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1.
Clin Liver Dis ; 28(2): 237-252, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38548436

RESUMO

Minimal hepatic encephalopathy (MHE) is a pervasive frequent complication of cirrhosis of any etiology. The diagnosis of MHE is difficult as the standard neurologic examination is essentially within normal limits. None of the symptoms and signs of overt HE is present in a patient with MHE, such as confusion, disorientation, or asterixis. Progress has been made in diagnostic tools for detection of attention and cognitive deficits at the point of care of MHE. The development of MHE significantly impacts quality of life and activities of daily life in affected patients including driving motor vehicles and machine operation.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Encefalopatia Hepática , Humanos , Encefalopatia Hepática/diagnóstico , Encefalopatia Hepática/etiologia , Encefalopatia Hepática/terapia , Qualidade de Vida , Cirrose Hepática/complicações , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia
2.
Breast J ; 27(9): 706-714, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34235801

RESUMO

Cardiovascular disease remains a leading cause of death in women. 10-year likelihood for a cardiovascular event is determined by the American College of Cardiology Atherosclerotic Cardiovascular disease risk score calculator (ASVCD); however, this does not encompass risk factors unique to women. Breast arterial calcifications (BAC) detected on screening mammography may serve as a proxy for coronary atherosclerosis (CAC) in women. Our purpose was to investigate the correlation between BAC and CAC on imaging in women without a diagnosis of atherosclerosis to determine the potential clinical impact. Retrospective review was performed on a cohort of females evaluated by internists at our institution in 2019. Study patients had a screening mammogram within 1 year of a noncardiac chest CT. Clinical data were collected to determine ASCVD risk score. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of BAC in detecting CAC were determined. 222 women met inclusion criteria, ranging from 41 to 77 years of age, among which 25% (56/222) had BAC. 84% (47/56) of women with BAC had CAC on CT, yielding a sensitivity, specificity, PPV, and NPV of 51%, 93%, 84%, and 72%, respectively. Of the 47 patients who had both BAC and CAC, 66% had an unknown or low-to-borderline ASCVD score. Women with BACs have a high specificity for CAC. The reporting of BACs should prompt clinicians to risk stratify women for atherosclerotic disease. These women may otherwise be undetected by conventional risk calculators.


Assuntos
Neoplasias da Mama , Doença da Artéria Coronariana , Mama/diagnóstico por imagem , Doença da Artéria Coronariana/diagnóstico por imagem , Detecção Precoce de Câncer , Feminino , Humanos , Mamografia , Estudos Retrospectivos
4.
Sci Rep ; 10(1): 2737, 2020 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-32066765

RESUMO

Astronauts on interplanetary missions - such as to Mars - will be exposed to space radiation, a spectrum of highly-charged, fast-moving particles that includes 56Fe and 28Si. Earth-based preclinical studies show space radiation decreases rodent performance in low- and some high-level cognitive tasks. Given astronaut use of touchscreen platforms during training and space flight and given the ability of rodent touchscreen tasks to assess functional integrity of brain circuits and multiple cognitive domains in a non-aversive way, here we exposed 6-month-old C57BL/6J male mice to whole-body space radiation and subsequently assessed them on a touchscreen battery. Relative to Sham treatment, 56Fe irradiation did not overtly change performance on tasks of visual discrimination, reversal learning, rule-based, or object-spatial paired associates learning, suggesting preserved functional integrity of supporting brain circuits. Surprisingly, 56Fe irradiation improved performance on a dentate gyrus-reliant pattern separation task; irradiated mice learned faster and were more accurate than controls. Improved pattern separation performance did not appear to be touchscreen-, radiation particle-, or neurogenesis-dependent, as 56Fe and 28Si irradiation led to faster context discrimination in a non-touchscreen task and 56Fe decreased new dentate gyrus neurons relative to Sham. These data urge revisitation of the broadly-held view that space radiation is detrimental to cognition.


Assuntos
Cognição/efeitos da radiação , Radiação Cósmica , Giro Denteado/efeitos da radiação , Aprendizagem por Associação de Pares/efeitos da radiação , Reconhecimento Visual de Modelos/efeitos da radiação , Reversão de Aprendizagem/efeitos da radiação , Animais , Astronautas , Ciências Biocomportamentais , Cognição/fisiologia , Giro Denteado/fisiologia , Isótopos de Ferro , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Neurônios/citologia , Neurônios/fisiologia , Neurônios/efeitos da radiação , Aprendizagem por Associação de Pares/fisiologia , Reconhecimento Visual de Modelos/fisiologia , Reversão de Aprendizagem/fisiologia , Voo Espacial , Irradiação Corporal Total
5.
Int J Mol Sci ; 19(10)2018 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-30304778

RESUMO

High-charge and -energy (HZE) particles comprise space radiation and they pose a challenge to astronauts on deep space missions. While exposure to most HZE particles decreases neurogenesis in the hippocampus-a brain structure important in memory-prior work suggests that 12C does not. However, much about 12C's influence on neurogenesis remains unknown, including the time course of its impact on neurogenesis. To address this knowledge gap, male mice (9⁻11 weeks of age) were exposed to whole-body 12C irradiation 100 cGy (IRR; 1000 MeV/n; 8 kEV/µm) or Sham treatment. To birthdate dividing cells, mice received BrdU i.p. 22 h post-irradiation and brains were harvested 2 h (Short-Term) or three months (Long-Term) later for stereological analysis indices of dentate gyrus neurogenesis. For the Short-Term time point, IRR mice had fewer Ki67, BrdU, and doublecortin (DCX) immunoreactive (+) cells versus Sham mice, indicating decreased proliferation (Ki67, BrdU) and immature neurons (DCX). For the Long-Term time point, IRR and Sham mice had similar Ki67+ and DCX+ cell numbers, suggesting restoration of proliferation and immature neurons 3 months post-12C irradiation. IRR mice had fewer surviving BrdU+ cells versus Sham mice, suggesting decreased cell survival, but there was no difference in BrdU+ cell survival rate when compared within treatment and across time point. These data underscore the ability of neurogenesis in the mouse brain to recover from the detrimental effect of 12C exposure.


Assuntos
Giro Denteado/citologia , Giro Denteado/efeitos da radiação , Células Piramidais/metabolismo , Células Piramidais/efeitos da radiação , Irradiação Corporal Total , Animais , Biomarcadores , Isótopos de Carbono , Contagem de Células , Proliferação de Células , Sobrevivência Celular , Proteína Duplacortina , Imuno-Histoquímica , Antígeno Ki-67/metabolismo , Camundongos , Neurogênese , Células Piramidais/citologia
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