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Carbon and other volatiles in the form of gases, fluids or mineral phases are transported from Earth's surface into the mantle at convergent margins, where the oceanic crust subducts beneath the continental crust. The efficiency of this transfer has profound implications for the nature and scale of geochemical heterogeneities in Earth's deep mantle and shallow crustal reservoirs, as well as Earth's oxidation state. However, the proportions of volatiles released from the forearc and backarc are not well constrained compared to fluxes from the volcanic arc front. Here we use helium and carbon isotope data from deeply sourced springs along two cross-arc transects to show that about 91 per cent of carbon released from the slab and mantle beneath the Costa Rican forearc is sequestered within the crust by calcite deposition. Around an additional three per cent is incorporated into the biomass through microbial chemolithoautotrophy, whereby microbes assimilate inorganic carbon into biomass. We estimate that between 1.2 × 108 and 1.3 × 1010 moles of carbon dioxide per year are released from the slab beneath the forearc, and thus up to about 19 per cent less carbon is being transferred into Earth's deep mantle than previously estimated.
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Dióxido de Carbono/análise , Sequestro de Carbono , Sedimentos Geológicos/química , Biomassa , Isótopos de Carbono , Costa Rica , Sedimentos Geológicos/microbiologia , HélioRESUMO
Change history: In this Article, the original affiliation 2 was not applicable and has been removed. In addition, in the Acknowledgements there was a statement missing and an error in a name. These errors have been corrected online.
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An Amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Everyday client stressors are often challenging to replicate in clinical and research environments, which hinders the ability to reliably reproduce clinical outcomes. To overcome this obstacle, tools that can bridge the inherent disconnect between these settings and the real-world experiences of clients are urgently needed. Virtual reality (VR) promises to provide immersive experiences within controlled laboratory or clinical settings. While the potential opportunities and challenges of VR applications have been scientifically reviewed, clinical adoptions into psychology are hampered by a paucity of practical and methodological publications. This paper intends to address that gap, by providing a four-step process for decision-making considerations, including practical recommendations and an applied case study of developing an exposure-based system for obsessive-compulsive disorder. We provide a framework to make VR accessible for clinician-researchers to create similar systems that realise the promise while encouraging ongoing scientific rigour.
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Realidade Virtual , HumanosRESUMO
AIM: To determine whether there was a relationship between the neutrophil/lymphocyte (NLR), monocyte//lymphocyte (MLR), and the platelet/lymphocyte ratios (PLR) measured in blood samples taken at admission and clinical outcomes (CO) on the 90th day in patients, who were diagnosed as acute ischemic stroke (AIS) in the emergency department (ED) and underwent a mechanical thrombectomy (MT). METHOD: Patients aged ≥ 18 years, who were diagnosed as AIS in the ED and underwent MT were included in the study. Patients, who received diagnostic codes of "Cerebrovascular Diseases" (CVD) according to the ICD-10 diagnostic codes were identified. One hundred fifty patients were enrolled in the study. Modified Rankin Scale (mRS) score was used to determine neurologic status on the 90th day. The patients were divided into the two groups: good and poor CO (mRS 0-2 and mRS 3-6, respectively). The groups were compared in terms of age, sex, and NIHSS, ASPECT, and mRS scores. RESULTS: The rates of successful recanalization and good CO were 81.3 % and 38.7 %, respectively. The mortality rate was 22 %. The recanalization rates in the good and poor CO groups were 100 % and 69.6 %,respectively. Recanalization was achieved in 73.6 % of those with hyperlipidaemia and 88.5 % of those without hyperlipidaemia, which was statistically significant (p = 0.034). We observed a statistically significant relationship between the clinical outcome and NLR, MLR, PLR (p < 0.05). As the result of multivariate analysis, we found only NLR as an independent risk factor for poor CO (p = 0.043). There was also a statistically significant difference between mortality and NLR, PLR (p = 0.001). CONCLUSION: We found that NLR, MLR, PLR values were associated with CO after 90 days; high rates were associated with poor CO and low rates were associated with good CO (Tab. 7, Ref. 38). Text in PDF www.elis.sk Keywords: acute ischemic stroke; neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio; platelet/ /lymphocyte ratio; thrombectomy.
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Isquemia Encefálica , Contagem de Linfócitos , Monócitos , Contagem de Plaquetas , Acidente Vascular Cerebral , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/terapia , Serviço Hospitalar de Emergência , Feminino , Humanos , Linfócitos , Masculino , Neutrófilos , Prognóstico , Acidente Vascular Cerebral/diagnósticoRESUMO
OBJECTIVES: We aimed to compare the plasma levels of biomarkers such as: serum Gal-3, H-FABP, cTnI, and CK-MB in patients, who were admitted to the emergency room with chest pain, and to determine whether these biomarkers have early diagnostic value of acute coronary syndrome (ACS). METHODS: The study was performed in 60 patients aged ≥ 18 years, who were admitted to emergency room. These patients were divided into 3 groups: patients with STEMI (group I, n = 20), patients with NSTEMI (group II, n = 20), and patients with USAP (group III, n = 20). Serum Gal-3, H-FABP, cTnI, and CK-MB levels were measured at admission, and at the 2nd and 4th hours. RESULTS: There were statistically significant differences between the groups in terms of Gal-3 levels at admission, and the 2nd and 4th hours (p = 0.007, p = 0.002, and p = 0.001, respectively). There were statistically significant differences between the groups in terms of H-FABP levels at admission, and the 2nd and 4th hours (p = 0.001, p = 0.003, and p = 0.003, respectively).There were statistically significant differences between the groups in terms of cTnI levels at admission, and the 2nd and 4th hours (p < 0.001, p < 0.001, and p < 0.001, respectively). CONCLUSIONS: According to the results of the study, cTnI, H-FABP, and Gal-3 are useful parameters that can be used in the early diagnosis of ACS (Tab. 4, Ref. 36).
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Síndrome Coronariana Aguda , Biomarcadores , Proteína 3 Ligante de Ácido Graxo , Fatores de Transcrição , Síndrome Coronariana Aguda/sangue , Síndrome Coronariana Aguda/diagnóstico , Adulto , Biomarcadores/análise , Biomarcadores/sangue , Diagnóstico Precoce , Proteína 3 Ligante de Ácido Graxo/sangue , Proteínas de Ligação a Ácido Graxo , Humanos , Sensibilidade e Especificidade , Fatores de Transcrição/sangue , Troponina IRESUMO
INTRODUCTION: This study was conducted to evaluate the occurrence of violent incidents in the workplace among the various professional groups working in the emergency department. We characterised the types of violence encountered by different occupation groups and the attitude of individuals working in different capacities. METHODS: This cross-sectional study included 323 people representing various professional groups working in two distinct emergency departments in Turkey. The participants were asked to complete questionnaires prepared in advance by the researchers. The data were analysed using the Statistical Package for the Social Sciences (Windows version 15.0). RESULTS: A total of 323 subjects including 189 (58.5%) men and 134 (41.5%) women participated in the study. Their mean (± standard deviation) age was 31.5 ± 6.5 years and 32.0 ± 6.9 years, respectively. In all, 74.0% of participants had been subjected to verbal or physical violence at any point since starting employment in a medical profession. Moreover, 50.2% of participants stated that they had been subjected to violence for more than 5 times. Among those who reported being subjected to violence, 42.7% had formally reported the incident(s). Besides, 74.3% of participants did not enjoy their profession, did not want to work in the emergency department, or would prefer employment in a non-health care field after being subjected to violence. According to the study participants, the most common cause of violence was the attitude of patients or their family members (28.7%). In addition, 79.6% (n=257) of participants stated that they did not have adequate safety protection in their working area. According to the study participants, there is a need for legal regulations to effectively deter violence and increased safety measures designed to reduce the incidence of violence in the emergency department. CONCLUSION: Violence against employees in the emergency department is a widespread problem. This situation has a strong negative effect on employee satisfaction and work performance. In order to reduce the incidence of violence in the emergency department, both patients and their families should be better informed so they have realistic expectations as an emergency patient, deterrent legal regulations should be put in place, and increased efforts should be made to provide enhanced security for emergency department personnel. These measures will reduce workplace violence and the stress experienced by emergency workers. We expect this to have a positive impact on emergency health care service delivery.
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Atitude do Pessoal de Saúde , Serviço Hospitalar de Emergência/estatística & dados numéricos , Satisfação no Emprego , Violência no Trabalho/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Turquia/epidemiologia , Violência no Trabalho/psicologia , Adulto JovemRESUMO
BACKGROUND: There is evidence to suggest that cognitive deficits might persist beyond the acute stages of illness in major depressive disorder (MDD). However, the findings are somewhat inconsistent across the individual studies conducted to date. Our aim was to conduct a systematic review and meta-analysis of existing studies that have examined cognition in euthymic MDD patients. METHOD: Following a systematic search across several publication databases, meta-analyses were conducted for 27 empirical studies that compared euthymic adult MDD patients (895 participants) and healthy controls (997 participants) across a range of cognitive domains. The influence of demographic variables and confounding factors, including age of onset and recurrent episodes, was examined. RESULTS: Compared with healthy controls, euthymic MDD patients were characterized by significantly poorer cognitive functions. However, the magnitude of observed deficits, with the exception of inhibitory control, were generally modest when late-onset cases were excuded. Late-onset cases demonstrated significantly more pronounced deficits in verbal memory, speed of information processing and some executive functions. CONCLUSIONS: Cognitive deficits, especially poor response inhibition, are likely to be persistent features, at least of some forms, of adult-onset MDD. More studies are necessary to examine cognitive dysfunction in remitted psychotic, melancholic and bipolar spectrum MDD. Cognitive deficits overall appear to be more common among patients with late-onset depression, supporting the theories suggesting that possible vascular and neurodegenerative factors play a role in a substantial number of these patients.
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Transtornos Cognitivos/etiologia , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/classificação , HumanosRESUMO
OBJECTIVE: We aimed to show the effectiveness of different treatment methods in the prevention of clinical symptoms and recurrence of De Quervain Tenosynovitis (DQT), which is often seen in nursing women. PATIENTS AND METHODS: Three different treatment methods were used in 124 patients, all of whom were breastfeeding women who visited our clinic between 2017-2022 with a positive Finkelstein test and DQT. Group I comprised 56 patients who underwent surgical treatment under local anesthesia, Group II, 41 patients who received steroid injections as conservative treatment, and Group III, 27 patients who received wrist splints. The patient files of all groups were reviewed retrospectively, and the effects of the treatment methods on clinical symptoms and recurrence were investigated in patients who were followed up at the 2nd, 4th and 8th weeks. RESULTS: The recurrence rate of Group I patients, which were treated surgically, was significantly lower than that of Group II and III (p=0.0001). Among those who received conservative treatment, patients in Group II had significantly lower recurrence rates than those in Group III. At the 8th week of treatment, clinical symptoms had improved by 96.45%, 58.5%, and 7.4% in Groups I, II, and III, respectively. CONCLUSIONS: It is thought that the repetitive movements made during baby care and the edema that develops in breastfeeding women prepare the ground for DQT. Surgery is the most effective treatment method for the improvement of clinical symptoms and prevention of recurrence.
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Doença de De Quervain , Tenossinovite , Humanos , Feminino , Tratamento Conservador , Doença de De Quervain/cirurgia , Doença de De Quervain/diagnóstico , Estudos Retrospectivos , Resultado do TratamentoRESUMO
In this study, the presence and level of macrolide group antibiotics (tylosin and tilmicosin) were analyzed by the High-Performance Liquid Chromatography (HPLC) method in a total of 126 raw meat samples, including 42 chicken breast and 84 beef neck, available for consumption in the Burdur province (Turkey). The method demonstrated good linearity (R2 > 0.999) over the assayed concentration range (0.10-10 µg/mL). Intra-day and inter-day recoveries were used to express the accuracy of the method at three different levels of 0.5, 1, 2.5 µg/mL. Intraday recoveries and relative standard deviation values ranged from 97.270 (0.054)% to 98.643 (0.061)%, and inter-day recoveries and relative standard deviation values ranged from 97.057 (0.070)% to 98.197(0.042)% for tylosin. Intraday recoveries and relative standard deviation values ranged from 96.360 (0.065)% to 98.153 (0.046)%, and inter-day recoveries and relative standard deviation values ranged from 96.050 (0.058)% to 97.053 (0.096)% for tilmicosin. The limit of detection (LOD) value was calculated as 0.473 µg/kg for tylosin, and 0.481 µg/kg for tilmicosin; the limit of quantification (LOQ) value was calculated as 1.561 µg/kg for tylosin, and 1.587 µg/kg for tilmicosin. In general, tylosin and tilmicosin were determined in the range of 8-256 µg/kg and 30-447 µg/kg, respectively, in chicken breast meat samples; also, they were detected in the range of 36-1209 µg/kg and 30-1102 µg/kg, respectively, in beef neck meat samples. It was also found that the residues of tylosin and tilmicosin in chicken and beef meats from the market were at a much higher level than the acceptable limits specified in the regulations. This creates serious problems in terms of the ecosystem, food technology, and public health, and causes significant economic losses.
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Ecossistema , Tilosina , Bovinos , Animais , Tilosina/análise , Cromatografia Líquida de Alta Pressão/veterinária , Cromatografia Líquida de Alta Pressão/métodos , Antibacterianos , Macrolídeos , Carne/análiseRESUMO
Within the framework of effective mass theory, we investigate the effects of spin-orbit interaction (SOI) and Zeeman splitting on the electronic properties of an electron confined in GaAs single quantum rings. Energies and envelope wavefunctions in the system are determined by solving the Schrödinger equation via the finite element method. First, we consider an inversely quadratic model potential to describe electron confining profiles in a single quantum ring. The study also analyzes the influence of applied electric and magnetic fields. Solutions for eigenstates are then used to evaluate the linear inter-state light absorption coefficient through the corresponding resonant transition energies and electric dipole matrix moment elements, assuming circular polarization for the incident radiation. Results show that both SOI effects and Zeeman splitting reduce the absorption intensity for the considered transitions compared to the case when these interactions are absent. In addition, the magnitude and position of the resonant peaks have non-monotonic behavior with external magnetic fields. Secondly, we investigate the electronic and optical properties of the electron confined in the quantum ring with a topological defect in the structure; the results show that the crossings in the energy curves as a function of the magnetic field are eliminated, and, therefore, an improvement in transition energies occurs. In addition, the dipole matrix moments present a non-oscillatory behavior compared to the case when a topological defect is not considered.
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BACKGROUND: Recent evidence from genetic and familial studies revitalized the debate concerning the validity of the distinction between schizophrenia and bipolar disorder. Comparing brain imaging findings is an important avenue to examine similarities and differences and, therefore, the validity of the distinction between these conditions. However, in contrast to bipolar disorder, most patient samples in studies of schizophrenia are predominantly male. This a limiting factor for comparing schizophrenia and bipolar disorder since male gender is associated with more severe neurodevelopmental abnormalities, negative symptoms and cognitive deficits in schizophrenia. METHOD: We used a coordinate-based meta-analysis technique to compare grey matter (GM) abnormalities in male-dominated schizophrenia, gender-balanced schizophrenia and bipolar disorder samples based on published voxel-based morphometry (VBM) studies. In total, 72 English-language, peer reviewed articles published prior to January 2011 were included. All reports used VBM for comparing schizophrenia or bipolar disorder with controls and reported whole-brain analyses in standard stereotactic space. RESULTS: GM reductions were more extensive in male-dominated schizophrenia compared to gender-balanced bipolar disorder and schizophrenia. In gender-balanced samples, GM reductions were less severe. Compared to controls, GM reductions were restricted to dorsal anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex in schizophrenia and ACC and bilateral fronto-insular cortex in bipolar disorder. CONCLUSIONS: When gender is controlled, GM abnormalities in bipolar disorder and schizophrenia are mostly restricted to regions that have a role in emotional and cognitive aspects of salience respectively. Dorsomedial and dorsolateral prefrontal cortex were the only regions that showed greater GM reductions in schizophrenia compared to bipolar disorder.
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Transtorno Bipolar/patologia , Córtex Cerebral/patologia , Imageamento por Ressonância Magnética/estatística & dados numéricos , Esquizofrenia/patologia , Feminino , Humanos , Masculino , Fatores SexuaisRESUMO
BACKGROUND: Depression has been associated with functional alterations in several areas of the cingulate cortex. In this study we have taken a systematic approach to examining how alterations in functional connectivity vary across the functionally diverse subregions of the rostral cingulate cortex. Method Eighteen patients with major depressive disorder, aged 15 to 24 years, were matched with 20 healthy control participants. Using resting-state functional connectivity magnetic resonance imaging (fcMRI), we systematically investigated the functional connectivity of four subregions of the rostral cingulate cortex. Voxelwise statistical maps of each subregion's connectivity with other brain areas were compared between the patient and control groups. RESULTS: The depressed participants showed altered patterns of connectivity with ventral cingulate subregions. They showed increased connectivity between subgenual anterior cingulate cortex (ACC) and dorsomedial frontal cortex, with connectivity strength showing positive correlation with illness severity. Depressed participants also showed increased connectivity between pregenual ACC and left dorsolateral frontal cortex, and decreased connectivity between pregenual ACC and the caudate nucleus bilaterally. CONCLUSIONS: The results reinforce the importance of subgenual ACC for depression, and show a close link between brain regions that support self-related processes and affective visceromotor function. The pregenual ACC also has an important role, with its increased connectivity with dorsolateral frontal cortex suggesting heightened cognitive regulation of affect; and reduced connectivity with the caudate nucleus potentially underlying symptoms such as anhedonia, reduced motivation and psychomotor dysfunction.
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Encéfalo/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Giro do Cíngulo/fisiopatologia , Adolescente , Estudos de Casos e Controles , Núcleo Caudado/fisiopatologia , Feminino , Lobo Frontal/fisiopatologia , Neuroimagem Funcional , Humanos , Imageamento por Ressonância Magnética , Masculino , Vias Neurais/fisiopatologia , Adulto JovemRESUMO
BACKGROUND: Abnormalities in cortico-striatal-pallidal-thalamic (CSPT) circuits have been implicated in major depressive disorder (MDD). However, the robustness of these findings across studies is unclear, as is the extent to which they are influenced by demographic, clinical and pharmacological factors. METHOD: With the aim of clarifying these questions, we conducted a meta-analysis to map the volumetric abnormalities that were most robustly identified in CSPT circuits of individuals with MDD. A systematic search identified 41 studies meeting our inclusion criteria. RESULTS: There were significant volume reductions in prefrontal (especially orbitofrontal) and anterior cingulate cortices, and also in subcortical structures such as the caudate nucleus and putamen, with effect sizes ranging from small to moderate. The subgenual anterior cingulate and orbitofrontal cortices were significantly smaller in antidepressant-free samples compared to medicated patients. Late-life depression (LLD) tended to be associated with smaller volumes in circumscribed frontal and subcortical structures, with the most robust differences being found in thalamic volume. CONCLUSIONS: Individuals with major depression demonstrate volumetric abnormalities of CSPT circuits. However, these observations may be restricted to certain subgroups, highlighting the clinical heterogeneity of the disorder. On the basis of this meta-analysis, CSPT abnormalities were more prominent in those with LLD whereas antidepressant use seemed to normalize certain cortical volumetric abnormalities.
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Encéfalo/patologia , Transtorno Depressivo Maior/patologia , Fatores Etários , Gânglios da Base , Encéfalo/fisiopatologia , Mapeamento Encefálico , Grupos Controle , Interpretação Estatística de Dados , Transtorno Depressivo Maior/fisiopatologia , Giro do Cíngulo , Humanos , Imageamento por Ressonância Magnética , Córtex Pré-Frontal , Análise de Regressão , Índice de Gravidade de Doença , TálamoRESUMO
The aim of the present study was to evaluate the effects of phosphodiesterase type 5 (PDE5) inhibitory drugs, Tadalafil and Sildenafil, on inducible NOS (iNOS), endothelial NOS (eNOS) and p53 genes expressions and apoptosis in ischemia/reperfusion (I/R) induced oxidative injury in rat renal tissue. Eighty Sprague-Dawley rats (300-350 g) were divided into four groups. In ischemia/reperfusion group, rats were subjected to renal ischemia by clamping the left pedicle for 60 min, and then reperfused for 90 min. On the other hand, in other two groups the rats were individually pretreated with Tadalafil and Sildenafil 1 h before the induction of ischemia. Malondialdehyde (MDA) is determined in renal tissue homogenates by high-performance liquid chromatography, the number of apoptotic cell were calculated by TUNEL method and p53 and eNOS expression were detected with immunohistochemistry. On the other hand, myeloperoxidase (MPO) levels were measured by spectrophotometric method and the mRNA level of iNOS in renal tissue was determined by Real-time PCR (RT-PCR). Our results indicate that MDA and MPO levels were increased in the I/R group than those in the control group. Both Tadalafil and Sildenafil treatment decreased the MDA levels in ischemia/reperfusion group, whereas this effect was more potent with Sildenafil. RT-PCR results showed that, iNOS gen expression increased in the I/R group, but decreased in the PDE5 inhibitory drugs treated group. Apoptotic cells, eNOS levels and p53 positive cells were also decreased in PDE5 inhibitory drugs treated group. We suggest that Tadalafil and Sildenafil have beneficial effects against I/R related renal tissue injury and this protective effect is clearer for Sildenafil than Tadalafil.
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Carbolinas/farmacologia , Isquemia/tratamento farmacológico , Rim/efeitos dos fármacos , Inibidores da Fosfodiesterase 5/farmacologia , Piperazinas/farmacologia , Traumatismo por Reperfusão/tratamento farmacológico , Sulfonas/farmacologia , Animais , Apoptose , Carbolinas/uso terapêutico , Expressão Gênica/efeitos dos fármacos , Isquemia/enzimologia , Isquemia/patologia , Rim/irrigação sanguínea , Rim/enzimologia , Rim/patologia , Masculino , Malondialdeído , Óxido Nítrico Sintase Tipo II/genética , Óxido Nítrico Sintase Tipo II/metabolismo , Óxido Nítrico Sintase Tipo III/genética , Óxido Nítrico Sintase Tipo III/metabolismo , Estresse Oxidativo , Peroxidase , Inibidores da Fosfodiesterase 5/uso terapêutico , Piperazinas/uso terapêutico , Purinas/farmacologia , Purinas/uso terapêutico , Ratos , Ratos Sprague-Dawley , Traumatismo por Reperfusão/enzimologia , Traumatismo por Reperfusão/patologia , Citrato de Sildenafila , Sulfonas/uso terapêutico , Tadalafila , Proteína Supressora de Tumor p53/genética , Proteína Supressora de Tumor p53/metabolismoRESUMO
BACKGROUND: The cerebellum is rich in cannabinoid receptors and implicated in the neuropathology of schizophrenia. Long-term cannabis use is associated with functional and structural brain changes similar to those evident in schizophrenia, yet its impact on cerebellar structure has not been determined. We examined cerebellar grey and white matter in cannabis users with and without schizophrenia. METHOD: Seventeen patients with schizophrenia and 31 healthy controls were recruited; 48% of the healthy group and 47% of the patients were long-term heavy cannabis users (mean 19.7 and 17.9 years near daily use respectively). Cerebellar measures were extracted from structural 3-T magnetic resonance imaging (MRI) scans using semi-automated methods, and examined using analysis of covariance (ANCOVA) and correlational analyses. RESULTS: Cerebellar white-matter volume was reduced in cannabis users with and without schizophrenia compared to healthy non-users, by 29.7% and 23.9% respectively, and by 17.7% in patients without cannabis use. Healthy cannabis users did not differ in white-matter volume from either of the schizophrenia groups. There were no group differences in cerebellar grey matter or total volumes. Total cerebellar volume decreased as a function of duration of cannabis use in the healthy users. Psychotic symptoms and illness duration correlated with cerebellar measures differentially between patients with and without cannabis use. CONCLUSIONS: Long-term heavy cannabis use in healthy individuals is associated with smaller cerebellar white-matter volume similar to that observed in schizophrenia. Reduced volumes were even more pronounced in patients with schizophrenia who use cannabis. Cannabis use may alter the course of brain maturational processes associated with schizophrenia.
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Cerebelo/patologia , Abuso de Maconha/patologia , Esquizofrenia/patologia , Adulto , Austrália/epidemiologia , Estudos de Casos e Controles , Cerebelo/crescimento & desenvolvimento , Doença Crônica , Comorbidade , Humanos , Imageamento por Ressonância Magnética , Masculino , Abuso de Maconha/epidemiologia , Pessoa de Meia-Idade , Tamanho do Órgão , Esquizofrenia/epidemiologiaRESUMO
OBJECTIVE: The clinical distinction between bipolar II disorder (BD II) and bipolar I disorder (BD I) is not clear-cut. Cognitive functioning offers the potential to explore objective markers to help delineate this boundary. To examine this issue, we conducted a quantitative review of the cognitive profile of clinically stable patients with BD II in comparison with both patients with BD I and healthy controls. METHOD: Meta-analytical methods were used to compare cognitive functioning of BD II disorder with both BD I disorder and healthy controls. RESULTS: Individuals with BD II were less impaired than those with BD I on verbal memory. There were also small but significant difference in visual memory and semantic fluency. There were no significant differences in global cognition or in other cognitive domains. Patients with BD II performed poorer than controls in all cognitive domains. CONCLUSION: Our findings suggest that with the exception of memory and semantic fluency, cognitive impairment in BD II is as severe as in BD I. Further studies are needed to investigate whether more severe deficits in BD I are related to neurotoxic effects of severe manic episodes on medial temporal structures or neurobiological differences from the onset of the illness.
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Transtorno Bipolar/psicologia , Cognição , Atenção/fisiologia , Transtorno Bipolar/fisiopatologia , Cognição/fisiologia , Transtornos Cognitivos/fisiopatologia , Transtornos Cognitivos/psicologia , Humanos , Memória/fisiologia , Memória de Curto Prazo/fisiologia , Testes NeuropsicológicosRESUMO
The patient-clinician relationship is known to significantly affect the pain experience, as empathy, mutual trust and therapeutic alliance can significantly modulate pain perception and influence clinical therapy outcomes. The aim of the present study was to use an EEG hyperscanning setup to identify brain and behavioral mechanisms supporting the patient-clinician relationship while this clinical dyad is engaged in a therapeutic interaction. Our previous study applied fMRI hyperscanning to investigate whether brain concordance is linked with analgesia experienced by a patient while undergoing treatment by the clinician. In this current hyperscanning project we investigated similar outcomes for the patient-clinician dyad exploiting the high temporal resolution of EEG and the possibility to acquire the signals while patients and clinicians were present in the same room and engaged in a face-to-face interaction under an experimentally-controlled therapeutic context. Advanced source localization methods allowed for integration of spatial and spectral information in order to assess brain correlates of therapeutic alliance and pain perception in different clinical interaction contexts. Preliminary results showed that both behavioral and brain responses across the patient-clinician dyad were significantly affected by the interaction style.Clinical Relevance- The context of a clinical intervention can significantly impact the treatment of chronic pain. Effective therapeutic alliance, based on empathy, mutual trust, and warmth can improve treatment adherence and clinical outcomes. A deeper scientific understanding of the brain and behavioral mechanisms underlying an optimal patient-clinician interaction may lead to improved quality of clinical care and physician training, as well as better understanding of the social aspects of the biopsychosocial model mediating analgesia in chronic pain patients.
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Encéfalo , Dor Crônica , Manejo da Dor , Relações Profissional-Paciente , Encéfalo/fisiologia , Humanos , Imageamento por Ressonância Magnética , Percepção da DorRESUMO
Voxel-based morphometry (VBM) is a popular tool for mapping neuroanatomical changes in schizophrenia patients. Several recent meta-analyses have identified the brain regions in which patients most consistently show grey matter reductions, although they have not examined whether such changes reflect differences in grey matter concentration (GMC) or grey matter volume (GMV). These measures assess different aspects of grey matter integrity, and may therefore reflect different pathological processes. In this study, we used the Anatomical Likelihood Estimation procedure to analyse significant differences reported in 37 VBM studies of schizophrenia patients, incorporating data from 1646 patients and 1690 controls, and compared the findings of studies using either GMC or GMV to index grey matter differences. Analysis of all studies combined indicated that grey matter reductions in a network of frontal, temporal, thalamic and striatal regions are among the most frequently reported in literature. GMC reductions were generally larger and more consistent than GMV reductions, and were more frequent in the insula, medial prefrontal, medial temporal and striatal regions. GMV reductions were more frequent in dorso-medial frontal cortex, and lateral and orbital frontal areas. These findings support the primacy of frontal, limbic, and subcortical dysfunction in the pathophysiology of schizophrenia, and suggest that the grey matter changes observed with MRI may not necessarily result from a unitary pathological process.
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Mapeamento Encefálico , Encéfalo/patologia , Funções Verossimilhança , Esquizofrenia/patologia , Bases de Dados Bibliográficas/estatística & dados numéricos , Progressão da Doença , Feminino , Lateralidade Funcional , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Metanálise como AssuntoRESUMO
BACKGROUND: Social anxiety often involves a combination of hypervigilance and avoidance to potentially warning signals including the facial expression of emotions. Functional imaging has demonstrated an increase in amygdala response to emotional faces in subjects with social anxiety. Nevertheless, it is unclear to what extent visual areas processing faces influence amygdala reactivity in different socially anxious individuals. We assessed the influence of the fusiform gyrus activation on amygdala response to emotional faces in the non-clinical range of social anxiety. METHOD: Twenty-two normal subjects showing a wide range in social anxiety scores were examined using functional magnetic resonance imaging (fMRI) during the processing of happy and fearful faces. A dimensional analysis approach was used involving voxel-wise mapping of the correlation between subjects' social anxiety scores and amygdala activation, before and after controlling for fusiform gyrus activation. RESULTS: We observed that only after controlling for subjects' level of activation of the fusiform gyrus was there an association between social anxiety ratings and amygdala response to both happy and fearful faces. The fusiform gyrus influence was more robust during the fear condition. Of note, fusiform gyrus response to fearful faces showed a negative correlation with additional behavioral assessments related to avoidance, including social anxiety scores, harm avoidance and sensitivity to punishment. CONCLUSIONS: Relevant interactions among the emotional face-processing stages exist in the non-clinical range of social anxiety that may ultimately attenuate amygdala responses. Future research will help to establish the role of this effect in a clinical context.