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Medicine (Baltimore) ; 99(10): e18954, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32150046


RATIONALE: In patients receiving biological therapies, serious infections are a major concern. Infections associated with anti-tumor necrosis factor antibody therapy include tuberculosis, viral, fungal, and bacterial infections. Likewise, severe infections of the upper and lower respiratory tract, lung, skin and soft tissue, urinary tract, gastrointestinal tract, joint, and bone have also been reported previously. However, infections involving the central nervous system are rare, especially an intracranial infection caused by odontogenic infection. To date, only few cases have been reported of this infection. This is the first case of a patient with psoriatic arthritis receiving adalimumab and developing brain abscess of odontogenic origin. PATIENT CONCERNS: A 39-year-old male with psoriatic arthritis receiving adalimumab treatment came to the emergency department with initial presentation of sudden onset convulsions. He had been receiving adalimumab treatment for 1 month. Two days after the third injection, the patient had an episode of sudden-onset general convulsion for nearly 5 min with the upgazing and general tonic presentation. Magnetic resonance imaging (MRI) showed left frontal lobe brain abscess. Pus culture from the brain abscess detected Streptococcus sanguinis (S. sanguinis), Fusobacterium nucleatum (F. nucleatum), and Parvimonas micra (P. micra). DIAGNOSIS: Brain abscess with odontogenic infection. INTERVENTIONS: The patient received left frontal craniotomy, abscess drainage and systemic empiric antibiotics treatment with vancomycin, cefepime, and metronidazole. Due to drug rash with eosinophilia and systemic symptoms during the treatment, vancomycin and metronidazole were discontinued, and systemic antibiotics were switched to teicoplanin and ceftriaxone. OUTCOMES: A brain MRI follow-up performed after 1 month of initial treatment revealed the reduced size of the abscess lesion and minimal oedema. The patient was discharged with stable condition. LESSONS: To the best of our knowledge, this is the first case of a patient with psoriatic arthritis receiving adalimumab and developing brain abscess of odontogenic origin. Such a rare diagnosis must be kept in mind when patients treated with adalimumab present with sudden-onset convulsions. Careful dental examination should be performed before administration of adalimumab.

Adalimumab/efectos adversos , Antirreumáticos/efectos adversos , Artritis Psoriásica/tratamiento farmacológico , Absceso Encefálico/diagnóstico , Cerebro , Adulto , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Absceso Encefálico/diagnóstico por imagen , Absceso Encefálico/etiología , Absceso Encefálico/microbiología , Ceftriaxona/administración & dosificación , Ceftriaxona/uso terapéutico , Terapia Combinada , Craneotomía , Diagnóstico Diferencial , Firmicutes/aislamiento & purificación , Fusobacterium nucleatum/aislamiento & purificación , Humanos , Imagen por Resonancia Magnética , Masculino , Periodontitis/complicaciones , Streptococcus/aislamiento & purificación , Teicoplanina/administración & dosificación , Teicoplanina/uso terapéutico
Adv Exp Med Biol ; 1232: 209-214, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31893412


Cognitive function is reported to improve by moderate aerobic exercise. However, the effects of intermittent exercise with rest between the moderate-intensity exercise are unclear. Therefore, this study aimed to compare the effects of continuous and intermittent exercise on cerebral oxygenation and cognitive function. This study included 18 healthy adults. For the continuous exercise protocol, 5 min of rest was followed by 30 min of exercise; 5 min of rest was allowed after each exercise. For the intermittent exercise protocol, 3 sets of 10 min of exercise were completed, with 5 min of rest between the sets. Exercise intensity was 50% of maximum oxygen uptake. Oxyhemoglobin (O2Hb) in the prefrontal cortex (PFC) was measured during each protocol, and cognitive tasks (Stroop test) were performed before and after exercise. O2Hb levels for the left and right PFCs were significantly higher post-exercise than pre-exercise for both exercise protocols (p < 0.01). The average reaction time in the Stroop test was significantly shorter post-exercise than pre-exercise for both protocols (p < 0.01). There was no significant difference in the error rate pre- and post-exercise for both protocols (continuous p = 0.22; intermittent p = 0.44). There was no significant difference between both protocols in all measurement results (O2Hb: p = 0.67; average reaction time p = 0.50; error rate p = 0.24). O2Hb was higher and average reaction time was shorter after exercise than before exercise for both exercise protocols. Intermittent and continuous exercise may improve cognitive function to the same degree after exercise.

Cerebro , Cognición , Ejercicio , Oxígeno , Espectroscopía Infrarroja Corta , Adulto , Cerebro/metabolismo , Cognición/fisiología , Humanos , Oxígeno/metabolismo , Consumo de Oxígeno
Adv Exp Med Biol ; 1232: 299-306, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31893424


Hypoxic ischemic encephalopathy (HIE) is a significant cause of death and neurological disability in newborns. Therapeutic hypothermia at 33.5 °C is one of the most common treatments in HIE and generally improves outcome; however 45-55% of injuries still result in death or severe neurodevelopmental disability. We have developed a systems biology model of cerebral oxygen transport and metabolism to model the impact of hypothermia on the piglet brain (the neonatal preclinical animal model) tissue physiology. This computational model is an extension of the BrainSignals model of the adult brain. The model predicts that during hypothermia there is a 5.1% decrease in cerebral metabolism, 1.1% decrease in blood flow and 2.3% increase in cerebral tissue oxygenation saturation. The model can be used to simulate effects of hypothermia on the brain and to help interpret bedside recordings.

Circulación Cerebrovascular , Cerebro , Hipotermia , Modelos Biológicos , Animales , Animales Recién Nacidos , Circulación Cerebrovascular/fisiología , Cerebro/metabolismo , Simulación por Computador , Humanos , Hipotermia Inducida , Hipoxia-Isquemia Encefálica , Porcinos
Arch. med ; 20(1): 226-241, 2020-01-18.
Artículo en Inglés | LILACS | ID: biblio-1053287


This paper aims at pointing out the contributions of Edgar Morin´s complexity theory for the study of the brain. According to Morin, the brain is a unity of multiplicities, "Unitas multiplex," given that it works through dialog and sociocultural, genetic brain domains converge within it, from which multiple ecosystem religares emerge, which turn it into the core of the phenomenal association, shaping, and reproduction. The brain is polycentric, poly-phenomenal and multidimensional; order­chaos­organization come together as a result of a recursive, recurrent, organizational operation..(AU)

Este es un artículo de reflexión que tiene como objetivo señalar los aportes de la teoría de la complejidad de Edgar Morin al estudio del cerebro. Para Morin el cerebro es unidad de multiplicidades «unitas multiplex¼ dado que, funciona dialógicamente y en él convergen dominios genético-cerebro-socioculturales, de los cuales emergen múltiples religares ecosistémicos, los cuales lo constituyen en el centro de asociación, formación y reproducción fenoménica. El cerebro es policéntrico, polifenoménico y multidimensional, en él se reúnen orden-caos-organización a partir de un funcionamiento recursivo-recurrente-organizacional..(AU)

J Stroke Cerebrovasc Dis ; 29(1): 104454, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31699572


BACKGROUND AND PURPOSE: Transcranial direct current stimulation (tDCS) is a treatment used in the rehabilitation of stroke patients aiming to improve functionality of the plegic upper extremity. Currently, tDCS is not routinely used in post stroke rehabilitation. The aim of this study was to establish the effects of bihemspheric tDCS combined with physical therapy (PT) and occupational therapy (OT) on upper extremity motor function. METHODS: Thirty-two stroke inpatients were randomised into 2 groups. All patients received 15 sessions of conventional upper extremity PT and OT over 3 weeks. The tDCS group (n = 16) also received 30 minutes of bihemispheric tDCS and the sham group (n = 16) 30 minutes of sham bihemispheric tDCS simultaneously to OT. Patients were evaluated before and after treatment using the Fugl Meyer upper extremity (FMUE), functional independence measure (FIM), and Brunnstrom stages of stroke recovery (BSSR) by a physiatrist blind to the treatment group RESULTS: The improvement in FIM was higher in the tDCS group compared to the sham group (P = .001). There was a significant within group improvement in FMUE, FIM and BSSR in those receiving tDCS (P = .001). There was a significant improvement in FIM in the chronic (> 6months) stroke sufferers who received tDCS when compared to those who received sham tDCS and when compared to subacute stroke (3-6 months) sufferers who received tDCS/sham. CONCLUSIONS: Upper extremity motor function in hemiplegic stroke patients improves when bihemispheric tDCS is used alongside conventional PT and OT. The improvement in functionality is greater in chronic stroke patients.

Cerebro/fisiopatología , Actividad Motora , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/terapia , Estimulación Transcraneal de Corriente Directa , Extremidad Superior/inervación , Actividades Cotidianas , Adolescente , Adulto , Anciano , Evaluación de la Discapacidad , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Terapia Ocupacional , Modalidades de Fisioterapia , Estudios Prospectivos , Recuperación de la Función , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Turquia , Adulto Joven
J Stroke Cerebrovasc Dis ; 29(2): 104488, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31787498


BACKGROUND: We aimed to assess the correlation of lesion location and clinical outcome in patients with large hemispheric infarction (LHI). METHODS: We analyzed admission MRI data from the GAMES-RP trial, which enrolled patients with anterior circulation infarct volumes of 82-300 cm3 within 10 hours of onset. Infarct lesions were segmented and co-registered onto MNI-152 brain space. Voxel-wise general linear models were applied to assess location-outcome correlations after correction for infarct volume as a co-variate. RESULTS: We included 83 patients with known 3-month modified Rankin scale (mRS). In voxel-wise analysis, there was significant correlation between admission infarct lesions involving the anterior cerebral artery (ACA) territory and its middle cerebral artery (MCA) border zone with both higher 3-month mRS and post-stroke day 3 and 7 National Institutes of Health Stroke Scale (NIHSS) total score and arm/leg subscores. Higher NIHSS total scores from admission through poststroke day 2 correlated with left MCA infarcts. In multivariate analysis, ACA territory infarct volume (P = .001) and admission NIHSS (P = .005) were independent predictors of 3-month mRS. Moreover, in a subgroup of 36 patients with infarct lesions involving right MCA-ACA border zone, intravenous (IV) glibenclamide (BIIB093; glyburide) treatment was the only independent predictor of 3-month mRS in multivariate regression analysis (P = .016). CONCLUSIONS: Anterior extension of LHI with involvement of ACA territory and ACA-MCA border zone is an independent predictor of poor functional outcome, likely due to impairment of arm/leg motor function. If confirmed in larger cohorts, infarct topology may potentially help triage LHI patients who may benefit from IV glibenclamide. CLINICAL TRIAL REGISTRATION: URL: Unique identifier: NCT01794182.

Arteria Cerebral Anterior/diagnóstico por imagen , Cerebro/irrigación sanguínea , Imagen de Difusión por Resonancia Magnética , Extremidades/inervación , Infarto de la Arteria Cerebral Anterior/diagnóstico por imagen , Infarto de la Arteria Cerebral Media/diagnóstico por imagen , Arteria Cerebral Media/diagnóstico por imagen , Administración Intravenosa , Anciano , Arteria Cerebral Anterior/fisiopatología , Circulación Cerebrovascular , Ensayos Clínicos como Asunto , Ensayos Clínicos Fase II como Asunto , Evaluación de la Discapacidad , Femenino , Gliburida/administración & dosificación , Humanos , Hipoglucemiantes/administración & dosificación , Infarto de la Arteria Cerebral Anterior/fisiopatología , Infarto de la Arteria Cerebral Anterior/terapia , Infarto de la Arteria Cerebral Media/fisiopatología , Infarto de la Arteria Cerebral Media/terapia , Masculino , Persona de Mediana Edad , Arteria Cerebral Media/fisiopatología , Admisión del Paciente , Valor Predictivo de las Pruebas , Recuperación de la Función , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Estados Unidos
Acta Neurochir Suppl ; 127: 185-190, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31407083


The purpose was to determine the status of the cerebral arterial compliance (cAC) in a concomitant head injury and cerebral vasospasm (CVS) with and without the development of intracranial hematomas (ICH). In Materials and Methods, we examined 80 polytrauma patients with severe TBI and CVS. During or immediately after dynamic helical computed tomography angiography (DHCTA), the monitoring of the transcranial Doppler of the MCA was recorded bilaterally with 2-MHz probes. The cerebral blood volumes were calculated from the DHCTA data with complex mathematical procedures using the "direct flow model" algorithm. In Results, CAC was significantly decreased (p < 0.001) in both the first and second group TBI and CVS (with or without ICH) in comparison with normal data (p < 0.001) and TBI without CVS. The cAC was significantly decreased on the side of the former hematoma with CVS than on the contralateral side with CVS (р = 0.003). In Conclusion, the cAC in TBI and CVS gets significantly lower as compared to the normal condition (p < 0.001). After removal of the ICH and development of CVS, the compliance in the perifocal zone remains much lower (р = 0.003) as compared to compliance of the other brain hemisphere.

Arterias Cerebrales , Cerebro , Traumatismos Craneocerebrales , Hemorragia Subaracnoidea , Rigidez Vascular , Vasoespasmo Intracraneal , Arterias Cerebrales/fisiopatología , Humanos , Ultrasonografía Doppler Transcraneal
J Shoulder Elbow Surg ; 29(1): 79-85, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31405715


BACKGROUND: The beach chair position is commonly used when performing shoulder arthroplasty. However, this position has been associated with hypotension, potentially leading to cerebral hypoperfusion, which may cause neurologic injury. In addition, shoulder arthroplasty cases are associated with longer operative times, posing a potentially greater risk of cerebral hypoperfusion. We aim to evaluate the risk of cerebral desaturation events (CDEs) during the course of total shoulder arthroplasty. METHODS: Twenty-six patients undergoing shoulder arthroplasties were monitored for changes in cerebral perfusion. Seven specific time-points during the procedure were labeled for comparison of events: baseline, beach chair, incision, humeral broaching, glenoid reaming, glenoid component implantation, and humeral component implantation. Cerebral oxygen perfusion was measured using near-infrared spectroscopy. A CDE was described as a decrease of oxygen saturation greater than 20%. RESULTS: Nineteeen of 25 subjects experienced a CDE. 42% of these patients experienced CDEs during semi-beach chair positioning. Patients experienced the largest oxygen saturation drop during semi-beach chair positioning. Transition from baseline to semi-beach chair was the only event to have a statistically significant decrease in cerebral perfusion (8%, P < .05). There was a statistically significant percentage change in mean oxygen saturation in the semi-beach chair interval (10%, P < .01) and the semi-beach chair to incision interval (7%, P < .01). CONCLUSIONS: Most patients experienced an intraoperative CDE, with greatest incidence during semi-beach chair positioning. The largest decline in cerebral oxygen saturation occurred during semi-beach chair positioning. Implant implantation was not associated with decrease in cerebral oximetry.

Artroplastía de Reemplazo de Hombro , Cerebro/metabolismo , Oxígeno/metabolismo , Posicionamiento del Paciente , Anciano , Circulación Cerebrovascular , Femenino , Humanos , Hipotensión/etiología , Hipotensión/fisiopatología , Masculino , Persona de Mediana Edad , Oximetría , Posicionamiento del Paciente/efectos adversos , Estudios Prospectivos , Espectroscopía Infrarroja Corta
Clin Ter ; 170(1): e7-e10, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31850477


Whiplash injuries, a common sequel of road traffic accidents, may be defined as a musculo-ligamentous sprain resulting from forced acceleration/deceleration and flexion/ extension neck injury. We report a non-fatal case of vertebral right artery dissection after a minor rear-lateral collision. The injury was detected twenty-four days after trauma when a computerized tomography (CT) scan and cerebral angiography revealed multiple ischemic lesions of the right cerebellum. Digital subtraction angiography (DSA) has been the most sensitive imaging modality to describe the types and degree of vascular injury. The accuracy of such imaging allows linking several injuries with minor car crash avoiding patients seeking litigation for correct financial compensation.

Cerebro/diagnóstico por imagen , Arteria Vertebral/cirugía , Lesiones por Latigazo Cervical/diagnóstico , Lesiones por Latigazo Cervical/cirugía , Accidentes de Tránsito , Adulto , Humanos , Italia , Masculino , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Adulto Joven
Brain Nerve ; 71(12): 1341-1347, 2019 Dec.
Artículo en Japonés | MEDLINE | ID: mdl-31787623


My study has been a chain of successes and failures, including those of cerebellar efferent system and laminar dependency of visual cortical circuitry and plasticity. It could have never been in existence but for Professor Masao Ito.

Cerebelo/fisiología , Cerebro/fisiología , Plasticidad Neuronal , Corteza Visual/fisiología , Humanos
Brain Nerve ; 71(12): 1391-1396, 2019 Dec.
Artículo en Japonés | MEDLINE | ID: mdl-31787628


Comment Professor Masao Ito's last lecture, delivered at the University of Tokyo Faculty of Medicine on March 7, 1989, is reproduced here in an abridged form. Its original title was "the Cerebellum and Cerebrum," and this lecture was a real masterpiece, full of insights and suggestions on brain functions, together with humorous phrases here and there. When I tried to reproduce this lecture by using all figures at that time, just one week after Professor Ito passed away, I was struck by his foresight even after thirty years. I deeply appreciate his family's permission for the reproduction.

Cerebelo/fisiología , Cerebro/fisiología , Neurociencias/historia , Historia del Siglo XX , Humanos
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 30(6): 305-308, nov.-dic. 2019. ilus
Artículo en Español | IBECS | ID: ibc-186961


Presentamos el caso de una mujer de 52 años, sin antecedentes de interés, que fue derivada a nuestro centro tras ser diagnosticada de una lesión ocupante de espacio en el hemisferio cerebeloso derecho. La sospecha inicial era de metástasis. En la RMN cerebral, sin embargo, se apreciaba una marcada restricción en la secuencia de difusión concordante con un absceso cerebeloso. La paciente se había sometido a una limpieza dental tres semanas antes. El análisis microbiológico tras la evacuación quirúrgica de la lesión mostró la presencia de Streptococcus intermedius

A 52-year-old woman with no relevant previous medical history was diagnosticated of an infratentorial bulky cerebellar mass. The mass showed restricted diffusion on MR images, which was consistent with cerebellar abscess. The patient had undergone a minor dental procedure three weeks before. Microbiological analysis after surgical evacuation of the mass confirmed the presence of Streptococcus intermedius

Humanos , Femenino , Persona de Mediana Edad , Profilaxis Dental/efectos adversos , Streptococcus intermedius/patogenicidad , Fosa Craneal Posterior/diagnóstico por imagen , Absceso/microbiología , Fosa Craneal Posterior/patología , Cerebro/diagnóstico por imagen , Cerebro/patología , Craneotomía/métodos , Neuroimagen/métodos , Absceso/tratamiento farmacológico
ABCS health sci ; 44(2): 120-130, 11 out 2019. tab, ilus
Artículo en Portugués | LILACS | ID: biblio-1022353


O número de indivíduos diagnosticados com o transtorno do espectro autista (TEA) registrou aumento evidente na última década. Os principais sintomas, apresentados pelo portador, são neurológicos e digestórios, estando às intervenções nutricionais dentre as terapêuticas mais promissoras para amenizar a sintomatologia clínica. Assim, objetivou-se revisar sistematicamente os estudos sobre distúrbios alimentares e do trato gastrointestinal apresentado pelo indivíduo portador do TEA, a fim de compreender como o comportamento alimentar influência na etiopatogênese e manifestações clínicas da doença, com foco no eixo intestinocérebro. Para isso realizou-se uma revisão sistemática, seguindo as diretrizes PRISMA. A partir de uma busca estruturada e abrangente em bases de dados eletrônicas, 23 estudos foram recuperados e incluídos na revisão. Os critérios de inclusão definiam ser artigos originais relacionando o TEA com alterações nutricionais e/ou com o eixo intestino-cérebro. Após análise da composição da microbiota intestinal, os estudos mostraram um quadro de desequilíbrio. Foram encontradas, também, alterações na barreira de muco e permeabilidade intestinal e alterações em proteínas envolvidas na digestão e absorção de alimentos. Dietas restritivas e a modulação da microbiota, com uso de probióticos e de antibióticos específicos, são apresentadas como estratégias terapêuticas adjuvantes promissoras. Conclui-se que o eixo intestino-cérebro está envolvido tanto na etiologia, quanto nas manifestações clínicas do TEA. Porém, não sendo certo se alterações intestinais são causa ou consequência das alterações neurológicas. Até o presente momento, a comunidade científica não tem conclusões suficientes para indicar o uso de dietas restritivas, e uso de probióticos e de antibióticos como terapêutica para o TEA.

The number of individuals diagnosed with autism spectrum disorder (ASD) had an evident increase in the last decade. The primary symptoms exhibited amongst these patients were mostly digestive and neurological disorders; with nutritional interventions being one of the most promising therapies to assuage this clinical symptomology. As such, following the PRISMA guidelines, we systematically reviewed the research studies apropos of the ASD patients manifesting said digestive disorders, to comprehend how dietary behavior can influence the etiopathogenesis and clinical manifestations of the disease, with primary focus on the gut-brain axis. From a comprehensive and structured search through electronic databases, 23 studies were retrieved and admitted in this review. The inclusion criteria defined that there be original articles consociating ASD with nutritional disorders and/or with the gut-brain axis. These studies analyzed the composition of the intestinal flora of diagnosed patients, subsequently discerning cases of varying imbalances. Alterations in the gene expression of the proteins involved in the digestion and absorption of food, the mucous barrier and the intestinal permeability were described. Accordingly, restrictive diets and the modulation of the microbiota by administering specific anti- & probiotics were initially identified as promissory therapies. In conclusion, the gut-brain axis was observed to be a determinant factor in both the etiology and clinical symptomology of ASD - though it is still debatable the correlation of intestinal alterations with neurological changes. At present, there is no concrete scientific proof accrediting to restrictive diets and the use of specific anti- & probiotics, as successful treatments for ASD.

Humanos , Preescolar , Niño , Ciencias de la Nutrición del Niño , Cerebro , Trastorno del Espectro Autista , Intestinos , Neurotoxinas , Pediatría
Fa Yi Xue Za Zhi ; 35(4): 393-395, 2019 Aug.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-31532144


Abstract: Objective To explore the relationship between the electrical conductivity (EC) and biochemical indicators of rat cerebrum tissues and postmortem intervals (PMIs) and discuss the mechanism of applying EC to infer PMI. Methods Forty healthy Sprague-Dawley rats were sacrificed and stored in an environment of about 25 ℃. The whole cerebrum tissues of rats were removed respectively at different PMIs of 0, 1, 2, 3, 4, 5, 6, and 7 d, and then made into homogenized impregnation solution. The EC and related biochemical indicators (potassium, sodium, chloride, calcium, inorganic phosphorus, magnesium, uric acid, urea nitrogen and creatinine) in cerebrum tissue impregnation solution were determined, and the relationships among EC in impregnation solution, related biochemical indicators and PMI were analyzed. Results The EC in cerebrum tissues increased gradually with the extension of PMI, and the content of uric acid, urea nitrogen and inorganic phosphorus in its impregnation solution also increased gradually with the extension of PMI. The correlation of EC, uric acid, urea nitrogen, and inorganic phosphorus with PMI was relatively good (R2 was 0.95-0.99), and there was a linear correlation between the content change of uric acid, urea nitrogen, inorganic phosphorus and EC (R2 was 0.97-0.99). The changes of the other 6 kinds of biochemical indicators with the extension of PMI within 7 d after the rats' death were non-significant (P>0.05). Conclusion The correlation between EC in cerebrum tissues, uric acid, urea nitrogen, inorganic phosphorus and PMI were relatively good, and combining various indicators can also improve the accuracy of PMI estimation.

Cerebro/patología , Conductividad Eléctrica , Cambios Post Mortem , Animales , Patologia Forense , Ratas , Ratas Sprague-Dawley , Factores de Tiempo
Pregnancy Hypertens ; 17: 121-126, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31487628


OBJECTIVES: Preeclampsia is a pregnancy-related hypertensive disorder with endothelial dysfunction. Impaired cerebral autoregulation may lead to symptomatic cerebral hyperperfusion, which sometimes manifests not until after delivery. This study investigated, whether cerebral autoregulation was altered after delivery in healthy and preeclamptic women, and whether this associated with cerebral hyperperfusion. STUDY DESIGN: In a prospective study, 35 preeclamptic and 35 healthy women were examined with transcranial Doppler within 10 days postpartum and 6 months later. Continuous arterial blood pressure and cerebral blood flow velocities (CBFV) in the middle (MCA) and posterior cerebral arteries (PCA) were recorded at rest. MAIN OUTCOME MEASURES: Dynamic cerebral autoregulation was assessed upon regular breathing at 0.1 Hz via transfer function phase and gain between arterial blood pressure and CBFV oscillations. RESULTS: In preeclamptic women, phase was reduced after delivery in both, MCA and PCA. During the postpartum period, CBFV of the MCA, but not PCA, correlated with higher arterial blood pressure and poorer dynamic cerebral autoregulation. In healthy women with only moderately altered cerebral autoregulation, CBFV remained in the normal range. At both measurements, arterial blood pressure was higher in preeclamptic compared to healthy women. CONCLUSIONS: Women with preeclampsia had poorer cerebral autoregulation and an increased risk of transient cerebral hyperperfusion after delivery.

Cerebro/fisiopatología , Parto Obstétrico , Preeclampsia/fisiopatología , Trastornos Puerperales/fisiopatología , Adulto , Velocidad del Flujo Sanguíneo , Estudios de Casos y Controles , Circulación Cerebrovascular , Femenino , Homeostasis , Humanos , Periodo Posparto , Embarazo , Ultrasonografía Doppler Transcraneal
Archives ; 41: 101419, set. 2019.
Artículo en Inglés | Sec. Est. Saúde SP, SESSP-IPPROD, Sec. Est. Saúde SP | ID: biblio-1021629


The present study sought to characterize the phenomena involved in the histopathology of rabies and to assess the presence and amount of viral antigen in situ in different brain regions of naturally infected equines and bovines. The histopathological examination showed several changes due to inflammation, being most often infected cells neurons. The neuronal degeneration involved 100% of cases, in addition to a diffuse lymphocytic Infiltration and gliosis, characterized by vasculitis and perivasculitis. The presence of Negri bodies was in most cases in discreet, and the fragments with higher concentrations of antigen by both techniques employed were the cerebellum and the brain stem. Immunohistochemistry test (IHC) demonstrated greater sensitivity when applied to samples of bovines. Our results showed that in 37.5% of the total number of fragments analyzed, viral inclusions were not observed, however, was the presence of inflammatory process. In relation to the species, the fragments from bovine's animals showed a slight increase when examined under this feature. These findings highlight the importance of submitting samples from suspected animals for laboratory diagnostic, even when there are no apparent abnormal histological findings. (AU)

O presente estudo buscou caracterizar os fenômenos envolvidos na histopatologia da raiva e avaliar a presença e quantidade de antígeno viral in situ nas diferentes regiões cerebrais de equinos e bovinos naturalmente infectados. O exame histopatológico demonstrou várias mudanças devido à inflamação, sendo mais frequentemente infectadas as células neuronais. A degeneração neuronal foi observada em 100% dos casos, além de uma infiltração linfocitária difusa e gliose, caracterizada por vasculite e perivasculite. A presença de corpúsculos de Negri foi observada na maioria dos casos de maneira discreta, e os fragmentos com maior concentração de antígeno, por ambos os testes empregadas foram o cerebelo e o tronco encefálico. O teste de Imuno-histoquímica (IHC) demonstrou maior sensibilidade quando aplicada em amostras de bovinos. Nossos resultados demostraram que em 37,5% do número total de fragmentos analisados, inclusões virais não foram observadas, no entanto, havia processo inflamatório. Em relação à espécie, os fragmentos de bovinos demonstraram um ligeiro aumento quando examinado sob este aspecto. Esses achados destacam a importância de submeter amostras de animais suspeitos para diagnóstico laboratorial, mesmo quando não houver nenhum achado histopatológico anormal.Palavras-chave: raiva, equinos, bovinos, imuno-histoquímica, IFD, alterações histopatológicas. (AU)

Animales , Rabia/patología , Inmunohistoquímica/métodos , Virus de la Rabia/inmunología , Bovinos , Equidae , Cerebro/patología
Eur. j. anat ; 23(5): 361-368, sept. 2019. ilus
Artículo en Inglés | IBECS | ID: ibc-183866


Peg10 (paternally expressed 10) is a retrotransposon-derived gene that is highly conserved across mammalian species. Peg10 is involved in cell proliferation and differentiation, and is essential for placenta formation in mice. Although a number of studies have examined Peg10 expression in the placenta, its cellular localization in the brain is still unclear. The function of Peg10 in the brain is also unknown. Here, we examined Peg10 distribution in the mouse brain. In situ hybridization revealed intense expression of the gene in the core region of the accumbens nucleus, lateral division of the bed nucleus of the stria terminalis, medial preoptic nucleus, paraventricular nucleus, arcuate nucleus, dorsomedial hypothalamic nucleus, premammillary nucleus, central amygdaloid nucleus and lateral parabrachial nucleus. Moderate to intense expression of Peg10 was also observed in monoaminergic nuclei such as the substantia nigra, dorsal raphe nucleus and locus coeruleus. These results suggest that Peg10 may play a role in motivational processes, emotional regulation, and autonomic functions in the brain. The findings also suggest that Peg10 may have contributed to the evolution of mammals, not only by participating in placenta formation, but also by regulating parental behavior and hormonal secretions necessary for maternal responsiveness

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Animales , Ratones , Cerebro/anatomía & histología , Hipotálamo/anatomía & histología , Sistema Límbico/anatomía & histología , Proteínas/genética , Hibridación Fluorescente in Situ/veterinaria , Hipocampo/anatomía & histología , Diencéfalo/anatomía & histología
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 30(4): 167-172, jul.-ago. 2019. ilus, tab
Artículo en Inglés | IBECS | ID: ibc-183582


Introduction and objectives: This study aims at presenting our experience of the MRI-guided frame-based stereotactic brainstem biopsy method, and evaluating the outcomes of the procedure. Patients and methods: The current study involved 18 cases that underwent MRI-guided frame-based stereotactic biopsy for brainstem lesions between 2011 and 2018 in our clinic. The relevant data regarding the technique of the biopsy procedure, morbidity, histopathological diagnosis it yields and diagnostic accuracy was retrospectively analyzed. Results: Stereotactic biopsy procedure was performed on 18 patients, including 16 adults and two children. MRI was used as guidance for the biopsy procedure in all patients. The adult patients had the biopsy under local anesthesia; as for the pediatric patients local anesthesia plus sedation was used. All patients received diagnosis based on the histopathological examination of their biopsy samples. No equivocal or negative results, and no major morbidity or mortality was seen in the patients after the procedure. Conclusions: MRI-guided frame-based stereotactic biopsy can be considered as a safe and efficient diagnostic method for brainstem lesions when its diagnostic yield and its morbidity and/or mortality rates are evaluated. Choosing the best trajectory for each lesion, using MRI as guidance for targeting, taking a limited number of biopsy samples are valuable criteria for the decreased morbidity rates in stereotactic brainstem biopsy procedures

Introducción y objetivos: Este estudio tiene como objetivo presentar nuestra experiencia del método estereotáctico de biopsia del tronco encefálico guiado por IRM, y evaluar los resultados del procedimiento. Pacientes y métodos: El estudio actual incluyó 18 casos que se sometieron a biopsia estereotáctica basada en un marco guiada por IRM para lesiones del tronco encefálico entre 2011 y 2018 en nuestra clínica. Los datos relevantes con respecto a la técnica del procedimiento de biopsia, la morbilidad, el diagnóstico histopatológico que produce y la precisión diagnóstica se analizaron retrospectivamente. Resultados: Se realizó un procedimiento de biopsia estereotáctica en 18 pacientes, incluidos 16 adultos y 2 niños. La RM se utilizó como guía para el procedimiento de biopsia en todos los pacientes. Los pacientes adultos se hicieron la biopsia bajo anestesia local; en cuanto a los pacientes pediátricos se utilizó anestesia local más sedación. Todos los pacientes recibieron un diagnóstico basado en el examen histopatológico de sus muestras de biopsia. No hubo resultados equívocos ni negativos, y no se observó una mayor morbilidad o mortalidad en los pacientes después del procedimiento. Conclusiones: La biopsia estereotáctica basada en un marco guiada por IRM se puede considerar como un método de diagnóstico seguro y eficiente para las lesiones del tronco cerebral cuando se evalúa su rendimiento diagnóstico y sus tasas de morbilidad y/o mortalidad. La elección de la mejor trayectoria para cada lesión, utilizando la RM como guía para la selección, tomando un número limitado de muestras de biopsia, son criterios valiosos para la disminución de las tasas de morbilidad en los procedimientos de biopsia estereotáctica del tronco cerebral

Humanos , Masculino , Femenino , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Tronco Encefálico/diagnóstico por imagen , Reproducibilidad de los Resultados , Técnicas Estereotáxicas , Biopsia/métodos , Procedimientos Neuroquirúrgicos/métodos , Cerebro/patología , Espectroscopía de Resonancia Magnética , Estudios Retrospectivos , Tronco Encefálico/patología , Neoplasias Encefálicas/diagnóstico