We aimed to characterize the clinical features associated with REM sleep behaviour disorder (RBD) in early stage Parkinson's disease (PD). Presence of clinical RBD was determined according to ICSD minimal clinical criteria and a validated RBD questionnaire. We registered time of appearance of RBD symptoms in relation to PD onset and the occurrence of RBD symptoms in the past in non-RBD patients. RBD and non-RBD groups were compared in terms of motor and cognitive dysfunction. The same comparisons were made between patients who reported RBD symptoms at some point in time (including those non-RBD patients that reported occurrence of RBD symptoms in the past) and those who did not (RBDS and non-RBDS, respectively). We assessed 75 patients. Forty-one (55%) patients presented with RBD, 19 beginning before PD onset. Five non-RBD patients reported having had RBD symptoms in the past. There were no significant differences between RBD and non-RBD patients. RBDS group presented a significantly higher proportion of non-tremor motor sub-type compared to non-RBDS patients. Our results suggest that RBD is very frequent in the early stages of PD. In some patients, RBD symptoms could have disappeared before or in the first years after motor disturbance onset. Non-tremor motor sub-type was related to RBD symptoms history, rather than to the presence of RBD clinical criteria at time of evaluation, suggesting that the physiopathological changes that cause the association with motor status could remain, in spite of symptom fluctuation.

Psychiatric complaints are common in Parkinson's disease (PD), and have a significant influence in disease outcome and quality of life. Little attention has been paid to psychiatric symptoms at early stage disease. We aimed to screen a population of early stage PD patients for psychiatric symptoms and to study the relation with motor and cognitive function. Thirty-six early stage PD patients underwent motor [Hoehn and Yahr (HY), Unified Parkinson's Disease Rating Scale] and cognitive [Frontal Assessment Battery, Mini-Mental State Examination (MMSE)] assessment as well as general psychiatric [Symptom Check-List 90 (SCL-90-R)] and psychosis [Brief Psychiatric Rating Scale (BPRS)] screening. Relation between psychiatric domains scores was studied with principal component analysis. Relation between psychiatric, disease related, cognitive and motor function was assessed with bivariate correlation (Pearson). SCL-90-R scores were higher for somatization (significant scores in 66.7% of patients), depression (36.1%), anxiety (27%) and obsessive-compulsive symptoms (OCS) (52.8%). Scores were highly correlated, except for psychosis and phobia. Depression and anxiety were negatively correlated to MMSE score and dopaminergic doses, respectively. BPRS scores were higher for somatic concern, depression, anxiety and hallucinations. There was segregation between depression, anxiety, hallucinations, other positive psychotic symptoms and negative psychotic symptoms. Depression was related to MMSE score. We found a high prevalence of psychiatric complaints in PD patients, mostly related to depression, anxiety, somatization and OCS. Hallucinations were also frequent, but not associated to cognitive function or dopaminergic doses, suggesting a different physiopathological background.

Zanthoxylum rhoifolium Lam. (Rutaceae) has been traditionally used in the treatment of microbial infections and parasitic diseases. In the present study, the antileishmanial effect induced by the ethanol extract of stem barks from Z. rhoifolium (ZR-EEtOH) and its n-hexane fraction (ZR-FHEX) on infection and infectivity of murine macrophages by promastigote forms of Leishmania amazonensis were investigated. In different set of experiments, macrophages or promastigotes were pretreated with ZR-EEtOH or ZR-FHEX at non-lethal concentrations for 24 hours, and then macrophages were submitted to infection by promastigotes. Moreover, their effects on activation of macrophages, as well as on the DNA content, size and number of promastigotes by flow cytometry were also evaluated. The infection rate and the number of internalized amastigote forms were markedly decreased after pretreatment of macrophages or promastigotes when compared with nontreated cells. The increase in phagocytic capability and nitrite content was also observed. Furthermore, the decrease of DNA content, size and number of promastigotes was also observed. In conclusion, ZREEtOH and ZR-FHEX promoted a markedly significant antileishmanial effect and reduction of infection of macrophages, probably underlying defense mechanisms activation in macrophages. These findings reinforce the potential application of Z. rhoifolium in the treatment of leishmaniasis.

Psychotic symptoms in Parkinson's disease (PD) are frequent, disabling, and an important prognostic factor. Thus, screening instruments for detecting psychosis in PD are needed. For this purpose, we applied the Parkinson's Psychosis Questionnaire (PPQ), a short structured questionnaire, which requires no specific training, along with the Brief Psychiatric Rating Scale, expanded version (BPRS-E), for rating general psychopathology, including psychotic symptoms. We evaluated, in a cross-sectional study, a Portuguese sample of 36 early-stage PD patients (mean age of 73 years; mean duration of illness of 3.2 years). The PPQ total score correlated with the BPRS-E total score (0.359; P = 0.032) and with the BPRS-E-positive symptoms score (0.469; P = 0.004). The prevalence of psychosis (41.7%) was higher than expected. Sampling bias and detection of minor psychotic phenomena may have contributed to this result. These findings suggest that the PPQ should be further evaluated as a feasible assessment for psychotic symptoms in PD.

Eventually, there are reports of inadequacies in relation to the quality of medicines, and there are still doubts regarding the quality and effectiveness of similar and generic medicines compared to reference medicines. Therefore, this study aimed to investigate in the literature, studies that deal with the quality of similar, generic and reference drugs sold in Brazil. To carry out the present study, a bibliographic survey was carried out in the Medline, Lilacs, Scielo and VHL databases, of articles published in the period from 2015 to 2020, in English and Portuguese that fit the inclusion and exclusion criteria, 10 were selected articles. In all studies, the authors unanimously concluded that most generic and similar drugs sold in Brazil have the same quality profile and can be safely inserted by patients. Therefore, this review demonstrates that generic drugs have the same therapeutic quality and efficacy as reference drugs. However, some authors have shown that similar drugs, despite undergoing quality tests to be released on the market, do not meet the criteria of quality and efficacy when compared to generic or reference drugs.