Barriers and facilitators in the orthodontic treatment of teenagers with neurodevelopmental disabilities.

INTRODUCTION: Patients with neurodevelopmental disabilities often experience barriers to dental care. Despite greater access to orthodontic treatment, information about the perceptions of patients with neurodevelopmental disabilities regarding orthodontic care remains scarce. The objective of this research was to investigate perceptions of patients, caretakers, and orthodontic residents regarding the barriers to and facilitators of orthodontic care for patients with neurodevelopmental disabilities. METHODS: A qualitative study was conducted through semistructured interviews of 26 subjects: 10 patients with neurodevelopmental disabilities (4 with cognitive disabilities, 4 with autism spectrum disorder, and 2 with communication disorder), 8 caretakers, and 8 orthodontic residents. The responses were analyzed qualitatively by content analysis. RESULTS: Four dimensions of analysis were identified: previous experience, barriers to care, facilitators of care, and perception of care. There are different orthodontic care barriers and facilitators perceived by patients, caretakers, and residents treating patients with neurodevelopmental disabilities. Factors such as the reason for consultation, previous experience or exposure to orthodontic care or attention, and personal motivation of those involved were used to model the care of these patients. CONCLUSIONS: There are barriers and facilitators in orthodontic care for patients with neurodevelopmental disabilities, caretakers, and orthodontic residents. Educational programs in orthodontics must work to improve access and care for patients and educational training programs for students and clinical faculty.

Nucleophilic Fluorination with KF Catalyzed by 18-Crown-6 and Bulky Diols: A Theoretical and Experimental Study.

The activation of potassium fluoride for nucleophilic fluorination of alkyl halides is an important challenge because of the high lattice energy of this salt and its low solubility in many polar aprotic solvents. Crown ethers have been used for increasing the solubilization of KF during several decades. Nevertheless, these macrocycles are not enough to produce a high reaction rate. In this work, theoretical methods were used for designing a synergic combination of bulky diols with crown ethers able to accelerate this kind of reaction. The calculations have predicted that the bulky diol 1,4-Bis(2-hydroxy-2-propyl)benzene, which has distant hydroxyl groups, is able to catalyze nucleophilic fluorination in combination with 18-crown-6 via two hydrogen bonds to the SN2 transition state. Experimental studies following the theoretical predictions have confirmed the catalytic effect and the estimated kinetic data point out that the bulky diol at 1 mol L-1 in combination with 18-crown-6 is able to produce an 18-fold increase in the reaction rate in relation to crown ether catalysis only. The reaction produces 46% yield of fluorination after 24 h at moderate temperature of 82 °C, with minimal formation of the side elimination product. Thus, this work presents an improved method for fluorination with KF salt.

Cooling Effectiveness of a Data Center Room under Overhead Airflow via Entropy Generation Assessment in Transient Scenarios.

Forecasting data center cooling demand remains a primary thermal management challenge in an increasingly larger global energy-consuming industry. This paper proposes a dynamic modeling approach to evaluate two different strategies for delivering cold air into a data center room. The common cooling method provides air through perforated floor tiles by means of a centralized distribution system, hindering flow management at the aisle level. We propose an idealized system such that five overhead heat exchangers are located above the aisle and handle the entire server cooling demand. In one case, the overhead heat exchangers force the airflow downwards into the aisle (Overhead Downward Flow (ODF)); in the other case, the flow is forced to move upwards (Overhead Upward Flow (OUF)). A complete fluid dynamic, heat transfer, and thermodynamic analysis is proposed to model the system's thermal performance under both steady state and transient conditions. Inside the servers and heat exchangers, the flow and heat transfer processes are modeled using a set of differential equations solved in MATLAB™ 2017a. This solution is coupled with ANSYS-Fluent™ 18, which computes the three-dimensional velocity, temperature, and turbulence on the Airside. The two approaches proposed (ODF and OUF) are evaluated and compared by estimating their cooling effectiveness and the local Entropy Generation. The latter allows identifying the zones within the room responsible for increasing the inefficiencies (irreversibilities) of the system. Both approaches demonstrated similar performance, with a small advantage shown by OUF. The results of this investigation demonstrated a promising approach of data center on-demand cooling scenarios.

[Severity of COVID-19 in patients with multiple sclerosis in Argentina]. / Infección grave por COVID-19 en pacientes con esclerosis múltiple en la Argentina.

INTRODUCTION: There is limited local information on the risk of severe COVID-19 infection in patients with multiple sclerosis (MS) who are receiving disease-modifying treatments (DMT). The aim of the study was to assess the impact of COVID-19 disease (severity and lethality) in MS patients receiving DMT. METHODS: The study was performed on a prospective cohort with EM. We included 111 patients with MS and a confirmed diagnosis of COVID-19 treated with DMT and followed up until the resolution of COVID-19. RESULTS: A total of six patients (5.4%; 95% CI: 2-11.4%) developed severe COVID-19 defined as requiring hospitalization in intensive care unit or death and three died (crude case fatality rate of 2.7%; 95% CI: 1.1-4.3%). The age-adjusted case fatality rate was 1.5% (95% CI: 0.6-2.4%). The factor that was independently associated with severe COVID-19 was age (OR 1.1; CI 1.0-1.3; p < 0.05) with a trend in the Expanded Disability Status Scale (EDSS) = 6 (OR 6.2; CI 0.6-56.4; p = 0.10). CONCLUSION: The lethality due to COVID-19 in MS patients is low, and severity was significantly associated with age and showed a trend with EDSS = 6.

Introducción: Existe poca información local sobre el riesgo de infección grave por COVID-19 en pacientes con esclerosis múltiple (EM) que reciben tratamiento modificador de la enfermedad (DMT). El objetivo del estudio fue evaluar el impacto de la enfermedad por COVID-19 (gravedad y letalidad) en pacientes con EM que reciben DMT. Métodos: El estudio se realizó sobre una cohorte prospectiva de pacientes con EM. Se incluyeron 111 con EM y diagnóstico confirmado de COVID-19 tratados con DMT, seguidos hasta la resolución del COVID-19. Resultados: Un total de seis (5.4%; IC 95%: 2-11.4%) desarrollaron COVID-19 grave definido como requerimiento de internación en terapia intensiva o muerte, y tres fallecieron (tasa de letalidad cruda del 2.7%; IC 95%: 1.1-4.3%). La tasa de letalidad ajustada por edad fue del 1.5% (IC 95%: 0.6-2.4%). El factor que se asoció independientemente con COVID-19 grave fue la edad (OR 1.1; IC 1.0-1.3; p < 0.05) con una tendencia en la Escala del Estado de Incapacidad Ampliada (EDSS) = 6(OR 6.2; IC 0.6-56.4; p = 0.10). Conclusión: La letalidad por COVID-19 en pacientes con EM es baja y la gravedad se asoció significativamente con la edad y mostró una tendencia con EDSS = 6.

Identification of Potential Multitarget Compounds against Alzheimer's Disease through Pharmacophore-Based Virtual Screening.

Alzheimer's disease (AD) is a neurodegenerative disease characterized by progressive loss of cognitive functions, and it is the most prevalent type of dementia worldwide, accounting for 60 to 70% of cases. The pathogenesis of AD seems to involve three main factors: deficiency in cholinergic transmission, formation of extracellular deposits of ß-amyloid peptide, and accumulation of deposits of a phosphorylated form of the TAU protein. The currently available drugs are prescribed for symptomatic treatment and present adverse effects such as hepatotoxicity, hypertension, and weight loss. There is urgency in finding new drugs capable of preventing the progress of the disease, controlling the symptoms, and increasing the survival of patients with AD. This study aims to present new multipurpose compounds capable of simultaneously inhibiting acetylcholinesterase (AChE), butyrylcholinesterase (BChE)-responsible for recycling acetylcholine in the synaptic cleft-and beta-secretase 1 (BACE-1)-responsible for the generation of amyloid-ß plaques. AChE, BChE, and BACE-1 are currently considered the best targets for the treatment of patients with AD. Virtual hierarchical screening based on a pharmacophoric model for BACE-1 inhibitors and a dual pharmacophoric model for AChE and BChE inhibitors were used to filter 214,446 molecules by QFITBACE > 0 and QFITDUAL > 56.34. The molecules selected in this first round were subjected to molecular docking studies with the three targets and further evaluated for their physicochemical and toxicological properties. Three structures: ZINC45068352, ZINC03873986, and ZINC71787288 were selected as good fits for the pharmacophore models, with ZINC03873986 being ultimately prioritized for validation through activity testing and synthesis of derivatives for SAR studies.

Rhodium-catalyzed intramolecular formation of N-sulfamoyl 2,3-aziridino-γ-lactones and their use for the enantiospecific synthesis of α,ß-diamino acid derivatives.

4-Hydroxymethylbutenolide 4 was transformed into its sulfamoyl derivative 5, which upon treatment with iodosobenzene diacetate and magnesium oxide in the presence of a rhodium catalyst afforded the product of intramolecular aziridination 6. Reaction of 6 with primary or secondary amines in DMA led to regioselective opening of the aziridine ring at C2 to give the corresponding bicyclic derivatives 7a-7g in good to excellent yields. Methanolysis of the lactone ring of the N-benzyl-N-methyl derivative 7c followed by protection of the resulting secondary hydroxy group and treatment of the product with Boc anhydride provided the activated cyclic sulfamates 13 and 14. The latter then reacted with a second nucleophile (azide or thiophenol) to give the corresponding difunctionalized α,ß-diamino methyl esters 15-18, 20.

Laser confers less embryo exposure than acid tyrode for embryo biopsy in preimplantation genetic diagnosis cycles: a randomized study.

We compared two methods of zona pellucida drilling. 213 embryos were biopsied with acid Tyrode. Each biopsy took 3 minutes and the entire procedure ~29 minutes. 5% of blastomeres lysed, 49% of embryos became blastocyst and 36% of patients became pregnant. 229 embryos were biopsied with laser. Each biopsy took 30 seconds and the entire procedure ~7 minutes. 2.5% of blastomeres lysed, 50.6% of embryos became blastocyst and 47% of patients became pregnant. We can conclude that laser can be used for embryo biopsy. Reduction of embryo exposure and of removed blastomeres is associated with increased blastocysts available for transfer and a better clinical outcome.

COtab: Expedient and Safe Setup for Pd-Catalyzed Carbonylation Chemistry.

Bench-stable tablets (COtabs) have been developed for the rapid and safe production of carbon monoxide. The tablets can be made in less than 5 min without the use of a glovebox and only require a stock solution of an amine base to liberate a specific quantity of CO in a two-chamber system. The COtabs were tested in five different carbonylation reactions and provided similar yields compared to literature procedures. Finally, a gram-scale reaction was conducted, as well as 13C-isotope labeling of the anticancer drug, olaparib.

Synthesis and biological aspects of mycolic acids: an important target against Mycobacterium tuberculosis.

Mycolic acids are an important class of compounds, basically found in the cell walls of a group of bacteria known as mycolata taxon, exemplified by the most famous bacteria of this group, the Mycobacterium tuberculosis (M. tb.), the agent responsible for the disease known as tuberculosis (TB). Mycolic acids are important for the survival of M. tb. For example, they are able to help fight against hydrophobic drugs and dehydration, and also allow this bacterium to be more effective in the host's immune system by growing inside macrophages. Due to the importance of the mycolic acids for maintenance of the integrity of the mycobacterial cell wall, these compounds become attractive cellular targets for the development of novel drugs against TB. In this context, the aim of this article is to highlight the importance of mycolic acids in drug discovery.

Infección grave por COVID-19 en pacientes con esclerosis múltiple en la Argentina / Severity of COVID-19 in patients with multiple sclerosis in Argentina

Resumen Introducción: Existe poca información local sobre el riesgo de infección grave por COVID-19 en pacientes con esclerosis múltiple (EM) que reciben tratamiento modificador de la enfermedad (DMT). El objetivo del estudio fue evaluar el impacto de la enfermedad por COVID-19 (gravedad y letalidad) en pacientes con EM que reciben DMT. Métodos: El estudio se realizó sobre una cohorte prospectiva de pacientes con EM. Se incluyeron 111 con EM y diagnóstico confirmado de COVID-19 tratados con DMT, seguidos hasta la resolución del COVID-19. Resultados: Un total de seis (5.4%; IC 95%: 2-11.4%) desarrollaron COVID-19 grave definido como requerimiento de internación en terapia intensiva o muerte, y tres fallecieron (tasa de letalidad cruda del 2.7%; IC 95%: 1.1-4.3%). La tasa de letalidad ajustada por edad fue del 1.5% (IC 95%: 0.6-2.4%). El factor que se asoció independientemente con COVID-19 grave fue la edad (OR 1.1; IC 1.0-1.3; p < 0.05) con una tendencia en la Escala del Estado de Incapacidad Ampliada (EDSS) ≥ 6(OR 6.2; IC 0.6-56.4; p = 0.10). Conclusión: La letalidad por COVID-19 en pacientes con EM es baja y la gravedad se asoció significativamente con la edad y mostró una tendencia con EDSS ≥ 6.

Abstract Introduction: There is limited local information on the risk of severe COVID-19 infection in patients with multiple sclerosis (MS) who are receiving disease-modifying treatments (DMT). The aim of the study was to assess the impact of COVID-19 disease (severity and lethality) in MS patients receiving DMT. Methods: The study was performed on a prospective cohort with EM. We included 111 patients with MS and a confirmed di agnosis of COVID-19 treated with DMT and followed up until the resolution of COVID-19. Results: A total of six patients (5.4%; 95% CI: 2-11.4%) developed severe COVID-19 defined as requiring hospitalization in intensive care unit or death and three died (crude case fatality rate of 2.7%; 95% CI: 1.1-4.3%). The age-adjusted case fatality rate was 1.5% (95% CI: 0.6-2.4%). The factor that was independently associated with severe COVID-19 was age (OR 1.1; CI 1.0-1.3; p < 0.05) with a trend in the Expanded Disability Status Scale (EDSS) ≥ 6 (OR 6.2; CI 0.6-56.4; p = 0.10). Conclusion: The lethality due to COVID-19 in MS patients is low, and severity was significantly associated with age and showed a trend with EDSS ≥ 6.

Mechanism of the Piperidine-Catalyzed Knoevenagel Condensation Reaction in Methanol: The Role of Iminium and Enolate Ions.

The free energy profile of the piperidine catalyzed Knoevenagel condensation reaction of acetylacetone with benzaldehyde has been obtained by theoretical calculations. The carbinolamine formation step involves catalysis by methanol solvent, and its decomposition takes place via hydroxide ion elimination without a classical transition state, leading to the iminium ion. Hydroxide ion deprotonates the acetylacetone, forming an enolate that attacks the iminium ion and leads to an addition intermediate. The final step involves elimination of piperidine catalyst. Our analysis suggests the iminium ion formation has the highest barrier and the catalytic effect of piperidine is facilitating the elimination step rather than activation of the benzaldehyde electrophile. Experimental measures of the kinetics lead to an observed free energy barrier of 20.0 kcal mol-1, in good agreement with the theoretical value of 21.8 kcal mol-1 based on the free energy profile.

[Hantavirus in human and rodent population in an endemic area for hantavirus pulmonary syndrome in Argentina]. / Hantavirus en población humana y de roedores de un área endémica para el síndrome pulmonar por Hantavirus en la Argentina.

This paper analyzed the prevalence and distribution of serological reactivity to hantavirus (antibody against ANDES virus) of human population exposed to hantavirus and rodents trapped in the studied area. This study was developed in Salta (Orán and San Martín Departments), area with the highest incidence for Hantavirus Pulmonary Syndrome (HPS) in Argentina. In December 1997, 453 healthy people were studied by serology and 39 rodents by serology and PCR. The studied individuals were distributed as: 145 farm inhabitants (FI), 212 people living in the same dwelling with healthy individuals (controls) (Cco), 87 people living in the same dwelling with persons undergoing SPH in 1997 (cases) (Cca). Moreover, 19 physicians and nurses who cared for patients with SPH in 1997 were also studied. The prevalence of hantavirus infection among the studied population was 6.3%. The prevalence was 10.3% among FI, 6.9% among Cca and 3.3% among Cco (p < 0.02). There was no serological reactivity among PS. The prevalence in 39 trapped rodents was 10.2%, with infection only for Oligoryzomys chacoensis, O. flavescens and Akodon varius species. The prevalence of human cases with asymptomatic infection in Salta is higher than in other regions of the country, and we are presenting a hypothesis to explain these differences. The analyzed data suggest that in this region up to the time this study was performed, there would not have been person to person transmission of hantavirus. The transmission would be from rodent contact exclusively and mainly in ongoing deforestation areas and domestic habitat surrounding rural dwellings.

Synthesis and antimalarial activity of dihydroperoxides and tetraoxanes conjugated with bis(benzyl)acetone derivatives.

Dihydroperoxides and tetraoxanes derived from symmetrically substituted bis(arylmethyl)acetones were synthesized in modest to good yields using several methods. Three of these compounds exhibit an important in vitro antimalarial activity (1.0 µm ≤ IC(50) ≤ 5.0 µm) against blood forms of the human malaria parasite Plasmodium falciparum.

Acute intermittent porphyria: case report and review of the literature. / Porfiria aguda intermitente: relato de caso e revisão da literatura.

Acute intermittent porphyria is an unusual pathology with potentially severe consequences when not early detected. Among the possible causes of porphyric crises decrease of caloric intake has been described. A case of acute intermittent porphyria in the late postoperative period of a bariatric surgery performed for treatment of obesity is reported. A review of the diagnostic aspects and management of this pathology in the intensive care unit follows. A 31 year old woman was admitted in the intensive care unit three weeks after a bariatric surgery, with decreased level of consciousness and respiratory distress. The patient evolved with psychomotor agitation, mental confusion, abdominal pain and proximal tetraparesis. Diagnosis investigation disclosed severe hyponatremia (92mEq/L), hypomagnesemia, hypophosfatemia and hypocalcemia and cloudy urine without hematuria. Acute porphyria was suspected and the urine test detected high delta amino-levulinic acid and porphobilinogen. Treatment consisted of a correction of electrolyte disturbances and high carbohydrate intake. Hematin and heme arginate were not used, due to the difficulty to acquire the medication. After 8 months the patient progressed with full recovery of muscle strength and a clinical improvement. Acute intermittent porphyria has signs and symptoms common to several clinical, neurological, psychiatric and gastroenterological pathologies, which complicate diagnosis. Therefore, acute intermittent porphyria should be included in the differential diagnosis of neurological, psychiatric and gastroenterological alterations when results of all other exams are normal. Attention must be given to patients undergoing surgery mainly bariatric that, in addition to procedure stress, substantially limit the total caloric intake, potentially triggering crises. Review of literature did not disclose any report of acute intermittent porphyria crisis induced by bariatric surgery.

Cross-protection against challenge with Puumala virus after immunization with nucleocapsid proteins from different hantaviruses.

Hantaviruses are rodent-borne agents that cause hemorrhagic fever with renal syndrome or hantavirus pulmonary syndrome in humans. The nucleocapsid protein (N) is relatively conserved among hantaviruses and highly immunogenic in both laboratory animals and humans, and it has been shown to induce efficient protective immunity in animal models. To investigate the ability of recombinant N (rN) from different hantaviruses to elicit cross-protection, we immunized bank voles with rN from Puumala (PUUV), Topografov (TOPV), Andes (ANDV), and Dobrava (DOBV) viruses and subsequently challenged them with PUUV. All animals immunized with PUUV and TOPV rN were completely protected. In the group immunized with DOBV rN, 7 of 10 animals were protected, while only 3 of 8 animals were protected in the group immunized with ANDV rN, which is more closely related to PUUV rN than DOBV rN. Humoral and cellular immune responses after rN immunization were also investigated. The highest cross-reactive humoral responses against PUUV antigen were detected in sera from ANDV rN-immunized animals, followed by those from TOPV rN-immunized animals, and only very low antibody cross-reactivity was observed in sera from DOBV rN-immunized animals. In proliferation assays, T lymphocytes from animals immunized with all heterologous rNs were as efficiently recalled in vitro by PUUV rN as were T lymphocytes from animals immunized with homologous protein. In summary, this study has shown that hantavirus N can elicit cross-protective immune responses against PUUV, and the results suggest a more important role for the cellular arm of the immune response than for the humoral arm in cross-protection elicited by rN.

Andes virus and first case report of Bermejo virus causing fatal pulmonary syndrome.

Two suspected hantavirus pulmonary syndrome (HPS) cases from Bolivia occurred in May and July 2000 and were confirmed by enzyme-linked immunosorbent assay (ELISA)-ANDES using N-Andes recombinant antigen serology. Clot RNAs from the two patients were subjected to reverse transcription-polymerase chain reaction (PCR) amplification and sequencing. We describe two characterized cases of HPS. One was caused by infection with Bermejo virus and the other with Andes Nort viral lineage, both previously obtained from Oligoryzomys species. This is the first report of molecular identification of a human hantavirus associated with Bermejo virus.

Porfiria aguda intermitente: relato de caso e revisão da literatura / Acute intermittent porphyria: case report and review of the literature

Porfiria aguda intermitente é patologia incomum, com conseqüências potencialmente graves se não reconhecida precocemente. Dentre as possíveis causas de indução de crises de porfiria, a redução da ingestão calórica é descrita na literatura. Relatamos um caso de porfiria aguda intermitente no pós-operatório tardio de gastroplastia indicada para tratamento da obesidade, revisando aspectos do diagnóstico e tratamento da patologia na unidade de terapia intensiva. Paciente feminina, 31 anos, com história de gastroplastia há 3 semanas admitida na unidade de terapia intensiva com rebaixamento do nível de consciência e desconforto respiratório. Evoluiu com agitação psicomotora, confusão mental, dor abdominal e tetraparesia proximal. Na investigação diagnóstica foi encontrado hiponatremia grave (92 mEq/L), hipomagnesemia, hipofosfatemia e hipocalcemia, urina turva, sem hematúria. Aventou-se hipótese de porfiria aguda, realizado dosagem do ácido delta-aminolevulínico e porfobilinogênio na urina de 24h, com elevação de ambos. Iniciado tratamento com dieta rica em carboidratos, sem utilizar hematina ou arginato de heme, devido à dificuldades no fornecimento destas medicações. Evoluiu com melhora clínica gradativa e recuperação completa da força muscular após 8 meses. A porfiria aguda intermitente possui sinais e sintomas comuns a muitas patologias clínicas e neuropsiquiátricas dificultando o diagnóstico, em especial quando estes se manifestam isoladamente. Assim, deve-se incluir a porfiria aguda intermitente no diagnóstico diferencial de distúrbios neurológicos, psiquiátricos e gastroenterológicos em crises, no qual todos os demais exames estejam normais. Atenção deve ser dada a pacientes submetidos à cirurgias, em especial cirurgia bariátrica que, além do estresse cirúrgico, limita substancialmente a ingesta calórica podendo desencadear crises. Não há descrito na literatura, até o momento, nenhum caso de porfiria aguda intermitente no pós-operatório...

Acute intermittent porphyria is an unusual pathology with potentially severe consequences when not early detected. Among the possible causes of porphyric crises decrease of caloric intake has been described. A case of acute intermittent porphyria in the late postoperative period of a bariatric surgery performed for treatment of obesity is reported. A review of the diagnostic aspects and management of this pathology in the intensive care unit follows. A 31 year old woman was admitted in the intensive care unit three weeks after a bariatric surgery, with decreased level of consciousness and respiratory distress. The patient evolved with psychomotor agitation, mental confusion, abdominal pain and proximal tetraparesis. Diagnosis investigation disclosed severe hyponatremia (92mEq/L), hypomagnesemia, hypophosfatemia and hypocalcemia and cloudy urine without hematuria. Acute porphyria was suspected and the urine test detected high delta amino-levulinic acid and porphobilinogen. Treatment consisted of a correction of electrolyte disturbances and high carbohydrate intake. Hematin and heme arginate were not used, due to the difficulty to acquire the medication. After 8 months the patient progressed with full recovery of muscle strength and a clinical improvement. Acute intermittent porphyria has signs and symptoms common to several clinical, neurological, psychiatric and gastroenterological pathologies, which complicate diagnosis. Therefore, acute intermittent porphyria should be included in the differential diagnosis of neurological, psychiatric and gastroenterological alterations when results of all other exams are normal. Attention must be given to patients undergoing surgery mainly bariatric that, in addition to procedure stress, substantially limit the total caloric intake, potentially triggering crises. Review of literature did not disclose any report of acute intermittent porphyria crisis induced by bariatric surgery.

Aplicaçäo e achados da tomografia computadorizada de crânio em pacientes com 60 ou mais anos / Appication and findings of computerized tomography of skull in patients with 60 years age or older

O estudo avalia as queixas e impressöes diagnósticas iniciais nas solicitaçöes das tomografias computadorizadas de crânio (TCC), bem como os laudos destes exames em pacientes com 60 ou mais anos. A doença cerebrovascular (DCV) foi o principal diagnóstico inicial e razäo de demanda. Há uma tendência geral ao aumento de vários problemas neurológicos e achados na TCC com o envelhecimento, considerando-se achados patológicos ou fisiológicos, especialmente atrofia cortical, hidrocefalia ex-vácuo, além de alteraçöes sugestivas de DCV. A DCV ocupa lugar de destaque entre as doenças neurológicas do idoso, representando um campo onde medidas efetivas de prevençäo podem ser implementadas.

Modificaciones de los niveles de acido delta aminolevulico dehidrasa en pacientes alcoholicos cronicos / Changes in the levels of delta-aminolevulinic acid dehydratase in chronic alcoholic patients

Estudios clínicos y bioquímicos fueron realizados sobre 58 pacientes con alcoholismo crónico a su vez divididos en 3 grupos: A (hepatopatia alcohólica), B (hepatopatía y neuropatía alcohólica) y C (neuropatía alcohólica). Simultáneamente se investigaron varios parámetros relacionados con la biosíntesis del hemo. Se comprobó que el ácido delta-aminolevúlico (ALA), porfobilinógeno (PBG) urinarios y las porfirinas urinarias y fecales, no presentaron diferencias significativas entre los grupos estudiados. También se determinaron en eritrocitos las actividades de ALA-dehidrasa (ALA-D), uroporfirinógeno-I-sintetasa y uroporfirinógeno-III-sintetasa. De todos los datos obtenidos se comprobó que solamente el ALA-dehidrasa en los grupos B y C se hallaba significativamente disminuida (P < 0,002). La disminución de los niveles de ALA-D se correspondió con la severidad de la neuropatía. (AU)