IntroductionCall Fleming syndrome is a reversible cerebral vasoconstriction syndrome of idiopathic etiology that causes thunderclap headache. It is a condition with a good prognosis, but clinically and radiologically similar to other diseases, such as nervous system vasculitis. Objectives To bring clinical, radiological and laboratorial aspects of Call Fleming Syndrome and nervous system vasculitis and provide the differentiation of both. MethodologyThe research is an integrative review, carried out in June 2022, using the SciElo and Pubmed databases. From the keywords: Call-Fleming syndrome) AND (Diagnosis), (Case report), (Radiology), the clinical, laboratorial and radiological profile of the Call-Fleming Syndrome was traced while the keywords (Nervous System) AND (Vasculitis) AND (Diagnosis), (Case report), (Radiology) were used to CNS vasculitis. Then, from case reports, radiology articles and laboratory analyses, the diseases in question were compared in terms of similarities and differences. ResultsBoth pathologies are similar from a clinical point of view: they are frequent causes of thunderclap headache, a sudden and severe headache that reaches its maximum intensity within 1 minute. Some patients with Call-Fleming Syndrome may present several neurological deficits, the more frequents in case reports are hemiparesis, hemianopia, and loss of balance. The disease has a limited course that lasts from 1 to 3 months, however, its main complications are hemorrhages and cerebral infarction. The age group affected in the reported cases ranges from 10 to 76 years and there is a slight predominance of cases in women. (To see the complete abstract, please, check out the pdf).

IntroductionRocky Mountain spotted fever is a tick-borne rickettsiosis. The main clinical signs and symptoms are fever, severe headache, rashes and myalgia. Endothelium tropism can lead to vasculitis, thrombosis, and hemorrhage. In addition, the disease can generate neurological impairment through meningoencephalitis, characterized by holocranial headache. It is considered difficult to diagnose and underreported because nonspecific signs and it is commonly confused with dengue. Objectives To analyze the epidemiology of spotted fever in São Paulo (state) between 2010 and 2020. MethodologyThe work is a descriptive cross-sectional study that statistically analyzes the cases of spotted fever in São Paulo between 2010 and 2020 through data obtained by the Information System of Notifiable Diseases (SINAN). The proportions of spotted fever cases were calculated according to: sex, age group, race/color, infection environment, confirmation criteria and evolution. The correlation coefficient between human development index (HDI) and that of the reporting city and mortality was estimated. The number of inhabitants and HDI were from the latest IBGE (Brazilian Institute of Geography and Statistics) census in 2010. ResultsThere are 869 cases were confirmed (representing 44% of the country's cases), of which 324 are from the metropolitan region of Campinas. The correlation coefficient between HDI and deaths is 0.06 and the average HDI of the cities is 0.79. (To see the complete abstract, please, check out the PDF).

Introduction: The kinetic energy of TBI generates mechanical deformation, which causes release of glutamate, activating ionotropic receptors, principally NMDA receptors, favoring the flow of Ca++ and Na+ into the cell, producing edema. Then, the neurotoxicity generated by glutamate release can be avoided by NMDA antagonists. Objectives: To define if NMDA antagonists are promising for the treatment of TBI by literature analysis and to verify if there are reports of adverse reactions. Methodology: The review utilized the Scielo and Pubmed databases and the keywords used were: NMDA antagonist, Brain edema and Brain injury. The review contains 5 animal tests and 5 clinical studies. Results: Animal tests: CP-98,133 minimized edema, motor damage and is promising in the treatment of memory dysfunction after TBI. The NPS 1506 reduced edema in 24h, without altering the necrosis significantly. Ketamine decreased the volume of necrosis without altering the edema. HU-211 reduced the edema slightly. Clinical studies: NPS 1506 showed a neuroprotective profile and no serius effects. Traxoprodil decreased the mortality rate by 7%. CP-101.606 improved the patient’s condition, without adverse effects. Conclusion: Although NMDA antagonists demonstrate effectiveness in TBI treatment, more studies about adverse effects and efficiency are still needed. Among those analyzed, traxoprodil, NPS-1506 and CP-101.606 still don’t present serious adverse effects and demonstrate effectiveness, proving promising for new studies.

Introduction: The main symptoms of Parkinson are: tremors, movement resistance, postural instability and bradykinesia. However, other diseases such as Progressive Supranuclear Paralysis, Multiple System Atrophy and Corticobasal Degeneration have similar symptoms. This similarity generates a difficulty of diagnosis, for example, Corticobasal Degeneration is often diagnosed by autopsy. Objectives: To define the differentiating symptoms of Parkinson and the diseases mentioned and to find clinical tests that could aid in the diagnosis. Methodology: The integrative review utilized Scielo and Pubmed databases and the selected clinical examinations were obtained by the book Exame Clinico - 8° edition. Results: Multiple Systems Atrophy is distinguished from Parkinson by occurrence of cerebelar abnormalities, therefore Romberg Test can evidence modified coordination, which may be indicative of Multiple System Atrophy. Corticobasal Degeneration causes loss of ability to identify things by touch and impaired sensitivity on one side of the body, thereby the verification of stereognosia and the examination of superficial sensitivity are useful. Supranuclear Paralysis Progressive generates difficulty of performing vertical movements, thus the examination of ocular motility is necessary. Conclusion: Only clinical examinations aren’t sufficient to generate an accurate diagnosis and complementary exams are necessary for greater precision. However, knowledge about differentiating clinical examinations helps to generate a line of reasoning and examinations to be requested.

Hepatite auto-imune. Colestase. Cirrose ÁREA TEMÁTICA: Outras. INTRODUÇÃOA colangite esclerosante primária (CEP) é uma síndrome autoimune caracterizada clinicamente por início gradativo com sinais e sintomas de síndrome colestática como: fadiga, prurido e icterícia, além de episódios de dor em hipocôndrio direito associados a febre, que são atribuídos a quadros recorrentes de colangite bacteriana ascendente. Trata-se, portanto, de uma doença de difícil diagnóstico que pode iniciar o quadro de forma subclínica apresentando curso variável evoluindo para insuficiência hepática grave, caracterizada por inflamação e fibrose de ductos biliares intra e extra-hepáticos e progressão lenta para a cirrose hepática.