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1.
Nature ; 606(7913): 351-357, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-35545677

RESUMEN

Death is defined as the irreversible cessation of circulatory, respiratory or brain activity. Many peripheral human organs can be transplanted from deceased donors using protocols to optimize viability. However, tissues from the central nervous system rapidly lose viability after circulation ceases1,2, impeding their potential for transplantation. The time course and mechanisms causing neuronal death and the potential for revival remain poorly defined. Here, using the retina as a model of the central nervous system, we systemically examine the kinetics of death and neuronal revival. We demonstrate the swift decline of neuronal signalling and identify conditions for reviving synchronous in vivo-like trans-synaptic transmission in postmortem mouse and human retina. We measure light-evoked responses in human macular photoreceptors in eyes removed up to 5 h after death and identify modifiable factors that drive reversible and irreversible loss of light signalling after death. Finally, we quantify the rate-limiting deactivation reaction of phototransduction, a model G protein signalling cascade, in peripheral and macular human and macaque retina. Our approach will have broad applications and impact by enabling transformative studies in the human central nervous system, raising questions about the irreversibility of neuronal cell death, and providing new avenues for visual rehabilitation.


Asunto(s)
Fototransducción , Rehabilitación Neurológica , Cambios Post Mortem , Retina , Animales , Autopsia , Muerte Celular/efectos de la radiación , Sistema Nervioso Central/efectos de la radiación , Humanos , Fototransducción/efectos de la radiación , Macaca , Ratones , Retina/metabolismo , Retina/efectos de la radiación , Factores de Tiempo
2.
Sensors (Basel) ; 24(14)2024 Jul 19.
Artículo en Inglés | MEDLINE | ID: mdl-39066092

RESUMEN

(1) Background: Restoring arm and hand function is one of the priorities of people with cervical spinal cord injury (cSCI). Noninvasive electromagnetic neuromodulation is a current approach that aims to improve upper-limb function in individuals with SCI. The aim of this study is to review updated information on the different applications of noninvasive electromagnetic neuromodulation techniques that focus on restoring upper-limb functionality and motor function in people with cSCI. (2) Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used to structure the search protocol. A systematic review of the literature was performed in three databases: the Cochrane Library, PubMed, and Physiotherapy Evidence Database (PEDro). (3) Results: Twenty-five studies were included: four were on transcranial magnetic stimulation (TMS), four on transcranial direct current stimulation (tDCS), two on transcutaneous spinal cord stimulation (tSCS), ten on functional electrical stimulation (FES), four on transcutaneous electrical nerve stimulation (TENS), and one on neuromuscular stimulation (NMS). The meta-analysis could not be completed due to a lack of common motor or functional evaluations. Finally, we realized a narrative review of the results, which reported that noninvasive electromagnetic neuromodulation combined with rehabilitation at the cerebral or spinal cord level significantly improved upper-limb functionality and motor function in cSCI subjects. Results were significant compared with the control group when tSCS, FES, TENS, and NMS was applied. (4) Conclusions: To perform a meta-analysis and contribute to more evidence, randomized controlled trials with standardized outcome measures for the upper extremities in cSCI are needed, even though significant improvement was reported in each non-invasive electromagnetic neuromodulation study.


Asunto(s)
Traumatismos de la Médula Espinal , Estimulación Magnética Transcraneal , Extremidad Superior , Humanos , Traumatismos de la Médula Espinal/fisiopatología , Traumatismos de la Médula Espinal/rehabilitación , Traumatismos de la Médula Espinal/terapia , Extremidad Superior/fisiopatología , Estimulación Magnética Transcraneal/métodos , Sistema Nervioso Periférico/fisiopatología , Sistema Nervioso Central/fisiopatología , Sistema Nervioso Central/efectos de la radiación , Sistema Nervioso Central/fisiología , Estimulación Eléctrica Transcutánea del Nervio/métodos , Estimulación Transcraneal de Corriente Directa/métodos , Médula Cervical/lesiones
3.
Cancer Metastasis Rev ; 38(4): 657-671, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31820149

RESUMEN

The cure rate of acute lymphoblastic leukemia (ALL), the commonest childhood cancer, has been sharply improved and reached almost 90% ever since the central nervous system (CNS)-directed therapy proposed in the 1960s. However, relapse, particularly in the central nervous system (CNS), is still a common cause of treatment failure. Up to now, the classic CNS-directed treatment for CNS leukemia (CNSL) has been aslant from cranial radiation to high-dose system chemotherapy plus intrathecal (IT) chemotherapy for the serious side effects of cranial radiation. The neurotoxic effects of chemotherapy and IT chemotherapy have been reported in recent years as well. For better prevention and treatment of CNSL, plenty of studies have tried to improve the detection sensitivity for CNSL and prevent CNSL from happening by targeting cytokines and chemokines which could be key factors for the traveling of ALL cells into the CNS. Other studies also have aimed to completely kill ALL cells (including dormant cells) in the CNS by promoting the entering of chemotherapy drugs into the CNS or targeting the components of the CNS niche which could be in favor of the survival of ALL cells in CNS. The aim of this review is to discuss the imperfection of current diagnostic methods and treatments for CNSL, as well as new attempts which could be significant for better elimination of CNSL.


Asunto(s)
Sistema Nervioso Central/efectos de los fármacos , Sistema Nervioso Central/efectos de la radiación , Infiltración Leucémica/tratamiento farmacológico , Infiltración Leucémica/radioterapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/patología , Animales , Sistema Nervioso Central/patología , Niño , Irradiación Craneana , Humanos , Inyecciones Espinales , Infiltración Leucémica/diagnóstico , Infiltración Leucémica/patología
4.
J Neuroinflammation ; 17(1): 279, 2020 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-32951604

RESUMEN

BACKGROUND: Microglia, the primary resident myeloid cells of the brain, play critical roles in immune defense by maintaining tissue homeostasis and responding to injury or disease. However, microglial activation and dysfunction has been implicated in a number of central nervous system (CNS) disorders, thus developing tools to manipulate and replace these myeloid cells in the CNS is of therapeutic interest. METHODS: Using whole body irradiation, bone marrow transplant, and colony-stimulating factor 1 receptor inhibition, we achieve long-term and brain-wide (~ 80%) engraftment and colonization of peripheral bone marrow-derived myeloid cells (i.e., monocytes) in the brain parenchyma and evaluated the long-term effects of their colonization in the CNS. RESULTS: Here, we identify a monocyte signature that includes an upregulation in Ccr1, Ms4a6b, Ms4a6c, Ms4a7, Apobec1, Lyz2, Mrc1, Tmem221, Tlr8, Lilrb4a, Msr1, Nnt, and Wdfy1 and a downregulation of Siglech, Slc2a5, and Ccl21a/b. We demonstrate that irradiation and long-term (~ 6 months) engraftment of the CNS by monocytes induces brain region-dependent alterations in transcription profiles, astrocytes, neuronal structures, including synaptic components, and cognition. Although our results show that microglial replacement with peripherally derived myeloid cells is feasible and that irradiation-induced changes can be reversed by the replacement of microglia with monocytes in the hippocampus, we also observe that brain-wide engraftment of peripheral myeloid cells (relying on irradiation) can result in cognitive and synaptic deficits. CONCLUSIONS: These findings provide insight into better understanding the role and complexity of myeloid cells in the brain, including their regulation of other CNS cells and functional outcomes.


Asunto(s)
Células de la Médula Ósea/inmunología , Trasplante de Médula Ósea/métodos , Encéfalo/citología , Encéfalo/inmunología , Células Mieloides/inmunología , Animales , Médula Ósea/inmunología , Médula Ósea/efectos de la radiación , Encéfalo/efectos de la radiación , Sistema Nervioso Central/citología , Sistema Nervioso Central/inmunología , Sistema Nervioso Central/efectos de la radiación , Masculino , Ratones , Ratones Endogámicos C57BL , Monocitos/fisiología , Monocitos/efectos de la radiación , Células Mieloides/efectos de la radiación , Transcripción Genética/fisiología , Transcripción Genética/efectos de la radiación
5.
Artículo en Inglés | MEDLINE | ID: mdl-32607762

RESUMEN

Diverse animals use Earth's magnetic field to guide their movements, but the neural and molecular mechanisms underlying the magnetic sense remain enigmatic. One hypothesis is that particles of the mineral magnetite (Fe3O4) provide the basis of magnetoreception. Here we examined gene expression in the central nervous system of a magnetically sensitive invertebrate, the Caribbean spiny lobster (Panulirus argus), after applying a magnetic pulse known to alter magnetic orientation behavior. Numerous genes were differentially expressed in response to the pulse, including 647 in the brain, 1256 in the subesophageal ganglion, and 712 in the thoracic ganglia. Many such genes encode proteins linked to iron regulation, oxidative stress, and immune response, consistent with possible impacts of a magnetic pulse on magnetite-based magnetoreceptors. Additionally, however, altered expression also occurred for numerous genes with no apparent link to magnetoreception, including genes encoding proteins linked to photoreception, carbohydrate and hormone metabolism, and other physiological processes. Overall, the results are consistent with the magnetite hypothesis of magnetoreception, yet also reveal that in spiny lobsters, a strong pulse altered expression of > 10% of all expressed genes, including many seemingly unrelated to sensory processes. Thus, caution is required when interpreting the effects of magnetic pulses on animal behavior.


Asunto(s)
Palinuridae/efectos de la radiación , Animales , Conducta Animal/efectos de la radiación , Región del Caribe , Sistema Nervioso Central/metabolismo , Sistema Nervioso Central/efectos de la radiación , Perfilación de la Expresión Génica , Campos Magnéticos , Orientación/fisiología , Palinuridae/genética , Palinuridae/metabolismo , Transcriptoma/efectos de la radiación
6.
Ann Diagn Pathol ; 48: 151610, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32889391

RESUMEN

High-grade diffuse large B-cell lymphoma (HG-DLBCL) refers to DLBCL with MYC and BCL2 and/or BCL6 rearrangements (double-hit or triple-hit DLBCL) that exhibits poor prognosis. Double-expressor DLBCL (c-myc+/bcl-2+) has intermediate prognosis when compared to HG-DLBCL. Primary central nervous system lymphoma (PCNSL) has distinct pathophysiology (frequent non-germinal center-like subtype and double-expressor) and has worse prognosis than systemic DLBCL. By fluorescence in situ hybridization (FISH), 25-30% of PCNSLs harbor BCL6 abnormalities with rare alterations in MYC, BCL2, double-hit or triple-hit events. We describe the clinicopathologic features and status of MYC, BCL2 and BCL6 in 12 PCNSLs (7 women, 5 men; median age 63 years; range: 28-79). Six cases showed focal starry-sky pattern. Immunohistochemically, all (100%) were of non-germinal center-like subtype, and 8/10 (80%) cases were double-expressors. Ki-67 ranged from 70 to 100%. FISH was positive in 9/12 (75%) cases: 4 (33%) harbored a BCL6 rearrangement, 3 (25%) had a gain of BCL2, 2 (17%) cases each had a gain of BCL6 and gain of IGH, and gain of MYC and deletion of MYC were observed in 1 case each (8%). Two (16%) cases were MYC/BCL6 double-hit PCNSLs. No MYC/BCL2 or triple-hit cases were identified. Eleven (92%) patients received chemotherapy and one also received whole brain radiation. The median time of follow-up was 4.4 months (range, 0.3-40.3). Seven (58%) patients are alive, 4 (33%) have died, and 1 (8%) had no follow-up. Five alive patients are in remission, including one MYC/BCL6 double-hit PCNSL. Our results add two new cases of rare double-hit PCNSL to the literature.


Asunto(s)
Sistema Nervioso Central/patología , Genes myc/genética , Linfoma de Células B Grandes Difuso/genética , Proteínas Proto-Oncogénicas c-bcl-6/genética , Adulto , Anciano , Estudios de Casos y Controles , Sistema Nervioso Central/efectos de la radiación , Quimioterapia/métodos , Femenino , Estudios de Seguimiento , Humanos , Hibridación Fluorescente in Situ/métodos , Antígeno Ki-67/metabolismo , Linfoma de Células B Grandes Difuso/clasificación , Linfoma de Células B Grandes Difuso/patología , Linfoma de Células B Grandes Difuso/terapia , Masculino , Persona de Mediana Edad , Clasificación del Tumor/métodos , Pronóstico , Radioterapia/métodos , Resultado del Tratamiento
7.
Int J Mol Sci ; 21(11)2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-32492909

RESUMEN

(1) Background: Cancer ion therapy is constantly growing thanks to its increased precision and, for heavy ions, its increased biological effectiveness (RBE) with respect to conventional photon therapy. The complex dependence of RBE on many factors demands biophysical modeling. Up to now, only the Local Effect Model (LEM), the Microdosimetric Kinetic Model (MKM), and the "mixed-beam" model are used in clinics. (2) Methods: In this work, the BIANCA biophysical model, after extensive benchmarking in vitro, was applied to develop a database predicting cell survival for different ions, energies, and doses. Following interface with the FLUKA Monte Carlo transport code, for the first time, BIANCA was benchmarked against in vivo data obtained by C-ion or proton irradiation of the rat spinal cord. The latter is a well-established model for CNS (central nervous system) late effects, which, in turn, are the main dose-limiting factors for head-and-neck tumors. Furthermore, these data have been considered to validate the LEM version applied in clinics. (3) Results: Although further benchmarking is desirable, the agreement between simulations and data suggests that BIANCA can predict RBE for C-ion or proton treatment of head-and-neck tumors. In particular, the agreement with proton data may be relevant if the current assumption of a constant proton RBE of 1.1 is revised. (4) Conclusions: This work provides the basis for future benchmarking against patient data, as well as the development of other databases for specific tumor types and/or normal tissues.


Asunto(s)
Cordoma/radioterapia , Neoplasias de Cabeza y Cuello/radioterapia , Radioterapia de Iones Pesados , Terapia de Protones/métodos , Médula Espinal/metabolismo , Animales , Células CHO , Carbono/química , Supervivencia Celular/efectos de la radiación , Sistema Nervioso Central/efectos de la radiación , Cricetinae , Cricetulus , Bases de Datos Factuales , Humanos , Cinética , Método de Montecarlo , Radiometría , Ratas , Efectividad Biológica Relativa
8.
Eur J Haematol ; 100(3): 279-285, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29240262

RESUMEN

OBJECTIVE: To explore the value of flow cytometric (FCM) analysis of cerebrospinal fluid (CSF) in the diagnosis of central nervous system involvement in adult patients with acute lymphoblastic leukemia (ALL) during follow-up. METHODS: A total of 2871 CSF samples from 357 adult patients with newly diagnosed ALL between the year of 2009 and 2015 were analyzed retrospectively. These patients were divided into 3 groups according to CSF results, FCM+/conventional cytology (CC)+ group, FCM+/CC- group, and FCM-/CC- group, respectively. The overall survival (OS) of the three groups was analyzed. RESULTS: Fifteen (4.2%) and 26 (7.3%) patients' CSF samples were FCM+/CC+ and FCM+/CC-, respectively. The remaining 316 (88.5%) patients' samples were FCM-/CC-. The 2-year OS for the FCM+/CC+, FCM+/CC-, and FCM-/CC- groups was 40.0%, 20.6%, and 64.2%, respectively (P < .001). There was no statistically significant difference in OS between FCM+/CC+ and FCM+/CC- patients (P = .195). In multivariate analysis, a high WBC count and LDH level were independent risk factors for central nervous system involvement in adult patients with ALL. CONCLUSIONS: FCM demonstrated a superior sensitivity over conventional cytology in the diagnosis of central nervous system involvement in adult patients with ALL. FCM+/CC- patients showed a similar survival with FCM+/CC+ patients, suggesting that an isolated FCM-positive status holds clinical significance.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Trasplante de Células Madre Hematopoyéticas , Leucemia-Linfoma Linfoblástico de Células Precursoras/líquido cefalorraquídeo , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Adolescente , Adulto , Anciano , Sistema Nervioso Central/efectos de los fármacos , Sistema Nervioso Central/metabolismo , Sistema Nervioso Central/patología , Sistema Nervioso Central/efectos de la radiación , Citarabina/uso terapéutico , Dexametasona/uso terapéutico , Femenino , Citometría de Flujo , Humanos , Masculino , Metotrexato/uso terapéutico , Persona de Mediana Edad , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidad , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Estudios Retrospectivos , Análisis de Supervivencia , Trasplante Homólogo , Irradiación Corporal Total
9.
Int J Mol Sci ; 19(11)2018 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-30463349

RESUMEN

In preparation for lunar and Mars missions it is essential to consider the challenges to human health that are posed by long-duration deep space habitation via multiple stressors, including ionizing radiation, gravitational changes during flight and in orbit, other aspects of the space environment such as high level of carbon dioxide, and psychological stress from confined environment and social isolation. It remains unclear how these stressors individually or in combination impact the central nervous system (CNS), presenting potential obstacles for astronauts engaged in deep space travel. Although human spaceflight research only within the last decade has started to include the effects of radiation transmitted by galactic cosmic rays to the CNS, radiation is currently considered to be one of the main stressors for prolonged spaceflight and deep space exploration. Here we will review the current knowledge of CNS damage caused by simulated space radiation with an emphasis on neuronal and glial responses along with cognitive functions. Furthermore, we will present novel experimental approaches to integrate the knowledge into more comprehensive studies, including multiple stressors at once and potential translation to human functions. Finally, we will discuss the need for developing biomarkers as predictors for cognitive decline and therapeutic countermeasures to prevent CNS damage and the loss of cognitive abilities.


Asunto(s)
Sistema Nervioso Central/fisiología , Sistema Nervioso Central/efectos de la radiación , Radiación Cósmica , Animales , Conducta Animal/efectos de la radiación , Sistema Nervioso Central/patología , Cognición , Humanos , Inflamación/patología , Neuronas/patología
10.
Oncology ; 89(2): 111-7, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25895699

RESUMEN

OBJECTIVE: Midline and central lesions of the brain requiring conventional radiotherapy (RT) present complex difficulties in dose avoidance to organs at risk (OAR). In either definitive or adjuvant settings, proper RT coverage of these lesions involves unnecessary treatment of large volumes of normal brain. We propose a class solution for these lesions using proton radiotherapy (PrT). MATERIALS AND METHODS: The records of the Indiana University Health Proton Therapy Center were reviewed for patients presenting between January 1, 2005 and October 1, 2013 with midline central nervous system (CNS) lesions. Twenty-four patients were identified. After Institutional Review Board approval was granted, their dosimetry was reviewed for target volume doses and OAR dose avoidance. RESULTS: For these cases, meningiomas were the most common histology (8 cases), and next most prevalent were craniopharyngiomas (6 cases). The others were various different deep midline brain tumors (10 cases). In all cases, fields formed by vertex and/or anterior/posterior superior oblique PrT beams along the midsagittal plane were used to provide coverage with minimal dose to the brain stem or to the cerebral hemispheres. The median prescribed dose to the planning target volume for treating these patients was 54.0 Gy RBE (range 48.6-62.5) with a mean dose of 53.5 Gy RBE. The average of the mean doses to the brain stems using these fields in the 24 plans was 18.4 Gy RBE (range 0.0-44.7). Similarly, the average of the mean doses to the hippocampi was 15.8 Gy RBE (range 0.0-52.6). CONCLUSIONS: We consider these patients to be optimally treated with PrT. The use of modified midsagittal PrT schemas allows for the treatment of midline CNS lesions with sparing of most of the uninvolved brain.


Asunto(s)
Neoplasias Encefálicas/radioterapia , Sistema Nervioso Central/patología , Sistema Nervioso Central/efectos de la radiación , Terapia de Protones/efectos adversos , Neoplasias Encefálicas/patología , Relación Dosis-Respuesta en la Radiación , Humanos , Órganos en Riesgo , Dosificación Radioterapéutica , Planificación de la Radioterapia Asistida por Computador , Radioterapia Conformacional/efectos adversos , Radioterapia Conformacional/métodos
11.
Pediatr Blood Cancer ; 62 Suppl 5: S460-513, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26700917

RESUMEN

Central nervous system cancers or exposure to CNS-directed therapies increase risk for neuropsychological deficits. There are no accepted guidelines for assessment of neuropsychological functioning in this population. A multifaceted literature search was conducted and relevant literature reviewed to inform the guidelines. Studies of neuropsychological outcomes are widely documented in the pediatric oncology literature. There is strong evidence of need for neuropsychological assessment, but insufficient evidence to guide the timing of assessment, nor to recommend specific interventions. Children with brain tumors and others at high risk for neuropsychological deficits should be monitored and assessed for neuropsychological deficits.


Asunto(s)
Pruebas Neuropsicológicas/normas , Guías de Práctica Clínica como Asunto , Nivel de Atención/normas , Antineoplásicos/efectos adversos , Neoplasias Encefálicas/complicaciones , Sistema Nervioso Central/efectos de los fármacos , Sistema Nervioso Central/efectos de la radiación , Humanos , Radioterapia/efectos adversos
12.
Int J Clin Oncol ; 19(5): 963-71, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24297187

RESUMEN

BACKGROUND: The aim of our study was to analyze changes over time in the characteristics, treatment, and outcome of patients with primary central nervous system lymphoma (PCNSL). METHODS: Data on 315 patients with histologically proven PCNSL undergoing radiotherapy between 2005 and 2009 were collected from 20 Japanese institutions using a questionnaire. These data were then compared with data on 273 patients treated during the period 1995-2004 and those on 466 patients treated during the period 1985-1994. RESULTS: In terms of patient and tumor characteristics, we found a significant increase in mean patient age in the 2005-2009 period compared to the 1985-2004 period (63 vs. 58-59 years, respectively) and in the percentage of patients with better performance status (PS) during the 2005-2009 period compared with the 1995-2004 period (World Health Organization PS 0-2: 73 vs. 65 %, respectively). Regarding treatment, relative to the 1995-2004 period, significant changes in the 2005-2009 period were (1) decreased rate of attempting tumor resection (23 vs. 44 %); (2) increased use of chemotherapy (78 vs. 68 %), and (3) increased use of methotrexate (MTX)-containing regimens (84 vs. 53 %). The 5-year overall survival rates were 15.3, 30.1, and 36.5 % for patients seen during the 1985-1994, 1995-2004, and 2005-2009 periods, respectively, but relapse-free survival did not improve between the 1995-2004 and 2005-2009 periods (26.7 vs. 25.7 % at 5 years, respectively). Patients receiving MTX-containing chemotherapy had 5-year survival rates of 19, 50, and 44 % during these three periods, respectively. CONCLUSIONS: Although patient backgrounds differed among the study periods, recent trends were a high patient age, better PS, avoidance of extensive tumor resection, more frequent use of chemotherapy, and improved survival. The recent improvement in survival may be due to improvements in second-line treatment and supportive care.


Asunto(s)
Neoplasias del Sistema Nervioso Central/radioterapia , Sistema Nervioso Central/patología , Linfoma/radioterapia , Recurrencia Local de Neoplasia/patología , Adulto , Anciano , Sistema Nervioso Central/efectos de la radiación , Neoplasias del Sistema Nervioso Central/tratamiento farmacológico , Neoplasias del Sistema Nervioso Central/patología , Femenino , Humanos , Japón , Linfoma/patología , Masculino , Metotrexato/administración & dosificación , Persona de Mediana Edad , Recurrencia Local de Neoplasia/tratamiento farmacológico , Encuestas y Cuestionarios , Tasa de Supervivencia
13.
Curr Pain Headache Rep ; 18(11): 459, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25239766

RESUMEN

Cancer treatment-related chronic neuropathic pain (NP) is a pervasive and distressing problem that negatively influences function and quality of life for countless cancer survivors. It occurs because of cancer treatment-induced damage to peripheral and central nervous system structures. NP becomes chronic when pain signal transmission persists, eventually sensitizing neurons in the dorsal horn and other pain-processing regions in the central nervous system. Frequently overlooked, NP due to cancer treatment has been understudied. Consequently, only a few pharmacologic interventions have been shown to be effective based on the results of randomized controlled trials. Future research designed to explore pathophysiologic mechanisms and effective mechanism-targeted interventions is sorely needed.


Asunto(s)
Antineoplásicos/efectos adversos , Neoplasias/terapia , Neuralgia/tratamiento farmacológico , Neuralgia/etiología , Traumatismos por Radiación/complicaciones , Sobrevivientes/psicología , Sistema Nervioso Central/efectos de los fármacos , Sistema Nervioso Central/efectos de la radiación , Humanos , Neuralgia/epidemiología , Dimensión del Dolor , Umbral del Dolor , Sistema Nervioso Periférico/efectos de los fármacos , Sistema Nervioso Periférico/efectos de la radiación , Calidad de Vida , Traumatismos por Radiación/epidemiología , Ensayos Clínicos Controlados Aleatorios como Asunto
14.
Int J Mol Sci ; 15(4): 5366-87, 2014 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-24681584

RESUMEN

There is a growing concern in the population about the effects that environmental exposure to any source of "uncontrolled" radiation may have on public health. Anxiety arises from the controversial knowledge about the effect of electromagnetic field (EMF) exposure to cells and organisms but most of all concerning the possible causal relation to human diseases. Here we reviewed those in vitro and in vivo and epidemiological works that gave a new insight about the effect of radio frequency (RF) exposure, relating to intracellular molecular pathways that lead to biological and functional outcomes. It appears that a thorough application of standardized protocols is the key to reliable data acquisition and interpretation that could contribute a clearer picture for scientists and lay public. Moreover, specific tuning of experimental and clinical RF exposure might lead to beneficial health effects.


Asunto(s)
Campos Electromagnéticos/efectos adversos , Exposición a Riesgos Ambientales/efectos adversos , Ondas de Radio/efectos adversos , Animales , Barrera Hematoencefálica/efectos de la radiación , Supervivencia Celular/efectos de la radiación , Sistema Nervioso Central/efectos de la radiación , Humanos , Ratones , Neoplasias/diagnóstico por imagen , Enfermedades Neurodegenerativas/diagnóstico por imagen , Estrés Oxidativo/efectos de la radiación , Salud Pública , Radiografía
15.
Undersea Hyperb Med ; 41(2): 87-96, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24851545

RESUMEN

Increased use of radiation therapy and increasing life spans following radiation treatment has led to an increase in the finding of post-radiation central nervous system injury in patients who have previously undergone radiation treatments. At this time, information regarding treatment for patients suffering from this serious side effect is limited and not readily available. It is imperative to examine possible treatment options, complications and success rates for these patients. This retrospective review will look at 10 patients who underwent hyperbaric oxygen therapy for post-radiation injury to the central nervous system. Review and investigation of the subjective, clinical and radiologic outcomes of these patients was conducted. It was determined that for patients with post-radiation central nervous system injury it is important to distinguish the exact diagnosis for each patient. For those patients with radiation necrosis, conclusion was made that hyperbaric oxygen (HBO2) therapy does lead to improvement in subjective, clinical and radiologic outcomes. However, the results were not consistent across all patients. For those patients with non-specific delayed radiation injury, findings showed that HBO2 does not lead to any improvement. Therefore, we conclude that for those patients who have been diagnosed with radiation necrosis of the central nervous system, we recommend HBO2 therapy as a potential treatment option for some patients.


Asunto(s)
Sistema Nervioso Central/patología , Sistema Nervioso Central/efectos de la radiación , Oxigenoterapia Hiperbárica/métodos , Traumatismos por Radiación/terapia , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/secundario , Ensayos de Uso Compasivo , Femenino , Humanos , Malformaciones Arteriovenosas Intracraneales/radioterapia , Neoplasias Pulmonares/radioterapia , Masculino , Neoplasias Meníngeas/radioterapia , Meningioma/radioterapia , Persona de Mediana Edad , Necrosis/etiología , Necrosis/terapia , Neoplasias Hipofisarias/radioterapia , Traumatismos por Radiación/patología , Dosificación Radioterapéutica , Estudios Retrospectivos , Esteroides/uso terapéutico , Enfermedad de von Hippel-Lindau/radioterapia
16.
Klin Onkol ; 27(3): 161-5, 2014.
Artículo en Checo | MEDLINE | ID: mdl-24918273

RESUMEN

BACKGROUND: Very late effects of radiotherapy occur within decades after the initial exposure. Their development is induced by low doses of ionizing radiation (from 4 Gy per radiation series) and their clinical manifestations are difficult to distinguish from other independent diseases diagnosed in individuals not formerly treated with radiation. A long time period from the exposure confounds any causal relationships between radiation and adverse events. Still, these side effects not only reduce the patients quality of life but also lead to an early morbidity and mortality, hence generating significant costs in health care and social systems. PURPOSE: This article summarizes findings about the most common very late consequences of radiotherapy, which include cardiotoxicity, CNS toxicity, pneumotoxicity, renal toxicity and secondary malignancies. This issue is crucial in the group of children cancer patients, malignant lymphomas, testicular tumors and CNS tumors. Generally, the risk of very late effects of radiotherapy (RT) should be considered in all patients irradiated at a relatively early age with a high chance of long term survival. The risk of very late effects of RT is also one of the key limiting factors in the use of RT in the treatment of patients with benign lesions with longterm survival expectation, e. g. in patients with glomus tumors, neurofibromas, desmoid tumors or hemangiomas or other benign lesions (arterio venous malformations). Currently, the only known prevention of these very late adverse effects is to minimize the dose to critical structures to the lowest achievable level.


Asunto(s)
Neoplasias Inducidas por Radiación/etiología , Neoplasias Primarias Secundarias/etiología , Traumatismos por Radiación/complicaciones , Radioterapia/efectos adversos , Sistema Nervioso Central/efectos de la radiación , Niño , Corazón/efectos de la radiación , Humanos , Riñón/efectos de la radiación , Pulmón/efectos de la radiación , Órganos en Riesgo/efectos de la radiación , Factores de Riesgo , Factores de Tiempo
17.
Cancer ; 119(14): 2654-9, 2013 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-23633429

RESUMEN

BACKGROUND: The objective of this study was to evaluate local control and patterns of failure in pediatric patients with low-grade glioma (LGG) who received treatment with intensity-modulated radiation therapy (IMRT). METHODS: In total, 39 children received IMRT after incomplete resection or disease progression. Three methods of target delineation were used. The first was to delineate the gross tumor volume (GTV) and add a 1-cm margin to create the clinical target volume (CTV) (Method 1; n = 19). The second was to add a 0.5-cm margin around the GTV to create the CTV (Method 2; n = 6). The prescribed dose to the GTV was the same as dose to the CTV for both Methods 1 and 2 (median, 50.4 grays [Gy]). The final method was dose painting, in which a GTV was delineated with a second target volume (2TV) created by adding 1 cm to the GTV (Method 3; n = 14). Different doses were prescribed to the GTV (median, 50.4 Gy) and the 2TV (median, 41.4 Gy). RESULTS: The 8-year progression-free and overall survival rates were 78.2% and 93.7%, respectively. Seven failures occurred, all of which were local in the high-dose (≥95%) region of the IMRT field. On multivariate analysis, age ≤5 years at time of IMRT had a detrimental impact on progression-free survival. CONCLUSIONS: IMRT provided local control rates comparable to those provided by 2-dimensional and 3-dimensional radiotherapy. Margins ≥1 cm added to the GTV may not be necessary, because excellent local control was achieved by adding a 0.5-cm margin (Method 2) and by dose painting (Method 3).


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/radioterapia , Glioma/tratamiento farmacológico , Glioma/radioterapia , Radioterapia de Intensidad Modulada , Adolescente , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/cirugía , Carboplatino/administración & dosificación , Sistema Nervioso Central/efectos de la radiación , Niño , Preescolar , Cognición/efectos de la radiación , Progresión de la Enfermedad , Supervivencia sin Enfermedad , Femenino , Glioma/patología , Glioma/cirugía , Humanos , Estimación de Kaplan-Meier , Masculino , Análisis Multivariante , Clasificación del Tumor , Neoplasia Residual/radioterapia , Dosificación Radioterapéutica , Planificación de la Radioterapia Asistida por Computador , Radioterapia Adyuvante , Radioterapia de Intensidad Modulada/efectos adversos , Radioterapia de Intensidad Modulada/métodos , Estudios Retrospectivos , Vincristina/administración & dosificación
18.
Rev Neurosci ; 24(2): 205-26, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23492552

RESUMEN

Irradiation in the red/near-infrared spectrum (R/NIR, 630-1000 nm) has been used to treat a wide range of clinical conditions, including disorders of the central nervous system (CNS), with several clinical trials currently underway for stroke and macular degeneration. However, R/NIR irradiation therapy (R/NIR-IT) has not been widely adopted in clinical practice for CNS injury or disease for a number of reasons, which include the following. The mechanism/s of action and implications of penetration have not been thoroughly addressed. The large range of treatment intensities, wavelengths and devices that have been assessed make comparisons difficult, and a consensus paradigm for treatment has not yet emerged. Furthermore, the lack of consistent positive outcomes in randomised controlled trials, perhaps due to sub-optimal treatment regimens, has contributed to scepticism. This review provides a balanced précis of outcomes described in the literature regarding treatment modalities and efficacy of R/NIR-IT for injury and disease in the CNS. We have addressed the important issues of specification of treatment parameters, penetration of R/NIR irradiation to CNS tissues and mechanism/s, and provided the necessary detail to demonstrate the potential of R/NIR-IT for the treatment of retinal degeneration, damage to white matter tracts of the CNS, stroke and Parkinson's disease.


Asunto(s)
Enfermedades del Sistema Nervioso Central/radioterapia , Sistema Nervioso Central/efectos de la radiación , Rayos Infrarrojos/uso terapéutico , Traumatismos del Sistema Nervioso/radioterapia , Humanos
19.
Indian J Exp Biol ; 51(3): 187-200, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23678539

RESUMEN

Wireless technologies are ubiquitous today and the mobile phones are one of the prodigious output of this technology. Although the familiarization and dependency of mobile phones is growing at an alarming pace, the biological effects due to the exposure of radiations have become a subject of intense debate. The present evidence on mobile phone radiation exposure is based on scientific research and public policy initiative to give an overview of what is known of biological effects that occur at radiofrequency (RF)/ electromagnetic fields (EMFs) exposure. The conflict in conclusions is mainly because of difficulty in controlling the affecting parameters. Biological effects are dependent not only on the distance and size of the object (with respect to the object) but also on the environmental parameters. Health endpoints reported to be associated with RF include childhood leukemia, brain tumors, genotoxic effects, neurological effects and neurodegenerative diseases, immune system deregulation, allergic and inflammatory responses, infertility and some cardiovascular effects. Most of the reports conclude a reasonable suspicion of mobile phone risk that exists based on clear evidence of bio-effects which with prolonged exposures may reasonably be presumed to result in health impacts. The present study summarizes the public issue based on mobile phone radiation exposure and their biological effects. This review concludes that the regular and long term use of microwave devices (mobile phone, microwave oven) at domestic level can have negative impact upon biological system especially on brain. It also suggests that increased reactive oxygen species (ROS) play an important role by enhancing the effect of microwave radiations which may cause neurodegenerative diseases.


Asunto(s)
Encéfalo/efectos de la radiación , Teléfono Celular , Animales , Apoptosis , Biofisica/métodos , Neoplasias Encefálicas/etiología , Ciclo Celular , Línea Celular Tumoral , Sistema Nervioso Central/efectos de la radiación , Daño del ADN/efectos de la radiación , Campos Electromagnéticos , Exposición a Riesgos Ambientales , Radicales Libres , Humanos , Ratones , Modelos Biológicos , Mutágenos , Neoplasias Inducidas por Radiación/diagnóstico , Radiometría , Ratas , Especies Reactivas de Oxígeno
20.
Radiats Biol Radioecol ; 53(6): 625-33, 2013.
Artículo en Ruso | MEDLINE | ID: mdl-25486746

RESUMEN

This work represents generalization and the analysis of the long-term own materials characterizing reaction of the brain on electromagnetic radiation of low intensity (energy flow density in the continuous regime or in the impulse approximately 500 microW/sm2) and a short exposition (approximately 30 min). A set of the experimental results received on separate neurons, formations and brain as a whole give an idea about the reaction of the central nervous system to the studied influence. Comparison of these data with the corresponding responses to the known incentives (light, sound, electric current) testifies to the electromagnetic radiation of low energy flow density and a short exposition as a sub-threshold irritant for the central nervous system.


Asunto(s)
Encéfalo/efectos de la radiación , Sistema Nervioso Central/efectos de la radiación , Radiación Electromagnética , Neuronas/efectos de la radiación , Adulto , Animales , Humanos , Conejos
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