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Sena LS, Furtado GV, Pedroso JL, Barsottini O, Cornejo-Olivas M, Nóbrega PR, Braga Neto P, Soares DMB, Vargas FR, Godeiro C, Medeiros PFVD, Camejo C, Toralles MBP, Fagundes NJR, Jardim LB, Saraiva-Pereira ML. Spinocerebellar ataxia type 2 has multiple ancestral origins. Parkinsonism Relat Disord 2024; 120:105985. [PMID: 38181536 DOI: 10.1016/j.parkreldis.2023.105985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/13/2023] [Accepted: 12/28/2023] [Indexed: 01/07/2024]
Abstract
INTRODUCTION Spinocerebellar ataxia type 2 (SCA2) is a dominant neurodegenerative disorder due to expansions of a CAG repeat tract (CAGexp) at the ATXN2 gene. Previous studies found only one ancestral haplotype worldwide, with a C allele at rs695871. This homogeneity was unexpected, given the severe anticipations related to SCA2. We aimed to describe informative ancestral haplotypes found in South American SCA2 families. METHODS Seventy-seven SCA2 index cases were recruited from Brazil, Peru, and Uruguay; 263 normal chromosomes were used as controls. The SNPs rs9300319, rs3809274, rs695871, rs1236900 and rs593226, and the STRs D12S1329, D12S1333, D12S1672 and D12S1332, were used to reconstruct haplotypes. RESULTS Eleven ancestral haplotypes were found in SCA2 families. The most frequent ones were A-G-C-C-C (46.7 % of families), G-C-C-C-C (24.6 %) and A-C-C-C-C (10.3 %) and their mean (sd) CAGexp were 41.68 (3.55), 40.42 (4.11) and 45.67 (9.70) (p = 0.055), respectively. In contrast, the mean (sd) CAG lengths at normal alleles grouped per haplotypes G-C-G-A-T, A-G-C-C-C and G-C-C-C-C were 22.97 (3.93), 23.85 (3.59), and 30.81 (4.27) (p < 0.001), respectively. The other SCA2 haplotypes were rare: among them, a G-C-G-A-T lineage was found, evidencing a G allele in rs695871. CONCLUSION We identified several distinct ancestral haplotypes in SCA2 families, including an unexpected lineage with a G allele at rs695871, a variation never found in hundreds of SCA2 patients studied worldwide. SCA2 has multiple origins in South America, and more studies should be done in other regions of the world.
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Affiliation(s)
- Lucas Schenatto Sena
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9500, 91501-970, Porto Alegre, Brazil; Centros de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2340, 90035-903, Porto Alegre, Brazil.
| | - Gabriel Vasata Furtado
- Centros de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2340, 90035-903, Porto Alegre, Brazil
| | - José Luiz Pedroso
- Universidade Federal do Estado de São Paulo, Rua Pedro de Toledo 650, 04039-031, São Paulo, Brazil
| | - Orlando Barsottini
- Universidade Federal do Estado de São Paulo, Rua Pedro de Toledo 650, 04039-031, São Paulo, Brazil
| | - Mario Cornejo-Olivas
- Neurogenetics Working Group, Universidad Cientifica del Sur, 19 Panamericana S Avenue, 15067, Lima, 15067, Peru; Neurogenetics Research Center, Instituto Nacional de Ciencias Neurológicas, 1271 Ancas St, 15003, Lima, Peru
| | - Paulo Ribeiro Nóbrega
- Setor de Neurologia, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal do Ceará, Rua Professor Costa Mendes, 1608, 60430-140, Fortaleza, CE, Brazil; Centro Universitário Christus, Rua Alexandre Baraúna 949, 60430-160, Fortaleza, CE, Brazil
| | - Pedro Braga Neto
- Setor de Neurologia, Departamento de Medicina Clínica, Faculdade de Medicina, Universidade Federal do Ceará, Rua Professor Costa Mendes, 1608, 60430-140, Fortaleza, CE, Brazil; Curso de Medicina, Centro de Ciências da Saúde, Universidade Estadual do Ceará, Avenida Dr. Silas Munguba, 1700, 60714-903, Fortaleza, CE, Brazil
| | - Danyela Martins Bezerra Soares
- Curso de Medicina, Centro de Ciências da Saúde, Universidade Estadual do Ceará, Avenida Dr. Silas Munguba, 1700, 60714-903, Fortaleza, CE, Brazil
| | - Fernando Regla Vargas
- Departamento de Genética e Biologia Molecular, Universidade Federal do Estado do Rio de Janeiro, Rua Frei Caneca 94, 20211-010, Rio de Janeiro, Brazil; Laboratório de Epidemiologia de Malformações Congênitas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Avenida Brasil 4365, 21040-900, Rio de Janeiro, Brazil
| | - Clecio Godeiro
- Departamento de Medicina Integrada, Hospital Universitário Onofre Lopes, Avenida Nilo Peçanha, 59012-300, Natal, Brazil
| | - Paula Frassinetti Vasconcelos de Medeiros
- Unidade Acadêmica de Medicina, Hospital Universitário Alcides Carneiro, Universidade Federal de Campina Grande, Rua Carlos Chagas S/n, 58107-670, Campina Grande, Brazil
| | - Claudia Camejo
- Facultad de Medicina. Universidad de La República, Avenida General Flores 3461, 11700, Montevideo, Uruguay
| | | | - Nelson Jurandi Rosa Fagundes
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9500, 91501-970, Porto Alegre, Brazil; Departamento de Genética, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9500, 91501-970, Porto Alegre, Brazil
| | - Laura Bannach Jardim
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9500, 91501-970, Porto Alegre, Brazil; Centros de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2340, 90035-903, Porto Alegre, Brazil; Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2340, 90.035-903, Brazil; Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2400, 90035-002, Porto Alegre, Brazil
| | - Maria Luiza Saraiva-Pereira
- Programa de Pós-Graduação em Genética e Biologia Molecular, Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9500, 91501-970, Porto Alegre, Brazil; Centros de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2340, 90035-903, Porto Alegre, Brazil; Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2340, 90.035-903, Brazil; Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600, 90035-003, Porto Alegre, Brazil
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Jardim LB, Hasan A, Kuo SH, Magaña JJ, França M, Marques W, Camejo C, Santana-da-Silva LC, Leão EE, Espíndola G, Canals F, Miranda M, Salvatierra I, Cornejo-Olivas M, Fernandez-Ruiz J, Braga-Neto P, Dávila-Ortiz de Montellano DJ, Flores-Lagunes LL, Dupré N, Brais B, Vargas FR, Godeiro C, Coutinho L, Teive HG, Kaufmann M, Saffie P, Furtado GV, Saraiva-Pereira ML, Barsottini O, Pedroso JL, Rodríguez-Labrada R, Velázquez-Pérez L, Gomez C. An Exploratory Survey on the Care for Ataxic Patients in the American Continents and the Caribbean. Cerebellum 2023; 22:708-718. [PMID: 35796998 PMCID: PMC10461795 DOI: 10.1007/s12311-022-01442-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Little is known about access of rare disease carriers to health care. To increase this knowledge, the Pan American Hereditary Ataxia Network (PAHAN) conducted an exploratory survey about care for hereditary ataxias in American continents and the Caribbean. A questionnaire was sent to health professionals about the hereditary ataxias identified; access to care; and local teaching and research. The number of ataxics under current care per 100,000 inhabitants was subtracted from the expected overall prevalence of 6/100,000, to estimate the prevalence of uncovered ataxic patients. Local Human Development Indexes (HDI) were used to measure socio-economic factors. Twenty-six sites participated. Twelve sites had very high, 13 had high, and one site had medium HDI. Participants reported on 2239 and 602 patients with spinocerebellar ataxias and recessive forms under current care. The number of patients under current care per inhabitants varied between 0.14 and 12/100,000. The estimated prevalence of uncovered ataxic patients was inversely proportional to HDIs (rho = 0.665, p = 0.003). Access to diagnosis, pre-symptomatic tests, and rehabilitation were associated with HDIs. More and better molecular diagnostic tools, protocols and guidelines, and professional training for ataxia care were the top priorities common to all respondents. Evidence of inequalities was confirmed. Lower HDIs were associated with high potential numbers of uncovered ataxic subjects, and with lack of molecular diagnosis, pre-symptomatic testing, and rehabilitation. More and better diagnostic tools, guidelines, and professional training were priorities to all sites. PAHAN consortium might help with the last two tasks.
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Affiliation(s)
- Laura Bannach Jardim
- Serviço de Genética Médica e Centros de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2400, 90035-003, Porto Alegre, Brazil.
- Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, 90035-003, Brazil.
| | - Ali Hasan
- Departamento de Medicina Interna, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, 90035-003, Brazil
| | - Sheng-Han Kuo
- Columbia University, 710 West 168th Street, New York, NY, 10032, USA
| | - Jonathan Javier Magaña
- Instituto Nacional de Rehabilitación - LGII, Calz México-Xochimilco 289, Coapa, Guadalupe Tlalpan, Tlalpan, 14389, Ciudad de México, CDMX, México
| | - Marcondes França
- Universidade Estadual de Campinas, Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP, 13083-970, Brazil
| | - Wilson Marques
- Faculdade de Medicina, Universidade de São Paulo, R. Ten. Catão Roxo, 3900 - Vila Monte Alegre, Ribeirão Preto, SP, 14015-010, Brazil
| | | | - Luiz Carlos Santana-da-Silva
- Instituto de Ciências Biológicas da Universidade Federal do Pará, Av. Perimetral, 2-224 - Guamá, Belém, 66077-830, Brazil
| | - Emília Embiruçu Leão
- Singular Medicina de Precisão, Rua Ewerton Visco, 290 - Sala 1301 - Caminho das Árvores, Salvador, 41820-022, Brazil
| | - Gisele Espíndola
- Hospital Universitário Polydoro Ernani de São Thiago da Universidade Federal de Santa Catarina, R. Profa. Maria Flora Pausewang - Trindade, Florianópolis, 88036-800, Brazil
| | - Francisca Canals
- Clinica Alemana, Av Vitacura 5951, Vitacura, Santiago, Región Metropolitana, Chile
| | - Marcelo Miranda
- Fundacion Diagnosis, Antonio Varas 175 of 32, Providencia, Santiago, Chile
| | - Igor Salvatierra
- Hospital Materno Infantil, Clinica Los Andes, GR46+9V7, El Alto, Bolívia
| | - Mario Cornejo-Olivas
- Instituto Nacional de Ciencias Neurologicas, Jr. Ancash 1271, Cercado de Lima 15003, Lima, Peru
| | - Juan Fernandez-Ruiz
- Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Circuito Interior de La Ciudad Universitaria, AV. Universidad 3000, 04510, Ciudad de México, México
| | - Pedro Braga-Neto
- Departamento de Medicina Clínica, Universidade Federal Do Ceará, Rua Pro. Costa Mendes, 1608 - Bloco Didático, 4° andar - Rodolfo Teófilo, Fortaleza, Brazil
| | | | - Luis Leonardo Flores-Lagunes
- Instituto Nacional de Medicina Genómica, Periférico Sur 4809, Arenal Tepepan, Tlalpan, 14610, Ciudad de México, Mexico
| | - Nicolas Dupré
- Department of Medicine, Faculty of Medicine, Université Laval, Ferdinand Vandry Pavillon, 1050 Av. de la Médecine, Quebec City, Quebec, G1V 0A6, Canada
| | - Bernard Brais
- Departments of Neurology and Neurosurgery and Human Genetics, Montreal Neurological Institute-Hospital, Faculty of Medicine, McGill University, University Street, Montreal, Quebec, 3801H3A 2B4, Canada
| | - Fernando Regla Vargas
- Laboratório de Epidemiologia de Malformações Congênitas, Fundação Oswaldo Cruz, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Clécio Godeiro
- Universidade Federal do Rio Grande do Norte, Campus Universitário - Lagoa Nova, Natal, 59078-970, Brazil
| | - Léo Coutinho
- Hospital das Clínicas da Universidade Federal do Paraná, R. Gen. Carneiro, 181 - Alto da Glória, Curitiba, 80060-900, Brazil
| | - Helio G Teive
- Hospital das Clínicas da Universidade Federal do Paraná, R. Gen. Carneiro, 181 - Alto da Glória, Curitiba, 80060-900, Brazil
| | - Marcelo Kaufmann
- Neurogenetics Unit, Hospital Jose Ramos Mejia, Gral. Urquiza 609, C1221 ADC, Buenos Aires, Argentina
| | - Paula Saffie
- Centro de Estudios de Trastornos del Movimiento, Avenida José Joaquín Prieto Vial #7271, Santiago, Chile
| | - Gabriel Vasata Furtado
- Serviço de Genética Médica e Centros de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2400, 90035-003, Porto Alegre, Brazil
| | - Maria Luiza Saraiva-Pereira
- Serviço de Genética Médica e Centros de Pesquisa Clínica e Experimental, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2400, 90035-003, Porto Alegre, Brazil
- Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2600-Prédio Anexo, Porto Alegre, 90035-003, Brazil
| | - Orlando Barsottini
- Universidade Federal do Estado de São Paulo, R. Napoleão de Barros, 715 - Vila Clementino, São Paulo, São Paulo, Brasil
| | - José Luiz Pedroso
- Universidade Federal do Estado de São Paulo, R. Napoleão de Barros, 715 - Vila Clementino, São Paulo, São Paulo, Brasil
| | - Roberto Rodríguez-Labrada
- Cuban Centre for Neurosciences, 190st number 19818 between 27th and 27th, 11600, Playa, Havana, Cuba
- Centro para la Investigación y Rehabilitación de las Ataxias Hereditarias, Libertad Street number 26, between 12th and 16th, 80100, Holguin, Cuba
| | - Luis Velázquez-Pérez
- Centro para la Investigación y Rehabilitación de las Ataxias Hereditarias, Libertad Street number 26, between 12th and 16th, 80100, Holguin, Cuba
- Cuban Academy of Sciences, Cuba St Number 460 Between Teniente Rey and Amargura. Habana Vieja, 10100, Havana, Cuba
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Amorín I, Savia A, Gaye A, Camejo C, Triviño B, Muñoz M, Yancev S, Menendez T, Decima R. National stroke management plan in Uruguay: Challenges and opportunities. Front Neurol 2023; 13:973380. [PMID: 36818723 PMCID: PMC9930904 DOI: 10.3389/fneur.2022.973380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/11/2022] [Indexed: 02/04/2023] Open
Abstract
Stroke accounts for 5.5% of the national Global Burden of Disease (GBD) and ~2,000 deaths per year in Uruguay. To respond to this medical emergency, the Ministry of Public Health (MPH) of Uruguay devised the National Stroke Plan (NSP). Scientific associations, universities, scholars, and patient organizations, both at the national and international levels, took part in the process, which ended with the generation of the national stroke management guidelines, including measures based on the best evidence available. This was accompanied by presidential regulatory decrees and several ordinances that set the foundations of the legal framework for their implementation as of 2020. Forty-two Stroke Ready Centers (SRC) and seven Comprehensive Stroke Centers (CSC) were strategically established and interlinked to ensure compliance with international accessibility recommendations, offering, in turn, the required training for their healthcare teams. A pre-hospital care protocol was also created for all countrywide mobile units. For NSP assessment, stroke was included as a "Care Goal (objective)" for the whole health system, providing the involved healthcare organizations with a financial incentive for compliance with the basic objectives related to the treatment of hyper acute stroke. The NSP came into force during the COVID-19 pandemic and, considering the special circumstances imposed, it made it possible to maintain hyper acute medical care and increase population access to recanalization treatment, particularly mechanical thrombectomy. The purpose of this article is to share our experience in the development of the NSP by describing some preliminary outcomes.
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Affiliation(s)
- Ignacio Amorín
- Brain Health Program, Ministry of Public Health of Uruguay, Montevideo, Uruguay,*Correspondence: Ignacio Amorín
| | - Adolfo Savia
- Hospital San Juan de Dios (San Juan de Dios Hospital), Buenos Aires, Argentina
| | - Andres Gaye
- Hospital de Clínicas (Clinic Hospital), School of Medicine, Montevideo, Uruguay
| | - Claudia Camejo
- Sociedad Uruguaya de Neurología (Uruguayan Neurology Association), Montevideo, Uruguay
| | - Brayan Triviño
- Sociedad Uruguaya de Emergencistas (Uruguayan Association of Emergency Physicians), Montevideo, Uruguay
| | - Matías Muñoz
- Comisión Honoraria de Salud Cardiovascular (Honorary Commission for Cardiovascular Health), Montevideo, Uruguay
| | - Sebastian Yancev
- Sociedad Uruguaya de Emergencistas (Uruguayan Association of Emergency Physicians), Montevideo, Uruguay
| | - Tamara Menendez
- Hospital de Clínicas (Clinic Hospital), School of Medicine, Montevideo, Uruguay
| | - Rodrigo Decima
- Hospital de Clínicas (Clinic Hospital), School of Medicine, Montevideo, Uruguay
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Martins SCO, Lavados P, Secchi TL, Brainin M, Ameriso S, Gongora-Rivera F, Sacks C, Cantú-Brito C, Alvarez Guzman TF, Pérez-Romero GE, Muñoz Collazos M, Barboza MA, Arauz A, Abanto Argomedo C, Novarro-Escudero N, Amorin Costabile HI, Crosa R, Camejo C, Mernes R, Maldonado N, Mora Cuervo DL, Pontes Neto OM, Silva GS, Carbonera LA, de Souza AC, de Sousa EDG, Flores A, Melgarejo D, Santos Carquin IR, Hoppe A, de Carvalho JJF, Mont'Alverne F, Amaya P, Bayona H, Navia González VH, Duran JC, Urrutia VC, Araujo DV, Feigin VL, Nogueira RG. Fighting Against Stroke in Latin America: A Joint Effort of Medical Professional Societies and Governments. Front Neurol 2021; 12:743732. [PMID: 34659101 PMCID: PMC8517273 DOI: 10.3389/fneur.2021.743732] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Stroke is one of the leading causes of death in Latin America, a region with countless gaps to be addressed to decrease its burden. In 2018, at the first Latin American Stroke Ministerial Meeting, stroke physician and healthcare manager representatives from 13 countries signed the Declaration of Gramado with the priorities to improve the region, with the commitment to implement all evidence-based strategies for stroke care. The second meeting in March 2020 reviewed the achievements in 2 years and discussed new objectives. This paper will review the 2-year advances and future plans of the Latin American alliance for stroke. Method: In March 2020, a survey based on the Declaration of Gramado items was sent to the neurologists participants of the Stroke Ministerial Meetings. The results were confirmed with representatives of the Ministries of Health and leaders from the countries at the second Latin American Stroke Ministerial Meeting. Results: In 2 years, public stroke awareness initiatives increased from 25 to 75% of countries. All countries have started programs to encourage physical activity, and there has been an increase in the number of countries that implement, at least partially, strategies to identify and treat hypertension, diabetes, and lifestyle risk factors. Programs to identify and treat dyslipidemia and atrial fibrillation still remained poor. The number of stroke centers increased from 322 to 448, all of them providing intravenous thrombolysis, with an increase in countries with stroke units. All countries have mechanical thrombectomy, but mostly restricted to a few private hospitals. Pre-hospital organization remains limited. The utilization of telemedicine has increased but is restricted to a few hospitals and is not widely available throughout the country. Patients have late, if any, access to rehabilitation after hospital discharge. Conclusion: The initiative to collaborate, exchange experiences, and unite societies and governments to improve stroke care in Latin America has yielded good results. Important advances have been made in the region in terms of increasing the number of acute stroke care services, implementing reperfusion treatments and creating programs for the detection and treatment of risk factors. We hope that this approach can reduce inequalities in stroke care in Latin America and serves as a model for other under-resourced environments.
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Affiliation(s)
- Sheila Cristina Ouriques Martins
- Hospital Moinhos de Vento, Porto Alegre, Brazil.,Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Brazilian Stroke Network, Porto Alegre, Brazil.,World Stroke Organization, Geneva, Switzerland
| | - Pablo Lavados
- Clinica Alemana, Universidad del Desarollo, Santiago, Chile
| | - Thaís Leite Secchi
- Hospital Moinhos de Vento, Porto Alegre, Brazil.,Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Brazilian Stroke Network, Porto Alegre, Brazil
| | - Michael Brainin
- World Stroke Organization, Geneva, Switzerland.,Department of Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems an der Donau, Austria
| | - Sebastian Ameriso
- Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia, Buenos Aires, Argentina
| | - Fernando Gongora-Rivera
- Servicio de Neurología - Unidad Neurovascular, Hospital Universitario José Eleuterio González, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.,Instituto de Neurología y Neurocirugía, Centro Médico Zambrano Hellion, Tec Salud, San Pedro Garza García, Mexico.,Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Aiutónoma de Nuevo León, Monterrey, Mexico
| | - Claudio Sacks
- Department of Neurology, Universidad del Valparaiso, Valparaiso, Chile
| | - Carlos Cantú-Brito
- Department of Neurology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Mexico City, Mexico
| | - Tony Fabian Alvarez Guzman
- Hospital Regional Manuela Beltran, Socorro, Colombia.,Asociación Colombiana de Neurología, Bogotá, Colombia
| | - Germán Enrique Pérez-Romero
- Asociación Colombiana de Neurología, Bogotá, Colombia.,Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.,Fundación Hospital San Carlos, Bogotá, Colombia
| | | | - Miguel A Barboza
- Hospital Dr. Rafael A. Calderon, Neuroscience Department, San José, Costa Rica
| | - Antonio Arauz
- Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Clínica de Enfermedad Vascular Cerebral, Ciudad de México, Mexico
| | - Carlos Abanto Argomedo
- Departamento de Enfermedades Neurovasculares, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | | | | | | | | | - Ricardo Mernes
- Hospital de Clinicas, Faculdad de Medicina, Universidad Nacional de Asuncion, San Lorenzo, Paraguay
| | - Nelson Maldonado
- Hospital Central del Instituto de Previsión Social, Asunción, Paraguay
| | | | - Octávio Marques Pontes Neto
- Brazilian Stroke Network, Porto Alegre, Brazil.,Universidad San Francisco de Quito, Hospital de los Valles, Quito, Ecuador.,Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Gisele Sampaio Silva
- Brazilian Stroke Network, Porto Alegre, Brazil.,Brazilian Stroke Society, São Paulo, Brazil.,Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Ana Claudia de Souza
- Hospital Moinhos de Vento, Porto Alegre, Brazil.,Brazilian Stroke Network, Porto Alegre, Brazil
| | | | - Alan Flores
- Hospital de Clinicas, Faculdad de Medicina, Universidad Nacional de Asuncion, San Lorenzo, Paraguay
| | - Donoban Melgarejo
- Hospital de Clinicas, Faculdad de Medicina, Universidad Nacional de Asuncion, San Lorenzo, Paraguay.,Hospital Central del Instituto de Previsión Social, Asunción, Paraguay
| | - Irving R Santos Carquin
- Emergency Hospital Public Assistance, Santiago, Chile.,Faculty of Medicine, University of Chile, Santiago, Chile.,Ministry of Health, Santiago, Chile
| | - Arnold Hoppe
- Clinica Alemana, Universidad del Desarollo, Santiago, Chile.,Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
| | | | - Francisco Mont'Alverne
- Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile.,Sociedade Brazileira de Neurorradiologia Diagnóstica e Terapêutica, São Paulo, Brazil
| | - Pablo Amaya
- Servicio de Neurología - Unidad Neurovascular, Hospital Universitario José Eleuterio González, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.,Asociación Colombiana de Neurología, Bogotá, Colombia.,Fundación Valle del Lili, Cali, Colombia
| | - Hernan Bayona
- Asociación Colombiana de Neurología, Bogotá, Colombia.,Fundación Santa Fé de Bogotá, Bogotá, Colombia
| | | | | | - Victor C Urrutia
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Denizar Vianna Araujo
- Ministry of Health, Brasília, Brazil.,Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Valery L Feigin
- National Institute for Stroke and Applied Neurosciences, School of Public Health and Psychosocial Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Raul G Nogueira
- Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, Emory University, Atlanta, GA, United States
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Gaye Saavedra A, Camejo C, Salamano R, Brunet F, Albisu S. Stroke care organization in public health of Montevideo, Uruguay. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.1344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Brunet F, Gaye Saavedra A, Gil J, Camejo C, Albisu S, Salamano R. Lacunar infarction (LI) in the hospital de clínicas stroke unit, Montevideo Uruguay. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.1345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Brunet F, Gaye Saavedra A, Camejo C, Albisu S, Salamano R. Intravenous thrombolysis in cerebral infarction (CI) in Uruguay. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.1343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Scaramelli A, Braga P, Avellanal A, Bogacz A, Camejo C, Rega I, Messano T, Arciere B. Prodromal symptoms in epileptic patients: clinical characterization of the pre-ictal phase. Seizure 2008; 18:246-50. [PMID: 19042142 DOI: 10.1016/j.seizure.2008.10.007] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Revised: 10/17/2008] [Accepted: 10/23/2008] [Indexed: 10/21/2022] Open
Abstract
Although recent advances in seizure anticipation have been achieved with the development of several biomathematical electroencephalographic (EEG) methods, pre-ictal clinical phenomena have not been extensively investigated. The aim of the study was to thoroughly analyze premonitory or prodromal symptoms (PS) in a randomly selected sample of 100 adult epileptic patients. A semi-structured protocol was used for in-person interviews to both patients and observers. PS were found in 39% of patients, the most frequent ones being behavioral, cognitive and mood changes. Both patients with focal and generalized epilepsies reported prodromes, although they were more frequently found in the former group. PS were mostly perceived preceding complex partial and generalized tonic-clonic seizures. Prodromal symptoms were reported to have an insidious onset and their duration ranged from 30min to several hours. The potential value of prodromes in seizure anticipation would allow the use of preventive and therapeutic measures, including drugs, neurostimulation procedures and behavioral intervention.
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Affiliation(s)
- Alejandro Scaramelli
- Instituto de Neurología, Hospital de Clínicas, Av. Italia S/N, Montevideo 11600, Uruguay.
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Rodríguez M, Camejo C, Bertoni B, Braida C, Rodríguez MM, Brais B, Medici M, Roche L. (GCG)11 founder mutation in the PABPN1 gene of OPMD Uruguayan families. Neuromuscul Disord 2005; 15:185-90. [PMID: 15694141 DOI: 10.1016/j.nmd.2004.10.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2004] [Revised: 10/20/2004] [Accepted: 10/27/2004] [Indexed: 10/26/2022]
Abstract
The dominant oculo-pharyngeal muscular dystrophy mutation consists of an expanded (GCN)(12-17) in the coding region of the PolyA Binding Protein Nuclear 1 gene. A founder effect has been demonstrated in Canadian and Bukhara Jewish populations with relatively high prevalence of this disease. Since the oculo-pharyngeal muscular dystrophy prevalence was remarkably high in Southern Uruguay, a founder effect was hypothesized. To identify the ancestral haplotype we determined the (GCN) repeat number and the variants of four intragenic SNPs in Uruguayan OPMD families and a control sample. All families carrying the mutation (GCG)(11)(GCA)(3)(GCG) shared a common ancestral haplotype and the age of the mutation was estimated in 37-53 generations by a composite likelihood method. One family carrying the (GCG)(9)(GCA)(3)(GCG) allele had a different haplotype. The genealogical and molecular data suggested that the common ancestors were Canary Islands' settlers that arrived in Uruguay in the XIX century.
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Affiliation(s)
- M Rodríguez
- Departamento de Genética, Facultad de Medicina, Universidad de la República, Avda. Gral. Flores 2125, 11800 Montevideo, Uruguay
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Scaramelli A, Martinez C, Yorio D, Piñeyrúa M, Camejo C, Emanuelli G, Coirolo G, Rega I, Caseres R, Orellana C, Avellanal A, Aguilar J. 4-17-23 Precipitating factors in a population of epileptic patients. Preliminary results. J Neurol Sci 1997. [DOI: 10.1016/s0022-510x(97)86032-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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