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1.
Front Cardiovasc Med ; 10: 1252533, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37771670

RESUMEN

Aim: Early/follow-up durability of superior mesenteric artery (SMA) stent-grafts is crucial after fenestrated/branched endografting (FB-EVAR) in complex abdominal aortic aneurysms (CAAAs) and thoracoabdominal aortic aneurysms (TAAAs). The study aimed to report early/midterm outcomes of SMA incorporated during FB-EVAR procedures. Methods: FB-EVAR procedures performed between 2016 and 2021 in a single institution were reviewed. Anatomical SMA characteristics were analyzed. The SMA configuration was classified into three types according to the angle between the SMA main trunk and the aorta: (A) perpendicular, (B) downward, and (C) upward. SMA-related technical success (SMA-TS: cannulation and stenting, patency at completion angiography without endoleak, stenosis/kinking, dissection, bleeding, and 24-h mortality) and SMA-adverse events (SMA-AEs: one among bowel ischemia, stenosis, occlusion, endoleak, reinterventions, or SMA-related mortality) were assessed. Results: Two hundred FB-EVAR procedures with SMA as the target artery were performed. The indication for FB-EVAR was CAAAs and TAAAs in 99 (49%) and 101 (51%) cases, respectively. The SMA configuration was A, B, and C in 132 (66%), 63 (31%), and 5 (3%) cases, respectively. SMA was incorporated with fenestrations and branches in 131 (66%) and 69 (34%) cases, respectively. Directional branch (P < .001), aortic diameter ≥35 mm at the SMA level (P < .001), and ≥2 SMA bridging stent-grafts (P = .001) were more frequent in TAAAs. Relining of the SMA stent-graft with a bare metal stent was necessary in 41 (21%) cases to correct an acute angle between the stent-graft and native artery (39), stent-graft stenosis (1), or SMA dissection (1). Relining was associated with type A or C SMA configuration (OR: 17; 95% CI: 1.8-157.3; P = .01). SMA-TS was achieved in all cases. Overall, 15 (7.5%) patients had SMA-AEs [early: 9 (60%), follow-up: 6 (40%)] due to stenosis (2), endoleak (8), and bowel ischemia (5). Aortic diameter ≥35 mm at the SMA level was an independent risk factor for SMA-AEs (OR: 4; 95% CI: 1.4-13.8; P = .01). Fourteen (7%) patients died during hospitalization with 10 (5%) events within the 30-postoperative day. Emergency cases (OR: 33; 95% CI: 5.7-191.3; P = .001), peripheral arterial occlusive disease (OR: 14; 95% CI: 2.3-88.8; P = .004), and bowel ischemia (OR: 41; 95% CI: 1.9-87.9; P = .01) were risk factors for 30-day/in-hospital mortality. The mean follow-up was 32 ± 24 months; estimated 3-year survival was 81%, with no case of late SMA-related mortality or occlusion. The estimated 3-year freedom from overall and SMA-related reinterventions was 74% and 95%, respectively. Conclusion: SMA orientation determines the necessity of stent-graft relining. Aortic diameter ≥35 mm at the SMA level is a predictor of SMA-AEs. Nevertheless, SMA-related outcomes of FB-EVAR are satisfactory, with excellent technical success and promising clinical outcomes during the follow-up.

2.
Int J Immunopathol Pharmacol ; 24(3 Suppl): S13-20, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-22014921

RESUMEN

Anesthetics and other products used during the perioperative period may influence immune function not only merely by reducing the HPA-axis stress response but also by directly modulating innate and adaptive immune responses. Most of the literature on the immune effects of anesthetics has been derived from in vitro or animal studies, due to the number of confounding variables in real life surgical settings. These immunosuppressive effects might not normally have clinical consequences for an immune-competent patient, but may act as important modifiers in postoperative morbidity and mortality. Furthermore, some inhibitory effects on neutrophil functions may provide a therapeutically beneficial effect under specific surgical clinical conditions, such as ischemia-reperfusion injury.


Asunto(s)
Sistema Inmunológico/fisiología , Periodo Perioperatorio , Analgésicos Opioides/farmacología , Anestésicos por Inhalación/farmacología , Anestésicos Intravenosos/farmacología , Anestésicos Locales/farmacología , Animales , Humanos , Sistema Inmunológico/efectos de los fármacos
3.
J Psychosom Res ; 147: 110539, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34091378

RESUMEN

OBJECTIVE: The contribution of psychological and psychiatric symptoms in the development of Functional Neurological Disorders (FND) is unclear. We therefore aimed to investigate the role of different attachment styles (AS) and their relationship with psychiatric symptoms in FND patients as compared with both subjects with neurological disorders (ND) and healthy controls (HC); and the possible differences between patients with functional movement disorders (FMD) and with functional seizures. METHODS: In this case-control study, forty-six patients with FND were compared to 34 with ND and 30 HC, by means of an extensive battery to investigate the presence of alexithymia, depression, anxiety, dissociation and to explore their AS using the Revised Experiences in Close Relationships instrument (ECR-R). RESULTS: Patients with FND had higher depression and alexithymia as well as an avoidant pattern on the ECR-R than patients with ND. In the FND group, ECR-R avoidance was an independent predictor of psychiatric symptoms and, altogether, ECR-R avoidance, the somatic-affective component of depression and difficulty identifying feelings were independent predictors of FND. Gender, anxiety and difficulty identifying feelings predicted the presence of functional seizures. CONCLUSION: The avoidant AS may be an important psychological factor influencing the presence of mood disorders and alexithymia. Their co-occurence might drive maladaptive responses underlying the presence of FND. Although we demonstrated a large overlap between FND phenotypes, patients with functional seizures might have higher alexithymia, which in turn could explain a defensive response less anchored to body reactions and physical symptoms.


Asunto(s)
Síntomas Afectivos , Ansiedad , Trastornos de Ansiedad , Estudios de Casos y Controles , Humanos , Convulsiones
4.
Anal Chem ; 81(17): 7373-8, 2009 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-19663448

RESUMEN

Water pollution by organochlorine pesticides (OCPs) is considered as an analytical challenge, since these persistent and nonbiodegradable pollutants are not amenable by liquid chromatography coupled to atmospheric pressure ionization mass spectrometry (LC/API-MS). This represents a significant constraint in multiresidue analysis of real samples, when high polar, poorly volatile compounds are present as well. This paper reports the development of an innovative single-step method for the simultaneous determination of OCPs and polar pesticides belonging to the class of phenoxy acids in water samples. The method is based on an off-line solid-phase extraction (SPE) procedure with Carbograph 4 followed by liquid chromatography coupled to a direct electron ionization mass spectrometer (LC/direct-EI-MS). The direct-EI capability of acquiring high-quality EI spectra and operation in selected ion monitoring mode allowed a precise quantification of OCPs and phenoxy acids in a single chromatographic run without derivatization. The instrumental response was characterized by excellent sensitivity, linearity, and precision. The SPE recovery rates in river water gave values equal or better than 80% for most of the compounds. The method limits of detection (LODs) span from 0.002 to 0.052 microg/L, allowing the detection of the selected pesticides at the limits required by the European Union (EU) legislation for drinking water.

5.
Anal Chem ; 80(9): 3445-9, 2008 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-18345691

RESUMEN

Contamination of water resources by organochlorine pesticides (OCPs) continues to receive widespread attention because of the increasing concern regarding their high persistence and bioaccumulation. These organic pollutants are not amenable by liquid chromatography (LC) coupled to atmospheric pressure ionization-mass spectrometry, which represents the method of choice for the characterization of pesticide residues in water. Gas chromatography-mass spectrometry provides excellent response for OCPs, but it falls short when complex, multiresidue analyses are required. As recently demonstrated, an efficient EI-based LC-MS interface can generate very good spectra for an extremely wide range of small-medium molecular weight molecules of different polarity and can represent a valid tool in solving the analytical challenge of analyzing OCPs by LC-MS. Based on this assumption, we present a new approach for the determination of 12 OCPs in water samples. The method requires a solid-phase extraction preconcentration step followed by nanoscale liquid chromatography coupled to a direct-electron ionization direct interface (Direct-EI). Direct-EI is a miniaturized interface for efficiently coupling a liquid chromatograph with an EI mass spectrometer. The capability to acquire high-quality EI spectra in a wide range of concentrations, and to operate in selected ion monitoring mode during analyses, allowed a precise quantification of the OCPs. Without sample injection enrichment, limits of detection of the method span from 0.044 to 0.33 microg/L, corresponding to an instrumental detection limit of 120-850 pg. In addition, a careful evaluation of the matrix effect showed that the response of the Direct-EI interface was never affected by sample interferences. From our knowledge, the proposed method represents the first application of LC-MS in the analysis of organochlorine pesticides.


Asunto(s)
Cromatografía Liquida/métodos , Hidrocarburos Clorados/análisis , Espectrometría de Masas/métodos , Plaguicidas/análisis , Contaminantes Químicos del Agua/análisis
6.
Eur J Histochem ; 52(1): 53-60, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18502723

RESUMEN

In an attempt to investigate the neoplastic progression in different stages of actinic keratosis (AK), a standardized AgNOR analysis was performed in 94 cases of AK, 35 of which were associated with squamous cell carcinoma (SCC) or basal cell carcinoma (BCC), and in 31 cases of SCC and 22 cases of BCC. The cases were subdivided into low- and high-AgNOR-expressing (AgNOR status) AK by using the mean area of AgNORs per cell (NORA) value (3.996 micro(2)) as the cut-off. In AK samples, a progressive increase of the mean NORA value from Stage I to Stage IV was encountered. In addition, a significantly higher mean NORA value was found in the AK cases associated with SCC, in comparison to those without SCC; by contrast, no significant differences in the mean NORA value were noted between AK cases with or without BCC. A highly significant association between a high AgNOR quantity and the coexistence of SCC was encountered in AK; no association was appreciable between the AgNOR quantity and the co-occurrence of BCC. Moreover, when the co-existence of SCC in AK was considered as the reference point, the AK cases associated with SCC mostly (95.5%) presented a high AgNOR quantity (high sensitivity), but only 57.6% of cases without SCC displayed a low AgNOR quantity (low specificity). Additionally, our data document that the standardised AgNOR analysis represents a strong negative predictor for the association between SCC and AK. Indeed, a low AgNOR quantity mostly is associated with AK cases without SCC.


Asunto(s)
Antígenos Nucleares/análisis , Carcinoma Basocelular/química , Carcinoma de Células Escamosas/química , Queratosis/metabolismo , Región Organizadora del Nucléolo/química , Neoplasias Cutáneas/química , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma Basocelular/patología , Carcinoma de Células Escamosas/patología , Progresión de la Enfermedad , Femenino , Humanos , Queratosis/patología , Masculino , Persona de Mediana Edad , Pronóstico , Tinción con Nitrato de Plata , Neoplasias Cutáneas/patología
7.
Mar Environ Res ; 65(4): 325-37, 2008 May.
Artículo en Inglés | MEDLINE | ID: mdl-18289661

RESUMEN

Produced formation waters (PFWs), a by-product of both oil and gas extraction, are separated from hydrocarbons onboard oil platforms and then discharged into the sea through submarine outfalls. The dispersion of PFWs into the environment may have a potential impact on marine ecosystems. We reproduce the initial PFW-seawater mixing process by means of the UM3 model applied to offshore natural gas platforms currently active in the Northern Adriatic Sea (Mediterranean Sea). Chemical analyses lead to the identification of a chemical tracer (diethylene glycol) which enables us to follow the fate of PFWs into receiving waters. The numerical simulations are realized in different seasonal conditions using both measured oceanographic data and tracer concentrations. The numerical results show the spatial and temporal plume development in different stratification and ambient current conditions. The analytical approach measures concentrations of the diethylene glycol at a maximum sampling distance of 25 m. The results show a good agreement between field observations and model predictions in the near-field area. The integration of numerical results with chemical analyses also provides new insight to plan and optimize PFW monitoring and discharge.


Asunto(s)
Glicoles de Etileno/análisis , Modelos Teóricos , Agua de Mar/química , Eliminación de Residuos Líquidos , Contaminantes Químicos del Agua/análisis , Simulación por Computador , Monitoreo del Ambiente , Océanos y Mares , Estaciones del Año , Movimientos del Agua
8.
Arch Gen Psychiatry ; 57(3): 270-6, 2000 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10711913

RESUMEN

BACKGROUND: The cognitive, behavioral, and mood effects of N-methyl-D-aspartate (NMDA) receptor antagonists, such as phencyclidine and ketamine, have been used to study the effects of NMDA receptor dysfunction. Pharmacological modulation of the effects of NMDA receptor antagonists, such as ketamine, may lead to development of novel therapeutic agents for psychiatric illnesses such as schizophrenia. Preclinical studies indicate that some ketamine effects may be mediated through increased glutamate release. In this study, we tested the hypothesis that lamotrigine, a drug reported to inhibit glutamate release, will reduce the neuropsychiatric effects of ketamine in humans. METHOD: Healthy subjects (n = 16) completed 4 test days involving the administration of lamotrigine, 300 mg by mouth, or placebo 2 hours prior to administration of ketamine (0.26 mg/kg by intravenous bolus and 0.65 mg/kg per hour by intravenous infusion) or placebo in a randomized order under double-blind conditions. Behavioral and cognitive assessments were performed at baseline and after administration of the medications. RESULTS: Lamotrigine significantly decreased ketamine-induced perceptual abnormalities as assessed by the Clinician-Administered Dissociative States Scale (P<.001); positive symptoms of schizophrenia as assessed by the Brief Psychiatric Rating Scale positive symptoms subscale (P<.001); negative symptoms as assessed by the Brief Psychiatric Rating Scale negative symptoms subscale (P<.05); and learning and memory impairment as assessed by the Hopkins Verbal Learning Test (P<.05). However, lamotrigine increased the immediate mood-elevating effects of ketamine (P<.05). CONCLUSIONS: Glutamate release-inhibiting drugs may reduce the hyperglutamatergic consequences of NMDA receptor dysfunction implicated in the pathophysiologic processes of neuropsychiatric illnesses such as schizophrenia. Further study is needed.


Asunto(s)
Antagonistas de Aminoácidos Excitadores/farmacología , Ketamina/farmacología , Trastornos Mentales/inducido químicamente , Receptores de N-Metil-D-Aspartato/antagonistas & inhibidores , Triazinas/farmacología , Adulto , Afecto/efectos de los fármacos , Escalas de Valoración Psiquiátrica Breve/estadística & datos numéricos , Trastornos del Conocimiento/inducido químicamente , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/prevención & control , Método Doble Ciego , Femenino , Glutamatos/metabolismo , Glutamatos/fisiología , Humanos , Ketamina/antagonistas & inhibidores , Lamotrigina , Masculino , Trastornos Mentales/diagnóstico , Trastornos Mentales/prevención & control , Trastornos de la Percepción/inducido químicamente , Trastornos de la Percepción/diagnóstico , Trastornos de la Percepción/prevención & control , Placebos , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Receptores de N-Metil-D-Aspartato/efectos de los fármacos , Receptores de N-Metil-D-Aspartato/fisiología , Esquizofrenia/metabolismo , Esquizofrenia/fisiopatología , Psicología del Esquizofrénico , Aprendizaje Verbal/efectos de los fármacos
9.
Arch Gen Psychiatry ; 56(5): 395-403, 1999 May.
Artículo en Inglés | MEDLINE | ID: mdl-10232292

RESUMEN

BACKGROUND: Although state-related alterations in catecholamine function have been well-described in depressed subjects, enduring abnormalities have been less reliably identified. In our study, medication-free subjects with fully remitted major depression underwent a paradigm of catecholamine depletion, via use of the tyrosine hydroxylase inhibitor alpha-methylparatyrosine. METHOD: Subjects underwent 2 sets of testing conditions in a double-blind, random-ordered, crossover design, approximately 1 week apart. They underwent active catecholamine depletion (via oral administration of 5 g alpha-methylparatyrosine) or sedation-controlled, sham catecholamine depletion (via oral administration of 250 mg diphenhydramine hydrochloride), during a 2-day observation. Serial mood ratings and blood samples were obtained. RESULTS: Fourteen subjects completed the active testing condition; 13 completed sham testing. Subjects experienced marked, transient increases in core depressive and anxiety symptoms, as demonstrated by a mean 21-point increase on Hamilton Depression Rating Scale scores. Furthermore, 10 (71%) of 14 subjects fulfilled relapse criteria during active testing, whereas 1 (8%) of 13 subjects did so during sham testing. The severity of the depressive reaction correlated with baseline plasma cortisol levels (r = 0.59; P =.04). CONCLUSIONS: Euthymic, medication-free subjects with a history of major depression demonstrate significant depressive symptoms when undergoing testing with alpha-methylparatyrosine. This depressive reaction may represent a reliable marker for a history of depression. Further work is needed to clarify the significance of this finding.


Asunto(s)
Catecolaminas/metabolismo , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/genética , Inhibidores Enzimáticos , alfa-Metiltirosina , Adulto , Catecolaminas/sangre , Catecolaminas/deficiencia , Estudios Cruzados , Trastorno Depresivo/inducido químicamente , Método Doble Ciego , Inhibidores Enzimáticos/farmacología , Femenino , Marcadores Genéticos , Ácido Homovanílico/sangre , Humanos , Masculino , Metoxihidroxifenilglicol/sangre , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Recurrencia , Índice de Severidad de la Enfermedad , alfa-Metiltirosina/farmacología
10.
Biol Psychiatry ; 45(9): 1170-7, 1999 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-10331109

RESUMEN

BACKGROUND: Preliminary reports have suggested that concomitant institution of pindolol and serotonin reuptake inhibitors robustly hastens clinical response; however, contradictory evidence from a randomized double-blind, controlled trial was recently reported by this group in a population of depressed patients who were prescribed fluoxetine and pindolol. Herein, we report final results from an extended sample size. METHODS: Drug-free outpatients with a major depressive episode were randomized in a double-blind manner to one of two treatment conditions: fluoxetine (20 mg daily) with pindolol (7.5 to 10 mg daily) or fluoxetine (20 mg daily) with placebo. After 6 weeks, patients were followed for 3 more weeks in a single-blind manner, on fluoxetine and placebo pindolol. RESULTS: Eighty-six patients completed at least 1 or more weeks on protocol, with 45 and 41 patients randomized to the pindolol and placebo groups respectively. After 2 weeks on protocol, partial remission (i.e., at least 50% decrease in depression rating scores from baseline) rates for pindolol (16%) and placebo (19%) groups were comparable. By the study's end, a partial remission was achieved, at least transiently, for 67% of the pindolol group and 80% of the placebo group. Pindolol treatment was associated with statistically significant reduction in blood pressure and pulse as compared to the control group. The two groups did not have overall differences in rates of attrition, time to response, and side effects. CONCLUSIONS: In accord with our previously published findings, these extended results do not support the efficacy of pindolol in hastening clinical response to fluoxetine in a patient population with predominantly chronic and recurrent depression.


Asunto(s)
Trastorno Depresivo/tratamiento farmacológico , Fluoxetina/uso terapéutico , Pindolol/uso terapéutico , Adulto , Método Doble Ciego , Femenino , Fluoxetina/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Pindolol/efectos adversos
11.
Biol Psychiatry ; 45(8): 972-8, 1999 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-10386179

RESUMEN

BACKGROUND: This study investigated the effects of catecholamine depletion with alpha-methylparatyrosine (AMPT) on mood indices in patients with bipolar disorder who were in long-term remission with lithium therapy. METHODS: Eight subjects with DSM-IV bipolar disorder currently in remission for > 3 months on lithium were included in the study. Subjects were given either AMPT or placebo, in a randomized double-blind manner, in two test sessions of 4 days each. RESULTS: Subjects did not have any significant changes in mood during AMPT or placebo administration; however, 24-48 hours after the last active AMPT dose subjects had a transient relapse of hypomanic symptoms. Relapse of hypomanic symptoms did not correlate with increases in serum levels of homovanillic acid or 3-methoxy-4-hydroxyphenylglycol. CONCLUSIONS: These findings suggest that the mechanism of prevention of manic relapse by long-term lithium therapy may be dependent on stability of the catecholamine system.


Asunto(s)
Antimaníacos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Trastorno Bipolar/metabolismo , Catecolaminas/metabolismo , Inhibidores Enzimáticos/farmacología , Litio/uso terapéutico , alfa-Metiltirosina/farmacología , Adulto , Trastorno Bipolar/diagnóstico , Trastorno Bipolar/prevención & control , Método Doble Ciego , Femenino , Ácido Homovanílico/sangre , Ácido Homovanílico/metabolismo , Humanos , Masculino , Metoxihidroxifenilglicol/sangre , Metoxihidroxifenilglicol/metabolismo , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Recurrencia , Inducción de Remisión , Índice de Severidad de la Enfermedad , Factores de Tiempo
12.
Biol Psychiatry ; 47(4): 351-4, 2000 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-10686270

RESUMEN

BACKGROUND: A growing body of preclinical research suggests that brain glutamate systems may be involved in the pathophysiology of major depression and the mechanism of action of antidepressants. This is the first placebo-controlled, double-blinded trial to assess the treatment effects of a single dose of an N-methyl-D-aspartate (NMDA) receptor antagonist in patients with depression. METHODS: Seven subjects with major depression completed 2 test days that involved intravenous treatment with ketamine hydrochloride (.5 mg/kg) or saline solutions under randomized, double-blind conditions. RESULTS: Subjects with depression evidenced significant improvement in depressive symptoms within 72 hours after ketamine but not placebo infusion (i.e., mean 25-item Hamilton Depression Rating Scale scores decreased by 14 +/- SD 10 points vs. 0 +/- 12 points, respectively during active and sham treatment). CONCLUSIONS: These results suggest a potential role for NMDA receptor-modulating drugs in the treatment of depression.


Asunto(s)
Antidepresivos/uso terapéutico , Trastorno Depresivo Mayor/tratamiento farmacológico , Antagonistas de Aminoácidos Excitadores/uso terapéutico , Ketamina/uso terapéutico , Adulto , Antidepresivos/farmacología , Trastorno Depresivo Mayor/diagnóstico , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Antagonistas de Aminoácidos Excitadores/farmacología , Femenino , Ácido Glutámico/metabolismo , Humanos , Inyecciones Intravenosas , Ketamina/farmacología , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Receptores de N-Metil-D-Aspartato/efectos de los fármacos , Índice de Severidad de la Enfermedad
13.
Biol Psychiatry ; 47(2): 96-106, 2000 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-10664825

RESUMEN

BACKGROUND: Alterations in benzodiazepine receptor function have long been hypothesized to play a role in anxiety. Animal models of anxiety involving exposure to chronic stress have shown a specific decrease in benzodiazepine receptor binding in frontal cortex and hippocampus. The purpose of this study was to examine benzodiazepine receptor binding patients with panic disorder and comparison subjects. METHODS: A quantitative measure related to benzodiazepine receptor binding (Distribution Volume (DV)) was obtained with single photon emission computed tomography (SPECT) imaging of [123I]iomazenil and measurement of radioligand concentration in plasma in patients with panic disorder and healthy controls. DV image data were analyzed using statistical parametric mapping (spm96). RESULTS: A decrease in measures of benzodiazepine receptor binding (DV) was found in left hippocampus and precuneus in panic disorder patients relative to controls. Panic disorder patients who had a panic attack compared to patients who did not have a panic attack at the time of the scan had a decrease in benzodiazepine receptor binding in prefrontal cortex. CONCLUSIONS: Findings of a decrease in left hippocampal and precuneus benzodiazepine receptor binding may be related to alterations in benzodiazepine receptor binding, or other factors including changes in GABAergic transmission or possible endogenous benzodiazepine compounds. Benzodiazepine receptor function in prefrontal cortex appears to be involved in changes in state-related panic anxiety.


Asunto(s)
Flumazenil/análogos & derivados , Radioisótopos de Yodo , Trastorno de Pánico/diagnóstico por imagen , Trastorno de Pánico/metabolismo , Receptores de GABA-A/metabolismo , Tomografía Computarizada de Emisión de Fotón Único , Adolescente , Adulto , Anciano , Femenino , Moduladores del GABA/metabolismo , Hipocampo/diagnóstico por imagen , Hipocampo/metabolismo , Hipocampo/patología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Trastorno de Pánico/patología
14.
Anal Chem ; 72(16): 3841-6, 2000 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-10959971

RESUMEN

The use of a new LC-MS interface (cap-EI), part of a Waters Integrity system, capable of generating EI spectra at micro flow rates is presented. The cap-EI interface relies on the production of a fine aerosol by means of a nebulizer and supported by a nitrogen jet. Sensitivity, response linearity, reproducibility, and LC compatibility of the interface were thoroughly examined using testosterone, caffeine, a mixture of antiinflammatory drugs, and 3,4-dihydroxybenzoic acid as test compounds. The interface is fully compatible with LC requirements such as high-water- and/or -buffer-content mobile phases. Reproducibility, high sensitivity in scan mode, as well, to produce library-searchable EI spectra, 2 orders of magnitude linearity, together with an intrinsic simplicity of the entire system are the key features of cap-EI interface.

15.
Neuropsychopharmacology ; 17(4): 246-57, 1997 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-9326749

RESUMEN

Clinical studies suggest that 5-HT1A receptor function may be blunted in depression, while 5-HT1A agonists may possess antidepressant activity. Preclinical findings implicate changes in 5-HT1A receptor sensitivity in the mechanism of antidepressant action. The hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis in depression could be related to those observations, since 5-HT1A receptors are inhibited by glucocorticoids. To evaluate the interaction of the HPA and 5-HT1A systems, we pretreated 15 unipolar depressed patients and 12 healthy control subjects with the antiglucocorticoid ketoconazole (KTCZ) prior to administration of a test dose of the 5-HT1A agonist ipsapirone (IPS). Neuroendocrine (ACTH, cortisol, growth hormone), physiological (hypothermia), and behavioral responses to IPS were assessed. As expected, KTCZ inhibited cortisol biosynthesis, but non-HPA responses to IPS were not enhanced. This study failed to show that glucocorticoid modulation of 5-HT1A receptor function is altered in depression.


Asunto(s)
Trastorno Depresivo/metabolismo , Glucocorticoides/antagonistas & inhibidores , Antagonistas de Hormonas/farmacología , Receptores de Serotonina/efectos de los fármacos , Hormona Adrenocorticotrópica/sangre , Adulto , Temperatura Corporal/efectos de los fármacos , Método Doble Ciego , Retroalimentación/fisiología , Femenino , Hormona del Crecimiento/sangre , Humanos , Hidrocortisona/sangre , Sistema Hipotálamo-Hipofisario/efectos de los fármacos , Cetoconazol/farmacología , Masculino , Persona de Mediana Edad , Pirimidinas/sangre , Pirimidinas/farmacología , Agonistas de Receptores de Serotonina/sangre , Agonistas de Receptores de Serotonina/farmacología
16.
Neuropsychopharmacology ; 15(5): 475-83, 1996 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-8914120

RESUMEN

Seasonality of mood disorders might involve alterations in the rhythmicity of serotonin [5-HT] function. We examined seasonal effects on the neuroendocrine and mood responses to L-tryptophan (L-TRP) in depressed patients and healthy subjects. In this study, 126 drug-free patients with DSM-III-R major depression and 58 healthy subjects received in i.v. infusion of L-TRP. Serum prolactin (PRL) and plasma tryptophan levels were measured. Mood was assessed with visual analogue scales. Cosinor analysis revealed seasonal variation in peak change (delta) PRL and baseline tryptophan levels in the combined depressed and in unipolar, nonmelancholic, and nonpsychotic patients. Peak delta PRL and tryptophan levels were inversely correlated in combined depressed and unipolar patients. Seasonality was more evident in female than in male patients. These data support previous evidence that 5-HT function is abnormal in depression and further suggest a seasonal variability of such abnormalities that is absent in healthy subjects.


Asunto(s)
Afecto/efectos de los fármacos , Trastorno Depresivo/tratamiento farmacológico , Estaciones del Año , Triptófano/uso terapéutico , Adulto , Trastorno Depresivo/sangre , Femenino , Humanos , Inyecciones Intravenosas , Masculino , Persona de Mediana Edad , Prolactina/sangre , Método Simple Ciego , Triptófano/sangre
17.
J Am Soc Mass Spectrom ; 6(2): 132-9, 1995 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24222075

RESUMEN

Coumarins are a large group of compounds that are naturally present in plant tissues and that exhibit a wide range of pharmacological properties. Analytical methods based on chromatographic techniques and conventional detectors are inadequate to accurately analyze coumarins in complex matrices such as plant extracts. In this article a new method based on a modified particle beam liquid chromatography-mass spectrometry interface is described. The method allows specific and accurate determination of several coumarins in biological matrices. An application regarding the analysis of 18 coumarins in the extract of Smyrnium perfoliatum L. is also reported.

18.
J Am Soc Mass Spectrom ; 7(8): 753-8, 1996 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24203568

RESUMEN

A method for the analysis of four widely used explosives based on reversed-phase liquid chromatography coupled to a quadrupole mass spectrometer is presented. A microflow rate particle beam interface was employed that offers simplified operation procedures and improved interfacing performance. A positive role played by the reduced size of the aerosol droplets generated by the microflow rate interface is outlined in this work. Greater vaporization efficiency and negligible thermal decomposition were observed for the selected compounds in the ion source of the mass spectrometer. Electron capture ionization allowed specific and sensitive determination of the analytes. Detection limits that ranged between 60 and 200 pg and had a signal-to-noise ratio of 5:1 were obtained in selected ion monitoring mode after column elution.

19.
Ann Thorac Surg ; 64(3): 678-83, 1997 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-9307456

RESUMEN

BACKGROUND: A retrospective study of 444 patients undergoing urgent and emergent coronary artery bypass grafting for acute coronary insufficiency was performed to identify the risk factors for hospital death specifically associated with the clinical severity of the acute coronary insufficiency syndrome. METHODS: The patients were divided into three groups-urgent, emergent A, and emergent B-on the basis of the evolution of the clinical pattern of the acute coronary insufficiency syndrome on full medical treatment. The three categories were defined as follows: urgent (257 patients), surgical revascularization could be delayed for 24 to 36 hours after surgical consultation because of adequate control of ischemia; emergent A (127 patients), prompt myocardial revascularization was required because medical treatment achieved only transient regression of an unrelenting ischemic pattern; and emergent B (60 patients), prompt myocardial revascularization was required because the acute coronary insufficiency was entirely refractory to medical treatment. RESULTS: Mortality rates were 7.4% for the urgent group, 13.4% for the emergent A group, and 31.7% for the emergent B group. Multivariate analysis identified the following as risk factors for hospital mortality: ejection fraction (p = 0.023) and aortic cross-clamp time (p = 0.10) for the urgent group; aortic cross-clamp time (p = 0.017), ejection fraction (p = 0.03), and nonuse of blood cardioplegia (p = 0.04) for the emergent A group; and cardiogenic shock (p = 0.00), preoperative ischemic interval (p = 0.00), aortic cross-clamp time (p = 0.018), and nonuse of blood cardioplegia (p = 0.012) for the emergent B group. CONCLUSIONS: A more exact definition of patient risk can be achieved when predictive outcome models are constructed using the risk factors specifically related to each level of clinical severity of the ischemic syndrome.


Asunto(s)
Puente de Arteria Coronaria/mortalidad , Mortalidad Hospitalaria , Isquemia Miocárdica/cirugía , Sangre , Soluciones Cardiopléjicas/uso terapéutico , Puente Cardiopulmonar , Puente de Arteria Coronaria/efectos adversos , Puente de Arteria Coronaria/métodos , Enfermedad Coronaria/complicaciones , Trombosis Coronaria/complicaciones , Urgencias Médicas , Femenino , Predicción , Paro Cardíaco Inducido , Humanos , Complicaciones Intraoperatorias , Italia/epidemiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Isquemia Miocárdica/tratamiento farmacológico , Isquemia Miocárdica/fisiopatología , Reproducibilidad de los Resultados , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Volumen Sistólico , Síndrome , Terapia Trombolítica , Factores de Tiempo , Resultado del Tratamiento
20.
J Chromatogr A ; 855(2): 515-27, 1999 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-10519089

RESUMEN

A capillary-scale particle beam interface was used to detect 18 phenolic compounds in red wine samples. This technique allows reproducible, library searchable electron ionization spectra at only 1 microliter/min mobile phase flow-rate for a sensitive detection of the analytes in complex matrices. The method makes use of a narrow bore, reversed-phase packed capillary column for sample separation. Detection limits were in the low picogram range for most compounds. Sensitivity and response linearity were evaluated for eight phenolic acids, which are often encountered in red wines. The phenolic compound composition was outlined in two red wines obtained using different aging processes.


Asunto(s)
Cromatografía Liquida/métodos , Espectrometría de Masas/métodos , Fenoles/análisis , Sensibilidad y Especificidad
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