Reversible cerebral vasoconstriction syndrome associated with probable drug poisoning.

Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical condition characterized by arterial involvement of the intracranial vessels, manifesting with vasospasm. The most common clinical manifestation related to the syndrome is the thunderclap headache, which consists of a severe headache that reaches the peak of pain within minutes. The imaging study assumes a leading role in the complementary investigation. Laboratory tests and cerebrospinal fluid analysis are often nonspecific and without significant diagnostic importance. Non-contrast studies of the brain parenchyma reveal variable results that can often be normal. Angiographic findings, which initially may not reveal any changes, allow the visualization of diffuse narrowing of the vessels, with the posterior cerebral circulation being preferentially affected. The present study reports the case of a 19-year-old woman with no relevant medical history, except that she was a regular user of marijuana and a drug based on chloroform and ether. The patient showed clinical and imaging signs compatible with RCVS, and the narcotics used by her were considered precipitating factors.

Vertical one-and-a-half syndrome in a patient with pecheron artery ischemia: A case report.

Vertical one-and-a-half syndrome (VOHS) is an uncommon presentation resulting from a unilateral thalamomesencephalic stroke with involvement of the rostral interstitial nucleus of the medial longitudinal fasciculus and posterior commissure. The artery of Percheron (aPe) is a branch of the posterior cerebral artery (PCA) and it is a variant that arises as a solitary trunk supplying both medial thalami and upper midbrain. A 78-year-old female patient, presented at the hospital emergency with approximately 12 hours of sudden onset of diplopia, associated with dizziness. Neurological exam revealed torsional nystagmus associated with bilateral upgaze palsy with limitation of infraduction on the left. We describe a rare case of VOHS associated with ischemic alterations at the MRI suggesting an aPe impairment. The conjugate gaze control lies anatomically at the midbrain at the central nervous system (CNS). This report describes a rare type of VOHS and brings a new insight on a possible aPe topography possibly causing this clinical presentation.

Estado nutricional e consumo de frutas e hortaliças por alunos de escolas pública e particular / Nutritional status and consumption of fruits and vegetables for students in private and public school

Objetivo ­ Descrever o perfil antropométrico e o consumo de frutas e hortaliças por escolares do primeiro ano do ensino fundamental de uma escola particular e outra pública da cidade de Marília-SP e realizar a comparação entre ambas. Métodos ­ Foram coletadas as medidas de peso e estatura, a partir dos quais foi determinado o IMC/l (Índice de massa corpórea para idade), adotando-se os pontos de corte apontados pela Organização Mundial da Saúde. Foi aferida também a medida da circunferência abdominal que foi classificada segundo o sexo e a idade, sendo considerada elevada quando a medida situou-se acima do percentil 75. A investigação do consumo de frutas e hortaliças foi realizada por meio do Questionário de Frequência de Consumo de frutas e hortaliças (QFCFH) o qual foi elaborado com base no instrumento de Slater et al. (2010). Resultados ­ Com base no IMC/l foi observado prevalência de eutrofia em ambas redes de ensino, enquanto que cerca de 45% delas apresentava excesso de peso em seus diferentes níveis. Não foi encontrado diagnóstico de magreza entre os participantes. Não houve diferença significativa nos valores de Escore-z do IMC/l comparando as duas redes de ensino. Com relação à circunferência abdominal, 74% e 79% das crianças das escolas pública e particular, respectivamente, apresentaram esta medida elevada. No parâmetro alimentar, foi observado que a frequência diária de consumo das frutas de hortaliças investigadas foi maior entre as crianças da escola pública. Conclusão ­ Dos apontamentos presentes nesta publicação emergem a necessidade de maiores investimentos no tocante ao hábito alimentar.

Objective ­ To describe the anthropometric profile and consumption of fruits and vegetables for students of the first year of elementary level to a private and a public school in the town of Marilia/SP and to make a comparison between them. Methods ­ The weight and height measurements were collected, from which was determined the BMI / A (body massa index por age), adopting the cut off points raised by de World Health Organization. Abdominal circunference measure was also assessed and was classified according to sex and age, considered high when the measure was above the 75 percentile. The study on consumption of fruits and vegetables was carried out through the Questionanaire of Fruit and Vegetable Consuption Frequency (QFVCF), which based on the instrument Slater et al. (2010). Results ­ Based on BMI / A was observed prevalence of normal weight in both school systems, while about 45% of them had excess weight at different levels. It was found diagnosis of thinness among participants. There was no significant difference in score z values of BMI / I compared the two school systems. Regarding the abdominal circumference, 74% and 79% of children of public and private schools, respectively, presented this high measure. In the food parameter, it was observed that the daily frequency of consumption of fruits and vegetables investigated was greater among children in public school. Conclusions ­ From the notes presented in this publication emerge the need for greater investment in regard to eating habits.