Eyelid ptosis associated with pachydermoperiostosis: case report

We describe a clinical case of a patient with pachydermoperiostosis and bilateral palpebral ptosis. It is a hereditary, dominant autosomic disease, which affects skin, bones and soft tissues. In the eyelid, it causes an important tarsal hypertrophy. We discuss the physiopathology and treatment of the ptosis.     

Family health program as a strategy of primary attention: a reality at Juazeiro do Norte

This study analyzes the practices and organization of Family Health Program, in the municipality of Juazeiro do Norte according to the discussion of elements that feature the primary attention, as proposed by Starfield. The theoretical context chosen understands the primary attention as a level of attention organized by the features: First contact, longitude, integrality, coordination. This is a qualitative research, using focus group techniques, semi-structured interview and non-participant observation in eight family health units in the municipality. There are difficulties in accessing the primary care in the units, caused by structural barriers imposed to the organization of attention, represented by an excess of clients for each team and reduced availability of medical professional. Considering that there are a compulsory enrollment of the population to the Family Health Care program health units, this level of attention in the city presents itself as a traditional doctor-hegemonic model of healing practices associated with the prioritization of vertical programs of the Ministry of Health.     

Malnutrition in infancy as a susceptibility factor for temporal lobe epilepsy in adulthood induced by the pilocarpine experimental model

Malnutrition during the earliest stages of life may result in innumerable brain problems. Moreover, this condition could increase the chances of developing neurological diseases, such as epilepsy. We analyzed the effects of early-life malnutrition on susceptibility to epileptic seizures induced by the pilocarpine model of epilepsy. Wistar rat pups were kept on a starvation regimen from day 1 to day 21 after birth. At day 60, 16 animals (8 = well-nourished; 8 = malnourished) were exposed to the pilocarpine experimental model of epilepsy. Age-matched well-nourished (n = 8) and malnourished (n = 8) rats were used as controls. Animals were video-monitored over 9 weeks. The following behavioral parameters were evaluated: first seizure threshold (acute period of the pilocarpine model); status epilepticus (SE) latency; first spontaneous seizure latency (silent period), and spontaneous seizure frequency during the chronic phase. The cell and mossy fiber sprouting (MFS) density were evaluated in the hippocampal formation. Our results showed that the malnourished animals required a lower pilocarpine dose in order to develop SE (200 mg/kg), lower latency to reach SE, less time for the first spontaneous seizure and higher seizure frequency, when compared to well-nourished pilocarpine rats. Histopathological findings revealed a significant cell density reduction in the CA1 region and intense MFS among the malnourished animals. Our data indicate that early malnutrition greatly influences susceptibility to seizures and behavioral manifestations in adult life. These findings suggest that malnutrition in infancy reduces the threshold for epilepsy and promotes alterations in the brain that persist into adult life.