RESUMO
BACKGROUND: The duration of electroencephalography (EEG) recordings varies widely among laboratories. Although several recommendations had been published, there are no previous studies directly addressing this. AIMS OF THE STUDY: To assess the effect of the recording duration on detection of EEG abnormalities in a tertiary referral centre for epilepsy. METHODS: We have reviewed 1005 EEG recordings and determined the shortest recording duration necessary to identify interictal EEG abnormalities. RESULTS: Standard, awake recordings shorter than 20 min yielded a significantly lower incidence of abnormal findings as compared to longer recordings. Although there was an increase in the diagnostic yield from 30 to 180 min recording duration, this failed to reach the level of significance. For sleep recordings, there was no significant increase in the diagnostic yield beyond 30 min. CONCLUSIONS: Our results provide evidence for recommending at least 20 min recording duration for standard awake EEGs and 30 min for sleep EEG recordings. As data were derived from patients referred to our epilepsy centre, the results are only valid for epilepsy-related indications.
Assuntos
Eletroencefalografia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Encéfalo/fisiopatologia , Criança , Pré-Escolar , Epilepsia/diagnóstico , Epilepsia/fisiopatologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Polissonografia/métodos , Estudos Retrospectivos , Sono/fisiologia , Fatores de Tempo , Vigília/fisiologia , Adulto JovemRESUMO
Minimization or withdrawal of immunosuppressive treatments after organ transplantation represents a major objective for improving quality of life and long-term survival of grafted patients. Such a goal may be reached under some clinical conditions, particularly in liver transplantation, making these patients good candidates for tolerance trials. In this context in liver transplantation, the central questions are (1) how to promote the natural propensity of the liver graft to be accepted, (2) which type of immunosuppressive drug should be used for induction and maintenance, and (3) which biomarkers could be used to discriminate tolerant patients from those requiring long-term immunosuppression. Induction therapies using aggressive T-cell-depleting agents may favor graft acceptance. However, persistent and/or rapidly reemerging cell lines, such as memory-type cells or CD8(+) T cells, could represent a significant barrier for induction of tolerance. The type of maintenance drugs also remains questionable. Calcineurin inhibitors may be eventually deleterious in the context of tolerance protocols, through inhibitory effects on regulatory T cells, that are not observed with rapamycin. In conclusion, significant efforts must be made to achieve reliable strategies for immunosuppression minimization or withdrawal after organ transplantation into the clinics.
Assuntos
Protocolos Clínicos/normas , Imunossupressores/uso terapêutico , Transplante de Fígado/imunologia , Tolerância ao Transplante/fisiologia , Relação Dose-Resposta a Droga , Humanos , Terapia de Imunossupressão/métodos , Imunossupressores/efeitos adversos , Testes de Função Hepática , Transplante de Fígado/fisiologia , Depleção Linfocítica , Guias de Prática Clínica como Assunto , Linfócitos T/imunologia , Tolerância ao Transplante/efeitos dos fármacosRESUMO
BACKGROUND: Immunosuppression withdrawal is feasible in some liver transplant (OLT) recipients but may lead to severe rejection in others, underlying the need for reliable biomarkers to identify patients with tolerant profile in whose weaning/withdrawal could be safely proposed. We evaluated the value of real-time polymerase chain reaction (PCR)-based measurement of interleukin (IL)-2 mRNA in mixed lymphocyte reaction (MLR) to monitor in vitro anti-donor reactivity in OLT patients. METHODS: MLR were performed in three patients undergoing living donor OLT using a tolerogenic protocol including donor stem cells. IL-2 mRNA production in MLR was measured by PCR at several intervals after OLT. RESULTS: In the early posttransplant period, three patients presented with global immunodeficiency, as indicated by low IL-2 mRNA production against both donor and third-party antigens. In the two patients who has immunosuppression successfully withdrawn, donor-specific hyporesponsiveness was observed thereafter: IL-2 mRNA production against donor cells remained low, while IL-2 mRNA production against a third-party antigen-presenting cells progressively recovered. No such modulation of the anti-donor response was observed in the patient in whom withdrawal led to rapid rejection. CONCLUSION: Measurement of IL-2 mRNA production in MLR might prefer a tool to monitor anti-donor reactivity after OLT for decisions to minimize or withdraw immunosuppression in patients displaying donor-specific hyporesponsiveness.
Assuntos
Interleucina-2/genética , Transplante de Fígado/imunologia , RNA Mensageiro/genética , Citocinas/genética , Regulação da Expressão Gênica , Humanos , Teste de Cultura Mista de Linfócitos , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
The sensitive nuclear analytical technique Instrumental Neutron Activation Analysis (INAA) has been applied on several types of metallic biomaterials (Heraenium CE, Ventura Nibon, Wiron 99 and Ducinox which are currently used for restoration in the dental clinics) to study its performance in elemental analysis and identify eventual limitations. The investigation has been performed by two NAA Laboratories and aimed at getting an answer to the question on how the biomaterials compositions influence the patients' health over the course of time, taking into account the EC Directive 94/27/EC recommendations concerning Ni toxicity.
Assuntos
Materiais Biocompatíveis/análise , Materiais Dentários/química , Metais/análise , Análise de Ativação de Nêutrons/métodosRESUMO
The investigations were performed in a building enterprise with 7,500 workers with a mean age of 37 years, mainly males. It aimed at identifying the risk factors for the common diseases. The knowledge of these factors should be considered when elaborating the health programmes intended to prevent the frequent diseases (traumas, respiratory locomotor and digestive diseases).
Assuntos
Acidentes de Trabalho/prevenção & controle , Doenças Profissionais/epidemiologia , Serviços de Saúde do Trabalhador , Atenção Primária à Saúde , Adulto , Humanos , Masculino , Doenças Profissionais/prevenção & controle , Fatores de Risco , RomêniaRESUMO
We have isolated from mouse a novel WD-motif-containing gene designated Preb. This gene encodes a predicted protein of 416 amino acids and has significant homology with other members of the WD-motif gene superfamily that play a role in cell fate determination. Preb maps to the proximal end of chromosome 5 in mouse, near the Hmx1 homeobox gene. Preb is detectable in early stage embryos in the peripheral nervous system, developing liver, and surface ectoderm. Later, Preb is expressed in the anterior portion of Rathke's pouch, which gives rise to the anterior pituitary, the organ responsible for the production of prolactin and other hormones. In midgestation embryos, the most extensive expression of Preb is observed in the perichondrium of the craniofacial, axial, and appendicular skeleton. The expression pattern of Preb in murine embryos suggests a potential role in the specification of multiple cell types, in particular, the fetal skeleton.