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2.
Braz. J. Pharm. Sci. (Online) ; 59: e20467, 2023. graf
Artigo em Inglês | LILACS | ID: biblio-1439510

RESUMO

Abstract Prolonged overexposure to catecholamines causes toxicity, usually credited to continuous adrenoceptor stimulation, autoxidation, and the formation of reactive pro-oxidant species. Non-differentiated SH-SY5Y cells were used to study the possible contribution of oxidative stress in adrenaline (ADR)-induced neurotoxicity, as a model to predict the toxicity of this catecholamine to peripheral nerves. Cells were exposed to several concentrations of ADR (0.1, 0.25, 0.5 and 1mM) and two cytotoxicity assays [lactate dehydrogenase (LDH) release and 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl tetrazolium bromide (MTT) reduction] were performed at several time-points (24, 48, and 96h). The cytotoxicity of ADR was concentration- and time-dependent in both assays, since the lowest concentration tested (0.1mM) also caused significant cytotoxicity at 96h. N-acetyl-cysteine (1mM), a precursor of glutathione synthesis, prevented ADR-induced toxicity elicited by 0.5mM and 0.25mM ADR following a 96-h exposure, while the antioxidant Tiron (100µM) was non-protective. In conclusion, ADR led to mitochondrial distress and ultimately cell death in non-differentiated SH-SY5Y cells, possibly because of ADR oxidation products. The involvement of such processes in the catecholamine-induced peripheral neuropathy requires further analysis.


Assuntos
Epinefrina/agonistas , Doenças do Sistema Nervoso Periférico/classificação , Toxicidade , Neurônios/classificação , Nervos Periféricos/anormalidades , Brometos/antagonistas & inibidores , Estresse Oxidativo/efeitos dos fármacos , Antioxidantes/farmacologia
4.
Rev. habanera cienc. méd ; 21(3): e4710, mayo.-jun. 2022. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1409482

RESUMO

Introducción: El SARS-CoV-2 afecta principalmente al sistema respiratorio, pero el daño producido por este virus también se extiende a otros sistemas, incluido el sistema nervioso, y los mecanismos de infección neurológica pueden ser directos o indirectos. Objetivo: Determinar la relación entre las manifestaciones neurológicas y la severidad de la enfermedad en pacientes sintomáticos positivos a la COVID-19. Hospital San Vicente de Paúl. 2021. Material y Métodos: Estudio observacional de corte transversal, empleando el registro de historias clínicas de los pacientes hospitalizados con la COVID-19 y manifestaciones neurológicas, las cuales se clasificaron en manifestaciones del sistema nervioso central y manifestaciones del sistema nervioso periférico. Resultados: 74,1 por ciento pacientes presentaron manifestaciones neurológicas, el mayor porcentaje se concentró en pacientes que desarrollaron enfermedad grave (15 [60 por ciento], SNC; 91 [77,1 por ciento], SNP; 125 [65,4 por ciento], SNC y SNP). La presencia conjunta de manifestaciones neurológicas centrales y periféricas se asoció significativamente con la COVID-19 crítica (P valor= 0,011; OR: 2,005). El índice de mortalidad alcanzó 2,69 por ciento. Conclusiones: Las manifestaciones neurológicas en pacientes hospitalizados con la COVID-19 son muy frecuentes, y la COVID-19 crítica tiene mayor probabilidad de presentar manifestaciones neurológicas(AU)


Introduction: SARS-CoV-2 mainly affects the respiratory system, but the damage caused by this virus also extends to other systems, including the nervous system, and the mechanisms of neurological infection can be direct or indirect. Objective: To determine the relationship between neurological manifestations and disease severity in symptomatic COVID-19 positive patients at San Vicente de Paul Hospital in 2021. Material and Methods: A cross-sectional observational study was conducted using medical records of patients hospitalized with COVID-19 and neurological manifestations, which were classified into manifestations of the central nervous system and manifestations of the peripheral nervous system. Results: The results show that 74,1 percent of patients presented neurological manifestations; the highest percentage was concentrated in patients who developed severe disease (15 [60 percent], CNS; 91 [77,1 percent], PNS; 125 [65,4 percent], CNS and PNS). The joint presence of central and peripheral neurological manifestations was significantly associated with critical COVID-19 (P value= 0,011; OR: 2,005). The mortality rate reached 2,69 percent. Conclusions: Neurological manifestations in hospitalized COVID-19 patients are very common, and critical COVID-19 is more likely to have neurological manifestations(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Índice de Gravidade de Doença , Doenças do Sistema Nervoso Central/complicações , Doenças do Sistema Nervoso Periférico/complicações , COVID-19/complicações , Razão de Chances , Estudos Transversais , COVID-19/mortalidade , Centenários , Octogenários , Saturação de Oxigênio , Nonagenários
5.
Int. j. morphol ; 40(1): 233-241, feb. 2022. ilus
Artigo em Inglês | LILACS | ID: biblio-1385574

RESUMO

SUMMARY: This study aims to investigate the effect of Tangzhouling on the morphological changes of Nissl bodies in the dorsal root ganglion of DM Rats. In this study, 69 rats were randomly divided into a control group (n = 10) and a model group (n = 59). The rats in the model group were randomly divided into a diabetic group (n = 11), a vitamin C group (n = 12), a low dose Tangzhouling group (n = 12), a medium dose Tangzhouling group (n = 12) and a high dose Tangzhouling group (n = 12). The dose of Tangzhouling in the low dose group was 5 times that of the adult dose, being 0.44g/kg/d. The dose of Tangzhouling in the medium dose group was 10 times that of the adult dose, being 0.88g/kg/d. The dose of Tangzhouling in the high dose group was 20 times that of the adult dose, being 1.75g/kg/d. All doses above are crude drug dosages. Rats in the vitamin C group were given 10 times the dose of an adult, being, 0.05 g/ kg/d. The diabetic group and the control group were given the same amount of distilled water. Drug delivery time is 16 weeks. The dorsal root ganglion was placed in a freezing tube at the end of the experiment. The morphological changes of Nissl bodies in the dorsal root ganglion were detected by HE and Nissl staining. The study results showed that vitamin C had no significant effect on the quantity, size and nucleolus. Tangzhouling can improvee the morphology, quantity and nucleolus of Nissl bodies to a certain extent, and the high dose is better than the lower dose. Tangzhouling capsules can improve the nerve function of DM rats through Nissl bodies.


RESUMEN: Este estudio tuvo como objetivo investigar el efecto de Tangzhouling en los cambios morfológicos de los cuerpos de Nissl en el ganglio de la raíz dorsal de las ratas DM. En este estudio, 69 ratas se dividieron aleatoriamente en un grupo control (n = 10) y un grupo modelo (n = 59). Las ratas del grupo modelo se dividieron aleatoriamente en un grupo diabéticos (n = 11), un grupo vitamina C (n = 12), un grupo de dosis baja de Tangzhouling (n = 12), un grupo de dosis media de Tangzhouling (n = 12) y un grupo de dosis alta de Tangzhouling (n = 12). La dosis de Tangzhouling en el grupo de dosis baja fue 5 veces mayor que la dosis del adulto, siendo 0,44 g/kg/d. La dosis de Tangzhouling en el grupo de dosis media fue 10 veces mayor que la dosis del adulto, siendo 0,88 g/kg/d. La dosis de Tangzhouling en el grupo de dosis alta fue 20 veces mayor que la dosis del adulto, siendo 1,75 g/kg/d. Todas las dosis anteriores son dosis de fármaco crudo. Se les administró 10 veces la dosis de un adulto a las ratas del grupo vitamina C, siendo 0,05 g/kg/d. El grupo de diabéticos y el grupo de control recibieron la misma cantidad de agua destilada. El tiempo de entrega del fármaco fue de 16 semanas. El ganglio de la raíz dorsal se colocó en un tubo de congelación al final del experimento. Los cambios morfológicos de los cuerpos de Nissl en el ganglio de la raíz dorsal se detectaron mediante tinción de HE y Nissl. Los resultados del estudio mostraron que la vitamina C no tuvo un efecto significativo sobre la cantidad, el tamaño y el nucléolo. Tangzhouling puede mejorar la morfología, la cantidad y el nucléolo de los cuerpos de Nissl hasta cierto punto, y es mejor la dosis alta que la dosis baja. Las cápsulas de Tangzhouling pueden mejorar la función nerviosa de las ratas DM a través de los cuerpos de Nissl.


Assuntos
Animais , Ratos , Doenças do Sistema Nervoso Periférico , Neuropatias Diabéticas , Gânglios Espinais/efeitos dos fármacos , Corpos de Nissl/efeitos dos fármacos , Coloração e Rotulagem , Modelos Animais de Doenças
6.
Braz. J. Pharm. Sci. (Online) ; 58: e21010, 2022. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1420430

RESUMO

Abstract Acrylamide is a neurotoxic compound. Moreover, anakinra is an interleukin-1 (IL-1) receptor antagonist used in rheumatoid arthritis treatment. This study investigated the effect of anakinra on acrylamide-related neuropathy and neuropathic pain. Acrylamide exposure caused a significant decrease in the pain threshold; an increase in malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α), and interleukin-1 beta (IL-1ß) levels; and a decrease in total glutathione (tGSH) values in the sciatic nerve. This indicates hyperalgesia presence, oxidative stress, and peripheral nerve tissue inflammation. Anakinra treatment significantly reduced the MDA, IL-1ß, and TNF-α levels, and increased the pain threshold and mean tGSH values. The analgesic effect of anakinra was 67.9% at the first hour, increasing to 74.9% and 76.7% at the second and third hours, respectively. The group receiving acrylamide exhibited histopathological changes (e.g., swollen and degenerated axons, hypertrophic and hyperplasic Schwann cells, and congested vessels). The use of anakinra significantly improved these morphological changes. Anakinra is concluded to reduce neuropathic pain and prevent neurotoxic effect of acrylamide on peripheral nerves due to its analgesic, antioxidant, and anti-inflammatory properties


Assuntos
Animais , Masculino , Ratos , Doenças do Sistema Nervoso Periférico/patologia , Acrilamida/efeitos adversos , Proteína Antagonista do Receptor de Interleucina 1/antagonistas & inibidores , Inflamação/classificação , Nervos Periféricos/anormalidades , Artrite Reumatoide/patologia , Fator de Necrose Tumoral alfa/farmacologia , Limiar da Dor/classificação , Estresse Oxidativo/efeitos dos fármacos
7.
Int. j. morphol ; 40(4): 1035-1042, 2022. ilus, tab, graf
Artigo em Inglês | LILACS | ID: biblio-1405240

RESUMO

SUMMARY: Peripheral nerve damage (PNI) can cause demyelination, axonal degeneration and loss of motor and sensory function. Melatonin with its antioxidative effect, has been reported to reduce scar formation in nerve injury, take a role in repair process by suppressing fibroblast proliferation in the damaged area. It was aimed to investigate the effect of melatonin in the repair of peripheral nerve damage and the relationship between S100 proteins and angiogenic regulation. Wistar albino rats were divided into 3 groups. In the Defect group, 6 mm tibial bone defect using a motorized drill was created and kept immobile for 28 days. In Defect + graft group, tibial bone defect with allograft treatment was applied and kept immobile for 28 days. In Defect + graft + Melatonin group, melatonin was administered to defect + allograft group. All rats were sacrified by decapitation, skin and tibia bone were removed then fixed with 10 % neutral buffered formalin and embedded in paraffin, sections were examined under light microscopy. In the Defect+Graft group, enlargement and occlusion of the vessels with degeneration of the epineural sheath, thickening of the endoneural sheath and mild hyperplasia of schwannocytus (Schwann cells) were remarkable. In the Defect+Graft+Melatonin group, the epineural sheath was tight and regular, the axonal structures were prominent in the endoneural area. Mild S100 expression was observed in Defect+Graft group in fibers of the endoneural region with a prominent expression in schwannocytus. In Defect+Graft+Melatonin group (10mg/kg), S100 expression was moderate in areas where schwannocytus proliferated and nerve-connective tissue sheaths were reconstructed. VEGF expression was moderate in endoneural, perineural and epineural connective tissue sheaths in the Defect+Graft+Melatonin group, with negative expression in blood vessel endothelial cells, but with a positive expression in schwannocytus. We conclude that with the application of melatonin; oxidative stress decreases, schwannocytus proliferation increases, having positive influence on nerve repair with the regulation of S100 signaling and angiogenetic structuring.


RESUMEN: El daño a los nervios periféricos puede causar desmielinización, degeneración axonal y pérdida de la función motora y sensorial. Se ha informado que la melatonina, con su efecto antioxidante, reduce la formación de cicatrices en lesiones nerviosas y desempeña un papel en el proceso de reparación al suprimir la proliferación de fibroblastos en el área dañada. El objetivo de este trabajo fue investigar el efecto de la melatonina en la reparación del daño de los nervios periféricos y la relación entre las proteínas S100 y la regulación angiogénica. Ratas albinas Wistar se dividieron en 3 grupos. En el grupo Defecto, se creó un defecto óseo tibial de 6 mm con un taladro motorizado y se mantuvo inmóvil durante 28 días. En el grupo Defecto + injerto, se aplicó tratamiento de defecto óseo tibial con aloinjerto y se mantuvo inmóvil durante 28 días. En el grupo Defecto + injerto + Melatonina, se administró melatonina al grupo defecto + aloinjerto. Todas las ratas fueron sacrificadas por decapitación, se extrajo la piel y el hueso de la tibia y luego se fijaron con formalina tamponada neutra al 10 % y se incluyeron en parafina, las secciones se examinaron bajo microscopía óptica. En el grupo Defecto+Injerto, fueron notables el agrandamiento y la oclusión de los vasos con degeneración de la vaina epineural, engrosamiento de la vaina endoneural e hiperplasia leve de los schwannocitos (neurolemnocitos). En el grupo Defecto+Injerto+Melatonina, la vaina epineural era estrecha y regular, las estructuras axonales eran prominentes en el área endoneural. Se observó expresión leve de S100 en el grupo Defecto+Injerto en fibras de la región endoneural con una expresión prominente en los schwannocitos. En el grupo Defecto+Injerto+Melatonina, la expresión de S100 fue moderada en áreas donde proliferaron los schwannocitos y se reconstruyeron las vainas de tejido conectivo nervioso. La expresión de VEGF fue moderada en vainas de tejido conectivo endoneural, perineural y epineural en el grupo Defecto+Injerto+Melatonina, con expresión negativa en células endoteliales de vasos sanguíneos, pero con expresión positiva en schwannocitos. Concluimos que con la aplicación de melatonina; disminuye el estrés oxidativo, aumenta la proliferación de schwannocitos, influyendo positivamente en la reparación nerviosa con la regulación de la señalización S100 y la estructuración angiogenética.


Assuntos
Animais , Ratos , Tíbia/patologia , Doenças do Sistema Nervoso Periférico/tratamento farmacológico , Melatonina/administração & dosagem , Antioxidantes/administração & dosagem , Nervos Periféricos/efeitos dos fármacos , Tíbia/inervação , Proteínas S100 , Ratos Wistar , Fator A de Crescimento do Endotélio Vascular , Modelos Animais de Doenças , Fibroblastos
8.
Arq. neuropsiquiatr ; 79(10): 924-928, Oct. 2021. tab
Artigo em Inglês | LILACS | ID: biblio-1345324

RESUMO

ABSTRACT Background: This mini-review aims to summarize and discuss previous and recent advances in the clinical presentation, pathophysiology, diagnosis, treatment, and outcome of SARS-CoV-2-associated peripheral neuropathies. Methods: Literature review. Results: Altogether, 105 articles about SARS-CoV-2-associated neuropathy describing 261 patients were retrieved. Peripheral neuropathy in patients with COVID-19 is frequent and predominantly due to immune mechanisms or neurotoxic side effects of drugs used to treat the symptoms of COVID-19 and, to a lesser extent, due to the compression of peripheral nerves resulting from prolonged bedding in the Intensive Care Unit (ICU) and pre-existing risk factors such as diabetes. SARS-CoV-2 does not cause viral neuropathy. Neurotoxic drugs such as daptomycin, linezolid, lopinavir, ritonavir, hydro-chloroquine, cisatracurium, clindamycin, and glucocorticoids should be administered with caution and patients should be appropriately bedded in the ICU to prevent SARS-CoV-2-associated neuropathy. Patients with Guillain-Barré syndrome (GBS) benefit from immunoglobulins, plasma exchange, and steroids. Conclusions: Neuropathies of peripheral nerves in patients with COVID-19 are frequent and mostly result from immune mechanisms or neurotoxic side effects of drugs used to treat the symptoms of COVID-19 and, to a lesser extent, from the compression of peripheral nerves due to prolonged bedding on the ICU. SARS-CoV-2 does not cause infectious neuropathy.


RESUMO Introdução: A presente minirrevisão tem como objetivo resumir e discutir os avanços dos aspectos clínicos, fisiopatológicos, de diagnóstico, tratamento e evolução das neuropatias dos nervos periféricos associadas à COVID-19. Métodos: Revisão da literatura. Resultados: Foram avaliados 105 artigos sobre neuropatia associada à COVID-19. Nesses estudos, 261 pacientes apresentaram boa evolução. As neuropatias dos nervos periféricos em pacientes com COVID-19 são frequentes e se devem, principalmente, aos mecanismos immunológicos ou efeitos colaterais neurotóxicos dos medicamentos utilizados para o tratamento da COVID-19, a fatores de risco pré-existentes, como diabetes e, em menor parte, à compressão dos nervos periféricos nos leitos da UTI. A COVID-19 não causa neuropatia viral. Os medicamentos neurotóxicos, como daptomicina, linezolida, lopinavir, ritonavir, hidro-cloroquina, cisatracúrio, clindamicina e glicocorticoides devem ser administrados com cautela, e os pacientes deve ser adequadamente admitidos nos leitos da UTI para prevenir o desenvolvimento de neuropatia associada à COVID-19. Pacientes com síndrome de Guillain-Barré (GBS) se beneficiam de imunoglobulinas, plasmaférese e esteroides. Conclusões: As neuropatias dos nervos periféricos em pacientes com COVID-19 são raras e predominantemente devidas aos efeitos colaterais neurotóxicos das mecanismos immunológicos ou drogas utilizadas para o tratamento de COVID-19 e, em menor parte, devido à compressão dos nervos periféricos nos leitos da UTI. A COVID-19 não causa neuropatia infeciosa.


Assuntos
Humanos , Preparações Farmacêuticas , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Síndrome de Guillain-Barré/induzido quimicamente , COVID-19 , Antivirais , Roupas de Cama, Mesa e Banho , Fatores de Risco , SARS-CoV-2 , Unidades de Terapia Intensiva
9.
Arq. bras. neurocir ; 40(3): 215-221, 15/09/2021.
Artigo em Inglês | LILACS | ID: biblio-1362106

RESUMO

Objective To outline the epidemiological profile of surgical patients treated at the peripheral-nerve outpatient clinic of a public hospital in the state of Pernambuco, Brazil, from 2008 (the year this service was implemented in the hospital ) to 2016. Material and Methods A cross-sectional study with data collection from the medical records. A descriptive analysis was performed with the qualitative variables presented as relative and absolute frequencies, and the quantitative variables, as means and standard deviations. The studied variables were gender, age, diagnosis, and surgical techniques. Results In total, 506 medical records were analyzed. Of these, 269 were of male patients (53%), and 238 were of female patients (46%). The age of the sample ranged from 5 to 84 years (41 14 years). The most prevalent diagnoses were: carpal tunnel syndrome (38.9%) followed by traumatic brachial plexus injury (33.2%). The first diagnosis was more frequent among women, while the second, among men. This collaborates with the predominant findings of upper-limb lesions (91%), in which men accounted for 52,75% (244) and women, for 47,25% (217). Conclusion The present study provided relevant information regarding the reality of peripheral-nerve surgeries performed at a public hospital in the state of Pernambuco, Brazil. Public health issues increasingly require the continuity of public policies and government incentive.


Assuntos
Síndrome do Túnel Carpal/epidemiologia , Síndromes de Compressão do Nervo Ulnar/epidemiologia , Doenças do Sistema Nervoso Periférico/cirurgia , Doenças do Sistema Nervoso Periférico/epidemiologia , Neuropatias do Plexo Braquial/epidemiologia , Fatores Socioeconômicos , Procedimentos Cirúrgicos Operatórios , Brasil/epidemiologia , Registros Médicos , Epidemiologia Descritiva , Estudos Transversais , Estudos Retrospectivos , Interpretação Estatística de Dados , Estatísticas não Paramétricas
11.
Rev. chil. obstet. ginecol. (En línea) ; 86(1): 81-90, feb. 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1388634

RESUMO

INTRODUCCIÓN: La endometriosis afecta hasta un 10-15% de las mujeres jóvenes. Se define como tejido endometrial funcional fuera de la cavidad uterina y su presentación clásica es la dismenorrea. La variedad profunda afecta a un 1-2% y las localizaciones más frecuentes son el peritoneo pélvico, ovarios, ligamentos útero-sacros y septum recto-vaginal; sin embargo, puede presentarse de forma muy infrecuente como implantes aislados localizados en relación al nervio ciático. El diagnóstico habitualmente es complejo y tardío, dado que los síntomas son inespecíficos y el examen físico puede ser indistinguible de otras etiologías. El estudio imagenológico de elección para la endometriosis profunda es la resonancia magnética (RM) de pelvis ya que una adecuada localización pre-quirúrgica de las lesiones es fundamental. CASO CLÍNICO: Paciente de sexo femenino de 46 años, con tres años de dolor pélvico, dismenorrea y dispareunia. El síntoma cardinal fue dolor ciático progresivo, con déficit motor y alteraciones sensitivas, los cuales se exacerbaban durante la menstruación y no presentaban respuesta al tratamiento farmacológico. En la RM se identifica nódulo sólido sospechoso de endometriosis en relación al nervio ciático derecho. El caso es evaluado por un comité multidisciplinario y se realiza cirugía laparoscópica. El diagnóstico de sospecha es confirmado histológicamente. La paciente presenta buena recuperación post-quirúrgica y cese completo de los síntomas descritos. DISCUSIÓN: La endometriosis profunda presenta un reto diagnóstico y habitualmente es tardío. Este caso presenta el resultado exitoso de una buena sospecha clínica, un estudio imagenológico completo y la resolución con una técnica quirúrgica compleja.


INTRODUCTION: Endometriosis is a disease that affects 10-15% of young women. It is characterized as functional endometrial tissue outside the uterine cavity. The most common form of presentation is dysmenorrhea. Deep endometriosis affects 1-2% of the patients, and is frequently located in the pelvic peritoneum, ovaries, utero-sacral ligaments and recto-vaginal septum. The isolated endometriosis of the sciatic nerve is a very uncommon presentation of this disease. Late diagnosis is frequent, mainly because the symptoms are non-specific, and the physical examination may be indistinguishable from other etiologies. The imaging study of choice is the pelvic magnetic resonance imaging (MRI) and an accurate pre-surgical location of the lesions is critical for a successful surgical outcome. CLINICAL CASE: 46-year-old female patient with 3 years of pelvic pain, dysmenorrhea and dyspareunia. The cardinal symptom was progressive sciatic pain, with motor deficit and sensory alterations. The pain was persistent despite pharmacological treatment and exacerbated during menstruation. MRI identifies a nodule located in the pelvic portion of the right sciatic nerve, suggestive of an endometriosis implant. The case was discussed by a multidisciplinary committee and laparoscopic surgery was performed. The diagnosis was confirmed with histology. The patient recovered well from surgery with significant improvement of the previously described symptoms. DISCUSSION: The diagnosis of deep endometriosis is challenging and usually delayed. This rare disease had a successful outcome, due to an early clinical suspicion, a thorough imaging study and an effective resolution with a complex surgical technique.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Nervo Isquiático/cirurgia , Nervo Isquiático/diagnóstico por imagem , Doenças do Sistema Nervoso Periférico/cirurgia , Doenças do Sistema Nervoso Periférico/diagnóstico por imagem , Endometriose/cirurgia , Endometriose/diagnóstico por imagem , Imageamento por Ressonância Magnética , Laparoscopia , Dor Pélvica/etiologia
12.
Artigo em Português | LILACS | ID: biblio-1359777

RESUMO

RESUMO: A atrofia óptica autossômica dominante (ADOA) é uma das formas mais comuns de atrofias ópticas hereditárias, e causada por mutações no gene OPA1. Os pacientes afetados por essa doença geralmente apresentam perda visual na primeira década de vida, podendo apresentar manifestações extraoftalmológicas no decorrer dos anos, configurando uma síndrome chamada OPA1 plus ou ADOA-plus. Objetivos: Relatar caso de paciente portadora da síndrome ADOA-plus, estabelecendo correlações com casos descritos na literatura. Relato de caso: Paciente feminino, 30 anos, foi encaminhada para avaliação de quadro de atrofia óptica progressiva associada a sintomas de neuropatia periférica. Aos dois anos, foi diagnosticada com perda visual parcial em consulta de puericultura. Não relatou outros sintomas associados durante a infância e a adolescência. Aos 20 anos, apresentou dificuldades de deambular, fraqueza em membros inferiores e falta de equilíbrio. Aos 25 anos, após extensa investigação, foi identificada, através de sequenciamento de exoma, mutação patológica no gene OPA1 confirmando o diagnóstico ADOA-plus e iniciado tratamento com Coenzima Q10. Atualmente a paciente relata ataxia sensitiva, diminuição da acuidade visual progressiva, fasciculações e câimbras em MMII, disfagia e dispneia. Discussão: Muitos pacientes com ADOA-plus apresentam surdez neurossensorial como sintoma extraoftalmológico mais comum, além de quadros de parkinsonismo e demência, ataxia e ptose. Paciente relatada constitui um caso de atrofia óptica associado à neuropatia periférica, ataxia e miopatia. Devido à ampla variabilidade clínica dessa doença, deve-se investigar mutações no OPA1 em casos de paraparesia espástica progressiva associada à atrofia óptica, visto que possibilidade de tratamento com Coenzima Q10. (AU)


ABSTRACT: Introduction: Autosomal dominant optic atrophy (ADOA) is one of the most common forms of inherited optic atrophies and is caused by mutations in the OPA1 gene. Patients affected by this disease usually present visual loss in the first decade of life, and may present extra-ophthalmologic manifestations over the years, configuring a syndrome called OPA1 plus or ADOA-plus. Objectives: to report the case of a patient with ADOA-plus syndrome, establishing correlations with cases described in the literature, Case report: a 30-year-old female patient was referred for evaluation of progressive optic atrophy associated with symptoms of peripheral neuropathy. At two years of age, she was diagnosed with partial visual loss during a childcare visit. She reported no other associated symptoms during childhood and adolescence. At the age of 20, she presented with difficulty walking, lower limb weakness, and poor balance. At 25, after extensive investigation, a pathological mutation in the OPA1 gene was identified through exome sequencing, confirming the diagnosis of ADOA-plus, and treatment with Coenzyme Q10 was initiated. Currently the patient reports sensory ataxia, progressive decrease in visual acuity, fasciculations and cramps in the lower limbs, dysphagia and dyspnea. Discussion: Many patients with ADOA-plus present sensorineural deafness as the most common extra-ophthalmologic symptom, in addition to parkinsonism and dementia, ataxia and ptosis. The patient reported is a case of optic atrophy associated with peripheral neuropathy, ataxia and myopathy. Due to the wide clinical variability of this disease, OPA1 mutations should be investigated in cases of progressive spastic paraparesis associated with optic atrophy, since the possibility of treatment with Coenzyme Q10. (AU)


Assuntos
Humanos , Feminino , Adulto , Ataxia , Transtornos de Deglutição , Acuidade Visual , Coenzimas , Doenças do Sistema Nervoso Periférico , Transtornos Parkinsonianos , Paraparesia Espástica , Atrofia Óptica Autossômica Dominante , Perda Auditiva Neurossensorial , Cãibra Muscular
13.
Rev. chil. neuro-psiquiatr ; 58(4): 324-336, dic. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1388362

RESUMO

INTRODUCCIÓN: Disfunción del sistema nervioso autonómico ocurre en enfermedades del sistema nervioso central y periférico. Es importante cuantificar el compromiso simpático y parasimpático, diagnosticar la disfunción, monitorizar la evolución y la respuesta a terapias. Las principales pruebas funcionales son las cardiovasculares y sudomotoras. Existen además exámenes para estudiar la disfunción autonómica en distintos órganos y que son específicos de las especialidades médicas respectivas. DESARROLLO: Se describen los síntomas, las pruebas funcionales y métodos de estudio a nivel cardiovascular: simpáticas vasomotoras (noradrenérgicas) y cardiovagales (colinérgicas) y las pruebas para la sudoración: sudomotoras simpáticas (colinérgicas). Se describen los síntomas y exámenes a nivel pupilar, urogenital y gastrointestinal. Se señala la utilidad de las pruebas funcionales autonómicas en el estudio de distintas patologías neurológicas. CONCLUSIONES: la evaluación conjunta de los hallazgos clínicos y de las pruebas funcionales autonómicas permiten determinar el nivel anatómico y el grado de severidad de la disfunción autonómica con un fundamento fisiopatológico.


INTRODUCTION: Autonomic dysfunction occurs in patients with central and peripheral nervous system diseases. It is important to quantify the sympathetic and parasympathetic involvement for the diagnosis of the autonomic failure, for follow up and evaluate the response to a specific treatment. The most important studies are cardiovascular and sudomotor functional tests. There are other tests for the study of autonomic dysfunction in different organs, that are specific to respectively medical specialty. DEVELOPMENT: we describe main symptoms, functional autonomic tests and other methods to study cardiovascular: sympathetic vasomotor (noradrenergic) and cardiovagal (cholinergic) and sudomotor: sympathetic (cholinergic) functions. We describe symptoms and tests for assessment pupillary, genitourinary and gastrointestinal autonomic dysfunction. The indications for autonomic function testing in the different clinical scenarios are reported. CONCLUSIONS: combined evaluation of clinical and tests of autonomic function results allow to obtain the level and severity of autonomic dysfunction based upon pathophysiological support.


Assuntos
Humanos , Doenças do Sistema Nervoso Autônomo/fisiopatologia , Doenças do Sistema Nervoso Periférico/diagnóstico , Sistema Nervoso Parassimpático/fisiopatologia , Sudorese , Sistema Nervoso Simpático/fisiopatologia
14.
Metro cienc ; 28(3): 8-13, 2020/09/01. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1146013

RESUMO

RESUMEN La distrofia muscular de cinturas de las extremidades (LGMD, por sus siglas en inglés) incluye varios trastornos con etiologías heterogéneas. Se heredan en patrón autosómico recesivo o autosómico dominante y constituyen la cuarta causa genética más común de debilidad muscular, reportando una prevalencia de 1 en 20,000. Las manifestaciones clínicas son inespecíficas, pueden presentarse desde la primera infancia hasta la edad adulta, dependiendo del subtipo de la enfermedad y de la proteína afectada. El diagnóstico inicial se realiza mediante pruebas genéticas antes de obtener una biopsia muscular. Hasta la actualidad no hay tratamientos que modifiquen la evolución de la enfermedad. El propósito de la terapia es conservar la independencia funcional y tratar las complicaciones asociadas, manteniendo al máximo la calidad de vida.A continuación se reporta el caso de un paciente pediátrico, residente en Quito, Ecuador sin antecedentes patológicos ni familiares previos, con alteración de la motricidad fina progresiva dado por trastorno motor en manos, dedos en flexión, hipotrofia de eminencias tenar e hipotenar y atrofia de interóseos de manos, se realizan estudios en relación a neuropatía periférica distal con afectación de sensibilidad bilateral y simétrica, encontrando como única variante, cambios electromiográficos: polineuropatía crónica, sensitiva y motora de predominio axonal, (desmielinizante en menor grado), de grado marcado presumi-blemente de etiología hereditaria. El diagnostico final lo determinó estudio genético con mutación del gen TTN en relación con: Distrofia muscular de cinturas, tipo 2J (CINTURA ESCAPULAR DE PREDOMINIO DISTAL).


ABSTRACT Limb girdle muscular dystrophy (LGMD) includes several disorders with heterogeneous etiologies. They are inherited in an autosomal recessive or autosomal dominant pattern and constitute the fourth most common genetic cause of muscle weakness, reporting a prevalence of 1 in 20,000. The clinical manifestations are nonspecific, can begin from early childhood to adulthood depending on the subtype of the disease and the protein affected. The initial diagnosis is made by genetic testing before obtaining a muscle biopsy. To date there are no treatments that modify the evolution of the disease. The purpose of therapy is to preserve functional independence and treat associated complications, maintaining quality of life as much as possible.The following is the case of a pediatric patient, resident in Quito, Ecuador with no prior family or pathological history, with progressive fine motor disorder due to motor disorder in the hands, flexed fingers, hypotrophy of tenar and hypothenar eminences, and atrophy of interosseous hands, studies are performed in relation to distal peripheral neuropathy with bilateral and symmetrical sensitivity involvement, finding electromyographic changes as the only variant: chronic, sensitive and motor polyneuropathy with axonal predominance (demyelinating to a lesser degree), of marked degree presumably of hereditary etiology. The final diagnosis was determined by a genetic study with a mutation of the TTN gene in relation to: Girdle Muscular dystrophy, type 2J (DISTAL PREDOMINANT SCAPULAR GIRDLE).


Assuntos
Humanos , Masculino , Criança , Distrofia Muscular do Cíngulo dos Membros , Genética , Distrofias Musculares , Polineuropatias , Atrofia , Doenças do Sistema Nervoso Periférico
15.
Arq. bras. neurocir ; 39(3): 228-231, 15/09/2020.
Artigo em Inglês | LILACS | ID: biblio-1362413

RESUMO

Colorectal cancer is one of the most common oncological diseases. Chemotherapy is usually recommended as an adjuvant treatment for stage-II, -III, and -IV tumors. Approximately 10% of the patients develop neuropathic pain after chemotherapy, and they may remain refractory despite the administration of drugs that are commonly used to treat neuropathic pain. Spinal cord stimulation is a good treatment option for neuropathic pain of the lower limbs, and it should be trialed in patients with chemotherapy-induced peripheral neuropathy. We report the case of a patient with oxaliplatin-induced neuropathy and neuropathic pain refractory to oral medication who was successfully treated by spinal cord stimulation.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Polineuropatias/cirurgia , Polineuropatias/diagnóstico , Polineuropatias/induzido quimicamente , Estimulação da Medula Espinal/métodos , Neoplasias Colorretais Hereditárias sem Polipose/epidemiologia , Quimioterapia Adjuvante , Doenças do Sistema Nervoso Periférico/terapia , Dor do Câncer
16.
Braz. j. med. biol. res ; 53(11): e10263, 2020. graf
Artigo em Inglês | LILACS, Coleciona SUS | ID: biblio-1132488

RESUMO

Sensory neuropathy is a dose-limiting side effect of oxaliplatin-based cancer treatment. This study investigated the antinociceptive effect of amifostine and its potential neuroprotective mechanisms on the oxaliplatin-related peripheral sensory neuropathy in mice. Oxaliplatin (1 mg/kg) was injected intravenously in Swiss albino male mice twice a week (total of nine injections), while amifostine (1, 5, 25, 50, and 100 mg/kg) was administered subcutaneously 30 min before oxaliplatin. Mechanical and thermal nociceptive tests were performed once a week for 49 days. Additionally, c-Fos, nitrotyrosine, and activating transcription factor 3 (ATF3) immunoexpressions were assessed in the dorsal root ganglia. In all doses, amifostine prevented the development of mechanical hyperalgesia and thermal allodynia induced by oxaliplatin (P<0.05). Amifostine at the dose of 25 mg/kg provided the best protection (P<0.05). Moreover, amifostine protected against neuronal hyperactivation, nitrosative stress, and neuronal damage in the dorsal root ganglia, detected by the reduced expression of c-Fos, nitrotyrosine, and ATF3 (P<0.05 vs the oxaliplatin-treated group). In conclusion, amifostine reduced the nociception induced by oxaliplatin in mice, suggesting the possible use of amifostine for the management of oxaliplatin-induced peripheral sensory neuropathy.


Assuntos
Animais , Masculino , Coelhos , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Doenças do Sistema Nervoso Periférico/prevenção & controle , Amifostina/uso terapêutico , Oxaliplatina , Hiperalgesia/induzido quimicamente , Hiperalgesia/prevenção & controle , Hiperalgesia/tratamento farmacológico , Antineoplásicos/toxicidade
18.
Arq. bras. neurocir ; 38(4): 308-314, 15/12/2019.
Artigo em Inglês | LILACS | ID: biblio-1362566

RESUMO

Introduction Schwannomas are benign tumors originating from the cells, which wrap around axons that are usually encapsulated and solitary. These tumors usually lead to little or no symptomatology. They are usually the most common peripheral nerve tumors in adults, with their highest incidence between the third and fifth decades of life. Objective To perform a review about schwannoma of the peripheral nerves, presenting its definition, epidemiology, diagnosis, symptomatology and treatment. Methodology This is a descriptive work, based on a review of articles available in the PubMed database with the descriptors schwannoma and peripheral nerves. Results and Discussion Only papers published between 1981 and 2019, describing studies in humans, and that were available as full articles were selected. A total of 391 articles were included; after reading the titles, we noted that 67 articles fit the topic of the present study. Among the articles selected for reading, 33 fit the objectives of the present work, and were considered for the writing of the present article. Conclusion Schwannomas are benign myelin sheath tumors that develop with local symptomatology or asymptomatic and present a good surgical prognosis with generally reduced rates of surgical complications.


Assuntos
Neurilemoma/cirurgia , Neurilemoma/etiologia , Neurilemoma/fisiopatologia , Neurilemoma/epidemiologia , Neurilemoma/diagnóstico por imagem , Doenças do Sistema Nervoso Periférico
19.
Acta fisiátrica ; 26(3): 139-143, set. 2019.
Artigo em Português | LILACS | ID: biblio-1122756

RESUMO

Neuropatia periférica induzida por quimioterapia (NIPQ) é uma condição incapacitante resultante de tratamento quimioterápico para câncer. Dentre os fatores de risco destaca-se a presença de neuropatia prévia e baixo clearance de creatinina. Objetivo: Avaliar a ocorrência de NPIQ entre os pacientes portadores de câncer de mama submetidos ao uso do Paclitaxel (taxol) adjuvante e sua relação com obesidade. Métodos: Estudo observacional, retrospectivo, que avaliou os prontuários médicos de portadores de câncer de mama em tratamento adjuvante com uso do Paclitaxel no primeiro semestre de 2019, coletando dados referentes a CIPN, peso, altura e índice de massa corpórea (IMC). Resultados: Dentre os 70 pacientes avaliados, 44,3% apresentaram IMC entre 25,0 e 29,9 kg/m2, 15,7% entre 30,0 e 34,9 Kg/m2,, 8,6% entre 35,0 e 39,9 kg/m2, e 1,4% maior do que 40,0 kg/m2. A presença de neuropatia periférica foi documentada em 57,14 % dos pacientes. A média do IMC encontrado nos pacientes sem neuropatia foi de 25,05 e nos pacientes com neuropatia foi de 29,10 (p = 0,0005). A correlação de Spearman entre a presença de neuropatia e valores do IMC mostrou correlação positiva com r=0,40 e p=0,0006. O Risco Relativo RR para o surgimento de neuropatia em relação aos valores de IMC foi de 1.833 para o IMC acima de 25 (IC 95%). Conclusões: Há correlação positiva entre valores de IMC e o surgimento da NPIQ nesta amostra de pacientes, o que sugere que a obesidade pode ser um fator de risco para o surgimento da NPIQ.


Chemotherapy-induced peripheral neuropathy (CIPN) is a disabling condition resulting from chemotherapy for cancer. Among the risk factors, the presence of previous neuropathy and low creatinine clearance stands out. Objective: To assess the occurrence of CIPN among breast cancer patients submitted to the use of adjuvant Paclitaxel (TAXOL) and its relationship with obesity. Methods: An observational, retrospective study that evaluated the medical records of breast cancer patients undergoing adjuvant treatment with the use of Paclitaxel in the first half of 2019, collecting data related to CIPN, weight, height and BMI. Results: Among the 70 patients evaluated, 44.3% had a BMI between 25.0 and 29.9 kg / m2, 15.7% between 30.0 and 34.9 kg / m2, 8.6% between 35, 0 and 39.9 Kg / m2, and 1.4% greater than 40.0 Kg / m2. The presence of peripheral neuropathy was documented in 57.14% of the patients. The mean BMI found in patients without neuropathy was 25.05 and in patients with neuropathy it was 29.10 (p = 0.0005). Spearman's correlation between the presence of neuropathy and BMI values ​​showed a positive correlation with r = 0.40 and p = 0.0006. The Relative Risk RR for the occurrence of neuropathy in relation to BMI values ​​was 1,833 for BMI above 25 (95% CI). Conclusion: There is a positive correlation between BMI values ​​and the ocurrence of CIPN in this sample of patients, which suggests that obesity may be a risk factor for the emergence of CIPN.


Assuntos
Reabilitação , Fatores de Risco , Doenças do Sistema Nervoso Periférico , Tratamento Farmacológico , Obesidade
20.
Fisioter. Pesqui. (Online) ; 26(3): 247-257, jul.-set. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1039888

RESUMO

ABSTRACT The purpose of this study is to analyze the effects of using customized insoles and leg and foot exercises on the feet of patients with neuropathy caused by leprosy. Thirty volunteers diagnosed with leprosy were assigned to one of three groups: (1) Exercise group (n=10): performed exercises for the intrinsic muscles of the foot; (2) Insole group (n=10): used insoles to correct foot positioning; (3) Insole and Exercise group (n=10): used insoles and performed an exercise routine. The results of the treatments were analyzed with photogrammetry using the Alcimagem® and AutoCAD® programs. Left hindfoot posture changed after treatment in the Exercise and Insole groups (hindfoot, pre versus post <0.001). We also found that combining exercise and insoles did not alter the alignment of the feet during the study's evaluation period (customized insoles and exercises, pre versus post <0.05), which suggests that follow-up for more than four months may be needed. The left hindfoot's alignment can be changed with supervised exercises and the use of insoles.


RESUMO O objetivo deste estudo é analisar a influência do uso de palmilhas personalizadas e exercícios para perna e pés nos ângulos do antepé, retropé e arco plantar de pacientes com neuropatia causada por hanseníase. Trinta voluntários diagnosticados com hanseníase foram designados para um dos três grupos: (1) grupo exercício (n=10): realização de exercícios para pernas e pés; (2) grupo palmilha (n=10): utilização de palmilhas para corrigir o posicionamento do pé; (3) grupo palmilha e exercícios (n=10): uso de palmilhas associado a uma rotina de exercícios. O resultado dos tratamentos foi analisado por meio de fotogrametria, com os softwares Alcimagem e AutoCAD. A postura do retropé esquerdo foi modificada após o tratamento no "grupo exercício" e "grupo palmilha" (retropé, pré versus pós<0,001). Também foi observado que a combinação entre exercícios e palmilhas não alterou o alinhamento dos pés durante o período de avaliação do estudo (palmilha e exercícios, pré versus pós>0,05), o que sugere que o acompanhamento por mais de quatro meses pode ser necessário. Assim, o uso isolado de exercícios supervisionados ou de palmilhas altera o alinhamento do retropé, como aferido por fotogrametria.


RESUMEN El presente estudio tiene como objetivo analizar la influencia del uso de plantillas personalizadas y la práctica ejercicios de piernas y pies en los ángulos del antepié, del retropié y del arco plantar de pacientes con neuropatía debido a lepra. Treinta voluntarios diagnosticados con lepra fueron asignados a uno de estos tres grupos: (1) grupo de ejercicios (n=10): hacer ejercicios de piernas y pies; (2) grupo de plantillas (n=10): utilizar plantillas para corregir la posición del pie; (3) grupo de plantillas y ejercicios (n=10): utilizar plantillas asociadas con una rutina de ejercicios. Los resultados de los tratamientos se analizaron mediante fotogrametría, con los softwares Alcimagem y AutoCAD. La postura del retropié izquierdo se modificó tras el tratamiento en el "grupo de ejercicios" y en el "grupo de plantillas" (retropié, pre versus pos <0,001). También se observó que la combinación de ejercicios y plantillas no alteró la alineación del pie durante el período de evaluación del estudio (plantilla y ejercicios, pre versus pos >0,05), lo que sugiere que puede requerirse seguimiento durante más de cuatro meses. Por lo tanto, la práctica aislada de ejercicios supervisados o el uso de plantillas altera la alineación del retropié, medido por fotogrametría.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Aparelhos Ortopédicos , Doenças do Sistema Nervoso Periférico/reabilitação , Terapia por Exercício , Fotogrametria , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Pé/etiologia , Doenças do Pé/reabilitação , Hanseníase/complicações
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