Abstract
Background: There is a high demand for stroke rehabilitation in the Brazilian public health system, however most studies that addressed rehabilitation for unilateral spatial neglect (USN) after stroke have been performed in highincome countries. Objectives: Analyze the USN patient recruitment in a multicenter non-invasive brain stimulation clinical trial performed in Brazil. Design and setting: Observation study of reasons for exclusion of patients in a multicenter, randomized, double-blinded clinical trial performed at Botucatu Medical School. Methods: We evaluated reasons for exclusion of patients in a multicenter, randomized, double-blinded clinical trial of rehabilitation of USN patients after stroke. Results: 173 of 1956 potential neglect patients (8.8%) passed initial screening. After screening evaluation, 87/173 patients (50.3%) were excluded for clinical reasons. Cognitive impairment led to exclusion of 21/87 patients (24.1%). Low socioeconomic status led to exclusion of 37/173 patients (21.4%). Difficulty in transportation to access treatment was the most common reason (16/37 patients, 43.3%). Conclusions: The analyzed Brazilian institutions have potential for conducting studies in USN. Recruitment of stroke survivors with USN was restricted by the study design and limited financial support. Cognitive impairment, presence of stent or craniectomy and lack of transportation was the most common barriers to participate in a multicenter non-invasive brain stimulation trial in patients with unilateral spatial neglect after stroke.
Highlights
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack
Objectives: 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
The analyses showed significantly higher frequency of the genotype VV in those who had depression, compared with the allele A
Summary
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack. Neuroinfections are pathologies that affect the CNS, for example, we have Murcomycosis, a progressive infection caused by opportunistic fungi of the order Mucorales, with high frequency in Immunodepressed patients, Diabetes Mellitus (DM) is the main underlying pathology associated with the development of Rhinocerebral Murcomycosis, which represents 50% of the cases, with a mortality rate of 70% (Sidrim, 2012, p.168). The COVID-19 pandemic has been alarming the world since its first outbreak in December 2019 In this scenario, the presence of aggravating factors such as the elevation of the D-dimer and the reduction of the angiotensin-converting enzyme 2 (ACE2) during the clinical course of the disease, collaborated in the appearance of thromboembolic events derived from inflammatory processes and extensive intravascular coagulation, contributing to the emergence of diseases such as Hemorrhagic Stroke (ICH), leading the patient to have a worse clinical prognosis and a consecutive worsening of their health. Despite being classically associated with this etiology, the finding may be present in other diseases, especially infiltrative ones
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