Techniques chirurgicales utilisées dans la reconstruction du LCA

No grupo DP, o tremor foi o sintoma mais relatado e a maioria dos indivíduos era do gênero masculino. Esta amostra em grande parte foi constituída por pacientes que apresentavam a forma esporádica da DP.

Foram determinadas as frequências _{alélicas e genotípicas dos polimorfismos} rs4839797, rs2518261, rs2227281, rs2227283, rs3213607 e rs2235076 no gene GRIK2 no grupo DP e grupo controle. Três SNPs foram excluídos das análises de associação por não estarem em equilíbrio de Hardy-Weinberg (rs2227281 e 2227283) ou por apresentar frequência do menor alelo menor que 5% (rs2235076).

Quanto aos SNPs rs4839797 e rs3213607 não foram encontradas diferenças estatisticamente significativas entre os dois grupos (DP e controle) ou com as características clinico-epidemiológicas dos pacientes (sinais clínicos e idade de início dos sintomas).

Foi verificada a existência de uma associação do SNP rs2518261 (C/T) no grupo DP. Observou-se que o alelo T pareceu ter um efeito de risco para a DP, e que o genótipo TT foi associado com a ocorrência de tremor no grupo DP.

Os resultados obtidos entre o gene GRIK2 e a DP neste estudo inicial, instiga a realização de investigações maiores e mais precisas, no intuito de confirmar os achados aqui relatados.

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ANEXOS

Anexo I – Critérios Clínicos de Diagnóstico de DP

Critérios Clínicos de Diagnóstico do Banco de Cérebro da Sociedade de Doença de Parkinson do Reino Unido

(UK Parkinson’s Disease Society Brain Bank Clinical Diagnostic Criteria) Etapa 1: Diagnóstico de síndrome parkinsoniana

Bradicinesia e pelo menos um dos seguintes: rigidez muscular, tremor de repouso de 4 a 6 Hz, instabilidade postural não causada por disfunção primária visual, vestibular, cerebelar ou proprioceptiva.

Etapa 2: Critérios de Exclusão para Doença de Parkinson

História de acidente cerebrovascular de repetição com progressão em degrau das características parkinsonianas; história de traumatismo craniano de repetição; história de encefalite definida; crises oculógiras; tratamento com neurolépticos no início dos sintomas; mais de um parente afetado; remissão sustentada; características estritamente unilaterais após 3 anos; paralisia supranuclear do olhar; sinais cerebelares; envolvimento autonômico precoce grave, demência precoce grave com distúrbios de memória, linguagem e praxia; sinal de Babinski; presença de tumor cerebral ou hidrocefalia comunicante na tomografia computadorizada; resposta negativa a altas doses de levodopa (excluindo-se mal absorção); exposição a MPTP.

Etapa 3: Critérios Prospectivos Positivos de Suporte para Doença de Parkinson (são requeridos três ou mais para o diagnóstico de doença de Parkinson definida)

Início unilateral, tremor de repouso presente, doença progressiva, assimetria persistente afetando mais do lado de início, resposta excelente (70 a 100%) à levodopa, coréia grave induzida por levodopa, resposta à levodopa por 5 ou mais anos, curso clínico de 10 anos ou mais.

Dans le document Entorses graves du genou ( a propos de 10 cas). (Page 105-118)