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1.
Osteoporos Int ; 22(8): 2283-93, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20941479

RESUMO

UNLABELLED: Diabetic obesity is associated with increased fracture risk in adults and adolescents. We find in both adolescent and adult mice dramatically inferior mechanical properties and structural quality of cortical bone, in agreement with the human fracture data, although some aspects of the response to obesity appear to differ by age. INTRODUCTION: The association of obesity with bone is complex and varies with age. Diabetic obese adolescents and adult humans have increased fracture risk. Prior studies have shown reduced mechanical properties as a result of high-fat diet (HFD) but do not fully address size-independent mechanical properties or structural quality, which are important to understand material behavior. METHODS: Cortical bone from femurs and tibiae from two age groups of C57BL/6 mice fed either HFD or low-fat diet (LFD) were evaluated for structural and bone turnover changes (SEM and histomorphometry) and tested for bending strength, bending stiffness, and fracture toughness. Leptin, IGF-I, and non-enzymatic glycation measurements were also collected. RESULTS: In both young and adult mice fed on HFD, femoral strength, stiffness, and toughness are all dramatically lower than controls. Inferior lamellar and osteocyte alignment also point to reduced structural quality in both age groups. Bone size was largely unaffected by HFD, although there was a shift from increasing bone size in obese adolescents to decreasing in adults. IGF-I levels were lower in young obese mice only. CONCLUSIONS: While the response to obesity of murine cortical bone mass, bone formation, and hormonal changes appear to differ by age, the bone mechanical properties for young and adult groups are similar. In agreement with human fracture trends, adult mice may be similarly susceptible to bone fracture to the young group, although cortical bone in the two age groups responds to diabetic obesity differently.


Assuntos
Envelhecimento , Osso e Ossos/fisiopatologia , Dieta Hiperlipídica/efeitos adversos , Obesidade/fisiopatologia , Envelhecimento/patologia , Envelhecimento/fisiologia , Animais , Fenômenos Biomecânicos , Glicemia/metabolismo , Composição Corporal , Densidade Óssea/fisiologia , Osso e Ossos/patologia , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Experimental/patologia , Diabetes Mellitus Experimental/fisiopatologia , Fêmur/fisiopatologia , Fêmur/ultraestrutura , Produtos Finais de Glicação Avançada/sangue , Fator de Crescimento Insulin-Like I/metabolismo , Leptina/sangue , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Microscopia Eletrônica de Varredura , Obesidade/sangue , Obesidade/patologia , Fraturas por Osteoporose/etiologia , Fraturas por Osteoporose/patologia , Fraturas por Osteoporose/fisiopatologia , Tíbia/fisiopatologia , Tíbia/ultraestrutura , Aumento de Peso/fisiologia
2.
Nano Lett ; 10(8): 2794-8, 2010 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-20698591

RESUMO

Phase change materials are essential to a number of technologies ranging from optical data storage to energy storage and transport applications. This widespread interest has given rise to a substantial effort to develop bulk phase change materials well suited for desired applications. Here, we suggest a novel and complementary approach, the use of binary eutectic alloy nanoparticles embedded within a matrix. Using GeSn nanoparticles embedded in silica as an example, we establish that the presence of a nanoparticle/matrix interface enables one to stabilize both nanobicrystal and homogeneous alloy morphologies. Further, the kinetics of switching between the two morphologies can be tuned simply by altering the composition.

3.
Heart ; 96(12): 956-66, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20538671

RESUMO

OBJECTIVES: Compare the diagnostic performance of stress echocardiography (SE) and myocardial perfusion imaging (MPI) for the diagnosis of left main disease (LM) and triple vessel disease (TVD). BACKGROUND: Limited comparative data on MPI and SE for the detection of LM and TVD (high-risk coronary artery disease) exist in the literature. METHODS: Quantitative meta-analysis was performed using studies identified by systematic electronic literature search. Articles were included if they reported data on exercise, dobutamine SE or exercise, adenosine, dipyridamole, thallium201, technetium 99m sestamibi MPI and used coronary angiography as the reference test. Summary receiver-operating characteristic (SROC) curves were constructed for each imaging modality. Additionally, pooled sensitivity, specificity and likelihood ratios were calculated per modality. Meta-regression was performed to adjust for patient and study characteristics. RESULTS: Thirty-two studies met inclusion criteria; 23 (MPI-15; SE-14; Common studies-6) provided sufficient data for analysis. In a SROC model comparing the two imaging modalities, SE was associated with higher area under curve (0.82 (0.03) vs 0.73 (0.02), p=0.01) and index Q* value (0.75 (0.02) vs 0.67 (0.02), p=0.01). Using pooled summary point estimates, SE had higher pooled sensitivity (94% vs 75%, p<0.001) and lower negative likelihood ratio (0.21 vs 0.47, p<0.001) compared to MPI. No evidence of a difference in the pooled specificity (40% vs 48%, p=0.16) and positive likelihood ratio (1.52 vs 1.58, p=0.36) was seen between the two stress modalities. Pooled diagnostic OR on meta-regression (9.78 vs 4.06, p=0.02) remained significantly higher for SE compared to MPI for identification of LM and TVD even after adjustment for study characteristics. CONCLUSIONS: Since LM alone or in combination with TVD are categorised as representing potentially life-threatening variants of CAD, a screening test with high sensitivity, low negative likelihood ratio or higher discriminatory capacity would be desirable for risk stratification. In the absence of a direct head-to-head comparison of the diagnostic accuracies of SE and MPI, our findings indicate that SE appears to be the preferred screening modality for high-risk coronary artery disease.


Assuntos
Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/patologia , Ecocardiografia sob Estresse/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Imagem de Perfusão do Miocárdio/métodos , Sensibilidade e Especificidade
4.
Nat Nanotechnol ; 5(2): 143-7, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20062051

RESUMO

In conventional solid-state photovoltaics, electron-hole pairs are created by light absorption in a semiconductor and separated by the electric field spaning a micrometre-thick depletion region. The maximum voltage these devices can produce is equal to the semiconductor electronic bandgap. Here, we report the discovery of a fundamentally different mechanism for photovoltaic charge separation, which operates over a distance of 1-2 nm and produces voltages that are significantly higher than the bandgap. The separation happens at previously unobserved nanoscale steps of the electrostatic potential that naturally occur at ferroelectric domain walls in the complex oxide BiFeO(3). Electric-field control over domain structure allows the photovoltaic effect to be reversed in polarity or turned off. This new degree of control, and the high voltages produced, may find application in optoelectronic devices.


Assuntos
Eletroquímica/instrumentação , Nanotecnologia/instrumentação , Fotoquímica/instrumentação , Eletricidade , Eletricidade Estática
5.
Bone ; 46(1): 217-25, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19853069

RESUMO

Overweight and obesity are rapidly expanding health problems in children and adolescents. Obesity is associated with greater bone mineral content that might be expected to protect against fracture, which has been observed in adults. Paradoxically, however, the incidence of bone fractures has been found to increase in overweight and obese children and adolescents. Prior studies have shown some reduced mechanical properties as a result of high-fat diet (HFD) but do not fully address size-independent measures of mechanical properties, which are important to understand material behavior. To clarify the effects of HFD on the mechanical properties and microstructure of bone, femora from C57BL/6 mice fed either a HFD or standard laboratory chow (Chow) were evaluated for structural changes and tested for bending strength, bending stiffness and fracture toughness. Here, we find that in young, obese, high-fat fed mice, all geometric parameters of the femoral bone, except length, are increased, but strength, bending stiffness, and fracture toughness are all reduced. This increased bone size and reduced size-independent mechanical properties suggests that obesity leads to a general reduction in bone quality despite an increase in bone quantity; yield and maximum loads, however, remained unchanged, suggesting compensatory mechanisms. We conclude that diet-induced obesity increases bone size and reduces size-independent mechanical properties of cortical bone in mice. This study indicates that bone quantity and bone quality play important compensatory roles in determining fracture risk.


Assuntos
Osso e Ossos/patologia , Dieta , Gorduras na Dieta/efeitos adversos , Obesidade/induzido quimicamente , Obesidade/patologia , Animais , Fenômenos Biomecânicos , Composição Corporal , Densidade Óssea , Osso e Ossos/metabolismo , Osso e Ossos/fisiopatologia , Modelos Animais de Doenças , Teste de Tolerância a Glucose , Fator de Crescimento Insulin-Like I/metabolismo , Leptina/sangue , Masculino , Camundongos , Microscopia Eletrônica de Varredura , Microscopia Eletrônica de Transmissão , Obesidade/metabolismo , Tomografia Computadorizada por Raios X
6.
Phys Rev Lett ; 102(14): 146101, 2009 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-19392456

RESUMO

Ion beam synthesis of nanoclusters is studied via both kinetic Monte Carlo simulations and the self-consistent mean-field solution to a set of coupled rate equations. Both approaches predict the existence of a steady-state shape for the cluster-size distribution that depends only on a characteristic length determined by the effective diffusion coefficient, the ion solubility, and the volumetric ion flux. The average cluster size in the steady-state regime is determined by the implanted species or matrix interface energy.

7.
Lupus ; 18(5): 400-6, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19318391

RESUMO

Our aim was to better define the coagulation abnormalities in patients with systemic lupus erythematosus who had thrombosis or high-risk clinical settings for thrombosis. Clinical and laboratory data of 111 patients with lupus referred for coagulation assessment because of thrombosis, pregnancy loss or high-risk clinical settings for thrombosis were reviewed retrospectively. Increased activity of procoagulant factors and decreased activity of anti-coagulant factors were observed well above the expected 5% prevalence. All comparisons were significant at the P < 0.001 level. Anticardiolipin antibodies were present in 70.5% of patients tested (55/78) in this high-risk group, but usually in low titres. Platelet hyperfunction was detected in the majority of patients tested (85.7%, 78/91). Hypercoagulability in lupus is complex and is better defined by assessing multiple haemostatic factors in addition to platelet function. Platelet hyperfunction contributes significantly to thrombophilia in lupus and this is the key finding of our study.


Assuntos
Transtornos Plaquetários/epidemiologia , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/epidemiologia , Trombofilia/epidemiologia , Adulto , Síndrome Antifosfolipídica/epidemiologia , Transtornos Plaquetários/complicações , Estudos de Coortes , Fator V/genética , Feminino , Predisposição Genética para Doença/epidemiologia , Predisposição Genética para Doença/genética , Humanos , Lúpus Eritematoso Sistêmico/complicações , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Michigan/epidemiologia , Pessoa de Meia-Idade , Prevalência , Protrombina/genética , Estudos Retrospectivos , Trombofilia/complicações
8.
Bone ; 43(5): 798-812, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18647665

RESUMO

Quantitative assessment of the strength and toughness of bone has become an integral part of many biological and bioengineering studies on the structural properties of bone and their degradation due to aging, disease and therapeutic treatment. Whereas the biomechanical techniques for characterizing bone strength are well documented, few studies have focused on the theory, methodology, and various experimental procedures for evaluating the fracture toughness of bone, i.e., its resistance to fracture, with particular reference to whole bone testing in small animal studies. In this tutorial, we consider the many techniques for evaluating toughness and assess their specific relevance and application to the mechanical testing of small animal bones. Parallel experimental studies on wild-type rat and mouse femurs are used to evaluate the utility of these techniques and specifically to determine the coefficient of variation of the measured toughness values.


Assuntos
Osso e Ossos/anatomia & histologia , Modelos Anatômicos , Animais , Fenômenos Biomecânicos , Elasticidade , Fraturas Ósseas , Humanos , Matemática , Estresse Mecânico , Resistência à Tração
9.
Nat Mater ; 7(8): 672-7, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18587403

RESUMO

Bone is more difficult to break than to split. Although this is well known, and many studies exist on the behaviour of long cracks in bone, there is a need for data on the orientation-dependent crack-growth resistance behaviour of human cortical bone that accurately assesses its toughness at appropriate size scales. Here, we use in situ mechanical testing to examine how physiologically pertinent short (<600 microm) cracks propagate in both the transverse and longitudinal orientations in cortical bone, using both crack-deflection/twist mechanics and nonlinear-elastic fracture mechanics to determine crack-resistance curves. We find that after only 500 microm of cracking, the driving force for crack propagation was more than five times higher in the transverse (breaking) direction than in the longitudinal (splitting) direction owing to major crack deflections/twists, principally at cement sheaths. Indeed, our results show that the true transverse toughness of cortical bone is far higher than previously reported. However, the toughness in the longitudinal orientation, where cracks tend to follow the cement lines, is quite low at these small crack sizes; it is only when cracks become several millimetres in length that bridging mechanisms can fully develop leading to the (larger-crack) toughnesses generally quoted for bone.


Assuntos
Fraturas do Fêmur/patologia , Fraturas do Fêmur/fisiopatologia , Fêmur/fisiopatologia , Fêmur/ultraestrutura , Modelos Biológicos , Simulação por Computador , Elasticidade , Dureza , Humanos
10.
Phys Rev Lett ; 97(15): 155701, 2006 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-17155336

RESUMO

The melting behavior of Ge nanocrystals embedded within SiO2 is evaluated using in situ transmission electron microscopy. The observed melting-point hysteresis is large (+/-17%) and nearly symmetric about the bulk melting point. This hysteresis is modeled successfully using classical nucleation theory without the need to invoke epitaxy.

11.
Phys Rev Lett ; 97(22): 227401, 2006 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-17155840

RESUMO

We resolve the remarkably sharp bound exciton transitions of highly enriched 28Si using a single-frequency laser and photoluminescence excitation spectroscopy, as well as photocurrent spectroscopy. Well-resolved doublets in the spectrum of the 31P donor reflect the hyperfine coupling of the electronic and nuclear donor spins. The optical detection of the nuclear spin state, and selective pumping and ionization of donors in specific electronic and nuclear spin states, suggests a number of new possibilities which could be useful for the realization of silicon-based quantum computers.

12.
Phys Rev Lett ; 96(12): 125505, 2006 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-16605926

RESUMO

The first evidence of successful p-type doping of InN is presented. It is shown that InN:Mg films consist of a p-type bulk region with a thin n-type inversion layer at the surface that prevents electrical contact to the bulk. Capacitance-voltage measurements indicate a net concentration of ionized acceptors below the -type surface. Irradiation with 2 MeV He+ ions is used to convert the bulk of InN:Mg from p to n-type, at which point photoluminescence is recovered. The conversion is well explained by a model assuming two parallel conducting layers (the surface and the bulk) in the films.

13.
J Biomed Opt ; 10(3): 034012, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16229656

RESUMO

The age-related deterioration in bone quality and consequent increase in fracture incidence is an obvious health concern that is becoming increasingly significant as the population ages. Raman spectroscopy with deep-ultraviolet excitation (244 nm) is used to measure vibrational spectra from human cortical bone obtained from donors over a wide age range (34-99 years). The UV Raman technique avoids the fluorescence background usually found with visible and near-infrared excitation and, due to resonance Raman effects, is particularly sensitive to the organic component of bone. Spectral changes in the amide I band at 1640 cm(-1) are found to correlate with both donor age and with previously reported fracture toughness data obtained from the same specimens. These results are discussed in the context of possible changes in collagen cross-linking chemistry as a function of age, and are deemed important to further our understanding of the changes in the organic component of the bone matrix with aging.


Assuntos
Envelhecimento/fisiologia , Osso e Ossos/fisiologia , Calcificação Fisiológica/fisiologia , Espectrofotometria Ultravioleta/métodos , Análise Espectral Raman/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Cadáver , Feminino , Testes de Dureza , Humanos , Técnicas In Vitro , Masculino , Pessoa de Meia-Idade , Resistência à Tração/fisiologia
15.
Acta Biomater ; 1(1): 31-43, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16701778

RESUMO

Although healthy dentin is invariably hydrated in vivo, from a perspective of examining the mechanisms of fracture in dentin, it is interesting to consider the role of water hydration. Furthermore, it is feasible that exposure to certain polar solvents, e.g., those found in clinical adhesives, can induce dehydration. In the present study, in vitro deformation and fracture experiments, the latter involving a resistance-curve (R-curve) approach (i.e., toughness evolution with crack extension), were conducted in order to assess changes in the constitutive and fracture behavior induced by three common solvents-acetone, ethanol and methanol. In addition, nanoindentation-based experiments were performed to evaluate the deformation behavior at the level of individual collagen fibers and ultraviolet Raman spectroscopy to evaluate changes in bonding. The results indicate a reversible effect of chemical dehydration, with increased fracture resistance, strength, and stiffness associated with lower hydrogen bonding ability of the solvent. These results are analyzed both in terms of intrinsic and extrinsic toughening phenomena to further understand the micromechanisms of fracture in dentin and the specific role of water hydration.


Assuntos
Dentina/química , Dentina/fisiologia , Animais , Fenômenos Biomecânicos , Colágeno/química , Dessecação , Elefantes , Ligação de Hidrogênio , Técnicas In Vitro , Masculino , Teste de Materiais , Microscopia de Força Atômica , Nanotecnologia , Solventes , Análise Espectral Raman , Fraturas dos Dentes/etiologia , Fraturas dos Dentes/fisiopatologia , Água
16.
Behav Res Ther ; 40(5): 529-39, 2002 May.
Artigo em Inglês | MEDLINE | ID: mdl-12038645

RESUMO

This work aims is to evaluate the therapeutic efficacy of cognitive behavior therapy (CBT) in pediatric patients with obsessive-compulsive disorder (OCD) who had not previously been treated with either pharmacotherapy or psychotherapy and who remained medication-free during CBT. Sixteen OCD outpatients, 8-17 years of age, were treated in a 12-week open trial with manualized CBT. Target symptoms were rated at two-week intervals with the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the National Institute of Mental Health Global Obsessive-Compulsive Scale (NIMH Global), the Clinical Global Impression Scale (CGI), and the Hamilton Anxiety Rating Scale (Ham-A). Statistical analyses showed a significant benefit for treatment. Ten patients experienced at least a 50% reduction in symptoms on the CY-BOCS; seven were asymptomatic on the NIMH Global. These results build on previous reports that CBT may be effective in the acute treatment of pediatric OCD. Further, the results of this study suggest that CBT can be efficacious in alleviating OCD symptoms in the absence of pharmacotherapy. These results must be considered preliminary, given the small sample size and open administration of treatment.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Transtorno Obsessivo-Compulsivo/terapia , Adolescente , Criança , Feminino , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/diagnóstico , Índice de Gravidade de Doença , Resultado do Tratamento
17.
Pediatrics ; 108(2): E34, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11483844

RESUMO

OBJECTIVE: Moderate to heavy levels of prenatal alcohol exposure have been associated with alterations in child behavior, but limited data are available on adverse effects after low levels of exposure. The objective of this study was to evaluate the dose-response effect of prenatal alcohol exposure for adverse child behavior outcomes at 6 to 7 years of age. METHODS: Beginning in 1986, women attending the urban university-based maternity clinic were routinely screened at their first prenatal visit for alcohol and drug use by trained research assistants from the Fetal Alcohol Research Center. All women reporting alcohol consumption at conception of at least 0.5 oz absolute alcohol/day and a 5% random sample of lower level drinkers and abstainers were invited to participate to be able to identify the associations between alcohol intake and child development. Maternal alcohol, cigarette, and illicit drug use were prospectively assessed during pregnancy and postnatally. The independent variable in this study, prenatal alcohol exposure, was computed as the average absolute alcohol intake (oz) per day across pregnancy. At each prenatal visit, mothers were interviewed about alcohol use during the previous 2 weeks. Quantities and types of alcohol consumed were converted to fluid ounces of absolute alcohol and averaged across visits to generate a summary measure of alcohol exposure throughout pregnancy. Alcohol was initially used as a dichotomous variable comparing children with no prenatal alcohol exposure to children with any exposure. To evaluate the effects of different levels of exposure, the average absolute alcohol intake was relatively arbitrarily categorized into no, low (>0 but <0.3 fl oz of absolute alcohol/day), and moderate/heavy (>/=0.3 fl oz of absolute alcohol/day) for the purpose of this study. Six years later, 665 families were contacted. Ninety-four percent agreed to testing. Exclusions included children who missed multiple test appointments, had major congenital malformations (other than fetal alcohol syndrome), possessed an IQ >2 standard deviations from the sample mean, or had incomplete data. The Achenbach Child Behavior Checklist (CBCL) was used to assess child behavior. The CBCL is a parent questionnaire applicable to children ages 4 to 16 years. It is widely used in the clinical assessment of children's behavior problems and has been extensively used in research. Eight syndrome scales are further grouped into Externalizing or undercontrolled (Aggressive and Delinquent) behavior and Internalizing or overcontrolled (Anxious/Depressed, Somatic Complaints, and Withdrawn) behaviors. Three syndromes (Social, Thought, and Attention Problems) fit neither group. Higher scores are associated with more problem behaviors. Research assistants who were trained and blinded to exposure status independently interviewed the child and caretaker. Data were collected on a broad range of control variables known to influence childhood behavior and/or to be associated with prenatal alcohol exposure. These included perinatal factors of maternal age, education, cigarette, cocaine, and other substances of abuse and the gestational age of the baby. Postnatal factors studied included maternal psychopathology, continuing alcohol and drug use, family structure, socioeconomic status, children's whole blood lead level, and exposure to violence. Data were collected only from black women as there was inadequate representation of other racial groups. STATISTICAL ANALYSES: Statistical analyses were performed using the SPSS statistical package. Frequency distribution, cross-tabulation, odds ratio, and chi(2) tests were used for analyzing categorical data. Continuous data were analyzed using t tests, analyses of variance (ANOVAs) with posthoc tests, and regression analysis. RESULTS: Testing was available for 501 parent-children dyads. Almost one fourth of the women denied alcohol use during pregnancy. Low levels of alcohol use were reported in 63.8% and moderate/heavy use in 13% of pregnancies. Increasing prenatal alcohol exposure was associated with lower birth weight and gestational age, higher lead levels, higher maternal age, and lower education level, prenatal exposure to cocaine and smoking, custody changes, lower socioeconomic status, and paternal drinking and drug use at the time of pregnancy. Children with any prenatal alcohol exposure were more likely to have higher CBCL scores on Externalizing (Aggressive and Delinquent) and Internalizing (Anxious/Depressed and Withdrawn) syndrome scales and the Total Problem Score. The odds ratio of scoring in the clinical range for Delinquent behavior was 3.2 (1.3-7.6) in children with any prenatal exposure to alcohol compared with nonexposed controls. The threshold dose was evaluated with the 3 prenatal alcohol exposure groups. One-way ANOVA revealed a significant between group difference for Externalizing (Aggressive and Delinquent) and the Total Problem Score. (ABSTRACT TRUNCATED)


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Transtornos do Comportamento Infantil/epidemiologia , Etanol/efeitos adversos , Exposição Materna , Efeitos Tardios da Exposição Pré-Natal , Consumo de Bebidas Alcoólicas/epidemiologia , Criança , Transtornos do Comportamento Infantil/induzido quimicamente , Transtornos do Comportamento Infantil/diagnóstico , Pré-Escolar , Feminino , Transtornos do Espectro Alcoólico Fetal/complicações , Transtornos do Espectro Alcoólico Fetal/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Análise de Regressão
18.
Gynecol Oncol ; 82(1): 4-6, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11426953

RESUMO

OBJECTIVE: The aim of this study was to review Pap smear reports in women with systemic lupus erythematosus and compare them to a large control population. METHODS: Pap smear results of 29 women with a diagnosis of lupus seen consecutively were compared to those of a control population of 747 women attending the gynecology clinic at the same medical center during the same year. Records of lupus patients were reviewed to obtain clinical data. Fisher's exact test and chi(2) analysis were used to determine statistical significance, as appropriate. RESULTS: Of 29 women with lupus, 1/29 had high-grade squamous intraepithelial lesions (HGSIL) and 6/29 had low-grade squamous intraepithelial lesions (LGSIL). The control population of 747 women had 9/747 with HGSIL and 63/747 with LGSIL. chi(2) and Fisher's exact tests showed that the lupus population had a statistically significant increase in Pap smear reports of dysplasia compared to the control group (P < 0.021 for HGSIL/LGSIL combined, P < 0.036 for LGSIL alone). Examination of serial Pap smear results revealed that 45% of the lupus patients had cervical dysplasia at some time. CONCLUSION: Women with lupus have an increased prevalence of cervical dysplasia. Serial observation revealed dysplastic cytologies in nearly half of the patients, suggesting that this may be a more common problem than previously reported. Serial prospective studies are needed to assess better the risk of premalignant cervical lesions in lupus.


Assuntos
Lúpus Eritematoso Sistêmico/complicações , Neoplasias de Células Escamosas/complicações , Teste de Papanicolaou , Displasia do Colo do Útero/complicações , Neoplasias do Colo do Útero/complicações , Esfregaço Vaginal , Adulto , Estudos de Coortes , Feminino , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico , Estudos Retrospectivos
19.
Ann Neurol ; 49(5): 618-26, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11357952

RESUMO

During brain development in nonhuman primates, there are large changes in GABAA receptor binding and subunit expression. An understanding of human GABAA receptor ontogeny is highly relevant in elucidating the pathophysiology of neurodevelopmental disorders in which GABAergic mechanisms play a role as well as in understanding differences that occur during development in the pharmacology of drugs acting on this system. We have measured age-related changes in the brain distribution of the GABAA receptor complex in vivo using positron emission tomography (PET) in epileptic children under evaluation for surgical treatment. PET imaging was performed using the tracer [11C]flumazenil (FMZ), a ligand that binds to alpha subunits of the GABAA receptor. FMZ binding was quantified using a two-compartment model yielding values for the volume of distribution (VD) of the tracer in tissue. All brain regions studied showed the highest value for FMZ VD at the youngest age measured (2 years), and the values then decreased exponentially with age. Medial temporal lobe structures, primary visual cortex, and thalamus showed larger differences between values for age 2 years and adults (approximately 50% decrease) than did basal ganglia, cerebellum, and other cortical regions (25-40% decreases). Furthermore, subcortical regions reached adult values earlier (14-17.5 years) than did cortical regions (18-22 years). The ontogeny data of FMZ VD from children may contribute to understanding regional differences in synaptic plasticity as well as improve rational therapeutic use of drugs acting at the GABAA receptor in the pediatric population.


Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/crescimento & desenvolvimento , Epilepsia/diagnóstico por imagem , Receptores de GABA-A/metabolismo , Tomografia Computadorizada de Emissão , Adolescente , Adulto , Fatores Etários , Benzodiazepinas/metabolismo , Criança , Pré-Escolar , Humanos
20.
Pediatr Pulmonol ; 31(3): 220-6, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11276135

RESUMO

The aim of this study was to define the inflammatory changes occurring in the lungs of infants at risk for bronchopulmonary dysplasia (BPD) over the first 28 days of life, and to define an optimal strategy for steroids therapy in the prevention of BPD. We measured levels of interleukin-6 (IL-6) and interleukin-1 beta (IL-1beta) in tracheal aspirate (TA) samples and blood of premature infants with severe respiratory distress syndrome RDS (n = 45) on the first day of life prior to initiation of surfactant therapy and on days 5-7, 12-14, 19-21, and 26-28. Levels of IL-6 and IL-1beta were determined with a commercially available enzyme-linked immunoassay. Logistic regression analyses were performed in order to examine differences in trends in levels of IL-6 and IL-1beta between groups of infants. Infants were divided into group I (n = 30, FiO(2) < or = 0.35 at 28 days) and group II (n = 15, FiO(2) > 0.35 based on their likelihood of developing BPD at 36 weeks postconceptional age (PCA). The infants were comparable with respect to mean ( +/- SEM) birth weight (895 +/- 33 g vs. 900 +/- 40 g), gestational age (27 +/- 0.38 weeks vs. 27 +/- 0.54 weeks), and severity of respiratory illness at entry into the study (mean airway pressure: 12 +/- 1 cmH(2)O vs. 12 +/- 1 cmH(2)O, and oxygen index: 15 +/- 2 vs. 19 +/- 4) (group I vs. group II, respectively). Logistic regression analyses failed to reveal any significant differences in linear trends of levels of IL-6 and IL-1beta in TA samples between both groups of infants. No particular pattern of change in levels of IL-6 or IL-1beta could be identified among groups of infants. Levels of IL-6 and IL-1beta in TA samples on the first day of life failed to predict the need for FiO(2) > 0.35 at 28 days of age. We could not identify an increasing trend or a specific pattern of changes in postnatal levels of IL-6 or IL-1beta in TA samples of infants who were at greater risk of developing BPD at 36 weeks PCA compared to infants who were not.


Assuntos
Displasia Broncopulmonar/etiologia , Displasia Broncopulmonar/metabolismo , Recém-Nascido Prematuro/metabolismo , Interleucina-1/metabolismo , Interleucina-6/metabolismo , Displasia Broncopulmonar/fisiopatologia , Feminino , Humanos , Recém-Nascido , Inflamação/fisiopatologia , Mediadores da Inflamação/metabolismo , Pulmão/fisiopatologia , Masculino , Fatores de Risco
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