Prevalência de síndrome das pernas inquietas em pacientes com demência: uma atualização

RESUMO Objetivo Realizar uma revisão atualizada para avaliar a prevalência de síndrome das pernas inquietas e/ou movimentos periódicos dos membros em pacientes com demência, além de discutir dados sobre possíveis fatores de risco desses transtornos. Métodos A revisão foi realizada utilizando a base de dados do PubMed, com o seguinte cruzamento de descritores: (dementia, Alzheimer’s disease, dementia with Lewy’s body or frontotemporal dementia) e (restless legs syndrome or periodic leg movements). Resultados Foram selecionados sete artigos, os quais encontraram prevalência de síndrome das pernas inquietas, que variou de 4% a 24% em idosos com demência. Houve diferenças importantes entre os métodos utilizados para o diagnóstico, tamanho das amostras e causas de demência estudadas. Conclusão Mais estudos com o objetivo de refinar os critérios diagnósticos e definir fatores de risco, especialmente relacionadas a idosos com demência, são necessários. Além disso, deve-se ficar atento a essa comorbidade na prática clínica.

Mechanisms of formation and function of eosinophil lipid bodies: inducible intracellular sites involved in arachidonic acid metabolism

Lipid bodies, inducible lipid-rich cytoplasmic inclusions, are characteristically abundant in cells associated with inflammation, including eosinophils. Here we reviewed the formation and function of lipid bodies in human eosinophils. We now have evidence that the formation of lipid bodies is not attributable to adverse mechanisms, but is centrally mediated by specific signal transduction pathways. Arachidonic acid and other cis fatty acids by an NSAID-inhibitable process, diglycerides, and PAF by a 5-lipoxygenase dependent pathway are potent stimulators of lipid body induction. Lipid body formation develops rapidly by processes that involve PKC, PLC, and de novo mRNA and protein synthesis. These structures clearly serve as repositoires of arachidonyl-phospholipids and are more than inert depots. Specific enzymes, including cytosolic phospholipase A2, MAP kinases, lipoxygenases and cyclooxygenases, associate with lipid bodies. Lipid bodies appear to be dynamic, organelle-like structures involved in intracellular pathways of lipid mobilization and metabolism. Indeed, increases in lipid body numbers correlated with enhanced production of both lipoxygenase- and cyclooxygenase-derived eicosanoids. We hypothesize that lipid bodies are distinct inducible sites for generating eicosanoids as paracrine mediators with varied activities in inflammation. The capacity of lipid body formation to be specifically and rapidly induced in leukocytes enhances eicosanoid mediator formation, and conversely pharmacologic inhibition of lipid body induction represents a potential novel and specific target for anti-inflammatory therapy.

Unintentionally retained foreign bodies after surgical procedures. Analysis of 4547 cases

Objective: this study aims to explore the experience of Brazilian surgeons on Unintentionally Retained Foreign Bodies (RFB) after surgical procedures. Methods: A questionnaire was sent to surgeons by electronic mail, between March and July 2012. The questions analyzed their experience with foreign bodies (FB), foreign bodies' types, clinical manifestations, diagnoses, risk factors and legal implications. Results: in the 2872 eligible questionnaires, 43% of the surgeons asserted that they had already left FB and 73% had removed FB in one or more occasions, totalizing 4547. Of these foreign bodies, 90% were textiles, 78% were discovered in the first year and 14% remained asymptomatic. Among doctors with less than five years after graduation, 36% had already left a FB. The most frequently surgical procedures mentioned were the elective (57%) and routine (85%) ones. Emergency (26%), lack of counting (25%) and inadequate conditions of work contributed (12.5%) to the occurrence. In 46% of the cases patients were alerted about the FB, and 26% of them sued the doctors or the institution. Conclusions: challenging medical situations, omission of security protocols and inadequate work conditions contributed to RFB. However, RFB occurs mostly in routine procedures such as cesarean or cholecystectomy, and at the beginning of the professional career, highlighting, particularly in poorest countries, the need for primary prevention. Textiles predominated causing clinical repercussions and they were diagnosed in the first postoperative months. Surgeons were sued in 11.3% of the RFB cases.

Breve notícia sôbre a espermatogênese de Lutosa brasiliensis Brunner (Tettigoniodea-Stenopelmatidae)

Lutosa brasiliensis, an Orthopteran Tettigonioidean belonging to the family Stenopelmatidae is referred to in this paper The spermatogonia are provided with 15 chromosomes, that is, 7 pairs of autosomes and a single sex chromosome. One pair of autosomes is much larger than the rest, two pairs are of median sized elements, and four pairs are of small ones. The daughter sex chromosomes show at anaphase great difficulty in reaching the poles, being left for a long while in the region of the equator where they are seen stretched one after the other on the same line or lying side by side in different positions. When the spermatogonium divides each daughter cell gets passively its sex chromosome. Though slowly, the sex chromosome finishes by beins enclosed in the nucleus. Its behavior may be attributed to a very weak kinetic activity of the centromere. In view of se pronouced an inertness of the sex chromosomes, two things may be expected : primary spermatocyte nuclei with two sex chromosomes, and primary spermatocytes with the sex chromosome lying outside the nucleus. Both situations have been discovered. The latter, together with the delay of the spermatogonial sex chromosome in reaching the poles suggested to the anther the mechanism which might have given origin to the cases in which the sex chromosome normally does not enter the nucleus to rejoin the autosomes, remaning outside in its own nucleus. It may well be supposed that accidents like that found in the present individual have turned to be a normal event in the course of the evolution of some species. Trie primary spermatocytes are provided with chromatoid bodies which remain visible all over the whole history of the cells and pass to one of the resulting secondary spermatocytes, the larger of them being found later in the area occupied by the tails of the spermatozoa. No relation of these bodies to nucleoli con?d be established. Pachytene and diplotene nuclei are normal Metaphase nuclei show 7 autosomal tetrads, one of which being much larger than the rest. At this stage the chromosomes have a pronounced tendency to form clumps. Even when they are separated from each other they generally appear competed by chromosomal substance. The sex chromosome Hes always in one of the poles, being enclosed in the nucleus formed there. The stickness of the chromosomes can also be noted at anaphase. Telophase chromosomes distend them- selves for giving origin to secondary spermatocyte nuclei in a state comparable to a beginning prophase. As the secondary spermatocytes approach metaphase the autosomes appear entirely divided except at the kinetochore where the chromatids remain united. In the division of the secondary spermatocytes nothing else merits special reference.

Diagnostic of Biomphalaria snails and Schistosoma mansoni: DNA obtained from traces of shell organic materials

Freshwater snails belonging to the genus Biomphalaria act as intermediate hosts for the parasite trematode Schistosoma mansoni in Africa and in the neotropical region. Identification of such molluscs is carried out based on morphological characters and the presence of cercariae is verified through squeezing snails between two glass slides or by exposing them to artificial light. However, sometimes, the material collected includes molluscs with decomposed bodies or, yet, only empty shells, which precludes their identification and S. mansoni detection. Due to these difficulties, we have developed a methodology in which DNA may be extracted from traces of organic material from inside shells in order to identify molluscs through polymerase chain reaction and restriction fragment length polymorphism and to detect S. mansoni into these snails, by using low stringency polymerase chain reaction. Species-specific profiles obtained from B. glabrata, B. straminea, and B. tenagophila snails and their shells, maintained in laboratory for ten years, showed the same profiles. S. mansoni profiles showed to be present in shell specimens as far as the eighth week after being removed from aquarium.

Histochemical and ultrastructural study of Caesalpinia peltophoroides Benth. (Leguminosae-Caesalpinoideae) seeds

The objective of this work was to correlate data on light microscopy observations through histochemical analysis and polarized light techniques and investigations in transmission electron microscopy (TEM) to characterize the reserve materials in C. peltophoroides Benth. (Leguminosae-Caesalpinoideae) cotyledons, popularly known as "sibipiruna", a tropical tree species with wide distribution in Brazil. The cotyledon mesophyll, especially in the abaxial face, is rich in unsaturated neutral lipids contained in numerous lipid bodies dispersed in the cytoplasm. Proteins, more concentrated in the adaxial face of the cotyledons, occur in all the mesophyll and are stored in protein bodies containing globoids, with variable number and size, responsible for accumulation of mineral reserves. Calcium oxalate druses have distribution restricted to the cotyledons adaxial face and are associated with protein bodies. Starch, also distributed all over the cotyledon mesophyll, occurs in small amounts in plastids with developed lamellar system. Secretory cavities rich in phenolic compounds occur among procambial strands.

Identification of croplands of winter cereals in Rio Grande do Sul state, Brazil, through unsupervised classification of normalized difference vegetation index images

This study aimed to propose methods to identify croplands cultivated with winter cereals in the northern region of Rio Grande do Sul State, Brazil. Thus, temporal profiles of Normalized Difference Vegetation Index (NDVI) from MODIS sensor, from April to December of the 2000 to 2008, were analyzed. Firstly, crop masks were elaborated by subtracting the minimum NDVI image (April to May) from the maximum NDVI image (June to October). Then, an unsupervised classification of NDVI images was carried out (Isodata), considering the crop mask areas. According to the results, crop masks allowed the identification of pixels with greatest green biomass variation. This variation might be associated or not with winter cereals areas established to grain production. The unsupervised classification generated classes in which NDVI temporal profiles were associated with water bodies, pastures, winter cereals for grain production and for soil cover. Temporal NDVI profiles of the class winter cereals for grain production were in agree with crop patterns in the region (developmental stage, management standard and sowing dates). Therefore, unsupervised classification based on crop masks allows distinguishing and monitoring winter cereal crops, which were similar in terms of morphology and phenology.

Culture of mouse peritoneal macrophages with mouse serum induces lipid bodies that associate with the parasitophorous vacuole and decrease their microbicidal capacity against Toxoplasma gondii

Lipid bodies [lipid droplets (LBs)] are lipid-rich organelles involved in lipid metabolism, signalling and inflammation. Recent findings suggest a role for LBs in host response to infection; however, the potential functions of this organelle in Toxoplasma gondii infection and how it alters macrophage microbicidal capacity during infection are not well understood. Here, we investigated the role of host LBs in T. gondii infection in mouse peritoneal macrophages in vitro. Macrophages cultured with mouse serum (MS) had higher numbers of LBs than those cultured in foetal bovine serum and can function as a model to study the role of LBs during intracellular pathogen infection. LBs were found in association with the parasitophorous vacuole, suggesting that T. gondii may benefit from this lipid source. Moreover, increased numbers of macrophage LBs correlated with high prostaglandin E2 (PGE2) production and decreased nitric oxide (NO) synthesis. Accordingly, LB-enriched macrophages cultured with MS were less efficient at controlling T. gondii growth. Treatment of macrophages cultured with MS with indomethacin, an inhibitor of PGE2 production, increased the microbicidal capacity against T. gondii. Collectively, these results suggest that culture with MS caused a decrease in microbicidal activity of macrophages against T. gondii by increasing PGE2 while lowering NO production.

The demands of family caregivers of elderly individuals with dementia

The purpose of this cross-sectional observational study was to identify characteristics of caregivers of elderly people with dementia, types of care demands and to relate demands to the stage of dementia. The study was carried out in 2004 with 104 older adults and 90 caregivers in Ribeirão Preto, state of São Paulo. The OARS instrument was utilized and a questionnaire answered by caregivers. Among older adults, 66.3% were female, aged 75.5 years in average and 86.5% had caregivers. Eighty percent of the caregivers were women family members, aged 52.3 years in average. They spent 15.10 hours/day with care, without help. An important relationship was observed between caregiver's burden, physical and emotional effort and stage of dementia. Emotional overburden was higher at dementia early and late stages, this difference was statistically non-significant. Results reveal the urgent need to plan formal and informal support strategies to caregivers of Brazilian elderly people with dementia.

Insects associated with exposed decomposing bodies in the Colombian Andean Coffee Region

In Colombia, mainly classic forensic medicine methods were used to clarify crimes until 2004. However, other disciplines, including forensic entomology, started to be considered only after the New Accusatory System introduction in Bogotá and the Coffee Region in 2005. In order to provide tools for obtaining evidentiary material elements in judicial trials, it is presented here the succession of insects throughout the decomposition process of an exposed carcass of Sus scrofa Linnaeus 1758 (Suidae) and the Occurrence Matrix of colonizing species. This process was evaluated under ambient conditions in the Andean rural area of the city of Pereira, in the Mundo Nuevo district, located in a pre-montane Wet Forest area, from October to November 2006. A sampling period of 27 days and 3198 individuals were collected. We found these colonizing species in the following stages of decomposition: Lucilia eximia (Wiedemann, 1819) fresh; Hemilucilia semidiaphana (Rondani, 1850), Oxelytrum discicolle (Brullé, 1840), and Cochliomyia macellaria (Fabricius 1775) bloated; Chrysomya albiceps (Wiedemann 1819), Compsomyiops verena (Walker, 1849), Ophyra aenescens (Wiedemann, 1830) and Musca domestica Linnaeus, 1758 active; Fannia sp. advanced and Stearibia nigriceps (Meigen, 1826) remains. This study provides support tools to define the Post Mortem Interval that may be used by experts from government institutions and laboratories officially accredited.

A Brazilian family with hereditary inclusion body myopathy associated with Paget disease of bone and frontotemporal dementia

Inclusion body myopathy associated with Paget disease and frontotemporal dementia (IBMPFD) is a progressive and usually misdiagnosed autosomal dominant disorder. It is clinically characterized by a triad of features: proximal and distal myopathy, early onset Paget disease of bone (PDB), and frontotemporal dementia (FTD). It is caused by missense mutations in the valosin-containing protein (VCP) gene. We describe here the clinical and molecular findings of the first Brazilian family identified with IBMPFD. Progressive myopathy affecting the limb girdles was detected by clinical examination followed by muscle biopsy and creatine kinase measurement. PDB was suggested after anatomopathological bone examination and FTD was diagnosed by clinical, neuropsychological and language evaluations. Brain magnetic resonance revealed severe atrophy of the anterior temporal lobes, including the hippocampi. A R93C mutation in VCP was detected by direct sequencing screening in subject W (age 62) and in his mother. Four more individuals diagnosed with "dementia" were reported in this family. We also present a comprehensive genotype-phenotype correlation analysis of mutations in VCP in 182 patients from 29 families described in the literature and show that while IBM is a conspicuously penetrant symptom, PDB has a lower penetrance when associated with mutations in the AAAD1 domain and FTD has a lower penetrance when associated with mutations in the Junction (L1-D1) domain. Furthermore, the R93C mutation is likely to be associated with the penetrance of all the clinical symptoms of the triad.

Cardiac plexus of dogs experimentally infected with Trypanosoma cruzi: inflammatory lesions and quantitative studies

Qualitative and quantitative aspects of the superficial and profound cardiac plexus of dogs experimentally infected with Be-62 and Be-78 strains of Trypanosoma cruzi were studied. Animals were autopsied in the acute phase of infection. The inflammatory process, lesions and number of parasites were more intense and frequent in animals infected with the Be-78 strain than in those infected with Be-62. Despite this, no statistically significant differences could be found between the number of neuron bodies in the ganglia of infected and control dogs.