Aline Vitali da Silva

Clinical features of multiple sclerosis in the south of Brazil: a partial analysis

UNLABELLED There are no published studies on the characteristics of multiple sclerosis (MS) patients from the south of Brazil. OBJECTIVE To identify the clinical features of a series of MS patients and to compare to other Brazilian series. METHOD Retrospective study with 67 patients followed in The MS Reference Center - RS, Brazil during the year of 2008. We analyzed demographic and clinical data. RESULTS Most were women (74.6%), the general average age was 43.5 years old, and the general average EDSS score was 4.1. Of those patients, 81.8% had relapsing-remitting MS. Sexual dysfunction prevalence was 31.1% in men and 68.9% in women (p<0.01). We found a positive correlation (Spearman=0.444, p<0.05) between EDSS and depressive symptoms. CONCLUSION This study showed a very similar sample compared to other states of Brazil. Moreover, there was found a high prevalence of sexual dysfunction and a straight relation between EDSS and depressive symptoms.

Imipenem-associated encephalopathy: alert to physicians

Hospital de Clínicas de Porto Alegre, Porto Alegre RS, Brazil: Neurologist, Neurology Unit; Physician, Neurology Resident; Medical student, Federal University of Rio Grande do Sul. Imipenem, one of the first antibiotics of the carbapenem class, was developed more than 2 decades ago and has been utilized for multi-resistant bacterial infections in more than 26 million patients. It also has been a life-saving drug, as some bacteria are frequently resistant to other broadspectrum antibiotics. Imipenem-related encephalopathy was not formally reported, and can be overlooked by practitioners. The aim of this report is to alert physicians to this condition.

Type 2 deiodinase Thr92Ala polymorphism is associated with disrupted placental activity but not with dysglycemia or adverse gestational outcomes: a genetic association study

OBJECTIVE To study whether the D2 Thr92Ala polymorphism-a genetic marker that is associated with reduced thyroid type 2 deiodinase (D2) activity, increased insulin resistance, and risk for type 2 diabetes-is associated with disrupted placental D2 activity and with glycemic control and gestational outcomes. DESIGN Cross-sectional study. SETTING Tertiary hospital in Brazil. PATIENT(S) Consecutive singleton-pregnancy patients, 18-45 years old. INTERVENTION(S) Clinical examination and genotyping of the D2 Thr92Ala polymorphism, with placental samples collected and assayed for D2 mRNA and activity. MAIN OUTCOME MEASURE(S) Glucose homeostasis and gestational outcomes. RESULT(S) A total of 294 patients were included in the study. The clinical and laboratory characteristics were similar among the D2 genotypes. No differences were observed in D2 placental mRNA levels, but D2 activity was decreased in patients with the Ala92Ala genotype (0.35 ± 0.15 vs. 1.96 ± 1.02 fmol/mg/min.). Newborn serum thyroid-stimulating hormone levels (TSHneo) did not differ according to maternal D2 Thr92Ala genotype. Also, maternal glucose control, insulin resistance evaluated by the homeostasis model assessment (HOMA-IR), and gestational outcomes did not differ across D2 genotypes. CONCLUSION(S) The D2 Ala92Ala genotype is associated with reduced placental D2 activity but is not associated with dysglycemia, increased insulin resistance, or worse gestational outcomes.