HIV-1 clade C isolates show reduced Tat protein chemoattractant activity compared with clade B. This might influence neuropathogenesis by altering trafficking of monocytes into the CNS. A previous study suggested low rates of HIV-associated dementia in clade C infected individuals. The present study evaluated neurocognitive impairment rates in clade B- and C-infected individuals from the same local population. HIV+ and HIV- participants were recruited from the same geographic region in southern Brazil. We evaluated neuropsychological (NP) impairment using a screening instrument (the International HIV Dementia Scale; IHDS), as well as a Brazilian Portuguese adaptation of a comprehensive battery that has demonstrated sensitivity to HIV associated neurocognitive disorders (HAND) internationally. NP performance in controls was used to generate T-scores and impairment ratings by the global deficit score (GDS) method. Clade assignments were ascertained by sequencing pol and env. Blood and cerebrospinal fluid (CSF) were collected from all HIV+ participants. HIV+ and HIV- participants were comparable on demographic characteristics. HIV+ participants overall were more likely to be impaired than HIV- by the IHDS and the GDS. Clade B and C infected individuals were demographically similar and did not differ significantly in rates of impairment. The prevalence of pleocytosis, a marker of intrathecal cellular chemotaxis, also did not differ between clade B and C infections. Clade B and C HIV-infected individuals from the same geographic region, when ascertained using comparable methods, did not differ in their rates of neurocognitive impairment, and there was no evidence of differences in CNS chemotaxis.

Background Brazil accounts for the largest number of HIV+ persons in Latin America, and this epidemic poses a significant public health burden in this country. Little is known about the neuropsychiatric and functional consequences of HIV infection in this population. Methods Participants were 43 HIV+ and 29 HIV- individuals who underwent a neuropsychological, psychiatric and neurological evaluation that included self-report measures of mood (Beck Depression Inventory-II; BDI-II), neurocognitive complaints (Patient's Assessment of Own Functioning Inventory) and declines in instrumental activities of daily living (Activities of Daily Living questionnaire). The MINI-Plus generated Major depressive disorder (MDD) diagnoses. Apathy, defined as social withdrawal, decision-making difficulty, loss of interest and pleasure, was measured using items from the BDI-II and the neurological evaluation. Results When compared with seronegative participants, HIV+ individuals endorsed higher levels of apathy spectrum symptoms. After adjusting for mood and other covariates, apathy significantly predicted worse everyday functioning. Limitations: The small sample size, along with the self-report measures used to evaluate apathy and functional difficulties limit the inferences that may be drawn from our findings. Conclusions Our Brazilian HIV+ cohort endorsed apathy and depression as well as significant functional complaints. Although correlated with depression, apathy was uniquely associated with functional difficulties. Clinical attention to apathy and depression in HIV-infected Brazilians may help identify patients at risk for functional difficulties who may benefit from additional support to maintain independence.

Magnesium sulfate (MgSO4) is used to treat and prevent eclamptic seizures, and several anticonvulsant drugs (e.g., sodium valproate) are clinically effective antimanic drugs. Psychostimulant-induced hyperlocomotion has been proposed as an animal model for the study of antimanic drugs. The present study evaluated the effects of MgSO4 and sodium valproate (as a positive control) on hyperlocomotion induced by methylphenidate in mice. Acute MgSO4 (300-400 mg/kg), but not sodium valproate (100-300 mg/kg), prevented the increase in locomotor activity induced by methylphenidate (5.0 mg/kg). In contrast, repeated treatment (14 days) with valproate (300 mg/kg), but not MgSO4 (400 mg/kg), blocked methylphenidate-induced hyperlocomotion. Thus, acute MgSO4 exerted antimanic-like effects in this animal model.

Only four early years postgraduate surgical training posts in the UK meet nationally approved minimum quality standards. Specific recommendations are made to improve training in this cohort and to bolster recruitment and retention into Higher Surgical Training.

Major depressive disorder (MDD) is among the most prevalent neuropsychiatric disorders associated with HIV infection; however, its risks and neurobiologic correlates in diverse cultures are poorly understood. This study aimed to examine the frequency of MDD among HIV+ participants in southern Brazil. We hypothesized that the frequency and severity of MDD would be higher among individuals HIV+ compared with HIV−, and higher in HIV subtype B compared with C. Individuals with HIV (n=39) as well as seronegative controls (n=22) were enrolled in a cross-sectional, prospective, observational study. Current and lifetime history of MDD was diagnosed by MINI-Plus; symptom severity was assessed by BDI-II. Current and past episodes of MDD were significantly more frequent in the HIV+ versus HIV− group: current MDD, 15 (38.5%) vs. 0 (0%), p = 0.0004; past MDD, 24 (61.5%) vs. 3 (13.6%), p = 0.0004. The median BDI-II score in the HIV+ group was significantly higher than in the HIV− (13 [8–27.5] vs. 2.5 [1–5.5]; p < 0.0001). Current suicide risk, defined as during the last month, was found in 18% of participants in the HIV-positive and in none in the HIV-negative group. Neither current MDD frequency (8 (57.1%) vs. 6 (40%), p = 0.47) nor BDI-II score differed across subtypes B and C. Conclusions HIV+ group may be more likely to experience current MMD than HIV−. This was the first study to compare the frequency and severity of MDD in HIV subtype B and C; we found no difference between HIV subtypes B or C.

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Background:In recent decades, considerable advances have been made in the treatment of acute ischemic stroke (IS) and its prevention. However, even after treatment, approximately two-thirds of patients with IS have some degree of disability that requires rehabilitation, along with an increased possibility of developing psychiatric disorders, particularly depression.Objective: To determine the predictors of post-stroke depression in a 6-month period in patients with IS.Method: Ninety-seven patients with IS without previous depression were included in the study. The study protocol was applied during hospitalization and at 30, 90, and 180 days after hospital discharge. A binary logistic regression was then used. Age, sex, marital status, occupation, education, thrombolysis, National Institute of Health Stroke Scale, modified Rankin scale (mRS) score, Barthel index, and Mini-Mental State Examination score were included as independent variables. Results:Of the 97 patients, 24% of patients developed post-stroke depression. In the longitudinal follow-up, an mRS score of >0 was the lone significant predictor of depression development (odds ratio = 5.38; 95% confidence interval: 1.25-23.12; p < 0.05).

tests like enzyme-linked (Elisa), Quimioluminescence (QMIA) or western blot analysis [1]. The infection diagnosis is very stressful for the patient, the patient is informed of the likelihood of serious disease (HAM/TSP or Adult T lymphotropic leukemia). Another aggravating issue is when the viral pathology cannot be ascertained by health professionals and is not common in other patients [2]. The northeast and southeast regions of Brazil are highly endemic for HTLVI/II, although southern Brazil is non-endemic [3]. This report aimed to evaluate the impact of HTLV-I/II diagnosis in causing mood disorders in a non-endemic area. The ratio of asymptomatic HTLV-I carriers to patients with symptomatic HAM/TSP is approximately 2,000-3,000:1 [4]. Materials and MethodsSix patients, five with HAM/TSP and one asymptomatic HTLV-I infected participant from the neuroinfection outpatient clinic of HC-UFPR, Paraná, Brazil were evaluated by a multiprofessional group. All patients underwent psychiatric evaluation with the Brazilian version of a structured interview (MINI Plus); beck depression inventory (BDI) and beck anxiety inventory (BAI). Functional independence measure (FIM) scale was conducted by trained professionals, FIM Total scores range from 18 (totally dependent) to 126 (totally independent). Cerebrospinal fluid (CSF) and blood samples were collected for QMIA (ARCHITECT rHTLV-I/II, Abbott ® ) and confirmatory Western Blot (INNO-LIA TM HTLV-I/II Score, INNOGENETICS ® ). Flow cytometry of CSF and blood (FACSCALIBUR BD ® , 4 colors, limit of detection 0.1%) was performed for CD4 and CD8 quantification. ResultsSix patients with HTLV infection, confirmed by Western blot, were evaluated in depth demographic; CSF and immunological characteristics of participants with HAM/TSP and asymptomatic are listed on in Table 1 and Table 2 respectively. Among the patients with HAM/TSP (mean ± SD): age 54 ± 18 (years); time of diagnosis (years) 7.6 ± 9.3; time of symptoms (years) 16.8 ± 6.3 FIM scale 98.6