RESUMO
Single photon emission computed tomography (SPECT) is a useful tool in measuring dynamic brain functioning. Its potential to reveal the physiological mechanisms of neurotoxicity has not been fully explored. In the present study, the SPECT findings for 25 healthy control subjects were compared to the findings for 25 mixed organic solvent exposure subjects. Specific physiological abnormalities related to regional cerebral blood flow activity (rCBF) were revealed. In the early phase of uptake, significantly decreased uptake was found in the mixed organic solvent group; in the late phase of uptake, a significant increase in uptake was found in specific regions of interest. The discovery of this abnormality in brain functioning may be a significant step toward the creation of a biological marker of neurotoxicity. Early detection of neurotoxicity is important in occupational medicine to prevent neurotoxic illnesses in working populations.
Assuntos
Encéfalo/metabolismo , Circulação Cerebrovascular/efeitos dos fármacos , Solventes/farmacologia , Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/efeitos dos fármacos , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional , Valores de ReferênciaRESUMO
We retrospectively reviewed the outcome of extracorporeal shock wave lithotripsy in patients with renal calculi less than 3 cm. in size who were treated at a large multi-user lithotripsy center. Patients in whom indwelling ureteral stents were placed before lithotripsy treatment were subjected to higher levels of total power (shocks times voltage), yet the rate free of stones did not differ from those treated without a stent. In addition, the patients with internal ureteral stents experienced a significantly higher incidence of urinary urgency (43 versus 25 per cent) and hematuria (40 versus 23 per cent) than nonstented patients, respectively (p less than 0.05). Also, the duration of bladder discomfort was longer for stented patients (26 versus 13 per cent) as was the duration of urinary frequency (31 versus 16 per cent), compared to nonstented patients (p less than 0.05). The results suggest that use of an indwelling ureteral stent may not contribute to a higher rate free of stones for the treatment of small to medium sized renal calculi and, in fact, it may make the treatment more uncomfortable for the patient than performing lithotripsy without ureteral stenting. Of course, in selected cases (solitary kidney, large stone burden and aid in stone localization) ureteral stenting has a useful adjunctive role in extracorporeal shock wave lithotripsy.
