RESUMO
Several clinical conditions leading to traumatic brain injury can cause hematomas or edemas inside the cerebral tissue. If these are not properly treated in time, they are prone to produce long-term neurological disabilities, or even death. Low-cost, portable and easy-to-handle devices are desired for continuous monitoring of these conditions and Near Infrared Spectroscopy (NIRS) techniques represent an appropriate choice. In this work, we use Time-Resolved (TR) Monte Carlo simulations to present a study of NIR light propagation over a digital MRI phantom. Healthy and injured (hematoma/edema) situations are considered. TR Diffuse Reflectance simulations for different lesion volumes and interoptode distances are performed in the frontal area and the left parietal area. Results show that mean partial pathlengths, photon measurement density functions and time dependent contrasts are sensitive to the presence of lesions, allowing their detection mainly for intermediate optodes separations, which proves that these metrics represent robust means of diagnose and monitoring. Conventional Continuous Wave (CW) contrasts are also presented as a particular case of the time dependent ones, but they result less sensitive to the lesions, and have higher associated uncertainties.
Assuntos
Edema Encefálico/diagnóstico por imagem , Lesões Encefálicas Traumáticas/diagnóstico por imagem , Hematoma/diagnóstico por imagem , Fótons , Espectroscopia de Luz Próxima ao Infravermelho , Edema Encefálico/etiologia , Lesões Encefálicas Traumáticas/complicações , Hematoma/etiologia , Humanos , Raios Infravermelhos , Método de Monte Carlo , Imagens de Fantasmas , Espectroscopia de Luz Próxima ao Infravermelho/métodosRESUMO
This study aimed to identify whether genetic manipulation of four systems implicated in the pathogenesis of depression converge on shared molecular processes underpinning depression-like behaviour in mice. Altered 5HT function was modelled using the 5-HT transporter knock out mouse, impaired glucocorticoid receptor (GR) function using an antisense-induced knock down mouse, disrupted glutamate function using a heterozygous KO of the vesicular glutamate transporter 1 gene, and impaired cannabinoid signalling using the cannabinoid 1 receptor KO mouse. All 4 four genetically modified mice were previously shown to show exaggerated helpless behaviour compared to wild-type controls and variable degrees of anxiety and anhedonic behaviour. mRNA was extracted from frontal cortex and hybridised to Illumina microarrays. Combined contrast analysis was used to identify genes showing different patterns of up- and down-regulation across the 4 models. 1823 genes were differentially regulated. They were over-represented in gene ontology categories of metabolism, protein handling and synapse. In each model compared to wild-type mice of the same genetic background, a number of genes showed increased expression changes of >10%, other genes showed decreases in each model. Most of the genes showed mixed effects. Several previous array findings were replicated. The results point to cellular stress and changes in post-synaptic remodelling as final common mechanisms of depression and resilience.
Assuntos
Depressão/genética , Transtorno Depressivo/genética , Lobo Frontal/metabolismo , Regulação da Expressão Gênica , Animais , Ansiedade/genética , Depressão/metabolismo , Transtorno Depressivo/metabolismo , Modelos Animais de Doenças , Regulação para Baixo , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Transtornos do Humor/genética , Prazer/fisiologia , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Receptor CB1 de Canabinoide/genética , Receptor CB1 de Canabinoide/metabolismo , Receptores de Glucocorticoides/genética , Receptores de Glucocorticoides/metabolismo , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética , Proteínas da Membrana Plasmática de Transporte de Serotonina/metabolismo , Proteína Vesicular 1 de Transporte de Glutamato/genética , Proteína Vesicular 1 de Transporte de Glutamato/metabolismoRESUMO
This project won the First Edition 2007 VAC Therapy Prize. This project tells the story of a woman suffering from lesions in her left leg and running a fever whose prognosis was complicated. The article describes the nurses' evaluation of the patient's lesions, skin sores, and the application of a treatment plan using nursing diagnoses and the satisfactory treatment with negative topical pressure.
Assuntos
Úlcera do Pé/diagnóstico , Úlcera do Pé/terapia , Tratamento de Ferimentos com Pressão Negativa , Diagnóstico de Enfermagem , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do TratamentoRESUMO
Objetivo: conocer las características epidemiológicas, manifestaciones clínicas y la evolución de las hepatitis producidas por fármacos en los últimos 22 años. Diseño experimental y pacientes: estudio observacional, retrospectivo entre 1982 y 1993 y prospectivo entre 1994 y 2003, donde incluimos todos los pacientes atendidos en nuestro Servicio que fueron diagnosticados de hepatitis por fármacos. Analizamos los factores epidemiológicos -edad, sexo, número de casos por año, ingresos hospitalarios-, clínicos -antecedentes de enfermedad hepática, manifestaciones clínicas-, analíticas y evolutivos -evolución a curación o cronicidad. Resultados: diagnosticamos un total de 61 pacientes con hepatitis por fármacos, 26 hombres y 35 mujeres, con edad media 52.4 ± 17 años y edades superiores a los 40 años en el 72,2%. Se produjo ingreso hospitalario en el 43% de los casos. En la mayoría de los pacientes (87%) existían dos o más fármacos siendo los antiinflamatorios no esteroideos, neurofármacos y antituberculosos, los que con más frecuencia encontramos implicados en la aparición de la enfermedad hepática. La evolución a curación se produce en el 94% de los casos. Conclusiones: las hepatitis por fármacos se presentan más frecuentemente en edades superiores a los 40 años (72%) y en mujeres (57%), siendo los fármacos más frecuentemente implicados los antiinflamatorios (45 casos), neurofármacos (26 casos) y antituberculosos (19 casos). La mayoría de los casos evolucionó a la curación
Objective: to ascertain the epidemiological characteristics, clinical symptoms, and evolution of drug-induced hepatitis over the last 22 years. Experimental design and subjects: an observational, retrospective study between 1982 and 1993, and prospective study between 1994 and 2003. All patients in our department diagnosed with having drug-induced hepatitis were studied analyzing epidemiological (age, sex, cases per year, hospitalization) and clinical features (previous liver disease, hepatic symptoms, laboratory results), and follow-up (complete recovery or chronicity). Results: a total of 61 patients were diagnosed as having drug-induced hepatitis, 26 men and 35 women (57%), mean age 52.4 years ± 17 years, of which 72.2% were older than 40 years. A total of 43% were admitted to hospital. In 87% of cases, two or more drugs were involved, the most frequent being antituberculosis (19 cases), psychotropic (26 cases), and non-steroidal anti-inflammatory drugs (45 cases). Evolution showed that 94% of patients recovered after the withdrawal of suspected causal drugs. Conclusions: the incidence of drug-induced hepatitis is higher in patients over 40 years of age, it being more common in females. Non-steroidal anti-inflammatory, psychotropic, and anti-tuberculosis agents were the main drugs involved. Most patients made a complete recovery after withdrawal of the suspected causal drug
