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Biomedical subjects

C M Santos

Publications and source records attributed to C M Santos.

17 recordsLinked to original sources
PubMed2006

Effects of antidepressant treatment with rTMS and fluoxetine on brain perfusion in PD.

BACKGROUND: Although depression is highly prevalent in Parkinson disease (PD), little is known about the neural correlates associated with depression and antidepressant treatment in PD. OBJECTIVE: To examine the effects of fluoxetine and repetitive transcranial magnetic stimulation (rTMS) on regional cerebral blood flow (rCBF) using SPECT in patients with PD and depression. METHODS: Twenty-six patients were enrolled into two groups: One received active rTMS and placebo medication and the other sham rTMS and fluoxetine 20 mg/day. Brain SPECT was performed at baseline and after 2 and 8 weeks. Changes in rCBF were compared across timepoints and correlated with clinical scores. In addition, baseline rCBF of these patients was compared with that of 29 healthy, age-matched subjects. RESULTS: At baseline, patients with PD and depression showed significantly lower rCBF in the left prefrontal cortex, posterior cingulate gyrus, left insula, and right parietal cortex when compared with healthy controls. Both treatments induced significant clinical improvement and increases in rCBF in the posterior cingulate gyrus and decreases in rCBF in the right medial frontal gyrus. These changes were significantly correlated to the clinical outcome. Furthermore, the comparison between these two treatments revealed that whereas rTMS treatment was associated with an increased perfusion in the right and left prefrontal cortex, fluoxetine treatment was associated with a relative rCBF increase in the occipital lobe. CONCLUSION: Depression in patients with Parkinson disease is correlated with a dysfunction of the frontal-limbic network that can be modulated by two different antidepressant therapies.

Aged↗
PubMed2005

A sham stimulation-controlled trial of rTMS of the unaffected hemisphere in stroke patients.

The authors investigated the use of slow-frequency repetitive transcranial magnetic stimulation (rTMS) to the unaffected hemisphere to decrease interhemispheric inhibition of the lesioned hemisphere and improve motor function in patients within 12 months of a stroke. Patients showed a significant decrease in simple and choice reaction time and improved performance of the Purdue Pegboard test with their affected hand after rTMS of the motor cortex in the intact hemisphere as compared with sham rTMS.

Adult↗
PubMed2004

Repetitive transcranial magnetic stimulation is as effective as fluoxetine in the treatment of depression in patients with Parkinson's disease.

OBJECTIVE: To study the efficacy of 15 Hz repetitive transcranial magnetic stimulation (rTMS) in treating depression in patients with Parkinson's disease. METHODS: 42 patients were enrolled into two groups: group 1, active rTMS (15 Hz rTMS for 10 days) and placebo drug treatment; group 2, sham rTMS and fluoxetine 20 mg/day. A specially designed sham coil was used for sham stimulation. The unified Parkinson's disease rating scale (UPDRS), activities of daily living (ADL), Hamilton rating scale for depression (HRSD), Beck depression inventory (BDI), and mini-mental state examination (MMSE) were assessed by a rater blinded to treatment arm. RESULTS: HRSD and BDI were improved to the same extent in both groups after two weeks of treatment (38% and 32% for group 1, 41% and 33% for group 2, respectively). At week 8 there was a tendency for worse motor UPDRS scores in group 2 (NS). ADL showed improvement at week 8 only in group 1. MMSE improved in both groups after treatment, but faster in group 1 than in group 2. There were fewer adverse effects in group 1 than in group 2. CONCLUSIONS: rTMS has the same antidepressant efficacy as fluoxetine and may have the additional advantage of some motor improvement and earlier cognitive improvement, with fewer adverse effects.

Administration, Oral↗
PubMed2001

Metabolic changes in the nucleus of the optic tract after monocular enucleation as revealed by cytochrome oxidase histochemistry.

The histochemistry for the mitochondrial enzyme cytochrome oxidase (CO) was used to evaluate the levels of metabolic activity in neurons of the nucleus of the optic tract (NOT) and dorsal terminal nucleus (DTN) in the opossum (Didelphis aurita). The observations were performed in four groups: normal juveniles (4 months old), monocularly enucleated juveniles analysed when adults, normal adults (8 to 18 months old) and monocularly enucleated adults. CO labeled cells were observed to have a similar distribution along the NOT-DTN anteroposterior axis in both juvenile and adult normal animals. Monocular enucleation performed in adults produced a significant reduction of the reactive neuropil but not of the number of CO labeled cells in the deafferented NOT-DTN: the number of labeled neurons per section in the deafferented side matched those of the ipsilateral complex. In juveniles, however, this procedure caused a systematic reduction of the number of CO labeled cells in the contralateral NOT-DTN in comparison to the spared complex. The lack of reduction in the number of neurons found on the deafferented side of the NOT-DTN of monocularly enucleated adult opossums compared with the ipsilateral side might result from the presence of compensatory inputs to maintain their metabolic equivalence. However, when the monocular enucleation was performed in juvenile opossums, a statistically significant asymmetry of CO neurons in the NOT-DTN was observed. In other words, the compensatory mechanisms proposed for the adults were either absent or insufficient to achieve symmetry in juveniles, suggesting a more heavily reliance in the retinal input.

Adaptation, Physiological↗
PubMed2000

The interactive Web-based histology atlas system.

Molecular pathways and mechanisms underlying human cancer are frequently investigated in animal models. Studies to identify and dissect molecular pathways include the discovery of genes and their subsequent analysis in transgenic and 'knock-out' mice. A critical aspect in such investigations is the evaluation of organ integrity and histology upon the alteration or inactivation of specific genes. Results from such studies are usually published in scientific journals. However, due to print space and costs the display of large high quality images is limited. Furthermore, the printed media does not permit an easy comparison of histological images published in different journals and different years. The Internet provides a tool for the timely and inexpensive dissemination of scientific data to the research community. However, its potential for the analysis of histological images has not been explored. Here we present a web-based interactive histology atlas (http://histology.nih.gov) that permits the retrieval of annotated, high-resolution histology images via the Internet. This histology atlas also takes advantage of the interactive nature of the Internet to support the communication between different research groups. As an outline forum this atlas provides the framework to evaluate and understand cancer pathology, and to develop a consensus between veterinary and human pathologists.

Animals↗
PubMed2000

Observations on 17 patients with retinocytoma.

OBJECTIVE: To study the clinical features and natural history of 17 patients with retinocytoma. DESIGN: A retrospective case series. SETTING: Tertiary referral center. PATIENTS: Data on 17 patients with retinocytoma were reviewed for clinical features. The natural history of retinocytoma and its risk for malignant transformation were also evaluated. RESULTS: Among 920 consecutive patients who had retinoblastoma, retinocytoma, or both, we identified 24 tumors in 17 patients (1.8%) with clinical features compatible with retinocytoma. The median age at diagnosis was 15 years (range, 4-45 years). Of the 24 tumors, the retinocytoma was bilateral in 3 cases (13%) and the family history of retinoblastoma was positive in 3 cases (13%). Seventeen (71%) of the tumors were extramacular in location, and 7 (29%) were located in the macular area. Ophthalmoscopic features characteristic of retinocytoma included the presence of a translucent retinal mass in 21 (88%), calcification in 15 (63%), and retinal pigment epithelial alteration in 13 (54%) of the 24 tumors. A combination of all 3 features was observed in 8 (33%) of the 24 tumors. In 13 (54%) of the tumors, a zone of chorioretinal atrophy could be observed. In 1 patient, subtle tumor regression was documented photographically. Only 1 retinocytoma (4%) underwent malignant transformation into retinoblastoma. At the last follow-up visit, none of the patients had developed a pineoblastoma or another second malignant neoplasm. CONCLUSIONS: Retinocytoma is a rare benign retinal tumor that has characteristic clinical features. The areas of chorioretinal atrophy were suggestive of tumor regression. In our series, the risk for malignant transformation of retinocytoma into retinoblastoma was 4%; therefore, patients with a presumed diagnosis of retinocytoma should be closely observed.

Adolescent↗
PubMed2000

[The pain of burns: terrible for him who feels it, stressful for those who care for him].

The goals of the study were to understand the cultural meaning that the nursing team and burn patients attribute to burn pain. Participant observations were carried out during one year at a Burn Unit. Semi-structured interviews with four nurses, five nursing auxiliaries and 12 patients were recorded. The burn pain is understood by nurses as physical and emotional pain. For professionals and patients, bath and dressing changes are stressful. For patients, burn pain is terrible and they can not explain it. However, they feel they should hold it up.

Attitude of Health Personnel↗
PubMed1998

Cytochrome oxidase and NADPH-diaphorase on the afferent relay branch of the optokinetic reflex in the opossum.

In the present study, histochemical techniques combined with more conventional anatomical methods were used to refine the identification of the nucleus of the optic tract and the nuclei of the accessory optic system in the opossum. The distribution of the enzyme cytochrome oxidase (CO) was examined in the cells and the neuropil of the opossum's mesodiencephalic region. Strong CO labeling was present in the nucleus of the optic tract (NOT)-dorsal terminal nucleus (DTN). Alternate sections, taken from animals that had received bilateral injections of horseradish peroxidase centered in the region of the inferior olive, were subjected to assays for CO and horseradish peroxidase. The region occupied by CO-labeled cells in the NOT-DTN superimposed with the one defined by retrogradely labeled cells. Cell counts along the NOT-DTN anteroposterior axis revealed that although the olivary and CO-positive cells were confined within similar boundaries, the latter are up to twofold more numerous than the former. As revealed by cytochrome oxidase histochemistry, the outlines of the NOT-DTN, the other pretectal nuclei and the nuclei belonging to the accessory optic system coincided with those revealed by the histochemistry for nicotinamide dinucleotide phosphate diaphorase (NADPH-d). After an intraocular injection of cholera toxin beta subunit and alternate sections processing for NADPH-d and CO, the distribution of labeled retinal terminal fields in the mesodiencephalic region was shown to be coincident with regions of high levels of histochemical labeling. These results are discussed in the light of previous anatomofunctional assessments of the pretectum and accessory optic system.

Animals↗
PubMed1995

Losartan improves baroreflex control of heart rate of coarcted hypertensive rats.

To assess the role of angiotensin (ANG) II in both the increased heart rate (HR) and the impaired baroreceptor reflex control of HR that characterize the chronic phase of coarctation hypertension (CH), we compared basal HR, mean arterial pressure (MAP), and baroreflex sensitivity of coarcted hypertensive rats treated chronically with losartan, captopril, or vehicle. Baseline HR was recorded daily, and MAP and reflex HR changes and plasma renin activity (PRA) were measured in coarcted and sham-coarcted rats on the 5th day after coarctation. Both captopril (10 mg.kg-1.day-1 po) and losartan (10 mg.kg-1.day-1 po) caused a small nonsignificant reduction of hypertension (132 +/- 5 and 133 +/- 5, respectively, vs. 147 +/- 9 mmHg in vehicle-treated rats), but equally inhibited the late tachycardic phase (-37 +/- 13 and -29 +/- 12 beats/min in captopril- and losartan-treated groups, respectively, vs. +79 +/- 19 beats/min in vehicle treated rats). Similar results were obtained for other groups of coarcted hypertensive rats after suppression of PRA by bilateral nephrectomy. Although hypertensive levels were the same during both treatments, only losartan given orally or intracerebroventricularlly (1.25 micrograms.kg-1.h-1) was effective in improving the reflex bradycardia. The depressed reflex tachycardia was corrected by chronic oral treatment with losartan. The data suggest that the tachycardia occurring in the chronic phase of CH is mediated by blood-borne ANG II and that the normalization of the reflex control of HR by losartan is achieved by blockade of type I receptors of ANG II in central areas accessible to oral or centrally administered losartan but not to oral captopril.

Administration, Oral↗
PubMedDate not supplied

[Follow-up of pediatric patients evaluated for liver transplantation].

OBJECTIVE: To analyze the evolution of pediatric patients chosen for hepatic transplantation. METHODS: A review was made of the clinical charts of the first 65 children and adolescents with chronic liver disease, aged 5 months to 19 years (X = 6.8%), chosen for liver transplantation during the period of August 1994 to March 1996. Data refer to the patients' demographic characteristics, etiology of their liver disease, their psychosocial situation and of their parents, and their clinical and laboratorial evaluation. According to the severity of the disease, patients were classified as active (waiting for a donor), in evaluation, inactive (compensated liver disease), and excluded for psychosocial or medical conditions, or because of bad indication. RESULTS: Eight patients (12%) received transplantation, and one of them died. Seven (11%) died when in evaluation or waiting for a donor. Ten patients (15%) were excluded from the waiting list: 6 for social problems, and 4 for medical problems. No patient was excluded for bad indication. Six patients are in the active list, waiting for donor. The other 23 patients (35%) are in evaluation, and 11 (17%) are classified as inactive in the waiting list. CONCLUSIONS: Eleven patients (17%) were not operated on due to the advanced stage of the liver disease. We emphasize the necessity of organ donation, and the early contact of the patients with a reference center.

English Abstract↗
PubMedDate not supplied

Electromyographic analysis of the masseter and temporal muscles in oralized deaf individuals.

Deaf individuals show a number of difficulties related to the functionality of the stomatognathic system, mainly by reason of the little or no use of facial musculature during speech either due to the use of sign language or to the difficulty that these individuals have in articulating words. The stomatognathic system muscles play important roles in functions such as mastication, deglutition, and phonation. This study aimed to assess, by means of computerized bilateral electromyography (EMG), masseter and temporal muscles of 12 oralized deaf individuals in clinical activities that involve part of this masticatory musculature and compare this system's functionality with that of 12 normal listening individuals, performing the same activities. An 8-channel K6-I EMG Light Channel Surface Electromyography device was used (Myo-Tronics Co.Seattle, WA, USA), in addition to disposable double electrodes covered with silver chloride (Duotrodes; Myo-tronics Co., Seattle, WA) containing a conductor gel (Myogel- Myo-tronics Co., Seatlle, WA). The averaged rectified EMG values were normalized with reference to the EMG amplitude induced by a maximum bite force. The statistical analysis confirmed that there were any significant differences between the groups, clinical activities, and muscles, and also effects of interaction among them. The analysis made use of Variance Analysis (ANOVA). Significant differences (p < 0.01) for both muscles were found among the clinical conditions, with deaf individuals showing greater electromyographic activity for both muscles for the clinical activity protrusion. Deaf individuals showed a lower muscular activity for clinical activities that demanded a greater masseter and temporal muscular activity such as mastication, mouth opening and closing, and dental compression. Greater electromyographic values were found for both deaf individuals and healthy controls during clinical activities of mastication and dental compression. Based on the obtained data, we concluded that deaf individuals showed a lower activity of the masticatory musculature than healthy individuals; the differences were significant at the level of p < 0.01 between the performed clinical activities; and all deaf individuals and healthy controls showed greater electromyographic values for mastication and dental compression.

Adolescent↗
PubMedDate not supplied

In situ saphenous vein arterial bypass for infrainguinal revascularization: initial experience using an open technique.

The authors describe their initial experience with the use of the in situ saphenous vein arterial by-pass technique for infrainguinal revascularization. From December 1986 to August 1989, we performed 101 in situ saphenous vein arterial by-passes. From these 101 by-pass, 18 composite or partial in situ vein by-passes (in situ + reversed vein) and 2 extra-anatomical sequencial by-passes (one axillofemoral and one cross-over femorofemoral proximal by-passes extended by in situ saphenous vein femoropopliteal arterial by-passes) were withdrawn from the statistics, with the purpose of analysing the natural evolution of the in situ vein arterial by-pass without the insertion of reversed vein segments and/or the influence of artificial grafts to improve arterial inflow. Therefore only 81 in situ by-pass cases will be analysed in the present paper. From these 81 cases, 44 (54.3%) were performed in diabetic patients and limb salvage was the indication for by-pass in 63 (81%). The saphenous vein valves were rendered incompetent utilising the retrograde Mills-Leather valvulotome and exposing the greater saphenous vein with a continuous incision. In the 81 cases, wound complications occurred in 18 limbs (22%) and operative mortality (30 days) was 6.1%. Primary cumulative patency rate of the 81 cases was 77% and secondary cumulative patency rate was 80%, at the end of the analysed period. The open technique, using a retrograde valvulotome and exposing the entire conduit of the greater saphenous vein, became our preferred technique for infrainguinal revascularization.

Adult↗
PubMedDate not supplied

Cell-mediated immune response to antirabies vaccine in man.

Specific cell-mediated immunity was demonstrated in three healthy volunteers submitted to antirabies vaccination with the Fuenzalida & Palacios vaccine. Evaluation of the immunological response was carried out by both "in vitro" (leucocyte migration inhibition) and "in vivo" (cutaneous tests) methods. "In vitro" tests were positive from days 15 to 30 after the onset of vaccination while the skin tests became positive earlier and remained so until day 28, when the last tests were carried out. Biopsies performed at the site of positive cutaneous tests, 24 and 48 hours after antigen inoculation, showed histological pictures compactible with simultaneous humoral and cellular responses and typical delayed hypersensitivity, respectively. The possibility of using a skin tests for monitoring the immune response during or after antirabies vaccination is discussed.

Adult↗