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1.
Revista brasileira de ciência e movimento ; 29(1): [1-14], nov. 2021. tab, ilus
Article in Portuguese | LILACS | ID: biblio-1348181

ABSTRACT

O objetivo desse artigo foi analisar criticamente a literatura a respeito da ativação muscular pelo uso do Conceito Bobath em indivíduos com Paralisia Cerebral. As bases de dados consultadas foram Pubmed, Science Direct, Scielo, Lilacs, PEDro e ResearchGate, não limitando o período de publicação, sendo incluídos artigos publicados até maio de 2020. Foram encontrados na literatura 827 estudos, destes apenas cinco foram incluídos nessa revisão. Os artigos inclusos, a partir de critérios pré-estabelecidos, avaliaram através da eletromiografia diferentes musculaturas pelo uso de manuseios do Conceito Bobath. As musculaturas avaliadas estão relacionadas ao controle de cervical e de tronco, além dos músculos oblíquo interno, transverso do abdome e reto abdominal. A ativação muscular foi avaliada nas posturas de decúbito lateral, decúbito ventral e sedestação. Os artigos revisados identificaram através da eletromiografia que ocorre ativação muscular durante alguns manuseios do Conceito Bobath em indivíduos com paralisia cerebral, contudo as pesquisas são escassas, já que os estudos apresentam limitações nos desenhos experimentais e amostras pequenas. Isso reforça a importância de ampliar a investigação acerca da ativação muscular durante os manuseios com esta abordagem, o que poderá contribuir efetivamente na tomada de decisão dos profissionais que atuam nesta área, visando maior eficácia no tratamento e qualidade de vida desta população.AU)


The aim of this article was to critically analyze the literature on muscle activation by the use of the Bobath Concept in individuals with Cerebral Palsy. The databases consulted were Pubmed, Science Direct, Scielo, Lilacs, PEDro and ResearchGate, not limiting the publication period, including articles published until May 2020. A total of 827 studies were found in the literature, and of these only five were included in this review. The included articles, based on pre-established criteria, evaluated through electromyography different muscles using the Bobath Concept handling. The muscles evaluated are related to cervical and trunk control, in addition to the internal oblique, transverse muscles of the abdomen and rectum. Muscle activation was evaluated in lateral decubitus postures, ventral decubitus and sedestation. The reviewed articles identified, through electromyography, that muscle activation occurs during some handling of the Bobath Concept in individuals with cerebral palsy, however research is scarce, since studies have limitations in experimental designs and small samples. This reinforces the importance of expanding the investigation about muscle activation during handling with this approach, which can effectively contribute to the decision making of professionals working in this area, aiming at greater efficiency in the treatment and quality of life of this population.(AU)


Subject(s)
Humans , Child , Adolescent , Cerebral Palsy , Physical Therapy Modalities , Electromyography , Publications , Research , Brain Injuries , Treatment Outcome , Prone Position , PubMed , Abdomen , Exercise Therapy , Muscle Stretching Exercises , Transcranial Direct Current Stimulation , LILACS , Literature , Motor Activity , Muscles
2.
Article in Spanish | LILACS | ID: biblio-1353440

ABSTRACT

ABSTRACT: Introduction: According to the world health organization, injuries represent more than 20% of health problems in the world. Head trauma and the absence of neurosurgery and radiology services in less populated areas make it difficult to assess and manage patients with brain injury. Objective: To describe the clinical findings and benefits derived from the implementation of teleradiology in neurotrauma in areas of difficult geographic access. Materials and methods: A systematic search was carried out in Pubmed, Scopus, Ebsco host, Sciencedirect, and Embase, with the thesauri "Teleradiology" and "Craniocerebral Trauma". Results: The decision to intervene in a patient with brain trauma and the period of time until surgery are essential for the clinical outcome. Those centers that use teleradiology require transfers to specialized hospitals, for which portable technological devices contribute to the response time of neurosurgery care. Conclusion: Teleradiology has a positive impact on patients with traumatic brain injury in geographical areas of difficult access, facilitating communication with specialists; providing timely care and optimizing transfers to high complexity centers.


RESUMEN: Introducción: Según la organización mundial de la saludlos traumatismos representan más del 20% de los pro-blemas en salud en el mundo. El trauma craneoencefálico y la ausencia de servicios de neurocirugía y radiología en zonas menos pobladas dificultan la valoración y manejo de pacientes con lesión cerebral. Objetivo: Describir los hallazgos clínicos y beneficios derivados de la implementación de la telerradiología en neurotrauma en áreas de difícil acceso geográfico. Materiales y métodos: Se realizó una búsqueda sistemática en Pubmed, Scopus, Ebsco host, Sciencedirect, y Embase, con los tesauros "Teleradiology" y "Craniocerebral Trauma". Resultados: La decisi-ón de intervenir a un paciente con traumatismo cerebral y el periodo de tiempo hasta la cirugía son fundamentales para el desenlace clínico. Aquellos centros que usan la telerradiología, precisan los traslados a los hospitales espe-cializados, por lo cual los dispositivos tecnológicos portátiles contribuyen en el tiempo de respuesta de la atención en neurocirugía. Conclusión: La telerradiología impacta positivamente en pacientes con trauma craneoencefálico en zonas geográficas de difícil acceso, facilitando la comunicación con especialistas; brindando atención oportuna y optimizando los traslados a centros de alta complejidad. (AU)


Subject(s)
Radiology , Brain Injuries , Teleradiology , Brain Injuries, Traumatic , Craniocerebral Trauma
3.
Rev. bras. ter. intensiva ; 33(3): 412-421, jul.-set. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1347289

ABSTRACT

RESUMO Objetivo: Calcular as velocidades médias da dilatação de pupila para classificar a gravidade da lesão derivada da escala de coma de Glasgow, estratificada por variáveis de confusão. Métodos: Neste estudo, analisaram-se 68.813 exames das pupilas para determinar a velocidade normal de dilatação em 3.595 pacientes com lesão cerebral leve (13 - 15), moderada (9 - 12) ou grave (3 - 8), segundo a escala de coma de Glasgow. As variáveis idade, sexo, raça, tamanho da pupila, tempo de permanência na unidade de terapia intensiva, pressão intracraniana, uso de narcóticos, classificação pela escala de coma de Glasgow e diagnóstico foram consideradas confundidoras e controladas para análise estatística. Empregou-se regressão logística com base em algoritmo de classificação com aprendizado de máquina para identificar os pontos de corte da velocidade de dilatação para as categorias segundo a escala de coma de Glasgow. Resultados: As razões de chance e os intervalos de confiança desses fatores se mostraram estatisticamente significantes em sua influência sobre a velocidade de dilatação. A classificação com base na área sob a curva mostrou que, para o grau leve, na escala de coma de Glasgow, o limite da velocidade de dilatação foi de 1,2mm/s, com taxas de falsa probabilidade de 0,1602 e 0,1902 e áreas sob a curva de 0,8380 e 0,8080, respectivamente, para os olhos esquerdo e direito. Para grau moderado na escala de coma de Glasgow, a velocidade de dilatação foi de 1,1mm/s com taxas de falsa probabilidade de 0,1880 e 0,1940 e áreas sob a curva de 0,8120 e 0,8060, respectivamente, nos olhos esquerdo e direito. Mais ainda, para o grau grave na escala de coma de Glasgow, a velocidade de dilatação foi de 0,9mm/s, com taxas de falsa probabilidade de 0,1980 e 0,2060 e áreas sob a curva de 0,8020 e 0,7940, respectivamente, nos olhos esquerdo e direito. Esses valores foram diferentes dos métodos prévios de descrição subjetiva e das velocidades de dilatação previamente estimadas. Conclusão: Observaram-se velocidades mais lentas de dilatação pupilar em pacientes com escores mais baixos na escala de coma de Glasgow, indicando que diminuição da velocidade pode indicar grau mais grave de lesão neuronal.


ABSTRACT Objective: To calculate mean dilation velocities for Glasgow coma scale-derived injury severity classifications stratified by multiple confounding variables. Methods: In this study, we examined 68,813 pupil readings from 3,595 patients to determine normal dilation velocity with brain injury categorized based upon a Glasgow coma scale as mild (13 - 15), moderate (9 - 12), or severe (3 - 8). The variables age, sex, race, pupil size, intensive care unit length of stay, intracranial pressure, use of narcotics, Glasgow coma scale, and diagnosis were considered as confounding and controlled for in statistical analysis. Machine learning classification algorithm-based logistic regression was employed to identify dilation velocity cutoffs for Glasgow coma scale categories. Results: The odds ratios and confidence intervals of these factors were shown to be statistically significant in their influence on dilation velocity. Classification based on the area under the curve showed that for the mild Glasgow coma scale, the dilation velocity threshold value was 1.2mm/s, with false probability rates of 0.1602 and 0.1902 and areas under the curve of 0.8380 and 0.8080 in the left and right eyes, respectively. For the moderate Glasgow coma scale, the dilation velocity was 1.1mm/s, with false probability rates of 0.1880 and 0.1940 and areas under the curve of 0.8120 and 0.8060 in the left and right eyes, respectively. Furthermore, for the severe Glasgow coma scale, the dilation velocity was 0.9mm/s, with false probability rates of 0.1980 and 0.2060 and areas under the curve of 0.8020 and 0.7940 in the left and right eyes, respectively. These values were different from the previous method of subjective description and from previously estimated normal dilation velocities. Conclusion: Slower dilation velocities were observed in patients with lower Glasgow coma scores, indicating that decreasing velocities may indicate a higher degree of neuronal injury.


Subject(s)
Humans , Brain Injuries , Pupil , Biomarkers , Glasgow Coma Scale , Dilatation
5.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(1): 40-46, maio 5, 2021. fig, tab
Article in Portuguese | LILACS | ID: biblio-1354796

ABSTRACT

Objetivo: analisar a influência de atividades de dupla tarefa na cinemática da marcha de indivíduos com hemiparesia espástica. Metodologia: amostra de 12 indivíduos, com idade entre 30 e 71 anos. Primeiramente, as tarefas simples foram realizadas: marcha simples (tarefa motora), tarefa de fluência verbal (tarefa cognitiva) e tarefa visuoespacial (tarefa cognitiva). Após, as duplas tarefas foram realizadas, onde foi realizada a marcha ao mesmo tempo das tarefas cognitivas. Para a avaliação da marcha, foi utilizado um sistema de captura da trajetória tridimensional da marcha e as variáveis estudadas foram cadência, velocidade, comprimento da passada, largura do passo, tempo da passada, apoio simples e apoio duplo. Para a análise dos resultados utilizou-se estatística descritiva, o teste t pareado e o teste de Correlação de Pearson (p<0,05). Resultados: na comparação com a marcha simples, durante as atividades de dupla tarefa os indivíduos apresentarem piores resultados nas variáveis cinemáticas da marcha. Durante a dupla tarefa de fluência verbal, as principais diferenças quando comparado com a marcha simples foram: velocidade, cadência, o tempo da passada, comprimento da passada e apoio simples. Já a dupla tarefa cognitiva visuoespacial demonstrou as principais diferenças na: velocidade, comprimento da passada e apoio simples. Houve correlação forte e significativa do Mini Exame do Estado Mental com a tarefa de fluência verbal simples e com a dupla tarefa; assim como para a tarefa visuoespacial simples e na dupla tarefa. Conclusão: conclui-se que ocorreu alteração em alguns parâmetros cinemáticos da marcha quando associado à dupla tarefa, com maior influência negativa da tarefa cognitiva de fluência verbal quando comparadas com a visuoespacial.


Objective: o analyze the influence of dual task activities on gait's kinematics in individuals with plastic hemiparesis. Methodology: included 12 individuals, aged between 30 and 71 years old. Firstly, simple tasks were performed: simple gait (motor task), verbal fluency task (cognitive task) and visuospatial task (cognitive task). Afterwards, the dual tasks were performed, where the gait was performed at the same time as the cognitive tasks. For gait assessment, a three-dimensional gait trajectory capture system was used and the variables studied were cadence, velocity, stride length, stride width, stride time, single support and double support. Descriptive statistics, paired t-test and Pearson's correlation test were used to analyze the results (p<0.05). Results: in comparison with single gait, during dual task activities, individuals showed worse results in gait's kinematic variables. During the dual task of verbal fluency and gait, the main differences when compared to simple gait were: velocity, cadence, stride time, stride length and simple support. Already visual-spatial cognitive task and gait demonstrated the main differences in: velocity stride length, simple support. There was a strong and significant correlation between Mini Mental State Examination with the simple verbal fluency task and with the double task; as well as for the simple visuospatial task and with the double task. Conclusion: it was concluded that modifications on some gait's kinematic parameters of gait occurred when associated with the double task, with a greater negative influence of the cognitive task of verbal fluency when compared with the visuospatial task.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Paresis , Brain Injuries , Cognition , Gait , Comparative Study , Demography , Epidemiology, Descriptive , Observational Study
6.
Pesqui. vet. bras ; 41: e06912, 2021. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1346689

ABSTRACT

Equine leukoencephalomalacia (LEM) is a disease caused by the ingestion of food, especially corn, contaminated by fumonisin, a Fusarium verticillioides (synonymous with F. moniliforme) metabolite. The clinical signs of brain injuries have an acute onset and rapid evolution. This study aimed to describe the clinical findings in 11 animals diagnosed with LEM, including cerebrospinal fluid (CSF) analysis. Of these animals, 91% (10/11) were horses, and only 9% (1/11) were asinine. The clinical localization of the lesions was 64% (7/10) cerebral, manifested mainly by altered mental state and behavioral disturbance, and 36% (4/11) were brainstem lesions, manifested by incoordination, head tilt, nystagmus, facial hypoalgesia, difficulty in apprehension, chewing, and swallowing food. Postmortem findings revealed that 82% (9/11) of the lesions were in the cerebrum and 18% (2/11) in the brainstem. CSF findings, such as xanthochromia (43%, 3/7), hyperproteinorrachia (50%, 3/6), and pleocytosis (43%, 3/7) were observed. The affected animals showed neurological signs that were compatible with cerebral and/or brainstem injuries. The CSF from animals with LEM may present with xanthochromia, hyperproteinorrachia, and pleocytosis, reinforcing the fact that this disease should be included in the differential diagnosis of encephalomyelopathies.(AU)


A leucoencefalomalácia (LEM) é uma enfermidade que acomete equídeos causada pela ingestão de milho e seus derivados e feno contaminados pela micotoxina fumonisina, um metabólito do fungo Fusarium verticillioides (sinônimo para F. moniliforme). Os sinais clínicos apresentam início agudo e evolução rápida e são decorrentes de lesões encefálicas. O objetivo deste estudo é descrever os achados clínicos de 11 equídeos diagnosticados com LEM, incluindo a análise do líquido cefalorraquidiano (LCR). 91% dos animais afetados eram equinos e somente 9% (1/11) era asinino. A localização clínica das lesões era 64% (7/10) cerebrais, manifestadas por alterações no estado mental e comportamento e 36% (4/10) no tronco encefálico, manifestadas por incoordenação, desvio lateral de cabeça, nistagmo, hipoalgesia da face e dificuldade de apreensão, mastigação e deglutição de alimentos. Comparativamente, os achados post mortem revelaram que 82% (9/11) das lesões eram no cérebro e 18% (2/11) no tronco encefálico. Alterações no LCR, tais como xantocromia (43%, 3/7), hiperproteinorraquia (50%, 3/6) e pleocitose (43%, 3/7), foram observadas. Os animais afetados apresentaram sinais clínicos compatíveis com lesões encefálicas e/ou de tronco cerebral. O LCR de animais com LEM pode apresentar xantocromia, hiperproteinorraquia, e pleocitose, reforçando que esta doença deve ser incluída como diagnóstico diferencial de encefalomielites.(AU)


Subject(s)
Animals , Brain Injuries , Cerebrospinal Fluid , Leukoencephalopathies/microbiology , Fusarium , Horses , Leukocytosis , Mycotoxins , Eating
7.
Article in Chinese | WPRIM | ID: wpr-888473

ABSTRACT

OBJECTIVE@#To determine the association of circular RNA (circRNA) and circRNA-microRNA (miRNA) network regulation with brain injury induced by inflammation in preterm mice.@*METHODS@#Pregnant mice were treated with intraperitoneally injected lipopolysaccharide to establish a preterm mouse model of brain injury induced by inflammation (inflammation preterm group with 3 mice). Preterm mice born to normal pregnant mice by cesarean section were selected as controls (non-inflammation preterm group with 3 mice). The gene microarray technique was used to screen out the circRNAs associated with brain injury in preterm mice. The miRNA target prediction software was used to predict the binding sites between circRNAs and miRNAs and analyze the regulatory mechanism.@*RESULTS@#A total of 365 differentially expressed circRNAs were screened out between the inflammation preterm and non-inflammation preterm groups (fold change > 1.5, @*CONCLUSIONS@#Inflammation induces a significant change in the expression profile of circRNAs in the brain tissue of mice, and the change in the expression of circRNAs plays an important role in brain injury induced by inflammation and subsequent brain development in preterm mice.


Subject(s)
Animals , Brain Injuries , Cesarean Section , Female , Gene Expression Profiling , Inflammation/genetics , Mice , MicroRNAs/genetics , Pregnancy , RNA/genetics , RNA, Circular
8.
Article in Chinese | WPRIM | ID: wpr-888241

ABSTRACT

Sports-related traumatic brain injury (srTBI) is a traumatic brain injury (TBI) caused by sports, which can result in cognitive and motor dysfunction. Currently, research on the molecular mechanism of srTBI and related drug development mainly relies on monolayer culture models and animal models. However, many differences exist in cell populations and inflammatory responses between these models and human pathophysiological processes. Most of the researches derived from the models can't effectively conducted translational research. Emerging three-dimensional (3D)


Subject(s)
Animals , Brain Injuries , Brain Injuries, Traumatic , Humans
9.
Chinese Journal of Traumatology ; (6): 333-343, 2021.
Article in English | WPRIM | ID: wpr-922708

ABSTRACT

PURPOSE@#Patients' gender, which can be one of the most important determinants of traumatic brain injury (TBI) outcomes, is also likely to interact with many other outcome variables of TBI. This multicenter descriptive study investigated gender differences in epidemiological, clinical, treatment, mortality, and variable characteristics in adult TBI patients.@*METHODS@#The selection criteria were defined as patients who had been diagnosed with TBI and were admitted to the hospital between January 1, 2016 and December 31, 2018. A total of 4468 adult TBI patients were enrolled at eight University Hospitals. Based on the list of enrolled patients, the medical records of the patients were reviewed and they were registered online at each hospital. The registered patients were classified into three groups according to the Glasgow coma scale (GCS) score: mild (13-15), moderate (9-12), and severe (3-8), and the differences between men and women in each group were investigated. The risk factors of moderated and severe TBI compared to mild TBI were also investigated.@*RESULTS@#The study included 3075 men and 1393 women and the proportion of total males was 68.8%. Among all the TBI patients, there were significant differences between men and women in age, past history, and GCS score. While the mild and severe TBI groups showed significant differences in age, past history, and clinical symptoms, the moderate TBI group showed significant differences in age, past history, cause of justice, and diagnosis.@*CONCLUSION@#To the best of our knowledge, this multicenter study is the first to focus on gender differences of adult patients with TBI in Korea. This study shows significant differences between men and women in many aspects of adult TBI. Therefore, gender differences should be strongly considered in TBI studies.


Subject(s)
Adult , Brain Injuries , Brain Injuries, Traumatic/epidemiology , Female , Glasgow Coma Scale , Humans , Male , Prospective Studies , Sex Factors
10.
Acta Physiologica Sinica ; (6): 909-916, 2021.
Article in Chinese | WPRIM | ID: wpr-921295

ABSTRACT

The aim of the present study was to investigate the effects of different courses of electroacupuncture on synaptic structure and synaptic function-related proteins expression in the hippocampal CA1 region of radiation-induced brain injury mice. Sixty C57BL/6J male mice were randomly divided into control group, radiation-induced brain injury model group, 1-week electroacupuncture group (EA1), 2-week electroacupuncture group (EA2), 3-week electroacupuncture group (EA3), and electroacupuncture-control (EA-Ctrl) group. The mice in model group were exposed to X-ray irradiation (8 Gy, 10 min) to establish radiation-induced brain injury model. The mice in EA groups were acupunctured at electroacupuncture points (Baihui, Fengfu and bilateral Shenshu) for 1 week, 2 weeks and 3 weeks respectively after radiation. Immunohistochemistry was used to observe synaptic structure in hippocampal CA1 region. The expressions of brain-derived neurotrophic factor (BDNF), synapsin-1 and postsynaptic density 95 (PSD95) in the hippocampal CA1 region of each group were detected by RT-PCR and Western blotting. The results showed that the nuclear gap in model and EA-Ctrl groups was significantly decreased compared to control group, however nucleus to cytoplasm ratio was significantly increased. The synaptic cleft, postsynaptic density (PSD) thickness, the mitochondrial surface density, volume density and specific surface area were significantly reduced. Compared with model group, the nucleus to cytoplasm ratio of EA2 group was significantly decreased, the PSD thickness and mitochondrial volume density were significantly increased; the nuclear gap of EA3 group was significantly increased, nucleus to cytoplasm ratio was significantly decreased, synaptic cleft and PSD thickness were significantly increased, and the mitochondrial surface density and specific surface area were all increased significantly. In addition, compared with the control group, the gene and protein expressions of BDNF, synapsin-1 and PSD95 in the hippocampal CA1 region of the model group and EA-Ctrl group were significantly decreased. However, compared with the model group, the gene expression of synapsin-1 in EA groups was significantly up-regulated, the gene expression of BDNF in EA1 and EA2 groups was significantly up-regulated, and the gene expression of PSD95 in EA2 group was significantly up-regulated. Moreover, the protein expressions of BDNF, synapsin-1 and PSD95 of EA groups were significantly up-regulated compared with the model group. These results indicate that the synaptic structure and the expression of synaptic function-related proteins in hippocampal CA1 region were injured by radiation exposure, whereas electroacupuncture intervention can significantly improve the synaptic structure and function damage caused by radiation.


Subject(s)
Animals , Brain Injuries , CA1 Region, Hippocampal , Electroacupuncture , Hippocampus , Male , Mice , Mice, Inbred C57BL
11.
In. Manzanares Castro, William; Aramendi Epstein, Ignacio; Pico, José Luis do. Disionías en el paciente grave: historias clínicas comentadas. Montevideo, Cuadrado, 2021. p.51-68, tab.
Monography in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1344692
12.
In. Manzanares Castro, William; Aramendi Epstein, Ignacio; Pico, José Luis do. Disionías en el paciente grave: historias clínicas comentadas. Montevideo, Cuadrado, 2021. p.103-117.
Monography in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1344695
15.
Int. j. morphol ; 38(5): 1217-1222, oct. 2020. graf
Article in English | LILACS | ID: biblio-1134428

ABSTRACT

SUMMARY: Repeated stress is a risk factor for memory impairment and neurological abnormalities in both humans and animals. We sought to investigate the extent of (i) brain tissue injury; (ii) nitrosative and oxidative stress in brain tissue homogenates; (iii) apoptotic and survival biomarkers in brain tissue homogenates; and (iv) immobility and climbing abilities, induced over a period of three weeks by chronic unpredictable stress (CUS). Wistar rats were either left untreated (Control group) or exposed to a variety of unpredictable stressors daily before being sacrificed after 3 weeks (model group). Assessment of depression-like behavior was performed and animals were then culled and harvested brain tissues were stained with basic histological staining and examined under light microscopy. In addition, brain tissue homogenates were prepared and assayed for these parameters; inducible nitric oxide synthase (iNOS), malondialdehyde (MDA), superoxide dismutase (SOD), caspase-3, and B-cell lymphoma 2 (Bcl-2). Histology images showed CUS induced profound damage to the cerebral cortex as demonstrated by severe neuronal damage with shrunken cells, disrupted atrophic nuclei, perineuronal vacuolation and swollen glial cells. CUS also significantly (p<0.05) induced iNOS, MDA, and caspase-3, whereas SOD and Bcl-2 brain tissue levels were inhibited by CUS. In addition, data from the depression-like behavior, forced swimming test showed significant (p<0.05) increase in animal immobility and decrease in climbing ability in the model group of rats. Thus, here we demonstrated a reliable rat model of chronic stress-induced brain injury, which can further be used to investigate beneficial drugs or agents used for a period of three weeks to protect against CUS-induced brain damage.


RESUMEN: El estrés crónico es un factor de riesgo para el deterioro de la memoria y las anomalías neurológicas tanto en humanos como en animales. Intentamos investigar el alcance de lesión del tejido cerebral; (ii) estrés nitrosativo y oxidativo en homogeneizados de tejido cerebral; (iii) biomarcadores apoptóticos y de supervivencia en homogeneizados de tejido cerebral; y (iv) inmovilidad y habilidades de escalada, inducidas durante un período de tres semanas por estrés crónico impredecible (ECI). Se dejaron sin tratamiento (grupo control) ratas Wistar, o se expusieron a una variedad de factores estresantes impredecibles diariamente antes de ser sacrificadas después de 3 semanas (grupo modelo). Se realizó una evaluación del comportamiento similar a la depresión y luego se sacrificaron los animales y se tiñeron los tejidos cerebrales con tinción histológica básica y se examinaron con microscopía óptica. Además, se prepararon homogeneizados de tejido cerebral y se analizaron los siguientes parámetros; óxido nítrico sintasa inducible (iNOS), malondialdehído (MDA), superóxido dismutasa (SOD), caspasa- 3 y linfoma de células B 2 (Bcl-2). Las imágenes histológicas mostraron que el CUS indujo un daño profundo en la corteza cerebral como lo demuestra el daño neuronal severo con células encogidas, núcleos atróficos alterados, vacuolación perineuronal y células gliales inflamadas. ECI también indujo significativamente (p <0,05) iNOS, MDA y caspase-3, mientras que los niveles de tejido cerebral SOD y Bcl-2 fueron inhibidos por ECI. Además, los datos del comportamiento similar a la de- presión, la prueba de natación forzada mostró un aumento significativo (p <0,05) en la inmovilidad animal y una disminución en la capacidad de escalada en el grupo modelo de ratas. Por lo tanto, aquí demostramos un modelo confiable de daño cerebral crónico en rata inducido por el estrés, que se puede utilizar para investigar medicamentos o agentes beneficiosos usados durante un período de tres semanas para proteger el daño cerebral inducido por ECI.


Subject(s)
Animals , Male , Rats , Stress, Psychological/complications , Brain Damage, Chronic/pathology , Superoxide Dismutase/analysis , Behavior, Animal , Brain Injuries/metabolism , Biomarkers , Cerebral Cortex , Chronic Disease , Analysis of Variance , Rats, Wistar , Apoptosis , Oxidative Stress , Nitric Oxide Synthase/analysis , Proto-Oncogene Proteins c-bcl-2 , Depression , Disease Models, Animal , Caspase 3/analysis , Nitrosative Stress , Malondialdehyde/analysis
16.
Psicol. reflex. crit ; 33: 18, 2020. tab
Article in English | LILACS-Express | LILACS, INDEXPSI | ID: biblio-1135901

ABSTRACT

Abstract Background Evaluating patients in the acute phase of brain damage allows for the early detection of cognitive and linguistic impairments and the implementation of more effective interventions. However, few cross-cultural instruments are available for the bedside assessment of language abilities. The aim of this study was to develop a brief assessment instrument and evaluate its content validity. Methods Stimuli for the new assessment instrument were selected from the M1-Alpha and MTL-BR batteries (Stage 1). Sixty-five images were redesigned and analyzed by non-expert judges (Stage 2). This was followed by the analysis of expert judges (Stage 3), where nine speech pathologists with doctoral training and experience in aphasiology and/or linguistics evaluated the images, words, nonwords, and phrases for inclusion in the instrument. Two pilot studies (Stage 4) were then conducted in order to identify any remaining errors in the instrument and scoring instructions. Results Sixty of the 65 figures examined by the judges achieved inter-rater agreement rates of at least 80%. Modifications were suggested to 22 images, which were therefore reanalyzed by the judges, who reached high levels of inter-rater agreement (AC1 = 0.98 [CI = 0.96-1]). New types of stimuli such as nonwords and irregular words were also inserted in the Brief Battery and favorably evaluated by the expert judges. Optional tasks were also developed for specific diagnostic situations. After the correction of errors detected in Stage 4, the final version of the instrument was obtained. Conclusion This study confirmed the content validity of the Brief MTL-BR Battery. The method used in this investigation was effective and can be used in future studies to develop brief instruments based on preexisting assessment batteries.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aphasia/diagnosis , Translations , Brain Injuries/complications , Reproducibility of Results , Surveys and Questionnaires
17.
In. Verga, Federico; Burghi, Gastón. Encares de paciente crítico. Montevideo, Oficina del Libro FEFMUR, 2020. p.297-310.
Monography in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1342659
18.
CoDAS ; 32(1): e20180306, 2020. tab
Article in English | LILACS | ID: biblio-1039627

ABSTRACT

ABSTRACT Purpose Search for reliability and validity evidence for the Montreal Communication Evaluation Brief Battery (MEC B) for adults with right brain damage. Methods Three hundred twenty-four healthy adults and 26 adults with right brain damage, aged 19-75 years, with two or more years of education were evaluated with MEC B. The MEC B Battery contains nine tasks that aim to evaluate communicative abilities as discourse, prosody, lexical-semantic and pragmatic process. Two sources of reliability evidence were used: internal consistency (Cronbach's alpha) and interrater reliability. Construct validity was evaluated comparing the Montreal Communication Evaluation Battery (MEC), expanded version and MEC B tasks. Results Internal consistence was satisfactory and the interrater reliability was considered excellent, as were correlations between MEC Battery and MEC B Battery tasks. Conclusion The MEC B Battery showed satisfactory reliability and validity evidences. It can be used as outcome measure of intervention programs and assist speech therapists to plan rehabilitation programs.


RESUMO Objetivo Buscar evidências de validade e fidedignidade da Bateria Montreal de Avaliação da Comunicação Breve (MAC B) para adultos com lesão do hemisfério direito. Método Trezentos e vinte e quatro adultos saudáveis e 26 adultos com lesão cerebral direita, com idades de 19 a 75 anos, com dois ou mais anos de escolaridade, foram avaliados com a Bateria MAC B. Essa bateria contém nove tarefas que visam avaliar habilidades comunicativas, como: discurso prosódia; processo léxico-semântico e pragmática. Duas fontes de evidências de fidedignidade foram utilizadas, ou seja, a consistência interna (alfa de Cronbach) e a concordância entre avaliadores. A validade foi avaliada comparando as tarefas da Bateria MAC na versão expandida e da MAC B. Resultados Em relação à fidedignidade, a consistência interna foi satisfatória e as taxas de concordância entre os avaliadores foram consideradas excelentes, assim como as correlações entre as tarefas da Bateria MAC e Bateria MAC B. Conclusão A Bateria MAC B apresentou evidências de fidedignidade e validade satisfatórias, podendo ser usada como medida para resultado de programas de intervenção, e também auxiliar o fonoaudiólogo a planejar o programa de reabilitação.


Subject(s)
Humans , Male , Female , Adult , Aged , Brain Injuries/physiopathology , Communication Disorders/diagnosis , Neuropsychological Tests/statistics & numerical data , Speech Therapy/methods , Brazil , Case-Control Studies , Reproducibility of Results , Middle Aged
19.
Rev. argent. radiol ; 83(4): 141-150, oct. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1057416

ABSTRACT

Resumen Objetivo: Describir los hallazgos en resonancia magnética (RM) de encéfalo en pacientes menores de 65 años que fueron estudiados por Doppler transcraneal (DTC) con contraste de microburbujas, con antecedentes de accidente cerebrovascular (ACV) criptogénico y sospecha de foramen oval permeable (FOP). Materiales y métodos: Este estudio transversal retrospectivo incluyó pacientes de ambos sexos, menores de 65 años. Resultados: Nuestra muestra (n = 47, 47% masculino y 53% femenino, edad media de 42 años) presentó señales transitorias de alta intensidad (HITS, por su sigla en inglés) positivo en el 61,7% y HITS-negativo en el 38,3%. En pacientes HITS-positivo, predominaron las lesiones a nivel de las fibras en U subcorticales, únicas o múltiples con distribución bilateralmente simétrica. En pacientes con HITS moderados, predominaron las lesiones en el territorio vascular de la circulación posterior. Conclusión: En pacientes menores de 65 años con ACV criptogénico y lesiones en fibras en U subcorticales, únicas o múltiples con distribución bilateral y simétrica, debe tenerse en cuenta un FOP como posible causa de dichas lesiones.


Abstract Objectives: To analyze the findings on brain magnetic resonance imaging (MRI) in patients less than 65 years of age with history of cryptogenic stroke and suspected patent foramen ovale (PFO) who were studied with Contrast-Transcranial Doppler. Materials and Methods: This transversal retrospective study included both, men and women less than 65 years of age. Results: Our sample (n = 47, 47% male and 53% female, average age 42 years old) had High Intensity Transient Signals (HITS)-positive in 61.7% and HITS-negative in 38.3%. In HITS-positive patients, lesions were predominantly located on the subcortical U fibers, lone or multiple bilateral symmetric distributions. In patients with moderate-severity HITS, the posterior circulation was the most affected. Conclusion: In patients less than 65 years of age with cryptogenic stroke with lesions affecting the subcortical U fibers, with unique or multiple bilateral symmetric distributions, a PFO should be considered as an underlying cause.


Subject(s)
Humans , Male , Female , Middle Aged , Brain , Brain Injuries , Brain Injuries/diagnostic imaging , Magnetic Resonance Spectroscopy , Wounds and Injuries , Magnetic Resonance Imaging , Causality , Retrospective Studies , Ultrasonography, Doppler, Transcranial/methods , Stroke , Foramen Ovale, Patent
20.
Medicina (B.Aires) ; 79(supl.3): 10-14, set. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1040542

ABSTRACT

Los nacimientos prematuros son uno de los principales indicadores de salud de un país. Están asociados a una alta mortalidad e importante morbilidad en niños con parálisis cerebral y otros trastornos del neurodesarrollo, incluyendo problemas cognitivos y del aprendizaje. Los principales tipos de lesión encefálica en los recién nacidos prematuros son: a) las lesiones de la sustancia blanca, generalmente asociadas a alteraciones neuronales y axonales en la corteza cerebral y otras zonas de sustancia gris; b) hemorragias intracraneanas que incluyen las de la matriz germinal, intraventriculares e intraparenquimatosas y c) del cerebelo. Las lesiones de sustancia blanca incluyen la leucomalacia periventricular quística, no quística (con focos de necrosis microscópicos) y lesiones difusas de sustancia blanca, no necróticas. Estas lesiones tienen múltiples factores etiológicos. Las características anatómicas y fisiológicas de las estructuras vasculares periventriculares predisponen a la sustancia blanca a ser muy vulnerable a las situaciones de isquemia cerebral y, en interacción con factores infecciosos/inflamatorios, activan a las microglías generando estrés oxidativo (por liberación de radicales libres del oxígeno y del nitrógeno), liberación de citoquinas proinflamatorias, liberación de glutamato, fallo energético y alteración de la integridad vascular. Todo lo anteriormente mencionado genera una particular vulnerabilidad de los pre-oligodendrocitos que termina alterando la mielinización. La hipoxia-isquemia también puede producir necrosis neuronal selectiva en diferentes regiones encefálicas. La matriz germinal es un área altamente vascularizada en la región subependimaria periventricular con una estructura capilar muy frágil que la predispone a las hemorragias.


Preterm birth is one of the main country health indicators. It is associated with high mortality and significant morbidity in preterm newborns with cerebral palsy and potential long-term neurodevelopmental disabilities like cognitive and learning problems. The main lesions could be: a) white matter injuries, generally associated with cortical and other regions of grey matter neuronal-axonal disturbances; b) intracranial hemorrhage that includes germinal matrix, intraventricular and parenchymal, c) cerebellum injuries. The white matter lesions include cystic and non-cystic (with microscopic focal necrosis) periventricular leukomalacia and non-necrotic diffuse white matter injury. Multiple etiologic factors are associated with these injuries. Anatomical and physiological characteristics of periventricular vascular structures predispose white matter to cerebral ischemia and, interacting with infection/inflammation factors, activate microglia, generating oxidative stress (mediated by free oxygen and nitrogen radicals), pro-inflammatory cytokine and glutamate toxicity, energetic failure and vascular integrity disturbances. All these factors lead to a particular vulnerability of pre-oligodendrocytes that will affect myelination. Hypoxia-ischemia also may produce selective neuronal necrosis in different cerebral regions. Germinal matrix is a highly vascularized zone beneath ependymal or periventricular region that constitutes a capillary bed with a particular structural fragility that predispose it to hemorrhage.


Subject(s)
Humans , Infant, Newborn , Leukomalacia, Periventricular/etiology , Brain Injuries/etiology , Infant, Premature , Brain Ischemia/etiology , Cerebral Palsy/etiology , Hypoxia-Ischemia, Brain/etiology , Brain Injuries/mortality , Brain Injuries/diagnostic imaging , Brain Ischemia/mortality , Brain Ischemia/diagnostic imaging , Cerebral Palsy/mortality , Hypoxia-Ischemia, Brain/mortality , Hypoxia-Ischemia, Brain/diagnostic imaging , White Matter/pathology
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