Assuntos
Aborto Induzido , Habitação , Gravidez , Feminino , Humanos , Estados Unidos , Decisões da Suprema Corte , Aborto LegalRESUMO
BACKGROUND: The use of routinely collected health data for secondary research purposes is increasingly recognised as a methodology that advances medical research, improves patient outcomes, and guides policy. This secondary data, as found in electronic medical records (EMRs), can be optimised through conversion into a uniform data structure to enable analysis alongside other comparable health metric datasets. This can be achieved with the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM), which employs a standardised vocabulary to facilitate systematic analysis across various observational databases. The concept behind the OMOP-CDM is the conversion of data into a common format through the harmonisation of terminologies, vocabularies, and coding schemes within a unique repository. The OMOP model enhances research capacity through the development of shared analytic and prediction techniques; pharmacovigilance for the active surveillance of drug safety; and 'validation' analyses across multiple institutions across Australia, the United States, Europe, and the Asia Pacific. In this research, we aim to investigate the use of the open-source OMOP-CDM in the PATRON primary care data repository. METHODS: We used standard structured query language (SQL) to construct, extract, transform, and load scripts to convert the data to the OMOP-CDM. The process of mapping distinct free-text terms extracted from various EMRs presented a substantial challenge, as many terms could not be automatically matched to standard vocabularies through direct text comparison. This resulted in a number of terms that required manual assignment. To address this issue, we implemented a strategy where our clinical mappers were instructed to focus only on terms that appeared with sufficient frequency. We established a specific threshold value for each domain, ensuring that more than 95% of all records were linked to an approved vocabulary like SNOMED once appropriate mapping was completed. To assess the data quality of the resultant OMOP dataset we utilised the OHDSI Data Quality Dashboard (DQD) to evaluate the plausibility, conformity, and comprehensiveness of the data in the PATRON repository according to the Kahn framework. RESULTS: Across three primary care EMR systems we converted data on 2.03 million active patients to version 5.4 of the OMOP common data model. The DQD assessment involved a total of 3,570 individual evaluations. Each evaluation compared the outcome against a predefined threshold. A 'FAIL' occurred when the percentage of non-compliant rows exceeded the specified threshold value. In this assessment of the primary care OMOP database described here, we achieved an overall pass rate of 97%. CONCLUSION: The OMOP CDM's widespread international use, support, and training provides a well-established pathway for data standardisation in collaborative research. Its compatibility allows the sharing of analysis packages across local and international research groups, which facilitates rapid and reproducible data comparisons. A suite of open-source tools, including the OHDSI Data Quality Dashboard (Version 1.4.1), supports the model. Its simplicity and standards-based approach facilitates adoption and integration into existing data processes.
Assuntos
Pesquisa Biomédica , Humanos , Austrália , Bases de Dados Factuais , Registros Eletrônicos de Saúde , Europa (Continente) , Farmacovigilância , Atenção Primária à SaúdeRESUMO
Objectives In this overview, we describe theObservational Medical Outcomes Partnership Common Data Model (OMOP-CDM), the established governance processes employed in EMR data repositories, and demonstrate how OMOP transformed data provides a lever for more efficient and secure access to electronic medical record (EMR) data by health service providers and researchers.Methods Through pseudonymisation and common data quality assessments, the OMOP-CDM provides a robust framework for converting complex EMR data into a standardised format. This allows for the creation of shared end-to-end analysis packages without the need for direct data exchange, thereby enhancing data security and privacy. By securely sharing de-identified and aggregated data and conducting analyses across multiple OMOP-converted databases, patient-level data is securely firewalled within its respective local site.Results By simplifying data management processes and governance, and through the promotion of interoperability, the OMOP-CDM supports a wide range of clinical, epidemiological, and translational research projects, as well as health service operational reporting.Discussion Adoption of the OMOP-CDM internationally and locally enables conversion of vast amounts of complex, and heterogeneous EMR data into a standardised structured data model, simplifies governance processes, and facilitates rapid repeatable cross-institution analysis through shared end-to-end analysis packages, without the sharing of data.Conclusion The adoption of the OMOP-CDM has the potential to transform health data analytics by providing a common platform for analysing EMR data across diverse healthcare settings.
Assuntos
Saúde Digital , Registros Eletrônicos de Saúde , Humanos , Atenção à Saúde , Bases de Dados Factuais , Gerenciamento de DadosRESUMO
INTRODUCTION: Digitized patient progress notes from general practice represent a significant resource for clinical and public health research but cannot feasibly and ethically be used for these purposes without automated de-identification. Internationally, several open-source natural language processing tools have been developed, however, given wide variations in clinical documentation practices, these cannot be utilized without appropriate review. We evaluated the performance of four de-identification tools and assessed their suitability for customization to Australian general practice progress notes. METHODS: Four tools were selected: three rule-based (HMS Scrubber, MIT De-id, Philter) and one machine learning (MIST). 300 patient progress notes from three general practice clinics were manually annotated with personally identifying information. We conducted a pairwise comparison between the manual annotations and patient identifiers automatically detected by each tool, measuring recall (sensitivity), precision (positive predictive value), f1-score (harmonic mean of precision and recall), and f2-score (weighs recall 2x higher than precision). Error analysis was also conducted to better understand each tool's structure and performance. RESULTS: Manual annotation detected 701 identifiers in seven categories. The rule-based tools detected identifiers in six categories and MIST in three. Philter achieved the highest aggregate recall (67%) and the highest recall for NAME (87%). HMS Scrubber achieved the highest recall for DATE (94%) and all tools performed poorly on LOCATION. MIST achieved the highest precision for NAME and DATE while also achieving similar recall to the rule-based tools for DATE and highest recall for LOCATION. Philter had the lowest aggregate precision (37%), however preliminary adjustments of its rules and dictionaries showed a substantial reduction in false positives. CONCLUSION: Existing off-the-shelf solutions for automated de-identification of clinical text are not immediately suitable for our context without modification. Philter is the most promising candidate due to its high recall and flexibility however will require extensive revising of its pattern matching rules and dictionaries.
Assuntos
Registros Eletrônicos de Saúde , Medicina Geral , Humanos , Confidencialidade , Anonimização de Dados , Austrália , Processamento de Linguagem NaturalRESUMO
The nucleus rotundus of the turtles Emys orbicularis and Testudo horsfieldi was analysed by axonal tracing methods and post-embedding GABA immunocytochemistry. After injections of horseradish peroxidase or biotinylated dextran amine into the optic tectum, electron microscopic observations showed that the vast majority of ipsilateral tectorotundal axon terminals were small in size, had smooth contours and contained small, round, densely packed synaptic vesicles. These terminals were GABA-immunonegative, often gathered in clusters, and established asymmetrical synaptic contacts with either small- or medium-sized GABA-negative dendritic profiles and with GABA-immunoreactive (GABA-ir) dendrites, which did not contain synaptic vesicles. Occasional GABA-ir-labelled axon terminals were observed; these may arise from the rare GABAergic neurons in the central tectal layer, or from neurons in the ventral pretectal nucleus, which projects both to the optic tectum and nucleus rotundus. In addition to tracer-labelled axon terminals, we observed both GABA-negative and GABA-ir cell bodies and dendrites also labelled by the tracer. No GABA-ir presynaptic dendritic profiles containing synaptic vesicles were observed. The existence in reptiles of reciprocal connections between the nucleus rotundus and the optic tectum as a phylogenetically ancient feedback system is discussed.
Assuntos
Vias Neurais/ultraestrutura , Colículos Superiores/ultraestrutura , Sinapses/ultraestrutura , Núcleos Talâmicos/ultraestrutura , Tartarugas/anatomia & histologia , Ácido gama-Aminobutírico/metabolismo , Animais , Axônios/metabolismo , Axônios/ultraestrutura , Vias Neurais/metabolismo , Colículos Superiores/metabolismo , Sinapses/metabolismo , Núcleos Talâmicos/metabolismo , Tartarugas/metabolismoRESUMO
Neurochemical and key connectional characteristics of the anterior entopeduncular nucleus (Enta) of the turtle (Testudo horsfieldi) were studied by axonal tracing techniques and immunohistochemistry of parvalbumin, gamma-aminobutyric acid (GABA) and glutamic acid decarboxylase (GAD). We showed that the Enta, which is located within the dorsal peduncle of the lateral forebrain bundle (Pedd), has roughly topographically organized reciprocal connections with the dorsal thalamic visual nuclei, the nucleus rotundus (Rot) and dorsal lateral geniculate nucleus (GLd). The Enta receives projections from visual telencephalic areas, the anterior dorsal ventricular ridge and dorsolateral cortex/pallial thickening. Most Enta neurons contained GABA and parvalbumin, and some of them were retrogradely labeled when the tracer was injected into the visual dorsal thalamic nuclei. Further experiments using double immunofluorescence revealed colocalization of GAD and parvalbumin in the vast majority of Enta neurons, and many of these cells showed retrograde labeling with Fluoro-gold injected into the Rot and/or GLd. According to these data, the Enta may be considered as a structural substrate for recurrent inhibition of the visual thalamic nuclei. Based on morphological and neurochemical similarity of the turtle Enta, caiman Pedd nucleus, the superior reticular nucleus in birds, and the thalamic reticular nucleus in mammals, we suggest that these structures represent a characteristic component which is common to the thalamic organization in amniotes.
Assuntos
Núcleos Intralaminares do Tálamo/anatomia & histologia , Núcleos Talâmicos/anatomia & histologia , Tartarugas/anatomia & histologia , Vias Visuais/anatomia & histologia , Jacarés e Crocodilos/anatomia & histologia , Jacarés e Crocodilos/metabolismo , Animais , Evolução Biológica , Aves/anatomia & histologia , Aves/metabolismo , Corpos Geniculados/anatomia & histologia , Corpos Geniculados/metabolismo , Glutamato Descarboxilase/metabolismo , Imuno-Histoquímica , Núcleos Intralaminares do Tálamo/metabolismo , Mamíferos/anatomia & histologia , Mamíferos/metabolismo , Parvalbuminas/metabolismo , Filogenia , Estilbamidinas , Telencéfalo/anatomia & histologia , Telencéfalo/metabolismo , Núcleos Talâmicos/metabolismo , Tartarugas/metabolismo , Córtex Visual/anatomia & histologia , Córtex Visual/metabolismo , Vias Visuais/metabolismo , Ácido gama-Aminobutírico/metabolismoRESUMO
Thin varicose centrifugal visual fibers, between 30-45 in number and displaying cGnRH-I immunoreactivity, were identified in Crocodylus niloticus. Approximately 80% of these fibers were also FMRF-amide-like immunoreactive. The cGnRH-I fibers extended from the preoptic region to the retina where they appeared to terminate in the external portion of the inner plexiform layer. The location of their neurons of origin could not be determined precisely following the intraocular injection of the retrograde axonal tracer RITC. Nevertheless, the presence of cGnRH-I-immunoreactive neurons exclusively within the complex comprising the terminal nerve and the septo-preoptic region, and of several retinopetal fibers labelled retrogradely with the axonal tracer at the septo-preoptic junction, indicates that the cGnRH-immunoreactive centrifugal visual system originates from within this complex.
Assuntos
Jacarés e Crocodilos/metabolismo , Hormônio Liberador de Gonadotropina/metabolismo , Fibras Nervosas/metabolismo , Vias Visuais/metabolismo , Animais , FMRFamida/metabolismo , Imuno-Histoquímica/métodos , Vias Visuais/anatomia & histologiaRESUMO
The retinopetal neurons of Crocodylus niloticus were visualized by retrograde transport of rhodamine beta-isothiocyanate or Fast Blue administered by intraocular injection. Approximately 6,000 in number, these neurons are distributed in seven regions extending from the mesencephalic tegmentum to the rostral rhombencephalon, approximately 70% being located contralaterally to the injected eye. None of the centrifugal neurons projects to both retinae. The retinopetal neurons are located in rostrocaudal sequence in seven regions: the formatio reticularis lateralis mesencephali, the substantia nigra, the griseum centralis tectalis, the nucleus subcoeruleus dorsalis, the nucleus isthmi parvocellularis, the locus coeruleus, and the commissura nervi trochlearis. The greatest number of cells (approximately 93%) is found in the nucleus subcoeruleus dorsalis. The majority are multipolar or bipolar in shape and resemble the ectopic centrifugal visual neurons of birds, although a small number of monopolar neurons resembling those of the avian isthmo-optic nucleus may also be observed. A few retinopetal neurons in the griseum centralis tectalis were tyrosine hydroxylase (TH) immunoreactive. Moreover, in the nuclei subcoeruleus dorsalis and isthmi parvocellularis, both ipsilaterally and contralaterally, approximately one retinopetal neuron in three (35%) was immunoreactive to nitric oxide synthase (NOS), and a slightly higher proportion (38%) of retinopetal neurons were immunoreactive for choline acetyltransferase (ChAT). Some of them contained colocalized ChAT and NOS/reduced nicotinamide adenine dinucleotide phosphate-diaphorase. Fibers immunoreactive to TH, serotonin (5-HT), neuropeptide Y (NPY), or Phe-Met-Arg-Phe-amide (FMRF-amide) were frequently observed to make intimate contact with rhodamine-labeled retinopetal neurons. These findings are discussed in relation to previous results obtained in other reptilian species and in birds.
Assuntos
Jacarés e Crocodilos , Mesencéfalo/anatomia & histologia , Neurônios/química , Retina/anatomia & histologia , Rombencéfalo/anatomia & histologia , Vias Visuais/anatomia & histologia , Animais , Encéfalo/anatomia & histologia , Contagem de Células , Colina O-Acetiltransferase/análise , FMRFamida/análise , Técnicas Histológicas , Imuno-Histoquímica , Mesencéfalo/citologia , Microscopia Confocal , NADP/análise , Neuropeptídeo Y/análise , Óxido Nítrico Sintase/análise , Rombencéfalo/citologia , Serotonina/análise , Tirosina 3-Mono-Oxigenase/análise , Vias Visuais/químicaRESUMO
The development of the catecholaminergic system of the brain of the lamprey (Lampetra fluviatilis) was studied with immunocytochemistry in a series of larvae of different sizes by using two different antibodies directed against tyrosine hydroxylase (TH), the rate-limiting enzyme of catecholamine synthesis. In group 1 larvae (length: 29-54 mm, ages: 8 months to 1.5 years), the only TH-immunoreactive somata observed were located in the caudal wall of the recessus praeopticus (RP) and in the nucleus tuberculi posterioris (NTP). In group 2 larvae (length: 55-80 mm, ages: 1.5-2.5 years), the somata of immunolabeled cells of the NTP give rise to fibers, most of which are ascending and terminate in the corpus striatum. Additional immunoreactive cells are observed in the nucleus praeopticus (NP), which has differentiated, and in the spinal cord. In group 3 larvae (length: 81-110 mm, ages: 2.5-4 years), the spatial distribution of TH-immunoreactive elements (somata, fibers, and terminals) bears many resemblances to that seen in the adult. Immunolabeled cells may be observed in the olfactory bulb, in the nucleus commissurae postopticae (NCP), and in the nucleus dorsalis hypothalami (NDH). Nevertheless, some groups of TH-immunoreactive cells found in the adult are not observed in group 3 larvae; these may appear during the metamorphic phase. By comparative analysis, we show that, in spite of several differences, the spatiotemporal sequence of appearance of TH-immunoreactive cell bodies and fibers in the lamprey presents many similarities to that described in gnathostomes.
Assuntos
Encéfalo/crescimento & desenvolvimento , Catecolaminas/biossíntese , Lampreias/crescimento & desenvolvimento , Larva/crescimento & desenvolvimento , Vias Neurais/crescimento & desenvolvimento , Neurônios/enzimologia , Tirosina 3-Mono-Oxigenase/metabolismo , Envelhecimento/metabolismo , Animais , Encéfalo/citologia , Encéfalo/enzimologia , Mapeamento Encefálico , Diferenciação Celular/fisiologia , Diencéfalo/citologia , Diencéfalo/enzimologia , Diencéfalo/crescimento & desenvolvimento , Imuno-Histoquímica , Lampreias/anatomia & histologia , Lampreias/metabolismo , Larva/citologia , Larva/enzimologia , Mesencéfalo/citologia , Mesencéfalo/enzimologia , Mesencéfalo/crescimento & desenvolvimento , Vias Neurais/citologia , Vias Neurais/enzimologia , Neurônios/citologia , Rombencéfalo/citologia , Rombencéfalo/enzimologia , Rombencéfalo/crescimento & desenvolvimento , Medula Espinal/citologia , Medula Espinal/enzimologia , Medula Espinal/crescimento & desenvolvimento , Telencéfalo/citologia , Telencéfalo/enzimologia , Telencéfalo/crescimento & desenvolvimentoRESUMO
The pretectal and tectal projections to the dorsal lateral geniculate nucleus (GLd) of two species of turtle (Emys orbicularis and Testudo horsfieldi) were examined under the electron microscope by using axonal tracing techniques (horseradish peroxidase or biotinylated dextran amine) and postembedding gamma-aminobutyric acid (GABA) immunocytochemistry. After injection of tracer into the pretectum, two types of axon terminals were identified as those of pretectogeniculate pathways. Both contained pleomorphic synaptic vesicles and were more numerous in the inner part of the nucleus. They could be distinguished on the bases of size and shape of their synaptic vesicles, type of synaptic contact, and level of GABA immunoreactivity. One type had a higher density of immunolabeling and established symmetric synaptic contacts, whereas the other, less densely immunolabeled, made asymmetric synaptic contacts. In both cases, synaptic contacts were mainly with relay cells and occasionally with interneurons. We suggest that these two types of pretectogeniculate terminals originate in two separate pretectal nuclei. After injection of tracer into the optic tectum, a single population of GABA-immunonegative tracer-labeled terminals was identified as belonging to the tectogeniculate pathway. These were small, had smooth contours, contained very small round synaptic vesicles, and established asymmetric synaptic contacts with long active zones, predominantly with relay cells and less frequently with interneurons, in the inner part of the nucleus. In addition, a population of GABA-negative and occasionally GABA-positive terminals, labeled by tracer injected into either the pretectum or the tectum, was identified as retinal terminals; these were presumably labeled by the retrograde transport of tracer in collateral branches of visual fibers innervating both the GLd and the pretectum or tectum. Comparison of the present ultrastructural findings in turtles with those previously reported in mammals shows that the cytological features, synaptic morphology, and immunochemical properties of the pretectogeniculate and tectogeniculate terminals of both groups share many similarities. Nevertheless, the postsynaptic targets of these two categories of terminals display some pronounced differences between the two groups, which are discussed in terms of their possible functional significance.
Assuntos
Axônios/ultraestrutura , Corpos Geniculados/ultraestrutura , Colículos Superiores/ultraestrutura , Tartarugas/anatomia & histologia , Tartarugas/fisiologia , Ácido gama-Aminobutírico/análise , Vias Aferentes/química , Vias Aferentes/ultraestrutura , Animais , Axônios/química , Corpos Geniculados/química , Colículos Superiores/químicaRESUMO
In two species of turtle (Emys orbicularis and Testudo horsfieldi), retrograde and anterograde tracer techniques were used to study projections from the optic tectum to the nucleus rotundus (Rot) and to the dorsal lateral geniculate nucleus (GLd). The ipsilateral Rot received the most massive tectal projections, stemming from numerous neurons located in the stratum griseum centrale (SGC). These neurons varied in size and shape, many of them having a wide zone of dendritic arborization within both the (SGC) and the stratum griseum et fibrosum superficiale (SGFS). Projections from the tectum to the GLd were ipsilateral, were extremely scarce, and arose from a small number of neurons of various shapes situated in the SGFS; these cells were, as a rule, smaller than those projecting to the Rot. For the most part, these neurons were radially oriented, with rather restricted dendritic arborizations in the most superficial sublayers of the SGFS; smaller numbers of projection neurons were horizontally oriented, with long dendrites branching throughout the layer. Some neurons located in the stratum griseum periventriculare (SGP) projected to both the Rot and the GLd. Most of these neurons had dendritic arborizations within the retinorecipient zone of the SGFS. We were unable to rule out the possibility that some cells projecting to the GLd were situated in the SGC. Both the GLd and the main body of the Rot did not contain neurons projecting to the optic tectum. Thalamic neurons projecting to the tectum were observed in the ventral lateral geniculate nucleus, the intergeniculate leaflet and the interstitial nuclei of the tectothalamic tract, and the nucleus of the decussatio supraoptica ventralis. The question of whether variation in the laminar organization of the tectorotundal and tectogeniculate projection neurons in reptiles, birds, and mammals may be related to different degrees of differentiation of the tectal layers is discussed.
Assuntos
Corpos Geniculados/citologia , Neurônios/citologia , Colículos Superiores/citologia , Núcleos Talâmicos/citologia , Tartarugas/anatomia & histologia , Vias Visuais/anatomia & histologia , Animais , Transporte Axonal , Mapeamento Encefálico , Corpos Geniculados/anatomia & histologia , Coloração e Rotulagem , Colículos Superiores/anatomia & histologia , Núcleos Talâmicos/anatomia & histologia , Vias Visuais/citologiaRESUMO
A small contingent of 30-50 of centrifugal visual fibres, showing FMRF-amide-like immunoreactivity, has been identified in C. niloticus; these fibres extend from the chiasmatic region into the retina. They do not take the marginal optic tract, but pass medially to the chiasmatic fascicles, from the preoptic region. The cells of origin of these fibres have not been identified. However, none of the retinopetal neurons of the brainstem [M. Medina, J. Reperant, R. Ward, D. Miceli, Centrifugal visual system of Crocodylus niloticus : a hodological, histochemical and immunocytochemical study, J. Comp. Neurol. 468 (2004) 65-85], labelled by retrograde transport of rhodamine beta-isothiocyanate after intraocular injection of this tracer, show FMRF-amide-like immunoreactivity; neither are any of the FMRF-amide-like immunopositive neurons in the crocodile brain, particularly those of the complex involving the terminal nerve and the septo-preoptic region, labelled by rhodamine after its intraocular injection.
Assuntos
Jacarés e Crocodilos/metabolismo , FMRFamida/análise , FMRFamida/biossíntese , Retina/química , Retina/metabolismo , Animais , Imuno-Histoquímica , Vias Visuais/química , Vias Visuais/metabolismoRESUMO
The distribution of Kin protein, the vertebrate homologue of the bacterial recA nuclear protein involved in illegitimate recombinant DNA repair and gene regulation, was analysed in the brain of the mouse, quail, turtle and frog by immunocytochemical methods. The protein was expressed in all brains, but not in a uniform manner. Immunoreactivity was absent from major fibre tracts. In the cerebral nuclei, immunolabelling in the various species showed an important variation. A comparative analysis, based on the homologies between different brain structures in these species, showed that this variation was not due to interspecific variation but that of an ancestral pattern of distribution of Kin protein. It is also shown that whatever the species examined, Kin protein is consistently more highly expressed in those regions of the brain with a conservative evolutionary history (e.g. the olfactory and limbic systems, the hypothalamus, the monoaminergic system, the cerebellum, and the nuclei of sensory and motor cranial nerves). The protein is markedly less heavily expressed in the dorsal striatum and the sensory nuclei of the thalamus.
Assuntos
Encéfalo/metabolismo , Proteínas de Ligação a DNA/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Proteínas Nucleares/metabolismo , Animais , Coturnix , Técnicas Imunoenzimáticas , Camundongos , Camundongos Endogâmicos BALB C , Rana esculenta , Especificidade da Espécie , TartarugasRESUMO
PURPOSE: Injured patients who require aggressive resuscitation with intravenous (IV) fluids and blood products will frequently acquire low levels of serum calcium (CA) and albumin (ALB) in the intensive care unit (ICU) as result of this therapy. The purpose of this longitudinal study was to determine the time course of CA and ALB during ICU admission in survivors (S) compared to nonsurvivors (N) after major trauma. The study design is to verify if CA, ALB, or albumin-corrected CA can be used as indicators of patient survivability after critical injury. MATERIALS AND METHODS: CA and ALB values were retrospectively recorded in 64 random subjects (S= 32 and N= 32) admitted to the Trauma ICU for 3 or more days. CA and ALB data points were partitioned into 6 time frames of ICU care. Mean values and standard error of the mean for each frame were obtained to depict parametric differences in the time profiles for S versus N. Subgroup analysis was used to determine the impact of blood transfusions on CA and ALB levels. Albumin-corrected CA was computed for every patient at each measurement point and then partitioned into the 6 time frames of ICU care. Parametric t-test and nonparametric rank sum analysis were used to evaluate the ability of CA, ALB, and ALB-corrected CA at discriminating S from N. Each predictive covariate was ranked, divided into quartiles (grades = normal, mild, moderate, severe), and correlated with patient survival likelihood (viz., ratio of S to N in each quartile). RESULTS: Parametric and non-parametric analysis of collected data indicates that the response patterns of CA were significantly different ( P<.00005 ) in S versus N. Time profiles of CA and ALB exhibited similar reductions in both S and N during the resuscitation phase (ie, "hypocalcemia of trauma"). But from these nadir points, CA response patterns in S tended to steadily elevate toward normal levels (ie, "responders"), while N exhibited no such increase in CA values (ie, "nonresponders"). Data revealed that survival likelihood in trauma patients after 3 ICU days is proportional to the upward response of CA from depressed values present after the initial resuscitation. Decreased CA levels after 3 ICU days were associated with decreased survival (Table 1). Rank sum testing showed that values of CA corrected for ALB creates less obvious difference in S and N than uncorrected CA. Subgroup analysis showed a linear decrease in CA and ALB levels with increasing units of blood transfused during treatment for trauma. CONCLUSIONS: CA changes during ICU care demonstrate distinct response patterns (P <.00005) for survivors versus nonsurvivors. The magnitude of upward response in CA after the fluid resuscitation phase is a marker that correlates with a patient's ability to withstand the physiologic stresses encountered during ICU treatment after major trauma. Our findings indicate that uncorrected CA values are a better guide for calcium replacement therapy in trauma patients than albumin-adjusted CA. This study suggests that response patterns of CA can be a useful reference to aid in monitoring the progress of critically injured patients.
Assuntos
Estado Terminal , Hipoalbuminemia/epidemiologia , Hipocalcemia/epidemiologia , Ferimentos e Lesões/mortalidade , Adulto , Idoso , Biomarcadores/sangue , Transfusão de Sangue , Cálcio/sangue , Humanos , Hipoalbuminemia/sangue , Hipoalbuminemia/etiologia , Hipocalcemia/sangue , Hipocalcemia/etiologia , Unidades de Terapia Intensiva , Estudos Longitudinais , Los Angeles , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Ressuscitação , Estudos Retrospectivos , Albumina Sérica/análise , Análise de Sobrevida , Resultado do Tratamento , Ferimentos e Lesões/sangue , Ferimentos e Lesões/complicações , Ferimentos e Lesões/terapiaRESUMO
Using double immunofluorescence labeling, quantitative ratio between parvalbumin- and calbindin-containing neurons, neurons that co-localize both peptides, as well as the intensity of their immunoreactivities were studied in the brainstem, midbrain and forebrain auditory centers of two chelonian species, Testudo horsfieldi and Emys orbicularis. In the spiral ganglion and first-order cochlear nuclei, highly immunoreactive parvalbumin-containing neurons predominated, and almost all neurons in these nuclei also exhibited weak immunoreactivity to calbindin. The number of strongly calbindin-immunoreactive (-ir) cells increased in the second-order brainstem auditory centers (the laminar cochlear nucleus, superior olivary complex, lateral lemniscal nucleus), and co-localization with parvalbumin in some of them was observed. In the midbrain, a complementary distribution of parvalbumin and calbindin immunoreactivity was found: the central (core) region of the torus semicircularis showed strong parvalbumin immunoreactivity, while the laminar (belt) nucleus was strongly calbindin-ir. In the thalamic nucleus reuniens, almost complete topographic overlapping of the parvalbumin-ir and calbindin-ir neurons was shown in its dorsomedial region (core), with the intensity of immunoreactivity to calbindin being much higher than that to parvalbumin. The predominance of calbindin immunoreactivity in neurons of the dorsomedial region of the nucleus reuniens is correlated with the existence of the dense calbindin-ir terminal field in its projection area in the telencephalon. We conclude that the turtle auditory pathway is chemically heterogeneous with respect to calcium-binding proteins, the predominance of parvalbumin in the brainstem and midbrain centers giving way to that of calbindin in the forebrain centers; the portion of neurons co-localizing both peptides nonlinearly decreases from lower to higher order centers.
Assuntos
Vias Auditivas/química , Encéfalo/metabolismo , Neurônios/química , Parvalbuminas/análise , Proteína G de Ligação ao Cálcio S100/análise , Tartarugas/metabolismo , Animais , Vias Auditivas/metabolismo , Química Encefálica , Calbindinas , Imunofluorescência , Neurônios/metabolismo , Parvalbuminas/metabolismo , Proteína G de Ligação ao Cálcio S100/metabolismoRESUMO
The distribution of immunoreactivity to the calcium-binding proteins parvalbumin, calbindin and calretinin and of cytochrome oxidase activity was studied in the mesencephalic (torus semicircularis), thalamic (nucleus reuniens) and telencephalic (ventromedial part of the anterior dorsal ventricular ridge) auditory centres of two chelonian species Emys orbicularis and Testudo horsfieldi. In the torus semicircularis, the central nucleus (core) showed intense parvalbumin immunoreactivity and high cytochrome oxidase activity, whereas the laminar nucleus (belt) showed low cytochrome oxidase activity and dense calbindin/calretinin immunoreactivity. Within the central nucleus, the central and peripheral areas could be distinguished by a higher density of parvalbumin immunoreactivity and cytochrome oxidase activity in the core than in the peripheral area. In the nucleus reuniens, the dorsal and ventromedial (core) regions showed high cytochrome oxidase activity and immunoreactivity to all three calcium-binding proteins, while its ventrolateral part (belt) was weakly immunoreactive and showed lower cytochrome oxidase activity. In the telencephalic auditory centre, on the other hand, no particular region differed in either immunoreactivity or cytochrome oxidase activity. Our findings provide additional arguments in favour of the hypothesis of a core-and-belt organisation of the auditory sensory centres in non-mammalian amniotes though this organisation is less evident in higher order centres. The data are discussed in terms of the evolution of the auditory system in amniotes.
Assuntos
Vias Auditivas/metabolismo , Mesencéfalo/metabolismo , Proteínas de Répteis/metabolismo , Telencéfalo/metabolismo , Tálamo/metabolismo , Tartarugas/metabolismo , Animais , Vias Auditivas/enzimologia , Calbindina 2 , Calbindinas , Complexo IV da Cadeia de Transporte de Elétrons/metabolismo , Imuno-Histoquímica , Neurônios/enzimologia , Neurônios/metabolismo , Parvalbuminas/metabolismo , Prosencéfalo/enzimologia , Prosencéfalo/metabolismo , Proteína G de Ligação ao Cálcio S100/metabolismo , Especificidade da Espécie , Telencéfalo/enzimologia , Tálamo/enzimologiaRESUMO
A centrifugal visual system showing FMRF-amide-like immunoreactivity has been demonstrated in Lampetra fluviatilis by using immunocytochemical and hodological techniques. From 50 to 60 immunoreactive neurons, labelled after contralateral intraocular injection of rhodamine beta-isothiocyanate, form a small, clearly defined, nucleus in the lateral neural plate of the magnocellular preoptic nucleus. These cells give rise to immunoreactive axons which have been observed at the base of the nucleus, in the optic chiasma and in the optic nerve, to project into the intermediate plexiform layer of the retina, which separates the layer of internal horizontal cells from the layer of external horizontal cells. This FMRF-amide-like immunoreactive centrifugal visual system is compared to that described in Gnathostomes.
Assuntos
Axônios/metabolismo , FMRFamida/metabolismo , Lampreias/metabolismo , Área Pré-Óptica/metabolismo , Retina/metabolismo , Vias Visuais/metabolismo , Animais , Axônios/ultraestrutura , Mapeamento Encefálico , Vias Eferentes/citologia , Vias Eferentes/metabolismo , Corantes Fluorescentes , Imuno-Histoquímica , Lampreias/anatomia & histologia , Nervo Óptico/citologia , Nervo Óptico/metabolismo , Área Pré-Óptica/citologia , Retina/citologia , Células Horizontais da Retina/citologia , Células Horizontais da Retina/metabolismo , Rodaminas , Especificidade da Espécie , Vias Visuais/citologia , Percepção Visual/fisiologiaRESUMO
The ultrastructure of the retinorecipient layers of the lamprey optic tectum was analysed using tract tracing techniques combined with GABA and glutamate immunocytochemistry. Two types of neurons were identified; a population of large GABA-immunonegative cells, and a population of smaller, highly GABA-immunoreactive interneurons, some of whose dendrites contain synaptic vesicles (DCSV). Five types of axon terminals were identified and divided into two major categories. The first of these are GABA-immunonegative, highly glutamate-immunoreactive, contain round synaptic vesicles, make asymmetrical synaptic contacts, and can in turn be divided into AT1 and AT2 terminals. The AT1 terminals are those of the retinotectal projection. The origin of the nonretinal AT2 terminals could not be determined. AT1 and AT2 terminals establish synaptic contacts with DCSV, with dendrites of the retinopetal neurons (DRN), and with conventional dendritic (D) profiles. The terminals of the second category are GABA-immunoreactive and can similarly be divided into AT3 and AT4 terminals. The AT3 terminals contain pleiomorphic synaptic vesicles and make symmetrical synaptic contacts for the most part with glutamate-immunoreactive D profiles. The AT4 terminals contain rounded synaptic vesicles and make asymmetrical synaptic contacts with DRN, with DCSV, and with D profiles. A fifth, rarely observed category of terminals (AT5) contain both clear synaptic vesicles and a large number of dense-core vesicles. Synaptic triads involving AT1, AT2 or AT4 terminals are rare. Our findings are compared to these of previous studies of the fine structure and immunochemical properties of the retinorecipient layers of the optic tectum or superior colliculus of Gnathostomes.
Assuntos
Ácido Glutâmico/metabolismo , Lampreias/metabolismo , Lampreias/fisiologia , Colículos Superiores/metabolismo , Colículos Superiores/fisiologia , Ácido gama-Aminobutírico/metabolismo , Animais , Dendritos/metabolismo , Imuno-Histoquímica , Vias Neurais/metabolismo , Vias Neurais/fisiologia , Neurônios/metabolismo , Terminações Pré-Sinápticas/metabolismo , Coloração e Rotulagem , Vesículas Sinápticas/metabolismo , Vias Visuais/metabolismo , Vias Visuais/fisiologiaRESUMO
The ultrastructure of the lateroventral subcomponent of the visual dorsolateral anterior thalamic nucleus of the pigeon (DLLv) was analyzed using hodological techniques and GABA-immunocytochemistry. Two types of GABA-immunonegative hyperpalliopetal neurons and a single type of strongly GABA-immunoreactive (-ir) interneuron were identified, the latter displaying long dendrites with some containing synaptic vesicles (DCSV). Ten types of axon terminal were identified and divided into two categories. The first, GABA-immunonegative and making asymmetrical synaptic contact, contain round (RT1, RT2, RT3) or pleiomorphic synaptic and many dense-core vesicles (DCT). RT1 terminals are retinothalamic and RT2 terminals hyperpalliothalamic; both mainly contact dendrites of projection neurons (72% and 78% respectively), less frequently dendrites of interneurons and sometimes DCSV; RT1 terminals are rarely involved in synaptic triads. The second category are consistently GABA-immunopositive. Four types (PT1-4), distinguished by their pleiomorphic synaptic vesicles, make symmetrical synaptic contact essentially with dendrites of projection neurons, more rarely on dendrites of interneurons (PT2). PT1 terminals are very probably those of interneurons, whereas the rare PT4 terminals are of retinal origin. A fifth type (RgT) contains round synaptic vesicles and makes asymmetrical synaptic contact with dendrites of projection neurons and interneurons. PT2 and RgT terminals occasionally contact DCSV of interneurons, which are sometimes involved in synaptic triads. Two final subcategories (DCgT1-2) contain many dense-core vesicles. Our findings are compared with those of previous studies concerning the fine structure and neurochemical properties of the GLd of reptiles and mammals, with special reference to the origin of the extraretinal and extracortical projections to this structure.
Assuntos
Columbidae/anatomia & histologia , Interneurônios/metabolismo , Núcleos Talâmicos/citologia , Vias Visuais/citologia , Ácido gama-Aminobutírico/metabolismo , Animais , Dendritos/metabolismo , Dendritos/ultraestrutura , Imuno-Histoquímica , Interneurônios/ultraestrutura , Microscopia Eletrônica , Retina/citologia , Sinapses/metabolismo , Sinapses/ultraestruturaRESUMO
We report a novel method for rapidly fabricating ordered nanoneedles using an ion beam that cuts through the Fe/GaAs single thin layer or the Fe/MgO/Fe/GaAs multilayer producing a pillar pattern followed by raster-scanning normal to the patterned area. However, such ordered nanoneedles were not formed on the pure GaAs substrate surface without the thin Fe film coating, nor were nanoneedles formed on the GaAs substrate coated with a thin Cr epitaxial film, when this method was used. It has advantages over other methods, being simple, fast and well controlled for fabricating one-dimensional nanostructure arrays, leading to a range of applications such as high aspect ratio sharp tips for atomic force microscope/atom probes and consequent possible quantum confinement effects or arrays of nanostructures for field-optical/photoluminescence emission and data recording.