Síndrome das pernas inquietas: Diagnóstico e tratamento. Opinião de especialistas Brasileiros

This article contains the conclusions of the November 17-18, 2006 meeting of the Brazilian Study Group of Restless Legs Syndrome (GBE-SPI) about diagnosis and management of restless legs syndrome (RLS). RLS is characterized by abnormal sensations mostly but not exclusively in the legs which worsen in the evening and are improved by motion of the affected body part. Its diagnosis is solely based on clinical findings. Therapeutic agents with efficacy supported by Class I studies are dopamine agonists, levodopa and gabapentine. Class II studies support the use of slow release valproic acid, clonazepan and oxycodone. The GBE-SPI recommendations for management of SPI are sleep hygiene, withdrawal of medications capable of worsening the condition, treatment of comorbidities and pharmacological agents. The first choice agents are dopaminergic drugs, second choice are gabapentine or oxycodone, and the third choice are clonazepan or slow release valproic acid.

Polineuropatia associada a hipotireoidismo em cães: Relato de seis casos

Six Doberman Pinscher, between six and eight years of age, were presented to the Veterinary Hospital from Faculty of Veterinary Science of The University of Buenos Aires. Neurological examination revealed tetraparesis with inability to walk, decreased muscle tonus and myotatic reflexes in all dogs. Serum cholesterol levels, creatine kinase and alkaline phosphatase activities were mildly to markedly elevated, and tibial motor nerve conduction velocities were slow in all dogs. Basal measurements of free T4 and TSH were determined by radioimmunoassay. Although fT4 values were within normal range, in all dogs TSH values were elevated. Based on this results, hypothyroidism was diagnosed and a supplementation therapy was established with oral levothyroxine (T4). Two weeks after treatment has been started, all patients had an improvement in clinical signs, and within a month gait became normal, as well as muscular tonus and spinal reflexes.

Recidiva Neural em hanseníase multibacilar após 6 anos de tratamento

This article presents a case of relapse, with isolated neural manifestation, in a multibacillary patient previously treated with multidrug therapy for multibacillary leprosy (24 doses). The patient returned to the service six years after the end of treatment, with pain in hands and legs. He was investigated, and the serological monitoring showed an important increase in anti-phenolic glycolipid serum levels. A neural recurrence was suspected, since the patient had no new skin lesions. A new biopsy in the right ulnar nerve showed a bacilloscopy of 2 +, compatible with relapse. This is a literature review of the etiological, clinical, propedeutical and diagnostic aspects of this situation so poorly understood. © 2012 by Anais Brasileiros de Dermatologia.

Análise do equilíbrio postural de indivíduos diabéticos por meio de baropodometria

Objective of this study was to analyze the postural balance of neuropathic diabetic individuals through baropodometry, related to losses in the sensorimotor system. Twenty-eight healthy and 25 diagnosed with diabetic neuropathy were subjected to static evaluation (measurement of displacement of body center of pressure) and dynamic (temporal analysis of the stance phase of gait cycle). The tactile sensitivity of the feet was assessed by Semmes Weinstein monofilaments and isometric muscle strength of ankle dynamometry. Analyses of multivariânvia (MANOVAs) and variance (ANOVAs) indicated lower performance in tactile sensitivity, muscle strength and dynamic balance, but showed no difference for static equilibrium of diabetic neuropathy. With this study by regression analysis, one can infer that the equilibrium differences in gait of neuropathic insensitivity may result from tactile and muscle strength. © FTCD/FIP-MOC.

Muscle strength and ankle mobility for the gait parameters in diabetic neuropathies

Aims: To evaluate the spatio-temporal variables of gait and the isometric muscle strength component of the ankle in patients with peripheral diabetic neuropathy. Also, verify the relationship between these variables and gait parameters. Methods: This study involved 25 diabetic peripheral neuropathy (DPN) participants (62.4 ± 8.36 years) and 27 age-matched healthy control individuals (64.48 ± 6.21 years). The assessment of the spatio-temporal parameters of gait was performed using an electronic baropodometry treadmill. Prior to the collection data, each participant was instructed to walk on the treadmill in her/his habitual self-selected speed. Results: Diabetic neuropathy group showed impairment of gait, with a smaller stride and length speed of the cycle, and increased duration of support time. Restricted dorsiflexion mobility and increased plantarflexion mobility were found, with a decrease in muscle strength of the dorsiflexors and plantiflexors. There was a significant relationship between plantiflexor muscle strength and the length and speed of the gait cycle. Also the muscle strengths of the plantiflexors and dorsiflexors, and the range of motion of dorsiflexion were predictors of gait performance. Conclusions: The ankle, muscle strength and ankle mobility variables could explain changes in gait speed and range of motion in patients with DPN, allowing for the application of preventive strategies. © 2012 Elsevier Ltd.

European Ancestry Predominates in Neuromyelitis Optica and Multiple Sclerosis Patients from Brazil

Background: Neuromyelitis optica (NMO) is considered relatively more common in non-Whites, whereas multiple sclerosis (MS) presents a high prevalence rate, particularly in Whites from Western countries populations. However, no study has used ancestry informative markers (AIMs) to estimate the genetic ancestry contribution to NMO patients. Methods: Twelve AIMs were selected based on the large allele frequency differences among European, African, and Amerindian populations, in order to investigate the genetic contribution of each ancestral group in 236 patients with MS and NMO, diagnosed using the McDonald and Wingerchuck criteria, respectively. All 128 MS patients were recruited at the Faculty of Medicine of Ribeirão Preto (MS-RP), Southeastern Brazil, as well as 108 healthy bone marrow donors considered as healthy controls. A total of 108 NMO patients were recruited from five Neurology centers from different Brazilian regions, including Ribeirão Preto (NMO-RP). Principal Findings: European ancestry contribution was higher in MS-RP than in NMO-RP (78.5% vs. 68.7%) patients. In contrast, African ancestry estimates were higher in NMO-RP than in MS-RP (20.5% vs. 12.5%) patients. Moreover, principal component analyses showed that groups of NMO patients from different Brazilian regions were clustered close to the European ancestral population. Conclusions: Our findings demonstrate that European genetic contribution predominates in NMO and MS patients from Brazil. © 2013 Brum et al.

Parâmetros espaço temporais da marcha e inter-relação com equilíbrio e força muscular isométrica de tornozelos em diabéticos com neuropatia periférica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da distribuição da pressão plantar e equilíbrio de diabéticos neuropatas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Controle postural, equilíbrio funcional e estabilidade do ato de locomoção na neuropatia diabética periférica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Parâmetros da marcha, pressões plantares e equilíbrio corporal de diabéticos neuropatas e vasculopatas, com o uso de palmilhas

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Diabetes mellitus tipo 2 e esquema terapêutico: impacto da prática de atividades físicas sobre o custo do tratamento ambulatorial em Unidade Básica de Saúde da cidade de Bauru -SP

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação dos efeitos da crotoxina isolada do veneno de serpente Crotalus durissus terrificus sobre a transecção do nervo ciático de ratos: avaliação histológica da formação do neuroma e capacidade de interferir com a condutividade nervosa (dor)

Pós-graduação em Medicina Veterinária - FMVZ

Avaliação auditiva em pacientes diabéticos do tipo 1 e do tipo 2

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Construção de uma plataforma de força para avaliação da pressão plantar em indivíduos com diabetes mellitus

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)