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1.
Fisioterapia (Madr., Ed. impr.) ; 46(2): 68-75, mar.-abr2024. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-231437

RESUMO

Objetivos: Explorar las actitudes de los fisioterapeutas de Puerto Rico: 1) hacia el acceso directo (AD), 2) las implicaciones para la profesión, la práctica y los servicios de salud, y 3) la implementación del AD a través de un cambio en política pública. Métodos: El diseño fue exploratorio transversal, no experimental y con un enfoque cuantitativo. Los participantes eran fisioterapeutas con licencia vigente, mayores de 21 años de edad, con cualquier grado académico en fisioterapia y que actualmente ejercen la práctica en Puerto Rico. Fueron excluidos fisioterapeutas sin experiencia clínica, que estaban completando un grado doctoral transicional o con experiencia ejerciendo con AD. Para abordar los objetivos de investigación, se construyó un cuestionario, cuyo contenido fue validado por 4 fisioterapeutas expertos utilizando el modelo de Lawshe modificado por Tristán. Resultados: Participaron de este estudio 100 fisioterapeutas. El 96% de los participantes estuvo de acuerdo con la implementación del AD en Puerto Rico. El 83% indicó estar preparado para ejercer la profesión por AD. El 55% entienden que fisioterapeutas con grado doctoral están más preparados para ejercer por AD. El 59% indicó que el AD debe estar restringido por nivel educativo y/o experiencia. Conclusión: La actitud de los fisioterapeutas en Puerto Rico respecto al AD resultó ser favorable, independientemente del grado académico, ya que están a favor con incorporar el AD a la fisioterapia, se sienten preparados para ejercer por AD y consideran el AD beneficioso para los pacientes, la práctica y la profesión. (AU)


Objectives: To explore the attitudes of physiotherapists in Puerto Rico: (1) towards direct access (DA), (2) the implications for the profession, practice, and health services, and (3) the implementation of DA through a change in public policy. Methods: The design was cross-sectional exploratory, non-experimental, and quantitative in nature. Participants were licensed physiotherapists, over 21 years old, with any academic degree in physiotherapy, currently practicing in Puerto Rico. Physiotherapists without clinical experience, those completing a transitional doctoral degree, or with experience practicing with DA were excluded. To address the research objectives, a questionnaire was constructed, whose content was validated by 4 expert physiotherapists using the Lawshe model modified by Tristán. Results: One hundred physiotherapists participated in this study. 96% of participants agreed with the implementation of DA in Puerto Rico. However, only 83% indicated being prepared to practice the profession through DA. 55% understood that physiotherapists with doctoral degrees were better prepared to practice through DA. 59% indicated that DA should be restricted based on educational level and/or experience. Conclusion: The attitude of physiotherapists in Puerto Rico towards DA was favorable regardless of academic degree. They are in favor of incorporating DA into physiotherapy, feel prepared to practice through DA, and consider it beneficial for patients, practice, and the profession. (AU)


Assuntos
Humanos , Fisioterapeutas , Atitude/etnologia , Política Pública , Encaminhamento e Consulta , Autonomia Profissional , Serviços de Saúde , Porto Rico , Estudos Transversais
2.
Eur Arch Paediatr Dent ; 24(1): 139-145, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36437430

RESUMO

INTRODUCTION: The aim of this study is to evaluate the knowledge of infant oral health in mothers who have breastfeeding for a period longer than 6 months. METHODS: A descriptive, observational and cross-sectional study was carried out in 1126 mothers who had breastfed for more than 6 months, using a validated questionnaire. RESULTS: 57% of the mothers surveyed had a high or very high level of knowledge about oral health during pregnancy and breastfeeding; a statistically significant association (p < 0.05) was found between this and the variables of mother's age, duration of breastfeeding, level of education and previous information received about oral health. CONCLUSIONS: The age of the mothers is positively related to the level of oral health knowledge, the elder the mothers the higher the knowledge. Mothers with a longer duration of breastfeeding beyond 24 months have a higher degree of oral health knowledge compared to the rest of the respondents, while their level of educations was also positively related to their degree of knowledge. There is a direct relationship between mothers having received previous information on oral hygiene and their surveyed degree of knowledge.


Assuntos
Aleitamento Materno , Mães , Lactente , Feminino , Gravidez , Humanos , Estudos Transversais , Saúde Bucal , Escolaridade
4.
Sci Rep ; 8(1): 5727, 2018 04 10.
Artigo em Inglês | MEDLINE | ID: mdl-29636483

RESUMO

Dengue is a mosquito-borne viral disease of global impact. In Venezuela, dengue has emerged as one of the most important public health problems of urban areas with frequent epidemics since 2001. The long-term pattern of this disease has involved not only a general upward trend in cases but also a dramatic increase in the size and frequency of epidemic outbreaks. By assuming that climate variability has a relevant influence on these changes in time, we quantified the periodicity of dengue incidence in time-series of data from two northern regions of Venezuela. Disease cycles of 1 and 3-4 years (p < 0.05) were detected. We determined that dengue cycles corresponded with local climate and the El Niño Southern Oscillation (ENSO) variation at both seasonal and inter-annual scales (every 2-3 years). Dengue incidence peaks were more prevalent during the warmer and dryer years of El Niño confirming that ENSO is a regional climatic driver of such long-term periodicity through local changes in temperature and rainfall. Our findings support the evidence of the effect of climate on dengue dynamics and advocate the incorporation of climate information in the surveillance and prediction of this arboviral disease in Venezuela.


Assuntos
Clima , Dengue/epidemiologia , Surtos de Doenças , El Niño Oscilação Sul , Dengue/transmissão , Dengue/virologia , Geografia Médica , Humanos , Incidência , Estações do Ano , Análise Espaço-Temporal , Venezuela/epidemiologia
7.
Proc Natl Acad Sci U S A ; 114(47): 12442-12447, 2017 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-29087302

RESUMO

Both modern humans (MHs) and Neanderthals successfully settled across western Eurasian cold-climate landscapes. Among the many adaptations considered as essential to survival in such landscapes, changes in the nasal morphology and/or function aimed to humidify and warm the air before it reaches the lungs are of key importance. Unfortunately, the lack of soft-tissue evidence in the fossil record turns difficult any comparative study of respiratory performance. Here, we reconstruct the internal nasal cavity of a Neanderthal plus two representatives of climatically divergent MH populations (southwestern Europeans and northeastern Asians). The reconstruction includes mucosa distribution enabling a realistic simulation of the breathing cycle in different climatic conditions via computational fluid dynamics. Striking across-specimens differences in fluid residence times affecting humidification and warming performance at the anterior tract were found under cold/dry climate simulations. Specifically, the Asian model achieves a rapid air conditioning, followed by the Neanderthals, whereas the European model attains a proper conditioning only around the medium-posterior tract. In addition, quantitative-genetic evolutionary analyses of nasal morphology provided signals of stabilizing selection for MH populations, with the removal of Arctic populations turning covariation patterns compatible with evolution by genetic drift. Both results indicate that, departing from important craniofacial differences existing among Neanderthals and MHs, an advantageous species-specific respiratory performance in cold climates may have occurred in both species. Fluid dynamics and evolutionary biology independently provided evidence of nasal evolution, suggesting that adaptive explanations regarding complex functional phenotypes require interdisciplinary approaches aimed to quantify both performance and evolutionary signals on covariation patterns.


Assuntos
Aclimatação/fisiologia , Simulação por Computador , Homem de Neandertal/fisiologia , Nariz/fisiologia , Animais , Antropologia , Clima Frio , Fósseis , Homem de Neandertal/anatomia & histologia , Nariz/anatomia & histologia , Respiração , Especificidade da Espécie
8.
J Dairy Sci ; 95(9): 4851-4862, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22916889

RESUMO

The objective of this study was to determine the effectiveness of high-pressure processing to inactivate Listeria innocua (a Listeria monocytogenes surrogate) in Queso Fresco, and to study the effects of the high-pressure treatment on cheese-crumbling properties. Queso Fresco was made with pasteurized, homogenized milk, lactic acid bacterial starter culture, chymosin, and flake salt. Cheeses were pressed (0.1 MPa) for 1h before crumbling and inoculation with a cocktail of 3 strains of L. innocua, and then pressed for 12 h (0.1 MPa). High-pressure processing treatments of sliced cheese rounds included pressure from 400 to 600 MPa for 1 to 25 min. Cheese sample temperatures, initially approximately 21°C, increased during pressurization and decreased gradually during the holding time. The highest temperature increase was to 23.6°C at 600 MPa. Greater than 5-log reductions occurred at set-point pressures of 500, 550, or 600 MPa when held for at least 15, 3, or 1 min, respectively. However, because inactivation was neither complete nor permanent and crumbling properties were not maintained under the conditions tested in this study, high-pressure processing is not recommended for Queso Fresco applications.


Assuntos
Queijo/microbiologia , Listeria/metabolismo , Pasteurização/métodos , Queijo/análise , Queijo/normas , Manipulação de Alimentos , Microbiologia de Alimentos , Qualidade dos Alimentos , Concentração de Íons de Hidrogênio , Microscopia Eletrônica de Varredura , Pressão , Temperatura
9.
Rev. Soc. Esp. Dolor ; 18(3): 176-186, mayo-jun. 2011. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-89801

RESUMO

El interés de los investigadores por el dolor, su evaluación e intervención en personas con demencia es creciente. Dada la tendencia demográfica a un incremento del envejecimiento poblacional, aumentando las patologías que presentan dolor y el avance en los conocimientos en el campo de las demencias, se identifican cambios que se producen en diferentes áreas cerebrales implicadas en el control del dolor. La presente revisión se centra en las modificaciones que se producen en la percepción del dolor en las personas con demencia, así como analizar los instrumentos más eficaces para reconocer, valorar y tratar el dolor en las personas con demencia. El abordaje integral del dolor debe tener en cuenta a los cuidadores, para prevenir la sobrecarga de los mismos y garantizar la máxima calidad de vida posible de los pacientes (AU)


The interest of researchers for the pain assessment and intervention in people with dementia is growing. Given the demographic trend to an increased aging population, increasing with pain conditions and progress in knowledge in the field of dementia, identify changes that occur in different brain areas involved in pain control. This review focuses on the changes that occur in the perception of pain in people with dementia as well as analyzing the most effective tools to identify, assess and treat pain in people with dementia. The comprehensive approach of pain should take into account carers, to prevent overload them and ensure the highest possible quality of life of patients (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Demência/epidemiologia , Dor/complicações , Dor/terapia , Qualidade de Vida , Confusão/complicações , Doença de Alzheimer/complicações , Peptídeos Opioides/uso terapêutico , Analgesia , Transtornos Psicóticos Afetivos/complicações , Transtornos Psicóticos Afetivos/diagnóstico , Demência/complicações , Demência/fisiopatologia , Limitação da Mobilidade , Dor/fisiopatologia , Envelhecimento/patologia , Envelhecimento/fisiologia , Psicometria/métodos , Delírio/complicações , Transtornos Neurocognitivos/complicações
10.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 29(1): 4-12, ene.-mar. 2009. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-61961

RESUMO

El Estudio Longitudinal Donostia ha investigado el efecto de las intervenciones de tipo no farmacológicoen personas mayores sin deterioro cognitivo, condeterioro cognitivo leve y con demencia. El presentetrabajo se deriva de dicho estudio y pretende profundizaren el perfil lingüístico de las personas participantes,así como realizar una primera aproximaciónempírica al efecto de una intervención de tipomulticomponente en variables de tipo lingüístico.Para ello se ha contado con una muestra de 395 sujetosdistribuidos entre los estadios 1 y 4 de la GlobalDeterioration Scale (GDS). Se han realizado tres grupospor cada estadio: uno de ellos siguió una intervenciónde acuerdo a un modelo de deterioro por estadios, elsegundo realizó tareas de estimulación sin ningúnmodelo prefijado y el tercero no recibió ningún tipo deintervención.Los resultados muestran un mejor rendimiento enlos participantes con GDS 1 y 2 respecto a aquellosque presentan deterioro cognitivo. Entre GDS 3 y 4, seproducen diferencias en vocabulario, escritura y fluidezsemántica, pero no en comprensión auditiva,comprensión escrita y fluidez fonológica. Respecto alefecto de la intervención estimulativa, se observa unamejora en las variables que miden procesos léxicofonológicosen aquéllos participantes que no presentandeterioro cognitivo(AU)


Donostia Longitudinal Study has investigated the effect of non-pharmacological interventions inolder adults without cognitive impairment, withmild cognitive impairment and with dementia. Thecurrent work is derived from this study and aimsto go in depth into the linguistic profile of participants,as well as to perform a first empiricalapproximation to the effect of multi-type interventionin linguistic constructs.We have had a sample of 395 subjects dividedbetween stages from 1 to 4 of the Global DeteriorationScale (GDS). There have been threegroups for each stage: one of them followed anintervention established according to a patternof decline by stages; the second performed stimulationtasks without any theoretical backgroundand the third did not receive any kind ofintervention.The results showed a better performance in participantswith GDS 1 and 2 compared to those withcognitive impairment. Between GDS 3 and 4, differenceswere found in vocabulary, writing andsemantic fluency, but not in listening comprehension,reading comprehension and phonologicalfluency. Regarding to the effect of the intervention,an improvement is observed for those variablesthat measure lexical-phonological processesin those participants who do not suffer cognitiveimpairment(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Transtornos Cognitivos/complicações , Transtornos da Linguagem/complicações , Envelhecimento/psicologia , Doença de Alzheimer/complicações , Transtornos da Memória/complicações , Testes Neuropsicológicos
11.
J Dairy Sci ; 90(6): 2705-9, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17517709

RESUMO

Low methoxyl (LM) pectin was combined with 3-kDa molecular weight cut-off permeates from milk subjected to pH 6.7 to 5 and 7 degrees C or 40 degrees C with the objective of studying the effect of solubilized micellar calcium on viscoelastic properties of LM-pectin-milk mixes. Lowering the pH of skim milk with hydrochloric acid during ultrafiltration gradually promoted permeates to exhibit gel-like behavior when combined with LM-pectin. The onset of the gel-like behavior (G' > 1) occurred at a higher pH when permeates were obtained from milk filtered at 7 degrees C compared with 40 degrees C. As pH value during ultrafiltration approached 5 and regardless of temperature, G' for permeate-pectin mixes approached the same values (approximately 70 Pa) as G' for skim milk-pectin mixes. In all cases G' was highly correlated with free calcium concentration (r > 0.95). The gradual acidification of skim milk-LM-pectin using glucono-delta-lactone, promoted a sharp increase in storage modulus as pH approached 5.2 and a maximum G' increment (DeltaG') at pH approximately 4.9. From pH 4.9 to 4, G' continued to increase but at smaller increments. It was concluded that LM-pectin-casein micelle interaction in milk is a 2-step process: 1) solubilized micellar calcium dependent pectin-pectin interaction as pH approaches 5.0 to 4.9, and 2) pectin-casein micelle interaction in the 5.0-4.9 to 4.0 pH range.


Assuntos
Cálcio/química , Manipulação de Alimentos/métodos , Concentração de Íons de Hidrogênio , Leite/química , Pectinas/química , Animais , Tecnologia de Alimentos , Géis , Temperatura Alta , Micelas , Peso Molecular , Tamanho da Partícula , Solubilidade , Viscosidade
12.
Vasc Med ; 6(1): 15-21, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11358155

RESUMO

The purpose of this cross-sectional study was threefold: (1) to examine ethnic differences in plasma lipoprotein(a) [Lp(a)] concentrations; (2) to examine the relationship between physical activity levels (moderate, moderate-vigorous, and total MET-min/day) and Lp(a) concentrations; and (3) to determine the relationship between maximal treadmill time and Lp(a) concentrations among African-American, Native American, and Caucasian women (n=140, ages 40-70 years: 54.5+/-10.7). Physical activity records were kept for two 4-day periods, scheduled 1 month apart, a total of 8 days, and each activity was assigned a code from the 'Compendium of physical activity'. Subjects completed a graded exercise test to determine maximal treadmill time, and a fasted blood sample was collected to quantify Lp(a) concentration. Lp(a) concentrations were negatively skewed with a geometric mean of 28.3 mg/dl (25-75%: 10.4-43.1 mg/dl) in African-Americans (n=47), 2.9 mg/dl (25-75%: 1.2-7.4 mg/dl) in Native Americans (n=45), and 9.4 mg/dl (25-75%: 2.6-22.4 mg/dl) in Caucasians (n=48). African-American women had significantly higher (p<0.05) Lp(a) concentrations than either Native Americans or Caucasians. No relationships were observed among moderate, moderate-vigorous, and total MET-min/day of physical activity, maximal treadmill time, and Lp(a) concentrations. Significant ethnic differences in Lp(a) concentrations were found, with African-American women having higher Lp(a) concentrations than Native American and Caucasian women. Lp(a) concentrations were not associated with any physical activity variables. Therefore, physical activity and maximal treadmill time did not influence Lp(a) concentrations in this tri-ethnic population of women.


Assuntos
População Negra , Exercício Físico/fisiologia , Indígenas Norte-Americanos , Lipoproteína(a)/sangue , Aptidão Física/fisiologia , População Branca , Adulto , Idoso , Constituição Corporal , Índice de Massa Corporal , Estudos Transversais , Teste de Esforço , Feminino , Humanos , Pessoa de Meia-Idade
13.
Hypertension ; 34(4 Pt 1): 673-8, 1999 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10523345

RESUMO

Mibefradil and amlodipine are calcium antagonists with different channel selectivities. Mibefradil blocks both L- and T-type calcium channels; although in the usual pharmacological doses, it predominantly blocks the T-type channels. In contrast, amlodipine selectively blocks L-type channels. The goal of the present study was to assess whether this differential selectivity would result in different effects on end-organ damage in experimental hypertension. For this purpose, deoxycorticosterone acetate (DOCA)-salt hypertensive rats were treated either with equipotent doses of mibefradil or amlodipine (30 mg. kg(-1). d(-1) as food admix). Despite the fact that both drugs decreased systolic arterial pressure to the same extent (140+/-5 mm Hg in the mibefradil group and 144+/-3 mm Hg in the amlodipine group versus 225+/-5 mm Hg in the untreated-DOCA group), only mibefradil decreased proteinuria (35. 5+/-6.5 versus 103.3+/-14.1 mg/24 h in untreated DOCA-salt animals) and prevented glomerular lesions. Both drugs, however, prevented the occurrence of vascular renal lesions. To elucidate the mechanism responsible for this difference, we evaluated in an additional series of experiments the effects of mibefradil and amlodipine on plasma and renal renin concentrations, as well as the effects of the addition of enalapril, an ACE inhibitor, given on top of both drugs on proteinuria. Amlodipine, in contrast to mibefradil, markedly stimulated the plasma (17.8+/-2.6 ng Ang I. mL(-1). h(-1) in the amlodipine group versus 3.9+/-0.4 ng Ang I. mL(-1). h(-1) in the mibefradil group and 3.2+/-0.3 ng Ang I. mL(-1). h(-1) in the untreated-DOCA group) and renal (2.42+/-0.37 ng Ang I. mL(-1). h(-1) in the amlodipine group versus 0.36+/-0.04 ng Ang I. mL(-1). h(-1) in the mibefradil group and 0.26+/-0.08 ng Ang I. mL(-1). h(-1) in the untreated-DOCA group) renin concentrations. Stimulation of the renin-angiotensin system could explain the absence of a renal protective effect of amlodipine. This was also suggested by the fact that enalapril given in addition to amlodipine could decrease proteinuria. In conclusion, T-type channel blockade by mibefradil decreases blood pressure without stimulation of the renin-angiotensin system and therefore prevents most of the glomerular damage in DOCA hypertensive rats.


Assuntos
Anlodipino/uso terapêutico , Bloqueadores dos Canais de Cálcio/uso terapêutico , Canais de Cálcio/efeitos dos fármacos , Hipertensão/tratamento farmacológico , Glomérulos Renais/efeitos dos fármacos , Mibefradil/uso terapêutico , Anlodipino/farmacologia , Análise de Variância , Animais , Pressão Sanguínea/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Bloqueadores dos Canais de Cálcio/farmacologia , Circulação Coronária , Desoxicorticosterona , Hemodinâmica/efeitos dos fármacos , Hipertensão/induzido quimicamente , Hipertensão/fisiopatologia , Glomérulos Renais/metabolismo , Masculino , Mibefradil/farmacologia , Tamanho do Órgão/efeitos dos fármacos , Ratos , Ratos Wistar , Renina/sangue , Renina/metabolismo
14.
Arch. Inst. Cardiol. Méx ; 69(1): 55-62, ene.-feb. 1999. ilus
Artigo em Espanhol | LILACS | ID: lil-258813

RESUMO

La taquicardia congénita de la unión A-V es muy rara, con manifestación clínica temprana, pobre respuesta a los diferentes fármacos antiarrítmicos y con una gran morbimortalidad infantil (mortalidad del 35 por ciento). Merece una especial atención tanto en su oportuna detección como en su adecuado manejo con los diferentes procedimientos terapéuticos farmacológicos y no farmacológicos disponibles actualmente. Nosotros reportamos los casos de dos enfermos cuya edad de presentación de la taquiarritmia fue a los tres meses y cuya peculiaridad fue la buena respuesta a los fármacos antiarrítmicos. El Verapamilo y posteriormente la Propafenona intravenosa se usaron para las etapas agudas y una combinación de Propafenona más propranolol inicialmente para la fase crónica. Por manifestaciones de intolerancia, fue necesario cambiar después de un año tal combinación por Sotalol y Digital, con buena respuesta. Hacemos además una revisión de la literatura disponible hasta el momento sobre esta entidad


Assuntos
Humanos , Masculino , Lactente , Criança , Antiarrítmicos/uso terapêutico , Quimioterapia Combinada , Eletrocardiografia , Taquicardia Ectópica de Junção/congênito , Propafenona/administração & dosagem , Propafenona/uso terapêutico , Taquicardia Ectópica de Junção/diagnóstico , Taquicardia Ectópica de Junção/tratamento farmacológico , Verapamil/uso terapêutico
15.
Rev Neurol ; 29(12): 1134-7, 1999.
Artigo em Espanhol | MEDLINE | ID: mdl-10652735

RESUMO

INTRODUCTION: In the cognitive sphere, alterations have been found in up to 65% of patients with multiple sclerosis (MS). Study of the P300 wave is a positive component of long latency related to cognitive function: amplitude with attention, and latency with the ability to process information. OBJECTIVE: To assess a study of the P300 wave in a group of patients with MS. PATIENTS AND METHODS: The P300 wave was studied in 26 patients, 22 women and 4 men, with definite clinical MS (on criteria of Poser et al), with normal motor and sensory conduction velocity studies. All patients had a battery of multi-modal evoked potentials (MEP), nuclear magnetic resonance imaging and immunological study of the cerebrospinal fluid. Seventeen patients had the exacerbation-remission (ER) and nine the primary progressive (PP) clinical forms of the disorder. RESULTS: The most markedly altered MEP were the visual and somatosensory evoked potentials (SSEP) of the patients with MS. When the types of clinical course were compared, the SSEP were statistically significant in the PP form, which may be explained by the greater spinal involvement of these patients. Comparative analysis of the P300 wave was done for 26 healthy patients of similar age and sex to that of the patients, and significant differences were found in P300 latency and amplitude between the MS and control groups. The patients who had had the disease for longer had significantly greater anomalies in the P300 waves. CONCLUSION: Study of the evolution of the P300 wave, which is cheap and easy to do, may be valuable in the evolutional assessment of cognitive changes in patients with MS.


Assuntos
Encéfalo/fisiologia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Potenciais Evocados P300/fisiologia , Esclerose Múltipla/complicações , Adolescente , Adulto , Encéfalo/patologia , Líquido Cefalorraquidiano/imunologia , Potenciais Somatossensoriais Evocados/fisiologia , Potenciais Evocados Visuais/fisiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/líquido cefalorraquidiano
16.
J Comp Neurol ; 384(3): 323-36, 1997 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-9254030

RESUMO

Functional development of the rat whisker somatosensory system was studied by using the (14C) 2-deoxyglucose (2DG) metabolic mapping technique. Restrained rat pups had their left mystacial vibrissae stroked for 30 minutes and their brains harvested, sectioned, and autoradiographed from the level of the lower medulla to the frontal cortex. Subjects were tested at postnatal days (PNDs) 0-9 and 21. At birth, all subjects exhibited a significant increase of 2DG uptake in the left spinal trigeminal nuclei, the principal trigeminal sensory nucleus, and a portion of the right ventral posteromedial thalamic nucleus. The primary somatosensory cortex exhibited significant 2DG uptake contralateral to stimulation by PND 6, followed by the secondary somatosensory cortex at PND 7. The pattern of 2DG uptake in the somatosensory cortices became more intense and well defined by PND 9. Given that the somatosensory system develops in an orderly fashion from the periphery to higher brain structures, the present results show that brain structures mediating whisker sensory input are not metabolically active until projections from lower somatosensory centers are established. Neurons become responsive to whisker stimulation in the subcortical structures at birth and in the somatosensory cortex a few days later. This cortical activity follows the organization of the upper tier of thalamocortical fibers into a "barrelfield." Moreover, there is a gradual enhancement in functional activity of the vibrissa neurons at different somatosensory nuclei as rats mature. The present study elucidates the time course of functional development in the rat somatosensory system.


Assuntos
Mapeamento Encefálico/métodos , Desoxiglucose/metabolismo , Córtex Somatossensorial/fisiologia , Vibrissas/inervação , Animais , Radioisótopos de Carbono , Feminino , Masculino , Ratos , Ratos Sprague-Dawley , Tálamo/metabolismo , Núcleos do Trigêmeo/metabolismo
17.
J Vasc Surg ; 23(1): 36-43, discussion 43-5, 1996 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8558740

RESUMO

PURPOSE: Fifty-one consecutive patients with premature lower extremity atherosclerosis were prospectively evaluated for atherogenic risk factors and primary or acquired hypercoagulability, which might contribute to early ischemia and revascularization failure. METHODS: Laboratory tests included plasma assays of (1) natural anticoagulants (NAC), lipoprotein (a) (Lp[a]), and anticardiolipin antibodies, and (2) fibrinolytic activators and inhibitors at baseline and stimulated after 20 minutes of upper extremity venous occlusion. RESULTS: Forty-six (90%) of these 51 patients had laboratory abnormalities. One or more NAC deficiencies were found in 15 (30%) patients and included antithrombin III (n = 5), protein C (n = 8), protein S (n = 4), and heparin cofactor II (n = 2). Hypofibrinolysis was identified as a deficiency of stimulated tissue plasminogen activator in 22 (45%) patients and elevated plasminogen activator inhibitor-1 (PAI-1) in 29 (59%). Elevated Lp(a) was found in 43 (86%) patients. Five (10%) patients had anticardiolipin antibodies. Ten patients had combined NAC deficiency and hypofibrinolysis. Five (10%) patients had no abnormality. NAC deficiencies, especially protein C deficiency, were associated with acute ischemia (p < 0.01), prior vascular intervention (p < 0.01), an increasing number of total vascular procedures (p < 0.01), and major amputation (p < 0.01). PAI-1 was associated with a history of heart disease (p < 0.05) and prior vascular procedures (p < 0.05). Elevated Lp(a) was associated with elevated PAI-1 (p < 0.05). Retesting in 20 patients suggested that 80% of NAC deficiencies were acquired, but abnormalities persisted in 66% of patients with elevated PAI-1 and in 93% of those with elevated Lp(a). CONCLUSIONS: These data strongly support the hypothesis that the convergence of atherogenic risk factors and hypercoagulability play an important role in early ischemia and poor results reported for lower extremity vascular procedures in young adults.


Assuntos
Arteriosclerose/diagnóstico , Transtornos da Coagulação Sanguínea/diagnóstico , Perna (Membro)/irrigação sanguínea , Adulto , Análise de Variância , Arteriosclerose/sangue , Arteriosclerose/epidemiologia , Biomarcadores/sangue , Transtornos da Coagulação Sanguínea/sangue , Transtornos da Coagulação Sanguínea/epidemiologia , Distribuição de Qui-Quadrado , Feminino , Humanos , Incidência , Isquemia/sangue , Isquemia/diagnóstico , Isquemia/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco
18.
Angiology ; 46(9): 853-8, 1995 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-7661391

RESUMO

The authors describe a healthy young male smoker with familial history of recurrent thromboembolism who presented with severe, rapidly progressive lower limb ischemia and abnormal results from liver function tests. An arteriogram of the lower extremities showed bilateral infrainguinal atherosclerotic arterial occlusions. The laboratory findings, in addition to abnormal liver function findings, included moderately elevated antiphospholipid antibodies and hemostatic abnormalities involving elevated fibrinogen, lipoprotein (a) levels, and deficient fibrinolysis. He underwent bilateral femoral thrombectomy, which was followed by a meticulous anticoagulation, and had gradual improvement of ischemic symptoms and liver functions. This is, to their knowledge, the first reported case in the English literature of premature lower extremity atherosclerosis and antiphospholipid syndrome associated with elevated lipoprotein (a) levels and documented complex hemostatic abnormalities contributing to systemic thrombosis.


Assuntos
Síndrome Antifosfolipídica/complicações , Arteriosclerose/complicações , Artéria Femoral , Hiperlipoproteinemias/complicações , Perna (Membro)/irrigação sanguínea , Lipoproteínas HDL/sangue , Falência Hepática Aguda/etiologia , Trombose/etiologia , Doença Aguda , Adulto , Síndrome Antifosfolipídica/diagnóstico , Síndrome Antifosfolipídica/terapia , Arteriosclerose/diagnóstico , Arteriosclerose/terapia , Terapia Combinada , Artéria Femoral/diagnóstico por imagem , Humanos , Hiperlipoproteinemias/diagnóstico , Hiperlipoproteinemias/terapia , Claudicação Intermitente/diagnóstico , Claudicação Intermitente/etiologia , Claudicação Intermitente/terapia , Falência Hepática Aguda/diagnóstico , Falência Hepática Aguda/terapia , Masculino , Radiografia , Fumar/efeitos adversos , Trombose/diagnóstico , Trombose/terapia
19.
Clin Exp Hypertens ; 17(5): 847-60, 1995 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-7655452

RESUMO

Plasma renin-angiotensin parameters were measured before and 24h after binephrectomy (BNx) in male Swiss (Ren-1, Ren-2) and BALB/c (Ren-1) female mice (representing the extremes of differences in tissue renin expression), together with in vivo inhibition of residual renin. Plasma Ang II increased from 18.9 +/- 7.3 to 48.1 +/- 16.9 pg/ml after BNx in conscious Swiss mice (+/- sd, p < 0.001, n = 11&12), renin activity (PRA) increased 2.76 times, angiotensinogen (aogen) increased 4.57 times and renin concentration (PRC) fell by 65%. In BALB/c, Ang II+Ang III decreased slightly (56.6 +/- 11 to 37.7 +/- 14.7, p < 0.05, n = 5&6), PRA was unchanged, aogen increased 12 times and PRC fell by 93%. Plasma ACE decreased by 26% and 28% respectively. Aogen did not increase further when post BNx plasma renin was inhibited with antirenin in vivo during 20h. Thus plasma angiotensin is maintained or considerably increased following BNx in mice and the change is consistent with first-order kinetics with respect to renin and aogen in the circulation. Whether the strain carries one or two renin genes, high renal and extrarenal renin production combined with a low plasma aogen phenotype yields resting angiotensin levels similar to other mammals. A kinetic regulation of aogen levels is proposed in mice wherein Ang II production is limited by low substrate concentration thereby ensuring normotension in the face of abundant extrarenal renin secretion.


Assuntos
Angiotensina II/sangue , Nefrectomia , Angiotensina III/sangue , Angiotensinogênio/sangue , Animais , Feminino , Cinética , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Renina/sangue , Sistema Renina-Angiotensina/fisiologia
20.
Brain Res Dev Brain Res ; 87(1): 62-8, 1995 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-7554233

RESUMO

Capsaicin, a selective neurotoxin of unmyelinated C-fibers, was administered to neonatal rat pups at birth. Following a recovery period of 10 days, pups were injected with 2-deoxy-glucose (2DG) and subjected to repetitive mechanical stimulation to the left whiskerpad. Their brains were then harvested for autoradiography. The observed changes in 2DG uptake in the somatosensory cortex of capsaicin-treated rats were compared to vehicle-treated rats. The cross-sectional area and density of 2DG uptake by the primary and the secondary somatosensory cortex (SSI and SSII, respectively) were measured. Capsaicin-treated rats significantly exhibited a reduction in area of activation and a decrease of 2DG uptake in both structures. The present data indicates that neonatal capsaicin affects the functional activity of the rat somatosensory cortex. It is suggested that unmyelinated sensory afferents play a role in the development of the rat somatosensory system.


Assuntos
Alcaloides/farmacologia , Animais Recém-Nascidos/metabolismo , Capsaicina/farmacologia , Córtex Somatossensorial/efeitos dos fármacos , Vibrissas/inervação , Fatores Etários , Animais , Peso Corporal , Mapeamento Encefálico , Desoxiglucose , Mecanorreceptores/fisiologia , Ratos , Ratos Sprague-Dawley , Córtex Somatossensorial/embriologia , Córtex Somatossensorial/metabolismo
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