RESUMO
Along with environmental pollution caused by rapid economic development and industrialization, plastic waste is emerging as a global concern in relation to marine ecosystems and human health. Among the microplastics, fiber-type microfibers (MF) and bisphenol A (BPA), which are widely used as plasticizers, do not decompose well in the ocean, and tend to accumulate in organisms, generating an increased oxidative stress response. This study investigated the abalones' antioxidant and cell death responses following exposure to the environmental pollutants MF and BPA. Levels of malondialdehyde (MDA) and DNA damage increased over time, demonstrating the degree of lipid peroxidation and DNA damage in abalones exposed to individual and combined environmental conditions of MF and BPA. Compared to the single MF and BPA exposure groups, the combined exposure group showed a higher expression of antioxidant enzymes. A similar pattern was seen in the expression of the apoptosis enzyme caspase-3. Both MF and BPA caused oxidative stress and antioxidant enzymes were expressed to alleviate it, but it is believed that cell damage occurred because the stress level exceeded the allowed range.
Assuntos
Antioxidantes , Gastrópodes , Humanos , Animais , Antioxidantes/metabolismo , Microplásticos , Plásticos/toxicidade , Bioacumulação , Ecossistema , Estresse Oxidativo , Gastrópodes/genética , Gastrópodes/metabolismoRESUMO
High ocean temperatures caused by global warming induce oxidative stress in aquatic organisms. Melatonin treatment and irradiation using red light-emitting diodes (LEDs) have been reported to reduce oxidative stress in a few aquatic organisms. However, the effects of red LED irradiation and melatonin injection on the antioxidant capacity and degree of apoptosis in abalones, which are nocturnal organisms, have not yet been reported. In this study, we compared the expression levels of antioxidant enzymes, total antioxidant capacity, and the degree of apoptosis in abalones subjected to red LED irradiation and melatonin treatment. The results revealed that at high water temperatures (25 °C), the mRNA expression levels of the superoxide dismutase (SOD) and glutathione peroxidase (GPx) genes and the antioxidant activity of SOD decreased in abalones in the red-LED irradiated and melatonin-treated groups compared with those in abalones in the control group. Although high water temperatures induced DNA damage in the abalone samples, the degree of apoptosis was lower in the red-LED irradiated and melatonin-treated groups than in the control group. Overall, the abalones in the melatonin-treated and red-LED irradiated groups showed reduced oxidative stress and increased antioxidant enzyme levels under thermal stress compared with those in the control group. Therefore, red LED irradiation is a promising alternative to melatonin treatment, which is difficult to administer continuously for a long time, for protecting abalones from oxidative stress.
Assuntos
Antioxidantes , Apoptose , Gastrópodes , Glutationa Peroxidase , Luz , Melatonina , Estresse Oxidativo , Superóxido Dismutase , Melatonina/farmacologia , Apoptose/efeitos dos fármacos , Animais , Antioxidantes/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Superóxido Dismutase/metabolismo , Gastrópodes/efeitos da radiação , Gastrópodes/efeitos dos fármacos , Gastrópodes/metabolismo , Glutationa Peroxidase/metabolismo , Glutationa Peroxidase/genética , Dano ao DNARESUMO
Microplastics (MP) are harmful, causing stress in aquatic species and acting as carriers of hydrophobicity. In aquatic environments, benzo[α]pyrene (BaP) is an endocrine-disrupting chemical that accumulates in the body and causes toxic reactions in living organisms. We investigated the effects of single and combined microbead (MB) and BaP environments on goldfish antioxidant response and apoptosis. For 120 h, goldfish were exposed to single (MB10, MB100, and BaP5) and combined (MB10+BaP5 and MB100+BaP5) environments of 10 and 100 beads/L of 0.2 µm polystyrene MB and 5 µg/L BaP. We measured MB and BaP bioaccumulation as well as plasma parameters including ALT, AST, and glucose. The level of oxidative stress was determined by evaluating lipid peroxidation (LPO) and total antioxidant capacity (TAC) in plasma, as well as antioxidant-related genes for superoxide dismutase and catalase (SOD and CAT) and caspase-3 (Casp3) mRNA expression in liver tissue. The TUNEL assay was used to examine SOD in situ hybridization and apoptosis in goldfish livers. Except for the control group, plasma LPO levels increased at the end of the exposure period in all experimental groups. TAC increased up to 24 h of exposure and then maintained a similar level until the trial ended. SOD, CAT, and Casp3 mRNA expression increased substantially up to 120 h as the exposure concentration and time increased. The TUNEL assay revealed more signals and apoptotic signals in the combined exposure environments as a consequence of SOD in situ hybridization than in single exposure environments. These results suggest that combined exposure to toxic substances causes oxidative stress in organisms, which leads to apoptosis.
Assuntos
Antioxidantes , Carpa Dourada , Pirenos , Animais , Antioxidantes/metabolismo , Carpa Dourada/metabolismo , Benzo(a)pireno/toxicidade , Benzo(a)pireno/metabolismo , Caspase 3/genética , Caspase 3/metabolismo , Poliestirenos/toxicidade , Poliestirenos/metabolismo , Bioacumulação , Microesferas , Plásticos/metabolismo , Catalase/metabolismo , Estresse Oxidativo , Fígado/metabolismo , Superóxido Dismutase/metabolismo , RNA Mensageiro/metabolismoRESUMO
BACKGROUND: Despite the growing necessity for government-led policy changes on clinical research ethics during pandemic, the scope of previous literature is limited to Korean government's pandemic response strategies or reflections of research ethics at the level of institutions and academic societies. This paper examines the proactive policy changes and responses by the South Korean government in addressing the challenges and issues of research ethics against the backdrop of the urgency of rapid development and emergency supply of medical products during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: We conducted searches of various government documents, using predetermined keywords related to research ethics and integrity during the COVID-19 pandemic. Only documents issued by governments or public institutions were included. A total of 24 documents were selected for analysis. They were divided into two phases: the first phase for urgent response (January 2020-February 2021) and the second phase (March 2021-February 2023) for long-term preparedness. RESULTS: The Korean government recommended several measures of research governance to accelerate the ethical review of COVID-related research to be shortened less than one week: the joint operation of Institutional Review Boards (IRBs), exempted or expedited review by a special review committee, guidelines for urgent reviews, and designation of the Korean Academy of Medical Sciences as the supervising agency for the Clinical Trial Safety Support Institution as well as the Central IRB. It allowed temporary non-face-to-face methods for informed consent process (telephone explanations and a photo of the original signed consent) and clinical trials (telephone counselling and prescription, proxy prescription, and drug delivery and supply to clinical trial participants, and online ethics training). CONCLUSION: As a result of South Korea's commitment to ethical principles in their pandemic response, the medical system did not experience collapses due to the pandemic, and pandemic research was conducted with careful ethical considerations. The pandemic ethics immunization during the Middle East respiratory syndrome epidemic in 2015 laid the foundation for prompt government initiatives that ensured both pandemic research ethics and pandemic response ethics.
Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Pandemias/prevenção & controle , SARS-CoV-2 , República da Coreia/epidemiologia , Ética em Pesquisa , GovernoRESUMO
Global warming significantly impacts aquatic ecosystems, with changes in the salt environment negatively affecting the physiological responses of fish. We investigated the impact of hyposalinity on the physiological responses and intestinal microbiota of Sebastes schlegelii under the context of increased freshwater influx due to climate change. We focused on the osmoregulatory capacity, oxidative stress responses, and alterations in the intestinal microbiome of S. schlegelii under low-salinity conditions. Our findings revealed compromised osmoregulatory capacity in S. schlegelii under low-salinity conditions, accompanied by the activation of oxidative stress responses, indicating physiological adaptations to cope with environmental stress. Specifically, changes in Na+/K+-ATPase (NKA) activity in gill tissues were associated with decreased osmoregulatory capacity. Furthermore, the analysis of the intestinal microbiome led to significant changes in microbial diversity. Exposure to low-salinity environments led to dysbiosis, with notable decreases in the relative abundance of Gammaproteobacteria at the class level and specific genera such as Enterovibrio, and Photobacterium. Conversely, Bacilli classes, along with genera like Mycoplasma, exhibited increased proportions in fish exposed to low-salinity conditions. These findings underscore the potential impact of environmental salinity changes on the adaptive capacity of fish species, particularly in the context of aquaculture. Moreover, they highlight the importance of considering both physiological and microbial responses in understanding the resilience of aquatic organisms to environmental stress. Additionally, they highlight the importance of intestinal microbiota analyses in understanding the immune system and disease management in fish.
RESUMO
Bay scallops were exposed to four BaP concentrations (0.5, 1.0, 10 and 50 µg/L) for 72 h to elucidate their immune response. Immune parameters were evaluated by measuring nitric oxide (NO) levels in hemolymph. Additionally, we measured peptidoglycan recognition proteins (PGRP), fibrinogen-domain-containing protein (FReDC1), metallothionein (MT), and heat shock protein (HSP) 70 mRNA expression in digestive diverticula. NO as well as FReDC1 and MT expression in each BaP group increased significantly over time except for the BaP 0.5 group. The PGRP and HSP70 mRNA expression in the BaP 50 group increased in the range 6-24 h and then decreased. In situ hybridization also confirmed that there was higher MT mRNA expression in the BaP 50 group than in the control group at 72 h. Our results suggest that higher levels of BaP dampened scallop immune responses, while simultaneously reducing their ability to cope with oxidative stress and DNA damage. BaP exposure can be considered a potential immune inducer in bay scallop.
Assuntos
Benzo(a)pireno , Pectinidae , Animais , Benzo(a)pireno/toxicidade , Proteínas de Choque Térmico HSP70/genética , Hemolinfa/metabolismo , Metalotioneína/genética , RNA Mensageiro/metabolismoRESUMO
BACKGROUND: Ethiopia has experienced great improvements in life expectancy (LE) at birth over the last three decades. Despite consistent increases in LE for both males and females in Ethiopia, the country has simultaneously witnessed an increasing discrepancy in LE between males and females. METHODS: This study used Pollard's actuarial method of decomposing LE to compare age- and cause- specific contributions to changes in sex differences in LE between 1995 and 2015 in Ethiopia. RESULTS: Life expectancy at birth in Ethiopia increased for both males and females from 48.28 years and 50.12 years in 1995 to 65.59 years and 69.11 years in 2015, respectively. However, the sex differences in LE at birth also increased from 1.85 years in 1995 to 3.51 years in 2015. Decomposition analysis shows that the higher male mortality was consistently due to injuries and respiratory infections, which contributed to 1.57 out of 1.85 years in 1995 and 1.62 out of 3.51 years in 2015 of the sex differences in LE. Increased male mortality from non-communicable diseases (NCDs) also contributed to the increased difference in LE between males and females over the period, accounting for 0.21 out of 1.85 years and 1.05 out of 3.51 years in 1995 and 2015, respectively. CONCLUSIONS: While injuries and respiratory infections causing male mortality were the most consistent causes of the sex differences in LE in Ethiopia, morality from NCDs is the main cause of the recent increasing differences in LE between males and females. However, unlike the higher exposure of males to death from injuries due to road traffic injuries or interpersonal violence, to what extent sex differences are caused by the higher male mortality compared to female mortality from respiratory infection diseases is unclear. Similarly, despite Ethiopia's weak social security system, an explanation for the increased sex differences after the age of 40 years due to either longer female LE or reduced male LE should be further investigated.
Assuntos
Doenças Transmissíveis , Disparidades nos Níveis de Saúde , Expectativa de Vida , Doenças não Transmissíveis , Ferimentos e Lesões , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Doenças Transmissíveis/epidemiologia , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Expectativa de Vida/tendências , Masculino , Pessoa de Meia-Idade , Doenças não Transmissíveis/epidemiologia , Distribuição por Sexo , Ferimentos e Lesões/epidemiologia , Adulto JovemRESUMO
Laser speckle flowgraphy (LSFG) is a noninvasive technique that can measure relative blood flow velocity in the optic fundus contributed by the ophthalmic artery, the main first branch originating from the internal carotid artery (ICA). The aim of this study was to assess the feasibility of ocular blood flow measurement by LSFG to detect ischemic stress due to carotid clamping during carotid endarterectomy (CEA). Nineteen patients undergoing CEA with ocular blood flow measurement by LSFG and intraoperative monitoring (IOM) were prospectively enrolled between August 2016 and March 2019. The mean blur rate (MBR) of ocular blood flow by LSFG, representing relative blood flow of the branch of the retinal artery originating from the optic nerve head, was compared between before and after carotid clamping during CEA. The correlation between the reduction ratio of MBR and the regional saturation oxygen (rSO2) index by near infrared spectroscopy was investigated. Ocular blood flow measurement by LSFG could not be performed in one patient with a severe cataract. In the other 18 patients, LSFG could be performed in all 106 sessions during surgery. The MBR reduction ratio between before and after carotid clamping ranged from - 12 to 100%. The MBR reduction ratio was positively correlated with the rSO2 index (r = 0.694, 95% confidence interval: 0.336-0.877, p = 0.001). The MBR reduction ratio of ocular blood flow by LSFG after carotid clamping was significantly correlated with the rSO2 index. The ocular blood flow by LSFG could be considered an adjunct modality for evaluating cerebral ischemic tolerance during CEA.
Assuntos
Isquemia Encefálica , Endarterectomia das Carótidas , Velocidade do Fluxo Sanguíneo , Humanos , Fluxometria por Laser-Doppler , Lasers , Fluxo Sanguíneo RegionalRESUMO
Balloon test occlusion (BTO) is a useful examination for evaluating ischemic tolerance to internal carotid artery (ICA) occlusion. The aim of this study was to investigate the relationships between intraoperative motor evoked potential (MEP) monitoring and the results of preoperative BTO. Between 2013 and 2017, 32 patients undergoing surgery under general anesthesia with intraoperative MEP monitoring, in whom preoperative BTO was performed, were identified. A receiver operator characteristic (ROC) analysis was performed to determine the appropriate cutoff value of MEP amplitude for BTO-positive. Furthermore, the accuracy of MEP monitoring for BTO-positive was compared with electroencephalogram (EEG) and somatosensory evoked potential (SEP) monitoring. Four of 32 (12.5%) patients were BTO-positive. The cutoff value of MEP amplitude for BTO-positive was a > 80% reduction from the baseline level, which showed sensitivity of 100% and specificity of 100%. Thus, the sensitivity and specificity for BTO-positive were significantly higher for MEP than for EEG (100% and 72.0%, p = 0.02) in 28 patients, but they were not significantly different compared with SEP (33.3% and 100%, p = 0.48) in 21 patients. MEP monitoring might be one of the alternatives for evaluating ischemic tolerance to ICA occlusion during surgery. The cutoff value of MEP amplitude was a > 80% reduction.
Assuntos
Doenças das Artérias Carótidas , Potencial Evocado Motor , Artérias Carótidas , Doenças das Artérias Carótidas/cirurgia , Potenciais Somatossensoriais Evocados , Humanos , Monitorização IntraoperatóriaRESUMO
Reproductive hormones play essential roles in the control of reproduction and gonadal maturation in fish. The purpose of this study was to determine the effects of cortisol administration (10 µg/g or 50 µg/g) or red light irradiation at two intensities (0.5 W/m2 or 1.0 W/m2) on the reproductive hormones in goldfish (Carassius auratus). The effects of different treatments were analyzed by determining the mRNA expression levels of gonadotropin-inhibitory hormone receptor (GnIH-R), chicken gonadotropin-releasing hormone (cGnRH-II), salmon GnRH (sGnRH), FSHß, LHß, and plasma testosterone and the level of 17ß-estradiol for 48 h. Additionally, by double immunofluorescence staining, we detected the expression of both GnIH and GnRH in the diencephalons of goldfish brains. The mRNA expression of GnIH-R was significantly higher in the cortisol group and red light-irradiated group from 3 to 48 h than in the control group. Additionally, the mRNA levels of cGnRH-II, sGnRH, FSHß, LHß, testosterone, and 17ß-estradiol were significantly lower in the cortisol group than in the other groups from 3 to 48 h. These results indicated that both cortisol and red light-emitting diode (LED) light increased GnIH expression and inhibited GnRH expression. In particular, red light irradiation suppressed reproductive responses as much as the cortisol treatment at 48 h. Thus, it could be an alternative method for suppressing reproductive responses in future aquacultures.
Assuntos
Carpa Dourada , Hidrocortisona , Luz , Reprodução , Animais , Estradiol , Subunidade beta do Hormônio Folículoestimulante , Hormônio Liberador de Gonadotropina , Hidrocortisona/farmacologia , RNA Mensageiro , Reprodução/efeitos dos fármacos , Reprodução/efeitos da radiação , TestosteronaRESUMO
BACKGROUND: Recent life expectancy gains in high-income Asia-pacific countries have been largely the result of postponement of death from non-communicable diseases in old age, causing rapid demographic ageing. This study compared and quantified age- and cause-specific contributions to changes in old-age life expectancy in two high-income Asia-pacific countries with ageing populations, South Korea and Japan. METHODS: This study used Pollard's actuarial method of decomposing life expectancy to compare age- and cause-specific contributions to changes in old-age life expectancy between South Korea and Japan during 1997 and 2017. RESULTS: South Korea experienced rapid population ageing, and the gaps in life expectancy at 60 years old between South Korea and Japan were reduced by 2.47 years during 1997 and 2017. Decomposition analysis showed that mortality reductions from non-communicable diseases in South Korea were the leading causes of death contributing to the decreased gaps in old-age life expectancy between the two countries. More specifically, mortality reductions from cardiovascular diseases (stroke, ischaemic and hypertensive heart disease) and cancers (stomach, liver, lung, pancreatic cancers) in South Korea contributed to the decreased gap by 1.34 and 0.41 years, respectively. However, increased mortality from Alzheimer and dementia, lower respiratory tract disease, self-harm and falls in South Korea widened the gaps by 0.41 years. CONCLUSIONS: Age- and cause- specific contributions to changes in old-age life expectancy can differ between high-income Asia-pacific countries. Although the gaps in old-age life expectancy between high-income Asia-pacific countries are primarily attributed to mortality changes in non-communicable diseases, these countries should also identify potential emerging threats of communicable diseases and injuries along with demographic ageing in pursuit of healthy life years in old age.
Assuntos
Causas de Morte/tendências , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/mortalidade , Expectativa de Vida/tendências , Mortalidade/tendências , Doenças não Transmissíveis/epidemiologia , Doenças não Transmissíveis/mortalidade , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Previsões , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologiaRESUMO
We describe a rare case of extradural schwannoma in the upper cervical spine compressing the dominant internal jugular vein (IJV) presenting with atypical headaches. A 50-year-old woman complained of a subcutaneous neck mass associated with atypical headaches. Radiological examinations revealed the right IJV was compressed anteriorly by C2 extradural mass and occluded with markedly dilated collateral cerebral venous drainage through deep cervical veins. Subtotal removal was performed via the posterolateral approach and the atypical headaches resolved immediately. This case demonstrates that extradural schwannoma in the upper cervical spine could compress the IJV and manifest as cerebral venous circulation disturbances.
Assuntos
Veias Jugulares/diagnóstico por imagem , Neurilemoma/diagnóstico por imagem , Veias Cerebrais/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , RadiografiaRESUMO
While Asians are becoming the largest ethnic group in the United States, studies have focused on Asians as a single population. The purpose of this study was to explore the racial and ethnic mental health differences between non-Hispanic Whites and Asians, with an emphasis on understudied subgroups, from the California Health Interview Survey 2011/2012. In this dataset Asians had significantly lower adjusted odds ratios for both mental distress and serious mental illness. However, when Asians were divided into subgroups and compared to Whites, Vietnamese and Japanese subgroups were significantly lower than Whites for mental distress while Koreans were significantly higher. Vietnamese and Chinese were found to have significantly less serious mental illness than Whites in the subgroup analyses. Our results underscore the importance of recognizing that Asian subgroups should not be overlooked, and all Asians should not automatically be treated as a homogenous group.
Assuntos
Asiático/psicologia , Disparidades nos Níveis de Saúde , Transtornos Mentais/etnologia , População Branca/psicologia , Adolescente , Adulto , Idoso , California/epidemiologia , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: Fusiform aneurysms in the posterior inferior cerebellar artery (PICA) are rare and challenging to treat. Surgical treatment options for a fusiform aneurysm in the PICA include trapping with/without bypass and wrap-clipping, when elimination of the pathological wall from the systemic circulation and prevention of perforator injury are important. In addition, lower cranial nerve impairment due to surgical manipulation should also be avoided. METHOD: A fusiform-shaped aneurysm was found in a proximal part of the PICA by magnetic resonance angiography undertaken for evaluation of repeated vertigo in a 36-year-old man. The patient underwent direct surgery via a lateral suboccipital transcondylar fossa approach. The entrance of the pseudolumen was the only part to be wrapped and obstructed by clip application, through the corridor between the acoustic and glossopharyngeal nerves to avoid lower cranial nerve injury. RESULTS: Indocyanine green (ICG) videoangiography demonstrated obliteration of pseudolumen and patency of peripheral PICA and perforator contributing to the medulla oblongata. The postoperative course was uneventful without periprocedural complications, including dysphagia and hoarseness. CONCLUSIONS: Partial wrap-clipping technique for obstruction of the entrance into a pseudolumen is one of alternatives for dissecting fusiform-shaped aneurysm in the PICA. ICG videoangiography was helpful to confirm the obliteration of the pseudolumen and patency of parent vessel and perforators.
Assuntos
Dissecção Aórtica/cirurgia , Cerebelo/irrigação sanguínea , Aneurisma Intracraniano/cirurgia , Procedimentos Neurocirúrgicos/métodos , Adulto , Dissecção Aórtica/diagnóstico por imagem , Artérias/patologia , Artérias/cirurgia , Cerebelo/diagnóstico por imagem , Angiografia Cerebral/métodos , Transtornos de Deglutição/etiologia , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Masculino , Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Neurocirúrgicos/instrumentação , Complicações Pós-Operatórias/etiologia , Instrumentos CirúrgicosRESUMO
BACKGROUND: The aim of this study was to identify the correlation between the location of the internal carotid artery (ICA) and the need for an orbitozygomatic approach (OZA) when approaching a basilar apex (BX) aneurysm. MATERIALS AND METHODS: By imaging the virtual trajectory to access the basilar artery (BA) through the ICA, the correlations among the height of the BX, the height and lateral breadth of the bifurcation of the ICA, and the need for removal of the orbital rim or zygomatic arch were investigated using three-dimensional computed tomography angiography (3DCTA) data of approximately 80 random samples not limited to BX aneurysms. Furthermore, the utility of 3D simulation to determine the need for the OZA was verified using data from five patients with BX aneurysms. RESULTS: The height of the bifurcation of the ICA was inversely correlated and the height of the BX was positively correlated with the need for the OZA (both p < 0.017). Among patients undergoing surgery, clipping was successfully performed without the OZA in two patients in whom the distance from the simulated skull point on the extended line from the BX through the bifurcation of the ICA was more than 4 cm from the zygoma and orbital rim. CONCLUSIONS: It is necessary to determine the spatial relationship between the basilar artery and the ICA to decide whether the OZA is needed for surgery. Correlations of the height of the ICA and BX with the need for the OZA were not very strong individually, though they were significant. Therefore, simulation using 3DCTA appears to be important for planning the surgical approach for the treatment of BX aneurysms.
Assuntos
Artéria Basilar/diagnóstico por imagem , Artéria Carótida Interna/diagnóstico por imagem , Aneurisma Intracraniano/diagnóstico por imagem , Órbita/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Zigoma/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Aneurisma Intracraniano/cirurgia , Masculino , Pessoa de Meia-Idade , Zigoma/cirurgiaRESUMO
AIM: To evaluate efficacy of telephone-delivered interventions following suicide attempts. METHODS: Systematic review, meta-analysis, and narrative synthesis. RESULTS: Five papers evaluating telephone interventions were included. Three studies provided suicide attempters with telephone contact intervention, and two studies provided deliberate self-harm patients with crisis cards to help after discharge. Meta-analyses showed that telephone contact intervention did not significantly reduce further suicide attempts and completed suicides, and the crisis card did not significantly reduce further deliberate self-harm. CONCLUSION: Telephone-delivered interventions have been suggested as an alternative to face-to-face psychotherapy, but their effectiveness in reducing the recurrence of suicide attempts is not supported.
Assuntos
Psicoterapia Breve/métodos , Comportamento Autodestrutivo/prevenção & controle , Tentativa de Suicídio/prevenção & controle , Telefone , HumanosRESUMO
BACKGROUND: Cerebral venous ischemia (CVI) is a rare but potentially significant complication of neurosurgical procedures. However, it is still unclear how cerebral venous occlusion (VO) affects regional cerebral blood flow (rCBF) dynamics. To elucidate its pathophysiology in detail, we examined the real-time perfusion dynamics during adjacent vein occlusions using laser speckle contrast imaging (LSCI) in a rat 2-vein occlusion model. METHODS: Two cortical veins were occluded photochemically using rose Bengal dye in 6 male Wistar rats; rCBF was measured in real time with an LSCI before and after VO. Regions of interest were defined between the 2 veins (A) and on the opposite side of the first occluded vein (B) on semi-quantitative pseudocolor images for off-line analysis. Histopathologic evaluation was performed 3 days after the procedure to assess the extent of infarction. RESULTS: LSCI revealed a stepwise reduction in CBF, with a sudden decrease just after the first vein occlusion (~20%) and a further decrease after the second (~30%). Significant differences were observed between rCBF dynamics within regions of interest A and B (P = .0004). All rats exhibited infarcts in the superficial cerebral cortex histopathologically. CONCLUSIONS: This is the first report of LSCI specifically applied to the study of CVI. The extensive real-time measurement with high temporal and spatial resolution revealed the stepwise reduction in rCBF during sequential VO and the ensuing infarcts.
Assuntos
Veias Cerebrais/patologia , Circulação Cerebrovascular/fisiologia , Transtornos Cerebrovasculares/fisiopatologia , Fluxometria por Laser-Doppler , Animais , Córtex Cerebral/irrigação sanguínea , Meios de Contraste/metabolismo , Modelos Animais de Doenças , Processamento de Imagem Assistida por Computador , Masculino , Ratos , Ratos WistarRESUMO
A 76-year-old woman was admitted to our hospital because of dementia, nausea, and speech disturbances. Computed tomography(CT)of her brain showed hydrocephalus and an intra-ventricular mass with a left temporo-parieto-occipital low density area. She underwent emergency ventricular drainage. Thereafter, she was referred to our department: neurosurgery. Gadolinium-enhanced magnetic resonance imaging of the brain showed homonymous enhancement in the left lateral, third, and fourth ventricles. CT of her chest and abdomen showed no abnormal findings. Initially, we performed a neuro-endoscopic biopsy and made a histopathological diagnosis of noncaseating granuloma. However, because we did not detect pulmonary or ocular lesions, we eventually made a diagnosis of isolated neurosarcoidosis. She received a ventricular-peritoneal shunt and steroid pulse therapy, and recovered from all her symptoms. Neurosurgeons should be aware of the possibility of hydrocephalus mimicking an intraventricular tumor and caused by isolated neurosarcoidosis. In this article, we provide a case description and review of the literature.
Assuntos
Doenças do Sistema Nervoso Central/patologia , Sarcoidose/patologia , Idoso , Biópsia , Neoplasias Encefálicas/diagnóstico , Doenças do Sistema Nervoso Central/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Hidrocefalia/cirurgia , Imageamento por Ressonância Magnética , Imagem Multimodal , Neuroendoscopia , Sarcoidose/cirurgia , Tomografia Computadorizada por Raios XRESUMO
We report a case of a 56-year-old woman admitted to our hospital for status epilepticus. Three months before hospitalization, the patient underwent gross total removal of a glioblastoma with BCNU wafer implantation in the left parietal lobe. The cavity was subsequently lined with five BCNU wafers. After admission, magnetic resonance imaging(MRI)showed cyst formation accompanied by strong edema, with no recurrence of glioblastoma. She was initially administered antiepileptic drugs and glycerol with betamethasone, after which her seizures stopped but recurred one month later due to a decrease in betamethasone. The BCNU wafers were removed four months after the initial surgery, after which the seizures completely stopped. Histopathological examination of the cavity indicated the presence of inflamed tissue and no recurrence of glioblastoma. Neurosurgeons should be aware of the possibility of cyst formation after BCNU wafer implantation for malignant gliomas. In this manuscript, we provide a case presentation and a review of the literature.
Assuntos
Antineoplásicos Alquilantes/efeitos adversos , Neoplasias Encefálicas/cirurgia , Carmustina/efeitos adversos , Cistos/cirurgia , Glioblastoma/cirurgia , Recidiva Local de Neoplasia/cirurgia , Antineoplásicos Alquilantes/uso terapêutico , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/patologia , Carmustina/uso terapêutico , Terapia Combinada/métodos , Cistos/diagnóstico , Cistos/etiologia , Feminino , Glioblastoma/diagnóstico , Glioblastoma/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Resultado do TratamentoRESUMO
The simultaneous presence of cavernous angiomas in both the brain and spinal cord is a very rare finding, as is the location of a cavernous angioma in the cauda equina. We reported a unique case of coexisting with multiple cerebral cavernous angiomas in the brain and cauda equina.