Assuntos
Humanos , Masculino , Feminino , Radioimunoterapia/instrumentação , Radioimunoterapia/métodos , Isótopos de Ítrio , Radioisótopos de Ítrio , Linfoma não Hodgkin/diagnóstico , Medicina Nuclear/métodos , Medicina Nuclear/tendências , Radioimunoterapia/ética , Radioimunoterapia/estatística & dados numéricos , Radioimunoterapia/tendências , Linfoma não Hodgkin , Doença de Hodgkin/diagnóstico , Radioterapia/tendênciasAssuntos
Anticorpos Monoclonais/uso terapêutico , Imunoconjugados/uso terapêutico , Linfoma de Células B/radioterapia , Radioimunoterapia/métodos , Radioisótopos de Ítrio/uso terapêutico , Antígenos CD20/imunologia , Linfócitos B/imunologia , Linfócitos B/efeitos da radiação , Contraindicações , Esquema de Medicação , Humanos , Imunoconjugados/administração & dosagem , Imunoconjugados/efeitos adversos , Consentimento Livre e Esclarecido , Anamnese , Dosagem Radioterapêutica , Radioisótopos de Ítrio/administração & dosagem , Radioisótopos de Ítrio/efeitos adversosAssuntos
Artrite Infecciosa/diagnóstico por imagem , Transfusão de Leucócitos , Leucócitos , Osteomielite/diagnóstico por imagem , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Exametazima , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrite Infecciosa/etiologia , Artrite Infecciosa/fisiopatologia , Placas Ósseas/efeitos adversos , Quimiotaxia de Leucócito , Pré-Escolar , Pé Diabético/complicações , Pé Diabético/diagnóstico por imagem , Pé Diabético/cirurgia , Discite/diagnóstico por imagem , Feminino , Humanos , Prótese Articular/efeitos adversos , Masculino , Pessoa de Meia-Idade , Osteomielite/etiologia , Osteomielite/fisiopatologia , Complicações Pós-Operatórias/diagnóstico por imagem , Infecções Relacionadas à Prótese/diagnóstico por imagem , Cintilografia , Espondilite/diagnóstico por imagem , Infecção da Ferida Cirúrgica/diagnóstico por imagemRESUMO
Cerebral single-photon emission computed tomography (SPECT) is a sensitive technique for the detection of central nervous system (CNS) involvement in systemic lupus erythematosus (SLE). The objective was to determine whether a relationship exists between cerebral hypoperfusion as detected by cerebral SPECT, cumulative tissue damage and the clinical activity of SLE. Cerebral technetium-99m-L,L-ethyl cysteinate dimer (99mTc-ECD) SPECT was performed in two groups of patients: 10 women with SLE (Group A) who had no previous history of major neuropsychiatric (NPS) manifestations and no minor NPS symptoms in the last six months, and 57 unselected women with SLE (Group B). In the same week that SPECT was performed, the SLE disease activity index (SLEDAI), SLICC/ACR damage index, native anti-DNA antibodies (ELISA) and erythrocyte sedimentation rate (ESR) were determined. In Group A, cerebral SPECT showed moderate or severe hypoperfusion (abnormal SPECT) in five patients without NPS symptoms, unrelated to age (mean 24.8 versus 27.8 years) or disease duration (mean 6.8 versus 9 years). Patients with significant cerebral hypoperfusion had greater clinical disease activity (mean SLEDAI 13.6 versus 7.6) (SLEDAI > 7 in 5/5 versus 1/5; Fisher: 0.023; OR: 33; 95% CI: 2.3-469.8) and ESR (mean 43.6 versus 9.8; P < 0.05). In Group B, the mean age of the 57 unselected women with SLE was 37 years (SD 6.3) and the mean duration of the disease was 9.7 years (SD 6.3). Cerebral SPECT revealed normal perfusion or mild hypoperfusion (normal SPECT) in 30 patients (52.6%), and moderate or severe hypoperfusion in 27 (47.4%). Hypoperfusion was unrelated to age, duration of SLE or concentrations of anti-DNA antibodies and C3 and C4 fractions. Patients with significant cerebral hypoperfusion had more active clinical disease (mean SLEDAI 13.92; SD 8.44 versus 4.56; SD 4.15) (Mann-Whitney, P < 0.005), more cumulative tissue damage (mean SLICC 2.66; SD 2.84 versus 1.03; SD 1.51) (Mann-Whitney, P = 0.035), and higher ESR values (mean 28.7; SD 22.5 versus 17.7; SD 13.3) (Mann-Whitney, P = 0.023) than patients with normal SPECT studies. Significant cerebral hypoperfusion was related both to NPS manifestations present at the time of the study (17 of 27, 63% versus 3 of 30, 10%) (OR: 15.3) and cumulative manifestations (19 of 27, 70.4% versus 8 of 30, 26.7%) (OR: 6.5), whether mild (OR: 5.5) or severe (OR: 8.2). In conclusion, cerebral hypoperfusion detected by SPECT in patients with SLE is related to clinical activity (SLEDAI), cumulative tissue damage (SLICC) and concomitant or previous NPS manifestations.
Assuntos
Circulação Cerebrovascular , Cisteína/análogos & derivados , Lúpus Eritematoso Sistêmico/fisiopatologia , Tomografia Computadorizada de Emissão de Fóton Único , Adolescente , Adulto , Idoso , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/fisiopatologia , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/patologia , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Compostos de Organotecnécio , Compostos Radiofarmacêuticos , Índice de Gravidade de DoençaRESUMO
El Test de Supresion con Dexametasona (TSD) se ha propuesto como un marcador de estado de la melancolia, aunque existen resultados discrepantes seguin los autores. En nuestro trabajo, realizado con 117 pacientes hospitalizados diagnosticados de transtorno afectivo mayor y subclasificados seguin los criterios de Newcastle en endogenos (67) y no endogenos (50), encontramos una mayor frecuencia de respuestas anormales al TSD, en el grupo endogeno, aunque estos resultados no nos permitem afirmar que esta prueba pueda considerarse especifica de la depresion endogena.
Assuntos
Depressão , Transtorno Depressivo , Transtorno DepressivoRESUMO
The results of the overnight 1 mg dexamethasone suppression test (DST) administered to 26 unipolar delusional depressed patients and 47 unipolar non-delusional depressed controls are reported. There were no significant differences between the rates of abnormal responses in the two groups. However, there was a higher percentage of normal responses in the delusional depressive sample with mood incongruency. While 55% of the mood-congruent depressive patients were non-suppressors, only 12% of the depressed patients with mood-incongruent psychotic features had abnormal DST responses.
Assuntos
Delusões/diagnóstico , Transtorno Depressivo/diagnóstico , Dexametasona , Adulto , Delusões/sangue , Delusões/psicologia , Transtorno Depressivo/sangue , Transtorno Depressivo/psicologia , Diagnóstico Diferencial , Feminino , Humanos , Hidrocortisona/sangue , Masculino , Pessoa de Meia-Idade , Projetos de PesquisaRESUMO
We have studied the suppression of plasma cortisol after dexamethasone (1 mg) and the peak post-dexamethasone cortisol values in 84 hospitalized patients with a diagnosis of primary unipolar depression. The non-suppressor responses in the three familial subgroups (Winokur) were: 11/22 in familial pure depressive disorder (FPDD), 21/49 in sporadic depressive disease (SDD) and 1/13 in depression spectrum disease (DSD) (FPDD vs. SDD, p less than 0.05; SDD vs. DSD, p less than 0.05). When considering the peak post-dexamethasone cortisol value, or the 8.30-9.00-hour values, the results in the DSD group were lower than in the other two groups (p less than 0.05). These results suggest a different behaviour of DSD as compared with FPDD and SDD.
Assuntos
Transtorno Depressivo/genética , Dexametasona , Hidrocortisona/sangue , Hormônio Adrenocorticotrópico/sangue , Adulto , Transtorno Depressivo/sangue , Transtorno Depressivo/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação PsiquiátricaRESUMO
Prolactin (PRL) serum levels in a group of patients with acute schizophrenia (AS) and in a group of patients with chronic schizophrenia (CS) have been investigated in order to differentiate the dopaminergic sensitivity in response to chlorpromazine (CPZ) treatment. AS patients show both a greater dopaminergic sensitivity to CPZ and a stronger response in PRL secretion to TRH stimulation after a 14-day CPZ treatment.
