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RESUMO O DC de Neuroimunologia da ABN e o BCTRIMS trazem, nesse documento, as recomendações sobre vacinação da população com doenças desmielinizantes do sistema nervoso central (SNC) contra infecções em geral e contra o coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2), causador da COVID-19. Destaca-se a gravidade do atual momento frente ao avanço da COVID-19 em nosso País, o que torna mais evidente e importante a criação de guia de referência para orientação aos médicos, pacientes e autoridades de saúde pública quanto à vacinação, meio efetivo e seguro no controle de determinadas doenças infecciosa. O DCNI/ABN e o BCTRIMS recomendam que os pacientes com doenças desmielinizantes do SNC (ex., EM e NMOSD) sejam constantemente monitorados, quanto a atualização do seu calendário vacinal, especialmente, no início ou antes da mudança do tratamento com uma droga modificadora de doença (DMD). É importante também salientar que as vacinas são seguras e os médicos devem estimular o seu uso em todos os pacientes. Evidentemente, deve ser dada especial atenção às vacinas com vírus vivos atenuados. Por fim, é importante que os médicos verifiquem qual DMD o paciente está em uso e quando foi feita a sua última dose, pois cada fármaco pode interagir de forma diferente com a indução da resposta imune.

ABSTRACT The Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) provide recommendations in this document for vaccination of the population with demyelinating diseases of the central nervous system (CNS) against infections in general and against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. We emphasize the seriousness of the current situation in view of the spread of COVID-19 in our country. Therefore, reference guides on vaccination for clinicians, patients, and public health authorities are particularly important to prevent some infectious diseases. The DCNI/ABN and BCTRIMS recommend that patients with CNS demyelinating diseases (e.g., MS and NMOSD) be continually monitored for updates to their vaccination schedule, especially at the beginning or before a change in treatment with a disease modifying drug (DMD). It is also important to note that vaccines are safe, and physicians should encourage their use in all patients. Clearly, special care should be taken when live attenuated viruses are involved. Finally, it is important for physicians to verify which DMD the patient is receiving and when the last dose was taken, as each drug may affect the induction of immune response differently.

https://doi.org/10.1590/0004-282x-anp-2021-0162 1 downloads

Long-term obesity is associated with depression and neuroinflammation
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Lorena, Fernanda B.

; Nascimento, Bruna P. P do

; Camargo, Esther L. R. A.

; Bernardi, Maria M.

; Fukushima, André R.

; Panizza, Julia do N.

; Nogueira, Paula de B.

; Brandão, Marllos E. S.

; Ribeiro, Miriam O.

Archives of Endocrinology and Metabolism

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2021, Volume 65 Nº 5 Páginas 537 - 548

Resumo: En | Texto: En | PDF: En

ABSTRACT Objective: Obesity is characterized by a state of chronic, low-intensity systemic inflammation frequently associated with insulin resistance and dyslipidemia. Materials and methods: Given that chronic inflammation has been implicated in the pathogenesis of mood disorders, we investigated if chronic obesity that was initiated early in life – lasting through adulthood – could be more harmful to memory impairment and mood fluctuations such as depression. Results: Here we show that pre-pubertal male rats (30 days old) treated with a high-fat diet (40%) for 8-months gained ~50% more weight when compared to controls, exhibited depression and anxiety-like behaviors but no memory impairment. The prefrontal cortex of the obese rats exhibited an increase in the expression of genes related to inflammatory response, such as NFKb, MMP9, CCl2, PPARb, and PPARg. There were no alterations in genes known to be related to depression. Conclusion: Long-lasting obesity with onset in prepuberal age led to depression and neuroinflammation but not to memory impairment.

https://doi.org/10.20945/2359-3997000000400 36 downloads

A decade of molecular diagnosis of Mucolipidosis II and III in Brazil: a pooled analysis of 32 patients
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Ludwig, Nataniel F

; Sperb-Ludwig, Fernanda

; Randon, Dévora N

; Bernardi, Pricila

; Giuliani, Liane R

; Moreno, Carolina A

; Cavalcanti, Denise P

; Silva, Luiz CS da

; Schwartz, Ida V D

Journal of Inborn Errors of Metabolism and Screening

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2021, Volume 9 elocation e20200029

Resumo: En | Texto: En | PDF: En

Abstract GlcNAc-1-phosphotransferase is a hexameric complex formed by subunits α, β, and γ, where the first two are encoded by the GNPTAB gene and the third by the GNPTG gene. Pathogenic variants identified in the GNPTAB gene cause the diseases Mucolipidosis II and III alpha/beta, which are severe and characterized by an overflow of lysosomal hydrolases into the extracellular environment, and their absence in lysosomal compartments causes an accumulation of non-degraded macromolecules. Methodology: a retrospective study that included 32 unrelated Brazilian patients with a clinical and genetic diagnosis of Mucolipidosis II/III alpha/beta. The regional frequency of the altered alleles was determined. Results: The patients were from all regions of Brazil. The most prevalent variants were c.3503_3504del, associated with the severe form of the disease, and c.1208T>C, associated with the milder form. Variant c.3503_3504del is the most frequently found in the Midwest, Northeast, and Southeast regions of Brazil. In the South, 42.8% of the alleles present the c.1196C>T variant. Conclusions: From the perspective of all patients diagnosed with Mucolipidosis II/III in Brazil, it is possible to conclude that different regions present allelic frequencies of specific pathogenic variants, which can be explained by the occurrence of a founding effect or high inbreeding rates.

https://doi.org/10.1590/2326-4594-jiems-2020-0029 225 downloads

Laboratory and field assessments of lethal and sublethal toxicities of acetogenin-based bioinsecticides against Zaprionus indianus (Diptera: Drosophilidae)
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Geisler, Fernanda C.S.

; Martins, Liliane N.

; Treptow, Rute C.B.

; Baronio, Cléber A.

; Stupp, Paloma

; Ribeiro, Leandro P.

; Garcia, Flávio R.M.

; Bernardi, Daniel

Chilean journal of agricultural research

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Dez 2019, Volume 79 Nº 4 Páginas 501 - 511

Resumo: En | Texto: En | PDF: En

ABSTRACT Neotropical Annonaceae-derived bioinsecticides have shown promising control of insect pest species. In order to develop an alternative tool for control Zaprionus indianus (Gupta, 1970), an important invasive pest of Brazilian orchards, this study investigated the insecticidal activity of a formulation prepared from ethanolic seed extract of different Annona species (Annona mucosa Jacq., Annona muricata L., and Annona sylvatica A. St.-Hil.) at discriminatory concentration of 2000 mg L-1 in comparison with a limonoid-based bioinsecticide and a synthetic insecticide (spinetoram) as positive controls. In an ingestion and topical application bioassay, the formulation based on A. mucosa caused more than 95% mortality, which was equivalent to the mortality caused by the synthetic insecticide spinetoram. In a free-choice bioassay, A. mucosa (83%), bioinsecticide (88%) and synthetic insecticide (98%) produced a significant reduction in the number of eggs per fruit. In addition, formulations based on A. mucosa, A. sylvatica, A. muricata and bioinsecticide resulted in a 50% reduction in egg viability. In the field, A. mucosa and bioinsecticide negatively influenced the infestation by Z. indianus in figs, producing a significant reduction in the number of larvae per fruit (3.6 and 2.29 larvae per fruit, respectively) in relation to the control treatment (11 larvae per fruit). However, they were significantly inferior to the synthetic insecticide (0.71 larvae per fruit). Thus, A. mucosa, bioinsecticide and spinetoram have the potential to be used in the framework of Z. indianus management.

709 downloads

Latent tuberculosis infection in patients with rheumatic diseases
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Anton, Camila

; Machado, Felipe Dominguez

; Ramirez, Jorge Mario Ahumada

; Bernardi, Rafaela Manzoni

; Palominos, Penélope Esther

; Brenol, Claiton Viegas

; Mello, Fernanda Carvalho de Queiroz

; Silva, Denise Rossato

Jornal Brasileiro de Pneumologia

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2019, Volume 45 Nº 2 elocation e20190023

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO A maioria das pessoas infectadas por Mycobacterium tuberculosis (Mtb) não possui sinais ou sintomas da doença, quadro conhecido como infecção latente por tuberculose (ILTB). A introdução de agentes biológicos, sobretudo inibidores do fator de necrose tumoral (iTNF), para o tratamento de doenças imunomediadas, como artrite reumatoide (AR) e outras doenças reumatológicas, aumentou o risco de reativação de ILTB, levando ao desenvolvimento de tuberculose (TB) ativa. Assim, esta revisão abordará os aspectos relacionados à ILTB em pacientes com doenças reumatológicas, especialmente naqueles em uso de medicamentos iTNF. Para tanto, serão considerados a definição e a prevalência de ILTB, os mecanismos associados às doenças e às medicações em uso, bem como os critérios para rastreamento, diagnóstico e tratamento da ILTB. Como a reativação da ILTB é responsável pela grande proporção de casos de TB ativa, o diagnóstico e o tratamento adequados são cruciais, principalmente em grupos de alto risco, como os pacientes com doenças reumatológicas.

ABSTRACT Most people infected by Mycobacterium tuberculosis (Mtb) do not have any signs or disease symptoms, a condition known as latent tuberculosis infection (LTBI). The introduction of biological agents, mainly tumor necrosis factor (TNF) inhibitors, for the treatment of immune-mediated diseases such as Rheumatoid Arthritis (RA) and other rheumatic diseases, increased the risk of reactivation of LTBI, leading to development of active TB. Thus, this review will approach the aspects related to LTBI in patients with rheumatologic diseases, especially those using iTNF drugs. For this purpose it will be considered the definition and prevalence of LTBI, mechanisms associated with diseases and medications in use, criteria for screening, diagnosis and treatment. Considering that reactivation of LTBI accounts for a large proportion of the incidence of active TB, adequate diagnosis and treatment are crucial, especially in high-risk groups such as patients with rheumatologic diseases.

https://doi.org/10.1590/1806-3713/e20190023 3912 downloads

Effects of Diabetes and Hypertension on Oral Mucosa and TGFβ1 Salivary Levels
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Bernardi, Lisiane

; Souza, Bárbara Capitanio de

; Sonda, Nicole Canalli

; Visioli, Fernanda

; Rados, Pantelis Varvaki

; Lamers, Marcelo Lazzaron

Brazilian Dental Journal

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Mai 2018, Volume 29 Nº 3 Páginas 309 - 315

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo O objetivo deste estudo foi investigar os níveis de TGFβ1 na saliva e a proliferação/maturação das células epiteliais da mucosa em paciente diabéticos e hipertensos. Neste estudo transversal, saliva estimulada e amostras de citologia exfoliativa de mucosa oral foram coletadas de um total de 39 pacientes que se apresentavam saudáveis (controle, n=10) ou com história de hipertensão arterial (HAS, n=9), diabetes mellitus (DM, n=10) ou ambos (DM+HAS, n=10). Taxa de fluxo salivar (SFR), níveis de TGFβ1 na saliva, AgNORs e maturação epitelial foram avaliados. Teste não-paramétrico de Kruskal-Wallis, seguido de comparação múltipla de Dunn e correlação de Spearman foram utilizados para as análises. SFR diminuiu significantemente em DM e DM+HAS (0,47±0,11 e 0,64±0,43 mL/min) quando comparado ao controle (1,4±0,38 mL/min). DM+HAS apresentou os maiores valores de concentração de TGFβ1 (24,72±5,89 pg/mL). Foi observada uma correlação positiva entre TGFβ1 e glicemia (R=0,6371; p<0,001) e uma correlação negativa entre TGFβ1 e saliva (R=-0,6162; p<0,001) e glicemia e SFR (R=-0,5654; p=0,001). Número de AgNORs e o padrão da maturação das células epiteliais foram similares entre os todos grupos. DM e DM+HAS apresentaram os menores valores de SFR, os quais foram correlacionados com o aumento nos níveis de TGFβ1. Apesar da maior secreção de TGFβ1, não foram observadas mudanças na morfologia ou proliferação das células epiteliais quando o paciente apresentava diabetes ou hipertensão.

Abstract The aim of this study was to investigate salivary levels of TGFβ1 and proliferation/ maturation of epithelial mucosa cells in diabetic and hypertensive patients. Design: in this cross-sectional study, whole stimulated saliva and oral mucosa exfoliative cytology specimens were collected from 39 patients that were healthy (control, n=10) or presented history of arterial hypertension (HAS, n=9), diabetes mellitus (DM, n=10) or both (DM+HAS, n=10). Salivary flow rate (SFR), TGFβ1 level in saliva, AgNORs and the epithelial maturation were evaluated. Non-parametric Kruskal-Wallis test, followed by Dunn’s multiple comparison post-test and the Spearman test correlation analysis were used. SFR showed a significant decreased in DM and DM+HAS (0.47±0.11 and 0.64±0.43 mL/min) when compared to control (1.4±0.38 mL/min). DM+HAS presented the highest value of TGFβ1 concentration (24.72±5.89 pg/mL). It was observed a positive correlation between TGFβ1 and glycaemia (R=0.6371; p<0.001) and a negative correlation between TGFβ1 and saliva (R=-0.6162; p<0.001) and glycaemia and SFR (R=-0.5654; P=0.001). AgNORs number and status of maturation of mucosa cells were similar for all conditions. DM and DM+HAS presented the lowest SFR, which correlated with increased TGFβ1 levels. Despite the higher TGFβ1 secretion it was not observed changes in the morphology or proliferation of epithelial cells when diabetes or hypertension was present.

https://doi.org/10.1590/0103-644020181868 2032 downloads

Diagnosis and Management of Classica Homocystinuria in Brazil: A Summary of 72 Late-Diagnosed Patients
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Poloni, Soraia

; Hoss, Giovana W.

; Sperb-Ludwig, Fernanda

; Borsatto, Taciane

; Doriqui, Maria Juliana R.

; Leão, Emília K.E.A

; Boa-Sorte, Ney

; Lourenço, Charles M.

; Kim, Chong A.

; Souza, Carolina F. M. de

; Rocha, Helio

; Ribeiro, Marcia

; Steiner, Carlos E.

; Moreno, Carolina A.

; Bernardi, Pricila

; Valadares, Eugenia

; Artigalas, Osvaldo

; Carvalho, Gerson

; Wanderley, Hector Y. C.

; D’Almeida, Vânia

; Santana-da-Silva, Luiz C.

; Blom, Henk J.

; Schwartz, Ida V. D.

Journal of Inborn Errors of Metabolism and Screening

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2018, Volume 6 elocation e180007

Resumo: En | Texto: En | PDF: En

Abstract This study described a broad clinical characterization of classical homocystinuria (HCU) in Brazil. This was a cross-sectional, observational study including clinical and biochemical data from 72 patients (60 families) from Brazil (South, n = 13; Southeast, n = 37; Northeast, n = 8; North, n = 1; and Midwest, n = 1). Parental consanguinity was reported in 42% of families. Ocular manifestations were the earliest detected symptom (53% of cases), the main reason for diagnostic suspicion (63% of cases), and the most prevalent manifestation at diagnosis (67% of cases). Pyridoxine responsiveness was observed in 14% of patients. Only 22% of nonresponsive patients on treatment had total homocysteine levels <100 mmol/L. Most commonly used treatment strategies were pyridoxine (93% of patients), folic acid (90%), betaine (74%), vitamin B12 (27%), and low-methionine diet + metabolic formula (17%). Most patients diagnosed with HCU in Brazil are late diagnosed, express a severe phenotype, and poor metabolic control. Milder forms of HCU are likely underrepresented due to underdiagnosis.

https://doi.org/10.1177/2326409818788900 1352 downloads

Production of hydrolysate from processed Nile tilapia (Oreochromis niloticus) residues and assessment of its antioxidant activity
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BERNARDI, Daniela Miotto

; PARIS, Leandro Daniel de

; DIETERICH, Fabiana

; SILVA, Fernanda Guimarães Dummond e

; BOSCOLO, Wilson Rogério

; SARY, Cezar

; SIGNOR, Altevir

; BERTOL, Teresinha Marisa

; SGARBIERI, Valdemiro Carlos

Food Science and Technology

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Dez 2016, Volume 36 Nº 4 Páginas 709 - 716

Resumo: En | Texto: En | PDF: En

Abstract The objective of this work was to produce protein hydrolysates from by-products of the Nile tilapia fileting process, and to assess the effects of different hydrolysis times on the antioxidant activity of the hydrolysed animal-based protein, in free form and incorporated into a food matrix. Gutted tilapia heads and carcasses were hydrolysed by Alcalase® for different hydrolysis times producing six hydrolysates. The protein content, degree of hydrolysis, reverse-phase high-performance liquid chromatography, and antioxidant activity by the ORAC, FRAP and TEAC methods were analysed. Three mini-hamburger formulations were produced and the lipidic oxidation of mini-hamburger was determined by TBARS. The protein contained in the residue was completely recovered in the process. The hydrolysates varied in their degree of hydrolysis, but presented similar levels of antioxidant activity. In the mini-hamburgers the hydrolysate was capable of delaying oxidation after 7 days of storage. Hydrolysis of tilapia processing by-products produced peptides may be used in the formulation of functional foods.

https://doi.org/10.1590/1678-457x.15216 1647 downloads

Evaluation of QuEChERS Sample Preparation and Gas Chromatography Coupled to Mass Spectrometry for the Determination of Pesticide Residues in Grapes
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Volpatto, Fernanda

; Wastowski, Arci D.

; Bernardi, Gabrieli

; Prestes, Osmar D.

; Zanella, Renato

; Adaime, Martha B.

Journal of the Brazilian Chemical Society

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Set 2016, Volume 27 Nº 9 Páginas 1533 - 1540

Resumo: En | Texto: En | PDF: En

An effective analytical method for pesticides multiresidue determination in grape samples was developed and validated. A modified quick, easy, cheap, effective, robust and safe (QuEChERS) method was used to extract the target compounds. Several sorbent materials were tested for the clean-up step using dispersive solid phase extraction (d-SPE) and Florisil® was selected. Samples extracts were evaporated before injection in the gas chromatography with mass spectrometry (GC-MS) system in order to improve detectability. Recoveries from blank samples spiked at 0.04, 0.3 and 1.0 mg kg−1 ranged from 95 to 102% with relative standard deviation (RSD) from 1.3 to 19.7%. Method limits of detection (LODm) and quantification (LOQm) ranged from 0.006 to 0.012 and 0.02 to 0.04 mg kg−1, respectively. The positive matrix effect caused an increase in the peak areas of all compounds and matrix matched calibration curve linearity (coefficient of determination, r2) was higher than 0.98 for all target analytes. The validated method was successfully applied for the determination of 19 pesticides in grape samples.

https://doi.org/10.5935/0103-5053.20160032 2390 downloads

10.

Effect of Resveratrol on periodontal pathogens during experimental periodontitis in rats
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CIRANO, Fabiano Ribeiro

; CASARIN, Renato Correa Viana

; RIBEIRO, Fernanda Vieira

; CASATI, Marcio Zaffalon

; PIMENTEL, Suzana Peres

; TAIETE, Tiago

; BERNARDI, Maria Martha

Brazilian Oral Research

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2016, Volume 30 Nº 1 elocation e128

Resumo: En | Texto: En | PDF: En

Abstract The objective of this study was to investigate the antibacterial effect of resveratrol against putative periodontal pathogens during the progression of experimental periodontitis in rats. Periodontitis was induced in rats in one of the first molars chosen to receive a ligature. Animals were assigned to one of two groups: daily administration of the placebo solution (control group, n = 12) or 10 mg/Kg of resveratrol (RESV group, n = 12). The therapies were administered systemically for 30 days, for 19 days before periodontitis induction and then for another 11 days. Then, the presence and concentrations of Porphyromonas gingivalis, Tannerella forsythia and Aggregatibacter actinomycetemcomitans in the cotton ligatures collected from the first molars were evaluated using real-time PCR. Inter-group comparisons of the microbiological outcomes revealed that no differences were detected for P. gingivalis, T. forsythia and A. actinomycetemcomitans levels (p > 0.05). Continuous use of resveratrol did not promote additional benefits in microbiological outcomes during experimental periodontitis in rats.

https://doi.org/10.1590/1807-3107bor-2016.vol30.0128 2349 downloads

11.

Prevalência e fatores de risco para a leptospirose e brucelose na população canina da Estância Turística de Ibiúna, São Paulo, Brasil
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Mascolli, Roberta

; Soto, Francisco Rafael Martins

; Bernardi, Fernanda

; Ito, Fumio Honma

; Pinheiro, Sônia Regina

; Guilloux, Aline Gil Alves

; Azevedo, Sérgio Santos de

; Fernandes, Annielle Regina da Fonseca

; Keid, Lara Borges

; Morais, Zenaide Maria de

; Souza, Gisele de Oliveira

; Vasconcellos, Silvio Arruda

Arquivos do Instituto Biológico

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2016, Volume 83 elocation 0842014

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO: O objetivo do trabalho foi determinar a prevalência de leptospirose e brucelose por Brucella canis e determinar os fatores de risco associados com a positividade em cães da Estância Turística de Ibiúna, estado de São Paulo, Brasil. Foram examinados 570 animais distribuídos em 4 regiões nos 48 bairros do município, no período de setembro de 2007 a março de 2008. O diagnóstico sorológico da leptospirose foi efetuado com o teste de soroaglutinação microscópica (SAM), e para o diagnóstico de brucelose foi realizado hemocultivo. Dos 570 animais examinados, 187 (32,8%; IC95% 28,9 - 36,8) foram soropositivos para leptospirose, com predomínio de reações para os sorovares Pyrogenes, Autumnalis e Canicola, e 6 (1,05%; IC95% 0,4 - 2,2) foram positivos para brucelose. A variável atividade sexual (OR = 1,73) foi identificada como fator de risco associado à positividade para leptospirose, e o manejo do tipo solto foi considerado fator de risco tanto para leptospirose (OR = 1,96) quanto para brucelose (OR = 10,85). Conclui-se que a leptospirose e a brucelose estão presentes em cães da Estância Turística de Ibiúna, São Paulo, e que a atividade sexual e o acesso irrestrito à rua são condições associadas com a prevalência das infecções.

ABSTRACT: The aim of this survey was to determine the prevalence of leptospirosis and brucellosis due to Brucella canis and to determine the risk factors associated with positivity in dogs of the Tourist Resort of Ibiúna, State of São Paulo, Brazil. A total of 570 blood samples were collected from dogs from 4 regions of 48 districts of the county of Ibiúna during the period of September 2007 to March 2008. Serological diagnosis of leptospirosis was performed with the microscopic agglutination test (MAT), and blood culture was used for the diagnosis of brucellosis. Of the 570 dogs used 187 (32.8%; 95%CI 28.9 - 36.8) were seropositive to leptospirosis, with predominance of reactions to serovars Pyrogenes, Autumnalis and Canicola, and 6 (1.05%; 95%CI 0.4 - 2.2) were positive to brucellosis. Variable sexual activity (OR = 1.73) was identified as risk factor associated with the positivity to leptospirosis, and free access to street was considered risk factor for both leptospirosis (OR = 1.96) and brucellosis (OR = 10.85). It is concluded that leptospirosis and brucellosis are present in dogs of the Tourist Resort of Ibiúna, State of São Paulo, and sexual activity and free access to street are conditions associated with the prevalence of infections.

https://doi.org/10.1590/1808-1657000842014 3735 downloads

12.

Why this is not multiple sclerosis: a case based approach
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Nicolau, Zaira Fernanda Martinho

; Oliveira, Enedina Maria Lobato de

; Bichuetti, Denis Bernardi

Arquivos de Neuro-Psiquiatria

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Dez 2015, Volume 73 Nº 12 Páginas 985 - 992

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Objetivo Apresentar uma série de casos de pacientes previamente diagnosticados como esclerose múltipla (EM) que tiveram um diagnóstico final alternativo, e descrever os sinais clínicos e paraclínicos que levaram à esta mudança. Método Nove pacientes encaminhados para confirmação diagnóstica de EM. Revisamos os prontuários, imagens de ressonância magnética (MRI) e líquido cefalorraquidiano. Resultados Houve uma média de três sintomas típicos de EM e quatro sinais de alerta por paciente. Sinais de alerta de ressonância magnética foram encontrados em 88,9% dos casos, com média de 3 por paciente. Conclusão Identificou-se que, não só os pacientes com diagnóstico incorreto não cumprem critérios de diagnóstico, mas também como os sinais de alerta já descritos são uma ferramenta útil na diferenciação de EM de outras doenças. Esta informação é importante para orientar a assertividade diagnóstica, especialmente para os clínicos e neurologistas gerais, com interferencia direta no tratamento, prognóstico e qualidade de vida do paciente.

Objective To present a case series of patients previously diagnosed as multiple sclerosis (MS) which were later confirmed as an alternative diagnosis, and describe the clinical and paraclinical signs that led to this change. Method Nine patients are described. We reviewed the patient’s clinical chart, magnetic resonance images (MRI) and cerebrospinal fluid. Results There was a mean of three typical symptoms of MS and four clinical red flags per patient. MRI red flags were found in 88,9% of all referrals, with a mean of 3 encountered per patient. Conclusion We identified that, not only the misdiagnosed patients did not fulfill MS diagnosis criteria, but also how the described red flags are a useful tool in the differentiation of MS from other diseases. This data is important for guiding future diagnosis, especially for general clinicians and neurologists, which directly interfere with the patient’s management, treatment, prognosis and quality of life.

https://doi.org/10.1590/0004-282X20150163 5931 downloads

13.

Demineralization and Hydrogen Peroxide Penetration in Teeth with Incipient Lesions
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Briso, André Luiz Fraga

; Gonçalves, Rafael Simões

; Costa, Fernanda Bernardi da

; Gallinari, Marjorie de Oliveira

; Cintra, Luciano Tavares Angelo

; Santos, Paulo Henrique dos

Brazilian Dental Journal

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Abr 2015, Volume 26 Nº 2 Páginas 135 - 140

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

O objetivo deste estudo foi avaliar a desmineralização e a penetração do peróxido de hidrogênio (HP) em dentes com lesões incipientes submetidos ao tratamento clareador. Para analisar a penetração do peróxido de hidrogênio, discos de esmalte/dentina hígidos e desmineralizados foram posicionados em câmaras pulpares artificiais contendo solução tampão de acetato. Após o tratamento clareador, esta solução foi submetida à análise da densidade óptica no espectrofotômetro e as superfícies dos discos foram analisadas por meio de microscopia eletrônica de varredura (MEV) e microscopia de luz polarizada (MLP). Os discos restantes foram submetidos à análise de microdureza transversal em diferentes profundidades. Os dados foram submetidos aos testes ANOVA e teste PLSD Fisher (= 5%). Observou-se que os dentes previamente desmineralizados mostraram maior penetração de HP (p<0,05). O tratamento clareador causou alterações em uma profundidade de 20 μm em esmalte hígido e até 90 μm em esmalte desmineralizado. As imagens obtidas em PLM e MEV mostraram que o tratamento clareador promove alterações superficiais no esmalte, sendo mais pronunciadas em dentes previamente desmineralizados. Foi concluído que o nível de mineralização do esmalte influencia a penetração do PH e que o agente clareador contribuiu para o aumento da profundidade de desmineralização.

The aim of this study was to evaluate the demineralization and hydrogen peroxide (HP) penetration in teeth with incipient lesions submitted to bleaching treatment. For analysis of HP penetration, sound and demineralized enamel/dentin discs were placed in artificial pulp chambers containing acetate buffer solution. After bleaching treatment, this solution was subjected for analysis of optical density by spectrophotometry and the disc surfaces were analyzed with scanning electron microscopy (SEM) and polarized light microscopy (PLM). The remaining discs were subjected for cross-sectional hardness analysis at different depths. Data were analyzed by repeated measures ANOVA and PLSD Fisher test (a=0.05). It was observed that previously demineralized teeth showed greater HP penetration (p<0.05). The bleaching treatment caused changes to a depth of 20 µm in sound enamel and up to 90 µm in demineralized enamel. SEM and PLM images revealed that the bleaching treatment caused superficial changes that were considerably more accentuated in previously demineralized teeth. It may be concluded that the enamel mineralization level influences HP penetration and the bleaching agent contributed to increase the demineralization depth.

https://doi.org/10.1590/0103-6440201300225 4697 downloads

14.

The profile of patients followed at the Neuroimmunology Clinic at UNIFESP: 20 years analysis
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Bichuetti, Denis Bernardi

; Falcão, Alessandra Billi

; Boulos, Fernanda de Castro

; Morais, Marilia Mamprim de

; Lotti, Claudia Beatriz de Campos

; Fragomeni, Manuela de Oliveira

; Campos, Maria Fernanda

; Souza, Nilton Amorim de

; Oliveira, Enedina Maria Lobato

Arquivos de Neuro-Psiquiatria

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Abr 2015, Volume 73 Nº 4 Páginas 304 - 308

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Objetivo Descrever a casuística de pacientes atendidos no setor de Neuroimunologia da Universidade Federal de São Paulo (UNIFESP) de 1994 a 2013. Método Analisamos o diagnóstico final de todos os pacientes atendidos de 1999 a 2013, sendo o diagnóstico revisado na última consulta e estabelecido de acordo com os critérios específicos para cada doença. O volume de atendimentos clínicos e não clínicos (relatórios e receitas) foram contabilizados para avaliar a carga de trabalho da equipe. Resultados 1.599 pacientes foram avaliados: 816 com esclerose múltipla (EM), 172 com síndromes clínicas isoladas, 178 com neuromielite óptica (NMO), 216 com outras doenças desmielinizantes, 20 com doenças metabólicas, 42 com doenças vasculares e 155 com outros diagnósticos ou diagnósticos indefinidos. Identificamos uma média de 219 consultas e 65 solicitações de relatórios por mês. Conclusão Identificamos que 15% dos pacientes atendidos tem NMO. Por ser uma doença mais incapacitante que a EM estes dados podem ser importantes para o planejamento de políticas de saúde locais.

Objective To describe the clinical activities at the Neuroimmunology Clinic of the Universidade Federal de São Paulo (UNIFESP) from 1994 to 2013. Method The final diagnosis of all patients that attended the center was reviewed and established upon specific guidelines for each disease. The number of total appointments and extra clinical activities (reports and prescriptions) were also analyzed, as are part of routine activities. Results 1,599 patients attended the Clinic from 1994 to 2013: 816 with multiple sclerosis (MS), 172 with clinical isolated syndromes, 178 with neuromyelitis optica (NMO), 216 with other demyelinating disease, 20 with metabolic disorder, 42 with a vascular disease and 155 with other or undetermined diagnosis. A mean 219 outpatient visits and 65 extra clinical activities were performed monthly. Conclusion We identified that 15% of patients seen have NMO. As patients with NMO have a more severe disease than MS, this data may be important for planning local health care policies.

https://doi.org/10.1590/0004-282X20150004 2595 downloads

15.

ECAE processed NiTi shape memory alloy
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Lucas, Fernanda Lídia Carvalho

; Guido, Vanessa

; Käfer, Karine Andrea

; Bernardi, Heide Heloise

; Otubo, Jorge

Materials Research

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Ago 2014, Volume 17 Páginas 186 - 190

Resumo: En | Texto: En | PDF: En

The current work evaluated the microstructures and martensitic transformation temperatures of NiTi shape memory alloy (SMA) deformed by equal channel angular extrusion (ECAE). The Ti-55.27wt.%Ni alloy was processed by 1 ECAE pass at 250 °C using a die with an intersection angle of 120°. After processing, samples were annealed at 300 °C, 400 °C and 500 °C for 1h to evaluate the microstructural changes. Microstructural characterization was performed by scanning electron microscopy (SEM) equipped with an energy dispersive spectrometer (EDS) device, and Vickers hardness measurement. Martensitic transformations temperatures were analyzed by differential scanning calorimetry (DSC). Results show that the annealing treatments presented no significant change in the microstructure of the ECAE processed samples. Meanwhile, the DSC curves corresponding to the annealing treatments performed at 300 °C and 400 °C show two step martensitic transformation related to B2→R→B19'. For the annealing at 500 °C, the martensitic transformation temperatures returned to the ST condition, indicating a reduction of the processing defects.

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