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1.
J Public Health (Oxf) ; 43(1): 89-97, 2021 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-32776147

RESUMO

BACKGROUND: To describe the implementation of a medicalized hotel in the community of Madrid as a public health resource for the containment of coronavirus disease (COVID-19) and to describe the characteristics of population benefitted. METHODS: A descriptive study of the implementation of the Via Castellana Medicalised Hotel (VCMH) was conducted. The average monthly household income, educational level and occupational social class of the subjects admitted were obtained through a survey conducted during their stay. RESULTS: There was no guidance for launching; however the hotel was coordinated by a tertiary referral hospital and attended the preventive medicine regulations and the decrees of legal regimes and authorization of health services in Madrid. Between 19 March and the 9 May 2020, 399 patients were admitted; 59% (235) were migrant; the main reason for referral (58%) was a lack of house conditions for quarantining, including overcrowding, which when compared with the migrant status a positive correlation was found. Some other reasons for referral were homelessness and eviction. Most of the survey participants had low monthly household income, educational level and social class. CONCLUSIONS: This medicalized hotel provided medical care and offered housing to a subgroup of vulnerable population who could not afford a safe quarantine.


Assuntos
COVID-19 , Controle de Doenças Transmissíveis/métodos , Habitação , Quarentena , Pessoas Mal Alojadas , Hospitalização , Humanos , Controle de Infecções/métodos , Saúde Pública , Fatores Socioeconômicos , Espanha , Populações Vulneráveis
2.
Biol Lett ; 16(4): 20200005, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32228400

RESUMO

Here, we use 30 long-term, high-resolution palaeoecological records from Mexico, Central and South America to address two hypotheses regarding possible drivers of resilience in tropical forests as measured in terms of recovery rates from previous disturbances. First, we hypothesize that faster recovery rates are associated with regions of higher biodiversity, as suggested by the insurance hypothesis. And second, that resilience is due to intrinsic abiotic factors that are location specific, thus regions presently displaying resilience in terms of persistence to current climatic disturbances should also show higher recovery rates in the past. To test these hypotheses, we applied a threshold approach to identify past disturbances to forests within each sequence. We then compared the recovery rates to these events with pollen richness before the event. We also compared recovery rates of each site with a measure of present resilience in the region as demonstrated by measuring global vegetation persistence to climatic perturbations using satellite imagery. Preliminary results indeed show a positive relationship between pre-disturbance taxonomic richness and faster recovery rates. However, there is less evidence to support the concept that resilience is intrinsic to a region; patterns of resilience apparent in ecosystems presently are not necessarily conservative through time.


Assuntos
Ecossistema , Florestas , Biodiversidade , México , América do Sul , Árvores
3.
Georgian Med News ; (299): 39-43, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32242842

RESUMO

Cancer in children, and mainly the acute lymphoblastic leukemia (ALL), is considered as one of the leading public health problems in Mexico. Glucocorticoids used to treat ALL may cause suppression of the hypothalamic-pituitary-adrenal axis. The aim of the present study was to determine whether cortisol levels in saliva of the patients with ALL are related to the response to the remission induction therapy. The authors have conducted a clinical, prospective and comparative study. The Mann-Whitney U test was used to compare the variables values by gender or type of evolution. According to the patients' evolution, ROC curves were made for salivary cortisol levels and uric acid. An absolute value of 1000 blasts in peripheral blood count after a week of prednisone regimen was defined as a satisfactory response to the treatment. Review of the data has shown that area under the salivary cortisol levels' curve (AUC) was greater than that under the uric acid levels', as a predictor of a poor response to the remission induction. There were no statistically significant gender-associated differences in any variables except in erythrocytes. High levels of cortisol in saliva at the time of diagnosis of ALL seem to be of bad prognosis of the response to the remission induction therapy.


Assuntos
Hidrocortisona/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Saliva/química , Criança , Humanos , Hidrocortisona/análise , Sistema Hipotálamo-Hipofisário/metabolismo , Sistema Hipófise-Suprarrenal/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Estudos Prospectivos , Indução de Remissão , Saliva/metabolismo
5.
J Evol Biol ; 29(4): 690-703, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26779975

RESUMO

Migration is a significant trait of the animal kingdom that can impose a strong selective pressure on several structures to overcome the amount of energy that the organism invests in this particular behaviour. Wing linear dimensions and planform have been a traditional focus in the study of flying migratory species; however, other traits could also influence aerodynamic performance. We studied the differences in several flight-related traits of migratory and nonmigratory Libellulid species in a phylogenetic context to assess their response to migratory behaviour. Wings were compared by linear measurements, shape, surface corrugations and microtrichia number. Thorax size and pilosity were also compared. Migratory species have larger and smoother wings, a larger anal lobe that is reached through an expansion of the discoidal region, and longer and denser thoracic pilosity. These differences might favour gliding as an energy-saving displacement strategy. Most of the changes were identified in the hind wings. No differences were observed for the thorax linear dimensions, wetted aspect ratio, some wing corrugations or the wing microtrichiae number. Similar changes in the hind wing are present in clades where migration evolved. Our results emphasize that adaptations to migration through flight may extend to characteristics beyond the wing planform and that some wing characteristics in libellulids converge in response to migratory habits, whereas other closely related structures remain virtually unchanged. Additionally, we concluded that despite a close functional association and similar selective pressures on a structure, significant differences in the magnitude of the response may be present in its components.


Assuntos
Migração Animal , Voo Animal/fisiologia , Odonatos/anatomia & histologia , Odonatos/fisiologia , Animais , Tamanho Corporal , Odonatos/classificação , Filogenia , Especificidade da Espécie , Asas de Animais/anatomia & histologia
6.
Brain Behav Immun ; 49: 246-54, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26100488

RESUMO

All individuals experience stress and hormones (e.g., glucocorticoids/GCs) released during stressful events can affect the structure and function of neurons. These effects of stress are best characterized for brain neurons; however, the mechanisms controlling the expression and binding affinity of glucocorticoid receptors in the spinal cord are different than those in the brain. Accordingly, whether stress exerts unique effects on spinal cord neurons, especially in the context of pathology, is unknown. Using a controlled model of focal excitotoxic lower motor neuron injury in rats, we examined the effects of acute or chronic variable stress on spinal cord motor neuron survival and glial activation. New data indicate that stress exacerbates excitotoxic spinal cord motor neuron loss and associated activation of microglia. In contrast, hypertrophy and hyperplasia of astrocytes and NG2+ glia were unaffected or were modestly suppressed by stress. Although excitotoxic lesions cause significant motor neuron loss and stress exacerbates this pathology, overt functional impairment did not develop in the relevant forelimb up to one week post-lesion. These data indicate that stress is a disease-modifying factor capable of altering neuron and glial responses to pathological challenges in the spinal cord.


Assuntos
Microglia/fisiologia , Neurônios Motores/patologia , Traumatismos da Medula Espinal/patologia , Traumatismos da Medula Espinal/fisiopatologia , Estresse Psicológico/patologia , Estresse Psicológico/fisiopatologia , Animais , Proliferação de Células , Modelos Animais de Doenças , Agonistas de Aminoácidos Excitatórios/farmacologia , Feminino , Ácido Glutâmico/farmacologia , Microglia/efeitos dos fármacos , Neurônios Motores/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Restrição Física , Medula Espinal/efeitos dos fármacos , Medula Espinal/patologia , Medula Espinal/fisiopatologia
7.
Clin Dev Immunol ; 2013: 194064, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24106515

RESUMO

Candida albicans causes opportunistic systemic infections with high mortality (30%-50%). Despite significant nephrotoxicity, amphotericin (AmB) is still used for the treatment of this serious fungal infection. Therefore, alternative treatments are urgently needed. Dialyzable leukocyte extracts have been used successfully to treat patients with mucocutaneous candidiasis, but their effectiveness in systemic candidiasis has not been evaluated. In this study, low-dose AmB (0.1 mg/kg) plus 10 pg of murine dialyzable spleen extracts (mDSE) were tested in a systemic candidiasis mouse model. Survival, tissue fungal burden, kidney damage, kidney cytokines, and serum levels of IL-6 and hepcidin were evaluated. Our results showed that the combined treatment of low-dose AmB plus mDSE improved survival and reduced kidney fungal burden and histopathology; these effects correlated with increased kidney concentration of IFN- γ and TGF- ß 1, decreased levels of TNF- α , IL-6, and IL-10, as well as high levels of systemic IL-6 and hepcidin. Low-dose AmB and mDSE synergized to clear the infectious agent and reduced tissue damage, confirming the efficacy of a low dose of AmB, which might decrease the risk of drug toxicity. Further studies are necessary to explore these findings and its implications in future therapeutic approaches.


Assuntos
Anfotericina B/administração & dosagem , Antifúngicos/administração & dosagem , Candidíase/tratamento farmacológico , Linfocinas/administração & dosagem , Baço/metabolismo , Animais , Candidíase/mortalidade , Candidíase/patologia , Citocinas/biossíntese , Modelos Animais de Doenças , Feminino , Hepcidinas/biossíntese , Interleucina-6/biossíntese , Rim/metabolismo , Rim/microbiologia , Camundongos
8.
Med Intensiva ; 37(8): 519-74, 2013 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-23773859

RESUMO

INTRODUCTION: Optimal management of sedation, analgesia and delirium offers comfort and security for the critical care patient, allows support measures to be applied more easily and enables an integral approach of medical care, at the same time that lowers the incidence of complications, wich translates in better patient outcomes. OBJECTIVE: To update the Guía de práctica clínica basada en la evidencia para el manejo de la sedoanalgesia en el paciente adulto críticamente enfermo published in Medicina Intensiva in 2007, and give recommendations for the management of sedation, analgesia, and delirium. METHODOLOGY: A group of 21 intensivists from 9 countries of the Federación Panamericana e Ibérica de Sociedades de Medicina Crítica y Terapia Intensiva, 3 of them also specialists in clinical epidemiology and methodology, gathered for the development of guidelines. Assessment of evidence quality and recommendations were made based on the Grading of Recommendations Assessment, Development and Evaluation system. Strength of recommendations was classified as 1=strong, or 2=weak, and quality of evidence as A=high, B=moderate, or C=low. Two authors searched the following databases: MEDLINE through PUBMED, The Cochrane Library and Literatura Latinoamericana y del Caribe en Ciencias de la Salud and retrieved pertinent information. Members assigned to the 11 sections of the guidelines, based on the literature review, formulated the recommendations, that were discussed in plenary sessions. Only those recommendations that achieved more than 80% of consensus were approved for the final document. The Colombian Association of Critical Medicine and Intensive Care (AMCI) supported the elaboration of this guidelines. RESULTS: Four hundred sixty-seven articles were included for review. An increase in number and quality of publications was observed. This allowed to generate 64 strong recommendations with high and moderate quality of evidence in contrast to the 28 recommendations of the previous edition. CONCLUSIONS: This Guidelines contains recommendations and suggestions based on the best evidence available for the management of sedation, analgesia and delirium of the critically ill patient, including a bundle of strategies that serves this purpose. We highlight the assessment of pain and agitation/sedation through validated scales, the use of opioids initially to apropiate analgesic control, associated with multimodal strategies in order to reduce opioide consumption; to promote the lowest level of sedation necessary avoiding over-sedation. Also, in case of the need of sedatives, choose the most appropiate for the patient needs, avoiding the use of benzodiazepines and identify risk factors for delirium, in order to prevent its occurrence, diagnose delirium and treat it with the most suitable pharmacological agent, whether it is haloperidol, atypical antipsychotics or dexmedetomidine, once again, avoiding the use of benzodiazepines and decreasing the use of opioids.


Assuntos
Analgesia , Sedação Consciente , Cuidados Críticos/normas , Estado Terminal/terapia , Sedação Profunda , Algoritmos , Procedimentos Cirúrgicos Cardíacos , Delírio/terapia , Humanos , Falência Hepática/terapia , Doenças do Sistema Nervoso/terapia , Cuidados Pós-Operatórios , Insuficiência Renal/terapia , Respiração Artificial , Síndrome de Abstinência a Substâncias/terapia , Desmame do Respirador
9.
J Neurosci ; 31(27): 9910-22, 2011 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-21734283

RESUMO

Macrophages exert divergent effects in the injured CNS, causing either neurotoxicity or regeneration. The mechanisms regulating these divergent functions are not understood but can be attributed to the recruitment of distinct macrophage subsets and the activation of specific intracellular signaling pathways. Here, we show that impaired signaling via the chemokine receptor CX3CR1 promotes recovery after traumatic spinal cord injury (SCI) in mice. Deficient CX3CR1 signaling in intraspinal microglia and monocyte-derived macrophages (MDMs) attenuates their ability to synthesize and release inflammatory cytokines and oxidative metabolites. Also, impaired CX3CR1 signaling abrogates the recruitment or maturation of MDMs with presumed neurotoxic effects after SCI. Indeed, in wild-type mice, Ly6C(lo)/iNOS(+)/MHCII(+)/CD11c(-) MDMs dominate the lesion site, whereas CCR2(+)/Ly6C(hi)/MHCII(-)/CD11c(+) monocytes predominate in the injured spinal cord of CX3CR1-deficient mice. Replacement of wild-type MDMs with those unable to signal via CX3CR1 resulted in anatomical and functional improvements after SCI. Thus, blockade of CX3CR1 signaling represents a selective anti-inflammatory therapy that is able to promote neuroprotection, in part by reducing inflammatory signaling in microglia and MDMs and recruitment of a novel monocyte subset.


Assuntos
Antígenos Ly/metabolismo , Macrófagos/metabolismo , Óxido Nítrico Sintase Tipo II/metabolismo , Receptores de Quimiocinas/deficiência , Recuperação de Função Fisiológica/genética , Transdução de Sinais/fisiologia , Traumatismos da Medula Espinal/patologia , Traumatismos da Medula Espinal/fisiopatologia , Análise de Variância , Animais , Antígenos CD11/metabolismo , Receptor 1 de Quimiocina CX3C , Células Cultivadas , Quimiocina CXCL1/genética , Quimiocina CXCL1/metabolismo , Modelos Animais de Doenças , Citometria de Fluxo , Regulação da Expressão Gênica/genética , Proteínas de Fluorescência Verde/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Atividade Motora/genética , Atividade Motora/fisiologia , Proteína Básica da Mielina/metabolismo , Óxido Nítrico/metabolismo , Transdução de Sinais/genética , Traumatismos da Medula Espinal/genética
10.
Neural Plast ; 2012: 261345, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22530155

RESUMO

The proinflammatory cytokine TNFα contributes to cell death in central nervous system (CNS) disorders by altering synaptic neurotransmission. TNFα contributes to excitotoxicity by increasing GluA2-lacking AMPA receptor (AMPAR) trafficking to the neuronal plasma membrane. In vitro, increased AMPAR on the neuronal surface after TNFα exposure is associated with a rapid internalization of GABA(A) receptors (GABA(A)Rs), suggesting complex timing and dose dependency of the CNS's response to TNFα. However, the effect of TNFα on GABA(A)R trafficking in vivo remains unclear. We assessed the effect of TNFα nanoinjection on rapid GABA(A)R changes in rats (N = 30) using subcellular fractionation, quantitative western blotting, and confocal microscopy. GABA(A)R protein levels in membrane fractions of TNFα and vehicle-treated subjects were not significantly different by Western Blot, yet high-resolution quantitative confocal imaging revealed that TNFα induces GABA(A)R trafficking to synapses in a dose-dependent manner by 60 min. TNFα-mediated GABA(A)R trafficking represents a novel target for CNS excitotoxicity.


Assuntos
Membrana Celular/metabolismo , Neurônios/efeitos dos fármacos , Receptores de GABA-A/metabolismo , Medula Espinal/metabolismo , Fator de Necrose Tumoral alfa/farmacologia , Animais , Western Blotting , Membrana Celular/efeitos dos fármacos , Feminino , Microscopia Confocal , Neurônios/metabolismo , Transporte Proteico/efeitos dos fármacos , Ratos , Ratos Long-Evans , Medula Espinal/citologia , Sinapses/metabolismo
11.
Parasite Immunol ; 33(12): 661-8, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21919917

RESUMO

To define the role of CD38 in the migration of neutrophils to the liver and consequently in the induction of an innate immune response during murine hepatic amoebiasis by Entamoeba histolytica, we examined amoebic liver abscess development (ALA), presence of amoebae and neutrophils, and expression levels of cytokines and other inflammation mediators mRNA, in infected wild-type and CD38 Knockout (CD38KO) C57BL/6J mice. Results showed that CD38KO mice undergo a delay in ALA development in comparison with the wild-type strain. The presence of amoebae lasted longer in CD38(-/-), and although neutrophils arrived to the liver in both strains, there was a clear difference in the time between the two strains; whereas in the wild-type strain, neutrophils arrived at early times (6-12 h), in the CD38KO strain, neutrophils arrived later (48-72 h). Cytokines profile during the innate immune response development (TNF-α, IL-1ß, IL-6) was, for WT mice concomitant with, and preceded, for CD38KO mice, the time in which neutrophils were present in the liver lesion. In conclusion, CD38 is important for neutrophils migration during hepatic amoebiasis, and in turn, these cells play an important role in the innate immune response.


Assuntos
ADP-Ribosil Ciclase 1/deficiência , Entamoeba histolytica/imunologia , Imunidade Inata , Abscesso Hepático Amebiano/imunologia , Fígado/imunologia , Glicoproteínas de Membrana/deficiência , Neutrófilos/imunologia , ADP-Ribosil Ciclase 1/imunologia , Animais , Citocinas/biossíntese , Modelos Animais de Doenças , Perfilação da Expressão Gênica , Mediadores da Inflamação/imunologia , Masculino , Glicoproteínas de Membrana/imunologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Fatores de Tempo
12.
Vet Pathol ; 48(2): 475-81, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20861503

RESUMO

The number of Tasmanian devils in the wild is rapidly declining owing to a transmissible cancer, devil facial tumor disease (DFTD). Although progress has been made to understand the spread of this disease, crucial research on the pathogenesis of DFTD has been limited because of the threatened status of the host species. Here, the authors describe the development of a NOD/SCID (nonobese diabetic / severe combined immunodeficiency) mouse model that reproduces DFTD and provides a much-needed model to undertake studies into this intriguing transmissible cancer. Histologically, the DFTD produced in NOD/SCID mice (xenografted DFTD) was indistinguishable from the DFTD identified in Tasmanian devils. At the protein level, all xenografted DFTD tumors expressed periaxin, a marker that confirmed the diagnosis of DFTD. The karyotype of DFTD in NOD/SCID mice reproduced similar chromosomal alterations as seen in diseased devils. Furthermore, each NOD/SCID mouse inoculated with cultured DFTD tumor cells developed tumors, whereas DFTD did not develop in any of the inoculated immune-competent BALB/c mice.


Assuntos
Modelos Animais de Doenças , Transmissão de Doença Infecciosa/veterinária , Espécies em Perigo de Extinção , Neoplasias Faciais/patologia , Neoplasias Faciais/veterinária , Marsupiais , Animais , Biomarcadores Tumorais/metabolismo , Neoplasias Faciais/genética , Imuno-Histoquímica/veterinária , Cariotipagem , Proteínas de Membrana/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos NOD , Camundongos SCID , Transplante de Neoplasias/veterinária
13.
Vet Pathol ; 48(6): 1195-203, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21383118

RESUMO

Devil facial tumor disease (DFTD) is a transmissible neoplasm that is threatening the survival of the Tasmanian devil. Genetic analyses have indicated that the disease is a peripheral nerve sheath neoplasm of Schwann cell origin. DFTD cells express genes characteristic of myelinating Schwann cells, and periaxin, a Schwann cell protein, has been proposed as a marker for the disease. Diagnosis of DFTD is currently based on histopathology, cytogenetics, and clinical appearance of the disease in affected animals. As devils are susceptible to a variety of neoplastic processes, a specific diagnostic test is required to differentiate DFTD from cancers of similar morphological appearance. This study presents a thorough examination of the expression of a set of Schwann cell and other neural crest markers in DFTD tumors and normal devil tissues. Samples from 20 primary DFTD tumors and 10 DFTD metastases were evaluated by immunohistochemistry for the expression of periaxin, S100 protein, peripheral myelin protein 22, nerve growth factor receptor, nestin, neuron specific enolase, chromogranin A, and myelin basic protein. Of these, periaxin was confirmed as the most sensitive and specific marker, labeling the majority of DFTD cells in 100% of primary DFTD tumors and DFTD metastases. In normal tissues, periaxin showed specificity for Schwann cells in peripheral nerve bundles. This marker was then evaluated in cultured devil Schwann cells, DFTD cell lines, and xenografted DFTD tumors. Periaxin expression was maintained in all these models, validating its utility as a diagnostic marker for the disease.


Assuntos
Biomarcadores Tumorais/análise , Neoplasias Faciais/veterinária , Marsupiais , Proteínas de Membrana/análise , Neoplasias de Bainha Neural/veterinária , Animais , Biomarcadores Tumorais/metabolismo , Células Cultivadas , Neoplasias Faciais/patologia , Imunofluorescência/veterinária , Xenoenxertos , Imuno-Histoquímica/veterinária , Masculino , Proteínas de Membrana/metabolismo , Camundongos , Camundongos SCID , Neoplasias de Bainha Neural/patologia , Células de Schwann/metabolismo , Sensibilidade e Especificidade , Células Tumorais Cultivadas
14.
Glia ; 58(11): 1304-19, 2010 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-20607865

RESUMO

Wallerian degeneration in the dorsal columns (DC) after spinal cord injury (SCI) is associated with microglial activation and prolonged oligodendrocyte (OL) apoptosis that may contribute to demyelination and dysfunction after SCI. But, there is an increase in OL lineage cells after SCI that may represent a reparative response, and there is evidence for remyelination after SCI. To assess the role of axonal degeneration per se in OL apoptosis and proliferation, we cut the L2-S2 dorsal roots producing massive axonal degeneration and microglial activation in the DC, and found no evidence of OL loss or apoptosis. Rather, the numbers of OL-lineage cells positive for NG2 and APC (CC1) increased, and BrdU studies suggested new OL formation. We then tested contusion SCI (cSCI) that results in comparable degeneration in the DC rostral to the injury, microglial activation, and apoptosis of DC OLs by eight days. NG2+ cell proliferation and oligodendrogenesis was seen as after rhizotomy. The net result of this combination of proliferation and apoptosis was a reduction in DC OLs, confirming earlier studies. Using an antibody to oxidized nucleic acids, we found rapid and prolonged RNA oxidation in OLs rostral to cSCI, but no evidence of oxidative stress in DC OLs after rhizotomy. These results suggest that signals associated with axonal degeneration are sufficient to induce OL proliferation, and that secondary injury processes associated with the central SCI, including oxidative stress, rather than axonal degeneration per se, are responsible for OL apoptosis.


Assuntos
Apoptose/fisiologia , Axônios/patologia , Linhagem da Célula/fisiologia , Oligodendroglia/patologia , Rizotomia/métodos , Traumatismos da Medula Espinal/patologia , Células-Tronco/patologia , Degeneração Walleriana/patologia , Animais , Modelos Animais de Doenças , Feminino , Oligodendroglia/citologia , Ratos , Ratos Long-Evans , Recuperação de Função Fisiológica/fisiologia , Traumatismos da Medula Espinal/cirurgia , Células-Tronco/citologia , Degeneração Walleriana/prevenção & controle
15.
Crit Care Med ; 37(7): 2160-6, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19487936

RESUMO

OBJECTIVE: To use magnetic resonance imaging (MRI) to characterize secondary injury immediately after spinal cord injury (SCI), and to show the effect of hypertonic saline on MRI indices of swelling, edema, and hemorrhage within the cord. DESIGN: A prospective, randomized, placebo-controlled study. SETTING: Research laboratory. SUBJECTS: Twelve adult Long-Evans female rats. INTERVENTIONS: Rats underwent a unilateral 12.5 mm SCI at vertebral level C5. Animals were administered 0.9% NaCl (n = 6) or 5% NaCl (n = 6) at 1.4 mL/kg intravenously every hour starting 30 minutes after SCI. Immediately after SCI, rats were placed in a 4.7T Bruker MRI system and images were obtained continuously for 8 hours using a home-built transmitter/receiver 3 cm Helmholtz coil. Rats were killed 8 hours after SCI. MEASUREMENTS AND MAIN RESULTS: Quantification of cord swelling and volumes of hypointense and hyperintense signal within the lesion were determined from MRI. At 36 minutes after SCI, significant swelling of the spinal cord at the lesion center and extending rostrally and caudally was demonstrated by MRI. Also, at this time point, a hypointense core was identified on T1, PD, and T2 weighted images. Over time this hypointense core reduced in size and in some animals was no longer visible by 8 hours after SCI, although histopathology demonstrated presence of red blood cells. A prominent ring of T2-weighted image hyperintensity, characteristic of edema, surrounded the hypointense core. At the lesion center, this rim of edema occupied the entire unilateral injured cord and in all animals extended to the contralateral side. Administration of HS resulted in increased serum [Na], attenuation of cord swelling, and decreased volume of hypointense core and edema at the last time points. CONCLUSIONS: We were able to use MRI to detect rapid and acute changes in the evolution of tissue pathophysiology, and show potentially beneficial effects of hypertonic saline in acute cervical SCI.


Assuntos
Edema/prevenção & controle , Imageamento por Ressonância Magnética , Mielite/prevenção & controle , Solução Salina Hipertônica/uso terapêutico , Traumatismos da Medula Espinal/tratamento farmacológico , Traumatismos da Medula Espinal/patologia , Animais , Vértebras Cervicais , Esquema de Medicação , Edema/etiologia , Edema/patologia , Feminino , Hemorragia/etiologia , Hemorragia/patologia , Hemorragia/prevenção & controle , Mielite/etiologia , Mielite/patologia , Valor Preditivo dos Testes , Ratos , Ratos Long-Evans , Traumatismos da Medula Espinal/complicações , Fatores de Tempo
16.
J Neurotrauma ; 25(1): 1-18, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18355154

RESUMO

Magnetic resonance imaging (MRI) should be a powerful tool for characterization of spinal cord pathology in animal models. We evaluated the utility of medium-field MRI for the longitudinal assessment of progression of spinal cord injury (SCI) in a rat model. Thirteen adult rats were subjected to a 6.25 or 25 g-cm unilateral cervical SCI, and underwent MRI and behavioral tests during a 3-week study period. MRI was also performed post-mortem. Quantification of cord swelling, hypointense and hyperintense signal, and lesion length were the most valuable parameters to determine and were highly correlated to behavioral and histopathological measures. Immediately after injury, MRI showed loss of gray matter-white matter differentiation, presence of scattered hyperintense signal and local hypointense signal, and cord swelling in both groups. At 7 days after injury, the spinal cord in the 25 g-cm group was significantly larger than that of the 6.25 g-cm group (p = 0.02). Contrast enhancement of the lesion was seen at 24 h in the 6.25 g-cm group, and at 24 h and 7 days in the 25 g-cm group. The volume of hypointense signal, representing hemorrhage, throughout the lesion region was significantly larger in the 25 g-cm compared to the 6.25 g-cm group at both 14 and 21 days after SCI (p,

Assuntos
Imageamento por Ressonância Magnética/métodos , Traumatismos da Medula Espinal/diagnóstico , Medula Espinal/patologia , Animais , Vértebras Cervicais , Diagnóstico Diferencial , Modelos Animais de Doenças , Progressão da Doença , Edema/diagnóstico , Edema/etiologia , Edema/fisiopatologia , Feminino , Hemorragia/diagnóstico , Hemorragia/fisiopatologia , Processamento de Imagem Assistida por Computador , Estudos Longitudinais , Fibras Nervosas Mielinizadas/patologia , Vias Neurais/lesões , Vias Neurais/patologia , Vias Neurais/fisiopatologia , Valor Preditivo dos Testes , Ratos , Índice de Gravidade de Doença , Processamento de Sinais Assistido por Computador , Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/fisiopatologia , Fatores de Tempo
17.
J Neuroinflammation ; 4: 28, 2007 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-18039385

RESUMO

BACKGROUND: Oligodendrocyte progenitor cells (OPCs) and mature oligodendrocytes are both lost in central nervous system injury and disease. Activated microglia may play a role in OPC and oligodendrocyte loss or replacement, but it is not clear how the responses of OPCs and oligodendrocytes to activated microglia differ. METHODS: OPCs and microglia were isolated from rat cortex. OPCs were induced to differentiate into oligodendrocytes with thyroid hormone in defined medium. For selected experiments, microglia were added to OPC or oligodendrocyte cultures. Lipopolysaccharide was used to activate microglia and microglial activation was confirmed by TNFalpha ELISA. Cell survival was assessed with immunocytochemistry and cell counts. OPC proliferation and oligodendrocyte apoptosis were also assessed. RESULTS: OPCs and oligodendrocytes displayed phenotypes representative of immature and mature oligodendrocytes, respectively. Activated microglia reduced OPC survival, but increased survival and reduced apoptosis of mature oligodendrocytes. Activated microglia also underwent cell death themselves. CONCLUSION: Activated microglia may have divergent effects on OPCs and mature oligodendrocytes, reducing OPC survival and increasing mature oligodendrocyte survival. This may be of importance because activated microglia are present in several disease states where both OPCs and mature oligodendrocytes are also reacting to injury. Activated microglia may simultaneously have deleterious and helpful effects on different cells after central nervous system injury.


Assuntos
Diferenciação Celular/fisiologia , Microglia/fisiologia , Oligodendroglia/fisiologia , Células-Tronco/fisiologia , Análise de Variância , Animais , Animais Recém-Nascidos , Caspase 1/metabolismo , Comunicação Celular , Morte Celular/fisiologia , Diferenciação Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Córtex Cerebral/citologia , Ensaio de Imunoadsorção Enzimática/métodos , Fatores de Crescimento de Fibroblastos/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , Regulação da Expressão Gênica/fisiologia , Lipopolissacarídeos/farmacologia , Fator de Crescimento Derivado de Plaquetas/farmacologia , Ratos , Ratos Long-Evans , Células-Tronco/efeitos dos fármacos , Hormônios Tireóideos/farmacologia , Fator de Necrose Tumoral alfa/metabolismo
18.
Diabetes Res Clin Pract ; 76(3): 410-7, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17084478

RESUMO

AIMS: The purpose of the study was to evaluate the feasibility and preliminary clinical effects of the DIADEM disease management programme for type 2 diabetic patients. METHODS: The study was performed at two test sites (Cardiff, UK: Aachen, Germany) including 137 and 166 patients, respectively. In 16 study centres any patients with type 2 diabetes capable of communicating by phone and able to perform blood pressure, blood glucose or urine glucose self-measurements were included. The maximum programme duration was 6 months at Cardiff and 4 months at Aachen, during which patients were assessed for glycaemic control, cardiovascular risk profile and the presence of complications of diabetes. Data were entered via the internet to a central server. RESULTS: At entry into the programme the patient group in Cardiff had significantly lower mean age (60.3+/-9.4 years versus 64.9+/-8.7 years, p<0.001) and duration of diabetes (6.1+/-5.7 years versus 7.4+/-7.0 years, p<0.05) than in Aachen, however body mass index (31.6+/-5.2 kg/m(2) versus 29.5+/-4.9 kg/m(2), p<0.01), HbA1c (7.7+/-1.2% versus 7.1+/-1.2%, p<0.001) and systolic blood pressure (138.4+/-15.1 mmHg versus 133.5+/-11.5 mmHg, p<0.001) were significantly higher. In contrast, total cholesterol (4.7+/-1.0 mmol/l versus 5.5+/-1.1 mmol/l, p<0.001) was significantly lower in Cardiff compared to Aachen. Following entry into the programme highly significant improvements in HbA1c (Cardiff from 7.7% to 7.1%, p<0.001; Aachen from 7.2% to 6.8%, p<0.05) and total cholesterol concentrations (Cardiff: 4.66-4.46 mmol/l; Aachen: 5.33-5.15 mmol/l; both p<0.05) were observed. There were no significant changes in blood pressure at either site. CONCLUSIONS: Intensive diabetes care was delivered to DIADEM patients and relevant and significant improvements in diabetes care were achieved demonstrating that an IT-based diabetes disease management service can improve care for patients with type 2 diabetes.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Gerenciamento Clínico , Idoso , Pressão Sanguínea , Colesterol/sangue , Feminino , Alemanha , Hemoglobinas Glicadas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Projetos Piloto , Software , País de Gales
19.
J Neurotrauma ; 23(1): 36-54, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16430371

RESUMO

Most experimental studies of spinal cord injury (SCI) in rats damage the thoracic cord, with the consequent functional loss being due to interruption of long tracts connecting the caudal spinal cord to the rostral nervous system. Less work has been done evaluating injury to the cervical cord, even though it is the most common level of human SCI. In addition to the long tracts, the cervical spinal cord contains the sensory and motor neurons responsible for upper extremity function. The purpose of this study was to further develop a rat model of cervical spinal cord contusion injury using a modified NYU/MASCIS weight drop device. Mild (6.25 mm) and moderate (12.5 mm) C5 unilateral injuries were produced. Behavioral recovery was examined using a grooming test, a paw preference test, a walkway test (The Catwalk), and a horizontal ladder test. Histological outcome measures included sparing at the lesion epicenter, sparing throughout the extent of the lesion, quantification of myelin loss rostral and caudal to the lesion, and motor neuron counts. Compared to controls, animals receiving SCI exhibited injury severity-specific deficits in forelimb, locomotor, and hindlimb function persisting for 6-weeks post-SCI. Histological analysis revealed ipsilateral containment of the injury, and differentiation between groups on all measures except motor neuron counts. This model has many advantages: (1) minimal animal care requirements post-SCI, (2) within subject controls, (3) functional loss involves primarily the ipsilateral forelimb, and (4) it is a behavioral and histological model for both gray and white matter damage caused by contusive SCI.


Assuntos
Vias Eferentes/fisiopatologia , Neurônios Motores/patologia , Fibras Nervosas Mielinizadas/patologia , Traumatismos da Medula Espinal/fisiopatologia , Medula Espinal/fisiopatologia , Degeneração Walleriana/fisiopatologia , Animais , Morte Celular/fisiologia , Vértebras Cervicais , Avaliação da Deficiência , Modelos Animais de Doenças , Vias Eferentes/patologia , Feminino , Membro Anterior/inervação , Membro Anterior/fisiopatologia , Lateralidade Funcional/fisiologia , Transtornos Neurológicos da Marcha/diagnóstico , Transtornos Neurológicos da Marcha/fisiopatologia , Membro Posterior/inervação , Membro Posterior/fisiopatologia , Modelos Neurológicos , Exame Neurológico , Valor Preditivo dos Testes , Ratos , Ratos Long-Evans , Recuperação de Função Fisiológica/fisiologia , Medula Espinal/patologia , Traumatismos da Medula Espinal/diagnóstico , Degeneração Walleriana/patologia
20.
J Neurotrauma ; 22(4): 429-41, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15853461

RESUMO

Disruption of bladder function and sexual reflexes are major complications following spinal cord injury (SCI). We examined the use of telemetric monitoring of corpus spongiosum penis (CSP) pressures for assessment of micturition and erectile events following SCI in rats. Pressure catheters were implanted in the bulb of the CSP of seven male Long-Evans hooded rats, subjected to a standardized weight drop SCI (10 g x 12.5 mm) at T10. CSP pressures were analyzed for spontaneously occurring micturition and erectile events, and during ex copula reflex erection tests until 25 days after SCI. Urine volume was determined until 21 days after SCI. Results show initial loss of bladder function after SCI with gradual return of reflex micturition. When compared to baseline (BL), micturition pressure characteristics after SCI included prolonged duration, increased area under the curve (AUC), increased mean pressures, increased number of pressure peaks, and increased peak frequency. At 21 days after SCI, the urine volume per micturition was significantly increased. The number of full erectile events decreased significantly following SCI. Pressure wave analyses demonstrated increased AUC, increased maximum pressures, increased suprasystolic peak duration, increased AUC of the suprasystolic peaks, and increased maximum pressures of the suprasystolic peaks during recovery. The number of partial erectile events decreased significantly following SCI. Ex copula reflex erection testing demonstrated significantly decreased latency. The study demonstrates that telemetric monitoring of CSP pressures in conscious rats is a valuable and reliable method for assessing recovery of autonomic function following SCI.


Assuntos
Monitorização Fisiológica/métodos , Pênis/fisiopatologia , Disfunções Sexuais Fisiológicas/fisiopatologia , Traumatismos da Medula Espinal/fisiopatologia , Telemetria/métodos , Transtornos Urinários/fisiopatologia , Animais , Estado de Consciência , Copulação/fisiologia , Modelos Animais de Doenças , Pressão Hidrostática , Masculino , Monitorização Fisiológica/instrumentação , Pênis/irrigação sanguínea , Pênis/inervação , Ratos , Ratos Long-Evans , Recuperação de Função Fisiológica/fisiologia , Reflexo/fisiologia , Disfunções Sexuais Fisiológicas/etiologia , Traumatismos da Medula Espinal/complicações , Telemetria/instrumentação , Transdutores de Pressão , Cateterismo Urinário , Micção/fisiologia , Transtornos Urinários/etiologia
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