Toxic and metabolic encephalopathies: iconographic essay / Encefalopatias tóxicas e metabólicas: ensaio iconográfico

Generally, toxic-metabolic diseases affecting the central nervous system can hardly be differentiated just on the basis of their clinical presentation. However, some typical neuroradiological features can guide the correct diagnosis. In this context, magnetic resonance imaging is an important tool which, in association with clinical and laboratory data, can establish an early and specific treatment. The present pictorial essay with selected cases from the archives of the authors' institution describes imaging findings which might help in the etiologic diagnosis of toxic-metabolic diseases.

As doenças toxicometabólicas do sistema nervoso central geralmente são de difícil diferenciação apenas pelo quadro clínico. Entretanto, existem algumas características neurorradiológicas típicas que podem orientar o diagnóstico correto. Neste sentido, a ressonância magnética é uma ferramenta importante que, junto ao quadro clinicolaboratorial, auxilia na instituição de uma terapêutica precoce e específica. Este ensaio iconográfico com casos selecionados dos arquivos da instituição dos autores tem como objetivo demonstrar achados de imagem que possam auxiliar no diagnóstico etiológico das doenças toxicometabólicas.

Toxoplasma gondii infection: seroprevalence and associated risk factors among primary schoolchildren in Lagos City, Southern Nigeria

INTRODUCTION: Toxoplasma gondii infection has been described as the most widespread zoonotic infection of humans and other animals. Information concerning T. gondii infection among schoolchildren is unavailable in Lagos City, Nigeria. METHODS: This cross-sectional study investigated the seroprevalence and risk factors associated with T. gondii infection among primary schoolchildren (PSC) from a community located in the center of Lagos, southern Nigeria, from November 2013 to March 2014. A total of 382 PSC were screened for the presence of sera anti-T. gondii antibodies using a latex agglutination test (TOXO Test-MT, Tokyo, Japan). A cutoff titer of ≥ 1:32 was considered positive, while titers ≥ 1:1,024 indicated high responders. Questionnaires were also used to obtain data on possible risk factors from parents/guardians. RESULTS: The overall seroprevalence was 24% (91/382), and 83.5% (76/91) of seropositive PSC were classified as high responders. Among the risk factors tested, including contact with cats and soil, consumption of raw meat and vegetables, and drinking unboiled water, none showed statistical significance after multivariate adjustment. No associations were observed among age, gender, body mass index (BMI), and parents' occupation/educational level. CONCLUSIONS: The findings in this study show evidence of active infection, and hence, there is need for urgent preventive measures in this city. Further investigation is required to clarify the transmission routes. Policy makers also need to initiate prevention and control programs to protect pregnant women and immunocompromised patients in particular because they are more severely affected by T. gondii infection. .

Oral maxillofacial fractures seen at a ugandan tertiary hospital: a six-month prospective study

AIM: To investigate the epidemiological characteristics of maxillofacial fractures and associated fractures in patients seen in the Oral Surgery Unit of Mulago Hospital, Kampala, Uganda. METHODOLOGY: A six-month prospective study was conducted. Data collected included socio-demographic factors, type and etiology of injury, additional fractures, and post-surgery complications. RESULTS: One hundred thirty-two (132) cases ranging from 5-70 yrs of age were reported, with a male: female ratio of 7.7:1. The 21-30 yr age group was the largest, comprising 51.51 percent of cases (n=68). Road traffic accidents contributed to 56.06 percent (n=74) of fractures. In total, 66 percent of the sample (n=87) suffered isolated mandibular fractures. Symphyseal and maxillary fractures were the most common mandibular and mid-facial fractures, respectively. Among associated fractures, the femur was most affected. A total of 39 (29.54 percent) of patients had post-operative complications, of which infection accounted for 48.71 percent (n= 19), and malocclusion accounted for 17.94 percent (n=7). CONCLUSIONS: Anticipated changes in maxillofacial trauma trends necessitate regular epidemiologic studies of facial fractures to allow for development and implementation of timely novel preventive measures.