The connection between the gastrointestinal system (GI) and the central nervous system (CNS), together with the performance of the enteric nervous system (ENS), forms a complex communication network called the “gut-brain axis”. Scientific evidence indicates that the gut microbiota coordinates a multitude of bodily functions, closely linked to the immune, metabolic and nervous systems. In this context, any alteration that occurs in the “gut-brain axis” will result in damage to the homeostasis of the systems, because a dysfunction of the intestine-brain axis can lead to a dynamic impairment of the action of the protective barriers of the intestinal walls. Through directional gut-brain communication, the changes detected in the gastrointestinal tract affect the neurochemical transformations that occur in the CNS. The recognition of the relationship of neural aspects to the dynamics of the human microbiome contributes to the emergence of physiological imbalances that can contribute to the worsening of a wide spectrum of psychiatric disorders, with emphasis in the literature on anxiety disorders, depression, and autism spectrum disorders (ASD), schizophrenia and attention-deficit hyperactivity disorder (ADHD). The present literature review aims to verify the function and impact of the gut-brain axis in mood disorders, aiming to identify and strengthen evidence that the brain and gut have a strong and intimate connection responsible for the modulation of neurons, neurotransmitters, hormones and immunological mediators.

Background: stroke is a highly common neurologic disease, with great mortality and morbidity rates. It is a cerebrovascular condition characterized by a deficiency in the blood supply that should reach the nervous tissue. It can be classified into two types, depending on its etiology: ischemic and hemorrhagic stroke, the first one being the most common. The correct diagnosis of this condition is a challenge, especially in cases of confusing conditions, such as stroke mimics (SM). A highly detailed epidemiologic description and previous knowledge of the disease can help to recognize it. In cases of stroke, a quick revascularization treatment is necessary for a good clinical outcome, however, the inadvertent administration of thrombolytics to the patient with SM can cause hemorrhage and death, as well as unnecessary costs. The present study consisted in evaluating the patients admitted in the stroke unit of the Clinical Hospital Complex of the Federal University of Paraná in Brazil, between October 2012 and September 2013, and describing the prevalence, clinical presentation, etiology, and treatment outcomes in the SM cases primarily diagnosed as a stroke. Results: 10 patients (7.1%) of the total number of patients with less than four hours of symptoms onset were considered SM and six were submitted to intravenous thrombolysis. The main clinical presentations were motor symptoms (90%) and dysarthria and sensitive symptoms (60%). Regarding the etiology of the patients with SM, six patients (60%) had functional disorders, one (10%) had Todd paresis, one (10%) exogenous intoxication, one (10%) diabetic ketoacidosis, and one (10%) presented with a clinically isolated syndrome. Conclusions: our results showed that an important percentage of patients admitted to a stroke unit are SM and that a significant part of these SM is subjected to unnecessary thrombolytic procedures. Thus, further studies are necessary and important to develop well-defined guidelines that stratify the risk of SM and evaluate, based on the stratification, the risk-benefit of soliciting imaging methods that can help to distinguish between stroke and SM.

Dengue fever is a tropical infectious pathology caused by an arbovirus from the Flaviviridae family, the dengue virus goes through an initial replication in striated and smooth muscle cells. The bioindicators of hepatic functions are enzymes that detect lesions in the hepatocytes. Thrombocytopenia is one of the bioindicators of the key clinical manifestations in dengue patients. Besides the natural process of the platelets in the anti-inflammatory activity, the used drugs act and the auto medication overcharges hepatic functions due to the hepatotoxicity of non-opioid analgesics. Usually, the most used analgesic is paracetamol. The present article aims to associate hepatic biomarkers with the dengue infection and the hepatotoxicity caused by the indiscriminate use of anti-inflammatory drugs like paracetamol. As a research method, the literature review was utilized, with the utilization of scientific articles related to the theme, taken from electronic databases such as Scielo and Google Scholar. Aiming to associate dengue with hepatic biomarkers such as thrombocytopenia and hepatotoxicity caused by the anti-inflammatory drug known as paracetamol. It is important to highlight the relation between thrombocytopenia and dengue´s hemorrhage episodes, besides the hepatic overload caused by the indiscriminate use of paracetamol.

Introdução: A neurodegeneração com acúmulo de ferro cerebral (NBIA) é um grupo heterogêneo de doenças genéticas raras que levam ao acúmulo de ferro nos gânglios da base, levando a inúmeras desordens neurológicas. Esta doença tem sido associada a muitos genes, sendo o PKAN2 o mais comum. O tratamento continua a ser maioritariamente sintomático e recomenda-se a abordagem baseada numa equipa multidisciplinar. Relato do caso: O caso apresentado é de um homem de 67 anos com acúmulo bilateral de ferro no globo pálido e delirium há 8 meses, além de disfunção visuoespacial e executiva e distúrbios comportamentais. A ressonância magnética do paciente mostrou anormalidades e o sinal "olho de tigre". Além disso, o tratamento de escolha foi a administração de antipsicóticos atípicos, que controlavam parcialmente o quadro do paciente. Discussão: A localização mais recorrente do acúmulo de ferro no cérebro é nos gânglios da base e está relacionada principalmente a mutações na pantotenato quinase 2 (PKAN2), que leva a manifestações psiquiátricas de progressão insidiosa e pode ser inferida quando o sinal é encontrado. o "olho do tigre" em uma ressonância magnética. Conclusão: O paciente foi diagnosticado com transtorno psicótico de início tardio, déficit cognitivo leve e síndrome parkisoniana. Não foram realizados testes genéticos para diagnosticar a etiologia. Portanto, o caso é considerado um NBIA de causa desconhecida com características atípicas e provável mutação ligada a PANK2.

Introduction: The COVID-19 pandemic came with impasses, one of them in the educational area, creating numerous barriers. During this period, the access to traditional study methodologies became impracticable, causing some difficulties in the comprehension of some subjects for healthcare students. Therefore a 3D model was elaborated as a learning facilitator, whose main goal was to help healthcare students in the understanding of the voluntary motor movement, addressing the cortico-basal, ganglia-thalamic and cortico-ponto-cerebellar pathways, since the observation in cadavers is not possible. Objective: evaluate the impact of the 3D models in the teaching-learning process and present the comparison and the effects of using a biscuit model and the plastinated cadaveric pieces in the multimodal teaching of human anatomy. Methods: this study involved 47 students from the Physiotherapy course. A prototype was developed using biscuit dough, wood, polystyrene and paint and it illustrated in special dimensions the pyramidal tract and the cortico-basal, ganglia-thalamic and cortico-ponto-cerebellar pathways. The participants performed identical tests before and after the display of the different methodologic resources, 3D model and multimodal, where they were randomly grouped and divided. Results: It was verified that in spite of the greater number of correct answers in the post-test form, there was not, in fact, a significant statistical difference (p=0,654)  between the participating groups, which states the necessity of developing an alternative approach and a more significant sample. A significant statistical difference was observed (p<0.001) when comparing the students´ post-test knowledge with their pre-test knowledge when both methodologies were used, setting a multimodal approach, which is an alternative strategy that promotes a better development in teaching and learning. Conclusion: In our study, the teaching  with cadaveric pieces (p=0.010) and the use of the 3D model singly (p=0.006) and the multimodal model (p<0.001) obtained similar results statistically. Therefore, the professors must choose the teaching methodology based on their aim and not for the intrinsic qualities in each method.