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1.
Environ Monit Assess ; 195(3): 425, 2023 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-36826723

RESUMO

Coastal upland forests are facing widespread mortality as sea-level rise accelerates and precipitation and storm regimes change. The loss of coastal forests has significant implications for the coastal carbon cycle; yet, predicting mortality likelihood is difficult due to our limited understanding of disturbance impacts on coastal forests. The manipulative, ecosystem-scale Terrestrial Ecosystem Manipulation to Probe the Effects of Storm Treatments (TEMPEST) experiment addresses the potential for freshwater and estuarine-water disturbance events to alter tree function, species composition, and ecosystem processes in a deciduous coastal forest in MD, USA. The experiment uses a large-unit (2000 m2), un-replicated experimental design, with three 50 m × 40 m plots serving as control, freshwater, and estuarine-water treatments. Transient saturation (5 h) of the entire soil rooting zone (0-30 cm) across a 2000 m2 coastal forest was attained by delivering 300 m3 of water through a spatially distributed irrigation network at a rate just above the soil infiltration rate. Our water delivery approach also elevated the water table (typically ~ 2 m belowground) and achieved extensive, low-level inundation (~ 8 cm standing water). A TEMPEST simulation approximated a 15-cm rainfall event and based on historic records, was of comparable intensity to a 10-year storm for the area. This characterization was supported by showing that Hurricane Ida's (~ 5 cm rainfall) hydrologic impacts were shorter (40% lower duration) and less expansive (80% less coverage) than those generated through experimental manipulation. Future work will apply TEMPEST treatments to evaluate coastal forest resilience to changing hydrologic disturbance regimes and identify conditions that initiate ecosystem state transitions.


Assuntos
Ecossistema , Solo , Monitoramento Ambiental , Florestas , Água Doce
2.
Front Genet ; 12: 801253, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35126465

RESUMO

Spinal Muscular Atrophy (SMA) is a heterogeneous group of neuromuscular diseases characterized by degeneration of anterior horn cells of the spinal cord, leading to muscular atrophy and weakness. Although the major cause of SMA is autosomal recessive exon deletions or loss-of-function mutations of survival motor neuron 1 (SMN1) gene, next generation sequencing technologies are increasing the genetic heterogeneity of SMA. SMA type 4 (SMA4) is an adult onset, less severe form of SMA for which genetic and pathogenic causes remain elusive.Whole exome sequencing in a 30-year-old brother and sister with SMA4 identified a compound heterozygous mutation (p. G492R/p. F610C) in calpain-1 (CAPN1). Mutations in CAPN1 have been previously associated with cerebellar ataxia and hereditary spastic paraplegia. Using skin fibroblasts from a patient bearing the p. G492R/p. F610C mutation, we demonstrate reduced levels of CAPN1 protein and protease activity. Functional characterization of the SMA4 fibroblasts revealed no changes in SMN protein levels and subcellular distribution. Additional cellular pathways associated with SMA remain unaffected in the patient fibroblasts, highlighting the tissue specificity of CAPN1 dysfunction in SMA4 pathophysiology. This study provides genetic and functional evidence of CAPN1 as a novel gene for the SMA4 phenotype and expands the phenotype of CAPN1 mutation disorders.

3.
Eur J Clin Microbiol Infect Dis ; 36(5): 823-829, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27987047

RESUMO

Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) are worldwide prevalent healthcare-associated pathogens. We have evaluated three Qiagen artus QS-RGQ assays for the detection of these pathogens. We examined 200 stool samples previously tested for C. difficile infection (CDI), 94 rectal swabs previously screened for VRE and 200 MRSA screening nasal swabs. With the routine diagnostic laboratory results being adopted as the gold standard, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the artus C. difficile assay were 100%, for the artus VanR QS-RGQ assay, 95, 68, 44 and 98%, and for the artus MRSA/SA assay, 80, 94, 93 and 83%, respectively. The artus VanR assay detected the vanA and/or vanB genes in 32% of culture-negative VRE screens; in 71% of these cases, only vanB was detected. An over-estimation of the rate of faecal VRE colonisation could be due to a patient population with high rates of faecal carriage of non-enterococcal species carrying vanB. Based on our findings, we conclude that all three artus QS-RGQ assays could be a useful addition to a diagnostic laboratory, and that the optimal choice of assay should be determined according to user needs.


Assuntos
Técnicas de Laboratório Clínico/métodos , Clostridioides difficile/isolamento & purificação , Infecções por Bactérias Gram-Positivas/diagnóstico , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Técnicas de Diagnóstico Molecular/métodos , Enterococos Resistentes à Vancomicina/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Fezes/microbiologia , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex/métodos , Valor Preditivo dos Testes , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reto/microbiologia , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
4.
J Clin Microbiol ; 53(6): 1931-4, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25788549

RESUMO

Prevention and management of Clostridium difficile infection (CDI) can be improved by rapid and reliable diagnostics. The Vidas C. difficile glutamate dehydrogenase assay had performance comparable to that of the Quik Chek-60 assay (overall agreement, 95%) and a sensitivity of >93%; thus, it is suitable as the first test in two-stage algorithms for a CDI diagnosis.


Assuntos
Transportadores de Cassetes de Ligação de ATP/genética , Proteínas de Bactérias/genética , Técnicas de Tipagem Bacteriana/métodos , Clostridioides difficile/isolamento & purificação , Ensaio de Imunoadsorção Enzimática/métodos , Fezes/microbiologia , Reação em Cadeia da Polimerase/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Clostridioides difficile/genética , Meios de Cultura , Enterocolite Pseudomembranosa/diagnóstico , Enterocolite Pseudomembranosa/microbiologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
5.
AJNR Am J Neuroradiol ; 34(10): 1958-65, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23578674

RESUMO

BACKGROUND AND PURPOSE: AD is one of the few leading causes of death without a disease-modifying drug; however, hopeful agents are in various phases of development. MR imaging abnormalities, collectively referred to as amyloid-related imaging abnormalities, have been reported for several agents that target cerebral Aß burden. ARIA includes ARIA-E, parenchymal or sulcal hyperintensities on FLAIR indicative of parenchymal edema or sulcal effusions, and ARIA-H, hypointense regions on gradient recalled-echo/T2* indicative of hemosiderin deposition. This report describes imaging characteristics of ARIA-E and ARIA-H identified during studies of bapineuzumab, a humanized monoclonal antibody against Aß. MATERIALS AND METHODS: Two neuroradiologists with knowledge of imaging changes reflective of ARIA reviewed MR imaging scans from 210 bapineuzumab-treated patients derived from 3 phase 2 studies. Each central reader interpreted the studies independently, and discrepancies were resolved by consensus. The inter-reader κ was 0.76, with 94% agreement between neuroradiologists regarding the presence or absence of ARIA-E in individual patients. RESULTS: Thirty-six patients were identified with incident ARIA-E (17.1%, 36/210) and 26 with incident ARIA-H (12.4%, 26/210); of those with incident ARIA-H, 24 had incident microhemorrhages and 2 had incident large superficial hemosiderin deposits. CONCLUSIONS: In 49% of cases of ARIA-E, there was the associated appearance of ARIA-H. In treated patients without ARIA-E, the risk for incident blood products was 4%. This association between ARIA-E and ARIA-H may suggest a common pathophysiologic mechanism. Familiarity with ARIA should permit radiologists and clinicians to recognize and communicate ARIA findings more reliably for optimal patient management.


Assuntos
Doença de Alzheimer/tratamento farmacológico , Doença de Alzheimer/patologia , Amiloidose/induzido quimicamente , Amiloidose/patologia , Anticorpos Monoclonais Humanizados/efeitos adversos , Imageamento por Ressonância Magnética , Doença de Alzheimer/epidemiologia , Peptídeos beta-Amiloides/metabolismo , Amiloidose/epidemiologia , Anticorpos Monoclonais Humanizados/administração & dosagem , Encéfalo/metabolismo , Encéfalo/patologia , Edema Encefálico/epidemiologia , Edema Encefálico/patologia , Hemorragia Cerebral/epidemiologia , Hemorragia Cerebral/patologia , Ensaios Clínicos Fase II como Assunto , Gadolínio , Hemossiderina/metabolismo , Humanos , Incidência , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Índice de Gravidade de Doença
6.
Behav Brain Res ; 238: 119-23, 2013 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-23085477

RESUMO

Brain regional analyses of total GluA1 and GluA1-pSer(845) were used to delineate plasticity of the AMPA receptor in conjunction with cocaine-cue extinction learning. Rats were trained to self-administer cocaine paired with a 2-s light cue and later underwent a single 2 h extinction session for which cocaine was withheld but response-contingent cues were presented. Control groups received yoked-saline sessions or received cocaine self-administration training without undergoing extinction training. Extinction-related increases and decreases, respectively, in total GluA1 were observed in the ventromedial prefrontal cortex (vmPFC) and basolateral amygdala (BLA). Phosphorylation of GluA1 at Ser(845) was increased in the vmPFC and nucleus accumbens (NAc). Though total GluA1 did not change in NAc, there was a positive association between the number of responses during extinction training and the magnitude of total GluA1 in NAc. No significant changes were evident in the dorsal hippocampus. We conclude that the BLA and vmPFC, in particular, appear to be loci for the inhibition of learned behavior induced via extinction training, but each site may have different signaling functions for cocaine-cue extinction learning.


Assuntos
Cocaína/administração & dosagem , Inibidores da Captação de Dopamina/administração & dosagem , Extinção Psicológica/efeitos dos fármacos , Receptores de AMPA/metabolismo , Tonsila do Cerebelo/efeitos dos fármacos , Tonsila do Cerebelo/metabolismo , Animais , Comportamento Aditivo/metabolismo , Condicionamento Operante/efeitos dos fármacos , Condicionamento Operante/fisiologia , Sinais (Psicologia) , Extinção Psicológica/fisiologia , Masculino , Núcleo Accumbens/efeitos dos fármacos , Núcleo Accumbens/metabolismo , Fosforilação , Córtex Pré-Frontal/efeitos dos fármacos , Córtex Pré-Frontal/metabolismo , Ratos , Autoadministração
7.
Behav Brain Res ; 234(1): 100-6, 2012 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-22721675

RESUMO

Extinguishing abnormally strengthened learned responses to cues associated with drugs of abuse remains a key tactic for alleviating addiction. To assist in developing pharmacotherapies to augment exposure therapy for relapse prevention, investigation into neurobiological underpinnings of drug-cue extinction learning is needed. We used regional analyses of c-Fos and GluR2 protein expression to delineate neural activity and plasticity that may be associated with cocaine-cue extinction learning. Rats were trained to self-administer cocaine paired with a light cue, and later underwent a single 2h extinction session for which cocaine was withheld but response-contingent cues were presented (cocaine-cue extinction). Control groups consisted of rats yoked to animals self-administering cocaine and receiving saline non-contingently followed by an extinction session, or rats trained to self-administer cocaine followed by a no-extinction session for which levers were retracted, and cocaine and cues were withheld. Among 11 brain sites examined, extinction training increased c-Fos expression in basolateral amygdala and prelimbic prefrontal cortex of cocaine-cue extinguished rats relative to both control conditions. In dorsal subiculum and infralimbic prefrontal cortex, extinction training increased c-Fos expression in both cocaine-cue and saline-cue extinguished rats relative to the no-extinction control condition. GluR2 protein expression was not altered in any site examined after extinction or control training. Findings suggest that basolateral amygdala and prelimbic prefrontal cortex neurons are activated during acquisition of cocaine-cue extinction learning, a process that is independent of changes in GluR2 abundance. Other sites are implicated in processing the significance of cues that are present early in extinction training.


Assuntos
Encéfalo/efeitos dos fármacos , Cocaína/farmacologia , Extinção Psicológica/efeitos dos fármacos , Aprendizagem/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-fos/metabolismo , Animais , Comportamento Aditivo , Comportamento Animal/efeitos dos fármacos , Encéfalo/metabolismo , Masculino , Ratos , Ratos Wistar , Receptores de AMPA/metabolismo
8.
Behav Brain Res ; 207(2): 353-9, 2010 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-19840820

RESUMO

Conditioned opiate reward (COR) is rapidly acquired and slowly extinguished. The slow rate of extinction of the salience of drug-related cues contributes to drug craving and relapse. The gamma-aminobutyric acid receptor type B (GABA(B)) agonist, baclofen, attenuates the unconditioned rewarding actions of several drugs of abuse and was investigated for effects on the extinction of COR. C57BL/6 mice were utilized in an unbiased conditioned place preference (CPP) protocol using morphine (10mg/kg, s.c.) and saline. CPP was measured by increases in time spent in the morphine-associated (CS+) vs. the saline-associated (CS-) chamber in a 15-min test after four morphine and four saline alternated conditioning sessions. CPP and locomotor sensitization were produced to the CS+ chamber. Subsequently, sixteen daily extinction sessions were conducted with either vehicle or baclofen (1 or 2.5mg/kg, s.c.) treatment given either before or after the sessions. This design was used to create the baclofen drug state before or after the activation of the CPP memory trace in the extinction protocol. After morphine CPP development, its extinction was significantly facilitated in a dose-dependent manner by post-session, but not by pre-session, baclofen treatments. No significant sedative effects of baclofen were detected during any extinction training or testing phase. Baclofen treatment facilitated the extinction of COR and reduced conditioned sensitization during extinction when given after, but not before, the activation of the CPP memory trace. Baclofen appears to have disrupted reconsolidation of conditioned reward memory during extinction training and might similarly facilitate extinction learning in human opiate addiction.


Assuntos
Analgésicos Opioides/farmacologia , Baclofeno/farmacologia , Condicionamento Clássico/efeitos dos fármacos , Extinção Psicológica/efeitos dos fármacos , Agonistas GABAérgicos/farmacologia , Morfina/farmacologia , Animais , Baclofeno/administração & dosagem , Relação Dose-Resposta a Droga , Agonistas GABAérgicos/administração & dosagem , Camundongos , Camundongos Endogâmicos C57BL , Atividade Motora/efeitos dos fármacos , Percepção Espacial/efeitos dos fármacos , Fatores de Tempo
9.
J Appl Microbiol ; 102(2): 410-5, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17241346

RESUMO

AIMS: To evaluate three previously unreported substrates for the detection of beta-glucosidase activity in clinically relevant bacteria and to compare their performance with a range of known substrates in an agar medium. METHODS AND RESULTS: The performance of 11 chromogenic beta-glucosidase substrates was compared using 109 Enterobacteriaceae strains, 40 enterococci and 20 strains of Listeria spp. Three previously unreported beta-glucosides were tested including derivatives of alizarin, 3',4'-dihydroxyflavone and 3-hydroxyflavone. These were compared with esculin and beta-glucoside derivatives of 3,4-cyclohexenoesculetin, 8-hydroxyquinoline and five indoxylics. All substrates yielded coloured precipitates upon hydrolysis in agar. Alizarin-beta-D-glucoside was the most sensitive substrate tested and detected beta-glucosidase activity in 72% of Enterobacteriaceae strains and all enterococci and Listeria spp. The two flavone derivatives showed poor sensitivity with Gram-negative bacteria but excellent sensitivity with enterococci and Listeria spp. CONCLUSIONS: Alizarin-beta-d-glucoside is a highly sensitive substrate for detection of bacterial beta-glucosidase and compares favourably with existing substrates. beta-glucosides of 3',4'-dihydroxyflavone and 3-hydroxyflavone are effective substrates for the detection of beta-glucosidase in enterococci and Listeria spp. SIGNIFICANCE AND IMPACT OF THE STUDY: The data presented allow for informed decisions to be made regarding the optimal choice of beta-glucosidase substrate for detection of pathogenic and/or indicator bacteria.


Assuntos
Compostos Cromogênicos , Bactérias Gram-Negativas/enzimologia , Infecções por Bactérias Gram-Negativas/diagnóstico , beta-Glucosidase/análise , Antraquinonas/química , Técnicas de Tipagem Bacteriana , Compostos Cromogênicos/química , Meios de Cultura , Enterobacteriaceae/enzimologia , Enterobacteriaceae/isolamento & purificação , Enterococcus/enzimologia , Enterococcus/isolamento & purificação , Flavonoides/química , Bactérias Gram-Negativas/isolamento & purificação , Listeria/enzimologia , Listeria/isolamento & purificação
10.
J Psychopharmacol ; 21(1): 10-41, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17092962

RESUMO

Attention-deficit/hyperactivity disorder (ADHD) is an established diagnosis in children, associated with a large body of evidence on the benefits of treatment. Adolescents with ADHD are now leaving children's services often with no readily identifiable adult service to support them, which presents problems as local pharmacy regulations often preclude the prescription of stimulant drugs by general practitioners (GPs). In addition, adults with ADHD symptoms are now starting to present to primary care and psychiatry services requesting assessment and treatment. For these reasons, the British Association for Psychopharmacology (BAP) thought it timely to hold a consensus conference to review the body of evidence on childhood ADHD and the growing literature on ADHD in older age groups. Much of this initial guidance on managing ADHD in adolescents in transition and in adults is based on expert opinion derived from childhood evidence. We hope that, by the time these guidelines are updated, much evidence will be available to address the many directions for future research that are detailed here.


Assuntos
Serviços de Saúde do Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Necessidades e Demandas de Serviços de Saúde , Serviços de Saúde Mental , Atenção Primária à Saúde , Adolescente , Adulto , Fatores Etários , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Estimulantes do Sistema Nervoso Central/efeitos adversos , Comorbidade , Medicina Baseada em Evidências , Humanos , Serviços de Saúde Mental/organização & administração , Modelos Organizacionais , Atenção Primária à Saúde/organização & administração , Escalas de Graduação Psiquiátrica , Reino Unido
11.
J Appl Microbiol ; 101(5): 977-85, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17040220

RESUMO

AIMS: Enzyme substrates based on 4-methylumbelliferone are widely used for the detection of Escherichia coli and enterococci in water, by detection of beta-glucuronidase and beta-glucosidase activity respectively. This study aimed to synthesize and evaluate novel umbelliferone-based substrates with improved sensitivity for these two enzymes. METHODS AND RESULTS: A novel beta-glucuronide derivative based on 6-chloro-4-methylumbelliferone (CMUG) was synthesized and compared with 4-methylumbelliferyl-beta-D-glucuronide (MUG) using 42 strains of E. coli in a modified membrane lauryl sulfate broth. Over 7 h of incubation, the fluorescence generated from the hydrolysis of CMUG by E. coli was over twice that from MUG, and all of the 38 glucuronidase-positive strains generated a higher fluorescence with CMUG compared with MUG. Neither substrate caused inhibition of bacterial growth in any of the tested strains. Four beta-glucosidase substrates were also synthesized and evaluated in comparison with 4-methylumbelliferyl-beta-D-glucoside (MU-GLU) using 42 strains of enterococci in glucose azide broth. The four substrates comprised beta-glucoside derivatives of umbelliferone-3-carboxylic acid and its methyl, ethyl and benzyl esters. Glucosides of the methyl, ethyl and benzyl esters of umbelliferone-3-carboxylic acid, were found to be superior to MU-GLU for the detection of enterococci, especially after 18 h of incubation, while umbelliferone-3-carboxylic acid-beta-D-glucoside was inferior. However, the variability in detectable beta-glucosidase activity among the different strains of enterococci in short-term assays using the three carboxylate esters (7 h incubation) may compromise their use for rapid detection and enumeration of these faecal indicator bacteria. CONCLUSIONS: The beta-glucuronidase substrate CMUG appears to be a more promising detection system than the various beta-glucosidase substrates tested. SIGNIFICANCE AND IMPACT OF THE STUDY: The novel substrate CMUG showed enhanced sensitivity for the detection of beta-glucuronidase-producing bacteria such as E. coli, with a clear potential for application in rapid assays for the detection of this indicator organism in natural water and other environmental samples.


Assuntos
Enterococcus/isolamento & purificação , Escherichia coli/isolamento & purificação , Corantes Fluorescentes , Celulases/biossíntese , Meios de Cultura/química , Enterococcus/enzimologia , Escherichia coli/enzimologia , Glucuronidase/biossíntese , Humanos , Umbeliferonas , Microbiologia da Água
12.
Neurology ; 65(8): 1325-7, 2005 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-16247073

RESUMO

The authors developed an 8-week psychoeducational group intervention for patients with systemic lupus erythematosus (SLE) who reported cognitive dysfunction but were not globally impaired on neuropsychological testing. Results of a nonrandomized, uncontrolled pilot study of this program in 17 women with SLE suggest that metamemory and memory self-efficacy improve after participation. One hundred percent retention throughout the study further suggests that patients with SLE are willing and capable of successfully completing the program.


Assuntos
Transtornos Cognitivos/etiologia , Transtornos Cognitivos/terapia , Vasculite Associada ao Lúpus do Sistema Nervoso Central/complicações , Transtornos da Memória/etiologia , Transtornos da Memória/terapia , Educação de Pacientes como Assunto/métodos , Psicoterapia de Grupo/métodos , Adaptação Psicológica , Adulto , Idoso , Transtornos Cognitivos/psicologia , Feminino , Processos Grupais , Humanos , Vasculite Associada ao Lúpus do Sistema Nervoso Central/psicologia , Transtornos da Memória/psicologia , Pessoa de Meia-Idade , Testes Neuropsicológicos , Projetos Piloto , Apoio Social , Inquéritos e Questionários , Ensino/métodos , Resultado do Tratamento
13.
Med J Aust ; 174(3): 126-9, 2001 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-11247615

RESUMO

OBJECTIVE: To examine the consistency of decisions by pathology staff and general practitioners in managing women in whom minor cervical abnormalities are detected by screening, with current National Health and Medical Research (NHMRC) Council guidelines, and to look at reasons for inconsistencies. DESIGN: Qualitative interview study. PARTICIPANTS: 14 pathology staff (12 pathologists and two cytoscientists) from 10 of the 17 laboratories providing cervical cytology services in Victoria, and a sample of 22 GPs from metropolitan and rural locations in Victoria. MAIN OUTCOME MEASURES: Comparison of management practice with NHMRC guidelines; reasons for current decision-making practice. RESULTS: Most pathologists provided more cautious recommendations for minor abnormalities of the cervix than the NHMRC recommendations in all reporting categories except human papillomavirus. Pathologists had concerns about the appropriateness of the NHMRC recommendations, particularly for glandular atypia, lack of an endocervical component and inflammatory smears, where they believed that the NHMRC recommendations were not well supported by evidence. GPs generally followed the recommendations of their laboratories. Medicolegal concerns were a major influence on clinical decisions for both pathologists and GPs, and have contributed to the development of cautious management practice. Reporting and management practice of pathologists and GPs reflects the ambiguity of minor cervical abnormalities that the NHMRC guidelines fail to highlight. CONCLUSION: Many pathologists and GPs are reluctant to follow NHMRC guidelines because they believe they are inadequate for some minor cervical abnormalities. The cervical screening guidelines should be reviewed according to the NHMRC guidelines for developing clinical practice guidelines, to promote consistent practice based on an up-to-date, accurate evidence base.


Assuntos
Medicina de Família e Comunidade/normas , Fidelidade a Diretrizes , Patologia Clínica/normas , Padrões de Prática Médica , Displasia do Colo do Útero/terapia , Esfregaço Vaginal , Medicina Defensiva , Feminino , Humanos , Papillomaviridae , Infecções por Papillomavirus/complicações , Guias de Prática Clínica como Assunto , Infecções Tumorais por Vírus/complicações , Displasia do Colo do Útero/patologia , Displasia do Colo do Útero/virologia , Vitória
14.
J Pain ; 2(1): 46-56, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-14622785

RESUMO

Earlier research has shown that cutaneous experimental pain can elevate the vibrotactile threshold at the same skin locus. The purpose of this study was to determine whether vibrotactile and pain thresholds in a clinical (temporomandibular disorders [TMD]) population are consistent with the hypothesis that chronic pain causes a similar elevation. Specifically, we predicted that TMD subjects with soreness (low palpation-pain threshold) at a given skin site would have relatively high vibrotactile thresholds at the same location. Measurements on the skin overlying the masseter in 18 individuals with TMD showed that pain sensitivity was negatively correlated with sensitivity to 20-Hz vibration (presumed to activate a rapidly adapting mechanoreceptive channel), but not with sensitivity to 200-Hz vibration (thought to activate primarily a slowly adapting channel, because the Pacinian channel is lacking in the orofacial region). There was no relationship between vibration thresholds over the masseter and pain threshold at other orofacial sites, including the contralateral masseter. Vibrotactile and pain thresholds were uncorrelated in control participants without chronic pain (n = 18). The results indicate that in TMD, a localized relationship exists between pain sensitivity and the sensitivity of a low-frequency vibrotactile channel.

15.
Int J Sports Med ; 21 Suppl 2: S109-11; discussion S112, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11142595

RESUMO

Few studies have assessed quality of life in pediatric heart and/or lung transplant recipients, and have varied by the tool used, the design employed, and the time of assessment from transplant. The results also varied including normal to abnormal "psychologic adjustment", diminishing problem behavior at home following transplantation, as well as improvements and no change in quality of life using tools designed specifically for the objective assessment of quality of life. This area of study is in its infancy and thus future studies should: 1) design and utilize standard tools (both global and disease-specific) that have documented validity and reliability in pediatric transplant recipients; 2) examine changes in quality of life longitudinally, and 3) identify predictors of quality of life and potential treatments that can help improve quality of life in pediatric transplant recipients.


Assuntos
Transplante de Coração , Transplante de Pulmão , Qualidade de Vida , Criança , Humanos , Período Pós-Operatório
16.
Alcohol ; 19(2): 157-62, 1999 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10548160

RESUMO

The role of adenosine receptor-mediated signaling was examined in the alcohol withdrawal syndrome. CD-1 mice received a liquid diet containing ethanol (6.7%, v/v) or a control liquid diet that were abruptly discontinued after 14 days of treatment. Mice consuming ethanol showed a progressive increase in signs of intoxication throughout the drinking period. Following abrupt discontinuation of ethanol diet, mice demonstrated reversible signs of handling-induced hyperexcitability that were maximal between 5-8 h. Withdrawing mice received treatment with adenosine receptor agonists at the onset of peak withdrawal (5.5 h) and withdrawal signs were blindly rated (during withdrawal hours 6 and 7). Adenosine A1-receptor agonist R-N6(phenylisopropyl)adenosine (0.15 and 0.3 mg/ kg) reduced withdrawal signs 0.5 and 1.5 h after drug administration in a dose-dependent fashion. Adenosine A2A-selective agonist 2-p-(2-carboxyethyl)phenylethyl-amino-5'-N-ethylcarboxamidoadenosine (0.3 mg/kg) reduced withdrawal signs at both time points. In ethanol-withdrawing mice, there were significant decreases in adenosine transporter sites in striatum without changes in cortex or cerebellum. In ethanol-withdrawing mice, there were no changes in adenosine A1 and A2A receptor concentrations in cortex, striatum, or cerebellum. There appears to be a role for adenosine A1 and A2A receptors in the treatment of the ethanol withdrawal syndrome. Published by Elsevier Science Inc.


Assuntos
Adenosina/análogos & derivados , Depressores do Sistema Nervoso Central/efeitos adversos , Etanol/efeitos adversos , Fenetilaminas/uso terapêutico , Agonistas do Receptor Purinérgico P1 , Receptores Purinérgicos P1/efeitos dos fármacos , Síndrome de Abstinência a Substâncias/tratamento farmacológico , Adenosina/uso terapêutico , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Depressores do Sistema Nervoso Central/administração & dosagem , Etanol/administração & dosagem , Masculino , Camundongos , Receptor A2A de Adenosina , Receptores Purinérgicos P1/fisiologia , Síndrome de Abstinência a Substâncias/psicologia , Tioinosina/análogos & derivados , Tioinosina/metabolismo
17.
Neurosci Lett ; 273(3): 147-50, 1999 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-10515180

RESUMO

We examined the effects of chronic in vivo antipsychotic drug treatments on G protein function and regulation. Mice were treated with typical antipsychotic haloperidol (6 mg/kg per day) and atypical agent olanzapine (20 mg/kg per day) for 14 days via mini-osmotic pumps. G protein-activated adenylyl cyclase activity in brain tissues was measured in the presence of guanine nucleotide analogue guanosine-5'-O(3-thiotriphosphate) tetralithium salt, or GTPgammaS. In frontal cortex, haloperidol treatment produced 21% increases in the GTPgammaS -mediated adenylyl cyclase Emax value (vs. vehicle controls) while olanzapine produced 20% reductions in this value (vs. controls); these effects were significant. In striatum, olanzapine treatment produced significant 31 and 27% decreases in Emax values compared with vehicle and haloperidol treatment, respectively. Chronic haloperidol treatment produced significant 24% reductions in the immunoreactivity of cortical, but not striatal, Gialpha1,2 subunits. There were no effects of chronic olanzapine treatment on G(i)alpha1,2 levels and no effects of either antipsychotic on G(s)alpha, levels. Chronic haloperidol and olanzapine treatments differentially regulate G protein-mediated adenylyl cyclase responses in brain regions possibly relating to their unique effects on G protein-coupled receptors.


Assuntos
Adenilil Ciclases/efeitos dos fármacos , Antipsicóticos/farmacologia , Proteínas de Ligação ao GTP/efeitos dos fármacos , Guanosina 5'-O-(3-Tiotrifosfato)/metabolismo , Haloperidol/farmacologia , Pirenzepina/análogos & derivados , Adenilil Ciclases/metabolismo , Animais , Benzodiazepinas , Córtex Cerebral/efeitos dos fármacos , Córtex Cerebral/metabolismo , Corpo Estriado/efeitos dos fármacos , Corpo Estriado/metabolismo , Proteínas de Ligação ao GTP/metabolismo , Masculino , Camundongos , Olanzapina , Pirenzepina/farmacologia
18.
Brain Res ; 804(1): 52-62, 1998 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-9729274

RESUMO

Regulation of post-receptor signaling provides a mechanism of adaptation to chronic psychotropic drug treatment. In this study, the regulation of guanine nucleotide binding proteins (G proteins) and G protein-stimulated adenylyl cyclase activity was examined in brain regions of caffeine-tolerant and -dependent mice. Chronic caffeine doses were administered via mini-osmotic pumps over 7 days at 0, 42, 85 and 125 mg kg-1 day-1. These chronic caffeine doses were linearly correlated with plasma caffeine concentrations. In behavioral studies, the stimulant effects of acute caffeine on motor activity were significantly diminished in a dose-dependent manner after chronic caffeine, suggesting the development of tolerance. Abrupt discontinuation of chronic caffeine treatment (at 85 and 125 mg kg-1 day-1) produced a dose-dependent and reversible reduction in motor activity 24 h later, suggestive of a caffeine withdrawal syndrome. Utilizing quantitative immunoblotting methods, we found that hippocampal Gialpha1,2 and Gialpha3 subunits were significantly reduced by 20.2% and 11.1%, respectively, in caffeine tolerant/dependent mice (caffeine 125 mg kg-1 day-1 vs. vehicle controls). Decreases in inhibitory G protein subunit concentrations in hippocampus were accompanied by a significant increase (by 21%) in hippocampal G protein function, as measured by guanine nucleotide-stimulated adenylyl cyclase activity, in caffeine-treated mice. This same caffeine treatment also produced significant decreases in cortical Gsalpha subunits of 14.0%. Since short-term caffeine treatment has been shown to reduce adenylyl cyclase activity, chronic caffeine treatment could produce adaptive increases in G protein-stimulated adenylyl cyclase to oppose this effect via G protein regulation.


Assuntos
Adenilil Ciclases/metabolismo , Encéfalo/metabolismo , Cafeína/farmacologia , Proteínas de Ligação ao GTP/metabolismo , Transtornos Relacionados ao Uso de Substâncias/metabolismo , Animais , Comportamento Animal/efeitos dos fármacos , Relação Dose-Resposta a Droga , Tolerância a Medicamentos , Guanilil Imidodifosfato/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos , Atividade Motora/efeitos dos fármacos , Concentração Osmolar , Síndrome de Abstinência a Substâncias/fisiopatologia , Distribuição Tecidual
19.
Brain Res ; 788(1-2): 104-10, 1998 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-9554971

RESUMO

Previous research has demonstrated that acute and chronic opiate treatment alters receptor- and postreceptor-mediated adenylyl cyclase activity. This study examined the regulation of G protein- and forskolin-mediated adenylyl cyclase activity in mouse striatum and cortex after short- and long-term opiate exposure. To directly measure adenylyl cyclase enzymatic activity, assays were done in the presence of catalytic site activator forskolin. To measure G protein-mediated adenylyl cyclase activity, assays were performed in the presence of non-hydrolyzable guanosine 5'-triphosphate (GTP) analogue, 5'-guanylyl-imidodiphosphate. Short-term in vitro morphine exposure produced reductions in forskolin-stimulated adenylyl cyclase activity in striatal and cortical tissues. Long-term morphine treatment in mice was performed via morphine- or placebo-pellet implantation for 72 h; this treatment has been shown to produce opiate dependence and withdrawal. In both opiate-dependent and opiate withdrawing mice (1 h post-naloxone induction), there were significant increases in G protein-mediated adenylyl cyclase activity in the striatum (vs. controls). In opiate-dependent mice, there was an decrease in G protein-mediated adenylyl cyclase activity in cortex. In opiate-dependent mice, there were no changes in forskolin-stimulated adenylyl cyclase in the striatum or cortex. Increases in striatal G protein-mediated adenylyl cyclase could represent a compensatory adaptation that opposes the persistent inhibition of adenylyl cyclase by chronic opiate treatment contributing to the expression of opiate dependence and withdrawal.


Assuntos
Adenilil Ciclases/metabolismo , Proteínas de Ligação ao GTP/fisiologia , Dependência de Morfina/enzimologia , Morfina/efeitos adversos , Síndrome de Abstinência a Substâncias , Telencéfalo/efeitos dos fármacos , Análise de Variância , Animais , Córtex Cerebral/efeitos dos fármacos , Colforsina/farmacologia , Corpo Estriado/efeitos dos fármacos , Modelos Logísticos , Masculino , Camundongos , Camundongos Endogâmicos , Telencéfalo/enzimologia
20.
Brain Res ; 763(2): 215-20, 1997 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-9296562

RESUMO

Opioid-adenosine interactions have been demonstrated at both cellular and behavioral levels. Short-term morphine treatment has been shown to enhance adenosine release in brain and spinal tissues. Since adenosine uptake and release is regulated by a nitrobenzylthioinosine-sensitive adenosine transporter, we examined the effects of morphine treatment on this transporter-binding site. Adenosine transporter-binding sites were examined using equilibrium binding studies with [3H]nitrobenzylthioinosine in brain regions of morphine-treated mice. A 72-hour morphine pellet implantation procedure, which previously produced up-regulation of central adenosine A1 receptors and created a state of opiate dependence [G.B. Kaplan, K.A. Leite-Morris and M.T. Sears, Alterations in adenosine A receptors in morphine dependence, Brain Res., 657 (1994) 347-350], was used in this current study. This chronic morphine treatment significantly increased adenosine transporter-binding site concentrations in striatum and hypothalamus by 12 and 37%, respectively, compared to vehicle pellet implantation. No effects of morphine treatment were demonstrated in cortex, hippocampus, brainstem or cerebellum. In behavioral studies, mice receiving this same chronic morphine or vehicle treatment were given saline or morphine injections (40 or 50 mg/kg i.p.) followed by ambulatory activity monitoring. In the chronic vehicle treatment group, morphine injections significantly stimulated ambulatory activity while in the chronic morphine treatment group there was no such stimulation by acute morphine, suggestive of opiate tolerance. Morphine-induced up-regulation of striatal and hypothalamic adenosine transporter sites could potentially alter extracellular adenosine release and adenosine receptor activation and mediate aspects of opiate tolerance and dependence.


Assuntos
Adenosina/metabolismo , Proteínas de Transporte/metabolismo , Corpo Estriado/química , Hipotálamo/química , Proteínas de Membrana/metabolismo , Morfina/farmacologia , Entorpecentes/farmacologia , Animais , Sítios de Ligação/efeitos dos fármacos , Sítios de Ligação/fisiologia , Tronco Encefálico/química , Tronco Encefálico/metabolismo , Cerebelo/química , Cerebelo/metabolismo , Corpo Estriado/metabolismo , Tolerância a Medicamentos , Hipotálamo/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos , Proteínas de Transporte de Nucleosídeos , Regulação para Cima/efeitos dos fármacos
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