Consultas para o coronavírus em Curitiba e região metropolitana
O coronavírus em Curitiba está explodindo em abril, como previmos na primeira versão deste artigo no fim de fevereiro. Na prática, tem sido difícil confirmar o diagnóstico no Paraná. Suspeitos de coronavírus em Curitiba passam por uma rotina de consultas e exames que podem demorar vários dias. Como nos EUA, onde 5 estados tinham kits […]
The bottom line on healthy diet and habits
Presumably people would aquire a healthy diet and habits in order to live free of disease or disability for a longer time. That is the case in the countries that surround the Mediterranean Sea and in Japan, according to very reliable statistics and epidemiology over the past 20 years. In these regions people are living […]
A origem do alcoolismo na genética e na cultura
A origem do alcoolismo é reconhecidamente multifatorial, consequência de fatores intrínsecos da pessoa e de sua interação com o meio ambiente. É o mesmo caso que o abuso de algumas substâncias, sempre as mesmas, que acompanha a humanidade desde 4 mil anos atrás. Foi só nos últimos 100 anos que começou o movimento no sentido […]
Canabinoides e canabidiol disponíveis no Brasil
Canabinóides são uma fonte frequente de interesse por parte de muitas pessoas com uma variedade de problemas clínicos. A impressão é que estas pessoas enxergam nos canabinoides uma solução para muitas situações clínicas. Porém, transformar esta ideia em algo prático esbarra inicialmente na disponibilidade no Brasil. Agora mesmo tive um caso de um paciente com […]
Daily high dose vitamin D in multiple sclerosis has no effect
Daily high dose vitamin D has been a treatment of choice for many people with multiple sclerosis, more specifically a few pockets of patients who follow some physicians in certain places in the world, such as São Paulo. The complete package these physicians and patients use is vitamin D enough to keep the blood level […]
Neuroimaging of multiple sclerosis and disease progression
Neuroimaging of multiple sclerosis has made many relevant discoveries on the the natural history of multiple sclerosis, nowadays very well known. Patients have neurological relapses followed by remissisons for a decade (adults) or 2 decades ( children), when they develop neurological progression, usually consisting of progressive paraparesis. The cause of this progression has been debated. […]
Ocrelizumab, teriflunomide and dymethylfumarate
Ocrelizumab, teriflunomide and dymethylfumarate are becoming increasingly available and useful in therapy of multiple sclerosis. Ocrelizumab has been shown to be superior to interferon already in the first few weeks of use. Barkhoff et al. Neurology 2019, 93:e1778-e1786 These investigators looked at MRI and clinically assessed disease activity in 1800 patientsw ho had participated in […]
Natalizumab loses effect with time of infusion
That natalizumab loses effect as time of infusion goes on is well known. A study has confirmed the experience of many patients that natalizumab loses effect over time, and has demonstrated that it is not due to the pharmacokinetic or pharmacodynamic mechanisms evaluated. The authors were based in Amsterdam and looked at 93 adults aged […]
CT perfusion imaging takes over the scene in acute stroke
CT perfusion imaging has entered the scene of those involved in the quest for decreasing the burden of stroke. Specifically, in the case of people that reach care more than 6h after they were last well, with large artery occlusions in the anterior circulation, involving the carotid and middle cerebral arteries. It has been calculated […]
Functional tremor and cognitive behavioral therapy
Functional tremor and functional movement disorders are a daily clinical problem. They are common and difficult to diagnose. They become even more difficult to manage, as many people do not accept or understand the functional nature of their problem. It is as if they prefered to have some complex disease, impossible to treat. Many come […]
