SUMMARY -H T L V -I (Human T-lymphotropic virus type I ) associated myelopathy/tropical spastic paraparesis ( H A M / T S P ) is an immunomediated myelopathy induced by the H T L V -I .Some patients, specially those from Japan, seem to have a good response to steroid treatment. However, this has not been found in other regions of the world. High dose intravenous methylprednisolone has been used with success in patients with relapses of multiple sclerosis (MS), another autoimmune disease of the central nervous system. To test the effectiveness of methylprednisolone in patients with H A M / T S P , we devised an open trial in 23 patients. W e found a very limited benefit of this form of treatment in these patients. Only one patient, who had the shortest disease duration (five months) in the whole group, showed a sustained benefit. W e speculate that those patients with a shorter history, with presumably less demyelination and more inflammatory lesions, would show a better response to immunossupressive treatments. K E Y W O R D S : H T L V -I , tropical spastic paraparesis, methylprednisolone. Metilprednisolona endovenosa na mielopatia associada ao HTX.V-1/Paraparesia Espástica Tropical (MAH/PET) RESUMO -A mielopatia associada ao protovírus T-linfotrópico humano ( H T L V -I ) , também conhecida como paraparesia espástica tropical associada ao H T L V -I ( M A H / P E T ) , constituienfermidade imunomediada desencadeada pela infecção pelo H T L V -I . Nesta condição tem sido demonstrada, particularmente em pacientes japoneses, boa resposta clínica à terapêutica com cor ticos teróid es. Este efeito benéfico todavia não foi encontrado em todas as regiões do mundo. Pulsoterapia com metilprednisolona endovenosa tem sido utilizada com sucesso em pacientes com esclerose múltipla, outro exemplo de doença auto-imune do sistema nervoso central, especialmente durante as fases de exacerbação da doença. Objetivando testar a eficácia da pulsoterapia com metilprednisolona em pacientes com M A H / P E T , conduzimos estudo aberto em 23 doentes. Não constatamos efeito benéfico significativo desta forma de tratamento na maioria dos enfermos estudados. Apenas um dos pacientes, o qual exibia o menor tempo de duração de doença (cinco meses), obteve benefício a longo prazo. Acreditamos que tratamentos imunossupressivos devam ser de maior utilidade naqueles doentes com menor tempo de evolução, nos quais, possivelmente, há preponderância do processo inflamatório sobre o desmielinizante. P A L A
We did a non-systematic review of articles on the Google Scholar platform from January 1992 until February 2018.Preference was given to articles in Portuguese or English whose title presented the descriptors "seizures" or "epilepsy" associated with the most commonly used classes of antibiotics: penicillins, cephalosporins, quinolones, carbapenems, metronidazole and isoniazid. From this Abstract Objective: make a review about the risk of seizures related to the use of antibiotics. Method: We perform a non-systematic review using Google Scholar platform approaching the relationship between seizures and the most used antibiotics classes in clinical practice. Results and Discussion: 34 papers in English language were used for this review. Conclusion:Rarely antibiotics may cause seizures, mainly in patients with renal dysfunction, hepatic or previous brain disease. It is important to learn about drugs at greatest risk of seizures in each class of antibiotics. The treatment involves the use of correct medications, primarilygabaergic drugs, avoiding ineffective anticonvulsants.
objective: To identify and discuss the scientific production on Health-Promoting Schools in Latin America published in indexed databases, by understanding the scope of the health education initiatives reported in the programs or interventions. Methods: This was a scientific literature review study, performed in LILACS, MEDLINE and SCOPUS databases, using as the main search term 'Health Promoting School', followed by 'Latin America'. It covered the period from 1996 to 2009, situating the start point ten years after the publication of the Ottawa Charter and one year after the official launch of the Health-Promoting Schools Regional Initiative (Iniciativa Regional de Escolas Promotoras de Saúde -IREPS) by the Pan-American Health Organization (PAHO). Inclusion criteria were defined, articles were retrieved in English, Portuguese and Spanish, and data was processed in three arrays of analysis. Results: The application of search keys led to 2,429 documents, reduced to 28 after applying the filter for Latin America, on which the inclusion criteria were applied, resulting in eight articles. Most of them stressed the importance of effectiveness studies, and half focused on the reduction of some specific morbidity, without prioritization of the conceptual axes contained in the Ottawa Charter. Conclusion: The publications addressed mainly the effectiveness of the interventions, conceptual coherence between the interventions and the health promotion principles, and the education process of the actors involved. Qualitative approaches, including documentary analysis, semi-structured interviews, focal group and participant observation, were the predominant methodological procedures. Intersectoral coordination was pointed out as the main strategy for sustainability of the experiences.
Human T-cell lymphotropic virus type I (HTLV-I) associated myelopathy/tropical spastic paraparesis (HAM/TSP) is the most common chronic myelopathy in Brazil. We present the case of a 53 year old man that fulfilled the diagnostic criteria for HAM/TSP but had at the magnetic resonance imaging (MRI) of the spinal cord evidences of syringohydromyelia at the C6-C7 and D2-D7 levels along with Chiari type I malformation. The clinical picture was more typical of HAM/TSP than of syringohydromyelia, which was probably asymptomatic. The present case clearly demonstrates that serology and neuroimaging should be always used together. We conclude that, specially in places where HTLV-I is endemic, every patient with a spastic paraparesis, even with a radiological picture suggestive of a structural spinal cord lesion, should have a screening test for HTLV-I. The clinical picture must dictate the final direction of the diagnosis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.