Arquivos de neuro-psiquiatria最新文献_第6页

Rewriting the prognosis of multiple sclerosis in Brazil: a 25-year perspective on evolving diagnostic criteria. 改写巴西多发性硬化症的预后：25年来不断发展的诊断标准

IF 1.6 4区医学

Arquivos de neuro-psiquiatria Pub Date : 2025-06-01 Epub Date: 2025-07-02 DOI: 10.1055/s-0045-1809937

Dagoberto Callegaro, Guilherme Diogo Silva

引用次数: 0

Angiocentric glioma in refractory epilepsy: when to suspect? 难治性癫痫的血管中心性胶质瘤：何时怀疑？

IF 1.6 4区医学

Arquivos de neuro-psiquiatria Pub Date : 2025-06-01 Epub Date: 2025-06-25 DOI: 10.1055/s-0045-1809659

Angelo Dante de Carvalho Corrêa, Sérgio Ferreira Alves Júnior, Luis Alcides Quevedo Canete, Nina Ventura

引用次数: 0

Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: a narrative review. 动脉瘤性蛛网膜下腔出血后迟发性脑缺血：叙述性回顾。

IF 1.6 4区医学

Arquivos de neuro-psiquiatria Pub Date : 2025-06-01 Epub Date: 2025-06-25 DOI: 10.1055/s-0045-1809885

Ingrid Pereira Marques, Carolina Rouanet Cavalcanti de Albuquerque, Natalia Vasconcellos de Oliveira Souza, João Brainer Clares de Andrade, Gisele Sampaio Silva, Pedro Kurtz

{"title":"Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: a narrative review.","authors":"Ingrid Pereira Marques, Carolina Rouanet Cavalcanti de Albuquerque, Natalia Vasconcellos de Oliveira Souza, João Brainer Clares de Andrade, Gisele Sampaio Silva, Pedro Kurtz","doi":"10.1055/s-0045-1809885","DOIUrl":"10.1055/s-0045-1809885","url":null,"abstract":"Aneurismal subarachnoid hemorrhage (aSAH) is a condition with elevated mortality and morbidity, which usually affects a working-age population, leading to a high socioeconomic burden. Among those who survive the initial bleeding, approximately 30% will experience delayed cerebral ischemia (DCI), which is a significant factor in poor outcomes. However, it is potentially reversible if appropriate treatment is promptly initiated. The amount of blood present on the initial computed tomography (CT) scan, assessed through the modified Fisher scale (mFisher), and the patient's neurological status upon admission, are the strongest predictors of DCI. Early prevention is essential and typically involves administration of enteral nimodipine and the maintenance of euvolemia, while other treatment options have limited supporting evidence. Diagnosing remains a challenge, primarily due to its reliance on clinical examinations. This is more pronounced in high-grade aSAH patients who are unconscious or sedated. In such cases, additional methods may be necessary, such as transcranial Doppler (TCD), continuous electroencephalography (cEEG), or CT with perfusion (CTP). Treatment aims to prevent cerebral infarction and poor clinical outcomes, and it is based on hemodynamic optimization, hypertension induction, cardiac output augmentation, and endovascular therapy. Nevertheless, randomized data on DCI management remains scarce, highlighting the urgent need for more studies and a better understanding of this SAH complication. Addressing this gap may lead to more effective preventive strategies and treatments, which is crucial for improving the prognosis of these patients.","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 6","pages":"1-14"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The influence of hospital type (public versus private) on mortality and survival after stroke. 医院类型（公立与私立）对中风后死亡率和生存率的影响。

IF 1 4区医学

Arquivos de neuro-psiquiatria Pub Date : 2025-06-01 Epub Date: 2025-06-20 DOI: 10.1055/s-0045-1809418

Carla Heloisa Cabral Moro, Maria Izabel Rodrigues Mendes, Milena Veiga Wiggers, Thaís de Faria Cardoso, Henrique Diegoli, Luciano Henrique Pinto, Helbert do Nascimento Lima

{"title":"The influence of hospital type (public versus private) on mortality and survival after stroke.","authors":"Carla Heloisa Cabral Moro, Maria Izabel Rodrigues Mendes, Milena Veiga Wiggers, Thaís de Faria Cardoso, Henrique Diegoli, Luciano Henrique Pinto, Helbert do Nascimento Lima","doi":"10.1055/s-0045-1809418","DOIUrl":"10.1055/s-0045-1809418","url":null,"abstract":"Stroke has been a leading cause of death in Brazil throughout the past three decades. Although several cities in the country have implemented urgent/emergency stroke care units, the impact of the hospital type (public versus private) has not been evaluated.To compare the mortality and survival of patients admitted with stroke to two private hospitals without stroke units with a public hospital with a stroke unit.We conducted a historical cohort in the city of Joinville, Southern Brazil. Stroke patients admitted to a public hospital with a stroke unit were compared with those admitted to private hospitals without stroke units in terms of fatality rate and 30-day survival between January 2018 and December 2020. The Cox regression was used.Of the 4,508 patients, 85.6% were from public hospital, and 14.4%, from the 2 private hospitals. The crude mortality rate was of 11.4% among the public hospital patients, and of 9.1% among the patients from the private hospitals (p = 0.085). In the multivariate analysis, there was no difference in mortality between patients treated in the public hospital with a stroke unit (hazard ratio = 1.21; 95%CI: 0.87-1.68; p = 0.262) and those admitted to the 2 private hospitals without a stroke unit.Stroke units are an important public policy that minimizes the impact of stroke.","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 6","pages":"1-9"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Charcot revived. 夏科恢复。

IF 1.6 4区医学

Arquivos de neuro-psiquiatria Pub Date : 2025-06-01 Epub Date: 2025-06-11 DOI: 10.1055/s-0045-1804489

Hélio A G Teive

引用次数: 0

The impact of changing diagnostic criteria on disability in a Brazilian multiple sclerosis cohort. 巴西多发性硬化症队列中改变诊断标准对残疾的影响。

IF 1.6 4区医学

Arquivos de neuro-psiquiatria Pub Date : 2025-06-01 Epub Date: 2025-06-25 DOI: 10.1055/s-0045-1809662

Felipe Toscano Lins de Menezes, Jéssica Monique Dias Alencar, Alexandre Bussinger Lopes, Leizian de Souza Amorim, Raquel Paiva Portugal, Flávia Timbó Albuquerque, Natasha Pryanca de Araújo Bessa, Larissa Sabino Ferreira Vicente, Nilton Amorim de Souza, Denis Bernardi Bichuetti, Enedina Maria Lobato de Oliveira

{"title":"The impact of changing diagnostic criteria on disability in a Brazilian multiple sclerosis cohort.","authors":"Felipe Toscano Lins de Menezes, Jéssica Monique Dias Alencar, Alexandre Bussinger Lopes, Leizian de Souza Amorim, Raquel Paiva Portugal, Flávia Timbó Albuquerque, Natasha Pryanca de Araújo Bessa, Larissa Sabino Ferreira Vicente, Nilton Amorim de Souza, Denis Bernardi Bichuetti, Enedina Maria Lobato de Oliveira","doi":"10.1055/s-0045-1809662","DOIUrl":"10.1055/s-0045-1809662","url":null,"abstract":"Updating multiple sclerosis (MS) diagnostic criteria over recent decades may have impacted disability progression.To assess the effects of the passage of time and changes in diagnostic criteria on disability.A retrospective study of Brazilian people with relapsing-remitting MS from 1994 to 2019. Descriptive analysis compared three periods based on admission: Epoch 1 (1994-2001), 2 (2002-2010), and 3 (2011-2019). Cox regressions were performed for the outcomes of the expanded disability status scale (EDSS) 6.0 and conversion to secondary progressive MS (SPMS). We compared the three Epochs in sequence, the Poser with all McDonald criteria combined, and Poser versus each McDonald criteria (2001, 2005, 2010, and 2017). A multivariate logistic regression assessed the impact of diagnostic criteria on patients reaching EDSS 6.0.Time to diagnosis and treatment decreased across Epochs. For reaching EDSS 6.0, the Cox regression indicated a hazard ratio (HR) 63% lower for Epoch 3 compared with 1, an HR 50% lower for the McDonald criteria combined, and an HR 65% lower for McDonald 2010 compared with Poser. Regarding the conversion to SPMS, the HR was 53% lower for Epoch 3, 48% lower for the McDonald criteria combined, and 64% lower for McDonald 2010. The multivariate logistic regression demonstrated that incomplete recovery of initial symptoms was the main prognostic factor for reaching EDSS 6.0. However, transitioning diagnostic criteria from Poser to McDonald 2001 and 2005 decreased these odds by 54%.Newer diagnostic criteria have reduced the likelihood of reaching EDSS 6.0 and converting to SPMS over the past 25 years.","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 6","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Application value of the FOCUS-PDCA cycle in nursing care for dysphagia in patients with cerebral infarction: a meta-analysis. FOCUS-PDCA循环在脑梗死患者吞咽困难护理中的应用价值：meta分析。

IF 1 4区医学

Arquivos de neuro-psiquiatria Pub Date : 2025-06-01 Epub Date: 2025-06-17 DOI: 10.1055/s-0045-1809417

Xiaojing Lu, Jiandong Zhang, Ranran Wang, Xiujuan Liu

{"title":"Application value of the FOCUS-PDCA cycle in nursing care for dysphagia in patients with cerebral infarction: a meta-analysis.","authors":"Xiaojing Lu, Jiandong Zhang, Ranran Wang, Xiujuan Liu","doi":"10.1055/s-0045-1809417","DOIUrl":"https://doi.org/10.1055/s-0045-1809417","url":null,"abstract":"In recent years, there has been growing interest in applying quality improvement methodologies to healthcare processes. One such approach is the Find, Organize, Clarify, Understand, Select-Plan, Do, Check, and Act (FOCUS-PDCA) cycle.To evaluate the effectiveness of the FOCUS-PDCA cycle in the management of dysphagia in patients with cerebral infarction.We conducted a comprehensive literature search on the PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, and Wanfang databases for articles published up to October 31st, 2024, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Randomized controlled trials and high-quality retrospective studies comparing the FOCUS-PDCA cycle with conventional care were included. The primary outcomes were swallowing function, quality of life, neurological and limb functions, and complication rates. Data were pooled using random-effects models, and heterogeneity was assessed using the I2 statistic.We included 6 studies involving 638 patients. The FOCUS-PDCA group showed significant improvements in swallowing function (standardized mean difference [SMD] = 1.65; 95%CI: 0.08-3.21), quality of life (SMD = 2.16; 95%CI: 0.54-3.79), and neurological and limb functions (SMD = 1.03; 95%CI: 0.07-2.00) compared with the conventional care group. The FOCUS-PDCA approach significantly reduced complication rates (risk ratio = 0.48; 95%CI: 0.32-0.68).The FOCUS-PDCA cycle appears to be an effective strategy to improve outcomes in patients with cerebral infarction and dysphagia. However, more high-quality studies are needed to confirm these findings and guide clinical practice.","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 6","pages":"1-8"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acute arterial ischemic stroke in children: single-center experience. 儿童急性动脉缺血性卒中：单中心经验。

IF 1.6 4区医学

Arquivos de neuro-psiquiatria Pub Date : 2025-06-01 Epub Date: 2025-06-25 DOI: 10.1055/s-0045-1809661

Muharrem Bostancı, Arzu Ekici, Cengiz Havalı

{"title":"Acute arterial ischemic stroke in children: single-center experience.","authors":"Muharrem Bostancı, Arzu Ekici, Cengiz Havalı","doi":"10.1055/s-0045-1809661","DOIUrl":"10.1055/s-0045-1809661","url":null,"abstract":"Arterial ischemic stroke (AIS) is an increasingly common disorder in childhood that causes severe mortality and morbidity.To emphasize the importance of early diagnosis and treatment of AIS cases, as well as the early initiation of physical therapy.We retrospectively reviewed the medical records of 23 patients aged 1 month to 18 years, who were admitted with acute neurological complaints and diagnosed radiologically with AIS at the Bursa Yüksek İhtisas Training and Research Hospital, a tertiary healthcare facility, between January 2016 and June 2020.Neurological deficit was the most common (12 patients; 52%) complaint, followed by seizure in 5 patients (21%), facial paralysis in 5 patients (21%), and visual impairment in 3 patients (13%). We performed brain computed tomography (CT) scans in 12 (52%) patients at the first application, and infarction was detected in 8 (66%). Infarction was in the cerebrum in 19 (82%) patients. Mutations of the methylenetetrahydrofolate reductase (MTHFR; A1298C and 677C > T) gene were found most frequently. Cardiac anomalies were detected in 7 (30%) patients, and 2 patients had ventriculoperitoneal shunts.Arterial ischemic stroke presents very different clinical findings, such as hiccups, anisocoria, and upward gaze paralysis. We wanted to emphasize the importance of cranial CT scanning because sometimes MRI is not always easily performed in children. Concomitant conditions, such as intracranial operation, ventriculoperitoneal shunt, and hypochondroplasia, may increase the risk of stroke.","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 6","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A moral history of seizures: reported causes of seizures in the nineteenth century. 癫痫发作的道德史：19世纪癫痫发作的报告原因。

IF 1.6 4区医学

Arquivos de neuro-psiquiatria Pub Date : 2025-06-01 DOI: 10.1055/s-0045-1806829

Márcio Pinheiro Lima, Elza Márcia Targas Yacubian

引用次数: 0

Statin versus no statin after treatment with pipeline embolization device for intracranial aneurysms: a meta-analysis. 他汀类药物与不使用他汀类药物治疗颅内动脉瘤：一项荟萃分析。

IF 1.6 4区医学

Arquivos de neuro-psiquiatria Pub Date : 2025-06-01 Epub Date: 2025-06-21 DOI: 10.1055/s-0045-1809545

Nathalia Soares Barbosa, Felipe Araujo Gouhie, Bezalel Hakkeem, Amanda Machado, João Paulo Mota Telles, Luís Gustavo Biondi Soares, Leandro de Assis Barbosa

{"title":"Statin versus no statin after treatment with pipeline embolization device for intracranial aneurysms: a meta-analysis.","authors":"Nathalia Soares Barbosa, Felipe Araujo Gouhie, Bezalel Hakkeem, Amanda Machado, João Paulo Mota Telles, Luís Gustavo Biondi Soares, Leandro de Assis Barbosa","doi":"10.1055/s-0045-1809545","DOIUrl":"10.1055/s-0045-1809545","url":null,"abstract":"Some studies demonstrated the role of statin therapy in improving outcomes after coil embolization or surgical clipping of cerebral aneurysm. However, the benefit of statins after pipeline embolization device (PED) for intracranial aneurysms is not well established.To evaluate the effects of statins on hemorrhagic and ischemic complications as well as on complete occlusion of aneurysm in the treatment with PED.We searched the PubMed, Embase, and Cochrane Library databases for articles published from their inception to November 2024. Data were collected from observational studies comparing statin to no statin therapy following pipeline embolization.Four studies were included, comprising 2,822 patients and 3,063 aneurysms, 127 of which were ruptured and 4 of which received adjunctive coil embolization. Total hemorrhagic complication was reduced in the statin group (risk ratio [RR] = 0.50; 95%CI: 0.29-0.85; p = 0.010; I2 = 0%) but did not reveal difference in restricted propensity score-matched (PSM) analysis (RR= 0.50; 95%CI: 0.24-1.07 p = 0.073; I2 = 27%). There was no difference between the groups in complete occlusion of aneurysm rate at the last follow-up (RR = 0.94; 95%CI: 0.88-1.00; p = 0.055; I2 = 8.0%) or total ischemic complications (RR = 1.48; 95%CI: 1.06-2.07; p = 0.021; I2 = 0%).Statin use significantly reduced hemorrhagic complications after PED; however, this result should be interpreted cautiously due to study limitations. No significant differences were noted in complete occlusion rates or ischemic complications between the groups.","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"83 6","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0