RESUMO
Persistent impairment in cognitive functioning postoperatively is reported by clinical and animal studies, and is labeled as postoperative cognitive dysfunction (POCD). Evidence points to an exaggerated neuroinflammatory response resulting from peripheral systemic inflammation after surgery, with subsequent cytokine-induced glutamatergic excitotoxicity and synaptic impairment. These immunological changes, among many others, are also observed in Alzheimer's disease. Memantine is an N-methyl-D-aspartate receptor (NMDAR) antagonist commonly used to treat Alzheimer's disease. Surprisingly, little research exists on the role of memantine in preventing POCD. The purpose of this study is to investigate the effects of memantine on a spectrum of cognitive functions postoperatively. Mice were divided into 3 groups and each received treatment for 4 weeks. Placebo groups received a placebo then underwent either a sham procedure or a laparotomy procedure. The memantine group received memantine hydrochloride then underwent a laparotomy procedure. Cognitive tests were performed on postoperative days (POD) 1 and 7. Compared to sham-operated mice, placebo groups that underwent a laparotomy procedure showed impaired memory in the Morris water maze test, higher anxiety-like behavior in the open field and the elevated plus maze tests, increased depression-like behavior in the tail suspension test, and lack of preference for social novelty in the three-chamber test. On the other hand, memantine-treated mice that underwent a laparotomy procedure showed enhanced memory on POD7, improved depression-like behavior on POD1 and POD7, enhanced preference for social novelty on POD1, and no improvement in anxiety-like behavior. These findings suggest a potential protective effect of memantine in mice postoperatively on memory, depression-like behavior, and preference for social novelty.
RESUMO
In the treatment of patients with dementia Alzheimer's type non-current and are facing tough situations. Treatment should be tailored to each stage of the disease and for each patient. In this type of disease is very important to involve families and caregivers to improve the quality of life of patients. The main goal with these patients is prevention. Patients should be all oral manifestations caused by the lack of inadequate oral hygiene, xerostomia and manifestations derived by taking drugs. The aim of this review is to describe the main oral manifestations that can result from this disease and the best treatment options taking into account the clinical stages in which patients are found.
En el tratamiento a pacientes con demencias tipo Alzheimer se afrontan situaciones infrecuentes y comprometidas. El tratamiento debe personalizarse para cada estadio de la enfermedad y para cada paciente. En este tipo de enfermedades es muy importante involucrar a los familiares y cuidadores para mejorar la calidad de vida del enfermo. El principal objetivo con estos pacientes es la prevención. Se deben controlar todas las manifestaciones orales provocadas por la falta de una inadecuada higiene oral, la xerostomía y las manifestaciones derivadas por los fármacos que consumen. El objetivo de esta revisión es describir cuáles son las principales manifestaciones orales que pueden derivar de esta enfermedad y las mejores opciones de tratamiento teniendo en cuenta las etapas clínicas en las que se encuentran los pacientes.
Assuntos
Humanos , Doença de Alzheimer/complicações , Doenças da Boca/epidemiologia , Doenças da Boca/prevenção & controle , Candidíase Bucal/epidemiologia , Candidíase Bucal/prevenção & controle , Saúde Bucal , Xerostomia/epidemiologia , Xerostomia/prevenção & controleRESUMO
En este artículo se revisan las principales evidencias de la neurotoxicidad in vitro del aluminio, y algunos hallazgos en cerebros de pacientes de la enfermedad de Alzheimer, se muestran algunos estudios realizados con pacientes que sufren deficiencias renales, como los tipos más importantes de ostodistrofias causados por aluminio. El problema de analizar la baja concentración de aluminio presente en fluidos humanos se resuelve con métodos analíticos muy sensibles como la espectrofotometría electrotérmica de absorción atómica ETAS, y métodos voltamperométricos con agentes acomplejantes; que permiten adsorción sobre electrodos sólidos o de gota suspendida de mercurio. Es muy importante conocer con exactitud la concentración de aluminio en agua usada en para preparar las disoluciones usadas en la hemodiálisis, o en las disoluciones usadas en la diálisis peritoneal ambulatoria, como primer paso para evitar la contaminación de los pacientes con aluminio. La prevención de la contaminación durante el muestreo, almacenaje y análisis de fluidos dializados es prioritaria y el agua usada en diálisis debe ser tan baja como sea posible en contenido de por aluminio.
This article reviews the principal evidences about aluminum neurotoxicity in vitro, and some evidences in brain tissues of Alzheimer patients; and also show some studies realized with humans that suffer renal deficiencies, dealing with the principal osteodystrophy. The problem of analyzing low aluminum concentration in human fluids is overcomed with very sensitive analytical methods as Electrothermal Atomic Absorption Spectrometry (ETAS) and voltammetric methods as Anodic Striping Voltammetry with complexing agents that easing adsorption over solid electrodes or mercury hanging drop. Is a vital question to know with accuracy the aluminum concentration in water used in hemodialysis or in fluids used in ambulatory peritoneal dialysis, as a first stage to prevent contamination by aluminium. So the prevention of contamination during sampling, storage and analysis of biological fluids should be the first need and the sources of water used in renal dialysis keep be as clean as possible of aluminium contamination.
