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1.
Mar Pollut Bull ; 203: 116463, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38776641

RESUMO

Industrial waste barrels were discarded from 1947 to 1961 at a DDT dumpsite in the San Pedro Basin (SPB) in southern California, USA at ~890 m. The barrels were studied for effects on sediment concentrations of DDX, PCBs, PAHs and sediment properties, and on benthic macrofaunal assemblages, including metazoan meiofaunal taxa >0.3 mm. DDX concentration was highest in the 2-6 cm fraction of the 10-cm deep cores studied but exhibited no correlation with macrofaunal density, composition or diversity. Macrofaunal diversity was lowest and distinct in sediments within discolored halos surrounding the barrels. Low macrobenthos density and diversity, high dominance by Entoprocta, and numerical prevalence of large nematodes may result from the very low oxygen concentrations in bottom waters (< 4.4 µM). There is potential for macrofauna to remobilize DDX into the water column and ultimately the food web in the SPB.


Assuntos
Monitoramento Ambiental , Poluentes Químicos da Água , Animais , California , Poluentes Químicos da Água/análise , Sedimentos Geológicos/química , DDT/análise , Invertebrados , Bifenilos Policlorados/análise , Biodiversidade , Hidrocarbonetos Policíclicos Aromáticos/análise , Resíduos Industriais/análise
2.
Alzheimers Dement ; 19(12): 5885-5904, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37563912

RESUMO

INTRODUCTION: Artificial intelligence (AI) and neuroimaging offer new opportunities for diagnosis and prognosis of dementia. METHODS: We systematically reviewed studies reporting AI for neuroimaging in diagnosis and/or prognosis of cognitive neurodegenerative diseases. RESULTS: A total of 255 studies were identified. Most studies relied on the Alzheimer's Disease Neuroimaging Initiative dataset. Algorithmic classifiers were the most commonly used AI method (48%) and discriminative models performed best for differentiating Alzheimer's disease from controls. The accuracy of algorithms varied with the patient cohort, imaging modalities, and stratifiers used. Few studies performed validation in an independent cohort. DISCUSSION: The literature has several methodological limitations including lack of sufficient algorithm development descriptions and standard definitions. We make recommendations to improve model validation including addressing key clinical questions, providing sufficient description of AI methods and validating findings in independent datasets. Collaborative approaches between experts in AI and medicine will help achieve the promising potential of AI tools in practice. HIGHLIGHTS: There has been a rapid expansion in the use of machine learning for diagnosis and prognosis in neurodegenerative disease Most studies (71%) relied on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset with no other individual dataset used more than five times There has been a recent rise in the use of more complex discriminative models (e.g., neural networks) that performed better than other classifiers for classification of AD vs healthy controls We make recommendations to address methodological considerations, addressing key clinical questions, and validation We also make recommendations for the field more broadly to standardize outcome measures, address gaps in the literature, and monitor sources of bias.


Assuntos
Doença de Alzheimer , Doenças Neurodegenerativas , Humanos , Doença de Alzheimer/diagnóstico por imagem , Prognóstico , Inteligência Artificial , Encéfalo/diagnóstico por imagem , Neuroimagem/métodos
3.
J Neurol ; 270(10): 4949-4958, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37358635

RESUMO

BACKGROUND: Past evidence shows that changes in functional brain connectivity in multiple resting-state networks occur in cognitively healthy individuals who have non-modifiable risk factors for Alzheimer's Disease. Here, we aimed to investigate how those changes differ in early adulthood and how they might relate to cognition. METHODS: We investigated the effects of genetic risk factors of AD, namely APOEe4 and MAPTA alleles, on resting-state functional connectivity in a cohort of 129 cognitively intact young adults (aged 17-22 years). We used Independent Component Analysis to identify networks of interest, and Gaussian Random Field Theory to compare connectivity between groups. Seed-based analysis was used to quantify inter-regional connectivity strength from the clusters that exhibited significant between-group differences. To investigate the relationship with cognition, we correlated the connectivity and the performance on the Stroop task. RESULTS: The analysis revealed a decrease in functional connectivity in the Default Mode Network (DMN) in both APOEe4 carriers and MAPTA carriers in comparison with non-carriers. APOEe4 carriers showed decreased connectivity in the right angular gyrus (size = 246, p-FDR = 0.0079), which was correlated with poorer performance on the Stroop task. MAPTA carriers showed decreased connectivity in the left middle temporal gyrus (size = 546, p-FDR = 0.0001). In addition, we found that only MAPTA carriers had a decreased connectivity between the DMN and multiple other brain regions. CONCLUSIONS: Our findings indicate that APOEe4 and MAPTA alleles modulate brain functional connectivity in the brain regions within the DMN in cognitively intact young adults. APOEe4 carriers also showed a link between connectivity and cognition.


Assuntos
Doença de Alzheimer , Humanos , Adulto , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/genética , Mapeamento Encefálico , Encéfalo/diagnóstico por imagem , Cognição , Imageamento por Ressonância Magnética , Rede Nervosa , Fatores de Risco
4.
Front Behav Neurosci ; 17: 1096720, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37091594

RESUMO

Introduction: Millions of people worldwide take medications such as L-DOPA that increase dopamine to treat Parkinson's disease. Yet, we do not fully understand how L-DOPA affects sleep and memory. Our earlier research in Parkinson's disease revealed that the timing of L-DOPA relative to sleep affects dopamine's impact on long-term memory. Dopamine projections between the midbrain and hippocampus potentially support memory processes during slow wave sleep. In this study, we aimed to test the hypothesis that L-DOPA enhances memory consolidation by modulating NREM sleep. Methods: We conducted a double-blind, randomised, placebo-controlled crossover trial with healthy older adults (65-79 years, n = 35). Participants first learned a word list and were then administered long-acting L-DOPA (or placebo) before a full night of sleep. Before sleeping, a proportion of the words were re-exposed using a recognition test to strengthen memory. L-DOPA was active during sleep and the practice-recognition test, but not during initial learning. Results: The single dose of L-DOPA increased total slow-wave sleep duration by approximately 11% compared to placebo, while also increasing spindle amplitudes around slow oscillation peaks and around 1-4 Hz NREM spectral power. However, behaviourally, L-DOPA worsened memory of words presented only once compared to re-exposed words. The coupling of spindles to slow oscillation peaks correlated with these differential effects on weaker and stronger memories. To gauge whether L-DOPA affects encoding or retrieval of information in addition to consolidation, we conducted a second experiment targeting L-DOPA only to initial encoding or retrieval and found no behavioural effects. Discussion: Our results demonstrate that L-DOPA augments slow wave sleep in elderly, perhaps tuning coordinated network activity and impacting the selection of information for long-term storage. The pharmaceutical modification of slow-wave sleep and long-term memory may have clinical implications. Clinical trial registration: Eudract number: 2015-002027-26; https://doi.org/10.1186/ISRCTN90897064, ISRCTN90897064.

5.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1441594

RESUMO

Introducción: El mieloma múltiple con expresión de inmunoglobulina M de superficie constituye una enfermedad rara cuya causa es desconocida y se caracteriza por una alta tasa de anormalidades genéticas en las células plasmáticas o sus precursores. Objetivo: Determinar las características clínicas y sus asociaciones con la expresión inmunofenotípica de inmunoglobulina M de superficie e inmunohistoquímica de CD20 en una paciente afectada de mieloma múltiple precedido por síndrome mielodisplásico. Presentación del caso: Paciente femenina, 68 años de edad. Admitida en el Servicio de Hematología Clínica. Al momento del diagnóstico presentó palidez, trombocitopenia, hipercalcemia y lesiones óseas. Inicialmente, mediante citometría de flujo se detectaron patrones aberrantes para granulocitos, neutrófilos, monocitos y serie eritroide, sugerentes de síndrome mielodisplásico. Posteriormente se observó aumento de las células plasmáticas del 18 % en el frotis de médula ósea, exhibiendo una morfología similar a linfocitos. Se reportó una población patológica de 6 % de la celularidad total, mostrando positividad para CD38, CD117 e inmunoglobulina M de superficie, negatividad para CD19 y CD45, fenotipo coherente con células plasmáticas anormales. Adicionalmente resultados de inmunohistoquímica relataron tinción difusa de CD20 en biopsia de médula ósea. La paciente logró recuperarse luego de un trasplante autólogo de células progenitoras hematopoyéticas. Conclusión: Los resultados resaltan la importancia de diagnosticar y monitorear casos únicos que permitan un tratamiento oportuno del paciente.


Introduction: Multiple Myeloma with expression of surface immunoglobulin M is a rare entity, whose cause is unknown, and is characterized by a high rate of genetic abnormalities in plasma cells or their precursors. Objective: To determining the clinical characteristics and their associations with the immunophenotypic expression of surface immunoglobulin M and CD20 immunohistochemistry in a patient affected by Multiple Myeloma preceded by Myelodysplastic syndrome. Case presentation: A 68-year-old female patient is admitted to the Clinical Hematology Service. At the time of diagnosis, she presented pallor, thrombocytopenia, hypercalcemia, and bone lesions. Initially, flow cytometry detected aberrant patterns for neutrophilic granulocytes, monocytes, and the erythroid series suggestive of myelodysplastic syndrome. Subsequently, an 18% increase in plasma cells was observed in the bone marrow smear, exhibiting a lymphocyte-like morphology. A pathological population of 6% of the total cellularity was reported, showing positivity for CD38, CD117 and surface immunoglobulin M, negativity for CD19 and CD45, a phenotype consistent with abnormal plasma cells. Additionally, immunohistochemical results reported diffuse CD20 staining in bone marrow biopsy. The patient managed to recover after an autologous hematopoietic stem cell transplant. Conclusion: The results found highlight the importance of diagnosing and monitoring single cases that allow timely treatment of the patient.


Assuntos
Feminino , Idoso
6.
Clin. transl. oncol. (Print) ; 24(8): 1515–1523, agosto 2022.
Artigo em Inglês | IBECS | ID: ibc-206240

RESUMO

In spite of the good prognosis of patients with early-stage melanoma, there is a substantial proportion of them that develop local or distant relapses. With the introduction of targeted and immune therapies for advanced melanoma, including at the adjuvant setting, early detection of recurrent melanoma and/or second primary lesions is crucial to improve clinical outcomes. However, there is a lack of universal guidelines regarding both frequency of surveillance visits and diagnostic imaging and/or laboratory evaluations. In this article, a multidisciplinary expert panel recommends, after careful review of relevant data in the field, a consensus- and experience-based follow-up strategy for melanoma patients, taking into account prognostic factors and biomarkers and the high-risk periods and patterns of recurrence in each (sub) stage of the disease. Apart from the surveillance intensity, healthcare professionals should focus on patients’ education to perform regular self-examinations of the skin and palpation of lymph nodes. (AU)


Assuntos
Humanos , Consenso , Melanoma/diagnóstico , Melanoma/patologia , Melanoma/terapia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia , Seguimentos
7.
Clin Transl Oncol ; 24(8): 1515-1523, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35349041

RESUMO

In spite of the good prognosis of patients with early-stage melanoma, there is a substantial proportion of them that develop local or distant relapses. With the introduction of targeted and immune therapies for advanced melanoma, including at the adjuvant setting, early detection of recurrent melanoma and/or second primary lesions is crucial to improve clinical outcomes. However, there is a lack of universal guidelines regarding both frequency of surveillance visits and diagnostic imaging and/or laboratory evaluations. In this article, a multidisciplinary expert panel recommends, after careful review of relevant data in the field, a consensus- and experience-based follow-up strategy for melanoma patients, taking into account prognostic factors and biomarkers and the high-risk periods and patterns of recurrence in each (sub) stage of the disease. Apart from the surveillance intensity, healthcare professionals should focus on patients' education to perform regular self-examinations of the skin and palpation of lymph nodes.


Assuntos
Melanoma , Neoplasias Cutâneas , Consenso , Seguimentos , Humanos , Melanoma/diagnóstico , Melanoma/patologia , Melanoma/terapia , Recidiva Local de Neoplasia/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia
8.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1398366

RESUMO

Objetivo: CConocer el tiempo de diferimiento y recaída posterior a quimioterapia de inducción en niños con leucemia linfoblástica aguda (LLA) en un hospital nacional de Lambayeque. Estudio: Estudio observacional analítico, cohorte retrospectiva. Se revisaron las historias clínicas de pacientes de 2 y 15 años con diagnóstico de LLA que alcanzaron remisión completa al término de la inducción atendidos en un hospital nacional de Lambayeque. Hallazgos: Los pacientes presentaron una mediana de edad de 5 años. Aunque la mayoría respondió al término de la inducción IA; 43/75 niños con LLA recayeron. Los niños con recaída tuvieron un diferimiento de 6 días [RIC: 0-25] entre fin de la inducción y el inicio de la fase de consolidación. Conclusión: el diferimiento ≥ 7 días en los esquemas de quimioterapia afecta a la sostenibilidad de la remisión.


Objetive:To know the delay and relapse time after induction chemotherapy in children with acute lymphoblastic leukemia (ALL) in a national hospital in Lambayeque. Analytical observational study of a retrospective The study:cohort. The medical records of patients whose age is 2 and 15 years with diagnosis of ALLwho achieved complete remission at the end of induction treated and a national hospital in Lambayeque ,were reviewed. The Findings:patients studied had a median age of 5 years. Although the majority responded at the end of IAinduction, still 43/75 children with ALLrelapsed. Children with relapse had a delay of 6 days [IQR: 0-25] between the end of induction and the beginningoftheconsolidationphase.Delay≥7daysin Conclusion:chemotherapy regimens affects the sustainability of remission

9.
Ginecol. obstet. Méx ; 90(4): 371-377, ene. 2022. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1385035

RESUMO

Resumen INTRODUCCIÓN: Los síndromes paraneoplásicos son manifestaciones a distancia de las neoplasias, que se originan por mecanismos secundarios pero no por invasión tumoral. Son poco frecuentes, anteceden a la manifestación propia del tumor y desaparecen con su curación. Si bien la miastenia gravis tradicionalmente se ha relacionado con timomas, aquí se busca reportar un caso de miastenia gravis como síndrome paraneoplásico de un tumor de ovario y hacer una revisión de la bibliografía disponible referente a su diagnóstico. CASO CLÍNICO: Paciente de 46 años, con múltiples episodios de debilidad generalizada e insuficiencia ventilatoria que requirió ventilación mecánica y estancia en cuidados intensivos. Se estableció el diagnóstico clínico de miastenia gravis. A pesar del adecuado tratamiento y de la timectomía, las crisis persistieron. Al poco tiempo se le diagnosticó un adenocarcinoma seroso de ovario que se trató con cirugía y quimioterapia. Con esto desaparecieron los síntomas neurológicos, con una remisión total después de cuatro años de seguimiento, sin tratamiento médico. Para la revisión bibliográfica se emprendió una búsqueda en Medline, Cochrane, LILACS, Google Scholar y literatura gris con los términos "myasthenia gravis AND ovarian cancer". Se encontraron 18 artículos de los que se incluyeron solo dos publicaciones para la revisión completa. CONCLUSIONES: Los síndromes neurológicos, entre estos la miastenia gravis, asociados con tumores de ovario a modo de síndromes paraneoplásicos son poco frecuentes y plantean la necesidad de incluir el estudio ginecológico en pacientes con miastenia gravis de manifestación atípica.


Abstract BACKGROUND: Paraneoplastic syndromes are distant manifestations of neoplasms originated by secondary mechanisms but not by tumor invasion. They are infrequent, precede the manifestation of the tumor itself and disappear when the tumor is cured. Although myasthenia gravis has traditionally been related to thymomas, here we report a case of myasthenia gravis as a paraneoplastic syndrome of an ovarian tumor and review the available literature on its diagnosis. CLINICAL CASE: 46-year-old patient with multiple episodes of generalized weakness and ventilatory failure requiring mechanical ventilation and intensive care stay. The clinical diagnosis of myasthenia gravis was established. Despite adequate treatment and thymectomy, the crises persisted. Soon after, she was diagnosed with serous adenocarcinoma of the ovary, which was treated with surgery and chemotherapy. With this, the neurological symptoms disappeared, with total remission after four years of follow-up, without medical treatment. For the literature review a search was undertaken in Medline, Cochrane, LILACS, Google Scholar and grey literature with the terms "myasthenia gravis AND ovarian cancer". Eighteen articles were found of which only two publications were included for the full review. CONCLUSIONS: Neurological syndromes, among this myasthenia gravis, associated with ovarian tumors as paraneoplastic syndromes are rare and raise the need to include gynecological study in patients with myasthenia gravis of atypical manifestation.

10.
Rev. cuba. med. mil ; 50(4)dic. 2021.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1408748

RESUMO

RESUMEN Introducción: El cáncer de cabeza y cuello es un problema de salud a nivel global. La cirugía oncológica desempeña importantes funciones en la terapéutica del cáncer y las complicaciones son en mayor o menor medida inherentes a ella. Los niveles de albúmina pretratamiento han demostrado tener valor pronóstico en pacientes oncológicos, pero se desconoce la relación entre la hipoalbuminemia y las complicaciones posquirúrgicas en pacientes con cáncer de cabeza y cuello. Objetivo: Evaluar la relación entre complicaciones posoperatorias e hipoalbuminemia en pacientes con cáncer de cabeza y cuello. Métodos: Se realizó un estudio transversal, con una muestra de 133 casos, se utilizaron las variables: edad, sexo, hipoalbuminemia, complicaciones y tipo de complicaciones. Se utilizó el test exacto de Fisher y su significación exacta, con un nivel de confianza del 95 %. Para el análisis pronóstico de la relación entre las complicaciones y la hipoalbuminemia se calculó el riesgo absoluto con el odds ratio. Resultados: El 54,8 % correspondió al grupo con más de 60 años, el 75,9 % al sexo masculino, el 20,3 % de los casos tenía hipoalbuminemia y solo presentaron complicaciones el 19,5 %. El riesgo absoluto de complicaciones en los pacientes con hipoalbuminemia fue 1312,5. Conclusiones: La hipoalbuminemia es un factor de mal pronóstico para la aparición de complicaciones postoperatorias en pacientes con cáncer de cabeza y cuello.


ABSTRACT Introduction: Head and neck cancer is a global health problem. Cancer surgery plays important roles in cancer therapy and complications are, to a greater or lesser extent, inherent to it. Pretreatment albumin levels have been shown to have prognostic value in cancer patients; but the relationship between hypoalbuminemia and postoperative complications in patients with head and neck cancer is unknown. Objective: To evaluate the relationship between postoperative complications and hypoalbuminemia in patients with head and neck cancer. Method: A cross-sectional study was carried out, with a sample of 133 cases, the variables were used: age, sex, hypoalbuminemia, complications and type of complications. Fisher's exact test and its exact significance were used, with a confidence level of 95 %. For the prognostic analysis of the relationship between complications and hypoalbuminemia, the absolute risk was calculated with the odds ratio. Results: 54,8 % corresponded to the group over 60 years old, 75,9 % to the male sex, 20,3 % of the cases had hypoalbuminemia and only 19,5 % presented complications. The absolute risk of complications in patients with hypoalbuminemia was 1312,5. Conclusions: Hypoalbuminemia is a poor prognostic factor for the appearance of postoperative complications in patients with head and neck cancer.

11.
Food Chem ; 360: 129951, 2021 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33989882

RESUMO

The kanihua (Chenopodium pallidicaule Aellen) Andean grain from the Peruvian Altiplano presents proteins of 15% to 19%. The objective was to obtain purified bioactive antimicrobial peptides (AMPs), hydrolyzed with Alcalase and Pepsin-pancreatin sequential system of protein fractions of kanihua varieties Ramis (KR) and Cupi-Sayhua (KS), and hydrolysates with different degrees of hydrolysis (DH) and percentage inhibition (IP) of the growth of E. coli, S. aureus, and C. albicans. To obtain AMPs, nutraceuticals, bio-preservatives, and novel ingredients in food design. The results showed 216 hydrolysates (1%, w/v), only 28 presented significant difference compared to controls (IP ≥ 45%, p ≤ 0.05), 4 AMPs were purified by chromatography, glutelins KS 4 h (1:10) stood out with DH 40% and IP 52% and 70% of S. aureus and C. albicans, respectively (p ≤ 0.05), showed minimum inhibitory concentration (MIC) of 95% for E. coli (p ≤ 0.05), and presented an anionic charge. In conclusion, the simulated digestion in vitro showed higher DH (7%-67%) than Alcalase (13%-54%); the majority were extensive; of 28 hydrolysates with IP ≥ 45% 4 AMPs with important IPs were obtained, and one was anionic.


Assuntos
Chenopodium/embriologia , Proteínas Citotóxicas Formadoras de Poros/isolamento & purificação , Sementes/química , Chenopodium/química , Escherichia coli/metabolismo , Hidrólise , Testes de Sensibilidade Microbiana , Hidrolisados de Proteína/química , Sementes/metabolismo , Staphylococcus aureus/metabolismo
12.
J Alzheimers Dis ; 73(3): 833-848, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31884475

RESUMO

Alzheimer's disease (AD) and frontotemporal dementia (FTD) are the most common neurodegenerative early-onset dementias. Despite the fact that both conditions have a very distinctive clinical pattern, they present with an overlap in their cognitive and behavioral features that may lead to misdiagnosis or delay in diagnosis. The current review intends to summarize briefly the main differences at the clinical, neuropsychological, and behavioral levels, in an attempt to suggest which aspects would facilitate an adequate diagnosis in a clinical setting, especially in Latin American and low- and middle-income countries, where the resources needed for a differential diagnosis (such as MRI or biomarkers) are not always available. A timely diagnosis of AD and FTD have significant implications for the medical management and quality of life of patients and careers.


Assuntos
Doença de Alzheimer/diagnóstico , Demência Frontotemporal/diagnóstico , Doença de Alzheimer/psicologia , Diagnóstico Diferencial , Função Executiva/fisiologia , Demência Frontotemporal/psicologia , Humanos , Memória/fisiologia , Testes Neuropsicológicos , Cognição Social
13.
Neuroimage Clin ; 24: 102066, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31795052

RESUMO

Altered insight into disease or specific symptoms is a prominent clinical feature of frontotemporal dementia (FTD). Understanding the neural bases of insight is crucial to help improve FTD diagnosis, classification and management. A systematic review to explore the neural correlates of altered insight in FTD and associated syndromes was conducted. Insight was fractionated to examine whether altered insight into different neuropsychological/behavioural objects is underpinned by different or compatible neural correlates. 6 databases (Medline, Embase, PsycINFO, Web of Science, BIOSIS and ProQuest Dissertations & Theses Global) were interrogated between 1980 and August 2019. 15 relevant papers were found out of 660 titles screened. The studies included suggest that different objects of altered insight are associated with distinctive brain areas in FTD. For example, disease unawareness appears to predominantly correlate with right frontal involvement. In contrast, altered insight into social cognition potentially involves, in addition to frontal areas, the temporal gyrus, insula, parahippocampus and amygdala. Impaired insight into memory problems appears to be related to the frontal lobes, postcentral gyrus, parietal cortex and posterior cingulate. These results reflect to a certain extent those observed in other neurodegenerative conditions like Alzheimer's disease (AD) and also other brain disorders. Nevertheless, they should be cautiously interpreted due to variability in the methodological aspects used to reach those conclusions. Future work should triangulate different insight assessment approaches and brain imaging techniques to increase the understanding of this highly relevant clinical phenomenon in dementia.


Assuntos
Encéfalo/diagnóstico por imagem , Demência Frontotemporal/diagnóstico por imagem , Metacognição , Autoimagem , Esclerose Lateral Amiotrófica/diagnóstico por imagem , Esclerose Lateral Amiotrófica/fisiopatologia , Esclerose Lateral Amiotrófica/psicologia , Afasia Primária Progressiva/diagnóstico por imagem , Afasia Primária Progressiva/fisiopatologia , Afasia Primária Progressiva/psicologia , Encéfalo/fisiopatologia , Demência Frontotemporal/fisiopatologia , Demência Frontotemporal/psicologia , Humanos , Imageamento por Ressonância Magnética , Tomografia por Emissão de Pósitrons , Afasia Primária Progressiva não Fluente/diagnóstico por imagem , Afasia Primária Progressiva não Fluente/fisiopatologia , Afasia Primária Progressiva não Fluente/psicologia , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X
14.
J Neurol ; 266(6): 1310-1322, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30949817

RESUMO

BACKGROUND: Impairments in activities of daily living (ADL) are a criterion for Alzheimer's disease (AD) dementia. However, ADL gradually decline in AD, impacting on advanced (a-ADL, complex interpersonal or social functioning), instrumental (IADL, maintaining life in community), and finally basic functions (BADL, activities related to physiological and self-maintenance needs). Information and communication technologies (ICT) have become an increasingly important aspect of daily functioning. Yet, the links of ADL, ICT, and neuropathology of AD dementia are poorly understood. Such knowledge is critical as it can provide biomarker evidence of functional decline in AD. METHODS: ADL were evaluated with the Technology-Activities of Daily Living Questionnaire (T-ADLQ) in 33 patients with AD and 30 controls. ADL were divided in BADL, IADL, and a-ADL. The three domain subscores were covaried against gray matter atrophy via voxel-based morphometry. RESULTS: Our results showed that three domain subscores of ADL correlate with several brain structures, with a varying degree of overlap between them. BADL score correlated mostly with frontal atrophy, IADL with more widespread frontal, temporal and occipital atrophy and a-ADL with occipital and temporal atrophy. Finally, ICT subscale was associated with atrophy in the precuneus. CONCLUSIONS: The association between ADL domains and neurodegeneration in AD follows a traceable neuropathological pathway which involves different neural networks. This the first evidence of ADL phenotypes in AD characterised by specific patterns of functional decline and well-defined neuropathological changes. The identification of such phenotypes can yield functional biomarkers for dementias such as AD.


Assuntos
Atividades Cotidianas , Doença de Alzheimer/patologia , Doença de Alzheimer/fisiopatologia , Córtex Cerebral/patologia , Progressão da Doença , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico por imagem , Atrofia/patologia , Córtex Cerebral/diagnóstico por imagem , Estudos de Coortes , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino
15.
Mar Pollut Bull ; 126: 204-214, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29421090

RESUMO

Polychlorinated biphenyl (PCB) concentrations were determined in surface sediments from three recreational marinas in San Diego Bay, California. Total PCB concentrations ranged from 23 to 153, 31-294, and 151-1387ngg-1 for Shelter Island Yacht Basin (SIYB), Harbor Island West (HW) and Harbor Island East (HE), respectively. PCB concentrations were significantly higher in HE and PCB group composition differed relative to HW and SIYB, which were not significantly different from each other in concentration or group composition. In marina sediments there was a predominance (82-85%) of heavier molecular weight PCBs with homologous groups (6CL-7CL) comprising 59% of the total. In HE 75% of the sites exceeded the effect range median (ERM), and toxicity equivalence (TEQ dioxin-like PCBs) values were higher relative to those of HW and SIYB, suggesting a potential ecotoxicological risk.


Assuntos
Poluentes Ambientais/análise , Bifenilos Policlorados/análise , Instalações Esportivas e Recreacionais/estatística & dados numéricos , Organismos Aquáticos , Baías , California , Monitoramento Ambiental , Sedimentos Geológicos/análise , Dibenzodioxinas Policloradas/análise , Recreação , Medição de Risco , Poluentes Químicos da Água/análise
16.
J Alzheimers Dis ; 61(2): 589-600, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29226861

RESUMO

Episodic memory tests with cued recall, such as the Free and Cued Selective Reminding Test (FCSRT), allow for the delineation of hippocampal and prefrontal atrophy contributions to memory performance in Alzheimer's disease (AD). Both Word and Picture versions of the test exist but show different profiles, with the Picture version usually scoring higher across different cohorts. One possible explanation for this divergent performance between the different modality versions of the test might be that they rely on different sets of neural correlates. The current study explores this by contrasting the neural correlates of the Word and Picture versions of the FCSRT with voxel-based morphometry (VBM) in AD and healthy subjects. We predicted that the Picture version would be associated with different cortical regions than the Word version, which might be more hippocampal-centric. When comparing 35 AD patients and 34 controls, AD patients exhibited impairments on both versions of the FCSRT and both groups performed higher in the Picture version. A region of interest analysis based on prior work revealed significant correlations between free recall of either version with atrophy of the temporal pole and hippocampal regions. Thus, contrary to expectations, performance on both the Word and the Picture version of the FCSRT is associated with largely overlapping networks. Free recall is associated with hippocampal volume and might be properly considered as an indicator of hippocampal structural integrity.


Assuntos
Doença de Alzheimer/psicologia , Hipocampo/patologia , Memória Episódica , Rememoração Mental , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/patologia , Biomarcadores , Estudos de Casos e Controles , Sinais (Psicologia) , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Estimulação Luminosa
17.
Dement Neuropsychol ; 11(2): 129-136, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29213504

RESUMO

The Neuropsychiatric Inventory Questionnaire (NPI-Q) is an informant-based instrument that measures the presence and severity of 12 Neuropsychiatric Symptoms (NPS) in patients with dementia, as well as informant distress. OBJECTIVE: To measure the psychometric properties of the NPI-Q and the prevalence of NPS in patients with Alzheimer's disease (AD) in Chile. METHODS: 53 patients with AD were assessed. Subjects were divided into two different groups: mild AD (n=26) and moderate AD (n=27). Convergent validity was estimated by correlating the outcomes of the NPI-Q with Neuropsychiatric Inventory (NPI) scores and with a global cognitive efficiency test (Addenbrooke's Cognitive Examination - Revised - ACE-R). Reliability of the NPI-Q was analysed by calculating its internal consistency. Prevalence of NPS was estimated with both the NPI and NPI-Q. RESULTS: Positive and significant correlations were observed between the NPI-Q, the NPI, and the ACE-R (r=0.730; p<0.01 and 0.315; p<0.05 respectively). The instrument displayed an adequate level of reliability (Cronbach's alpha=0.783). The most prevalent NPS were apathy/indifference (62.3%) and dysphoria/depression (58.5%). CONCLUSION: The NPI-Q exhibited acceptable validity and reliability indicators for patients with AD in Chile, indicating that it is a suitable instrument for the routine assessment of NPS in clinical practice.


O Questionário de Inventário Neuropsiquiátrico (NPI-Q) é um instrumento baseado em informantes que mede a presença e a gravidade de 12 Sintomas Neuropsiquiátricos (NPS) em pacientes com demência, bem como o sofrimento do informante. OBJETIVO: Avaliar as propriedades psicométricas do NPI-Q e a prevalência de NPS em pacientes com doença de Alzheimer (DA). MÉTODOS: Foram avaliados 53 pacientes com DA. Eles foram divididos em dois grupos diferentes: AD leve (n=26) e AD moderado (n=27). A validade convergente foi estimada correlacionando os resultados do NPI-Q com os escores do Inventário Neuropsiquiátrico (NPI) e um teste de eficiência cognitiva global (Addenbrooke's Cognitive Examination - Revised - ACE-R). A confiabilidade do NPI-Q foi analisada pelo cálculo da sua consistência interna. A prevalência de NPS foi estimada com NPI e NPI-Q. RESULTADOS: Foram observadas correlações positivas e significativas entre NPI-Q, NPI e ACE-R (r=0,730; p<0,01 e 0>315; p<0>05). O instrumento apresentou um nível adequado de confiabilidade (alfa de Cronbach=0J83). Os NPS mais prevalentes foram apatia/indiferença (62,3%) e disforia/depressão (58,5%). CONCLUSÃO: O NPI-Q apresenta indicadores de validade e confiabilidade aceitáveis em pacientes com DA, o que indica que é um instrumento adequado para a avaliação rotineira de NPS na prática clínica.

18.
Dement. neuropsychol ; 11(2): 129-136, Apr.-June 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-891004

RESUMO

ABSTRACT. The Neuropsychiatric Inventory Questionnaire (NPI-Q) is an informant-based instrument that measures the presence and severity of 12 Neuropsychiatric Symptoms (NPS) in patients with dementia, as well as informant distress. Objective: To measure the psychometric properties of the NPI-Q and the prevalence of NPS in patients with Alzheimer's disease (AD) in Chile. Methods: 53 patients with AD were assessed. Subjects were divided into two different groups: mild AD (n=26) and moderate AD (n=27). Convergent validity was estimated by correlating the outcomes of the NPI-Q with Neuropsychiatric Inventory (NPI) scores and with a global cognitive efficiency test (Addenbrooke's Cognitive Examination - Revised - ACE-R). Reliability of the NPI-Q was analysed by calculating its internal consistency. Prevalence of NPS was estimated with both the NPI and NPI-Q. Results: Positive and significant correlations were observed between the NPI-Q, the NPI, and the ACE-R (r=0.730; p<0.01 and 0.315; p<0.05 respectively). The instrument displayed an adequate level of reliability (Cronbach's alpha=0.783). The most prevalent NPS were apathy/indifference (62.3%) and dysphoria/depression (58.5%). Conclusion: The NPI-Q exhibited acceptable validity and reliability indicators for patients with AD in Chile, indicating that it is a suitable instrument for the routine assessment of NPS in clinical practice.


RESUMO. O Questionário de Inventário Neuropsiquiátrico (NPI-Q) é um instrumento baseado em informantes que mede a presença e a gravidade de 12 Sintomas Neuropsiquiátricos (NPS) em pacientes com demência, bem como o sofrimento do informante. Objetivo: Avaliar as propriedades psicométricas do NPI-Q e a prevalência de NPS em pacientes com doença de Alzheimer (DA). Métodos: Foram avaliados 53 pacientes com DA. Eles foram divididos em dois grupos diferentes: AD leve (n=26) e AD moderado (n=27). A validade convergente foi estimada correlacionando os resultados do NPI-Q com os escores do Inventário Neuropsiquiátrico (NPI) e um teste de eficiência cognitiva global (Addenbrooke's Cognitive Examination - Revised - ACE-R). A confiabilidade do NPI-Q foi analisada pelo cálculo da sua consistência interna. A prevalência de NPS foi estimada com NPI e NPI-Q. Resultados: Foram observadas correlações positivas e significativas entre NPI-Q, NPI e ACE-R (r=0,730; p<0,01 e 0>315; p<0>05). O instrumento apresentou um nível adequado de confiabilidade (alfa de Cronbach=0J83). Os NPS mais prevalentes foram apatia/indiferença (62,3%) e disforia/depressão (58,5%). Conclusão: O NPI-Q apresenta indicadores de validade e confiabilidade aceitáveis em pacientes com DA, o que indica que é um instrumento adequado para a avaliação rotineira de NPS na prática clínica.


Assuntos
Humanos , Prevalência , Manifestações Neurocomportamentais , Demência , Doença de Alzheimer , Testes de Estado Mental e Demência
19.
Mar Pollut Bull ; 114(1): 466-479, 2017 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-27751573

RESUMO

Polycyclic aromatic hydrocarbons (PAHs) have garnered much attention due to their bioaccumulation, carcinogenic properties, and persistence in the environment. Investigation of the spatial distribution, composition, and sources of PAHs in sediments of three recreational marinas in San Diego Bay, California revealed significant differences among marinas, with concentrations in one site exceeding 16,000ngg-1. 'Hotspots' of PAH concentration suggest an association with stormwater outfalls draining into the basins. High-molecular weight PAHs (4-6 rings) were dominant (>86%); the average percentage of potentially carcinogenic PAHs was high in all sites (61.4-70%) but ecotoxicological risks varied among marinas. Highly toxic benzo(a)pyrene (BaP) was the main contributor (>90%) to the total toxic equivalent quantity (TEQ) in marinas. PAHs in San Diego Bay marina sediments appear to be derived largely from pyrogenic sources, potentially from combustion products that reach the basins by aerial deposition and stormwater drainage from nearby streets and parking lots.


Assuntos
Sedimentos Geológicos/análise , Hidrocarbonetos Policíclicos Aromáticos/análise , Poluentes Químicos da Água/análise , Animais , Baías , California , Carcinógenos/análise , Carcinógenos/química , Ecotoxicologia/métodos , Monitoramento Ambiental , Humanos , Peso Molecular , Hidrocarbonetos Policíclicos Aromáticos/química , Poluentes Químicos da Água/química , Poluição Química da Água/análise
20.
J Alzheimers Dis ; 55(4): 1595-1603, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27911301

RESUMO

BACKGROUND: Intracellular neurofibrillary tangles are part of the core pathology of Alzheimer's disease (AD), which are mainly composed of hyperphosphorylated tau protein. OBJECTIVES: The purpose of this study is to determine whether high molecular weight (HMW) or low molecular weight (LMW) tau protein levels, as well as the ratio HMW/LMW, present in platelets correlates with brain magnetic resonance imaging (MRI) structural changes in normal and cognitively impaired subjects. METHODS: We examined 53 AD patients and 37 cognitively normal subjects recruited from two Memory Clinics at the Universidad de Chile. Tau levels in platelets were determined by immunoreactivity and the MRI scans were analyzed using voxel-based morphometry in 41 AD patients. RESULTS: The HMW/LMW tau ratio was statistically different between controls and AD patients, and no associations were noted between HMW or LMW tau and MRI structures. In a multivariate analysis controlled for age and education level, the HMW/LMW tau ratio was associated with reduced volume in the left medial and right anterior cingulate gyri, right cerebellum, right thalamus (pulvinar), left frontal cortex, and right parahippocampal region. CONCLUSIONS: This exploratory study showed that HMW/LMW tau ratio is significantly higher in AD patients than control subjects, and that it is associated with specific brain regions atrophy. Determination of peripheral markers of AD pathology can help understanding the pathophysiology of neurodegeneration in AD.


Assuntos
Doença de Alzheimer/sangue , Doença de Alzheimer/complicações , Plaquetas/metabolismo , Encéfalo/patologia , Proteínas tau/sangue , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico por imagem , Atrofia/diagnóstico por imagem , Atrofia/etiologia , Encéfalo/diagnóstico por imagem , Chile , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Entrevista Psiquiátrica Padronizada , Pessoa de Meia-Idade
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