dentre as causas tóxicas, as intoxicações por plantas se destacaram (63/91; 69,2%) e foram responsáveis por 26,6% de todos os casos. Destacaram-se ainda a polioencefalomalácia, a meningoencefalite trombótica por Histophilus somni e o botulismo. Essas informações contribuem para que os médicos veterinários adotem condutas mais efetivas de diagnóstico e de prevenção, e são valiosas para o sistema oficial de vigilância epidemiológica do estado.(AU)

The aim of this study was to identify the neurological diseases that affected cattle in Paraná state between the years 2009 and 2015. The investigation took place, preferably, in the farms where cases occurred. Information on the evolution of the diseases in the affected cattle of the herd was recorded, and the probable risk factors were identified. All general and neurological examination procedures were performed systematically for the characterization of the neurological syndrome in each case. Samples of blood and CSF for laboratory exams were also collected. According to the evolution features and the severity of the observed clinical signs, the diseased cattle were kept alive to follow the progress of the disease, or were submitted to euthanasia followed by necropsy. Fragments of tissues from nervous system and other organs were collected for histopathological examination. Direct immunofluorescence test and biological test were performed on all the cattle that died, in order to confirm or rule out the diagnosis of rabies. Specific virology, bacteriology and toxicology laboratory methods were used as complementary exams in order to establish differential diagnosis. A total of 236 cattle with neurological disease were investigated, 85 cases of individual occurrence and 151 cases distributed by outbreaks that occurred in 79 herds. Encephalopathies (180/236, 76.2%) predominated over mielopathies (27/236, 11.4%). Inflammatory diseases caused by infections (98/236, 41.5%) and the toxic diseases (91/236, 38.6%) were the main causes, while degenerative (10/236, 4.2%), metabolic (9/236; 3.8%), physical (9/236, 3.8%), neoplastic (4/236, 1.7%), and congenital defects (1/236, 0.4%) occurred less often. The inconclusive cases were 5.9% (14/236). BoHV-5 meningoencephalitis and rabies were diseases of higher frequency and may be considered the most important. Among the toxic causes, plant poisonings were highlighted (63/91, 69.2%) and were responsible for 26.6% of all cases. Polioencephalomalacia, thrombotic meningoencephalitis caused by Histophilus somni and botulism were also highlighted. This information helps veterinarians to adopt more effective diagnostic and preventive approaches and is valuable to the state's official epidemiological surveillance system.(AU)

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ABSTRACT: The aim of this study was to identify the neurological diseases that affected cattle in Paraná state between the years 2009 and 2015. The investigation took place, preferably, in the farms where cases occurred. Information on the evolution of the diseases in the affected cattle of the herd was recorded, and the probable risk factors were identified. All general and neurological examination procedures were performed systematically for the characterization of the neurological syndrome in each case. Samples of blood and CSF for laboratory exams were also collected. According to the evolution features and the severity of the observed clinical signs, the diseased cattle were kept alive to follow the progress of the disease, or were submitted to euthanasia followed by necropsy. Fragments of tissues from nervous system and other organs were collected for histopathological examination. Direct immunofluorescence test and biological test were performed on all the cattle that died, in order to confirm or rule out the diagnosis of rabies. Specific virology, bacteriology and toxicology laboratory methods were used as complementary exams in order to establish differential diagnosis. A total of 236 cattle with neurological disease were investigated, 85 cases of individual occurrence and 151 cases distributed by outbreaks that occurred in 79 herds. Encephalopathies (180/236, 76.2%) predominated over mielopathies (27/236, 11.4%). Inflammatory diseases caused by infections (98/236, 41.5%) and the toxic diseases (91/236, 38.6%) were the main causes, while degenerative (10/236, 4.2%), metabolic (9/236; 3.8%), physical (9/236, 3.8%), neoplastic (4/236, 1.7%), and congenital defects (1/236, 0.4%) occurred less often. The inconclusive cases were 5.9% (14/236). BoHV-5 meningoencephalitis and rabies were diseases of higher frequency and may be considered the most important. Among the toxic causes, plant poisonings were highlighted (63/91, 69.2%) and were responsible for 26.6% of all cases. Polioencephalomalacia, thrombotic meningoencephalitis caused by Histophilus somni and botulism were also highlighted. This information helps veterinarians to adopt more effective diagnostic and preventive approaches and is valuable to the states official epidemiological surveillance system.

RESUMO: O objetivo deste trabalho foi identificar as doenças neurológicas que acometeram bovinos no estado do Paraná entre os anos de 2009 e 2015. A investigação aconteceu, preferencialmente, nas propriedades rurais onde os casos ocorreram. Foram registradas as informações sobre a evolução das doenças nos bovinos afetados do rebanho, e os prováveis fatores de risco foram identificados. Todos os procedimentos de exame físico geral e neurológico foram realizados sistematicamente para a caracterização da síndrome neurológica presente. Amostras de sangue e de líquor foram colhidas para a realização de exames laboratoriais. De acordo com o tempo de evolução e com a gravidade dos sinais clínicos observados, os bovinos doentes eram mantidos vivos para acompanhamento da evolução ou da resposta ao tratamento, ou eram submetidos à eutanásia seguida de necropsia. Fragmentos do sistema nervoso e dos demais órgãos foram colhidos para exame histopatológico. O exame de imunofluorescência direta e a prova biológica em camundongos foram realizados em todos os bovinos que morreram, com a finalidade de confirmar ou descartar o diagnóstico de raiva. Métodos laboratoriais específicos das rotinas de virologia, bacteriologia e toxicologia foram empregados, como complementares, para o estabelecimento do diagnóstico diferencial. Foram investigados 236 bovinos com doença neurológica, sendo 85 casos de ocorrência individual e 151 casos distribuídos por surtos que ocorreram em 79 rebanhos. As encefalopatias (180/236; 76,2%) predominaram sobre as mielopatias (27/236; 11,4%). As doenças inflamatórias determinadas por infecções (98/236; 41,5%) e as doenças tóxicas (91/236; 38,6%) foram as principais, enquanto as causas degenerativas (10/236; 4,2%), metabólicas (9/236; 3,8%), físicas (9/236; 3,8%), neoplásicas (4/236; 1,7%), e os defeitos congênitos (1/236; 0,4%) ocorreram menos frequentemente. Os casos inconclusivos somaram 5,9% (14/236). A meningoencefalite por BoHV-5 e a raiva foram as doenças de frequência maior e podem ser consideradas as mais importantes. Dentre as causas tóxicas, as intoxicações por plantas se destacaram (63/91; 69,2%) e foram responsáveis por 26,6% de todos os casos. Destacaram-se ainda a polioencefalomalácia, a meningoencefalite trombótica por Histophilus somni e o botulismo. Essas informações contribuem para que os médicos veterinários adotem condutas mais efetivas de diagnóstico e de prevenção, e são valiosas para o sistema oficial de vigilância epidemiológica do estado.

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Background: Herpetic meningoencephalitis is an infectious contagious disease worldwide distributed, most often caused by bovine alphaherpesvirus type 5 (BoHV-5), although bovine alphaherpesvirus type 1 (BoHV-1) may occasionally be the causative agent. The disease is characterized by subacute to acute clinical onset, often affecting animals submitted to stressful situations. Clinical signs are mainly neurologic due to meningoencephalitis and cortical necrosis. The involvement of the spinal cord has also been reported, however in BoHV-1 associated disease only. The aim of this report is to describe an outbreak of bovine meningoencephalomyelitis associated to BoHV-5.Case: In August 2017, nine 1-year-old calves died in a beef cattle farm with a flock of approximately 400 bovines. The animals presented neurological clinical signs characterized by excessive salivation, nasal and ocular discharges, incoordination, apathy, head tremors, head pressing, wide-based stance, recumbency followed by convulsions and paddling. According to the owner and referring veterinarian, affected animals displayed severe clinical signs with rapid progression and often leading to death in up to seven days. Four of these calves were submitted for necropsy, and gross lesions were present in the brain, characterized by mild to moderate multifocal hemorrhagic and soft areas. On cut surface, extensive areas of dark brown discoloration and malacia were observed. Histologically, lesions were characterized by extensive areas of liquefactive necrosis in the cerebral cortex grey matter, associated with inflammatory infiltrates composed of neutrophils, lymphocytes, plasma cells and foamy macrophages, as well as multifocal to coalescing areas of hemorrhage and fibrin deposition. Intranuclear eosinophilic inclusion bodies were rarely observed in neurons and astrocytes. On leptomeninges, there was diffuse inflammatory infiltrates of lymphocytes and plasma cells.[...](AU)

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Background: Herpetic meningoencephalitis is an infectious contagious disease worldwide distributed, most often caused by bovine alphaherpesvirus type 5 (BoHV-5), although bovine alphaherpesvirus type 1 (BoHV-1) may occasionally be the causative agent. The disease is characterized by subacute to acute clinical onset, often affecting animals submitted to stressful situations. Clinical signs are mainly neurologic due to meningoencephalitis and cortical necrosis. The involvement of the spinal cord has also been reported, however in BoHV-1 associated disease only. The aim of this report is to describe an outbreak of bovine meningoencephalomyelitis associated to BoHV-5.Case: In August 2017, nine 1-year-old calves died in a beef cattle farm with a flock of approximately 400 bovines. The animals presented neurological clinical signs characterized by excessive salivation, nasal and ocular discharges, incoordination, apathy, head tremors, head pressing, wide-based stance, recumbency followed by convulsions and paddling. According to the owner and referring veterinarian, affected animals displayed severe clinical signs with rapid progression and often leading to death in up to seven days. Four of these calves were submitted for necropsy, and gross lesions were present in the brain, characterized by mild to moderate multifocal hemorrhagic and soft areas. On cut surface, extensive areas of dark brown discoloration and malacia were observed. Histologically, lesions were characterized by extensive areas of liquefactive necrosis in the cerebral cortex grey matter, associated with inflammatory infiltrates composed of neutrophils, lymphocytes, plasma cells and foamy macrophages, as well as multifocal to coalescing areas of hemorrhage and fibrin deposition. Intranuclear eosinophilic inclusion bodies were rarely observed in neurons and astrocytes. On leptomeninges, there was diffuse inflammatory infiltrates of lymphocytes and plasma cells.[...]

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This cross-sectional study investigated depression as the middle- (4 years) and long-term (7 and 10 years) psychological impact of pre-symptomatic testing (PST) for 3 autosomal dominant late-onset diseases: Huntington's disease (HD), Machado-Joseph disease (MJD) and familial amyloidotic polyneuropathy (FAP) TTR V30M. It included 203 subjects: 170 (83.7%) underwent the PST for FAP, 29 (14.3%) for HD and 4 (2%) for MJD. Of these 203, 73 were still asymptomatic carriers, 29 (14.5%) were symptomatic, 9 (4.5%) were FAP liver transplanted patients and 89 (44.5%) were non-carriers. Subjects were mainly women (58.1%) and married (66.5%). The Beck Depression Inventory (BDI) was used to evaluate depression. Scores were higher for symptomatic carriers and for those who have made one or more psychological support consultations over the years. For the formers, the mean scores pointed to mild depression. Asymptomatic carriers and non-carriers had similar scores but it was impossible to differentiate the psychological impact between the medium and long-term. For symptomatic carriers, there were significant differences between the middle- and long-term. The study indicates that depression occurs only when subjects had previously manifested the first symptoms of their neurologic disease.(AU)

Este estudo transversal investigou a depressão como indicador do impacto psicológico do teste pré-sintomático (TPS) a médio (quatro anos) e longo prazo (de 7 a 10 anos) de doenças neurológicas de início tardio: a doença de Huntington (DH), doença de Machado-Joseph (DMJ) e polineuropatia amiloidótica familiar PAF (TTR V30M). 203 sujeitos participaram no estudo: 170 (83,7%) submetidos ao TPS para PAF, 29 (14,3%) para o DH e 4 (2%) para DMJ. Destes 203, 73 eram portadores assintomáticos, 29 (14,5%) já eram sintomáticos, 9 (4,5%) pacientes com PAF, já tinham realizado o transplante hepático e 89 (44,5%) eram não-portadores. A amostra era constituída maioritariamente por mulheres (58,1%) e por sujeitos casados (66,5%). Utilizou-se o Inventário da Depressão de Beck (BDI). Os scores mais elevados foram observados nos portadores sintomáticos e nos sujeitos que tinham realizado consultas de psicologia com scores indicadores de depressão leve. Os portadores assintomáticos e os não-portadores apresentaram médias semelhantes. Para os portadores sintomáticos, encontrámos diferenças significativas entre o médio e o longo prazo. Este estudo conclui que a depressão pode ocorrer nos indivíduos que já manifestam os primeiros sintomas da respectiva doença neurológica.(AU)

Este estudio transversal investigó la depresión a la media (4 años) y largo plazo (7 y 10 años) del impacto psicológico de la prueba pre-sintomática (PPS) para 3 enfermedades autosómicos, dominantes, de aparición tardía: la enfermedad de Huntington (EH), la enfermedad de Machado-Joseph (EMJ) y la polineuropatia amiloide familiare (PAF) o polineuropatia amiloide da transtiretina FAP (TTR V30M). Participaron 203 sujetos: 170 (83,7%) para PPS para PAF, 29 (14,3%) para EH y 4 (2%) para EMJ. De estos 203, 73 estaban todavía portador asintomático, 29 (14,5%) eran sintomáticos, 9 (4,5%) fueron PAF pacientes con trasplante hepático y 89 (44,5%) eran no-portadores. Eran en su mayoría mujeres (58,1%) y casados (66,5%). Se utilizó el Inventario de Depresión de Beck (IDB). Los puntajes fueron mayores para las portadoras sintomáticas y para aquellos que han hecho consultas de apoyo psicológico con puntuaciones medias de depresión leve. Los portadores asintomáticos y no portadores tuvieron puntajes similares. Para portadores sintomáticos, hubo diferencias significativas entre el medio y largo plazo. Este estudio concluye que la depresión puede ocurrir en personas que ya muestran los primeros síntomas de la enfermedad neurológica.(AU)

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This cross-sectional study investigated depression as the middle- (4 years) and long-term (7 and 10 years) psychological impact of pre-symptomatic testing (PST) for 3 autosomal dominant late-onset diseases: Huntington's disease (HD), Machado-Joseph disease (MJD) and familial amyloidotic polyneuropathy (FAP) TTR V30M. It included 203 subjects: 170 (83.7%) underwent the PST for FAP, 29 (14.3%) for HD and 4 (2%) for MJD. Of these 203, 73 were still asymptomatic carriers, 29 (14.5%) were symptomatic, 9 (4.5%) were FAP liver transplanted patients and 89 (44.5%) were non-carriers. Subjects were mainly women (58.1%) and married (66.5%). The Beck Depression Inventory (BDI) was used to evaluate depression. Scores were higher for symptomatic carriers and for those who have made one or more psychological support consultations over the years. For the formers, the mean scores pointed to mild depression. Asymptomatic carriers and non-carriers had similar scores but it was impossible to differentiate the psychological impact between the medium and long-term. For symptomatic carriers, there were significant differences between the middle- and long-term. The study indicates that depression occurs only when subjects had previously manifested the first symptoms of their neurologic disease.

Este estudo transversal investigou a depressão como indicador do impacto psicológico do teste pré-sintomático (TPS) a médio (quatro anos) e longo prazo (de 7 a 10 anos) de doenças neurológicas de início tardio: a doença de Huntington (DH), doença de Machado-Joseph (DMJ) e polineuropatia amiloidótica familiar PAF (TTR V30M). 203 sujeitos participaram no estudo: 170 (83,7%) submetidos ao TPS para PAF, 29 (14,3%) para o DH e 4 (2%) para DMJ. Destes 203, 73 eram portadores assintomáticos, 29 (14,5%) já eram sintomáticos, 9 (4,5%) pacientes com PAF, já tinham realizado o transplante hepático e 89 (44,5%) eram não-portadores. A amostra era constituída maioritariamente por mulheres (58,1%) e por sujeitos casados (66,5%). Utilizou-se o Inventário da Depressão de Beck (BDI). Os scores mais elevados foram observados nos portadores sintomáticos e nos sujeitos que tinham realizado consultas de psicologia com scores indicadores de depressão leve. Os portadores assintomáticos e os não-portadores apresentaram médias semelhantes. Para os portadores sintomáticos, encontrámos diferenças significativas entre o médio e o longo prazo. Este estudo conclui que a depressão pode ocorrer nos indivíduos que já manifestam os primeiros sintomas da respectiva doença neurológica.

Este estudio transversal investigó la depresión a la media (4 años) y largo plazo (7 y 10 años) del impacto psicológico de la prueba pre-sintomática (PPS) para 3 enfermedades autosómicos, dominantes, de aparición tardía: la enfermedad de Huntington (EH), la enfermedad de Machado-Joseph (EMJ) y la polineuropatia amiloide familiare (PAF) o polineuropatia amiloide da transtiretina FAP (TTR V30M). Participaron 203 sujetos: 170 (83,7%) para PPS para PAF, 29 (14,3%) para EH y 4 (2%) para EMJ. De estos 203, 73 estaban todavía portador asintomático, 29 (14,5%) eran sintomáticos, 9 (4,5%) fueron PAF pacientes con trasplante hepático y 89 (44,5%) eran no-portadores. Eran en su mayoría mujeres (58,1%) y casados (66,5%). Se utilizó el Inventario de Depresión de Beck (IDB). Los puntajes fueron mayores para las portadoras sintomáticas y para aquellos que han hecho consultas de apoyo psicológico con puntuaciones medias de depresión leve. Los portadores asintomáticos y no portadores tuvieron puntajes similares. Para portadores sintomáticos, hubo diferencias significativas entre el medio y largo plazo. Este estudio concluye que la depresión puede ocurrir en personas que ya muestran los primeros síntomas de la enfermedad neurológica.

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Al exponer la humanidad y favorecer reflexiones críticas, el cine desempeña su papel de suplir experiencias que no todos pueden vivenciar. De esa forma, se constituye como valiosa fuente de recurso para la educación médica. El cine amplia las posibilidades de promoción de una formación más amplia e integrada, pues involucra habilidades y competencias que van más allá del conocimiento biomédico, lo que es esencial en el contexto del abordaje del paciente anciano. En este artículo se refieren largometrajes que didácticamente se centran en pacientes ancianos portadores de enfermedades neurológicas, como enfermedad de Alzheimer, accidente vascular encefálico y demencia vascular, enfermedad de Parkinson y esclerosis lateral amiotrófica.(AU)

By exposing humanity and promoting critical thinking, cinema plays your part by supplying experiences that not everyone can see. In this way, constitutes a valuable source of resource for medical education. Films expand the possibilities of promoting a more comprehensive and integrated training, involving skills and competencies that go beyond biomedical knowledge, which is essential in the context of approach to elderly patient. This article describes some didactic films that shows elderly patients with neurological diseases like Alzheimer’s, stroke and vascular dementia, Parkinson's disease and amyotrophic lateral sclerosis.(AU)

Ao expor a humanidade e favorecer reflexões críticas, o cinema desempenha seu papel de suprir experiências que nem todos podem vivenciar. Dessa forma, constitui-se como valiosa fonte de recurso para a educação médica. Os filmes ampliam as possibilidades de promoção de uma formação mais ampla e integrada, pois envolvem habilidades e competências que vão além do conhecimento biomédico, o que é essencial no contexto da abordagem ao paciente idoso. Neste artigo são referidos filmes de longa-metragem que didaticamente focam pacientes idosos portadores de doenças neurológicas, como doença de Alzheimer, acidente vascular encefálico e demência vascular, doença de Parkinson e esclerose lateral amiotrófica.(AU)

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Ao expor a humanidade e favorecer reflexões críticas, o cinema desempenha seu papel de suprir experiências que nem todos podem vivenciar. Dessa forma, constitui-se como valiosa fonte de recurso para a educação médica. Os filmes ampliam as possibilidades de promoção de uma formação mais ampla e integrada, pois envolvem habilidades e competências que vão além do conhecimento biomédico, o que é essencial no contexto da abordagem ao paciente idoso. Neste artigo são referidos filmes de longa-metragem que didaticamente focam pacientes idosos portadores de doenças neurológicas, como doença de Alzheimer, acidente vascular encefálico e demência vascular, doença de Parkinson e esclerose lateral amiotrófica.

By exposing humanity and promoting critical thinking, cinema plays your part by supplying experiences that not everyone can see. In this way, constitutes a valuable source of resource for medical education. Films expand the possibilities of promoting a more comprehensive and integrated training, involving skills and competencies that go beyond biomedical knowledge, which is essential in the context of approach to elderly patient. This article describes some didactic films that shows elderly patients with neurological diseases like Alzheimer's, stroke and vascular dementia, Parkinson's disease and amyotrophic lateral sclerosis.

Al exponer la humanidad y favorecer reflexiones críticas, el cine desempeña su papel de suplir experiencias que no todos pueden vivenciar. De esa forma, se constituye como valiosa fuente de recurso para la educación médica. El cine amplia las posibilidades de promoción de una formación más amplia e integrada, pues involucra habilidades y competencias que van más allá del conocimiento biomédico, lo que es esencial en el contexto del abordaje del paciente anciano. En este artículo se refieren largometrajes que didácticamente se centran en pacientes ancianos portadores de enfermedades neurológicas, como enfermedad de Alzheimer, accidente vascular encefálico y demencia vascular, enfermedad de Parkinson y esclerosis lateral amiotrófica.

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OBJECTIVE: To perform the first prospective survey of neurologic and neurosurgical emergency department (ED) admissions in Haiti. METHODS: Data of all ED admissions at 3 Haitian hospitals for 90 consecutive days per site were collected prospectively. Patients who were given a diagnosis of a neurologic or neurosurgical disorder by the ED physician were entered in a deidentified database including demographics, presenting symptoms, brain imaging (when available), requests for neurosurgical consultation, and outcome. RESULTS: Of the 7628 patients admitted to the ED during this study, 1243 patients had a neurologic disorder, yielding an ED-based neurologic disease prevalence of 16%. The 3 most common neurologic diseases were cerebrovascular disease (31%), neurotrauma (28%), and altered mental status (12%). Neurosurgical pathologies represented 19% of all neurologic admissions with a combined ED-based disease prevalence of 3%. Mortality rate was 9%. The most common neurosurgical disease was neurotrauma (87%), caused by motor vehicle accidents (59%), falls (20%), and assault (17%). Neurosurgical procedures were performed in 14 of 208 patients with a mortality rate of 33%. CONCLUSIONS: This prospective survey represents the first study of neurosurgical or neurologic disease patterns in Haiti. The results suggest specific disease priorities for this population that can guide efforts to improve Haitian health care and conduct more comprehensive epidemiologic studies in Haiti.

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