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1.
Elife ; 132024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38809774

RESUMO

In the 'double-drift' illusion, local motion within a window moving in the periphery of the visual field alters the window's perceived path. The illusion is strong even when the eyes track a target whose motion matches the window so that the stimulus remains stable on the retina. This implies that the illusion involves the integration of retinal signals with non-retinal eye-movement signals. To identify where in the brain this integration occurs, we measured BOLD fMRI responses in visual cortex while subjects experienced the double-drift illusion. We then used a combination of univariate and multivariate decoding analyses to identify (1) which brain areas were sensitive to the illusion and (2) whether these brain areas contained information about the illusory stimulus trajectory. We identified a number of cortical areas that responded more strongly during the illusion than a control condition that was matched for low-level stimulus properties. Only in area hMT+ was it possible to decode the illusory trajectory. We additionally performed a number of important controls that rule out possible low-level confounds. Concurrent eye tracking confirmed that subjects accurately tracked the moving target; we were unable to decode the illusion trajectory using eye position measurements recorded during fMRI scanning, ruling out explanations based on differences in oculomotor behavior. Our results provide evidence for a perceptual representation in human visual cortex that incorporates extraretinal information.


Assuntos
Ilusões , Imageamento por Ressonância Magnética , Percepção de Movimento , Córtex Visual , Humanos , Percepção de Movimento/fisiologia , Feminino , Masculino , Córtex Visual/fisiologia , Córtex Visual/diagnóstico por imagem , Adulto , Ilusões/fisiologia , Movimentos Oculares/fisiologia , Adulto Jovem , Estimulação Luminosa , Mapeamento Encefálico , Encéfalo/fisiologia , Encéfalo/diagnóstico por imagem
2.
eNeuro ; 10(10)2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37699706

RESUMO

Similar to a camera aperture, pupil size adjusts to the surrounding luminance. Unlike a camera, pupil size is additionally modulated both by stimulus properties and by cognitive processes, including attention and arousal, though the interdependence of these factors is unclear. We hypothesized that different stimulus properties interact to jointly modulate pupil size while remaining independent from the impact of arousal. We measured pupil responses from human observers to equiluminant stimuli during a demanding rapid serial visual presentation (RSVP) task at fixation and tested how response amplitude depends on contrast, spatial frequency, and reward level. We found that under constant luminance, unattended stimuli evoke responses that are separable from changes caused by general arousal or attention. We further uncovered a double-dissociation between task-related responses and stimulus-evoked responses, suggesting that different sources of pupil size modulation are independent of one another. Our results shed light on neural pathways underlying pupillary response.


Assuntos
Nível de Alerta , Pupila , Humanos , Pupila/fisiologia , Atenção/fisiologia , Visão Ocular , Estimulação Luminosa
3.
Nat Commun ; 14(1): 4422, 2023 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-37479723

RESUMO

Primary sensory regions are believed to instantiate stable neural representations, yet a number of recent rodent studies suggest instead that representations drift over time. To test whether sensory representations are stable in human visual cortex, we analyzed a large longitudinal dataset of fMRI responses to images of natural scenes. We fit the fMRI responses using an image-computable encoding model and tested how well the model generalized across sessions. We found systematic changes in model fits that exhibited cumulative drift over many months. Convergent analyses pinpoint changes in neural responsivity as the source of the drift, while population-level representational dissimilarities between visual stimuli were unchanged. These observations suggest that downstream cortical areas may read-out a stable representation, even as representations within V1 exhibit drift.


Assuntos
Córtex Visual Primário , Córtex Visual , Humanos , Mapeamento Encefálico/métodos , Córtex Visual/fisiologia , Imageamento por Ressonância Magnética/métodos , Tempo , Percepção Visual/fisiologia
4.
Nat Commun ; 13(1): 6469, 2022 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-36309512

RESUMO

Orientation selectivity in primate visual cortex is organized into cortical columns. Since cortical columns are at a finer spatial scale than the sampling resolution of standard BOLD fMRI measurements, analysis approaches have been proposed to peer past these spatial resolution limitations. It was recently found that these methods are predominantly sensitive to stimulus vignetting - a form of selectivity arising from an interaction of the oriented stimulus with the aperture edge. Beyond vignetting, it is not clear whether orientation-selective neural responses are detectable in BOLD measurements. Here, we leverage a dataset of visual cortical responses measured using high-field 7T fMRI. Fitting these responses using image-computable models, we compensate for vignetting and nonetheless find reliable tuning for orientation. Results further reveal a coarse-scale map of orientation preference that may constitute the neural basis for known perceptual anisotropies. These findings settle a long-standing debate in human neuroscience, and provide insights into functional organization principles of visual cortex.


Assuntos
Mapeamento Encefálico , Córtex Visual , Animais , Humanos , Mapeamento Encefálico/métodos , Estimulação Luminosa/métodos , Córtex Visual/diagnóstico por imagem , Córtex Visual/fisiologia , Imageamento por Ressonância Magnética/métodos , Anisotropia
5.
Elife ; 112022 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-35389340

RESUMO

Early visual cortex exhibits widespread hemodynamic responses in the absence of visual stimulation, which are entrained to the timing of a task and not predicted by local spiking or local field potential. Such task-related responses (TRRs) covary with reward magnitude and physiological signatures of arousal. It is unknown, however, if TRRs change on a trial-to-trial basis according to behavioral performance and task difficulty. If so, this would suggest that TRRs reflect arousal on a trial-to-trial timescale and covary with critical task and behavioral variables. We measured functional magnetic resonance imaging blood-oxygen-level-dependent (fMRI-BOLD) responses in the early visual cortex of human observers performing an orientation discrimination task consisting of separate easy and hard runs of trials. Stimuli were presented in a small portion of one hemifield, but the fMRI response was measured in the ipsilateral hemisphere, far from the stimulus representation and focus of spatial attention. TRRs scaled in amplitude with task difficulty, behavioral accuracy, reaction time, and lapses across trials. These modulations were not explained by the influence of respiration, cardiac activity, or head movement on the fMRI signal. Similar modulations with task difficulty and behavior were observed in pupil size. These results suggest that TRRs reflect arousal and behavior on the timescale of individual trials.


Assuntos
Córtex Visual , Atenção/fisiologia , Hemodinâmica , Humanos , Imageamento por Ressonância Magnética , Estimulação Luminosa , Córtex Visual/diagnóstico por imagem , Córtex Visual/fisiologia
6.
J Vis ; 22(4): 11, 2022 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-35323869

RESUMO

Neural responses throughout the visual cortex encode stimulus location in a retinotopic (i.e., eye-centered) reference frame, and memory for stimulus position is most precise in retinal coordinates. Yet visual perception is spatiotopic: objects are perceived as stationary, even though eye movements cause frequent displacement of their location on the retina. Previous studies found that, after a single saccade, memory of retinotopic locations is more accurate than memory of spatiotopic locations. However, it is not known whether various aspects of natural viewing affect the retinotopic reference frame advantage. We found that the retinotopic advantage may in part depend on a retinal afterimage, which can be effectively nullified through backwards masking. Moreover, in the presence of natural scenes, spatiotopic memory is more accurate than retinotopic memory, but only when subjects are provided sufficient time to process the scene before the eye movement. Our results demonstrate that retinotopic memory is not always more accurate than spatiotopic memory and that the fidelity of memory traces in both reference frames are sensitive to the presence of contextual cues.


Assuntos
Movimentos Sacádicos , Córtex Visual , Movimentos Oculares , Humanos , Visão Ocular , Córtex Visual/fisiologia , Percepção Visual/fisiologia
7.
PLoS Biol ; 18(11): e3000921, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33156829

RESUMO

The brain exhibits widespread endogenous responses in the absence of visual stimuli, even at the earliest stages of visual cortical processing. Such responses have been studied in monkeys using optical imaging with a limited field of view over visual cortex. Here, we used functional MRI (fMRI) in human participants to study the link between arousal and endogenous responses in visual cortex. The response that we observed was tightly entrained to task timing, was spatially extensive, and was independent of visual stimulation. We found that this response follows dynamics similar to that of pupil size and heart rate, suggesting that task-related activity is related to arousal. Finally, we found that higher reward increased response amplitude while decreasing its trial-to-trial variability (i.e., the noise). Computational simulations suggest that increased temporal precision underlies both of these observations. Our findings are consistent with optical imaging studies in monkeys and support the notion that arousal increases precision of neural activity.


Assuntos
Córtex Visual/fisiologia , Percepção Visual/fisiologia , Nível de Alerta/fisiologia , Mapeamento Encefálico , Cognição/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Modelos Neurológicos , Acoplamento Neurovascular/fisiologia , Estimulação Luminosa , Recompensa , Análise e Desempenho de Tarefas , Córtex Visual/irrigação sanguínea , Córtex Visual/diagnóstico por imagem
8.
Ultrasound Obstet Gynecol ; 54(5): 655-660, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30693591

RESUMO

OBJECTIVE: Chromosomal microarray analysis (CMA) is the modality of choice for prenatal diagnosis in pregnancy with fetal malformation, as it has a high diagnostic yield for microdeletion/duplication syndromes. The aim of this study was to demonstrate the additional utility of single-nucleotide polymorphism (SNP)-based CMA in diagnosing monogenic diseases, imprinting disorders and uniparental disomy (UPD). METHODS: CMA was performed using Affymetrix CytoScan array, for all indications in 6995 pregnancies, at a tertiary referral hospital from November 2013 to June 2018. We describe four cases that had a CMA result that provided a more comprehensive understanding of the complex genetic mechanisms underlying the clinical presentation. RESULTS: In the first fetus, CMA was performed due to intrauterine growth restriction and revealed a 75 kbp maternally inherited microdeletion encompassing the Bloom syndrome gene (BLM). A diagnosis of Bloom syndrome was made upon identifying a paternally inherited common Ashkenazi founder mutation. In the second case, CMA was performed due to severely abnormal maternal serum analytes and revealed a deletion in 14q32.2q32.31 on the maternally inherited copy, leading to a diagnosis of Kagami-Ogata syndrome, which is an imprinting disorder. In the third case, amniocentesis was performed because of late-onset fetal macrosomia and mild polyhydramnios. CMA detected a deletion encompassing the locus of Prader-Willi/Angelman syndrome. In the fourth case, amniocentesis was performed due to maternal cytomegalovirus seroconversion. Maternal UPD of the entire long arm of chromosome 11 was detected. CONCLUSION: Prenatal CMA, based on oligo and SNP platforms, increases the diagnostic yield and enables a wider spectrum of disorders to be detected through the identification of complex genetic etiologies beyond only copy number variants. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.


Assuntos
Deleção Cromossômica , Transtornos Cromossômicos/diagnóstico , Polimorfismo de Nucleotídeo Único/genética , Diagnóstico Pré-Natal/métodos , Dissomia Uniparental/diagnóstico , Transtornos Cromossômicos/genética , Feminino , Impressão Genômica , Humanos , Análise em Microsséries/métodos , Gravidez , Dissomia Uniparental/genética
9.
Elife ; 72018 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-30106372

RESUMO

Neural selectivity to orientation is one of the simplest and most thoroughly-studied cortical sensory features. Here, we show that a large body of research that purported to measure orientation tuning may have in fact been inadvertently measuring sensitivity to second-order changes in luminance, a phenomenon we term 'vignetting'. Using a computational model of neural responses in primary visual cortex (V1), we demonstrate the impact of vignetting on simulated V1 responses. We then used the model to generate a set of predictions, which we confirmed with functional MRI experiments in human observers. Our results demonstrate that stimulus vignetting can wholly determine the orientation selectivity of responses in visual cortex measured at a macroscopic scale, and suggest a reinterpretation of a well-established literature on orientation processing in visual cortex.


Assuntos
Biologia Computacional , Neurônios/fisiologia , Orientação Espacial/fisiologia , Córtex Visual/fisiologia , Mapeamento Encefálico , Sensibilidades de Contraste/fisiologia , Humanos , Imageamento por Ressonância Magnética , Estimulação Luminosa , Córtex Visual/diagnóstico por imagem
10.
Front Integr Neurosci ; 10: 16, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27242455

RESUMO

Neural responses in visual cortex are governed by a topographic mapping from retinal locations to cortical responses. Moreover, at the voxel population level early visual cortex (EVC) activity enables accurate decoding of stimuli locations. However, in many cases information enabling one to discriminate between locations (i.e., discriminative information) may be less relevant than information regarding the relative location of two objects (i.e., relative information). For example, when planning to grab a cup, determining whether the cup is located at the same retinal location as the hand is hardly relevant, whereas the location of the cup relative to the hand is crucial for performing the action. We have previously used multivariate pattern analysis techniques to measure discriminative location information, and found the highest levels in EVC, in line with other studies. Here we show, using representational similarity analysis, that availability of discriminative information in fMRI activation patterns does not entail availability of relative information. Specifically, we find that relative location information can be reliably extracted from activity patterns in posterior intraparietal sulcus (pIPS), but not from EVC, where we find the spatial representation to be warped. We further show that this variability in relative information levels between regions can be explained by a computational model based on an array of receptive fields. Moreover, when the model's receptive fields are extended to include inhibitory surround regions, the model can account for the spatial warping in EVC. These results demonstrate how size and shape properties of receptive fields in human visual cortex contribute to the transformation of discriminative spatial representations into relative spatial representations along the visual stream.

11.
J Neurosci ; 35(33): 11559-71, 2015 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-26290233

RESUMO

Parietal cortex is often implicated in visual processing of actions. Action understanding is essentially abstract, specific to the type or goal of action, but greatly independent of variations in the perceived position of the action. If certain parietal regions are involved in action understanding, then we expect them to show these generalization and selectivity properties. However, additional functions of parietal cortex, such as self-action control, may impose other demands by requiring an accurate representation of the location of graspable objects. Therefore, the dimensions along which responses are modulated may indicate the functional role of specific parietal regions. Here, we studied the degree of position invariance and hand/object specificity during viewing of tool-grasping actions. To that end, we characterize the information available about location, hand, and tool identity in the patterns of fMRI activation in various cortical areas: early visual cortex, posterior intraparietal sulcus, anterior superior parietal lobule, and the ventral object-specific lateral occipital complex. Our results suggest a gradient within the human dorsal stream: along the posterior-anterior axis, position information is gradually lost, whereas hand and tool identity information is enhanced. This may reflect a gradual transformation of visual input from an initial retinotopic representation in early visual areas to an abstract, position-invariant representation of viewed action in anterior parietal cortex. SIGNIFICANCE STATEMENT: Since the seminal study of Goodale and Milner (1992), there is general agreement that visual processing is largely divided between a ventral and dorsal stream specializing in object recognition and vision for action, respectively. Here, we address the specific representation of viewed actions. Specifically, we study the degree of position invariance and hand/object manipulation specificity in the human visual pathways, characterizing the information available in patterns of fMRI activation during viewing of object-grasping videos, which appeared in different retinal locations. We find converging evidence for a gradient within the dorsal stream: along the posterior-anterior axis, position information is gradually lost, whereas hand and action identity information is enhanced, leading to an abstract, position-invariant representation of viewed action in the anterior parietal cortex.


Assuntos
Movimento/fisiologia , Reconhecimento Visual de Modelos/fisiologia , Desempenho Psicomotor/fisiologia , Reconhecimento Psicológico/fisiologia , Percepção Espacial/fisiologia , Córtex Visual/fisiologia , Mapeamento Encefálico/métodos , Humanos , Imageamento por Ressonância Magnética/métodos , Modelos Neurológicos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
12.
Cereb Cortex ; 25(9): 2427-39, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24692511

RESUMO

One feature of visual processing in the ventral stream is that cortical responses gradually depart from the physical aspects of the visual stimulus and become correlated with perceptual experience. Thus, unlike early retinotopic areas, the responses in the object-related lateral occipital complex (LOC) are typically immune to parameter changes (e.g., contrast, location, etc.) when these do not affect recognition. Here, we use a complementary approach to highlight changes in brain activity following a shift in the perceptual state (in the absence of any alteration in the physical image). Specifically, we focus on LOC and early visual cortex (EVC) and compare their functional magnetic resonance imaging (fMRI) responses to degraded object images, before and after fast perceptual learning that renders initially unrecognized objects identifiable. Using 3 complementary analyses, we find that, in LOC, unlike EVC, learned recognition is associated with a change in the multivoxel response pattern to degraded object images, such that the response becomes significantly more correlated with that evoked by the intact version of the same image. This provides further evidence that the coding in LOC reflects the recognition of visual objects.


Assuntos
Lateralidade Funcional/fisiologia , Aprendizagem/fisiologia , Imageamento por Ressonância Magnética , Lobo Occipital/irrigação sanguínea , Reconhecimento Visual de Modelos/fisiologia , Reconhecimento Psicológico , Adulto , Análise de Variância , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imaginação , Masculino , Oxigênio/sangue , Estimulação Luminosa , Estatística como Assunto , Fatores de Tempo , Adulto Jovem
13.
Eur J Surg Oncol ; 34(7): 795-9, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17845837

RESUMO

OBJECTIVE: The L1 adhesion molecule (L1-CAM,CD171) is over expressed in ovarian and endometrial carcinomas and other tumors derived from the Mullerian tract. Here we evaluated whether L1-CAM could serve as a novel tumor marker for the diagnosis of metastatic abdominal-pelvic cancers of uncertain origin in women. PATIENTS AND METHODS: During a 6-year period we investigated 28 patients with metastatic abdominal or pelvic cancer with uncertain primary-origin. In all these cases a thorough clinical, surgical, pathologic and immunohistochemistry evaluation was performed and correlated to the L1-CAM expression as determined by immunohistochemical staining. RESULTS: In 20 patients where the differential diagnosis was primary ovarian or endometrial cancer and primary or recurrent colon cancer, L1 immunohistochemistry staining allowed or supported the correct diagnosis. In four cases L1 staining allowed the correct diagnosis between breast and ovarian cancer. In two cases vaginal metastases of unknown origin were positive to L1 immunohistochemistry staining implying their mullerian origin and one case each of inguinal lymph node metastases and abdominal wall cancer that were positive for L1-CAM, allowed the correct diagnosis of primary ovarian cancer. In a whole, L1-CAM was of crucial role of delinating the final diagnosis in 17 of the 28 cases described. CONCLUSIONS: L1-CAM, a new tumor marker, was found to be specific for metastatic cancer originating from mullerian origin. Its incorporation into the conventional immunohistochemistry analysis in cases of cancer of unknown primary in women, allows a correct diagnosis and subsequent treatment in the majority of cases with abdominal-pelvic carcinomatosis.


Assuntos
Neoplasias Abdominais/patologia , Biomarcadores Tumorais/metabolismo , Neoplasias Primárias Desconhecidas/patologia , Molécula L1 de Adesão de Célula Nervosa/metabolismo , Neoplasias Pélvicas/patologia , Neoplasias Abdominais/secundário , Estudos de Casos e Controles , Diagnóstico Diferencial , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/secundário , Feminino , Humanos , Imuno-Histoquímica , Ductos Paramesonéfricos , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/secundário , Neoplasias Pélvicas/secundário
14.
Int J Gynecol Cancer ; 15(6): 1124-6, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16343193

RESUMO

We present a case history of a woman who developed dermatomyositis following the diagnosis of stage IV ovarian cancer. Dermatomyositis is a rare paraneoplastic syndrome that usually precedes the diagnosis of ovarian cancer by several months or years. Ours is the fifth reported case of dermatomyositis after an established diagnosis of ovarian cancer in the literature.


Assuntos
Dermatomiosite/etiologia , Recidiva Local de Neoplasia/tratamento farmacológico , Neoplasias Ovarianas/patologia , Síndromes Paraneoplásicas/etiologia , Idoso , Antineoplásicos/administração & dosagem , Biomarcadores Tumorais/sangue , Antígeno Ca-125/sangue , Dermatomiosite/tratamento farmacológico , Progressão da Doença , Evolução Fatal , Feminino , Humanos , Imunossupressores/uso terapêutico , Terapia Neoadjuvante , Estadiamento de Neoplasias , Neoplasias Ovarianas/sangue , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/tratamento farmacológico , Síndromes Paraneoplásicas/tratamento farmacológico
15.
Prim Dent Care ; 12(3): 78-82, 2005 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16004713

RESUMO

AIM: The aim of this study was to evaluate the self-perceived educational needs of a randomly selected group of general dental practitioners (GDPs) in the Merseyside region (UK). MATERIALS AND METHODS: Eighty-seven GDPs were randomly selected from 850 in the region and asked to complete a self-evaluation questionnaire regarding their self-perceived educational needs. RESULTS: Seventy-five (86%) responded, of which 52 (69.3%) were male and 23 (30.7%) female. There was no significant difference in self-perceived knowledge in any of the dental disciplines when gender and period of time since qualification were used as predictor variables. The majority of the GDPs felt they had a good knowledge of restorative dentistry and dental radiography. Some of the GDPs felt they had poor knowledge in implant dentistry, oral medicine, orthodontics, dental sedation techniques, oral surgery, endodontics, periodontics and dental radiography. None of the respondents felt they had poor knowledge in restorative dentistry, prosthodontics and paediatric dentistry. Seventy-four (98.7%) of the responding GDPs were motivated to attend continuing professional development (CPD) courses because of an interest in a particular dental discipline and only one reported attending out of personal learning needs. Implant dentistry was indicated by 30 (40.0%) of the respondents as their training programme of choice. CONCLUSIONS: The respondents had high self-perceived knowledge of restorative dentistry, dental radiography, periodontics, endodontics, paediatric dentistry and prosthodontics. The respondents had low self-perceived knowledge of implant dentistry, orthodontics, oral medicine and dental sedation techniques. Of GDPs surveyed, 98.7% applied for courses they liked to attend, rather than needed to attend. Fifty-two per cent of male GDPs surveyed expressed a desire for training in implant dentistry.


Assuntos
Atitude do Pessoal de Saúde , Educação Continuada em Odontologia , Odontologia Geral/educação , Avaliação das Necessidades , Anestesiologia/educação , Sedação Consciente , Implantação Dentária/educação , Dentística Operatória/educação , Endodontia/educação , Inglaterra , Feminino , Humanos , Masculino , Medicina Bucal/educação , Ortodontia/educação , Odontopediatria/educação , Periodontia/educação , Prostodontia/educação , Radiografia Dentária , Radiologia/educação , Fatores Sexuais , Cirurgia Bucal/educação , Fatores de Tempo
16.
Cancer ; 92(3): 684-90, 2001 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-11505416

RESUMO

BACKGROUND: Stomatitis is a common consequence of chemotherapy and a condition for which there is little effective treatment. Although the management of patients with other chemotherapy-related toxicities has improved in recent years, the incidence of stomatitis is increasing because of more intensive treatment and is often a dose limiting factor in chemotherapy. The authors assessed the efficacy of a homeopathic remedy, TRAUMEEL S(R), in the management of chemotherapy-induced stomatitis in children undergoing bone marrow transplantation. METHODS: A randomized, placebo-controlled, double-blind clinical trial was conducted in 32 patients ages 3-25 years who had undergone allogeneic (16 patients) or autologous (16 patients) stem cell transplantation. Of the 30 evaluable patients, 15 were assigned placebo, and 15 were assigned TRAUMEEL S both as a mouth rinse, administered five times daily from 2 days after transplantation for a minimum of 14 days, or until at least 2 days after all signs of stomatitis were absent. Stomatitis scores were evaluated according to the World Health Organization grading system for mucositis. RESULTS: A total of five patients (33%) in the TRAUMEEL S treatment group did not develop stomatitis compared with only one patient (7%) in the placebo group. Stomatitis worsened in only 7 patients (47%) in the TRAUMEEL S treatment group compared with 14 patients (93%) in the placebo group. The mean area under the curve stomatitis scores were 10.4 in the TRAUMEEL S treatment group and 24.3 in the placebo group. This difference was statistically significant (P < 0.01). CONCLUSIONS: This study indicates that TRAUMEEL S may reduce significantly the severity and duration of chemotherapy-induced stomatitis in children undergoing bone marrow transplantation.


Assuntos
Anti-Inflamatórios/uso terapêutico , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Homeopatia , Minerais/uso terapêutico , Extratos Vegetais/uso terapêutico , Estomatite/tratamento farmacológico , Adolescente , Adulto , Distribuição por Idade , Anti-Inflamatórios/efeitos adversos , Criança , Pré-Escolar , Método Duplo-Cego , Tolerância a Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Humanos , Estomatite/induzido quimicamente , Resultado do Tratamento
17.
J Hum Hypertens ; 15(4): 271-8, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11319676

RESUMO

OBJECTIVE: To examine the efficacy of a new device, which slows and regularises breathing, as a non-pharmacological treatment of hypertension and thus to evaluate the contribution of breathing modulation in the blood pressure (BP) reduction. DESIGN AND SETTING: Randomised, double-blind controlled study, carried out in three urban family practice clinics in Israel. PATIENTS: Sixty-five male and female hypertensives, either receiving antihypertensive drug therapy or unmedicated. Four patients dropped out at the beginning of the study. INTERVENTION: Self treatment at home, 10 minutes daily for 8 consecutive weeks, using either the device (n = 32), which guides the user towards slow and regular breathing using musical sound patterns, or a Walkman, with which patients listened to quiet music (n = 29). Medication was unchanged 2 months prior to and during the study period. MAIN OUTCOME MEASURES: Systolic BP, diastolic BP and mean arterial pressure (MAP) changes from baseline. RESULTS: BP reduction in the device group was significantly greater than a predetermined 'clinically meaningful threshold' of 10.0, 5.0 and 6.7 mm Hg for the systolic BP, diastolic BP and MAP respectively (P = 0.035, P = 0.0002 and P = 0.001). Treatment with the device reduced systolic BP, diastolic BP and MAP by 15.2, 10.0 and 11.7 mm Hg respectively, as compared to 11.3, 5.6 and 7.5 mm Hg (P = 0.14, P = 0.008, P = 0.03) with the Walkman. Six months after treatment had stopped, diastolic BP reduction in the device group remained greater than the 'threshold' (P < 0.02) and also greater than in the walkman group (P = 0.001). CONCLUSIONS: The device was found to be efficacious in reducing high BP during 2 months of self-treatment by patients at home. Breathing pattern modification appears to be an important component in this reduction.


Assuntos
Pressão Sanguínea/fisiologia , Exercícios Respiratórios , Hipertensão/fisiopatologia , Hipertensão/terapia , Musicoterapia/instrumentação , Musicoterapia/métodos , Adulto , Idoso , Determinação da Pressão Arterial , Método Duplo-Cego , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade
18.
Isr J Med Sci ; 30(8): 634-9, 1994 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-8045748

RESUMO

In an attempt to improve hemopoietic recovery after autologous bone marrow transplantation (ABMT), a project of peripheral blood stem cells (PBSC) harvest was initiated. Thirty-six children awaiting ABMT underwent 126 PBSC harvests primed by a conventional scheduled chemotherapy course and rGMCSF 5 micrograms/kg per day/s.c. Ages ranged from 12 months to 19 years and weight from 9 to 84 kg. PBSC harvest was carried out using the Fenwall CS 3000 Plus with the small volume collection chamber at a maximum whole blood flow rate of 15-45 ml/min; total volume processed was 1,700-10,000 ml. Total nucleated cells per collection was 0.35-5.62 x 10(8) cells per kg, and the number of CD34+ cells, 0.23-1.1 x 10(6)/kg. The number of colony forming units-granulocyte macrophages (CFU-GM) varied in these heavily pretreated patients from 0 to 5.3 CFU-GM x 10(4)/kg per collection. Immunophenotyping of the cells collected was performed by double staining for CD34, CD33, CD15, CD71, Ia and CD56. Most of the CD34+ cells were found to be CD38+; some were CD33+ and some CD33-. Low coexpression of CD34+ CD71+ cells may correlate with the low proliferating capacity of PBSC as compared to the BM cells. To date 22 children have undergone transplantation using combined autologous PBSC and bone marrow. We conclude that PBSC harvest is a feasible and safe procedure even in small children, and can be successfully performed following scheduled chemotherapy and administration of growth factors, resulting in substantial yield, also in heavily pretreated patients. This procedure is recommended in responding high risk patients at the stage of minimal residual disease and may replace ABMT in the future.


Assuntos
Transplante de Medula Óssea , Células Precursoras Eritroides/fisiologia , Hematopoese Extramedular/fisiologia , Neoplasias/fisiopatologia , Adolescente , Adulto , Transplante de Medula Óssea/métodos , Criança , Pré-Escolar , Ensaio de Unidades Formadoras de Colônias , Feminino , Citometria de Fluxo , Humanos , Lactente , Masculino , Neoplasias/cirurgia
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