Revista da Associacao Medica Brasileira (1992)
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Rev Assoc Med Bras (1992) · Feb 2021
Evaluation of serum ghrelin, nesfatin-1, irisin, and vasoactive intestinal peptide levels in temporal lobe epilepsy patients with and without drug resistance: a cross-sectional study.
Epilepsy is a common disorder that affects the nervous systems of 1% of worldwide population. In epilepsy, one-third of patients are unresponsive to current drug therapies and develop drug-resistant epilepsy. Alterations in ghrelin, nesfatin-1, and irisin levels with epilepsy were reported in previous studies. Vasoactive intestinal peptide is among the most common neuropeptides in the hippocampus, which is the focus of the seizures in temporal lobe epilepsy. However, there is also lack of evidence of whether these four neuropeptide levels are altered with drug resistant temporal lobe epilepsy or not. The aim herein was the evaluation of the serum levels of nesfatin-1, ghrelin, irisin, and Vasoactive intestinal peptide in drug-resistant temporal lobe epilepsy patients and temporal lobe epilepsy (TLE) without drug resistance, and to compare them to healthy controls. ⋯ The results herein suggested that ghrelin might contribute to the pathophysiology of drug resistant temporal lobe epilepsy. However, further studies are needed to confirm this hypothesis.
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The objective of this study is to compare the clinical outcome among patients who are surgically treated for lumbar disc herniation by transforaminal and interlaminar endoscopy techniques. ⋯ Although both the endoscopic techniques, compared in this study, are safe and effective for the surgical treatment of lumbar herniated disc, the interlaminar technique presented significantly better results and lower rates of complications than the transforaminal technique.
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Rev Assoc Med Bras (1992) · Feb 2021
Case ReportsEthical support to psychiatry residents: a report of a Brazilian ethics consultation group.
It is not uncommon for medical residents to deal with critically ill patients who frequently show several ethical and human dilemmas, highlighting the need for a consultation with ethical specialists. The objective of this article is to present a description of a Brazilian Ethics Consultation group designed to attend psychiatry residents. ⋯ Medical educators and staff from academic hospitals should pay attention to the needs of the medical residents. The development and support of ethics consultation groups must be provided to fulfill the need of those residents who face serious ethical and human dilemmas.
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Rev Assoc Med Bras (1992) · Feb 2021
Comparison of cardiovascular risk calculators in patients with diabetes.
Cardiovascular risk stratification is an important clinical practice to estimate the severity of cardiovascular disease in patients with type 2 diabetes. This study aimed to compare the stratification of global cardiovascular risk with the specific risk stratification for patients with type 2 diabetes, seen at specialized outpatient clinics, and to evaluate possible differences in diagnoses and treatments. ⋯ The substantial disagreements among the cardiovascular risk calculators may lead to different diagnoses and may consequently influence therapeutic strategies. The findings herein highlight the need for specific validated cardiovascular risk calculators for patients with DM2 that can reliably estimate risk in these individuals.
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Rev Assoc Med Bras (1992) · Feb 2021
Case ReportsRefractory celiac disease type 2: how to diagnose and treat?
Refractory celiac disease is an uncommon condition which might be associated to poor prognosis. It is often treated with immunosuppressive medications, with poor results. ⋯ A case of a 41 year old female patient with refractory celiac disease type 2 is reported. She was treated with oral budesonide for six months, achieving histological remission.