Frequency and risk factors for HIV-associated neurocognitive disorder and depression in older individuals with HIV in northeastern Brazil.

BACKGROUND: The study was undertaken to describe the frequency of HIV-associated neurocognitive disorders (HAND) and depressive symptoms in an older population with human immunodeficiency virus (HIV). METHODS: A cross-sectional analysis of patients aged 50 years or older infected with HIV was carried out in an outpatient setting in Brazil from March to November 2008. Patients selected were submitted to cognitive evaluation using the Mini-Mental State Examination and International HIV Dementia Scale, and also to functional and depression evaluations. RESULTS: Among the 52 patients evaluated, the frequency of neurocognitive disorder was 36.5%, while for dementia the frequency was 13.5%. No risk factors were identified. Among the patients with cognitive impairment, 73.7% had cortical impairment. The frequency of depressive symptoms was of 34.6%. The female gender was identified as a risk factor (p = 0.018) and patients with depressive symptoms had greater functional impairment (p < 0.001). CONCLUSION: HAND and depressive symptoms are common in an older population. Patients with cognitive impairment achieved lower scores on the cortical assessment scales. Depressive symptoms are a stronger factor for functional impairment.

Comparação de dipirona intravenosa com metoclopramida intravenosa no tratamento de crise aguda de enxaqueca: ensaio clínico randomizado / Comparison of intravenous dipyrone to intravenous metoclopramide in the treatment of acute crisis of migraine: randomized clinical trial

INTRODUÇÃO: A enxaqueca é uma das doenças mais comuns da prática clínica. OBJETIVO: Comparar o efeito analgésico da dipirona com a metoclopramida no alívio da dor. MÉTODO: Conduzimos um estudo piloto randomizado comparando dipirona intravenosa com metoclopramida intravenosa em 27 pacientes apresentando crise de enxaqueca. O objetivo primário foi comparar a redução da intensidade da dor até 2 horas, assim como efeitos colaterais. RESULTADOS: Os grupos tinham faixas etárias semelhantes, mas diferença entre os sexos. Nos homens a metoclopramida reduziu a dor em 80,0 por cento contra 55,0 por cento da dipirona (p=0,052). Já nas mulheres houve uma redução de 65,0 por cento com a metoclopramida e 71,2 por cento com a dipirona (p=0,748). Esses resultados podem ter sido influenciados pelo reduzido número de pacientes no estudo. Não foram encontrados efeitos colaterais significativos. CONCLUSÃO: Não houve diferença quanto à redução da dor nem quanto ao surgimento de efeitos colaterais quando comparados dipirona com metoclopramida.

INTRODUCTION: Migraine is one of the commonest diseases of clinical practice. OBJETIVE: To compare the analgesic effect of dipyrone to metoclopramide in the relief of pain. METHOD: We conducted a pilot randomized study comparing intravenous dipyrone to intravenous metoclopramide in 27 patients presenting acute crisis of migraine. The primary end point was to compare reduction of intensity of pain up to 2 hours, as well as the development of collateral effects. RESULTS: The groups had similar ages, but there were difference between the sexes. In men, metoclopramide reduced pain in 80.0 percent compared with 55.0 percent from dipyrone (p=0.052). In women, there was a reduction of 65.0 percent with metoclopramide and 71.2 percent with dipyrone (p=0.748). The small number of patients in the study might have influenced these results. Significant collateral effects were not found. CONCLUSION: There was no difference about the intensity of pain reduction neither about the development of collateral effects comparing dipyrone to metoclopramide.

[Comparison of intravenous dipyrone to intravenous metoclopramide in the treatment of acute crisis of migraine: randomized clinical trial]. / Comparação de dipirona intravenosa com metoclopramida intravenosa no tratamento de crise aguda de enxaqueca: ensaio clínico randomizado.

INTRODUCTION: Migraine is one of the commonest diseases of clinical practice. OBJECTIVE: [corrected] To compare the analgesic effect of dipyrone to metoclopramide in the relief of pain. METHOD: We conducted a pilot randomized study comparing intravenous dipyrone to intravenous metoclopramide in 27 patients presenting acute crisis of migraine. The primary end point was to compare reduction of intensity of pain up to 2 hours, as well as the development of collateral effects. RESULTS: The groups had similar ages, but there were difference between the sexes. In men, metoclopramide reduced pain in 80.0% compared with 55.0% from dipyrone (p=0.052). In women, there was a reduction of 65.0% with metoclopramide and 71.2% with dipyrone (p=0.748). The small number of patients in the study might have influenced these results. Significant collateral effects were not found. CONCLUSION: There was no difference about the intensity of pain reduction neither about the development of collateral effects comparing dipyrone to metoclopramide.