Disfagia orofaríngea neurogênica: análise de protocolos de videofluoroscopia brasileiros e norte-americanos

Resumo: Este artigo tem por objetivo analisar e comparar o uso de protocolos brasileiros e norte-americanos para videofluoroscopia da deglutição em pacientes com histórico de acidente vascular encefálico. Trata-se de uma revisão bibliográfica de artigos brasileiros e norte-americanos. Foram selecionados artigos com descrição de procedimentos para videofluoroscopia da deglutição em sujeitos que sofreram acidente vascular encefálico, publicados entre 2003 e 2013. Os procedimentos descritos para realização de videofluoroscopias foram analisados de forma quantitativa e qualitativa. Consideraram-se as variáveis: posicionamento para o exame, consistências e quantidades de oferta de bolo, tipos de utensílios e utilização de protocolos Foram encontrados 16 artigos que atenderam aos critérios supracitados, sendo nove (56,25%) norte-americanos e sete (43,75%) brasileiros. Observou-se que quatro dos estudos nacionais (57,14%) não relatam as quantidades oferecidas, enquanto todos os artigos norte-americanos detalharam as quantidades, que variaram entre 2 e 15 mL; os tipos de alimento e suas consistências foram detalhadas em todos os estudos nacionais e norte-americanos, porém os nacionais o fizeram de forma genérica, sem identificação dos alimentos. Quanto à posição do paciente durante o exame, 57,14% dos artigos nacionais não relataram e todos os artigos norte-americanos o fizeram. Os utensílios para oferta do bolo são citados em 55,55% dos artigos norte-americanos e em apenas 14,28 % dos nacionais. Quanto à utilização de protocolos para avaliação 33% dos estudos norte-americanos não os citam, comparados aos 71,42% dos nacionais. Observou-se a necessidade de padronização dos procedimentos e terminologias utilizadas na videofluoroscopia da deglutição, de modo a facilitar a intercompreensão e reprodutibilidade dos estudos

Relevant aspects of golden retriever muscular dystrophy for the study of Duchenne muscular dystrophy in humans

ABSTRACT: Golden Retriever muscular dystrophy (GRMD) is the most representative model for studying Duchenne muscular dystrophy (DMD) in humans, owing its phenotypic expression. DMD is a recessive disorder linked to the X chromosome in which the loss of dystrophin induces progressive weakness and degeneration of the skeletal and cardiac muscles, which lead to replacement by connective and adipose tissues. Onset of clinical signs occurs between 2 and 5 years of age, and many patients die from heart or respiratory failure. The main studies concerning dystrophic Golden Retrievers (DGR) sought to elucidate the pathophysiology of the disease and its clinical implications to develop therapies and alternative treatments to improve the quality of life and increase longevity of DMD patients. This review presents an overview of relevant contributions of the DGR model for elucidating DMD in humans

Pharmacological mechanisms involved in the antinociceptive effects of dexmedetomidine in mice

Made available in DSpace on 2015-06-01T19:34:21Z (GMT). No. of bitstreams: 2 license.txt: 1914 bytes, checksum: 7d48279ffeed55da8dfe2f8e81f3b81f (MD5) marcos_lessa2etal_IOC_2014.pdf: 337544 bytes, checksum: 63463e8807ca0e74db3e2306c0569cc9 (MD5) Previous issue date: 2014Universidade do Estado do Rio de Janeiro. Departamento de Farmacologia e Psicobiologia. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Instituto de Ciências Biomédicas. Programa de Desenvolvimento de Fármacos. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Instituto de Ciências Biomédicas. Programa de Desenvolvimento de Fármacos. Rio de Janeiro, RJ, BrasilUniversidade do Estado do Rio de Janeiro. Departamento de Farmacologia e Psicobiologia. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Investigação Cardiovascular. Rio de Janeiro, RJ, Brasil.Dexmedetomidine (DEX) is a α2-adrenoceptor (α2-AR) agonist used as an anesthetic adjuvant and as sedative in critical care settings. Typically, α2-AR agonists release nitric oxide (NO) and subsequently activate NO-GMPc pathway and have been implicated with antinociception. In this study, we investigate the pharmacological mechanisms involved in the antinociceptive effects of DEX, using an acetic acid-induced writhing assay in mice. Saline or DEX (1, 2, 5, or 10 μg/kg) was intravenously injected 5 min before ip administration of acetic acid and the resulting abdominal constrictions were then counted for 10 min. To investigate the possible mechanisms related to antinociceptive effect of DEX (10 μg/kg), the animals were also pretreated with one of the following drugs: 7-nitroindazole (7-NI; 30 mg/kg ip); 1H-[1,2,4] oxadiazole [4,3-a] quinoxaline-1-one (ODQ; 2.5 mg/kg, ip); yohimbine (YOH; 1 mg/kg, ip); atropine (ATRO; 2 mg/kg, ip); glibenclamide (GLIB; 1 mg/kg, i.p.) and naloxone (NAL; 0.2 mg/kg, ip). A rotarod and open-field performance test were performed with DEX at 10 μg/kg dose. DEX demonstrated its potent antinociceptive effect in a dose-dependent manner. The pretreatment with 7-NI, ODQ, GLIB, ATRO, and YOH significantly reduced the antinociceptive affects of DEX. However, NAL showed no effecting DEX-induced antinociception. The rotarod and open-field tests confirmed there is no detectable sedation or even significant motor impairment with DEX at 10 μg/kg dose. Our results suggest that the α2-AR and NO-GMPc pathways play important roles in the systemic antinociceptive effect of DEX in a murine model of inflammatory pain. Furthermore, the antinociceptive effect exerted by DEX appears to be dependent on KATP channels, independent of opioid receptor activity

Colonization of Aedes aegypti midgut by the endosymbiont-bearing trypanosomatid Blastocrithidia culicis

Monoxenous trypanosomatids inhabit invertebrate hosts throughout their life cycle. However, there have been cases of HIV-positive patients who have presented opportunistic infections caused by these protozoa, offering new perspectives to the study of interactions between monoxenics and hematophagous insect vectors. Some monoxenous trypanosomatids present a symbiotic bacterium in the cytoplasm, which seems to promote biochemical and morphological changes in the host trypanosomatids, such as alterations in plasma membrane carbohydrates and the reduction of the paraxial rod. In this work, we investigated the colonization of Aedes aegypti with Blastocrithidia culicis, an endosymbiont-bearing trypanosomatid. B. culicis remained in the insect digestive tract for 38 days after feeding. Optical microscopy analysis revealed an infection process characterized by a homogenous distribution of the trypanosomatid along the midgut epithelium; no preferential interaction of protozoa with any cell type was observed. Ultrastructural analysis showed that during the colonization process, trypanosomatids interacted mainly with midgut cells through their flagellum, which penetrates the microvilli preferentially near the tight junctions. Prolonged infections promoted insect midgut degradation, culminating with the arrival of protozoa in the hemocel. By demonstrating B. culicis colonization in a bloodsucking insect, we suggest that vector transmission of monoxenous trypanosomatids to vertebrate host may occur in nature.2025-01-0

Decision theory applied to image quality control in radiology

Abstract Background The present work aims at the application of the decision theory to radiological image quality control (QC) in diagnostic routine. The main problem addressed in the framework of decision theory is to accept or reject a film lot of a radiology service. The probability of each decision of a determined set of variables was obtained from the selected films. Methods Based on a radiology service routine a decision probability function was determined for each considered group of combination characteristics. These characteristics were related to the film quality control. These parameters were also framed in a set of 8 possibilities, resulting in 256 possible decision rules. In order to determine a general utility application function to access the decision risk, we have used a simple unique parameter called r. The payoffs chosen were: diagnostic's result (correct/incorrect), cost (high/low), and patient satisfaction (yes/no) resulting in eight possible combinations. Results Depending on the value of r, more or less risk will occur related to the decision-making. The utility function was evaluated in order to determine the probability of a decision. The decision was made with patients or administrators' opinions from a radiology service center. Conclusion The model is a formal quantitative approach to make a decision related to the medical imaging quality, providing an instrument to discriminate what is really necessary to accept or reject a film or a film lot. The method presented herein can help to access the risk level of an incorrect radiological diagnosis decision