The ketogenic diet (KD) is a nonpharmacologic treatment that has been used for refractory epilepsy since 1921. The KD is a high-fat, low-carbohydrate, and restricted protein diet, which is calculated and weighed for each individual patient. Introducing and maintaining the diet for a long time remains a challenge. In this study, we evaluated the acceptability, tolerance, and efficacy of a formula-based KD in 10 children with refractory epilepsy. The ketogenic formula tested herein caused only mild KD-related adverse events and adequate adherence. Moreover, 60% of patients had more than 50% seizure frequency reduction and 10% were seizure-free.Keywords: ketogenic diet; epilepsy; diet therapy RESUMO A dieta cetogênica (DC) é um tratamento não farmacológico utilizado para epilepsia refratária desde 1921. A DC possui um alto teor de gordura, sendo restrita em carboidratos e adequada em proteínas, calculada e pesada para cada paciente. A introdução e manutenção da DC por um tempo prolongado permanece um desafio. Neste estudo foi avaliada a aceitação, tolerância e eficácia da DC baseada em fórmula em 10 crianças com epilepsia refratária. A DC apresentou adequada aderência e efeitos adversos leves. Além disso, 60% dos pacientes apresentaram mais de 50 % de redução frequência das crises e 10% ficaram livres de crises.
This study describes toxoplasmosis in a by caught Guiana dolphin (Sotalia guinensis) from Paranaguá Bay, Paraná, Brazil. Interstitial pneumonia, multisystemic arteritis, multifocal adrenalitis and hepatitis were the primary lesions observed. These tissues had moderate to severe necrosis and mononuclear cells infiltration usually surrounded by tachyzoites and tissue cysts. Moderate lymphoid depletion was evident in the spleen. Toxoplasma gondii was positive by immunohistochemical and ultrastructural evaluation. Furthermore, the animal was negative for Morbillivirus by immunohistochemistry and had low levels of persistent organochlorines. There is evidence of environmental changes in the Paranaguá Bay that could justify the occurrence of toxoplasmosis in Guiana dolphin. The sewage run-off from main urban areas and the presence of domestic and wild felids in areas surrounding the bay could be a source of T. gondii oocysts from land to sea. Based on its habitat, the authors recommend this dolphin species as sentinels for the health of bays and estuaries where they occur.
The current observations provide morphological evidence that the exocytosis-phagocytosis mechanisms of mast cell granules represents one pathophysiological example of mast cells-dermal dendrocytes interactions in urticaria.
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