Abstract
Background: Stroke can injure the upper motor neuron, and may develop spasticity, a speed-dependent excessive contraction that makes muscle extension difficult. The botulinum toxin type A make contraction difficult, by inhibiting acetylcholine liberation by the lower motor neuron. Thus, it is hypothesized that the botulinum toxin has benefits in post-stroke spasticity. Objective: To evaluate the benefits of botulinum toxin in post-stroke spasticity. Methods: This is a literature review, which articles were searched via PubMed, with MeSH descriptors, using the formula: (“Botulinum toxin type A”) AND (“stroke”) AND (“spasticity”). Clinical trials, systematics reviews and metanalysis, that used botulinum toxin type A as intervention were included. Results: The search resulted in 16 articles, and 5 were selected. A metanalysis, that included 10 clinical trials, evaluated 950 patients and the botulinum toxin type A in superior limbs spasticity has not shown benefits. Yet, another metanalysis which evaluated 27 clinical trials with 2793 patien ts, with both superior and inferior limbs spasticity, demonstrated improvement in levels of tonicity and deficiency evaluation scales. A prospective cohort whose outcome was based in doctor-patient goals has shown great improvement in mobility (87%), positioning (100%), pain relief and spasms (>80%). A clinical trial has also shown improvement on inferior limb function after 3 months of botulinum toxin use. Conclusions: The botulinum toxin use for improvement in inferior limbs spasticity is well described on the literature. However, its use for superior limbs is still controversial, requiring more studies.
Highlights
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack
The present review study aimed to address the mechanisms of action of capsaicin and other chemical inducers in mast cell degranulation and an interaction of nerves and events that happen in the dura mater with the activation of mast cells
Conclusion: the analyzed data indicate that the polymorphisms contributed to the susceptibility to Parkinson’s disease (PD), further studies related to the polymorphisms and their relationship to PD are still needed for more ethnic groups, and early diagnosis is possible
Summary
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack. Methods: A literature review and an observational, descriptive and transversal data collect on treatment for acute demyelinating polyradiculoneuritis, available at DATASUS from January 2008 to December 2020, and articles available at Scielo and PubMed. Results: There were 7,917 hospitalizations, representing a total expenditure of R$ 9,392,552.04, 2009 being the year with the highest number of hospitalizations (809) and 2017 with the highest amount spent during the period (R$ 967,284.65). Methods: A literature review and an observational, descriptive and transversal data collect on surgical treatment was carried out, available from January 2008 to December 2020 and articles available in Scielo, Lilacs and PubMed. Results: There were 15,148 hospitalizations for surgical procedures for the treatment of chronic subdural hematoma, representing a total expenditure of R$ 45,365,258.21, with 2018 being the year with the highest number of hospitalizations (1,418) and with the highest amount spent during the period (R$ 4,570,334.28). Conclusions: The “Coca-Cola Bottle sign” is a classic sign of Graves’ disease, some signs, such as, unilateral and single orbital musculature involvement, may be suggestive of involvement by other etiologies, suggesting the benefit of an early expanded investigation
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