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Background and Purpose: Stroke is a leading cause of death in Brazil. Knowledge about the clinical manifestations of stroke as well as its risk factors and its management is still poor in the country. We intended to assess the stroke knowledge of an urban population in Belo Ho­rizonte, Brazil. Methods: Individuals assisted by a basic health unit were interviewed between February and August 2014. After demographic data collection, the participants were asked to watch a video that consisted of a person presenting stroke signals and they were asked to answer questions about the condition shown on the video. Afterwards, they answered a semi-structured questionnaire to evaluate their stroke knowledge. Results: A total of 703 people were interviewed (62.1% female, mean age 46.7 years). Recognition of a person having a stroke on the presented video was achieved by 56.1% of the subjects. Female sex (p = 0.029) and contact with someone who had had a stroke (family member [p < 0.01], neighbor [p < 0.05]) increased the odds of correctly identifying the condition showed on the video. The most commonly mentioned clinical manifestations of stroke were weakness (34.7%) and speech disturbance (31.6%). Stroke risk factors that were most named were “unbalanced diet” (42.3%) and hypertension (33.7%). Most participants (66.8%) said they would call the emergency medical services, while 17.8% would go directly to a hospital. Only 17 subjects knew thrombolytic therapy for acute stroke. Conclusion: Female sex and a family history of stroke increased the odds of recognizing the signs of stroke. Knowledge about the clinical manifestations, risk factors, and management of stroke was low in the studied population.

Background: The Alberta Stroke Program Early CT Score (ASPECTS) scale was developed for monitoring early ischemic changes on CT, being associated with clinical outcomes. The ASPECTS can also associate with peripheral biomarkers that reflect the pathophysiological response of the brain to the ischemic stroke. Objective: To investigate the association between peripheral biomarkers with the Alberta Stroke Program Early CT Score (ASPECTS) in individuals after ischemic stroke. Methods: Patients over 18 years old with acute ischemic stroke were enrolled in this study. No patient was eligible for thrombolysis. The patients were submitted to non-contrast CT in the first 24 hours of admission, being the Alberta Stroke Program Early CT Score and clinical and molecular evaluations applied on the same day. The National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale and the Mini-Mental State Examination for clinical evaluation were also applied to all subjects. Plasma levels of BDNF, VCAM-1, VEGF, IL-1β, sTNFRs and adiponectin were determined by ELISA. Results: Worse neurological impairment (NIHSS), cognitive (MEEM) and functional (Rankin) performance was observed in the group with changes in the NCTT. Patients with NCTT changes also exhibited higher levels of IL-1β and adiponectin. In the linear multivariate regression, an adjusted R coefficient of 0.515 was found, indicating adiponectin and NIHSS as independent predictors of ASPECTS. Conclusion: Plasma levels of adiponectin are associated with the ASPECTS scores.

, a healthy 35-year-old Brazilian man with a medical history of dengue fever 18 months prior (confirmed by serology at the time) developed fever, a sore throat, myalgia, and arthralgia. Four days later, he was hospitalized with urinary retention, proximal paraparesis (Medical Research Council [MRC] grade 4), and paresthesias in lower limbs and face. On the first day of hospitalization, sagittal short T1 inversion recovery (STIR) spine MRI showed hyperintense, nonenhancing lesions between T1-T4 and T6-T9 compatible with an acute myelitis (figure, A). Brain MRI was normal. Lumbar puncture revealed 1/mm 3 cells, 56 mg/dL protein, 60 mg/dL glucose, and presence of oligoclonal bands. Immunoglobulin G (IgG) index was 0.55. Zika virus (ZIKV) PCR was positive in CSF, blood, urine, and saliva. PCR in the CSF for other viruses, including herpes, dengue (DENV), chikungunya, yellow fever, West Nile, and Saint Louis encephalitis, were all negative. Blood aquaporin-4 IgG (AQP4-IgG) was negative. Rheumatologic disease and other infections, including syphilis, hepatitis, HIV, cytomegalovirus, Epstein-Barr virus, and tuberculosis, were all negative in serologic testing. Methylprednisolone (1 g/d IV for 5 days) was started on the second day of hospitalization. One day later, the patient deteriorated, with increased weakness of the legs (MRC 1), bilateral Babinski sign and ankle clonus, a T2 sensory level, oscillatory vertigo with central pattern nystagmus, constipation, vomiting, somnolence, and discrete hearing loss. Brain MRI 7 days after admission revealed hyperintensity in the pons, superior and middle left cerebellar peduncle, and periependymal lesions on T2-weighted fluid-attenuated inversion recovery (FLAIR) sequences (figure, B). At this time, the patient met the criteria 1 for NMOSD with negative AQP4-IgG based on the presence of acute brainstem syndrome with periependymal lesion and acute myelitis with a compatible MRI (intramedullary lesion extending over 3 segments). After corticosteroid therapy, he received IV immunoglobulin for 5 days (2 g/ kg total dose) and was discharged with minor sensory impairment and partial recovery of bladder and bowel control, and was able to walk using a walker. The day after discharge, however, the patient returned with visual impairment, dyschromatopsia, afferent pupillary defect, and pain in the right eye (day 27). Another brain MRI showed hyperintense T2 signs of the right optic nerve and an extensive T1 gadolinium-enhancing lesion compromising at least 50% of the nerve length, compatible with optic neuritis (figure, C). Another methylprednisolone course was administered, and his visual acuity improved. Maintenance treatment with oral prednisone (60 mg/d) was started. After remaining stable for 1 month, the patient developed tactile and temperature allodynia of both arms (day 63). Sagittal STIR spinal MRI showed hyperintensities at C3 to C6 segments (figure, D). AQP4-IgG and ZIKV PCR in blood were negative. Anti-MOG was not available for testing. He received a third course of methylpre...

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Purpose To investigate potential associations among executive, physical and food functions in the acute phase after stroke. Methods This is a cross-sectional study that evaluated 63 patients admitted to the stroke unit of a public hospital. The exclusion criteria were other neurological and/or psychiatric diagnoses. The tools for evaluation were: Mini-Mental State Examination and Frontal Assessment Battery for cognitive functions; Alberta Stroke Program Early CT Score for quantification of brain injury; National Institutes of Health Stroke Scale for neurological impairment; Modified Rankin Scale for functionality, and the Functional Oral Intake Scale for food function. Results The sample comprised 34 men (54%) and 29 women with a mean age of 63.6 years. The Frontal Assessment Battery was significantly associated with the other scales. In multivariate analysis, executive function was independently associated with the Functional Oral Intake Scale. Conclusion Most patients exhibited executive dysfunction that significantly compromised oral intake.

Introdução: A CCD caracteriza-se por quinze episódios dolorosos mensais nos últimos três meses consecutivos. Na gênese do quadro encontram-se fatores como comorbidades psiquiátricas, abuso de analgésicos e fragilidade sociofamiliar. Abordar tais aspectos constitui tarefa importante na sua condução. Objetivos: Descrever a utilização do PRACTICE e ICPC-2 na abordagem da CCD. Avaliar quantitativamente o resultado da codificação pelo ICPC-2. Metodologia: Pacientes consecutivos apresentando CCD foram entrevistados utilizando o PRACTICE. A ferramenta compõe-se de sete domínios que exploram a dinâmica familiar no enfrentamento do problema. As informações foram codificadas pela ICPC-2, que permite a classificação das queixas da maneira enunciada, utilizando um sistema biaxial compreendendo sistemas orgânicos, psicológicos e sociais no primeiro eixo e as características do relato no segundo. Resultados: Foram abordados 14 pacientes, 86% mulheres e média de idade 42,7 anos. O diagnóstico mais frequente foi cefaleia por abuso de medicação, abrangendo 86% dos casos, com período de evolução médio da doença de 18,7 anos, e frequência semanal média de episódios dolorosos de 5,2 dias. Os códigos ICPC mais relevantes foram P01 (57,1%); P03 (57,1%); P18 (85,7%); Z10 (50%); Z20 (85,7%). Conclusões: A amostra apresentou características compatíveis com a literatura. A codificação pela ICPC-2 indicou fatores reconhecidamente envolvidos na manutenção do quadro. O presente estudo é o primeiro utilizando as ferramentas PRACTICE e ICPC-2 na CCD e nas cefaleias em geral. A codificação dos dados qualitativos obtidos pelo PRACTICE através da ICPC-2, possibilitando a análise quantitativa dos relatos, não foi utilizada em outros trabalhos pelo conhecimento dos autores até o momento.

na Publicação (CIP) (eDOC BRASIL, Belo Horizonte/MG) S518 Sexualidade e relações de gênero [recurso eletrônico] / Organizadora Denise Pereira. -Ponta Grossa (PR): Atena Editora, 2019. -(Sexualidade e Relações de Gênero; v. 1)