Literatura académica sobre el tema "Neurologia"
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Artículos de revistas sobre el tema "Neurologia"
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Lana-Peixoto, Marco Aurélio. "O papel da academia brasileira de neurologia no ensino da neurologia uma visão pessoal". Arquivos de Neuro-Psiquiatria 49, n.º 4 (diciembre de 1991): 475–79. http://dx.doi.org/10.1590/s0004-282x1991000400020.
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A Academia Brasileira de Neurologia (ABN) tem demonstrado crescente interesse pelo ensino da neurologia, tanto na graduação quanto na residência médica. Ela deve definir o padrão da prática da neurologia no país, traçar o perfil de competência mínima do neurologista, determinar a competência mínima em neurologia do médico não-neurologista, desenvolver suas próprias atividades de ensino, e definir e propiciar o desenvolvimento das qualidades humanísticas desejáveis no neurologista. A ABN deve formular um currículo mínimo de neurologia na graduação e na residência médica e esforçar por sua adoção pelas escolas médicas e pelos Programas de Residência. Além disso, a ABN deve, por si própria, tornar-se agente efetora do ensino através: de um Programa de Educação Continuada, promovendo cursos e simpósios; da elaboração de um sistema de ensino programado em neurologia, via postal; da implantação de videoteca e de banco de dados da literatura. A Comissão de Ensino deve desempenhar papel fundamental em todas as atividades de ensino promovida pela ABN, definindo sua política, estabelecendo prioridades e coordenando as ações de ensino dos Grupos de Trabalho e Pesquisa.
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Boeri, R. "Neurologia". Italian Journal of Neurological Sciences 9, n.º 4 (agosto de 1988): 406. http://dx.doi.org/10.1007/bf02334009.
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Botia Paniagua, Enrique y Santiago Mola Caballero de Rodas. "Neurologia@net". Revista de Neurología 26, n.º 151 (1998): 497. http://dx.doi.org/10.33588/rn.26151.98232.
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Botia Paniagua, Enrique y Santiago Mola Caballero de Rodas. "Neurologia@net". Revista de Neurología 26, n.º 152 (1998): 672. http://dx.doi.org/10.33588/rn.26152.98233.
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Botia Paniagua, Enrique. "Neurologia@net". Revista de Neurología 26, n.º 153 (1998): 846. http://dx.doi.org/10.33588/rn.26153.98234.
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Spina-França, Antonio. "Neurologia clínica". Arquivos de Neuro-Psiquiatria 63, n.º 1 (marzo de 2005): 192. http://dx.doi.org/10.1590/s0004-282x2005000100047.
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Ferri-de-Barros, João Eliezer y Ricardo Nitrini. "Que pacientes atende um neurologista? Alicerce de um currículo em neurologia". Arquivos de Neuro-Psiquiatria 54, n.º 4 (diciembre de 1996): 637–44. http://dx.doi.org/10.1590/s0004-282x1996000400013.
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OBJETIVO: Apresentar os diagnósticos mais freqüentes em pacientes encaminhados a neurologistas e discutir a importância destes achados para a definição de um currículo em neurologia. EMBASAMENTO:O desenvolvimento de subespecialidades em neurologia tem interferido na definição do que deveria ser ensinado no treinamento de um médico ou de um neurologista. O conhecimento de quais são as doenças neurológicas mais comuns pode contribuir para a construção deste currículo. MÉTODO: Os diagnósticos iniciais de 1815 pacientes encaminhados a um ambulatório de neurologia, num hospital público universitário em São Paulo, Brasil, são analisados. RESULTADOS:Os diagnósticos mais comuns, em ordem decrescente de frequência, foram: cefaléia, epilepsia, transtornos mentais, doença encéfalo-vascular, traumatismo craniencefálico, polineuropatia, síndrome vestibular, paraparesia crural espástica, síndrome extrapiramidal, síndrome demencial, hipertensão intracraniana e paralisia facial. CONCLUSÕES: A importância das subespecialidades no currículo deve ser relacionada à frequência da doença neurológica na comunidade.
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Mescolotte, Guilherme Menezes y Carlos Roberto Martins Junior. "Biomarcadores em Neurologia". Revista Paulista de Reumatologia, n.º 2019 jul-set;18(3) (30 de septiembre de 2019): 11–17. http://dx.doi.org/10.46833/reumatologiasp.2019.18.3.11-17.
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As doenças autoimunes representam uma grande parcela das afecções neurológicas, muitas vezes, com diagnósticos difíceis do ponto de vista sintomático. Neste sentido, a utilização de biomarcadores (BM) é de grande valia, pois corrobora para o diagnóstico, prognóstico e resposta ao tratamento. Com o avanço tecnológico, estão sendo descobertas novas entidades patológicas e BM, sendo necessário o seu reconhecimento e a distinção de suas características para a melhor condução das enfermidades. Unitermos: Autoimune. Neurologia. Biomarcadores. Encefalite. Anticorpos.
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Martins, Isabel. "Neurologia do Comportamento". PSICOLOGIA 16, n.º 1 (10 de febrero de 2014): 9. http://dx.doi.org/10.17575/rpsicol.v16i1.465.
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Spina-França, Antonio. "Neurologia das artes performáticas". Arquivos de Neuro-Psiquiatria 54, n.º 4 (diciembre de 1996): 717. http://dx.doi.org/10.1590/s0004-282x1996000400031.
Texto completoTesis sobre el tema "Neurologia"
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Pérez, Roca Laia. "El papel del sistema autofágico lisosomal en las enfermedades con cuerpos de Lewy". Doctoral thesis, Universitat Autònoma de Barcelona, 2021. http://hdl.handle.net/10803/672055.
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En aquesta tesi hem estudiat el paper de sistema autofágic-lisosomal durant el desenvolupament de les malalties amb cossos de Lewy, especialment la demència amb cossos de Lewy (DCL). Tot i que aquesta demència representa, després de la malaltia d’Alzheimer (MA), la segona causa més important de la demència, el seu diagnòstic clínic és molt complex i fins al 80% de tots els casos segueixen sent diagnosticats erròniament. La causa per aquesta dificultat diagnòstica es troba a nivell neuropatològic, ja que la DCL comparteix canvis característics amb l’EA, d’una banda, i a el ser una sinucleinopatía, amb la malaltia de Parkinson (MP), per una altra. La majoria dels pacients amb DCL es diagnostiquen com MA i, conseqüentment, reben els tractaments corresponents, els quals causen reaccions adverses severes en un 50% d’ells. Per això, la caracterització molecular de la DCL identificant mecanismes específics per a aquesta és de cabdal importància, perquè només coneixent aquests mecanismes serà possible desenvolupar les teràpies necessàries. Fins al moment es disposa de dades limitades sobre el paper de sistema autofàgic-lisosomal en la patogènesi de la DCL. En aquest context, el gen més estudiat és GBA, mutacions en el qual s’havien descrit recentment com a factors de risc per DCL i MP. Per això, en el primer estudi vam analitzar l’expressió de tres transcrits de GBA en cervells i sang de pacients amb DCL i MP. Trobem la disminució dels nivells de GBA en cervell, al còrtex de DCL i en el nucli caudat d’MP amb demència. També en sang es va detectar l’expressió de GBA disminuïda. La correlació entre paràmetres clínics i els nivells d’expressió de GBA va revelar que els nivells més baixos de GBA es corresponien a les formes més agressives de DCL i MP. Per identificar les possibles causes de la disminució de GBA, hem analitzat l’expressió de diferents transcrits de dos dels seus gens reguladors, LIMP2 i TFEB, en cervell. Com troballa principal, identifiquem una marcada sobreexpressió de TFEB, especialment en l’escorça temporal amb patologia Lewy pura. Aquest increment de TFEB estava acompanyat d’una sobreexpressió important d’un dels transcrits de SCARB2 en la mateixa àrea cerebral. En l’escorça temporal trobem també una correlació entre els nivells d’expressió de TFEB i GBA així com SCRAB2tv2 i GBA, corresponent els nivells més elevats de TFEB o SCARB2 amb la disminució més pronunciada de GBA. Com el sistema lisosomal està estretament relacionat amb el sistema autofàgic, hem analitzat l’expressió de sis gens implicats en punts específics de l’autofàgia. Encara BECN1, ATG3 i ATG5 s’expressaven de forma diferencial, la troballa més important d’aquest tercer estudi va ser que canvis transcripcionals en els gens autofàgics no estan primàriament involucrats en el desenvolupament de les malalties amb cossos de Lewy. En conclusió, els estudis que composen aquesta tesi van revelar que el sistema lisosomal juga un paper important en la patogènesi de la DCL. En canvi, el sistema autofàgic no pateix canvis importants sinó només canvis específics per a cada cas. Especialment l’escorça temporal, àrea d’afectació primerenca en la malaltia, es caracteritza per la disminució de GBA acompanyada de l’increment del seu receptor SCARB2 i el regulador transcricional TFEB. Així, GBA disminuïda pot activar l’expressió d’TFEB com a resposta cel·lular per restaurar la proteostasi lisosomal, però l’activació de TFEB resultaria a el mateix temps a la sobreexpressió d’altres gens lisosomals, incloent SCARB2.En esta tesis hemos estudiado el papel del sistema autofágico-lisosomal durante el desarrollo de las enfermedades con cuerpos de Lewy, especialmente la demencia con cuerpos de Lewy (DCL). Aunque esta demencia representa, después de la enfermedad de Alzheimer (EA), la segunda causa más importante de la demencia, su diagnóstico clínico es muy complejo y hasta el 80% de todos los casos siguen siendo diagnosticados erróneamente. La causa para esta dificultad diagnóstica se encuentra a nivel neuropatológico, ya que la DCL comparte cambios característicos con la EA, por una parte, y al ser una sinucleinopatía, con la enfermedad de Parkinson (EP), por otra. La mayoría de los pacientes con DCL se diagnostican como EA y, consecuentemente, reciben los tratamientos correspondientes, los cuales causan reacciones adversas severas en un 50% de ellos. Por eso, la caracterización molecular de la DCL identificando mecanismos específicos para ésta es de primordial importancia, porque solamente conociendo dichos mecanismos será posible desarrollar las terapias necesarias. Hasta el momento se dispone de datos limitados sobre el papel del sistema autofágico-lisosomal en la patogénesis de la DCL. En este contexto, el gen más estudiado es GBA, mutaciones en el cual se habían descrito recientemente como factores de riesgo para DCL y EP. Por eso, en el primer estudio analizamos la expresión de tres transcritos de GBA en cerebros y sangre de pacientes con DCL y EP. Encontramos la disminución de los niveles de GBA en cerebro, en el córtex de DCL y en el núcleo caudado de EP con demencia. También en sangre se detectó la expresión de GBA disminuida. La correlación entre parámetros clínicos y los niveles de expresión de GBA reveló que los niveles más bajos de GBA se correspondían a las formas más agresivas de DLB y EP. Para identificar las posibles causas de la disminución de GBA, analizamos la expresión de diferentes transcritos de dos de sus genes reguladores, LIMP2 y TFEB, en cerebro. Como hallazgo principal, identificamos una marcada sobreexpresión de TFEB, especialmente en la corteza temporal con patología Lewy pura. Este incremento de TFEB estaba acompañado de una sobreexpresión importante de uno de los transcritos de SCARB2 en la misma área cerebral. En la corteza temporal encontramos también una correlación entre los niveles de expresión de TFEB y GBA así como SCRAB2tv2 y GBA, correspondiendo los niveles más elevados de TFEB o SCARB2 con la disminución más pronunciada de GBA. Como el sistema lisosomal está estrechamente relacionado con el sistema autofágico, analizamos la expresión de seis genes implicados en puntos específicos de la autofagia. Aunque BECN1, ATG3 y ATG5 se expresaban de forma diferencial, el hallazgo más importante de este tercer estudio fue que cambios transcripcionales en los genes autofágicos no están primariamente involucrados en el desarrollo de enfermedades con cuerpos de Lewy. En conclusión, los estudios que componen esta tesis revelaron que el sistema lisosomal juega un papel importante en la patogénesis de la DCL. En cambio, sistema autofágico no sufre cambios importantes sino solo cambios específicos para cada caso. Especialmente la corteza temporal, área de afectación temprana en la enfermedad, se caracteriza por la disminución de GBA acompañada del incremento de su receptor SCARB2 y el regulador transcricional TFEB. Así, GBA disminuida puede activar la expresión de TFEB como respuesta celular para restaurar la proteostasis lisosomal, pero la activación de TFEB resultaría al mismo tiempo en la sobreexpresión de otros genes lisosomales, incluyendo SCARB2.
In this thesis we have studied the role of the autophagy-lysosomal system during the development of Lewy body diseases, especially of dementia with Lewy bodies (DLB). Although this dementia represents the second most important cause of dementia after Alzheimer’s disease (AD), its clinical diagnosis is very complex and up to 80% of all cases continue to be misdiagnosed. The cause for this diagnostic difficulty is the important neuropathological overlap between DLB and AD, since DLB shares characteristic changes with AD, on one hand, and as a synucleinopathy, with Parkinson’s disease (PD), on the other. Most of DLB patients are diagnosed as AD and, consequently, receive the corresponding treatments which may cause severe adverse reactions. Therefore, the molecular characterization of DLB identifying disease specific mechanisms is of primary importance, because only unveiling these mechanisms will permit the development of the necessary therapies. To date, limited data are available on the role of the autophagy-lysosomal system in the pathogenesis of DLB. In this context, the most studied gene is GBA, mutations in which have been recently described as risk factors for DLB and PD. Therefore, in the first study we analyzed the expression of three GBA transcripts in the brains and blood of patients with DLB and PD. We found a decrease in GBA levels in the brain, in DLB cortices and in the caudate nucleus of PD with dementia. Decreased GBA expression was also detected in blood. The correlation between clinical parameters and GBA expression levels revealed that the lowest GBA levels corresponded to the most aggressive forms of DLB and EP. To identify the possible causes of GBA diminution in brain, we analyzed the expression of different transcripts of two of its regulatory genes, LIMP2 and TFEB, in the same brain areas as for GBA. As the main finding, we identified a marked overexpression of TFEB, especially in the temporal cortex with pure Lewy pathology. This TFEB increase was accompanied by a significant overexpression of one of the SCARB2 transcripts in the same brain area. In the temporal cortex we also found a correlation between the expression levels of TFEB and GBA as well as SCRAB2tv2 and GBA, the highest levels of TFEB or SCARB2 corresponding to the most pronounced decrease in GBA. As the lysosomal system is closely related to the autophagy system, we analyzed the expression of six genes involved in specific points of autophagy. Although BECN1, ATG3, and ATG5 showed a slight differential expression between groups, the most important finding from this third study was that transcriptional changes in autophagy genes are not primarily involved in the development of Lewy body diseases. In conclusion, the studies composing this thesis revealed that the lysosomal system plays an important role in the pathogenesis of DLB, but the autophagy system does not show major changes undergoing only case-specific changes. Especially the temporal cortex, an area of early involvement in the disease, is characterized by a decrease in GBA accompanied by an increase in its receptor SCARB2 and the transcriptional regulator TFEB. Thus, decreased GBA can activate the expression of TFEB as a cellular response to restore lysosomal proteostasis, but the activation of TFEB would at the same time result in the overexpression of other lysosomal genes, including SCARB2.
Universitat Autònoma de Barcelona. Programa de Doctorat en Cirurgia i Ciències Morfològiques
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Bento, Maria Joana Barros Pereira Afonso. "Estágio Clínico em Neurologia". Master's thesis, Instituto de Ciências Biomédicas Abel Salazar, 2010. http://hdl.handle.net/10216/62302.
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Bento, Maria Joana Barros Pereira Afonso. "Estágio Clínico em Neurologia". Dissertação, Instituto de Ciências Biomédicas Abel Salazar, 2010. http://hdl.handle.net/10216/62302.
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Ortega, Cano Juan Alberto. "Function and Regulation of Bone Morphogenetic Protein 7 (BMP7) in Cerebral Cortex Development". Doctoral thesis, Universitat de Barcelona, 2011. http://hdl.handle.net/10803/51614.
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Brain derived neurotrophic factor (BDNF) is a chemokine which levels are regulated by neuronal activity and could act as a sensor in front of distinct physiologic stimulus, activating the transcription of specific group of genes. In this work we show that BDNF induces the expression of BMP7 in neurons through TrkB receptor and MAPK/ERK pathways, an induction mechanism that is mediated in part by the release of the transcriptional repression exerted by p53 family proteins.
BMP members in mammals are expressed in the growing nervous system where emerged as crucial regulators of dorsoventral patterning of the neural tube, neural cell fate determination, and cell death as well as terminal neural cell differentiation. In the earlier cerebral cortex development (at embryonic day 13, E13) BMPs predominantly induce cell death and inhibit the proliferation, as a mechanism for the regulation of cell number and phenotype within the developing cortex. Subsequently they exert sequential actions promoting neuronal differentiation at E16 and increasingly with time, they promote astrocytic differentiation and inhibit oligodendrocytes generation.
This thesis demonstrates that BMP7 injection at midgestation alters the laminar distribution of pyramidal neurons in the cerebral cortex while GABAergic neurons distribution was not affected. We observed that abnormal high levels of BMP7 during cerebral cortex development induce the premature radial glia maturation into astrocytes impairing the radial migration of upper layers pyramidal neurons that remained accumulated in lower cortical regions.
We also observed that altered BMP7 levels during midgestation lead to corpus callosum malformation. Although corpus callosum agenesis can be due to multiple causes, our analysis show that the correct pattern of BMP7 expression is necessary for the proper maturation of intermediate structures such as the glial wedge, the induseum griseum and the subcallosal sling, that provide essential guidepost signals for the proper corpus callosum development.
Based on these results, it is proposed a physiologic model where the expression of BDNF induced by the initial electrical activity in the perinatal period would induce in turn, an increase in BMP7 expression. Both chemokines may act co-ordinately maturating neurons and glial cells at the end of neurogenic period. The alteration of BDNF and BMP7 spatio-temporal expression patterns could dramatically affect the proper cerebral cytoarchitecture and consequently the cerebral functioning. Indeed, different traumas occurred during embryonic and perinatal development are associated with an imbalance in BDNF and BMP7 levels.
To check this hypothesis we reproduced an embryonic sublethal hypoxia, a pathological condition that can be associated to altered BDNF and BMP7 expression. Moreover, perinatal reduction of oxygen input can dramatically affect the cerebral cortex developmental program. As a result, many behavioural and learning disorders in infants have been associated to this pathological condition. We observed that this condition reduces BMP7 expression and signalling in the cerebral cortex promoting the differentiation of cortical progenitors into the oligodendrocytes in detrimental to the astroglial fate in vitro and in vivo.
So, our findings indicate that changes on BMP7 expression in the tightly regulated developmental program of the central nervous system might importantly modify the cellular fate choice of cortical progenitors. When this change occurs during the critic perinatal developmental period, it could compromise the normal brain functionality in the affected individual.“FUNCIÓN Y REGULACIÓN DE LA PROTEINA MORFOGENÉTICA DE HUESO (BMP7) EN EL DESARROLLO DE LA CORTEZA” TEXTO: "Brain derived neurotrophic factor" (BDNF) es una citoquina regulada por la actividad neuronal y puede actuar como sensor en respuesta a distintos estímulos fisiológicos, activando grupos específicos de genes. En este trabajo demuestro que BDNF induce la expresión de BMP7 en neuronas a través del receptor TrkB y la vía de señalización MAPK/ERK. Un mecanismo de inducción mediado en parte por la liberación de la represión transcripcional ejercida por la familia de proteínas p53. La inyección intraventricular de BMP7 durante la corticogenesis altera la distribución de las neuronas piramidales en la corteza cerebral. BMP7 induce la maduración prematura de la glia radial hacia astrocito alterando la migración radial de las neuronas piramidales de capas altas, que quedan anormalmente acumuladas en capas corticales inferiores. Niveles anormales de BMP7 durante fases gestacionales intermedias provocan malformación del cuerpo calloso (CC). Aunque la agénesis del CC puede ser debida a múltiples causas, nuestros análisis muestran que BMP7 es necesario para la formación de poblaciones de la línea media (glial wedge, induseum griseum y subcallosal sling) que participan en mecanismos de guía axonal necesarios para el desarrollo del CC. Proponemos un modelo fisiológico donde la expresión de BDNF inducida por el aumento de actividad eléctrica perinatal induciría a su vez un aumento de los niveles de BMP7. Ambas citoquinas actuarían conjuntamente madurando de una manera sincrónica las poblaciones neuronales y gliales de la corteza cerebral. La modificación del patrón de expresión espacio-temporal de ambas citoquinas podría afectar la composición celular y por tanto la correcta funcionalidad de la corteza cerebral. De hecho, diferentes traumas producidos durante el desarrollo embrionario y perinatal, donde se observa alteración de los niveles de BDNF y BMP7, están asociados a distintos desordenes neurológicos. En este trabajo reproducimos una hipoxia embrionaria sub-letal y observamos que los niveles de expresión y señalización de BMP7 están reducidos en animales hipóxicos. Esta reducción en los niveles de BMP7 promueve la diferenciación de los progenitores corticales hacia un fenotipo oligodendroglial en detrimento del fenotipo astroglial. Por tanto, BMP7 es vital para la correcta determinación de diferentes progenitores neurales durante el desarrollo cortical.
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AIELLO, EDOARDO NICOLÒ. "Cognitive screening in Italy: study framework and recent advances". Doctoral thesis, Università degli Studi di Milano-Bicocca, 2023. https://hdl.handle.net/10281/403048.
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In individui con disturbi cerebrali sospetti o confermati, lo screening cognitivo tramite test performance-based convoglia informazioni di rilievo sia in termini diagnostici e prognostici che in ambito interventistico. Inoltre, tali test vengono spesso impiegati come misure di outcome nell’ambito di studi clinici aventi come oggetto la cognizione. Pertanto, gli screener cognitivi devono possedere solide caratteristiche statistiche e di usabilità. Tuttavia, nel panorama Italiano, gli screener cognitivi non sempre possiedono tali caratteristiche. Inoltre, in Italia, le pratiche di screening cognitivo da remoto sono state storicamente poco considerate, nonostante si prestino facilmente ad essere erogate a distanza tramite media di facile impiego, come il telefono. Tuttavia, avendo il potenziale di abbattere barriere geografiche, logistiche, socio-demografiche ed economiche, la disponibilità di screener cognitivi telefonici implicherebbe rilevanti vantaggi sia in ambito clinico che per l’implementazione e la portata a termine di studi clinici.
In ragione di quanto suddetto, nelle prime due Sezioni della presente Dissertazione, in seguito ad una panoramica generale dei principi sottesi alle procedure di screening, viene fornita un’esauriente cornice per lo studio statistico degli screener cognitivi – affrontando 1) le loro applicazioni a fini di screening di popolazione e di case-finding nella pratica e ricerca cliniche, nonché le questioni relative a 2) proprietà clinimetriche (i.e., caratteristiche psicometriche e diagnostiche), 3) taratura (con un focus sul metodo dei Punteggi Equivalenti) e 4) usabilità trasversale/longitudinale. Inoltre, la Sezione 2 riporta una discussione dettagliata e critica 1) sul razionale, 2) su vantaggi e svantaggi e 3) sulle applicazioni cliniche/di ricerca degli screener cognitivi telefonici – focalizzandosi anche 4) sugli aspetti statistici relativi alla loro standardizzazione.
Nella terza Sezione, in seguito ad una sinossi aggiornata in merito allo status quo Italiano relativo alle caratteristiche statistiche degli screener di persona e telefonici, viene riassunta una serie di studi recentemente pubblicati e focalizzantesi sull’aggiornamento della taratura e/o sul miglioramento delle proprietà clinimetriche e dell’usabilità di tre screener Italiani di persona – i.e., 1) la Frontal Assessment Battery (FAB), 2) il Montreal Cognitive Assessment (MoCA) e 3) la sezione cognitiva dell’Edinburgh Cognitive and Behavioural ALS Screen (ECAS).
In seguito, la Sezione 3 include la descrizione di alcuni studi di standardizzazione Italian di screener telefonici – i.e., la Telephone Interview for Cognitive Status (TICS), 2) l’ALS Cognitive Behavioural Screen-Phone Version (ALS-CBS-PhV) e 3) la telephone-based Frontal Assessment Battery (t-FAB).
Successivamente, la Sezione 4 riporta per intero due studi al momento non ancora pubblicati – il primo, relativo alla valutazione dell’usabilità clinica della TICS Italiana, il secondo, riportante la standardizzazione di uno screening telefonico per i disturbi linguistici, i.e. il Telephone Language Screener (TLS).
Infine, la quinta e conclusiva Sezione riporta uno sguardo sinottico al contenuto della presente Dissertazione, le prospettive future derivanti da essa e una serie di considerazioni critiche in merito alle questioni aperte sul tema dello screening cognitivo in Italia.In individuals with suspected or confirmed brain disorders, cognitive screening via performance-based tests conveys pivotal information both towards diagnosis and prognosis and within interventional settings. Moreover, such tests are often employed as outcomes measures within clinical studies addressing cognition. Hence, cognitive screeners need to come with sound statistical and feasibility features. However, within the Italian scenario, cognitive screeners do not always present with such characteristics. Moreover, remote cognitive screening procedures have been historically underdeveloped in Italy, despite easily lending themselves to be delivered from a distance via practicable media, such as the telephone. However, by bridging down geographical, logistical, socio-demographic and economic barriers, the availability of telephone-based cognitive screeners would both entail improvements in healthcare settings and ease the implementation and accomplishment of clinical studies. Given the above premises, within the first two Sections of the present Dissertation, after outlining the principles underlying screening procedures in general, a comprehensive, practical framework for the statistical study of cognitive screeners is delivered – addressing 1) their applications for population-screening and case-findings aims within both clinical practice and research, as well as the issues of 2) clinimetrics (i.e., psychometrics and diagnostics), 3) norm derivation (with a focus on the Equivalent Score method) and 4) cross-sectional/longitudinal feasibility. In addition, Section 2 delivers an extensive, critical discussion on the 1) rationale, 2) benefits and shortcomings and 3) clinical/research applications of telephone-based cognitive screeners – also focusing on 4) the statistical issues related to their standardization. Within the third Section, after providing an up-to-date synopsis of the Italian status quo as to the statistical features of both in-person and telephone-based cognitive screeners, a number of recently published investigations are summarized that focused on updating norms and/or improving the clinimetrics and feasibility of three Italian, in-person cognitive screeners – i.e., 1) the Frontal Assessment Battery (FAB), 2) the Montreal Cognitive Assessment (MoCA) and 3) the cognitive section of the Edinburgh Cognitive and Behavioural ALS Screen (ECAS). Subsequently, Section 3 displays the description of recently published, Italian standardization studies of telephone-based cognitive screeners – i.e., 1) the Telephone Interview for Cognitive Status (TICS), 2) the ALS Cognitive Behavioural Screen-Phone Version (ALS-CBS-PhV) and 3) the telephone-based Frontal Assessment Battery (t-FAB). Then, Section 4 reports in full two currently unpublished studies – the first, addressing the assessment of the clinical usability of the Italian TICS, the second, providing the Italian standardization of a telephone-based screener for language disorders, i.e. the Telephone Language Screener (TLS). A synoptic glance at the content of the present Dissertation, the future perspectives yielding from it and a number of critical considerations related to outstanding issues on the topic of cognitive screening in Italy are finally delivered within the conclusive, fifth Section.
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González, Cuevas Montserrat. "Estado de mal epiléptico diagnóstico y pronóstico". Doctoral thesis, Universitat Autònoma de Barcelona, 2020. http://hdl.handle.net/10803/669522.
Texto completoResumen
Un problema important en el maneig de l’Estat Epiléptico (EE) és el diagnòstic precoç d’aquest.
Se sap que l’activitat epilèptica causa un augment de la demanda metabòlica a nivell cerebral, que s’acompanya d’un augment temporal de la perfusió cerebral, per això investiguem si la TC cerebral de perfusió (TC-P) podia ser una eina de diagnòstic útil per a pacients amb EE.
Realitzem un estudi de pacients amb EE, diagnosticats per semiologia clínica i EEG, en els quals es va realitzar de manera prospectiva un TC-P en fase crítica. Es va realitzar una anàlisi visual i quantitatiu dels mapes de perfusió. Es van calcular els índexs de asimetría-(IA) per al flux cerebral regional-(rCBF), el volum-(rCBV), el temps a l’pic-(TTP) i el temps de trànsit mig-(MTT).
En 9 dels casos es va realitzar una TC-P de seguiment un cop resolt el EE i es van comparar amb les TC-P realitzades en fase crítica. A més, incloem un grup de control en els quals també es va realitzar un TC-P.
Incloem 19 pacients. L’anàlisi visual dels mapes de perfusió durant la fase crítica, va mostrar àrees de hiperperfusión en el 78,9% dels pacients. L’anàlisi quantitativa va mostrar un augment significatiu dels valors de rCBF (p=0.002) i rCBV (p=0.004), i una disminució de TTP (p <0.001) MTT (p=0.001) en les àrees corticals de el costat afectat versus el costat no afectat. Dels 9 pacients amb una TC-P de seguiment, 8 van mostrar disminució de la intensitat, rCBV (p=0.035) i rCBF (p=0.024) en les àrees de hiperperfusión. La sensibilitat de la detecció de hiperperfusión per al diagnòstic d’EE va ser 78.95%, i l’especificitat de l’90%. L’anàlisi quantitativa comparativa dels índexs de asimetria per rCBF, rCBV i MTT entre les TC-P crítiques i el grup control va mostrar diferències significatives per a tots els paràmetres (rCBF p=0.001; rCBV p=0.002; TTP p=0.001 i MTT p=0.001)
En aquest estudi vam demostrar que la TC-P pot proporcionar informació diagnòstica valuosa en pacients amb EE i complementar a l’EEG.
D’altra banda, la identificació de factors clínics que puguin predir l’evolució dels pacients en EE és important. L’escala STESS-(Status-epilepticus-Severity-Score) és una eina per predir la mortalitat en el EE. No obstant això, aquesta escala no té en compte la situació funcional prèvia de l’malalt. Per això en el nostre segon estudi vam voler valorar si l’Rankin modificat-(mRS) podria ser un factor pronòstic en el EE i si afegint aquesta variable a l’STESS es podria millorar la predicció de el pronòstic en aquests pacients.
Es va realitzar un registre retrospectiu dels pacientes≥16 anys que van presentar un EE. Realitzem corbes ROC i models de regressió logística per estimar les puntuacions d’una nova escala “”mSTESS””(modified STESS) i comparem amb els resultats de l’STESS.
Es van incloure 136 pacients. La capacitat de l’STESS per predir la mortalitat va ser de l’74,3%, mentre que la capacitat de l’mRS per predir la mortalitat va ser de l’65,2%. El model de regressió logística i les corbes ROC van permetre classificar el mRS en tres grups: 0 (mRS=0); 1 (mRS=1 a 3) i 2 (mRS> 3). Aquests valors van ser afegits als altres ítems de l’STESS, resultant una nova escala, el mSTESS, amb puntuacions entre 0 i 8 punts. La capacitat de l’mSTESS per predir la mortalitat va ser de l’80,1%. Un mSTESS> 4 va establir una precisió general de 81.8% per predir la mortalitat, que va ser considerablement més gran que la precisió general de l’STESS≥3 (59.6%).
Concloem que el mRS basal s’associa amb un alt risc de mortalitat, i que el mSTESS, podria ser una escala més precisa per predir el pronòstic de pacients amb EE.Un problema importante en el manejo del Estado Epiléptico (EE) es el diagnóstico precoz del mismo. Se sabe que la actividad epiléptica causa un aumento de la demanda metabólica en la corteza cerebral, que se acompaña de un aumento temporal de la perfusión cerebral, por ello investigamos si la TC cerebral de perfusión (TC-P) podía ser una herramienta de diagnóstico útil para pacientes con EE. Realizamos un estudio de pacientes con EE, diagnosticados por semiología clínica y EEG, en los que se realizó de forma prospectiva una TC-P en fase crítica. Se realizó un análisis visual y cuantitativo de los mapas de perfusión. Se calcularon los índices de asimetría-(IA) para el flujo cerebral regional-(rCBF), el volumen-(rCBV), el tiempo al pico-(TTP) y el tiempo de tránsito medio-(MTT). En 9 de los casos se realizó una TC-P de seguimiento una vez resuelto el EE y se compararon con las TC-P realizadas en fase crítica. Además, incluimos un grupo de control en los que también se realizó un TC-P. Incluimos 19 pacientes. El análisis visual de los mapas de perfusión durante la fase crítica, mostró áreas de hiperperfusión en el 78,9% de los pacientes. El análisis cuantitativo mostró un aumento significativo de los valores de rCBF (p=0.002) y rCBV (p=0.004), y una disminución de TTP (p <0.001) MTT (p=0.001) en las áreas corticales del lado afectado versus el lado no afectado. De los 9 pacientes con una TC-P de seguimiento, 8 mostraron disminución de la intensidad, rCBV (p=0.035) y rCBF (p=0.024) en las áreas de hiperperfusión. La sensibilidad de la detección de hiperperfusión para el diagnóstico de EE fue 78.95%, y la especificidad del 90%. El análisis cuantitativo comparativo de los índices de asimetría para rCBF, rCBV y MTT entre las TC-P críticas y el grupo control mostró diferencias significativas para todos los parámetros (rCBF p=0.001; rCBV p=0.002; TTP p=0.001 y MTT p=0.001) En este estudio demostramos que la TC-P puede proporcionar información diagnóstica valiosa en pacientes con EE y complementar al EEG. Por otro lado, la identificación de factores clínicos que puedan predecir la evolución de los pacientes en EE es importante. La escala STESS (Status-Epilepticus-Severity-Score) es una herramienta para predecir la mortalidad en el EE. Sin embargo, esta escala no tiene en cuenta la situación funcional previa del enfermo. Por ello en nuestro segundo estudio quisimos valorar si el Rankin modificado (mRS) podría ser un factor pronóstico en el EE y si añadiendo esta variable al STESS se podría mejorar la predicción del pronóstico en estos pacientes. Se realizó un registro retrospectivo de los pacientes≥16 años que presentaron un EE. Realizamos curvas ROC y modelos de regresión logística para estimar las puntaciones de una nueva escala “mSTESS”(modified STESS) y comparamos con los resultados del STESS. Se incluyeron 136 pacientes. La capacidad del STESS para predecir la mortalidad fue del 74,3%, mientras que la capacidad del mRS para predecir la mortalidad fue del 65,2%. El modelo de regresión logística y las curvas ROC permitieron clasificar el mRS en tres grupos: 0 (mRS=0); 1 (mRS=1 a 3) y 2 (mRS> 3). Estos valores fueron añadidos a los otros ítems del STESS, resultando una nueva escala, el mSTESS, con puntajes entre 0 y 8 puntos. La capacidad del mSTESS para predecir la mortalidad fue del 80,1%. Un mSTESS> 4 estableció una precisión general de 81.8% para predecir la mortalidad, que fue considerablemente mayor que la precisión general del STESS≥3 (59.6%). Concluimos que el mRS basal se asocia con un alto riesgo de mortalidad, y que el mSTESS, podría ser una escala más precisa para predecir el pronóstico de pacientes con EE.
One challenge in SE management is establishing the diagnosis, particularly in patients with nonconvulsive seizures. It is known that epileptic activity causes an increase in the metabolic demand of the affected cerebral cortex, and this is accompanied by a transient increase in blood perfusion of the region, Therefore, we wanted to evaluate if the PCT cerebral perfusion could a be of value for diagnosing a SE. We included SE patients, diagnosed by EEG and clinical semiology, who prospectively underwent a PCT study in the ictal phase. Visual and quantitative analysis of the perfusion maps were performed. Asymmetry index-(AI) between affected and unaffected hemispheres were calculated for regional-cerebral blood flow-(rCBF), regional-cerebral blood volume-(rCBV), time to peak-(TTP), and mean transit time-(MTT). Nine patients underwent a follow-up PCT after SE resolution, and the corresponding maps were compared to the ictal maps. In addition, we included a control group, who also underwent acute PCT during the study period. We included 19 patients. On visual analysis of parametric perfusion maps during the ictal phase, regional cortical hyperperfusion was depicted in 78.9% of patients. Quantitative analysis showed significantly increased rCBF (p=0.002) and rCBV (p=0.004) values, and decreased TTP (p<0.001) MTT (p=0.001) in cortical areas of the affected versus the unaffected side. In the 9 patients with a follow-up PCT, 8 showed decreased intensity, rCBV (p=0.035), and rCBF (p=0.024) in the hyperperfusion areas. The sensitivity of hyperperfusion detection for the diagnosis of SE was 78.95%, specificity 90%. Comparative quantitative analysis of asymmetry indices for rCBF, rCBV, and MTT between ictal PCT and control patients showed significant differences for all parameters (rCBF p=0.001; rCBV p=0.002; TTP p=0.001 and MTT p=0.001). In this study we demonstrate that PCT may provide valuable diagnostic information in patients with SE and complement the diagnostic value of EEG. On the other hand, identifying the clinical factors that predict the outcome of patients with SE is important. The Status Epilepticus Severity Score (STESS) is a score for predicting mortality in SE. However, this scale does not consider the previous functional situation of the patient. Therefore, in our second study we wanted to assess if the baseline modified Rankin Scale (mRS) might be a prognostic factor for assessing the short-tem outcomes of SE and whether its addition to STESS can improves the prediction of mortality. We recruited consecutive patients with SE >16 years. We developed ROC curves and a logistic regression model to estimate the scores of the new score, designated as modified STESS (mSTESS) and subsequently compared it with the STESS. We included 136 patients. The capacity of STESS to predict mortality was 74.3% (IC:63.8-81.8%), while the capacity of the mRS to predict mortality was 65.2% (IC:54.2-76.2%). The logistic regression model and ROC curves enabled the classification of mRS as follows: 0 (mRS=0); 1 (mRS=1 to 3) and 2 (mRS>3). These values, when added to the other items of the STESS, resulted in the mSTESS with scores between 0 and 8 points. The capacity of the mSTESS to predict mortality was 80.1%. A mSTESS>4 established an overall accuracy of 81.8% for predicting mortality, which was considerably higher than the overall accuracy of STESS≥3 (59.6%). In this second study, we conclude that the baseline mRS was associated with high mortality risk and we propose to use mSTESS to improve the prediction of mortality risk in SE.
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Azevedo, Gerson Florence Carvalheira de. "Dinamicas não-lineares do burst epileptiforme e da sua transição para a depressão alastrante". [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/260924.
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Orientadores: Jose Wilson Magalhães Bassani, Antonio Carlos Guimarães de AlmeidaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Eletrica e de Computação
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Resumo: Durante o burst epileptiforme e a depressão alastrante (DA), são observados um aumento da [K+]o (concentração extracelular de potássio) e uma diminuição da [Ca2+]o (concentração extracelular de cálcio), evidenciando a participação deste mecanismo não-sináptico nestes padrões oscilatórios anormais. Essas variações nas [K+]o e [Ca2+]o elevam a excitabilidade neuronal. No entanto, não está claro se a alta [K+]o é um fator primário na geração destas atividades neuronais ou se apenas desempenha um papel secundário neste processo. Para melhor compreender a dinâmica não-linear destes padrões, as condições experimentais de alta [K+]o e zero [Ca2+]o foram replicadas em um modelo ampliado de Golomb, referente à região CA1 da formação hipocampal. Importantes mecanismos regulatórios de concentração iônica, como a bomba Na+/K+, a difusão iônica e o sistema de buffer da glia, foram acrescentados ao modelo de Golomb. Dentro destas condições, foi possível simular atividades elétricas neuronais tipicamente apresentadas no burst epileptiforme em sua fase ictal. A DA foi iniciada pela interrupção da atividade da bomba Na+/K+. O bloqueio da bomba Na+/K+ por meio da hipóxia celular é uma manobra experimental para se obter a DA, conhecida também como depressão alastrante hipóxica - DAH. A teoria de bifurcação e o método fast-slow analysis foram utilizados para estudar a interferência do K+ extracelular na excitabilidade celular. Este estudo indicou que o sistema perde a sua estabilidade com o aumento da [K+]o, transitando para um elevado estado de excitabilidade. Este crescimento da [K+]o provoca bifurcações no comportamento dinâmico neuronal, que determinam transições entre diferentes estágios dessas atividades elétricas. No primeiro estágio, o aumento da [K+]o propicia a deflagração do burst epileptiforme e da DA via bifurcações sela-nó e de Hopf supercrítica, respectivamente. Ao longo da atividade neuronal, o nível de excitabilidade é mantido por meio de um crescimento contínuo da [K+]o, que deprime as correntes de K+ em um processo de realimentação positiva. Neste estágio, em relação ao burst epileptiforme, a amplitude e a freqüência dos disparos dos potenciais de ação são alteradas via bifurcação de Hopf supercrítica. No último estágio, com a depressão das correntes de K+, a bomba de Na+/K+ tem uma participação importante no término da atividade neuronal. O burst epileptiforme e a DA são finalizados por meio das bifurcações sela-órbita homoclínica e sela-nó, respectivamente. Portanto, este trabalho sugere que o K+ extracelular pode desempenhar um papel fundamental na dinâmica não-linear do burst epileptiforme e da sua transição para a DA.
Abstract: During the epileptiform burst and the spreading depression (SD), it is observed an increase of [K+]o (extracellular potassium concentration) and a decrease of [Ca2+]o (extracellular calcium concentration), pointing out the participation of this nonsynaptic mechanism in these abnormal oscillatory patterns. These ionic variations raise the neuronal excitability. However, whether the high [K+]o is a primary factor in the beginning of these neuronal activities or just plays a secondary role into this process is unclear. To better understand the nonlinear dynamics of these patterns, the experimental conditions of high [K+]o and zero [Ca2+]o were replicated in an extended Golomb model in which we added important regulatory mechanisms of ion concentration as Na+/K+ pump, ion diffusion and glial buffering. Within these conditions, it was possible to simulate epileptiform burst within the ictal phase. The SD was elicited by the interruption of the Na+/K+ pump activity. The blockage of Na+/K+ pump by cellular hypoxia is an experimental procedure to elicit SD, known as hypoxic spreading depression - HSD. The bifurcation theory and the method of fast-slow analysis were used to study the interference of extracellular K+ in the cellular excitability. This analysis indicates that the system loses its stability at a high [K+]o, transiting to an elevated state of neuronal excitability. This raise of [K+]o provokes bifurcations in the neuronal dynamic behavior, that determine transitions between different stages of these electrical activities. In the initial stage, the increase of [K+]o creates favorable conditions to trigger the epileptiform burst and the SD by saddle-node and supercritical Hopf bifurcations, respectively. During the neuronal activity, the level of excitability is maintained by a continuous growth of [K+]o that depresses K+ currents in a positive feedback way. At this stage, concerning epileptiform burst, the amplitude and frequency of action potentials are changed by supercritical Hopf bifurcation. At the last stage, with the depression of K+ currents, the Na+/K+ pump plays an important role in the end of neuronal activity. The epileptiform burst and SD activities terminate by saddle-homoclinic orbit and saddle-node bifurcations, respectively. Thus, this work suggests that [K+]o may play a fundamental role in the nonlinear dynamics of the epileptiform burst and the transition to SD.
Doutorado
Engenharia Biomedica
Doutor em Engenharia Elétrica
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Rosa-Ballaben, Nátalie Massaro. "Trauma raquimedular : avaliação do potencial neuroregenerador e neuroprotetor da fração proteica extraída do látex /". Universidade Estadual Paulista (UNESP), 2018. http://hdl.handle.net/11449/154292.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
A lesão medular não é um evento incomum na medicina humana e veterinária e resulta em disfunções neurológicas de graus variados. Apesar dos esforços no tratamento, lesões medulares frequentemente causam sequelas permanentes, desde déficit proprioceptivo isolado até paralisia completa de membros. A membrana confeccionada à base de látex natural extraído da seringueira Hevea brasiliensis tem sido utilizada com sucesso para regeneração de tecidos, e seu potencial regenerador foi reconhecido como sendo de uma fração proteica conhecida como proteína P1. Este novo biomaterial foi eficaz em vários testes de regeneração em animais de experimentação e humanos, e, ainda que tenha mostrado potencial regenerador em teste de lesão de nervo periférico, a proteína ainda não foi testada em Sistema Nervoso Central. Objetivou-se avaliar o potencial regenerador da fração proteica extraída do látex natural (P1) na hemissecção da medula espinhal em ratos. Foram utilizados 18 ratos machos adultos submetidos à hemissecção medular no segmento medular T13 subdivididos em dois grupos: GHP (tratados com proteína P1 em gel de ácido hialurônico) e GHSP (tratado somente com ácido hialurônico). Foram realizadas análises neuroclínicas, bem como avaliação funcional da marcha em plataforma de acrílico. Após oito semanas os animais foram submetidos à eutanásia e os segmentos medulares envolvidos foram avaliados por histoquímica pela coloração Tricrômico de Masson e Luxol Fast Blue, além de avaliação da reação astroglial por imunoistoquímica. Não houve diferença significativa entre os dois grupos para as avaliações neuroclínicas, não sendo observado melhora clínica satisfatória para as variáveis analisadas, porém, em relação à análise histológica foi notada diferença importante entre os grupos, evidenciando menor reação cicatricial e degeneração do tecido medular restante, além de presença de hipercelularidade organizada e menor reação astroglial nos animais tratados com a fração protéica P1. Apesar da não evidência de melhora nos parâmetro neuroclínicos com o uso da proteína P1, houve alterações histológicas notórias e relevantes nos animais em que foi utilizada, além de ser benéfica como indutora de neuroproteção.
Spinal cord injury is not an uncommon event in human and veterinary medicine and results in neurological dysfunctions of varying degrees. Despite efforts in treatment, spinal cord injuries often cause permanent sequelae, ranging from isolated proprioceptive deficit to complete limb paralysis. The membrane made from natural latex extracted from the rubber tree Hevea brasiliensis has been successfully used for tissue regeneration and its regenerative potential has been recognized as being of a protein fraction known as P1 protein. This new biomaterial has been effective in several regeneration tests in experimental animals and humans, and although it has shown a potential regenerator in a peripheral nerve injury test, the protein has not yet been tested in the Central Nervous System. The objective of this study was to evaluate the regenerative potential of the protein fraction extracted from natural latex (P1) in the hemisection of the spinal cord in rats. Eighteen adult male rats submitted to medullary hemisection in the T13 medullary segment were subdivided into two groups: GHP (treated with protein P1 in hyaluronic acid gel) and GHSP (treated with hyaluronic acid only). Neuroclinical analyzes were performed as well as functional evaluation of gait on acrylic platform. After eight weeks the animals were submitted to euthanasia and the involved spinal segments were evaluated by histochemistry by Masson and Luxol Fast Blue Trichrome staining, as well as evaluation of the astroglial reaction by immunohistochemistry. There was no significant difference between the two groups for the neuroclinical evaluations, and no satisfactory clinical improvement was observed for the analyzed variables; however, in relation to the histological analysis, an important difference between the groups was observed, evidencing a smaller cicatricial reaction and degeneration of the remaining spinal cord tissue, besides the presence of organized hypercellularity and less astroglial reaction in the animals treated with the protein fraction P1. Although there was no evidence of improvement in the neuroclinical parameters with the use of the P1 protein, there were significant and relevant histological changes in the animals in which it was used, besides being beneficial as inducer of neuroprotection.
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Sarmento, Analuiza Silva Tenório Luna. "Metodologias ativas no processo ensino aprendizagem na área de neurologia". Universidade Federal de Alagoas, 2015. http://www.repositorio.ufal.br/handle/riufal/1420.
Texto completoResumen
The survey was conducted in order to verify the acquisition of skills and competencies in Neurology for medical training, required by the National Curriculum Guidelines. Introduced methodological innovation in Neurology discipline, encouraging the students to produce a vídeo on Stroke as a pedagogical activity. For this the students performed literature search and preparation of the script of the vídeos considered relevant aspects of the clinical picture, diagnosis, as well as ethical and social issues surrounding this type of pathology. The choice of vídeo contente was due to the high incidence and prevalence of the condition, being relevant to the medical population been abled in diagnosis, treatment and empower people about prevention and care strategies. After the presentation of the videos, students completed questionnaires about the use of this methodology for learning, to develop skills and competencies in medical training. The information obtained was analyzed and showed that the vídeo production favored the learning contentand contributed to the development of skills, competencies and attitudes in Neurology for medical training.A pesquisa foi realizada com o objetivo de verificar a aquisição de habilidades e competências em Neurologia, para a formação médica, requeridas pelas Diretrizes Curriculares Nacionais. Introduzimos inovação metodológica na disciplina de Neurologia, estimulando os discentes a produzirem um vídeo sobre Acidente Vascular Cerebral como atividade pedagógica. Para isso os estudantes realizaram pesquisa bibliográfica e na elaboração do roteiro dos vídeos consideraram aspectos relevantes do quadro clinico, diagnóstico, bem como questões éticas e sociais que envolvem esse tipo de patologia. A escolha do conteúdo dos vídeos foi decorrente da alta incidência e prevalência da patologia, sendo relevante para a comunidade médica estar habilitada no diagnóstico, tratamento e empoderando a população sobre estratégias de prevenção e cuidados. Após a apresentação dos vídeos, os estudantes responderam questionários sobre o uso dessa metodologia para a aprendizagem, para o desenvolvimento de habilidades e competências na formação médica. As informações obtidas foram analisadas e apontaram que a produção de vídeo favoreceu a aprendizagem do conteúdo e contribuiu para o desenvolvimento de habilidades, competências e atitudes em Neurologia para a formação médica. As oficinas foram o Produto de Intervenção proposto com o objetivo de envolver os integrantes do processo educacional, proporcionando o compartilhar de saberes e o incentivo para a implementação das estratégias de ensino-aprendizagem coerentes com as competências gerais das Diretrizes Curriculares Nacionais do Curso de Graduação em Medicina.
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Carvalho, Patrícia Alexandra Teixeira de. "Reabilitação física do paciente neurológico pós-cirúrgico". Master's thesis, Universidade de Lisboa. Faculdade de Medicina Veterinária, 2014. http://hdl.handle.net/10400.5/7596.
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Dissertação de Mestrado Integrado em Medicina VeterináriaAs hérnias discais resultam de um deslocamento parcial ou total do disco intervertebral (DIV), o qual pode ter como causa a degeneração do DIV ou, mais raramente, um trauma. Quando o DIV altera as forças mecânicas normais exercidas sobre a coluna vertebral resultam, frequentemente, na deslocação de material degenerado do disco para o exterior e consequente compressão da medula espinhal. As hérnias discais podem ocorrer em qualquer espécie animal, no entanto, ocorrem mais frequentemente em cães, sobretudo em raças condrodistróficas. Os sinais clínicos são variáveis, podendo ser confundidos com outras lesões medulares. O diagnóstico precoce, assim como um tratamento adequado são essenciais para que a resolução da lesão seja bem sucedida. O tratamento das hérnias discais pode ser médico ou cirúrgico dependendo da gravidade dos sinais clínicos. O tratamento médico consiste em manter o animal em repouso absoluto numa jaula, de modo a restingir os seus movimentos durante três a quatro semanas, devendo o exercício físico ser posteriormente reintroduzido de uma forma gradual, enquanto o tratamento cirúrgico deve ser realizado até um período de 48h após o início dos sinais clínicos. Qualquer uma das situações deve ser sempre combinada com um protocolo de reabilitação física, o qual é definido consoante os sinais clínicos apresentados e os problemas a resolver. Nesta dissertação serão apresentados e discutidos quatro casos clínicos de hérnias discais e algumas das possíveis razões para o insucesso na reabilitação física das mesmas.
ABSTRACT - Physical rehabilitation of postsurgical neurological patient - Discal herniation results from a partial or a total displacement of the intervertebral disc (IVD), which may be caused by degeneration of the IVD or more rarely by a trauma. When IVD degenerate, normal mechanical forces exerted on the spinal column, often result in degenerated disc material from being squeezed out and, therefore, in spinal cord compression. The disc herniation can occur in any animal species, but they are more common in dogs, especially in condrodistrophic races. The clinical signs are variable and can be confused with other spinal injuries. Early diagnosis and the appropriate treatment are essential for a successful lesion resolution. The treatment of discal herniation may be medical or surgical depending on the severity of clinical signs. Medical treatment consists on keeping the animal in a cage, to restricte their movements for three to four weeks, so exercise can later be reintroduced in a gradual manner, while surgical treatment should be performed within 48h after onset of clinical signs. Either situation should always be combined with a physical therapy protocol, which is defined according to the presented clinical signs and problems to solve. In this dissertation will be presented and discussed four clinical cases of discal herniation and some of the possible reasons for the failure of the physical rehabilitation of the same.
Libros sobre el tema "Neurologia"
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Diament, Aron J. y Saul Cypel. Neurologia infantil. 4a ed. São Paulo: Atheneu, 2005.
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Lima, César Luiz Ferreira de Andrade. Paralisia cerebral: Neurologia, ortopedia, reabilitação. Rio de Janeiro, Brazil: MEDSI, 2004.
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Tobeña, Adolf. El cervell eròtic: Neurologia sentimental. Barcelona: Edicions La Campana, 1995.
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1926-, Adelman George, ed. Encyclopedia of neuroscience. Boston: Birkhäeuser, 1987.
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Oliveira, Antonella Carvalho de, ed. Tratado de neurologia clínica e cirúrgica: -. Brazil: Atena Editora, 2022.
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Oliveira, Antonella Carvalho de, ed. Frente Diagnóstica e Terapêutica na Neurologia 3: -. Brazil: Atena Editora, 2021.
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Oliveira, Antonella Carvalho de, ed. Neurologia: Perspectivas de futuro e posição atual: -. Brazil: Atena Editora, 2022.
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Rubens, Reimão y Alonso-Nieto José Luiz, eds. História da neurologia no Estado de São Paulo. São Paulo, SP: Lemos, 1996.
Buscar texto completoCapítulos de libros sobre el tema "Neurologia"
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Teive, Hélio A. Ghizoni. "HISTÓRIA DA NEUROLOGIA". En Tratado de neurologia clínica e cirúrgica, 1–11. Atena Editora, 2022. http://dx.doi.org/10.22533/at.ed.3462213041.
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Rezende, Joffre Marcondes de. "A neurologia na antiguidade". En À sombra do Plátano: crônicas de história da medicina, 61–71. Editora Fap-Unifesp, 2009. http://dx.doi.org/10.7476/9788561673635.0007.
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Porto, Silvio, Catarina Ramacciotti Graca do Espirito Santo, Daniel Abreu y Jaquisson Guimarães. "Residências em Neurocirurgia e Neurologia". En PAPO CABEÇA, 375–84. Instituto de Neurologia de Curitiba, 2022. http://dx.doi.org/10.56088/hinc.978-65-993721-2-4.046.
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Prado, Eduardo Faria, Marcos Cardoso Vieira Borges, Renato Silveira Vilas Boas Filho, Rodolfo Cassiano Pires de Souza y Renato Ortolani Marcondes Castro. "NEUROLOGIA E NEUROCIRURGIA - CASO 3". En Medicina em Casos Clínicos: Uma Coletânea baseada em Casos Reais, 141–52. Atena Editora, 2021. http://dx.doi.org/10.22533/at.ed.30421180236.
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Souza, Juliana Navas braga de, Tarquínio brito Oliveira Júnior, Gabriela Silva Batista, Augusto Heyden Boczar y Renato Ortolani Marcondes Castro. "NEUROLOGIA E NEUROCIRURGIA – CASO 1". En Medicina em Casos Clínicos: Uma Coletânea baseada em Casos Reais, 130–35. Atena Editora, 2021. http://dx.doi.org/10.22533/at.ed.30421180234.
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Silva, Ana Carolina, Karina Macedo Reis, Felipe Carluccio Falavigna, Renan Zuliani Solidário de Souza y Renato Ortolani Marcondes Castro. "NEUROLOGIA E NEUROCIRURGIA - CASO 2". En Medicina em Casos Clínicos: Uma Coletânea baseada em Casos Reais, 136–40. Atena Editora, 2021. http://dx.doi.org/10.22533/at.ed.30421180235.
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LEAL, A. G. y J. L. NOVAK FILHO. "LIGA ACADÊMICA DE NEUROLOGIA E NEUROCIRURGIA DO INSTITUTO DE NEUROLOGIA DE CURITIBA (INC)". En NEURO FUNDAMENTAL, 15–16. EDITORA CRV, 2019. http://dx.doi.org/10.24824/978854443952.4.15-16.
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BORGES, I. S., J. V. A. MOREIRA, P. H. P. MACIEL, A. P. SANTOS, G. N. M. ASSUNÇÃO, A. M. LUPPI, R. F. P. BARBIERI y D. F. SANTOS. "EXAMES DE IMAGEM COMPLEMENTARES EM NEUROLOGIA". En MANUAL DE SEMIOLOGIA NEUROLÓGICA VOLUME 2, 291–304. EDITORA CRV, 2021. http://dx.doi.org/10.24824/978652510996.1.291-304.
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Meltzer, Ethan. "A woman with loss of consciousness while driving". En How to Think Like a Neurologist, 175–83. Oxford University Press, 2022. http://dx.doi.org/10.1093/med/9780197576663.003.0024.
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This case follows a young woman with recurrent, stereotypical spells of loss of consciousness. A neurology case-based book is an artificial construct, as no non-neurologic disorders are going to be included. In real life, however, patients do not come with labels that say whether a symptom is neurologic or non-neurologic. The job of the neurologist is often to determine whether or not the patient has a neurologic disease. The line that divides a neurologic from a non-neurologic symptom or syndrome is somewhat arbitrary. This case explores the challenges when a patient’s symptoms don’t clearly fit on one side of that line or the other.
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Carvalho, Max Medeiros Mendonça e., Sebastião Gilberto Mota Tavares Júnior, Laianne Barros Martins de Alcântara, Pedro Henrique Daldegan Couto y Bernardo Alves Barbosa. "Exames de Imagem em Neurologia e Neurocirurgia". En PAPO CABEÇA, 370–75. Instituto de Neurologia de Curitiba, 2022. http://dx.doi.org/10.56088/hinc.978-65-993721-2-4.045.
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Ribas, Michelle Zonkowski, Gabriella Augustin, Valéria Cristina Scavasine, Renata Dal Prá Ducci y Marcos Christiano Lange. "Teleregulation in Neurology: A decision-making process for neurology evaluation in a large Brazilian city". En XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.106.
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Background: There is an increasing demand for neurological consultations. However, geographical and economic barriers and the long waiting lines limit the access. Teleregulation (TR), an asynchronous evaluation made by the neurologist, could optimize the need for presential evaluation. Objectives: The aim of this study was to analyze TR for neurological referral of patients, regarding the information provided, the main reasons for consultation, and the teleneurologist’s final decision. Design and setting: Observational cross-sectional study in Complexo Hospital de Clínicas in Curitiba-PR. Methods: The study selected neurological referrals for evaluation by TR between October 2018 and February 2020. The referrals who had incomplete information were excluded. The main variables analyzed were age, sex, reasons for TR, and final decision by the teleneurologist. Results: Of the 1035 included referrals, 56% were women and the mean age was 50±19.6 years old. The main reasons for TR were therapeutic conduct (32%), diagnosis (31%), and test request (13%) and the main specific clinical reasons were headache (30%), epilepsy (19%), dementia (16%), cerebrovascular diseases (11%), and neuromuscular disorders (10%). More information was requested in 427 (41%) of the consults and no need for in-person consultation occurred in 713 (68%) of cases. Conclusions: The main reasons for TR were management and diagnosis. The study showed that TR can reduce the need for presential assessment by a neurologist in more than two-thirds of cases. However, a great part of the consultations needed additional data. Thus, the optimization of the referrals could further improve this system, reducing its overhead.
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Matias, Rafael Bragança Rodrigues, Bruna Cardoso de Mattos Boccalini, Renata de Oliveira Costa y Maria Fernanda Mélega Mingossi. "Mantle Cell Lymphoma recurrence and involvement of the central nervous system after bone marrow transplantation: case report." En XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.215.
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Introduction: Mantle cell lymphoma (MCL) is a subtype of uncommon nonHodgkin lymphoma. The involvement of the central nervous system (CNS) is uncommon in the course of the disease. Objective: To report a case of recurrence of MCL in the CNS as the first manifestation, after chemotherapy and bone marrow transplantation. Case report: Male patient, 49 years old, with no previous comorbidities diagnosed with stage IV MCL (bone marrow), submitted to chemotherapy and autologous transplantation. After two years, he sought out the neurology clinic with a complaint of blurred vision. Neurological examination: without motor deficit; bilateral partial ptosis, bilateral divergent strabismus, tongue shift to the right. CSF with 230 leukocytes/mm³, 70% of lymphocytes, glucose of 71 mg /dl and protein of 85 mg /dl; Skull MRI demonstrated bilateral and symmetrical enhancement of segments of the cisterns of the optic and oculomotor nerves; Trigeminal, facial, vestibulocochlear and glossopharyngeal, vagus and accessory nerves more exuberant on the left. CSF immunophenotyping showed CD19, CD5 and Kappa positive monoclonal, compatible with MCL recurrence. Intrathecal and systemic chemotherapy with methotrexate were initiated. Discussion: Risk of recurrence of MCL and infiltration of the CNS is uncommon (3.9 - 5%). The patient did not show any signs of systemic involvement, only the neurological findings, which is atypical since the neurological presentation is more associated with recurrence of MCL with a course of systemic findings. Conclusion:The authors point out that in patients with treated MCL who have neurological manifestations without systemic findings, tumor recurrence should be considered.
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Maia, Jade Menezes y Karine Gomes Bandeira Desteffani. "Main neurological changes in patients infected with Covid- 19: literature review". En XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.067.
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Background: The world is experiencing a pandemic caused by COVID-19, which has already led to the death of 3.5 million individuals. In this context, the scientific community has made several discoveries, above all, that COVID-19 can promote other disorders, in addition to respiratory, such as the impairment of the nervous system. Objectives: To analyze the main neurological changes resulting from the infection by COVID-19. Design and setting: Cross-sectional observational study. Methods: Literature review with articles published in 2020, in journals indexed in the PubMed and Scielo databases, using the descriptors “Neurologic Manifestations” AND “covid-19, including articles in Portuguese and English. Results: Neurological symptoms have become increasingly recurrent in patients with COVID-19. SARS-CoV-2 reaches the Central Nervous System (CNS) through hematogenous or retrograde neuronal dissemination. Peripheral neuropathies and cerebrovascular events are associated with the severity of the disease. The elevation of D-dimer in critically ill patients triggers cerebrovasculares events, especially the development of ischemic stroke (stroke), which becomes more evident due to its risk factors. Changes in mental status are not limited to severe cases, and can occur at any stage of the disease, especially neuropsychiatric syndromes, such as anxiety, depression and post- traumatic stress. Conclusion: COVID-19, in an advanced stage, promotes peripheral neuropathies and cerebrovascular events. Furthermore, regardless of the severity stage, it can lead to changes in mental status.
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Pinto, Guilherme Dantas Campos, Gabriela Arcoverde Wanderley, Gustavo Sales Santa Cruz, Luís Eduardo Nobrega Nogueira Alves y Wagner Gonçalves Horta. "Use of glucocorticoids in acute spinal cord injuries: a last decade analysis". En XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.057.
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Introduction: The early use of methylprednisolone (MP) pulse represents the only treatment suggested to stop neurological outcomes in non-operable acute spinal cord injuries (ASCI). The protocol of the drug use dates from the 1990s and results of the NASCIS 2 randomized clinical trial. However, such conduct is still an issue for discussion, due to limited evidence. Objective: To compare the results of the main studies about the use of MP in the ASCI published in the last decade. Methods: This is a narrative review of the use of MP in the ASCI. A search was carried out using the keywords “acute spinal cord injury” and “methylprednisolone” on PubMed and Cochrane, in April 2021. Indexed meta- analysis from 2011 to 2020 were used as filters. All studies (3) were selected for analysis and comparison of their results. Results: Cochrane meta-analysis, in 2012 concluded that MP administration results in an improvement of the neurological outcome and presents good safety margin. Although it agrees with the drug harmless, a Canadian study in 2017 pointed out the MP offers a poor motor function benefit in the long term. Recently, in 2019, a meta-analysis from the American Academy of Neurology, did not recommend the use of MP in the ASCI, because of the lack of benefit in neurological function and increased occurrence of complications after the adoption of the therapy. Conclusion: Data from the last ten years of analysis demonstrates a progressive decrease in the evidence in favor of the use of MP in the ASCI.
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Garcia, Ana Carolina Pereira, Alice Campos Meneses, Ana Karolinne Cruz Cavalcante, Caroline Rodrigues de Morais, Gabriel Dias Henz, Gabriela Rodrigues Pessôa y Liana Lisboa Fernandez. "Cognitive impairment associated with COVID-19: a literature review". En XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.683.
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Background: SARS-CoV-2 is capable of causing neurological symptoms of the CNS in addition to respiratory and gastrointestinal symptoms. Early knowledge of the possible cognitive functions compromised by the infection will allow the health system to anticipate and create measures to minimize irreversible damage. Objectives: to analyze the cognitive impairment associated with COVID-19, taking into account its pathophysiological mechanisms and their short and long-term consequences. Methods: Narrative review of 62 articles, based on an active search on the PubMed, Google Scholar, Jama and American Academy of Neurology research platforms. Results: Cognitive impairment can be present both during and after infection. The main risk factors for cognitive impairments in the short term are: other neurological symptoms (headache, anosmia, dysgeusia); diarrhea and oxygen therapy. The main cognitive functions affected were memory, attention, executive functions (mental flexibility) and language (semantic and phonetic fluency) associated with anxiety and depression. The factors that contribute to long-term cognitive decline are: previous cognitive weakness (comorbidities); the inflammatory process of COVID-19 with pulmonary (hypoxia), vascular (ischemia), neurological (neuronal damage) and hospitalization (sedation, isolation, delirium). The hippocampus appears to be particularly vulnerable to coronavirus infections. Conclusion: Short-term and long-term cognitive impairment associated with COVID-19 may be related to the increased likelihood of cognitive impairment, as well as the acceleration of neurodegenerative diseases, such as Alzheimer’s disease. Follow-up with neuropsychological assessments of these patients and epidemiological studies are necessary to analyze this impact and to create prevention and treatment programs.
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ROSA, Elaine Rodrigues. "HERPETIC ENCEPHALITIS IN A ELDERLY WOMAN". En XXVIII CONGRESSO BRASILEIRO DE NEUROLOGIA. Recife, Brasil: Even3, 2017. http://dx.doi.org/10.29327/1.1413.28-1.
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ROSA, Elaine Rodrigues. "MARCHIAFAVA-BIGNAMI : RELATO DE CASO". En XXVIII CONGRESSO BRASILEIRO DE NEUROLOGIA. Recife, Brasil: Even3, 2018. http://dx.doi.org/10.29327/1.1413.28-2.
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Lemanski, Francisco Costa Beber, Vitor Dalepiane Rossato, Nathalia Beck Corrêa, Letícia Reginato y Gabriel Tarasconi Zanin. "Wilson’s disease: neuroimaging features". En XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.002.
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Background: Wilson’s disease (DW) is a genetic disorder characterized by the accumulation of copper in the body. The copper accumulation is systemic and occurs in several tissues, with the central nervous system (CNS) being one of the most affected sites. The use of imaging tests is not necessary for the diagnosis. However, in the suspicion of neurological damage, Magnetic Resonance Imaging (MRI) plays an important role in the assessment of the metal deposit in the CNS and in the clinico-anatomical correlation in symptomatic patients. Objectives: to identify the characteristic findings of DW in neuroimaging exams. Methods: a narrative literature review. Results: in MRI, the most affected sites in the CNS are the basal ganglia (mainly the outermost portion of the putamen), followed by the midbrain, the pons, and the thalamus. Alterations are bilaterally and symmetrically. T2 sequence reveals hyperintensity in putamen, the most common abnormality, as well as in the rest of the basal ganglia. Eventually, it is possible to identify the “panda sign” in the axial section of the midbrain, due to the involvement of the tegmental region associated with the normal signal of the red nuclei and hypointensity of the superior colliculus, characteristic of DW. In the T1 sequence, patients with neurological symptoms present hypointense images. Conclusions: MRI has a diagnostic and prognostic role in DW. The putamen is the most affected structure, but abnormalities in the pons, midbrain, and thalamus are part of the neuroimaging spectrum of Wilson’s disease. The “panda sign” is the classic MRI finding.
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Costa, Raisa Ferreira, Emanuela Paz Rosas, Daniella Araújo de Oliveira y Marcelo Moraes Valença. "Action of capsaicin in the degranulation of mast cells in dura mater of rats: literature review". En XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.001.
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Introduction: Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack. Objectives: The present review study aimed to address the mechanisms of action of capsaicin and other chemical inducers in mast cell degranulation and an interaction of nerves and events that happen in the dura mater with the activation of mast cells. Design: A survey was carried out in the literature, from 1980 to 2019, in different databases (SciELO, U.S. National Library of Medicine and the National Institutes Health (PubMed) and Web of Science) using the following terms: capsaicin, mast cell and dura mater. Methods: 36 articles were selected for this review. The inclusion criteria were experimental model studies in rats that described the mechanisms of action of chemical inducers, including capsaicin. Results: Studies indicate that the main mechanisms of action of capsaicin are chemical induction through the activation of TRPV1 channels, allowing calcium influx into neurons in the trigeminal ganglion of the dura mater, activating mast cell degranulation, releasing pro-inflammatory (e.g., histamine, oxide nitric) and vasoactive (e.g., CGRP and substance P) substances. Conclusion: Therefore, the use of capsaicin may be a tool to be used in na animal model to better understand the pathophysiology of migraine.
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Ueno, Augusto Yoshiro, Ivo Emilio da Cruz Jung, Ivana Beatrice Mânica da Cruz y Fernanda Barbisan. "Depression and psychological distress in elders are influenced by the antioxidant enzyme SOD2". En XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.003.
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Introduction: Depression and psychological stress have high prevalence and incidence rates, affecting the individual welfare and increasing the risks for non-infectious chronic diseases. Studies have shown relations between inflammation and oxidative stress. In genetics, the single nucleotide polymorphism (SNP), inside the superoxide dismutase gene (Val16Ala-SOD2), is an important study subject to comprehend the risks of developing depression because its different genotypes can impact the balance between superoxide and hydrogen peroxide. The genotype VV favors the superoxide, the AA favors the peroxide and the AV generates similar amounts. Objectives: Evaluate the relation between oxidative unbalance, generated by Val16Ala-SOD2 SNP, and the rates of depression in elders. Methods: The study, approved by the ethics committee of UFSM, was a case-control analysis to examine the association between Val16Ala-SOD2 SNP, depression and stress in elders. Genetical analysis was made by polymerase chain reactions. The sample had 612 elders from Gravataí (RS). Depression was diagnosed using the geriatric depression scale- 15 and the stress by self perception. Statistical analysis was made by SSPS. Results: From the 612 elders (with similar ages and lifestyles), 115 were diagnosed with depression; the other 497 composed the control group. The analyses showed significantly higher frequency of the genotype VV in those who had depression, compared with the allele A. Conclusion: The results indicate strong association of the Val16Ala-SOD2 SNP, the risks of depression and psychological stress, probably due to the increasing oxidative stress and inflammatory state associated with the recessive genotype, VV.
Informes sobre el tema "Neurologia"
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van Ginneken, Nadja, Simon Lewin y Vikram Patel. Do non-specialist health workers improve the care of people with mental, neurological and substance-use disorders? SUPPORT, 2017. http://dx.doi.org/10.30846/170213.
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Non specialist health workers (including doctors, nurses, lay health workers) who are not specialists in mental health or neurology, but who have some training in these fields, and other professionals, such as teachers, may have an important role to play in delivering mental, neurological or substance abuse care.
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Balls, J. D. Neurological Diagnostic Accelerometer. Office of Scientific and Technical Information (OSTI), mayo de 2000. http://dx.doi.org/10.2172/755833.
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Bell, Ronald C. Diagnostic Exercise: Neurologic Disorder in a Cat. Fort Belvoir, VA: Defense Technical Information Center, diciembre de 1989. http://dx.doi.org/10.21236/ada218031.
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Gardner, John M. Neurology Falls. Patient Falls Risk Assessment, Neurology Clinic, Johns Hopkins Hospital, Baltimore, MD. Fort Belvoir, VA: Defense Technical Information Center, julio de 2009. http://dx.doi.org/10.21236/ada516519.
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Tapley, S. R., J. S. Ramsdell y D. Xi. The neurological effects of brevetoxin on neonatal rats. Office of Scientific and Technical Information (OSTI), diciembre de 1994. http://dx.doi.org/10.2172/121307.
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McGuire, Stephen, Paul Sherman, Patrick Grogan, John Sladky, Gerald York, Roger Hesselbrock, Alan Flower, III Wood, Ford Joe y Gary. Neurological Effects of Exposure to Non-Hypoxic Hypobaria. Fort Belvoir, VA: Defense Technical Information Center, abril de 2014. http://dx.doi.org/10.21236/ada608671.
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Litwin, Tomasz, Lukasz Smolinski, Agnieszka Antos, Bembenek Jan, Czlonkowska Anna, Iwona Kurkowska-Jastrzębska, Adam Przybyłkowski y Marta Skowronska. Early neurological deterioration in Wilson’s disease: a systematic literature review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, septiembre de 2022. http://dx.doi.org/10.37766/inplasy2022.9.0111.
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Review question / Objective: The frequency and predictors of early neurological deterioration in patients with Wilson’s disease (WD). Condition being studied: Early neurological deterioration in WD. Eligibility criteria: All studies published until 15 September 2022 for original studies (prospective and retrospective), and case series or case reports analyzing early neurological deterioration in WD. Included will be studies published in English.
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Proctor, Susan P. Jet Fuel Exposure and Neurological Health in Military Personnel. Fort Belvoir, VA: Defense Technical Information Center, julio de 2010. http://dx.doi.org/10.21236/ada601668.
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Noble, Linda J., Christopher J. Sontag, Alpa Mahuvakar, Thomas Fandel y Aida F. Martinez. Targeting L-Selectin to Improve Neurologic and Urologic Function After Spinal Cord Injury. Fort Belvoir, VA: Defense Technical Information Center, octubre de 2013. http://dx.doi.org/10.21236/ada599594.
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Noble, Linda J., Alpa Mahuvakar, Thomas Fandel, Aida F. Martinez y Jon Levine. Matrix Metalloproteinases as a Therapeutic Target to Improve Neurologic Recovery After Spinal Cord Injury. Fort Belvoir, VA: Defense Technical Information Center, diciembre de 2015. http://dx.doi.org/10.21236/ada637014.
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