Safety and efficacy of repetitive stimulation of the left dorsolateral prefrontal cortex using transcranial focused ultrasound in treatment-resistant depressed patients: A non-inferiority randomized controlled trial protocol.

BACKGROUND: About 30% of patients diagnosed with major depressive disorder fail with the mainstream pharmacological treatment. Patients who do not achieve clinical remission of symptoms, even with two different antidepressants, are classified with treatment-resistant depression (TDR). This condition imposes an additional burden with increased Disability Adjusted Life Years. Therefore, complementary treatments, such as neuromodulation, are necessary. The transcranial focused ultrasound (tFUS) has emerged in the past few years as a reliable method for non-invasive neuromodulation in humans and may help treat TRD. This study aims to propose a research protocol for a non-inferiority randomized clinical trial of TDR with tFUS. METHODS: Patients with documented TRD will be screened upon entering the TRD outpatient clinic at UFMG (Brazil). One hundred patients without a clinical history of other psychiatric illness, anatomical abnormalities on magnetic resonance imaging (MRI), or treatment with electroconvulsive therapy will be invited to participate. Patients will be randomized (1:1) into two groups: 1) treatment with a previously established protocol of transcranial magnetic stimulation; and 2) treatment with a similar protocol using the stimulation. Besides regular consultations in the outpatient clinic, both groups will attend 7 protocolled spaced days of brain stimulation targeted at the left dorsolateral prefrontal cortex. They will also be submitted to 4 sessions of image studies (2 MRIs, 2 positron-emission tomography), 3 of neuropsychological assessments (at baseline, 1 week and 2 months after treatment), the Montgomery-Åsberg Depression Rating Scale to analyze the severity of depressive symptoms. DISCUSSION: This clinical trial intends to verify the safety and clinical efficacy of tFUS stimulation of the dorsolateral prefrontal cortex of patients with TRD, compared with a previously established neuromodulation method.

Endovascular treatment in Behçet's disease: an integrative review.

Behçet's Disease (BD) is a rare, chronic, relapsing, inflammatory, and multisystemic disease. There is no universally described test for confirming diagnosis, so it is made clinically, on the basis of its classic triad of signs: oral ulcers, genital ulcers, and uveitis (inflammation of the uveal tract of the eye). The aim of this study is to evaluate the importance of endovascular treatment in Behçet's disease. The literature review conducted to achieve this objective covered 30 articles published between 2002 and 2021. Behçet's Disease affects both the venous and arterial systems. Rupture of aneurysms is the main cause of death and thus requires treatment, which can be clinical, open surgical, or endovascular. Endovascular surgery has been gaining ground for surgical treatment of arterial aneurysms, including those related to BD, although the therapy of choice is still controversial.

Tratamento endovascular na doença de Behçet: uma revisão integrativa / Endovascular treatment in Behçet's disease: an integrative review

Resumo A doença de Behçet (DB) é caracterizada por ser uma doença rara, crônica, recidivante, inflamatória e multissistêmica. Quanto ao diagnóstico, não existe nenhum teste universalmente descrito; logo, ele é feito de maneira clínica, por meio da presença da sua tríade clássica de sinais: úlceras orais, úlceras genitais e uveíte (inflamação do trato uveal do olho). O objetivo deste estudo foi avaliar a importância do tratamento endovascular na doença de Behçet, sendo que a revisão de literatura para obter essa resposta foi realizada a partir de 30 artigos publicados entre 2002 e 2021. A DB acomete tanto o sistema venoso quanto o arterial. A ruptura de aneurismas é a principal causa de morte e necessita de tratamento, podendo ser clínico, cirúrgico aberto ou por via endovascular. A cirurgia endovascular vem ganhando espaço no tratamento cirúrgico nos casos de aneurismas arteriais, inclusive nos relacionados com DB, apesar de a terapia de escolha ainda ser controversa.

Abstract Behçet's Disease (BD) is a rare, chronic, relapsing, inflammatory, and multisystemic disease. There is no universally described test for confirming diagnosis, so it is made clinically, on the basis of its classic triad of signs: oral ulcers, genital ulcers, and uveitis (inflammation of the uveal tract of the eye). The aim of this study is to evaluate the importance of endovascular treatment in Behçet's disease. The literature review conducted to achieve this objective covered 30 articles published between 2002 and 2021. Behçet's Disease affects both the venous and arterial systems. Rupture of aneurysms is the main cause of death and thus requires treatment, which can be clinical, open surgical, or endovascular. Endovascular surgery has been gaining ground for surgical treatment of arterial aneurysms, including those related to BD, although the therapy of choice is still controversial.

Studying 2D materials with advanced Raman spectroscopy: CARS, SRS and TERS.

Raman spectroscopy has been established as a valuable tool to study and characterize two-dimensional (2D) systems, but it exhibits two drawbacks: a relatively weak signal response and a limited spatial resolution. Recently, advanced Raman spectroscopy techniques, such as coherent anti-Stokes spectroscopy (CARS), stimulated Raman scattering (SRS) and tip-enhanced Raman spectroscopy (TERS), have been shown to overcome these two limitations. In this article, we review how useful physical information can be retrieved from different 2D materials using these three advanced Raman spectroscopy and imaging techniques, discussing results on graphene, hexagonal boron-nitride, and transition metal di- and mono-chalcogenides, thus providing perspectives for future work in this early-stage field of research, including similar studies on unexplored 2D systems and open questions.

Micro-Raman spectroscopy of lipid halo and dense-core amyloid plaques: aging process characterization in the Alzheimer's disease APPswePS1ΔE9 mouse model.

The deposition of amyloid plaques is considered one of the main microscopic features of Alzheimer's disease (AD). Since plaque formation can precede extensive neurodegeneration and it is the main clinical manifestation of AD, it constitutes a relevant target for new treatment and diagnostic approaches. Micro-Raman spectroscopy, a label-free technique, is an accurate method for amyloid plaque identification and characterization. Here, we present a high spatial resolution micro-Raman hyperspectral study in transgenic APPswePS1ΔE9 mouse brains, showing details of AD tissue biochemical and histological changes without staining. First we used stimulated micro-Raman scattering to identify the lipid-rich halo surrounding the amyloid plaque, and then proceeded with spontaneous (conventional) micro-Raman spectral mapping, which shows a cholesterol and sphingomyelin lipid-rich halo structure around dense-core amyloid plaques. The detailed images of this lipid halo relate morphologically well with dystrophic neurites surrounding plaques. Principal Component Analysis (PCA) of the micro-Raman hyperspectral data indicates the feasibility of the optical biomarkers of AD progression with the potential for discriminating transgenic groups of young adult mice (6-month-old) from older ones (12-month-old). Frequency-specific PCA suggests that plaque-related neurodegeneration is the predominant change captured by Raman spectroscopy, and the main differences are highlighted by vibrational modes associated with cholesterol located majorly in the lipid halo.

Nonlinear and vibrational microscopy for label-free characterization of amyloid-ß plaques in Alzheimer's disease model.

Given the long subclinical stage of Alzheimer's disease (AD), the study of biomarkers is relevant both for early diagnosis and the fundamental understanding of the pathophysiology of AD. Biomarkers provided by Amyloid-ß (Aß) plaques have led to an increasing interest in characterizing this hallmark of AD due to its promising potential. In this work, we characterize Aß plaques by label-free multimodal imaging: we combine two-photon excitation autofluorescence (TPEA), second harmonic generation (SHG), spontaneous Raman scattering (SpRS), coherent anti-Stokes Raman scattering (CARS), and stimulated Raman scattering (SRS) to describe and compare high-resolution images of Aß plaques in brain tissues of an AD mouse model. Comparing single-laser techniques images, we discuss the origin of the SHG, which can be used to locate the plaque core reliably. We study both the core and the halo with vibrational microscopy and compare SpRS and SRS microscopies for different frequencies. We also combine SpRS spectroscopy with SRS microscopy and present two core biomarkers unexplored with SRS microscopy: phenylalanine and amide B. We provide high-resolution SRS images with the spatial distribution of these biomarkers in the plaque and compared them with images of the amide I distribution. The obtained spatial correlation corroborates the feasibility of these biomarkers in the study of Aß plaques. Furthermore, since amide B enables rapid imaging, we discuss its potential as a novel fingerprint for diagnostic applications.

Second harmonic generation in defective hexagonal boron nitride.

Determining the role of defects in materials can be an important task both for the fundamental understanding of their influence on material properties and for future applications. In this work, we studied the influence of defects on the second harmonic generation (SHG) in hexagonal boron nitride (h-BN). We characterized the sample by photoluminescence imaging and spectroscopy, showing strong and sharp photoluminescence emission at visible range from h-BN flakes due to single defect states. By doing second harmonic imaging, we found strong emission from the h-BN flakes that correlates spatially with the photoluminescence imaging. By doing polarization-resolved SHG, we found deviations from the expected polarization pattern in pristine h-BN samples. We also characterized the nonlinear optical susceptibility of h-BN with defects with a value of one order of magnitude larger than for pristine h-BN, which highlights the role of defects in the efficiency of SHG. Therefore defect engineering could be used as a potential tool for nonlinear optical signal enhancement.

A fingerprint of amyloid plaques in a bitransgenic animal model of Alzheimer's disease obtained by statistical unmixing analysis of hyperspectral Raman data.

The global prevalence of Alzheimer's disease (AD) points to endemic levels, especially considering the increase of average life expectancy worldwide. AD diagnosis based on early biomarkers and better knowledge of related pathophysiology are both crucial in the search for medical interventions that are able to modify AD progression. In this study we used unsupervised spectral unmixing statistical techniques to identify the vibrational spectral signature of amyloid ß aggregation in neural tissues, as early biomarkers of AD in an animal model. We analyzed spectral images composed of a total of 55 051 Raman spectra obtained from the frontal cortex and hippocampus of five bitransgenic APPswePS1ΔE9 mice, and colocalized amyloid ß plaques by other fluorescence techniques. The Raman signatures provided a multifrequency fingerprint consistent with the results of synthesized amyloid ß fibrils. The fingerprint obtained from unmixed analysis in neural tissues is shown to provide a detailed image of amyloid plaques in the brain, with the potential to be used as biomarkers for non-invasive early diagnosis and pathophysiology studies in AD on the retina.

Síndrome de Marfan - Manejo de Complicación durante el embarazo: reporte de caso / Marfan syndrome - management of complication during pregnancy: case study

Marfan syndrome (MFS) is an autosomal dominant disorder, due to mutations on the gene that encodes fbrillin-1 (FBN1), which is a major component of extracellular microfbrils of the connective tissue [1, 2]. The incidence of MFS is about 2 to 3 per 10,000 individuals, with no difference in gender prevalence and, in approximately 75% of cases, the mutation is inherited from an affected parent, and the other cases can be due to de novo mutations [1]. The syndrome usually affects the skeletal, cardiovascular and optical systems, among others, and the accurate diagnosis is based on family history, clinical signs, and Ghent criteria [1­6]. Cardiovascular manifestations of MFS, in special aorta ecstasy and/or dissection, are related to poor outcomes, involving the most severe complications and the majority of deaths in this population. Therefore, additional care is recommended for patients intending to get pregnant

El síndrome de Marfan (MFS) es un trastorno autosómico dominante, debido a mutaciones en el gen que codifica fbrillin-1 (FBN1), que es un importante componente de microfrilos extracelulares del tejido conectivo [1, 2]. los la incidencia de MFS es de aproximadamente 2 a 3 por 10,000 individuos, sin diferencia en prevalencia de género y, en aproximadamente el 75% de los casos, la mutación se hereda de un padre afectado, y los otros casos pueden deberse a Mutaciones de novo [1]. El síndrome suele afectar al esqueleto, cardiovascular y óptico. sistemas, entre otros, y el diagnóstico preciso se basa en historia familiar, signos clínicos y criterios de Gante [1­6]. Cardiovascular Las manifestaciones de MFS, en éxtasis especial de aorta y / o disección, son relacionados con los malos resultados, que implican las complicaciones más graves y La mayoría de las muertes en esta población. Por lo tanto, la atención adicional es Recomendado para pacientes con intención de quedar embarazada