Apathy in multiple sclerosis: gender matters.

Apathy has been recognized as a frequent symptom in multiple sclerosis (MS) but uncertainty remains about its prevalence and clinical correlates. Therefore, the objective of this work was to assess the prevalence of apathy in patients with MS and to identify clinical and demographic correlates. A case-control study with 30 patients and 30 healthy controls matched for age, gender and education was performed. Apathy diagnosis was established using Robert et al.'s criteria. Additionally, apathy was assessed using the 10-item short version of the clinical-rated Apathy Evaluation Scale (AES-C-10). The Beck Depression Inventory (BDI), Modified Fatigue Impact Scale (MFIS), and Montreal Cognitive Assessment (MoCA) were used to evaluate depression, fatigue and cognitive impairment, respectively. Apathy prevalence in MS patients was 43.3%. Patients with MS had higher AES-C-10 scores than controls (13.9 vs. 12.0, p=0.015). Patients with apathy presented a higher proportion of males (53.8% vs. 11.8%, p=0.02), lower educational level (53.8% vs. 11.8% of patients with up to 9years of education), higher scores on cognitive dimension of MFIS (18.0 vs. 8.0, p=0.048) and BDI (13.0 vs. 7.0, p=0.035) and worse performance on MoCA (24.0 vs. 26.0, p=0.028). Gender was the only independent predictor of apathy, with men presenting a higher risk compared to women (OR: 9.62; 95%CI: 1.02-90.61; p=0.048). In conclusion, apathy is a common neuropsychiatric disorder in MS and it is probably underdiagnosed. Male patients seem to have an increased risk of apathy, and this finding may be related to the generally more unfavorable course of MS in men.

Vestibular Migraine: Clinical Challenges and Opportunities for Multidisciplinarity.

Migraine and vertigo are two very prevalent conditions in general population. The coexistence of both in the same subject is a significant clinical challenge, since it is not always possible to understand whether they are causally related or associated by chance, requiring different diagnostic and therapeutic approaches. In this review we analyze and summarize the actual knowledge about vestibular migraine (VM), focusing on the new concepts proposed by the International Classification of Headache Disorders 3-beta and by the Bárány Society and also addressing the former concepts, which are still present in clinical practice. We conclude that clinical studies using a multidisciplinary approach are crucial in this field, since different specialists observe the same pathology with different eyes. Clinical presentation of VM is variable in what concerns vestibular symptoms temporal relation with migraine headache, as well as in their accompanying manifestations. Biomarkers, either genomics or functional, and molecular imaging techniques will be helpful to clarify many aspects of the complexity of this entity, helping to define to what extent can VM be considered a separate and independent clinical entity.

ATP - bioluminescence as a technique to evaluate the microbiological quality of water in food industry

A qualidade microbiológica da água do manancial de captação para tratamento na ETA/UFV, da água de resfriamento de amônia e da água industrial de uso em um laticínio foi avaliada pela técnica de ATP-bioluminescência. Nas águas, foram efetuadas, também, as contagens de mesófilos aeróbios, expressos em UFC.mL-1 e coliformes totais, expressos em NMP.100 mL-1. Foi utilizado um luminômetro para os testes de determinação de ATP total e livre, expressos em Unidades Relativas de Luz (URL), nas diversas águas. O ATP microbiano foi determinado pela diferença entre o ATP total e livre. Em relação à água industrial, houve a concordância entre os métodos de bioluminescência e de contagem de mesófilos aeróbios e coliformes totais. As amostras de água de manancial e de resfriamento não apresentaram diferença (p>0,05), pelo teste de Tukey, para as quantidades de ATP total, livre e também para as contagens microbianas. Constataram-se concentrações diferentes de ATP microbiano para essas amostras de água. Os resultados indicam que o teste de ATP total é o mais recomendado para avaliar a qualidade microbiológica da água e sugerem que a qualidade físico-química da mesma pode afetar a formação de luz.