Tropical spastic paraparesis in Northeastern Brazil

Ten possible cases of tropical spastic paraparesis (TSP) in Northeastern Brazil (Ceará) are presented. They show the typical symptoms and signs of TSP consisting of weakness of the lower limbs, spastic gait, hyperreflexia, bladder dysfunction and variable signs of posterior columns impairment. The laboratory examinations excluded other compressive, infective, degenerative or demyelinating lesions of their spinal cord. Our patients age ranged from 21 to 59 years, all were of black origin and all were of lower social class. There was a slight preponderance of females. An etiological implication of a retrovirus (HTLV-I) has been shown for TSP, but for lack of technical conditions we could not determine it in our patients, and that stands as our subsequent step in those and further cases.     

High prevalence of calcified silent neurocysticercosis in a rural village of Mexico

Human neurocysticercosis (NC) is a parasitic disease caused by TAENIA SOLIUM when its larvae lodge in the central nervous system. NC prevalence estimates are obscured by the variable and often asymptomatic clinical picture. While infection depends on exposure, severity is possibly related with various host factors (immunity, genes and gender). This epidemiological study of cranial CT scans in an endemic rural community found that 9.1% of apparently healthy subjects had calcified lesions and were completely asymptomatic. Silent NC cases did not correlate with the exposure factors tested but showed family aggregation and higher rates of positive serology. Thus, NC prevalence may be higher than currently considered and host-related factors appear to be involved in infection and pathogenesis.     

A prevalence survey of mental disorders among children in a rural Malaysian village

This is the first epidemiological survey of mental disorders among children in a Malaysian village. The WHO Research Questionnaire for Children (RQC) was used for initial screening followed by a semistructured interview, the Follow-up Interview for Children (FIC) at its second stage. Diagnosis was obtained by using Rutter's multi-axial classification. The prevalence rates obtained for the diagnostic categories were described in 3 age groups, in accordance with the age of attending school in Malaysia. Of 507 children screened aged 1–15, 6.1% were classified as having a mental disorder.     

High prevalence of Rett syndrome in a small area

Five cases of Rett syndrome were revealed in a population of 2,269 girls 4-14 years of age and born in 1973-83. This gives a prevalence of 22.03 per 10,000 girls in this small rural area situated around the city of Crema in northern Italy. Family history of these families did not reveal any inbreeding among these families. This unusual concentration of patients with this syndrome is apparently the first example of a strong geographical concentration of Rett syndrome.     

Local Adaptations to Implement the Strengthening Families Program in Northeastern Brazil

International Journal of Mental Health and Addiction - Local adaptations can promote user engagement and sustainability in the preventive program. The objective of this study is to evaluate local...     

Lifetime prevalence of mental disorders among homeless people in a southeast city in Brazil

Several studies have shown a high prevalence of mental disorders among homeless people. Data from developing countries, like Brazil, are conspicuously lacking, making it difficult to plan interventions targeted to this group’s mental health. The sample was selected from street dwellers in Juiz de Fora, a city with 424 479 inhabitants in the Southeast of Brazil. People of 18 years of age or more who had been living outdoors for at least 12 months were eligible for the study. The psychophathology was assessed by using SCAN (Schedule for Clinical Assessment in Neuropsychiatry). After 3 months, it was possible to assess 83 persons. All but one had at least one psychiatric diagnosis according to ICD-10. The most frequent diagnoses were alcohol abuse/dependence (82%), mood disorders (32.5%), drug abuse/dependence (31.3%), and schizophreniform psychosis (9.6%), with a high rate of comorbidity (78.3%). The occurrence of mental disorders was present in almost the entire sample. The authors link this to sampling framing and weakness of the homeless care network system, due to economic constrain and social inequality within the country. Received: 6 August 1998 / Accepted:29 October 1998     

Case-finding for MS prevalence studies in small communities requires a community-based approach

In response to citizen concerns in 5 small Illinois towns, community-based case-finding determined the prevalence of multiple sclerosis (MS). Potential cases were identified through town meetings, publicity, advocacy groups and local volunteer outreach coordinators. Estimated prevalence based on available medical records for self-identifying individuals for 3 of the 5 communities was high (218-231 per 100,000 population) compared to other studies. Scanning databases in medical offices used in many other studies may miss MS cases; yet tracking medical records is labor-intensive and sometimes restricted by privacy guidelines. MS registries could improve case-finding accuracy and efficiency.     

Neuropsychiatric symptoms in Alzheimer disease and cognitively impaired, nondemented elderly from a community-based sample in Brazil: prevalence and relationship with dementia severity.

OBJECTIVES: The objectives of this study were to describe the prevalence of neuropsychiatric symptoms of dementia in Alzheimer disease (AD) and cognitively impaired nondemented (CIND) subjects from a community-based Brazilian sample and to correlate these symptoms with severity of cognitive deficits. METHOD: A total of 1,563 randomly selected subjects were evaluated with the following screening tests: Mini-Mental Status Examination, Fuld Object Memory Evaluation, Informant Questionnaire on Cognitive Decline in the Elderly, and Activities of Daily Living-International Scale. Screen positives were submitted to a workup for dementia, physical and neurologic examination, cranial computed tomography or cerebral magnetic resonance imaging, the Cambridge Examination for Mental Disorders, Clinical Dementia Rating Scale (CDR), and the Neuropsychiatric Inventory (NPI). Diagnosis was made according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. RESULTS: Sixty patients with AD, 25 CIND, and 78 healthy elderly subjects were evaluated. Informants reported that 78.33% of patients with AD had one or more neuropsychiatric symptoms. Apathy (53.33%), depression (38.33%), sleep alterations (38.33%), and anxiety (25%) were the most prevalent disturbances in AD subjects. These disturbances were more prevalent in patients with AD than in the comparison group and CIND individuals. In the CIND group, the most frequent neuropsychiatric symptoms were anxiety and sleep alterations (both with 24%) followed by depression (16%). Total NPI scores were significantly different between AD and CIND groups, AD and comparison groups, and CIND and the comparison group. Apathy was the only neuropsychiatric symptom that was significantly different between the groups divided according to the CDR being more frequent in subjects with moderate to severe dementia. CONCLUSIONS: Neuropsychiatric symptoms seem to be as common in patients living in a developing country as they are in demented patients from the developed world. Indeed, the fact that some of our results are similar to other population-based studies may suggest that cultural factors play a minor role in the emergence of these symptoms, at least in a Latin American country like Brazil.     

Motor neuron diseases in the university hospital of Fortaleza (Northeastern Brazil): a clinico-demographic analysis of 87 cases

In this retrospective (1980-1998) study, we have analyzed clinico-demographically, from the records of the University Hospital of Fortaleza (Brazil), a group of 87 patients showing signs and symptoms of motor neuron diseases (MNDs). Their diagnosis was determined clinically and laboratorially. The WFN criteria were used for amyotrophic lateral sclerosis (ALS) diagnosis. The clinico-demographic analysis of the 87 cases of MNDs showed that 4 were diagnosed as spinal muscular atrophy (SMA), 5 cases as ALS subsets: 2 as progressive bulbar paralysis (PBP), 2 as progressive muscular atrophy (PMA) and 1 as monomelic amyotrophy (MA), and 78 cases of ALS. The latter comprised 51 males and 27 females, with a mean age of 42.02 years. They were sub-divided into 4 groups according to age: from 15 to 29 years (n= 17), 30 to 39 years (n= 18), 40 to 69 years (n= 39) and 70 to 78 years (n= 4). From the 78 ALS patients, 76 were of the classic sporadic form whilst only 2 were of the familial form. The analysis of the 87 patients with MNDs from the University Hospital of Fortaleza showed a predominance of ALS patients, with a high number of cases of juvenile and early onset adult sporadic ALS.     

Intraparenchymal cerebral cysticercosis in children: a benign prognosis

This paper reports 26 consecutive cases of cerebral cysticercosis in children, 21 presenting with intraparenchymal mass lesions, two with encephalitic disease, and three with intraventricular (racemous) cysticercosis. The intraparenchymal and encephalitic forms of the disease were benign. Regression of the lesions occurred within four months of diagnosis in all children treated conservatively with antiepileptic drugs, but no antiparasitic drugs. Major morbidity was limited to those patients who were subjected to operative intervention. Intraventricular disease was most malignant; all three patients manifested acute, severely increased intracranial pressure, all required immediate surgical decompression, and one patient died. The apparent overall benign course of intraparenchymal cerebral cysticercosis in children appears not to warrant antiparasitic drug therapy.