Neuropsychiatric disturbances in acute subarachnoid haemorrhage.

BACKGROUND: Acute and unexpected neuropsychiatric disturbances can herald subarachnoid haemorrhage (SAH). We investigated the risk factors for neuropsychiatric disturbances in acute SAH and analysed the relation between neuropsychiatric disturbances and location and amount of haematic densities and hydrocephalus. METHODS: We assessed a sample of 108 consecutive patients with an acute (≤ 4 days) SAH (61 aneurysmal, 47 non-aneurysmal SAH), before aneurysmal treatment, using DSM-IV-TR criteria and the Montgomery Åsberg Depression Rating Scale and Mania Rating Scale, the Denial of Illness Scale, the Catastrophic Reaction Scale and the Apathy Evaluation Scale, excluding patients with severe consciousness or language disturbance. Performance on each scale was related to (i) the total amount of haematic densities in 10 basal cisterns/fissures and in the four ventricles, using the Hijdra et al. rating scale, (ii) the haematic densities in the prepontine cistern and the convexity of the brain and (iii) hydrocephalus. RESULTS: Depression (45%), apathy (42%), denial (21%) and catastrophic reaction (17%) were frequent in acute SAH patients. Mania was present in two patients. Denial was associated with higher haematic densities in the left and right basal sylvian fissure and in the 4th ventricle (P < 0.01) and with hydrocephalus (P = 0.05). Catastrophic reaction and depression were associated with previous mood disorder (P < 0.007). Apathy was associated with blood in the left or right lateral ventricles (P < 0.03). CONCLUSIONS: In the first 4 days of SAH, depression, apathy, catastrophic reaction and denial were rather frequent. SAH haematic densities were associated with denial and apathy, but not with depression, mania or catastrophic reaction.

Effect of dietary lipid-lowering drugs upon plasma lipids and egg yolk cholesterol levels of laying hens.

To evaluate the effect of lipid-lowering agents upon egg quality, reproductive performance, plasma lipids, and egg yolk cholesterol levels, 30-week-old Shaver laying hens were fed a basal diet (commercial ration) supplemented with 0.1% probucol (PROB), 0.025% gemfibrozil (GEMF), or lovastatin at 0.0005% (LOV1), 0.001% (LOV2), or 0.0015% (LOV3) for a 12-week experimental period. It was observed that the supplementation of the drugs did not impair albumen and shell quality. Hen performance was not adversely affected. The depression in triglyceride concentrations approached statistical significance only in LOV2 (38.5%), and total cholesterol was significantly depressed in LOV2 (36.0%), LOV3 (36.8%), PROB (29.6%), and GEMF (30.4%) treatments. Egg cholesterol content, expressed per gram of yolk, was significant lowered in LOV1 (7.5%) and LOV3 (12. 7%).

Anti-HCV related to HCV PCR and risk factors analysis in a blood donor population of central Brazil.

Data concerning HCV infection in Central Brazil are rare. Upon testing 2,350 voluntary blood donors from this region, we found anti-HCV prevalence rates of 2.2% by a second generation ELISA and 1.4% after confirmation by a line immunoassay. Antibodies against core, NS4, and NS5 antigens of HCV were detected in 81.8%, 72.7%, and 57.5%, respectively, of the positive samples in the line immunoassay. HCV viremia was present in 76.6% of the anti-HCV-positive blood donors. A relation was observed between PCR positivity and serum reactivity in recognizing different HCV antigens in the line immunoassay. The majority of the positive donors had history of previous parenteral exposure. While the combination of ALT > 50 IU/l and anti-HBc positivity do not appear to be good surrogate markers for HCV infection, the use of both ALT anti-HCV tests is indicated in the screening of Brazilian blood donors.

[Neurological disorders in workers with low levels of lead in the blood. II--Neuropsychological disorders]. / Distúrbios neurológicos em trabalhadores com baixos níveis de chumbo no sangue. II--Disfunções neurocomportamentais.

This is a cross-sectional study with a randomized choice of individuals aiming at studying the validity of the Brazilian biological exposure limits applied to lead level in the blood (PbB) and delta-aminolevulinic acid in the urine (ALAU), which are 60 mu/dl and 10 mg/g.creat., respectively. Thus, twenty workers, whose PbB and ALAU values have been below these limits over the past two years, were selected at random at a battery plant in the State of S. Paulo, Brazil. The workers were submitted to a variation of the WHO Neurobehavioral Core Test Battery. The results were compared with those obtained for workers of a control group also chosen at random. The lead workers showed memory, mood and motor coordination disorders. Comparing these results with those obtained from the control group, a significant difference was observed (p-value < 0.02). The results indicate that the Brazilian biological exposure limits above should be reconsidered.

Substâncias fenólicas, flavonoides e capacidade antioxidante em erveiras sob diferentes coberturas do solo e sombreamentos / Phenolic Substances, Flavonoids, and Antioxidant Capacity in Herbs under Different Soil Covers and Shadings

RESUMO Objetivou neste trabalho analisar a concentração de polifenóis totais, flavonoides e capacidade antioxidantes por meio dos métodos ABTS e FRAP, em erveiras jovens cultivadas em solo coberto e com sombreamento. Mudas de erva-mate foram submetidas aos tratamentos com solos cobertos e desnudos em sombreamentos de 0, 18, 35 e 50%, após sete e onze meses de cultivo, verão e outono, respectivamente. Foram coletadas folhas maduras para realização dos extratos utilizados para as análises de compostos fenólicos por meio da reação de oxirredução com reagente de Folin-Ciocalteu, flavonoides por método colorimétrico e capacidade antioxidante por frente ao radical ABTS e poder de redução do ferro (FRAP). O teor de compostos fenólicos foi maior nos tratamentos com 35% de sombreamento em comparação ao grupo dos flavonoides e capacidade antioxidante, o que foi demonstrado pela correlação do sombreamento com estes parametros. No método FRAP a maior correlação demonstra que o outono é a melhor época de colheita por apresentar maior concentração de compostos fitoquímicos. Ficou evidente a influência positiva dos sombreamentos (35 e 50%) no teor de compostos fenólicos e flavonoides relacionados à capacidade antioxidante e à qualidade da erva-mate para atender ao mercado consumidor.

ABSTRACT This study aimed to analyze the concentration of total polyphenols, flavonoids, and antioxidant capacity, by the methods ABTS and FRAP, in young herbs grown in covered and shaded soil. Yerba mate seedlings were subjected to treatment with bare and covered soils in shadings of 0, 18, 35, and 50%, after seven and eleven months cultivation, summer and fall, respectively. Mature leaves were collected to perform the analyses of phenolic compounds by redox reaction with Folin-Ciocalteu reagent, of flavonoids by colorimetric method, and of antioxidant capacity by ABTS radical and FRAP (iron reduction method). The content of phenolic compounds was higher in the treatments with 35% shading in correlation with the group of flavonoids and antioxidant capacity. In the FRAP method, the higher correlation shows that autumn is the best time to harvest because of the higher concentration of phytochemical compounds. The positive influence of shading (35 and 50%) was evident in the content of phenolic compounds and flavonoids related to antioxidant capacity and better quality of yerba mate to meet the consumer market.

White matter changes and diabetes predict cognitive decline in the elderly: the LADIS study.

OBJECTIVE: We aimed to study if age-related white matter changes (WMC) and vascular risk factors were predictors of cognitive decline in elderly subjects with WMC living independently. METHODS: The Leukoaraiosis and Disability prospective multinational European study (LADIS) evaluates the impact of WMC on the transition of independent elderly subjects into disability. Independent elderly were enrolled due to the presence of WMC. Subjects were evaluated yearly during 3 years with a comprehensive clinical protocol and a neuropsychological battery. Additionally, dementia, subtypes of dementia, and cognitive decline without dementia were classified according to usual clinical criteria. MRI was performed at entry and at the end of the study. RESULTS: A total of 639 subjects were included (74.1 +/- 5 years, 55% women, 9.6 +/- 3.8 years of schooling). At end of follow-up, 90 patients had dementia and 147 had cognitive impairment no dementia. Using Cox regression analysis, WMC severity independently predicted cognitive decline (dementia and not dementia), independently of age, education, and medial temporal atrophy (MTA). Diabetes at baseline was the only vascular risk factor that independently predicted cognitive decline during follow-up, controlling for age, education, WMC severity, and temporal atrophy. Considering subtypes of dementia, Alzheimer disease (AD) was predicted only by MTA, while vascular dementia was predicted by previous stroke, WMC severity, and MTA. CONCLUSION: WMC severity and diabetes are independent predictors of cognitive decline in an initially nondisabled elderly population. Vascular dementia is predicted by previous stroke and WMC, while AD is predicted only by MTA.

Anger, hostility and aggression in the first days of acute stroke.

In acute stroke patients, anger can disturb management and rehabilitation and creates a stressful situation for family, health-care providers and other patients. We aim to describe the presence of anger and its association with demographic, clinical, psychiatric, lesion variables and functional outcome in acute stroke patients. We screened anger prospectively in 202 consecutive acute stroke patients (< or =4 days) using eight items from three psychiatric scales (Catastrophic Reaction Scale, Mania Rating Scale and Comprehensive Psychopathological Rating Scale). Anger was present if the patient scored in at least one item. Anger was detected in 71 (35%) patients and 26 of these were severely angry (> or =4 points). There was no association between anger and the considered variables. Analysis of the items extracted two factors: (i) the emotional-cognitive and (ii) the behavioural components of anger. These components were independent of each other in 26 patients. In 38 patients we found a dissociation between clinical observation and patients' subjective expression. Anger was frequent in acute stroke patients. Anger was probably triggered by the brain lesion, which interfered with the emotional control. The lack of an association with clinical and imaging variables suggests a contribution of psychological/psychosocial dimensions.

Anti-HCV related to HCV PCR and risck factors analysis in a blood donor population of central Brazil

Ainda sao raros os casos de infeccao por hepatite C (HCV)na regiao central do Brasil. Neste estudo, 2.350 doadores voluntarios de sangue foram avaliados, resultando em prevalencias para o anti-HCV de 2,2 (por cento), pelo ELISA de segunda geracao, e de 1,4 por cento, apos o ensaio confirmatorio "line immunoassay". Anticorpos contra os antigenos "core", NS4 e NS5 do HCV foi observada em 76,6 (por cento) dos doadores anti-HCV positivos. A positividade da reacao em cadeia da polimerase (PCR) mostrou-se relacionada a reatividade aos diferentes antigenos do HCV no "line immunoassay". A maioria dos doadores positivos tiveram historia previa de exposicao parenteral. A combinacao de ALT>50 UI/1 e positividade ao anti-HBc parece nao ser eficaz como marcadores indiretos para a infeccao pelo HCV, entretanto a dosagem do ALT e a deteccao de anti-HCV sao indicadas na triagem de doadores de sangue brasileiros.