[Bipolar disorder: staging and neuroprogression]. / Choroba afektywna dwubiegunowa--etapy przebiegu i neuroprogresja choroby.

In bipolar disorder illness progression has been associated with a higher number of mood episodes and hospitalizations, poorer response to treatment, and more severe cognitive and functional impairment. This supports the notion of the use of staging models in this illness. The value of staging models has long been recognized in many medical and malignant conditions. Staging models rely on the fact that different interventions may suit different stages of the disorder, and that better outcomes can be obtained if interventions are implemented earlier in the course of illness. Thus, treatment planning would benefit from the assessment of cognition, functioning and comorbidities. Staging may offer a means to refine treatment options, and most importantly, to establish a more precise diagnosis. Moreover, staging could have utility as course specifier and may guide treatment planning and better information to patients and their family members of what could be expected in terms of prognosis. The present study reviews the clinical and biological basis of the concept of illness progression in bipolar disorder.

Seroepidemiology of Toxoplasma gondii infection in bats from São Paulo city, Brazil.

Toxoplasmosis is a parasitic zoonosis caused by Toxoplasma gondii protozoan with a worldwide distribution. The aim of this study was to determine the frequency of IgG anti-T. gondii antibodies in bats from São Paulo city, Brazil. A total of 616 serum samples were collected from 22 species of bats. Anti-T. gondii antibodies were searched using the indirect fluorescent antibody test (IFAT ≥ 1:16) and IgG anti-bat antibodies produced in sheep on samples collected during 2006-2011; 32.62% (201/616) of bats had T. gondii antibodies. The modified agglutination test (MAT ≥ 1:25) was performed on samples collected during 2010-2011; 18.61% (35/188) were seropositive. The concordance between IFAT and MAT (serum samples from 2010 to 2011) by Kappa (95% CI) was 0.144, resulting in a low agreement between the techniques. The specificity and sensitivity of MAT and IFAT have not been evaluated for the diagnosis of toxoplasmosis in bats. Thus, it was verified that bats are exposed to T. gondii during their lifetime and they are also part of the toxoplasmosis epidemiology.