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1.
Alzheimers Dement ; 20(2): 1298-1308, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37985413

RESUMO

INTRODUCTION: Genome-wide association studies (GWAS) are fundamental for identifying loci associated with diseases. However, they require replication in other ethnicities. METHODS: We performed GWAS on sporadic Alzheimer's disease (AD) including 539 patients and 854 controls from Argentina and Chile. We combined our results with those from the European Alzheimer and Dementia Biobank (EADB) in a meta-analysis and tested their genetic risk score (GRS) performance in this admixed population. RESULTS: We detected apolipoprotein E ε4 as the single genome-wide significant signal (odds ratio  = 2.93 [2.37-3.63], P = 2.6 × 10-23 ). The meta-analysis with EADB summary statistics revealed four new loci reaching GWAS significance. Functional annotations of these loci implicated endosome/lysosomal function. Finally, the AD-GRS presented a similar performance in these populations, despite the score diminished when the Native American ancestry rose. DISCUSSION: We report the first GWAS on AD in a population from South America. It shows shared genetics modulating AD risk between the European and these admixed populations. HIGHLIGHTS: This is the first genome-wide association study on Alzheimer's disease (AD) in a population sample from Argentina and Chile. Trans-ethnic meta-analysis reveals four new loci involving lysosomal function in AD. This is the first independent replication for TREM2L, IGH-gene-cluster, and ADAM17 loci. A genetic risk score (GRS) developed in Europeans performed well in this population. The higher the Native American ancestry the lower the GRS values.


Assuntos
Doença de Alzheimer , Azidas , Estudo de Associação Genômica Ampla , Humanos , Chile , Doença de Alzheimer/genética , Predisposição Genética para Doença/genética , Polimorfismo de Nucleotídeo Único/genética
2.
Behav Sci (Basel) ; 13(5)2023 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-37232601

RESUMO

In the last two years, the obligatory use of technologies due to the COVID-19 pandemic has increased the technostress suffered by education professionals. This study investigates the relationships between technostress and perceived organizational support and the influence of certain socio-demographic variables. An online survey was administered to 771 teachers working in different educational stages in various autonomous communities in Spain. Perceived organizational support was found to be significantly correlated with technostress. Women tend to experience more technostress in general and significant gender differences were also found in the dimension of anxiety. The analyzed data also suggest that perceived organizational support is higher in private schools. In urban centers, teachers' technostress increases in higher educational stages, such as secondary education and baccalaureate. Further work is needed to develop school policies that address the needs of teachers and provide support for those at risk of technostress. In addition, there is a need to design coping strategies and prioritize the most at-risk sectors to improve their overall health and well-being.

3.
Health Place ; 79: 102691, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-34656430

RESUMO

Long-term community resilience, which privileges a long view look at chronic issues influencing communities, has begun to draw more attention from city planners, researchers and policymakers. In Phoenix, resilience to heat is both a necessity and a way of life. In this paper, we attempt to understand how residents living in Phoenix experience and behave in an extreme heat environment. To achieve this goal, we introduced a smartphone application (ActivityLog) to study spatio-temporal dynamics of human interaction with urban environments. Compared with traditional paper activity log results we have in this study, the smartphone-based activity log has higher data quality in terms of total number of logs, response rates, accuracy, and connection with GPS and temperature sensors. The research results show that low-income residents in Phoenix mostly stay home during the summer but experience a relatively high indoor temperature due to the lack/low efficiency of air-conditioning (AC) equipment or lack of funds to run AC frequently. Middle-class residents have a better living experience in Phoenix with better mobility with automobiles and good quality of AC. The research results help us better understand user behaviors for daily log activities and how human activities interact with the urban thermal environment, informing further planning policy development. The ActivityLog smartphone application is also presented as an open-source prototype to design a similar urban climate citizen science program in the future.


Assuntos
Calor Extremo , Temperatura Alta , Humanos , Arizona , Cidades , Estações do Ano
4.
Environ Plan B Urban Anal City Sci ; 50(5): 1262-1279, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38603327

RESUMO

COVID-19 dashboards with geospatial data visualization have become ubiquitous. There is a growing sense of responsibility to report public health data pushing governments and community organizations to develop and share web-based dashboards. While a substantial body of literature exists on how these GIS technologies and urban analytics approaches support COVID-19 monitoring, their level of social embeddedness, quality and accessibility of user interface, and overall decision-making capabilities has not been rigorously assessed. In this paper, we survey 68 public web-based COVID-19 dashboards using a nominal group technique to find that most dashboards report a wealth of epidemiologic data at the state and county levels. However, these dashboards have limited emphasis on providing granular data (city and neighborhood level) broken down by population sub-groups. We found severe inadequacy in reporting social, behavioral, and economic indicators that shape the trajectory of the pandemic and vice versa. Our survey reveals that most COVID-19 dashboards ignore the provision of metadata, data download options, and narratives around visualizations explaining the data's background, source, and purpose. Based on these lessons, we illustrate an empirical experiment of building a dashboard prototype-the COVID-19 Economic Resilience Dashboard in Arizona. Our dashboard project demonstrates a model that can inform decision-making (beyond plain information sharing) while being accessible by design. To achieve this, we provide localized data, drill-down options by geography and sub-population, visualization narratives, open access to the data source, and accessible features on the interface. We exhibited the value of linking pandemic-related information with socioeconomic data. Our findings suggest a pathway forward for researchers and governments to incorporate more action-oriented data and easy-to-use interfaces as they refine existing and develop new information systems and data analytics dashboards.

5.
Int J Environ Health Res ; 32(5): 1147-1154, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-33228411

RESUMO

This study aims to examine the spatially varying relationships between social vulnerability factors and COVID-19 cases and deaths in the contiguous United States. County-level COVID-19 data and the Centers for Disease Control and Prevention social vulnerability index (SVI) dataset were analyzed using local Spearman's rank correlation coefficient. Results suggested that SVI and four social vulnerability themes have spatially varying relationships with COVID-19 cases and deaths, which means spatial heterogeneity is an essential factor that influences the relationship, and the strength of association varies significantly across counties. County hot spots that were subject to all four social vulnerability themes during the pandemic were also identified. Local communities and health authorities should pay immediate attention to the most influential social vulnerability factors that are dominant in their region and incorporate measures tailored to the specific groups of people who are under the greatest risk of being affected during the COVID-19 pandemic.


Assuntos
COVID-19 , COVID-19/epidemiologia , Humanos , Pandemias , Prevalência , Fatores de Risco , Vulnerabilidade Social , Estados Unidos/epidemiologia
6.
J Urban Health ; 98(3): 344-361, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33768466

RESUMO

The objective of the present study was to examine the effects of a confluence of demographic, socioeconomic, housing, and environmental factors that systematically contribute to heat-related morbidity in Maricopa County, Arizona, from theoretical, empirical, and spatial perspectives. The present study utilized ordinary least squares (OLS) regression and multiscale geographically weighted regression (MGWR) to analyze health data, U.S. census data, and remotely sensed data. The results suggested that the MGWR model showed a significant improvement in goodness of fit over the OLS regression model, which implies that spatial heterogeneity is an essential factor that influences the relationship between these factors. Populations of people aged 65+, Hispanic people, disabled people, people who do not own vehicles, and housing occupancy rate have much stronger local effects than other variables. These findings can be used to inform and educate local residents, communities, stakeholders, city managers, and urban planners in their ongoing and extensive efforts to mitigate the negative impacts of extreme heat on human health in Maricopa County.


Assuntos
Temperatura Alta , Arizona/epidemiologia , Cidades , Humanos , Morbidade , Análise Espacial
7.
PLoS One ; 15(8): e0237361, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764815

RESUMO

Normal aging involves changes in the ability to acquire, consolidate and recall new information. It has been recently proposed that the reconsolidation process is also affected in older adults. Reconsolidation is triggered after reminder presentation, allowing memories to be modified: they can be impaired, strengthened or changed in their content. In young adults it was previously shown that the presentation of repetitive reminders induces memory strengthening one day after reactivation and the presentation of at least one reminder increases memory persistence several days after reactivation. However, until now this process has remained elusive in older adults. We hypothesize that older adults need a stronger reminder to induce memory strengthening through the reconsolidation process than young adults. To test this, we perform a three-day experiment. On day 1, participants learned 15 sound-word associations, on day 2 they received no reminders (NR group), one reminder (R group) or two rounds of reactivations (Rx2 group). Finally, they were tested on day 7. We found that, contrary to our hypothesis, older adults show a memory improvement triggered by repeated labilization/reconsolidation processes to an equal extent than young adults. These results open new perspectives into the use of reconsolidation to improve daily acquired information and the development of therapeutic home used tools to produce memory enhancement in healthy older adults or those with cognitive decline.


Assuntos
Envelhecimento/fisiologia , Memória , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Adulto Jovem
8.
Epilepsia ; 61(8): 1595-1605, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32652588

RESUMO

OBJECTIVE: Depressive disorders are common among about 50% of the patients with drug-resistant temporal lobe epilepsy (TLE). The underlying etiology remains elusive, but hypothalamus-pituitary-adrenal (HPA) axis activation due to changes in glucocorticoid receptor (GR) protein expression could play an important role. Therefore, we set out to investigate expression of the GR in the hippocampus, an important brain region for HPA axis feedback, of patients with drug-resistant TLE, with and without comorbid depression. METHODS: GR expression was studied using immunohistochemistry on hippocampal sections from well-characterized TLE patients with depression (TLE + D, n = 14) and without depression (TLE - D, n = 12) who underwent surgery for drug-resistant epilepsy, as well as on hippocampal sections from autopsy control cases (n = 9). Video-electroencephalography (EEG), magnetic resonance imaging (MRI), and psychiatric and memory assessments were performed prior to surgery. RESULTS: Abundant GR immunoreactivity was present in dentate gyrus granule cells and CA1 pyramidal cells of controls. In contrast, neuronal GR expression was lower in patients with TLE, particularly in the TLE + D group. Quantitative analysis showed a smaller GR+ area in TLE + D as compared to TLE - D patients and controls. Furthermore, the ratio between the number of GR+/NeuN+ cells was lower in patients with TLE + D as compared to TLE - D and correlated negatively with the depression severity based on psychiatric history. The expression of the GR was also lower in glial cells of TLE + D compared to TLE - D patients and correlated negatively to the severity of depression. SIGNIFICANCE: Reduced hippocampal GR expression may be involved in the etiology of depression in patients with TLE and could constitute a biological marker of depression in these patients.


Assuntos
Transtorno Depressivo/metabolismo , Epilepsia Resistente a Medicamentos/metabolismo , Epilepsia do Lobo Temporal/metabolismo , Hipocampo/metabolismo , Receptores de Glucocorticoides/metabolismo , Adulto , Idoso , Região CA1 Hipocampal/metabolismo , Estudos de Casos e Controles , Giro Denteado/metabolismo , Transtorno Depressivo/complicações , Epilepsia Resistente a Medicamentos/complicações , Epilepsia Resistente a Medicamentos/cirurgia , Epilepsia do Lobo Temporal/complicações , Epilepsia do Lobo Temporal/cirurgia , Feminino , Humanos , Sistema Hipotálamo-Hipofisário , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos , Sistema Hipófise-Suprarrenal , Células Piramidais/metabolismo , Adulto Jovem
9.
Behav Neurol ; 2019: 7396793, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31191739

RESUMO

PURPOSE: Changes in calbindin (CB) expression have been reported in patients with temporal lobe epilepsy (TLE) with controversial implications on hippocampal functions. The aim of this study was to determine the CB immunoreactivity in hippocampal dentate gyrus of patients who underwent epilepsy surgery for drug-resistant TLE with and without comorbid depression and/or memory deficits. METHODS: Selected hippocampal samples from patients with TLE who underwent epilepsy surgery were included. Clinical and complementary assessment: EEG, video-EEG, MRI, psychiatric assessment (structured clinical interview, DSM-IV), and memory assessment (Rey auditory verbal learning test, RAVLT; Rey-Osterrieth complex figure test, RCFT), were determined before surgery. Hippocampal sections were processed using immunoperoxidase with the anti-calbindin antibody. The semiquantitative analysis of CB immunoreactivity was determined in dentate gyrus by computerized image analysis (ImageJ). RESULTS: Hippocampal sections of patients with TLE and HS (n = 24) and postmortem controls (n = 5) were included. A significant reduction of CB+ cells was found in patients with TLE (p < 0.05, Student's t-test). Among TLE cases (n = 24), depression (n = 12) and memory deficit (n = 17) were determined. Depression was associated with a higher % of cells with the CB dendritic expression (CB-sprouted cells) (F(1, 20) = 11.81, p = 0.003, hp2 = 0.37), a higher CB+ area (µm2) (F(1, 20) = 5.33, p = 0.032, hp2 = 0.21), and a higher optical density (F(1, 20) = 15.09, p = 0.001, hp2 = 0.43) (two-way ANOVA). The GAF scale (general assessment of functioning) of DSM-IV inversely correlated with the % of CB-sprouted cells (r = -0.52, p = 0.008) and with the CB+ area (r = -0.46, p = 0.022). CONCLUSIONS: In this exploratory study, comorbid depression was associated with a differential pattern of CB cell loss in dentate gyrus combined with a higher CB sprouting. These changes may indicate granular cell dysmaturation associated to the epileptic hyperexcitability phenomena. Further investigations should be carried out to confirm these preliminary findings.


Assuntos
Calbindinas/genética , Depressão/genética , Epilepsia do Lobo Temporal/genética , Adulto , Calbindinas/imunologia , Comorbidade , Giro Denteado/imunologia , Depressão/fisiopatologia , Eletroencefalografia , Epilepsia/complicações , Epilepsia/cirurgia , Epilepsia do Lobo Temporal/complicações , Epilepsia do Lobo Temporal/cirurgia , Feminino , Perfilação da Expressão Gênica/métodos , Hipocampo/metabolismo , Humanos , Imageamento por Ressonância Magnética , Masculino , Transtornos da Memória/complicações , Pessoa de Meia-Idade , Neurônios/metabolismo , Projetos Piloto , Lobo Temporal/metabolismo , Transcriptoma/genética
10.
Transl Psychiatry ; 9(1): 55, 2019 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-30705288

RESUMO

Rare coding variants in TREM2, PLCG2, and ABI3 were recently associated with the susceptibility to Alzheimer's disease (AD) in Caucasians. Frequencies and AD-associated effects of variants differ across ethnicities. To start filling the gap on AD genetics in South America and assess the impact of these variants across ethnicity, we studied these variants in Argentinian population in association with ancestry. TREM2 (rs143332484 and rs75932628), PLCG2 (rs72824905), and ABI3 (rs616338) were genotyped in 419 AD cases and 486 controls. Meta-analysis with European population was performed. Ancestry was estimated from genome-wide genotyping results. All variants show similar frequencies and odds ratios to those previously reported. Their association with AD reach statistical significance by meta-analysis. Although the Argentinian population is an admixture, variant carriers presented mainly Caucasian ancestry. Rare coding variants in TREM2, PLCG2, and ABI3 also modulate susceptibility to AD in populations from Argentina, and they may have a European heritage.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/genética , Doença de Alzheimer/etnologia , Doença de Alzheimer/genética , Glicoproteínas de Membrana/genética , Fosfolipase C gama/genética , Receptores Imunológicos/genética , Idoso , Idoso de 80 Anos ou mais , Argentina/etnologia , População Negra/genética , Feminino , Predisposição Genética para Doença , Variação Genética , Estudo de Associação Genômica Ampla , Genótipo , Humanos , Indígenas Norte-Americanos/genética , Masculino , Pessoa de Meia-Idade , População Branca/genética
11.
Brain Lang ; 171: 31-41, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28478355

RESUMO

OBJECTIVE: Discourse skills - in which the right hemisphere has an important role - enables verbal communication by selecting contextually relevant information and integrating it coherently to infer the correct meaning. However, language research in epilepsy has focused on single word analysis related mainly to left hemisphere processing. The purpose of this study was to investigate discourse abilities in patients with right lateralized medial temporal lobe epilepsy (RTLE) by comparing their performance to that of patients with left temporal lobe epilepsy (LTLE). METHODS: 74 pharmacoresistant temporal lobe epilepsy (TLE) patients were evaluated: 34 with RTLE and 40 with LTLE. Subjects underwent a battery of tests that measure comprehension and production of conversational and narrative discourse. Disease related variables and general neuropsychological data were evaluated. RESULTS: The RTLE group presented deficits in interictal conversational and narrative discourse, with a disintegrated speech, lack of categorization and misinterpretation of social meaning. LTLE group, on the other hand, showed a tendency to lower performance in logical-temporal sequencing. SIGNIFICANCE: RTLE patients showed discourse deficits which have been described in right hemisphere damaged patients due to other etiologies. Medial and anterior temporal lobe structures appear to link semantic, world knowledge, and social cognition associated areas to construct a contextually related coherent meaning.


Assuntos
Epilepsia do Lobo Temporal/fisiopatologia , Epilepsia do Lobo Temporal/psicologia , Lateralidade Funcional/fisiologia , Fala , Adolescente , Adulto , Idade de Início , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Semântica , Lobo Temporal/patologia , Lobo Temporal/fisiopatologia
12.
Int J Clin Health Psychol ; 17(1): 38-45, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-30487879

RESUMO

Background/Objective: Ageing and progressive increase in life expectancy in people with intellectual disability present significant challenges. The present study is to examine the needs that arise in the aging process of this population. To detect these needs is fundamental to ensure personal wellbeing; almost no psychometrically sound instruments have been developed. Method: A structured interview was developed and evaluated by a panel of 20 experts to obtain evidence of content validity. The interview was then applied to 1,173 people with intellectual disability. The ages ranged from 35 to 80 (M = 52.27; SD = 7.5). Results: The interview consisted of 93 items evaluating four areas: perceived needs, personal problems, future perspectives, and solutions required. The results demonstrated the proximity and relationship of the various needs evaluated. In addition it was observed that those with intellectual disability who were older, male and users of residential services tended to indicate more needs, problems, and required more solutions. Conclusions: The instrument has adequate evidence of validity, allowing the evaluation of specific needs of people with intellectual disability. The results advocate the design of transversal intervention policies in order to effectively meet the needs and requirements of this population.


Introducción/Objetivo: El envejecimiento y progresivo incremento de la esperanza de vida de las personas con discapacidad intelectual supone importantes retos. El presente estudio examina las necesidades relacionadas con el proceso de envejecimiento de estas personas. La detección de dichas necesidades resulta fundamental para asegurar su bienestar personal, siendo necesarios instrumentos de evaluación que muestren garantías psicométricas. Método: Se elaboró una entrevista estructurada valorada por un panel de 20 expertos para la obtención de evidencias de validez de contenido. La entrevista fue aplicada a 1.173 personas con discapacidad intelectual de entre 35 y 80 años (M = 52,27; DT = 7,5). Resultados: La entrevista consta de 93 ítems que evalúan cuatro áreas: necesidades percibidas, problemas personales, perspectivas de futuro y soluciones demandadas. Se muestra la proximidad e interacción de las diferentes necesidades evaluadas y la tendencia a que sean las personas con discapacidad intelectual de mayor edad, hombres y usuarios de servicios residenciales quienes refieran mayor número de necesidades y problemas, y demanden más soluciones. Conclusiones: El instrumento desarrollado muestra adecuadas evidencias de validez, permitiendo evaluar necesidades específicas de las personas con discapacidad intelectual. Los resultados abogan por el diseño de políticas de intervención transversales que permitan cubrir eficientemente las necesidades y demandas de este colectivo.

13.
Rev. Hosp. El Cruce ; (17): 1-6, 20151022.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-948075

RESUMO

El propósito del trabajo fue analizar las características clínicas y electrofisiológicas de pacientes que presentaron crisis originadas en ambas regiones temporales en los registros de Video- EEG de scalp. Del total de la población con epilepsia temporal mesial (ET), resistente a las drogas, que ingresó a la Unidad de Video-EEG del Hospital Municipal Ramos Mejía y del Hospital de Alta Complejidad en Red El Cruce Dr. Néstor C. Kirchner, desde marzo de 2009 a marzo de 2014 (n=150), se seleccionaron 9 pacientes con crisis originadas en ambas regiones temporales (40 crisis focales con compromiso de la conciencia). Del total de los pacientes con epilepsia del lóbulo temporal fármaco-resistente, candidatos a cirugía de la epilepsia, en un 6% de los casos resultó difícil lateralizar la zona epileptógena con el registro de Video-EEG de scalp.


Assuntos
Diagnóstico por Imagem , Lobectomia Temporal Anterior , Epilepsia , Epilepsia do Lobo Temporal
14.
Epilepsy Behav ; 52(Pt A): 57-61, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26409130

RESUMO

Several studies suggest that highly emotional information could facilitate long-term memory encoding and consolidation processes via an amygdala-hippocampal network. Our aim was to assess emotional perception and episodic memory for emotionally arousing material in patients with temporal lobe epilepsy (TLE) who are candidates for surgical treatment. We did this by using an audiovisual paradigm. Forty-six patients with medically resistant TLE (26 with left TLE and 20 with right TLE) and 19 healthy controls were assessed with a standard narrative test of emotional memory. The experimental task consisted of sequential picture slides with an accompanying narrative depicting a story that has an emotional central section. Subjects were asked to rate their emotional arousal reaction to each stimulus after the story was shown, while emotional memory (EM) was assessed a week later with a multiple choice questionnaire and a visual recognition task. Our results showed that ratings for emotional stimuli for the patients with TLE were significantly higher than for neutral stimuli (p=0.000). It was also observed that patients with TLE recalled significantly less information from each slide compared with controls, with a trend to lower scores on the questionnaire task for the group with LTLE, as well as poorer performance on the visual recognition task for the group with RLTE. Emotional memory was preserved in patients with RTLE despite having generally poorer memory performance compared with controls, while it was found to be impaired in patients with LTLE.


Assuntos
Emoções , Epilepsia do Lobo Temporal/psicologia , Memória , Adulto , Nível de Alerta , Epilepsia Resistente a Medicamentos/psicologia , Feminino , Humanos , Masculino , Rememoração Mental , Pessoa de Meia-Idade , Desempenho Psicomotor , Reconhecimento Psicológico , Inquéritos e Questionários , Adulto Jovem
15.
Epilepsy Res Treat ; 2014: 157452, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25548661

RESUMO

Autobiographical memory (AM) is understood as the retrieval of personal experiences that occurred in specific time and space. To date, there is no consensus on the role of medial temporal lobe structures in AM. Therefore, we investigated AM in medial temporal lobe epilepsy (TLE) patients. Twenty TLE patients candidates for surgical treatment, 10 right (RTLE) and 10 left (LTLE), and 20 healthy controls were examined with a version of the Autobiographical Interview adapted to Spanish language. Episodic and semantic AM were analyzed during five life periods through two conditions: recall and specific probe. AM scores were compared with clinical and cognitive data. TLE patients showed lower performance in episodic AM than healthy controls, being significantly worst in RTLE group and after specific probe. In relation to semantic AM, LTLE retrieved higher amount of total semantic details compared to controls during recall, but not after specific probe. No significant differences were found between RTLE and LTLE, but a trend towards poorer performance in RTLE group was found. TLE patients obtained lower scores for adolescence period memories after specific probe. Our findings support the idea that the right hippocampus would play a more important role in episodic retrieval than the left, regardless of a temporal gradient.

16.
Epilepsy Behav ; 37: 165-70, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25036902

RESUMO

OBJECTIVES: Temporal lobe resistant epilepsy has been associated with a high incidence of psychotic disorders; however, there are many controversies; while some patients get better after surgery from their psychiatric condition, others develop psychosis or de novo depression. The aim of this study was to determine the psychiatric and seizure outcome after epilepsy surgery in patients with a previous history of psychoses. METHODS: Surgical candidates with temporal lobe drug-resistant epilepsy and a positive history of psychosis diagnosed during the presurgical psychiatric assessment were included. A two-year prospective follow-up was determined after surgery. The DSM-IV Structural Interview, GAF (global assessment of functionality, DSM-IV), Ictal Classification for psychoses, and Engel's classification were used. The Student t test and chi-square-Fisher tests were used. RESULTS: During 2000-2010, 89 patients were admitted to the epilepsy surgery program, 14 patients (15.7%) presented psychoses and were included in this series. After surgery, six patients (43%) did not develop any psychiatric complications, three patients (21%) with chronic interictal psychosis continued with no exacerbation, three patients (21%) developed acute and transient psychotic symptoms, and two patients (14%) developed de novo depression. Seizure outcome was Engel class I-II in 10 patients (71%). Total GAF scores were higher after surgery in patients found to be in Engel class I-II (p<0.05). CONCLUSIONS: Patients with comorbid psychosis and temporal lobe drug-resistant epilepsy may benefit from epilepsy surgery under close psychiatric supervision.


Assuntos
Epilepsia do Lobo Temporal/complicações , Epilepsia do Lobo Temporal/cirurgia , Transtornos Mentais/etiologia , Transtornos Mentais/psicologia , Procedimentos Neurocirúrgicos , Psicocirurgia , Transtornos Psicóticos/complicações , Adulto , Idoso , Manual Diagnóstico e Estatístico de Transtornos Mentais , Resistência a Medicamentos , Epilepsia do Lobo Temporal/psicologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Convulsões/psicologia , Convulsões/cirurgia , Resultado do Tratamento , Adulto Jovem
17.
Radiat Res ; 182(2): 139-48, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25003313

RESUMO

To understand the impact of clinically relevant radiation therapy (RT) on tumor immune gene expression and to utilize the changes that occur during treatment to improve cancer treatment outcome, we examined how immune response genes are modulated in prostate cancer cells of varying p53 status. LNCaP (p53 wild-type), PC3 (p53 null) and DU145 (p53 mutant) cells received a 10 Gy single dose or 1 Gy × 10 multifractionated radiation dose to simulate hypofractionated and conventionally fractionated prostate radiotherapy. Total RNA was isolated 24 h after multifractionated radiation treatment and single-dose treatments and subjected to microarray analysis and later validated by RT-PCR. RT-PCR was utilized to identify total-dose inflection points for significantly upregulated genes in response to multifractionated radiation therapy. Radiation-induced damage-associated molecular pattern molecules (DAMPs) and cytokine analyses were performed using bioluminescence and ELISA. Multifractionated doses activated immune response genes more robustly than single-dose treatment, with a relatively larger number of immune genes upregulated in PC3 compared to DU145 and LNCaP cells. The inflection point of multifractionated radiation-induced immune genes in PC3 cells was observed in the range of 8-10 Gy total radiation dose. Although both multifractionated and single-dose radiation-induced proinflammatory DAMPs and positively modulated the cytokine environment, the changes were of higher magnitude with multifractionated therapy. The findings of this study together with the gene expression data suggest that cells subjected to multifractionated radiation treatment would promote productive immune cell-tumor cell interactions.


Assuntos
Imunidade/efeitos da radiação , Neoplasias da Próstata/patologia , Radioterapia/métodos , Linhagem Celular Tumoral , Citocinas/metabolismo , Fracionamento da Dose de Radiação , Humanos , Imunidade/genética , Masculino , Neoplasias da Próstata/genética , Neoplasias da Próstata/imunologia , Neoplasias da Próstata/radioterapia , Transcriptoma/imunologia , Transcriptoma/efeitos da radiação , Resultado do Tratamento
18.
Epilepsy Res Treat ; 2012: 370351, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22957227

RESUMO

The aim of the present study is to compare pre- and postsurgical neuropsychological outcome in individuals suffering from mesial temporal lobe epilepsy (mTLE), in order to evaluate prognosis. The selected thirty-five patients had medically mTLE and had undergone an anterior temporal lobectomy (ATL). Neuropsychological evaluation was performed in three different stages: before ATL, 6 months after resection, and a year afterwards. Neuropsychological protocol evaluated attention, verbal memory, visual memory, executive function, language, intelligence, and handedness. There was a significant improvement (P = 0.030) in the group with visual memory deficit after surgery, whereas no changes were observed across patients with verbal memory deficit. No changes were observed in language after surgery. Executive function showed significant improvement 6 months after surgery (P = 0.035). Postoperative outcome of cognitive impairments depends on baseline neuropsychological status of the patients with TLE. In our case series, deficits found in patients with mTLE after ATL did not result in a subjective complaint.

19.
Epilepsy Behav ; 14(4): 604-9, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19236954

RESUMO

The issue of psychotic disorders in epilepsy has given rise to great controversy among professionals; however, there are not many studies in this area and the physiopathological mechanisms remain unknown. The aim of this study was to describe the spectrum of psychotic disorders in an Argentine population with refractory temporal lobe epilepsy (RTLE) and to determine the risk factors associated with psychotic disorders. Clinical variables of the epileptic syndrome were compared among a selected population with RTLE with and without psychotic disorders (DSM-IV/Ictal Classification of psychoses). Logistic regression was performed. Sixty-three patients with psychotic disorders (Psychotic Group, PG) and 60 controls (Control Group, CG) were included. The most frequent psychotic disorders were brief psychotic episodes (35%) (DSM-IV) and interictal psychosis (50%) (Ictal Classification). Risk factors for psychotic disorders were bilateral hippocampal sclerosis, history of status epilepticus, and duration of epilepsy greater than 20 years.


Assuntos
Epilepsia do Lobo Temporal/complicações , Epilepsia do Lobo Temporal/epidemiologia , Transtornos Psicóticos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Estudos de Casos e Controles , Manual Diagnóstico e Estatístico de Transtornos Mentais , Eletroencefalografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Psicometria , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/etiologia , Estudos Retrospectivos , Fatores de Risco , Estatísticas não Paramétricas , Adulto Jovem
20.
An. Fac. Med. (Perú) ; 69(1): 42-45, ene.-mar. 2008. tab, graf
Artigo em Espanhol | LILACS, LIPECS | ID: lil-537426

RESUMO

Objetivo: Cuantificar la participación estudiantil en la publicación de artículos originales en revistas médicas peruanas indizadas a SciELO Perú. Diseño: Estudio observacional retrospectivo. Lugar: Hemeroteca de la Facultad de Medicina UNMSM y en www.scielo.org.pe. Población: Artículos originales, comunicaciones cortas (incluye casos clínicos) y cartas al editor publicadas en volúmenes correspondientes a 1997 hasta 2005, en revistas de periodicidad trimestral actualizadas. Intervenciones: Revisión de la filiación de los autores (estudiante o profesional; sexo, universidad y carrera de procedencia), tipo de artículo y área de investigación (clínica, biomédica y salud pública). Principales resultados: Frecuencia y porcentaje de artículos con participación estudiantil. Resultados: Se incluyó 865 contribuciones originales de cuatro revistas; en 4,5 por ciento (39) de ellas hubo participación estudiantil en la autoría, 74 por ciento (29/39) fueron artículos originales, 10 comunicaciones cortas y ninguna carta al editor. Anales de la Facultad de Medicina fue la revista que publicó más artículos estudiantiles (6,6 por ciento). La mediana fue de cinco artículos estudiantiles por año. Diez artículos fueron realizados solo por estudiantes, 87 por ciento procedía de tres universidades (Universidad Nacional Mayor de San Marcos, Universidad Peruana Cayetano Heredia y Universidad Privada Antenor Orrego) y 58 por ciento, del área clínica. La mayoría (72 por ciento) de los autores fue varón. Conclusiones: La participación estudiantil en la publicación de artículos en revistas médicas peruanas indizadas en SciELO Perú es baja. Se recomienda capacitar a los estudiantes en la publicación de sus investigaciones, incluyendo cursos o tópicos en la formación médica universitaria.


Objective: To quantify student participation in the publication of original contributions in Peruvian medical journals indexed to SciELO Peru. Design: Retrospective observational study. Setting: Archives of the UNMSM Faculty of Medicine and in www.scielo.org.pe. Population: Original papers, short communications (included case reports) and letters to the editor published from 1997 through 2005 in updated quarterly journals. Interventions: Review of authors affiliation (student or professional; sex, university and professional studies of origin), article type and research area (clinical, biomedical, public health). Principal outcome measures: Frequency and percentage of papers with student participation. Results: We included 865 original contributions from four journals; in 4,5 per cent (39) students participated in the authorship, 74 per cent (29/39) were original papers, 10 short communications and there was no letter to the editor. Anales de la Facultad de Medicina was the journal that published most of the student papers (6,6 percent). The median was five student papers per year. Ten articles were done only by students, 87 per cent came from three universities (Universidad Nacional Mayor de San Marcos, Universidad Peruana Cayetano Heredia, and Universidad Privada Antenor Orrego) and 58 percent pertained to the clinical area. The majority (72 percent) of the authors was male. Conclusions: Student participation in papers published in Peruvian medical journals is poor. We recommend training students in publishing their research; this course should be included in the medical curricula.


Assuntos
Autoria na Publicação Científica , Estudantes de Medicina , Publicações Científicas e Técnicas
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