RESUMO
Central venous access is necessary in patients candidate for peripheral blood stem cell (PBSC) collection. We report our experience with a dual lumen femoral catheter (Gamcath, 11 french), initially designed for hemodialysis. We studied 147 patients and performed 488 collections after mobilization with either G-CSF alone or chemotherapy + G-CSF, when the white blood cell count exceeded 1 x 10(9)/L, or when a measurable population of CD34+ cells (20/microL) was detected in peripheral blood. All patients received systemic anticoagulation with a low weight heparin and ultrasound examination was performed after the removal of the catheter. Seven patients developed thrombosis (4.7%), ten experienced hematomas at the site of catheter placement (6.8%) despite prophylactic platelet transfusions, while only one patient (0.6%) had a catheter-related infection. In conclusion, the short-term use of large bore femoral catheters in setting up PBSC collection seems to be associated with minimal risk of infection and low thrombotic incidence.
Assuntos
Cateterismo Periférico/instrumentação , Mobilização de Células-Tronco Hematopoéticas/instrumentação , Transplante de Células-Tronco Hematopoéticas/instrumentação , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/métodos , Segurança de Equipamentos , Feminino , Veia Femoral , Neoplasias Hematológicas/diagnóstico , Neoplasias Hematológicas/terapia , Mobilização de Células-Tronco Hematopoéticas/métodos , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Masculino , Poliuretanos/química , Sensibilidade e Especificidade , Transplante Autólogo , Trombose Venosa/epidemiologia , Trombose Venosa/etiologiaRESUMO
The authors sought a demonstration of the validity of brain stimulation reward (BSR) models of depression. It was predicted that chronic, but not acute antidepressant treatment would enhance BSR responding. Rats with medial forebrain bundle electrodes were separated into 4 groups that received either saline or desmethylimipramine at 5, 10, or 20 mg/kg daily. A rate-free, threshold measure that has not previously been employed in studies of BSR and antidepressants was used. BSR thresholds were monitored every 3rd day over a 9-day baseline period and an 18-day drug treatment period, and after 12 days of drug withdrawal. Groups did not differ from one another till the 15th and 18th day of drug treatment. The greatest effects were seen in the 10 and 20 mg groups. The 20 mg group returned to baseline after drug withdrawal, but the 10 mg group did not. The absolute size of the effect was considered to be small, leading the authors to speculate that antidepressants act on homeostatic mechanisms that stabilize BSR substrates, only indirectly enhancing transmission of the reward signal.
Assuntos
Encéfalo/fisiologia , Desipramina/farmacologia , Autoestimulação/efeitos dos fármacos , Animais , Relação Dose-Resposta a Droga , Eletrodos , Masculino , Ratos , Ratos Endogâmicos , Esquema de Reforço , Recompensa , Limiar Sensorial/efeitos dos fármacos , Técnicas EstereotáxicasRESUMO
Rats were subjected to a 15-min inescapable swim in a procedure which induces "behavioral despair" (immobility) 24 hr later. Their thresholds for brain stimulation reward were measured six times over the subsequent two weeks. Under one condition thresholds were first determined 3 hr postswim and, under a second condition, 24 hr postswim. Rats tested in the 3-hr condition showed elevated thresholds compared to preswim baselines. Elevations remained significant for six days. Thresholds for rats in the 24-hr condition did not change. Results are discussed in terms of a) the lack of correspondence between behavioral despair and brain stimulation reward models of depression, b) possible mechanisms for the 3-hr condition effect, and c) the significance of long-term changes in brain reward substrates.
