Search

We report on the clinical characteristics of amyotrophic lateral sclerosis (ALS) in Fortaleza (Northeastern Brazil). For this, we analyzed retrospectively (from 1980 to 1999) 78 cases of ALS from the Service of Neurology of the University Hospital of Fortaleza diagnosed clinically and laboratorially (EMG, muscle biopsy, myelography, blood biochemistry, muscle enzymes and cranio-cervical X-ray). The results showed that they were mostly sporadic ALS (76/78), and they were divided into definite (n= 36), probable (n= 20), possible (n= 15) and suspected (n= 7), according to the level of diagnostic certainty. They were also subdivided into juvenile (n= 17), early-onset adult (n= 18), age-specific (n= 39) and late-onset (n= 4) groups. Clinically, they presented as initials symptoms, principally, asymmetrical (30/78) and symmetrical (24/78) weakness of extremities, besides bulbar signs, fasciculations, and atrophy. Curiously, pain as first symptom occurred in an expressive fashion (17/78). The predominant initial anatomic site, in this series, was the spinal cord, and mainly affecting the arms. As to the symptom accrual from region to region, this occurs more quickly in contiguous areas, and fasciculations are predominant when bulbar region was associated.

Despite considerable advances in machine translation (MT), adoption by professional translators still meets with resistance. Research on the human factors associated with MT (non-)adoption is required to understand this state of affairs. We investigate whether two specific groups of professional translators use MT, what reasons they advance for its use/non-use and what factors might explain the reasons given. Participants advanced an equally diverse set of reasons for using MT as for not using it, and this was strongly linked to text type, language pair, quality and trust. Using an agency theory lens, we found evidence of Pickering’s dialectics of resistance and accommodation in the focus group data. We also found that one group of translators is more open to the use of MT, and suggest that the socio-technical context of deployment might explain this finding. [ABSTRACT FROM AUTHOR]

Tyrosol is a quorum-sensing molecule of Candida albicans able to induce hyphal development in the early and intermediate stages of biofilm growth. In the present study, we evaluated the effect of high concentrations of exogenous tyrosol on planktonic cells and biofilms of C. albicans (n = 10) and C. tropicalis (n = 10), and investigated whether tyrosol could be synergic to antifungals that target cellular ergosterol. Antifungal susceptibility and drug interaction against planktonic cells were investigated by the broth microdilution method. Tyrosol was able to inhibit planktonic cells, with MIC values ranging from 2.5 to 5.0 mM for both species. Synergism was observed between tyrosol/amphotericin B (11/20 strains), tyrosol/itraconazole (18/20 strains) and tyrosol/fluconazole (18/20 strains). Exogenous tyrosol alone or combined with antifungals at both 10 × MIC and 50 × MIC were able to reduce biofilm of both Candida species. Mature biofilms were susceptible to tyrosol alone at 50 × MIC or combined with amphotericin at both 10 × MIC and 50 × MIC. On the other hand, tyrosol plus azoles at both 10 × MIC and 50 × MIC enhanced biofilm growth. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the antifungal activity of farnesol and its interaction with traditional antifungals against drug-resistant strains of Candida species. To do so, we studied the minimum in vitro inhibitory concentration (MIC) of amphotericin B (AMB), fluconazole (FLC), itraconazole (ITC), caspofungin (CAS) and farnesol against 45 isolates of Candida spp., i.e., 24 C. albicans, 16 C. parapsilosis and 5 C. tropicalis through the use of the broth microdilution method. Then, the isolates were tested with the combination of farnesol plus drugs to which they were previously found to be resistant. Additionally, the strains were pre-incubated at sub-inhibitory farnesol concentrations and their antifungal susceptibilities were re-evaluated. We found the MIC values for farnesol varied from 4.68-150 µM for Candida spp., with 19 isolates having a MIC > 1 mg/l, 18 a MIC ≥ 64 mg/l, 35 having a MIC ≥ 1 mg/l and 6 isolates a MIC ≥ 2 mg/l or were resistant to AMB, FLC, ITC and CAS, respectively. Significant MIC reductions were observed when farnesol and antifungal drugs were combined ( P < 0.05) and when Candida strains were incubated with farnesol ( P < 0.05). We conclude that the in vitro effects of farnesol improved the activity of traditional antifungals to which the Candida spp. isolates were resistant. These results support further investigation of the role of farnesol in the balance of the sterol biosynthetic pathway and how it interferes with cell viability. [ABSTRACT FROM AUTHOR]

We report a case of Crohn's disease in a patient with relapsing-remitting Multiple Sclerosis diagnosed and in treatment at Walter Cantidio Hospital -- UFC -- Fortaleza, state of Ceara, Brazil. N.N.O.A., female, 44 years old, no smoker, started in 1994 sensitive alteration in the legs with sensitive level until T4. She was submitted to investigation and was diagnosed with multiple sclerosis. After 6 years started treatment with immunomodulators, however she had 6 outbreaks and collateral effects, so in 2012 changed treatment to natalizumab, and her EDSS decreased from 2 to zero after 6 pulses. The Crohn's disease was diagnosed in 2002 by biopsy, and started with proctitis, diarrhea and fecal incontinence. Actually, she treats the Crohn's disease with mesalazine. In September of 2008 she had a relapse of the Crohn's disease in concurrence with an outbreak of the multiple sclerosis (MS), and was submitted to pulse with methylprednisolone, improving both diseases. Although MS and inflammatory bowel disease (IBL) may share common predisposing factors, not enough information is available to speculate about possible mechanisms. Concurrence of the 2 diseases is greater than expected, so cases like this may be reported to trace an adequate therapeutic. [ABSTRACT FROM AUTHOR]

Fourteen (14) patients living in Fortaleza, state of Ceara, Brazil (3o 43' S and 38o 29'W) are treated with natalizumab for relapsing-remitting or progressive-relapsing Multiple Sclerosis (RRMS). The estimated prevalence of MS in Bazil is around 15 cases for 100.000 inhabitants. The reasons for introducing natalizumab were lack of response or intolerance to first line immunomodulators (interferons beta 1a or beta lb and glatiramer acetate), in many instances associated with the appearance of new, gadolinium-enhancing lesions on brain or spine MRI. Lack of response or treatment failure was defined according to the Brazilian guidelines. The prevalent gender was female (10 patients). Median age of disease onset was 27 years old (range from 7 to 48). Only one patient had less than 8 years of study. Two patients used to smoke at disease onset. Five patients had positive oligoclonal bands, five had negative and four patients didn't need oligoclonal bands to diagnose MS. Twelve patients were negative for JCV and only two were positive. Two patients (14%) were previously treated with mitoxantrone, thus enforcing a 6 month washout period before starting natalizumab. Only one patient didn't use any immunomodulator before starting natalizumab; thirteen used at least one immunomodulator. Six patients improved EDSS after using natalizumab, six didn't change EDSS and two worsened EDSS. Two patients quitted the use of natalizumab; one because JCV was positive and one because EDSS didn't become better. Only five patients had one new outbreak after starting natalizumab and nine patients stopped having outbreaks, showing the effectiveness of the treatment and better life quality of the treated patients, even those who had many outbreaks while using immunomodulators. [ABSTRACT FROM AUTHOR]

Risk factors for development of multiple sclerosis (MS) are still a matter of debate. Latitude gradient, vitamin D deficiency and season of birth are among the most investigated environmental factors associated with the disease. Several international studies suggest that birth in spring is a substantial risk factor for MS. We investigated the season of birth as a potential risk for MS in different geographical regions of Brazil. We conducted a cross-sectional retrospective study with 2257 clinically definite MS patients enrolled in 13 Brazilian MS clinics in the south, southeast, and northeast regions of Brazil. Demographic and clinical data relating to date of birth and clinical features of the disease were collected and analysed, and subsequently compared with birth date among the general Brazilian population. The distribution of date of birth of MS patients showed an increase in spring and a decrease in autumn, with no difference being observed in the other seasons. In conclusion, season of birth is a probable risk factor for MS in most parts of Brazil. These findings may be related to the role that vitamin D plays in MS pathogenesis., (Copyright © 2013 Elsevier B.V. All rights reserved.)