Purpose. To report a case of successful thrombolysis performed in a patient with an incidental unruptured intracranial aneurysm and review the literature. Case Report. Patient admitted for ischemic stroke due to left posterior cerebral artery occlusion, with an incidental right middle cerebral artery aneurysm, who underwent treatment with tissue plasminogen activator (rtPA) resulting in clinical improvement without complications. Conclusion. The presence of unruptured intracranial aneurysms is considered as a contraindication to thrombolysis, due to a potentially higher hemorrhagic risk of aneurysm rupture. Patients, otherwise, eligible for thrombolysis are usually excluded from receiving this emergent treatment, despite its potential benefits. A reevaluation of the strict exclusion criteria for thrombolysis in acute stroke patients should be considered.

Aims To investigate the association between BsmI and DM2 in patients with and without DR and to correlate with clinical parameters in a population in northeastern Brazil. Methods Cross-sectional case-control study in which data were collected from 285 individuals, including 128 patients with DM2 and 157 with DR. Clinical, biochemical and anthropometric parameters were analyzed, in addition to the single nucleotide polymorphism (SNP) BsmI of the VDR gene (rs1544410), genotyped by PCR-RFLP. Results In the DR group we found a greater number of patients using insulin therapy (p = 0.000) and with longer duration of DM2 (p = 0.000), in addition to higher serum creatinine values (p = 0.001). Higher fasting glucose levels and higher frequency of insulinoterapy were independently observed in patients with DR and b allele carriers, when compared to BB. Conclusion The association of the bb/Bb genotypes (rs1544410) of the VDR gene with increased blood glucose levels and insulinoterapy may represent worse glicemic control in rs1544410 b allele carriers in DR Latin American individuals.

Background: Diabetes Mellitus (DM) is directly associated with cardiovascular dysfunctions and microvascular complications, such as diabetic retinopathy (DR). The association between DR and increased risks of developing cardiovascular diseases has been described. The low activity of the Methylenetetrahydrofolate reductase (MTHFR), an enzyme involved in the metabolism of homocysteine, can lead to hyperhomocysteinemia that has already been related to cardiac outcomes and resistance to insulin. The A1298C and C677T polymorphisms in the MTHFR can reduce enzyme activity. Objective: Analyze the association between MTHFR genotypes and cardiac parameters in patients with DR. Method: DM patients diagnosed with DR (n=65) were categorized and compared according to MTHFR genotypes A1298C (AA and AC+CC groups) and C677T (CC and CT+TT) groups; biochemical, cardiological, anthropometric, genetic, lifestyle and vitamin B9 and B12 consumption variables. Fischer's exact test and Poisson regression were performed to assess the relationship between variables. Results: Comparing echocardiographic and electrocardiogram parameters within genotypic groups, we found a significant association between left atrial dilation and C677T polymorphism. Left atrium diameter was higher in the T allele carriers (CT+TT group), with a prevalence ratio of 0.912. This association was confirmed in the regression model including confounding variables. The other cardiac structural and functional parameters studied were not significantly associated with the A1298C or C677T genotypes. Conclusion: The MTHFR C677T genotype may contributes for atrial remodeling in RD patients. We found an association between the diameter of the left atrium and the T allele of the MTHFR C677T polymorphism in patients with DR.

Aim The study aimed to evaluate the effects of vitamin D3 (VD3) supplementation on inflammation and oxidative stress markers in overweight and obese women with deficiency or insufficiency of vitamin D. Methods Twenty-nine overweight or obese women who had a deficiency or insufficiency of vitamin D were placed into two groups according to VD3 intervention. Patients in the supplemented group received a single oral megadose of VD3 (VD3, n=14). Patients in placebo group received a single oral identical capsule without vitamin D (placebo, n = 15). Anthropometric and biochemical variables were assessed at baseline and after 4-weeks intervention. Results Anthropometric variables (waist circumference, waist–hip ratio, waist–height ratio and body mass index) were similar between groups ( p > 0.05). VD3 supplementation increased the serum levels of 25-hydroxyvitamin D (p=0.000), malondialdehyde ( p =0.021) and C-reactive protein ( p =0.043) in overweight and obese women. Additionally, VD3 supplementation reduced the serum levels of aspartate aminotransferase (AST, p =0.035), alanine aminotransferase (ALT, p <0.0001) in overweight and obese women. Despite this, the serum levels of parathyroid hormone (PTH), fasting glucose (FG), and alpha-1- acid glycoprotein (A1GPA), total antioxidant capacity (TAC) were similar between groups. Conclusion In summary, a single oral megadose of VD3 increased 25-hydroxyvitamin D serum levels but did not improve oxidative stress and inflammation markers.