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Magnetic resonance diffusion tensor imaging for the pedunculopontine nucleus: proof of concept and histological correlation
The pedunculopontine nucleus (PPN) has been proposed as target for deep brain stimulation (DBS) in patients with postural instability and gait disorders due to its involvement in muscle tonus adjustments and control of locomotion. However, it is a deep-seated brainstem nucleus without clear imaging or electrophysiological markers. Some studies suggested that diffusion tensor imaging (DTI) may help guiding electrode placement in the PPN by showing the surrounding fiber bundles, but none have provided a direct histological correlation. We investigated DTI fractional anisotropy (FA) maps from in vivo and in situ post-mortem magnetic resonance images (MRI) compared to histological evaluations for improving PPN targeting in humans. A post-mortem brain was scanned in a clinical 3T MR system in situ. Thereafter, the brain was processed with a special method ideally suited for cytoarchitectonic analyses. Also, nine volunteers had in vivo brain scanning using the same MRI protocol. Images from volunteers were compared to those obtained in the post-mortem study. FA values of the volunteers were obtained from PPN, inferior colliculus, cerebellar crossing fibers and medial lemniscus using histological data and atlas information. FA values in the PPN were significantly lower than in the surrounding white matter region and higher than in areas with predominantly gray matter. In Nissl-stained histologic sections, the PPN extended for more than 10 mm in the rostro-caudal axis being closely attached to the lateral parabrachial nucleus. Our DTI analyses and the spatial correlation with histological findings proposed a location for PPN that matched the position assigned to this nucleus in the literature. Coregistration of neuroimaging and cytoarchitectonic features can add value to help establishing functional architectonics of the PPN and facilitate neurosurgical targeting of this extended nucleus
Fundamentos filosóficos e teóricos para novas concepções do cuidar em enfermagem: contribuição da sociopoética Fundamentos filosóficos y teóricos para nuevas concepciones del cuidar en enfermería: contribución de la sociopoética Philosophical and theoretical basis for new conceptions of nursing care: contribution of the social poetic
Este trabalho identifica a aplicação de princípios filosóficos e fundamentos teóricos da sociopoética em novas concepções do cuidar. Revisão sistemática de 30 trabalhos científicos. Categorias delimitadas: Dialogicidade no cuidar como instrumento tecnológico; Cuidar em enfermagem como tecnologia não invasiva. Nas novas concepções do cuidar, o cliente é o principal alvo do trabalho em enfermagem. Concluiu-se que os fundamentos da sociopoética foram aplicados revelando uma perspectiva onde a ética do cuidar, traduzida no respeito aos clientes e aos seus saberes para o autocuidado, conduz à autonomia e à solidariedade entre estes e os profissionais. A sociopoética, como método de pesquisa e prática social, revela aspectos orientadores de uma nova perspectiva a ser desenvolvida no cuidar em enfermagem.<br>Este trabajo identifica la aplicación de los principios filosóficos y fundamentos teóricos de la sociopoética en nuevas concepciones del cuidar. Revisión sistemática de 30 trabajos científicos. Categorías delimitadas: Diálogo en el cuidar como instrumento tecnológico; Cuidar en enfermería como tecnología no invasiva. En las nuevas concepciones del cuidar, el cliente es la primera meta del trabajo en enfermería. Se concluyó que los fundamentos de la sociopoética fueron aplicados revelando una perspectiva donde la ética del cuidar, traducida en el respecto a los clientes y a sus conocimientos para el autocuidado, conducen a la autonomía, a la solidaridad entre estos y los profesionales. La sociopoética, como método de investigación y práctica social, revela aspectos orientadores de una nueva perspectiva a ser desarrollada en el cuidar en enfermería.<br>This work identifies the application of the philosophical and theoretical basis of the social poetic in new conceptions of nursing care. Systematic review of 30 research works. Delimited categories: Dialogue in taking care of as technological instrument; To take care of in nursing as not invasive technology. In the new conceptions of to take care the client is considered the main target of the work in health. It was concluded that the social poetic basis were applied disclosing a perspective on the ethics of to take care, translated into respect with the clients and your knowledge for the self care, leads to the autonomy and solidarity between clients and professionals. The social poetic, as research method and social practice, discloses orienting aspects of a new perspective to be developed in nursing take care of