RESUMO
The episodes of cerebral dysfunction, known as encephalopathy, are usually coincident with liver failure. The primary metabolic marker of liver diseases is the increase in blood ammonium, which promotes neuronal damage. In the present project, we used an experimental model of hepatic encephalopathy in male rats by portacaval anastomosis (PCA) surgery. Sham rats had a false operation. After 13 weeks of surgery, the most distinctive finding was vacuolar/spongiform neurodegeneration exclusively in the molecular layer of the cerebellum. This cerebellar damage was further characterized by metabolic, histopathological, and behavioral approaches. The results were as follows: (a) Cellular alterations, namely loss of Purkinje cells, morphological changes, such as swelling of astrocytes and Bergmann glia, and activation of microglia; (b) Cytotoxic edema, shown by an increase in aquaporin-4 and N-acetylaspartate and a reduction in taurine and choline-derivate osmolytes; (c) Metabolic adjustments, noted by the elevation of circulating ammonium, enhanced presence of glutamine synthetase, and increase in glutamine and creatine/phosphocreatine; (d) Inflammasome activation, detected by the elevation of the marker NLRP3 and microglial activation; (e) Locomotor deficits in PCA rats as assessed by the Rotarod and open field tests. These results lead us to suggest that metabolic disturbances associated with PCA can generate the cerebellar damage that is similar to morphophysiological modifications observed in amyloidogenic disorders. In conclusion, we have characterized a distinctive cerebellar multi-disruption accompanied by high levels of ammonium and associated with spongiform neurodegeneration in a model of hepatic hypofunctioning.
Assuntos
Cerebelo/metabolismo , Cerebelo/patologia , Encefalopatia Hepática/metabolismo , Encefalopatia Hepática/patologia , Locomoção/fisiologia , Derivação Portocava Cirúrgica/tendências , Animais , Astrócitos/metabolismo , Astrócitos/patologia , Cerebelo/cirurgia , Encefalopatia Hepática/cirurgia , Masculino , Microglia/metabolismo , Microglia/patologia , Neurônios/metabolismo , Neurônios/patologia , Células de Purkinje/metabolismo , Células de Purkinje/patologia , Ratos , Ratos WistarRESUMO
Thyroid carcinoma is a neoplasia with a higher incidence in patients with chronic kidney disease. In recent years advances have been made in diagnostic and therapeutic trials. Dialysis patients are a particular group, their cancer being detected indirectly in the study of secondary hyperparathyroidism and during the study prior to renal transplantation. Thyroidectomy is the definitive treatment, but in patients with risk of recurrence, ablative therapy is required using radioactive iodine I-131, which is predominantly eliminated by renal excretion, therefore its use in patients on dialysis poses a problem in terms of dosage. Two cases are presented of patients on haemodialysis undergoing radioablation with radioactive iodine I-131, which with multidisciplinary treatment had the expected results in the patients.
Assuntos
Radioisótopos do Iodo/uso terapêutico , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Diálise Renal , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/radioterapia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Utilizando la entrevista clínica y varias escalas de evaluación se realizó la caracterización de un grupo de 28 niños con TOC en la ciudad de Bogotá. Estos hallazgos fueron contrastados con lo reportado en la literatura mundial