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1.
J Neuroendocrinol ; : e13375, 2024 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-38379225

RESUMEN

In temperate-zone songbirds, the neuroanatomical changes which occur in advance of breeding, including the growth of nuclei of the vocal control system, are believed to occur downstream of gonadal recrudescence. However, evidence from wild birds is mixed. Here, we captured black-capped chickadees from the wild in early spring (March-April), summer (August-September), and winter (December-January); in addition to measuring the volumes of two vocal control nuclei (Area X and HVC), we also quantified two indicators of reproductive state (gonads and circulating gonadal steroids). Most birds captured in early spring had regressed gonads and low levels of circulating gonadal steroids, indicating these birds were not yet in full breeding condition. However, these early spring birds still had a significantly larger Area X than winter birds, while HVC did not differ in size across groups. Using data from a previously published seasonal study of black-capped chickadees (Phillmore et al., Developmental Neurobiology, 2015;75:203-216), we then compared Area X and HVC volumes from our early spring group to a breeding group of chickadees captured 3-4 weeks later in the spring. While Area X volume did not differ between the studies, breeding males in Phillmore et al. (2015) had a significantly larger HVC. Taken together, this suggests that the vernal growth of Area X occurs ahead of HVC in black-capped chickadees, and that the overall vernal changes in the vocal control system occur at least partially in advance of the breeding-associated upregulation of the hypothalamic-pituitary-gonadal axis.

2.
Pulm Pharmacol Ther ; 82: 102232, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37451609

RESUMEN

PURPOSE: Oral treprostinil and selexipag are drugs targeting the prostacyclin pathway and are approved for treatment of pulmonary arterial hypertension (PAH). In the setting of unsatisfactory clinical response or tolerability issues while on selexipag, there is little data on clinical benefit, safety, or strategies on transitioning to oral treprostinil. Using prospective data from the ADAPT registry, we aimed to evaluate clinical outcomes, safety, and transition strategies in ten patients with PAH transitioning from selexipag to oral treprostinil. METHODS: ADAPT was a prospective, real-world, multicenter, United States-based registry of patients with PAH newly started on oral treprostinil, with a cohort of patients (n = 10) transitioning from selexipag to oral treprostinil. PAH variables of interest were collected from standard-of-care clinic visits. Clinical improvement was defined by modified REPLACE criterion, and risk was assessed by REVEAL Lite 2 from baseline to last follow-up. Real world transition strategies were recorded. Healthcare utilization or worsening PAH was evaluated within 30 days of transitions. RESULTS: Seven patients transitioned due to worsening PAH or lack of efficacy on selexipag, and three patients transitioned due to tolerability issues. Based on the modified REPLACE criterion, five patients demonstrated clinical improvement after transition from selexipag to oral treprostinil. Using REVEAL Lite 2 to assess risk, three patients improved and five patients maintained risk category from baseline to last follow-up. All transitions occurred in an outpatient setting either as abrupt stop/start or cross-titration, without parenteral treprostinil bridging. CONCLUSION: Transition from selexipag to oral treprostinil was safe, performed without parenteral prostacyclin bridging, and resulted in clinical and categorical risk improvements in some patients.


Asunto(s)
Hipertensión Pulmonar , Hipertensión Arterial Pulmonar , Humanos , Hipertensión Arterial Pulmonar/tratamiento farmacológico , Antihipertensivos , Hipertensión Pulmonar/tratamiento farmacológico , Estudios Prospectivos , Administración Oral , Epoprostenol/efectos adversos , Hipertensión Pulmonar Primaria Familiar/tratamiento farmacológico , Sistema de Registros
3.
Learn Behav ; 50(1): 55-70, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-35237946

RESUMEN

Neural plasticity in the hippocampus has been studied in a wide variety of model systems, including in avian species where the hippocampus underlies specialized spatial behaviours. Examples of such behaviours include navigating to a home roost over long distances by homing pigeons or returning to a potential nest site for egg deposit by brood parasites. The best studied example, however, is food storing in parids and the interaction between this behaviour and changes in hippocampus volume and neurogenesis. However, understanding the interaction between brain and behaviour necessitates research that includes studies with at least some form of captivity, which may itself affect hippocampal plasticity. Captivity might particularly affect spatial specialists where free-ranging movement on a large scale is especially important in daily, and seasonal, behaviours. This review examines how captivity might affect hippocampal plasticity in avian spatial specialists and specifically food-storing parids, and also considers how the effects of captivity may be mitigated by researchers studying hippocampal plasticity when the goal is understanding the relationship between behaviour and hippocampal change.


Asunto(s)
Hipocampo , Plasticidad Neuronal , Animales , Columbidae
4.
Sci Total Environ ; 824: 153875, 2022 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-35181365

RESUMEN

The rapid development and application of drone technology has included water sampling and collection of physiochemical data from lakes. Previous research has demonstrated the significant potential of drones to play a future pivotal role in the collection of such data from lakes that fulfil requirements of large-scale monitoring programmes. However, currently the utilisation of drone technology for water quality monitoring is hindered by a number of important limitations: i) the low rate of successful sample captured; ii) the relatively low volume of water sample retrieved for analyses of multiple water chemistry parameters; and critically iii) differences between water chemistry parameters when using a drone versus samples collected by boat. Here we present results comparing the water chemistry results of a large number of parameters (pH, dissolved oxygen concentration, temperature, conductivity, alkalinity, hardness, true colour, chloride, silica, ammonia, total oxidised nitrogen, nitrite, nitrate, ortho-phosphate, total phosphorous and chlorophyll) sampled via drone with samples collected by boat in a number of lakes. The drone water sampling method used here is the first to collect a sufficiently large volume of water to meet the monitoring requirements of large scale water monitoring programmes, 2 L, at a 100% success rate and most crucially, with water chemistry variables that are not significantly different to those taken using traditional boat water sampling. This study therefore shows that drone technology can be utilised to collect water chemistry data and samples from lakes in a reliable, more rapid and cost effective manner than traditional sampling using boats, that is safer for personnel and poses less of a biosecurity risk.


Asunto(s)
Lagos , Dispositivos Aéreos No Tripulados , Calidad del Agua
5.
AIDS Care ; 32(sup2): 40-46, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32167374

RESUMEN

In the U.S., HIV incidence is highest among Black men who have sex with men (MSM) but PrEP uptake is low, in part due to lack of normative support for using PrEP. This research pilot tested a social network-level intervention designed to increase PrEP use willingness, interest, and peer supports among Black MSM in Milwaukee. Five community social networks (n = 40 participants) of racial minority MSM were assessed at baseline with measures of PrEP knowledge, interest, attitudes, and action taking. Persons most interconnected with others in each network attended an intervention that provided training to increase knowledge about PrEPbenefits, address PrEP concerns, endorse PrEP use as a symbol of pride and health, and deliver these messages to others in their social networks. All network members were re-administered the same measures at 3-month followup. Significant increases over time were found in network members' PrEP knowledge, attitudes, norm perceptions, self-efficacy, and willingness to use PrEP. Participants more often talked with friends about HIV and with their health care providers about PrEP. The percentage of participants who reported using PrEP increased from 3% to 11%. Larger-scale evaluations of this intervention model are needed.


Asunto(s)
Fármacos Anti-VIH/administración & dosificación , Negro o Afroamericano/psicología , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Homosexualidad Masculina/psicología , Aceptación de la Atención de Salud , Profilaxis Pre-Exposición/métodos , Red Social , Adulto , Fármacos Anti-VIH/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Homosexualidad Masculina/etnología , Humanos , Masculino , Grupo Paritario , Sexo Seguro , Wisconsin/epidemiología
6.
Int J Obes (Lond) ; 34(2): 302-8, 2010 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19901952

RESUMEN

BACKGROUND: Although several studies have shown a positive association between evidence of anti-adenovirus 36 (Ad-36) antibodies (Ad-36 exposure) and (1) obesity and (2) serum cholesterol in animals, there is limited research demonstrating this association in humans. There is also limited research on transmission, presentation and demographics of Ad-36 infection. DESIGN: (1) Body mass (body mass index (BMI)), (2) fasting serum cholesterol and triglyceride levels and (3) demographic characteristics were compared between Ad-36 seropositive and seronegative groups. The majority of subjects were matched as cases versus controls on a number of demographic variables. SUBJECTS: A total of 150 obese and 150 lean active-duty military personnel were studied. MEASUREMENTS: Subjects completed a questionnaire regarding demographic and behavioral characteristics. Subject serum samples were tested by serum neutralization assay for the presence of anti-Ad-36 antibodies. RESULTS: In all, 34% of obese and 39% of lean subjects had Ad-36 exposure, an insignificant difference. Serum cholesterol and triglyceride levels were significantly higher among the obese subjects than among the lean, but there were no associations between serum cholesterol and triglyceride levels and Ad-36 exposure. Positive associations were found between Ad-36 exposure and age, race and gender. CONCLUSION: The study stands in contrast to previous work that has shown a positive relationship between Ad-36 exposure and (1) obesity, and (2) levels of serum cholesterol and triglycerides. In this study there was no association in either case. Unanticipated relationships between Ad-36 exposure and age, race and gender were found, and this is the first time that such a link between Ad-36 exposure and demographics has been found.


Asunto(s)
Infecciones por Adenovirus Humanos/sangre , Anticuerpos Antivirales/sangre , Colesterol/sangre , Personal Militar , Obesidad/sangre , Triglicéridos/sangre , Infecciones por Adenovirus Humanos/etnología , Infecciones por Adenovirus Humanos/virología , Adenovirus Humanos/inmunología , Adolescente , Adulto , Índice de Masa Corporal , Estudios de Casos y Controles , Ayuno/sangre , Femenino , Humanos , Masculino , Obesidad/virología , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Adulto Joven
7.
Adv Protein Chem ; 70: 203-46, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-15837517

RESUMEN

Spectrin family proteins represent an important group of actin-bundling and membrane-anchoring proteins found in diverse structures from yeast to man. Arising from a common ancestral alpha-actinin gene through duplications and rearrangements, the family has increased to include the spectrins and dystrophin/utrophin. The spectrin family is characterized by the presence of spectrin repeats, actin binding domains, and EF hands. With increasing divergence, new domains and functions have been added such that spectrin and dystrophin also contain specialized protein-protein interaction motifs and regions for interaction with membranes and phospholipids. The acquisition of new domains also increased the functional complexity of the family such that the proteins perform a range of tasks way beyond the simple bundling of actin filaments by alpha-actinin in S. pombe. We discuss the evolutionary, structural, functional, and regulatory roles of the spectrin family of proteins and describe some of the disease traits associated with loss of spectrin family protein function.


Asunto(s)
Actinina/química , Distrofina/química , Espectrina/química , Actinina/fisiología , Secuencia de Aminoácidos , Animales , Distrofina/fisiología , Enfermedades Genéticas Congénitas/genética , Enfermedades Genéticas Congénitas/metabolismo , Humanos , Unión Proteica , Espectrina/fisiología
8.
Child Care Health Dev ; 28(1): 87-93, 2002 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11856191

RESUMEN

We report on the prevalence of severe neurodisability in children in the Southern Derbyshire Health Authority from different ethnic groups. Information was obtained from the health records of children at the Child Development Centre (CDC), and analysed according to ethnic group. There were 53 in the Pakistani group, 20 in the Indian group and 764 in a mixed group, of which 95% were of European origin. It was estimated that all children with severe disability in the area of the Health Authority had notes at the CDC, except for 10% of the mixed group living on the periphery. The numbers of children with different disabling conditions were recorded, together with a measure of the level of individual disability; the 'Disability Scores'. We also noted if the condition was genetic or chromosomal in origin. Pakistani children showed a higher prevalence than the other groups of severe learning disorder, severe and profound hearing loss and severe visual problems. They also had a slightly increased prevalence of autism and cerebral palsy. Conversely, they showed a lower prevalence of language disorder. Disability scores for Pakistani children attending the CDC were higher than for other groups. Genetic disease causing disability was 10 times more common in the Pakistani children than other ethnic groups. Disability is more common in Pakistani children probably as a result of the cultural practice of consanguineous marriages. This community needs special help for disabled children, and their families, for general support and appropriate genetic counselling.


Asunto(s)
Niños con Discapacidad/estadística & datos numéricos , Enfermedades del Sistema Nervioso/etnología , Adolescente , Adulto , Trastorno Autístico/etnología , Parálisis Cerebral/etnología , Niño , Sordera/etnología , Inglaterra/epidemiología , Europa (Continente)/etnología , Femenino , Humanos , India/etnología , Trastornos del Lenguaje/etnología , Discapacidades para el Aprendizaje/etnología , Masculino , Evaluación de Necesidades , Enfermedades del Sistema Nervioso/genética , Pakistán/etnología , Prevalencia
9.
Pediatrics ; 107(1): 130-4, 2001 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11134446

RESUMEN

OBJECTIVE: To determine the effect of a clinic-based literacy intervention on the language development of preschool children. METHODS: A convenience sample of families presenting to 2 urban pediatric clinics for well-child care met the following criteria: the family was Latino or black and English- or Spanish-speaking; the child was 2 to 5.9 years old, with no neurodevelopmental disability, at a gestational age of 34 weeks or more, and not attending kindergarten. Participants at the first clinic (intervention group) were exposed to a literacy support program, based on Reach Out and Read (ROR), during the previous 3 years. At the second clinic (comparison group), a similar program started 3 months before the study. Parent-child reading activities were measured using the READ Subscale of the StimQ. Language development was measured using the One-Word Expressive and Receptive Picture Vocabulary Tests, and was performed in the child's primary language. RESULTS: A total of 122 study participants (49 interventions and 73 comparisons) met inclusion criteria and completed all measures. Intervention and comparison families were similar for most sociodemographic variables. Intervention families reported reading together with their children approximately 1 more day per week. Intensity of exposure to ROR (measured by total number of contacts with the program) was associated with increased parent-child reading activities, as measured by the StimQ-Read Subscale (r = 0.20). Intervention children had higher receptive language (mean: 94.5 vs 84.8) and expressive language (mean: 84.3 vs 81.6). After adjusting for potential confounders in a multiple regression analysis, intervention status was associated with an 8.6-point increase (95% confidence interval [CI]: 3.3, 14.0) in receptive language (semipartial correlation [SR]coefficient = 0.27), and a 4.3-point increase (95% CI: 0.04, 8.6) in expressive language (SR = 0.17). In a similar multiple regression, each contact with ROR was associated with an adjusted mean 0.4-point increase (95% CI: 0.1, 0.6) in receptive score, and an adjusted mean 0.21-point increase (95% CI: 0. 02, 0.4) in expressive score. CONCLUSIONS: ROR is an important intervention, promoting parental literacy support and enhancing language development in impoverished preschool children. Integration of literacy promoting interventions such as these into routine pediatric health care for underserved populations can be recommended.


Asunto(s)
Educación , Desarrollo del Lenguaje , Distribución de Chi-Cuadrado , Preescolar , Factores de Confusión Epidemiológicos , Femenino , Humanos , Masculino , Ciudad de Nueva York , Relaciones Padres-Hijo , Análisis de Regresión , Salud Urbana
10.
Biol Cybern ; 82(5): 433-42, 2000 May.
Artículo en Inglés | MEDLINE | ID: mdl-10836588

RESUMEN

The adiabatic transformability hypothesis for non-conservative, non-rate-limited biological systems put forward by Kugler and Turvey [Kugler PN, Turvey MT (1987) Information, natural law, and the self-assembly of rhythmic movements, Erlbaum, Hillsdale, NJ] is evaluated in a ball-bouncing task as a function of skill level. We hypothesized that, when a basketball player increases or decreases the frequency of his limb motion in a vertical ball-bouncing task, the transformation should be characterized as adiabatic. Confirmation of this hypothesis would lend support to the body of knowledge that suggests that physical-biological laws guide the behavior of people engaged in motor tasks, including their acquisition of skill. We videotaped and analyzed four participants - two intermediates and two experts - bouncing a ball from various heights, and measured the energy and kinematic relations of the ball and the participants' body segments. The task presents a challenge to certain predictions of the adiabatic hypothesis in evaluating changes in movement velocity (v) or frequency (f), and energy as adiabatic transformations. Among these are the constant relation between kinetic energy (Ek) per cycle and v, constancy of energy dissipated per cycle (Et) over changes in v and Ek, the ratio of Ek to Et per cycle (the "Q" values), and the relation of amplitude to v. From our observations, which are examined in regard to the insights of Kugler and Turvey about the relation of Ehrenfest's adiabatic theorem to biological systems, we confirm the basic adiabatic character of the task in analyzing both the ball alone and the relations of various body segments. In the segmental frame of reference, we found evidence of differences in energy-kinematic relations in the Q values between skill levels.


Asunto(s)
Baloncesto/fisiología , Modelos Biológicos , Destreza Motora/fisiología , Termodinámica , Adulto , Brazo/fisiología , Fenómenos Biomecánicos , Femenino , Humanos , Movimiento/fisiología , Desempeño Psicomotor
11.
Kidney Int ; 57(4): 1764-9, 2000 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10760113

RESUMEN

Several techniques have been developed to study the transport properties of nanoliter samples of renal tubule segments, such as continuous flow colorimetry and continuous fluorometry. We have extended the capability of the NANOFLO, a flow-through microfluorometer, designed for measurement of carbon dioxide, urea, ammonia, glucose, lactate, etc., to analyze sodium, calcium and chloride ions, using three commercially available fluorescent indicators for intracellular and extracellular measurements. The selection of fluorescent indicator for each electrolyte was dependent on the optimal match of the dissociation constant and the analyte concentration range of interest. Using Fluo-3 dye we achieved a detection limit for Ca2+ of 0.1 pmol and selectivity over Mg2+ of between 7:1 to 10:1. Using sodium green dye we achieved detection limit for Na+ of 12 pmol and a selectivity over K+ of 40:1. The detection limit for Cl- using lucigenin dye was 10 pmol. This technique can be readily adapted for the measurement of other physiologically important ultralow volume.


Asunto(s)
Calcio/análisis , Cloruros/análisis , Fluorometría/instrumentación , Sodio/análisis , Acridinas , Compuestos de Anilina , Colorantes Fluorescentes , Compuestos Orgánicos , Soluciones/química , Xantenos
13.
J Telemed Telecare ; 4 Suppl 1: 62-3, 1998.
Artículo en Inglés | MEDLINE | ID: mdl-9640740

RESUMEN

A telemedicine link was established in 1996 between the island of Inishmore and the department of psychiatry in University College Hospital, Galway. The link was mainly used to facilitate emergency consultations between patients on the island and the duty psychiatrist, always at the request of the island's general practitioner. Nine patients were referred for assessment in this manner over eight months. Three patients had their first psychiatric contact and assessment through the video-link, and were followed up as outpatients via the link to eventual resolution of the episode of illness and discharge at the outpatient clinic. Our experience has been that videoconferencing systems are acceptable and satisfactory for patients and staff alike.


Asunto(s)
Urgencias Médicas , Psiquiatría/métodos , Consulta Remota/métodos , Adulto , Anciano , Femenino , Humanos , Irlanda , Masculino , Persona de Mediana Edad
14.
Stereotact Funct Neurosurg ; 71(2): 62-75, 1998.
Artículo en Inglés | MEDLINE | ID: mdl-10087470

RESUMEN

OBJECTIVE: Since a simple, rapid and accurate stereotactic system allowing CT monitoring would offer the neurosurgeon several advantages, the feasibility and application accuracy of frameless laser-guided freehand point stereotaxis for neurosurgical interventions was studied. METHODS: A Cartesian coordinate grid mounted upon the far wall of a CT scan room defined a plane. The scanner isocenter defined the origin of a three-dimensional coordinate system. Phantom entry point and target point coordinates were determined by the positional CT cursor. These coordinates were entered into a computer which determined the coordinates of the grid intersection point with a line passing through the entry and target points. A tripod-mounted laser assembly comprising two encased lasers oriented retrograde and antegrade along opposite vectors, was positioned near the grid. The retrograde laser was positioned to illuminate the marked grid intersection point while the antegrade laser simultaneously illuminated the entry point; the beams were thereby aligned along the line of trajectory. The tip of a probe was placed on the entry point; the hub was then moved into the path of the antegrade laser, thereby aligning the probe with the line of trajectory. The probe was then inserted to the target at a trigonometrically calculated distance. RESULTS: Ten consecutive phantom tests averaged 17.5 min. Phantom test application accuracy averaged +/-2 mm at an average insertion distance of 7.1 cm. CONCLUSION: Phantom tests indicate that simple, rapid and accurate CT-monitored frameless laser-guided freehand point stereotaxis is feasible. Clinical investigation is warranted.


Asunto(s)
Terapia por Láser , Monitoreo Intraoperatorio/métodos , Fantasmas de Imagen , Técnicas Estereotáxicas , Tomografía Computarizada por Rayos X , Humanos , Procesamiento de Imagen Asistido por Computador , Reproducibilidad de los Resultados
15.
Stroke ; 25(1): 4-10, 1994 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-8266380

RESUMEN

BACKGROUND AND PURPOSE: We compared two-dimensional time-of-flight magnetic resonance angiography (MRA) and duplex ultrasonography with arteriography for the detection of 70% to 99% stenoses at the carotid artery bifurcation (ie, surgical disease according to findings of the North American Carotid Endarterectomy Trial). METHODS: Three blinded readers independently measured stenoses on MRA in 73 vessels from 38 patients. Duplex ultrasonography was available in 66 vessels from 35 of these patients, and blinded reading was performed by one reader. Comparison was made to arteriography. RESULTS: Magnetic resonance angiography demonstrated a sensitivity of 92.4%, specificity of 74.5%, and negative predictive value of 95.8% for 70% to 99% stenoses. Interobserver agreement was high (kappa = 0.91). Absence of signal at stenoses with evidence of distal flow usually, but not always, corresponded to surgical disease. Duplex ultrasonography demonstrated a sensitivity of 81.0%, specificity of 82.2%, and negative predictive value of 90.2% for surgical disease. There was no significant difference between MRA and duplex ultrasonography for the sensitivity or specificity in detecting 70% to 99% stenoses (P > .1, exact form of the McNemar test). MRA had no false positives or false negatives for complete occlusions of the carotid artery, whereas duplex ultrasonography missed one occlusion and falsely called two patent vessels occluded. In seven cases, both MRA and duplex ultrasonography overestimated stenoses to miscategorize them as surgical disease. CONCLUSIONS: Although the sensitivity and specificity of MRA and duplex ultrasonography are not significantly different for distinguishing surgical and nonsurgical degrees of stenosis at the carotid bifurcation, MRA has some advantages that may make it the screening test of choice. Concordant MRA and duplex ultrasonography for surgical disease does not necessarily obviate the need for catheter arteriography.


Asunto(s)
Arterias Carótidas/diagnóstico por imagen , Arterias Carótidas/patología , Estenosis Carotídea/diagnóstico por imagen , Estenosis Carotídea/diagnóstico , Imagen por Resonancia Magnética , Anciano , Anciano de 80 o más Años , Angiografía Cerebral , Ensayos Clínicos como Asunto , Endarterectomía Carotidea , Estudios de Evaluación como Asunto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ultrasonografía , Grado de Desobstrucción Vascular
16.
Ann Neurol ; 33(2): 222-5, 1993 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-8434886

RESUMEN

Over a 2-year period, we treated 4 postpartum patients with acute neurologic problems appearing 4 to 9 days after delivery. Three patients either had no proteinuria or edema and therefore did not meet all accepted clinical criteria for the diagnosis of eclampsia. Magnetic resonance imaging (MRI) of the brain in all patients demonstrated high-signal foci most prominent in the parieto-occipital regions and the subcortical white matter. Cerebral angiogram in 2 patients revealed diffuse vasospasm. In 3 patients, MRI abnormalities resolved. MRI and angiographic abnormalities in our patients are identical to those of patients meeting accepted criteria for eclampsia. Our experience suggests that the current criteria for the diagnosis of eclampsia are too stringent, both in terms of clinical picture and days postpartum to cerebral manifestations.


Asunto(s)
Encefalopatías/diagnóstico , Trastornos Cerebrovasculares/diagnóstico , Eclampsia/diagnóstico , Trastornos Puerperales/diagnóstico , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética , Embarazo , Factores de Tiempo
17.
Radiother Oncol ; 25(3): 153-9, 1992 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-1470691

RESUMEN

The cosmetic and functional results of breast conserving therapy were evaluated in a sample of 76 patients with early stage breast cancer, treated by wide local excision, axillary dissection and postoperative radiotherapy between 1975 and 1985. A comparison was made between patients' ratings, independent ratings by two observers (an oncology nurse and a radiation oncologist) and objective measurements. In approximately 40% of the cases, moderate to large differences in the appearance of the treated versus the untreated breast were reported by patients and clinical observers alike. When evaluated on an individual level, the observers' ratings showed relatively high inter-rater agreement (kappa = 0.64), but low levels of concordance were found between the patients' and observers' ratings (kappa < 0.10). Approximately half of the patients reported limited arm or shoulder function, generally mild in nature. Compared to the patients', the observers' ratings of arm edema were significantly lower, indicating 20% mild and 5% more severe swelling. Objective measures of cosmesis and function correlated moderately with the observers' and patients' ratings. Both cosmetic and functional results were found to be significantly related to time elapsed since treatment, with patients treated longer ago exhibiting more problems. The cosmetic and functional outcomes were not related to the patients' age. The results suggest that the patients' opinion can provide important additional information in the evaluation of cosmetic and functional results of breast conserving treatment.


Asunto(s)
Neoplasias de la Mama/psicología , Neoplasias de la Mama/terapia , Satisfacción del Paciente , Complicaciones Posoperatorias , Adulto , Anciano , Actitud del Personal de Salud , Neoplasias de la Mama/cirugía , Terapia Combinada , Estética , Femenino , Humanos , Escisión del Ganglio Linfático , Mastectomía Segmentaria , Persona de Mediana Edad , Enfermeras y Enfermeros , Radiología , Radioterapia
18.
Radiother Oncol ; 25(3): 160-6, 1992 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-1470692

RESUMEN

The relationship between cosmetic and functional results of breast conserving therapy and psychosocial functioning was examined in a sample of 76 patients with early stage breast cancer, who received treatment between 1975 and 1985. The patients were interviewed at their homes regarding breast cosmesis, arm functioning and psychosocial health, and subsequently attended the hospital for independent assessment of cosmetic and functional outcomes by clinical observers. High levels of psychological distress, disturbance of body image, and decreased sexual functioning were noted in approximately one-quarter of the study sample. About half of the patients expressed heightened concern with disease recurrence and their future health. Psychosocial problems were only modestly associated with treatment-related cosmetic and functional outcomes, as determined by clinical ratings and objective assessments. The patients' own ratings of breast cosmesis and arm functioning exhibited somewhat higher correlations with self-reported psychosocial functioning. In particular, a significant association was noted between the patients' ratings of overall cosmesis and arm edema and their body image (r = 0.48 and r = 0.43, respectively). The association between cosmetic and functional results and self-reported psychosocial health was strongest among those patients younger in age and treated longer ago. These findings suggest that, in order to evaluate the impact of breast conserving therapy on the patients' quality of life, the patients' own assessments of cosmetic and functional outcomes should be used as a primary source of information.


Asunto(s)
Neoplasias de la Mama/psicología , Neoplasias de la Mama/terapia , Calidad de Vida , Adulto , Anciano , Actitud Frente a la Salud , Imagen Corporal , Edema/etiología , Estética , Femenino , Humanos , Persona de Mediana Edad , Complicaciones Posoperatorias , Conducta Sexual
20.
Br J Radiol ; 58(688): 331-4, 1985 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-3877543

RESUMEN

A special-purpose collimator with holes which converge in the plane of rotation has been used together with an IGE 400A gamma camera and STAR computer system in order to achieve high-resolution single-photon emission computed tomography (SPECT). The variation in width and shape of the reconstructed line-spread function with position in the field of view was quantified. A comparison with parallel-geometry SPECT showed an improved resolution and sensitivity.


Asunto(s)
Tomografía Computarizada de Emisión/métodos , Matemática , Modelos Teóricos
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