Soldier's heart: the forgotten circulatory neurasthenia - a systematic review.

Soldier's Heart (SH) is a former medical diagnosis, rarely mentioned nowadays, presented under several other names. Considering the controversy regarding the removal of Soldier's Heart diagnosis from DSM-5, this study aimed to conduct a systematic review to evaluate its usage in the clinical practice. Information on diagnosis, military stress, heart rate variability, treatment, and prognosis were collected from 19 studies included after a systematic literature search. Considering the lack of adequate use of Soldier's Heart diagnosis and the diagnostic overlapping with other conditions, the present systematic review supports the inclusion of Soldier's Heart under the umbrella of posttraumatic stress disorders (PTSDs). This proposal is also in line with the conception that physical symptoms are relevant features often associated with generalized anxiety disorder and PTSD. Also, it will be described the higher prevalence of cardiological comorbidities in SH and possible cardiological consequences. Pharmacotherapy based on benzodiazepines and beta-blockers, as well as biofeedback and mindfulness techniques are considered to be useful treatment options. Further studies are needed to better define psychopathological domains of this syndrome and possible novel treatment targets.

Luigi Luciani (1840-1919) - the Italian Claude Bernard with German shaping, and his studies on the cerebellum with projections to nowadays / Luigi Luciani (1840-1919) - o italiano Claude Bernard com formação alemã, e seus estudos sobre o cerebelo com projeções na atualidade

Luigi Luciani (1840-1919) was an illustrious Italian citizen and physiologist whose research scope covered mainly cardiovascular subjects, the nervous system, and fasting. He published in 1891 a modern landmark of the study of cerebellar physiology - "Il cervelletto: nuovistudi di normal and pathología physiology" / "The cerebellum: new studies on normal and pathological physiology." In his experiment, a dog survived after cerebellectomy, reporting a triad of symptoms (asthenia, atonia, and astasia). In this way, the eminent neurophysiologist improved the operative technique and sterile processes to redirect the issue of cerebellar symptoms. Luciani died at age 78, a hundred years ago, and left mainly the understanding of the role of the cerebellum in regulating postural tone and muscle strength, which represented a step forward in understanding cerebellar motor physiology. In recent decades, cognitive / affective function has been added to the cerebellar motor, and there has also been a better understanding of cerebellar circuits.

Luigi Luciani (1840-1919) foi um ilustre cidadão e fisiologista italiano, cujo escopo de pesquisa abrangia principalmente assuntos cardiovasculares, sistema nervoso e jejum. Ele publicou em 1891 um marco moderno do estudo da fisiologia do cerebelo - "Il cervelletto: nuovistudi di fisiologia normale and patologica" / "O cerebelo: novos estudos sobre fisiologia normal e patológica". Em seu experimento, um cão sobreviveu após a cerebelectomia, com o relatório de uma tríade de sintomas (astenia, atonia e astasia). Dessa maneira, o eminente neurofisiologista aprimorou a técnica operatória e os processos estéreis para redirecionar a questão dos sintomas cerebelares. Luciani morreu aos 78 anos, cem anos atrás, e deixou principalmente a compreensão do papel do cerebelo na regulação do tônus postural e da força muscular, o que representou um passo adiante na compreensão da fisiologia motora cerebelar. Nas últimas décadas, a função cognitivo / afetiva foi adicionada à motora cerebelar e, também, houve uma melhor compreensão dos circuitos do cerebelo.

Segurança do paciente: alterações da hemoglobina e ferro sérico após lipoaspiração e/ou abdominoplastia / Patient safety: changes in hemoglobin and serum iron after liposuction and/or abdominoplasty

Introdução: A lipoaspiração é o sendo segundo procedimento mais realizado no Brasil. Com os avanços da técnica, melhores equipamentos e aumento da segurança no ambiente cirúrgico, passaram-se a ser lipoaspiradas grandes áreas. Contudo, existe uma preocupação com a segurança do paciente. Comitês de segurança têm feito recomendações sobre a infiltração, anestesia, seleção do paciente, volume aspirado, entre outros. A Sociedade Brasileira de Cirurgia Plástica e o Conselho Federal de Medicina também determinaram parâmetros de volumes de segurança do aspirado e superfície corporal aspirada. Ainda assim, a literatura de apoio para as recomendações é escassa. O objetivo é avaliar as alterações dos níveis de hemoglobina, ferro sérico e proteínas totais no pré e pós-operatório mediato (7-10 dias), assim como seus reflexos nos pacientes. Métodos: Realizamos um estudo prospectivo, com pacientes submetidos à lipoaspiração isolada e associada à dermolipectomia abdominal, por indicações estéticas. Avaliamos 30 pacientes, sendo coletados dados demográficos, peso, Índice de Massa Corporal, níveis de hemoglobina, ferro sérico e proteínas totais, no pré-operatório, e entre 7 a 10 dias de pós-operatório. Resultados: A queda da hemoglobina foi entre 2-6g/dl, com média de 3,1g/dl aos 7-10 dia de PO. Tivemos como valor mínimo de hemoglobina 7,8g/dl no pós-operatório com 7-10 dias, enquanto o ferro sérico apresentou redução média de 44,87g/dl. Conclusão: A redução no nível da hemoblogina foi responsável pela sintomatolgia clinica apresentada. A reposição de ferro se mostrou necessária no pós-operatório imediato.

Introduction: Liposuction is the second commonest procedure performed in Brazil. The scope for liposuction has broadened with advances in the technique, with better equipment, and increased safety in the surgical environment. However, there are concerns about patient safety. Safety committees have made recommendations on various aspects of the procedure including infiltration, anesthesia, patient selection, and aspirated volume. The Brazilian Society of Plastic Surgery and the Federal Council of Medicine have also determined the parameters for aspiration safety volumes, and for the aspiration of body surface. However, supporting literature for the recommendations is scarce. The objective is to evaluate changes in hemoglobin, serum iron, and total protein levels in the peri-operative days (between 7 and 10 days), in addition to its impact in patients. Methods: We performed a prospective study, with patients submitted to either liposuction alone, or in conjunction with abdominal dermolipectomy for esthetic indications. We evaluated 30 patients, collecting their demographic data, weight, body mass index, hemoglobin, serum iron, and total protein levels in both, the pre-operative period, and between 7 and 10 post-operative days. Results: The fall in hemoglobin levels were between 2 and 6 g /dL, with an average of 3.1 g /dL between 7 and 10 post-operative days . A minimum hemoglobin value of 7.8 g/dL was noted between 7 and 10 days after surgery, while the mean reduction of serum iron was found to be 44.87 g/dL. Conclusion: The reduction in hemoglobin levels was responsible for the clinical symptoms. Iron supplementation was required in the immediate post-operative period.

Pain, balance, grip strength and gait parameters of older adults with and without post-chikungunya chronic arthralgia.

OBJECTIVE: To compare the levels of pain, grip strength, balance and gait in older adults with and without post-Chikungunya chronic arthralgia (PCCA). METHODS: Sixty-two older adults, 30 with and 32 without PCCA participated in the study. Pain level was assessed using a Visual Analogue Scale (VAS). Gait during a 10-m walk was assessed using inertial sensors. Semi-static balance was assessed during an eyes-closed bipedal balance test on a force platform, and grip strength was assessed using a hand dynamometer. RESULTS: Participants with PCCA presented severe levels of pain (VAS > 7.5), poorer balance, lower grip strength, walked slower, with lower cadence and stride length and higher stride time and stride length variability than participants without PCCA (P < 0.001 for all variables). CONCLUSIONS: Older adults with PCCA had high levels of pain, impaired balance and gait and lower grip strength compared to older adults without PCCA.

Prevalence study of SNP c.421G>T in the ADAMTS2 gene responsible for dermatosparaxis in White Dorper sheep in Brazil / Prevalência do SNP c.421G>T no gene ADAMTS2 responsável pela dermatosparaxia em ovinos White Dorper no Brasil

Dermatosparaxis is an autosomal recessive disorder of connective tissue; the disorder is clinically characterized by skin fragility and hyperextensibility. Dermatosparaxis in White Dorper sheep is caused by a single nucleotide polymorphism (SNP) (c.421G>T) in the ADAM metalloproteinase with thrombospondin type 1 motif, 2 (ADAMTS2) gene. The aim of this study was to investigate the prevalence of this SNP in a White Dorper herd in São Paulo state, Brazil. In this study, we collected blood DNA samples from 303 White Dorper sheep and performed polymerase chain reaction to amplify the SNP region. The samples were sequenced to determine the presence of the SNP in the ADAMTS2 gene. The SNP prevalence in the studied population was 15.5%; this finding indicates that more effective control measures should be used to prevent the inheritance of SNP c.421G>T in the ADAMTS2 gene in Brazilian White Dorper herds.(AU)

A dermatosparaxia é uma doença autossômica recessiva do tecido conjuntivo, clinicamente caracaterizada pela fragilidade e hiperextensibilidade da pele. A dermatosparaxia em ovinos White Dorper é causada pelo polimorfismo de base única (SNP) c.421G>T no gene ADAM metalopeptidase com trombospondina tipo 1 motif, 2 (ADAMTS2). O objetivo deste estudo foi investigar a prevalência deste SNP em ovinos White Dorper no estado de São Paulo, Brasil. Foram coletadas amostras de sangue de 303 ovinos White Dorper. O DNA foi purificado destas amostras sanguíneas e utilizado em uma reação em cadeia da polimerase (PCR) para amplificação da região do gene contendo SNP c.421G>T. Os produtos das PCR foram sequenciados para determinar o genótipo dos animais. A prevalência do SNP na população estudada foi de 15,5%, estes achados indicam que medidas de controle efetivas devem ser utilizadas para prevenir a disseminação deste SNP no rebanho brasileiro de White Dorper.(AU)

Prevalence study of SNP c.421G>T in the ADAMTS2 gene responsible for dermatosparaxis in white dorper sheep in Brazil / Prevalência do SNP c.421G>T no gene ADAMTS2 responsável pela dermatosparaxia em ovinos white dorper no Brasil

Dermatosparaxis is an autosomal recessive disorder of connective tissue; the disorder is clinically characterized by skin fragility and hyperextensibility. Dermatosparaxis in White Dorper sheep is caused by a single nucleotide polymorphism (SNP) (c.421G>T) in the ADAM metalloproteinase with thrombospondin type 1 motif, 2 (ADAMTS2) gene. The aim of this study was to investigate the prevalence of this SNP in a White Dorper herd in São Paulo state, Brazil. In this study, we collected blood DNA samples from 303 White Dorper sheep and performed polymerase chain reaction to amplify the SNP region. The samples were sequenced to determine the presence of the SNP in the ADAMTS2 gene. The SNP prevalence in the studied population was 15.5%; this finding indicates that more effective control measures should be used to prevent the inheritance of SNP c.421G>T in the ADAMTS2 gene in Brazilian White Dorper herds.

A dermatosparaxia é uma doença autossômica recessiva do tecido conjuntivo, clinicamente caracaterizada pela fragilidade e hiperextensibilidade da pele. A dermatosparaxia em ovinos White Dorper é causada pelo polimorfismo de base única (SNP) c.421G>T no gene ADAM metalopeptidase com trombospondina tipo 1 motif, 2 (ADAMTS2). O objetivo deste estudo foi investigar a prevalência deste SNP em ovinos White Dorper no estado de São Paulo, Brasil. Foram coletadas amostras de sangue de 303 ovinos White Dorper. O DNA foi purificado destas amostras sanguíneas e utilizado em uma reação em cadeia da polimerase (PCR) para amplificação da região do gene contendo SNP c.421G>T. Os produtos das PCR foram sequenciados para determinar o genótipo dos animais. A prevalência do SNP na população estudada foi de 15,5%, estes achados indicam que medidas de controle efetivas devem ser utilizadas para prevenir a disseminação deste SNP no rebanho brasileiro de White Dorper.

Ocular dimensions, corneal thickness, and corneal curvature in quarter horses with hereditary equine regional dermal asthenia.

OBJECTIVES: The aim of this study was to compare ocular dimensions, corneal curvature, and corneal thickness between horses affected with hereditary equine regional dermal asthenia (HERDA) and unaffected horses. ANIMALS: Five HERDA-affected quarter horses and five healthy control quarter horses were used. METHODS: Schirmer's tear test, tonometry, and corneal diameter measurements were performed in both eyes of all horses prior to ophthalmologic examinations. Ultrasonic pachymetry was performed to measure the central, temporal, nasal, dorsal, and ventral corneal thicknesses in all horses. B-mode ultrasound scanning was performed on both eyes of each horse to determine the dimensions of the ocular structures and to calculate the corneal curvature. RESULTS: Each corneal region examined in this study was thinner in the affected group compared with the healthy control group. However, significant differences in corneal thickness were only observed for the central and dorsal regions. HERDA-affected horses exhibited significant increases in corneal curvature and corneal diameter compared with unaffected animals. The ophthalmologic examinations revealed mild corneal opacity in one eye of one affected horse and in both eyes of three affected horses. No significant between-group differences were observed for Schirmer's tear test, intraocular pressure, or ocular dimensions. CONCLUSIONS: Hereditary equine regional dermal asthenia-affected horses exhibit decreased corneal thickness in several regions of the cornea, increased corneal curvature, increased corneal diameter, and mild corneal opacity. Additional research is required to determine whether the increased corneal curvature significantly impacts the visual accuracy of horses with HERDA.

Allele frequency of hereditary equine regional dermal asthenia in American Quarter horses in Brazil determined by quantitative real-time PCR with high resolution melting analysis.

Hereditary equine regional dermal asthenia (HERDA) is a genetic disorder that occurs in the American Quarter horse (AQH) and is caused by a c.115G>A missense mutation in the peptidylprolyl isomerase B (PPIB) gene. Using a quantitative real-time PCR high resolution melting analysis genotyping assay for the PPIB mutation, the estimated HERDA allele and carrier frequencies in a sample of Brazilian AQHs were 2.9% and 5.8%, respectively.

Abdominal pain and asthenia as common clinical features in hospitalized children for giardiasis.

Giardiasis is a disease with worldwide distribution, although its prevalence differs from country to country. In order to investigate the clinical pattern of giardiasis in in-patient children, a case-control study was carried out. In-patient children who had Giardia lamblia infection were compared with non Giardia-infected children, focusing only on 4 clinical manifestations: diarrhoea, abdominal pain, asthenia and vomiting. In multivariable analysis, abdominal pain (odds ratio [OR] 4.71, 95% confidence intervals [CI] 2.66-8.32) and asthenia (OR 3.30, 95% CI 1.16-9.37) had positive and independent associations with Giardia infection. The present study supports the potential role of G. lamblia in abdominal pain in children who attend- and are admitted- to a hospital in Havana City, and highlights the importance to keep abdominal pain and asthenia in mind in hospital admitted children in the event of an association with an evocative epidemiological context.

Manejo del síndrome caquexia-anorexia en el cáncer avanzado / Management cachexia-anorexia syndrome in advanced cancer

El síndrome de caquexia-anorexia (SCA) afecta aproximadamente al 80% de los pacientes con cáncer avanzado cercanos al final de la vida. La incidencia y la gravedad del SCA aumentan a medida que progresa la enfermedad primaria. En los últimos años se han producido grandes avances en el conocimiento de la fisiopatología y múltiples opciones terapéuticas para el SCA. Para hacer un uso racional de los avances terapéuticos, consideramos necesario hacer una distinción entre dos extremos diferentes en la evolución del SCA. Por un lado, consideraremos al paciente con SCA en etapa precoz, con diagnóstico de cáncer reciente, en tratamiento oncológico activo, buen performance status y posibilidades de curación o supervivencia prolongada. En esta situación clínica proponemos el uso racional e intensivo de todas las medidas basadas en la evidencia tendientes a corregir el SCA: suplementos dietarios, alimentación artificial, orexígenos, ejercicio, etc. En el otro extremo, encontramos al paciente caquéctico con cáncer avanzado, pérdida de peso progresiva, profunda astenia, pobre performance status, con escasa ingesta vía oral, enfermedad en progresión y una expectativa de vida corta. En esta situación, algunos tratamientos como la alimentación artificial carecen de utilidad e incluso podrían empeorar algunos síntomas físicos. Por lo tanto, el abordaje más apropiado para el manejo del SCA avanzado podría ser aquel orientado a mejorar la calidad de vida, priorizar el control de síntomas (anorexia, náuseas, vómitos, astenia, xerostomía, etc.), preservar la ingesta por vía oral y brindar contención emocional al paciente y su familia En este artículo, abordaremos el tratamiento paliativo del SCA en paciente con cáncer avanzado.

Cachexia-anorexia syndrome (CAS) affects approximately80% of advanced cancer patients near end of life. Incidenceand severity of CAS increase as primary disease progressesIn the last few years great advances has been made in theunderstanding of the pathophysiology and treatment ofCAS. To make a rational use of therapeutic advances, weconsider necessary to distinguish between two differentextremes in the evolution of CAS. On one hand, we willconsider the patient with CAS in early phase, recentlydiagnosed cancer, with active oncologic treatment, goodperformance status and chances of cure or prolongedsurvival. In this clinical setting, we propose the rationaland intensive use of all evidence-based measures directedto correct CAS: dietary supplements, artificial nutrition,orexigenics, exercise, etc. On the other hand, we find thecachectic patient with advanced cancer, progressive weightloss, profound asthenia, poor performance status, little oralintake, progressive disease and a short life expectancy. Inthis stage, some treatments like artificial nutrition lack ofutility and could even worsen some physical symptoms.Therefore, the more appropriate approach to advancedCAS could be that one oriented to improve quality of life,prioritize symptoms control (anorexia, nausea and vomiting,asthenia and xerostomy), to preserve oral intake andto provide emotional support to the patient and the family.In this article, we will focus on palliative treatment of CASin the patient with advanced cancer.

Astenia cutânea felina (síndrome de Ehlers-Danlos) - relato de caso / Feline cutaneous asthenia (Ehlers-Danlos syndrome) - case report

A astenia cutânea, conhecida como Síndrome de Ehlers-Danlos (ESD) em pacientes humanos, é umacondição hereditária caracterizada por um conjunto de alterações na síntese de colágeno, levando ahiperextensibilidade e decréscimo da força tênsil da pele. Relata-se um caso de astenia cutânea emum felino, macho, Burmês, três anos de idade, atendido no Hospital Veterinário Vet Care da NovaZelândia, com o objetivo de apresentar os possíveis meios de diagnóstico, tratamento e manejo dopaciente.

The cutaneous asthenia, known as Ehlers-Danlos Syndrome (ESD) in human patients, is an inheritedcondition characterized by a set of changes in collagen synthesis, and hiperextensibility leading to adecrease in tensile strength of the skin. We report a case of a feline cutaneous asthenia male Burmêsthree years old, The Veterinary Hospital Vet care New Zealand, with the aim of presenting the possiblediagnostics, treatment and patient management.

Astenia cutânea felina (síndrome de Ehlers-Danlos) - relato de caso / Feline cutaneous asthenia (Ehlers-Danlos syndrome) - case report

A astenia cutânea, conhecida como Síndrome de Ehlers-Danlos (ESD) em pacientes humanos, é umacondição hereditária caracterizada por um conjunto de alterações na síntese de colágeno, levando ahiperextensibilidade e decréscimo da força tênsil da pele. Relata-se um caso de astenia cutânea emum felino, macho, Burmês, três anos de idade, atendido no Hospital Veterinário Vet Care da NovaZelândia, com o objetivo de apresentar os possíveis meios de diagnóstico, tratamento e manejo dopaciente. (AU)

The cutaneous asthenia, known as Ehlers-Danlos Syndrome (ESD) in human patients, is an inheritedcondition characterized by a set of changes in collagen synthesis, and hiperextensibility leading to adecrease in tensile strength of the skin. We report a case of a feline cutaneous asthenia male Burmêsthree years old, The Veterinary Hospital Vet care New Zealand, with the aim of presenting the possiblediagnostics, treatment and patient management. (AU)

Astenia en pacientes que asisten a la consulta externa: valoración a través de la escala de intensidad de fatiga (FSS) / Asthenia in patients attending the outpatient clinic: valuation through the rating scale fatigue

Muchos pacientes acuden a consulta externa con un conjunto inespecífico de síntomas y signos que sugieren el diagnóstico de astenia, sin encontrarse una causa orgánica que explique dichos síntomas. Se realizó un estudio prospectivo a nivel nacional para diagnosticar y cuantificar la intensidad de la astenia en estos pacientes y medir la eficacia de la sulbutiamina 400 mg/día como tratamiento farmacológicoa corto plazo de primera línea. Se realizó un estudio abierto, prospectivo y multicéntrico,en el cual se ingresaron 341 pacientes, que consultaron ambulatoriamente y que presentaban síntomas de astenia. A través de la escala de Intensidad de Fatiga (por sus siglas en inglés: Fatigue Severity Scale - FSS) se determinó la presencia de astenia en estos pacientes y se evaluó la eficacia de la sulbutiamina 400 mg/día de Laboratorios Leti S.A.V., Venezuela (Tekron®). El estudio tuvo una duración de 15 días, en los cuales el paciente fue evaluado tres veces: día 1 (inicio), día 7 y día 15. Si el paciente presentaba astenia (puntuación ≥ 36 puntos en la FSS), se le indicaba sulbutiamina400 mg/día con el desayuno por 15 días. El 74,7% de los pacientes evaluados fueron del sexo femenino, con una edad media de 43,7 ± 12,5 años y el 25,3% del sexo masculino con una edad media de 41,7 ± 13,5 años. Al inicio del estudio la media de la puntuación de la FSS fue de 49,7 ± 7,3 puntos; a los 7 días de tratamiento con 400 mg/día de sulbutiamina fue de 37,2 ± 8,8 puntos con una disminucióndel 25,2% y al día 15 fue de 28,0 ± 9,8 puntos con una disminución de 43,7% con respecto al inicio del tratamiento, resultando estadísticamente significativo (p< 0,0001 y p< 0,0001 al día 7 y día 15 vs inicio, respectivamente). El 77,7% de los pacientes respondieron al tratamiento al día 15. La sulbutiamina resultó ser un tratamiento muy bien tolerado, se reportaron eventos adversos leves en 132 pacientes (38,7%) al día 7 y en 115 pacientes(33,7%) al día 15...

Many patients attending out patient clinics with a set of nonspecific symptoms and signs that suggest the diagnosis asthenia, without organic cause to explain the symptoms. In order to determine which of was these patients confirmed the diagnosis of functional asthenia, was performed a prospective nation wide, study to diagnose and quantify the intensity of fatigue in these patients and measure the effectiveness of sulbutiamine 400 mg/day treatment short-term drug frontline. Was realized an open, prospective, multicenter study, which entered 341 outpatient patients which showed signs of fati gue. The Fatigue Severity Scale (FSS) was used as a tool for the diagnosis and evaluation of severity of fatigue and was evaluated the effectiveness of sulbutiamine 400 mg/day to Leti Laboratories, S.A.V. (Tekron®), as first line treatment.The duration of the study was 15 days, with 3 evaluations (day 1 or baseline, day 7 and day 15). The score of the FSS had to be ≥ 36 points to be enrolled. 74,7% of patients were females with a mean age of 43,7 ± 12,5 years old and 25,3% were males with a mean age of 41,7 ± 13,5 years old. At baseline, the FSS score was 49,7 ± 7,3 points; at day 7 was 37,2 ± 8,8 points with a decrease of 25,2% and at day 15 was 28,0 ± 9,8 points, with a decrease of 43,7% respective to baseline, being statistically significant (p< 0,0001 and p< 0,0001 at day 7 and day 15, respectively). The percentage of response to treatment was 77,7% at day 15. Sulbutiamine was a very well tolerated treatment, there were reported mild adverse events in 132 patients (38,7%) at day 7 and in 115 patients (33,7%) at day 15. Sulbutiamine 400 mg/day is a secure treatment, it is well tolerated and effective in improving the asthenia symptoms, as demonstrated in this clinical trial by the significant decrease in the FSS mean score and the percentage of patients with asthenia at day 15 of treatment

Parálisis periódica hiperpotasémica / Hyperpotassemia periodic paralysis

La parálisis periódica hiperpotasémica es una canalopatía del músculo esquelético que se caracteriza por episodios recurrentes de debilidad muscular que pueden ser desencadenados por el ejercicio, el frío, el reposo poco después del ejercicio y el aporte de potasio. Se presenta el caso de una paciente de 13 años de edad, con diagnóstico de parálisis periódica hiperpotasémica, sin antecedentes familiares de esta entidad y sin miotonía asociada. Los ataques de debilidad muscular sucedían en ocasiones diariamente y cada 2 o 3 días, con duración variable desde media hora hasta 24 a 48 h. Durante un episodio de debilidad muscular se constataron concentraciones de potasio en sangre de 7,14 mmol/L y el electromiograma mostró un patrón miopático. Se observó una disminución de la frecuencia de los episodios de debilidad muscular a los 2 meses de iniciado el tratamiento con acetazolamida por vía oral

The periodic hyperpotassemia paralysis is a striated muscle channelopathy characterized by recurrent episodes of muscular asthenia that may to be triggered by exercise, cold, not rest after exercise and potassium support. This the case of a female patient aged 13 diagnosed with hyperpotassemia periodic paralysis without family backgrounds of this entity and also without associated myotonia. The seizures of muscular asthenia occurred almost daily and each 2 or 3 days with a variable length from a half hour to 24 to 48 hours. During a episode of muscular asthenia there were blood potassium concentrations of 7,14 mmol/L and the electromyogram showed a myopathic pattern. There was a frequency decrease of episodes of muscular asthenia at 2 months of treatment onset with oral acetazolamide

Astenia cutânea canina: relato de caso / Cutaneous canine asteny: case report

A astenia cutânea, também conhecida como Síndrome de Ehlers-Danlos, é uma síndrome rara, que ocorre em várias espécies animais e em pessoas, caracterizada por distúrbios do colágeno. Este artigo relata um caso de astenia cutânea em um cão macho sem raça definida (SRD), que apresentava a pele extremamente frouxa e elástica e severas alterações nas articulações, especialmente nas articulações rádio-cárpicas, na forma de luxação medial bilateral dos carpos em relação a rádio e uma. O diagnósticodefinitivo foi firmado a partir dos resultados do exame histopatológico de amostras cutâneas obtidas por meio de biópsia excisional e do índice de 21% de distensibilidade cutânea

Cutaneous asthenia, also known as Ehlers-Danlos syndrome, is a rare disease, occurring in many animal species and humans. This paper reports a case of cutaneous asthenia in a mongrel male dog, which presented extremely flaccid and elastic skin and severe articular changes, mainly in the radiocarpic joints, as medial bilateral luxation of carpus in relation to radius and ulna. Definitive diagnosis was defined by the association of the results of histopathological examination and the 21% index of, cutaneous distensibility

Astenia cutânea canina: relato de caso / Cutaneous canine asteny: case report

A astenia cutânea, também conhecida como Síndrome de Ehlers-Danlos, é uma síndrome rara, que ocorre em várias espécies animais e em pessoas, caracterizada por distúrbios do colágeno. Este artigo relata um caso de astenia cutânea em um cão macho sem raça definida (SRD), que apresentava a pele extremamente frouxa e elástica e severas alterações nas articulações, especialmente nas articulações rádio-cárpicas, na forma de luxação medial bilateral dos carpos em relação a rádio e uma. O diagnósticodefinitivo foi firmado a partir dos resultados do exame histopatológico de amostras cutâneas obtidas por meio de biópsia excisional e do índice de 21% de distensibilidade cutânea(AU)

Cutaneous asthenia, also known as Ehlers-Danlos syndrome, is a rare disease, occurring in many animal species and humans. This paper reports a case of cutaneous asthenia in a mongrel male dog, which presented extremely flaccid and elastic skin and severe articular changes, mainly in the radiocarpic joints, as medial bilateral luxation of carpus in relation to radius and ulna. Definitive diagnosis was defined by the association of the results of histopathological examination and the 21% index of, cutaneous distensibility(AU)

Tradução e adaptação transcultural da versão brasileira do Questionário de Ansiedade Cardíaca / Translation and cross-cultural adaptation of the Brazilian Version of the Cardiac Anxiety Questionnaire

INTRODUÇÃO: É crescente a produção científica brasileira na adaptação de instrumentos internacionais para avaliar ansiedade. A tradução e adaptação transcultural de escalas é um primeiro passo na obtenção de instrumentos válidos que permitam a comparação de diferentes populações. O objetivo do presente estudo foi traduzir e avaliar a equivalência semântica do Cardiac Anxiety Questionnaire, realizando um estudo piloto na população brasileira de diferentes níveis de escolaridade. MÉTODO: O processo de adaptação transcultural envolveu duas traduções e retrotraduções realizadas por avaliadores independentes, avaliação das versões e elaboração de uma versão síntese. Também examinamos os comentários dos participantes sobre a versão preliminar do questionário, os quais foram usados no desenvolvimento da versão final. RESULTADOS: Para cada item do instrumento, apresentam-se os resultados das quatro etapas. Os participantes com maior grau de escolaridade não apresentaram dificuldades na compreensão do instrumento, tendo apenas apresentado sugestões controversas acerca do item 5. Entretanto, os participantes apenas com escolaridade em nível fundamental relataram dificuldades com os itens 2, 4, 6, 7, 10, 11 e 14. Algumas alterações semânticas foram realizadas com o intuito de facilitar a compreensão do instrumento. CONCLUSÃO: A utilização de duas versões de tradução e retrotradução, discussão sobre a versão síntese e a interlocução com a população-alvo proporcionaram maior segurança ao processo de equivalência semântica da versão final brasileira.

INTRODUCTION: There has been a growing interest in the cross-cultural application of psychological questionnaires to assess anxiety. The translation and cross-cultural adaptation of the original instrument is the first step in validating an instrument in a new population that will permit comparisons between different populations. The goals of this study were to translate the Cardiac Anxiety Questionnaire, assess its semantic equivalence, and perform a preliminary test with participants from the Brazilian population that were drawn from different educational backgrounds. METHOD: The cross-cultural adaptation process consisted of two translations and back translations performed by two independent evaluators; a critical evaluation of the two versions, and the development of a synthesized version. We also examined comments provided by participants on the preliminary version of the questionnaire and used them for the development of the final version. RESULTS: We report the results of the four stages for each item of the instrument. Participants with tertiary education had no difficulties comprehending the translated items of the questionnaire, only pointing item 5 as ambiguous. Participants from the lower educational level reported comprehension problems regarding items 2, 4, 6, 7, 10, 11 and 14. Some small changes were made in our first version to enhance comprehensibility. CONCLUSION: The use of two versions of translations, a critical examination of the two versions, and suggestions made by participants resulted in a final Brazilian version with a satisfactory degree of semantic accuracy and semantic equivalence with the original version.