Rogerio Rizo Morales

Clinical aspects of neurocysticercosis in children

The purpose of this report was to evaluate the clinical aspects of neurocysticercosis in children from a Brazilian region. A retrospective study of 25 children with this neuroparasitosis was performed. The diagnosis was based on clinical, cerebrospinal fluid, and neuroimaging findings. The patients were predominantly male (72%), were 1 to 11 years of age (average = 8 years, 6 months), and most resided in urban areas (68%). The more frequent manifestations were epileptic seizures (72%), headache (60%), learning disability (24%), behavioral changes (12%), psychomotor involution (8%), and intracranial hypertension (4%). The neurologic examination was normal in 80% of the patients. Twenty-two children received only symptomatic drugs. Three patients underwent treatment with cysticidal drugs, one with praziquantel and two with albendazole, with complete remission of the signs in one patient (33%) and improvement in two others (67%). Of the 25 patients, 43.4% had remission and 47.8% had improvement. We emphasize the need to consider neurocysticercosis as a differential diagnosis in children coming from endemic areas and presenting with learning disabilities, behavioral changes, and psychomotor involution. The clinical aspects in most of the children from the Botucatu region suggest a spontaneous resolution of neurocysticercosis without the need for cysticidal treatment.

Qualidade de vida em portadores de esclerose múltipla

Propedeutica Neurologica Faculdade de Medicina Universidade Federal de Uberlândia, Uberlândia MG

Health-related quality of life and depressive symptoms in undergraduate nursing students

This is a descriptive, cross-sectional study aimed at investigating the health-related quality of life (HRQoL) of nursing students and its relationship with year of training, sociodemographic variables and the intensity of depressive symptoms. A convenience sample of 256 students, out of 353 eligible (72%), responded to the Medical Outcomes Study - The 36 Item Short-Form Health Survey (SF-36) and the Beck Depression Inventory (BDI) (self-administered). Final-year students, females and students with a higher intensity of depressive symptoms presented lower SF-36 scores in the physical functioning, vitality and social functioning domains. Institutional psychopedagogic support programs may minimize this negative impact on the HRQoL and encourage better professional performance of students in higher vulnerability situations.Trata-se de estudo descritivo e transversal, que investigou a qualidade de vida relacionada a saude (QVRS) de estudantes de Enfermagem e a relacao da QVRS com o ano de estudo, as variaveis sociodemograficas e a intensidade de sintomas depressivos. Uma amostra acidental de 256 estudantes dos 353 elegiveis (72%) respondeu ao Medical Outcomes Study - The 36 Item Short-Form Health Survey (SF-36) e ao Inventario de Depressao de Beck (IDB). Estudantes do ultimo ano do curso, sobretudo do sexo feminino e com maior intensidade de sintomas depressivos, apresentaram menores escores do SF-36 nos dominios capacidade funcional, vitalidade e aspectos sociais. O prejuizo na QVRS ocorre sobretudo no ultimo ano do curso, nos estudantes do sexo feminino ou com sintomas depressivos. Programas institucionais de aconselhamento psicopedagogico poderiam minimizar o impacto negativo detectado na QVRS e contribuir para melhor formacao e desempenho profissional dos estudantes em situacao de maior vulnerabilidade.

Multiple sclerosis starting before the age of 18 years: the Brazilian experience

Multiple sclerosis (MS) starting in childhood and adolescence poses a challenge for diagnosis and management of the disease. The aim of the present study was to assess the characteristics of early onset MS in Brazilian patients. Methods Retrospective data collection from specialized MS units. Results From 20 MS units in 11 Brazilian states, 117 cases of MS starting before the age of 18 years were collected. These patients had an average of 10 years of disease duration, still typically with low disability and one relapse every 2.5 years. The mean age for disease onset was 13.7 years. Conclusion The present study introduces a large series of Brazilian cases of pediatric MS. Although some patients presented a very severe form of MS, on the whole the group of patients with MS starting in childhood or adolescence presented a relatively mild form of this disease in Brazil.

Nearly one-half of Brazilian patients with multiple sclerosis using natalizumab are DNA-JC virus positive

OBJECTIVE Natalizumab is a new and efficient treatment for multiple sclerosis (MS). The risk of developing progressive multifocal leukoencephalopathy (PML) during the use of this drug has created the need for better comprehension of JC virus (JCV) infection. The objective of the present study was to assess the prevalence of JCV-DNA in Brazilian patients using natalizumab. METHOD Qualitative detection of the JCV in the serum was performed with real-time polymerase chain reaction (PCR). RESULTS In a group of 168 patients with MS who were undergoing treatment with natalizumab, JCV-DNA was detectable in 86 (51.2%) patients. DISCUSSION Data on JCV-DNA in Brazil add to the worldwide assessment of the prevalence of the JCV in MS patients requiring treatment with natalizumab.

Oligoclonal Bands in Cerebrospinal Fluid of Black Patients with Multiple Sclerosis

Genetic susceptibility is a well-recognized factor in the onset of multiple sclerosis (MS). The objective of this study was to determine the frequency of oligoclonal bands (OCB) restricted to the cerebrospinal fluid, in an ethnically mixed group of MS patients in the city of São Paulo, Brazil. Techniques used to detect OCB consisted of isoelectric focusing followed by immunoblotting. OCB were found in 49 (54.4%) out of 90 patients with clinically definite MS; out of the 23 brown/black patients, 17 (73.9%) were OCB+; out of the 66 white patients, 32 (48.5%) were OCB+; and the only patient yellow was OCB+ (p = 0.05). Analysis of the IgG index was also consistent with the findings, but with lower statistical significance. The data presented in our study show that the ethnic differences in MS extend to the immune response.

Calidad de vida relacionada a la salud y síntomas depresivos de estudiantes del curso de graduación en enfermería

This is a descriptive, cross-sectional study aimed at investigating the health-related quality of life (HRQoL) of nursing students and its relationship with year of training, sociodemographic variables and the intensity of depressive symptoms. A convenience sample of 256 students, out of 353 eligible (72%), responded to the Medical Outcomes Study - The 36 Item Short-Form Health Survey (SF-36) and the Beck Depression Inventory (BDI) (self-administered). Final-year students, females and students with a higher intensity of depressive symptoms presented lower SF-36 scores in the physical functioning, vitality and social functioning domains. Institutional psychopedagogic support programs may minimize this negative impact on the HRQoL and encourage better professional performance of students in higher vulnerability situations.Trata-se de estudo descritivo e transversal, que investigou a qualidade de vida relacionada a saude (QVRS) de estudantes de Enfermagem e a relacao da QVRS com o ano de estudo, as variaveis sociodemograficas e a intensidade de sintomas depressivos. Uma amostra acidental de 256 estudantes dos 353 elegiveis (72%) respondeu ao Medical Outcomes Study - The 36 Item Short-Form Health Survey (SF-36) e ao Inventario de Depressao de Beck (IDB). Estudantes do ultimo ano do curso, sobretudo do sexo feminino e com maior intensidade de sintomas depressivos, apresentaram menores escores do SF-36 nos dominios capacidade funcional, vitalidade e aspectos sociais. O prejuizo na QVRS ocorre sobretudo no ultimo ano do curso, nos estudantes do sexo feminino ou com sintomas depressivos. Programas institucionais de aconselhamento psicopedagogico poderiam minimizar o impacto negativo detectado na QVRS e contribuir para melhor formacao e desempenho profissional dos estudantes em situacao de maior vulnerabilidade.