Transcranial Doppler can predict intracranial hypertension in children with severe traumatic brain injuries.

Purpose: The purpose of this study is to evaluate the accuracy of emergency Transcranial Doppler (TCD) to predict intracranial hypertension and abnormal cerebral perfusion pressure in children with severe traumatic brain injury (TBI).

Patients And Methods: A descriptive and retrospective cross-sectional study was designed through data collected from medical records of children with severe TBI (Glasgow coma scale ≤ 8), admitted to a level I pediatric trauma center, between January 2000 and December 2005. Early TCD examination was performed upon admission, and TCD profiles were considered as altered using previously validated threshold values for diastolic velocity (<25 cm/s) and pulsatility index (>1.

Mortality in Children With Severe Head Trauma: Predictive Factors and Proposal for a New Predictive Scale.

Background: Traumatic brain injury is a public health problem around the world, and recognition of systemic sources of secondary brain lesions is crucial to improve outcome.

Objective: To identify the main predictors of mortality and to propose a grading scale to measure the risk of death.

Methods: This retrospective study was based on medical records of children with severe traumatic brain injury who were hospitalized at a level I pediatric trauma center between January 2000 and December 2005.

Star fruit intoxication in a chronic renal failure patient: case report.

Chronic renal failure is a high morbidity and mortality condition, with its terminal phase incidence and prevalence steadily growing year after year. According to the Sociedade Brasileira de Nefrologia [Brazilian Society of Nephrology], the main causes of renal failure are arterial hypertension, glomerulonephritis and diabetes mellitus. Several factors are implied on chronic renal failure patients' risk of mortality, particularly age, diabetes and associated co-morbidities.

Mortality in children with severe head trauma: predictive factors and proposal for a new predictive scale.

Background: Traumatic brain injury is a public health problem around the world, and recognition of systemic sources of secondary brain lesions is crucial to improve outcome.

Objective: To identify the main predictors of mortality and to propose a grading scale to measure the risk of death.

Methods: This retrospective study was based on medical records of children with severe traumatic brain injury who were hospitalized at a level I pediatric trauma center between January 2000 and December 2005.

Stroke history and Chagas disease are independent predictors of silent cerebral microembolism in patients with congestive heart failure.

Background: Chagas disease is endemic in South and Central America, where 18 million individuals are infected by Trypanosoma cruzi, causing congestive heart failure (CHF) and cardioembolic stroke. Transcranial Doppler (TCD) is able to detect real-time microembolic signals (MES) to the brain vessels and may represent a surrogate marker of stroke risk. We aimed to determine predictors of MES in a population of patients with CHF.

Sepsis in the postoperative period of cardiac surgery: problem description.

Background: In spite of the advances in sepsis diagnosis and treatment in the last years, the morbidity and mortality are still high.

Objective: To assess the prevalence, in-hospital evolution and prognosis of patients that presented sepsis in the postoperative period of cardiac surgery.

Methods: This is a prospective study that included patients (n = 7,332) submitted to cardiac surgery (valvular or coronary) between January 1995 and December 2007.

Identification, characterization and expression analysis of hepcidin gene in sheep.

Hepcidin is part of the innate immune system, and it plays a central role in the regulation of iron homeostasis. This peptide has been previously characterized in man, non-human primates, rat, mouse, dog, swine, cattle, horse, fishes, reptiles and birds but until now not in sheep. The aim of this study was to sequence, characterize and perform hepcidin expression analysis in different tissues collected from healthy sheep.

Do children with Glasgow 13/14 could be identified as mild traumatic brain injury?

Objective: To identify in mild head injured children the major differences between those with a Glasgow Coma Scale (GCS) 15 and GCS 13/14.

Method: Cross-sectional study accomplished through information derived from medical records of mild head injured children presented in the emergency room of a Pediatric Trauma Centre level I, between May 2007 and May 2008.

Results: 1888 patients were included.

Molecular characterization of ovine zygomycosis in central western Brazil.

Zygomycosis is an important granulomatous disease that affects humans and animals, particularly sheep in tropical regions. Rhinofacial and nasopharyngeal zygomycosis were described in sheep in association with Conidiobolus spp. The present study characterized 5 samples of Conidiobolus isolated from 3 herds with clinical disease in Mato Grosso State, Brazil.

Influence of heart rate on quality of life in patients with chronic atrial fibrillation.

Background: Current criteria for rate control in atrial fibrillation (AF) treatment are empirical and based on a small amount of scientific data.

Hypothesis: This study was designed to analyze the influence of heart rate (HR, measured by the 6-minute walk test [6MWT] and 24-hour Holter monitoring) on quality of life (QoL).

Methods: A total of 89 male patients with chronic atrial fibrillation (AF) and resting HR < 90 bpm were included.

Cloning, sequencing and expression analysis of the equine hepcidin gene by real-time PCR.

Equine serum or plasma iron concentration drops quickly during inflammation. Accumulation of iron inside macrophages and reduction of the intestinal absorption of this element cause hypoferremia during systemic inflammatory processes. These mechanisms are mediated by hepcidin, a 25 amino acids peptide synthesized mainly in the liver in response to iron stores and inflammation.

[Brazilian guidelines for the manegement of intracerebral hemorrhage].

Among the stroke subtypes, intracerebral hemorrhage (ICH) has the worst prognosis and still lacks a specific treatment. The present manuscript contains the Brazilian guidelines for the management of ICH. It was elaborated by the executive committee of the Brazilian Cerebrovascular Diseases Society and was based on a broad review of articles about the theme.

Hyperglycemia in pediatric head trauma patients: a cross-sectional study.

Objective: To verify the prevalence of acute hyperglycemia in children with head trauma stratified by the Glasgow coma scale (GCS).

Method: A prospective cross-sectional study carried out with information from medical records of pediatric patients presenting with head injury in the emergency room of a referral emergency hospital during a one year period. We considered the cut-off value of 150 mg/dL to define hyperglycemia.

Chagas disease is independently associated with brain atrophy.

Chagas disease (CD) remains a major cause of cardiomyopathy and stroke in developing countries. Brain involvement in CD has been attributed to left ventricular dysfunction, resulting in chronic brain ischemia due to hypoperfusion and/or embolic infarcts. However, cognitive impairment in CD may occur independently of cardiac disease.

Cognitive dysfunction in chronic Chagas disease cardiomyopathy.

Unlabelled: Chagas disease (CD) remains a major cause of stroke in developing countries, but cognitive repercussion of CD has not been well studied.

Objective: To compare the frequency and pattern of cognitive dysfunction in patients with CD cardiomyopathy (CDC) and other cardiomyopathies (OC).

Methods: We studied 37 patients with CDC and 42 patients with OC with similar age, educational level and cardiac systolic function.

Stroke and brain atrophy in chronic Chagas disease patients: A new theory proposition.

Chagas disease (CD) remains a major cause of cardiomyopathy and stroke in developing countries. Brain damage in CD has been attributed exclusively to the effects of structural heart disease on the brain, including cardioembolism and low cardiac output symptoms. However, CD patients also develop stroke and brain atrophy independently of cardiac disease severity.

Validation of the National Institutes of Health Stroke Scale, modified Rankin Scale and Barthel Index in Brazil: the role of cultural adaptation and structured interviewing.

Background: We aimed to validate three widely used scales in stroke research in a multiethnic Brazilian population.

Methods: The National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) and Barthel Index (BI) were translated, culturally adapted and applied by two independent investigators. The mRS was applied with or without a previously validated structured interview.

Skull radiographs and computed tomography scans in children and adolescents with mild head trauma.

Objective: To identify which pediatric patients with mild head trauma are candidates for skull radiographs or cranial computed tomography (CCT) scans.

Method: Patients with mild head trauma aged from 0 to 19 years presenting to the Emergency Department of a trauma centre from Salvador City, Brazil, between May 2007 and May 2008.

Results: A total of 1888 mild head trauma patients were admitted; mean age was 7.

[Profile of the elderly population in two poor municipalities in North and Northeast Brazil: the results of a cross-sectional population-based survey].

This study aimed to determine the profile of the elderly population (>or= 60 years) in two poor municipalities in North and Northeast Brazil in 2005. Using a cross-sectional survey with a systematic sample, previously trained interviewers applied a standard household questionnaire on demographic characteristics, socioeconomic status, household conditions, physical activity, immunization status, health problems, and expenditures on medicines. Of the total sample (n = 1,013), 528 lived in Caracol, Piauí State, and 478 in Garrafão do Norte, Pará State.

Exercise testing early after myocardial infarction: comparison with echocardiography, electrocardiographic monitoring and coronary arteriography.

Background: Predischarge exercise testing early after myocardial infarction is useful for risk stratification, exercise prescription, and assessment of prognosis and treatment.

Objective: The objective of this study was to compare the findings of exercise testing early after myocardial infarction with those of echocardiography, electrocardiographic monitoring (24-hour Holter monitoring) and coronary angiography.

Methods: We evaluated 60 cases (mean age of 51.

Brain magnetic resonance imaging white matter lesions are frequent in HTLV-I carriers and do not discriminate from HAM/TSP.

Human T lymphotropic virus (HTLV)-I is known to cause HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and other pronounced disease in less than 4% of those infected. However, evidence is accumulating that a proportion of HTLV-I carriers have neurological and urological symptoms without fulfilling criteria for HAM/TSP. Brain white matter (WM) lesions on magnetic resonance imaging (MRI) are frequently seen in HAM/TSP.

Potential roles of bone marrow stem cells in stroke therapy.

There is a need for improved therapies, in terms of utility and effectiveness, for stroke patients; however, over the years, numerous clinical trials of potential drugs have failed to demonstrate positive results. The emerging field of stem cell research has raised several hopes of a therapy for neurological diseases, including stroke. This review discusses the recent clinical trials and pilot studies using stem cells in stroke patients and highlights key issues that must be addressed to improve the chances of successfully developing a new strategy for stroke patients using adult stem cells.

Increase in systolic blood pressure during exercise testing after heart transplantation: correlation with the clinical condition and ventricular function assessed by dobutamine stress echocardiography.

Objective: Patients who underwent heart transplantation (HTX) experience a reduction in the elevation that is usual in systolic blood pressure during exercise testing. Of unknown origin, this phenomenon varies in frequency and intensity. The aim of this study was to analyze the relationship between systolic blood pressure increase (delta SBP) and clinical aspects, as well as variables measured during exercise testing (ET) and dobutamine stress echocardiography (DSE) in patients in the late post-transplantation course.

Modulation of T cell responses in HTLV-1 carriers and in patients with myelopathy associated with HTLV-1.

Objective: Human T lymphotropic virus-type 1 (HTLV-1) activates the immune system leading to a persistent and exacerbated T-cell response with increased production of IFN-gamma and TNF-alpha. Overproduction of pro-inflammatory cytokines is correlated with the development of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), although some HTLV-1 carriers also show high levels of these cytokines. In this study, the ability of regulatory cytokines and cytokine antagonists to inhibit spontaneous IFN-gamma production was investigated.