RESUMEN
OBJECTIVES: Encephalitis is a severe neurological syndrome for which herpesvirus and enteroviruses are the most common etiological agents. Arboviruses, a wildly diverse group of pathogens, are also critical epidemiological agents associated with encephalitis. In Brazil, little is known about the causative agents of encephalitis. METHODS: We conducted a hospital surveillance for encephalitis between 2020 and 2022. Molecular (RT-PCR and qPCR) and serological (virus-specific IgM and viral antigens) techniques were performed in cerebrospinal fluid and serum samples obtained from study participants. RESULTS: In the 43 participants evaluated, the etiologic agent or the presence of IgM was detected in 16 (37.2%). Nine (20.9%) cases were positive for chikungunya virus (CHIKV), three (7.0%) for dengue virus, two (4.7%) for human adenovirus, one (2.3%) for varicella-zoster virus, and one (2.3%) for enterovirus. Whole-genome sequencing revealed that the CHIKV identified belongs to the East/Central/South African lineage. CONCLUSION: Herein, CHIKV is a common pathogen identified in encephalitis cases. Our results reinforce previous evidence that chikungunya represents a significant cause of encephalitis during CHIKV outbreaks and epidemics and add to existing information on the epidemiology of encephalitis in Brazil.
Asunto(s)
Fiebre Chikungunya , Virus Chikungunya , Humanos , Brasil/epidemiología , Virus Chikungunya/genética , Virus Chikungunya/aislamiento & purificación , Masculino , Femenino , Fiebre Chikungunya/epidemiología , Fiebre Chikungunya/virología , Fiebre Chikungunya/diagnóstico , Fiebre Chikungunya/sangre , Adulto , Adolescente , Niño , Adulto Joven , Persona de Mediana Edad , Preescolar , Anticuerpos Antivirales/sangre , Encefalitis Viral/epidemiología , Encefalitis Viral/virología , Encefalitis Viral/diagnóstico , Inmunoglobulina M/sangre , Anciano , Virus del Dengue/genética , Virus del Dengue/aislamiento & purificación , Lactante , Filogenia , Herpesvirus Humano 3/genética , Herpesvirus Humano 3/aislamiento & purificación , Enterovirus/aislamiento & purificación , Enterovirus/genética , Secuenciación Completa del GenomaRESUMEN
OBJECTIVE: Evaluate the accuracy of diagnosis of major depression in patients with Parkinson's disease (PD) using the UPDRS, the 15-item Geriatric Depression Scale (GDS15) and the Beck Depression Inventory (BDI). METHOD: 50 consecutive patients with PD were evaluated. The diagnosis of major depression was made according to the DSM-IV criteria. RESULTS: We found a 24% prevalence of major depression. All depression scales were highly correlated but UPDRS depression item had the lowest diagnostic value. The GDS15 had the more appropriate "receiver operating characteristics" curve. The best cut-off scores for screening depression were 17/18 for BDI and 8/9 for GDS15. We did not find any correlation between the level of depression and intensity of motor symptoms, functional capacity and duration of the disease. CONCLUSION: GDS15 is better than the BDI and the UPDRS for screening depression in PD and depression is not related to the degree of parkinsonian symptoms.
Asunto(s)
Depresión/diagnóstico , Enfermedad de Parkinson/psicología , Escalas de Valoración Psiquiátrica , Encuestas y Cuestionarios , Anciano , Depresión/etiología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Evaluación Geriátrica , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Curva ROC , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
OBJECTIVE: Evaluate the accuracy of diagnosis of major depression in patients with Parkinson's disease (PD) using the UPDRS, the 15-item Geriatric Depression Scale (GDS15) and the Beck Depression Inventory (BDI). METHOD: 50 consecutive patients with PD were evaluated. The diagnosis of major depression was made according to the DSM-IV criteria. RESULTS: We found a 24 percent prevalence of major depression. All depression scales were highly correlated but UPDRS depression item had the lowest diagnostic value. The GDS15 had the more appropriate "receiver operating characteristics" curve. The best cut-off scores for screening depression were 17/18 for BDI and 8/9 for GDS15. We did not find any correlation between the level of depression and intensity of motor symptoms, functional capacity and duration of the disease. CONCLUSION: GDS15 is better than the BDI and the UPDRS for screening depression in PD and depression is not related to the degree of parkinsonian symptoms.
OBJETIVO: Avaliar a precisão do diagnóstico de depressão em pacientes com doença de Parkinson avaliados pela UPDRS, pela Escala Geriátrica de Depressão com 15 itens (EGD15) e pelo Inventário de Depressão de Beck (IDB). MÉTODO: 50 pacientes com DP foram avaliados. O diagnóstico de depressão maior foi feito segundo os critérios do DSM-IV. RESULTADOS: A prevalência de depressão foi 24 por cento. As escalas de depressão tiveram elevada correlação entre si. A UPDRS apresentou a menor sensibilidade para o diagnóstico. A EGD15 mostrou uma curva ROC mais apropriada que o IDB. Os melhores escores-de-corte para diagnóstico de depressão foram 17/18 para o IDB e 8/9 para a EGD15. Não houve correlação entre os níveis de depressão e a intensidade do parkinsonismo, a capacidade funcional ou a duração da doença. CONCLUSÃO: A EGD15 é melhor que o IDB para diagnosticar depressão na DP. A depressão não está relacionada à gravidade dos sintomas parkinsonianos.