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1.
Ann Hematol ; 103(8): 2845-2851, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38884787

RESUMO

FLT3-ITD and NPM1 mutations are key to defining the genetic risk profile of acute myeloid leukemia (AML). We aimed to assess the prognostic features of the FLT3-ITD and NPM1 mutations in old and/or unfit individuals with AML treated with non-intensive therapies in the era before azacitidine-venetoclax approbation. The results of various non-intensive regimens were also compared. We conducted a retrospective analysis that included patients treated with different non-intensive regimens, between 2007 and 2020 from PETHEMA AML registry. We compiled 707 patients with a median age of 74 years and median follow-up time of 37.7 months. FLT3-ITD patients (N = 98) showed a non-significant difference in overall survival (OS) compared to FLT3-ITD negative-patients (N = 608) (P = 0.17, median OS was 5 vs 7.3 months respectively). NPM1-mutated patients (N = 144) also showed a non-significant difference with NPM1 wild type (N = 519) patients (P = 0.25, median OS 7.2 vs 6.8 respectively). In the Cox regression analysis neither NPM1 nor FLT3-ITD nor age were significant prognostic variables for OS prediction. Abnormal karyotype and a high leukocyte count showed a statistically significant deleterious effect. Azacitidine also showed better survival compared to FLUGA (low dose cytarabine plus fludarabine). NPM1 and FLT3-ITD seem to lack prognostic value in older/unfit AML patients treated with non-intensive regimens other than azacitidine-venetoclax combination.


Assuntos
Leucemia Mieloide Aguda , Mutação , Proteínas Nucleares , Nucleofosmina , Tirosina Quinase 3 Semelhante a fms , Idoso , Feminino , Humanos , Masculino , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Tirosina Quinase 3 Semelhante a fms/genética , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/mortalidade , Leucemia Mieloide Aguda/diagnóstico , Proteínas Nucleares/genética , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Vidarabina/análogos & derivados , Vidarabina/uso terapêutico , Vidarabina/administração & dosagem
2.
Clin Exp Immunol ; 203(2): 315-328, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33025622

RESUMO

Decreasing graft rejection and increasing graft and patient survival are great challenges facing liver transplantation (LT). Different T cell subsets participate in the acute cellular rejection (ACR) of the allograft. Cell-mediated immunity markers of the recipient could help to understand the mechanisms underlying acute rejection. This study aimed to analyse different surface antigens on T cells in a cohort of adult liver patients undergoing LT to determine the influence on ACR using multi-parametric flow cytometry functional assay. Thirty patients were monitored at baseline and during 1 year post-transplant. Two groups were established, with (ACR) and without (NACR) acute cellular rejection. Leukocyte, total lymphocyte, percentages of CD4+ CD154+ and CD8+ CD154+ T cells, human leukocyte antigen (HLA) mismatch between recipient-donor and their relation with ACR as well as the acute rejection frequencies were analysed. T cells were stimulated with concanavalin A (Con-A) and surface antigens were analysed by fluorescence activated cell sorter (FACS) analysis. A high percentage of CD4+ CD154+ T cells (P = 0·001) and a low percentage of CD8+ CD154+ T cells (P = 0·002) at baseline were statistically significant in ACR. A receiver operating characteristic analysis determined the cut-off values capable to stratify patients at high risk of ACR with high sensitivity and specificity for CD4+ CD154+ (P = 0·001) and CD8+ CD154+ T cells (P = 0·002). In logistic regression analysis, CD4+ CD154+ , CD8+ CD154+ and HLA mismatch were confirmed as independent risk factors to ACR. Post-transplant percentages of both T cell subsets were significantly higher in ACR, despite variations compared to pretransplant. These findings support the selection of candidates for LT based on the pretransplant percentages of CD4+ CD154+ and CD8+ CD154+ T cells in parallel with other transplant factors.


Assuntos
Biomarcadores/sangue , Ligante de CD40/imunologia , Rejeição de Enxerto/imunologia , Cadeias HLA-DRB1/imunologia , Subpopulações de Linfócitos T/imunologia , Adulto , Idoso , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Feminino , Citometria de Fluxo/métodos , Transplante de Coração/métodos , Humanos , Transplante de Fígado/métodos , Ativação Linfocitária/imunologia , Masculino , Pessoa de Meia-Idade , Transplante Homólogo/métodos , Adulto Jovem
3.
Int J Oral Maxillofac Surg ; 50(1): 104-108, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32451234

RESUMO

The aim of this study was to compare the effectiveness of three agents - two antibiotics (amoxicillin and clindamycin) and an antiseptic (chlorhexidine) - to decontaminate bone grafts obtained by low-speed drilling. The study included 248 bone tissue samples harvested from 62 patients by low-speed drilling before dental implant placement. Each of four samples obtained from every patient was dropped, using a sterile instrument, into a sterile tube containing a 500-µl solution of 400µg/mL amoxicillin, 150µg/mL clindamycin, 0.12% chlorhexidine, or physiological saline for 1min. The number of colony-forming units (CFU) was determined at 48h of culture. The use of clindamycin, amoxicillin, or chlorhexidine as decontaminant for 1min significantly reduced the CFU count when compared to physiological saline (control agent). In both anaerobic and CO2-rich atmospheres, significant differences in CFU/mL were found between the control and chlorhexidine groups (P<0.001), control and amoxicillin groups (P<0.001), control and clindamycin groups (P<0.001), chlorhexidine and amoxicillin groups (P<0.0001), and chlorhexidine and clindamycin groups (P<0.0001). In conclusion, clindamycin had the highest decontaminating effect on bone particles obtained by low-speed drilling, followed by chlorhexidine and amoxicillin. Clindamycin may therefore be a valid alternative option for the routine decontamination of intraoral bone grafts.


Assuntos
Anti-Infecciosos Locais , Descontaminação , Amoxicilina , Antibacterianos/uso terapêutico , Osso e Ossos , Clorexidina , Humanos
4.
Neurochirurgie ; 67(4): 369-374, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33232711

RESUMO

INTRODUCTION: Brain metastases are the most common intracranial neoplasm in adult patients, and one of the fearsome complications proves to be intratumoral hemorrhage. The neurosurgical management of patients harboring a bleeding brain metastasis is not fully established and there is still today an ongoing debate on the optimal management of these patients. The aim of this article is to provide the neurosurgeons with practical tools to assist in their decision-making process in the management of BMs. METHODS: We conducted a literature review of the relevant Pubmed, Cochrane, and Google scholar-indexed articles published between 2000 and 2019. The following key words were entered in the Pubmed search engine: [metastasis], [metastases], [brain metastases], [brain metastasis], [hemorrhage], [hematoma], [blood clot], [intracerebral hemorrhage], [intracranial hemorrhage]. The review was performed in accordance with the PRISMA recommendations. RESULTS: Based on PubMed, Cochrane, and Google scholar, 459 articles were retained, 392 were then removed because of their non-adequacy with the topic and, 9 articles were removed because they were not written in English language. So, 58 articles were analyzed. Radiological evaluation is crucial, but few traps exist. The frequency of overall brain tumor-related with intracranial hematoma is 7.2%, with a higher frequency for secondary tumors. The local recurrence rate after resection of a hemorrhagic metastasis seems to be better probably because of an easier "en bloc" resection thanks to the hematoma. An atypical presentation is reported in up to 4% in patients with chronic or acute subdural hematoma. Patients with subarachnoid hemorrhage and epidural hematoma are rare. A clear-cut correlation between the incidence of bleeding event in brain mets and prior stereotactic radiosurgery was not established. CONCLUSION: The current literature pertaining to the neurosurgical management of acute bleeding in brain metastasis is scant and the level of evidence remains low (experts 'opinions; class C). Herein we suggest a flowchart to assist in dealing with those difficult patients.


Assuntos
Neoplasias Encefálicas/cirurgia , Gerenciamento Clínico , Tratamento de Emergência/métodos , Hemorragias Intracranianas/cirurgia , Neurocirurgiões , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/diagnóstico por imagem , Humanos , Hemorragias Intracranianas/diagnóstico por imagem , Hemorragias Intracranianas/etiologia , Radiocirurgia/métodos
5.
Mol Cell Endocrinol ; 426: 146-54, 2016 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-26930569

RESUMO

Aminopeptidases (APs) are involved in various physiological and pathological processes. In tumor tissues the expression of APs, cyclooxygenase-2 and its metabolites are increased. The objective was to determine the effect of certain NSAIDs on the AP activity of osteoblasts. Primary cultures of osteoblast were treated with different concentrations of indomethacin, meloxicam, naproxen, nimesulide, and piroxicam. The AP activity was fluorimetrically determined using aminoacyl-ß-naphthylamides (aa-ßNAs) as substrates: Ala-ßNA, Arg-ßNA, Gly-ßNA, Leu-ßNA, Lys-ßNA, Met-ßNA, and Phe-ßNA. The five NSAIDs showed an inhibitory effect of AP activity against the study substrates depending on the dose tested. Meloxicam and piroxicam had the highest inhibitory effect on enzymatic activity, with an IC50 of around 70 µM. Our results suggest that the physiological alteration of osteoblasts in the presence of NSAIDs may be a consequence of AP inhibition, suggesting a potential clinical role for these drugs against cancer in combination with chemotherapeutic agents.


Assuntos
Aminopeptidases/metabolismo , Anti-Inflamatórios não Esteroides/farmacologia , Osteoblastos/enzimologia , Adulto , Células Cultivadas , Avaliação Pré-Clínica de Medicamentos , Feminino , Humanos , Masculino , Osteoblastos/efeitos dos fármacos , Adulto Jovem
6.
Eur Psychiatry ; 30(8): 924-31, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26647868

RESUMO

OBJECTIVE: Elevated physical activity has been observed in some patients with anorexia nervosa (AN) despite their emaciated condition. However, its effects on treatment outcome remain unclear. This study aimed to examine objectively measured physical activity in this clinical population and how it might be related to a partial hospitalization therapy response, after considering potential confounders. METHOD: The sample comprised 88 AN patients consecutively enrolled in a day hospital treatment program, and 116 healthy-weight controls. All participants were female and a baseline assessment took place using an accelerometer (Actiwatch AW7) to measure physical activity, the Eating Disorders Inventory-2 and the Depression subscale of the Symptom Checklist-Revised. Outcome was evaluated upon the termination of the treatment program by expert clinicians. RESULTS: Although AN patients and controls did not differ in the average time spent in moderate-to-vigorous physical activity (MVPA) (P=.21), nor daytime physical activity (P=.34), fewer AN patients presented a high physical activity profile compared to the controls (37% vs. 61%, respectively; P=.014). Both lower levels of MVPA and greater eating disorder severity had a direct effect on a poor treatment outcome. Depression symptoms in the patients were associated with lower MVPA, as well as with an older age, a shorter duration of the disorder and greater eating disorder psychopathology. CONCLUSIONS: There is a notable variation in the physical activity profile of AN patients, characterized by either low or very high patterns. Physical activity is a highly relevant issue in AN that must be taken into account during the treatment process.


Assuntos
Anorexia Nervosa/terapia , Depressão/terapia , Exercício Físico , Satisfação do Paciente , Adolescente , Adulto , Anorexia Nervosa/complicações , Anorexia Nervosa/psicologia , Depressão/complicações , Depressão/psicologia , Feminino , Humanos , Pacientes Internados/psicologia , Masculino , Atividade Motora , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
7.
Neurochirurgie ; 61(5): 339-42, 2015 Oct.
Artigo em Francês | MEDLINE | ID: mdl-26249273

RESUMO

The action of synthetic progestogens, prescribed at a conventional dose in women, for a meningioma, is still poorly understood, and could be related to progesterone receptors. We report two cases illustrating multiple meningiomas with stabilization or tumor reduction after withdrawal of cyproterone acetate originally prescribed for a long term period. We also review the influence of synthetic progestogens on meningiomas, particularly the impact of treatment withdrawal.


Assuntos
Acetato de Ciproterona/farmacologia , Ciproterona/farmacologia , Neoplasias Meníngeas/tratamento farmacológico , Meningioma/tratamento farmacológico , Suspensão de Tratamento , Adulto , Feminino , Humanos , Neoplasias Meníngeas/patologia , Meningioma/patologia , Resultado do Tratamento
8.
Int J Immunogenet ; 42(1): 38-45, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25359546

RESUMO

Anti-inflammatory cytokines have an important role in disease, tumour and transplant processes. Alterations in the regulation of several cytokines have been implicated in a variety of inflammatory disorders, including IBD (inflammatory bowel disease) [Crohn's disease (CD) and ulcerative colitis (UC)]. Cytokine polymorphisms are also known to affect the level of gene expression. Thus, the aim of this study was to determine the relationship between cytokine polymorphisms and the IBD pathologies in a Spanish population. Polymorphisms analysis was performed using PCR-SSOP using a microbeads luminex assay. The following polymorphisms were determined: TNFα [-238G/A (rs361525) and -308G/A (rs1800629)], IFNγ [+874A/T (rs62559044)], TGFß [+869C/T (rs1982073) and +915G/C (rs1800471)], IL10 [-1082A/A (rs1800896), -592A/C (rs1800872), -819C/T (rs1800871)], IL6 [-174C/G (rs1800795)], IL12p40 [3'UTR -1188A/C (rs3212227)], IL1α [-889C/T (rs1800587)], IL1ß [-511C/T (rs1143634) and +3962C/T (rs1143633)], IL1R [Pst-1 1970C/T] and IL1RA [Mspa-1 11100C/T]. No statistical differences in TNFα, IFNγ, TGFß, IL10, IL6, IL1α, IL1ß, IL1R and IL1Ra genotypes and allele distributions between the IBD groups and healthy controls were found. However, we observed significant differences in the 3'UTR -1188A/C polymorphism of IL12p40. So -1188A allele was increased in patients with UC and the -1188C allele (high IL12p40 production) was increased in patients with CD with respect to controls. These data are in concordance with the fact that CD has been shown to be associated with a Th1 T-cell-mediated inflammation model and high IL12/IFNγ production at histological affected sites. These data suggest that cytokine polymorphisms in TNFα, IFNγ, TGFß, IL10, IL6 and IL1α, IL1ß, IL1R and IL1Ra cytokine gene do not seem to be relevant in IBD susceptibility and IL12p40 3'UTR -1188A/C polymorphism seems to be associated with a differential IBD development.


Assuntos
Colite Ulcerativa/genética , Doença de Crohn/genética , Citocinas/genética , Inflamação/genética , Adolescente , Adulto , Feminino , Genótipo , Humanos , Inflamação/imunologia , Masculino , Polimorfismo de Nucleotídeo Único , Adulto Jovem
9.
Clin Neurol Neurosurg ; 115(9): 1586-90, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23453153

RESUMO

OBJECT: To determine the effectiveness of fluorescence-guided resection of fronto-basal high grade gliomas by using the supraorbital trans-eyebrow craniotomy. METHODS: We present a single-institution experience of 6 consecutive patients presenting high grade brain glioma located on the fronto-basal area that were operated through a supraorbital trans-eyebrow craniotomy. Previous to surgery all patients were administered 20mg/kg of 5 aminolevulic acid so microscopic fluorescence-guided resection could be accomplished. Tumors were located on gyrus rectus (3 patients), medial orbital gyrus (2 patients), and anterior orbital gyrus (1 patient). RESULTS: Despite the narrow surgical corridor, fluorescence was useful in all cases. Fluorescence-guided resection allowed inclusion into the margins of resection of areas previously considered as normal under white light. Complete resection was obtained in 5 patients. No neurological postoperative new deficit was observed in this series. All six cases corresponded to glioblastoma. Only one case of superficial infection with delayed wound healing was reported as complication. All patients expressed a high level of satisfaction related to cosmetic result. CONCLUSIONS: Fluorescence-guided resection of fronto-basal high grade gliomas can be successfully achieved through supraorbital trans-eyebrow craniotomy. Benefits of supraorbital craniotomy in the management of fronto-basal high grade gliomas as well as usefulness of fluorescence-guided resection through a very narrow corridor are exposed.


Assuntos
Gânglios da Base/cirurgia , Neoplasias Encefálicas/cirurgia , Craniotomia/métodos , Lobo Frontal/cirurgia , Glioma/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Neurocirúrgicos/métodos , Órbita/cirurgia , Idoso , Ácido Aminolevulínico/uso terapêutico , Neoplasias Encefálicas/patologia , Quimiorradioterapia Adjuvante , Sobrancelhas , Feminino , Glioma/patologia , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Satisfação do Paciente , Fármacos Fotossensibilizantes/uso terapêutico , Estudos Retrospectivos , Cirurgia Assistida por Computador
10.
Pediatr Neurosurg ; 47(2): 88-92, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21952534

RESUMO

BACKGROUND/AIMS: Obstruction is the most common complication of ventriculoperitoneal shunts in patients with hydrocephalus. Despite technical advances, rates of obstruction have barely decreased and remain at over 40% of cases. Patients suffering from preterm-related posthaemorrhagic hydrocephalus are considered a group with a particularly high risk of obstruction. The aim of the present study was to review our series of patients with preterm-related posthaemorrhagic hydrocephalus and analyse the occurrence of the first ventricular shunt obstruction as well as the related clinical and radiological factors. METHODS: We conducted a retrospective review of 103 cases treated from 1982 to 2010. Descriptive analysis, raw and adjusted bivariate correlations and survival analysis were performed. RESULTS: Over the course of the follow-up, 42 patients presented at least one episode of obstruction that required proximal revision. Medium-opening pressure valves were associated with a higher rate of obstruction compared to low-opening pressure valves; however, in our series this association became statistically significant only in patients with a weight of over 2,000 g at the time of surgery (odds ratio 6.75). The occurrence of previous infection and the development of late slit ventricle syndrome were also significantly associated with obstruction of the ventricular catheter (odds ratios 3.35 and 4.27, respectively). CONCLUSIONS: Rates of shunt obstruction in preterm-related posthaemorrhagic hydrocephalus remain high but do not seem to be higher than in other groups of paediatric hydrocephalus. Prevention of infection and the use of the appropriate type of valve design can help to decrease the incidence of proximal shunt obstruction, which in turn could decrease the incidence of symptomatic slit ventricle syndromes.


Assuntos
Hemorragia Cerebral/epidemiologia , Hemorragia Cerebral/cirurgia , Hidrocefalia/epidemiologia , Hidrocefalia/cirurgia , Complicações Pós-Operatórias/epidemiologia , Derivação Ventriculoperitoneal/efeitos adversos , Hemorragia Cerebral/complicações , Falha de Equipamento , Feminino , Seguimentos , Humanos , Hidrocefalia/etiologia , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/epidemiologia , Doenças do Prematuro/cirurgia , Masculino , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Síndrome do Ventrículo Colabado/epidemiologia , Síndrome do Ventrículo Colabado/etiologia
11.
Ann N Y Acad Sci ; 1173 Suppl 1: E46-54, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19751414

RESUMO

Human osteoblasts isolated from bone tissue samples have their own specific antigen profile but also share expression of antigens that are characteristic of other immunocompetent cells. Given that these findings come from studies performed in primary cultures of human osteoblasts, it was decided to test whether these antigen profiles and functional characteristics are retained in a characterized osteoblast cell line (MG-63). We show that some of these characteristics are also found in the MG-63 osteosarcoma cell line. We have demonstrated, using monoclonal antibodies and cytometry, that these cells expressed CD10, CD13, CD44, and CD54 antigens but were negative for CD69 and HLA-DR antigens. Functionally, 100% of MG-63 cells showed phagocytic capacity with a high phagocytic index. This study corroborates that osteoblastic cells have an immunological profile.


Assuntos
Neoplasias Ósseas/genética , Neoplasias Ósseas/imunologia , Osteossarcoma/genética , Osteossarcoma/imunologia , Anticorpos Monoclonais , Antígenos CD/genética , Antígenos de Neoplasias/genética , Neoplasias Ósseas/fisiopatologia , Linhagem Celular Tumoral , Citometria de Fluxo , Antígenos HLA-DR/genética , Humanos , Osteoblastos/imunologia , Osteoblastos/fisiologia , Osteossarcoma/fisiopatologia , Fagocitose , Fenótipo
13.
Biosci Rep ; 26(4): 281-9, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17029006

RESUMO

BACKGROUND/AIMS: Recent reports demonstrated that osteoblast-like cells can also exert activities directly associated with the immune system (cytokine synthesis, antigen presentation, phagocytosis and stimulation of T lymphocytes). The present study aimed to analyze the effect of Transforming growth factorbeta1 (TGFbeta1), Fibroblast growth factor basic (FGFb), Platelet-derived growth factor-BB (PDGF-BB), Interleukin-1beta (IL-1beta), Interleukin-2 (IL-2), Lipopolysaccharide (LPS) and Interferon-gamma (IFNgamma) on the expression on osteoblast-like cells of antigens involved in antigen presentation. METHODS: Flow cytometry was used to investigate whether the growth factors FGFb, TGFbeta1, PDGF-BB, IL-2, IL-1beta, LPS and IFNgamma modulate the expression on cultured human osteoblast-like cells of different antigens involved in antigen-presentation and T cell activation. RESULTS: TGFbeta1 treatment significantly reduced the expression of CD54 and CD86. IL-1beta treatment significantly enhanced the expression of CD54, CD86 and HLA-DR. LPS and IFNgamma treatments produced a major increase in CD54, CD80, CD86 and HLA-DR expression. Expression of these antigen-presenting molecules was not significantly modified by FGFb, PDGF-BB or IL-2 treatment.


Assuntos
Citocinas/farmacologia , Interferon gama/farmacologia , Interleucina-1beta/farmacologia , Lipopolissacarídeos/farmacologia , Osteoblastos/efeitos dos fármacos , Fator de Crescimento Transformador beta1/farmacologia , Adulto , Antígenos CD/metabolismo , Antígeno B7-1/metabolismo , Antígeno B7-2/metabolismo , Becaplermina , Células Cultivadas , Feminino , Fator 2 de Crescimento de Fibroblastos/farmacologia , Citometria de Fluxo , Antígenos HLA-DR/metabolismo , Humanos , Molécula 1 de Adesão Intercelular/metabolismo , Interleucina-2/farmacologia , Masculino , Osteoblastos/citologia , Osteoblastos/metabolismo , Fator de Crescimento Derivado de Plaquetas/farmacologia , Proteínas Proto-Oncogênicas c-sis
14.
Biosci Rep ; 26(1): 39-43, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16779666

RESUMO

The antigenic profile of human osteoblasts was previously analyzed by our group using primary cultures as study samples. These studies suggested a novel functional approach to this cell population. Osteoblasts have a characteristic antigenic profile and share antigens in common with other cell populations that also originate in the bone marrow. Some of the detected antigens are constitutively expressed, while others are modulated by different factors and/or cytokines. The aim of the present study was to analyze the antigens present in osteoblasts in vivo, since the presence of certain biomolecules in fetal bovine serum may modulate the antigenic expression, compromising the results. For this purpose, human bone tissue sections were analyzed with a wide panel of mAbs and using the immunoperoxidase technique. CD10, CD44 and alkaline phosphatase antigens and IL-12, IL-18 and IFNgamma cytokines were detected in osteoblasts in the bone tissue. However, CD80 and HLA-DR antigens were not found in all samples and when present their expression was weak. The expression of CD54 antigen was moderate or weak. These results allow data obtained by the primary culture of osteoblast-like cells to be endorsed.


Assuntos
Osso e Ossos/citologia , Receptores de Hialuronatos/imunologia , Molécula 1 de Adesão Intercelular/imunologia , Neprilisina/imunologia , Osteoblastos/citologia , Adulto , Fosfatase Alcalina/análise , Anticorpos Monoclonais/imunologia , Feminino , Humanos , Técnicas Imunoenzimáticas , Interferon gama/genética , Interferon gama/metabolismo , Interleucina-12/genética , Interleucina-12/metabolismo , Interleucina-18/genética , Interleucina-18/metabolismo , Masculino , Microtomia/métodos , Osteoblastos/imunologia
15.
Neurologia ; 20(6): 311-3, 2005.
Artigo em Espanhol | MEDLINE | ID: mdl-16007514

RESUMO

Collet-Sicard is a rare syndrome that consists of the palsy of all the lower four cranial nerves. We describe this entity in relation with a schwannoma of the hypoglossal nerve. A 45 year-old-patient was admitted to the hospital referring hoarseness and difficulty in swallowing for two weeks. On neurological examination, the patient exhibited palsy of the ninth, tenth, eleventh and twelfth nerves. This is a syndrome of Collet-Sicard. The cranial MRI revealed a small intracranial and extracranial tumor adjacent to the hypoglossal foramen. The tumor involved the jugular foramen and was moderately enhanced with gadolinium The patient underwent surgical removal. The pathologic examination of the surgical specimen confirmed the diagnosis of a schwannoma of the hypoglossal nerve. We have carried out a research of the Collet-Sicard syndrome and of its aetiology. Although schwannoma the hypoglossal nerve is a rare disorder we consider that this entity should be included in the differential diagnosis of the Collet-Sicard syndrome.


Assuntos
Doenças do Nervo Hipoglosso , Neurilemoma , Paralisia/etiologia , Nervo Acessório/patologia , Nervo Glossofaríngeo/patologia , Humanos , Doenças do Nervo Hipoglosso/diagnóstico , Doenças do Nervo Hipoglosso/etiologia , Doenças do Nervo Hipoglosso/patologia , Angiografia por Ressonância Magnética , Masculino , Neurilemoma/complicações , Neurilemoma/diagnóstico , Neurilemoma/patologia , Síndrome , Nervo Vago/patologia
16.
Cyberpsychol Behav ; 8(2): 162-71, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15938656

RESUMO

Augmented reality (AR) refers to the introduction of virtual elements in the real world. That is, the person is seeing an image composed of a visualization of the real world, and a series of virtual elements that, at that same moment, are super-imposed on the real world. The most important aspect of AR is that the virtual elements supply to the person relevant and useful information that is not contained in the real world. AR has notable potential, and has already been used in diverse fields, such as medicine, the army, coaching, engineering, design, and robotics. Until now, AR has never been used in the scope of psychological treatment. Nevertheless, AR presents various advantages. Just like in the classical systems of virtual reality, it is possible to have total control over the virtual elements that are super-imposed on the real world, and how one interacts with those elements. AR could involve additional advantages; on one side it could be less expensive since it also uses the real world (this does not need to be modeled), and it could facilitate the feeling of presence (the sensation of being there), and reality judgment (the fact of judging the experience as real) of the person since the environment he or she is in, and what he or she is seeing is, in fact the "reality." In this paper, we present the data of the first case study in which AR has been used for the treatment of a specific phobia, cockroaches phobia. It addresses a system of AR that permits exposure to virtual cockroaches super-imposed on the real world. In order to carry out the exposure, the guidelines of Ost with respect to "one-session treatment" were followed. The results are promising. The participant demonstrated notable fear and avoidance in the behavioral avoidance test before the treatment, and not only was an important decrease in the scores of fear and avoidance observed after the treatment, but also the participant was capable of approaching, interacting, and killing live cockroaches immediately following the treatment. The results are maintained in a follow-up conducted 1 month after the termination of the treatment.


Assuntos
Terapia Comportamental/métodos , Baratas , Dessensibilização Psicológica/métodos , Transtornos Fóbicos/terapia , Terapia Assistida por Computador/métodos , Interface Usuário-Computador , Adulto , Animais , Gráficos por Computador , Simulação por Computador , Feminino , Humanos , Transtornos Fóbicos/psicologia , Terapia Assistida por Computador/instrumentação , Resultado do Tratamento
17.
Cephalalgia ; 25(1): 30-5, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15606567

RESUMO

Available studies offer only limited guidance on neuroimaging of non-acute headache patients. The aim of this study was to estimate the frequency of significant intracranial lesions in patients with headache and to determine the clinical variables helpful in identifying patients with intracranial lesions. All patients aged >or= 15 years attending the Neurology Clinic with non-acute headache were included in the study and followed prospectively. Every patient was investigated by neuroimaging studies, either computed tomography or magnetic resonance imaging. Neuroimaging results were classified as 'significant abnormalities', 'non-significant abnormalities' or 'normal'. Significant abnormalities included neoplastic disease, hydrocephalus, vascular malformations, Chiari malformation, large arachnoid cysts, intracranial haemorrhage, and acute cerebral infarcts. Consecutive patients (n=1876; 1243 women and 633 men) were included. Their mean age was 38 years (range 15-95 years). Neuroimaging studies detected significant lesions in 22 patients [1.2%, 95% confidence interval (CI) 0.7, 1.8]. The rate of significant intracranial abnormalities in patients with headache and normal neurological examination was 0.9% (95% CI 0.5, 1.4). The only clinical variable associated with a higher probability of intracranial abnormalities was neurological examination. The proportion of patients with headache and intracranial lesions is relatively small, but neither neurological examination nor the features in the clinical history permit us to rule out such abnormalities.


Assuntos
Cefaleia/diagnóstico , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Feminino , Cefaleia/patologia , Humanos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tomografia Computadorizada por Raios X/estatística & dados numéricos
18.
Rev. argent. clín. psicol ; 13(2): 91-109, ago. 2004. tab
Artigo em Espanhol | LILACS | ID: lil-428582

RESUMO

Este trabajo constituye un estudio preliminar en que el que se analiza la personalidad desde un enfoque categorial y dimensional en una muestra de trastornos alimentarios y se compara con una muestra de participantes controles. La muestra estaba compuesta por 44 mujeres, 22 de la cuales estaba diagnosticada de un trastorno de la conducta alimentaria


Assuntos
Anorexia Nervosa , Bulimia , Transtornos da Personalidade , Comportamento Alimentar
19.
Cyberpsychol Behav ; 4(4): 449-55, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11708724

RESUMO

Many of us grew up with the naive assumption that couches are the best used therapeutic tools in psychotherapy. But tools for psychotherapy are evolving in a much more complex environment than a designer's chaise lounge. In particular, virtual reality (VR) devices have the potential for appearing soon in many consulting rooms. The use of VR in medicine is not a novelty. Applications of virtual environments for health care have been developed in the following areas: surgical procedures (remote surgery or telepresence, augmented or enhanced surgery, and planning and simulation of procedures before surgery); preventive medicine and patient education; medical education and training; visualization of massive medical databases; and architectural design for health care facilities. However, there is a growing recognition that VR can play an important role in clinical psychology, too. To exploit and understand this potential is the main goal of the Telemedicine and Portable Virtual Environment in Clinical Psychology--VEPSY Updated--a European Community-funded research project (IST-2000-25323, http://www.vepsy.com). The project will provide innovative tools-telemedicine and portable-for the treatment of patients, clinical trials to verify their viability, and action plans for dissemination of its results to an extended audience-potential users and influential groups. The project will also develop different personal computer (PC)-based virtual reality modules to be used in clinical assessment and treatment. In particular, the developed modules will address the following pathologies: anxiety disorders; male impotence and premature ejaculation; and obesity, bulimia, and binge-eating disorders.


Assuntos
Psicologia Clínica , Transtornos Somatoformes/terapia , Interface Usuário-Computador , Adulto , Feminino , Humanos , Masculino , Microcomputadores , Equipe de Assistência ao Paciente , Transtornos Psicofisiológicos/diagnóstico , Transtornos Psicofisiológicos/terapia , Psicoterapia , Transtornos Somatoformes/diagnóstico , Telemedicina
20.
J Periodontol ; 71(4): 614-7, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10807126

RESUMO

BACKGROUND: Osteoblasts express the CD44 antigen and HLA class II antigens, molecules which, together with other costimulatory molecules such as CD80, CD86, and CD54, are involved in antigen presentation and T cell activation. The aim of this study was to investigate the expression of these molecules in human osteoblasts. METHODS: Human osteoblastic cells obtained from samples of normal bone obtained during mandibular osteotomy were isolated, maintained in culture, and characterized. The identity of the cells was confirmed by their alkaline phosphatase activity and their capacity to produce osteocalcin. Flow cytometry was used to examine the expression HLA-DR, CD80, CD86, CD44, and CD54 molecules involved in immune activities. RESULTS: We detected the expression of CD10, CD44, and HLA-DR antigens, molecules involved in antigen presentation in cultured osteoblastic cells. Although the cells were negative for CD45, the leukocyte common antigen and CD14 (an antigen detected on macrophages), they expressed CD54, CD80, and CD86 antigens, which are also involved in the mechanisms of antigen presentation to and activation of T cells. CONCLUSIONS: Our results suggest that osteoblastic cells or a subpopulation of these cells may have immune functions in bone. Further studies in which immune functions are assessed will be needed to test this hypothesis.


Assuntos
Apresentação de Antígeno/imunologia , Antígenos CD/imunologia , Antígenos HLA-DR/imunologia , Ativação Linfocitária/imunologia , Osteoblastos/imunologia , Linfócitos T/imunologia , Adulto , Fosfatase Alcalina/análise , Antígeno B7-1/imunologia , Antígeno B7-2 , Células Cultivadas , Feminino , Citometria de Fluxo , Humanos , Receptores de Hialuronatos/imunologia , Molécula 1 de Adesão Intercelular/imunologia , Antígenos Comuns de Leucócito/imunologia , Receptores de Lipopolissacarídeos/imunologia , Masculino , Mandíbula/citologia , Glicoproteínas de Membrana/imunologia , Neprilisina/imunologia , Osteocalcina/análise
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