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1.
Respir Res ; 20(1): 184, 2019 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-31416461

RESUMEN

BACKGROUND: Influenza attacks the epithelium of the lung, causing cell death and disruption of the epithelial barrier leading to fluid buildup in the lung and impairment of gas exchange. Limited treatment options for severe influenza pneumonia prioritize the need for the discovery of effective therapies. IL-22 is a cytokine that promotes tissue integrity and has strong promise as a treatment option. While research has been focused on the cytokine itself, there is limited understanding of the regulation of the IL-22 receptor (IL-22Ra1) at the epithelial surface during infection. METHODS: IL-22Ra1 levels were measured by qRT-PCR, western blot and immunofluorescence following H1N1 influenza infection (A/PR/8/34 H1N1) or synthetic TLR3 mimetic, Poly (I:C). Regulation of the receptor was determined using STAT inhibitors (STAT1, STAT3 and PanSTAT inhibitors), TLR3 inhibition, and neutralization of interferon alpha receptor 2 (IFNAR2). Significance was determined by a p-value of greater than 0.05. Significance between two groups was measured using unpaired t-test and significance between more than two groups was measured using one-way ANOVA with Tukey Multiple Comparison Test. RESULTS: Here we show both in vivo and in vitro that IL-22Ra1 was induced as early as 24 h after influenza (H1N1 PR8) infection. This induction was triggered by toll-like receptor 3 (TLR3) as a TLR3 mimetic [Poly (I:C)] also induced IL-22Ra1 and inhibition of endosomal formation required for TLR3 function inhibited this process. This upregulation was dependent upon IFNß signaling through STAT1. Importantly, induction of IL-22Ra1 significantly increased IL-22 signaling as evidenced by pSTAT3 levels following IL-22 treatment. CONCLUSION: Collectively, these data suggest epithelial cells may optimize the beneficial effects of IL-22 through the induction of the IL-22 receptor during viral infection in the lung.


Asunto(s)
Gripe Humana/metabolismo , Receptores de Interleucina/biosíntesis , Factor de Transcripción STAT1/biosíntesis , Receptor Toll-Like 3/biosíntesis , Células A549 , Animales , Cloroquina/farmacología , Humanos , Gripe Humana/patología , Interferones/farmacología , Masculino , Ratones , Ratones Endogámicos C57BL , Poli I-C/farmacología
2.
Mol Psychiatry ; 21(2): 270-6, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25824302

RESUMEN

Up to 30% of patients with obsessive-compulsive disorder (OCD) exhibit an inadequate response to serotonin reuptake inhibitors (SRIs). To date, genetic predictors of OCD treatment response have not been systematically investigated using genome-wide association study (GWAS). To identify specific genetic variations potentially influencing SRI response, we conducted a GWAS study in 804 OCD patients with information on SRI response. SRI response was classified as 'response' (n=514) or 'non-response' (n=290), based on self-report. We used the more powerful Quasi-Likelihood Score Test (the MQLS test) to conduct a genome-wide association test correcting for relatedness, and then used an adjusted logistic model to evaluate the effect size of the variants in probands. The top single-nucleotide polymorphism (SNP) was rs17162912 (P=1.76 × 10(-8)), which is near the DISP1 gene on 1q41-q42, a microdeletion region implicated in neurological development. The other six SNPs showing suggestive evidence of association (P<10(-5)) were rs9303380, rs12437601, rs16988159, rs7676822, rs1911877 and rs723815. Among them, two SNPs in strong linkage disequilibrium, rs7676822 and rs1911877, located near the PCDH10 gene, gave P-values of 2.86 × 10(-6) and 8.41 × 10(-6), respectively. The other 35 variations with signals of potential significance (P<10(-4)) involve multiple genes expressed in the brain, including GRIN2B, PCDH10 and GPC6. Our enrichment analysis indicated suggestive roles of genes in the glutamatergic neurotransmission system (false discovery rate (FDR)=0.0097) and the serotonergic system (FDR=0.0213). Although the results presented may provide new insights into genetic mechanisms underlying treatment response in OCD, studies with larger sample sizes and detailed information on drug dosage and treatment duration are needed.


Asunto(s)
Trastorno Obsesivo Compulsivo/genética , Adolescente , Adulto , Anciano , Niño , Femenino , Predisposición Genética a la Enfermedad , Variación Genética , Estudio de Asociación del Genoma Completo , Humanos , Desequilibrio de Ligamiento , Masculino , Proteínas de la Membrana/genética , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Autoinforme , Inhibidores Selectivos de la Recaptación de Serotonina/metabolismo , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Resultado del Tratamiento
3.
Mol Psychiatry ; 20(3): 337-44, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24821223

RESUMEN

Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by intrusive thoughts and urges and repetitive, intentional behaviors that cause significant distress and impair functioning. The OCD Collaborative Genetics Association Study (OCGAS) is comprised of comprehensively assessed OCD patients with an early age of OCD onset. After application of a stringent quality control protocol, a total of 1065 families (containing 1406 patients with OCD), combined with population-based samples (resulting in a total sample of 5061 individuals), were studied. An integrative analyses pipeline was utilized, involving association testing at single-nucleotide polymorphism (SNP) and gene levels (via a hybrid approach that allowed for combined analyses of the family- and population-based data). The smallest P-value was observed for a marker on chromosome 9 (near PTPRD, P=4.13 × 10(-)(7)). Pre-synaptic PTPRD promotes the differentiation of glutamatergic synapses and interacts with SLITRK3. Together, both proteins selectively regulate the development of inhibitory GABAergic synapses. Although no SNPs were identified as associated with OCD at genome-wide significance level, follow-up analyses of genome-wide association study (GWAS) signals from a previously published OCD study identified significant enrichment (P=0.0176). Secondary analyses of high-confidence interaction partners of DLGAP1 and GRIK2 (both showing evidence for association in our follow-up and the original GWAS study) revealed a trend of association (P=0.075) for a set of genes such as NEUROD6, SV2A, GRIA4, SLC1A2 and PTPRD. Analyses at the gene level revealed association of IQCK and C16orf88 (both P<1 × 10(-)(6), experiment-wide significant), as well as OFCC1 (P=6.29 × 10(-)(5)). The suggestive findings in this study await replication in larger samples.


Asunto(s)
Salud de la Familia , Predisposición Genética a la Enfermedad/genética , Trastorno Obsesivo Compulsivo/genética , Adulto , Cromosomas Humanos Par 9/genética , Conducta Cooperativa , Femenino , Estudios de Seguimiento , Perfilación de la Expresión Génica , Estudio de Asociación del Genoma Completo , Genotipo , Humanos , Masculino , Análisis de Secuencia por Matrices de Oligonucleótidos , Polimorfismo de Nucleótido Simple , Proteínas Tirosina Fosfatasas Clase 2 Similares a Receptores/genética , Adulto Joven
4.
J Environ Qual ; 43(2): 587-98, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25602660

RESUMEN

Nitrate lost from agricultural soils is an economic cost to producers, an environmental concern when it enters rivers and lakes, and a health risk when it enters wells and aquifers used for drinking water. Planting a winter wheat cover crop (CC) and/or use of controlled tile drainage-subirrigation (CDS) may reduce losses of nitrate (NO) relative to no cover crop (NCC) and/or traditional unrestricted tile drainage (UTD). A 6-yr (1999-2005) corn-soybean study was conducted to determine the effectiveness of CC+CDS, CC+UTD, NCC+CDS, and NCC+UTD treatments for reducing NO loss. Flow volume and NO concentration in surface runoff and tile drainage were measured continuously, and CC reduced the 5-yr flow-weighted mean (FWM) NO concentration in tile drainage water by 21 to 38% and cumulative NO loss by 14 to 16% relative to NCC. Controlled tile drainage-subirrigation reduced FWM NO concentration by 15 to 33% and cumulative NO loss by 38 to 39% relative to UTD. When CC and CDS were combined, 5-yr cumulative FWM NO concentrations and loss in tile drainage were decreased by 47% (from 9.45 to 4.99 mg N L and from 102 to 53.6 kg N ha) relative to NCC+UTD. The reductions in runoff and concomitant increases in tile drainage under CC occurred primarily because of increases in near-surface soil hydraulic conductivity. Cover crops increased corn grain yields by 4 to 7% in 2004 increased 3-yr average soybean yields by 8 to 15%, whereas CDS did not affect corn or soybean yields over the 6 yr. The combined use of a cover crop and water-table management system was highly effective for reducing NO loss from cool, humid agricultural soils.

5.
Vox Sang ; 105(2): 100-7, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23398307

RESUMEN

BACKGROUND AND OBJECTIVES: The '30-min rule' requires discarding red blood cells (RBCs) exposed to uncontrolled temperatures for >30 min to ensure safe RBC transfusion. This study was aimed at determining whether multiple room temperature (RT) exposures promote bacterial growth. MATERIALS AND METHODS: Pooled and split RBC units were inoculated with ~1 CFU/ml of Serratia marcescens, Yersinia enterocolitica, Escherichia coli or Staphylococcus epidermidis. Control units remained in storage, while test units were exposed to RT for six 30-min or three 60-min intervals. Bacterial concentrations and endotoxin levels were determined after each exposure and at 42 days of storage. RBC core temperature and RT were monitored in mock units with Escort iLog temperature loggers. A mixed model was used for statistical analyses. RESULTS: Red blood cell core temperature reached 10.7 ± 0.4°C and 14.2 ± 0.2°C during 30- and 60-min exposures, respectively. Staphylococcus epidermidis and E. coli did not grow in either control or exposed RBCs. Yersinia enterocolitica concentration and endotoxin levels were similar in both control and test units. Serratia marcescens concentration and endotoxin levels were higher in exposed units; however, differences between units exposed for 30 min or 60 min were not observed. CONCLUSION: There is no added risk to RBC safety by increasing RT exposures to 60 min with each removal from storage for up to a total of 3 h during RBC shelf life. Therefore, extending the 30-min limitation in RBCs exposed to uncontrolled temperatures to 60 min should be considered by regulatory agencies.


Asunto(s)
Bacterias/crecimiento & desarrollo , Conservación de la Sangre , Eritrocitos/microbiología , Seguridad , Endotoxinas/sangre , Transfusión de Eritrocitos , Femenino , Humanos , Masculino , Factores de Tiempo
6.
Transl Psychiatry ; 13(1): 134, 2023 04 26.
Artículo en Inglés | MEDLINE | ID: mdl-37185805

RESUMEN

Obsessive-compulsive disorder (OCD) affects 2-3% of the population. One-third of patients are poorly responsive to conventional therapies, and for a subgroup, gamma knife capsulotomy (GKC) is an option. We examined lesion characteristics in patients previously treated with GKC through well-established programs in Providence, RI (Butler Hospital/Rhode Island Hospital/Alpert Medical School of Brown University) and São Paulo, Brazil (University of São Paolo). Lesions were traced on T1 images from 26 patients who had received GKC targeting the ventral half of the anterior limb of the internal capsule (ALIC), and the masks were transformed into MNI space. Voxel-wise lesion-symptom mapping was performed to assess the influence of lesion location on Y-BOCS ratings. General linear models were built to compare the relationship between lesion size/location along different axes of the ALIC and above or below-average change in Y-BOCS ratings. Sixty-nine percent of this sample were full responders (≥35% improvement in OCD). Lesion occurrence anywhere within the targeted region was associated with clinical improvement, but modeling results demonstrated that lesions occurring posteriorly (closer to the anterior commissure) and dorsally (closer to the mid-ALIC) were associated with the greatest Y-BOCS reduction. No association was found between Y-BOCS reduction and overall lesion volume. GKC remains an effective treatment for refractory OCD. Our data suggest that continuing to target the bottom half of the ALIC in the coronal plane is likely to provide the dorsal-ventral height required to achieve optimal outcomes, as it will cover the white matter pathways relevant to change. Further analysis of individual variability will be essential for improving targeting and clinical outcomes, and potentially further reducing the lesion size necessary for beneficial outcomes.


Asunto(s)
Trastorno Obsesivo Compulsivo , Radiocirugia , Humanos , Brasil , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/cirugía , Radiocirugia/métodos , Resultado del Tratamiento , Cápsula Interna/diagnóstico por imagen , Cápsula Interna/cirugía
7.
Minim Invasive Neurosurg ; 54(4): 179-82, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21922447

RESUMEN

BACKGROUND: The expanded endonasal approach of the cranio-cervical junction provides comfortable working space while avoiding some of the disadvantages of the transoral route. We report a purely endonasal endoscopic resection of the odontoid process for basilar invagination in a patient with a Chiari type I malformation, without posterior decompression or fusion. CASE REPORT: A 54-year-old female patient presented with cranial nerve and brainstem deficits. CT and MRI showed a Chiari type I malformation and compression of the medulla by basilar invagination of the odontoid process. The tip of the latter was displaced up to the bulbo-pontine sulcus. The odontoid process was resected via the expanded endoscopic endonasal approach, without additional posterior decompression or fusion. The post-operative course was uneventful, including the absence of velopharyngeal insufficiency. Neurological deficits regressed rapidly. The preoperative cervical pain virtually disappeared. At 9 months follow-up, the patient had normal activity with minimal residual neurological deficits. Post-op dynamic radiography and CT showed stability of the cranio-cervical junction. CONCLUSION: Decompression of the bulbomedullary junction by purely endoscopic transnasal resection of the odontoid process is well tolerated and efficient. Immediate stabilization is not mandatory in all cases of congenital causes of basilar invagination.


Asunto(s)
Malformación de Arnold-Chiari/cirugía , Descompresión Quirúrgica/métodos , Endoscopía/métodos , Procedimientos Neuroquirúrgicos/métodos , Apófisis Odontoides/cirugía , Malformación de Arnold-Chiari/diagnóstico por imagen , Malformación de Arnold-Chiari/patología , Femenino , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Cavidad Nasal , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
8.
Minim Invasive Neurosurg ; 54(4): 155-61, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21922443

RESUMEN

BACKGROUND: Suprasellar tumors can be removed through a variety of approaches including conventional frontotemporal craniotomies, the transsphenoidal route, or the supraorbital (SO) eyebrow craniotomy. Herein we assess the utility of the SO route for recurrent or residual suprasellar tumors previously treated by an alternative route. MATERIAL AND METHODS: A retrospective analysis of all consecutive patients who underwent an SO approach for removal of a recurrent/residual tumor was undertaken. RESULTS: Between December 2007 and February 2010, 11 patients underwent an SO craniotomy for a recurrent or growing residual tuberculum sellae meningioma (n=7) or craniopharyngioma (n=4). All 11 patients had prior craniotomies, 5 had transsphenoidal surgery, 6 had radiation treatment, and 1 had chemotherapy. In the last 5 cases, the endoscope was used in addition to the microscope for intraoperative visualization. 3 patients underwent decompression of multicystic craniopharyngiomas and the remaining 8 patients had tumor debulking, all achieving 70% or more tumor removal. Of 9 patients with preoperative visual deterioration, 6 (67%) had improvement and no patient had visual worsening. No new adenohypophysis or neurohypophysis dysfunction was noted. One patient had a postoperative CSF leak requiring reoperation. CONCLUSION: The SO approach should be considered as a safe and effective alternative route for recurrent or residual suprasellar tumors previously treated by conventional craniotomy or TS surgery. It typically offers a simplified trajectory that minimizes scar tissue from prior approaches and provides excellent access for optic apparatus decompression. Endoscopy is helpful to visualize hidden tumor remnants and maximize safe tumor removal.


Asunto(s)
Craneofaringioma/cirugía , Craneotomía/métodos , Meningioma/cirugía , Recurrencia Local de Neoplasia/cirugía , Órbita/cirugía , Neoplasias Hipofisarias/cirugía , Adulto , Anciano , Craneofaringioma/patología , Craneotomía/instrumentación , Endoscopía/instrumentación , Endoscopía/métodos , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Meningioma/patología , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos/instrumentación , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Recurrencia Local de Neoplasia/patología , Neoplasia Residual , Neoplasias Hipofisarias/patología , Estudios Retrospectivos , Resultado del Tratamiento
9.
Minim Invasive Neurosurg ; 54(5-6): 250-2, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22278789

RESUMEN

BACKGROUND: Lesions originating in the vidian canal are extremely rare. Most frequently, they are extensions from contiguous carcinomas. We present a rare case of a vidian nerve neurofibroma and discuss its surgical management. CASE REPORT: A 62-year-old woman with a history of a basal cell skin cancer was evaluated for bilateral tinnitus. Imaging revealed a left-sided lesion at the medial aspect of the pterygoid process base, over the vidian canal. Under image-guidance, an endonasal endoscopic transpterygoid approach was performed. The histopathological examination supported the diagnosis of neurofibroma. CONCLUSION: Benign nerve sheath tumors of the vidian nerve should be considered in the differential diagnosis of a vidian canal lesion. Given the propensity of more aggressive tumors, a tissue diagnosis should be warranted in order to coordinate appropriate subsequent treatment. The expanded endonasal transpterygoid approach offers a safe, less invasive, and effective route to perform the excisional biopsy of such a lesion.


Asunto(s)
Neoplasias de los Nervios Craneales/cirugía , Endoscopía/métodos , Neurofibroma/cirugía , Procedimientos Neuroquirúrgicos/métodos , Neoplasias de los Nervios Craneales/diagnóstico por imagen , Neoplasias de los Nervios Craneales/patología , Diagnóstico Diferencial , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Neurofibroma/diagnóstico por imagen , Neurofibroma/patología , Fosa Pterigopalatina , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
10.
Mucosal Immunol ; 13(1): 64-74, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31597930

RESUMEN

The seasonal burden of influenza coupled with the pandemic outbreaks of more pathogenic strains underscore a critical need to understand the pathophysiology of influenza injury in the lung. Interleukin-22 (IL-22) is a promising cytokine that is critical in protecting the lung during infection. This cytokine is strongly regulated by the soluble receptor IL-22-binding protein (IL-22BP), which is constitutively expressed in the lungs where it inhibits IL-22 activity. The IL-22/IL-22BP axis is thought to prevent chronic exposure of epithelial cells to IL-22. However, the importance of this axis is not understood during an infection such as influenza. Here we demonstrate through the use of IL-22BP-knockout mice (il-22ra2-/-) that a pro-IL-22 environment reduces pulmonary inflammation during H1N1 (PR8/34 H1N1) infection and protects the lung by promoting tight junction formation. We confirmed these results in normal human bronchial epithelial cells in vitro demonstrating improved membrane resistance and induction of the tight junction proteins Cldn4, Tjp1, and Tjp2. Importantly, we show that administering recombinant IL-22 in vivo reduces inflammation and fluid leak into the lung. Taken together, our results demonstrate the IL-22/IL-22BP axis is a potential targetable pathway for reducing influenza-induced pneumonia.


Asunto(s)
Inflamación/terapia , Subtipo H1N1 del Virus de la Influenza A/fisiología , Gripe Humana/terapia , Interleucinas/metabolismo , Células Asesinas Naturales/inmunología , Pulmón/inmunología , Infecciones por Orthomyxoviridae/terapia , Receptores de Interleucina/metabolismo , Uniones Estrechas/patología , Animales , Células Cultivadas , Humanos , Inflamación/inmunología , Gripe Humana/inmunología , Pulmón/virología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Terapia Molecular Dirigida , Infecciones por Orthomyxoviridae/inmunología , Neumonía , Receptores de Interleucina/genética , Transducción de Señal , Uniones Estrechas/efectos de los fármacos , Uniones Estrechas/metabolismo , Interleucina-22
11.
J Environ Qual ; 37(3): 925-36, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18453415

RESUMEN

This study examined bacteria and nutrient quality in tile drainage and shallow ground water resulting from a fall land application of liquid municipal biosolids (LMB), at field application rates of 93,500 L ha(-1), to silt-clay loam agricultural field plots using two different land application approaches. The land application methods were a one-pass AerWay SSD approach (A), and surface spreading plus subsequent incorporation (SS). For both treatments, it took between 3 and 39 min for LMB to reach tile drains after land application. The A treatment significantly (p < 0.1) reduced application-induced LMB contamination of tile drains relative to the SS treatment, as shown by mass loads of total Kjeldahl N (TKN), NH(4)-N, Total P (TP), PO(4)-P, E. coli., and Clostridium perfringens. E. coli contamination resulting from application occurred to at least 2.0-m depth in ground water, but was more notable in ground water immediately beneath tile depth (1.2 m). Treatment ground water concentrations of selected nutrients and bacteria for the study period ( approximately 46 d) at 1.2-m depth were significantly higher in the treatment plots, relative to control plots. The TKN and TP ground water concentrations at 1.2-m depth were significantly (p < 0.1) higher for the SS treatment, relative to the A treatment, but there were no significant (p > 0.1) treatment differences for the bacteria. For the macroporous field conditions observed, pre-tillage by equipment such as the AerWay SSD, will reduce LMB-induced tile and shallow ground water contamination compared to surface spreading over non-tilled soil, followed by incorporation.


Asunto(s)
Aguas del Alcantarillado , Agua , Recolección de Datos , Conceptos Meteorológicos , Suelo , Microbiología del Agua
12.
Rev Sci Instrum ; 88(4): 046106, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28456268

RESUMEN

We describe a simple manganin foil resistance manometer for uniaxial stress measurements. The manometer functions at low pressures and over a range of temperatures. In this design, no temperature seasoning is necessary although the manometer must be prestressed to the upper end of the desired pressure range. The prestress pressure cannot be increased arbitrarily; irreversibility arising from shear stress limits its range. Attempting larger pressures yields irreproducible resistance measurements.

13.
Eur Neuropsychopharmacol ; 27(7): 657-666, 2017 07.
Artículo en Inglés | MEDLINE | ID: mdl-28641744

RESUMEN

Obsessive-compulsive disorder (OCD) and Autism spectrum disorder (ASD) are both highly heritable neurodevelopmental disorders that conceivably share genetic risk factors. However, the underlying genetic determinants remain largely unknown. In this work, the authors describe a combined genome-wide association study (GWAS) of ASD and OCD. The OCD dataset includes 2998 individuals in nuclear families. The ASD dataset includes 6898 individuals in case-parents trios. GWAS summary statistics were examined for potential enrichment of functional variants associated with gene expression levels in brain regions. The top ranked SNP is rs4785741 (chromosome 16) with P value=6.9×10-7 in our re-analysis. Polygenic risk score analyses were conducted to investigate the genetic relationship within and across the two disorders. These analyses identified a significant polygenic component of ASD, predicting 0.11% of the phenotypic variance in an independent OCD data set. In addition, we examined the genomic architecture of ASD and OCD by estimating heritability on different chromosomes and different allele frequencies, analyzing genome-wide common variant data by using the Genome-wide Complex Trait Analysis (GCTA) program. The estimated global heritability of OCD is 0.427 (se=0.093) and 0.174 (se=0.053) for ASD in these imputed data.


Asunto(s)
Trastorno del Espectro Autista/genética , Estudio de Asociación del Genoma Completo/métodos , Herencia Multifactorial/genética , Trastorno Obsesivo Compulsivo/genética , Polimorfismo de Nucleótido Simple/genética , Carácter Cuantitativo Heredable , Trastorno del Espectro Autista/diagnóstico , Bases de Datos Genéticas/estadística & datos numéricos , Humanos , Trastorno Obsesivo Compulsivo/diagnóstico , Factores de Riesgo
14.
Neurochirurgie ; 51(2): 107-12, 2005 May.
Artículo en Francés | MEDLINE | ID: mdl-16107085

RESUMEN

INTRODUCTION: Idiopathic subarachnoid hemorrhage (iSAH) is generally recognized as benign especially if its distribution is perimesencephalic. In this study we assessed the complications following an iSAH and analyzed them in relation to the perimesencephalic or diffuse distribution of the hemorrhage. METHOD: Retrospective study of 1,148 consecutive patients evaluated between January 1990 and April 2001 for iSAH documented by cerebral CT-scan with normal cerebral angiographic work-up. RESULTS: Of the eighty-seven patients (7.6%) presenting with iSAH, 52 presented with a perimesencephalic distribution, and 35 with a diffuse distribution. No statistically significant difference was observed between the two distributions with regards to complications following the hemorrhage, such as hydrocephalus, neurological deficits due to vasospasm, systemic effects and mortality. Fisher grade III was associated with an increased risk of complications. CONCLUSION: Perimesencephalic iSAH is not exempt from complications. Morbidity and mortality in this group are comparable to those observed in diffuse iSAH. The Fisher grade is a predicting factor of complications for any given hemorrhage distribution.


Asunto(s)
Mesencéfalo/patología , Hemorragia Subaracnoidea/clasificación , Causas de Muerte , Angiografía Cerebral , Infarto Cerebral/etiología , Femenino , Predicción , Humanos , Hidrocefalia/etiología , Masculino , Estudios Retrospectivos , Factores de Riesgo , Convulsiones/etiología , Hemorragia Subaracnoidea/complicaciones , Tomografía Computarizada por Rayos X , Vasoespasmo Intracraneal/etiología
15.
Eur Psychiatry ; 30(1): 145-51, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24908152

RESUMEN

OBJECTIVE: Individuals with obsessive-compulsive disorder (OCD) and separation anxiety disorder (SAD) tend to present higher morbidity than do those with OCD alone. However, the relationship between OCD and SAD has yet to be fully explored. METHOD: This was a cross-sectional study using multiple logistic regression to identify differences between OCD patients with SAD (OCD+SAD, n=260) and without SAD (OCD, n=695), in terms of clinical and socio-demographic variables. Data were extracted from those collected between 2005 and 2009 via the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders project. RESULTS: SAD was currently present in only 42 (4.4%) of the patients, although 260 (27.2%) had a lifetime diagnosis of the disorder. In comparison with the OCD group patients, patients with SAD+OCD showed higher chance to present sensory phenomena, to undergo psychotherapy, and to have more psychiatric comorbidities, mainly bulimia. CONCLUSION: In patients with primary OCD, comorbid SAD might be related to greater personal dysfunction and a poorer response to treatment, since sensory phenomena may be a confounding aspect on diagnosis and therapeutics. Patients with OCD+SAD might be more prone to developing specific psychiatric comorbidities, especially bulimia. Our results suggest that SAD symptom assessment should be included in the management and prognostic evaluation of OCD, although the psychobiological role that such symptoms play in OCD merits further investigation.


Asunto(s)
Ansiedad de Separación/epidemiología , Ansiedad de Separación/psicología , Trastorno Obsesivo Compulsivo/psicología , Adulto , Brasil/epidemiología , Comorbilidad , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Trastorno Obsesivo Compulsivo/epidemiología , Prevalencia
16.
Healthc (Amst) ; 3(1): 43-8, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26179588

RESUMEN

BACKGROUND: Determining '"value'" in health care, defined as outcomes per unit cost, depends on accurately measuring cost. We used time-driven activity-based costing (TDABC) to determine the cost of care in men with benign prostatic hyperplasia (BPH) - a common urologic condition. METHODS: We implemented TDABC across the entire care pathway for BPH including primary and specialist care in both inpatient and outpatient settings. A team of expert stakeholders created detailed process maps, determined space and product costs, and calculated personnel capacity cost rates. A model pathway was derived from practice guidelines and calculated costs were applied. RESULTS: Although listed as 'optional' in practice guidelines, invasive diagnostic testing can increase costs by 150% compared with the standalone urology clinic visit. Of five different surgical options, a 400% cost discrepancy exists between the most and least expensive treatments. CONCLUSIONS: TDABC can be used to measure cost across an entire care pathway in a large academic medical center. Sizable cost variation exists between diagnostic and surgical modalities for men with BPH. IMPLICATIONS: As financial risk is shifted toward providers, understanding the cost of care will be vital. Future work is needed to determine outcome discrepancy between the diagnostic and surgical modalities in BPH.


Asunto(s)
Costos de la Atención en Salud , Hiperplasia Prostática/terapia , Centros Médicos Académicos , Atención Ambulatoria , Control de Costos , Análisis Costo-Beneficio , Costos y Análisis de Costo , Atención a la Salud , Humanos , Masculino , Hiperplasia Prostática/economía , Factores de Tiempo
17.
Behav Brain Res ; 280: 72-7, 2015 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-25446749

RESUMEN

Obsessive-compulsive disorder (OCD), like other illnesses with prominent anxiety, may involve abnormal fear regulation and consolidation of safety memories. Impaired fear extinction memory (extinction recall, ER) has been shown in individuals with current symptoms of OCD [1]. However, contrary to expectations, the only previous study investigating this phenomenon showed a positive correlation between extinction recall abilities and OCD symptomology (i.e., as OCD symptoms worsened, extinction memory improved). The purpose of the current study was to determine if patients with a lifetime diagnosis of OCD (not necessarily currently symptomatic) also demonstrate impairments in extinction memory, and the relationship between OCD symptomology and extinction memory in this type of sample. In addition, we also examined fear renewal, which has never been investigated in an OCD sample. We enrolled 37 patients with OCD, the majority of whom were on serotonin reuptake inhibitors, and 18 healthy control participants in a 2-day paradigm assessing fear conditioning and extinction (Day 1) and extinction retention and renewal (Day 2). Skin conductance responses (SCRs) were the dependent measure. Results, as in the prior study, indicated that the only between-group difference was impaired ER in OCD patients relative to controls. Contrary to our prediction, OCD symptom severity was not correlated with the magnitude of extinction recall. There were no differences in fear renewal between OCD patients and controls.


Asunto(s)
Condicionamiento Psicológico , Extinción Psicológica , Miedo , Memoria , Trastorno Obsesivo Compulsivo/psicología , Adolescente , Adulto , Anciano , Electrochoque , Femenino , Respuesta Galvánica de la Piel , Mano , Humanos , Masculino , Persona de Mediana Edad , Trastorno Obsesivo Compulsivo/tratamiento farmacológico , Trastorno Obsesivo Compulsivo/fisiopatología , Escalas de Valoración Psiquiátrica , Pruebas Psicológicas , Psicofísica , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Adulto Joven
18.
J Clin Pathol ; 47(9): 850-1, 1994 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-7962656

RESUMEN

A young woman presented with progressive yellowing of her skin over a period of six months. Liver function tests were requested by her general practitioner and the results prompted the Chemical Pathology Department to instigate further tests to reach the final diagnosis. Hypercarotenaemia had caused her yellow skin, and various other biochemical abnormalities pointed towards primary hypothyroidism as an underlying cause. Thyroxine replacement treatment successfully corrected all the biochemical abnormalities including hypercarotenaemia. As far as is known, yellow skin as a sole presenting feature of hypothyroidism is extremely rare.


Asunto(s)
Hipotiroidismo/complicaciones , Trastornos de la Pigmentación/etiología , Adulto , Carotenoides/sangre , Femenino , Humanos , Hipotiroidismo/sangre , Pruebas de Función Hepática , Pruebas de Función de la Tiroides , Factores de Tiempo
19.
Brain Res ; 294(2): 211-23, 1984 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-6322921

RESUMEN

An investigation has been made of the effects of noradrenaline on excitatory transmission at the lateral olfactory tract (LOT)-superficial pyramidal cell synapse of the rat olfactory cortex slice by measuring the effects of bath-applied noradrenaline on the amplitudes and latencies of the field potentials evoked on LOT stimulation. Low concentrations of noradrenaline (0.1-5 microM) facilitate transmission whereas higher doses (20-250 microM) depress transmission. Both these effects were completely blocked by non-selective alpha- and beta-adrenoceptor antagonists, by 2-amino-5-phosphonovaleric acid (an antagonist of excitatory amino acid receptors of the N-methyl-D-aspartate type) and by the methylxanthine theophylline. The depressant effects of noradrenaline were mimicked by bath application of GABA or adenosine and specifically antagonized by bicuculline and picrotoxin. In parallel experiments, noradrenaline (100 microM) significantly increased the potassium-evoked release of endogenous aspartate, glutamate and GABA, proposed transmitters of the olfactory cortex, although the effect on GABA release was specifically antagonized by 2-amino-5-phosphonovaleric acid. Noradrenaline (100 microM) also significantly increased the potassium-evoked release of D-[3H]aspartate, an effect antagonized by a number of alpha- and beta-adrenoceptor antagonists. It is concluded that at low concentrations, noradrenaline facilitates transmission at the LOT-superficial pyramidal cell synapse by increasing excitatory amino acid neurotransmitter release. This effect is mediated by both alpha- and beta-adrenoceptors although the primary site of release is unknown. At higher concentrations of noradrenaline, the increased levels of excitatory transmitters release sufficient endogenous GABA (and possibly adenosine) to cause an overall depression of transmission. These conclusions are supported by the results of a series of experiments in which the effects of noradrenaline on stimulus input-evoked field potential output relationships were assessed. It is not possible to exclude additional direct effects of noradrenaline on membrane excitability.


Asunto(s)
Sistema Nervioso Central/fisiología , Corteza Cerebral/fisiología , Norepinefrina/farmacología , Vías Olfatorias/fisiología , Sinapsis/fisiología , Transmisión Sináptica/efectos de los fármacos , Adenosina/farmacología , Animales , Corteza Cerebral/efectos de los fármacos , Potenciales Evocados/efectos de los fármacos , Técnicas In Vitro , Vías Olfatorias/efectos de los fármacos , Picrotoxina/farmacología , Potasio/farmacología , Ratas , Sinapsis/efectos de los fármacos , Ácido gamma-Aminobutírico/farmacología
20.
Eur J Pharmacol ; 121(1): 91-6, 1986 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-2869959

RESUMEN

[3H]Idazoxan binding to membranes prepared from rat olfactory cortex obeyed saturation kinetics and was to a single population of sites. Although the density of sites was dependent on the incubation medium, binding was of high affinity (KD approximately 5.5 nM) with a Hill coefficient close to unity. Competition studies with a range of adrenoceptor agonists and antagonists confirmed that [3H]idazoxan binding was to alpha 2-adrenoceptors. Neither chemical lesions with the neurotoxin kainic acid nor chronic unilateral bulbectomy significantly altered any of the [3H]idazoxan binding parameters. These findings suggest that alpha 2-adrenoceptors are not located on the lateral olfactory tract terminals or pyramidal cells of the olfactory cortex.


Asunto(s)
Antagonistas Adrenérgicos alfa/metabolismo , Corteza Cerebral/metabolismo , Dioxanos/metabolismo , Dioxinas/metabolismo , Animales , Unión Competitiva/efectos de los fármacos , Idazoxan , Técnicas In Vitro , Ácido Kaínico/farmacología , Cinética , Masculino , Membranas/metabolismo , Ratas , Ratas Endogámicas
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