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1.
Eur Rev Med Pharmacol Sci ; 28(3): 1155-1162, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38375728

RESUMO

OBJECTIVE: The aim of this study is to assess whether the touch of osteopathic manipulative treatment (OMT) can affect the endogenous production of oxytocin in full-term pregnant women and the assessment of well-being following the treatment. PATIENTS AND METHODS: In this study have been enrolled 57 pregnant women at full-term pregnancy (37th-41st week) for evaluation of the concentration of salivary oxytocin 2 minutes before and 2 minutes after a single session of OMT by an osteopath lasting for 30 minutes. Pre-OMT and post-OMT saliva samples were collected with the use of Salivette® salivary swabs. 7 salivary swabs were excluded from the analysis. 50 samples were analyzed with an appropriate ELISA kit. RESULTS: The mean OT salivary concentration pre-OMT was 89.98±16.39, and post-OMT was 100.60±19.13 tends to increase with p=0.0000051. In multivariate analysis, two subgroups show interesting data in the mean difference in OT salivary concentration post-OMT: women with painful contractions (p=0.06) and women under 35 years (p=0.09). CONCLUSIONS: The results of this study demonstrate that the effectiveness of OMT-increasing endogenous oxytocin is statistically significant in full-term pregnant women. The sensation of well-being found in most women indicates that there has been a predominantly central rather than peripheral oxytocin release after OMT.


Assuntos
Osteopatia , Ocitocina , Feminino , Humanos , Gravidez , Osteopatia/métodos , Dor
2.
Eur Rev Med Pharmacol Sci ; 27(14): 6800-6808, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37522691

RESUMO

OBJECTIVE: Laparoscopic surgery offers many advantages compared to invasive surgery but one of the main problems is postoperative pain, partially resulting from the peritoneal inflammatory process mediated by inflammatory cytokines. The rationale of this study is that intraperitoneal washing could remove inflammatory mediators that are the cause of postoperative pain and could help in the removal of CO2 from the abdominal cavity. This article aims to analyze the effects of peritoneal lavage in the reduction of postoperative shoulder pain. PATIENTS AND METHODS: 277 patients enrolled to undergo laparoscopic gynecologic surgery were included in the study. Women are randomized into two groups, according to the use or non-use of peritoneal lavage with saline solution at the end of laparoscopic gynecological major procedures. RESULTS: Data show that the peritoneal lavage can significantly reduce postoperative pain in the first 36 hours after surgery, as well as patients' requests for analgesics: during the first 3 postoperative days, requests for paracetamol were lower in the YW (Yes Washing) group than the NW (No Washing) group (77 vs. 101; p<0.05); similar results are obtained considering ketorolac administration (62 vs. 71; p<0.05). CONCLUSIONS: Peritoneal lavage after gynecological laparoscopic procedures may be effective in the reduction of postoperative pain and use of analgesics.


Assuntos
Laparoscopia , Lavagem Peritoneal , Humanos , Feminino , Lavagem Peritoneal/efeitos adversos , Lavagem Peritoneal/métodos , Laparoscopia/efeitos adversos , Analgésicos/uso terapêutico , Dor Pós-Operatória/etiologia , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos
3.
J Neurol ; 268(12): 4415-4421, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34313818

RESUMO

In March 2020, WHO declared Covid-19 outbreak pandemic. There has been increasing evidence that frail, old, multi-pathological patients are at greater risk of developing severe Covid-19 infection than younger, healthy ones. Covid-19's impact on Parkinson's Disease (PD) patients could be analysed through both the influence on PD patients' health and their risk of developing severe Covid-19, and the consequences of lockdown and restrictive measures on mental and cognitive health on both patients and caregivers. Moreover, there are critical issues to be considered about patients' care and management through an unprecedented time like this. One important issue to consider is physiotherapy, as most patients cannot keep exercising because of restrictive measures which has profoundly impacted on their health. Lastly, the relationship between PD and Sars-Cov2 may be even more complicated than it seems as some studies have hypothesized a possible Covid-19-induced parkinsonism. Hereby, we review the state of the art about the relationship between Covid-19 and Parkinson's Disease, focusing on each of these five points.


Assuntos
COVID-19 , Doença de Parkinson , Controle de Doenças Transmissíveis , Humanos , Doença de Parkinson/complicações , Doença de Parkinson/epidemiologia , Doença de Parkinson/terapia , RNA Viral , SARS-CoV-2
4.
Clin Neurophysiol ; 131(10): 2402-2409, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32828043

RESUMO

OBJECTIVE: Sub-motor threshold 5 Hz repetitive paired associative stimulation (5 Hz-rPAS25ms) produces a long-lasting increase in corticospinal excitability. Assuming a spike-timing dependent plasticity-like (STDP-like) mechanism, we hypothesized that 5 Hz-rPAS at a shorter inter-stimulus interval (ISI) of 15 ms (5 Hz-rPAS15ms) would exert a lasting inhibitory effect on corticospinal excitability. METHODS: 20 healthy volunteers received two minutes of 5 Hz-rPAS15ms. Transcranial magnetic stimulation (TMS) was applied over the motor hotspot of the right abductor pollicis brevis muscle at 90% active motor threshold. Sub-motor threshold peripheral electrical stimulation was given to the left median nerve 15 ms before each TMS pulse. We assessed changes in mean amplitude of the unconditioned motor evoked potential (MEP), short-latency intracortical inhibition (SICI), intracortical facilitation (ICF), short-latency afferent inhibition (SAI), long-latency afferent inhibition (LAI), and cortical silent period (CSP) before and for 60 minutes after 5-Hz rPAS15ms. RESULTS: Subthreshold 5-Hz rPAS15ms produced a 20-40% decrease in mean MEP amplitude along with an attenuation in SAI, lasting at least 60 minutes. A follow-up experiment revealed that MEP facilitation was spatially restricted to the target muscle. CONCLUSIONS: Subthreshold 5-Hz rPAS15ms effectively suppresses corticospinal excitability. Together with the facilitatory effects of subthreshold 5-Hz rPAS25ms (Quartarone et al., J Physiol 2006;575:657-670), the results show that sub-motor threshold 5-Hz rPAS induces STDP-like bidirectional plasticity in the motor cortex. SIGNIFICANCE: The results of the present study provide a new short-time paradigm of long term depression (LTD) induction in human sensory-motor cortex.


Assuntos
Potencial Evocado Motor/fisiologia , Córtex Motor/fisiologia , Inibição Neural/fisiologia , Plasticidade Neuronal/fisiologia , Ritmo Teta/fisiologia , Adulto , Eletromiografia , Feminino , Humanos , Masculino , Músculo Esquelético/fisiologia , Estimulação Magnética Transcraniana , Adulto Jovem
5.
Neural Plast ; 2018: 4135708, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30405710

RESUMO

Background: Surround inhibition is a system that sharpens sensation by creating an inhibitory zone around the central core of activation. In the motor system, this mechanism probably contributes to the selection of voluntary movements, and it seems to be lost in dystonia. Objectives. To explore if sensory information is abnormally processed and integrated in focal hand dystonia (FHD) and if surround inhibition phenomena are operating during sensory-motor plasticity and somatosensory integration in normal humans and in patients with FHD. Methods. We looked at the MEP facilitation obtained after 5 Hz repetitive paired associative stimulation of median (PAS M), ulnar (PAS U), and median + ulnar nerve (PAS MU) stimulation in 8 normal subjects and 8 FHD. We evaluated the ratio MU/(M + U) ∗ 100 and the spatial and temporal somatosensory integration recording the somatosensory evoked potentials (SEPs) evoked by a dual nerve input. Results: FHD had two main abnormalities: first, the amount of facilitation was larger than normal subjects; second, the spatial specificity was lost. The MU/(M + U) ∗ 100 ratio was similar in healthy subjects and in FHD patients, and the somatosensory integration was normal in this subset of patients. Conclusions. The inhibitory integration of somatosensory inputs and the somatosensory inhibition are normal in patients with focal dystonia as well as lateral surrounding inhibition phenomena during sensory-motor plasticity in FHD.


Assuntos
Distúrbios Distônicos/fisiopatologia , Potencial Evocado Motor/fisiologia , Potenciais Somatossensoriais Evocados/fisiologia , Córtex Motor/fisiologia , Plasticidade Neuronal/fisiologia , Córtex Somatossensorial/fisiologia , Adulto , Idoso , Distúrbios Distônicos/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estimulação Magnética Transcraniana/métodos
6.
Arch Ital Biol ; 154(2-3): 68-77, 2016 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-27918064

RESUMO

Resistance to thyroid hormone (RTH) describes a rare syndrome in which serum levels of thyroid hormones are elevated but serum levels of thyroid stimulating hormone (TSH) are unsuppressed. The importance of thyroid hormones for the normal function of the adult brain is corroborated by the frequent association of thyroid dysfunctions with neurological and psychiatric symptoms. In this study we investigated whether adult thyroid hormone resistance affects cortical excitability and modulates inhibitory and excitatory intracortical circuitries by using transcranial magnetic stimulation. Cortical excitability was probed with transcranial magnetic stimulation in 4 patients with thyroid hormone resistance, 10 patients affected by overt hypothyroidism (OH) and 10 age-matched healthy controls. We tested motor thresholds, motor evoked potential recruitment curve, cortical silent period (CSP), short interval intracortical inhibition (SICI) and intracortical facilitation. In both OH and RTH patients, the inhibitory cortical circuits were affected compared with euthyroid controls, but in opposite ways. In OH patients, CSP was prolonged and SICI was decreased. On the contrary, in RTH patients CSP was shortened and SICI was increased. Thyroid hormones may influence cortical excitability and cortical inhibitory circuits.


Assuntos
Excitabilidade Cortical , Hipotireoidismo , Eletromiografia , Potencial Evocado Motor , Humanos , Córtex Motor , Inibição Neural , Hormônios Tireóideos , Estimulação Magnética Transcraniana
7.
Diabetes Obes Metab ; 17(4): 371-8, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25523815

RESUMO

AIMS: To provide a systematic review and meta-analysis of recent evidence on the effectiveness of lifestyle-based weight loss interventions for adults with type 2 diabetes. METHODS: A search of the literature from January 2003 to July 2013 was conducted (PubMed, Embase, CINAHL and Web of Science). The studies considered eligible were randomized controlled trials evaluating weight loss interventions (diet and physical activity, with or without behavioural strategies) of ≥12 weeks duration, compared with usual care or another comparison intervention. Ten studies were included for review. Some heterogeneity was present in the sample, therefore, random-effects models were used to calculate pooled effects. RESULTS: Intervention duration ranged from 16 weeks to 9 years, with all but one delivered via individual or group face-to-face sessions. From six studies comparing lifestyle intervention with usual care the pooled effect on weight (n = 5795) was -3.33 kg [95% confidence interval (CI) -5.06, -1.60 kg], and on glycated haemoglobin (HbA1c; n = 5784) was -0.29% (95% CI -0.61, 0.03%), with both attenuated in sensitivity analyses. The pooled within-group effect on weight (n = 3063) from all 10 lifestyle intervention groups was -5.33 kg (95% CI -7.33, -3.34 kg), also attenuated in sensitivity analyses. None of the participant or intervention characteristics examined explained the heterogeneity. Only one study assessed whether intervention effects were maintained after the end of the intervention. CONCLUSIONS: Lifestyle-based weight loss intervention trials in type 2 diabetes achieve, on average, modest reductions in weight and HbA1c levels, but results were heavily influenced by one trial. Evidence-based approaches for improving the effectiveness of lifestyle-based interventions in type 2 diabetes are needed, along with future studies reporting on maintenance and cost-effectiveness.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Dieta para Diabéticos , Dieta Redutora , Medicina Baseada em Evidências , Estilo de Vida , Atividade Motora , Obesidade/terapia , Terapia Comportamental , Terapia Combinada , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/terapia , Hemoglobinas Glicadas/análise , Humanos , Hiperglicemia/prevenção & controle , Obesidade/complicações , Obesidade/dietoterapia , Educação de Pacientes como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Redução de Peso
8.
Obes Rev ; 15(9): 749-68, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24891269

RESUMO

Obesity has been associated with poor health outcomes in breast cancer survivors. Thus, weight loss is recommended for overweight and obese survivors. We systematically reviewed studies (published up to July 2013) that evaluated behaviourally based, weight loss interventions in women with breast cancer exclusively. Completed randomized trials, single-arm trials and ongoing trials were reviewed. Within-group and between-group differences for weight loss were extracted, as was data on secondary outcomes, i.e. clinical biomarkers, patient-reported outcomes, adverse events. Ten completed randomized trials, four single-arm trials and five ongoing trials were identified. Statistically significant within-group weight loss was observed over periods of 2 to 18 months in 13 of the 14 trials, with six randomized and two single-arm trials observing mean weight loss ≥5%. Clinical biomarkers, psychosocial and patient-reported outcomes were measured in a small number of studies. No serious adverse events were reported. Only two trials assessed maintenance of intervention effects after the end-of-intervention and none reported on cost-effectiveness. The studies included in this review suggest that weight loss is feasible to achieve and is safe in women following treatment for breast cancer. Future studies should assess (and be powered for) a range of biomarker and patient-reported outcomes, and be designed to inform translation into practice.


Assuntos
Neoplasias da Mama/complicações , Dieta Redutora , Exercício Físico , Obesidade/complicações , Obesidade/terapia , Sobreviventes , Redução de Peso , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Obesidade/metabolismo , Obesidade/prevenção & controle , Avaliação de Resultados em Cuidados de Saúde , Prognóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Sobreviventes/psicologia , Sobreviventes/estatística & dados numéricos
9.
Int J Psychophysiol ; 92(2): 74-8, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24631627

RESUMO

Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition. Although its pathophysiology is not completely understood, neurophysiologic and neuroimaging data have disclosed functional abnormalities in the networks linking frontal cortex, supplementary motor and premotor areas, striatum, globus pallidus, and thalamus (CSPT circuits). By means of transcranial magnetic stimulation (TMS) it is possible to test inhibitory and excitatory circuits within motor cortex. Previous studies on OCD patients under medication have demonstrated altered cortical inhibitory circuits as tested by TMS. On the other hand there is growing evidence suggesting an alteration of sensory-motor integration. Therefore, the aim of the present study was to evaluate sensory-motor integration (SAI and LAI), intracortical inhibition, and facilitation in drug-naïve OCD patients, using TMS. In our sample, we have demonstrated a significant SAI reduction in OCD patients when compared to a cohort of healthy individuals. SAI abnormalities may be related to a dysfunction of CSPT circuits which are involved in sensory-motor integration processes. Thus, it can be speculated that hypofunctioning of such system might impair the ability of OCD patients to suppress internally triggered intrusive and repetitive movements and thoughts. In conclusion, our data suggest that OCD may be considered as a sensory motor disorder where a dysfunction of sensory-motor integration may play an important role in the release of motor compulsions.


Assuntos
Inibição Neural/fisiologia , Transtorno Obsessivo-Compulsivo/fisiopatologia , Córtex Sensório-Motor/fisiopatologia , Estimulação Magnética Transcraniana/métodos , Adulto , Eletromiografia , Feminino , Humanos , Masculino , Córtex Motor/fisiopatologia , Distribuição Aleatória , Estimulação Magnética Transcraniana/instrumentação
10.
Eur J Pharm Sci ; 52: 125-31, 2014 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-24215738

RESUMO

AIM: In this study we investigate in in vitro myometrial tissue samples of pregnant women: (a) the effects of proton pomp inhibitors (PPIs) (omeprazole, esomeprazole, pantoprazole, lansoprazole and rabeprazole) on spontaneous contractions; (b) the muscle-relaxant efficacy of the most active PPI considered (pantoprazole) in comparison with that of other known tocolytics (nifedipine, atosiban, MgSO4, isoxsuprine); (c) the effect of pantoprazole on contractions induced by calcium (Ca(++)), KCl, oxytocin and prostaglandin (PGE2); (d) the possible mediators of pantoprazole relaxant effect. METHODS: Organ bath studies were performed on myometrial tissue samples (40×10×10 mm) from pregnant women (38-42 weeks of gestational age) undergoing elective caesarian section. RESULTS: All the PPIs studied reduce the spontaneous contraction of the myometrial smooth muscle. Pantoprazole is the most effective and most potent inhibitor among those analyzed. Pantoprazole also reduces the contractions induced by Ca(++), KCl, oxytocin and PGE2. Neither NO, nor PGs, or the activation of Ca(++)-dependent K(+) currents mediate the muscle-relaxant effect of this PPI. CONCLUSION: These data, together with the fact that PPIs almost do not present side effects, suggest that these drugs can offer new therapeutic strategies for preterm delivery. Undoubtedly, further investigations and clinical studies are necessary before adding PPIs to the list of drugs available for the treatment of preterm delivery.


Assuntos
2-Piridinilmetilsulfinilbenzimidazóis/farmacologia , Miométrio/efeitos dos fármacos , Inibidores da Bomba de Prótons/farmacologia , Tocolíticos/farmacologia , Apamina/farmacologia , Cálcio/farmacologia , Dinoprostona/farmacologia , Esomeprazol/farmacologia , Feminino , Humanos , Técnicas In Vitro , Indometacina/farmacologia , Lansoprazol/farmacologia , Contração Muscular/efeitos dos fármacos , Miométrio/fisiologia , NG-Nitroarginina Metil Éster/farmacologia , Omeprazol/farmacologia , Ocitocina/farmacologia , Pantoprazol , Peptídeos/farmacologia , Cloreto de Potássio/farmacologia , Gravidez , Rabeprazol/farmacologia
11.
Schizophr Res ; 143(2-3): 367-76, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23231877

RESUMO

Schizophrenia is a neurodevelopmental disorder featuring complex aberrations in the structure, wiring, and chemistry of multiple neuronal systems. The abnormal developmental trajectory of the brain appears to be established during gestation, long before clinical symptoms of the disease appear in early adult life. Many genes are associated with schizophrenia, however, altered expression of no one gene has been shown to be present in a majority of schizophrenia patients. How does altered expression of such a variety of genes lead to the complex set of abnormalities observed in the schizophrenic brain? We hypothesize that the protein products of these genes converge on common neurodevelopmental pathways that affect the development of multiple neural circuits and neurotransmitter systems. One such neurodevelopmental pathway is Integrative Nuclear FGFR1 Signaling (INFS). INFS integrates diverse neurogenic signals that direct the postmitotic development of embryonic stem cells, neural progenitors and immature neurons, by direct gene reprogramming. Additionally, FGFR1 and its partner proteins link multiple upstream pathways in which schizophrenia-linked genes are known to function and interact directly with those genes. A th-fgfr1(tk-) transgenic mouse with impaired FGF receptor signaling establishes a number of important characteristics that mimic human schizophrenia - a neurodevelopmental origin, anatomical abnormalities at birth, a delayed onset of behavioral symptoms, deficits across multiple domains of the disorder and symptom improvement with typical and atypical antipsychotics, 5-HT antagonists, and nicotinic receptor agonists. Our research suggests that altered FGF receptor signaling plays a central role in the developmental abnormalities underlying schizophrenia and that nicotinic agonists are an effective class of compounds for the treatment of schizophrenia.


Assuntos
Modelos Animais de Doenças , Genômica/métodos , Esquizofrenia , Animais , Genômica/tendências , Humanos , Camundongos , Esquizofrenia/genética , Esquizofrenia/patologia , Esquizofrenia/terapia
12.
Med Sci Law ; 51 Suppl 1: S11-5, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22021626

RESUMO

AIM: of study Psychic trauma is described as the action of 'an emotionally overwhelming factor' capable of causing neurovegetative alterations leading to transitory or persisting bodily changes. The medico-legal concept of psychic trauma and its definition as a cause in penal cases is debated. The authors present three cases of death after psychic trauma, and discuss the definition of cause within the penal ambit of identified 'emotionally overwhelming factors'. MATERIALS AND METHODS: The methodological approach to ascertainment and criterion-based assessment in each case involved the following phases: (1) examination of circumstantial evidence, clinical records and documentation; (2) autopsy; (3) ascertainment of cause of death; and (4) ascertainment of psychic trauma, and its coexisting relationship with the cause of death. RESULTS: The results and assessment of each of the three cases are discussed from the viewpoint of the causal connotation of psychic trauma. In the cases presented, psychic trauma caused death, as deduced from assessment of the type of externally caused emotional insult, the subjects' personal characteristics and the circumstances of the event causing death. CONCLUSIONS: In cases of death due to psychic trauma, careful methodological ascertainment is essential, with the double aim of defining 'emotionally overwhelming factors' as a significant cause of death from the penal point of view, and of identifying the responsibility of third parties involved in the death event and associated dynamics of homicide.


Assuntos
Infarto do Miocárdio/etiologia , Estresse Psicológico/complicações , Fibrilação Ventricular/etiologia , Acidentes de Trânsito/psicologia , Idoso , Insuficiência da Valva Aórtica/patologia , Cardiomiopatia Dilatada/patologia , Conflito Familiar/psicologia , Patologia Legal , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/patologia , Violência/psicologia
13.
Bone ; 46(1): 112-20, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19761882

RESUMO

Sex steroid hormones are major determinants of bone morphology and quality and are responsible for sexually dimorphic skeletal traits. Hypogonadism results in suboptimal skeletal development and may lead to an increased risk of bone fracture later in life. The etiology of delayed puberty and/or hypothalamic amenorrhea is poorly understood, and experimental animal models addressing this issue are predominantly based upon short-term experimental induction of hormonal suppression via gonadotropin releasing hormone antagonists (GnRH-a). This acute change in hormone profile does not necessarily emulate the natural progression of hypogonadic bone disorders. We propose a novel animal model with which to explore the effects of chronic hypogonadism on bone quality, the naked mole-rat (NMR; Heterocephalus glaber). This mouse-size rodent may remain reproductively suppressed throughout its life, if it remains as a subordinate within the eusocial mole-rat colony. NMRs live in large colonies with a single dominant breeding female. She, primarily by using aggressive social contact, naturally suppresses the hypothalamic gonadotropic axis of subordinate NMRs and thereby their reproductive expression. However, should an NMR be separated from the dominant breeder, within less than a week reproductive hormones may become elevated and the animal attains breeding status. We questioned if sexual suppression of subordinates impact upon the development and maintenance of the femora and lead to a sexually indistinct monomorphic skeleton. Femora were obtained from male and female NMRs that were either non-breeders (subordinate) or breeders at the time of sacrifice. Diaphyseal cross-sectional morphology, metaphyseal trabecular micro-architecture and tissue mineral density of the femur were measured using microcomputed tomography and diaphyseal mechanical properties were assessed by four-point bending tests to failure. Subordinates were sexually monomorphic and showed no significant differences in body weight or femoral bone structure and quality between males and females. Femora of subordinate females differed significantly from that of breeding animals, whereas in males, the divergent trend among breeders and non-breeders did not reach statistical significance. Subordinate NMRs, naturally suppressed from entering puberty, may prove to be a useful model to tease apart the relationship between bone morphology and hypogonadism and evaluate skeletal development during pubertal maturation.


Assuntos
Osso e Ossos/patologia , Fêmur/patologia , Hipogonadismo/fisiopatologia , Puberdade Tardia/fisiopatologia , Caracteres Sexuais , Animais , Osso e Ossos/anatomia & histologia , Modelos Animais de Doenças , Feminino , Fêmur/anatomia & histologia , Masculino , Ratos-Toupeira
14.
Brain ; 132(Pt 10): 2871-7, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19690095

RESUMO

Dystonia is characterized by two main pathophysiological abnormalities: 'reduced' excitability of inhibitory systems at many levels of the sensorimotor system, and 'increased' plasticity of neural connections in sensorimotor circuits at a brainstem and spinal level. A surprising finding in two recent papers has been the fact that abnormalities of inhibition similar to those in organic dystonia are also seen in patients who have psychogenic dystonia. To try to determine the critical feature that might separate organic and psychogenic conditions, we investigated cortical plasticity in a group of 10 patients with psychogenic dystonia and compared the results with those obtained in a matched group of 10 patients with organic dystonia and 10 healthy individuals. We confirmed the presence of abnormal motor cortical inhibition (short-interval intracortical inhibition) in both organic and psychogenic groups. However, we found that plasticity (paired associative stimulation) was abnormally high only in the organic group, while there was no difference between the plasticity measured in psychogenic patients and healthy controls. We conclude that abnormal plasticity is a hallmark of organic dystonia; furthermore it is not a consequence of reduced inhibition since the latter is seen in psychogenic patients who have normal plasticity.


Assuntos
Distonia/fisiopatologia , Vias Eferentes/fisiopatologia , Vias Neurais/fisiopatologia , Plasticidade Neuronal/fisiologia , Adulto , Idoso , Toxinas Botulínicas Tipo A/uso terapêutico , Distonia/tratamento farmacológico , Distonia/etiologia , Estimulação Elétrica , Potencial Evocado Motor/fisiologia , Feminino , Lateralidade Funcional/fisiologia , Mãos/inervação , Mãos/fisiologia , Humanos , Masculino , Nervo Mediano/fisiologia , Pessoa de Meia-Idade , Córtex Motor/fisiopatologia , Músculo Esquelético/inervação , Músculo Esquelético/fisiologia , Fármacos Neuromusculares/uso terapêutico , Aprendizagem por Associação de Pares , Limiar Sensorial/fisiologia , Estimulação Magnética Transcraniana
15.
J Neurol Neurosurg Psychiatry ; 80(7): 744-8, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19276101

RESUMO

BACKGROUND: Positron emission tomography and single photon emission computed tomography scanning have 87-94% sensitivity and 80-100% specificity to differentiate patients with Parkinson's disease (PD) from control subjects and patients with essential (ET) or atypical tremor. More than 10% of patients diagnosed as early PD can have scans without evidence of dopaminergic deficiency (SWEDDs). This study investigated whether smell tests can help identify possible cases with SWEDDs. METHODS: The 40 item University of Pennsylvania Smell Test (UPSIT) was used to evaluate the sense of smell in 21 SWEDDs patients. Twenty-six ET patients, 16 patients with a diagnosis of idiopathic adult onset dystonia (D), 191 non-demented PD patients and 136 control subjects were also tested. Multiple regression analyses were used to compare the mean UPSIT score in the SWEDDs group with the other four groups (ET, D, PD and controls) after adjusting for the effects of relevant covariates. RESULTS: The mean UPSIT score for the SWEDDs group was greater than in the PD group (p<0.001) and not different from the mean UPSIT in the control (p = 0.7), ET (p = 0.4) or D (p = 0.9) groups. Smell tests indicated a high probability of PD in only 23.8% of SWEDDs as opposed to 85.3% of PD patients. CONCLUSIONS: In a patient with suspected PD, a high PD probability on smell testing favours the diagnosis of PD, and a low PD probability strengthens the indication for dopamine transporter imaging.


Assuntos
Distonia/fisiopatologia , Testes Neuropsicológicos , Transtornos Parkinsonianos/diagnóstico , Transtornos Parkinsonianos/fisiopatologia , Olfato , Tremor/fisiopatologia , Idade de Início , Idoso , Diagnóstico Diferencial , Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Distonia/diagnóstico por imagem , Distonia/psicologia , Feminino , Humanos , Radioisótopos do Iodo , Londres , Masculino , Pessoa de Meia-Idade , Transtornos Parkinsonianos/diagnóstico por imagem , Análise de Regressão , Tomografia Computadorizada de Emissão de Fóton Único , Tremor/diagnóstico por imagem , Tremor/psicologia
16.
Minerva Ginecol ; 61(1): 35-43, 2009 Feb.
Artigo em Italiano | MEDLINE | ID: mdl-19204659

RESUMO

The role of minimally invasive surgery in the management of gynecologic cancers is continuously expanding. Although few trials have focused on the safety of laparoscopy in oncology, laparoscopy is now widely used for most gynecological malignancies. Laparoscopy is widely used to manage benign ovarian masses, but its role in managing ovarian cancer still needs to be defined. The role of laparoscopy in ovarian cancer surgery may be divided into three following categories: 1) laparoscopic staging of apparent early ovarian cancer; 2) laparoscopic assessment of disease extent and potential for resectability; 3) laparoscopic reassessment, or second-look operation, or rule out recurrence. Laparoscopic approach has shown several advantages like a reduction in operating time, blood loss, hospital stay, and total hospital charges. The limitations of laparoscopic practice include inadequate port-site metastasis, tumour dissemination due to cyst rupture and incomplete staging. In addition, there were limitations in performing extensive laparoscopic sampling of areas of tumor persistence including retroperitoneal lymph nodes. In literature there are no randomized studies assessing the use of laparoscopy in the management of ovarian cancer. Moreover, most of the studies in literature comparing laparoscopy and laparotomy are carried out by surgeons specialized in one of two approaches, so that the results can not be compared.


Assuntos
Carcinoma/patologia , Carcinoma/cirurgia , Laparoscopia/métodos , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Carcinoma/diagnóstico , Ensaios Clínicos como Assunto , Medicina Baseada em Evidências , Feminino , Humanos , Laparoscopia/efeitos adversos , Tempo de Internação , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Inoculação de Neoplasia , Estadiamento de Neoplasias , Neoplasias Ovarianas/diagnóstico , Resultado do Tratamento
17.
Exp Brain Res ; 193(4): 555-63, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19048237

RESUMO

Practice of a motor task leads to an increase in amplitude of motor-evoked potentials (MEP) in the exercised muscle. This is termed practice-dependent plasticity, and is abolished by the NMDA antagonist dextromethorphan and the GABA(A) agonist lorazepam. Here, we sought to determine whether specific subtypes of GABA(A) circuits are responsible for this effect by comparing the action of the non-selective agonist, lorazepam with that of the selective GABA(A)-alpha(1) receptor agonist, zolpidem. In seven healthy subjects, transcranial magnetic stimulation (TMS) was used to quantify changes in amplitude of MEP after practice of a ballistic motor task. In addition we measured how the same drugs affected MEP amplitudes and the excitability of a number of cortical inhibitory circuits [short-interval intracortical inhibition (SICI), short-interval afferent inhibition (SAI) and long-interval intracortical inhibition]. This allowed us to explore correlations between drugs effects in measures of cortical excitability and practice-dependent plasticity of MEP amplitudes. As previously reported, lorazepam increased SICI and decreased SAI, while zolpidem only decreased SAI. The new findings were that practice-dependent plasticity of MEPs was impaired by lorazepam but not zolpidem, and that this was negatively correlated with lorazepam-induced changes in SICI but not SAI. This suggests that the intracortical circuits involved in SICI (and not neurons expressing GABA(A)-alpha(1) receptor subunits that are implicated in SAI) may be involved in controlling the amount of practice-dependent MEP plasticity.


Assuntos
Potencial Evocado Motor , Lorazepam/farmacologia , Córtex Motor/fisiologia , Plasticidade Neuronal , Piridinas/farmacologia , Adulto , Análise de Variância , Estudos Cross-Over , Método Duplo-Cego , Potencial Evocado Motor/efeitos dos fármacos , Feminino , Moduladores GABAérgicos/farmacologia , Agonistas de Receptores de GABA-A , Humanos , Masculino , Atividade Motora/efeitos dos fármacos , Córtex Motor/efeitos dos fármacos , Prática Psicológica , Estimulação Magnética Transcraniana , Zolpidem
18.
Forensic Sci Int ; 177(1): 37-41, 2008 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-18079080

RESUMO

The aim of this study was to highlight the importance of evaluating entomological evidence in forensic investigations on a regional scale. To evaluate climatic, geographical and environmental influences on the selection of carrion-breeding fauna in Northern Italy and consequently on inferred forensic data (post-mortem intervals and post-mortem transfer), we present details of six indoor-outdoor cases. Results show that the most abundant species was Lucilia sericata, together with other fly species of entomo-forensic interest, belonging to the Calliphoridae and Sarcophagidae families. In particular, for the first time in Italy, we report finding Phormia regina, Lucilia ampullacea, Lucilia caesar and Sarcophaga (Pandelleana) protuberans on fresh cadavers. The active period of L. sericata in Northern Italy, according to previous findings in Southern Europe, revealing clearcut differences with phenologies in Northern Europe, has important consequences in estimating the period (season, months) of death in cases of long post-mortem intervals (several months or years) if empty puparia of this fly are found. According to our results, the distribution of L. sericata in areas with urban sprawl, like Northern Italian regions, cannot be used to evaluate post-mortem transfer from an urban area to a rural one.


Assuntos
Dípteros/crescimento & desenvolvimento , Comportamento Alimentar , Estações do Ano , Tempo (Meteorologia) , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Entomologia , Europa (Continente) , Feminino , Antropologia Forense , Geografia , Humanos , Larva/crescimento & desenvolvimento , Masculino , Pessoa de Meia-Idade , Mudanças Depois da Morte
19.
J Neurol Neurosurg Psychiatry ; 79(9): 985-90, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17634214

RESUMO

OBJECTIVE: To test whether abnormal sensorimotor plasticity in focal hand dystonia is a primary abnormality or is merely a consequence of the dystonic posture. METHODS: This study used the paired associative stimulation (PAS) paradigm, an experimental intervention, capable of producing long term potentiation (LTP) like changes in the sensorimotor system in humans. PAS involves transcranial magnetic stimulation combined with median nerve stimulation. 10 patients with cranial and cervical dystonia, who showed no dystonic symptoms in the hand, and nine patients with hemifacial spasm (HFS), a non-dystonic condition, were compared with 10 healthy age matched controls. Motor evoked potential amplitudes and cortical silent period (CSP) duration were measured at baseline before PAS and for up to 60 min (T0, T30 and T60) after PAS in the abductor pollicis brevis and the first dorsal interosseus muscles. RESULTS: Patients with dystonia showed a stronger increase in corticospinal excitability than healthy controls and patients with HFS. In addition, patients with dystonia showed a loss of topographical specificity of PAS induced effects, with a facilitation in both the median and ulnar innervated muscles. While PAS conditioning led to a prolonged CSP in healthy controls and patients with HFS, it had no effect on the duration of the CSP in patients with cranial and cervical dystonia. CONCLUSION: The data suggests that excessive motor cortex plasticity is not restricted to the circuits clinically affected by dystonia but generalises across the entire sensorimotor system, possibly representing an endophenotypic trait of the disease.


Assuntos
Distúrbios Distônicos/fisiopatologia , Córtex Motor/fisiopatologia , Rede Nervosa/fisiopatologia , Plasticidade Neuronal/fisiologia , Aprendizagem por Associação de Pares/fisiologia , Desempenho Psicomotor/fisiologia , Adulto , Idoso , Distúrbios Distônicos/diagnóstico , Potencial Evocado Motor/fisiologia , Feminino , Mãos/fisiopatologia , Espasmo Hemifacial/fisiopatologia , Humanos , Masculino , Nervo Mediano/fisiopatologia , Pessoa de Meia-Idade , Músculo Esquelético/inervação , Postura , Tratos Piramidais/fisiologia , Estimulação Magnética Transcraniana/instrumentação
20.
Int J Immunogenet ; 34(6): 465-8, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18001304

RESUMO

We described two new highly polymorphic markers located 31 bp downstream of the last nucleotide of exon 12 in the 3' UTR region of the gene PLA2G7: 1344 +31TG(n) AG(m). Eight and 14 alleles were observed for the AG and TG repeats, respectively. These two markers have the highest heterozygosity until now reported for PLA2G7 gene.


Assuntos
Regiões 3' não Traduzidas , Doença da Artéria Coronariana/genética , Marcadores Genéticos , Fosfolipases A2/genética , 1-Alquil-2-acetilglicerofosfocolina Esterase , Alelos , Frequência do Gene , Humanos , Polimorfismo Genético , Sequências de Repetição em Tandem
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