Intervenções de enfermagem aos pacientes com acidente vascular encefálico: uma revisão integrativa de literatura

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Tahissa Frota Cavalcante

2011-12-01

Full Text Available O objetivo do estudo foi analisar o conhecimento sobre as intervenções de enfermagem aos pacientes hospitalizados por acidente vascular encefálico. Realizou-se uma revisão integrativa da literatura a partir de acesso on-line a cinco bases de dados, no mês de setembro de 2009. Utilizou-se os descritores Cuidados de Enfermagem e Acidente Cerebral Vascular nas línguas portuguesa, inglesa e espanhola. Foram encontrados 223 artigos e selecionados 12. Identificou-se nos artigos um maior número de intervenções de enfermagem assistenciais, seguidas das educacionais, gerenciais e de pesquisa. As do domínio assistencial estão mais relacionadas aos aspectos biológicos dos pacientes. Em relação às educativas, os artigos apontam o papel fundamental do enfermeiro, bem como dos familiares e dos cuidadores. A principal intervenção gerencial foi a coordenação dos cuidados. Quanto às intervenções de pesquisa foi identificada apenas uma descrita como o desenvolvimento e aprimoramento da prática de cuidados por meio de evidências clínicas.

BREVE ESTUDO DO ESTADO DA ARTE SOBRE ACIDENTE VASCULAR CEREBRAL E SERIOUS GAMES PARA APLICAÇAO NO PROJETO “AVC” DO NÚCLEO DE TECNOLOGIA ASSISTIVA DA UFS

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Saulo Lordão Andrade Barros

2013-03-01

Full Text Available O Acidente Vascular Cerebral é uma das principais causas de morte e de sequelas no mundo. A doença atinge cerca de 16 milhões de pessoas anualmente, dessas, seis milhões morrem. No Brasil, é a principal causa de morte e incapacidade, gerando impactos econômicos e sociais. O trabalho de recuperação desses pacientes é de suma importância para diminuir os impactos causados. Para isto, o presente artigo traz uma revisão da literatura existente sobre a doença e seu tratamento, com foco na utilização de novas tecnologias, como o uso de jogos eletrônicos sérios, a fim de aprimorar o trabalho de recuperação tanto no âmbito físico quanto no emocional.

Acidente vascular cerebral e outras complicações do sistema nervoso central nas doenças falciformes Stroke and other vascular complications of the central nervous system in sickle cell disease

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Ivan L. Angulo

2007-09-01

Full Text Available A principal complicação da doença falciforme na infância é a das artérias cerebrais, mas após os 20 anos também pode se manifestar, como seqüela de lesões anteriores ou neoformadas. A vasculopatia tem a maior importância no desenvolvimento da criança e na qualidade de vida. Além do acidente vascular cerebral completo ou incompleto ("silencioso", existem outras complicações do sistema nervoso central, porém não exclusivas. O diagnóstico da vasculopatia cerebral falciforme necessita auxílio neurorradiológico. O tratamento se faz basicamente com transfusões de eritrócitos contendo hemoglobina A. O objetivo deste trabalho é rever a literatura médica, procurando selecionar a melhor conduta em diagnóstico e tratamento que seja possível empregar de imediato, para reduzir a morbidade e mortalidade da vasculopatia cerebral e elevar a qualidade de vida dos pacientes, principalmente na infância. Os fatores de risco clínicos e laboratoriais, incluindo a triagem por ultra-sonografia Doppler das artérias cerebrais e imagens de ressonância magnética, devem influenciar a decisão de instituir transfusões crônicas e a quelação do ferro transfusional deve acompanhar este tratamento.In children with sickle cell disease, cerebral arteries are prone to lesions that may cause deficiencies and poor quality of life. After the age of 20, new lesions may also occur. Besides stroke and silent cerebral ischemia, other lesions may occur. Radiologic images are necessary to diagnose and blood transfusions to treat. We reviewed the literature to choose best practices and guidelines to reduce morbidity and mortality and improve the quality of life of children with sickle cell disease. Risk factors identified from clinical and laboratory data and screening by Doppler ultrasonography and magnetic resonance must be used in order to make decisions about transfusion and iron chelation therapy.

PERFIL DA DISFAGIA APÓS UM ACIDENTE VASCULAR CEREBRAL: UMA REVISÃO INTEGRATIVA

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CARINA TEIXEIRA PAIXÃO; LOLITA DOPICO DA SILVA; FLAVIA GIRON CAMERINI

2010-01-01

Este artículo trata de disfagia decurrente de una enfermedad vascular cerebral (EVC). El objetivo fue determinar el perfil de las publicaciones acerca de la disfagia en pacientes víctimas de EVC. Investigación de revisión integradora que usó los mismos descriptores en las bases Medline, Scielo e Lilacs, seleccionando 17 artículos entre 1998 a 2008. Los datos fueron analizados a partir de las categorías correspondientes a los enfoques de las publicaciones encontradas. Los resultados muestran d...

Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas

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Samia Jardelle Costa de Freitas Maniva

2013-04-01

Full Text Available Objetivou-se compreender o significado da experiência vivenciada pela pessoa adoecida por acidente vascular encefálico agudo. Trata-se de estudo qualitativo, fundamentado nos pressupostos teóricos do interacionismo simbólico, realizado em uma unidade especializada no tratamento de acidente vascular encefálico de um hospital terciário, situado na cidade de Fortaleza, CE. Participaram do estudo 10 pacientes. A coleta de dados ocorreu por meio de entrevista aberta e os dados foram organizados e analisados segundo a técnica de enunciação. Cumpriram-se todos os aspectos éticos. O significado da experiência de adoecimento foi construído com base na percepção dos sentimentos surgidos durante a hospitalização, caracterizados por medo da morte e das sequelas da doença; tristeza pelo distanciamento do lar; alívio, ao evidenciar-se melhora do quadro clínico, e desejo de mudança dos hábitos de vida. Apreendeu-se que a experiência de adoecimento por acidente vascular encefálico é complexa, e nela os significados são elaborados com base em sentimentos, ações e comportamentos dos sujeitos.

Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas

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Samia Jardelle Costa de Freitas Maniva

Full Text Available Objetivou-se compreender o significado da experiência vivenciada pela pessoa adoecida por acidente vascular encefálico agudo. Trata-se de estudo qualitativo, fundamentado nos pressupostos teóricos do interacionismo simbólico, realizado em uma unidade especializada no tratamento de acidente vascular encefálico de um hospital terciário, situado na cidade de Fortaleza, CE. Participaram do estudo 10 pacientes. A coleta de dados ocorreu por meio de entrevista aberta e os dados foram organizados e analisados segundo a técnica de enunciação. Cumpriram-se todos os aspectos éticos. O significado da experiência de adoecimento foi construído com base na percepção dos sentimentos surgidos durante a hospitalização, caracterizados por medo da morte e das sequelas da doença; tristeza pelo distanciamento do lar; alívio, ao evidenciar-se melhora do quadro clínico, e desejo de mudança dos hábitos de vida. Apreendeu-se que a experiência de adoecimento por acidente vascular encefálico é complexa, e nela os significados são elaborados com base em sentimentos, ações e comportamentos dos sujeitos.

O espessamento da íntima-média associa-se independentemente ao Acidente Vascular Cerebral Isquêmico

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Dário Freitas

2012-06-01

Full Text Available FUNDAMENTO: O Acidente Vascular Cerebral (AVC constitui uma das primeiras causas de morte a nível mundial. A importância do espessamento da íntima-média na estratificação de risco cardiovascular tem sido recorrentemente estudada; contudo, essa relação gera ainda alguma controvérsia. OBJETIVOS: Determinar se o espessamento da íntima-média na Artéria Carótida Comum (ACC pode ser utilizado como um marcador independente de alto risco para a ocorrência do AVC. MÉTODOS: A amostra compreende um grupo de 948 doentes consecutivamente estudados por Triplex Scan Cervical no período compreendido entre janeiro de 2004 e junho de 2009. Esses doentes foram agrupados em razão da presença ou ausência de AVC recente, do que resultou um grupo de doentes com AVC Isquémico (AVC I (n = 452, 48%, outro com AVC Hemorrágico (AVC H (n = 22, 2% e um grupo de doentes Sem Eventos (n = 474, 50%. RESULTADOS: Na análise de regressão logística ajustada para fatores de risco cardiovascular clássicos, o espessamento da íntima-média na ACC associou-se significativamente e de forma aproximadamente linear com o AVC I (Odds Ratio = 1.808, Intervalo de Confiança: 1.291-2.534, p = 0,01, mas não com o AVC H (p = ns. Uma interação significativa com a idade foi também encontrada, demonstrando-se uma capacidade discriminativa do risco de AVC I maior em indivíduos com idade inferior a 50 anos. CONCLUSÕES: O espessamento da íntima-média na ACC revelou-se um preditor de risco independente para o AVC I, mas não para AVC H reforçando assim a utilidade da sua avaliação na prática clínica. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0

Vasculite cerebral e uso de cocaína e crack Cerebral vasculitis and cocaine and crack abuse

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Fernando Madalena Volpe

1999-09-01

Full Text Available O abuso de cocaína e crack está associado com importante parcela dos acidentes vasculares cerebrais, especialmente em pacientes jovens. O presente estudo relata o caso de um usuário de cocaína e crack que desenvolveu vasculite do sistema nervoso central, resultando em infartos cerebrais e edema extensos, levando à demência com alterações comportamentais e convulsões. Ressalta-se a importância de suspeitar do uso de drogas em jovens que se apresentam com acidente vascular cerebral, assim como avaliar possíveis lesões cerebrais em usuários de drogas com deterioração cognitiva.Cocaine and crack abuse is strongly related to stroke, particularly in young patients. The present study reports the case of a cocaine and crack abuser who developed central nervous system vasculitis, resulting in extensive cerebral infarctions, leading to dementia, behavioural disturbances and seizures. The relevance of detecting drug abuse in young stroke patients is stressed. Assessing possible brain lesions in drug abusers with cognitive impairment is also important.

Neurofibromatosis, stroke and basilar impression: case report Neurofibromatose, acidente vascular cerebral e impressão basilar: relato de caso

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ELCIO JULIATO PIOVESAN

1999-06-01

Full Text Available Neurofibromatosis type 1 (NF1 can virtually affect any organ, presenting most frequently with "cafe au lait" spots and neurofibromas. Vasculopathy is a known complication of NF1, but cerebrovascular disease is rare. We report the case of a 51-year-old man admitted to the hospital with a history of stroke four months before admission. On physical examination, he presented various "cafe au lait" spots and cutaneous neurofibromas. Neurologic examination demonstrated right-sided facial paralysis, right-sided hemiplegia, and aphasia. Computed tomography scan of head showed hypodense areas in the basal ganglia and centrum semiovale. Radiographs of cranium and cervical spine showed basilar impression. Angiography revealed complete occlusion of both vertebral and left internal carotid arteries, and partial stenosis of the right internal carotid artery. A large network of collateral vessels was present (moyamoya syndrome. It is an uncommon case of occlusive cerebrovascular disease associated with NF1, since most cases described in the literature are in young people, and tend to spare the posterior cerebral circulation. Basilar impression associated with this case may be considered a pure coincidence, but rare cases of basilar impression and NF1 have been described.A neurofibromatose tipo 1 (NF1 pode acometer qualquer órgão mas as apresentações mais frequente são manchas café com leite e neurofibromas. O envolvimento de vasos é complicação conhecida da NF1, mas a doença cerebrovascular é rara. Relatamos o caso de paciente do sexo masculino de 51 anos com história de acidente vascular cerebral há quatro meses da admissão. Ao exame físico apresentava várias manchas café com leite e neurofibromas cutâneos. O exame neurológico demonstrou acometimento facial direito, hemiplegia direita e afasia. Tomografia computadorizada de crânio mostrou áreas hipodensas nos gânglios basais e centros semi-ovais. Radiografias do crânio e coluna cervical

Nursing diagnoses in patients with cerebral vascular accident: an integrative review.

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Lima, Ana Carolina Maria Araújo Chagas Costa; Silva, Aurilene Lima da; Guerra, Débora Rodrigues; Barbosa, Islene Victor; Bezerra, Karine de Castro; Oriá, Mônica Oliveira Batista

2016-01-01

to verify the nursing diagnoses in patients affected by CVAs. this is an integrative review of the literature. The search was conducted on LILACS, Scielo, Medline, CINAHL, and Scopus databases between February and March 2015, using the following keywords: "Enfermagem", "Acidente Vascular Cerebral", "Diagnóstico de Enfermagem"; and "Nursing", "Stroke", and "Nursing Diagnosis". we found 9 articles published between 2009 and 2015; most of them were Brazilian, cross-sectional, and exploratory, with a level of evidence of 6. The evidence from the publications was classified as: "Evaluation and validation of specific nursing diagnoses for subjects affected by CVAs" and "Application of the nursing process on subjects affected by CVAs". we noticed the publications focused on nursing diagnoses related to motor disorders, such as risk of falls and impaired physical mobility. Domains regarding safety/protection (domain 11) and sleep/resting (domain 4) were present in most evaluated publications.

Análise das barreiras à utilização de trombolíticos em casos de acidente vascular cerebral isquêmico em um hospital privado do Rio de Janeiro, Brasil

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Luiz Henrique de Oliveira Fonseca

2013-12-01

Full Text Available O acidente vascular cerebral isquêmico (AVCi é uma importante causa de sequela e morte. A correta utilização do trombolítico enfrenta várias barreiras. O objetivo foi discutir as barreiras à terapia trombolítica em pacientes que chegam, com sintomas de AVCi agudo, à emergência de um hospital privado do Rio de Janeiro, Brasil. Coorte retrospectiva de pacientes entre 2009 e 2011. Foram admitidos 257 pacientes com suspeita de AVCi. Dos pacientes com diagnóstico confirmado (156, 11,5% (18 foram trombolisados. Dos 30 pacientes com diagnóstico de AVCi, dentro da janela terapêutica e com NIHSS na faixa para trombólise, 20 não foram trombolisados, 9 por barreiras administrativas (45%. Neste trabalho o percentual de trombólise foi superior ao observado nos Estados Unidos, mas barreiras impediram o tratamento de 45% dos pacientes com indicação à trombólise. Imagina-se que na rede pública brasileira a situação seja ainda mais desfavorável.

Cerebrovascular disorders in childhood: etiology, clinical presentation, and neuroimaging findings in a case series study Acidente vascular cerebral na infância: etiologia, apresentação clínica e achados de neuroimagem em um estudo de série de casos

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André P.C. Matta

2006-06-01

Full Text Available OBJECTIVE: To describe the main etiologies, neurological manifestations and neuro-imaging findings among children with sequelae of cerebrovascular disorders. METHOD: Case series study of children whose diagnosis was stroke sequelae. Variables studied were age at the time of first episode, number of episodes, etiology, motor deficits, epilepsy, and effected vascular territory. RESULTS: Twenty three patients were studied. Average age at first episode was 6.91 (±2.08 years. Fourteen patients were female. The number of stroke events per patient ranged from one to five. The most frequent etiologies were heart disease and sickle cell anemia. The most frequent neurological deficit was right hemiparesis. Nine patients experienced seizures. The left middle cerebral artery was the most affected vascular area. CONCLUSION: Our findings are similar to those described in the literature. Despite a careful investigation, some causes of stroke remain unidentified.OBJETIVO: Descrever as principais etiologias, manifestações neurológicas e achados de neuroimagem entre crianças com seqüela de acidente vascular cerebral (AVC. MÉTODO: Estudo de série de casos de crianças com seqüela de AVC isquêmico ou hemorrágico, analisando-se as variáveis: idade no primeiro episódio, número de eventos, etiologia, déficit motor, epilepsia e território vascular acometido. RESULTADO: Vinte e três pacientes foram incluídos, sendo 14 do sexo feminino. A idade do primeiro episódio foi 6.91 (±2,08 anos. O número de eventos por paciente variou entre 1 e 5. As etiologias mais freqüentes foram cardiopatia e anemia falciforme. O déficit mais encontrado foi a hemiparesia direita. Nove pacientes apresentaram convulsões. A artéria cerebral média esquerda foi o território vascular mais afetado. COCLUSÃO: Os achados deste trabalho estão de acordo com a literatura em geral. Apesar de extensa investigação, alguns casos permanecem sem definição etiológica.

Cuidador familiar de seqüelados de acidente vascular cerebral: significado e implicações Family caregiver of stroke sequel patients: meanings and implications

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Fernanda de Freitas Mendonça

2008-01-01

Full Text Available O acidente vascular cerebral (AVC está entre as principais causas de morte no mundo. Diante das incapacidades impostas pelo AVC, surge o cuidador familiar. O objetivo desta pesquisa foi analisar o significado e as implicações de se tornar cuidador de um indivíduo seqüelado de AVC. Trata-se de um estudo qualitativo, realizado com cinco cuidadores, em Londrina-PR, no período de agosto a dezembro de 2005. Os dados foram coletados por meio de entrevistas semi-estruturadas e submetidos à análise de discurso proposta por Martins e Bicudo. Da análise das entrevistas emergiram sete categorias: voltando-se para o Ser cuidado, descrevendo os cuidados, apresentando as mudanças, o apoio da espiritualidade, compreendendo o significado do cuidado, expressando as necessidades para cuidar e perspectivas para o futuro. Os resultados revelaram que ser cuidador familiar é um fenômeno complexo, que gera nos sujeitos sentimentos de alegria e felicidade concomitantes aos sentimentos de medo, ansiedade e revolta.The brain vascular accident (BVA is one of the main death causes worldwide. Due to the impairments imposed by the BVA, there is the family caregiver. This work aims to analyze the meaning and implications of being a caregiver of a stroke sequel person. It is a qualitative research, carried out with five caregivers in Londrina-PR, from August to December 2005. Data were collected in semi-structured interviews and were subjected to discourse analysis proposed by Martins and Bicudo. From the analysis of interviews seven categories arouse: turning to the being cared, describing care, presenting changes, spirituality support, understanding the meaning of care, expressing the needs to take care and future perspectives. Results revealed that being a family caregiver is a complex phenomenon, that creates in the subjects feelings of happiness and along with feelings of fear, anxiety and revolt.

Deficiency of superoxide dismutase promotes cerebral vascular hypertrophy and vascular dysfunction in hyperhomocysteinemia.

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Sanjana Dayal

Full Text Available There is an emerging consensus that hyperhomocysteinemia is an independent risk factor for cerebral vascular disease and that homocysteine-lowering therapy protects from ischemic stroke. However, the mechanisms by which hyperhomocysteinemia produces abnormalities of cerebral vascular structure and function remain largely undefined. Our objective in this study was to define the mechanistic role of superoxide in hyperhomocysteinemia-induced cerebral vascular dysfunction and hypertrophy. Unlike previous studies, our experimental design included a genetic approach to alter superoxide levels by using superoxide dismutase 1 (SOD1-deficient mice fed a high methionine/low folate diet to produce hyperhomocysteinemia. In wild-type mice, the hyperhomocysteinemic diet caused elevated superoxide levels and impaired responses to endothelium-dependent vasodilators in cerebral arterioles, and SOD1 deficiency compounded the severity of these effects. The cross-sectional area of the pial arteriolar wall was markedly increased in mice with SOD1 deficiency, and the hyperhomocysteinemic diet sensitized SOD1-deficient mice to this hypertrophic effect. Analysis of individual components of the vascular wall demonstrated a significant increase in the content of smooth muscle and elastin. We conclude that superoxide is a key driver of both cerebral vascular hypertrophy and vasomotor dysfunction in this model of dietary hyperhomocysteinemia. These findings provide insight into the mechanisms by which hyperhomocysteinemia promotes cerebral vascular disease and ischemic stroke.

Reabilitação de déficits comunicativos pós-acidente vascular cerebral Rehabilitation of post-stroke communication impairments

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Gigiane Gindri

2012-01-01

Full Text Available Os processamentos comunicativos discursivo, léxico-semântico, pragmático-inferencial e/ou prosódico podem apresentar-se deficitários após um acidente vascular cerebral. Esses prejuízos demandam métodos e programas de intervenção para uma reabilitação efetiva da comunicação. Neste contexto, o objetivo desta revisão sistemática foi identificar e descrever métodos utilizados para reabilitação neuropsicológica da comunicação de adultos acometidos por lesão cerebrovascular, mais especificamente, abordagens sistematizadas de intervenção para cada um dos processamentos comunicativos. Foram avaliados resumos publicados nos últimos dez anos na base de dados PubMed, utilizando palavras-chave relacionadas aos construtos reabilitação, acidente vascular cerebral (AVC e comunicação. Para o construto comunicação foram utilizadas, ainda, palavras específicas dos quatro processamentos comunicativos. Inicialmente, foram encontrados 914 abstracts, dos quais, após exclusão dos repetidos, 460 foram analisados. Os critérios de inclusão de abstracts para análise de seus textos completos foram ser estudo empírico, ter a participação de pelo menos um indivíduo adulto pós-AVC, tratar de reabilitação da comunicação, apresentar intervenção para pelo menos um dos quatro processamentos comunicativos, ter avaliação pré e pós-tratamento, estar escrito em inglês, francês ou português, e ter sido publicado nos últimos dez anos. Apenas quatro artigos empíricos cumpriram tais critérios, sendo conduzidos predominantemente com adultos afásicos ou com aprosódia. Assim, tais achados podem ser considerados surpreendentes e alarmantes frente à escassez de estudos sistemáticos de reabilitação de componentes comunicativos. Ressalta-se a necessidade de descrição detalhada de procedimentos de intervenção com objetivos específicos para que estudos possam ser replicados, contribuindo também para a verificação do efeito

Lesão cerebral traumática e acidentes de trabalho: estudo de revisão

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Andreia Ramos

Full Text Available O objetivo do trabalho foi revisar os achados de pesquisas, nas literaturas nacional e internacional, sobre a associação entre lesão cerebral traumática (LCT e acidentes de trabalho. Para revisão do assunto utilizou-se como bases de dados o MEDLINE e LILACS do período de 1991 a 2001. Foram encontrados poucos estudos (n=4 investigando a associação entre LCT e acidente de trabalho. Estes apresentavam limitações metodológicas, tais como utilização de bancos de dados secundários, a caracterização da amostra e os critérios utilizados para definir LCT. Percebe-se uma preocupação com os estudos sobre reabilitação e gastos dos sistemas de saúde com este tipo de lesão - e suas seqüelas mas pouca pesquisa envolvendo a discussão da inter-relação da organização do trabalho com a incidência de LCT.

Eficácia da fonoterapia em um caso de afasia expressiva decorrente de acidente vascular encefálico

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Letícia Regina Kunst

2013-12-01

Full Text Available O objetivo deste estudo de caso foi relatar e analisar o caso de um paciente afásico adulto em tratamento fonoaudiológico na clínica escola do Curso de Fonoaudiologia de uma instituição federal de ensino. O sujeito estudado é um paciente do sexo masculino, com 68 anos de idade, em tratamento na clínica escola desde maio de 2009, sendo que seu processo terapêutico foi analisado até dezembro de 2010. Quanto à história clínica, o paciente sofreu acidente vascular encefálico isquêmico no hemisfério esquerdo, em janeiro de 2009, quando repentinamente apresentou um quadro de mutismo. Após serem realizadas avaliações fonoaudiológicas, concluiu-se que o mesmo apresentava como hipótese diagnóstica "Afasia de expressão, oral e escrita, decorrente de acidente vascular encefálico isquêmico." Diante disto foi elaborado o planejamento terapêutico. Desde o início do processo de terapia foi possível observar evoluções linguísticas no paciente. O fato de o sujeito ter procurado atendimento fonoaudiológico 15 dias após o acometimento pelo acidente vascular encefálico, provavelmente foi um fator fundamental para sua boa recuperação, pois há um grau de recuperação espontânea em pacientes afásicos, porém a melhora é mínima sem o tratamento adequado. Em aproximadamente um mês de terapia fonoaudiológica, o paciente expandiu consideravelmente seu vocabulário. Apesar de a área lesada ser extensa e fundamental para a linguagem, observou-se avanços bastante positivos com a terapia. Deste modo, acredita-se que a intervenção fonoaudiológica precoce contribuiu, em grande parte, para a reorganização da atividade linguística, visto que o paciente comunica-se satisfatoriamente considerando a grande extensão de sua lesão.

Correlação entre qualidade de vida e morbidade do cuidador de idoso com acidente vascular encefálico

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Nilce Maria de Freitas Santos

2012-08-01

Full Text Available Este estudo objetivou descrever as características sociodemográficas e a qualidade de vida dos cuidadores de idosos com histórico de acidente vascular cerebral e correlacionar o número de morbidades com os escores de qualidade de vida do cuidador. Inquérito domiciliar transversal que entrevistou cuidadores de idosos utilizando-se de instrumentos: semi-estruturado; World Health Organization Quality of Life-abreviado e Brazilian Multidimensional Functional Assessment Questionnaire. Foi realizada análise descritiva e correlação de Pearson (p<0,05. Prevaleceu o sexo feminino (93,5%, idade média de 55,4±14,17 anos, casados ou moram com companheiro (58,7%, com 4| - 8 anos de estudo (28,3% e renda de 1 salário mínimo (34,8%. O maior escore de qualidade de vida foi no domínio relações sociais (67,57 e, menor no meio ambiente (54,82. O maior número de morbidades do cuidador correlacionou-se com menores escores em todos os domínios de qualidade de vida.

Acidente vascular cerebral isquêmico em uma enfermaria de neurologia: complicações e tempo de internação Stroke in a neurology ward: etiologies, complications and length of stay

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Rodrigo Bomeny de Paulo

2009-01-01

Full Text Available OBJETIVOS: Os objetivos deste trabalho foram: avaliar as complicações e o tempo de internação de doentes com acidente vascular cerebral isquêmico (AVCI na fase aguda ou subaguda em uma enfermaria de Neurologia geral em São Paulo; investigar a influência de idade, fatores de risco para doença vascular, território arterial acometido e etiologia sobre as complicações e o tempo de internação. MÉTODOS: Foram coletados prospectivamente dados de 191 doentes com AVCI e posteriormente analisados. RESULTADOS: Cinquenta e um doentes (26,7% apresentaram alguma complicação clínica durante a internação. A pneumonia foi a complicação mais frequente. O tempo médio de internação na enfermaria foi de 16,8±13,8 dias. Na análise multivariável, o único fator que se correlacionou significativamente com menor taxa de complicações foi idade mais jovem (OR=0,92-0,97, p INTRODUCTION: Purposes of this study were: evaluate complications and length of stay of patients admitted with diagnosis of ischemic stroke (IS in the acute or subacute phase, in a general Neurology ward in São paulo, Brazil; investigate the influence of age, risk factors for vascular disease, arterial territory and etiology. METHODS: Data from 191 IS patients were collected prospectively. RESULTS: Fifty-one patients (26.7% presented at least one clinical complication during stay. pneumonia was the most frequent complication. Mean length of stay was 16.8+-13.8 days. Multivariate analysis revealed a correlation between younger age and lower complication rates (OR=0.92-0.97, p < 0.001. presence of complications was the only factor that independently influenced length of stay (OR=4.20; CI=1.928.84; p<0.0001. CONCLUSION: These results should be considered in the planning and organization of IS care in Brazil.

Cerebral blood measurements in cerebral vascular disease: methodological and clinical aspects

International Nuclear Information System (INIS)

Fieschi, C.; Lenzi, G.L.

1982-01-01

This paper is devoted mainly to studies performed on acute cerebral vascular disease with the invasive techniques for the measurement of regional cerebral blood flow (rCBF). The principles of the rCBF method are outlined and the following techniques are described in detail: xenon-133 inhalation method, xenon-133 intravenous method and emission tomography methods. (C.F.)

Acute cerebral vascular accident associated with hyperperfusion

International Nuclear Information System (INIS)

Soin, J.S.; Burdine, J.A.

1976-01-01

Cerebral radionuclide angiography can demonstrate decreased or normal radioactivity in the affected region during the arterial phase in patients who have sustained a cerebral vascular accident and thus enhances the diagnostic specificity of the static brain image. In an occasional patient, however, a seemingly paradoxical pattern of regional hyperperfusion with a return to normal or subnormal perfusion following the acute phase has been observed. This phenomenon, called luxury perfusion, has been defined using intra-arterial 133 Xe for semiquantitative cerebral blood flow measurements and should be kept in mind as a potentially misleading cerebral imaging pattern

Cerebral Vascular Injury in Traumatic Brain Injury.

Science.gov (United States)

Kenney, Kimbra; Amyot, Franck; Haber, Margalit; Pronger, Angela; Bogoslovsky, Tanya; Moore, Carol; Diaz-Arrastia, Ramon

2016-01-01

Traumatic cerebral vascular injury (TCVI) is a very frequent, if not universal, feature after traumatic brain injury (TBI). It is likely responsible, at least in part, for functional deficits and TBI-related chronic disability. Because there are multiple pharmacologic and non-pharmacologic therapies that promote vascular health, TCVI is an attractive target for therapeutic intervention after TBI. The cerebral microvasculature is a component of the neurovascular unit (NVU) coupling neuronal metabolism with local cerebral blood flow. The NVU participates in the pathogenesis of TBI, either directly from physical trauma or as part of the cascade of secondary injury that occurs after TBI. Pathologically, there is extensive cerebral microvascular injury in humans and experimental animal, identified with either conventional light microscopy or ultrastructural examination. It is seen in acute and chronic TBI, and even described in chronic traumatic encephalopathy (CTE). Non-invasive, physiologic measures of cerebral microvascular function show dysfunction after TBI in humans and experimental animal models of TBI. These include imaging sequences (MRI-ASL), Transcranial Doppler (TCD), and Near InfraRed Spectroscopy (NIRS). Understanding the pathophysiology of TCVI, a relatively under-studied component of TBI, has promise for the development of novel therapies for TBI. Published by Elsevier Inc.

Aneurisma luético de arco aórtico roto, complicado pela oclusão de vasos braquiocefálicos e acidente vascular encefálico isquêmico: relato de caso tratado cirurgicamente

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CORSO Ricardo Barros

2002-01-01

Full Text Available Homem de 44 anos, com dor torácica crônica há um ano, apresentou dois episódios de acidentes vasculares encefálicos isquêmicos, desencadeados pela oclusão e trombose das artérias carótida e subclávia esquerdas, em aneurisma sifilítico gigante de arco aórtico roto. O paciente foi submetido à correção cirúrgica com sucesso via esternotomia mediana, utilizando-se proteção cerebral anterógrada e perfusão corporal distal contínuas. Aspectos referentes à técnica operatória utilizada e ampla revisão bibliográfica das diferentes formas de apresentação do comprometimento cardiovascular na sífilis terciária são discutidos.

Chlamydia pneumoniae and stroke: is there a direct relationship? Chlamydia pneumoniae e acidente vascular cerebral aterotrombótico: existe relação direta?

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Rubens J. Gagliardi

2009-09-01

Full Text Available OBJECTIVE: To investigate the possible relationship between atherothrombotic stroke and Chlamydia pneumoniae. METHOD: 150 patients with carotid atherothrombosis were enrolled. The casuistic was divided in three groups: ischemic stroke (IS: 65 patients; transient ischemic attack (TIA: 26 patients; and control: 59. The IS or TIA onset was up to 30 days from the beginning of the study. Carotid atheromatoses was diagnosed by Doppler-ultrasonography. Patients with cardioembolic risk or non-atherothrombotic origin were excluded. Comparisons were done between the three groups, and within each group according to the different age sub-groups, to the main arteries affected, and to the atherogenic risk factors. Bacteria detection was done using polimerase chain reaction. RESULTS: Only one patient tested positive for C. pneumoniae belonging to the control group. CONCLUSION: These results do not suggest that C. pneumoniae participated in the onset of IS or TIA or that it has a role in carotid plaque destabilization.OBJETIVO: Investigar a possível relação entre Chlamydia pneumoniae e acidente vascular cerebral aterotrombótico (AVC. MÉTODO: 150 pacientes com aterotrombose carotídea foram estudados. A casuística foi dividida em 3 grupos: AVC: 65 pacientes; ataque isquêmico transitório (AIT: 26 pacientes e controles: 59. O início do AVC ou AIT era até 30 dias da inclusão no estudo. A ateromatose carotídea foi diagnosticada por ultrassonografia com Doppler. Os pacientes com risco cárdio-embólico ou sem evidência de aterotrombose foram excluídos. Foram estabelecidas comparações entre os 3 grupos e dentro de cada grupo, formado sub-grupos de acordo com diferentes idades, território arterial comprometido e fatores de risco. A detecção da bactéria foi feita por reação de polimerização em cadeia. RESULTADOS: Somente um paciente, pertencente ao grupo controle, teve resultado positivo. CONCLUSÃO: Estes achados não sugerem que a C. pneumoniae

A problemática do cuidador familiar do portador de acidente vascular cerebral La problemática del cuidador familiar con el portador de accidente cerebral vascular The problematic aspects of the family caregiver of people who suffered strokes

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Luciene Miranda de Andrade

2009-03-01

Full Text Available Objetivou-se identificar a problemática da família de pessoas acometidas de acidente vascular cerebral hospitalizadas e discutir as dificuldades do cuidador familiar para o cuidado no âmbito domiciliar. A amostra constou de 154 famílias de pacientes internados em um hospital da rede pública de saúde, Fortaleza-CE. Conforme os resultados denotam, a maioria dos cuidadores são mulheres, 104 (67,5%; 122 casos (79,2% apresentam comprometimento familiar e alterações na vida diária em 115 dos acompanhantes (74,7%; 150 (97,4% não receberam orientações acerca dos cuidados, mas 143 (92,9% sentem-se seguros para acompanhá-los. O sentimento predominante foi a tristeza, 125 (81,2%, e as dúvidas principais foram: alimentação, 64 (41,6%, administração de medicamentos, 49 (29,9%, e possíveis complicações clínicas após a alta, 49 (29,9%. Estes resultados alertam para o papel do enfermeiro como educador, não somente na prevenção das doenças crônico-degenerativas, mas, também, na orientação aos cuidadores familiares sobre os cuidados dispensados após a alta hospitalar.El objetivo fue identificar la problemática de la familia de personas acometidas de accidente vascular cerebral hospitalizadas y discutir las dificultades del cuidador familiar en el ámbito domiciliar. La muestra fue constituida por 154 familias de pacientes internados en un hospital de la red pública de salud, en Fortaleza, CE. Conforme los resultados denotan, la mayoría de los cuidadores son mujeres, 104 (67,5%, 122 casos (79,2% presentan comprometimiento familiar y alteraciones en la vida diaria en 115 de los acompañantes (74,7%; 150 (97,4% no recibieron orientaciones acerca de los cuidados; sin embargo 143 (92,9% se sienten seguros para acompañarlos. El sentimiento predominante fue la tristeza, 125 (81,2%, y las dudas principales fueron: alimentación, 64 (41,6%, administración de medicamentos, 49 (29,9%, y posibles complicaciones clínicas después del

Ischemic stroke in children: a study of the associated alterations Acidente vascular cerebral isquêmico na infância: estudo das alterações associadas

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Josiane Ranzan

2004-09-01

Full Text Available Arterial ischemic stroke (AIS in children is a relatively rare disease, not yet clearly understood and with a multifactored etiology. It can cause a severe impact on the child and be the first manifestation of a systemic disease. Delayed diagnosis is still common and research on the subject in our field practically does not exist. Prothrombotic disorders have been described as important causative factors of the ischemic event in children. Forty-six patients from zero to 18 years of age diagnosed with AIS were studied in the period between March 2002 and September 2003. Laboratory tests were realised including coagulation proteins and echocardiogram. AIS of the newborn occurred in 37% of the cases. Focal seizures and hemiparesis were the most frequent symptoms; 40% of the patients presented prior pathologies. Abnormalities of the S and C proteins occurred in 22% and 17%. Associated alterations, particularly those that generate a hypercoagulability state, indicate more than one risk factor for this disease in childhood.Acidente vascular cerebral Isquêmico (AVCI na infância é relativamente raro, de conhecimento ainda obscuro, e com etiologia multifatorial. Pode causar grave impacto na criança e ser a primeira manifestação de doença sistêmica. O subdiagnóstico ainda é comum e são praticamente inexistentes as pesquisas sobre o assunto no nosso meio. Desordens protrombóticas têm sido descritas como importantes fatores causais do evento isquêmico na infância. Foram estudados 46 pacientes de zero a 18 anos, com diagnóstico de AVCI, no período de março/2002 a setembro/2003. Exames laboratoriais, incluindo proteínas de coagulação e ecocardiograma foram realizados. AVCI neonatal ocorreu em 35% dos casos. Crise focal e hemiparesia foram os sintomas iniciais mais freqüentes; 40% dos casos apresentaram patologia prévia. Anormalidades nas proteínas S e C ocorreram em 22% e 17% da amostra. Alterações associadas, principalmente as que

Neural Vascular Mechanism for the Cerebral Blood Flow Autoregulation after Hemorrhagic Stroke

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Ming Xiao

2017-01-01

Full Text Available During the initial stages of hemorrhagic stroke, including intracerebral hemorrhage and subarachnoid hemorrhage, the reflex mechanisms are activated to protect cerebral perfusion, but secondary dysfunction of cerebral flow autoregulation will eventually reduce global cerebral blood flow and the delivery of metabolic substrates, leading to generalized cerebral ischemia, hypoxia, and ultimately, neuronal cell death. Cerebral blood flow is controlled by various regulatory mechanisms, including prevailing arterial pressure, intracranial pressure, arterial blood gases, neural activity, and metabolic demand. Evoked by the concept of vascular neural network, the unveiled neural vascular mechanism gains more and more attentions. Astrocyte, neuron, pericyte, endothelium, and so forth are formed as a communicate network to regulate with each other as well as the cerebral blood flow. However, the signaling molecules responsible for this communication between these new players and blood vessels are yet to be definitively confirmed. Recent evidence suggested the pivotal role of transcriptional mechanism, including but not limited to miRNA, lncRNA, exosome, and so forth, for the cerebral blood flow autoregulation. In the present review, we sought to summarize the hemodynamic changes and underline neural vascular mechanism for cerebral blood flow autoregulation in stroke-prone state and after hemorrhagic stroke and hopefully provide more systematic and innovative research interests for the pathophysiology and therapeutic strategies of hemorrhagic stroke.

Cerebral radiation necrosis: vascular and glial features

Energy Technology Data Exchange (ETDEWEB)

Husain, M M; Garcia, J H

1976-12-21

Glial and vascular abnormalities in brain, simulating intracranial neoplasia, are described in a patient who received radiation to the pituitary region for treatment of an adenoma, 13 months before death. In addition to the expected changes of cerebral radionecrosis, four interesting features are cited: (1) diffuse hyperplasia of capillaries in the cerebral cortex with marked endothelial hypertrophy; (2) abundant, large multipolar bizarre cells in the perivascular connective tissues; (3) focal astrocytic proliferation with many cells resembling either Alzheimer type I astrocytes or neoplastic cells, and (4) radiation changes in the non-irradiated brain.

Qualidade de vida em sobreviventes de acidente vascular cerebral: instrumentos de avaliação e seus resultados Quality of life in stroke survivors: assessment instruments and their outcomes

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Juliana Ferreira Mota

2008-01-01

Full Text Available OBJETIVOS: Os objetivos deste estudo foram identificar os instrumentos genéricos e específicos utilizados na avaliação da qualidade de vida (QV e os seus resultados em sobreviventes de acidente vascular cerebral (AVC. MÉTODOS: Realizou-se revisão da literatura dos últimos dez anos, com população acima de 18 anos, nos bancos de dados MedLine e Lilacs, cujas publicações utilizassem instrumentos padronizados e validados no país de origem. Combinaram-se os descritores quality of life, cerebrovascular accident, stroke, QV e acidente cerebrovascular. RESULTADOS: Consideraram-se relevantes 96 estudos e 31 entram neste trabalho, de acordo com os critérios de inclusão. Foram encontrados cinco tipos diferentes de instrumentos genéricos/perfil, nove genérico/utility e dois específicos. O mais freqüente foi o SF-36, em 45,2% dos estudos. Observou-se que a baixa QV relacionou-se, principalmente, ao déficit da função física, à presença de depressão ou de seus sintomas, ser do sexo feminino e ser mais idoso. De modo geral, os sujeitos no pós-AVC possuíam pior QV do que aqueles que não sofreram o evento. CONCLUSÃO: Foram encontrados 16 instrumentos para avaliação da QV. A baixa QV foi prevalente nos sobreviventes pós-AVC e se correlacionou com a função física, a depressão, o sexo e a idade.OBJECTIVE: The purpose of this study is to identify generical and specific instruments used for valueing quality of life (QOL and their outcomes in stroke survivors. METHODS: Review of literature of last 10 years, with people above 18 years old, in MedLine and Lilacs database. The instruments used on the studies were validated for the their countries. 96 articles have been considered relevant and 31 were in accordance with inclusion criteria. Five kind of generic/profile, nine generic/utility and two specific instruments were found. The more frequent was SF-36, on the 45,2% of the studies. It has been observed that poverty in quality of

Effects of Mild Blast Traumatic Brain Injury on Cerebral Vascular, Histopathological, and Behavioral Outcomes in Rats

Science.gov (United States)

Zeng, Yaping; Deyo, Donald; Parsley, Margaret A.; Hawkins, Bridget E.; Prough, Donald S.; DeWitt, Douglas S.

2018-01-01

Abstract To determine the effects of mild blast-induced traumatic brain injury (bTBI), several groups of rats were subjected to blast injury or sham injury in a compressed air-driven shock tube. The effects of bTBI on relative cerebral perfusion (laser Doppler flowmetry [LDF]), and mean arterial blood pressure (MAP) cerebral vascular resistance were measured for 2 h post-bTBI. Dilator responses to reduced intravascular pressure were measured in isolated middle cerebral arterial (MCA) segments, ex vivo, 30 and 60 min post-bTBI. Neuronal injury was assessed (Fluoro-Jade C [FJC]) 24 and 48 h post-bTBI. Neurological outcomes (beam balance and walking tests) and working memory (Morris water maze [MWM]) were assessed 2 weeks post-bTBI. Because impact TBI (i.e., non-blast TBI) is often associated with reduced cerebral perfusion and impaired cerebrovascular function in part because of the generation of reactive oxygen and nitrogen species such as peroxynitrite (ONOO−), the effects of the administration of the ONOO− scavenger, penicillamine methyl ester (PenME), on cerebral perfusion and cerebral vascular resistance were measured for 2 h post-bTBI. Mild bTBI resulted in reduced relative cerebral perfusion and MCA dilator responses to reduced intravascular pressure, increases in cerebral vascular resistance and in the numbers of FJC-positive cells in the brain, and significantly impaired working memory. PenME administration resulted in significant reductions in cerebral vascular resistance and a trend toward increased cerebral perfusion, suggesting that ONOO− may contribute to blast-induced cerebral vascular dysfunction. PMID:29160141

Terapia espelho no doente com hemiparesia pós AVC : revisão sistemática da literatura

OpenAIRE

Pereira, Catarina Isabel

2017-01-01

Introdução: O Acidente Vascular Cerebral é uma das principais causas de morte em Portugal e os doentes que sobrevivem a esta doença ficam frequentemente com hemiparesia e hemiplegia. Existem varias técnicas de reabilitação para recuperar a funcionalidade total ou parcial dos membros afetados, mas recentemente tem ganho destaque a técnica da terapia espelho. Objetivo: Avaliar níveis de recuperação da hemiparesia em doentes com acidente vascular cerebral após a aplicação da te...

Função vestibular no acidente vascular cerebral do território carot��deo Vestibular function in carotid territory stroke patients

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Anna Paula Batista de Ávila Pires

2013-02-01

Full Text Available Pacientes após Acidente Vascular Cerebral (AVC podem apresentar sintomas otoneurológicos. OBJETIVO: Avaliar a função vestibular de pacientes com antecedente pessoal de AVC no território carotídeo. Desenho científico: estudo de coorte histórica com corte transversal. MÉTODO: Quarenta pacientes foram submetidos à anamnese, exame otorrinolaringológico, Dizziness Handicap Inventory e vectoeletronistagmografia. RESULTADOS: Anormalidades discretas dos movimentos sacádicos foram encontradas em 20 pacientes (50,0%; nove referiram desequilíbrio e um tontura. O ganho do rastreio pendular foi anormal em 17 casos (42,5%; seis referiram desequilíbrio e um tontura. Preponderância direcional anormal do nistagmoperrotatório ocorreu em dois casos (5,0%, que referiram desequilíbrio. A prova calórica identificou três casos (7,5% com predomínio labiríntico anormal e dois (5,0% com preponderância direcional anormal do nistagmo; os cinco casos relataram desequilíbrio. Dos 11 pacientes que não referiram manifestações de alteração do equilíbrio corporal, 10 apresentaram alterações nos movimentos sacádicos e no rastreio pendular e um apresentou exame vestibular normal. CONCLUSÃO: Pacientes com antecedente pessoal de AVC no território carotídeo podem apresentar tontura ou desequilíbrio corporal e sinais de comprometimento da motilidade ocular e da função vestibular.Stroke patients may present otoneurological symptoms. OBJECTIVE: To assess the vestibular function of subjects with a history of carotid territory stroke. METHOD: This historical cohort cross sectional study enrolled 40 patients; subjects answered the Dizziness Handicap Inventory, were interviewed and submitted to ENT examination and vectorelectronystagmography. RESULTS: Mild saccadic movement anomalies were seen in 20 patients (50.0%; nine complained of imbalance and dizziness. Abnormal smooth pursuit gain was seen in 17 cases (42.5%; six subjects reported imbalance and

The influence of the day of the week of hospital admission on the prognosis of stroke patients Influencia del día de la semana de admisión hospitalaria en el pronóstico de pacientes con accidente vascular cerebral O dia da semana de admissão hospitalar influenciando o prognóstico de pacientes com acidente vascular cerebral

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Paulo A. Lotufo

2013-04-01

Full Text Available This study aimed to evaluate the weekday and weekend distribution of stroke case hospital admissions and their respective prognosis based on a sample from the Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral (EMMA, a cohort of stroke patients admitted to a community hospital in the city of São Paulo, Brazil. We ascertained all consecutive cases of first-time strokes between April 2006 and December 2008 and performed a subsequent one-year follow-up. No association was found between frequency of hospital admissions due to ischemic and hemorrhagic strokes and the specific day of the week on which the admission occurred. However, ten-day and twelve-month case-fatality was higher in hemorrhagic stroke patients admitted at the weekend. We also found that intracerebral hemorrhage patients admitted on weekends had a worse survival rate (50% compared with those admitted during weekdays (25.6%, P log-rank = 0.03. We found a multivariate hazard ratio of 2.49 (95%CI: 1.10-5.81, P trend = 0.03 for risk of death at the weekend compared to weekdays for intracerebral hemorrhage cases. No difference in survival was observed with respect to the overall sample of stroke or ischemic stroke patients.El estudio evaluó la distribución de casos incidentes de accidente vascular cerebral (AVC que fueron al hospital de lunes a viernes o durante los fines de semana en el Estudio de Mortalidad y Morbilidad del AVC (EMMA. El EMMA es una cohorte de pacientes con AVC en un hospital comunitario de la ciudad de São Paulo, Brasil. Casos consecutivos de primer episodio de AVC internados, entre abril de 2006 y diciembre de 2008, fueron seguidos prospectivamente durante un año. No hubo diferencia en la frecuencia de las internaciones por AVC isquémico o hemorrágico durante los días de la semana. Sin embargo, la letalidad en 10 días y tras un año había aumentado en el AVC hemorrágico. En el análisis de supervivencia de un año, pacientes admitidos los

Análise de terapias coadjuvantes de intervenção terapêutica na funcionalidade em doentes com acidente vascular encefálico

OpenAIRE

Sousa, João Paulo de

2015-01-01

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia Objectivo: Analisar as diferentes terapias coadjuvantes de intervenção terapêutica na funcionalidade de doentes com Acidente Vascular Encefálico (AVE). Metodologia: Foi realizada uma pesquisa nas bases de dados PubMed e PEDro. Foram utilizadas as palavras-chave: “stroke”, “physical therapy” e “outcome FIM”. Resultado: Obtiveram-se 144 estudos, após a...

Fluid-attenuated inversion recovery vascular hyperintensities in predicting cerebral hyperperfusion after intracranial arterial stenting

Energy Technology Data Exchange (ETDEWEB)

Wan, Chih-Cheng; Chen, David Yen-Ting; Tseng, Ying-Chi; Lee, Kun-Yu; Chiang, Chen-Hua; Chen, Chi-Jen [Taipei Medical University, Department of Radiology, Shuang-Ho Hospital, New Taipei City (China); Taipei Medical University, School of Medicine, College of Medicine, Taipei (China); Yan, Feng-Xian [Taipei Medical University, Department of Radiology, Shuang-Ho Hospital, New Taipei City (China)

2017-08-15

No reliable imaging sign predicting cerebral hyperperfusion after intracranial arterial stenting (IAS) had been described in the literature. This study evaluated the effect of fluid-attenuated inversion recovery vascular hyperintensities (FVHs), also called hyperintense vessel sign on T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) MR images, in predicting significant increase in cerebral blood flow (CBF) defined by arterial spin labeling (ASL) after IAS. We reviewed ASL CBF images and T2-FLAIR MR images before (D0), 1 day after (D1), and 3 days after (D3) IAS of 16 patients. T1-weighted MR images were used as cerebral maps for calculating CBF. The changes in CBF values after IAS were calculated in and compared among stenting and nonstenting vascular territories. An increase more than 50% of CBF was considered as hyperperfusion. The effect of FVHs in predicting hyperperfusion was calculated. The D1 CBF value was significantly higher than the D0 CBF value in stenting vascular, contralateral anterior cerebral artery, contralateral middle cerebral artery, and contralateral posterior cerebral artery (PCA) territories (all P <.05). The D1 and D3 CBF values were significantly higher than the D0 CBF value in overall vascular (P <.001), overall nonstenting vascular (P <.001), and ipsilateral PCA (P <.05) territories. The rate of more than 50% increases in CBF was significantly higher in patients who exhibited asymmetric FVHs than in those who did not exhibit these findings. FVHs could be a critical predictor of a significant increase in CBF after IAS. (orig.)

Fluid-attenuated inversion recovery vascular hyperintensities in predicting cerebral hyperperfusion after intracranial arterial stenting

International Nuclear Information System (INIS)

Wan, Chih-Cheng; Chen, David Yen-Ting; Tseng, Ying-Chi; Lee, Kun-Yu; Chiang, Chen-Hua; Chen, Chi-Jen; Yan, Feng-Xian

2017-01-01

No reliable imaging sign predicting cerebral hyperperfusion after intracranial arterial stenting (IAS) had been described in the literature. This study evaluated the effect of fluid-attenuated inversion recovery vascular hyperintensities (FVHs), also called hyperintense vessel sign on T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) MR images, in predicting significant increase in cerebral blood flow (CBF) defined by arterial spin labeling (ASL) after IAS. We reviewed ASL CBF images and T2-FLAIR MR images before (D0), 1 day after (D1), and 3 days after (D3) IAS of 16 patients. T1-weighted MR images were used as cerebral maps for calculating CBF. The changes in CBF values after IAS were calculated in and compared among stenting and nonstenting vascular territories. An increase more than 50% of CBF was considered as hyperperfusion. The effect of FVHs in predicting hyperperfusion was calculated. The D1 CBF value was significantly higher than the D0 CBF value in stenting vascular, contralateral anterior cerebral artery, contralateral middle cerebral artery, and contralateral posterior cerebral artery (PCA) territories (all P <.05). The D1 and D3 CBF values were significantly higher than the D0 CBF value in overall vascular (P <.001), overall nonstenting vascular (P <.001), and ipsilateral PCA (P <.05) territories. The rate of more than 50% increases in CBF was significantly higher in patients who exhibited asymmetric FVHs than in those who did not exhibit these findings. FVHs could be a critical predictor of a significant increase in CBF after IAS. (orig.)

Nuclide imaging and computed tomography in cerebral vascular disease

International Nuclear Information System (INIS)

Chiu, L.C.; Christie, J.H.; Schapiro, R.L.

1977-01-01

This report presents our experience with computed tomographic and radionuclide scans in 224 patients with ischemic or hemorrhagic infarcts or intracerebral hematomas secondary to cerebral occlusive vascular diseases. The results vary according to the site of vascular occlusion. The radionuclide angiograms and static scintigrams show four distinct patterns in cases of occlusion of the middle cerebral artery. Computed tomographic scans exhibit less variation in appearance and have a higher sensitivity in cases of recent ischemic infarction. The ''tentorial confluence sign'' is an important finding on static scintigrams in patients with occipital infarction; if this sign is not present, this diagnosis should be suspect. Earlier reports have established the value of computed tomography and radionuclide scans in the evaluation of cerebral infarction. In individual cases, however, each of these modalities may render nondiagnostic or false negative findings; combining both types of examinations and comparing results yield a greater likelihood of an accurate diagnosis of cerebrovascular disease. Computed tomography is clearly more valuable than radionuclide scans in the diagnosis and follow-up of hemorrhagic infarcts or parenchymal hematomas

O PRODUTO COMO CAUSADOR DE ACIDENTES

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Widomar Carpes Jr

2004-06-01

Full Text Available Neste artigo analisa-se a contribuição dos produtos para a geração de acidentes, apresentando-se estatísticas de acidentes de trabalho, de trânsito e aeronáuticos. Além disso, para melhor ilustrar a relação entre produtos e a ocorrência de acidentes, alguns casos de acidentes ocorridos e divulgados pela mídia são comentados. As estatísticas e os casos comentados demonstram a importância do estudo dos acidentes envolvendo produtos, evidenciando que praticamente todos os acidentes estão relacionados com o uso de produtos industrializados. Então, se analisa histórica e criticamente as principais teorias de acidentes de trabalho, porque são as únicas teorias existentes em relação aos acidentes. Além delas, são analisados os diversos conceitos sobre o erro humano e sua ocorrência, pois estes são apontados como grandes causadores de acidentes. Nesta análise, se observa que os acidentes estão mais relacionados aos perigos ou às características perigosas dos produtos do que às atitudes e ao comportamento do usuário. Faz-se uma revisão dos conceitos associados aos acidentes, tais como perigo, risco, acidente e dano, a partir dos quais apresenta-se um fluxograma contendo os elementos necessários para a manifestação dos acidentes. Ao final, conclui-se que a participação dos produtos na ocorrência de acidentes é evidente e que o comportamento do usuário é dependente das características do produto e da situação na qual ele é utilizado.

Tratamento cirúrgico da hemorragia cerebral: considerações a propósito de 11 casos

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Walter C. Pereira

1977-03-01

Full Text Available Após breves comentários sobre os achados angiográficos em 298 doentes com acidente vascular cerebral isquêmico ou hemorrágico, é realçada a importância da angiografia cerebral como o método ideal de diagnóstico, tendo em vista a variedade de fatores fisiopatogênicos e etiológicos envolvidos na gênese dessas síndromes. São discutidos a seguir, particularmente, os resultados obtidos com o tratamento cirúrgico de 11 pacientes com hematoma intracerebral espontâneo. Apesar da divergência de opiniões a este propósito, a melhora acentuada que observamos em 54,6% de nossos doentes, motiva-nos a considerar o tratamento cirúrgico indicado na maioria dos casos de hemorragia cerebral primária.

ESTUDIO DEL EFECTO DE LA CRANEOACUPUNTURA EN PACIENTES CON ENFERMEDAD VASCULAR CEREBRAL. (EVC)

OpenAIRE

PEREZ BRAVO, MIGUEL

2009-01-01

LA ENFERMEDAD VASCULAR CEREBRAL (EVC) EN MEXICO ES UN IMPORTANTE PROBLEMA DE SALUD PUBLICA, ES LA TERCERA CAUSA DE MUERTE Y LA SEGUNDA EN PRODUCIR INCAPACIDAD NEUROLOGICA. EL OBJETIVO DE ESTE ESTUDIO FUE EVALUAR EL EFECTO DE LA CRANEOACUPUNTURA EN PACIENTES CON ENFERMEDAD VASCULAR CEREBRAL (ZHONG FENG). EL PRESENTE ES UN ESTUDIO EXPERIMENTAL, PROSPECTIVO Y LONGITUDINAL, REALIZADO EN EL HOSPITAL DEL ISSSTE DE LA CIUDAD DE PUEBLA, A UN GRUPO DE 11 PACIENTES DE AMBOS SEXOS, CON...

Characterisation of cerebral blood flow via determining the vascular mean transit time

International Nuclear Information System (INIS)

Lindner, P.; Thelen, M.

1987-01-01

By using a recently developed algorithm it is possible to quantify the dynamic information of a DSA sequence of the brain. The theory of algorithm allows to calculate vascular mean transit from time density curves. The algorithm minimizes the problems of densitometry with regard to 'quantitative DSA'. There is a strong correlation between vascular mean transit times and cerebral blood flow values, and therefore the results for mean transit times also correspond to the results obtained for cerebral blood flow. By computerized postprocessing of DSA-images it is possible to generate functional images of the brain with a spatial resolution that had not been attainable so far. The images represent the distribution pattern of reverse vascular mean transit times. The results from 36 patients with proven stenoses of the cervical vessels are reported. (orig.) [de

Atuação da enfermagem no autocuidado e reabilitação de pacientes que sofreram Acidente Vascular Encefálico

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Juliana Cristina Lessmann

2011-02-01

Full Text Available Quando o cérebro sofre alterações vasculares podem ocorrer sérias sequelas motoras, sensoriais e na percepção. Nesta perspectiva o estudo objetiva relatar/ compartilhar assistência de Enfermagem ao indivíduo acometido pelo Acidente Vascular Encefálico enfatizando a reabilitação e o autocuidado baseado em Orem. Trata-se de relato de experiência de prática assistencial, realizada de maio a julho de 2006, com 15 indivíduos e seus familiares, em um centro de reabilitação da região sul do Brasil. O cuidado de Enfermagem integral ocorre com atividades de estimulação sensitiva, motora, controle postural, amplitude de movimentos e treino de marcha, sempre acompanhados por ações de educação em saúde. Estas habilidades conferem aos enfermeiros capacidades de atuação proporcionando a redução de danos e incapacidades

Decreased expression of transient receptor potential channels in cerebral vascular tissue from patients after hypertensive intracerebral hemorrhage

DEFF Research Database (Denmark)

Thilo, Florian; Suess, Olaf; Liu, Ying

2011-01-01

, TRPC5, TRPC6, TRPM4, TRPM6, and TRPM7 channels were detected in cerebral vascular tissue by quantitative real-time RT-PCR. Control cerebral vascular tissue was obtained from normotensive patients who underwent neurosurgical operation because of brain tumor. To examine a possible relation between...

A case with post-irradiation cerebral vascular disease accompanied by Cushing's disease

International Nuclear Information System (INIS)

Shinoda, Keiichi; Kuriyama, Takanobu; Kimura, Fumiharu; Kawamura, Hiroshi; Takamatsu, Junta; Mozai, Toshiji

1986-01-01

A 37-year-old man with Cushing's disease developed cerebral infarction 13 years after Co-60 irradiation of a total dose of 60 Gy for pituitary adenoma. Cerebral angiography showed stenosis or occlusion of the bilateral carotid arteries and basilar artery which were in the radiation fields. A basophilic adenoma was resected, and symptoms of Cushing's disease have resolved. The vascular lesions are likely to be not only radiation-induced, but also stimulated by hyperlipemia and hypertension associated with Cushing's disease. It is recommended to eliminate factors, such as hyperlipemia and hypertension, stimulatig vascular damage in the management of patients treated with radiation therapy. The relevant literature is reviewed. (Namekawa, K.)

Escalas para avaliação da sobrecarga de cuidadores de pacientes com Acidente Vascular Encefálico

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Ana Railka de Souza Oliveira

2012-10-01

Full Text Available O objetivo do estudo foi avaliar as escalas disponíveis na literatura para medir a sobrecarga de cuidadores de pacientes acometidos por acidente vascular encefálico. Realizou-se uma revisão bibliográfica nas três bases de dados: LILACS, CINAHL e SCOPUS. Selecionaram-se 23 trabalhos e identificaram-se 24 diferentes escalas. Destas, as mais citadas foram o Caregiver Strain Index, a Caregiver Burden Scale, a Caregiver Reaction Assessment, o Sense of Competence Questionnaire, a Relatives Stress Scale e a Zarit Burden Interview. O uso de escalas para mensurar a sobrecarga é uma ferramenta importante para avaliar o contexto no qual está inserido o cuidador, entretanto é mais fidedigno quando associado a outros instrumentos de mensuração. Portanto, é fundamental pesquisas de validação de escalas para essa população.

Uso de alteplase no tratamento do acidente vascular encefálico isquêmico agudo: o que sabem os enfermeiros?

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Samia Jardelle Costa de Freitas Maniva

2012-06-01

Full Text Available O estudo objetivou analisar o conhecimento de enfermeiros acerca do uso de alteplase no tratamento do acidente vascular encefálico (AVE isquêmico agudo. Estudo descritivo-exploratório realizado em uma unidade de AVE de um hospital público localizado na cidade de Fortaleza-CE, durante o mês de outubro de 2010. Participaram do estudo dez enfermeiros, com idade média de 25 anos. Os benefícios da medicação foram apresentados em justaposição com as limitações do uso. Estratégias para ampliar a utilização de alteplase foram apontadas pelos enfermeiros. O conhecimento da realidade investigada contribui na construção do saber de enfermagem e pode auxiliar o enfermeiro que presta assistência direta ao paciente que se submete a este tratamento.

Educação em saúde e família: o cuidado ao paciente, vítima de acidente vascular cerebral - DOI: 10.4025/actascihealthsci.v26i1.1663 Health education in family:nursing CVA patients - DOI: 10.4025/actascihealthsci.v26i1.1663

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Ana Ruth Macêdo Monteiro

2004-04-01

Full Text Available O presente estudo objetiva identificar o conhecimento dos familiares de pacientes acometidos por AVC (Acidente Vascular Cerebral sobre a doença e sobre seus cuidados e, ainda, elaborar uma cartilha de orientação quanto aos cuidados domiciliares a esses pacientes. Participaram da presente pesquisa 50 familiares de pacientes acometidos por AVC, os quais estavam acompanhando os pacientes por um período mínimo de 3 dias. Os dados obtidos da análise dos depoimentos dos familiares estão agrupados em 3 categorias: conhecendo as famílias, identificando o conhecimento dos familiares, atendendo às solicitações dos familiares. A cartilha de orientação, elaborada de acordo com o levantamento das principais dúvidas e/ou dificuldades dos familiares, busca favorecer o processo educativo dessas famílias no ambiente hospitalar, promovendo, assim, seu envolvimento nesse processo. A importância de um trabalho nesse sentido está baseada na possibilidade de uma maior compreensão dos problemas vivenciados pelos pacientes acometidos por AVC e por suas famílias, auxiliando, dessa forma, o enfermeiro a desenvolver ações visando minimizá-los e tornar a situação menos traumática para ambos.The present study aims to identify the knowledge of CVA (Cerebral Vascular Accident patients' close relatives on the disease and its specific cares; and also, to elaborate a guide for the home care of those patients. The present research evaluated family members from 50 CVA patients. These relatives were taking care of the patients for at least 3 days. The data obtained from the testimonies analysis are grouped in three categories: acquainting the families; identifying the family’s knowledge; assisting family’s requests. The guide, organized according to the relatives' main doubts and difficulties, intends to help the educational process of those families in the hospital’s atmosphere, promoting their engagement in the process. This work makes possible a

Eficácia da fonoterapia em um caso de afasia expressiva decorrente de acidente vascular encefálico Speech therapy effectiveness in a case of expressive aphasia resulting from stroke

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Letícia Regina Kunst

2012-01-01

Full Text Available O objetivo deste estudo de caso foi relatar e analisar o caso de um paciente afásico adulto em tratamento fonoaudiológico na clínica escola do Curso de Fonoaudiologia de uma instituição federal de ensino. O sujeito estudado é um paciente do sexo masculino, com 68 anos de idade, em tratamento na clínica escola desde maio de 2009, sendo que seu processo terapêutico foi analisado até dezembro de 2010. Quanto à história clínica, o paciente sofreu acidente vascular encefálico isquêmico no hemisfério esquerdo, em janeiro de 2009, quando repentinamente apresentou um quadro de mutismo. Após serem realizadas avaliações fonoaudiológicas, concluiu-se que o mesmo apresentava como hipótese diagnóstica "Afasia de expressão, oral e escrita, decorrente de acidente vascular encefálico isquêmico." Diante disto foi elaborado o planejamento terapêutico. Desde o início do processo de terapia foi possível observar evoluções linguísticas no paciente. O fato de o sujeito ter procurado atendimento fonoaudiológico 15 dias após o acometimento pelo acidente vascular encefálico, provavelmente foi um fator fundamental para sua boa recuperação, pois há um grau de recuperação espontânea em pacientes afásicos, porém a melhora é mínima sem o tratamento adequado. Em aproximadamente um mês de terapia fonoaudiológica, o paciente expandiu consideravelmente seu vocabulário. Apesar de a área lesada ser extensa e fundamental para a linguagem, observou-se avanços bastante positivos com a terapia. Deste modo, acredita-se que a intervenção fonoaudiológica precoce contribuiu, em grande parte, para a reorganização da atividade linguística, visto que o paciente comunica-se satisfatoriamente considerando a grande extensão de sua lesão.The purpose of this article was doing a report case of an aphasic client subjected to speech therapy in the clinic of a Speech Pathology and Audiology course of a federal university. The studied subject is

Infarto do miocárdio e acidente vascular cerebral associados à alta temperatura e monóxido de carbono em área metropolitana do sudeste do Brasil Miocardic infarcts and cerebral-vascular accidents associated with high temperature and carbon monoxide in an metropolitan area of Southeastern Brazil

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Davi Rumel

1993-02-01

Full Text Available Muito se tem publicado e discutido acerca de fatores de risco ligados a estilo de vida e a fatores hereditários em Acidente Vascular Cerebral (AVC e Infarto do Miocárdio (IM. Porém o estudo da influência de fatores ambientais como poluição por monóxido de carbono e temperatura na determinação nas ocorrências dessas patologias ainda é pouco discutido em nosso meio. Visando preencher esta lacuna, foi verificada a associação existente entre os valores de temperaturas máximas diárias e valores médio e máximo diários de monóxido de carbono e AVC e IM no Município de São Paulo, SP (Brasil. Foi coletada uma série histórica do número de casos novos de AVC e IM atendidos em Pronto Socorro de um hospital de clínicas e valores de temperatura e monóxido de carbono. Conclui-se que das internações anuais por IM, 2,1% são devidos à poluição atmosférica e 4,9% a altas temperaturas. Das internações anuais por AVC, 2,8% são devidas a altas temperaturas. Não foi identificado associação entre monóxido de carbono e AVC.Many studies have been published about the relationship between life style and genetic risk factors and stroke and heart attack, but there have been few about the relationship between atmospheric pollution, specifically with carbon monoxide, and temperature and stroke and heart attack. With a view to filling this gap the relationship between values of carbon monoxide concentration in the air, maximum and average by day, and maximum temperature by day and the number of new cases of CVA and IM admitted as emergencies at the biggest hospital complex of S. Paulo city was analysed. If was concluded, by the use of multivariable regression analysis, that 2.1% and 4.9% of heart attack admissions were due to carbon monoxide air pollution and high temperature, respectively. 2.8% of stroke admissions were due high temperature. Stroke and carbon monoxide were not associated in this population.

Imaging findings and cerebral perfusion in arterial ischemic stroke due to transient cerebral arteriopathy in children; Achados de imagem e perfusao arterial cerebral em acidente vascular cerebral isquemico devido a arteriopatia transitoria em crianca

Energy Technology Data Exchange (ETDEWEB)

Barbosa Junior, Alcino Alves, E-mail: alcinojr@uol.com.br [Departamento de Diagnostico por Imagem, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Ellovitch, Saada Resende de Souza [Neuropediatria, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Pincerato, Rita de Cassia Maciel [Hospital Samaritano, Sao Paulo, SP (Brazil)

2012-04-15

We report the case of a 4-year-old female child who developed an arterial ischemic stroke in the left middle cerebral artery territory, due to a proximal stenosis of the supraclinoid internal carotid artery, most probably related to transient cerebral arteriopathy of childhood. Computed tomography scan, magnetic resonance imaging, perfusion magnetic resonance and magnetic resonance angiography are presented, as well as follow-up by magnetic resonance and magnetic resonance angiography exams. Changes in cerebral perfusion and diffusion-perfusion mismatch call attention. As far as we know, this is the first report of magnetic resonance perfusion findings in transient cerebral arteriopathy. (author)

Presurgical fMRI evaluation of cerebral reorganization and motor deficit in patients with tumors and vascular malformations

International Nuclear Information System (INIS)

Baciu, M.; Le Bas, J.F.; Segebarth, C.; Benabid, A.L.

2003-01-01

The aim of this fMRI study was to evaluate the motor reorganization (cerebral plasticity) and the risk of motor deficit in patients presenting with tumors and vascular malformations, within the framework of their pre-surgical planning. Functional MR imaging data was obtained from 17 patients. Ten patients (seven with tumors and three with vascular malformations) presented with motor reorganization. The results of the present study suggest that the evaluation of the cerebral reorganization is an essential step in predicting the risk of motor deficit in patients having surgical indication for treatment. Furthermore, the cerebral reorganization constitutes an important factor for surgical decision

Response of the sensorimotor cortex of cerebral palsy rats receiving transplantation of vascular endothelial growth factor 165-transfected neural stem cells

Institute of Scientific and Technical Information of China (English)

Jielu Tan; Xiangrong Zheng; Shanshan Zhang; Yujia Yang; Xia Wang; Xiaohe Yu; Le Zhong

2014-01-01

Neural stem cells are characterized by the ability to differentiate and stably express exogenous ge-nes. Vascular endothelial growth factor plays a role in protecting local blood vessels and neurons of newborn rats with hypoxic-ischemic encephalopathy. Transplantation of vascular endothelial growth factor-transfected neural stem cells may be neuroprotective in rats with cerebral palsy. In this study, 7-day-old Sprague-Dawley rats were divided into ifve groups: (1) sham operation (control), (2) cerebral palsy model alone or with (3) phosphate-buffered saline, (4) vascular en-dothelial growth factor 165 + neural stem cells, or (5) neural stem cells alone. hTe cerebral palsy model was established by ligating the letf common carotid artery followed by exposure to hypox-ia. Phosphate-buffered saline, vascular endothelial growth factor + neural stem cells, and neural stem cells alone were administered into the sensorimotor cortex using the stereotaxic instrument and microsyringe. Atfer transplantation, the radial-arm water maze test and holding test were performed. Immunohistochemistry for vascular endothelial growth factor and histology using hematoxylin-eosin were performed on cerebral cortex. Results revealed that the number of vas-cular endothelial growth factor-positive cells in cerebral palsy rats transplanted with vascular endothelial growth factor-transfected neural stem cells was increased, the time for ifnding water and the ifnding repetitions were reduced, the holding time was prolonged, and the degree of cell degeneration or necrosis was reduced. hTese ifndings indicate that the transplantation of vascu-lar endothelial growth factor-transfected neural stem cells alleviates brain damage and cognitive deifcits, and is neuroprotective in neonatal rats with hypoxia ischemic-mediated cerebral palsy.

Estudo das freqüências dos principais fatores de risco para acidente vascular cerebral isquêmico em idosos Study of the main risk factors frequencies for ischemic cerebrovascular disease in elderly patients

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Sueli Luciano Pires

2004-09-01

Full Text Available Foram estudados retrospectivamente 262 pacientes com diagnóstico clínico de acidente vascular cerebral isquêmico (AVCi permanente, com idade igual ou superior a 60 anos, selecionados dos 1015 registros da Liga de Aterosclerose da Clínica Neurológica da ISCMSP, de 1990 a 2002. O estudo focalizou as freqüências dos fatores de risco modificáveis para AVCi nesta população idosa, considerando-se sexo e faixa etária dos pacientes. Os resultados evidenciaram que a hipertenção arterial sistêmica é significativamente freqüente (87,8% entre pacientes idosos com AVCi, independentemente do sexo e da faixa etária. Tabagismo (46,9% e etilismo (35,1% revelaram-se fatores de riscos modificáveis freqüentes especialmente entre os homens. As cardiopatias (27,0%, o Diabete Melito (19,9% e as dislipidemias (15,6% também se revelaram fatores de risco modificáveis freqüentes em pacientes idosos com AVCi, em ambos os sexos e em ambas as faixas etárias estudadas (60 a 70 anos e mais que 71 anos. Foi relativamente baixa a freqüência de hiperuricemia nesta amostra.Two hundred and sixty two patients with clinical diagnosis of permanent ischemic stroke, all of them aged 60 or more were retrospectively studied from the 1015 cerebrovascular diseases (CVD records of the Atherosclerosis Ligue of the Neurology Clinics of the ISCMSP, from 1990 to 2002. The study emphasized modifiable risk factors frequencies for ischemic stroke in this population, considering gender and age of the patients. Results have evidenced that systemic arterial hypertension is a main risk factor significantly frequent in old people (87.8%, independently of gender and age. Smoking (46.9% and alcohol consumption (35.1% have revealed to be very frequent important modifiable risk factors especially among men. Lower frequencies have been presented for cardiac diseases (27.0%, Diabetes Melitus (19.9%, and dislipidemia (15.6% as risk factors for ischemic stroke in old people of both

Post-mortem assessment of hypoperfusion of cerebral cortex in Alzheimer's disease and vascular dementia.

Science.gov (United States)

Thomas, Taya; Miners, Scott; Love, Seth

2015-04-01

Perfusion is reduced in the cerebral neocortex in Alzheimer's disease. We have explored some of the mechanisms, by measurement of perfusion-sensitive and disease-related proteins in post-mortem tissue from Alzheimer's disease, vascular dementia and age-matched control brains. To distinguish physiological from pathological reduction in perfusion (i.e. reduction exceeding the decline in metabolic demand), we measured the concentration of vascular endothelial growth factor (VEGF), a protein induced under conditions of tissue hypoxia through the actions of hypoxia-inducible factors, and the myelin associated glycoprotein to proteolipid protein 1 (MAG:PLP1) ratio, which declines in chronically hypoperfused brain tissue. To evaluate possible mechanisms of hypoperfusion, we also measured the levels of amyloid-β40, amyloid-β42, von Willebrand factor (VWF; a measure of microvascular density) and the potent vasoconstrictor endothelin 1 (EDN1); we assayed the activity of angiotensin I converting enzyme (ACE), which catalyses the production of another potent vasoconstrictor, angiotensin II; and we scored the severity of arteriolosclerotic small vessel disease and cerebral amyloid angiopathy, and determined the Braak tangle stage. VEGF was markedly increased in frontal and parahippocampal cortex in Alzheimer's disease but only slightly and not significantly in vascular dementia. In frontal cortex the MAG:PLP1 ratio was significantly reduced in Alzheimer's disease and even more so in vascular dementia. VEGF but not MAG:PLP1 increased with Alzheimer's disease severity, as measured by Braak tangle stage, and correlated with amyloid-β42 and amyloid-β42: amyloid-β40 but not amyloid-β40. Although MAG:PLP1 tended to be lowest in cortex from patients with severe small vessel disease or cerebral amyloid angiopathy, neither VEGF nor MAG:PLP1 correlated significantly with the severity of structural vascular pathology (small vessel disease, cerebral amyloid angiopathy or VWF

Case of radiation necrosis with vascular changes on main cerebral arteries

Energy Technology Data Exchange (ETDEWEB)

Ishibashi, Y; Okada, H; Mineura, K; Kodama, N [Tohoku Univ., Sendai (Japan). School of Medicine

1982-03-01

A 64-year-old woman had received radiotherapy, following surgery of a chromophobe pituitary adenoma. Six years after irradiation she began to complain of headache and dementia. Right vertebrogram demonstrated a right temporal mass lesion, stenosis and dilatation of middle cerebral artery and posterior communicating artery in the field of irradiation. CT scan showed the irregular low density area at the right temporal region, and the irregular enhancement after an intravenous injection of contrast medium was seen at the small part of affected area. From these findings, radiation necrosis at the right temporal lobe was diagnosed. Reports of vascular changes of the main cerebral arteries due to radiation are rare.

Efeitos da sondagem nasogástrica em pacientes com acidente cerebrovascular e disfagia

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Tahissa Frota Cavalcante

2014-10-01

Full Text Available O estudo teve por objetivo analisar os efeitos da sondagem gástrica em pacientes com acidente vascular cerebral e disfagia. Revisão sistemática da literatura, realizada em seis bases de dados, com os descritores stroke e intubation, gastrointestinal. Foram encontrados 120 estudos e selecionados três ensaios clínicos. Os resultados apontaram diferentes desfechos, entre os quais: aumento do nível sérico de albumina (gastrostomia, prognóstico ruim e risco de morte (gastrostomia, aumento das falhas no tratamento devido a bloqueio, deslocamento e reinserção da sonda nasogástrica, e aumento da incidência de hemorragia gastrointestinal (sonda nasogástrica. A partir dos resultados obtidos nesta revisão sistemática, ressaltam-se as seguintes evidências: a sondagem nasogástrica deve ser adotada precocemente como um método de alimentação enteral; as falhas do tratamento são mais comuns naqueles que utilizam a sonda nasogástrica como método de alimentação; os resultados relacionados à melhora do estado funcional dos pacientes foram semelhantes, independente do método de terapia nutricional empregado.

Cerebral Vascular Disease and Neurovascular Injury in Ischemic Stroke

Science.gov (United States)

Hu, Xiaoming; De Silva, T. Michael; Chen, Jun; Faraci, Frank M.

2017-01-01

The consequences of cerebrovascular disease are among the leading health issues worldwide. Large and small cerebral vessel disease can trigger stroke and contribute to the vascular component of other forms of neurological dysfunction and degeneration. Both forms of vascular disease are driven by diverse risk factors, with hypertension as the leading contributor. Despite the importance of neurovascular disease and subsequent injury following ischemic events, fundamental knowledge in these areas lag behind our current understanding of neuroprotection and vascular biology in general. The goal of this review is to address select key structural and functional changes in the vasculature that promote hypoperfusion and ischemia, while also affecting the extent of injury and effectiveness of therapy. In addition, as damage to the blood-brain barrier (BBB) is one of the major consequences of ischemia, we discuss cellular and molecular mechanisms underlying ischemia-induced changes in BBB integrity and function, including alterations in endothelial cells and the contribution of pericytes, immune cells, and matrix metalloproteinases. Identification of cell types, pathways, and molecules that control vascular changes before and after ischemia may result in novel approaches to slow the progression of cerebrovascular disease and lessen both the frequency and impact of ischemic events. PMID:28154097

Environmental pollutants and stroke-related hospital admissions Poluentes ambientais e internações devido a acidente vasculoencéfalico

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Luiz Fernando Costa Nascimento

2012-07-01

Full Text Available Some effects of environmental pollution on human health are known, especially those affecting the respiratory and cardiovascular systems. The current study aimed to estimate these effects on the production of hospital admissions for stroke. This was an ecological study using hospital admissions data in São José dos Campos, São Paulo State, Brazil, with diagnosis of stroke, from January 1, 2007, to April 30, 2008. The target pollutants were particulate matter, sulfur dioxide, and ozone. Use of a Poisson linear regression model showed that same-day exposure to particulate matter was associated with hospitalization for stroke (RR = 1.013; 95%CI: 1.001-1.025. An increase of 10µg/m³ in this pollutant increased the risk of hospitalization by 12% (RR = 1.137; 95%CI: 1.014-1.276. In the multi-pollutant model, it was thus possible to identify particulate matter as associated with hospitalization for stroke in a medium-sized city like São José dos Campos.Alguns dos efeitos da poluição ambiental na saúde humana são conhecidos, destacando aqueles nos sistemas respiratório e cardiovascular. Este trabalho tem por objetivo estimar esses efeitos na gênese das internações por acidente vasculoencefálico. Foi um estudo ecológico realizado com dados de internações da cidade de São José dos Campos, São Paulo, Brasil, relativos aos diagnósticos de acidente vascular cerebral, entre 1º de janeiro de 2007 e 30 de abril de 2008. Os poluentes estudados foram material particulado, dióxido de enxofre e ozônio. Utilizando-se de modelo linear generalizado da regressão de Poisson, foi possível identificar exposição ao material particulado, no mesmo dia, como associado à internação por acidente vasculoencefálico (RR = 1,013; IC95%: 1,001-1,025. O aumento de 10µg/m3 desse poluente aumenta o risco de internação em 12% (RR = 1,137; IC95%: 1,014-1,276. Assim, foi possível identificar o material particulado, no modelo multipoluente, como

Cerebral blood flow single-photon emission tomography with 123I-IMP in vascular dementia

International Nuclear Information System (INIS)

Kawahata, Nobuya; Gotoh, Chiharu; Yokoyama, Sakura; Daitoh, Nobuyuki

2001-01-01

Cerebral blood flow differences between patients with vascular dementia, patients with multiple lacunar infarction without cognitive dysfunction, and age-matched controls were examined. Thirty four patients with vascular dementia (VD) were selected from consecutive referrals to the Memory Clinic at Narita Memorial Hospital. All the patients had routine assessment including history, physical and neurological examinations, neuropsychological assessment, blood tests, EEG, head MRI, and single photon emission computed tomography (SPECT). All of them fulfilled the NINDS-AIREN diagnostic criteria for vascular dementia. Thirty nine patients with multiple lacunar infarction without cognitive dysfunction and 110 age-matched controls were included in this study. Mean cerebral blood flow (mCBF) and regional cerebral blood flow (rCBF) were measured using N-isopropyl-P- 123 I-iodoamphetamine ( 123 I-IMP) and SPECT imager. The mCBF in VD was 27.6±5.3 ml/100 g/min, while those in the control group and multiple lacunar infarction without cognitive dysfunction were 36.6±6.1 ml/100 g/min and 32.5±5.5 ml/100 g/min, respectively. The patients with VD demonstrated significantly reduced mCBF and rCBF in twenty regions including both cerebellar hemispheres as compared with those of the control group. Although there was no significant rCBF differences in bilateral inferior occipital regions and the right cerebellar hemisphere between patients with VD and multiple lacunar infarction without cognitive dysfunction, we could find significant lower rCBF in the remaining brain areas. In spite of the severity of VD, the diffuse decrease of cerebral blood flow was recognized in all patients with VD. (author)

Acidente de trabalho típico e bipoder

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Leonardo Del Puppo Luz

2012-08-01

Full Text Available Contemporaneamente, os acidentes de trabalho típico ainda vêm se mantendo como uma temática extremamente relevante à malha social. A Previdência (INSS, em 2007, registrou 653.090 acidentes de trabalho. Diante desse quadro estatístico, diversos órgãos públicos têm se empenhado no enfrentamento das ocorrências caracterizadas como acidentes de trabalho típico (ATs. Esta pesquisa originou-se de parte da dissertação que almejou colocar em análise práticas que permeiam as investigações de determinados órgãos públicos no Estado do Espírito Santo quanto à ocorrência dos acidentes de trabalho típico, buscando expandir as problematizações acerca da binarização da culpa pelo acidente, ora atribuída ao empregador, ora ao empregado. Recorreu-se, como aporte teórico-conceitual, ao conceito-ferramenta de Biopoder desenvolvido por Michel Foucault, para lançar uma análise acerca do Biopoder e das políticas de controle dos acidentes. Conclui que se processam mecanismos de subjetivação que parecem reduzir a importância da transversalidade/atravessamentos de instituições na constituição dos acidentes de trabalho.

Vascular permeability and iron deposition biomarkers in longitudinal follow-up of cerebral cavernous malformations

DEFF Research Database (Denmark)

Girard, Romuald; Fam, Maged D; Zeineddine, Hussein A

2017-01-01

OBJECTIVE Vascular permeability and iron leakage are central features of cerebral cavernous malformation (CCM) pathogenesis. The authors aimed to correlate prospective clinical behavior of CCM lesions with longitudinal changes in biomarkers of dynamic contrast-enhanced quantitative permeability (...

Effects of acetazolamide on the micro- and macro-vascular cerebral hemodynamics: a diffuse optical and transcranial doppler ultrasound study.

Science.gov (United States)

Zirak, Peyman; Delgado-Mederos, Raquel; Martí-Fàbregas, Joan; Durduran, Turgut

2010-11-19

Acetazolamide (ACZ) was used to stimulate the cerebral vasculature on ten healthy volunteers to assess the cerebral vasomotor reactivity (CVR). We have combined near infrared spectroscopy (NIRS), diffuse correlation spectroscopy (DCS) and transcranial Doppler (TCD) technologies to non-invasively assess CVR in real-time by measuring oxy- and deoxy-hemoglobin concentrations, using NIRS, local cerebral blood flow (CBF), using DCS, and blood flow velocity (CBFV) in the middle cerebral artery, using TCD. Robust and persistent increases in oxy-hemoglobin concentration, CBF and CBFV were observed. A significant agreement was found between macro-vascular (TCD) and micro-vascular (DCS) hemodynamics, between the NIRS and TCD data, and also within NIRS and DCS results. The relative cerebral metabolic rate of oxygen, rCMRO(2), was also determined, and no significant change was observed. Our results showed that the combined diffuse optics-ultrasound technique is viable to follow (CVR) and rCMRO(2) changes in adults, continuously, at the bed-side and in real time.

Cerebral blood flow single-photon emission tomography with {sup 123}I-IMP in vascular dementia

Energy Technology Data Exchange (ETDEWEB)

Kawahata, Nobuya; Gotoh, Chiharu; Yokoyama, Sakura; Daitoh, Nobuyuki [Narita Memorial Hospital, Toyohashi, Aichi (Japan)

2001-06-01

Cerebral blood flow differences between patients with vascular dementia, patients with multiple lacunar infarction without cognitive dysfunction, and age-matched controls were examined. Thirty four patients with vascular dementia (VD) were selected from consecutive referrals to the Memory Clinic at Narita Memorial Hospital. All the patients had routine assessment including history, physical and neurological examinations, neuropsychological assessment, blood tests, EEG, head MRI, and single photon emission computed tomography (SPECT). All of them fulfilled the NINDS-AIREN diagnostic criteria for vascular dementia. Thirty nine patients with multiple lacunar infarction without cognitive dysfunction and 110 age-matched controls were included in this study. Mean cerebral blood flow (mCBF) and regional cerebral blood flow (rCBF) were measured using N-isopropyl-P-{sup 123}I-iodoamphetamine ({sup 123}I-IMP) and SPECT imager. The mCBF in VD was 27.6{+-}5.3 ml/100 g/min, while those in the control group and multiple lacunar infarction without cognitive dysfunction were 36.6{+-}6.1 ml/100 g/min and 32.5{+-}5.5 ml/100 g/min, respectively. The patients with VD demonstrated significantly reduced mCBF and rCBF in twenty regions including both cerebellar hemispheres as compared with those of the control group. Although there was no significant rCBF differences in bilateral inferior occipital regions and the right cerebellar hemisphere between patients with VD and multiple lacunar infarction without cognitive dysfunction, we could find significant lower rCBF in the remaining brain areas. In spite of the severity of VD, the diffuse decrease of cerebral blood flow was recognized in all patients with VD. (author)

Vascular risk factors, atherosclerosis, cerebral white matter lesions and cerebral perfusion in a population-based study

International Nuclear Information System (INIS)

Claus, J.J.; Breteler, M.M.B.; Hasan, D.; Krenning, E.P.; Bots, M.L.; Grobbee, D.E.; Swieten, J.C. van; Harskamp, F. van; Hofman, A.

1996-01-01

We studied risk factors for cerebral vascular disease (blood pressure and hypertension, factor VIIc, factor VIIIc, fibrinogen), indicators of atherosclerosis (intima-media thickness and plaques in the carotid artery) and cerebral white matter lesions in relation to regional cerebral blood flow (rCBF) in 60 persons (aged 65-85 years) recruited from a population-based study. rCBF was assessed with single-photon emission tomography using technetium-99m d,l-hexamethylpropylene amine oxime ( 99m Tc-HMPAO). Statistical analysis was performed with multiple linear regression with adjustment for age, sex and ventricle-to-brain ratio. A significant positive association was found between systolic and diastolic blood pressure and temporo-parietal rCBF. In analysis with quartiles of the distribution, we found a threshold effect for the relation of low diastolic blood pressure (≤60 mmHg) and low temporo-parietal rCBF. Levels of plasma fibrinogen were inversely related to parietal rCBF, with a threshold effect of high fibrinogen levels (>3.2 g/l) and low rCBF. Increased atherosclerosis was related to low rCBF in all cortical regions, but these associations were not significant. No consistent relation was observed between severity of cerebral white matter lesions and rCBF. Our results may have implications for blood pressure control in the elderly population. (orig.)

Efeito da postura no controle da força de preensão do membro superior não parético ao acidente vascular encefálico

OpenAIRE

Silva, Fábio Santi Rosendo da

2011-01-01

Este trabalho teve como objetivo analisar a influência da condição postural sentado e em pé na adaptação do controle da força de preensão manual do membro superior não parético durante a atividade de pegar e levantar um objeto, em indivíduos com hemiparesia após acidente vascular encefálico (AVE). Foram avaliados 15 indivíduos com hemiparesia (GE) e 15 indivíduos saudáveis (GC) com idade de 57,3 ±10,17 e 55,5±11,27 anos respectivamente. Para caracterização do GE foram realizados os testes de ...

Perfil dos acidentes de trabalho em refinaria de petróleo

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Carlos Augusto Vaz de Souza

2002-10-01

Full Text Available OBJETIVO: O trabalho em refinarias de petróleo envolve o risco de acidentes triviais e ampliados. Os dados nacionais apontam para a relevância dos acidentes nesse setor. Assim, realizou-se pesquisa com o objetivo de identificar o perfil e avaliar a adequação dos instrumentos de registro dos acidentes de trabalho em refinaria. MÉTODOS: Foram padronizadas e analisadas informações referentes aos acidentes de trabalho nas atividades de produção e manutenção registradas em uma refinaria de petróleo do Estado do Rio de Janeiro, no ano de 1997. A população estudada constituiu-se de 153 pessoas, sendo 83 trabalhadores próprios lesionados e 69 trabalhadores terceirizados lesionados. As variáveis analisadas foram: tipo de acidente, modo de operação e função do trabalhador lesionado. RESULTADOS: Em relação aos trabalhadores próprios, houve predominância dos chamados acidentes triviais (54,2% e quanto ao modo de operação, houve concentração dos acidentes nas atividades em operação normal (62,9%. Quanto aos trabalhadores terceirizados, os acidentes triviais (75,5% tiveram predominância mais acentuada; e quanto ao modo de operação, houve um domínio quase total dos acidentes na atividade de manutenção (96,8%. CONCLUSÕES: Os resultados mostraram um perfil de acidentes que afeta principalmente os níveis hierárquicos mais baixos, concentrando-se de modo geral nas atividades de manutenção, além da necessidade de modificações no sistema de registro e investigação de acidentes por parte da empresa.

A case of radiation necrosis with vascular changes on main cerebral arteries

International Nuclear Information System (INIS)

Ishibashi, Yasuhiko; Okada, Hitoshi; Mineura, Katsuyoshi; Kodama, Namio

1982-01-01

A 64-year-old woman had received radiotherapy, following surgery of a chromophobe putuitary adenoma. Six years after irradiation she began to complain of headache and dementia. Right vertebrogram demonstrated a right temporal mass lesion, stenosis and dilatation of middle cerebral artery and posterior communicating artery in the field of irradiation. CT scan showed the irregular low density area at the right temporal region, and the irregular enhancement after an intravenous injection of contrast medium was seen at the small part of affected area. From these findings, radiation necrosis at the right temporal lobe was diagnosed. As vascular changes of the main cerebral arteries due to radiation are rare, we discussed on them from ever reported literature. (author)

Central Pulsatile Pressure and Flow Relationship in the Time and Frequency Domain to Characterise Hydraulic Input to the Brain and Cerebral Vascular Impedance.

Science.gov (United States)

Kim, Mi Ok; O'Rourke, Michael F; Adji, Audrey; Avolio, Alberto P

2016-01-01

In the time domain, pulsatile flow and pressure can be characterised as the ratio of the late systolic boost of flow or pressure to the pulse amplitude so as to estimate the hydraulic input to the brain. While vascular impedance has been widely used to represent the load presented to the heart by the systemic circulation, it has not been applied to the cerebral circulation.We set out to study the relationship between the pressure and the flow augmentation index (AIx) in the time domain and to determine cerebral vascular impedance using aortic blood pressure and cerebral blood flow waveforms in the frequency domain. Twenty-four young subjects (aged 21-39 years) were recruited; aortic pressure was derived using SphygmoCor from radial pressure. Flow waveforms were recorded from the middle cerebral artery. In three subjects, we performed the Valsalva manoeuvre to investigate their response to physiological intervention. There was a linear relationship between flow and pressure AIx, and cerebral impedance values were similar to those estimated for low resistance vascular beds. Substantial change in pressure and flow wave contour was observed during the Valsalva manoeuvre; however, the relationship in both the time and the frequency domains were unchanged. This confirms that aortic pressure and cerebral flow waveform can be used to study cerebral impedance.

Patent foramen ovale in a cohort of young patients with cryptogenic ischemic stroke Forame oval patente em uma coorte de pacientes jovens com acidente vascular cerebral isquêmico

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Marcus Tulius T. Silva

2005-06-01

Full Text Available OBJECTIVE: Although its role is a matter of debate, some studies described a higher prevalence of patent foramen ovale (PFO and atrial septal aneurysm (ASA in young stroke patients, with higher risk with PFO / ASA association (OR 4.96. The aim of this study was determine the prevalence of PFO and ASA in a cohort of cryptogenic ischemic stroke (IS patients younger than 55 years and to follow-up after surgical or percutaneous endovascular closure (PEC. METHOD: In 21 months we identified all patients less than 55 years old with IS who were admitted to our hospital. Cryptogenic IS was considered if there is not an identifiably cause to cerebral ischemia. Transesophageal echocardiography (TEE was performed in all patients. After interatrial septal abnormalities diagnosis, percutaneous device closure was offered to all. Patients were followed monthly and keeped with oral AAS or Clopidogrel. RESULTS: We identified 189 patients with IS and 32 were less than 55 years old (16.9%. In 29 the IS was cryptogenic. TEE was performed in all patients and some form of interatrial septal abnormality was identified in 12 (12/29 - 41.3%; 5 had a PFO and in 7 there was PFO plus ASA. Ten patients were submitted to PEC and 2 were submitted to surgical closure. In mid-term follow-up (28 months no ischemic events occurred and 2 patients related disappearance of migraine symptoms. CONCLUSION: Our small series description is in accordance with other studies and suggests a possible relation between interatrial septal abnormalities and IS in a cohort of young patient.OBJETIVO: A associação das anormalidades do septo interatrial - forame oval patente (FOP e aneurisma de septo interatrial (ASA - com acidente vascular cerebral isquêmico (AVCI ainda é questão de incerteza para muitos autores. No entanto, vários estudo mostram que em pacientes jovens tais anormalidades podem estar relacionadas à gênese de eventos isquêmicos. Nosso objetivo é descrever a prevalência do

Acidente de trabalho típico e bipoder

OpenAIRE

Luz,Leonardo Del Puppo; Andrade,Ângela Nobre de

2012-01-01

Contemporaneamente, os acidentes de trabalho típico ainda vêm se mantendo como uma temática extremamente relevante à malha social. A Previdência (INSS), em 2007, registrou 653.090 acidentes de trabalho. Diante desse quadro estatístico, diversos órgãos públicos têm se empenhado no enfrentamento das ocorrências caracterizadas como acidentes de trabalho típico (ATs). Esta pesquisa originou-se de parte da dissertação que almejou colocar em análise práticas que permeiam as investigações de determi...

Sobrecarga dos cuidadores de idosos com acidente vascular cerebral Sobrecarga de los cuidadores de ancianos con accidente cerebrovascular Burden on caregivers of elderly victims of cerebrovascular accident

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Roberta Amorim Pereira

2013-02-01

Full Text Available O objetivo deste estudo foi avaliar a sobrecarga dos cuidadores de idosos com acidente vascular cerebral (AVC, assim como correlacioná-la com as horas de cuidado, a idade e a independência funcional dos idosos. Trata-se de estudo transversal feito com 62 idosos com AVC e seus cuidadores. O instrumento continha variáveis sociodemográficas e econômicas, Mini-Exame do Estado Mental, Medida da Independência Funcional (MIF e a Escala de Zarit. A possível correlação entre os escores da escala de Zarit e as outras variáveis foi avaliada por meio do Coeficiente de Correlação de Pearson. A maioria dos cuidadores era adultos, filhos, casados e do sexo feminino. A média do escore de Zarit foi 34,92 (15,8. A MIF apresentou correlação negativa com a sobrecarga do cuidador, porém, não houve correlação com a idade e as horas de cuidado. A sobrecarga da maioria dos cuidadores variou de moderada a severa e parece estar relacionada ao nível de independência funcional dos idosos.Se objetivó evaluar la sobrecarga de cuidadores de ancianos con accidente cerebrovascular (ACV, y correlacionarla con horas de cuidado, edad e independencia funcional de los ancianos. Estudio transversal con 62 ancianos con ACV y sus cuidadores. El instrumento contenía variables sociodemográficas y económicas, Mini-Examen del Estado Mental, Medida de la Independencia Funcional (MIF y la Escala de Zarit. La posible correlación entre los puntajes de la escala de Zarit y las otras variables fue evaluada por Coeficiente de Correlación de Pearson. La mayoría de los cuidadores eran adultos, hijos, casados y de sexo femenino. El promedio de puntaje de Zarit fue 34,92 (15,8. La MIF presentó correlación negativa con la sobrecarga del cuidador, sin embargo no hubo correlación con edad y horas de cuidado. La sobrecarga de la mayoría de los cuidadores varió entre moderada y severa, y parece relacionarse con el nivel de independencia funcional del anciano.The aim was to

CT features on increased cerebral vascular density and its pathological mechanism in patients with cyanotic congenital disease

International Nuclear Information System (INIS)

Liu Hui; Zhang Xintang; Wang Jin; Tian Min; He Yuping; Zhao Jinqi; He Qian; Chen Huanjun; Li Fawei

2012-01-01

Objective: To investigate CT features on increased cerebral vascular density and its pathological mechanism in patients with cyanotic congenital heart disease (CCHD). Methods: Preoperative brain CT scan and clinical data in 82 patients suffering from CCHD were analyzed. According to the increased levels of vascular density, patients were divided into 4 groups: normal, mild, moderate and severe. Relationships between the increased levels of vascular density and Hb, RBC, HCT, as well as the degree of cyanosis,were studied. AVONA was carried out to test blood CT value of cerebral sinuses, Hb, RBC and HCT in different groups. Descriptive analysis and linear regression were adopted to study the correlation between blood CT value and Hb concentration. The relationship of increased vascular density to degrees of cyanosis was analysed by Spearman. Results: Among 82 patients, 12 patients (14.6%) were found in the group of normal vascular density and 70 patients (85.4%) in the increased vascular density group. Among 70 patients with increased vascular density, 22 patients (26.8% ) with (55.4 ± 2.6) HU, (169 ±6)g/L of Hb, (5.8 ±0.3) × 10 12 /L of RBC and 0.51 ±0.03 of HCT, 29 patients (35.4%) with (61.3 ± 2.9) HU, (209 ± 15 ) g/L, (7.1 ± 0.4) × 10 12 /L, 0.66 ± 0.06 and 19 patients (23.2%) with (68.8 ± 4.2) HU, (242 ± 23) g/L, (8.3 ± 0.9) × 10 12 /L, 0.78 ± 0.08 were observed in the mild,moderate and severe group,respectively. There were significant differences in distribution of blood CT value (HU), Hb, RBC and HCT in different groups (F=163.263, 134.703, 120.974, 136.541; P<0.01). Blood CT value was positively correlated with Hb concentration (r=0.98, P<0.01). Vascular density was also positively correlated with the degree of cyanosis (r=0.86, P<0.01). Conclusions: Cerebral vascular density of patients suffering from CCHD presented different levels of increases based on CT scan results due to rise of RBC stimulated by anoxia. The increased level of vascular

A theoretical framework for determining cerebral vascular function and heterogeneity from dynamic susceptibility contrast MRI.

Science.gov (United States)

Digernes, Ingrid; Bjørnerud, Atle; Vatnehol, Svein Are S; Løvland, Grete; Courivaud, Frédéric; Vik-Mo, Einar; Meling, Torstein R; Emblem, Kyrre E

2017-06-01

Mapping the complex heterogeneity of vascular tissue in the brain is important for understanding cerebrovascular disease. In this translational study, we build on previous work using vessel architectural imaging (VAI) and present a theoretical framework for determining cerebral vascular function and heterogeneity from dynamic susceptibility contrast magnetic resonance imaging (MRI). Our tissue model covers realistic structural architectures for vessel branching and orientations, as well as a range of hemodynamic scenarios for blood flow, capillary transit times and oxygenation. In a typical image voxel, our findings show that the apparent MRI relaxation rates are independent of the mean vessel orientation and that the vortex area, a VAI-based parameter, is determined by the relative oxygen saturation level and the vessel branching of the tissue. Finally, in both simulated and patient data, we show that the relative distributions of the vortex area parameter as a function of capillary transit times show unique characteristics in normal-appearing white and gray matter tissue, whereas tumour-voxels in comparison display a heterogeneous distribution. Collectively, our study presents a comprehensive framework that may serve as a roadmap for in vivo and per-voxel determination of vascular status and heterogeneity in cerebral tissue.

Interactive effects of vascular risk burden and advanced age on cerebral blood flow

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Katherine eBangen

2014-07-01

Full Text Available Vascular risk factors and cerebral blood flow (CBF reduction have been linked to increased risk of cognitive impairment and Alzheimer’s disease (AD; however the possible moderating effects of age and vascular risk burden on CBF in late life remain understudied. We examined the relationships among elevated vascular risk burden, age, CBF, and cognition. Seventy-one non-demented older adults completed an arterial spin labeling MR scan, neuropsychological assessment, and medical history interview. Relationships among vascular risk burden, age, and CBF were examined in a priori regions of interest (ROIs previously implicated in aging and AD. Interaction effects indicated that, among older adults with elevated vascular risk burden (i.e., multiple vascular risk factors, advancing age was significantly associated with reduced cortical CBF whereas there was no such relationship for those with low vascular risk burden (i.e., no or one vascular risk factor. This pattern was observed in cortical ROIs including medial temporal (hippocampus, parahippocampal gyrus, uncus, inferior parietal (supramarginal gyrus, inferior parietal lobule, angular gyrus, and frontal (anterior cingulate, middle frontal gyrus, medial frontal gyrus cortices. Furthermore, among those with elevated vascular risk, reduced CBF was associated with poorer cognitive performance. Such findings suggest that older adults with elevated vascular risk burden may be particularly vulnerable to cognitive change as a function of CBF reductions. Findings support the use of CBF as a potential biomarker in preclinical AD and suggest that vascular risk burden and regionally-specific CBF changes may contribute to differential age-related cognitive declines.

A resposta a acidentes tecnológicos : o caso do acidente de Goiânia

OpenAIRE

Barbosa, Tania Mara Alves

2010-01-01

Dissertação de mestrado em Sociologia (As Sociedades Nacionais Perante os Processos de Globalização) apresentada à Faculdade de Economia da Universidade de Coimbra Este trabalho se propôs analisar, num quadro comparativo, a suficiência e a adequação da resposta do acidente radiológico de Goiânia, tendo em conta a sua amplitude. Seu objetivo geral relaciona-se ao estudo das respostas (estratégias e ações) aos problemas gerados pela ocorrência do acidente radioativo com o Césio-137, e visa, ...

Placental growth factor deficiency is associated with impaired cerebral vascular development in mice.

Science.gov (United States)

Luna, Rayana Leal; Kay, Vanessa R; Rätsep, Matthew T; Khalaj, Kasra; Bidarimath, Mallikarjun; Peterson, Nichole; Carmeliet, Peter; Jin, Albert; Croy, B Anne

2016-02-01

Placental growth factor (PGF) is expressed in the developing mouse brain and contributes to vascularization and vessel patterning. PGF is dynamically expressed in fetal mouse brain, particularly forebrain, and is essential for normal cerebrovascular development. PGF rises in maternal plasma over normal human and mouse pregnancy but is low in many women with the acute onset hypertensive syndrome, pre-eclampsia (PE). Little is known about the expression of PGF in the fetus during PE. Pgf  (-/-) mice appear normal but recently cerebral vascular defects were documented in adult Pgf  (-/-) mice. Here, temporal-spatial expression of PGF is mapped in normal fetal mouse brains and cerebral vasculature development is compared between normal and congenic Pgf  (-/-) fetuses to assess the actions of PGF during cerebrovascular development. Pgf/PGF, Vegfa/VEGF, Vegf receptor (Vegfr)1 and Vegfr2 expression were examined in the brains of embryonic day (E)12.5, 14.5, 16.5 and 18.5 C57BL/6 (B6) mice using quantitative PCR and immunohistochemistry. The cerebral vasculature was compared between Pgf  (-/-) and B6 embryonic and adult brains using whole mount techniques. Vulnerability to cerebral ischemia was investigated using a left common carotid ligation assay. Pgf/PGF and Vegfr1 are highly expressed in E12.5-14.5 forebrain relative to VEGF and Vegfr2. Vegfa/VEGF is relatively more abundant in hindbrain (HB). PGF and VEGF expression were similar in midbrain. Delayed HB vascularization was seen at E10.5 and 11.5 in Pgf  (-/-) brains. At E14.5, Pgf  (-/-) circle of Willis showed unilateral hypoplasia and fewer collateral vessels, defects that persisted post-natally. Functionally, adult Pgf  (-/-) mice experienced cerebral ischemia after left common carotid arterial occlusion while B6 mice did not. Since Pgf  (-/-) mice were used, consequences of complete absence of maternal and fetal PGF were defined. Therefore, the effects of maternal versus fetal PGF

Tratamento da hipertensão e declínio da mortalidade por acidentes vasculares cerebrais The treatment of hypertension and the decline of mortality from cerebrovascular accidents

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José Eluf Neto

1990-08-01

Full Text Available É discutida a possível relação causa-efeito entre o declínio da mortalidade por acidentes vasculares cerebrais (AVC e o melhor tratamento da hipertensão arterial. Para isto são revistos criticamente na literatura internacional os possíveis artefatos estatísticos para a enumeração dos AVCs, a letalidade e a incidência de AVC a prevalência de outros fatores de risco como hipercolesterolemia, tabagismo, ingestão de sódio, potássio e álcool, a obesidade e também a contribuição da assistência médica.A possible cause-effect relation ship between the decline of mortality from cerebro-vascular accidents (CVA and a better control of arterial hypertension is discussed. The international literature on the subject is critically reviewed in the light of the possible statistical artifacts for enumeration of CVAs, the incidence and fatality of the disease, the prevalence of other risk factors such as hypercholesterolemia, smoking, and the consumption of sodium, potassium and alcohol, and obesity, as well as the contribution of health care.

Caracterização dos acidentes com tratores agrícolas

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Schlosser José Fernando

2002-01-01

Full Text Available Em despeito à sua importância, poucas pesquisas vêm sendo executadas com o intuito de caracterizar os acidentes de trabalho com tratores agrícolas, identificando sua natureza (tipo bem como suas causas. O objetivo deste trabalho foi caracterizar os acidentes envolvendo tratores agrícolas ocorridos na região da Depressão Central do Rio Grande do Sul e, a partir disto, delinear estratégias eficientes na sua prevenção. Para o levantamento dos dados, foi aplicado um questionário aos operadores de tratores agrícolas da região da Depressão Central do Rio Grande do Sul. Os dados demonstraram que 39% dos trabalhadores rurais entrevistados já sofreram algum tipo de acidente de trabalho com tratores agrícolas. Dentre os tipos de acidentes com tratores agrícolas detectados na pesquisa, destacam-se o capotamento, que correspondeu a 51,71% do total de acidentes graves, e os escorregões, que corresponderam a 40,82% dos acidentes leves. As principais causas dos acidentes relatados foram a falta de conhecimento a respeito das medidas de segurança na operação de tratores (32,77%, a falta de atenção (32,22% para a tarefa executada e o equipamento inadequado (22,22%. Os acidentes graves tiveram causas diferentes comparativamente aos leves. Operadores sem treinamento adequado, a não observação de regras básicas de segurança e a longa jornada de trabalho são tendências observadas neste trabalho que ampliam os riscos de ocorrência de acidentes. A inclusão de dispositivos que tornem a máquina mais segura e confortável, bem como o treinamento dos operadores de tratores agrícolas são práticas de importância fundamental para a prevenção dos acidentes com tratores agrícolas.

Impacto da intubação orotraqueal na deglutição do indivíduo pós-acidente vascular encefálico após cirurgia cardíaca

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Tatiana Magalhães de Almeida

2015-04-01

Full Text Available OBJETIVO:associar o grau de disfagia orofaríngea e o tempo de intubação orotraqueal no indivíduo pós-acidente vascular encefálico após cirurgia cardíaca.MÉTODOS:estudo clínico transversal descritivo, retrospectivo, realizado por meio da coleta de dados de protocolos e registros de prontuário, durante seis meses, em Hospital Público de Referência em Cardiologia. Foram analisados 25 protocolos e prontuários de indivíduos submetidos à cirurgia cardíaca, que evoluíram com acidente vascular encefálico e foram assistidos pela equipe de Fonoaudiologia. Os indivíduos foram divididos em dois grupos. O Grupo I (GI constou de 10 indivíduos com intubação orotraqueal menor que 24 horas e o Grupo II (GII de 15 indivíduos com intubação orotraqueal maior que 24 horas. Realizada avaliação clínica da deglutição e analisada a associação entre a classificação clínica do grau de comprometimento para disfagia e o tempo de intubação orotraqueal.RESULTADOS:verificou-se que no GI 40% apresentaram disfagia leve, 30% moderada e 20% grave. No GII 13,3% apresentaram disfagia leve, 33,3% moderada e 53,33% grave. Verificou-se associação linear significante entre o grau de disfagia e o tempo de IOT (p= 0,031, indicando que o número de indivíduos com disfagia moderada e grave foi maior no grupo com mais tempo de intubaçao.CONCLUSÕES:constatou-se que o tempo de intubação orotraqueal maior que 24 horas aumentou o grau da disfagia orofaríngea nesta população.

Are the angiotensin-converting enzime gene and acticity risk factors for stroke? São fatores de risco para acidente vascular cerebral o gene e a atividade da enzima conversora de angiotensina ?

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Miris Dikmen

2006-06-01

Full Text Available Stroke is a multifactorial disease in which genetic factors play an important role. This study was carried out to determine angiotensin-converting enzyme (ACE gene polymorphism in Turkish acute stroke patients and to establish whether there is an association of angiotensin-converting enzyme gene I/D polymorphism with clinical parameters. In this study 185 patients and 50 controls were recruited. We have investigated the association among the allelic distribution of the insertion/deletion (I/D polymorphism of the ACE gene identified by polymerase chain reaction. Distribution of ACE gene I/D genotypes and allele frequencies in patients were not significantly different from controls. D allele frequencies were 57.8% in patients versus 53.0% in controls and I allele 42.2% versus 47% respectively. History of hypertension, stroke, renal, heart and vessel diseases incidence and age, gender, systolic-diastolic blood pressures and creatinine levels were significantly high in patients. But these results and ACE activities had no significant differences among the ACE genotypes in patients and controls. Our results suggest that the ACE gene polymorphism is not associated with the pathogenesis of stroke in Turkish stroke patients.O acidente vascular cerebral (AVC é doença multifatorial em que fatores genéticos desempenham papel importante. Este estudo foi desenvolvido para verificar o polimorfismo do gene da enzima conversora da angiotensina (ECA em pacientes turcos com AVC agudo e estabelecer se existe associação do gene I/D da ECA com parâmetros clínicos. O estudo foi realizado com 185 pacientes e 50 controles. A associação entre a distribuição alélica da inserção / deleção (I/D do polimorfismo do gene da ECA foi estudada pela reação em cadeia da polimerase. A distribuição dos genótipos I/D do gene da ECA e suas freqüências não apresentaram significância estatística quando comparados os pacientes e controles. As freqüências dos

Genetic modification of cerebral arterial wall: implications for prevention and treatment of cerebral vasospasm.

Science.gov (United States)

Vijay, Anantha; Santhanam, R; Katusic, Zvonimir S

2006-10-01

Genetic modification of cerebral vessels represents a promising and novel approach for prevention and/or treatment of various cerebral vascular disorders, including cerebral vasospasm. In this review, we focus on the current understanding of the use of gene transfer to the cerebral arteries for prevention and/or treatment of cerebral vasospasm following subarachnoid hemorrhage (SAH). We also discuss the recent developments in vascular therapeutics, involving the autologous use of progenitor cells for repair of damaged vessels, as well as a cell-based gene delivery approach for the prevention and treatment of cerebral vasospasm.

Estudo prospectivo comparativo entre a endarterectomia e a angioplastia com stent e proteção cerebral no tratamento das lesões ateroscleróticas carotídeas: resultados em 30 dias Prospective and comparative study between endarterectomy and stent angioplasty with cerebral protection in carotid atherosclerotic lesions: 30-day results

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Eugênio Carlos de Almeida Tinoco

2006-12-01

Full Text Available OBJETIVO: Analisar comparativamente os resultados, em 30 dias, entre a endarterectomia e a angioplastia com stent auto-expansível e filtro de proteção cerebral, avaliando a incidência de acidente vascular cerebral e óbito, bem como o tempo de permanência hospitalar no tratamento das lesões ateroscleróticas da bifurcação carotídea. MÉTODO: Estudo prospectivo, em que foram tratados 80 pacientes, sintomáticos e assintomáticos, com lesões estenóticas maiores que 60 e 70%, respectivamente, da bifurcação carotídea. Os pacientes foram divididos em dois grupos de 40 pacientes, que foram avaliados quanto a sexo, idade, comorbidades associadas e tabagismo. RESULTADOS: A taxa de acidente vascular cerebral e óbito foi de 5,0% em ambas as técnicas. Ocorreu um caso (2,5% de ataque isquêmico transitório no grupo endovascular e nenhum na endarterectomia. No que se refere ao tempo de internação, o tratamento endovascular apresentou menor tempo em relação à endarterectomia, sendo estatisticamente significativo (P OBJECTIVE: To comparatively analyze the 30-day results between endarterectomy and angioplasty using self-expandable stent and filter protection in the treatment of carotid bifurcation atherosclerotic lesions. The primary endpoint was to analyze stroke and death rate, as well hospitalization time. METHODS: Comparative and prospective study in 80 symptomatic and asymptomatic patients, with carotid bifurcation stenotic lesions greater than 60 and 70%, respectively. The patients were divided into two groups of 40 and assessed according to gender, age, associated comorbid conditions and smoking. RESULTS: The stroke and death rate was 5.0% for both techniques. There was only one case of transient ischemic attack (2.5% in the endovascular group. Regarding hospitalization time, it was significantly lower in favor of the endovascular technique, with statistical significance (P < 0.002. CONCLUSIONS: This study demonstrated a 5

Prenatal diagnosis of concurrent facial and cerebral vascular malformation which caused congestive heart failure

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Behnaz Moradi

2017-12-01

Full Text Available Arteriovenous malformations (AVMs are rarely reported antenatally. Most in utero diagnosis of vascular malformation is related to vein of Galen malformation (VGM. We describe a case of simultaneously diagnosed pial arteriovenous fistula (AVF and facial vascular malformation in a 20 weeks old fetus. The dilated intracranial venous pouch appeared as a midline anechoic structure which was misdiagnosed as a VGM in her previous ultrasound exam. Another AVM was diagnosed in the same side of fetal face which fed by a branch of external carotid artery and communicated with the mentioned pial AVF. High output cardiac failure and hydrops were evident. To our knowledge this is the first report of prenatally detected combination of facial and cerebral vascular malformations at such as early pregnancy week.

Systemic and cerebral vascular endothelial growth factor levels increase in murine cerebral malaria along with increased Calpain and caspase activity and can be reduced by erythropoietin treatment

DEFF Research Database (Denmark)

Hempel, Casper; Hoyer, Nils; Kildemoes, Anna

2014-01-01

The pathogenesis of cerebral malaria (CM) includes compromised microvascular perfusion, increased inflammation, cytoadhesion, and endothelial activation. These events cause blood-brain barrier disruption and neuropathology and associations with the vascular endothelial growth factor (VEGF) signal...

Uso incorreto de medicamentos por pacientes após acidente vascular cerebral Uso incorrecto de medicamentos por pacientes después de un accidente cerebro vascular Incorrect use of medicines by patients post cerebrovascular accident

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Lolita Dopico da Silva

2011-07-01

Full Text Available Objetivo. Avaliar o emprego de medicamentos no lar pelos pacientes vítimas de um acidente vascular cerebral (AVC. Metodologia. Estudo transversal de uma mostra representativa de 30 pacientes que recebiam atendimento público domiciliário no Rio de Janeiro (Brasil em 2008. Por meio de entrevista estruturada aos pacientes se tomou informação sobre os fatores de risco para AVC, os medicamentos que estavam tomando e o uso correto ou incorreto dos mesmos, utilizando para isto a classificação de DRUGDEX® System. Resultados. Os participantes de idade avançada e com predomínio de mulheres. A média de medicamentos por foi 3.3. As causas do erro mais comuns foram: a tomada do medicamento com alimentos e com outras medicações. As proporções mais altas de uso incorreto de medicamento em mais de 50% das doses foram: espironolactona, glibenclamida e atenolol (a cada uma com 100.0%, sinvastatina (87.5%, furosemida (83.3%, captropril (72.5% e insulina NPH (66.7%. Conclusão. Uma grande proporção de pacientes depois de um AVC usam incorretamente os medicamentos prescritos para o tratamento no lar.Objetivo. Evaluar el empleo de medicamentos en el hogar por los pacientes víctimas de un accidente cerebrovascular (ACV. Metodología. Estudio transversal de una muestra representativa de 30 pacientes que recibían atención pública domiciliario en Río de Janeiro (Brasil en 2008. En la muestra predominaron las mujeres y los pacientes de edad avanzada. Por medio de entrevista estructurada a los pacientes se tomó información sobre los factores de riesgo para ACV, los medicamentos que estaban tomando y el uso correcto o incorrecto de los mismos, utilizando para esto la clasificación de DRUGDEX® System. Resultados. El promedio de medicamentos por fue 3.3. Las causas más comunes de error fueron la toma del medicamento con alimentos y con otras medicaciones. Las proporciones más altas de uso incorrecto de medicamento en más del 50% de las dosis

Cortical Cerebral Microinfarcts on 3 Tesla MRI in Patients with Vascular Cognitive Impairment.

Science.gov (United States)

Ferro, Doeschka A; van Veluw, Susanne J; Koek, Huiberdina L; Exalto, Lieza G; Biessels, Geert Jan

2017-01-01

Cerebral microinfarcts (CMIs) are small ischemic lesions that are a common neuropathological finding in patients with stroke or dementia. CMIs in the cortex can now be detected in vivo on 3 Tesla MRI. To determine the occurrence of CMIs and associated clinical features in patients with possible vascular cognitive impairment (VCI). 182 memory-clinic patients (mean age 71.4±10.6, 55% male) with vascular injury on brain MRI (i.e., possible VCI) underwent a standardized work-up including 3 Tesla MRI and cognitive assessment. A control group consisted of 70 cognitively normal subjects (mean age 70.6±4.7, 60% male). Cortical CMIs and other neuroimaging markers of vascular brain injury were rated according to established criteria. Occurrence of CMIs was higher (20%) in patients compared to controls (10%). Among patients, the presence of CMIs was associated with male sex, history of stroke, infarcts, and white matter hyperintensities. CMI presence was also associated with a diagnosis of vascular dementia and reduced performance in multiple cognitive domains. CMIs on 3 Tesla MRI are common in patients with possible VCI and co-occur with imaging markers of small and large vessel disease, likely reflecting a heterogeneous etiology. CMIs are associated with worse cognitive performance, independent of other markers of vascular brain injury.

Acidentes de trabalho em Barcelona (Espanha, no período de 1992-1993

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Rosana F. Sampaio

1998-08-01

Full Text Available INTRODUÇÃO: As estatísticas dos acidentes de trabalho, como qualquer outro sistema de notificação, devem servir de base para determinar prioridades e decidir quais medidas preventivas devem ser adotadas. Neste contexto, o objetivo do estudo é aprofundar a análise dos acidentes de trabalho através da utilização de técnicas estatísticas descritivas que permitam estabelecer a relação entre o número de acidentes de trabalho ocorridos em Barcelona (Espanha e as variáveis tipo de acidente, setor econômico, tamanho da empresa e tipo de contrato. MÉTODO: Como fonte de dados foi utilizado o sistema de notificação de acidentes graves e mortais ocorridos na cidade de Barcelona (Espanha, entre 1992 e 1993. Foram examinados 848 registros de acidentes de trabalho em trabalhadores do sexo masculino e a partir desses dados efetuou-se uma análise mediante modelos log-lineares. RESULTADOS E CONCLUSÕES: Os resultados evidenciam que os acidentes traumáticos e o setor de construção têm uma associação positiva, verificada, da mesma forma, entre os acidentes de trânsito e o setor de serviços. Os acidentes traumáticos e de trânsito apresentaram uma associação com as pequenas empresas e os acidentes não traumáticos demonstraram associar-se com as grandes empresas. Verificou-se, ainda, associação entre os trabalhadores temporais e o setor da construção frente aos trabalhadores com contrato fixo, em que se constatou uma associação com os setores de indústria e de serviços. Foi verificada associação positiva entre os acidentes ocorridos com os trabalhadores temporais e as pequenas e médias empresas.

Acidentes de trabalho em Barcelona (Espanha, no período de 1992-1993

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Sampaio Rosana F.

1998-01-01

Full Text Available INTRODUÇÃO: As estatísticas dos acidentes de trabalho, como qualquer outro sistema de notificação, devem servir de base para determinar prioridades e decidir quais medidas preventivas devem ser adotadas. Neste contexto, o objetivo do estudo é aprofundar a análise dos acidentes de trabalho através da utilização de técnicas estatísticas descritivas que permitam estabelecer a relação entre o número de acidentes de trabalho ocorridos em Barcelona (Espanha e as variáveis tipo de acidente, setor econômico, tamanho da empresa e tipo de contrato. MÉTODO: Como fonte de dados foi utilizado o sistema de notificação de acidentes graves e mortais ocorridos na cidade de Barcelona (Espanha, entre 1992 e 1993. Foram examinados 848 registros de acidentes de trabalho em trabalhadores do sexo masculino e a partir desses dados efetuou-se uma análise mediante modelos log-lineares. RESULTADOS E CONCLUSÕES: Os resultados evidenciam que os acidentes traumáticos e o setor de construção têm uma associação positiva, verificada, da mesma forma, entre os acidentes de trânsito e o setor de serviços. Os acidentes traumáticos e de trânsito apresentaram uma associação com as pequenas empresas e os acidentes não traumáticos demonstraram associar-se com as grandes empresas. Verificou-se, ainda, associação entre os trabalhadores temporais e o setor da construção frente aos trabalhadores com contrato fixo, em que se constatou uma associação com os setores de indústria e de serviços. Foi verificada associação positiva entre os acidentes ocorridos com os trabalhadores temporais e as pequenas e médias empresas.

Late radiation encephalopathy in the dog. A model for cerebral vascular disease

International Nuclear Information System (INIS)

Michaelson, S.M.; Kramer, M.W.

The Research Group on Industrial and Environmental Neurology has suggested that assessment of cerebral atherosclerosis should be considered as part of its purview of problems of interest. Although the present study is not related to the ordinary environmental or industrial situation, it can apply to accidental over-exposure to external ionizing radiation or radiation therapy and describes an animal model that can be used for fundamental study of cerebral vascular conditions and encephalomalacia. Ionizing radiation damage to nervous tissue may be apparent early after irradiation or may become evident after a variable latent period. The concept of late ionizing radiation-induced neuropathy, the subject of this study, is characterized by a long latent period between exposure and initial clinical signs, an inverse relationship between radiation dose and latency of appearance of late radiation encephalopathy, and an apparent lack of demonstrable physiological, biochemical, and morphological alterations until necrosis becomes manifest. (U.S.)

Cerebral infarcts resulting from trauma

International Nuclear Information System (INIS)

Busch, G.

1985-01-01

Vascular occlusions due to cerebral trauma have always been regarded as great rarities. However, we have found hypo-dense foci of vascular distribution in 3.5% of 3500 CT examinations for trauma during the late phase. Lesions in the vascular territory of the posterior cerebral artery are usually the result of supratentorial pressure rise from epidural and subdural haematomas, leading to compression of the vessels against the edge of the tentorium. Typical infacts in the territory of the medial and anterior cerebral arteries were found only rarely by CT after cerebral trauma. Infarcts at the watersheds between the three vascular territories were found with surprising frequency and small infarcts were found in the basal ganglia. It is assumed that these were due to ischaemic or hypoxic events due to cardiac or pulmonary complications during the initial phase. (orig.) [de

Acidentes de trabalho em indústria gráfica

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João de Barros Barreto

1947-03-01

Full Text Available Os autores analisam, dentro do campo da higiene industrial, as condições sanitárias de um grande estabelecimento de artes gráficas no Rio de Janeiro — a Imprensa Nacional, o regime de trabalho aí instituído; e revistam, um a um, os processos industriais executados, especialmente atenção às causas potenciais de acidentes, que aí existem, e também àquelas cuja responsabilidade já se positivou. Ressaltam, no ponto de vista doutrinário, os diversos fatores que podem interferir na ocorrência dêsses infortúnios de trabalho; e, mostrando como tem sido superestimada a culpabilidade das máquinas, realçam a importância dos fatores individuais — idade e experiência do operário, doenças e defeitos físicos, atitude mental, constituição fisio-psicologica. Salientam como a evidência da predisposição a acidentes, que se reconheça existir, possibilita manter os operários, já em função ou pretendentes a emprego, debaixo de supervisão rigorosa; e oportuniza mesmo colocá-los melhormente, em tarefas que, no máximo, só lhes possam acarretar aciden¬tes de natureza leve. Mostram que, no período em estudo — 1942 a 1945, houve ao todo 1.123 acidentes na I.N., com o coeficiente geral de incidência de 220.3 por 1.000 operários expostos. O coeficiente de acidentes médios ou graves foi de 32 por mil, no mesmo período. Apontando ainda a descenção, no quatriênio, das curvas relativas tanto aos acidentes totais, como aos médios ou graves e aos produzidos por máquinas, dão a ver que a taxa, que retrata essa descida, é, para os primeiros, 3.5 e cêrca de 10 vêzes maior, respectivamente, que a dos acidentes por máquinas e dos médios ou graves. Mostra-se significativa a diferença, entre a tendência observada nas curvas dos acidentes em geral e dos médios ou graves; já isso, porém, não acontece, quanto à diferença entre a primeira e a dos acidentes produzidos por máquinas. De fato, sendo os valores de t respec

Detection of vascular cell adhesion molecule-1 expression with USPIO-enhanced molecular MRI in a mouse model of cerebral ischemia

International Nuclear Information System (INIS)

Frechou, M.; Beray-Berthat, V.; Plotkine, M.; Marchand-Leroux, C.; Margaill, I.; Raynaud, J.S.; Gombert, F.; Lancelot, E.; Ballet, S.; Robert, P.; Louin, G.; Meriaux, S.

2013-01-01

Vascular damage plays a critical role after stroke, leading notably to edema, hemorrhages and stroke recurrence. Tools to characterize the vascular lesion are thus a real medical need. In this context, the specific nano-particular contrast agent P03011, an USPIO (ultra-small superparamagnetic iron oxide) conjugated to a peptide that targets VCAM-1 (vascular cell adhesion molecule-1), was developed to detect this major component of the vascular inflammatory response. This study aimed to make the proof of concept of the capacity of this targeted USPIO to detect VCAM-1 with MRI after cerebral ischemia in mouse. The time course of VCAM-1 expression was first examined by immunohistochemistry in our model of cerebral ischemia-reperfusion. Secondly, P03011 or non-targeted USPIO P03007 were injected 5 h after ischemia (100 mmol iron kg -1 ; i.v.) and in vivo and ex vivo MRI were performed 24 h after ischemia onset. Double labeling immunofluorescence was then performed on brain slices in order to detect both USPIO and VCAM-1. VCAM-1 expression was significantly up-regulated 24 h after ischemia in our model. In animals receiving P03011, both in vivo and ex vivo MRI performed 24 h after ischemia onset showed hypointense foci which could correspond to iron particles. Histological analysis showed a co-localization of the targeted USPIO and VCAM-1. This study demonstrates that VCAM-1 detection is possible with the USPIO P03011 in a model of cerebral ischemia. This kind of contrast agent could be an interesting clinical tool to characterize ischemic lesions in terms of vascular damage. (authors)

Does botulinum toxin improve the function of the patient with spasticity after stroke? Toxina botulínica proporciona melhora funcional em pacientes com espasticidade secundária a acidente vascular cerebral?

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Eduardo Cardoso

2007-09-01

Full Text Available Post-stroke spasticity is an important cause of disability in adults, due to muscle hyperactivity, which results in limb stiffness and muscle spasm. The prognosis for these patients depends on several features such as early management and adequate physical therapy to avoid muscle shortening, pain, and their consequences. Although several papers have shown that intramuscular injections of botulinum toxin type A (BT-A decreases spasticity in post-stroke patients, few authors have demonstrated functional improvement after this therapy. In order to assess if individualized BT-A injections improves upper limb function in post-stroke spastic patients, we prospectively followed 20 consecutive patients of 18 years of age or more with spastic hemiparesis secondary to stroke. Fulg-Meyer scale modified for upper limbs, measure of functional independence (MFI, Ashworth modified scale, and goniometry were applied in the beginning of the investigation and in the 16th and 32nd weeks. BT-A was applied at baseline and in the 16th week. All subjects were submitted to rehabilitation therapy. All patients showed improvement according to Ashworth modified scale and increase in the range of motion, which were sustained until the 32nd week (pEspasticidade secundária a acidente vascular cerebral (AVC é importante causa de incapacidade em adultos. O prognóstico para estes pacientes depende de vários fatores como tratamento precoce e terapia física adequada, evitando encurtamento muscular, dor e outras conseqüências. Vários estudos têm demonstrado que aplicacões intramusculares de toxina botulínica do tipo A (TxB-A reduzem a espasticidade após AVC, entretanto poucos autores observaram melhora funcional de membros superiores com esta terapêutica. Para determinar se aplicações individualizadas de TxB-A melhoram a função no membro superior espástico de pacientes com hemiparesia secundária a AVC, acompanhamos 20 pacientes com história de AVC entre 6 meses

Análise de custo-efetividade da trombólise com alteplase no Acidente Vascular Cerebral Análisis de costo-efectividad de la trombólisis con alteplase en el accidente vascular cerebral Analysis of the cost-effectiveness of thrombolysis with alteplase in stroke

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Denizar Vianna Araújo

2010-07-01

Full Text Available FUNDAMENTO: Acidente Vascular Cerebral (AVC é a principal causa de óbito no Brasil e pouca informação está disponível sobre custo do tratamento. OBJETIVO: Elaborar análise de custo-efetividade da trombólise no AVC, até três horas após o início dos sintomas, comparando o tratamento com alteplase versus conservador, sob a perspectiva do Sistema Único de Saúde (SUS. MÉTODOS: Modelo de análise de decisão foi desenvolvido para comparar os dois tratamentos. Ciclos foram considerados, durante os quais pacientes poderiam transitar entre cinco estágios de incapacidade pós-AVC, baseados na escala modificada de Rankin. A probabilidade de apresentar hemorragia intracerebral no primeiro ano foi obtida do ensaio NINDS. Para os anos subsequentes, ciclos de um ano foram considerados, para contabilizar a mortalidade dos pacientes. O desfecho foi expresso em Anos de Vida Ajustados pela Qualidade (QALY. Tanto os custos diretos quanto os indiretos foram considerados na análise. Custos e desfecho foram descontados em 5% ao ano. RESULTADOS: No primeiro ano, o QALY ganho foi de 0,06 para ambos os gêneros, com custo incremental de R$ 2.558 para homens e R$ 2.312 para mulheres. A razão de custo-efetividade incremental em um ano foi de R$ 40.539 / QALY (USD 28.956 para homens e R$ 36.640 / QALY (USD 26.171 para mulheres. Após o segundo ano, o tratamento com alteplase reduziu o custo do tratamento (índice de Paridade do Poder de Compra US$ 1 = R$ 1,4. CONCLUSÃO: Terapia trombolítica com alteplase nas primeiras três horas após o AVC é custo-efetiva no cenário do Sistema Único de Saúde.FUNDAMENTO: Accidente Vascular Cerebral (AVC es la principal causa de óbito en el Brasil y poca información está disponible sobre el costo del tratamiento. OBJETIVO: Elaborar análisis de costo-efectividad de la trombólisis en el AVC, hasta tres horas después del comienzo de los síntomas, comparando el tratamiento con alteplase versus conservador, bajo la

Comparison between digital subtraction angiography and magnetic resonance angiography in investigation of nonlacunar ischemic stroke in young patients: preliminary results Comparação entre arteriografia digital e angioressonância na investigação de acidente vascular cerebral isquêmico não-lacunar em pacientes jovens: resultados preliminares

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Adriana Bastos Conforto

2006-06-01

Full Text Available PURPOSE: We preliminarily investigated the relevance of performing digital subtraction angiography (DSA in addition to magnetic resonance angiography (MRA in definition of ischemic stroke etiology in young patients. METHOD: DSAs and MRAs from 17 young patients with nonlacunar ischemic stroke were blindly analyzed and their impact on stroke management was evaluated. RESULTS: Etiologies were the same considering results of either DSA or MRA in 12/17 cases. In 15/17 patients no changes would have been made in treatment, regardless of the modality of angiography considered. CONCLUSION: These preliminary results suggest that DSA may be redundant in two thirds of ischemic strokes in young patients. Further larger prospective studies are necessary to determine indications of DSA in this age group.PROPÓSITO DO ESTUDO: Investigar de forma preliminar a relevância da realização de angiografia digital (AD adicionalmente a angioressonância (AR na definição de etiologias de acidente vascular cerebral isquêmico (AVCI em pacientes jovens. MÉTODO: ADs e ARs de 17 pacientes jovens com AVCIs não-lacunares foram analisadas. Avaliamos o impacto destes exames no manejo clínico dos casos. RESULTADOS: Em 12/17 casos, as etiologias dos AVCIs de acordo com os resultados de AD ou de AR foram idênticas. Em 15/17 pacientes, nenhuma mudança de conduta terapêutica seria realizada, independentemente da modalidade de exame considerada. CONCLUSÃO: Estes resultados preliminares sugerem que os resultados da AD podem ser redundantes em relação à AR em até dois terços dos pacientes jovens com AVCI. Estudos prospectivos maiores são necessários para otimizar o estabelecimento de indicações de AD nesta faixa etária.

Cerebral vascular structure in the motor cortex of adult mice is stable and is not altered by voluntary exercise.

Science.gov (United States)

Cudmore, Robert H; Dougherty, Sarah E; Linden, David J

2017-12-01

The cerebral vasculature provides blood flow throughout the brain, and local changes in blood flow are regulated to match the metabolic demands of the active brain regions. This neurovascular coupling is mediated by real-time changes in vessel diameter and depends on the underlying vascular network structure. Neurovascular structure is configured during development by genetic and activity-dependent factors. In adulthood, it can be altered by experiences such as prolonged hypoxia, sensory deprivation and seizure. Here, we have sought to determine whether exercise could alter cerebral vascular structure in the adult mouse. We performed repeated in vivo two-photon imaging in the motor cortex of adult transgenic mice expressing membrane-anchored green fluorescent protein in endothelial cells (tyrosine endothelial kinase 2 receptor (Tie2)-Cre:mTmG). This strategy allows for high-resolution imaging of the vessel walls throughout the lifespan. Vascular structure, as measured by capillary branch point number and position, segment diameter and length remained stable over a time scale of months as did pericyte number and position. Furthermore, we compared the vascular structure before, during, and after periods of voluntary wheel running and found no alterations in these same parameters. In both running and control mice, we observed a low rate of capillary segment subtraction. Interestingly, these rare subtraction events preferentially remove short vascular loops.

Regional cerebral blood flow in vascular depression assessed by 123I-IMP SPECT

International Nuclear Information System (INIS)

Kimura, Mahito; Shimoda, Kengo; Mizumura, Sunao; Tateno, Amane; Fujito, Tatsuma; Mori, Takao; Endo, Shunkichi

2003-01-01

As the prevalence of white matter hyperintensities detected on T2 weighted MRI scans in patients with late-onset depression is higher than that in nondepressed patients, the concept of ''vascular depression'' (VDep) was introduced in 1997. However, the pathology of vascular depression has not been clarified. This study examined the differences in functional imaging between vascular and non-vascular depression (non-VDep). We utilized 123 I-IMP single photon emission computed tomography (SPECT) to compare regional cerebral blood flows (rCBF) between 9 patients with VDep (Krishnan criteria) and 11 age- and sex-matched patients with non-VDep in both depressed and remitted states. In both VDep and non-VDep patients, mean rCBF increased significantly as depression improved, partially aided by changes in left anterior temporal blood flow. In addition, compared to non-VDep patients, the left anterior frontal rCBF for VDep patients was significantly lower in both depressed and remitted states. Left anterior temporal rCBF therefore appears to represent a state marker that increases as symptoms associated with late-onset depression improve, regardless of vascular changes. Furthermore, in VDep patients, left anterior frontal rCBF was low in both states compared to non-VDep patients, and might not only represent a trait marker, but also correlated with the duration of disease and likelihood of recurrence and relapse. (author)

Disfunção intestinal em pacientes com lesão cerebral decorrente de acidente vascular cerebral e traumatismo craniencefálico: estudo retrospectivo de uma série de casos

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Cinthia Carlos Dourado

2012-01-01

Full Text Available La disfunción del intestino es una queja común entre los pacientes con daño cerebral debido a una lesión cerebral traumática y accidente cerebrovascular. Este estudio tuvo como objetivo investigar la prevalencia de disfunción del intestino (incontinencia y constipación en pacientes con daño cerebral debido a una lesión cerebral traumática y accidente cerebrovascular admitidos para la rehabilitación. Este es un estudio retrospectivo de una serie de casos a partir del análisis de los datos de 138 expedientes de los pacientes ingresados en el primer semestre de 2009. La prevalencia de disfunción del intestino fue de 41%, siendo 33 (24% incontinencia anal y 37 (27%, constipación. El comprometimiento motor, ayuda a la movilidad, cambios en la memoria y la comunicación se asocian con la presencia de la incontinencia anal. La prevalencia de disfunción del intestino es alta en esta población, identificar en forma temprana los factores relacionados, y promover el reentrenamiento intestinal pueden ayudar a mejorar la calidad de sus vidas.

Ocorrência de acidente do trabalho em uma unidade de terapia intensiva

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Vera Médice Nishide

Full Text Available Este estudo, de caráter descritivo, identificou os acidentes do trabalho ocorridos com trabalhadores de enfermagem de uma unidade de terapia intensiva, correlacionando-os com o procedimento que estava sendo executado pelo trabalhador no momento do acidente. Os dados foram coletados por meio de entrevista individual, realizado com 68 trabalhadores, no ano de 2001. Constatou-se que os acidentes ocorreram, predominantemente, devido ao contato da pele e da mucosa com sangue e secreções, ferimento por material perfurocortante, queda e lesões na coluna vertebral. Os acidentes acontecidos estavam relacionados aos procedimentos de aspiração de tubo orotraqueal, manuseio de excretas/secreções, preparo de medicação, coleta de sangue arterial, piso molhado e transporte de paciente. Concluiu-se que são necessárias mudanças no ambiente de trabalho e programas de prevenção, para minimizar os acidentes em procedimentos de assistência aos pacientes.

Effect of preceding exercise on cerebral and splanchnic vascular responses to mental task

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Someya Nami

2012-06-01

Full Text Available Abstract Background To investigate the effect of preceding acute exercise on the peripheral vascular response to a mental task, we measured splanchnic and cerebral blood flow responses to performing a mental task after exercise and resting. Methods In the exercise trial, 11 males exercised for 30 min on a cycle ergometer with a workload set at 70% of the age-predicted maximal heart rate for each individual. After a 15-min recovery period, the subjects rested for 5 min for pre-task baseline measurement and then performed mental arithmetic for 5 min followed by 5 min of post-task measurement. In the resting trial, they rested for 45 min and pre-task baseline data was obtained for 5 min. Then mental arithmetic was performed for 5 min followed by post-task measurement. We measured the mean blood velocity in the middle cerebral artery and superior mesenteric artery and the mean arterial pressure. Results Mean arterial pressure and mean blood velocity in the middle cerebral artery were significantly higher than the baseline during mental arithmetic in both exercise and resting trials. Mean blood velocity in the middle cerebral artery during mental arithmetic was greater in the control trial than the exercise trial. Mean blood velocity in the superior mesenteric artery showed no significant change during mental arithmetic from baseline in both trials. Conclusion These results suggest that acute exercise can moderate the increase in cerebral blood flow induced by a mental task.

Atuação da enfermagem no autocuidado e reabilitação de pacientes que sofreram Acidente Vascular Encefálico Actuación de la enfermería en el autocuidado y rehabilitación de pacientes que sufreran Accidente Nursing activities in self-care and rehabilitation of patients who suffered Stroke

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Juliana Cristina Lessmann

2011-02-01

Full Text Available Quando o cérebro sofre alterações vasculares podem ocorrer sérias sequelas motoras, sensoriais e na percepção. Nesta perspectiva o estudo objetiva relatar/ compartilhar assistência de Enfermagem ao indivíduo acometido pelo Acidente Vascular Encefálico enfatizando a reabilitação e o autocuidado baseado em Orem. Trata-se de relato de experiência de prática assistencial, realizada de maio a julho de 2006, com 15 indivíduos e seus familiares, em um centro de reabilitação da região sul do Brasil. O cuidado de Enfermagem integral ocorre com atividades de estimulação sensitiva, motora, controle postural, amplitude de movimentos e treino de marcha, sempre acompanhados por ações de educação em saúde. Estas habilidades conferem aos enfermeiros capacidades de atuação proporcionando a redução de danos e incapacidadesCuando o cerebro sufre alteraciones vasculares pueden ocurrir serias secuelas motoras, sensoriales y en la percepción. En esta perspectiva el estudio objetiva relatar/compartir asistencia de Enfermería al individuo afectado por accidente vascular cerebral enfatizando la rehabilitación y autocuidado basado en Orem. Se trata de relato de experiencia de práctica asistencial, realizada de mayo a julio de 2006, con 15 individuos y sus familiares, en un centro de rehabilitación de la región sur do Brasil. El cuidado de Enfermería integral ocurre con actividades de estimulación sensitiva, motora, control postural, amplitud de movimientos y entrenamiento de marcha, siempre acompañados por acciones de educación en salud. Estas habilidades confieren a los enfermeros capacidades de actuación, participando en la reducción de daños e incapacidadesThere can be serious damage to motor, sensatory, and perceptive capabilities when the brain suffers vascular alterations. With this in mind, the objective of this study is to report and share Nursing care to the individual who has suffered a cerebral vascular accident

Majewski osteodysplastic primordial dwarfism type II (MOPD II) complicated by stroke: clinical report and review of cerebral vascular anomalies.

Science.gov (United States)

Brancati, Francesco; Castori, Marco; Mingarelli, Rita; Dallapiccola, Bruno

2005-12-15

We report on a 2 9/12-year-old boy with disproportionate short stature, microcephaly, subtle craniofacial dysmorphisms, and generalized skeletal dysplasia, who developed a left hemiparesis. Brain neuroimaging disclosed a complex cerebral vascular anomaly (CVA) with stenosis of the right anterior cerebral artery and telangiectatic collateral vessels supplying the cerebral cortex, consistent with moyamoya disease. Based on clinical and skeletal features, a diagnosis of Majewski osteodysplastic primordial dwarfism type II (MOPD II) was established. Review of 16 published patients with CVA affected by either Seckel syndrome or MOPD II suggested that CVA is preferentially associated to the latter subtype affecting about 1/4 of the patients. 2005 Wiley-Liss, Inc.

Dinamometria de preensão manual como parâmetro de avaliação funcional do membro superior de pacientes hemiparéticos por acidente vascular cerebral Handgrip dynamometry as a parameter of functional evaluation of the upper extremity hemiparetic after stroke

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Antonio Vinicius Soares

2011-12-01

Full Text Available A força muscular é a valência física mais importante. É provável que exista correlação entre a força de preensão manual e outros testes para o membro superior afetado por um acidente vascular cerebral (AVC. O propósito deste estudo é analisar o valor preditivo da dinamometria de preensão manual (DPM para recuperação do membro superior parético por AVC. Foram avaliados 43 pacientes hemiparéticos pós-AVC (60,7 anos±12,1. Vários testes (Escala de movimento da mão (EMM, Estesiometria, Teste de caixa e blocos, 9 buracos e pinos, Escala de Ashworth modificada e Índice de Barthel foram relacionados com a DPM. Os resultados apontaram que a DPM apresenta boa correlação com EMM e, contrariamente, os testes de destreza manual, a sensibilidade e o índice de independência funcional não apresentaram valores significativos. A DPM é um teste rápido, fácil e acessível, e pode fazer parte dos protocolos de avaliação funcional do membro superior de pacientes hemiparéticos por AVC.Muscle strength is the most important physical valence. It is likely that there is a correlation between handgrip strength and other tests for the upper extremity affected by stroke. The purpose of this study is to analyze the predictive value of handgrip dynamometry (HD for upper limb recovery in stroke. Were studied 43 hemiparetic patients after stroke (60.7 years±12.1. Several tests (Hand moviment scale (HMS, Esthesiometry, Box and blocks test, 9 hole and peg test, Modified Ashworth scale and Barthel index were related to HD. The results showed that there is good correlation of the HD with HMS and, by contrast, the tests of manual dexterity, the sensitivity and index of functional independence showed no significant values. The HD is a quick, easy and affordable test, and can be part of protocols for functional evaluation of upper extremity of hemiparetic patients by stroke.

Cuidados Paliativos: o necessário para o idoso com acidente vascular encefálico

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Sônia Maria Dorta Ferreira

2014-03-01

Full Text Available A expectativa de vida do ser humano tem aumentado nas últimas décadas, o que vem exigindo o avanço da qualidade dos cuidados destinados a pessoas com fragilidades, especialmente em decorrência do crescimento considerável das doenças crônicas. Dentre essas doenças, destaca-se o acidente vascular encefálico (AVE que acomete grande parte da população idosa, ocasionando perdas e sequelas significativas. Formas inovadoras quanto à essência do cuidar devem ser estudadas e praticadas em nossa sociedade, reconhecendo-se como exemplar nesse sentido a intervenção em cuidados paliativos, que pode melhorar a qualidade de vida e confortar uma pessoa nos seus últimos dias. Nessa direção, objetiva este trabalho enfatizar a necessidade e o valor dos cuidados paliativos para a pessoa idosa com AVE e, para tal, foi realizado um levantamento da pesquisa científica sobre a temática nas principais revistas indexadas. Os resultados indicaram um número limitado de produção científica a esse respeito, assim como se verifica a escassez de serviços que assistam os idosos no final da vida, evidenciando ainda o desconhecimento dos serviços de cuidados paliativos à maior parte dos doentes e suas famílias. Os dados mostram que são múltiplos os sintomas físicos e psicológicos que comprometem a qualidade de vida dessas pessoas em terminalidade, e que a comunicação é essencial nas relações entre paciente, cuidador, família e equipe de saúde. No caso de idosos com AVE, a presença dos Cuidados Paliativos torna-se ainda mais relevante na relação desses pacientes com familiares e outros profissionais. Trabalhos futuros envolvendo os variados aspectos dos Cuidados Paliativos são necessários, para que se possa assegurar um atendimento mais competente e efetivo a essa população.

Burden and modifications in life from the perspective of caregivers for patients after stroke Sobrecarga y modificaciones de vida en la perspectiva de los cuidadores de pacientes con accidente vascular cerebral Sobrecarga e modificações de vida na perspectiva dos cuidadores de pacientes com acidente vascular cerebral

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Huana Carolina Cândido Morais

2012-10-01

ñados por el Programa de Servicio Domiciliar de tres hospitales. La colecta de los datos ocurrió mediante entrevista para identificar modificaciones de vida, y con la aplicación de tres escalas para investigar la sobrecarga percibida, estado mental y sufrimiento psíquico. Son ellas, respectivamente: Caregiver Burden Scale (CBS, Mini Examen del Estado Mental (MEEM y Self Reported Questionnaire (SRQ. Los cuidadores, en su mayoría, eran del sexo femenino, casados (as e hijo (as de los pacientes después del AVC. Edad Media de 48,2 años (±12,4. Las modificaciones de vida más citadas fueron referentes a la rutina diaria, a las actividades de ocio y agotamiento o cansancio. En cuanto a la sobrecarga, se destacaron las dimensiones Tensión general, Aislamiento y Decepción. Se verificó mayor sobrecarga cuanto más síntomas de sufrimiento psíquico el cuidador presentase, en la ausencia de cuidador secundario y cuando los cuidadores principales relataron percibir modificación en el cuerpo y en la salud. CONCLUSIÓN: no fue observada asociación de la sobrecarga con el estado mental del cuidador. Entender la coyuntura del cuidado, mediante análisis del recargo de trabajo, y del conocimiento de la situación biopsicosocial, suministrará subsidios para la actuación del enfermero para reducir la carga generada para los cuidadores familiares.OBJETIVO: analisar o impacto do cuidar para o cuidador familiar de paciente após acidente vascular cerebral (AVC, correlacionando modificações de vida e sofrimento psíquico com a sobrecarga percebida. MÉTODO: estudo transversal, quantitativo, realizado de janeiro a abril de 2010, em Fortaleza, Ceará, Brasil. RESULTADO: investigaram-se 61 indivíduos, acompanhados pelo Programa de Atendimento Domiciliar (PAD, de três hospitais. A coleta dos dados ocorreu mediante entrevista para identificar modificações de vida, e com a aplicação de três escalas para investigar sobrecarga percebida, estado mental e sofrimento psíquico. S�

Cerebral vascular disease in Hiroshima. Report of a six-year period of surveillance, 1958 to 1964

Energy Technology Data Exchange (ETDEWEB)

Johnson, K G; Yano, Katsuhiko; Kato, Hiroo

1966-08-25

Cerebral vascular disease (CVD) in the population of Hiroshima, Japan, is described for the period 1958 to 1964. The incidence of CVD in the male population over 30 years of age was 7.4 per 1000 per year and in females 4.1, approximately twice the observed incidence of coronary heart disease. Being based on examined individuals only, these estimates are biased downward, perhaps by a factor of 10%. The frequency of cerebral thrombosis was twice that of cerebral hemorrhage. These findings on incidence and type of CVD are in accord with the known high incidence of this disease in Japan but do not suggest that any disease other than atherosclerosis of the cerebral arteries is responsible. Hypertension, cardiomegaly (ascertained by ECG or chest film), and proteinuria were important factors in the risk of subsequent CVD. The singular association between hypertension and CVD, and the evidence that CVD is declining in Japan, the US and Europe during a period of widespread use of antihypertensive agents, encourage further epidemiologic study in CVD. 30 references, 15 figures, 8 tables.

Desarrumou tudo!O impacto do acidente vascular encefálico na família It changed everything! The impact of the stroke on the family

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Eliana Sales Brito

2008-06-01

Full Text Available O acidente vascular encefálico (AVE resulta em déficits neurológicos temporários ou permanentes, de variadas intensidades, que podem comprometer a independência do indivíduo acometido na realização de atividades de vida diária. Este estudo de caso investigou famílias de pacientes com diagnóstico de AVE, buscando compreender as dificuldades de ordem estrutural, socioeconômica e emocional pelas quais elas passam; a relação entre o grau de severidade de agravo, tempo de ocorrência da doença e o desenvolvimento de estratégias de proteção e cuidado ao familiar doente. Foram utilizados como instrumentos de coleta de dados: questionário; roteiro de entrevista; observações registradas em diário de pesquisa; aplicação do Índice de Barthel, escala de avaliação funcional internacionalmente validada. A análise dos dados foi realizada pelo Discurso do Sujeito Coletivo, produzindo representações sociais e idéias centrais. Constatou-se que a família passa por um processo de transformação que implica em reorganização e adoção de estratégias de enfrentamento favorecidas pela existência de uma rede de suporte. Esses resultados apontam para a necessidade de se habilitar a família para o cuidado ao paciente com incapacidade decorrente de acidente vascular encefálico e para o autocuidado.Strokes (cerebrovascular accidents result in temporal or permanent neurological deficits of varied intensities that can endanger the victim's independency in performing everyday activities. This qualitative case study investigated the families of patients with diagnosis of stroke, in order to understand the structural, socioeconomic and emotional difficulties that they face, and the relationship between the degree of damage severity, the time of disease occurrence and the development of strategies for the relative's protection and care. Data collection instruments were: questionnaire; interview guide; observations registered in a research

Análise de acidente de trabalho em uma refinaria de petróleo

OpenAIRE

Sandra Lorena Beltran Hurtado

2015-01-01

Introdução - Os acidentes de trabalho nas refinarias de petróleo se destacam por liderar vários indicadores de incidência e mortalidade dentro da indústria de transformação no Brasil. A abordagem das análises dos acidentes tem evoluído desde uma concepção do erro humano até as relações inter organizacionais. As empresas continuam usando abordagens tradicionais na investigação de acidentes que não ajudam na prevenção eficaz dos mesmos. Os estudos aprofundados em acidentes do setor que mostrem ...

Asthma is a risk factor for acute chest syndrome and cerebral vascular accidents in children with sickle cell disease

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Scott Paul J

2005-01-01

Full Text Available Abstract Background Asthma and sickle cell disease are common conditions that both may result in pulmonary complications. We hypothesized that children with sickle cell disease with concomitant asthma have an increased incidence of vaso-occlusive crises that are complicated by episodes of acute chest syndrome. Methods A 5-year retrospective chart analysis was performed investigating 48 children ages 3–18 years with asthma and sickle cell disease and 48 children with sickle cell disease alone. Children were matched for age, gender, and type of sickle cell defect. Hospital admissions were recorded for acute chest syndrome, cerebral vascular accident, vaso-occlusive pain crises, and blood transfusions (total, exchange and chronic. Mann-Whitney test and Chi square analysis were used to assess differences between the groups. Results Children with sickle cell disease and asthma had significantly more episodes of acute chest syndrome (p = 0.03 and cerebral vascular accidents (p = 0.05 compared to children with sickle cell disease without asthma. As expected, these children received more total blood transfusions (p = 0.01 and chronic transfusions (p = 0.04. Admissions for vasoocclusive pain crises and exchange transfusions were not statistically different between cases and controls. SS disease is more severe than SC disease. Conclusions Children with concomitant asthma and sickle cell disease have increased episodes of acute chest syndrome, cerebral vascular accidents and the need for blood transfusions. Whether aggressive asthma therapy can reduce these complications in this subset of children is unknown and requires further studies.

Can vascular risk factors influence number and size of cerebral metastases? A 3D-MRI study in patients with different tumor entities.

Science.gov (United States)

Nagel, Sandra; Berk, Benjamin-Andreas; Kortmann, Rolf-Dieter; Hoffmann, Karl-Titus; Seidel, Clemens

2018-02-01

There is increasing evidence that cerebral microangiopathy reduces number of brain metastases. Aim of this study was to analyse if vascular risk factors (arterial hypertension, diabetes mellitus, smoking, and hypercholesterolemia) or the presence of peripheral arterial occlusive disease (PAOD) can have an impact on number or size of brain metastases. 200 patients with pre-therapeutic 3D-brain MRI and available clinical data were analyzed retrospectively. Mean number of metastases (NoM) and mean diameter of metastases (mDM) were compared between patients with/without vascular risk factors (vasRF). No general correlation of vascular risk factors with brain metastases was found in this monocentric analysis of a patient cohort with several tumor types. Arterial hypertension, diabetes mellitus, hypercholesterolemia and smoking did not show an effect in uni- and multivariate analysis. In patients with PAOD the number of BM was lower than without PAOD. This was the case independent from cerebral microangiopathy but did not persist in multivariate analysis. From this first screening approach vascular risk factors do not appear to strongly influence brain metastasation. However, larger prospective multi-centric studies with better characterized severity of vascular risk are needed to more accurately detect effects of individual factors. Copyright © 2018 Elsevier B.V. All rights reserved.

Associação entre acidentes vasculares encefálicos e doença de Chagas

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Edison Reis Lopes

1991-06-01

Full Text Available Foi pesquisada a freqüência de acidentes vasculares encefálicos (A VE, isquêmicos e hemorrágicos, em chagásicos crônicos e em não chagásicos, maiores de 15 anos de idade, necropsiados em Uberaba, de 1979 a 1988, optando-se por estudo emparelhado por sexo e idade em 208 pares. Em 41 (19,7% dos chagásicos e em 55 (26,4% dos não chagásicos foram diagnosticados AVE, diferença não significante ao nível de 5%. Dos chagásicos 12 (75% tiveram infarto e 4 (25% hemorragia encefálica; dos não chagásicos 5 (31,3% tiveram infarto e 11 (68,7% hemorragia. As .diferenças são significantes ao nível de 5%. Os resultados demonstram menor freqüência de AVE hemorrágico em chagásicos que em não chagásicos e comprovam alta freqüência de AVE isqüêmico na doença de Chagas humana.The frequency of strokes was studied in chronic chagasic and years ofage, non-chagasicpatients, older than 15 coming to necropsy in Uberaba, from 1979 than 1988. The study consisted of paired sex and age matched controls. Two hundred and eight pairs were analysed. Either ischemic or hemorrhagic strokes were found in 41 (19,7% of the chagasics and in 55 (26.4% of the non-chagasic, a difference not significant at the level of 5%. Twelve (75% of the former had infarcts and 4(25% had brain hemorrhage; five (31,3% of the non-chagasics had ischemic strokes and 11 (68,7% had hemorrhagic strokes. The differences were significant to the level of 5%. The results indicate a high frequency of ischemic strokes in human Chagas'disease and demonstrate a lesser frequency of hemorrhagic stroke in chagasics when compared with non-chagasics.

Doença de Moyamoya e anestesia com sevoflurano fora do centro cirúrgico: relato de caso

OpenAIRE

Machado, Sheila Braga; Mendes, Florentino Fernandes; Angelini, Adriana de Campos

2002-01-01

JUSTIFICATIVA E OBJETIVOS: A doença de Moyamoya é uma desordem cerebrovascular progressiva que representa um desafio anestésico em virtude da precária circulação cerebral destes pacientes, constituindo-se numa importante causa de acidente vascular cerebral em indivíduos jovens. O objetivo deste relato é apresentar o caso de um paciente com doença de Moyamoya que foi submetido à anestesia geral com sevoflurano para procedimento diagnóstico fora do centro cirúrgico. RELATO DO CASO: Criança com ...

Doença de Moyamoya e anestesia com sevoflurano fora do centro cirúrgico: relato de caso Enfermedad de Moyamoya y anestesia con sevoflurano fuera del centro quirúrgico: relato de caso Moyamoya disease and sevoflurane anesthesia outside the surgery center: case report

OpenAIRE

Sheila Braga Machado; Florentino Fernandes Mendes; Adriana de Campos Angelini

2002-01-01

JUSTIFICATIVA E OBJETIVOS: A doença de Moyamoya é uma desordem cerebrovascular progressiva que representa um desafio anestésico em virtude da precária circulação cerebral destes pacientes, constituindo-se numa importante causa de acidente vascular cerebral em indivíduos jovens. O objetivo deste relato é apresentar o caso de um paciente com doença de Moyamoya que foi submetido à anestesia geral com sevoflurano para procedimento diagnóstico fora do centro cirúrgico. RELATO DO CASO: Criança com ...

Surgical prophylaxis secundary to cryptogenic stroke or transient ischemic attack in patients with patent foramen ovale Profilaxia cirúrgica secundária do acidente vascular cerebral ou ataque isquêmico transitório de origem indeterminada em pacientes com forame oval persistente

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Michele E.A. Guffi

2003-09-01

avoids recurrent stroke.INTRODUÇÃO: A prevenção do acidente vascular cerebral (AVC ou ataque isquêmico transitório (AIT de origem indeterminada recorrente em adultos com forame oval persistente (FOP representa um desafio terapêutico. O tratamento farmacológico antitrombótico é amplamente usado, mas a sua indicação é limitada, devido principalmente às suas importantes complicações. OBJETIVO: Demonstrar a eficácia da atriosseptorrafia como profilaxia secundária do AVC ou AIT de origem indeterminada em pacientes com FOP. MÉTODO: Foram estudados 47 pacientes, sendo 31 homens e 16 mulheres com eventos isquêmicos cerebrais. Todos foram submetidos a fechamento cirúrgico direto do FOP. A idade media foi de 40 anos. Não foi achada causa concomitante do AVC ou AIT após investigações, as quais incluíram testes de coagulação sanguínea, ecocardiografia transesofágica de contraste (ETE, ultra-sonografia doppler transcraniana e extracraniana (UDT, monitorização eletrocardiográfica de 24 horas, ressonância magnética cerebral (RMC e tomografia axial computadorizada (TAC. Os critérios para indicação cirúrgica foram pelo menos dois dos seguintes eventos: aneurisma do septo interatrial, infartos cerebrais múltiplos, eventos cerebrais múltiplos e história de manobra de Valsalva antes do AVC ou AIT. RESULTADOS: Não ocorreram complicações durante ou após as operações. Quatro pacientes apresentaram arritmia transitória algumas horas após a operação, sem fibrilação atrial, nem instabilidade hemodinâmica ou embolismo. Todos os pacientes sobreviveram em classe I (NYHA e durante seguimento médio de 36 meses nenhum paciente apresentou recorrência do AVC ou AIT. Todos os pacientes foram submetidos prospectivamente a RMC e ETE de contraste com simultânea UDT. Apenas um paciente apresentou desvio residual direita-esquerda, menor do que o desvio pré-operatório, porém sem lesões na RMC. CONCLUSÃO: A atriosseptorrafia em pacientes com suspeita

Cerebral vascular effects of hypovolemia and dopamine infusions

DEFF Research Database (Denmark)

Holst Hahn, Gitte; Heiring, Christian; Pryds, Ole

2012-01-01

Despite widespread use, effects of volume boluses and dopamine in hypotensive newborn infants remain controversial. We aimed to elucidate if hypovolemia alone impairs cerebral autoregulation (CA) and if dopamine affects cerebral vasculature.......Despite widespread use, effects of volume boluses and dopamine in hypotensive newborn infants remain controversial. We aimed to elucidate if hypovolemia alone impairs cerebral autoregulation (CA) and if dopamine affects cerebral vasculature....

Prevalência e fatores associados a acidentes de trânsito com mototaxistas

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Gilmara Celli Maia de Almeida

2016-04-01

Full Text Available RESUMO Objetivo: identificar a prevalência de acidentes motociclísticos envolvendo mototaxistas e fatores associados. Método: estudo transversal e exploratório, com aplicação de questionários aos mototaxistas das 32 praças de Caicó, Rio Grande do Norte, Brasil (N=420. Resultados: os mototaxistas têm alta carga horária de trabalho diária (12 horas em média e foi verificado que 63,6% já se envolveram em pelo menos um acidente motociclístico. A ocorrência de acidentes motociclísticos foi associada significativamente apenas com escolaridade (p<0,001, não havendo associação significativa com as demais variáveis, tais como idade (p=0,132, tempo de serviço (p=0,744 e carga horária de trabalho (p=0,830. Conclusão: é necessário implementar ações preventivas e educativas com os mototaxistas e usuários do serviço acerca dos acidentes e condutas emergenciais, devido à constante exposição a acidentes durante sua rotina de trabalho.

Regional cerebral blood flow analysis of vascular dementia by the single photon emission computed tomography

International Nuclear Information System (INIS)

Miyakawa, Kouichi; Watanabe, Sho; Suzuki, Michiyo; Kamijima, Gonbei

1989-01-01

In order to evaluate the relationship between the regional cerebral blood flow (CBF) and cerebrovascular dementia, eleven patients with vascular dementia and eight patients with non-demented infarction were studied and regional CBF were measured quantitatively with single photon emission computed tomography (SPECT) by using N-isopropyl-p-(I-123) iodoamphetamine. All cases were basal infarction and vascular dementia were diagnosed by less than 21.5 of the Hasegawa's dementia score and more than 7 of Hachinsk's ischemic score. The results of the present study were as follows: (1) Cerebrovascular dementia showed lower mean CBF value compared with non-demented group. (2) Regional CBF of bilateral frontal areas and affected basal ganglia were significantly reduced than occipital area in the dementia group. (3) A comparison of regional CBF and the Hasegawa's dementia score revealed a statistically significant correlation at the bilateral frontal areas in the dementia group. It is possible that measuring the regional CBF quantitatively by IMP-SPECT is useful for clinical analysis of vascular dementia. (author)

Structure and vascular function of MEKK3–cerebral cavernous malformations 2 complex

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Fisher, Oriana S. [Yale Univ., New Haven, CT (United States); Deng, Hanqiang [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China); Liu, Dou [Yale Univ. School of Medicine, New Haven, CT (United States); Zhang, Ya [Yale Univ. School of Medicine, New Haven, CT (United States); Wei, Rong [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China); Deng, Yong [Yale Univ. School of Medicine, New Haven, CT (United States); Zhang, Fan [Yale Univ. School of Medicine, New Haven, CT (United States); Louvi, Angeliki [Yale Univ. School of Medicine, New Haven, CT (United States); Turk, Benjamin E. [Yale Univ., New Haven, CT (United States); Boggon, Titus J. [Yale Univ., New Haven, CT (United States); Su, Bing [Shanghai Jiao Tong Univ. School of Medicine (SJTU-SM), Shanghai (China)

2015-08-03

Cerebral cavernous malformations 2 (CCM2) loss is associated with the familial form of CCM disease. The protein kinase MEKK3 (MAP3K3) is essential for embryonic angiogenesis in mice and interacts physically with CCM2, but how this interaction is mediated and its relevance to cerebral vasculature are unknown. Here we report that Mekk3 plays an intrinsic role in embryonic vascular development. Inducible endothelial Mekk3 knockout in neonatal mice is lethal due to multiple intracranial haemorrhages and brain blood vessels leakage. We discover direct interaction between CCM2 harmonin homology domain (HHD) and the N terminus of MEKK3, and determine a 2.35 Å cocrystal structure. We find Mekk3 deficiency impairs neurovascular integrity, which is partially dependent on Rho–ROCK signalling, and that disruption of MEKK3:CCM2 interaction leads to similar neurovascular leakage. We conclude that CCM2:MEKK3-mediated regulation of Rho signalling is required for maintenance of neurovascular integrity, unravelling a mechanism by which CCM2 loss leads to disease.

Dynamic digitized cerebral parenchymography

International Nuclear Information System (INIS)

Theron, J.; Alachkar, F.; Nelson, M.; Mazia, D.

1992-01-01

Aortic arch injections centred on the head have been performed routinely in patients with cerebral ischaemia. Digital angiograms with modified windowing (low and narrow) have been used. This 'cerebral' arch injection allows much improved analysis of the cerebral parenchymal vascularization, giving better understanding of hemispheric ischaemia and making the decision about revascularization more rational. (orig.)

Single Sustained Inflation followed by Ventilation Leads to Rapid Cardiorespiratory Recovery but Causes Cerebral Vascular Leakage in Asphyxiated Near-Term Lambs.

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Kristina S Sobotka

Full Text Available A sustained inflation (SI rapidly restores cardiac function in asphyxic, bradycardic newborns but its effects on cerebral haemodynamics and brain injury are unknown. We determined the effect of different SI strategies on carotid blood flow (CaBF and cerebral vascular integrity in asphyxiated near-term lambs.Lambs were instrumented and delivered at 139 ± 2 d gestation and asphyxia was induced by delaying ventilation onset. Lambs were randomised to receive 5 consecutive 3 s SI (multiple SI; n = 6, a single 30 s SI (single SI; n = 6 or conventional ventilation (no SI; n = 6. Ventilation continued for 30 min in all lambs while CaBF and respiratory function parameters were recorded. Brains were assessed for gross histopathology and vascular leakage.CaBF increased more rapidly and to a greater extent during a single SI (p = 0.01, which then decreased below both other groups by 10 min, due to a higher cerebral oxygen delivery (p = 0.01. Blood brain barrier disruption was increased in single SI lambs as indicated by increased numbers of blood vessel profiles with plasma protein extravasation (p = 0.001 in the cerebral cortex. There were no differences in CaBF or cerebral oxygen delivery between the multiple SI and no SI lambs.Ventilation with an initial single 30 s SI improves circulatory recovery, but is associated with greater disruption of blood brain barrier function, which may exacerbate brain injury suffered by asphyxiated newborns. This injury may occur as a direct result of the initial SI or to the higher tidal volumes delivered during subsequent ventilation.

Relationship of serum S1P and HC-II levels with vasoactive substances and cytokines in patients with cerebral vascular restenosis after stent implantation

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Yong Liu

2017-04-01

Full Text Available Objective: To study the relationship of serum sphingosine 1-phosphate (S1P and heparin cofactor II (HCII levels with vasoactive substances and cytokines in patients with cerebral vascular restenosis after stent implantation. Methods: 52 patients who received cerebrovascular stent implantation and developed restenosis in our hospital between May 2012 and December 2015 were collected as observation group, and 40 healthy patients with cerebrovascular stent implantation who had re-examination in our hospital during the same period were selected as control group. ELISA method was used to detect serum S1P and HC-II levels as well as vasoactive substance and inflammatory factor contents. Spearman correlation analysis was used to evaluate the relationship of serum S1P and HC-II levels with vasoactive substances and inflammatory factors. Results: Serum S1P and HC-II levels of observation group were lower than those of control group (P<0.05; serum vasoactive substances endothelin (ET, angiotensin II (AngII and thromboxane B2 (TXB2 contents of observation group were higher than those of control group while nitric oxide (NO content was lower than that of control group (P<0.05; serum inflammatory factors hypersensitive C-reactive protein (hs-CRP, interleukin-1 (IL-1, IL-6, IL-8 and IL-11 contents of observation group were higher than those of control group (P<0.05. Serum S1P and HC-II levels in patients with cerebral vascular restenosis after stent implantation were directly correlated with vasoactive substance and inflammatory factor contents. Conclusion: Serum S1P and HC-II levels decrease in patients with cerebral vascular restenosis after stent implantation, and it is an important cause of cerebral vascular dysfunction and systemic inflammatory response.

Perfil dos acidentes rurais em agências do INSS de São Paulo no ano 2000

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Ila Maria Corrêa

Full Text Available Levantamento realizado com o objetivo de caracterizar os acidentes rurais registrados em agências da previdência social. Foram amostradas dez agências no estado de São Paulo tomando-se como base o ano de 2000. Os acidentes foram avaliados em termos da distribuição percentual das seguintes características: perfil do acidentado (sexo, idade, estado civil, tarefa em execução na ocasião do acidente, natureza da causa do acidente, tipo de agente da lesão, partes do corpo atingidas, tipos de lesões e conseqüência do acidente (dias de afastamento, ocorrência de internação. Um total de 949 registros de acidentes foram identificados. Dos inúmeros relatos de acidentes apresentados observou-se que: a grande maioria deles está relacionada à colheita manual de produtos agrícolas (41,7 % sendo as ferramentas manuais a natureza predominante das causas (34,3 % e os ferimentos/contusões o tipo de lesão mais comum (68,9 %. O principal agente da lesão foram as batidas contra objetos ou partes mecânicas (43,8 % sendo os membros superiores os mais atingidos (43,2 %.

Clinical application of cerebral dynamic perfusion studies

International Nuclear Information System (INIS)

DeLand, F.H.

1975-01-01

Radionuclide cerebral perfusion studies are assuming a far greater importance in the detection and differential diagnosis of cerebral lesions. Perfusion studies not only contribute to the differential diagnosis of lesions but in certain cases are the preferred methods by which more accurate clinical interpretations can be made. The characteristic blood flow of arterio-venous malformations readily differentiates this lesion from neoplasms. The decreased perfusion or absent perfusion observed in cerebral infarctions is diagnostic without concurrent evidence from static images. Changes in rates and direction of blood flow contribute fundamental information to the status of stenosis and vascular occlusion and, in addition, offer valuable information on the competency and routes of collateral circulation. The degree of cerebral perfusion after cerebral vascular accidents appears to be directly related to patient recovery, particularly muscular function. Cerebral perfusion adds a new parameter in the diagnosis of subdural haematomas and concussion and in the differentiation of obscuring radioactivity from superficial trauma. Although pictorial displays of perfusion blood flow will offer information in most cerebral vascular problems, the addition of computer analysis better defines temporal relationships of regional blood flow, quantitative changes in flow and the detection of the more subtle increases or decreases in cerebral blood flow. The status of radionuclide cerebral perfusion studies has taken on an importance making it the primary modality for the diagnosis of cerebral lesions. (author)

In vivo evidence for long-term vascular remodeling resulting from chronic cerebral hypoperfusion in mice

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Struys, Tom; Govaerts, Kristof; Oosterlinck, Wouter; Casteels, Cindy; Bronckaers, Annelies; Koole, Michel; Van Laere, Koen; Herijgers, Paul; Lambrichts, Ivo; Himmelreich, Uwe; Dresselaers, Tom

2016-01-01

We have characterized both acute and long-term vascular and metabolic effects of unilateral common carotid artery occlusion in mice by in vivo magnetic resonance imaging and positron emission tomography. This common carotid artery occlusion model induces chronic cerebral hypoperfusion and is therefore relevant to both preclinical stroke studies, where it serves as a control condition for a commonly used mouse model of ischemic stroke, and neurodegeneration, as chronic hypoperfusion is causati...

Monitoring of cerebral haemodynamics in newborn infants

DEFF Research Database (Denmark)

Liem, K Djien; Greisen, Gorm

2010-01-01

The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral haemod...

Acidentes com motociclistas: comparacao entre os anos 1998 e 2010. Londrina, PR, Brasil

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Flavia Lopes Sant'Anna

2013-06-01

Full Text Available OBJETIVO: Comparar características de acidentes de motocicleta e de vítimas atendidas por serviços de atenção pré-hospitalar. MÉTODOS: Pesquisa transversal com dados de registros de atendimentos pré-hospitalares de motociclistas, vítimas de acidente de trânsito em Londrina, PR, em 2010, e dos resultados comparados com estudo similar de 1998. A fonte de dados foi o Registro de Atendimento do Socorrista (RAS. As frotas de motocicletas e as populações dos respectivos anos foram usadas para estimativas do risco de ocorrência de vítimas. O teste do Qui-quadrado foi usado para comparação dos perfis de acidentes e vítimas. RESULTADOS: Foram atendidos 1.576 e 3.968 motociclistas em 1998 e 2010, respectivamente (aumento de 151,8%. A taxa de motociclistas acidentados por mil habitantes passou de 396,4 para 783,1, e a de vítimas para cada mil motos de 53,1 para 61,1. Observaram-se mudanças (p < 0,05 nos perfis dos acidentes, com maiores proporções de quedas isoladas de moto, de acidentes entre motociclistas, no período da manhã, com diminuição dos ocorridos em final de semana. Em relação às vítimas, observaram-se maiores proporções de mulheres, condutores, com 35 anos ou mais. Foi menor a frequência relativa de percepção de hálito etílico e maior a prevalência do uso do capacete. Houve menor proporção de vítimas classificadas com escalas de coma e trauma moderado/grave e de encaminhamentos hospitalares. O coeficiente de letalidade imediato reduziu-se de 1,2% para 0,6%. CONCLUSÕES: Foram observadas mudanças nos perfis de acidentes e de vítimas no período. Apesar do aumento absoluto e relativo de vítimas de acidentes de motocicleta, observou-se menor gravidade proporcional desses acidentes.

Acidente ofídico no estado de Goiás

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Pinho Fábia Maria Oliveira

2004-01-01

Full Text Available OBJETIVO: Avaliar aspectos epidemiológicos dos acidentes por serpentes peçonhentas ocorridos no Estado de Goiás. MÉTODOS: Foram analisadas ''Fichas de investigação de acidentes por animais peçonhentos'', pertencentes ao sistema de notificação da Secretaria de Saúde do Estado de Goiás, no triênio 1998-2000. RESULTADOS: Foram notificados, neste período, 3.261 acidentes por serpentes peçonhentas, com coeficiente de incidência variando entre 20 e 23/100.000 habitantes. O maior número de casos ocorreu entre os meses de outubro e abril. Dentre os 2.350 casos em que houve referência ao gênero da serpente, 78,6% foram causados por Bothrops, 20,8% por Crotalus e 6% por Micrurus. Houve predominância do sexo masculino (78,5% e com faixa etária entre 20 e 39 anos de idade. As regiões anatômicas mais freqüentemente picadas foram: pé (43,6%, pernas (23,2% e mãos (20,1%. Em relação ao tempo de atendimento, mais de 80% dos envenenamentos foram atendidos com menos de 6 horas da picada. Os envenenamentos foram classificados, de acordo com a gravidade, em leves (31,6%, moderados (47,5% ou graves (9,6%. As complicações mais comuns foram necrose tecidual no local da picada (31,8% nos envenenamentos botrópicos e insuficiência renal aguda (1,2% nos envenenamentos crotálicos. A letalidade geral foi de 0,46%, sendo a maior taxa observada entre acidentes crotálicos (1%. CONCLUSÕES: Acidentes por serpentes peçonhentas no Estado de Goiás acometem principalmente a população jovem do sexo masculino e têm sido causa de óbito.

Tendências na incidência e mortalidade por acidentes de trabalho no Brasil, 1998 a 2008

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Flávia Souza e Silva de Almeida

2014-09-01

Full Text Available O objetivo do estudo foi avaliar as tendências na incidência e mortalidade por acidentes de trabalho no Brasil, de 1998 a 2008. Trata-se de estudo ecológico de séries temporais, que incluiu, para a análise, os acidentes de trabalho registrados nas estatísticas oficiais do Governo Federal. Foram calculadas as variações percentuais anuais (APC nas taxas de incidência e de mortalidade, através da modelagem pelo método Joinpoint, usando o ano calendário como variável regressora. Observou-se tendência significativa de decréscimo na taxa de incidência de acidentes de trabalho, o mesmo ocorrendo para os acidentes de trabalho típicos. Para ambos, o número de casos aumentou nesse período. O número de casos de acidentes de trabalho de trajeto e sua incidência mostraram tendência significativa de aumento. O número de óbitos e a taxa de mortalidade registraram tendência de decréscimo. São discutidos como fatores contribuintes para o declínio das taxas de incidência de acidentes de trabalho e de mortalidade por esta causa: melhoria das condições de trabalho, maior crescimento do setor de serviços do que do setor industrial, subnotificação dos acidentes de trabalho e terceirização dos serviços. O aumento dos acidentes de trabalho de trajeto sugere a influência da violência dos centros urbanos.

Panax ginseng extract attenuates neuronal injury and cognitive deficits in rats with vascular dementia induced by chronic cerebral hypoperfusion

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Jun-De Zhu

2018-01-01

Full Text Available Panax ginseng is a slow-growing perennial plant. Panax ginseng extract has numerous biological activities, including antitumor, anti-inflammatory and antistress activities. Panax ginseng extract also has a cognition-enhancing effect in rats with alcohol-induced memory impairment. In this study, we partially occluded the bilateral carotid arteries in the rat to induce chronic cerebral hypoperfusion, a well-known model of vascular dementia. The rats were then intragastrically administered 50 or 100 mg/kg Panax ginseng extract. Morris water maze and balance beam tests were used to evaluate memory deficits and motor function, respectively. Protein quantity was used to evaluate cholinergic neurons. Immunofluorescence staining was used to assess the number of glial fibrillary acidic protein-positive cells. Western blot assay was used to evaluate protein levels of vascular endothelial growth factor, basic fibroblast growth factor, Bcl-2 and Bax. Treatment with Panax ginseng extract for 8 weeks significantly improved behavioral function and increased neuronal density and VEGF and bFGF protein expression in the hippocampal CA3 area. Furthermore, Panax ginseng extract reduced the number of glial fibrillary acidic protein-immunoreactive cells, and it decreased apoptosis by upregulating Bcl-2 and downregulating Bax protein expression. The effect of Panax ginseng extract was dose-dependent and similar to that of nimodipine, a commonly used drug for the treatment of vascular dementia. These findings suggest that Panax ginseng extract is neuroprotective against vascular dementia induced by chronic cerebral hypoperfusion, and therefore might have therapeutic potential for preventing and treating the disease.

Via, homem e veiculo: fatores de risco associados a gravidade dos acidentes de transito

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Rosa Livia Freitas de Almeida

2013-08-01

Full Text Available OBJETIVO Analisar as características das vítimas, vias e veículos envolvidos em acidentes de trânsito e os fatores de risco de acidentes com ocorrência de óbito.  MÉTODOS Estudo de coorte não concorrente considerando os acidentes de trânsito em Fortaleza, CE, de janeiro de 2004 a dezembro de 2008. Foram utilizados dados do Sistema de Informação de Acidente de Trânsito de Fortaleza, do Sistema de Informações de Mortalidade, do Sistema de Informações Hospitalares e dos bancos de dados de Habilitação e Veículos do Departamento Estadual de Trânsito. Técnicas de relacionamento determinístico e probabilístico foram aplicadas para integrar as bases de dados. Efetuou-se a análise descritiva das variáveis relativas às pessoas, às vias, aos veículos e ao tempo. Foram utilizados os modelos lineares generalizados na investigação de fatores de risco para óbito por acidente de trânsito. O ajuste do modelo foi verificado pela razão de verossimilhança e análise ROC.  RESULTADOS Registraram-se 118.830 acidentes no período. Predominaram colisão/abalroamento (78,1%, atropelamentos (11,9% e choque com obstáculo fixo (3,9% e com motocicletas (18,1%. Ocorreram óbitos em 1,4% dos acidentes. Estiveram independentemente associados ao óbito por acidente de trânsito: bicicletas (OR = 21,2; IC95% 16,1;27,8, atropelamentos (OR = 5,9; IC95% 3,7;9,2, choque com obstáculo fixo (OR = 5,7; IC95% 3,1;10,5 e acidentes com motociclistas (OR = 3,5; IC95% 2,6;4,6. Os principais fatores contribuintes foram envolvimento de uma única pessoa (OR = 6,6; IC95% 4,1;10,73, presença de condutores não habilitados (OR = 4,1; IC95% 2,9;5,5 um único veículo envolvido (OR = 3,9; IC95% 2,3;6,4, sexo masculino (OR = 2,5; IC95% 1,9;3,3, tráfego em vias de jurisdição federal (OR = 2,4; IC95% 1,8;3,7, horário madrugada (OR = 2,4; IC95% 1,8;3,0 e dia de domingo (OR = 1,7; IC95% 1,3;2,2, todas ajustadas segundo modelo log-binomial.  CONCLUSÕES As a

mTOR drives cerebral blood flow and memory deficits in LDLR-/- mice modeling atherosclerosis and vascular cognitive impairment.

Science.gov (United States)

Jahrling, Jordan B; Lin, Ai-Ling; DeRosa, Nicholas; Hussong, Stacy A; Van Skike, Candice E; Girotti, Milena; Javors, Martin; Zhao, Qingwei; Maslin, Leigh Ann; Asmis, Reto; Galvan, Veronica

2018-01-01

We recently showed that mTOR attenuation blocks progression and abrogates established cognitive deficits in Alzheimer's disease (AD) mouse models. These outcomes were associated with the restoration of cerebral blood flow (CBF) and brain vascular density (BVD) resulting from relief of mTOR inhibition of NO release. Recent reports suggested a role of mTOR in atherosclerosis. Because mTOR drives aging and vascular dysfunction is a universal feature of aging, we hypothesized that mTOR may contribute to brain vascular and cognitive dysfunction associated with atherosclerosis. We measured CBF, BVD, cognitive function, markers of inflammation, and parameters of cardiovascular disease in LDLR -/- mice fed maintenance or high-fat diet ± rapamycin. Cardiovascular pathologies were proportional to severity of brain vascular dysfunction. Aortic atheromas were reduced, CBF and BVD were restored, and cognitive dysfunction was attenuated potentially through reduction in systemic and brain inflammation following chronic mTOR attenuation. Our studies suggest that mTOR regulates vascular integrity and function and that mTOR attenuation may restore neurovascular function and cardiovascular health. Together with our previous studies in AD models, our data suggest mTOR-driven vascular damage may be a mechanism shared by age-associated neurological diseases. Therefore, mTOR attenuation may have promise for treatment of cognitive impairment in atherosclerosis.

Major Vascular Neurocognitive Disorder: A Reappraisal to Vascular Dementia

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Emre Kumral

2017-03-01

Full Text Available Major vascular neurocognitive disorder (NCD is the second leading form of dementia after Alzheimer’s disease, accounting for 17-20% of all dementias. Vascular NCD is a progressive disease caused by reduced cerebral blood flow related to multiple large volume or lacunar infarcts that induce a sudden onset and stepwise decline in cognitive abilities. Despite its prevalence and clinical importance, there is still controversy in the terminology of vascular NCD. Only after the release of Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5 (2013 did the American Psychiatric Association define vascular dementia as “major vascular NCD”. This review includes an overview of risk factors, pathophysiology, types, diagnostic and clinical features of major vascular NCD, and current treatment options of vascular NCD regarding to DSM-5 criteria

Epidemiologia dos acidentes cerebrovasculares em Joinville, Brasil: estudo institucional Epidemiology of cerebrovascular disease in Joinville, Brazil: an institutional study

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Norberto L. Cabral

1997-09-01

Full Text Available A carência de dados epidemiológicos e a impressão prévia de elevada incidência de acidente vascular cerebral (AVC no Brasil criou o estímulo para estudo institucional prospectivo em Joinville. No período de 1-março-1995 a 1-março-1996, avaliamos o primeiro episódio e episódios recorrentes em AVC, incidência, mortalidade, taxa de fatalidade-caso em 30 dias (letalidade, freqüência de fatores de risco, tempo para admissão hospitalar e distribuição dos infartos cerebrais por subtipos patológicos. Registramos 429 pacientes no período, 320 destes com primeiro episódio. Tomografia de crânio foi realizada em 98% dos casos. A taxa de incidência anual ajustada por idade em primeiro episódio de AVC foi de 156/100000. A distribuição por diagnóstico foi: 73,4% para infarto cerebral, 18.4% para hemorragia cerebral e 7,5% para hemorragia subaracnóide. A taxa de mortalidade anual padronizada foi 25/100000. A letalidade foi 26%. Hipertensão, AVC prévio e diabetes foram os fatores de risco mais freqüentes. Somente 25% dos pacientes chegaram ao hospital nas primeiras três horas iniciais. Concluímos que a taxa de incidência em primeiro episódio de AVC em pacientes institucionalizados em Joinville, Brasil, é elevada. A taxa de mortalidade e letalidade são similares as de outras populações.The paucity of epidemiologic data, and the previous impression of high incidence of cerebrovascular disease in Brazil, made us elaborate a prospective institutional study in Joinville, Brazil, with the objective of identifying first and recurrent episodes in stroke. This study occurred from March 1995 to March 1996. We evaluated during the first episode of stroke: incidence, mortality and fatality-case rate (in 30 days letality, frequency of risk factor, time in hospital and distribution of cerebral infarcts by pathological subtypes. In this period, 429 patients with stroke were registered, 320 with the first episode. 98% of all the patients

Reestruturação produtiva e acidentes de trabalho no Brasil: estrutura e tendências

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Wünsch Filho Victor

1999-01-01

Full Text Available A incidência de acidentes de trabalho no Brasil apresenta tendência decrescente nas duas últimas décadas. A mortalidade também é decrescente, porém de forma menos acentuada. O subregistro tem sido o principal argumento para explanar tal fato. O estudo das séries temporais com base em dados secundários de 1970 a 1995 revela que a incidência de acidentes de trabalho é sensível às flutuações cíclicas da economia e vincula-se, em particular, ao nível de atividade industrial. Detectou-se uma correlação linear positiva (r = 0,80 entre a proporção de pessoas ocupadas na produção industrial e a incidência de acidentes em 14 estados brasileiros. A recessão econômica durante a década de 80 gerou desemprego. A queda da oferta de empregos formais no setor industrial ­ com maiores riscos de acidentes, foi acentuada pelo processo de reestruturação produtiva e a incorporação crescente da informática e da robótica em diferentes processos industriais. Como conseqüência houve o deslocamento de um maior volume de força de trabalho para o setor terciário ­ com menor risco de acidentes. Estes fatos foram determinantes na tendência dos acidentes de trabalho observada neste período de 25 anos.

Reestruturação produtiva e acidentes de trabalho no Brasil: estrutura e tendências

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Victor Wünsch Filho

Full Text Available A incidência de acidentes de trabalho no Brasil apresenta tendência decrescente nas duas últimas décadas. A mortalidade também é decrescente, porém de forma menos acentuada. O subregistro tem sido o principal argumento para explanar tal fato. O estudo das séries temporais com base em dados secundários de 1970 a 1995 revela que a incidência de acidentes de trabalho é sensível às flutuações cíclicas da economia e vincula-se, em particular, ao nível de atividade industrial. Detectou-se uma correlação linear positiva (r = 0,80 entre a proporção de pessoas ocupadas na produção industrial e a incidência de acidentes em 14 estados brasileiros. A recessão econômica durante a década de 80 gerou desemprego. A queda da oferta de empregos formais no setor industrial com maiores riscos de acidentes, foi acentuada pelo processo de reestruturação produtiva e a incorporação crescente da informática e da robótica em diferentes processos industriais. Como conseqüência houve o deslocamento de um maior volume de força de trabalho para o setor terciário com menor risco de acidentes. Estes fatos foram determinantes na tendência dos acidentes de trabalho observada neste período de 25 anos.

A família também adoece!: mudanças secundárias à ocorrência de um acidente vascular encefálico na família

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Eliana Sales Brito

2008-12-01

Full Text Available Este estudo buscou compreender o impacto da doença incapacitante na família de pacientes vítimas de acidente vascular encefálico (AVE, investigando as mudanças de ordem estrutural, social e emocional. Foram analisadas nove famílias de pacientes com primeiro episódio de AVE identificados pelo registro geral de doenças do Hospital São Rafael, Salvador, Bahia. A coleta dos dados foi realizada mediante aplicação de questionário, roteiro de entrevista, escala de avaliação funcional e observações registradas em diário de campo. O método empregado para análise dos dados foi o discurso do sujeito coletivo, produzindo representações sociais e transformando em um só discurso a fala dos sujeitos pesquisados. Constatou-se que a ocorrência de um AVE é uma experiência marcada por bruscas transformações no cotidiano familiar e na vida de cada um de seus membros. Os resultados indicam a necessidade de se habilitar a família para o cuidado ao paciente e para o autocuidado.

Estresse e acidentes de trabalho: Estudo Pró-Saúde

OpenAIRE

Alexandre dos Santos Brito

2007-01-01

Esta tese tem o objetivo geral de investigar a associação entre estresse e acidentes no trabalho em funcionários técnico-administrativos efetivos de uma universidade pública no Rio de Janeiro por meio de modelos multiníveis. Para alcançar tal objetivo, a tese foi distribuída em dois artigos. O primeiro artigo investiga a associação entre estresse e acidentes no trabalho considerando componentes hierárquicos da estrutura dos dados por meio de modelos multiníveis com funcionários no primeiro ní...

Cerebrovascular accident in the aged: changes in family relations El anciano tras accidente cerebrovascular: alteraciones en el relacionamento familiar O idoso após acidente vascular cerebral: alterações no relacionamento familiar

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Sueli Marques

2006-06-01

desarrollar un plan de acción que pueda favorecer las relaciones y la adaptación de la familia a las demandas, con vistas a mejorar las condiciones de vida de sus miembros, incluso el anciano.Os objetivos deste estudo foram: identificar os idosos atendidos, na Unidade de Emergência de um hospital governamental do município de Ribeirão Preto-SP, com diagnóstico médico de acidente vascular cerebral, e suas respectivas famílias, bem como identificar as alterações, no relacionamento familiar, que ocorreram após o evento. Utilizou-se a Técnica de Incidentes Críticos adaptada para identificar as alterações no relacionamento familiar ocorridas após a doença e, para a análise, a reflexão do Caminho do Pensamento. A amostra constou de 11 famílias, totalizando 34 participantes. A análise das conseqüências revelou as alterações no relacionamento familiar, que constituíram 13 subcategorias, 5 positivas e 8 negativas, perfazendo o total de 58 alterações, sendo 30 positivas e 28 negativas. O estudo revelou a necessidade de trabalhar com a família para identificar as alterações e desenvolver um plano de ações que possa favorecer as relações e a adaptação da família às demandas, com vistas a melhorar as condições de vida de seus membros, inclusive o idoso.

Variação temporal no desempenho em testes de memória em pacientes com doença vascular cerebral Temporal variation in memory tests performance in cerebral vascular disease patients

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Tania Fernandes Campos

2007-01-01

Full Text Available Buscando adequar a avaliação neuropsicológica à organização temporal do organismo humano, avaliou-se o desempenho em testes de memória em 12 pacientes pós Doença Vascular Cerebral e 12 indivíduos controle, de ambos os sexos, com idade de 45 a 65 anos. Foram aplicados dois testes de memória com estímulos visuais (figuras e dois com estímulos verbais (palavras, em 3 dias consecutivos por semana, às 08:00, 10:00 e 12:00 h na primeira semana e às 14:00 e 16:00 h na seguinte. Os pacientes apresentaram menor número de acertos do que os indivíduos controle em todos os testes aplicados (pThis study intended to investigate the performance in memory tests in order to adequate the neuropsychological evaluation to the temporal order of the human organism. Twelve cerebral vascular accident patients and 12 controls, of both sexes and 45-65 years old were studied. Two memory tests with visual stimuli (pictures and two with verbal stimuli (words were applied three times a day (08:00, 10:00 and 12:00 h during the first week and twice a day (14:00 and 16:00 h in the second week, during three consecutive days in two consecutive weeks. The patients showed lower scores than control subjects in all applied tests (p<0,05. The greater test sensitivity was at 14:00 h for the free recall test and at 16:00 h for recognition tests. According to these results, it is concluded that neuropsychological evaluations should be conducted preferably in the afternoon, as well for the first evaluation as for the re-evaluations.

Hemorrhagic stroke after naphazoline exposition: case report Acidente vascular encefálico hemorrágico após exposição à nafazolina: relato de caso

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Jorge A.A. Zavala

2004-09-01

Full Text Available Ten percent of all strokes are due to spontaneous cerebral hemorrhages. They are associated to drugs (licit and illicit in 9.5% of all cases in young adults. This is a case report of a 44-year-old man, without previous morbidities, who presented a sudden onset headache and arterial hypertension 24 hours after use of naphazoline as nasal decongestant. Cranial tomography showed right thalamus hemorrhage. Cerebral angiography showed no aneurisms, vascular malformations or vasculitis. No other risk factors were found during investigation in this patient and the stroke was attributed to naphazoline exposition.Dez por cento de todos os eventos vasculares encefálicos são devido às hemorragias intracerebrais espontâneas, associados a drogas (lícitas e ilícitas em 9,5% de todos os casos em adultos jovens. Relatamos o caso de um homem de 44 anos de idade, sem doenças prévias, que apresentou cefaléia súbita e hipertensão arterial 24 horas após o uso de congestionante nasal contendo nafazolina. A tomografia de crânio evidenciou hemorragia talâmica. Durante a investigação não foram encontrados outros fatores de risco e a hemorragia foi atribuída à exposição à nafazolina.

Prognostic significance of MR angiography in patients with cerebral infarction

International Nuclear Information System (INIS)

Moon, Woong Jae; Kim, Jun Ho; Seo, Jeong Jin; Cho, Ki Hyun; Kim, Yun Hyeon; Kim, Jae Kyu; Kang, Heoung Keun

1994-01-01

This study was designed to evaluate the prognostic significance of Magnetic resonance angiography(MRA) in patients with cerebral infarction. Magnetic Resonance Imaging(MRI) and 2 dimensional or 3 dimensional Time-of-Flight MRA were performed subsequently in 83 patients with cerebral infarction proven by brain CT and clinical manifestations, using GE Signa Advantage 1.5 T. We classified the size of infarction on MRI as Extent I( 6 cm) and classified the intracranial vascular occlusion according to visualizations of intracranial vascular branches on MRA as Grade 0, Grade I, Grade II, Grade III. And we evaluated clinical outcomes of these patients according to Rankin's disability scale, compared with MRI and MRA. In 72 cases(86.8%), the larger the size of infarction on MRI, the more severe vascular occlusion on MRA, the worse the clinical outcomes were noted(p < 0.01). However, in 7 cases(8.4%) who showed huge cerebral infarction on MRI with low grade intracranial vascular occlusion on MRA, the clinical outcomes were improved. In 4 cases(4.8%) who noted small sized cerebral infarction on MRI with high grade vascular occlusion on MRA, the clinical outcomes were worsened. MRA provides additional useful information to that provided by MRI in predicting the prognosis of patients with cerebral infarction

Cerebral vascular control and metabolism in heat stress

DEFF Research Database (Denmark)

Bain, Anthony R; Nybo, Lars; Ainslie, Philip N

2015-01-01

implications and pathologies known to confound cerebral functioning during hyperthermia. A reduction in cerebral blood flow (CBF), derived primarily from a respiratory-induced alkalosis, underscores the cerebrovascular changes to hyperthermia. Arterial pressures may also become compromised because of reduced...

Heart valve papillary fibroelastoma associated with cardioembolic cerebral events Fibroelastoma papilífero de valva cardíaca associado a eventos cerebrais cardioembólicos

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Luciano Cabral Albuquerque

2011-12-01

Full Text Available Papillary fibroelastomas of the heart valves are benign, slow-growing, rare tumors of the heart. This tumor represents a potential cause of systemic embolism, stroke, myocardial infarction and sudden death. Early diagnosis is very important, as surgical excision of these tumors can prevent cerebrovascular and cardiovascular complications. Diagnosis is usually made by transesophageal echocardiogram. We describe two cases of patients with papillary fibroelastomas causing cardioembolic cerebral events, which underwent successful surgical treatment. The authors present a brief review of the literature.Fibroelastoma papilífero é um tumor benigno, raro e de crescimento lento, que geralmente tem origem no endocárdio das valvas cardíacas. Este tumor representa uma causa potencial de embolia sistêmica, infarto agudo do miocárdio, acidente vascular cerebral e morte súbita. O diagnóstico precoce é fundamental, já que a excisão cirúrgica pode evitar complicações cerebrovasculares e cardiovasculares. O diagnóstico geralmente é feito pelo ecocardiograma transesofágico. Neste trabalho, são descritos dois casos de pacientes com fibroelastoma papilífero de valva aórtica, causando eventos cerebrais cardioembólicos, que foram submetidos com sucesso a tratamento cirúrgico. Apresenta-se, ainda, uma sucinta revisão da literatura.

Lesões craniofaciais decorrentes de acidentes por motocicleta: uma revisão integrativa

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Maria Gabriella Pacheco da Silva

2015-10-01

Full Text Available Resumo: Os acidentes de trânsito têm constituído um problema de saúde pública que mais cresce no Brasil e no mundo, com destaque para as motocicletas. Além dos altos índices de mortalidade, destacam-se também as lesões e sequelas causadas aos sobreviventes ao acidente. As lesões de face são comuns neste tipo de acidente, causando deformidades estéticas e funcionais no rosto, necessitando de reabilitação. Foi realizada uma busca na literatura para mapear as lesões na região craniofacial decorrentes de acidentes de trânsito por motocicleta, buscando também suas possíveis implicações para a Comunicação Humana. As bases de dados Pubmed, Lilacs e Scielo foram acessadas, selecionando os artigos pelos títulos, em seguida pelos resumos, para ao final selecionar os artigos para leitura na íntegra. Após este processo, foram selecionados 10 estudos para a revisão. Na região facial, as fraturas mais frequentes foram nos ossos da Mandíbula, Zigomático e Nasal, por serem os mais proeminentes na região. Destacaram-se os Traumas Cranianos como os tipos de lesões com maior gravidade, uma vez que podem levar ao óbito. Apesar do detalhamento das lesões, as sequelas e dados sobre a reabilitação dessas vítimas de acidentes por motocicletas foram raros na literatura.

Acidentes de trabalho autorreferidos pela população adulta brasileira, segundo dados da Pesquisa Nacional de Saúde, 2013

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Deborah Carvalho Malta

Full Text Available Resumo O objetivo deste artigo é descrever o perfil da ocorrência dos acidentes de trabalho na população adulta brasileira. Estudo descritivo com dados sobre acidentes de trabalho coletados em 2013 pela Pesquisa Nacional de Saúde. Os acidentes de trabalho ocorreram em 3,4% (IC95% 4,6-5,6 da população adulta brasileira, ou 4,9 milhões de acidentes foram referidos, sendo mais frequentes entre os homens, jovens, de 18 a 39 anos, de cor preta, na região Norte do país. O Pará foi o Estado de maior ocorrência, e o Rio de Janeiro, o menor. Cerca de um terço dos acidentes foram devidos a deslocamento para o trabalho (acidentes de trajeto. Dentre os acidentados pelo trabalho, 50,4% (IC95% 45,3-55,5 deixaram de realizar suas atividades habituais, 8,8% (IC95% 6,4-11,2 foram internados e 19% (IC95% 15,3-22,7 relataram sequelas decorrentes dos acidentes do trabalho. As ocorrências de acidente de trabalhos relatadas na Pesquisa Nacional de Saúde constituem uma fonte inédita no país, possibilitando informação inestimável sobre o cenário do trabalho no Brasil. A Pesquisa Nacional de Saúde identificou que os acidentes de trabalho são subnotificados, já que as informações oficiais cobrem apenas os trabalhadores com vínculo formal de trabalho.

Doppler Ultrasonographic Parameters for Predicting Cerebral Vascular Reserve in Patients with Acute Ischemic Stroke

International Nuclear Information System (INIS)

Jung, Han Young; Lee, Hui Joong; Kim, Hye Jung; Kim, Yong Sun; Kang, Duk Sik

2006-01-01

We investigated Doppler ultrasonographic (US) parameters of patients with acute stroke to predict the cerebral vascular reserve (CVR) measured by SPECT. We reviewed the flow velocity and cross-sectional area of the circular vessel at the common, external, and internal carotid arteries (ICA) and the vertebral arteries (VA) in 109 acute stroke patients who underwent SPECT. Flow volume (FV) of each artery was calculated as the product of the angle-corrected time averaged flow velocity and cross-sectional area of the circular vessel. Total cerebral FV (TCBFV) was determined as the sum of the FVs of the right and left ICA and VA. We compared the Doppler US parameters between 44 cases of preserved and 65 cases of impaired CVR. In the preserved CVR group, ICA FV, anterior circulating FV (ACFV) and TCBFV were higher than in the impaired CVR group (p < 0.05, independent t-test). In the impaired CVR group, the ROC curves showed ACFV and TCBFV were suitable parameters to predict CVR (p < 0.05). Doppler US was helpful for understanding the hemodynamic state of acute stroke. FV measurement by Doppler US was useful for predicting CVR

The arterial circle of Willis of the mouse helps to decipher secrets of cerebral vascular accidents in the human.

Science.gov (United States)

Okuyama, Shinichi; Okuyama, Jun; Okuyama, Junko; Tamatsu, Yuichi; Shimada, Kazuyuki; Hoshi, Hajime; Iwai, Junichi

2004-01-01

The human brain represents an elaborate product of hominizing evolution. Likewise, its supporting vasculature may also embody evolutionary consequences. Thus, it is conceivable that the human tendency to develop cerebral vascular accidents (CVAs) might represent a disease of hominization. In a search for hominizing changes on the arterial circle of Willis (hWAC), we attempted an anatomical comparison of the hWAC with that of the mouse (mWAC) by injecting aliquots of resin into the vasculature of the mouse and then creating vascular endocasts of the mWAC. The internal carotid artery of the mouse (mICA) unites with the mWAC midway between the middle cerebral artery (mMCA) and posterior cerebral artery (mPCA). The mWAC does not complete a circle: the mWAC nourishes the anterior portion of the circle which branches out to the olfactory artery (OlfA) and mPCA, along with the mMCA, and the basilar artery (mBA) does not connect to the mPCA. The OlfA is thicker than the mMCA. The relative brain weight of the mouse was 74 g on average for a 60 kg male and 86 g for a 60 kg female, respectively, as compared with 1424 g for a 60 kg man. These findings are consistent with the mouse being a nocturnal carnivore that lives on olfactory information in contrast to the human that lives diurnally and depends on visual and auditory information. In man, the human ICA (hICA) unites with the hWAC at a point where the human middle cerebral artery (hMCA) branches out, and thus, blood from the hICA does not flow through the hWAC but drains into the hMCA directly. The hMCA is thicker than the anterior cerebral artery. The hPCA receives blood from the hBA rather than from the hICA, and thus, the entire hWAC forms a closed circuit. Since the hICA drains directly into the hMCA without flowing a distance through the hWAC, the capacitor and equalizer functions of the WAC will be mitigated so much that the resultant hemodynamic changes would render the hMCA more likely to contribute to CVAs. Thus

Acidentes com material biológico relacionados ao trabalho: análise de uma abordagem institucional

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Ana Isabel Dias da Silva

Full Text Available RESUMO OBJETIVO: analisar o perfil de relatórios, instrumentos de registros e fluxos de tratamento, notificações, acompanhamentos, profilaxias e encaminhamentos devidos a acidentes causados por material perfurocortante em trabalhadores de saúde em uma instituição de saúde pública. Métodos: a coleta de dados usou um questionário semiestruturado aplicado aos profissionais responsáveis pelos registros de acidentes e avaliou os formulários utilizados em três setores da instituição de estudo. RESULTADOS: foram analisados 134 registros de acidentes biológicos. Quando comparamos os registros da instituição com os 50 registrados no mesmo período pelo banco de dados da Secretaria Municipal de Saúde do Rio de Janeiro, apenas 11 casos foram concordantes. Também identificamos falta de padronização nos formulários utilizados, fluxos diferentes e falta de registros de investigações dos casos, além de ausência de acompanhamento do desfecho dos acidentes. CONCLUSÃO: constataram-se subnotificação e discordância entre as fontes. Um formulário de registro para acidentes biológicos foi elaborado para informações de notificação e investigações, bem como criado um programa para monitorar acidentes causados por material perfurocortante, visando melhorar a vigilância de saúde dos trabalhadores da instituição.

Acidente ocupacional entre profissionais de enfermagem atuantes em setores críticos de um pronto-socorro

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Pollyanna Salles Rodrigues

2017-04-01

Full Text Available Resumo Objetivo: Identificar a prevalência de acidentes ocupacionais entre profissionais de enfermagem atuantes em setores críticos de um pronto-socorro e apreender a vivência profissional dentre os acidentados. Métodos: Pesquisa descritiva, transversal, realizada em duas etapas consecutivas, com 75 profissionais. A análise quantitativa foi realizada por estatística descritiva, enquanto os depoimentos foram processados no software IRaMuTeQ, analisados de acordo com a Classificação Hierárquica Descendente. Os achados foram fundamentados no método do Discurso do Sujeito Coletivo. Resultados: A prevalência geral de acidentes foi de 26,7%. Destes, 72,2% envolviam material perfurocortante e, em 84,2% deles, o sangue foi o principal agente biológico envolvido. Registraram-se três classes: "Vivenciando o Acidente Ocupacional"; "Condutas Pós-Exposição" e "Prevenção do Acidente Ocupacional". Conclusão: Registrou-se alta taxa de profissionais acidentados, com maior prevalência entre aqueles de nível técnico. A vivência do acidente parece encontrar-se imageticamente ligada a momentos (antes, após e durante, causas, consequências e sentimentos.

Vivendo o acidente vascular encefálico agudo: significados da doença para pessoas hospitalizadas Viviendo el accidente cerebrovascular agudo: significado de la enfermedad para personas hospitalizadas Experiencing acute stroke: the meaning of the illness for hospitalized patients

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Samia Jardelle Costa de Freitas Maniva

2013-04-01

Full Text Available Objetivou-se compreender o significado da experiência vivenciada pela pessoa adoecida por acidente vascular encefálico agudo. Trata-se de estudo qualitativo, fundamentado nos pressupostos teóricos do interacionismo simbólico, realizado em uma unidade especializada no tratamento de acidente vascular encefálico de um hospital terciário, situado na cidade de Fortaleza, CE. Participaram do estudo 10 pacientes. A coleta de dados ocorreu por meio de entrevista aberta e os dados foram organizados e analisados segundo a técnica de enunciação. Cumpriram-se todos os aspectos éticos. O significado da experiência de adoecimento foi construído com base na percepção dos sentimentos surgidos durante a hospitalização, caracterizados por medo da morte e das sequelas da doença; tristeza pelo distanciamento do lar; alívio, ao evidenciar-se melhora do quadro clínico, e desejo de mudança dos hábitos de vida. Apreendeu-se que a experiência de adoecimento por acidente vascular encefálico é complexa, e nela os significados são elaborados com base em sentimentos, ações e comportamentos dos sujeitos.Se objetivó comprender el significado de la experiencia de la persona que padeció accidente cerebrovascular agudo. Estudio cualitativo, fundamentado en los presupuestos teóricos del interaccionismo simbólico, realizado en unidad especializada en tratamiento de accidente cerebrovascular de un hospital terciario en Fortaleza-CE. Participaron diez pacientes. Datos recolectados mediante entrevista abierta, organizados y analizados según técnica de enunciación. Se cumplió con todos los aspectos éticos. El significado de la experiencia del padecimiento fue construido en base a la percepción de los sentimientos surgidos durante la internación, caracterizados por el miedo a la muerte y a las secuelas de la enfermedad; tristeza por alejarse del hogar; alivio al evidenciarse mejoras del cuadro clínico; e intención de cambio de hábitos de vida

Acidente vascular cerebral e fatores de risco para quedas em idosos

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Alice Gabrielle de Sousa Costa

2017-01-01

Full Text Available Objective: to verify and compare the intrinsic and extrinsic risk factors for falls among older community-dwelling people with and without a stroke history. Methods: a case group and three control groups were established and each group had 15 elderly individuals. Results: the statistical associations were: use of antihypertensive medication among the groups with falls, despite the occurrence of a stroke; use of angiotensin-converting enzyme inhibitor for elderly with a stroke who had an event of fall or not; foot alterations between the case group and people without falls or stroke. Gait difficulty and impaired physical mobility were statistically associated between the case group and people without the occurrence of stroke or falls. Conclusion: the stroke is associated with falls and the intrinsic factors presented greater statistical correlations, supporting the hypothesis that many factors influence the occurrence of falls.

The role of shear stress and arteriogenesis in maintaining vascular homeostasis and preventing cerebral atherosclerosis

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David Della-Morte

2015-01-01

Full Text Available Shear stress (SS is a biomechanical force that is determined by blood flow, vessel geometry, and fluid viscosity. Although a wide range of known vascular risk factors promote development of atherosclerosis, atherosclerotic changes occur predominately at specific sites within the arterial tree, suggesting a critical role for local factors within the vasculature. Atherosclerotic lesions develop predominantly at branches, bends, and bifurcations in the arterial tree because these sites are exposed to low or disturbed blood flow and low SS. Low SS predisposes arteries to atherosclerosis by causing endothelial dysfunction. A natural system of preexisting cerebral collateral arteries protects against ischemia by bypassing sites of arterial occlusion through a mechanism of arteriogenesis. The main trigger for arteriogenesis is impaired vascular homeostasis (VH in response to local changes in SS induced by ischemia. VH is a critical process for maintaining the physiological function of cerebral circulation. It is regulated through a complex biological system of blood flow hemodynamic and physiological responses to flow changes. Restoration of VH by increasing arteriogenesis and SS may provide a novel therapeutic target for stroke, especially in the elderly, who are more prone to VH impairment. In this review article, we discuss the mechanisms and structures necessary to maintain VH in brain circulation, the role of SS, and risk factors leading to atherosclerosis, including the effects of aging. We also discuss arteriogenesis as an adaptive and protective process in response to ischemic injury, the imaging techniques currently available to evaluate arterogenesis such as magnetic resonance imaging/positron emission tomography (MRI/PET, and the potential therapeutic approaches against ischemic injury that target arteriogenesis.

Cerebral aneurysms – an audit

African Journals Online (AJOL)

Enrique

Abstract. We performed an audit to determine the profile of cerebral aneurysms at the Universitas Hospital Bloem- fontein, the only government hospital with a vascular suite in the Free State and Northern Cape area. Two hun- dred and twenty-three government patients, diagnosed with cerebral aneurysms during the period.

Análise dos acidentes de trânsito ocorridos em uma Capital do Nordeste Brasileiro, em 2006.

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Francisco José de Paula Júnior

2013-06-01

Full Text Available Este trabalho teve como objetivo descrever os acidentes de trânsito ocorridos na cidade de Fortaleza, capital do Ceará, no ano de 2006. Foi realizado um estudo descritivo, transversal, a partir de dados do Sistema de Informação de Acidentes de Trânsito de Fortaleza, que agrega todas as informações pertinentes aos acidentes de trânsito ocorridos na capital cearense, além de informações do Sistema de Informações Hospitalares. Esses dados foram analisados utilizando o software EPI INFO®. Em 2006, foram registrados 23.443 acidentes de trânsito. Desses, houve uma proporção de 2:1, entre homens e mulheres e os óbitos ocorreram principalmente na faixa etária de 30 a 59 anos, liderados por pedestres 141 (41,34% e motociclistas com 76 (22,28%. Entre os tipos de acidentes 14.267 (60,85% registraram-se colisões, tendo o mês de dezembro e o intervalo de 18 às 20 horas apresentado o maior número de registros. Em relação aos ferimentos, os motociclistas foram os mais lesionados, atingindo 5.634 (40,57% pessoas. Parte significativa dos acidentes e óbitos envolveu adolescentes e adultos jovens, resultando em 341 (0,71% vitimas que evoluíram para óbito. É fundamental estimular políticas públicas para melhoria nas condições de trânsito e um maior investimento para os sistemas que coletam informações sobre os acidentes.

Use of decompressive craniectomy in the treatment of hemispheric infarction Uso da craniectomia descompressiva no tratamento do acidente vascular cerebral isquêmico hemisférico

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José Antonio Fiorot Jr.

2008-06-01

Full Text Available Decompressive craniectomy (DC has demonstrated efficacy in reducing mortality in hemispheric infarction of the middle cerebral artery. The aim of our study was to compare the outcome of patients submitted to DC to patients treated in a conservative way. Eighteen patients were submitted to DC and 14 received conservative treatment. Neurological status was assessed by the Glasgow Coma Score and National Institutes of Health Stroke Scale score. Mortality, modified Rankin Scale and Barthel Index scores were assessed at 90 days to evaluate outcome. We did not observe reduction in overall mortality and functional outcome in patients submitted to DC. The differences between our group and previously published series are probably related to the neurological status of the patients at the time of therapeutic decision.Craniectomia descompressiva (CD tem demonstrado eficácia em reduzir a mortalidade em pacientes com infarto hemisférico (IH da artéria cerebral média. Este estudo avaliou o prognóstico dos pacientes submetidos a CD comparando a pacientes com IH tratados de maneira conservadora. Dezoito pacientes foram submetidos a CD e 14 receberam tratamento conservador. Escala de Coma de Glasgow e Escala de AVC do National Institutes of Health foram utilizadas para graduar o déficit neurológico. A mortalidade, bem como os escores obtidos na escala modificada de Rankin e índice de Barthel foram avaliados em 90 dias. Não foi observada redução de mortalidade nos pacientes submetidos a CD. Essa diferença entre os nossos resultados e os estudos publicados previamente se deve, provavelmente, à decisão cirúrgica tardia em pacientes com sinais clínicos de herniação cerebral.

Cinesioterapia previne ombro doloroso em pacientes hemiplégicos/paréticos na fase sub-aguda do acidente vascular encefálico

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Horn Agnes Irna

2003-01-01

Full Text Available CONTEXTO: Ombro doloroso é freqüente em pacientes com hemiplegia/hemiparesia (H/P por acidente vascular encefálico (AVE, dificultando a recuperação neuromotora gerando incapacidade funcional. OBJETIVO: Estudar tratamento fisioterapêutico para a prevenção da dor no ombro com H/P em pacientes com AVE na fase sub-aguda, e analisar desfechos secundários (força muscular do ombro acometido e movimentos funcionais ativos básicos. MÉTODO: Estudaram-se 21 pacientes (12 homens, 9 mulheres; idades 26 a 87 anos com H/P. O tratamento fisioterapêutico consistiu de 30 minutos diários de cinesioterapia, desde as 48 horas após o AVE até a alta hospitalar. Os pacientes foram avaliados antes e após o tratamento em relação à presença ou ausência de dor no ombro H/P, à força dos diversos grupos musculares do ombro e quanto aos movimentos funcionais de transferência e manutenção postural básica. RESULTADOS: Nenhum paciente apresentava dor no ombro H/P na alta (p<0,001. A força muscular aumentou significativamente em relação à elevação, protusão, abdução e flexão do ombro (p<0,001. Houve melhora dos movimentos funcionais: decúbito dorsal para lateral, decúbito lateral para sentado e manter-se sentado (p<0,001. CONCLUSÃO: A cinesioterapia na fase aguda do AVE preveniu a dor no ombro H/P e favoreceu a recuperação motora.

Vascular malformations in pediatrics

International Nuclear Information System (INIS)

Reith, W.; Shamdeen, M.G.

2003-01-01

Vascular malformations are the cause of nearly all non-traumatic intracranial hemorrhage in children beyond the neonatal stage. Therefore, any child presenting with spontaneous intracranial hemorrhage should be evaluated for child abuse and for vascular malformations. Intracerebral malformations of the cerebral vasculature include vein of Galen malformations, arteriovenous malformation (AVM), cavernomas, dural arteriovenous fistulas, venous anomalies (DVA), and capillary teleangiectasies. Although a few familial vascular malformation have been reported, the majority are sporadic. Clinical symptoms, diagnostic and therapeutic options are discussed. (orig.) [de

Situação epidemiológica dos acidentes de trabalho na unidade regional de emergência de Sorocaba

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Dorival Manrique Duarte Junior

2014-10-01

Full Text Available Introdução: Apesar do avanço no Sistema de Informação de Agravos de Notificação (SINAN ainda há extensa subnotificação dos acidentes de trabalho no Brasil. Dentre os acidentes notificados, verifica­se falta de dados nas informações obtidas. Objetivo: Analisar o perfil epidemiológico dos acidentes de trabalho atendidos na Unidade Regional de Emergência (URE do Conjunto Hospitalar de Sorocaba (CHS. Metodologia: Estudo transversal com análise quantitativa e qualitativa dos acidentes de trabalho recebidos na URE do CHS através da Ficha de Notificação de Acidente de Trabalho Grave do SINAN. Realizada análise descritiva das variáveis categóricas e contínuas. Resultados: Foram analisadas 110 vítimas, cujas características predominantes eram: sexo masculino (77,27%, idade entre 20 e 39 anos (38,18% e presença de registro trabalhista (65,45%. As duas principais causas foram acidente com motocicleta (46,4% e queda (21,8%. Ademais, 57,3% dos acidentes foram classificados como de trajeto, de maior incidência nos períodos da noite e madrugada, e 41,2% típico, mais freqüente nos períodos da manhã e tarde (p=0,012. Da totalidade dos casos, 38,3% evoluíram para cura e 58,8% para incapacidade temporária. Conclusão: O acidente de trabalho é importante problema de saúde pública e gera grande impacto econômico por acometer principalmente indivíduos jovens e saudáveis. É muitas vezes negligenciado em decorrência da subnotificação e consequente subdimensionamento da sua gravidade, prejudicando o subsídio de políticas de saúde direcionadas a esses agravos.

Pathological review of late cerebral radionecrosis

International Nuclear Information System (INIS)

Yoshii, Yoshihiko

2008-01-01

Late cerebral radionecrosis may be considered to be a specific chronic inflammatory response, although it is unknown whether the initial damage by brain irradiation is to an endothelial cell or a glial cell. I discuss the pathological specificity of late cerebral radionecrosis by studying the published literature and a case that I experienced. In late cerebral radionecrosis, there are typical coagulation necrosis areas containing fibrinoid necrosis with occlusion of the lumina and poorly active inflammatory areas with many inflammatory ghost cells, focal perivascular lymphocytes, hyalinized vessels, and telangiectatic vascularization near and in the necrotic tissue, and more active inflammatory areas formed as a partial rim of the reactive zone by perivascular lymphocytes, much vascularization, and glial fibrillary acidic protein (GFAP)-positive astrocytes at the corticomedullary border adjacent to necrotic tissue in the white matter. It is difficult to believe that coagulation necrosis occurs without first disordering the vascular endothelial cells because fibrinoid necrosis is a main feature and a diffusely multiple lesion in late cerebral radionecrosis. Because various histological findings do develop, progress, and extend sporadically at different areas and times in the irradiated field of the brain for a long time after radiation, uncontrolled chronic inflammation containing various cytokine secretions may also play a key role in progression of this radionecrosis. Evaluation of the mechanism of the development/aggravation of late cerebral radionecrosis requires a further study for abnormal cytokine secretions and aberrant inflammatory reactions. (author)

The somatotopic localisation of the descending cortical tract in the cerebral peduncle: a study using MRI of changes following Wallerian degeneration in the cerebral peduncle after a supratentorial vascular lesion

International Nuclear Information System (INIS)

Waragai, M.; Watanabe, H.; Iwabuchi, S.

1994-01-01

We studied the effects of Wallerian degeneration in the cerebral peduncle shown by magnetic resonance imaging (MRI) following a supratentorial vascular lesion, to identify the somatotopic localisation of the descending cortical tracts. Patients with a lesion involving a large area of a cerebral hemisphere has an area of abnormal signal intensity in the whole cerebral peduncle, suggesting Wallerian degeneration of all the whole descending cortical tracts. With a small lesion confined to the precentral gyrus, corona radiata, or posterior limb of the internal capsule there was an abnormal signal at the centre of the peduncle, suggesting degeneration of the precentrospinal tract. Those with a small lesion confined to the paracentral gyrus had an abnormal area slightly lateral to the centre of the peduncle, suggesting degeneration of the parietospinal tract. Patients with a lesion of the parietal or temporal lobes, not including the paracentral or precentral gyri, corona radiata, or the posterior limb of the internal capsule, had an abnormal area laterally in the peduncle, suggesting degeneration of the parietopontine or temporopontine tract. (orig.)

Mortalidade por acidentes de motocicleta no Brasil: analise de tendencia temporal, 1996-2009

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Evandro Tostes Martins

2013-10-01

Full Text Available OBJETIVO Analisar a tendência da mortalidade por acidentes de motocicleta no Brasil. MÉTODOS Estudo descritivo de séries temporais sobre a taxa de mortalidade de acidentes de motocicleta no Brasil, segundo unidades federativas e faixas etárias entre 1996 e 2009. Os dados de óbitos foram obtidos no Sistema de Informação sobre Mortalidade do Ministério da Saúde e da população no Instituto Brasileiro de Geografia Estatística. Taxas de mortalidade padronizadas foram calculadas no período para o Brasil como um todo e Unidades Federativas. Variações anuais das taxas de mortalidade foram estimadas pelo método de Prais-Winsten de regressão linear. RESULTADOS A taxa de mortalidade por acidentes de motocicleta aumentou de 0,5 para 4,5/100.000 habitantes de 1996 a 2009 (aumento de 800% no período e 19% ao ano. Estados com maiores taxas em 2009 foram: Piauí, Tocantins, Sergipe e Mato Grosso. As maiores taxas de crescimento foram observadas nos Estados das regiões Norte, Nordeste e Centro-Oeste. CONCLUSÕES Houve grande aumento das taxas de mortalidade por acidente de motocicleta em todo o Brasil no período, principalmente nos Estados do Nordeste.

A clinical study of cerebral vaso paralysis during a period of cerebral vasospasm after subarachnoid hemorrhage

International Nuclear Information System (INIS)

Watanabe, Toshiichi; Sasaki, Takehiko; Nakagawara, Jyoji

2011-01-01

We employ the 123 I-infinitum (Imp) single photon emission computed tomography (SPECT) dual table autoradiography (Arg) method and stereotactic extraction estimation (SEE) analysis 7 or 8 days after subarachnoid hemorrhage (SAH) onset to predict cerebral vasospasm. We report new findings of cerebral vasoparalysis during a period of cerebral vasospasm after SAH. From January 1, 2005 to April 30, 2008, we encountered 330 cases of aneurysmal SAH, and treated 285 cases. Of these, 65 were excluded as unsuitable for this study, for reasons such as lack of SPECT data, external decompression, admission over 7 days from SAH onset. We studied 220 cases treated by microsurgical clipping (n=178) or endovascular coil embolization (n=42). Vasoparalysis was defined as a rise in resting cerebral blood flow (CBF) and a loss of vascular reserve on SEE analysis of CBF-SPECT. Vasoparalysis occurred in 15 cases (6.8%). Of these, 9 cases (60.0%) had cerebral hematoma, temporary clips had been used in the operation for 8 cases (53.3%), 9 cases (60.0%) experienced postoperative cerebral infarction, and 3 cases (20.0%) had postoperative convulsions. Vasoparalysis occurs in relation to perioperative cerebral damage. In terms of the loss of vascular reserve following SAH, vasoparalysis resembles hemodynamic cerebral ischemia, although the conditions are quite different. Differentiating between these 2 conditions is important, as different forms of management are required. Dual table ARG and SEE analysis are very useful for the evaluating these 2 conditions. (author)

Cerebral emboli and depressive symptoms in dementia.

NARCIS (Netherlands)

Purandare, N.; Oude Voshaar, R.C.; Hardicre, J.; Byrne, J.; McCollum, C.N.; Burns, A.

2006-01-01

BACKGROUND: The vascular depression hypothesis and our recent findings of increased frequency of spontaneous cerebral emboli in dementia suggest that such emboli may be involved in the causation of depressive symptoms in dementia. AIMS: To evaluate the association between spontaneous cerebral emboli

Acidentes múltiplos como sintoma neurótico

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Cicero Christiano de Sousa

1947-06-01

Full Text Available Assinalando o grande desenvolvimento atual da Medicina psicossomática, o A. chama a atenção para os casos em que a ação psicopatógena é indireta: do comportamento do doente resulta um dano qualquer ao seu organismo. Após recordar alguns casos na literatura cita o trabalho de Marbe que estabeleceu claramente, por meios estatísticos, que há pessoas mais sujeitas a acidentes do que outras. Para o A., de acordo com a gênese, os acidentes podem ser: 1 puramente casuais; 2 dependentes de falta de habilidade do indivíduo, ou de defeitos neurológicos; 3 constituir verdadeiros "atos falhados", comparáveis a lapsos da memória ou da linguagem, e causados por um conflito intrapsíquico de tendências conscientes ou inconscientes. Quando muito numerosos, os atos do último tipo constituem verdadeiro sintoma neurótico e evidentemente, só poderão ser afastados pela psicoterapia. O A. refere o caso de um operário que, em pouco mais de um ano de observação, sofreu 17 acidentes, de gravidade geralmente pequena. A tendência a se ferir era notada desde a adolescência. O exame mental revelou indivíduo com traços neuróticos acentuados: irritabilidade, dúvidas, inveja, ansiedade, fobias. O psico-diagnóstico de Rorschach confirmou tratar-se de um neurótico; em particular, todas as respostas são determinadas pela forma, sendo O: O o tipo de vivência; há 91% de F+; o tipo de percepção é G: (D: Dd; a seqüência é rígida; o choque de cores evidente no cartão II. Procurando dar uma explicação psicanalítica para o caso, e diante dos dados relativos à familia do paciente e à sua vida anterior, admite o A. que os acidentes indicam: 1 no plano mais profundo, uma agressividade pré-edipiana introjetada contra a mãe; 2 mais superficialmente, autocastração para se castigar dos desejos contidos no complexo de Édipo e evitar que se realizem; 3 mais superficialmente ainda, há a considerar o lucro secundário do sintoma, relativamente

Vascular permeability in cerebral cavernous malformations

DEFF Research Database (Denmark)

Mikati, Abdul G; Khanna, Omaditya; Zhang, Lingjiao

2015-01-01

Patients with the familial form of cerebral cavernous malformations (CCMs) are haploinsufficient for the CCM1, CCM2, or CCM3 gene. Loss of corresponding CCM proteins increases RhoA kinase-mediated endothelial permeability in vitro, and in mouse brains in vivo. A prospective case-controlled observ...

Non-invasive methods for measuring vascular changes in neurovascular headaches

DEFF Research Database (Denmark)

Schytz, Henrik W; Amin, Faisal M; Selb, Juliette

2018-01-01

Vascular changes during spontaneous headache attacks have been studied over the last 30 years. The interest in cerebral vessels in headache research was initially due to the hypothesis of cerebral vessels as the pain source. Here, we review the knowledge gained by measuring the cerebral vasculature...... studies of migraine and other headache disorders do not provide solid evidence for cerebral blood flow velocity changes during spontaneous attacks of migraine headache. SPECT studies have clearly shown cortical vascular changes following migraine aura and the differences between migraine with aura...... compared to migraine without aura. PET studies have shown focal activation in brain structures related to headache, but whether the changes are specific to different primary headaches have yet to be demonstrated. MR angiography has shown precise changes in large cerebral vessels during spontaneous migraine...

Perfil dos acidentes de trabalho em refinaria de petróleo Occupational accidents in an oil refinery in Brazil

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Carlos Augusto Vaz de Souza

2002-10-01

Full Text Available OBJETIVO: O trabalho em refinarias de petróleo envolve o risco de acidentes triviais e ampliados. Os dados nacionais apontam para a relevância dos acidentes nesse setor. Assim, realizou-se pesquisa com o objetivo de identificar o perfil e avaliar a adequação dos instrumentos de registro dos acidentes de trabalho em refinaria. MÉTODOS: Foram padronizadas e analisadas informações referentes aos acidentes de trabalho nas atividades de produção e manutenção registradas em uma refinaria de petróleo do Estado do Rio de Janeiro, no ano de 1997. A população estudada constituiu-se de 153 pessoas, sendo 83 trabalhadores próprios lesionados e 69 trabalhadores terceirizados lesionados. As variáveis analisadas foram: tipo de acidente, modo de operação e função do trabalhador lesionado. RESULTADOS: Em relação aos trabalhadores próprios, houve predominância dos chamados acidentes triviais (54,2% e quanto ao modo de operação, houve concentração dos acidentes nas atividades em operação normal (62,9%. Quanto aos trabalhadores terceirizados, os acidentes triviais (75,5% tiveram predominância mais acentuada; e quanto ao modo de operação, houve um domínio quase total dos acidentes na atividade de manutenção (96,8%. CONCLUSÕES: Os resultados mostraram um perfil de acidentes que afeta principalmente os níveis hierárquicos mais baixos, concentrando-se de modo geral nas atividades de manutenção, além da necessidade de modificações no sistema de registro e investigação de acidentes por parte da empresa.OBJECTIVE: Work in oil refineries involves the risk of minor to major accidents. National data show the impact of accidents on this industry. A study was carried out to describe accident profile and evaluate the adequacy of accident reporting system. METHODS: Data on all accidents reported in an oil refinery in the state of Rio de Janeiro for the year 1997 were organized and analyzed. The study population consisted of 153

Perfil dos acidentes de trabalho ocorridos no município de Araçatuba-SP nos anos de 2000 e 2001

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Eduardo Pizzatto

Full Text Available O objetivo do presente estudo consiste em descrever o perfil dos acidentes de trabalho ocorridos no município de Araçatuba-SP nos anos de 2000 e 2001. Para tanto, foram analisadas as Comunicações de Acidentes de Trabalho (CATs emitidas no referido período e as informações pertinentes transcritas em formulário específico elaborado através do programa estatístico Epi-Info versão 6.04, utilizado para tabulação e análise dos dados obtidos. Foram analisadas 772 CATs, das quais 656 correspondiam à ocorrência de acidentes típicos, 92 a acidentes de trajeto e 24 a doenças ocupacionais. A média de idade dos acidentados foi de 32,42 anos (d.p. 10,88 e o tempo médio trabalhado até o momento do acidente foi de 4,15 horas (d.p. 2,73. Quanto ao gênero, 632 acidentes (81,9% ocorreram com trabalhadores do sexo masculino e 140 (18,1% com trabalhadores do sexo feminino. O presente estudo revela um amplo predomínio de acidentes de trabalho classificados como típicos, além de uma maior prevalência em trabalhadores do sexo masculino.

Culpa da vítima: um modelo para perpetuar a impunidade nos acidentes do trabalho

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Vilela Rodolfo Andrade Gouveia

2004-01-01

Full Text Available Neste artigo analisam-se os laudos e dados obtidos das investigações de acidentes graves e fatais do trabalho efetuadas pelo Instituto de Criminalística (IC, Regional de Piracicaba. Foram analisados 71 laudos de acidentes ocorridos em 1998, 1999 e 2000. Os acidentes envolvendo máquinas representam 38,0%, seguido pelas quedas de altura (15,5% e em terceiro lugar os causados por corrente elétrica (11,3%. Os laudos concluem que 80,0% dos acidentes são causados por "atos inseguros" cometidos pelos trabalhadores, enquanto que a falta de segurança ou "condição insegura" responde por 15,5% dos casos. A responsabilização das vítimas ocorre mesmo em situações de elevado risco em que não são adotadas as mínimas condições de segurança, com repercussão favorável ao interesse dos empregadores. Observa-se que estas conclusões refletem os modelos explicativos tradicionais, reducionistas, em que os acidentes são fenômenos simples, de causa única, centrada via de regra nos erros e falhas das próprias vítimas. A despeito das críticas que tem recebido nas duas últimas décadas no meio técnico e acadêmico, esta concepção mantém-se hegemônica prejudicando o desenvolvimento de políticas preventivas e a melhoria das condições de trabalho.

Culpa da vítima: um modelo para perpetuar a impunidade nos acidentes do trabalho

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Rodolfo Andrade Gouveia Vilela

Full Text Available Neste artigo analisam-se os laudos e dados obtidos das investigações de acidentes graves e fatais do trabalho efetuadas pelo Instituto de Criminalística (IC, Regional de Piracicaba. Foram analisados 71 laudos de acidentes ocorridos em 1998, 1999 e 2000. Os acidentes envolvendo máquinas representam 38,0%, seguido pelas quedas de altura (15,5% e em terceiro lugar os causados por corrente elétrica (11,3%. Os laudos concluem que 80,0% dos acidentes são causados por "atos inseguros" cometidos pelos trabalhadores, enquanto que a falta de segurança ou "condição insegura" responde por 15,5% dos casos. A responsabilização das vítimas ocorre mesmo em situações de elevado risco em que não são adotadas as mínimas condições de segurança, com repercussão favorável ao interesse dos empregadores. Observa-se que estas conclusões refletem os modelos explicativos tradicionais, reducionistas, em que os acidentes são fenômenos simples, de causa única, centrada via de regra nos erros e falhas das próprias vítimas. A despeito das críticas que tem recebido nas duas últimas décadas no meio técnico e acadêmico, esta concepção mantém-se hegemônica prejudicando o desenvolvimento de políticas preventivas e a melhoria das condições de trabalho.

Cerebral vasculitis associated with Schistosoma mansoni infection

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Camuset Guillaume

2012-09-01

Full Text Available Abstract Background Cerebral involvement in schistosomiasis is not rare, but it is underdiagnosed because of the lack of clinical suspicion and the frequency of asymptomatic forms. Neurologic complications are generally supported by granuloma formation around ectopic eggs which have migrated to the brain. Moreover, vascular lesions and cerebral arteritis have been well documented in histopathological studies. Nevertheless, cerebral vasculitis in later stages of the Schistosoma mansoni infection have not yet been described in living subjects. Case presentation A 28-year-old french woman had a stroke linked with cerebral vasculitis, 6 monthes after returning from Burkina-Faso. At the same time, a S. mansoni disseminated infection was diagnosed. She suffered from a new stroke after undertaking praziquantel therapy, which lead us to associate the S. mansoni infection and cerebral vasculitis. Conclusion This is the first report of such association, since cerebral vasculitis has never been described in later stages of the S. mansoni infection. Although the causal link between the two pathologies could not be proved, we suggest that S. mansoni is able to cause severe vascular damage in cerebral vessels. Schistosomiasis must be investigated in the event of a brain infarct in young people, particularly in patients originating or returning from an endemic area.

Acidente Vascular Encefálico como Primeira Manifestação Clínica da Arterite de Takayasu – Relato de Caso / Brain Stroke as First Clinical Manifestation of Takayasu Arteritis – Case Report

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Mariana Pires de Sousa e Silva

2016-06-01

Full Text Available Introdução: A Arterite de Takayasu (AT é uma vasculite crônica de médios e grandes vasos cuja etiologia é desconhecida. A incidência anual de AT, segundo estatísticas americanas, é de cerca de 2,6 casos por milhão de pessoas, acometendo principalmente mulheres jovens na idade reprodutiva. Essa doença possui sintomas característicos, como claudicação de membros, dor torácica, ausência de pulsos braquiais, sopro carotídeo e ausência de pressão arterial nos membros superiores. Síndromes neurológicas, como Acidente Vascular Cerebral (AVC e Ataque Isquêmico Transitório (AIT são apresentadas por aproximadamente 10 a 20% dos pacientes com AT. Relato de Caso: Relatou-se o caso de paciente do sexo feminino, de 42 anos, branca, que apesar de apresentar os sintomas de AT com 15 anos, como dor em região torácica e hipertensão arterial, foi diagnosticada com AT somente após 25 anos. A paciente foi admitida no Pronto Socorro do Hospital Escola de Itajubá com sintomas que sugeriam um AVC, confirmado com Tomografia computadorizada (TC de crânio e, posteriormente, AngioTC cerebral e de artérias carótidas e vertebrais que, juntamente com os sinais clínicos observados, como pulsos radiais não palpáveis bilateralmente e sopro carotídeo diagnosticaram a AT. Discussão: A AT costuma apresentar intervalo entre início de sintomas e diagnóstico entre dois e onze anos e pode estar associada a várias manifestações características. O diagnóstico de AT tardio tendo o AVC como primeira manifestação clínica é raro. Conclusão: A importância de se conhecer a AT está no fato do diagnóstico, bem como tratamento precoce poderem evitar complicações ou retardar o seu aparecimento. Introduction: The Takayasu arteritis (TA is a chronic vasculitis of medium and large vessel, whose etiology is unknown. The annual incidence of TA, according to American statistics, is about 2.6 cases per one million people, mainly affects young women in

Treinamento de marcha, cardiorrespiratório e muscular após acidente vascular encefálico: estratégias, dosagens e desfechos

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Angélica Cristiane Ovando

Full Text Available INTRODUÇÃO: Um número crescente de programas de treinamento com resultados positivos tem sido proposto para a reabilitação de pacientes com sequelas motoras após acidente vascular encefálico (AVE. No entanto, observa-se que muitos não oferecem recomendações no que diz respeito a indicações para técnicas e procedimentos específicos. OBJETIVO: Revisar a literatura pertinente sobre programas de treinamento envolvendo marcha, condicionamento cardiorrespiratório e fortalecimento muscular de membros inferiores em pacientes portadores de hemiparesia por sequela de AVE, e descrever a eficácia, limitações e efeitos desses programas na recuperação cardiovascular, funcional e motora dessa população. MÉTODO: Foi realizada uma busca por ensaios clínicos, trabalhos pré-experimentais, meta-análises e revisões de literatura que abordassem os temas treinamento físico, fortalecimento muscular, treinamento de marcha e programas de exercícios para membros inferiores após AVE. RESULTADOS: Foram encontrados 27 artigos relatando diversos protocolos de treinamento (marcha, treinamento cardiovascular, fortalecimento muscular, entre outros e seus efeitos no sistema cardiovascular, músculo-esquelético e sobre o status funcional em indivíduos portadores de hemiparesia após AVE. CONCLUSÃO: Praticamente todas as intervenções relatam resultados positivos em termos de ganhos funcionais, além de efeitos específicos de acordo com o tipo de treinamento. No entanto, as diferenças metodológicas, a carência de grupo controle em alguns estudos, a variabilidade da população estudada e os critérios de análise nem sempre permitem a recomendação segura de procedimentos específicos na prática clínica.

Indian-ink perfusion based method for reconstructing continuous vascular networks in whole mouse brain.

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Songchao Xue

Full Text Available The topology of the cerebral vasculature, which is the energy transport corridor of the brain, can be used to study cerebral circulatory pathways. Limited by the restrictions of the vascular markers and imaging methods, studies on cerebral vascular structure now mainly focus on either observation of the macro vessels in a whole brain or imaging of the micro vessels in a small region. Simultaneous vascular studies of arteries, veins and capillaries have not been achieved in the whole brain of mammals. Here, we have combined the improved gelatin-Indian ink vessel perfusion process with Micro-Optical Sectioning Tomography for imaging the vessel network of an entire mouse brain. With 17 days of work, an integral dataset for the entire cerebral vessels was acquired. The voxel resolution is 0.35×0.4×2.0 µm(3 for the whole brain. Besides the observations of fine and complex vascular networks in the reconstructed slices and entire brain views, a representative continuous vascular tracking has been demonstrated in the deep thalamus. This study provided an effective method for studying the entire macro and micro vascular networks of mouse brain simultaneously.

Vascular and parenchymal amyloid pathology in an Alzheimer disease knock-in mouse model: interplay with cerebral blood flow.

Science.gov (United States)

Li, Hongmei; Guo, Qinxi; Inoue, Taeko; Polito, Vinicia A; Tabuchi, Katsuhiko; Hammer, Robert E; Pautler, Robia G; Taffet, George E; Zheng, Hui

2014-08-09

Accumulation and deposition of β-amyloid peptides (Aβ) in the brain is a central event in the pathogenesis of Alzheimer's disease (AD). Besides the parenchymal pathology, Aβ is known to undergo active transport across the blood-brain barrier and cerebral amyloid angiopathy (CAA) is a prominent feature in the majority of AD. Although impaired cerebral blood flow (CBF) has been implicated in faulty Aβ transport and clearance, and cerebral hypoperfusion can exist in the pre-clinical phase of Alzheimer's disease (AD), it is still unclear whether it is one of the causal factors for AD pathogenesis, or an early consequence of a multi-factor condition that would lead to AD at late stage. To study the potential interaction between faulty CBF and amyloid accumulation in clinical-relevant situation, we generated a new amyloid precursor protein (APP) knock-in allele that expresses humanized Aβ and a Dutch mutation in addition to Swedish/London mutations and compared this line with an equivalent knock-in line but in the absence of the Dutch mutation, both crossed onto the PS1M146V knock-in background. Introduction of the Dutch mutation results in robust CAA and parenchymal Aβ pathology, age-dependent reduction of spatial learning and memory deficits, and CBF reduction as detected by fMRI. Direct manipulation of CBF by transverse aortic constriction surgery on the left common carotid artery caused differential changes in CBF in the anterior and middle region of the cortex, where it is reduced on the left side and increased on the right side. However these perturbations in CBF resulted in the same effect: both significantly exacerbate CAA and amyloid pathology. Our study reveals a direct and positive link between vascular and parenchymal Aβ; both can be modulated by CBF. The new APP knock-in mouse model recapitulates many symptoms of AD including progressive vascular and parenchymal Aβ pathology and behavioral deficits in the absence of APP overexpression.

Cerebral monitoring during carotid endarterectomy – a comparison ...

African Journals Online (AJOL)

All patients had general anaesthesia and were operated on by the same vascular surgeon (JvM). All patients were evaluated preoperatively by an experienced sonographer. Cerebral monitoring during carotid endarterectomy – a comparison between electroencephalography, transcranial cerebral oximetry and carotid ...

Reduced cerebral vascularization in experimental neuronopathic Gaucher disease.

Science.gov (United States)

Smith, Nicholas Jc; Fuller, Maria; Saville, Jennifer T; Cox, Timothy M

2018-01-01

The glycosphingolipidosis, Gaucher disease, in which a range of neurological manifestations occur, results from a deficiency of acid β-glucocerebrosidase, with subsequent accumulation of β-glucocerebroside, its upstream substrates, and the non-acylated congener β-glucosylsphingosine. However, the mechanisms by which end-organ dysfunction arise are poorly understood. Here, we report strikingly diminished cerebral microvascular density in a murine model of disease, and provide a detailed analysis of the accompanying cerebral glycosphingolipidome in these animals, with marked elevations of β-glucosylsphingosine. Further in vitro studies confirmed a concentration-dependent impairment of endothelial cytokinesis upon exposure to quasi-pathological concentrations of β-glucosylsphingosine. These findings support a premise for pathogenic disruption of cerebral angiogenesis as an end-organ effect, with potential for therapeutic modulation in neuronopathic Gaucher disease. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Clinical significance of determination of plasma NPY levels and serum lipid profile in patients with cerebral hemorrhage and cerebral infarction

International Nuclear Information System (INIS)

Huang Fujuan; Shen Airong; Yang Yongqing

2010-01-01

Objective: To study the clinical significance of changes of plasma NPY levels and serum lipid profile in patients with cerebral hemorrhage and cerebral infarction. Methods: Plasma NPY levels (with RIA) and serum lipid profile (with biochemistry) were determined in (1) 48 patients with acute cerebral hemorrhage (2) 46 patients with acute cerebral infarction and (3) controls.Results Plasma NPY levels in both patients with cerebral hemorrhage and patients with cerebral infarction were significantly higher than those in controls (P 0.05). Conclusion: NPY played important roles in the development and pathogenesis of cerebral vascular accidents. Lipid profile changes was the basic etiological factor. (authors)

Cerebral energy metabolism in streptozotocin-diabetic rats

NARCIS (Netherlands)

Biessels, G.J.; Braun, K.P.J.; Graaf, de R.A.; Eijsden, van P.; Gispen, W.H.; Nicolaij, K.

2001-01-01

Aims/hypothesis. It is increasingly evident that the brain is another site of diabetic end-organ damage. The pathogenesis has not been fully explained, but seems to involve an interplay between aberrant glucose metabolism and vascular changes. Vascular changes, such as deficits in cerebral blood

Correlation of angiography and MR imaging in cerebral vasculitis

International Nuclear Information System (INIS)

Cloft, H.J.; Phillips, C.D.; Dix, J.E.; McNulty, B.C.; Kallmes, D.F.; Zagardo, M.T.

1999-01-01

Purpose: MR imaging and cerebral angiography were correlated in patients with primary angiitis of the central nervous system (PACNS) to assess the relative roles of these imaging modalities in the diagnosis. Material and Methods: In 9 patients, MR imaging and angiography were compared with regard to the relative involvement of each major vascular territory. Vascular territories assessed were the anterior, middle, and posterior cerebral arteries, and the posterior fossa. Results: All patients had angiographic findings consistent with vasculitis in multiple vascular territories. MR findings ranged from normal to diffusely abnormal. One patient had a completely normal MR investigation. Of 50 territories affected by vasculitis on angiography, 17 (34%) were normal on MR. Conclusion: Relative to cerebral angiography, MR imaging is a poor indicator of the presence or absence of PACNS. Angiography is indicated when clinical suspicion of PACNS is strong, regardless of the findings on MR. (orig.)

MRI of sickle cell cerebral infarction

International Nuclear Information System (INIS)

Zimmerman, R.A.; Goldberg, H.I.; Bilaniuk, L.T.; Hackney, D.B.; Johnson, M.; Grossman, R.I.; Hecht-Leavitt, C.; Gill, F.; Pennsylvania Univ., Philadelphia

1987-01-01

Eleven patients with sickle cell disease and neurological symptoms underwent MRI examination. Cerebral infarcts of two types were found, those in the vascular distribution of the middle cerebral artery and those in the deep white matter. In the patient whose hydration and whose oxygenation of erythrocytes has been treated, MRI offers diagnostic advantages over arteriography and CT. (orig.)

Vascular Variations Associated with Intracranial Aneurysms.

Science.gov (United States)

Orakdogen, Metin; Emon, Selin Tural; Somay, Hakan; Engin, Taner; Is, Merih; Hakan, Tayfun

2017-01-01

To investigate the vascular variations in patients with intracranial aneurysm in circle of Willis. We used the data on 128 consecutive intracranial aneurysm cases. Cerebral angiography images were analyzed retrospectively. Arteries were grouped as anterior cerebral arterial system (ACS), posterior cerebral arterial system (PCS) and middle cerebral arterial system (MCS) for grouping vascular variations. Lateralization, being single/multiple, gender; and also any connection with accompanying aneurysms" number, localization, dimension, whether bleeding/incidental aneurysm has been inspected. Variations were demonstrated in 57.8% of the cases. The most common variation was A1 variation (34.4%). The rate of variations was 36.7%, 24.2% and 10.2% respectively in ACS, PCS and MCS. MCS variations were significantly higher in males. Anterior communicating artery (ACoA) aneurysm observance rates were significantly higher and posterior communicating artery (PCoA) aneurysm and middle cerebral artery (MCA) aneurysm observance rates were significantly lower when compared to "no ACS variation detected" cases. In "PCS variation detected" cases, PCoA aneurysm observance rates and coexistence of multiple variations were significantly higher. The rate of vascular variations in patients with aneurysms was 57.8%. Arterial hypoplasia and aplasia were the most common variations. ACS was the most common region that variations were located in; they were mostly detected on the right side. Coexistence of ACoA aneurysm was higher than PCoA and MCA aneurysms. In the PCS variations group, PCoA aneurysms were the most common aneurysms that accompanying the variation and multiple variations were more common than in the other two groups. The variations in MCS were most common in males.

Acidentes de trabalho com material biológico ocorridos em municípios de Minas Gerais

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Renata Siqueira Julio

2014-01-01

Full Text Available O objetivo do estudo foi identificar o perfil dos acidentes com exposição a material biológico ocorridos em Minas Gerais. Estudo descritivo, transversal realizado por meio de consulta ao Sistema de Informação de Agravos de Notificação de 50 municípios do sul do Estado de Minas Gerais, Brasil, no período de 2007-2011. Foram registrados 460 acidentes, sendo que cerca da metade ocorreram entre auxiliares e técnicos de enfermagem, seguidos por enfermeiros e médicos. Houve predomínio dos acidentes ocorridos devido ao descarte inadequado de material perfurocortante. Entre os pacientes-fonte, verificou-se uma prevalência de 8,0% de sorologia reagente para o HIV; 1,0% para HBsAg; 6,0% para anti-HBC e 3% para o anti-HCV. Entre os acidentados, 14,0% não estavam imunizados para hepatite B, contudo, a prescrição de vacina e imunoglobulina foi inferior à necessidade. Os resultados subsidiarão o planejamento de ações preventivas e de novas condutas diante da ocorrência desse tipo de acidentes.

Spinal vascular malformations in non-perimesencephalic subarachnoid hemorrhage

NARCIS (Netherlands)

Germans, M. R.; Pennings, F. A.; Sprengers, M. E. S.; Vandertop, W. P.

2008-01-01

OBJECTIVE: In patients with non-traumatic subarachnoid hemorrhage (SAH) and no evidence for a cerebral aneurysm on angiography, a frequent cause of the hemorrhage is perimesencephalic hemorrhage or other cerebral vascular pathology. In some patients no cause is found. The exact incidence of a spinal

Estudo clínico e videofluoroscópico da disfagia na fase subaguda do acidente vascular encefálico

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Xerez Denise Rodrigues

2004-01-01

Full Text Available OBJETIVO: Correlacionar, em pacientes portadores de acidente vascular encefálico (AVE na fase subaguda, as alterações clínicas da deglutição com as observadas na videofluoroscopia. MATERIAIS E MÉTODOS: De 37 portadores de AVE subagudo confirmado por exame de imagem, 26 pacientes de ambos os sexos, com idade média de 59,69 anos, foram avaliados clínica e videofluoroscopicamente. Consideramos como variáveis para pareamento estatístico os parâmetros clínicos indicativos de penetração/aspiração e sua confirmação na videofluoroscopia. RESULTADOS: Identificamos disfagia em 19 (73% dos 26 pacientes que fizeram videofluoroscopia; dez (38,46% apresentaram penetração/aspiração de líquidos. Os dados resultantes mostraram não existir correlação (p < 0,05 entre a presença de disfagia e/ou disartria e a presença de penetração/aspiração de líquidos na videofluoroscopia. Houve correlação entre a presença de penetração/aspiração de líquidos observados na videofluoroscopia com os seguintes parâmetros clínicos: estado dos dentes (p = 0,047, mobilidade (p = 0,019 e sensibilidade da face (p = 0,039 e mobilidade da língua (p = 0,012. CONCLUSÃO: Não foi possível definir a presença de penetração/aspiração de líquidos nas vias aéreas por dados epidemiológicos do AVE. A existência de mau estado de preservação dos dentes, alterações na mobilidade da face e da língua e na sensibilidade da face mostrou risco aumentado de penetração/aspiração para líquidos. Permanece importante a indicação da videofluoroscopia para melhor avaliação dos quadros de disfagia após AVE.

O efeito da eletroestimulação neuromuscular na contração da musculatura supra-hióidea durante a deglutição de indivíduos com disfagia

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Maíra Barbosa Lobo

Full Text Available RESUMO Objetivo: verificar o efeito da Eletroestimulação Neuromuscular na contração da musculatura supra-hióidea durante a deglutição em indivíduos pós-Acidente Vascular Cerebral com disfagia orofaríngea. Métodos: participaram da pesquisa oito indivíduos pós-Acidente Vascular Cerebral com disfagia, de ambos os sexos, encaminhados para terapia fonoaudiológica com objetivo de trabalhar a função da deglutição, em início de processo terapêutico. Anteriormente ao início da primeira sessão, foi realizada a mensuração do tempo e amplitude da atividade elétrica muscular através da Eletromiografia de Superfície de Biofeedback. Os pacientes foram divididos aleatoriamente em dois grupos: Grupo Experimental (n=4: pacientes que receberam a fonoterapia tradicional e aplicação da Eletroestimulação Neuromuscular; Grupo Controle (n=4: pacientes que receberam a fonoterapia tradicional. Após oito sessões, todos os pacientes passaram novamente pela Eletromiografia de Superfície de Biofeedback para verificar a atividade elétrica da musculatura supra-hióidea. Os registros dos exames pré e pós intervenção foram comparados nos dois grupos. Resultados: comparando-se as médias das variáveis de amplitude e tempo da atividade elétrica muscular durante a deglutição de saliva e nas duas deglutições de pastoso, não foram observadas diferenças estatisticamente significantes entre os grupos estudados, na comparação dos valores pré e pós intervenção. Conclusões: o uso da Eletroestimulação Neuromuscular nos parâmetros e na metodologia empregada não mostrou-se eficiente em promover maior contração da musculatura supra-hióidea durante a deglutição em indivíduos pós-Acidente Vascular Cerebral com disfagia orofaríngea. Os dados encontrados podem ser decorrentes da metodologia utilizada nesta pesquisa com relação ao protocolo de aplicação da técnica e à forma de mensuração dos resultados.

Uso do EuroSCORE como preditor de morbidade no pós-operatório de cirurgia cardíaca

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Isaac Newton Guimarães Andrade

2014-03-01

Full Text Available Objetivo: Avaliar o uso do EuroSCORE como preditor de morbidade no pós-operatório de cirurgia cardíaca. Métodos: Foram analisados, retrospectivamente, os prontuários de 900 pacientes operados no Real Hospital Português do Recife e admitidos na unidade de terapia intensiva pós-operatória. Foram incluídos todos os pacientes com prontuários completos, sendo excluídos aqueles que foram a óbito no transoperatório, submetidos a transplante ou a correção de cardiopatia congênita. Foi avaliado o desenvolvimento de infecção respiratória, acidente vascular cerebral e insuficiência renal dialítica, sendo o EuroSCORE comparado em relação às três complicações, usando-se o teste de Mann-Whitney. A calibração do modelo para predição das morbidades estudadas foi avaliado com o teste de ajuste de bondade de Homer-Lemeshow. A acurácia do modelo foi avaliada utilizando-se a área sob a curva ROC (ASROC. Resultados: O modelo apresentou boa calibração na predição de infecção respiratória, insuficiência renal dialítica e acidente vascular cerebral (P=0,285; P=0,789; P=0,45, respectivamente, tendo boa acurácia para infecção respiratória (ASROC=0,710 e P<0,001 e insuficiência renal dialítica (ASROC=0,834 e P<0,001 e sem acurácia para acidente vascular cerebral (ASROC=0,519. Os pacientes de alto risco apresentaram maior chance de desenvolver infecção respiratória (OR=9,05; P<0,001 e insuficiência renal dialítica (OR=39,6; P<0,001. A probabilidade de desenvolver infecção respiratória e insuficiência renal dialítica foi de menos de 10% com EuroSCORE até 7 e de mais de 70% com EuroSCORE maior que 15. Conclusão: O EuroSCORE mostrou-se um bom preditor das principais morbidades pós-operatórias em cirurgia cardíaca: infecção respiratória e insuficiência renal dialítica.

Relation between prognosis and collateral circulation or recanalization in occlusive cerebral vascular diseases

International Nuclear Information System (INIS)

Saito, Yuko

1982-01-01

CT images and angiograms were compared, in occlusive cerebral vascular diseases with complete stroke in the region of internal carotid artery, and following subjects were discussed. 1) Relation between size of final low density area on CT and prognosis. 2) Effectiveness of collateral circulation and recanalization to the low density area on CT in the teritorry of occluded artery. For the subject 1,100 cases of infarction of the region of middle cerebral artery were chosen at random, and the prognosis was compared with the size of low density area on CT. For the subject 2,186 cases of infarction in the region on internal carotid artery were selected, and CT images and angiograms were compared, considering the duration between stroke and angiography. With these studies, following conclusions were obtained. There is tendency that cases with the smaller low density areas on CT have the better prognosis. The low density on CT appeares inside of the teritorry of the occluded artery. When there is neither collateral circulation nor recanalization, appearance of the low density on CT is not avoided. Collateral circulation or recanalization is able to rescue the affected area from appearance of low density on CT, even if it is formed later than 6 hours after ictus. The critical period when collateral circulation or recanalization effects on the involved area is variable depending on each cases, but it is suspected to be 24 or 72 hours after onset. Blood supply which begins later than 73 hours after occlusion of artery does not effect on the involved area. (J.P.N.)

Relation between prognosis and collateral circulation or recanalization in occlusive cerebral vascular diseases

Energy Technology Data Exchange (ETDEWEB)

Saito, Yuko (Tokyo Women' s Medical Coll. (Japan))

1982-09-01

CT images and angiograms were compared, in occlusive cerebral vascular diseases with complete stroke in the region of internal carotid artery, and following subjects were discussed. 1) Relation between size of final low density area on CT and prognosis. 2) Effectiveness of collateral circulation and recanalization to the low density area on CT in the territory of occluded artery. For the subject 1,100 cases of infarction of the region of middle cerebral artery were chosen at random, and the prognosis was compared with the size of low density area on CT. For the subject 2,186 cases of infarction in the region on internal carotid artery were selected, and CT images and angiograms were compared, considering the duration between stroke and angiography. With these studies, following conclusions were obtained. There is tendency that cases with the smaller low density areas on CT have the better prognosis. The low density on CT appears inside of the territory of the occluded artery. When there is neither collateral circulation nor recanalization, appearance of the low density on CT is not avoided. Collateral circulation or recanalization is able to rescue the affected area from appearance of low density on CT, even if it is formed later than 6 hours after ictus. The critical period when collateral circulation or recanalization effects on the involved area is variable depending on each cases, but it is suspected to be 24 or 72 hours after onset. Blood supply which begins later than 73 hours after occlusion of artery does not effect on the involved area.

Mechanical injury induces brain endothelial-derived microvesicle release: Implications for cerebral vascular injury during traumatic brain injury

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Allison M. Andrews

2016-02-01

occludin following brain trauma. These results indicate that following TBI, the cerebral endothelium undergoes vascular remodeling through shedding of eMVs containing TJPs and endothelial markers. The detection of this shedding potentially allows for a novel methodology for real-time monitoring of cerebral vascular health (remodeling, BBB status and neuroinflammation following a TBI event.

Mechanical Injury Induces Brain Endothelial-Derived Microvesicle Release: Implications for Cerebral Vascular Injury during Traumatic Brain Injury.

Science.gov (United States)

Andrews, Allison M; Lutton, Evan M; Merkel, Steven F; Razmpour, Roshanak; Ramirez, Servio H

2016-01-01

. These results indicate that following TBI, the cerebral endothelium undergoes vascular remodeling through shedding of eMVs containing TJPs and endothelial markers. The detection of this shedding potentially allows for a novel methodology for real-time monitoring of cerebral vascular health (remodeling), BBB status and neuroinflammation following a TBI event.

ACIDENTES COM MATERIAIS PERFURO-CORTANTES: UM ESTUDO DE CASO DA EMPRESA FHGV - HOSPITAL TRAMANDAÍ

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Machado, Leonel Camargo; Henkes, Jairo Afonso

2013-01-01

O presente trabalho evidencia as causas dos acidentes com material perfuro-cortantes em um hospital da região litorânea do Rio Grande do Sul. Considera-se acidente de trabalho o fato que ocorre no exercício do trabalho nas dependências da empresa ou nos seus deslocamentos para a residência do trabalhador, ou fora do local de trabalho, a serviço da empresa. Já material perfuro-cortante é definido como o que têm ponta ou gume, materiais utilizados para perfurar ou cortar, como por exemplo, bist...

Acidentes de trabalho com mototaxistas Occupational accidents among mototaxi drivers

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Camila Rego Amorim

2012-03-01

Full Text Available A utilização da motocicleta como meio de trabalho vem contribuindo para o aumento no número dos acidentes de trânsito e se constituindo em acidentes de trabalho para os mototaxistas. O objetivo deste estudo foi estimar a incidência anual de acidentes de trabalho entre mototaxistas cadastrados em Feira de Santana, BA. Trata-se de um estudo de caráter descritivo e censitário. Foram entrevistados 267 profissionais dos 300 cadastrados na Secretaria Municipal de Transporte e Trânsito - SMTT, através de questionário estruturado. Procedeu-se à análise descritiva e foram estimadas incidências anuais de acidentes de trabalho segundo as variáveis de interesse. Calcularam-se os riscos relativos e, como medida de significância estatística, utilizou-se o teste de qui-quadrado de Pearson e o teste exato de Fisher, adotando-se p The use of motorcycles as a means of work has contributed to the increase in traffic accidents, in particular, mototaxi accidents. The aim of this study was to estimate and characterize the incidence of occupational accidents among the mototaxis registered in Feira de Santana, BA. This is a cross-sectional study with descriptive and census data. Of the 300 professionals registered at the Municipal Transportation Service, 267 professionals were interviewed through a structured questionnaire. Then, a descriptive analysis was conducted and the incidence of accidents was estimated based on the variables studied. Relative risks were calculated and statistical significance was determined using the chi-square test and Fisher's exact test, considering p < 0.05. Logistic regression was used in order to perform simultaneous adjustment of variables. Occupational accidents were observed in 10.5% of mototaxis. There were mainly minor injuries (48.7%, 27% of them requiring leaves of absence from work. There was an association between the days of work per week, fatigue in lower limbs and musculoskeletal complaints, and accidents

Efeito protetor da flavana extraída da espécie Brosimum acutifolium contra danos causados por hipóxia em células retinianas: um estudo in vitro

OpenAIRE

FONSECA, Susanne Suely Santos da

2014-01-01

O acidente vascular cerebral isquêmico (AVCi) causa danos celulares por provocar intensa excitotoxicidade e estresse oxidativo após privação de oxigênio e glicose para uma região do encéfalo. Neste trabalho, investigamos o potencial neuroprotetor da planta amazônica Brosimum acutifolium que é rica em flavanas como a 4',7-diidroxi-8-(3,3-dimetilalil)flavana (brosimina b, aqui abreviada como Bb) que apresenta elevado potencial antioxidante. Utilizamos cultura de células retinianas de embrião de...

A influência dos principais factores de risco cardiovascular nos AVCs e consequente perturbação da linguagem adquirida

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Ferreira, Elisabete Duarte

2013-01-01

Trabalho de Projeto apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Terapêutica da Fala, área de especialização em Linguagem no Adulto Introdução: O acidente vascular cerebral (AVC) constitui um dos principais problemas de saúde pública, de morbimortalidade e de incapacidade prolongada. As alterações decorrentes do AVC incluem os défices motores, os défices cognitivos e as perturbações da linguagem adquirida, tal como a afasia. Foi se...

A stepwise approach to stroke surveillance in Brazil: the EMMA (Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral) study.

Science.gov (United States)

Goulart, Alessandra C; Bustos, Iara R; Abe, Ivana M; Pereira, Alexandre C; Fedeli, Ligia M; Benseñor, Isabela M; Lotufo, Paulo A

2010-08-01

Stroke mortality rates in Brazil are the highest in the Americas. Deaths from cerebrovascular disease surpass coronary heart disease. To verify stroke mortality rates and morbidity in an area of São Paulo, Brazil, using the World Health Organization Stepwise Approach to Stroke Surveillance. We used the World Health Organization Stepwise Approach to Stroke Surveillance structure of stroke surveillance. The hospital-based data comprised fatal and nonfatal stroke (Step 1). We gathered stroke-related mortality data in the community using World Health Organization questionnaires (Step 2). The questionnaire determining stroke prevalence was activated door to door in a family-health-programme neighbourhood (Step 3). A total of 682 patients 18 years and above, including 472 incident cases, presented with cerebrovascular disease and were enrolled in Step 1 during April-May 2009. Cerebral infarction (84.3%) and first-ever stroke (85.2%) were the most frequent. In Step 2, 256 deaths from stroke were identified during 2006-2007. Forty-four per cent of deaths were classified as unspecified stroke, 1/3 as ischaemic stroke, and 1/4 due to haemorrhagic subtype. In Step 3, 577 subjects over 35 years old were evaluated at home, and 244 cases of stroke survival were diagnosed via a questionnaire, validated by a board-certified neurologist. The population demographic characteristics were similar in the three steps, except in terms of age and gender. By including data from all settings, World Health Organization stroke surveillance can provide data to help plan future resources that meet the needs of the public-health system.

Análise dos acidentes de trabalho do tipo quedas em altura na indústria da construção

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Araújo, José António Faria

2011-01-01

Dissertação de mestrado em Engenharia Humana Os acidentes de trabalho constituem um problema que preocupa todos os técnicos de Segurança e Higiene do Trabalho. Um acidente de trabalho, quando occorre, pode provocar graves lesões no(s) trabalhador(es) sinistrado(s), bem como enormes prejuízos materiais para as entidades empregadoras. Apenas a análise dos acidentes permite a criação de mecanismos para minimizar, e se possível evitar, a futura ocorrência dos mesmos. O projecto ...

Proposal for a universal definition of cerebral infarction.

Science.gov (United States)

Saver, Jeffrey L

2008-11-01

Cerebral infarction is a leading cause of disability and death worldwide but has no uniform international definition. Recent diagnostic advances have revised fundamental concepts in cerebral and cardiac ischemia. Cardiologists, already possessed of a nosologic framework distinguishing myocardial infarction from unstable angina on the basis of tissue state, promulgated a new "universal" tissue definition of myocardial infarction incorporating insights afforded by assays of cardiac troponin, a serum biomarker exquisitely sensitive to myocardial injury. Concurrently, vascular neurologists proposed a new tissue, rather than time, criterion to distinguish transient ischemia attack from cerebral infarction, responding to perspectives provided by diffusion MRI and cerebral blood volume CT, imaging biomarkers highly sensitive to neuronal injury. To complete this conceptual realignment, vascular neurology must now advance a clear, uniform, and operationalizable tissue definition of cerebral infarction. This review proposes cerebral infarction be defined as brain or retinal cell death due to prolonged ischemia. This definition categorizes both pannecrosis and neuronal dropout ("complete" and "incomplete" infarcts in classic neuropathologic terminology) as cerebral infarcts. Making the presence of any neuronal or glial cell death essential yields a definition of cerebral infarction that has high relevance to patients, physicians, and policymakers; is more easily applied in clinical practice; fosters action in acute care; harmonizes with myocardial ischemia classification; and focuses diagnostic evaluation on the cause of brain ischemia and the occurrence of end organ injury. The term cerebral infarction should be used when there is evidence of brain or retinal cell death due to cerebral ischemia.

Relation of plasma homocyst(e)ine to cerebral infarction and cerebral atherosclerosis.

Science.gov (United States)

Yoo, J H; Chung, C S; Kang, S S

1998-12-01

A number of investigations support the theory that the elevated plasma homocyst(e)ine is associated with occlusive vascular disease. The aim of this study is to examine whether moderate hyperhomocyst(e)inemia is an independent risk factor for cerebral infarction. In addition, we examined the association between plasma homocyst(e)ine and the severity of cerebral atherosclerosis. We conducted a hospital-based case-control study with 140 male controls and 78 male patients with nonfatal cerebral infarction, aged between 39 and 82 years. Plasma homocyst(e)ine levels were analyzed in 218 subjects. Fifty-five patients were evaluated for cerebral vascular stenosis by MR angiography. The mean plasma level of homocyst(e)ine was higher in cases than in controls (11.8+/-5.6 versus 9.6+/-4.1 micromol/L; P=0.002). The proportion of subjects with moderate hyperhomocyst(e)inemia was significantly higher in cases than in controls (16.7% versus 5.0%; P=0.004). Based on the logistic regression model, the odds ratio of the highest 5% of homocyst(e)ine levels in control group was 4.17 (95% confidence interval, 3.71 to 4. 71)(P=0.0001). After additional adjustment for total cholesterol, hypertension, smoking, diabetes, and age, the odds ratio was 1.70 (95% confidence interval, 1.48 to 1.95) (P=0.0001). The plasma homocyst(e)ine levels of patients having vessels with 3 or 2 stenosed sites were significantly higher than those of patients having vessels with 1 stenosed site or normal vessels (14.6+/-1.4, 11.0+/-1.4 versus 7.8+/-1.5, 8.9+/-1.4 micromol/L respectively; P<0. 02). Multiple logistic regression analysis revealed that moderate hyperhomocyst(e)ienemia was significantly associated with the number of stenosed vessels (P=0.001). These findings suggest that moderate hyperhomocyst(e)inemia is an independent risk factor for cerebral infarction and may predict the severity of cerebral atherosclerosis in patients with cerebral infarction.

[Cerebral hemodynamics in patients with neurosensory hearing loss before and after magnetotherapy].

Science.gov (United States)

Morenko, V M; Enin, I P

2001-01-01

Magnetotherapy effects on cerebral hemodynamics were studied using rheoencephalography (REG). When the treatment results and changes in cerebral hemodynamics were compared it was evident that normalization or improvement of vascular status in vertebrobasilar and carotid territories registered at REG results in better hearing. This confirms the role of vascular factor in pathogenesis of neurosensory hypoacusis of different etiology and effectiveness of magnetotherapy in such patients.

Relationship between cerebral blood flow and later cognitive decline in hypertensive patients with cerebral small vessel disease

International Nuclear Information System (INIS)

Kitagawa, Kazuo; Oku, Naohiko; Yagita, Yoshiki; Sakaguchi, Manabu; Sakoda, Saburo; Kimura, Yasuyuku; Hatazawa, Jun

2009-01-01

Vascular risk factors are thought to be important for dementia. However, there is little evidence for a prospective association between cerebral blood flow and the risk of cognitive decline. Twenty-seven cognitively intact hypertensive patients aged 55 years and older with lacunar infarction or white matter lesions in magnetic resonance imaging (MRI) underwent positron emission tomography (PET) to measure cerebral blood flow (CBF) and cerebral vascular reactivity (CVR). Cognitive function was assessed at baseline and 3 years later with the mini-mental state examination (MMSE). Patients whose MMSE score fell by more than three points were classified as having cognitive decline. Six patients showed cognitive decline. Baseline CBF in these patients was significantly lower than that of the 21 patients without cognitive decline (31.2±2.4 vs. 42.6±5.9 ml per 100 gmin -1 , respectively; P<0.001). A moderate linear association was found between CBF and change in MMSE score over a 3-year period (r=0.59, P=0.001), not between CBF and baseline MMSE score. In contrast, no association between CVR and later cognitive decline was found. This study suggests that cerebral hypoperfusion is associated with later cognitive decline. (author)

Prevalência de acidente vascular cerebral em idosos no Município de Vassouras, Rio de Janeiro, Brasil, através do rastreamento de dados do Programa Saúde da Família Stroke prevalence among the elderly in Vassouras, Rio de Janeiro State, Brazil, according to data from the Family Health Program

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Ana Beatriz Calmon Nogueira da Gama Pereira

2009-09-01

Full Text Available O estudo estimou a prevalência de acidente vascular cerebral (AVC em idosos em Vassouras, Rio de Janeiro, Brasil, pelo rastreamento de dados do Programa Saúde da Família (PSF. A população idosa foi escolhida por seu aumento no Brasil e pelo risco do AVC aumentar com a idade. Foram rastreados todos os idosos de Vassouras cadastrados no PSF, identificando os acometidos por AVC e analisando o seu perfil sócio-demográfico. Foram utilizados os dados do Sistema de Informação e Atenção Básica, do censo populacional do Instituto Brasileiro de Geografia e Estatística e a ficha de atendimento padronizada pelo PSF, do Ministério da Saúde. Avaliou-se a qualidade dos diagnósticos de AVC do PSF. No rastreamento, foram encontrados 122 idosos com diagnóstico de AVC, com prevalência de 2,9%, e aumento progressivo com o avançar da idade, sendo a prevalência nos homens (3,2% maior do que nas mulheres (2,7%. A taxa de prevalência foi igual tanto na zona rural quanto na zona urbana (2,9%. O conhecimento da magnitude da prevalência do AVC na população idosa é fundamental para melhor planejamento de saúde.This study estimated the prevalence of stroke among the elderly in Vassouras, Rio de Janeiro State, Brazil, based on data from the Family Health Program (FHP. The elderly population was chosen since it is growing as a proportion of the general population, and since stroke risk increases with age. Data were screened for all the elderly registered in the FHP in Vassouras, identifying those with a history of stroke and analyzing their socio-demographic profile. The study used data from the Information System on Primary Care, the population census conducted by the Brazilian Institute of Geography and Statistics (IBGE, and the Ministry of Health's standardized FHP patient form. Quality of stroke diagnoses in the FHP was analyzed. Data screening detected 122 elderly with a history of stroke diagnosis (prevalence = 2.9%; 3.2% in men, 2.7% in women

Repercussão da pressão positiva expiratória final na pressão de perfusão cerebral em pacientes adultos com acidente vascular hemorrágico

OpenAIRE

Lima,Wildberg Alencar; Campelo,Antônio Roberto Leite; Gomes,Rodrigo Luís Mousinho; Brandão,Daniella Cunha

2011-01-01

A pressão positiva intratorácica pode levar a alterações hemodinâmicas com repercussão no compartimento intracraniano, alterando a pressão intracraniana e a pressão de perfusão cerebral. Esse efeito pode se tornar mais intenso quando utilizados elevados valores de pressão positiva expiratória final. OBJETIVO: Medir o impacto que diferentes valores de pressão positiva expiratória final causam na pressão intracraniana, na pressão de perfusão cerebral e pressão arterial média. MÉTODO: O estudo f...

Temporal variation in memory tests performance in cerebral vascular disease patients / Variação temporal no desempenho em testes de memória em pacientes com doença vascular cerebral

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Tania Fernandes Campos

2007-01-01

Full Text Available This study intended to investigate the performance in memory tests in order to adequate the neuropsychological evaluation to the temporal order of the human organism. Twelve cerebral vascular accident patients and 12 controls, of both sexes and 45-65 years old were studied. Two memory tests with visual stimuli (pictures and two with verbal stimuli (words were applied three times a day (08:00, 10:00 and 12:00 h during the first week and twice a day (14:00 and 16:00 h in the second week, during three consecutive days in two consecutive weeks. The patients showed lower scores than control subjects in all applied tests (p<0,05. The greater test sensitivity was at 14:00 h for the free recall test and at 16:00 h for recognition tests. According to these results, it is concluded that neuropsychological evaluations should be conducted preferably in the afternoon, as well for the first evaluation as for the re-evaluations.

Paradoxical embolisation and cerebral white matter lesions in dementia.

NARCIS (Netherlands)

Purandare, N.; Oude Voshaar, R.C.; McCollum, C.; Jackson, A.; Burns, A.

2008-01-01

The study aimed to examine the relationship between spontaneous cerebral emboli (SCE), patent foramen ovale (PFO) and white matter hyperintensities (WMH) on cerebral MRI in patients with Alzheimer's disease (AD) and vascular dementia (VaD). SCE were identified by transcranial Doppler of the middle

O planejamento urbano e os acidentes de trânsito: um estudo sobre o Município de Toledo - PR

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Ruschel, Andressa Carolina

2017-01-01

O artigo propõe identificar como o planejamento urbano influencia nos acidentes de trânsito no Município de Toledo - PR no período de 2011 a 2015, dentro do Perímetro Urbano, partindo da problematização criada pelo alto índice de acidentes de trânsito no município. A metodologia utilizada foi através de aspectos conceituais da análise espacial e do planejamento urbano; coleta de dados primários nos Boletins de Ocorrência de Acidentes de Trânsito, em seguida tabelados e analisados conforme fun...

Análise cinemática e eletromiográfica do alcance em pacientes com acidente vascular encefálico

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Karoline Cipriano Raimundo

Full Text Available INTRODUÇÃO: O movimento de alcance é muito estudado na literatura, no entanto, poucos estudos realizam análise cinemática e eletromiográfica desse movimento em sujeitos hemiparéticos. OBJETIVO: Avaliar o alcance de indivíduos hemiparéticos pós-acidente vascular encefálico (AVE em seus aspectos cinemáticos e eletromiográficos. MATERIAIS E MÉTODOS: Foram selecionados quatro indivíduos, idade média de 54,5 ± 10,7 anos, com diagnóstico de AVE associado à hemiparesia. Realizou-se a avaliação cinemática e eletromiográfica concomitantemente do movimento de alcance na postura sentada, tanto do lado parético quanto do não parético. RESULTADOS: Houve diferença significativa entre os sujeitos com relação ao deslocamento (F(3,63 = 3.081, p = 0.03, porém, não ocorreu diferença significativa entre os lados (F(1,63 = 1.441, p = 0.23. Com relação às articulações (ombro, cotovelo e punho, houve diferença significativa entre os deslocamentos de cada uma (F(2,63 = 27.496, p = 0.00, assim como entre as coordenadas x, y e z (F(2,63 = 36.702, p = 0.00. Na análise dos dados eletromiográficos, não houve diferença significativa entre os sujeitos (F(3,31 = 2.437, p = 0.08, entre os lados (F(1,31 = 3.384, p = 0.07 e entre os músculos (F(4,31 = 0.942, p = 0.45. Existiu diferença no tempo de execução dos movimentos quando comparado o lado não acometido com o acometido. CONCLUSÃO: As análises cinemática e eletromiográfica, de um modo geral, mostraram resultados semelhantes aos encontrados na literatura. No entanto, este estudo acrescenta uma visão mais sistematizada do movimento de alcance, considerando seus aspectos funcionais, diferindo de outros estudos por apresentar, concomitantemente, análises cinemática e eletromiográfica e por investigar ambos os membros superiores.

Serpentes da área urbana de Cuiabá, Mato Grosso: aspectos ecológicos e acidentes ofídicos associados

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Carvalho Marcos André de

1998-01-01

Full Text Available São apresentadas informações sobre as serpentes da área urbana do Município de Cuiabá, Mato Grosso, potencialmente causadoras de acidentes ofídicos. As informações estão baseadas em exemplares doados por populares ao Núcleo de Ofiologia Regional de Mato Grosso (Normat entre 1986 e 1993 e em registros efetuados pelo Centro de Informações Anti-Veneno (Ciave entre 1988 e 1993, que não fazem referência ao animal causador. Foram catalogadas 37 espécies de serpentes, em 25 gêneros e 3 famílias, com hábitos predominantemente diurnos, terrestres e com dietas baseadas em anfíbios e/ou lagartos. Dentre os 307 acidentes ofídicos registrados, 56% foram causados por serpentes sem interesse médico e 44% constituíram acidentes de importância médica. Cerca de 99% dos acidentes de importância médica foram atribuídos ao gênero Bothrops (Bothrops moojeni e Bothrops neuwiedi seriam as principais causadoras. Dentre as espécies sem interesse médico, Philodryas olfersii e Waglerophis merremii provavelmente foram as principais responsáveis pela maior parte dos acidentes.

Avaliação da capacidade funcional de idosos com acidente vascular encefálico Evaluación de la capacidad funcional de adultos mayores con accidente vascular encefálico Evaluation of functional capaciy in elders with encephalic vascular accident

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Keila Cristianne Trindade da Cruz

2009-10-01

Full Text Available OBJETIVO: Avaliar a capacidade funcional de idosos com acidente vascular encefálico (AVE e verificar a relação, bem como a influência de variáveis sociodemográficas e de saúde na capacidade funcional desses sujeitos. MÉTODOS: Foram realizadas entrevistas com 44 idosos, vítimas de AVE, durante o atendimento nos locais de coleta de dados. O instrumento de coleta de dados contemplou dados sociodemográficos e clínicos. Para avaliar a capacidade funcional dos sujeitos foi aplicado o instrumento de Medida de Independência Funcional (MIF. RESULTADOS: Houve predomínio da faixa etária entre 60 e 69 anos. A MIF apresentou boa consistência interna. A pontuação total MIF dos apresentou média de 97,0. Os pacientes com acesso ao serviço de saúde apresentaram valores superiores aos dos indivíduos que não tinham acesso (Teste de Mann-Whitney. Foi observada correlação negativa entre a MIF e seus domínios e a idade (Pearson. CONCLUSÃO: O AVE causou alteração na capacidade funcional dos sujeitos da pesquisa, o que aponta para a necessidade de se investir em estratégias de reabilitação que venham a amenizar as perdas funcionais advindas da própria idade e, principalmente, das seqüelas de AVE.OBJETIVO: Evaluar la capacidad funcional de personas adultas mayores con accidente vascular encefálico (AVE y verificar la relación, así como la influencia de variables sociodemográficas y de salud en la capacidad funcional de esos sujetos. MÉTODOS: Fueron entrevistadas 44 personas adultas mayores, víctimas de AVE, durante la atención en los locales de recolección de datos. El instrumento de recolección de datos incluyó datos sociodemográficos y clínicos. Para evaluar la capacidad funcional de los sujetos se aplicó el instrumento de Medida de Independencia Funcional (MIF. RESULTADOS: Hubo predominio del grupo etáreo comprendido entre 60 y 69 años. La MIF presentó buena consistencia interna. La puntuación total de la MIF present

Utilização de equipamentos de segurança entre vítimas de acidentes no município de Uberaba-MG

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Debora Prudencio e Silva

2010-03-01

Full Text Available Acidentes de trânsito correspondem à terceira causa de mortalidade no mundo. Estudo retrospectivo, com objetivo de identificar os equipamentos de segurança utilizados pelas vítimas de acidentes e os principais tipos de lesões ocorridas. Os dados foram coletados das fichas de atendimento pré-hospitalar do 8º Batalhão deBombeiros Militar, do município de Uberaba-MG, relativos ao período de junho/2006 a junho/2007 e foram analisados segundo estatística descritiva. A maioria das vítimas 69,77% era do sexo masculino e idade média de 30,44 anos. Observou-se que 50,70% foram acidentes motociclísticos. A maioria 66,10% apresentou escoriações. Nos acidentes automobilísticos, 25,94% utilizavam o cinto de segurança e 0,63% tiveram o air bag acionado, enquanto nos acidentes motociclísticos 68,32% faziam uso do capacete. Conclui-se que na maioria dos acidentes automobilísticos não utilizava o cinto de segurança embora seja equipamento de uso obrigatório,enquanto observa-se maior adesão ao uso de capacete. Enfatiza-se a necessidade de implementação de novos programas de educação que foquem a importância do uso de equipamentos de segurança contribuindo assim para a redução de lesões nos acidentes de trânsito.

13-Methyltetradecanoic acid mitigates cerebral ischemia/reperfusion injury

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Juan Yu

2016-01-01

Full Text Available 13-Methyltetradecanoic acid can stabilize cell membrane and have anti-inflammatory, antioxidant and anti-apoptotic effects. Previous studies mainly focused on peripheral nerve injury, but seldom on the central nervous system. We investigated whether these properties of 13-methyltetradecanoic acid have a neuroprotective effect on focal cerebral ischemia/reperfusion injury, and detected the expression of basic fibroblast growth factor and vascular endothelial growth factor. This study established rat models of middle cerebral artery occlusion/reperfusion injury by ischemia for 2 hours and reperfusion for 24 hours. At the beginning of reperfusion, 13-methyltetradecanoic acid 10, 40 or 80 mg/kg was injected into the tail vein. Results found that various doses of 13-methyltetradecanoic acid effectively reduced infarct volume, mitigate cerebral edema, and increased the mRNA and protein expression of basic fibroblast growth factor and vascular endothelial growth factor at 24 hours of reperfusion. The effect was most significant in the 13-methyltetradecanoic acid 40 and 80 mg/kg groups. The findings suggest that 13-methyltetradecanoic acid can relieve focal ischemia/reperfusion injury immediately after reperfusion, stimulate the upregulation of basic fibroblast growth factor and vascular endothelial growth factor to exert neuroprotective effects.

Acidente de trabalho, morte e fatalismo Work accident, death and fatalism

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Izabel Cristina Ferreira Borsoi

2005-04-01

Full Text Available Este artigo se propõe discutir a atitude fatalista diante do acidente de trabalho e da morte. Toma como suporte empírico a representação que trabalhadores acidentados na construção civil constroem acerca daqueles eventos. Parte de um conjunto de entrevistas com seis trabalhadores que se encontravam afastados do trabalho por invalidez decorrente do acidente. A análise realizada busca mostrar que os indivíduos tendem a construir explicações e justificativas a partir de uma perspectiva fatalista de modo a poderem aceitar e conviver com o medo do acidente e da morte ou com a dor da perda. Argumenta também que a atitude fatalista, não pode se modificar apenas com a tomada de consciência, por parte dos trabalhadores, de que acidentes e mortes no trabalho estão relacionados a condições precárias de trabalho. Para modificarem suas atitudes, seria necessário, também, que experimentassem novas condições de vida e trabalho, podendo, assim, construir uma nova concepção de mundo e de vida.This article proposes a discussion about the fatalistic posture adopted when a worker faces work accidents and death. It has its empirical support on the representation which injured construction workers create about these events. The study was based on interviews made with six workers who were unable to return to work due to the disability caused by accidents. The accomplished analysis intends to show that the individuals create explanations and justifications based on a fatalistic perspective. This way of thinking enables them to accept and to live with the fear of accidents and death, or with the pain caused by a loss. It also argues that the fatalistic attitude cannot be modified only by understanding that accidents and deaths that happen at the work environment are related to its precarious conditions. In order to change this attitude, it would be necessary to experience new conditions of life and work, so that the workers would be able to create

Morning Glory Syndrome with Carotid and Middle Cerebral Artery Vasculopathy.

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Nezzar, Hachemi; Mbekeani, Joyce N; Dalens, Helen

2015-12-01

To report a case of incidental asymptomatic atypical morning glory syndrome (MGS) with concomitant ipsilateral carotid and middle cerebral dysgenesis. A 6-year-old child was discovered to have incidental findings of MGS, with atypia. All visual functions were normal including vision and stereopsis. Neuroimaging revealed ipsilateral carotid and middle cerebral vascular narrowing without associated collateral vessels or cerebral ischemia commonly seen in Moyamoya disease. Subsequent annual examinations have been stable, without signs of progression. This case demonstrates disparity between structural aberrations and final visual and neurological function and reinforces the association between MGS and intracranial vascular disruption. Full ancillary ophthalmic and neuroimaging studies should be performed in all patients with MGS with interval reassessments, even when the patient is asymptomatic and functionally intact.

Percepção de exposição a cargas de trabalho e riscos de acidentes em Pelotas, RS (Brasil

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Rosângela C. Lima

1999-04-01

Full Text Available OBJETIVO: Investigar a associação entre a percepção de exposição às cargas de trabalho e o risco de acidentes. MÉTODOS: O delineamento do estudo foi o tipo de casos e controles. Os casos (n=264 incluíram os acidentes de trabalho típicos notificados no Instituto Nacional de Seguridade Social, de Pelotas, RS (Brasil, de janeiro a julho de 1996. Foram excluídos os óbitos (dois, os acidentes ocorridos na zona rural, e os que afastaram o trabalhador de suas atividades por menos de sete dias. Para cada caso foram selecionados três tipos de controles: um trabalhador da mesma empresa, um vizinho e um controle populacional. Os controles foram emparelhados com os casos por idade e sexo e precisavam ter vínculo empregatício formal e não ter sofrido acidente no último mês. Os dados foram analisados usando regressão logística condicional. RESULTADOS E CONCLUSÕES: Os trabalhadores que relatavam enfrentar situações de emergência, o trabalho em altura, perigo constante, ou ambientes ruidosos tinham cerca de duas vezes mais risco de acidentar-se. O trabalho em posições incômodas ou com esforço físico intenso aumentaram em 50% o risco de acidentes. As demais cargas de trabalho estudadas não se constituíram como fatores de risco para os acidentes. Os resultados foram ajustados para fatores de confusão.

Acidentes de trabalho na zona rural de Pelotas, Rio Grande do Sul, Brasil: um estudo transversal de base populacional

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Fehlberg Marta Fernanda

2001-01-01

Full Text Available São escassos os estudos de base populacional sobre a ocorrência de acidentes de trabalho rural. Para investigar este tema, realizou-se em Pelotas, Rio Grande do Sul, um estudo transversal com o objetivo de verificar a ocorrência e as características dos acidentes do trabalho rural. Uma amostra representativa da população foi obtida através de amostragem em estágios múltiplos, utilizando-se os setores censitários da Fundação Instituto Brasileiro de Geografia e Estatística. Em quatro meses, no ano de 1996, foram estudadas 258 famílias, e 580 trabalhadores rurais foram entrevistados, utilizando-se questionários padronizados e pré-codificados. Os acidentes de trabalho nos últimos doze meses atingiram 63 trabalhadores (11%, que referiram, pelo menos, um acidente no período. O total de acidentes ocorridos foi de 82, e foram causados, principalmente, por ferramentas manuais (29% e por animais domésticos (27%. A principal lesão provocada foi corte (50%, seguida por contusão (13% e queimadura (9%. As partes do corpo mais atingidas foram as mãos (34%, os pés (29% e as pernas (18%. Em apenas 32% dos casos, o trabalhador rural acidentado procurou tratamento. Desses, 46% procuraram o posto de saúde, e 36%, o pronto-socorro municipal.

Hyperacute unilateral contrast-induced parotiditis during cerebral angiography

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Song J. Kim, MD

2018-02-01

Full Text Available An uncommon complication of iodinated contrast administration is the development of bilateral sialadenitis. We report a unique case of hyperacute unilateral parotiditis during diagnostic cerebral angiography of the external carotid artery, which mimicked possible iatrogenic vascular event associated with cerebral endovascular procedures. Discussion includes the differential diagnosis, diagnostic studies, and treatments for this unusual condition.

Multichannel optical brain imaging to separate cerebral vascular, tissue metabolic, and neuronal effects of cocaine

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Ren, Hugang; Luo, Zhongchi; Yuan, Zhijia; Pan, Yingtian; Du, Congwu

2012-02-01

Characterization of cerebral hemodynamic and oxygenation metabolic changes, as well neuronal function is of great importance to study of brain functions and the relevant brain disorders such as drug addiction. Compared with other neuroimaging modalities, optical imaging techniques have the potential for high spatiotemporal resolution and dissection of the changes in cerebral blood flow (CBF), blood volume (CBV), and hemoglobing oxygenation and intracellular Ca ([Ca2+]i), which serves as markers of vascular function, tissue metabolism and neuronal activity, respectively. Recently, we developed a multiwavelength imaging system and integrated it into a surgical microscope. Three LEDs of λ1=530nm, λ2=570nm and λ3=630nm were used for exciting [Ca2+]i fluorescence labeled by Rhod2 (AM) and sensitizing total hemoglobin (i.e., CBV), and deoxygenated-hemoglobin, whereas one LD of λ1=830nm was used for laser speckle imaging to form a CBF mapping of the brain. These light sources were time-sharing for illumination on the brain and synchronized with the exposure of CCD camera for multichannel images of the brain. Our animal studies indicated that this optical approach enabled simultaneous mapping of cocaine-induced changes in CBF, CBV and oxygenated- and deoxygenated hemoglobin as well as [Ca2+]i in the cortical brain. Its high spatiotemporal resolution (30μm, 10Hz) and large field of view (4x5 mm2) are advanced as a neuroimaging tool for brain functional study.

Cerebral ischemia produced by four-vessel occlusion in the rat: a quantitative evaluation of cerebral blood flow

International Nuclear Information System (INIS)

Furlow, T.W. Jr.

1982-01-01

Cerebral ischemia was produced in the rat by simultaneous occlusion of the vertebral and carotid arteries according to the method of Pulsinelli and Brierley (Stroke 10: 267, 1979). Local cerebral blood flow (CBF) was determined by polarographic and autoradiographic techniques. Hydrogen-clearance measurements showed that mean CBF fell in four monitored regions of the hemispheres to between 0.11 and 0.18 ml/g/min, being least in deep rostal gray, intermediate in superficial gray, and greatest in deep caudal gray. However, individual animals had local CBF in excess of 0.20 and even 0.30 ml/g/min, and no animal showed zero CBF. When animals were rendered hypotensive (MABP of 50 Torr) during vascular occlusion, mean CBF ranged between 0.03 and 0.10 ml/g/min in the same regional order. With hypotension, total arrest of flow occurred. Autoradiographic data confirmed the above findings and indicated adequate CBF to the lower brainstem. During vascular occlusion, sufficient CBF may be present ot sustain cerebral tissue as in animals with a well developed spinal circulation or an inadvertently patent vertebral artery

Axon-glial disruption: the link between vascular disease and Alzheimer's disease?

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Horsburgh, Karen; Reimer, Michell M; Holland, Philip; Chen, Guiquan; Scullion, Gillian; Fowler, Jill H

2011-08-01

Vascular risk factors play a critical role in the development of cognitive decline and AD (Alzheimer's disease), during aging, and often result in chronic cerebral hypoperfusion. The neurobiological link between hypoperfusion and cognitive decline is not yet defined, but is proposed to involve damage to the brain's white matter. In a newly developed mouse model, hypoperfusion, in isolation, produces a slowly developing and diffuse damage to myelinated axons, which is widespread in the brain, and is associated with a selective impairment in working memory. Cerebral hypoperfusion, an early event in AD, has also been shown to be associated with white matter damage and notably an accumulation of amyloid. The present review highlights some of the published data linking white matter disruption to aging and AD as a result of vascular dysfunction. A model is proposed by which chronic cerebral hypoperfusion, as a result of vascular factors, results in both the generation and accumulation of amyloid and injury to white matter integrity, resulting in cognitive impairment. The generation of amyloid and accumulation in the vasculature may act to perpetuate further vascular dysfunction and accelerate white matter pathology, and as a consequence grey matter pathology and cognitive decline.

Protective or pathogenic effects of vascular endothelial growth factor (VEGF) as potential biomarker in cerebral malaria.

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Canavese, Miriam; Spaccapelo, Roberta

2014-03-01

Cerebral malaria (CM) is the major lethal complication of Plasmodium falciparum infection. It is characterized by persistent coma along with symmetrical motor signs. Several clinical, histopathological, and laboratory studies have suggested that cytoadherence of parasitized erythrocytes, neural injury by malarial toxin, and excessive inflammatory cytokine production are possible pathogenic mechanisms. Although the detailed pathophysiology of CM remains unsolved, it is thought that the binding of parasitized erythrocytes to the cerebral endothelia of microvessels, leading to their occlusion and the consequent angiogenic dysregulation play a key role in the disease pathogenesis. Recent evidences showed that vascular endothelial growth factor (VEGF) and its receptor-related molecules are over-expressed in the brain tissues of CM patients, as well as increased levels of VEGF are detectable in biologic samples from malaria patients. Whether the modulation of VEGF is causative agent of CM mortality or a specific phenotype of patients with susceptibility to fatal CM needs further evaluation. Currently, there is no biological test available to confirm the diagnosis of CM and its complications. It is hoped that development of biomarkers to identify patients and potential risk for adverse outcomes would greatly enhance better intervention and clinical management to improve the outcomes. We review and discuss here what it is currently known in regard to the role of VEGF in CM as well as VEGF as a potential biomarker.

Clinical application of three-dimensional spiral CT cerebral angiography with volume rendering

International Nuclear Information System (INIS)

Duan Shaoyin; Huang Xi'en; Kang Jianghe; Zhang Dantong; Lin Qingchi; Cai Guoxiang; Xu Meixin; Pang Ruilin

2002-01-01

Objective: To study the methodology and assess the clinical value of three-dimensional CT angiography (3D-CTA) with volume rendering (VR) in cerebral vessels. Methods: Sixty-two patients were examined by means of 3D-CTA with volume rendering. VR was used in the reconstruction of 3D images, and the demonstration of normal vessels and vascular lesions were particularly analyzed. At the same time, comparisons were made between the images of VR and SSD, MIP, and also between the diagnosis of VR-CTA and DSA or postoperative results. Results: In VR images, cerebral vessel routes and vessel cavities were showed clearly, while the relationship among vascular lesions, surrounding vessels, and neighboring structure was distinguished. 50 cases (80.6%) were found positive, 48 of which were correct and 2 were false-positive compared with DSA or postoperative results. The accurate rate of diagnosis was 96.0%. There was no obvious difference in showing the cerebral vessel among the images of VR, SSD and MIP (P > 0.25). Conclusion: Three-dimensional CT cerebral angiography with VR is a new noninvasive effective method. It can even partly replace the DSA. The 3D-images have the characteristics of showing the cerebral vascular cavity and overlapped vessels without cutting the skull

Non operative management of cerebral abscess

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Batubara, C. A.

2018-03-01

Cerebral abscess is a focal intracerebral infection that begins as a localized area of cerebritis and develops into a collection of pus surrounded by a well-vascularized capsule. Patients typically present with varying combinations of aheadache, progressive neurologic deficits, seizures, and evidence of infection. Computed Tomography and Magnetic Resonance Imagingare the most important diagnostic tools in diagnosing cerebral abscess. The treatment of cerebral abscess has been a challenge. Small cerebralabscesses (managed by the use of intravenous mannitol (or hypertonic saline) and dexamethasone. Acute seizures should be terminated with the administration of intravenous benzodiazepines or by intravenous fosphenytoin. Anticonvulsants prophylaxis must be initiated immediately and continued at least one year due to high risk in the cerebral abscesses. Easier detection of underlying conditions, monitoring of the therapeutic progress, and recognition of complications have probably contributed to the improved prognosis.

Effects of edaravone combined with hyperbaric oxygen on cerebral vascular dynamics, oxidative stress products and inflammatory factors in patients with acute cerebral hemorrhage

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Xia Li

2017-10-01

therapy can effectively improve cerebral vascular dynamics, reduce oxidative stress and inflammatory response in patients with ACH, which is beneficial to the prognosis of patients.

Endothelial Mineralocorticoid Receptor Mediates Parenchymal Arteriole and Posterior Cerebral Artery Remodeling During Angiotensin II-Induced Hypertension.

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Diaz-Otero, Janice M; Fisher, Courtney; Downs, Kelsey; Moss, M Elizabeth; Jaffe, Iris Z; Jackson, William F; Dorrance, Anne M

2017-12-01

The brain is highly susceptible to injury caused by hypertension because the increased blood pressure causes artery remodeling that can limit cerebral perfusion. Mineralocorticoid receptor (MR) antagonism prevents hypertensive cerebral artery remodeling, but the vascular cell types involved have not been defined. In the periphery, the endothelial MR mediates hypertension-induced vascular injury, but cerebral and peripheral arteries are anatomically distinct; thus, these findings cannot be extrapolated to the brain. The parenchymal arterioles determine cerebrovascular resistance. Determining the effects of hypertension and MR signaling on these arterioles could lead to a better understanding of cerebral small vessel disease. We hypothesized that endothelial MR signaling mediates inward cerebral artery remodeling and reduced cerebral perfusion during angiotensin II (AngII) hypertension. The biomechanics of the parenchymal arterioles and posterior cerebral arteries were studied in male C57Bl/6 and endothelial cell-specific MR knockout mice and their appropriate controls using pressure myography. AngII increased plasma aldosterone and decreased cerebral perfusion in C57Bl/6 and MR-intact littermates. Endothelial cell MR deletion improved cerebral perfusion in AngII-treated mice. AngII hypertension resulted in inward hypotrophic remodeling; this was prevented by MR antagonism and endothelial MR deletion. Our studies suggest that endothelial cell MR mediates hypertensive remodeling in the cerebral microcirculation and large pial arteries. AngII-induced inward remodeling of cerebral arteries and arterioles was associated with a reduction in cerebral perfusion that could worsen the outcome of stroke or contribute to vascular dementia. © 2017 American Heart Association, Inc.

The analysis of cerebro-vascular circulation time using digital subtraction angiography (DSA)

International Nuclear Information System (INIS)

Han, D. G.; Kim, D. H.; Lee, H. K.; Kwon, K. H.; Kim, K. J.

1986-01-01

We analyzed the cerebral arterio-venous circulation time of 141 cases of cranial DSA in 136 patients, for the assessment of cerebral circulatory dynamics. IV-DSA was 111 cases, IA-DSA 30 cases. The results were as follows: 1. There was no significant difference in arterio-venous circulation time between IA-DSA and IV-DSA, if the disease pattern was not considered (P > 0.1). 2. Prolongation of arterio-venous circulation time was noted in the cases of cerebral (cerebellar) hemorrhage, subarachnoid hemorrhage, intracranial hematoma, brain abscess, acute stage of cerebra-vascular occlusive disease, acute stage of postoperative follow up, and acute stage of cerebral contusion (p > 0.05). 3. Compared the chronic stage of cerebra-vascular occlusive disease, postoperative follow up, and cerebral contusion with acute stage, significant decrement of arterio-venous circulation time was resulted (p > 0.05). 4. DSA was a useful modality for the assessment of circulatory dynamics, including measurement of arterio-venous circulation time.

Ischemic Cardiomyopathy and Cerebral Infarction in a Young Patient Associated with Khat Chewing

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T. J. Meulman

2015-01-01

Full Text Available Khat is a stimulating agent used by many people in the Horn of Africa and the Arabian peninsula. Khat chewing is a known cardiovascular risk factor and is thought to cause vasoconstriction, systemic hypertension, and thrombogenicity. A 33-year-old Somalian man initially presented with loss of neurological function of the left arm, hazy vision, and headache. He smokes tobacco and chews two bundles of khat a week for more than 10 years. His ECG on admission showed a Q wave in V1 and V2 and 2 mm ST-elevations in V1, V2, and V3 and a terminal negative T wave in I, aVL, V2, V3, and V4, consistent with a recent, evolving anterior infarction. A noncontrast enhanced CT of the brain showed ischemia in the right middle cerebral artery vascular territory. An MRI showed recent ischemia in the vascular territory of the posterior division of the right middle cerebral artery. Coronary angiography showed a 70% stenosis with haziness of the proximal left anterior descending artery. Diagnostic tests and imaging are consistent with recent myocardial infarction in the LAD vascular territory because of coronary spasm and cerebral infarction in the middle cerebral artery vascular territory probably related to khat chewing.

Hospitalização por acidente vascular encefálico isquêmico no Brasil: estudo ecológico sobre possível impacto do Hiperdia

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Johnnatas Mikael Lopes

2016-03-01

Full Text Available RESUMO: Objetivo: O estudo avaliou a tendência de hospitalização por acidente vascular encefálico isquêmico (HAVEI e a sua mortalidade hospitalar no Brasil nos últimos 15 anos, assim como o impacto do programa Hiperdia nesse cenário. Métodos: Delineou-se um estudo ecológico com abordagem analítica e dados coletados no Sistema de Internação Hospitalar sobre episódios de AVEI, referentes aos anos de 1998 a 2012. Todos os dados foram estratificados por sexo e faixa etária, criando-se um indicador para HAVEI e proporção de mortalidade hospitalar. A fim de estimar a tendência dos dados criou-se uma curva polinomial de melhor aderência e para a averiguar o impacto do Hiperdia aplicou-se o Modelo Linear Generalizado tomados como desfecho a HAVEI e a mortalidade hospitalar. Adotou-se um nível de significância de 5% para minimizar um erro tipo I. Resultados: Foi evidenciada redução das HAVEI de 37,57/105 habitantes em 1998 a 2001 para 10,33/105 habitantes em 2002 a 2005, declinando 73,64%. A redução aconteceu em ambos os sexos, assim como para todas as faixas etárias. A mortalidade hospitalar por AVEI também declinou no Brasil a partir de 2002, tanto em homens como em mulheres, porém em menos de 3% e apenas nas faixas entre 0 e 14 anos e acima de 80 anos não detectamos tendência. Conclusão: Portanto, o declínio das HAVEI coincidiu temporalmente com a implementação do Hiperdia no ano de 2002 e essa tendência se mantém até hoje.

Atividade simpática, parassimpática e metabólica influenciadas pelo comportamento da distribuição do suporte de peso em pé adquirido na condição de hemiparesia crônica

OpenAIRE

Ramos, Gabrielly Craveiro

2016-01-01

Introdução: O acidente vascular cerebral (AVC) é a causa mais frequente de incapacidade neurológica crônica da população adulta. Esta afecção cerebrovascular pode gerar alterações tanto no controle postural, observada por assimetria na distribuição do suporte de peso em pé, quanto no controle autonômico, verificadas por meio das respostas simpática e parassimpática na variabilidade da frequência cardíaca (VFC). Assim, a modificação combinada dos controles promovida pelo dano encefálico poderi...

Efeitos da terapia espelho na recuperação motora e funcional do membro superior com paresia pós-AVC: uma revisão sistemática

OpenAIRE

Costa, Valton da Silva; Silveira, Júlio César Cunha da; Clementino, Tatiana Catarina Albuquerque; Borges, Lorenna Raquel Dantas de Macedo; Melo, Luciana Protásio de

2016-01-01

RESUMO Após um acidente vascular cerebral (AVC), o membro superior pode apresentar déficits motores que podem levar a incapacidades funcionais. A terapia espelho (TE) é uma possibilidade terapêutica na reabilitação do membro superior (MS). Este estudo objetivou reunir evidências que pudessem mostrar quais são os efeitos da TE na recuperação motora e funcional do MS com paresia pós-AVC. Foi realizada uma busca eletrônica nas bases de dados SciELO, LILACS, PubMed, PEDro e ScienceDirect, utiliza...

Cerebral aneurysms – an audit | Louw | SA Journal of Radiology

African Journals Online (AJOL)

We performed an audit to determine the profile of cerebral aneurysms at the Universitas Hospital Bloemfontein, the only government hospital with a vascular suite in the Free State and Northern Cape area. Two hundred and twenty-three government patients, diagnosed with cerebral aneurysms during the period 1 January ...

Fatores associados à ocorrência de acidentes de trânsito entre universitários = Factors associated with traffic accidents among university students

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Mesquita Filho, Marcos

2017-01-01

Full Text Available Objetivo: Investigar a ocorrência de acidentes de trânsito entre universitários de 18 a 25 anos e fatores associados. Materiais e Métodos: O estudo transversal, com 500 estudantes. Aplicou-se 3 instrumentos: sociodemográfico, AUDIT (The Alcohol Use Disorder Identification Test, para dependência ao álcool, e YRBS (Youth Risk Behavior Survey, que verificou riscos de acidente de trânsito. Resultados: Maioria de indivíduos eram mulheres e a idade média foi 21,2±2,1 anos. Uso de álcool em 67,4% (n=337; sendo 43,2% (n=216 bebedores de risco e 4,4% (n=22 usuários de drogas. Dos 71,2% (n=356 que dirigiam, 63,2% (n=316 eram habilitados. Circulava-se principalmente em automóvel e apenas 50,4% (n=252 dos motoristas e 45,2% (n=226 passageiros usavam cinto de segurança. Foram 42,0% (n=210 os que sofreram acidentes, 10,2% (n=51 no último ano. Houve predomínio masculino (p≤0,05 entre os que dirigiam, que sofreram acidentes, que usavam drogas, que dirigiam após uso de álcool no último mês, que praticaram rachas e os que sofreram acidentes como motoristas. As mulheres eram menos respeitadoras do sinal fechado. Sofrer acidente no último ano se associou ao sexo masculino, ao consumo de risco/dependência para o álcool e a trafegar num veículo cujo motorista consumira bebidas alcoólicas. Conclusão: Quase metade dos universitários haviam sofrido algum acidente, sendo associados ao fato de ser homem, o abuso do álcool e trafegar com um condutor sob efeito de bebidas. Devem ser desencadeadas ações para equacionamento deste importante problema do setor saúde

CITICOLIN IN THE TREATMENT OF STROKE AND VASCULAR COGNITIVE DISORDERS

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Vladimir Anatol'evich Parfenov

2009-01-01

Full Text Available Citicolin (ceraxon is used as a neuroprotector in the treatment of acute stroke and vascular cognitive disorders. Experimental animal studies have demonstrated that citicolin reduces the extent of cerebral infarct and increases the degree of functional recovery. A few clinical trials have provided evidence for the efficacy of intravenous or oral citicolin used within the first 24 hours of ischemic stroke or cerebral hemorrhage in recovery of neurological functions. Citicolin is effective in memory and behavioral disorders in elderly patients with chronic cerebrovascular diseases. The use of citicolin has been found to be safe in stroke and vascular cognitive disorders

Cerebral blood flow and cerebral oxygen metabolism in thalamic hemorrhage

International Nuclear Information System (INIS)

Yasui, Nobuyuki; Asakura, Ken

1987-01-01

Cerebral blood flow (CBF), cerebral oxygen consumption (CMRO 2 ), oxygen extraction fraction (OEF) and cerebral blood volume (CBV) were studied in 20 cases of thalamic hemorrhage using positron CT and 15 O labeled gas steady-state inhalation method. CBF reduction was limited around the thalamus in the small sized hematoma. CBF were significantly diminished in the mean cortical, parietal, temporal, basal ganglia and thalamic area ipsilateral and cerebellar cortex contralateral to the medium sized hematoma. There was bilateral and diffuse CBF reduction in the large sized hematoma which was caused by increased intracranial pressure. CMRO 2 value were similary changed as CBF. OEF change showed within normal limit. Diffuse CBV reduction was observed in the large sized hematoma. This reduction was the result of decreased vascular bed caused by mass effect of the hematoma and hydrocephalus. Effect of surgical treatment such as ventricular drainage and hematoma evacuation were also discussed in correlation to CBF in some case using positron and single photon ECT. (author)

A atualidade dos acidentes de trânsito na era da velocidade: uma visão geral

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Marín Letícia

2000-01-01

Full Text Available Este artigo focaliza, numa perspectiva interdisciplinar, os estudos sobre acidentes de trânsito em escala nacional e internacional. Ele começa analisando o aumento da produção e consumo de veículos motorizados em todo o mundo e as transformações sociais que esse fato acarretou. Atenção especial é dada à degradação do meio ambiente urbano e ao enorme custo social representado pelos acidentes de trânsito. Em seguida, é apresentado um panorama epidemiológico sobre as vítimas do trânsito. A relação entre personalidade e acidente de trânsito mereceu atenção especial, principalmente no que se refere ao comportamento infrator e ao consumo de bebidas alcoólicas e de outras drogas. O artigo conclui enfatizando a necessidade de o Estado implementar políticas públicas específicas consistentes, a fim de se poder controlar o problema.

Taxa de mortalidade por acidentes de trâsito e frota de veículos

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Samuel Kilsztajn

2001-06-01

Full Text Available OBJETIVO: A taxa de mortalidade específica por acidentes de trânsito de veículos a motor é usualmente utilizada para efeito das políticas de saúde pública. Para mensurar o grau de violência no trânsito, foi realizado estudo com o objetivo de analisar o número de óbitos por acidentes de trânsito por veículo a motor. MÉTODOS: Com base nos dados sobre frota de veículos, população e óbitos por acidente de trânsito, publicados no Statiscal Yearbook (1999, Demografic Yearbook (1997, Denatran (1999, Ministério da Saúde (2000 e Fundação IBGE (2000, foram estudados 61 países e 51 localidades brasileiras.A taxa de mortalidade específica foi decomposta em número de veículos por habitante e número de óbitos por veículo. Numa primeira aproximação, cada uma das amostras (internacional e brasileira foi subdividida em três grupos, de acordo com o número de veículos por habitante, para estudo da relação entre os três índices. Para testar a significância dessa relação, foi estimada uma função de regressão log-linear. RESULTADOS: Os resultados para as estimativas internacionais, assim como as do Brasil, demonstraram que, quanto maior o número de veículos por habitante, menor o número de óbitos por acidentes de trânsito por veículo, tendo-se elasticidade da ordem de -1,067, para as estimativas internacionais, e de -0,515, para as do Brasil. CONCLUSÕES: Para uma política de prevenção dos acidentes de trânsito, os resultados encontrados indicam a necessidade de estudar os fatores que possam explicar o maior número de óbitos por veículo nas regiões com menor número de veículos por habitante.

The Effect of Vascular Neuropathology on Late-life Cognition: Results from the SMART Project.

Science.gov (United States)

Kryscio, R J; Abner, E L; Nelson, P T; Bennett, D; Schneider, J; Yu, L; Hemmy, L S; Lim, K O; Masaki, K; Cairns, N; Xiong, C; Woltjer, R; Dodge, H H; Tyas, S; Fardo, D W; Lou, W; Wan, L; Schmitt, F A

2016-06-01

Cerebral vascular pathology may contribute to cognitive decline experienced by some elderly near death. Given evidence for mixed neuropathologies in advanced age, preventing or reducing cerebrovascular burden in late life may be beneficial. To correlate measures of cerebral vascular pathology with cognitive trajectories. Observational study. A cohort of 2,274 individuals who came to autopsy at a mean age of 89.3 years and 82 percent of whom had at least two cognitive assessments within the last six years of life was compiled from six centers conducting longitudinal studies. For each cognitive domain: immediate and delayed memory, language, and naming, three trajectories were examined: good, intermediate, and poor cognition. The probability of a participant belonging to each trajectory was associated with measures of cerebral vascular pathology after adjustment for demographics, APOE, and Alzheimer neuropathology. A large proportion of the cohort (72-94%) experienced good or intermediate cognition in the four domains examined. The presence of arteriolosclerosis and the presence of lacunar infarcts doubled the odds of belonging to the poor cognitive trajectory for language when compared to the good trajectory. The presence of lacunar infarcts increased the odds of an intermediate or poor trajectory for immediate and delayed recall while the presence of large artery infarcts increased the odds of poor trajectories for all four cognitive domains examined. Microinfarcts and cerebral amyloid angiopathy had little effect on the trajectories. Indicators of cerebral vascular pathology act differently on late life cognition.

Study of cerebral vascular diseases with radioisotopes in cerebral atherosclerotical subjects and/for subjects with sequelae of cerebral stroke, before and after use of the association piracetam-dihydroergotoxine

International Nuclear Information System (INIS)

Lara, P.F.; Ferreira, A.; Paulillo, L.F.; Cukierman, M.

1985-01-01

Twently subjects with cerebral sclerosis and/or sequelas of cerebral stroke were studied, before and after use of piracetam-dihydroergotoxine. We performed the complete hemispheric cerebral blood flow and cerebral scintigraphy, beyond clinical and neurological examination. Scintigraphies were unchanged. Cerebral circulation times, or both hemispheres, diminished. This occurred, probably, in relation with metabolic effects of both pharmaceutical drugs. The alpha sympatolytic and modulatory effects of dihydroergotoxine should be considered. (author) [pt

Prognosis after cerebral ischaemia of arterial origin: clinical characteristics and genetic information

NARCIS (Netherlands)

Achterberg, S.

2013-01-01

Background. Patients who have suffered from cerebral ischemia have a high risk of recurrent vascular events. Predictive models based on classical risk factors typically have limited prognostic value. Given that cerebral ischemia has a heritable component, addition of genetic information might

Acidentes de trabalho com profissionais de saúde de um hospital universitário Work accidents among healthcare professionals in a university hospital

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Hanne Alves Bakke

2010-12-01

Full Text Available Esta pesquisa almejou estudar os registros de acidentes de trabalho envolvendo profissionais de saúde em um hospital universitário, determinando as categorias profissionais com maiores índices de ocorrências e os setores mais críticos da organização. Os dados dos registros de acidentes analisados foram: sexo, idade, profissão, local do acidente, tipo de acidente, agente da lesão, área afetada e número de horas entre o início da jornada e a ocorrência do acidente. Os documentos foram obtidos através da Comissão Interna de Prevenção de Acidentes (CIPA do hospital e os dados foram analisados com a aplicação do teste do Qui-Quadrado para avaliar as diferenças entre dados. As mulheres e a equipe de enfermagem foram os mais acometidos e a maioria dos acidentes envolveu material biológico. Houve ocorrência significativa entre 0 e 4 horas após o início da jornada. Estas informações deverão embasar medidas preventivas entre os profissionais de saúde e da administração.This research aimed to study the occurrence of work accidents involving healthcare professionals in a university hospital, determining those professional categories with greatest number of occurrences and the most critical sectors in the organization. The data analyzed from the work accidents register were: sex, age, profession, place of accident, type of accident, cause of lesion, affected area and number of hours between the beginning of the work journey to the accident. The documents were obtained through the Comissão Interna de Prevenção de Acidentes (CIPA, and data were analyzed with Qui-Square Test. Female individuals and the nursing team were the most affected, and most of the accidents involved biological material. There were significant occurrences between 0 and 4 hours after the beginning of the work journey. Information from this study should provide a basis for preventive measures among health and administrative professionals.

Cerebral vasculitis and its simulators. Diagnostic and interventional radiology

International Nuclear Information System (INIS)

Ishimaru, Hideki; Nakajima, Kazuaki; Matsuoka, Yohjiro; Sakamoto, Ayami; Sakugawa, Takayuki; Morikawa, Minoru; Inuzuka, Michiko; Kimura, Seigo

2009-01-01

Cerebral vasculitis, although rare in general, is an important cause of cerebral ischemia, because the treatment strategy is different from that of usual cerebral infarction. On the other hand, a variety of common and uncommon nonvasculitic disorders may mimic vasculitis angiographically or clinically. It is also important to distinguish these vasculitis simulators from true vasculitis in order to avoid the unnecessary and harmful side effects of corticosteroid and immunosuppressant, the mainstay of drug therapy for vasculitis. The diagnosis is often difficult. Angiography is expected to demonstrate the underlying vascular pathology; however, many vasculitides affect small arteries beyond the spatial resolution of conventional angiography. The most important role of the diagnostic imaging is the identification of brain lesions consistent with cerebral vasculitis. Multiple lesions in more than one vascular territory should raise this suspicion, although no specific pattern for this entity exists. In large and medium-sized vessel vasculitis, MRI can directly demonstrate mural thickening and enhancement, which is considered to specific for active inflammation. We propose here a classification for cerebral vasculitis and simulators according to the size of the affected brain vessels, which would help us to make a differential diagnosis. We also review the endovascular techniques for this entity, and its indications. (author)

Acidentes de trabalho em Barcelona (Espanha, no período de 1992-1993 Work accidents in Barcelona (Spain, from 1992 to 1993

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Rosana F. Sampaio

1998-08-01

Full Text Available INTRODUÇÃO: As estatísticas dos acidentes de trabalho, como qualquer outro sistema de notificação, devem servir de base para determinar prioridades e decidir quais medidas preventivas devem ser adotadas. Neste contexto, o objetivo do estudo é aprofundar a análise dos acidentes de trabalho através da utilização de técnicas estatísticas descritivas que permitam estabelecer a relação entre o número de acidentes de trabalho ocorridos em Barcelona (Espanha e as variáveis tipo de acidente, setor econômico, tamanho da empresa e tipo de contrato. MÉTODO: Como fonte de dados foi utilizado o sistema de notificação de acidentes graves e mortais ocorridos na cidade de Barcelona (Espanha, entre 1992 e 1993. Foram examinados 848 registros de acidentes de trabalho em trabalhadores do sexo masculino e a partir desses dados efetuou-se uma análise mediante modelos log-lineares. RESULTADOS E CONCLUSÕES: Os resultados evidenciam que os acidentes traumáticos e o setor de construção têm uma associação positiva, verificada, da mesma forma, entre os acidentes de trânsito e o setor de serviços. Os acidentes traumáticos e de trânsito apresentaram uma associação com as pequenas empresas e os acidentes não traumáticos demonstraram associar-se com as grandes empresas. Verificou-se, ainda, associação entre os trabalhadores temporais e o setor da construção frente aos trabalhadores com contrato fixo, em que se constatou uma associação com os setores de indústria e de serviços. Foi verificada associação positiva entre os acidentes ocorridos com os trabalhadores temporais e as pequenas e médias empresas.INTRODUCTION: The statistics related to labor accidents as with any other notification system ought to be the basis for programs and policies with a view to the adoption of preventive measures. In order to establish preventive norms, however, the health system needs data from researchers focussing on the dynamics of and the pitfalls

Characteristics of Cerebral Blood Flow in Vascular Dementia using SPM Analysis Compared to Normal Control and Alzheimer's Dementia

International Nuclear Information System (INIS)

Kang, Do Young; Park, Kyung Won; Kim, Jae Woo

2003-01-01

Cerebral perfusion pattern of vascular dementia (VD) was not well established and overlap of cerebral perfusion pattern was reported between VD and Alzheimer's dementia (AD). The aim of this study is to assess the specific patterns of SPECT finding in VD compared with normal control subjects and to disclose differences of cerebral blood flow between subjects with VD and AD were investigated using statistic parametric mapping analysis. Thirty-two VD (mean age ; 67.86.4 years, mean CDR ; 0.980.27), 51 AD (mean age ; 71.47.2 years, CDR ; 1.160.47), which were matched for age and severity of dementia, and 30 normal control subjects (mean age ; 60.17.7 years) participated in this study. The Tc-99m HMPAO brain perfusion SPECT data were analyzed by SPM99. The SPECT data of the patients with VD were compared to those of the control subjects and then compared to the patients with AD. SPM analysis of the SPECT image showed significant perfusion deficits in the both frontal (both cingulate gyrus, both inferior frontal gyrus, B no.47, right frontal rectal gyrus, left frontal subcallosal gyrus, B no.25), both temporal (right insula, B no.13, left superior temporal gyrus, left parahippocampal gyrus, B no.35), occipital (occipital lingual gyrus), right corpus callosum and right cerebellar tonsil regions in subjects with VD compared with normal control subjects (uncorrected p<0.01). Comparison of the two dementia groups (uncorrected p<0.01) revealed significant hypoperfusion in both parietal posterior central gyrus, right inferior frontal gyrus (B no.47), left insula, right thalamus (ventral lateral nucleus), right claustrum and right occipital cuneus regions in VD group compared with AD. There were no typical confined regional hypoperfusion areas but scattered multiple perfusion deficits in VD compared AD. These findings may be helpful to reflect the pathophysiological mechanisms of VD and to disclose differences of cerebral blood flow between subjects with VD and AD

Epidemiologia dos acidentes do trabalho fatais em área metropolitana da região sudeste do Brasil, 1979-1989

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Sergio R. de Lucca

1993-06-01

Full Text Available Foram localizados e analisados 476 prontuários de acidentes do trabalho fatais arquivados na Agência de Campinas do INSS, ocorridos nos Municípios de Campinas, Cosmópolis, Paulínia, Sumaré e Valinhos, Estado de São Paulo, Brasil, no período de 1979 a 1989. Mediante as informações contidas na Comunicação de Acidente de Trabalho (CAT, Boletim de Ocorrência (BO e atestados de óbito, foram analisados os acidentes do trabalho segundo características das empresas, do acidentado e do acidente propriamente dito. Através dos dados disponíveis no Ministério do Trabalho/RAIS, sobre o número de trabalhadores registrados segundo ramo de atividade e ocupação dos municípios, estimou-se o risco de acidente de trabalho. A Densidade de Incidência foi maior para os "carpinteiros" (94,3 óbitos por 100.000 trabalhadores/ano, seguida dos "condutores de veículo" (69,6 e "pedreiros" (63,3. Comparada aos "técnicos", estes profissionais têm de três a cinco vezes mais probabilidade de morrer em função da atividade desempenhada (Razão de Densidade de Incidência. A Construção Civil (22,1% e Transportes (14,9%, sendo os ramos de atividade que mais contribuíram na mortalidade dos acidentados, apresentaram elevada Densidade de Incidência, de 59,8 e 57,3 óbitos por 100.000 trabalhadores/ano, respectivamente, se comparada ao do Comércio Varejista (9,4.

Epidemiologia dos acidentes do trabalho fatais em área metropolitana da região sudeste do Brasil, 1979-1989

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Lucca Sergio R. de

1993-01-01

Full Text Available Foram localizados e analisados 476 prontuários de acidentes do trabalho fatais arquivados na Agência de Campinas do INSS, ocorridos nos Municípios de Campinas, Cosmópolis, Paulínia, Sumaré e Valinhos, Estado de São Paulo, Brasil, no período de 1979 a 1989. Mediante as informações contidas na Comunicação de Acidente de Trabalho (CAT, Boletim de Ocorrência (BO e atestados de óbito, foram analisados os acidentes do trabalho segundo características das empresas, do acidentado e do acidente propriamente dito. Através dos dados disponíveis no Ministério do Trabalho/RAIS, sobre o número de trabalhadores registrados segundo ramo de atividade e ocupação dos municípios, estimou-se o risco de acidente de trabalho. A Densidade de Incidência foi maior para os "carpinteiros" (94,3 óbitos por 100.000 trabalhadores/ano, seguida dos "condutores de veículo" (69,6 e "pedreiros" (63,3. Comparada aos "técnicos", estes profissionais têm de três a cinco vezes mais probabilidade de morrer em função da atividade desempenhada (Razão de Densidade de Incidência. A Construção Civil (22,1% e Transportes (14,9%, sendo os ramos de atividade que mais contribuíram na mortalidade dos acidentados, apresentaram elevada Densidade de Incidência, de 59,8 e 57,3 óbitos por 100.000 trabalhadores/ano, respectivamente, se comparada ao do Comércio Varejista (9,4.

Neuroimaging of cerebral vasculitis

International Nuclear Information System (INIS)

Wengenroth, M.; Saam, T.; Haehnel, S.

2016-01-01

Cerebral vasculitis can have a variety of origins. Furthermore, there are no vasculitis-specific symptoms or imaging signs and vasculitis of the CNS can mimic many other neurological diseases, which require different treatment approaches. Thus, the clinical and radiological diagnosis of cerebral vasculitis is challenging. Magnetic resonance imaging (MRI) and MR angiography (MRA) should be the radiological imaging methods of choice to assess the degree of parenchymal damage and to detect vessel wall changes. If the results are unclear digital subtraction angiography (DSA) should be pursued in order to also detect changes in medium sized vessels. Vasculitis of small vessels cannot be detected by vascular imaging and requires brain or leptomeningeal biopsy. In this review we present the current diagnostic approach and a variety of imaging findings in cerebral vasculitis and discuss the main radiological differential diagnoses. (orig.) [de

Percepção do acidente fatal de trabalho para a família da vítima

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Ana Beatryce Tedesco Moraes

Full Text Available O trabalho humano constitui importante meio de inserção social, implicado na formação de identidade e de reconhecimento social. Em caso de acidente de trabalho fatal, a família sofre os impactos desse fenômeno em sua organização e dinâmica. Esta pesquisa teve por objetivo investigar a percepção do acidente de trabalho fatal para a família de uma vítima no sul do Estado do Espírito Santo, cuja análise se baseou nos seguintes temas: condições de trabalho do acidentado, impactos psicossociais gerados pelo acidente de trabalho e mudanças na dinâmica familiar em função dessa ocorrência. Foram entrevistados três membros da família da vítima e seu empregador. Os dados foram analisados conforme os critérios qualitativos da fenomenologia semiótica. Os resultados apontam um paradoxo na percepção da família da vítima e do empregador sobre o acidente: enquanto sua repercussão para a família se fundamenta na importância social do trabalho, para o empregador, associa-se à defesa da empresa e de sua responsabilidade sobre a morte no trabalho.

Malaria cerebral Cerebral malaria

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Carlos Hugo Zapata Zapata

2003-03-01

Full Text Available La malaria Cerebral (MC es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1 citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2 formación de rosetas y aglutinación de glóbulos rojos parasitados; 3 producción de citoquinas y activación de segundos mensajeros y, 4 apertura de la barrera hematoencefálica. Sin embargo, queda un interrogante sin resolver aún: ¿qué proceso se lleva a cabo para que el parásito, desde el espacio microvascular, pueda interferir transitoriamente con la función cerebral? Recientemente se ha utilizado el precursor de la proteína b-Amiloide como un marcador de daño neuronal en MC; este precursor será de gran ayuda en futuras investigaciones realizadas en nuestro medio que aporten información para comprender la patogénesis de la MC. Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains to be answered; how the host-parasite interaction in the vascular space interferes transiently with cerebral function? Recently, the beta amyloid precursor peptide has been employed as marker of neural injury in CM. It is expected that the beta amyloid precursor peptide will help to understand the pathogenesis of CM in complicated patients of endemic areas of Colombia.

Parâmetros de indenização no acidente do trabalho ou doença ocupacional

OpenAIRE

Tagliari, Rômulo Augusto

2013-01-01

O presente trabalho pretende tratar de parâmetros de indenização decorrentes de acidente do trabalho ou doença ocupacional, abordando principalmente decisões judiciais e doutrina referente ao tema. Para tanto, faz-se uma breve análise do instituto da responsabilidade civil, discorrendo-se quanto aos seus elementos e hipóteses em que é caracterizada de maneira geral. Após, examina-se a infortunística, demonstrando as características do acidente do trabalho, de forma a esclarecer a sua caracter...

Cerebral Amyloid Angiopathy

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Mahmut Edip Gürol

2009-03-01

Full Text Available Cerebral amyloid angiopathy (CAA is characterized by the accumulation of amyloid beta-peptides (Ab in the walls of leptomeningeal arteries, arterioles, and veins. Despite the fact that these pathological changes were first described in 1909, major advancement in our understanding of the clinicoradiological manifestations, neurobiology, and course of CAA has occurred only during the last 30 years. No significant associations have been shown between CAA and other systemic/visceral amyloidoses or vascular risk factors, including hypertension. CAA is well known as the most common cause of spontaneous and anticoagulant-related lobar parenchymal ICH in the elderly. It also causes lobar cerebral microbleeds (CMBs, small dot-like dark susceptibility artifacts visible with gradient recalled echo (GRE-magnetic resonance imaging (MRI. CMBs are important markers of disease severity and predictors of CAA progression. Amyloid angiopathy is also a common cause of ischemic microvascular white matter disease (WMD and deep cerebral infarctions. Such WMD is defined as subcortical and periventricular white matter changes without obvious infarction, as well as a dark appearance on computerized tomography (CT and a bright appearance on fluid attenuated inversion recovery (FLAIR-MRI. CAA-related vascular dysfunction, with its hemorrhagic and ischemic complications, is a recognized contributor to vascular cognitive impairment in the elderly, an independent effect that is synergistically increased by Alzheimer pathologies, such as plaques and tangles. A set of clinicoradiological criteria was established for the accurate diagnosis of CAA. According to the Boston Criteria, patients aged 55 years and older with multiple hemorrhages (on CT or GRE-MRI restricted to the lobar, cortical, or corticosubcortical regions (cerebellar hemorrhage allowed are diagnosed as probable CAA when no other etiology is found; a single hemorrhage in the same region is classified as possible

Hydrostatic determinants of cerebral perfusion

International Nuclear Information System (INIS)

Wagner, E.M.; Traystman, R.J.

1986-01-01

We examined the cerebral blood flow response to alterations in perfusion pressure mediated through decreases in mean arterial pressure, increases in cerebrospinal fluid (CSF) pressure, and increases in jugular venous (JV) pressure in 42 pentobarbital anesthetized dogs. Each of these three pressures was independently controlled. Cerebral perfusion pressure was defined as mean arterial pressure minus JV or CSF pressure, depending on which was greater. Mean hemispheric blood flow was measured with the radiolabeled microsphere technique. Despite 30-mm Hg reductions in mean arterial pressure or increases in CSF or JV pressure, CBF did not change as long as the perfusion pressure remained greater than approximately 60 mm Hg. However, whenever perfusion pressure was reduced to an average of 48 mm Hg, cerebral blood flow decreased 27% to 33%. These results demonstrate the capacity of the cerebral vascular bed to respond similarly to changes in the perfusion pressure gradient obtained by decreasing mean arterial pressure, increasing JV pressure or increasing CSF pressure, and thereby support the above definition of cerebral perfusion pressure

Incidência de acidentes de trabalho relacionada com a não utilização das precauções universais

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Marcia de Souza

1993-12-01

Full Text Available Entrevistados todos (57 os funcionários do serviço de enfermagem de um hospital geral governamental de São Paulo, que sofreram acidentes de trabalho relacionados a materiais pérfuro-cortantes, ou que tiveram contato com sangue ou fluidos corpóreos contaminados no período de janeiro a setembro de 1992. Desses, 15,8% (9 eram enfermeiras, 49,1% (28 auxiliares de enfermagem, 33,3% (19 atendentes de atendentes de enfermagem e 1,8% (1 escriturária, que apresentavam idade inferior a 40 anos. 66,1% possuiam 2º grau completo ou superior e entre 4 a 7 anos de experiência na função. Em relação ao turno de trabalho, 49,1% dos acidentes ocorreram pela manhã e 38,7% durante a noite, principalmente no Pronto Socorro (36,8%. Materiais pérfuro-cortantes foram responsáveis por 71 ,9% dos acidentes, sendo 75,0% entre os auxiliares de enfermagem. Os funcionários acidentados atribuiram a causa do acidente: a fatalidade, ao descuido ou imprudencia da equipe medica e ao reencape de agulhas. Quanto as consequencias, 57,0% dos acidentados por. respingo de secreção nos olhos desenvolveram conjuntivite e uma das funcionárias, Hepatite B. Este estudo mostrou que 78,1 % dos acidentes poderiam ter sido evitados, 57,0% apenas com o uso das Precauções Universais.

A quantitative brain map of experimental cerebral malaria pathology.

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Patrick Strangward

2017-03-01

Full Text Available The murine model of experimental cerebral malaria (ECM has been utilised extensively in recent years to study the pathogenesis of human cerebral malaria (HCM. However, it has been proposed that the aetiologies of ECM and HCM are distinct, and, consequently, no useful mechanistic insights into the pathogenesis of HCM can be obtained from studying the ECM model. Therefore, in order to determine the similarities and differences in the pathology of ECM and HCM, we have performed the first spatial and quantitative histopathological assessment of the ECM syndrome. We demonstrate that the accumulation of parasitised red blood cells (pRBCs in brain capillaries is a specific feature of ECM that is not observed during mild murine malaria infections. Critically, we show that individual pRBCs appear to occlude murine brain capillaries during ECM. As pRBC-mediated congestion of brain microvessels is a hallmark of HCM, this suggests that the impact of parasite accumulation on cerebral blood flow may ultimately be similar in mice and humans during ECM and HCM, respectively. Additionally, we demonstrate that cerebrovascular CD8+ T-cells appear to co-localise with accumulated pRBCs, an event that corresponds with development of widespread vascular leakage. As in HCM, we show that vascular leakage is not dependent on extensive vascular destruction. Instead, we show that vascular leakage is associated with alterations in transcellular and paracellular transport mechanisms. Finally, as in HCM, we observed axonal injury and demyelination in ECM adjacent to diverse vasculopathies. Collectively, our data therefore shows that, despite very different presentation, and apparently distinct mechanisms, of parasite accumulation, there appear to be a number of comparable features of cerebral pathology in mice and in humans during ECM and HCM, respectively. Thus, when used appropriately, the ECM model may be useful for studying specific pathological features of HCM.

A quantitative brain map of experimental cerebral malaria pathology.

Science.gov (United States)

Strangward, Patrick; Haley, Michael J; Shaw, Tovah N; Schwartz, Jean-Marc; Greig, Rachel; Mironov, Aleksandr; de Souza, J Brian; Cruickshank, Sheena M; Craig, Alister G; Milner, Danny A; Allan, Stuart M; Couper, Kevin N

2017-03-01

The murine model of experimental cerebral malaria (ECM) has been utilised extensively in recent years to study the pathogenesis of human cerebral malaria (HCM). However, it has been proposed that the aetiologies of ECM and HCM are distinct, and, consequently, no useful mechanistic insights into the pathogenesis of HCM can be obtained from studying the ECM model. Therefore, in order to determine the similarities and differences in the pathology of ECM and HCM, we have performed the first spatial and quantitative histopathological assessment of the ECM syndrome. We demonstrate that the accumulation of parasitised red blood cells (pRBCs) in brain capillaries is a specific feature of ECM that is not observed during mild murine malaria infections. Critically, we show that individual pRBCs appear to occlude murine brain capillaries during ECM. As pRBC-mediated congestion of brain microvessels is a hallmark of HCM, this suggests that the impact of parasite accumulation on cerebral blood flow may ultimately be similar in mice and humans during ECM and HCM, respectively. Additionally, we demonstrate that cerebrovascular CD8+ T-cells appear to co-localise with accumulated pRBCs, an event that corresponds with development of widespread vascular leakage. As in HCM, we show that vascular leakage is not dependent on extensive vascular destruction. Instead, we show that vascular leakage is associated with alterations in transcellular and paracellular transport mechanisms. Finally, as in HCM, we observed axonal injury and demyelination in ECM adjacent to diverse vasculopathies. Collectively, our data therefore shows that, despite very different presentation, and apparently distinct mechanisms, of parasite accumulation, there appear to be a number of comparable features of cerebral pathology in mice and in humans during ECM and HCM, respectively. Thus, when used appropriately, the ECM model may be useful for studying specific pathological features of HCM.

Percepção de sabores em pacientes com acidente vascular encefálico Taste perception in stroke patients

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Leda Maria Tavares Alves

2011-12-01

Full Text Available OBJETIVO: avaliar a percepção dos sabores amargo, azedo, doce e neutro. MÉTODO: foram estudados 36 pacientes com Acidente Vascular Encefálico (AVE (5 hemorrágicos e 31 isquêmicos e 30 sujeitos controles. Foi realizada avaliação fonoaudiológica estrutural e funcional incluindo postura, vedamento labial, presença de resíduos, tosse, engasgo, e ausculta cervical. Cada sujeito deglutiu em sequência aleatória 5 mL de líquido com os 4 sabores [chá de boldo (amargo, suco de limão diluído (azedo, sacarose diluída (doce e água (neutro] na temperatura ambiente. Entre as deglutições os participantes eram questionados sobre a dificuldade em deglutir e qual o sabor do líquido daquela deglutição. RESULTADOS: entre os pacientes houve maior freqüência de erros na identificação dos sabores amargo (controles: 16,7%, AVE: 47,3%, p=0,01 e azedo (controles: 6,7%, AVE: 27,8%, p=0,05, sem diferenças para o sabores neutro (controles: 10,0%, AVE: 16,7%, p=0,50 e doce (controles: 13,3%, AVE: 16,7%, p=0,80. Os pacientes com AVE tiveram maior dificuldade para deglutir os líquidos do que os controles (pPURPOSE: to assess the perception of bitter, sour, sweet and neutral flavors in stroke patients. METHOD: we studied 36 patients with stroke (5 hemorrhagic and 31 ischemic and had a 30 subjects' control group. W performed a structural and functional oral and pharyngeal evaluation including posture, lip sealing, presence of residues, cough, choking, and cervical auscultation. Five ml of fluids with the 4 flavors ["boldus" tea (bitter, diluted lemon juice (sour, diluted sucrose (sweet, and water (neutral] were offered in random sequence under room temperature. Participants were questioned, between swallows, on the difficulty in swallowing and which flavor they had just swallowed. RESULTS: patients with stroke had greater difficulty in swallowing the fluids than control group (p<0.04. Patients made more mistakes in identifying bitter (control: 16

Modeling cerebral blood flow during posture change from sitting to standing

DEFF Research Database (Denmark)

Ottesen, Johnny T.; Olufsen, M.; Tran, H.T.

2004-01-01

extremities, the brain, and the heart. We use physiologically based control mechanisms to describe the regulation of cerebral blood flow velocity and arterial pressure in response to orthostatic hypotension resulting from postural change. To justify the fidelity of our mathematical model and control......Abstract Hypertension, decreased cerebral blood flow, and diminished cerebral blood flow velocity regulation, are among the first signs indicating the presence of cerebral vascular disease. In this paper, we will present a mathematical model that can predict blood flow and pressure during posture...

Functional stability of cerebral circulatory system

Science.gov (United States)

Moskalenko, Y. Y.

1980-01-01

The functional stability of the cerebral circulation system seems to be based on the active mechanisms and on those stemming from specific of the biophysical structure of the system under study. This latter parameter has some relevant criteria for its quantitative estimation. The data obtained suggest that the essential part of the mechanism for active responses of cerebral vessels which maintains the functional stability of this portion of the vascular system, consists of a neurogenic component involving central nervous structures localized, for instance, in the medulla oblongata.

Cigarette smoking impairs nitric oxide-mediated cerebral blood flow increase: Implications for Alzheimer's disease

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Noboru Toda

2016-08-01

Full Text Available Cerebral blood flow is mainly regulated by nitrergic (parasympathetic, postganglionic nerves and nitric oxide (NO liberated from endothelial cells in response to shear stress and stretch of vasculature, whereas sympathetic vasoconstrictor control is quite weak. On the other hand, peripheral vascular resistance and blood flow are mainly controlled by adrenergic vasoconstrictor nerves; endothelium-derived NO and nitrergic nerves play some roles as vasodilator factors. Cigarette smoking impairs NO synthesis in cerebral vascular endothelial cells and nitrergic nerves leading to interference with cerebral blood flow and glucose metabolism in the brain. Smoking-induced cerebral hypoperfusion is induced by impairment of synthesis and actions of NO via endothelial nitric oxide synthase (eNOS/neuronal NOS (nNOS inhibition and by increased production of oxygen radicals, resulting in decreased actions of NO on vascular smooth muscle. Nicotine acutely and chronically impairs the action of endothelial NO and also inhibits nitrergic nerve function in chronic use. Impaired cerebral blood supply promotes the synthesis of amyloid β that accelerates blood flow decrease. This vicious cycle is thought to be one of the important factors involving in Alzheimer's disease (AD. Quitting smoking is undoubtedly one of the important ways to prevent and delay the genesis or slow the progress of impaired cognitive function and AD.

Exercise induces cerebral VEGF and angiogenesis via the lactate receptor HCAR1

DEFF Research Database (Denmark)

Morland, Cecilie; Andersson, Krister A.; Haugen, Oyvind P.

2017-01-01

-like cells along intracerebral microvessels. Activation of HCAR1 enhances cerebral vascular endothelial growth factor A (VEGFA) and cerebral angiogenesis. High-intensity interval exercise (5 days weekly for 7 weeks), as well as L-lactate subcutaneous injection that leads to an increase in blood lactate...

Acidentes de trabalho fatais e a qualidade das informações de seus registros em Uberaba, em Minas Gerais e no Brasil, 1997 a 2006

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Helena Hemiko Iwamoto

Full Text Available RESUMO OBJETIVO: caracterizar os acidentes de trabalho fatais e analisar a qualidade das informações de seus registros. MÉTODO: estudo ecológico com análise descritiva dos óbitos por acidentes de trabalho no Brasil, em Minas Gerais e no município de Uberaba, no período de 1997 a 2006. Utilizou-se como fonte de dados as informações do Sistema de Informações sobre Mortalidade (SIM, do Ministério da Saúde, e o Sistema Único de Benefícios (SUB, do Ministério da Previdência e Assistência Social. RESULTADOS: as causas mais comuns de acidentes de trabalho fatais estão relacionadas com os acidentes de trajeto e atingem principalmente homens da faixa etária entre 25 e 44 anos. Constatou-se um elevado percentual de informação ignorada no campo direcionado à identificação da relação do óbito com o acidente de trabalho, alcançando, no período, média de 82,9% em nível nacional, de 84,5% no estadual e de 79,6% no municipal. Quanto à qualidade das informações do SIM, segundo os critérios propostos pela Comissão Econômica para a América Latina e o Caribe, é considerada muito ruim para informar sobre acidentes de trabalho, sendo um fator limitante para o planejamento de ações no campo da saúde do trabalhador a partir desta fonte de dados. CONCLUSÃO: são necessárias, portanto, formas mais eficazes de registro das informações relacionadas aos acidentes de trabalho fatais.

Value of three-dimensional computed tomography in screening cerebral aneurysms

Energy Technology Data Exchange (ETDEWEB)

Yamaguchi, Tamaki; Sugiura, Yusuke; Suzuki, Atsushi; Yamagata, Yoshitaka [Hyogo Medical Coll. (Japan)

1997-10-01

We performed three-dimensional computed tomography (3D-CT) in 6 patients of cerebral aneurysm. Prior cerebral angiography showed a total of 17 aneurysms. 3D-CT alone detected 10 cerebral aneurysm (59%). It was possible to identify aneurysms larger than 10 mm even when located near the circle of Willis. It was difficult to identify aneurysms when smaller than 7 mm regardless of their location. 3D-CT was of limited value in detecting cerebral aneurysms, particularly when located near the circle of Willis with complex vascular network. As cases of oculomotor palsy may be caused by lesions other than cerebral aneurysm, we advocate that 3D-CT be performed after magnetic resonance imaging (MRI) in screening cases of suspected cerebral aneurysm. (author)

Magnetic resonance angiography in suspected cerebral vasculitis

International Nuclear Information System (INIS)

Demaerel, Philippe; De Ruyter, Nele; Wilms, Guido; Maes, Frederik; Velghe, Beatrijs

2004-01-01

The purpose of this study was to determine the technical capacity and diagnostic accuracy of 3D time-of-flight magnetic resonance angiography (MRA) in suspected cerebral vasculitis in a retrospective analysis of MRA and digital subtraction angiography (DSA) in 14 young patients with clinical and/or radiological suspicion of cerebral vasculitis. A total of nine arteries were evaluated in each patient. Consensus review of DSA by three observers was the reference standard. The sensitivity for detecting a stenosis varied from 62 to 79% for MRA and from 76 to 94% for DSA, depending on the observer. The specificity for detecting a stenosis varied from 83 to 87% for MRA and from 83 to 97% for DSA. Using the criterion ''more than two stenoses in at least two separate vascular distributions'' to consider the examination as being true positive, the false-positive rates for MRA and DSA were comparable. MRA plays a role as the first angiographical examination in the diagnostic work-up of suspected cerebral vasculitis. When more than two stenoses in at least two separate vascular distributions are depicted on MRA, DSA is not expected to add a significant diagnostic contribution in a patient with suspected cerebral vasculitis. DSA remains necessary when MRA is normal or when less than three stenoses are seen. (orig.)

Magnetic resonance angiography in suspected cerebral vasculitis

Energy Technology Data Exchange (ETDEWEB)

Demaerel, Philippe; De Ruyter, Nele; Wilms, Guido [Department of Radiology, Universitair Ziekenhuis, KU Leuven, 3000, Leuven (Belgium); Maes, Frederik [Department of Medical Imaging Computing, Universitair Ziekenhuis, KU Leuven, 3000, Leuven (Belgium); Velghe, Beatrijs [Department of Radiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk (Belgium)

2004-06-01

The purpose of this study was to determine the technical capacity and diagnostic accuracy of 3D time-of-flight magnetic resonance angiography (MRA) in suspected cerebral vasculitis in a retrospective analysis of MRA and digital subtraction angiography (DSA) in 14 young patients with clinical and/or radiological suspicion of cerebral vasculitis. A total of nine arteries were evaluated in each patient. Consensus review of DSA by three observers was the reference standard. The sensitivity for detecting a stenosis varied from 62 to 79% for MRA and from 76 to 94% for DSA, depending on the observer. The specificity for detecting a stenosis varied from 83 to 87% for MRA and from 83 to 97% for DSA. Using the criterion ''more than two stenoses in at least two separate vascular distributions'' to consider the examination as being true positive, the false-positive rates for MRA and DSA were comparable. MRA plays a role as the first angiographical examination in the diagnostic work-up of suspected cerebral vasculitis. When more than two stenoses in at least two separate vascular distributions are depicted on MRA, DSA is not expected to add a significant diagnostic contribution in a patient with suspected cerebral vasculitis. DSA remains necessary when MRA is normal or when less than three stenoses are seen. (orig.)

ACIDENTES OCUPACIONAIS COM PROFISSIONAIS DA EQUIPE DE ENFERMAGEM DE UM HOSPITAL DO VALE DO PARAÍBA PAULISTA

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Vanessa de Brito Poveda

2011-08-01

Full Text Available Objetivou-se descrever o perfil dos acidentes ocupacionais ocorridos com a equipe de enfermagem de um Hospital do Médio Vale do Paraíba Paulista, de dezembro de 2007 a novembro de 2008, analisando o conhecimento do profissional quanto ao seguimento sorológico, adoção das medicações prescritas, número de abandonos e identificação de alterações sociais oriundas do acidente. Trata-se de um estudo de natureza quantitativa e qualitativa. Os dados foram coletados por meio de um questionário semiestruturado, baseado no Manual do Ministério da Saúde sobre Recomendações para o Atendimento e Acompanhamento de Exposição Ocupacional a Material Biológico HIV e Hepatites B e C (2004 e a Ficha de Comunicação de Acidente de Trabalho. Os resultados foram analisados na forma descritiva e matemática estatística e as entrevistas submetidas à análise de conteúdo. Foram entrevistados 10 profissionais, dentre estes, cinco (50% vivenciaram o segundo acidente, sendo sete (70% ocasionados por material perfurocortante, sete (70% conheciam a importância da medicação antiretroviral, quatro (40% iniciaram a terapêutica e dois (20% finalizaram o tratamento e todos os profissionais vivenciaram sentimentos perturbadores diante da possibilidade de terem sido infectados pelo HIV. Conclui-se que a implantação de ações educativas aos profissionais de enfermagem é necessária para melhor entendimento aos riscos de exposição ocupacional.

Consumo abusivo de álcool e envolvimento em acidentes de trânsito na população brasileira, 2013

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Giseli Nogueira Damacena

Full Text Available Resumo O objetivo deste artigo é analisar o consumo abusivo e frequente de álcool segundo características sociodemográficas e investigar o risco de maior envolvimento em acidentes de trânsito, utilizando dados da Pesquisa Nacional de Saúde, 2013, Brasil. Eventos investigados: consumo abusivo e frequente de álcool (ingestão semanal igual ou superior de 8 doses para mulheres e 15 para homens por semana e envolvimento em acidente de trânsito com lesões corporais nos últimos 12 meses. Os dois eventos foram investigados segundo características sociodemográficas e a associação entre eles verificada por meio de regressão logística multivariada. A prevalência do consumo abusivo e frequente de álcool foi 6,1% para a população de 18 anos ou mais, sendo 8,9% entre os homens e 3,6% entre as mulheres. A prevalência de envolvimento em acidente de trânsito foi 3,1% na população geral e 6,1% entre os que referiram consumo abusivo e frequente de álcool. Após o controle por fatores sociodemográficos o consumo abusivo e frequente de álcool manteve associação estatisticamente significativa com o acidente de trânsito. Com o maior risco de envolvimento em acidentes de trânsito dentre os indivíduos que referiram consumo abusivo e frequente de álcool, monitorar a alcoolemia dos motoristas passa a ser uma possibilidade estratégica de intervenção.

Effects of forskolin on cerebral blood flow: implications for a role of adenylate cyclase

International Nuclear Information System (INIS)

Wysham, D.G.; Brotherton, A.F.; Heistad, D.D.

1986-01-01

We have studied cerebral vascular effects of forskolin, a drug which stimulates adenylate cyclase and potentiates dilator effects of adenosine in other vascular beds. Our goals were to determine whether forskolin is a cerebral vasodilator and whether it potentiates cerebral vasodilator responses to adenosine. We measured cerebral blood flow with microspheres in anesthetized rabbits. Forskolin (10 micrograms/kg per min) increased blood flow (ml/min per 100 gm) from 39 +/- 5 (mean +/- S.E.) to 56 +/- 9 (p less than 0.05) in cerebrum, and increased flow to myocardium and kidney despite a decrease in mean arterial pressure. Forskolin did not alter cerebral oxygen consumption, which indicates that the increase in cerebral blood flow is a direct vasodilator effect and is not secondary to increased metabolism. We also examined effects of forskolin on the response to infusion of adenosine. Cerebral blood flow was measured during infusion of 1-5 microM/min adenosine into one internal carotid artery, under control conditions and during infusion of forskolin at 3 micrograms/kg per min i.v. Adenosine alone increased ipsilateral cerebral blood flow from 32 +/- 3 to 45 +/- 5 (p less than 0.05). Responses to adenosine were not augmented during infusion of forskolin. We conclude that forskolin is a direct cerebral vasodilator and forskolin does not potentiate cerebral vasodilator responses to adenosine

Estimation of blood volume difference between bilateral cerebral hemispheres by means of subtraction method

International Nuclear Information System (INIS)

Ueno, Ichiro

1983-01-01

It would be admitted that by measuring radioactivity of the head after intravenous injection of RI some information could be afforded concerning the cerebral vascular bed. After intravenous injection of sup(99m)Tc-pertechnetate (15mCi), an anterior view scintiscanning was made using a gamma camera combined with a computer system. Two ROIs of about 30 cm 2 were set bilateral symmetrically and a count rate curve of each ROI was obtained. The brain transit time (BTT) was calculated from first derivative of the initial count rate courve. As an index devoting difference between vascular bed of each hemisphere, the vascular bed difference index (VBDI) was introduced BTT and VBDI were calculated in 104 subjects including 11 normal controls. In most of brain tumor, cerebral hemorrhage, severe head injury and cerebral aneurysm BTTs were prolonged in affected hemispheres. However, in a half of cerebral infarction cases BTTs were rather shortened on the affected side. In normal controls, the absolute value of VBDI was [0.16 +- 0.06(S.D.)]. In cases of brain tumor, cerebral hemorrhage and severe head injury, VBDI showed a significant deviation from the normal range, taking plus value. This results suggest, according to the definition of VBDI, vascular beds of the affected hemisphere are abnormally decreased compared with those of non-affected side. In cases of arteriovenous malformation VBDIs were increased on the affected side, reflecting enlarged tangle of arteriols and venous vessels. On the other hand, in cases of cerebral infarction, VBDI varied from case to case, making it difficult to get some conclusion from the present data. VBDI, however, invariably decreased in cases in which the occlusion of arteries were definitely confirmed by angiography

The pathology and pathophysiology of vascular dementia.

Science.gov (United States)

Kalaria, Raj N

2017-12-19

Vascular dementia (VaD) is widely recognised as the second most common type of dementia. Consensus and accurate diagnosis of clinically suspected VaD relies on wide-ranging clinical, neuropsychological and neuroimaging measures in life but more importantly pathological confirmation. Factors defining subtypes of VaD include the nature and extent of vascular pathologies, degree of involvement of extra and intracranial vessels and the anatomical location of tissue changes as well as time after the initial vascular event. Atherosclerotic and cardioembolic diseases combined appear the most common subtypes of vascular brain injury. In recent years, cerebral small vessel disease (SVD) has gained prominence worldwide as an important substrate of cognitive impairment. SVD is characterised by arteriolosclerosis, lacunar infarcts and cortical and subcortical microinfarcts and diffuse white matter changes, which involve myelin loss and axonal abnormalities. Global brain atrophy and focal degeneration of the cerebrum including medial temporal lobe atrophy are also features of VaD similar to Alzheimer's disease. Hereditary arteriopathies have provided insights into the mechanisms of dementia particularly how arteriolosclerosis, a major contributor of SVD promotes cognitive impairment. Recently developed and validated neuropathology guidelines indicated that the best predictors of vascular cognitive impairment were small or lacunar infarcts, microinfarcts, perivascular space dilation, myelin loss, arteriolosclerosis and leptomeningeal cerebral amyloid angiopathy. While these substrates do not suggest high specificity, VaD is likely defined by key neuronal and dendro-synaptic changes resulting in executive dysfunction and related cognitive deficits. Greater understanding of the molecular pathology is needed to clearly define microvascular disease and vascular substrates of dementia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Vitamin D status and vascular dementia due to cerebral small vessel disease in the elderly Asian Indian population.

Science.gov (United States)

Prabhakar, Puttachandra; Chandra, Sadanandavalli Retnaswami; Supriya, Manjunath; Issac, Thomas Gregor; Prasad, Chandrajit; Christopher, Rita

2015-12-15

Vitamin D plays vital roles in human health and recent studies have shown its beneficial effect on brain functioning. The present study was designed to evaluate the association of vitamin D with vascular dementia (VaD) due to cerebral small vessel disease (SVD) in Asian Indian population. 140 VaD patients aged ≥ 60 years with neuroimaging evidence of SVD, and 132 age and gender-matched controls, were investigated. Vitamin D status was estimated by measuring serum 25-hydroxy vitamin D. Logistic regression model revealed that deficient levels of vitamin D (vitamin D deficiency and insufficiency (12-20 ng/ml), the odds were increased to 31.6-fold and 14.4-fold, respectively. However, in hypertensives with vitamin D sufficiency (>20 ng/ml), the odds of VaD were increased by 3.8-fold only. Pearson correlation showed that serum vitamin D was inversely associated with systolic and diastolic blood pressure (r=-0.401 and -0.411, pvitamin D-deficient subjects. Since the combined presence of hypertension and vitamin D deficiency increases the probability of developing VaD, screening for vitamin D status in addition to regular monitoring of blood pressure, could reduce the risk of VaD associated with cerebral SVD in the elderly Asian Indian subjects. Copyright © 2015 Elsevier B.V. All rights reserved.

Trombose de artéria carótida interna relacionada a trauma de palato em criança

OpenAIRE

Almeida,Fernando de Souza; Hossotani,Márcia Harumi; Moura,Juliana Del Grossi

2012-01-01

OBJETIVO: Relatar um caso de trombose de artéria carótida interna secundária relacionada a trauma de palato mole em criança. DESCRIÇÃO DO CASO: Criança admitida com quadro de alteração do nível de consciência, sonolência, afasia e hemiplegia direita; tinha antecedente de trauma corto contuso leve em palato mole há oito horas. A investigação tomográfica evidenciou acidente vascular isquêmico secundário à interrupção do fluxo sanguíneo em território de artéria cerebral média esquerda. A arterio...

Terapia por contensão induzida: revisão de ensaios clínicos

OpenAIRE

Silva,Lidiane de Araújo; Tamashiro,Vanessa; Assis,Rodrigo Deamo

2010-01-01

INTRODUÇÃO: A Terapia por Contensão Induzida (TCI) é uma terapêutica que visa à recuperação da função do membro superior (MS) parético de pacientes com sequelas de um acidente vascular cerebral por meio de treinamento intensivo, uso de uma restrição no MS não-parético durante 90% do dia e pelo pacote de transferência. OBJETIVO: O objetivo deste trabalho é realizar uma revisão entre os estudos que compararem a TCI com outras terapêuticas. METODOLOGIA: Foi realizada uma pesquisa nas bases de da...

Em Torno da Fibrilação Auricular no Idoso...Complexo e Multifacetado

OpenAIRE

Marques da Silva, P

2016-01-01

A fibrilação auricular é a arritmia mais comum dos idosos. A prevenção dos eventos tromboembólicos (e do acidente vascular cerebral, em particular) e a anticoagulação oral é uma necessidade inadiável. No entanto, a fibrilação auricular no idoso é uma circunstância, por natureza, complexa e está associada a um número elevado de comorbilidades, de síndromes gerais geriátricos, de polimedicação e de fragilidade clínica. Por isso, os cuidados geriátricos primários passam pela avaliação do estado ...

Transient acute renal failure and functional hemispheric depression after cerebral arteriography in diabetic patients

DEFF Research Database (Denmark)

Olsen, Tom Skyhøj; Lund, P; Praestholm, J

1981-01-01

Cerebral angiography was carried out in two diabetic patients in the evaluation of minor vascular ischemic episodes. A transient acute renal failure following cerebral angiography was accompanied by a transient comatose episode with severe unilateral neurological deficits. A functional depression...

Vascular neurocognitive disorders and the vascular risk factors

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Carmen V. Albu

2018-04-01

Full Text Available Dementias are clinical neurodegenerative diseases characterized by permanent and progressive transformation of cognitive functions such as memory, learning capacity, attention, thinking, language, passing judgments, calculation or orientation. Dementias represent a relatively frequent pathology, encountered at about 10% of the population of 65-year olds and 20% of the population of 80-year olds. This review presents the main etiological forms of dementia, which include Alzheimer form of dementia, vascular dementia, dementia associated with alpha-synucleionopathies, and mixed forms. Regarding vascular dementia, the risk factors are similar to those for an ischemic or hemorrhagic cerebrovascular accident: arterial hypertension, diabetes mellitus, dyslipidemia, smoking, obesity, age, alcohol consumption, cerebral atherosclerosis/ arteriosclerosis. Several studies show that efficient management of the vascular risk factors can prevent the expression and/ or progression of dementia. Thus, lifestyle changes such as stress reduction, regular physical exercise, decreasing dietary fat, multivitamin supplementation, adequate control of blood pressure and serum cholesterol, and social integration and mental stimulation in the elderly population are important factors in preventing or limiting the symptoms of dementia, a disease with significant individual, social, and economic implications.

Effects of Cerebral Ischemia in Mice Deficient in Neuronal Nitric Oxide Synthase

Science.gov (United States)

Huang, Zhihong; Huang, Paul L.; Panahian, Nariman; Dalkara, Turgay; Fishman, Mark C.; Moskowitz, Michael A.

1994-09-01

The proposal that nitric oxide (NO) or its reactant products mediate toxicity in brain remains controversial in part because of the use of nonselective agents that block NO formation in neuronal, glial, and vascular compartments. In mutant mice deficient in neuronal NO synthase (NOS) activity, infarct volumes decreased significantly 24 and 72 hours after middle cerebral artery occlusion, and the neurological deficits were less than those in normal mice. This result could not be accounted for by differences in blood flow or vascular anatomy. However, infarct size in the mutant became larger after endothelial NOS inhibition by nitro-L-arginine administration. Hence, neuronal NO production appears to exacerbate acute ischemic injury, whereas vascular NO protects after middle cerebral artery occlusion. The data emphasize the importance of developing selective inhibitors of the neuronal isoform.

Cerebral hemodynamics in adult ischemic-type patients with moyamoya disease compared with those of atherothrombotic middle cerebral artery occlusion

International Nuclear Information System (INIS)

Idei, Masaru; Yamane, Kanji; Nishida, Masahiro; Manabe, Kazufumi; Yokota, Akira

2005-01-01

We measured regional cerebral blood flow (rCBF) in adult ischemic-type patients with moyamoya disease and in patients with atherothrombotic middle cerebral artery occlusion (MCAO) to investigate cerebral hemodynamics in adult ischemic-type of moyamoya disease. In this study we measured rCBF and regional cerebro-vascular response (rCVR) using acetazolamide by Xe-non-enhanced CT. Our subjects consisted of 15 adult ischemic-type patients with moyamoya disease and 27 atherothrombotic stroke patients with proximal occlusion of the middle cerebral artery. The region of inter est was conducted in the anterior cerebral artery, middle cerebral artery and posterior cerebral artery territories as well as basal ganglia regions. rGBF was preserved in all regions of patients with moyamoya disease. However, rCVR severely decreased in the anterior circulation territory in patients with moyamoya disease compared with those of MCAO. These results suggest that rCBF in the anterior circulation territory of adult ischemic-type patients with moyamoya disease is preserved by vasodilation of the cerebral arteries, while cerebral hemodynamic reserve capacity is severely reduced. The results indicated that basal moyamoya vessels are dilated. These findings may be one of the reasons why stroke occurs more frequently in adult than child patients with moyamoya disease. (author)

Aneurisma de artéria cerebral em criança com síndrome da imunodeficiência adquirida: relato de caso Cerebral arterial aneurysm in a child with acquired immunodeficiency syndrome: case report

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Arnolfo de Carvalho Neto

2001-06-01

Full Text Available A dilatação aneurismática dos vasos do polígono de Willis é manifestação incomum da infecção pelo vírus da imunodeficiência adquirida (HIV, tendo sido relatados, até o momento, 15 casos na literatura. O presente estudo tem por objetivo relatar um novo caso dessa apresentação rara, além de revisar aspectos importantes relacionados à mesma. Um paciente, do sexo masculino, 6 anos de idade, com síndrome da imunodeficiência adquirida (AIDS de transmissão perinatal e tetraparesia, desenvolveu sintomas caracterizados por episódios de crises distônicas. A tomografia computadorizada de crânio, que inicialmente era normal, mostrou dilatação aneurismática dos vasos do polígono de Willis. A revisão de literatura demonstra que os principais achados patológicos em casos similares, são, principalmente, fibrose de camada média com destruição da lâmina interna e hiperplasia da íntima. A etiologia da vasculite não é conhecida, acreditando-se que o vírus da varicela-zoster e o próprio HIV possam estar relacionados à mesma. Conclui-se que, apesar de incomum, tal complicação apresenta grande importância pelo fato dos aneurismas colocarem esses pacientes em grupo de alto risco para acidentes vasculares. A sobrevida relatada na literatura é de menos de 6 meses após o diagnóstico da arteriopatia aneurismática cerebral.Cerebral aneurysmal arteriopathy of the circle of Willis is an uncommon manifestation of acquired human immunodeficiency virus (HIV infection and up to now only 15 cases have been published in the literature. For this reason we add our experience of this rare case, and review the most important aspects related to this entity. The patient is a 6 year old male with perinatal transmitted AIDS, tetraparethic, developed symptoms characterized by episodes of dystonic postures. The computed tomography of the brain showed aneurismal arteriopathy of the circle of Willis. He had a previous normal examination. The review

Acidente com material biológico no atendimento pré-hospitalar móvel: realidade para trabalhadores da saúde e não saúde

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Tipple, Anaclara Ferreira Veiga; Silva, Elisangelo Aparecido Costa; Teles, Sheila Araújo; Mendonça, Katiane Martins; Souza, Adenícia Custódia Silva e; Melo, Dulcelene Sousa

2013-01-01

Estudo analítico transversal, com objetivos de identificar a prevalência e caracterizar os acidentes com material biológico entre profissionais do Atendimento Pré-Hospitalar (APH) e comparar os comportamentos de risco adotados entre os grupos saúde e não saúde que podem influenciar na ocorrência e na gravidade destes acidentes. Dados foram obtidos por meio de questionário aplicado a todos os trabalhadores do APH de Goiânia - GO. Verificou-se alta prevalência de acidentes envolvendo material b...

Risk factors for vascular dementia: Hypotension as a key point

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Rita Moretti

2008-04-01

Full Text Available Rita Moretti, Paola Torre, Rodolfo M Antonello, Davide Manganaro, Cristina Vilotti, Gilberto PizzolatoDepartment of Internal Medicine and Clinical Neurology University of Trieste, ItalyAbstract: Physiologically, the cerebral autoregulation system allows maintenance of constant cerebral blood flow over a wide range of blood pressure. In old people, there is a progressive reshape of cerebral autoregulation from a sigmoid curve to a straight line. This implies that any abrupt change in blood pressure will result in a rapid and significant change in cerebral blood flow. Hypertension has often been observed to be a risk factor for vascular dementia (VaD and sometimes for Alzheimer disease although not always. Indeed, high blood pressure may accelerate cerebral white matter lesions, but white matter lesions have been found to be facilitated by excessive fall in blood pressure, including orthostatic dysregulation and postprandial hypotension. Many recent studies observed among other data, that there was a correlation between systolic pressure reduction and cognitive decline in women, which was not accounted for by other factors. Baseline blood pressure level was not significantly related to cognitive decline with initial good cognition. Some researchers speculate that blood pressure reduction might be an early change of the dementing process. The most confounding factor is that low pressure by itself might be a predictor of death; nevertheless, the effect of low blood pressure on cognition is underestimated because of a survival bias. Another explanation is that clinically unrecognized vascular lesions in the brain or atherosclerosis are responsible for both cognitive decline and blood pressure reduction. We discuss the entire process, and try to define a possible mechanism that is able to explain the dynamic by which hypotension might be related to dementia.Keywords: vascular dementia, hypotension, low blood pressure, alzheimer disease

Acidentes envolvendo indígenas brasileiros atendidos em serviços de urgência e emergência do Sistema Único de Saúde

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Edinilsa Ramos de Souza

Full Text Available Resumo Foram analisados os acidentes ocorridos com indígenas brasileiros atendidos em serviços de urgência e emergência do Sistema Único de Saúde (SUS. Os dados provêm do Viva Inquérito de 2014, que incluiu 86 serviços de 24 capitais e do Distrito Federal. Caracterizou-se o perfil sociodemográfico dos indígenas, o evento e o atendimento. A maioria dos atendidos era do sexo masculino e tinha entre 20-39 anos. Acidentes de transporte e quedas foram os principais motivos dos atendimentos. O uso de bebida alcoólica foi informado por 5,6% dos atendidos. Nos acidentes de transporte esse uso sobe para 19,1%; 26,1% entre condutores e 22,8% nos motociclistas. Houve diferença estatística entre os sexos em relação à faixa etária, deficiência, local de ocorrência do evento, evento relacionado ao trabalho e condição da vítima no acidente de transporte. Destaca-se a importância de dar visibilidade aos acidentes com indígenas e de envolvê-los na prevenção desses eventos. A fidedignidade desses dados depende do seu adequado preenchimento nos sistemas de informações sobre saúde de indígenas.

Avaliação da aptidão cardiopulmonar em indivíduos com hemiparesia após acidente vascular encefálico

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Angélica Cristiane Ovando

2011-02-01

Full Text Available FUNDAMENTO: Devido à hemiparesia, a avaliação da aptidão cardiorrespiratória de indivíduos após acidente vascular encefálico (AVE, por meio de testes ergométricos com protocolos convencionais, tem se tornado um desafio. OBJETIVO: Realizar teste cardiopulmonar (TCP em hemiparéticos para uma avaliação pré-participação visando uma criteriosa prescrição de exercício aeróbico. MÉTODOS: Participaram do estudo 8 indivíduos com hemiparesia crônica, que foram submetidos a TCP realizado com protocolo individualizado em rampa, desenvolvido a partir da informação da velocidade de marcha dos indivíduos previamente avaliados em teste de pista. Foi considerada a proposta de inclinação variando entre 0 e 10,0%, velocidade inicial correspondente a 70,0% do ritmo de caminhada confortável e velocidade máxima 40,0% superior à velocidade máxima no teste de pista, na expectativa de que o TCP, com este incremento gradativo e constante da intensidade, durasse entre 6 e 8 minutos. RESULTADOS: Em 100,0% dos avaliados, o motivo para a interrupção do teste foi fadiga periférica. O VO2 de pico alcançado foi de 20,6 ± 5,7 ml/kg.min. O Limiar I foi identificado em todos os exames, situando-se em 82,64 ± 4,78% da FC de pico e 73,31 ± 4,97% do VO2 de pico. O quociente respiratório (R do grupo foi de 0,96 ± 0,09, e três dos 8 indivíduos (37,5% atingiram R superior a 1,00, sendo o Limiar II identificado nestes sujeitos. Foram encontradas relações positivas entre variáveis do TCP e escores de equilíbrio, desempenho no teste de caminhada de 6 minutos e velocidade de marcha no solo. CONCLUSÃO: O teste mostrou ser útil para prescrição de atividade física nesses indivíduos.

Raça e lesão de órgãos-alvo da hipertensão arterial em pacientes atendidos em um ambulatório universitário de referência na cidade de Salvador Race and hypertensive target-organ damage in patients from an university-affiliated outpatient care referral clinic in the city of Salvador

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Antonio Carlos Beisl Noblat

2004-02-01

Full Text Available OBJETIVO: Avaliar se a raça do paciente estaria associada à presença de hipertrofia ventricular esquerda, acidente vascular cerebral e insuficiência renal crônica em hipertensos atendidos em ambulatório de referência em Salvador-BA. MÉTODOS: Analisados dados de 622 pacientes com o primeiro atendimento em ambulatório de hipertensão, entre 1982 e 1986, e identificados os com história prévia ou seqüela de acidente vascular cerebral, hipertrofia ventricular esquerda ou insuficiência renal (creatinina sérica > 1,4 mg/dL. Modelos de regressão logística foram utilizados para estimar odds ratio (OR da associação entre raça (mulatos ou negros vs brancos e lesão de órgãos-alvo de hipertensão, ajustadas para sexo e idade. RESULTADOS: A média de idade dos pacientes foi 53,8±14,3 anos, 74,1% mulheres. Quanto à raça, 15,1% eram brancos, 65,9% mulatos e 19,0% negros. Acidente vascular cerebral foi significantemente mais freqüente em negros ou mulatos do que em brancos (odds ratio ajustada (ORa=3,44; intervalo de confiança (IC 95%=1,23-9,67. Quanto às associações envolvendo raça com os eventos hipertrofia ventricular esquerda e insuficiência renal as ORa não foram estatisticamente significantes, mas foram consistentes com maior prevalência de hipertrofia ventricular esquerda e insuficiência renal em negros e mulatos. CONCLUSÃO: Negros e mulatos hipertensos têm maior risco de lesão de órgão alvo do que brancos, com diferença racial maior para acidente vascular cerebral não fatal. Deve ser avaliada se diferenças raciais em mortalidade relacionada a complicações da hipertensão influenciam as associações observadas entre raça e lesão de órgãos-alvo.OBJECTIVE: To assess whether a patient's race is associated with the presence of left ventricular hypertrophy, stroke, and renal failure in hypertensive patients from an outpatient care referral clinic in the city of Salvador in the state of Bahia. METHODS: We

Exposição ocupacional ao ruído e acidentes do trabalho Occupational noise exposure and work accidents

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Adriano Dias

2006-10-01

Full Text Available O objetivo deste estudo foi verificar se a exposição ocupacional ao ruído é um fator de risco relevante para acidentes do trabalho na cidade de Piracicaba, São Paulo, Brasil. Foi realizado um estudo caso-controle de base hospitalar. Os casos foram 600 trabalhadores entre 15 e 60 anos que sofreram acidentes ocupacionais típicos entre maio e outubro de 2004, atendidos na Central de Ortopedia e Traumatologia de Piracicaba. Os controles foram 822 trabalhadores entre 15 e 60 anos que sofreram acidente não ocupacional e receberam o primeiro atendimento no serviço ou foram trabalhadores acompanhantes dos acidentados. Foi ajustado um modelo de regressão logística múltipla, tendo como variável independente o acidente do trabalho, controlada por co-variáveis de interesse, entre elas a exposição ao ruído. Estimou-se que o risco de sofrer acidente do trabalho é cerca de duas vezes maior entre trabalhadores expostos ao ruído, controlado para diversas co-variáveis. A exposição ocupacional ao ruído não só deteriora a saúde auditiva do trabalhador, mas também se constitui em fator de risco para acidentes do trabalho.The purpose of this study was to verify whether occupational noise exposure is a significant risk factor for work accidents in the city of Piracicaba, São Paulo State, Brazil. This hospital-based case-control study included 600 workers aged 15-60 who suffered typical occupational accidents between May and October 2004 and were seen at the Piracicaba Orthopedics and Trauma Center. The control group comprised 822 workers, aged 15-60, who were also seen at the Center, and either had a non-occupational accident or were accompanying someone who had suffered an accident. A multiple logistic regression model was adjusted with work accident as an independent variable, controlled by covariables of interest such as noise exposure. The risk of having a work accident was about twice as high among workers exposed to noise, after

Evolução dos acidentes de trânsito em um grande centro urbano, 1991-2000

OpenAIRE

Oliveira, Zenaide Calazans de; Mota, Eduardo Luiz Andrade; Costa, Maria da Conceição Nascimento

2008-01-01

p. 364-372, fev, 2008 Este estudo descreve a evolução dos acidentes de trânsito Salvador, Bahia, Brasil, entre 1991 e 2000, utilizando- se dados do Departamento Estadual de Trânsito do Estado da Bahia. Calculou-se taxas globais dos acidentes de trânsito, vítimas e taxas padronizadas de mortalidade por habitante e por veículos, e comparou-se médias destes indicadores para antes (1991 a 1994) e após (1995 a 2000) a adoção de medidas de intervenção como o uso do cinto de segurança e o Código ...

Acidentes graves do trabalho na Capital do Estado de São Paulo (Brasil Serious on-the-job accidents in the City of S. Paulo, Brazil

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Diogo Pupo Nogueira

1981-02-01

Full Text Available Em 1970, o Grupamento de Acidentes do Trabalho (GAT do INPS desenvolveu programa preventivo contra os acidentes de trabalho. Detalhes operacionais deste programa são descritos, e o resultado da investigação de 3.930 acidentes graves é analisado. Estes acidentes foram estudados quanto às seguintes variáveis: estado civil, faixa etária, sexo, profissão, tipo, conseqüências, fatores, dia da semana, hora do dia, horas decorridas do início do serviço, causas e número de lesões.In 1970, the Accidents On-the-Job Group of the National Institute of Social Security (INPS, began a special program for the prevention of on-the-job-accidents. The following factors were studied in 3,930 cases: age, sex, marital status, occupation, cause of accident, date of occurrence, time of occurrence, occurred how soon after beginning day's work, number and type of body lesions, limitation of working capacity.

Current status and outlook of endovascular therapy for cerebral ischemic diseases

International Nuclear Information System (INIS)

Li Minghua; Zhao Jungong

2005-01-01

Improvement of diagnostic technology and increasing advent of new materials for intervention has created a new area for endovascular therapy of cerebral ischemic diseases. Current research findings have shown that endovascular thrombolysis in acute stage of cerebral infarction can accelerate the rate of re-canalization of occluded arteries and greatly decrease the morbidity and mortality of cerebral ischemic vascular diseases. Stenting of arterial stenosis can the improve of blood supply distal to the lesion, prevent recurrent cerebral ischemic stroke. As a result, endovascular thrombolysis for acute cerebral infarction and stenting for intracranial and carotid arterial stenosis are booming both at home and abroad. Proper selection of patients of acute cerebral infarction for endovascular thrombolysis with less complications could be achieved through CT perfusion, MR perfusion-weighted image (PWI) and diffusion-weighted image (DWI), non-invasive vascular imaging technology including CEMRA and CTA for confirming and demonstrating the sites and causes of cerebral ischemia, and furthermore for evaluating the survival ability and etc. The research team administered albumin and magnesium sulfate as neurological protection drug to treat rat infarction model within 6 hours of onset resulting with the same effect of decreasing the damage of ischemic cerebral tissue and without hemorrhagic complication. It is certain that hemorrhagic complication in thrombolysis is a result of multiple factors with no single drug being able to solve the problem. It is predictable that, based on semi-quantitative or quantitative parameters of CT or MRI in conjunction with PWI/DWI mismatch model rather than simply on the onset time of infarction for proper selection of patients of cerebral infarction, mechanic thrombus-disruption and/or intra-arterial thrombolysis together with intervention of neurological protection drug will be the trend for treating acute cerebral infarction in the future

An investigation of cerebral magnetic resonance angiography, 4

International Nuclear Information System (INIS)

Takeda, Sadanori; Sadamoto, Kazuhiko; Ohue, Shiro; Todo, Hirooki; Sakaki, Saburo.

1991-01-01

We have been studying MR angiography using the 0.5 tesla system. Recently we developed three-dimensional MR angiography on the 0.5 tesla system using the gradient-echo technique. The purpose of this study is to evaluate the clinical ability of this newly developed 3-D MR angiography to detect intracranial vascular diseases in comparison with SE or 2-D MR angiography. Twenty-eight patients (15 cerebral aneurysms, 8 arteriovenous malformations, and 5 others) were examined. Three-dimensional MR angiography was performed with TRs of from 60 to 90 msec, TEs of from 16 to 22 msec, flip angls of from 15 to 45 degrees, and a 256x256x16 or 32 matrix. The imaging volumes ranged in thickness from 48 to 64 mm. In our study, a subtraction technique composed of rephased and dephased sequences was applied. As the result of utilizing 0.5 tesla 3-D MR angiography with optimal parameters, good visualization of main cerebral arteries such as second-order branches was obtained. Cerebral aneurysms, AVMs, and arterial occlusions were also well demonstrated, but some of the giant aneurysms were displayed insufficiently for the various flows to be determined. We concluded that 3-D MR angiography on the 0.5 tesla system has the ability to detect intracranial vascular lesions and should be the method for the screening and follow-up of intracranial vascular diseases. (author)

Atividade muscular durante a marcha após acidente vascular encefálico Muscle activity during gait following stroke

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Fernanda Ishida Corrêa

2005-09-01

Full Text Available OBJETIVO: Buscar parâmetros da marcha de pacientes após ter sofrido acidente vascular encefálico (AVE com hemiparesia. MÉTODO: Comparados 15 voluntários pós-AVE e 15 voluntários saudáveis com a mesma idade, gênero e peso. A comparação foi feita por eletromiografia utilizando cinco pares de eletrodos de superfície do lado comprometido (espástico e um eletrogoniômetro sobre o eixo articular de rotação da articulação do tornozelo em estudo. RESULTADOS: O início da atividade eletromiográfica, a partir da fase de apoio, para os músculos glúteo medial, reto femoral, tibial anterior, sóleo, e porção medial dos isquiotibiais foi significantemente ativados anteriormente durante o ciclo da marcha nos voluntários pós-AVE. O final da atividade eletromiográfica para os músculos reto femoral, tibial anterior, sóleo, e porção medial dos isquiotibiais foi significantemente prolongado nos voluntários pós-AVE. Voluntários pós-AVE demonstraram também mais co-ativação dos músculos agonistas e antagonistas da articulação do tornozelo e joelho durante a fase de balanceio. CONCLUSÃO: Essas alterações e co-contrações musculares da marcha permitem que os voluntários pós-AVE adotem um padrão de marcha mais seguro e mais estável para compensar a diminuição da informação sensorial da articulação do tornozelo.OBJECTIVE: To compare muscle activity and joint moments in the lower extremities during walking between subjects with stroke and control subjects. METHOD: We compared fifteen healthy volunteers and fifteen stroke patients, with the same age gender and weight data had been compared by electromyography. The system of signals acquisition used consisted of five pairs of electrodes of surface, beyond one electrogoniometer on the axis articulate of rotation of the joint of the ankle in study. RESULTS: Onset times with respect to heel-strike for the medial gluteus, tibialis anterior, soleus, rectus femoris and medial

Características epidemiológicas dos acidentes na infância Epidemiological characteristics of childhood accidents

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Carmen Vieira de Sousa Unglert

1987-06-01

Full Text Available Foram estudadas as características epidemiológicas dos acidentes na infância, através da aplicação de questionário. Foram levantados os acidentes ocorridos num período de 2 anos em crianças de famílias que freqüentavam dois postos de assistência médica de bairros situados na periferia da cidade de São Paulo, SP, Brasil. Foram entrevistadas 388 famílias, com um total de 1.036 crianças de 0 a 12 anos. Das famílias, 289 não referiram qualquer acidente nas crianças nos dois anos anteriores. Em 99 famílias foi referido pelo menos 1 acidente, sendo registrado um total de 122. Os tipos de acidentes mais freqüentes foram as quedas (54,1%, ferimentos causados por objetos cortantes ou penetrantes (13,1% e mordeduras por animais (9,8%. As lesões mais freqüentes foram os cortes (26,2%, contusões (24,6% e escoriações (17,2%. A maior incidência de acidentes ocorreu em meninos de 5 a 9 anos seguido de meninos de 10 a 12 anos. A recuperação foi total em 88,5% dos casos, havendo 9,8% de casos com recuperação parcial, com sinais, 1 caso de recuperação parcial, com limitações, e um óbito. Em 91% dos casos não houve necessidade de internação, mas em 32,0% dos casos foram necessários 15 dias ou mais para que a recuperação se desse. O coeficiente de mortalidade encontrado foi de 114,9 óbitos para cem mil crianças menores de 12 anos por ano e a letalidade foi de 8,2 óbitos por mil acidentes. O estudo permitiu acrescentar série de dados complementares que facilitam a caracterização epidemiológica dos acidentes na infância.The epidemiological characteristics of those accidents which had happened to children in the previous 2 years were studied by means of interviews with the families of children less than 12 years of age, who had been assisted in two Health Centres in an outlying area of S. Paulo City, Brazil. A total of 388 families were interviewed, with a total of 1036 children less than 12 years old. Of these

Statin therapy exacerbates alcohol-induced constriction of cerebral arteries via modulation of ethanol-induced BK channel inhibition in vascular smooth muscle.

Science.gov (United States)

Simakova, Maria N; Bisen, Shivantika; Dopico, Alex M; Bukiya, Anna N

2017-12-01

Statins constitute the most commonly prescribed drugs to decrease cholesterol (CLR). CLR is an important modulator of alcohol-induced cerebral artery constriction (AICAC). Using rats on a high CLR diet (2% CLR) we set to determine whether atorvastatin administration (10mg/kg daily for 18-23weeks) modified AICAC. Middle cerebral arteries were pressurized in vitro at 60mmHg and AICAC was evoked by 50mM ethanol, that is within the range of blood alcohol detected in humans following moderate-to-heavy drinking. AICAC was evident in high CLR+atorvastatin group but not in high CLR diet+placebo. Statin exacerbation of AICAC persisted in de-endothelialized arteries, and was blunted by CLR enrichment in vitro. Fluorescence imaging of filipin-stained arteries showed that atorvastatin decreased vascular smooth muscle (VSM) CLR when compared to placebo, this difference being reduced by CLR enrichment in vitro. Voltage- and calcium-gated potassium channels of large conductance (BK) are known VSM targets of ethanol, with their beta1 subunit being necessary for ethanol-induced channel inhibition and resulting AICAC. Ethanol-induced BK inhibition in excised membrane patches from freshly isolated myocytes was exacerbated in the high CLR diet+atorvastatin group when compared to high CLR diet+placebo. Unexpectedly, atorvastatin decreased the amount and function of BK beta1 subunit as documented by immunofluorescence imaging and functional patch-clamp studies. Atorvastatin exacerbation of ethanol-induced BK inhibition disappeared upon artery CLR enrichment in vitro. Our study demonstrates for the first time statin's ability to exacerbate the vascular effect of a widely consumed drug of abuse, this exacerbation being driven by statin modulation of ethanol-induced BK channel inhibition in the VSM via CLR-mediated mechanism. Copyright © 2017 Elsevier Inc. All rights reserved.

Vascular cognitive impairment

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N.V. Vakhnina

2014-01-01

Full Text Available Vascular pathology of the brain is the second most common cause of cognitive impairment after Alzheimer's disease. The article describes the modern concepts of etiology, pathogenetic mechanisms, clinical features and approaches to diagnosis and therapy of vascular cognitive impairment (VCI. Cerebrovascular accident, chronic cerebral circulatory insufficiency and their combination, sometimes in combination with a concomitant neurodegenerative process, are shown to be the major types of brain lesions leading to VCI. The clinical presentation of VCI is characterized by the neuropsychological status dominated by impairment of the executive frontal functions (planning, control, attention in combination with focal neurological symptoms. The diagnosis is based on comparing of the revealed neuropsychological and neurological features with neuroimaging data. Neurometabolic, acetylcholinergic, glutamatergic, and other vasoactive drugs and non-pharmacological methods are widely used to treat VCI. 

Compromiso vascular en la encefalitis herpética

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Carlos Alberto Cañas

1997-01-01

Full Text Available Describimos el caso de un paciente de 30 años de edad que desarrolla una encefalitis fatal par Herpes simple, en cuyos hallazgos de necropsia se destaca un compromiso vascular cerebral secundario. Se discute In posibilidad de que en la encefalitis herpética pueden presentarse dos tipos de compromiso vascular: uno reconocido desde hace tres décadas, la vasculomielinopatía diseminada, y otro, una forma de vasculitis séptica.

Vascular and hypoxic tissue lesions in cranial computerized tomography and their differential diagnosis

Energy Technology Data Exchange (ETDEWEB)

Kuckein, D

1982-09-01

CT findings and differential diagnosis in cerebral infarctions caused by vascular stenosis or occlusion, by emboli or arterial thrombosis are discussed; also in cerebral and sinus venous thrombosis. Brain damage due to hypoxia, to a combination of hypoxia and sinus venous thrombosis or to one of hypoxia and hyperpyrexia are presented.

Regional cerebral blood flow before and after vascular surgery in patients with transient ischemic attacks with 133-xenon inhalation tomography

DEFF Research Database (Denmark)

Vorstrup, S; Hemmingsen, Ralf; Lindewald, H

1982-01-01

Cerebral blood flow CBF was studied in 14 patients with transient ischemic attacks TIA and arteriosclerotic neck vessel disease. CBF was measured by a rapidly rotating single photon emission computerized tomograph using Xenon-133 inhalation. This method yields images of 3 brain slices depicting CBF...... with no abnormality on the CT-scan. The abnormal blood flow pattern was found to be unchanged after clinically successful reconstructive vascular surgery. This suggests the presence of irreversible ischemic tissue damage without gross emollition (incomplete infarction). It is concluded, that TIAs are often harmful...... events, as no less than 9 of the 14 patients studied had evidence of complete and/or incomplete infarction. Thorough examination and rational therapy should be instituted as soon as possible to prevent further ischemic lesions....

Subarachnoid hemorrhage enhances endothelin receptor expression and function in rat cerebral arteries

DEFF Research Database (Denmark)

Hansen-Schwartz, Jacob; Hoel, Natalie Løvland; Zhou, Mingfang

2003-01-01

OBJECTIVE: Inspired by organ culture-induced changes in the vascular endothelin (ET) receptor population, we investigated whether such changes occur in cerebral arteries in a rat subarachnoid hemorrhage (SAH) model. METHODS: SAH was induced with injection of 250 microl of blood into the prechiasm......OBJECTIVE: Inspired by organ culture-induced changes in the vascular endothelin (ET) receptor population, we investigated whether such changes occur in cerebral arteries in a rat subarachnoid hemorrhage (SAH) model. METHODS: SAH was induced with injection of 250 microl of blood...... into the prechiasmatic cistern. After 2 days, the middle cerebral artery, basilar artery, and posterior communicating artery were harvested. Pharmacological studies were performed in vitro, and levels of messenger ribonucleic acid (mRNA) were quantified in real-time reverse transcriptase-polymerase chain reaction assays....... RESULTS: In the middle cerebral artery and basilar artery from rats with induced SAH, enhanced biphasic responses to ET-1 were observed. The -log(50% effective concentration) value for the high-affinity phase was approximately 12, compared with approximately 8.5 for sham-operated animals...

Acidentes de trabalho e os religadores automáticos no setor elétrico: para além das causas imediatas

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Alessandro Jose Nunes da Silva

2018-05-01

Full Text Available Resumo: O setor elétrico brasileiro registra elevados índices de mortalidade por acidentes de trabalho que vêm sendo associados à terceirização, introduzida como forma de rebaixamento de custos. Para diminuir o tempo de interrupção do fornecimento de energia aos consumidores, o setor adotou, como solução tecnológica, o religador automático. Essa medida apresenta características perversas para os trabalhadores de manutenção. O objetivo deste estudo é analisar origens e consequências de acidentes de trabalho em sistemas elétricos dotados de religador automático utilizando o Modelo de Análise e Prevenção de Acidentes (MAPA. O MAPA foi usado na investigação de dois acidentes de trabalho visando a explorar as origens organizacionais dos eventos. Caso 1 - ao trocar linha secundária desenergizada, um trabalhador foi atingido por cabo primário energizado (13,8kV. O sistema foi religado três vezes, agravando as lesões (amputação de membro inferior. Caso 2 - acidente de trabalho fatal ocorrido durante instalação de cruzeta nova, em linha energizada, parcialmente isolada. A extremidade de uma mão francesa metálica encostou na linha secundária energizada e eletrocutou o operador de manutenção. O componente desligador do religador automático não funcionou. As análises contribuem para desvelar como a lógica de gestão de negócios pode participar nas origens de acidentes de trabalho via falhas da gestão de manutenção, da gestão de força de trabalho de terceiras e, em especial, da gestão de segurança em sistemas dotados de religadores. As decisões pela automação para garantir a distribuição de energia não podem negligenciar os riscos aos trabalhadores da rede elétrica e, tampouco, deixar de reconhecer a importância do controle sobre as condições de segurança.

A schizophrenic patient with cerebral infarctions after hemorrhagic shock

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Youichi Yanagawa

2013-01-01

Full Text Available We herein report the fourth case of cerebral infarction, concomitant with hemorrhagic shock, in English literature. A 33-year-old male, who had been diagnosed with schizophrenia and given a prescription for Olanzapine, was discovered with multiple self-inflicted bleeding cuts on his wrist. On arrival, he was in hemorrhagic shock without verbal responsiveness, but his vital signs were normalized following infusion of Lactate Ringer′s solution. The neuroradiological studies revealed multiple cerebral ischemic lesions without any vascular abnormality. He was diagnosed with speech apraxia, motor aphasia, and dysgraphia, due to multiple cerebral infarctions. As there was no obvious causative factor with regard to the occurrence of cerebral infarction in the patient, the hypoperfusion due to hemorrhagic shock, and the thromboembolic tendency due to Olanzapine, might have acted together to lead to the patient′s cerebral ischemia.

Attenuated flow‐induced dilatation of middle cerebral arteries is related to increased vascular oxidative stress in rats on a short‐term high salt diet

Science.gov (United States)

Cosic, Anita; Jukic, Ivana; Stupin, Ana; Mihalj, Martina; Mihaljevic, Zrinka; Novak, Sanja; Vukovic, Rosemary

2016-01-01

Key points Recent studies have shown that high salt (HS) intake leads to endothelial dysfunction and impaired vascular reactivity in different vascular beds in both animal and human models, due to increased oxidative stress.The objective of this study was to assess vascular response to flow‐induced dilatation (FID) and to elucidate the role of vascular oxidative stress/antioxidative capacity in middle cerebral arteries (MCAs) of HS‐fed rats in vitro.The novelty of this study is in demonstrating impaired flow‐induced dilatation of MCAs and down‐regulation of vascular antioxidant genes with HS intake, leading to increased levels of oxidative stress in blood vessels and peripheral lymph organs, which together contribute to impaired FID.In addition, results show increased oxidative stress in leukocytes of peripheral lymph organs, suggesting the occurrence of inflammatory processes due to HS intake.Recirculation of leukocytes might additionally increase vascular oxidative stress in vivo. Abstract The aim of this study was to determine flow‐induced dilatation (FID) and the role of oxidative stress/antioxidative capacity in isolated, pressurized middle cerebral arteries (MCAs) of high salt (HS)‐fed rats. Healthy male Sprague‐Dawley rats (11 weeks old) were fed low salt (0.4% NaCl; LS group) or high salt (4% NaCl; HS group) diets for 1 week. Reactivity of MCAs in response to stepwise increases in pressure gradient (Δ10–Δ100 mmHg) was determined in the absence or presence of the superoxide dismutase (SOD) mimetic TEMPOL and/or the nitric oxide synthases (NOS) inhibitor N ω‐nitro‐l‐arginine methyl ester (l‐name). mRNA levels of antioxidative enzymes, NAPDH‐oxidase components, inducible (iNOS) and endothelial nitric oxide synthases (eNOS) were determined by quantitative real‐time PCR. Blood pressure (BP), antioxidant enzymes activity, oxidative stress in peripheral leukocytes, lipid peroxidation products and the antioxidant capacity of plasma

Characteristics of Cerebral Blood Flow in Vascular Dementia using SPM Analysis Compared to Normal Control and Alzheimer's Dementia

Energy Technology Data Exchange (ETDEWEB)

Kang, Do Young; Park, Kyung Won; Kim, Jae Woo [College of Medicine, Univ. of Donga, Busan (Korea, Republic of)

2003-07-01

Cerebral perfusion pattern of vascular dementia (VD) was not well established and overlap of cerebral perfusion pattern was reported between VD and Alzheimer's dementia (AD). The aim of this study is to assess the specific patterns of SPECT finding in VD compared with normal control subjects and to disclose differences of cerebral blood flow between subjects with VD and AD were investigated using statistic parametric mapping analysis. Thirty-two VD (mean age ; 67.86.4 years, mean CDR ; 0.980.27), 51 AD (mean age ; 71.47.2 years, CDR ; 1.160.47), which were matched for age and severity of dementia, and 30 normal control subjects (mean age ; 60.17.7 years) participated in this study. The Tc-99m HMPAO brain perfusion SPECT data were analyzed by SPM99. The SPECT data of the patients with VD were compared to those of the control subjects and then compared to the patients with AD. SPM analysis of the SPECT image showed significant perfusion deficits in the both frontal (both cingulate gyrus, both inferior frontal gyrus, B no.47, right frontal rectal gyrus, left frontal subcallosal gyrus, B no.25), both temporal (right insula, B no.13, left superior temporal gyrus, left parahippocampal gyrus, B no.35), occipital (occipital lingual gyrus), right corpus callosum and right cerebellar tonsil regions in subjects with VD compared with normal control subjects (uncorrected p<0.01). Comparison of the two dementia groups (uncorrected p<0.01) revealed significant hypoperfusion in both parietal posterior central gyrus, right inferior frontal gyrus (B no.47), left insula, right thalamus (ventral lateral nucleus), right claustrum and right occipital cuneus regions in VD group compared with AD. There were no typical confined regional hypoperfusion areas but scattered multiple perfusion deficits in VD compared AD. These findings may be helpful to reflect the pathophysiological mechanisms of VD and to disclose differences of cerebral blood flow between subjects with VD and AD.

Perfil das vítimas de acidentes de transporte terrestre relacionados ao trabalho em unidades de saúde sentinelas de Pernambuco, 2012 - 2014

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Caroline Cordeiro Souto

Full Text Available Resumo OBJETIVO: descrever o perfil das vítimas de acidentes de transporte terrestre (ATT relacionados ao trabalho, notificados nas Unidades Sentinelas de Informação sobre Acidentes de Transporte Terrestre no estado de Pernambuco, Brasil, no período 2012-2014. MÉTODOS: estudo descritivo das vítimas (fatais e não fatais de acidente de transporte terrestre relacionados ao trabalho, notificados em 21 Unidades Sentinelas de Informação sobre ATT de Pernambuco. RESULTADOS: dos 10.691 casos notificados, 87,8% ocorreram entre homens; do total dos registros, 69,0% concentraram-se na faixa etária de 20 a 39 anos; os setores com mais trabalhadores acidentados foram Transporte (24,4% e Comércio (21,3%; a maioria das vítimas eram condutores (82,0% e a motocicleta o meio de locomoção mais utilizado no momento do acidente (77,0%. CONCLUSÃO: entre as vítimas, predominaram motociclistas jovens e do sexo masculino; os achados poderão subsidiar ações intersetoriais de prevenção dos ATT relacionados ao trabalho, adequadas ao perfil das vítimas.

Vascular hemichorea: case report and review

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Bárbara Martínez Alfonzo

2014-04-01

Full Text Available Chorea rarely complicates ischemic or hemorrhagic cerebral vascular lesions. Clinical symptoms usually involve one side of the body while the injury is situated on the contralateral cerebral hemisphere. Spontaneous remission is the norm, but sometimes symptomatic treatment is required. A 58-year-old male patient who suffers from untreated high blood pressure, type II obesity, smokes 6 packs of cigarettes per year and has a moderate intake of alcohol is presented. The patient’s recent history began three days before he appeared at the Emergency Department. His symptoms were ceaseless, involuntary movements in his left arm and foot during day and night with no restriction of voluntary movements. Physical examination and laboratory tests revealed no other findings. Magnetic resonance imaging of the brain showed hyperintensity in the right posterolateral thalamic region consistent with ischemic cerebrovascular disease. Symptomatic therapy was indicated and his underlying conditions were addressed. The importance of this case lies on the low prevalence as well as the scarcity of publications regarding vascular causes of hemichorea, including diagnosis, therapy and prognosis.

Evolução dos acidentes de trânsito em um grande centro urbano, 1991-2000

OpenAIRE

Oliveira,Zenaide Calazans de; Mota,Eduardo Luiz Andrade; Costa,Maria da Conceição N.

2008-01-01

Este estudo descreve a evolução dos acidentes de trânsito em Salvador, Bahia, Brasil, entre 1991 e 2000, utilizando-se dados do Departamento Estadual de Trânsito do Estado da Bahia. Calculou-se taxas globais dos acidentes de trânsito, vítimas e taxas padronizadas de mortalidade por habitante e por veículos, e comparou-se médias destes indicadores para antes (1991 a 1994) e após (1995 a 2000) a adoção de medidas de intervenção como o uso do cinto de segurança e o Código Nacional de Trânsito. A...

Modelling of increased homocysteine in ischaemic stroke: post-hoc cross-sectional matched case-control analysis in young patients Aumento de homocisteína em acidente vascular cerebral isquêmico: análise post-hoc com casos controles em pacientes jovens

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Penka A. Atanassova

2007-03-01

Full Text Available BACKGROUND & PURPOSE: Hyperhomocysteinaemia has been postulated to participate in pathogenesis of ischaemic stroke (IS. However, especially in young adults, there is possibility of significantly increased IS risk due to increased ‘normal’ homocysteinaemia, i.e., ‘hidden’ (‘pathologically dormant’ prevalence within a healthy, normally-defined range. We performed a post-hoc modelling investigation on plasma total homocysteinaemia (THCY in gender- and age-matched young patients in the acute IS phase. We evaluated relationships between THCY and prevalence of other potential risk factors in 41 patients vs. 41 healthy controls. METHOD: We used clinical methods, instrumental and neuroimmaging procedures, risk factors examination, total plasma homocysteine measurements and other laboratory and statistical modelling techniques. RESULTS: IS patients and healthy controls were similar not only for matching variables, but also for smoking, main vitamin status, serum creatinine and lipid profile. Patients with IS, however, had lower vitamin B6 levels and higher THCY, fibrinogen and triglycerides (TGL. At multivariate stepwise logistic regression only increased THCY and TGL were significantly and independently associated with the risk for stroke (72% model accuracy, p model=0.001. An increase of THCY with 1.0 µmol/L was associated with 22% higher risk of ischaemic stroke [adjusted OR=1.22 (95%CI 1.03?1.44]. In this way, novel lower cut-off value for HCY of 11.58 µmol/L in younger patients has been revealed (ROC AUC= 0.67, 95CI% 0.55-0.78, p=0.009. CONCLUSION: The new THCY cut-off clearly discriminated between absence and presence of IS (sensitivity>63%, specificity>68% irrespectively of age and gender and may be applied to better evaluate and more precisely define, as earlier as possible, the young patients at increased IS risk.OBJETIVO: Hiperhomocisteinemia tem sido postulada como um dos fatores de risco na patogênese do acidente vascular

Effects of smoking on regional cerebral blood flow in cerebral vascular disease patients and normal subjects

International Nuclear Information System (INIS)

Kubota, Kazuo; Yamaguchi, Tatsuo; Fujiwara, Takehiko; Matsuzawa, Taiju

1987-01-01

The chronic effect of smoking on the regional cerebral blood flow (r-CBF) was studied by 133-Xenon inhalation method and described with the Initial Slope Index (ISI). Fifty-two patients as the control group who had no abnormality neurologically or with CT scan, 32 patients with old cerebral infarction and 20 patients with old cerebral hemorrhage were introduced to the present study, and these patients were divided into smokers and non-smokers in each group. Those whose smoking index of 200 or more [(number of cigarettes/day) x (years of smoking history) ≥ 200] were designated as smokers. ISI values were decreased significantly in smokers than non-smokers in all groups. Mean ISI value of unaffected hemisphere in smokers decreased by 16 % in the infarction group and 22 % in the hemorrhage group comparing to the non-smokers', respectively. In the control group, mean ISI value of right hemisphere decreased by 15 % and left 14 % in smokers compared to the non-smokers. The r-CBF values in 44 of the 47 smokers were found to be lower than the expected age matched values in non-smokers. Serum high density lipoprotein cholesterol value in smokers was significantly lower than that in non-smokers. We demonstrated preliminarily that the smoking chronically reduced the r-CBF. Advanced atherosclerosis associated with the smoker was suggested to affect the CBF. (author)

Perfil do Inquérito de Violências e Acidentes em Serviços Sentinela de Urgência e Emergência

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Marta Maria Alves da Silva

Full Text Available Resumo O Inquérito de Violências e Acidentes em Serviços Sentinela de Urgência e Emergência (VIVA Inquérito é o componente de vigilância sentinela do Sistema de Vigilância de Violências e Acidentes (VIVA. Sua primeira edição foi realizada em 2006; outras foram realizadas em 2007, 2009, 2011 e 2014. A amostra é composta por vítimas de acidentes e violências atendidas em serviços de urgência e emergência vinculados ao Sistema Único de Saúde (SUS. Os serviços são selecionados de forma intencional, e posteriormente é realizada uma etapa de amostragem probabilística de turnos de 12 horas, por conglomerados em único estágio de seleção. Os dados são coletados por entrevistadores treinados, com formulário padronizado. As variáveis incluem dados sobre o estabelecimento, a vítima, a ocorrência, a lesão e a evolução do caso. O VIVA Inquérito disponibiliza informações fundamentais para a implementação de políticas de enfrentamento das violências e acidentes e promoção da saúde e da paz.

ACTIVITIES RESULTS AIMED AT IMPROVED MEDICAL ASSISTANCE TO THE VASCULAR PATIENTS IN TOMSK REGION

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D. M. Plotnikov

2013-01-01

Full Text Available Acute disorders of cerebral circulation remain serious medical and social problem associated with high disability and mortality rates. Since 2011 Tomsk oblast is a participating member of the medical campaign aimed at improved medical services to the vascular patients. The preliminary implementation data analysis for 2012 revealed improvement of most of the indices of medical support to patients suffering from acute cerebral circulation; increased number of the in-patient cases (Regional Vascular Center and primary vascular department, decreased lethality rates from strokes, specifically hemorrhagic cases. Strict observance of the Regulations on Medical Assistance for stroke patients and the using of modern methods of therapy allowed to decrease hospital mortality in the Primary Vascular Departments and early mortality in the Regional Vascular Center. The active implementation of neurorehabilitation approaches resulted in the increased number of patients who do not require third parties’ assistance. Analysis of the work of the departments helped to identifying current problems and perspectives of further development of special medical care for stroke patients.

Hemodynamics in the cerebral cortex and basal ganglia

International Nuclear Information System (INIS)

Yamaguchi, Shinya; Fukuyama, Hidenao; Yamauchi, Hiroshi; Kimura, Jun

1991-01-01

We examined ten healthy volunteers using positron emission tomography (PET) in order to elucidate regional changes and correlations in the cerebral circulation and oxygen metabolism. We also studied eight lacunar stroke patients so as to disclose the influences of vascular risk factors and aging on the cerebral blood flow and metabolism. We can conclude from our result as follows: (1) Cerebral blood volume (CBV) was minimum in the basal ganglia and cerebral blood flow (CBF)/CBV ratio was higher than that of cerebral cortex in healthy volunteers; (2) CBF of gray matter in healthy volunteers correlated with CBV and cerebral metabolic rate of oxygen where oxygen extraction fraction inversely correlated with CBF, CBV, and CBF/CBV; and (3) the basal ganglia CBF/CBV ratio in lacunar stroke patients was lower than that of healthy volunteers. These findings suggested that the perfusion pressure in the basal ganglia was so high in the normal condition than the angionecrosis or occlusion in the perforating arteries would be induced, especially in the aged and hypertensive patients. (author)

A model of the instantaneous pressure-velocity relationships of the neonatal cerebral circulation.

Science.gov (United States)

Panerai, R B; Coughtrey, H; Rennie, J M; Evans, D H

1993-11-01

The instantaneous relationship between arterial blood pressure (BP) and cerebral blood flow velocity (CBFV), measured with Doppler ultrasound in the anterior cerebral artery, is represented by a vascular waterfall model comprising vascular resistance, compliance, and critical closing pressure. One min recordings obtained from 61 low birth weight newborns were fitted to the model using a least-squares procedures with correction for the time delay between the BP and CBFV signals. A sensitivity analysis was performed to study the effects of low-pass filtering (LPF), cutoff frequency, and noise on the estimated parameters of the model. Results indicate excellent fitting of the model (F-test, p model parameters have a mean correlation coefficient of 0.94 with the measured flow velocity tracing (N = 232 epochs). The model developed can be useful for interpreting clinical findings and as a framework for research into cerebral autoregulation.

Percepção do acidente fatal de trabalho para a família da vítima

OpenAIRE

Moraes,Ana Beatryce Tedesco; Moulin,Maria das Graças Barbosa; Souza,Mariane Lima de; Pepino,Cláudia Balestreiro

2012-01-01

O trabalho humano constitui importante meio de inserção social, implicado na formação de identidade e de reconhecimento social. Em caso de acidente de trabalho fatal, a família sofre os impactos desse fenômeno em sua organização e dinâmica. Esta pesquisa teve por objetivo investigar a percepção do acidente de trabalho fatal para a família de uma vítima no sul do Estado do Espírito Santo, cuja análise se baseou nos seguintes temas: condições de trabalho do acidentado, impactos psicossociais ge...

An intelligent support system for automatic detection of cerebral vascular accidents from brain CT images.

Science.gov (United States)

Hajimani, Elmira; Ruano, M G; Ruano, A E

2017-07-01

This paper presents a Radial Basis Functions Neural Network (RBFNN) based detection system, for automatic identification of Cerebral Vascular Accidents (CVA) through analysis of Computed Tomographic (CT) images. For the design of a neural network classifier, a Multi Objective Genetic Algorithm (MOGA) framework is used to determine the architecture of the classifier, its corresponding parameters and input features by maximizing the classification precision, while ensuring generalization. This approach considers a large number of input features, comprising first and second order pixel intensity statistics, as well as symmetry/asymmetry information with respect to the ideal mid-sagittal line. Values of specificity of 98% and sensitivity of 98% were obtained, at pixel level, by an ensemble of non-dominated models generated by MOGA, in a set of 150 CT slices (1,867,602pixels), marked by a NeuroRadiologist. This approach also compares favorably at a lesion level with three other published solutions, in terms of specificity (86% compared with 84%), degree of coincidence of marked lesions (89% compared with 77%) and classification accuracy rate (96% compared with 88%). Copyright © 2017. Published by Elsevier B.V.

Diagnóstico clínico diferencial entre oclusão da artéria carótida interna e da artéria cerebral média A comparative symptomatological study of internal carotid artery occlusion and middle cerebral artery occlusion

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Roberto Melaragno

1971-03-01

Full Text Available Foi feito um estudo comparativo entre o quadro clínico inicial de 61 casos de oclusão da artéria carótida interna e o de 23 casos de oclusão da artéria cerebral média, diagnosticados pela angiografia cerebral e/ou pela necropsia em pacientes submetidos ou não à cirurgia vascular. Os autores comparam a idade dos pacientes, o sexo, o modo de início da afecção, a existência ou não de convulsões e/ou cefaléias, a ocorrência do acidente cerebral durante o sono ou em vigília, a existência de ictos prévios, os níveis de pressão arterial, o grau de consciência, a força muscular, os achados eletrencefalográficos, a palpação e ausculta das carótidas em nível cervical. Os resultados são demonstrados em índices percentuais, pelos quais os autores inferem que não há significância estatística nesses elementos com três exceções: a maior ocorrência de convulsões nas oclusões da artéria cerebral média em relação às da carótida, a oftalmodinamometria e a sintomatologia carotídea cervical. A oftalmodinamometria revela valores significantemente menores nas pressões da artéria central da retina, no mesmo lado da trombose da carótida em 70,0% dos casos, enquanto que medidas normais e simétricas verificaram-se em todos os casos de oclusão da artéria cerebral média em que o exame foi realizado. No que concerne a sinais arteriais no pescoço, havia anormalidades palpatórias e auscultatórias em 52,4% dos pacientes com trombose da carótida e em 8,6% dos casos com oclusão da cerebral média. Concluem os autores, portanto, que apenas a angiografia cerebral permite um diagnóstico seguro entre ambas as sedes da oclusão.A comparative study of the early clinical picture in 61 cases of internal carotid artery occlusion and 23 cases of middle cerebral artery occlusion, diagnosed by cerebral angiography and/or necropsy in patients who were either submitted to surgery or not operated upon is reported. The authors had

Ergonomia na aviação: um estudo crítico da responsabilidade dos pilotos na causalidade dos acidentes

OpenAIRE

Thomas Martins, Edgard

2006-01-01

Os registros oficiais de acidentes, sempre apontam para o humano como culpado ou como fator contribuinte nos acidentes numa proporção próxima a oitenta por cento. Deve-se considerar que o piloto recebe um artefato que iniciou seu projeto de fabricação alguns anos antes de ser entregue a este profissional. Ele agora é o responsável por mantê-la no ar, com segurança, que pesa 50.000 quilos ou mais e que transporta, cinco toneladas de combustível altamente inflamável e cerca de du...

A vivência dos trabalhadores de Enfermagem que sofreram acidente com fluido biológico: um olhar fenomenológico

OpenAIRE

Carolina Luiza Bernardes

2014-01-01

RESUMO A exposição ocupacional aos fluidos biológicos é inerente ao trabalho desempenhado pela equipe de enfermagem durante a realização da assistência, tornando o trabalhador susceptível a ocorrência de acidentes e exposto aos fluidos corporais que podem conter diferentes patógenos causadores de doenças como HIV, Hepatite B e C. Trata-se de um estudo de natureza qualitativa que objetivou compreender a experiência do acidente com fluido biológico e da assistência prestada aos trabalhadores de...

Microparticle Shedding from Neural Progenitor Cells and Vascular Compartment Cells Is Increased in Ischemic Stroke.

Science.gov (United States)

Chiva-Blanch, Gemma; Suades, Rosa; Crespo, Javier; Peña, Esther; Padró, Teresa; Jiménez-Xarrié, Elena; Martí-Fàbregas, Joan; Badimon, Lina

2016-01-01

Ischemic stroke has shown to induce platelet and endothelial microparticle shedding, but whether stroke induces microparticle shedding from additional blood and vascular compartment cells is unclear. Neural precursor cells have been shown to replace dying neurons at sites of brain injury; however, if neural precursor cell activation is associated to microparticle shedding, and whether this activation is maintained at long term and associates to stroke type and severity remains unknown. We analyzed neural precursor cells and blood and vascular compartment cells microparticle shedding after an acute ischemic stroke. Forty-four patients were included in the study within the first 48h after the onset of stroke. The cerebral lesion size was evaluated at 3-7 days of the stroke. Circulating microparticles from neural precursor cells and blood and vascular compartment cells (platelets, endothelial cells, erythrocytes, leukocytes, lymphocytes, monocytes and smooth muscle cells) were analyzed by flow cytometry at the onset of stroke and at 7 and 90 days. Forty-four age-matched high cardiovascular risk subjects without documented vascular disease were used as controls. Compared to high cardiovascular risk controls, patients showed higher number of neural precursor cell- and all blood and vascular compartment cell-derived microparticles at the onset of stroke, and after 7 and 90 days. At 90 days, neural precursor cell-derived microparticles decreased and smooth muscle cell-derived microparticles increased compared to levels at the onset of stroke, but only in those patients with the highest stroke-induced cerebral lesions. Stroke increases blood and vascular compartment cell and neural precursor cell microparticle shedding, an effect that is chronically maintained up to 90 days after the ischemic event. These results show that stroke induces a generalized blood and vascular cell activation and the initiation of neuronal cell repair process after stroke. Larger cerebral lesions

Microparticle Shedding from Neural Progenitor Cells and Vascular Compartment Cells Is Increased in Ischemic Stroke.

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Gemma Chiva-Blanch

Full Text Available Ischemic stroke has shown to induce platelet and endothelial microparticle shedding, but whether stroke induces microparticle shedding from additional blood and vascular compartment cells is unclear. Neural precursor cells have been shown to replace dying neurons at sites of brain injury; however, if neural precursor cell activation is associated to microparticle shedding, and whether this activation is maintained at long term and associates to stroke type and severity remains unknown. We analyzed neural precursor cells and blood and vascular compartment cells microparticle shedding after an acute ischemic stroke.Forty-four patients were included in the study within the first 48h after the onset of stroke. The cerebral lesion size was evaluated at 3-7 days of the stroke. Circulating microparticles from neural precursor cells and blood and vascular compartment cells (platelets, endothelial cells, erythrocytes, leukocytes, lymphocytes, monocytes and smooth muscle cells were analyzed by flow cytometry at the onset of stroke and at 7 and 90 days. Forty-four age-matched high cardiovascular risk subjects without documented vascular disease were used as controls.Compared to high cardiovascular risk controls, patients showed higher number of neural precursor cell- and all blood and vascular compartment cell-derived microparticles at the onset of stroke, and after 7 and 90 days. At 90 days, neural precursor cell-derived microparticles decreased and smooth muscle cell-derived microparticles increased compared to levels at the onset of stroke, but only in those patients with the highest stroke-induced cerebral lesions.Stroke increases blood and vascular compartment cell and neural precursor cell microparticle shedding, an effect that is chronically maintained up to 90 days after the ischemic event. These results show that stroke induces a generalized blood and vascular cell activation and the initiation of neuronal cell repair process after stroke. Larger

Cerebral angiographic findings in thromboangiitis obliterans

International Nuclear Information System (INIS)

No, Young J.; Lee, Eun M.; Kim, Jong S.; Lee, Deok H.

2005-01-01

Transient ischemic attacks (TIAs) or ischemic stroke may complicate thromboangiitis obliterans (TAO). However, there has been debate regarding the mechanism of ischemic stroke in TAO. We report the case of a patient with TAO who developed repeated TIAs. An angiogram showed multiple alternative areas of arterial occlusions in the distal segments of both middle cerebral arteries. Extensive collateral vessels around the occluded segment were also observed, which resembled the ''tree root'' or ''corkscrew'' vessels described in the peripheral arteries in TAO. Our patient illustrates that cerebral manifestations of TAO may occur with vascular changes that are identical with those encountered in the limb arteries in TAO. (orig.)

Hereditary cerebral hemorrhage with amyloidosis in patients of Dutch origin is related to Alzheimer disease

International Nuclear Information System (INIS)

van Duinen, S.G.; Castano, E.M.; Prelli, F.; Bots, G.T.A.B.; Luyendijk, W.; Frangione, B.

1987-01-01

Hereditary cerebral hemorrhage with amyloidosis in Dutch patients is an autosomal dominant form of vascular amyloidosis restricted to the leptomeninges and cerebral cortex. Clinically the disease is characterized by cerebral hemorrhages leading to an early death. Immunohistochemical studies of five patients revealed that the vascular amyloid deposits reacted intensely with an antiserum raised against a synthetic peptide homologous to the Alzheimer disease-related β-protein. Silver stain-positive, senile plaque-like structures were also labeled by the antiserum, yet these lesions lacked the dense amyloid cores present in typical plaques of Alzheimer disease. No neurofibrillary tangles were present. Amyloid fibrils were purified from the leptomeningeal vessels of one patient who clinically had no signs of dementia. The protein had a molecular weight of ∼ 4000 and its partial amino acid sequence to position 21 showed homology to the β-protein of Alzheimer disease and Down syndrome. These results suggest that hereditary cerebral hemorrhage with amyloidosis of Dutch origin is pathogenetically related to Alzheimer disease and support the concept that the initial amyloid deposition in this disorder occurs in the vessel walls before damaging the brain parenchyma. Thus, deposition of β-protein in brain tissue seems to be related to a spectrum of diseases involving vascular syndromes, progressive dementia, or both

Beta adrenergic overstimulation impaired vascular contractility via actin-cytoskeleton disorganization in rabbit cerebral artery.

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Hyoung Kyu Kim

Full Text Available BACKGROUND AND PURPOSE: Beta adrenergic overstimulation may increase the vascular damage and stroke. However, the underlying mechanisms of beta adrenergic overstimulation in cerebrovascular dysfunctions are not well known. We investigated the possible cerebrovascular dysfunction response to isoproterenol induced beta-adrenergic overstimulation (ISO in rabbit cerebral arteries (CAs. METHODS: ISO was induced in six weeks aged male New Zealand white rabbit (0.8-1.0 kg by 7-days isoproterenol injection (300 μg/kg/day. We investigated the alteration of protein expression in ISO treated CAs using 2DE proteomics and western blot analysis. Systemic properties of 2DE proteomics result were analyzed using bioinformatics software. ROS generation and following DNA damage were assessed to evaluate deteriorative effect of ISO on CAs. Intracellular Ca(2+ level change and vascular contractile response to vasoactive drug, angiotensin II (Ang II, were assessed to evaluate functional alteration of ISO treated CAs. Ang II-induced ROS generation was assessed to evaluated involvement of ROS generation in CA contractility. RESULTS: Proteomic analysis revealed remarkably decreased expression of cytoskeleton organizing proteins (e.g. actin related protein 1A and 2, α-actin, capping protein Z beta, and vimentin and anti-oxidative stress proteins (e.g. heat shock protein 9A and stress-induced-phosphoprotein 1 in ISO-CAs. As a cause of dysregulation of actin-cytoskeleton organization, we found decreased level of RhoA and ROCK1, which are major regulators of actin-cytoskeleton organization. As functional consequences of proteomic alteration, we found the decreased transient Ca(2+ efflux and constriction response to angiotensin II and high K(+ in ISO-CAs. ISO also increased basal ROS generation and induced oxidative damage in CA; however, it decreased the Ang II-induced ROS generation rate. These results indicate that ISO disrupted actin cytoskeleton proteome network

Endovascular treatment of cerebral aneurysms at Altai Regional Vascular Center

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Д. А. Долженко

2015-10-01

Full Text Available A retrospective analysis of the results of endovascular treatment of patients with the brain aneurysms was carried out at the Neurosurgical Department of Regional Clinical Hospital in Barnaul over a period from 2009 to 2011. 52 patients with 57 cerebral aneurysms were included in the study and 55 endovascular interventions were performed. Total embolization (type A was used in 77% of patients, embolization type B was performed in 19% of cases, incomplete embolization (type C occurred in 4% of cases. 14 (26,9% patients were operated in the acute period of SAH. Conclusions are made relating to the effectiveness and relative safety of intravascular treatment of aneurysms, the need for differentiated approaches to the tactics of surgical treatment of patients in the acute period of hemorrhagic stroke due to the rupture of a cerebral aneurysm.

Agreement between instruments for assessing balance after stroke

OpenAIRE

Correia, Anabela; Pimenta, Carla; Alves, Marta; Virella, Daniel

2017-01-01

Introdução – A perturbação do equilíbrio após acidente vascular cerebral (AVC) é importante pela sua frequência e repercussões. Instrumentos de avaliação do equilíbrio validados e de fácil aplicação são necessários para identificar risco de queda e para adequar estratégias de intervenção. Objetivos – Verificar a concordância entre as avaliações do equilíbrio estático, dinâmico e mobilidade funcional após AVC e verificar se a concordância varia com o grau de dependência. Metodologia – Estudo t...

Displasia fibro-muscular de vasos cerebrais: relato de sete casos

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Ápio Cláudio M. Antunes

1974-06-01

Full Text Available Os autores apresentam sete casos de displasia fibro-muscular (DFM, sendo seis deles na artéria carótida e um na artéria vertebral, estudados pelas correspondentes angiografias. São relatadas as histórias clínicas que, em cinco pacientes, são de acidente vascular cerebral isquêmico e, em dois, de hemorragia sub-aracnóide por rotura de aneurisma. Dois pacientes foram à cirurgia: um deles sofreu ligadura de carótida primitiva e outro sofreu endarterectomia para retirada de placa de ateroma da artéria carótida contralateral a aquela com DFM. Finalmente é feita breve discussão sobre a referida patologia, quadro clínico, dignóstico e tratamento, sendo ressaltada a importância do estudo angiográfico carotídeo e vertebral quando encontrada DFM em outro território vascular.

Fatores contribuintes aos acidentes aeronáuticos Factores contribuyentes de accidentes aeronáuticos Contributive factors to aviation accidents

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Marcia Fajer

2011-04-01

Full Text Available O objetivo do estudo foi comparar os resultados de investigações de acidentes aeronáuticos brasileiros do Centro de Investigação e Prevenção de Acidentes Aeronáuticos (Cenipa com os do sistema de análise e classificação de fatores humanos (Human Factors Analysis and Classification System - HFACS. Foram analisados e comparados os relatórios finais de 36 investigações de acidentes aeronáuticos ocorridos entre 2000 e 2005, no estado de São Paulo. Foram mencionados 163 fatores contribuintes dos acidentes aeronáuticos nos relatórios do Cenipa, enquanto 370 foram identificados por meio do HFACS. Conclui-se que as análises do Cenipa não contemplaram fatores organizacionais associados aos acidentes aéreos.El objetivo del estudio fue comparar los resultados de investigaciones de accidentes aeronáuticos brasileños del Centro de Investigación y Prevención de Accidentes Aeronáuticos (CENIPA con los del sistema de análisis y clasificación de factores humanos (Human Factors Analysis and Classification System - HFACS. Se analizaron y compararon los informes finales de 36 investigaciones de accidentes aeronáuticos ocurridos entre 2000 y 2005, en el estado de Sao Paulo, Sureste de Brasil. Se mencionaron 163 factores contribuyentes de accidentes aeronáuticos en los informes del CENIPA, mientras que 370 fueron identificados por medio del HFACS. Se concluye que los análisis del CENIPA no contemplaron factores organizacionales asociados con los accidentes aéreos.The objective of the study was to compare the results of aviation accident analyses performed by the Center for Investigation and Prevention of Aviation Accidents (CENIPA with the method Human Factors Analysis and Classification System (HFACS. The final reports of thirty-six general aviation accidents occurring between 2000 and 2005 in the State of São Paulo, Southeastern Brazil were analyzed and compared. CENIPA reports mentioned 163 contributive factors, while HFACS

Vivenciando a sobrecarga ao vir-a-ser um cuidador familiar de pessoa com acidente vascular cerebral (AVC: análise do conhecimento Viviendo la sobrecarga al convertirse en cuidador familiar de personas con accidente cerebrovascular: análisis del conocimiento Living the burden in becoming a family caregiver for a cerebrovascular accident survivor: knowledge analysis

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Silvia Cristina Mangini Bocchi

2004-02-01

Full Text Available Trata-se de trabalho do tipo bibliográfico com a finalidade de fazer uma análise temática da produção do conhecimento em periódicos, acerca da sobrecarga em cuidadores familiares de pessoas com Acidente Vascular Cerebral (AVC. O corpus de análise reuniu artigos localizados nas décadas de 80 e 90, a partir das bases de dados Medline, Lilacs e Cinahl. A análise de conteúdo foi o referencial metodológico que permitiu organizar todo o conhecimento, em um corpo de categorias e subcategorias, denominadas: Categoria 1 - As seqüelas do AVC gerando sobrecarga; Categoria 2 - Aspectos gerando sobrecarga, congregando as subcategorias: o isolamento social, as mudanças e as insatisfações conjugais, as dificuldades financeiras e os déficits na saúde física e no autocuidado do cuidador; Categoria 3 - Outras análises relacionadas à sobrecarga em cuidadores familiares.Se trata de un trabajo del tipo bibliográfico con la finalidad de hacer un análisis temático de producción del conocimiento en revistas, sobre la carga de cuidadores familiares de personas con Accidente Cerebrovascular (ACV. El corpus de análisis reunió artículos realizados en las décadas de 80 y 90 a partir de las bases de datos Medline, Lilacs y Cinahl. El análisis de contenido fue el referencial metodológico que permitió organizar todo el conocimiento en un cuerpo de categorías y subcategorías denominadas: categoría 1 - Las secuelas del ACV generando carga, Categoría 2 - Aspectos generadores de la carga que congregan las subcategorías: el aislamiento social, los cambios y las insatisfacciones conyugales, las dificultades financieras y los déficit en la salud física y en el cuidado consigo mismo, Categoría 3 - Otros análisis sobre la carga de cuidadores familiares de personas con ACV.This bibliographical research aims to carry out a thematic analysis of knowledge production in periodicals, about the burden placed on family caregivers of Cerebrovascular

Reduced cerebral oxygen–carbohydrate index during endotracheal intubation in vascular surgical patients

DEFF Research Database (Denmark)

Fabricius-Bjerre, Andreas; Overgaard, Anders; Winther-Olesen, Marie

2015-01-01

Brain activation reduces balance between cerebral consumption of oxygen versus carbohydrate as expressed by the so-called cerebral oxygen-carbohydrate-index (OCI). We evaluated whether preparation for surgery, anaesthesia including tracheal intubation and surgery affect OCI. In patients undergoing...... aortic surgery, arterial to internal jugular venous (a-v) concentration differences for oxygen versus lactate and glucose were determined from before anaesthesia to when the patient left the recovery room. Intravenous anaesthesia was supplemented with thoracic epidural anaesthesia for open aortic surgery...

Response of local vascular volumes to lower body negative pressure stress

Science.gov (United States)

Wolthuis, R. A.; Leblanc, A.; Carpentier, W. A.; Bergman, S. A., Jr.

1975-01-01

The present study involved an intravenous injection of radioactive iodinated serum albumin, equilibration of this isotope within the vascular space, and the continuous measurement of isotope activity over selected anatomical areas before, during and following multiple human LBNP tests. Both rate and magnitude of vascular pooling were distinctly different within each of five selected lower body anatomical areas. In the upper body, all areas except the abdomen showed depletions from their resting vascular volumes during LBNP. The presence of uniquely different pooling patterns in the lower body, the apparent stability of abdominal vascular volumes, and a possible decrease in cerebral blood volume during LBNP represent the major findings of this study.

Angiografía cerebral y muerte encefálica

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Angel J Lacerda Gallardo

1997-08-01

Full Text Available Este trabajo se realizó como parte de un protocolo de estudio, el cual fue aplicado a 57 pacientes atendidos por el servicio de Neurocirugía del Hospital Clinicoquirúrgico "Manuel Ascunce Domenech" de Camagüey, durante el período comprendido entre enero de 1993 y diciembre de 1994. Se realizaron estudios angiográficos a 50 pacientes (87,72 %, de los que se obtuvieron 55 angiogramas cerebrales. En 49 exámenes (89 %, se observó ausencia de flujo sanguíneo cerebral con distintos tipos de patrones vasculares, en la arteria carótida interna extra e intracraneal, lo cual confirma su utilidad en el diagnóstico de la muerte encefálica (ME. En 3 pacientes, con craniectomías osteoclásticas de más de 5 cm, no se demostró ausencia de flujo sanguíneo cerebral, a pesar del estado clínico de ME. No aparecieron complicaciones durante este proceder, gracias a la cuidadosa técnica utilizada. Los patrones vasculares demostrados sugieren realizar un estudio más detallado donde se compare esta imagen con el parámetro presión intracraneal (PIC elevadaThis work was carried out as a part of a study protocol which was applied to 57 patients treated at the Neurosurgical Servicie of "Manuel Ascunce Domenech" Clinicosurgical Hospital, Camagüey during January, 1993 and December, 1994. Angiographic studies were performed to 50 patients (87.72 % from which 55 cerebral angiograms were obtained. In 49 examinations (89 % absenece of brain blood flow was observed with different types of vascular patterns in the extra and intracraneal inner carotid artery proving its usefulness for the diagnosis of brain death. In 3 patients with osteoclastic cranioctomies greater than 5 cm, the absence of cerebral blood flow was not proved despite the clinical status of brain death. No complications were observed during the procedure thanks to the so careful technique that was used. Vascular patterns evidenced suggest that it is necessary to perform a more detailed study to

A study of radiation-induced cerebral vascular injury in nasopharyngeal carcinoma patients with radiation-induced temporal lobe necrosis.

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Jianhong Ye

Full Text Available To investigate radiation-induced carotid and cerebral vascular injury and its relationship with radiation-induced temporal lobe necrosis in nasopharyngeal carcinoma (NPC patients.Fifty eight NPC patients with radiation-induced temporal lobe necrosis (TLN were recruited in the study. Duplex ultrasonography was used to scan bilateral carotid arterials to evaluate the intima-media thickness (IMT and occurrence of plaque formation. Flow velocities of bilateral middle cerebral arteries (MCAs, internal carotid arteries (ICAs and basal artery (BA were estimated through Transcranial Color Doppler (TCD. The results were compared with data from 33 patients who were free from radiation-induced temporal lobe necrosis after radiotherapy and 29 healthy individuals.Significant differences in IMT, occurrence of plaques of ICAs and flow velocities of both MCAs and ICAs were found between patients after radiotherapy and healthy individuals (p<0.05. IMT had positive correlation with post radiation interval (p = 0.049. Compared with results from patients without radiation-induced TLN, the mean IMT was significantly thicker in patients with TLN (p<0.001. Plaques were more common in patients with TLN than patients without TLN (p = 0.038. In addition, flow velocities of MCAs and ICAs in patients with TLN were much faster (p<0.001, p<0.001. Among patients with unilateral TLN, flow velocity of MCAs was significantly different between ipsilateral and contralateral sides to the lesion (p = 0.001.Thickening of IMT, occurrence of plaque formation and hemodynamic abnormality are more common in patients after radiotherapy, especially in those with TLN, compared with healthy individuals.

Metodologia de análise espacial para identificação de locais críticos considerando a severidade dos acidentes de trânsito

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Marcelo Pereira Queiroz

2009-12-01

Full Text Available

Este artigo descreve e aplica uma metodologia de análise espacial para identificação dos locais críticos de acidentes de trânsito com base no índice de severidade do acidente, permitindo ao analista selecionar a forma mais adequada para tratamento de cada local crítico na malha viária de uma cidade. Como principal ferramenta de análise, utiliza-se a rotina de agrupamento espacial do vizinho mais próximo a qual possibilita identificar e representar os locais críticos (interseções, trechos, corredores e áreas de ocorrência de eventos espaciais em um mapa digital por intermédio do conceito de elipse de desvio padrão. Acredita-se que este trabalho apresenta uma significativa contribuição para a elaboração de novas metodologias de estudos de acidentes de trânsito que incorporem outras variáveis relacionadas aos acidentes, como volume de tráfego, e também outros eventos de caráter espacial que contribuem para a ocorrência deste grave fenômeno urbano.

Vascular injuries of the upper extremity Lesões vasculares de membros superiores

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Raafat Shalabi

2006-12-01

álise retrospectiva de 5 anos. De 01/01/2001 a 31/12/2005, 165 pacientes foram operados devido a lesões vasculares no King Fahd Hospital, Medina, Arábia Saudita. De todos os pacientes com trauma vascular periférico (115, trauma de membros superiores esteve presente em 58. O diagnóstico foi realizado por exame físico e Doppler manual isoladamente ou associado com ultra-som Doppler/angiografia. A restauração vascular primária foi realizada sempre que possível; do contrário, utilizou-se a interposição de veia. A fasciotomia foi considerada quando necessário. Pacientes com lesão de membro inferior não resgatável necessitando de amputação foram excluídos do estudo. RESULTADOS: Cinqüenta pacientes eram homens (86% e oito eram mulheres (14%, com idade entre 2,5 e 55 anos (média de 23 anos. A duração média de apresentação foi 8 h pós-lesão. O fator etiológico mais comum foi acidente em estradas, sendo responsável por 50,5% no grupo de trauma contuso e 33% entre as lesões penetrantes e por arma branca. A incidência de lesões ortopédicas concomitantes foi muito alta em nosso estudo (51%. A artéria braquial foi a mais afetada (51%. A interposição de veias foi utilizada em 53% dos casos. A taxa de preservação de membros foi de 100%. CONCLUSÃO: Pacientes que sofrem lesões vasculares de membros superiores devem ser transferidos para centros de cirurgia vascular o mais rápido possível. O tratamento imediato do trauma vascular periférico aumentará a sobrevida dos pacientes e a preservação dos membros. Devem-se estabelecer prioridades no tratamento de lesões associadas e evitar o atraso quando alterações isquêmicas estiverem presentes.

Multiple Spontaneous Cerebral Microbleeds and Leukoencephalopathy in PSEN1-Associated Familial Alzheimer's Disease: Mirror of Cerebral Amyloid Angiopathy?

Science.gov (United States)

Floris, Gianluca; Di Stefano, Francesca; Cherchi, Maria Valeria; Costa, Gianna; Marrosu, Francesco; Marrosu, Maria Giovanna

2015-01-01

Cerebral microbleeds (CMB) might reflect specific underlying vascular pathologies like cerebral amyloid angiopathy (CAA). In the present study we report the gradient-echo MRI pattern of two siblings with P284S PSEN1 mutation. T2* gradient-echo images of the two subjects demonstrated multiple microbleeds in lobar regions. The role and causes of CMB in sporadic Alzheimer's disease (AD) patients have not been clearly established and useful contributions could derive from familial AD studies. Furthermore, since CAA is a potential risk factor for developing adverse events in AD immunization trials, the identification in vivo of CAA through non-invasive MRI methods could be useful to monitoring side effects.

Arterial spasm as a finding intimately associated with the onset of vascular headache

International Nuclear Information System (INIS)

Garnic, J.D.; Schellinger, D.

1983-01-01

A patient with migraine headaches of the ''cluster'' variant type is presented in whom vasospasm of the middle cerebral artery, the anterior cerebral artery and the internal carotid artery triggered a pain episode identical in character and severity to the headaches which had led to his investigation. Vasospasm associated with the painful phase of headache in this case conflicts with the more accepted theory that the pain phase of a vascular headache is related to vasodilatation of cerebral or extracerebral vessels. The literature is reviewed. (orig.)

Cine gamma-angiography. Aids for the diagnosis of cerebral vascular disease

International Nuclear Information System (INIS)

Grasset, Gilles.

1975-01-01

Gamma-angioencephalography allows in a simple examination, the bilateral visualization of the injection of the main cerebral vessels, the regional measurement of transit times and, if it occurs, the observation of the diffusion of the tracer in a lesion. These different steps of the investigation are described and its diagnostic value is discussed. Sup(99m)Tc is the radioisotope used. To increase the accuracy of the qualitative data obtained from the gamma camera, a data processing system is used. Regions of interest are selected over the carotid and cerebral middle arteries. Time function curves are generated for each region of interest. From mathematical models, some pathological aspects of transit curves can be explained [fr

Homocisteína e transtornos psiquiátricos Homocysteine and neuropsychiatric disorders

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Perminder Sachdev

2004-03-01

Full Text Available O autor apresenta uma visão geral da literatura atual sobre homocisteína como um fator de risco para os transtornos neuropsiquiátricos. Foram pesquisados os bancos de dados MEDLINE, Current Contents e EMBASE (entre 1966 e 2002 para publicações em língua inglesa utilizando as palavras-chave ''Homocisteína'' e ''AVC''; ''Doença de Alzheimer''; ''Déficit Cognitivo'', ''Epilepsia'', ''Depressão'' ou ''Doença de Parkinson''. Artigos individuais foram pesquisados para referências cruzadas relevantes. É biologicamente plausível que altos níveis de homocisteína possam causar lesão cerebral e transtornos neuropsiquiátricos. A homocisteína é pró-aterogênica e pró-trombótica. Dessa forma, aumenta o risco de acidente vascular cerebral, podendo ter um efeito neurotóxico direto. Evidências de que a homocisteína seja um fator de risco para doença microvascular cerebral são conflitantes, mas justificam maiores estudos. Estudos transversais e alguns longitudinais suportam a crescente prevalência de acidente vascular cerebral e demência vascular em indivíduos com hiper-homocisteinemia. As evidências de crescente neurodegeneração estão se acumulando. A relação com a depressão ainda é experimental, da mesma forma como com a epilepsia. Atualmente, estudos sobre tratamentos são necessários para colocar as evidências sobre bases mais sólidas. Os pacientes de alto risco também devem ser pesquisados para hiper-homocisteínemia, cujo tratamento deve ser feito com ácido fólico. Mais evidências são necessárias antes que pesquisas populacionais possam ser recomendadas.The author presents an overview of the current literature on homocysteine as a risk factor for neuropsychiatric disorders. The databases MEDLINE, Current Contents and EMBASE were searched (between 1966 and 2002 for English language publications with the key words 'Homocysteine' and 'Stroke'; 'Alzheimer Disease'; 'Cognitive Impairment'; 'Epilepsy'; 'Depression

Regional cerebral blood flow levels as measured by xenon-CT in vascular territorial low-density areas after subarachnoid hemorrhage are not always ischemic

International Nuclear Information System (INIS)

Fainardi, E.; Tagliaferri, M.F.; Compagnone, C.; Tanfani, A.; Cocciolo, F.; Targa, L.; Chieregato, A.; Battaglia, R.; Frattarelli, M.; Pascarella, R.

2006-01-01

The aim of this study was to assess regional cerebral blood flow (rCBV) in areas of CT hypoattenuation appearing in the postoperative period in patients treated for aneurysmal subarachnoid hemorrhage (SAH) using xenon-enhanced CT scanning (Xe-CT). We analyzed 15 patients (5 male and 10 female; mean age 49.7±12.1 years) with SAH on CT performed on admission to hospital and who showed a low-density area within a well-defined vascular territory on CT scans after clipping or coiling of a saccular aneurysm. All zones of hypoattenuation were larger than 1 cm 2 and showed signs of a mass effect suggesting a subacute phase of evolution. Two aneurysms were detected in two patients. Aneurysms were located in the middle cerebral artery (n=7), in the anterior communicating artery (n=6), in the internal carotid artery (n=3), and in the posterior communicating artery (n=1). Treatments were surgical (n=8), endovascular (n=2) or both (n=1). A total of 36 Xe-CT studies were performed and rCBF values were measured in two different regions of interest (ROI): the low-density area, and an area of normal-appearing brain tissue located symmetrically in the contralateral hemisphere. rCBF levels were significantly lower in the low-density area than in the contralateral normal-appearing area (P 55 ml/100 g per minute) in 2/36 lesions (5.6%). Our study confirmed that rCBF is reduced in new low-density lesions related to specific vascular territories. However, only about one-third of the lesions showed rCBF levels consistent with irreversible ischemia and in a relatively high proportion of lesions, rCBF levels indicated penumbral, oligemic and hyperemic areas. (orig.)

Análise e classificação dos fatores humanos nos acidentes industriais Analysis and classification of the human factors in industrial accidents

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Cármen Regina Pereira Correa

2007-04-01

Full Text Available O presente texto apresenta a evolução do conhecimento do fenômeno "acidente", mostrando a mudança do conceito do acidente como obra do destino para um componente do processo produtivo de qualquer segmento - industrial, aeronáutico, serviços, transporte dentre outros. O método de análise e classificação dos fatores humanos nos acidentes é apresentado e discutido quanto à viabilidade de implementação. Finalmente, conclui-se que a forma atual e moderna para prevenção de acidentes está baseada na identificação antecipada das falhas latentes da organização e do sistema, e que a ferramenta apresentada contribui para a gestão proativa e conseqüentemente para a diminuição do impacto dos acidentes do trabalho no processo produtivo.The present text presents the evolution of the knowledge of the phenomenon "accident", showing the change of the concept of the accident as workmanship of the destination for one component of the productive process of any segment - industrial, aeronautical, services, transports amongst others. The method of analysis and classification of the human factors in the accidents is presented and argued how much to the implementation viability. Finally one concludes that the current and modern form for prevention of accidents is based on the anticipated identification of the latent failures of the organization and the system, and that the presented tool contributes consequently for the pro-active management and in the reduction of the impact of the employment-related accidents in the productive process.

A Means for the Scintigraphic Imaging of Regional Brain Dynamics. Regional Cerebral Blood Flow and Regional Cerebral Blood Volume

Energy Technology Data Exchange (ETDEWEB)

Potchen, E. J.; Bentley, R.; Gerth, W.; Hill, R. L.; Davis, D. O. [Washington University School Of Medicine, St. Louis, MO (United States)

1969-05-15

The use of freely diffusable inert radioactive gas as a washout indicator to measure regional cerebral blood flow has become a standardized kinetic procedure in many laboratories. Recent investigations with this technique have led us to conclude that we can reliably distinguish regional flow with perfusion against regional flow without perfusion from the early portion of the curve. Based on a detailed study of the early curve kinetics in patients with and without cerebral vascular disease we have defined the sampling duration necessary for application of the Anger gamma camera imaging process to regional changes in cerebral radioactivity. Using a standard camera and a small computer, a procedure has been developed and based upon entire field to determine the time of maximum height followed by analysis of the data in a matrix. This will permit a contour plot presentation of calculated regional cerebral blood flow in millilitres per 100 grams perfused brain per minute. In addition, we propose to augment this data by the display of regional non-perfusion blood flow versus regional cerebral flow with perfusion. Preliminary investigation on sampling duration, and Compton scattering were prerequisite to clinical scintigraphy of regional cerebral blood flow. In addition, the method of interface for the conventional Anger gamma camera to digital computers used in this procedure are discussed. Applications to further assess regional cerebral dynamics by scintigraphy are presented. (author)

O Acidente do trabalho e a responsabilidade civil do empregador

OpenAIRE

CAIRO JUNIOR, José

2002-01-01

O contrato de trabalho tem o seu conteúdo mínimo formado por cláusulas obrigatórias legais que, dentre outras determinações, impõem ao empregador zelar pela incolumidade psicofisiológica dos seus empregados. Vista sob esta ótica percebe-se que, em caso de dano sofrido pelo empregado, vítima de acidente do trabalho, a responsabilidade tem nítida natureza contratual, posto que decorrente de um inadimplemento contratual. A questão social impulsionou o surgimento de uma denomina...

Acidentes por lepidópteros (larvas e adultos de mariposas): estudo dos aspectos epidemiológicos, clínicos e terapêuticos

OpenAIRE

Cardoso,Alberto Eduardo Cox; Haddad Junior,Vidal

2005-01-01

Os autores apresentam e discutem aspectos dos acidentes causados por larvas de lepidópteros (mariposas), enfatizando as manifestações dermatológicas e a dor intensa que caracterizam estes agravos. Além disso, são apresentadas larvas de mariposas que causam manifestações extracutâneas, tais como severos distúrbios de coagulação e artropatias anquilosantes, e ainda dermatites provocadas por insetos adultos. Os principais grupos de lepidópteros causadores de acidentes em humanos são demonstrados...

Short-term prognosis for speech and language in first stroke patients Prognóstico em curto prazo para fala e linguagem em pacientes acometidos de infarto cerebral único

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Fabricio F. Oliveira

2009-09-01

Full Text Available OBJECTIVE: To evaluate the factors that can influence evolution of communication after a first stroke. METHOD: Thirty-seven adult patients were evaluated for speech and language within 72 hours after a single first-ever ischemic brain injury and later on. Patients who were comatose, with decompensated systemic diseases, or history of chronic alcoholism or illicit drug use were not included. Brain CT and/or 2T-MR exams were solicited for topographic correlation. Size of infarct was classified as large or small according to the TOAST classification. RESULTS: Patients who survived had lesser chances of presenting with aphasia or dysarthria 3 months after the stroke if the infarct size was small (p=0.017. Gender, age, schooling, aphasia subtype, infarct side and topography were non-significant in our sample. Subjects with global aphasia or lone cortical dysarthria had a slower evolution. CONCLUSION: Brain injury size was the most influential factor for neurological outcome at 3 months post-stroke.OBJETIVO: Avaliar os fatores que podem influenciar o desempenho neurolinguístico após um primeiro acidente vascular cerebral isquêmico. MÉTODO: Foram avaliados 37 pacientes quanto a fala e linguagem dentro de 72 horas após um primeiro infarto cerebral e posteriormente. Pacientes comatosos, com doenças sistêmicas descompensadas, história de etilismo crônico ou uso de drogas ilícitas não foram incluídos. TC e/ou RMN-2T cerebrais foram solicitadas para correlação topográfica. Utilizou-se a classificação TOAST para o tamanho do infarto (grande ou pequeno. RESULTADOS: Sobreviventes tiveram menores chances de apresentarem-se afásicos ou disártricos 3 meses após o evento agudo caso o infarto fosse pequeno (p=0.017. Gênero, idade, escolaridade, subtipo de afasia, lado e topografia da lesão cerebral não foram fatores estatisticamente significativos. Pacientes portadores de afasia global ou disartria cortical isolada evoluíram mais lentamente

Transcranial Doppler for detection of cerebral ischaemia during carotid endarterectomy

DEFF Research Database (Denmark)

Jørgensen, L G; Schroeder, T V

1992-01-01

We evaluated transcranial Doppler sonography (TCD) for the detection of cerebral ischaemia during carotid endarterectomy in 30 male and 14 female patients with ipsilateral focal cerebro-vascular symptoms. Surgery was performed during halothane-nitrous oxide anaesthesia with moderate hypocapnia...

Time Course of Changes in Extravascular Lung Water Index, Intracranial and Cerebral Perfusion Pressures in Acute Cerebral Circulatory Disorders

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Yu. A. Churlyaev

2009-01-01

Full Text Available Objective: to study the time course of changes in extravascular lung water index (ELWI and intracranial and cerebral perfusion pressures (ICP and CPP and to determine their possible relationships in acute cerebral circulatory disorders (ACCD. Subject and methods. ELWI, pulmonary vascular permeability index (PVPI, ICP, CPP, and central hemodynamics were studied by transpulmonary thermodilution and current X-ray studies were conducted in 18 patients on days 1, 3, 5, and 7 of ACCD. Results. Examinations revealed a supratentorial dislocation of the brain in 6 persons; its subtento-rial dislocation was found in 1 case; supra- and subtentorial dislocations were seen in 6. In patients, ELWI and PVPI increased from days 1 and 5, respectively. The high baseline ICP increased over time. CPP remained unchanged. Preserved left ventricular contractility, enhanced myocardial one, a significant direct correlation between ELWI and PVPI, as well as their increase confirmed that the noncardiogenic genesis was responsible for increased ELWI. A direct significant correlation was found between ICP and ELWI, ICP and PVPI. Against this background, acute respiratory distress syndrome developed in 14 patients with pneumonia evolving in its presence in 7 patients. Conclusion. In ACCD, ELWI increases in the first 24 hours of the acute period. One of its causes is, along with others, primary and/or secondary damage to the brainstem structures with elevated ICP and progressive brain dislocation. The determination of ICP, unlike CPP, is crucial in the diagnosis and treatment of primary/secondary brain injuries and in prognosis. Key words: acute cerebral circulatory disorder, extravascular lung fluid, pulmonary vascular permeability, intracranial pressure, cerebral perfusion pressure, acute respiratory distress syndrome.

Cerebral Perfusion Enhancing Interventions: A New Strategy for the Prevention of Alzheimer Dementia.

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de la Torre, Jack C

2016-09-01

Cardiovascular and cerebrovascular diseases are major risk factors in the development of cognitive impairment and Alzheimer's disease (AD). These cardio-cerebral disorders promote a variety of vascular risk factors which in the presence of advancing age are prone to markedly reduce cerebral perfusion and create a neuronal energy crisis. Long-term hypoperfusion of the brain evolves mainly from cardiac structural pathology and brain vascular insufficiency. Brain hypoperfusion in the elderly is strongly associated with the development of mild cognitive impairment (MCI) and both conditions are presumed to be precursors of Alzheimer dementia. A therapeutic target to prevent or treat MCI and consequently reduce the incidence of AD aims to elevate cerebral perfusion using novel pharmacological agents. As reviewed here, the experimental pharmaca include the use of Rho kinase inhibitors, neurometabolic energy boosters, sirtuins and vascular growth factors. In addition, a compelling new technique in laser medicine called photobiomodulation is reviewed. Photobiomodulation is based on the use of low level laser therapy to stimulate mitochondrial energy production non-invasively in nerve cells. The use of novel pharmaca and photobiomodulation may become important tools in the treatment or prevention of cognitive decline that can lead to dementia. © 2016 International Society of Neuropathology.

Anatomic vascular phantom for the verification of MRA and XRA visualization and fusion

International Nuclear Information System (INIS)

Mankovich, N.J.; Lambert, T.; Zrimec, T.; Hiller, J.

1995-01-01

A project is underway to develop automated methods of fusing cerebral magnetic resonance angiography (MRA) and x-ray angiography (XRA) for creating accurate visualizations used in planning treatment of vascular disease. The authors have developed a vascular phantom suitable for testing segmentation and fusion algorithms with either derived images (pseudo-MRA/pseudo-XRA) or actual MRA or XRA image sequences. The initial unilateral arterial phantom design, based on normal human anatomy, contains 48 tapering vascular segments with lumen diameters from 2.5 millimeter to 0.25 millimeter. The initial phantom used rapid prototyping technology (stereolithography) with a 0.9 millimeter vessel wall fabricated in an ultraviolet-cured plastic. The model fabrication resulted in a hollow vessel model comprising the internal carotid artery, the ophthalmic artery, and the proximal segments of the anterior, middle, and posterior cerebral arteries. The complete model was fabricated but the model's lumen could not be cleared for vessels with less than 1 millimeter diameter. Measurements of selected vascular outer diameters as judged against the CAD specification showed an accuracy of 0.14 mm and precision (standard deviation) of 0.15 mm. The plastic vascular model produced provides a fixed geometric framework for the evaluation of imaging protocols and the development of algorithms for both segmentation and fusion

Epidemiologia do acidente por serpentes peçonhentas: estudo de casos atendidos em 1988

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Lindioneza Adriano Ribeiro

1995-10-01

Full Text Available Foram avaliados aspectos epidemiológicos de acidentes por serpentes peçonhentas no Estado de São Paulo, Brasil, com base em prontuários de 322 pacientes e em entrevistas feitas com 209 deles e/ou seus acompanhantes. Os acidentes ocorreram principalmente com pessoas de 10 a 20 anos de idade, do sexo masculino, nos meses de outubro a abril e no período diurno. As regiões anatômicas mais freqüentemente picadas foram os pés, as mãos e as pernas. Bothrops, Crotalus e Micrurus foram responsáveis por, respectivamente, 95,0%, 4,4% e 0,6% dos casos. Não ocorreram óbitos, mas 2,2% dos pacientes apresentaram seqüelas. Dentre os 209 entrevistados, a ocupação de lavrador foi a mais freqüentemente relacionada ao acidente que, em aproximadamente 60% das vezes, ocorreu durante o trabalho. O total de 160 pacientes (76,6% submeteram-se a alguma forma de tratamento antes de chegarem a um serviço de saúde: foram mais comuns o uso de torniquete (50,2%, a expressão local na tentativa de retirar parte do veneno (33,5%, a colocação das mais diversas substâncias sobre o local da picada (36,8% e a ingestão de outras (12,9%; pouco mais de um quarto dos pacientes submeteram-se a alguma forma de tratamento médico antes de chegar ao HVB sendo mais comum a antissepsia (8,2%, a administração do antiveneno (6,2%, de anti-histamínicos (5,7% e de analgésicos (5,3%.

Comparison of acetazolamide-enhanced brain SPECT using Tc-99m ECD with cerebral angiography in patients with cerebrovascular disease

International Nuclear Information System (INIS)

Choi, Y. Y.; Moon, D. H.; Ryu, J. S.; Yang, S. H.; Lee, H. K.; Lee, J. H.; Kim, J. S.; Kim, K. A.

1997-01-01

Cerebral vascular reserve can be assessed by development of collateral channels (DCC) on cerebral angiography(CA) or vasoreactivity (VR) on acetazolamide-enhanced brain SPECT (ACZ-SPECT). The purpose of this study was to compare Tc-99m ECD ACZ-SPECT with CA in the evaluation of vascular reserve in patients (pts) with cerebrovascular disease(CVD). Twenty seven patients with CVD, including TIA (n=13), infarction (n=11) and asymptomatic pts (AS, n=3), underwent CA and ACZ-SPECT. Basal and ACZ-SPECT was obtained consecutively, and image subtraction was performed. On CA, degree of DCC was scored 0-3 (0: normal, 3: poor) according to parenchymal staining on delayed film. In ACZ-SPECT, decrease of VR was graded 0-3 (0: normal, 3: more than 30% decrease). The correlation between degree of stenosis, DCC and VR were analyzed. 1) Variable degree of VR or DCC was observed in totally occluded or stenotic cerebral arterial territories. 2) In arterial territories with poor DCC, ACZ-SPECT showed poor VR. However, in 5 out of 11 TIA or AS with good DCC, poor VR was observed. These data suggests that 1) cerebral hemodynamic status cannot be assessed by the degree of stenosis on CA alone. 2) DCC may overestimate the cerebral vascular reserve in patients with TIA or AS. 3) ACZ-SPECT plays a complementary role to CA for evaluation of cerebral hemodynamic status in pts with CVD

Arterial spasm as a finding intimately associated with the onset of vascular headache

Energy Technology Data Exchange (ETDEWEB)

Garnic, J.D.; Schellinger, D.

1983-03-01

A patient with migraine headaches of the ''cluster'' variant type is presented in whom vasospasm of the middle cerebral artery, the anterior cerebral artery and the internal carotid artery triggered a pain episode identical in character and severity to the headaches which had led to his investigation. Vasospasm associated with the painful phase of headache in this case conflicts with the more accepted theory that the pain phase of a vascular headache is related to vasodilatation of cerebral or extracerebral vessels. The literature is reviewed.

Comprehensive Overview of Contemporary Management Strategies for Cerebral Aneurysms.

Science.gov (United States)

Manhas, Amitoz; Nimjee, Shahid M; Agrawal, Abhishek; Zhang, Jonathan; Diaz, Orlando; Zomorodi, Ali R; Smith, Tony; Powers, Ciarán J; Sauvageau, Eric; Klucznik, Richard P; Ferrell, Andrew; Golshani, Kiarash; Stieg, Philip E; Britz, Gavin W

2015-10-01

Aneurysmal subarachnoid hemorrhage (SAH) remains an important health issue in the United States. Despite recent improvements in the diagnosis and treatment of cerebral aneurysms, the mortality rate following aneurysm rupture. In those patients who survive, up to 50% are left severely disabled. The goal of preventing the hemorrhage or re-hemorrhage can only be achieved by successfully excluding the aneurysm from the circulation. This article is a comprehensive review by contemporary vascular neurosurgeons and interventional neuroradiolgists on the modern management of cerebral aneurysms. Copyright © 2015 Elsevier Inc. All rights reserved.

Frequency of cerebral infarction secondary to head injury and the underlying mechanisms: CT study

International Nuclear Information System (INIS)

Fernande-Fresno, L.; Manzanares, R.; Caniego, J.L.; Velasco, M.; Parra, M.L.; Monasterio, F.

1997-01-01

To study the frequency of and possible mechanisms producing severe head injury (HI) by serial CT studies. We reviewed brain CT results in 154 HI patients examined over the past 31 months. All of them were hospitalized in the Intensive Care Unit (ICU) presenting coma with Glosgow Coma Scale scores of 9 or under. A first CT scan was performed when the patients arrived in the emergency room and at a least one more was carried out over the following 1 to 6 days. Sixteen of the 154 patients presented ischemic areas of low attenuation in a territory of defined vascular distribution that did not exist in the CT done at admission; the majority of them also had extensive extraaxial or intraaxial hematomas causing a considerable mass effect and cerebral displacement inducing different types of herniation. The vascular territories involved were anterior cerebral artery in five cases, middle cerebral artery in two, posterior cerebral artery in seven lenticulostriate arteries in six, anterior choroidal artery in five, perforating thalamus in six, recurrent artery in one case and superior cerebellar artery in another. In our series, there was a high prevalence (10.4%) of infarcts associated with severe HI; the most common etiopathogenic mechanisms are cerebral displacement accompanied by compression and vessel strain. (Author) 13 refs

Análise de um acidente por contaminação fúngica em uma biblioteca pública no município do Rio de Janeiro

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Maria Cristina Strausz

Full Text Available Partindo de um acidente de contaminação por fungos ocorrido em dezembro de 1997 em uma biblioteca pública no município do Rio de Janeiro, foi testada a aplicabilidade de uma proposta metodológica de análise sociotécnica de acidentes, que foi desenvolvida pelo Centro de Estudo de Saúde do Trabalhador e Ecologia Humana (CESTEH/Fiocruz, para análise de acidentes industriais ampliados. O acidente foi conseqüência de um fato anunciado meses antes, quando os trabalhadores da biblioteca denunciaram, através de um abaixo-assinado, os problemas de descontrole da temperatura ambiente, que se traduzia em desconforto, sintomas respiratórios e afastamento do trabalho, decorrentes daquelas condições. O evento foi caracterizado como um caso de Síndrome do Edifício Doente, que é um problema decorrente da má qualidade do ar de interiores, especialmente em ambientes climatizados artificialmente. Nesse sentido, despertou a atenção dos profissionais de bibliotecas do Brasil para um problema bastante comum, embora pouco estudado, especialmente no campo da saúde pública e, dentro dela, o campo da saúde do trabalhador.

A precarização do trabalho e a produção de acidentes na colheita de árvores

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Ada Ávila Assunção

Full Text Available A indústria florestal apresenta as maiores taxas de mortalidade associada ao trabalho no mundo, apesar da introdução da mecanização no setor. Neste artigo, foram estudados os documentos da Comissão Parlamentar de Inquérito instituída para verificar os acidentes fatais ocorridos em Minas Gerais. Analisou-se o processo de trabalho realizado pelas equipes de corte de árvores de uma empresa do setor de extrativismo vegetal e constatou-se que o conhecimento acumulado quanto aos fatores de risco de acidentes nesse setor não orientou a transformação das situações de trabalho. O momento da derrubada de árvores e os riscos consequentes de ser "atingido por" são as principais causas dos acidentes e motivaram a demanda do estudo, sendo coerentes com a descrição encontrada na literatura. As relações de trabalho precarizadas predominam no setor. Os autores associam a manutenção da exposição aos riscos à terceirização crescente, concentrada nas fases da produção, reconhecidas como perigosas.

MTHFR and ACE Gene Polymorphisms and Risk of Vascular and Degenerative Dementias in the Elderly

Science.gov (United States)

Pandey, Pratima; Pradhan, Sunil; Modi, Dinesh Raj; Mittal, Balraj

2009-01-01

Focal lacunar infarctions due to cerebral small vessel atherosclerosis or single/multiple large cortical infarcts lead to vascular dementia, and different genes and environmental factors have been implicated in causation or aggravation of the disease. Previous reports suggest that some of the risk factors may be common to both vascular as well as…

[Cerebral protection].

Science.gov (United States)

Cattaneo, A D

1993-09-01

metabolic standpoint, exposure to isoflurane at concentration of 2 MAC is credited with providing the same potential for protection as high dose barbiturate (isoelectric EEG). A possible major difference between barbiturates and isoflurane is the modest cerebral vasodilation induced by the latter while barbiturates are associated with decreased CBF. This suggests that in focal ischemia isoflurane may elicit an intracerebral steal. 3) Calcium entry blockers. Some calcium entry blockers with the distinctive feature of acting preferably on cerebral as opposed to systemic vascular smooth muscles may exert beneficial effects during or after brain ischemia. Two such drugs which have shown promise are nimodipine and lidoflazine. In animal and human studies nimodipine has been reported to improve the neurologic outcome of both the cerebral vasospasm and the postischemic hypoperfusion state.(ABSTRACT TRUNCATED AT 400 WORDS)

Autodestrucción espontánea de una malformación arteriovenosa cerebral Spontaneous self-destruction of a cerebral arteriovenous malformation

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Antonio Guevara Melcón

2011-12-01

Full Text Available Se presenta una paciente que fue investigada y operada en el Hospital Universitario "Gral. Calixto García", portadora de una malformación arteriovenosa cerebral, que desapareció espontáneamente después de un cuadro neurológico de intensa gravedad. Arteriográficamente se comprobó que estaba asociada a un aneurisma arterial en su mismo sistema vascular cerebral. La paciente había sufrido 3 eventos neurológicos en orden ascendente de gravedad, y fue el último motivo de ingreso en la Unidad de Terapia Intensiva, con un nivel de 5 en la escala de Glasgow para el coma y sin signos meníngeos evidenciables. La lesión valorada como malformación arteriovenosa cerebral en las tomografías axiales cumputarizadas previas, no se evidenció en la panangiografía cerebral realizada en la fase de mejoría clínica relativa después de su etapa más crítica. Dicha angiografía demostró un aneurisma arterial homolateral a la malformación arteriovenosa ya desaparecida, el cual fue excluido de la circulación por presillamiento de su cuello sin eventos transoperatorios ni posoperatorios relevantes. Se realiza una revisión de la literatura al respecto.Authors present the case of a patient researched and operated on in the "General Calixto García" University Hospital presenting with a cerebral arteriovenous malformation disappeared spontaneously after a neurologic picture of intense severity. From the arteriographic point of view it was verified that it was associated with an arterial aneurysm present in her same cerebral vascular system. The patient has had three neurological events in rising order of severity which was the last reason for admission in the Intensive Therapy Unit (ITU with a level of 5 in the Glasgow scale for the coma and without obvious meningeal signs. The injury classified as a cerebral arteriovenous malformation according to the previous computerized axial tomographies was not evidenced in the cerebral panangiograpy carried out

Effect of PPARγ Inhibition during Pregnancy on Posterior Cerebral Artery Function and Structure

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Siu-Lung eChan

2010-08-01

Full Text Available Peroxisome proliferator-activated receptor-γ (PPARγ, a ligand-activated transcription factor, has protective roles in the cerebral circulation, and, is highly activated during pregnancy. Thus, we hypothesized that PPARγ is involved in the adaptation of cerebral vasculature to pregnancy. Nonpregnant (NP and late-pregnant (LP rats were treated with a specific PPARγ inhibitor GW9662 (10 mg/kg/day, in food or vehicle for 10 days and vascular function and structural remodeling were determined in isolated and pressurized posterior cerebral arteries (PCA. Expression of PPARγ and angiotensin type 1 receptor (AT1R in cerebral (pial vessels was determined by real-time RT-PCR. PPARγ inhibition decreased blood pressure and increased blood glucose in NP rats, but not in LP rats. PPARγ inhibition reduced dilation to acetylcholine and sodium nitroprusside in PCA from NP (p<0.05 vs. LP-GW, but not LP rats. PPARγ inhibition tended to increase basal tone and myogenic activity in PCA from NP rats, but not LP rats. Structurally, PPARγ inhibition increased wall-thickness in PCA from both NP and LP rats (p<0.05, but increased distensibility only in PCA from NP rats. Pregnancy decreased expression of PPARγ and AT1R (p<0.05 in cerebral arteries that was not affected by GW9662 treatment. These results suggest that PPARγ inhibition had significant effects on the function and structure of PCA in the NP state, but appeared to have less influence during pregnancy. Down-regulation of PPARγ and AT1R in cerebral arteries may be responsible for the lack of effect of PPARγ in cerebral vasculature and may be part of the vascular adaptation to pregnancy.

Clinical implication and prognosis of normal baseline cerebral blood flow with impaired vascular reserve in patients with major cerebral artery occlusive disease

International Nuclear Information System (INIS)

Isozaki, Makoto; Arai, Yoshikazu; Kubota, Toshihiko; Kikuta, Ken-ichiro; Kudo, Takashi; Kiyono, Yasushi; Kobayashi, Masato; Okazawa, Hidehiko

2010-01-01

To investigate the prognosis of patients with cerebrovascular steno-occlusive disease who have preserved baseline cerebral blood flow (CBF) and reduced cerebral vasoreactivity (CVR), they were followed up after scans of positron emission tomography (PET). Fifty-seven patients with symptomatic unilateral major cerebral arterial occlusion or severe stenosis underwent O-15 gas and water PET scans to measure cerebral blood volume, metabolic rate of oxygen, oxygen extraction fraction (OEF), and CBF at the baseline and after acetazolamide administration. Thirty of them (mean age 60±10 years) had normal ipsilateral CBF, and were followed prospectively at least 30 months from the last ischemic event. They were medically treated for cerebral circulation and underlying diseases during follow-up periods. The primary endpoint was determined as stroke recurrence during the follow-up. Thirty patients were divided into two groups of reduced CVR (N=16, 63±8 years) and normal CVR (N=14, 56±10 years) on the basis of CVR values from healthy volunteers. None of them showed significant laterality in baseline CBF and OEF between the hemispheres although patients with reduced CVR showed a tendency of ipsilateral increases in OEF and CBV. Patients were followed up for 50.5±19.0 and 48.1±12.4 months in the reduced and normal CVR groups, respectively. Although one patient with reduced CVR died of heart disease, there was no incidence of ischemic events during follow-up periods for either group. In the present prospective study, patients with sufficient baseline CBF showed good prognosis and no difference in recurrent stroke risks even though they had poor CVR in the affected hemisphere, indicating that these patients can be treated by medication for cerebral circulation and baseline diseases if they have high risk factors for neurosurgical treatment. (author)

Functional genomics indicate that schizophrenia may be an adult vascular-ischemic disorder.

Science.gov (United States)

Moises, H W; Wollschläger, D; Binder, H

2015-08-11

In search for the elusive schizophrenia pathway, candidate genes for the disorder from a discovery sample were localized within the energy-delivering and ischemia protection pathway. To test the adult vascular-ischemic (AVIH) and the competing neurodevelopmental hypothesis (NDH), functional genomic analyses of practically all available schizophrenia-associated genes from candidate gene, genome-wide association and postmortem expression studies were performed. Our results indicate a significant overrepresentation of genes involved in vascular function (P < 0.001), vasoregulation (that is, perivascular (P < 0.001) and shear stress (P < 0.01), cerebral ischemia (P < 0.001), neurodevelopment (P < 0.001) and postischemic repair (P < 0.001) among schizophrenia-associated genes from genetic association studies. These findings support both the NDH and the AVIH. The genes from postmortem studies showed an upregulation of vascular-ischemic genes (P = 0.020) combined with downregulated synaptic (P = 0.005) genes, and ND/repair (P = 0.003) genes. Evidence for the AVIH and the NDH is critically discussed. We conclude that schizophrenia is probably a mild adult vascular-ischemic and postischemic repair disorder. Adult postischemic repair involves ND genes for adult neurogenesis, synaptic plasticity, glutamate and increased long-term potentiation of excitatory neurotransmission (i-LTP). Schizophrenia might be caused by the cerebral analog of microvascular angina.

Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment.

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Liu, Yang; Dong, Yan-Hong; Lyu, Pei-Yuan; Chen, Wei-Hong; Li, Rui

2018-03-05

Alzheimer's disease and vascular dementia are responsible for more than 80% of dementia cases. These two conditions share common risk factors including hypertension. Cerebral small vessel disease (CSVD) is strongly associated with both hypertension and cognitive impairment. In this review, we identify the pathophysiological changes in CSVD that are caused by hypertension and further explore the relationship between CSVD and cognitive impairment. We searched and scanned the PubMed database for recently published literatures up to December 2017. We used the keywords of "hypertension", "cerebral small vessel disease", "white matter lesions", "enlarged perivascular spaces", "lacunar infarcts", "cerebral microbleeds", and "cognitive impairment" in the database of PubMed. Articles were obtained and reviewed to analyze the hypertension-induced pathophysiological changes that occur in CSVD and the correlation between CSVD and cognitive impairment. In recent years, studies have demonstrated that hypertension-related changes (e.g., small vascular lesions, inflammatory reactions, hypoperfusion, oxidative stress, damage to autoregulatory processes and the blood-brain barrier, and cerebral amyloid angiopathy) can occur over time in cerebral small vessels, potentially leading to lower cognitive function when blood pressure (BP) control is poor or lacking. Both isolated and co-occurrent CSVD can lead to cognitive deterioration, and this effect may be attributable to a dysfunction in either the cholinergic system or the functionality of cortical and subcortical tracts. We explore the currently available evidence about the hypertensive vasculopathy and inflammatory changes that occur in CSVD. Both are vital prognostic indicators of the development of cognitive impairment. Future studies should be performed to validate the relationship between BP levels and CSVD progression and between the numbers, volumes, and anatomical locations of CSVD and cognitive impairment.

Exercise Training Could Improve Age-Related Changes in Cerebral Blood Flow and Capillary Vascularity through the Upregulation of VEGF and eNOS

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Sheepsumon Viboolvorakul

2014-01-01

Full Text Available This study aimed to investigate the effect of exercise training on age-induced microvascular alterations in the brain. Additionally, the association with the protein levels of vascular endothelial growth factor (VEGF and endothelial nitric oxide synthase (eNOS was also assessed. Male Wistar rats were divided into four groups: sedentary-young (SE-Young, n=5, sedentary aged (SE-Aged, n=8, immersed-aged (IM-Aged, n=5, and exercise trained-aged (ET-Aged, 60 minutes/day and 5 days/week for 8 weeks, n=8 rats. The MAPs of all aged groups, SE-Aged, IM-Aged, and ET-Aged, were significantly higher than that of the SE-Young group. The regional cerebral blood flow (rCBF in the SE-Aged and IM-Aged was significantly decreased as compared to SE-Young groups. However, rCBF of ET-Aged group was significantly higher than that in the IM-Aged group (P<0.05. Moreover, the percentage of capillary vascularity (%CV and the levels of VEGF and eNOS in the ET-Aged group were significantly increased compared to the IM-Aged group (P<0.05. These results imply that exercise training could improve age-induced microvascular changes and hypoperfusion closely associated with the upregulation of VEGF and eNOS.

Utilização de equipamentos de segurança entre vítimas de acidentes no município de Uberaba-MG

OpenAIRE

Debora Prudencio e Silva; Maria Helena Barbosa; Suzel Regina Ribeiro Chavaglia

2010-01-01

Acidentes de trânsito correspondem à terceira causa de mortalidade no mundo. Estudo retrospectivo, com objetivo de identificar os equipamentos de segurança utilizados pelas vítimas de acidentes e os principais tipos de lesões ocorridas. Os dados foram coletados das fichas de atendimento pré-hospitalar do 8º Batalhão deBombeiros Militar, do município de Uberaba-MG, relativos ao período de junho/2006 a junho/2007 e foram analisados segundo estatística descritiva. A maioria das vítimas 69,77% er...

The Serial Change of Cerebral Hemodynamics by Vascular Territory after Extracranial-Intracranial Bypass Surgery in Patients with Atherosclerosis of Cerebral Arteries

International Nuclear Information System (INIS)

Hong, Il Ki; Kim, Jae Seung; Ahn, Jae Sung; Kwon, Sun Uck; Im, Ki Chun; Lee, Jai Hyuen; Moon, Dae Hyuk

2008-01-01

To assess the effect of extracranial-intracranial (EC-IC) bypass surgery on hemodynamic improvement, we evaluated serial regional cerebral hemodynamic change of the middle cerebral artery (MCA) in symptomatic patients with atherosclerotic occlusion of the internal carotid artery (ICA) or MCA using 99m Tc-ECD acetazolamide stress brain perfusion SPECT (Acetazolamide SPECT). The patients who had suffered a recent stroke with atherosclerotic ICA or MCA occlusion underwent EC-IC bypass surgery and Acetazolamide SPECT at 1 week before and three to six months after surgery. For image analysis, attenuation corrected images were spatially normalized to SPECT templates with SPM2. Anatomical automated labeling was applied to calculate mean counts of each Volume-Of-Interest (VOI). Seven VOIs of bilateral frontal, parietal, temporal regions of the MCA territory and the ipsilateral cerebellum were defined. Using mean counts of 7 VOIs, cerebral perfusion index and perfusion reserve index were calculated. Seventeen patients (M:F=12:5, mean age: 53±2yr) were finally included in the analysis. The cerebral blood flow of the parietal region increased at 1 week (p=0.003) and decreased to the preoperative level at 3-6 months (p=0.003). The cerebrovascular reserve of the frontal and parietal regions increased significantly at 1 week after surgery (p<0.01) and improved further at 3-6 months. Cerebrovascular reserve of the MCA territory was significantly improved at early postoperative period after EC-IC bypass and kept improved state during long-term follow-up, although cerebral blood flow did not significantly improved. Therefore, cerebrovascular reserve may be a good indicator of postoperative hemodynamic improvement resulted from bypass effect

The Serial Change of Cerebral Hemodynamics by Vascular Territory after Extracranial-Intracranial Bypass Surgery in Patients with Atherosclerosis of Cerebral Arteries

Energy Technology Data Exchange (ETDEWEB)

Hong, Il Ki; Kim, Jae Seung; Ahn, Jae Sung; Kwon, Sun Uck; Im, Ki Chun; Lee, Jai Hyuen; Moon, Dae Hyuk [Asan Medial Center, Ulsan University School of Medicine, Seoul (Korea, Republic of)

2008-02-15

To assess the effect of extracranial-intracranial (EC-IC) bypass surgery on hemodynamic improvement, we evaluated serial regional cerebral hemodynamic change of the middle cerebral artery (MCA) in symptomatic patients with atherosclerotic occlusion of the internal carotid artery (ICA) or MCA using {sup 99m}Tc-ECD acetazolamide stress brain perfusion SPECT (Acetazolamide SPECT). The patients who had suffered a recent stroke with atherosclerotic ICA or MCA occlusion underwent EC-IC bypass surgery and Acetazolamide SPECT at 1 week before and three to six months after surgery. For image analysis, attenuation corrected images were spatially normalized to SPECT templates with SPM2. Anatomical automated labeling was applied to calculate mean counts of each Volume-Of-Interest (VOI). Seven VOIs of bilateral frontal, parietal, temporal regions of the MCA territory and the ipsilateral cerebellum were defined. Using mean counts of 7 VOIs, cerebral perfusion index and perfusion reserve index were calculated. Seventeen patients (M:F=12:5, mean age: 53{+-}2yr) were finally included in the analysis. The cerebral blood flow of the parietal region increased at 1 week (p=0.003) and decreased to the preoperative level at 3-6 months (p=0.003). The cerebrovascular reserve of the frontal and parietal regions increased significantly at 1 week after surgery (p<0.01) and improved further at 3-6 months. Cerebrovascular reserve of the MCA territory was significantly improved at early postoperative period after EC-IC bypass and kept improved state during long-term follow-up, although cerebral blood flow did not significantly improved. Therefore, cerebrovascular reserve may be a good indicator of postoperative hemodynamic improvement resulted from bypass effect.

Computed tomographic findings of cerebral arterial ectasia

International Nuclear Information System (INIS)

Choi, Woo Suk; Ko, Young Ho; Lim, Jae Hoon

1987-01-01

The computed tomographic findings of cerebral arterial ectasia in 8 patients, of which 5 cases were angiographically documented, are reported. The ecstatic arteries, located predominantly in the suprasellar and interpeduncular cisterns, appeared as serpignous, tubular structures on the unenhanced scan. The enhanced CT scan demonstrated dense, sharply defined, homogeneous intraluminal enhancement. Until recently, the diagnosis of cerebral arterial ectasia was usually established by angiography. With introduction of CT it has become possible to noninvasively identify and characterize this vascular disorder and its associated intracranial complications. The vertebrobasilar dolichoectasia may be diagnosed by CT as an extra-axial lesion in the cerebellopontine angle. It enhances in a tubular fashion after intravenous injection of contrast.

Miocárdio não compactado, Doença de Chagas e disfunção: relato de caso Miocardio no compactado, Enfermedad de Chagas y disfunción: caso clínico Noncompaction of the myocardium, Chagas' disease and dysfunction: a case report

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Ronaldo Peixoto de Mello

2010-07-01

Full Text Available Relatamos a associação entre a cardiopatia associada ao miocárdio não compactado do ventrículo esquerdo (MNCVE à cardiopatia chagásica crônica (CCC em paciente com clínica de insuficiência cardíaca, acidente vascular cerebral isquêmico e arritmia cardíaca. As imagens típicas de MNCVE e CCC foram documentadas pela ressonância magnética cardíaca (RMC.Relatamos la asociación entre la cardiopatía asociada al miocardio no compactado del ventrículo izquierdo (MNCVI con la cardiopatía chagásica crónica (CCC en paciente con clínica de insuficiencia cardíaca, accidente vascular cerebral isquémico y arritmia cardíaca. Las imágenes típicas de MNCVI y CCC fueron documentadas por resonancia magnética cardíaca (RMC.We report the association between heart disease associated with noncompaction of the left ventricular myocardium (NCLVM and chronic Chagas' heart disease (CCHD in a patient with heart failure, ischemic stroke and cardiac arrhythmia. Images typical of NCLVM and CCHD were documented by cardiac magnetic resonance imaging (CMRI.

Clinical value of detection on ser um monocyte chemotactant protein-1 and vascular endothelial cadher in levels in patients with acute cerebral infarction

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Xia Zhou

2016-11-01

Full Text Available Objective: To study the correlation of serum monocyte chemotactant protein-1 (MCP-1 and vascular endothelia cadherin (VE-cadherin levels in patients with acute cerebral infarction, and nerve injury molecules, interleukins and matrix metalloproteinases. Methods: A total of 86 patients with acute cerebral infarction treated in our hospital from April 2012 to October 2015 were selected as the observation group and 50 healthy subjects in the same period treated in our hospital were selected as the control group. The serums were collected and the contents of MCP-1, VE-cadherin, heart-type fatty acid binding protein (H-FABP, S100 calcium binding protein B (S100B, neuron-specific enolase (NSE, interleukin-lb (IL-1b, IL-6, IL-17, IL-18, matrix metalloproteinase-2 (MMP2, MMP3 and MMP9 were measured. Results: The serum contents of MCP-1, VE-cadherin, H-FABP, S100B, NSE, IL-1b, IL- 6, IL-17, IL-18, MMP2, MMP3 and MMP9 in observation group were significantly higher than those of control group. Carotid artery plaque formation and unstable plaque properties will increase the serum contents of MCP-1, VE-cadherin, H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 in patients with cerebral infarction. The serum levels of MCP-1, VE-cadherin and the contents of H-FABP, S100B, NSE, IL-1b, IL-6, IL-17, IL-18, MMP2, MMP3 and MMP9 were positively correlated. Conclusions: The serum levels of VE-cadherin and MCP-1 were significantly increased in patients with acute cerebral infarction. MCP-1 and VE-cadherin can increase the secretion of interleukins and matrix metalloproteinases, which can result in the carotid artery plaque formation, unstable plaque properties and the injury of nerve function.

Male-female differences in upregulation of vasoconstrictor responses in human cerebral arteries.

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Hilda Ahnstedt

Full Text Available BACKGROUND AND PURPOSE: Male-female differences may significantly impact stroke prevention and treatment in men and women, however underlying mechanisms for sexual dimorphism in stroke are not understood. We previously found in males that cerebral ischemia upregulates contractile receptors in cerebral arteries, which is associated with lower blood flow. The present study investigates if cerebral arteries from men and women differ in cerebrovascular receptor upregulation. EXPERIMENTAL APPROACH: Freshly obtained human cerebral arteries were placed in organ culture, an established model for studying receptor upregulation. 5-hydroxtryptamine type 1B (5-HT1B, angiotensin II type 1 (AT1 and endothelin-1 type A and B (ETA and ETB receptors were evaluated using wire myograph for contractile responses, real-time PCR for mRNA and immunohistochemistry for receptor expression. KEY RESULTS: Vascular sensitivity to angiotensin II and endothelin-1 was markedly lower in cultured cerebral arteries from women as compared to men. ETB receptor-mediated contraction occurred in male but not female arteries. Interestingly, there were similar upregulation in mRNA and expression of 5-HT1B, AT1, and ETB receptors and in local expression of Ang II after organ culture. CONCLUSIONS AND IMPLICATIONS: In spite of receptor upregulation after organ culture in both sexes, cerebral arteries from women were significantly less responsive to vasoconstrictors angiotensin II and endothelin-1 as compared to arteries from men. This suggests receptor coupling and/or signal transduction mechanisms involved in cerebrovascular contractility may be suppressed in females. This is the first study to demonstrate sex differences in the vascular function of human brain arteries.

Reduced vascular amyloid burden at microhemorrhage sites in cerebral amyloid angiopathy

NARCIS (Netherlands)

van Veluw, Susanne J.; Kuijf, Hugo J.; Charidimou, Andreas; Viswanathan, Anand; Biessels, Geert Jan; Rozemuller, Annemieke J M; Frosch, Matthew P.; Greenberg, Steven M.

Microhemorrhages are strongly associated with advanced cerebral amyloid angiopathy (CAA). Although it has been frequently proposed that the deposition of Aβ in the walls of cortical vessels directly causes microhemorrhages, this has not been studied in great detail, mainly because the ruptured

Fabrication of cerebral aneurysm simulator with a desktop 3D printer.

Science.gov (United States)

Liu, Yu; Gao, Qing; Du, Song; Chen, ZiChen; Fu, JianZhong; Chen, Bing; Liu, ZhenJie; He, Yong

2017-05-17

Now, more and more patients are suffering cerebral aneurysm. However, long training time limits the rapid growth of cerebrovascular neurosurgeons. Here we developed a novel cerebral aneurysm simulator which can be better represented the dynamic bulging process of cerebral aneurysm The proposed simulator features the integration of a hollow elastic vascular model, a skull model and a brain model, which can be affordably fabricated at the clinic (Fab@Clinic), under $25.00 each with the help of a low-cost desktop 3D printer. Moreover, the clinical blood flow and pulsation pressure similar to the human can be well simulated, which can be used to train the neurosurgical residents how to clip aneurysms more effectively.

Global Aphasia As A Predictor Of Mortality In The Acute Phase Of A First Stroke [afasia Global Prediz Mortalidade Na Fase Aguda De Um Primeiro Acidente Vascular Cerebral Isquêmico

OpenAIRE

de Oliveira F.F.; Damasceno B.P.

2011-01-01

OBJECTIVE: To establish whether vascular aphasic syndromes can predict stroke outcomes. METHOD: Thirty-seven adults were evaluated for speech and language within 72 hours after a single first-ever ischemic brain lesion, in blind association to CT and/or MR. RESULTS: Speech or language disabilities were found in seven (87.5%) of the eight deceased patients and twenty-six (89.7%) of the twenty-nine survivors. Global aphasia was identified in eleven patients, all with left hemisphere lesions (ni...

Post Traumatic Cerebral Oedema in Severe Head Injury is Related to Intracranial Pressure and Cerebral Perfusion Pressure but not to Cerebral Compliance

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U Nujaimin

2009-07-01

Full Text Available This was a prospective cohort study, carried out in the Neuro Intensive Care Unit, Department of Neurosciences, Hospital Universiti Sains Malaysia, Kubang Kerian Kelantan. The study was approved by the local ethics committee and was conducted between November 2005 and September 2007 with a total of 30 patients included in the study. In our study, univariate analysis showed a statistically significant relationship between mean intracranial pressure (ICP as well as cerebral perfusion pressure (CPP with both states of basal cistern and the degree of diffuse injury and oedema based on the Marshall classification system. The ICP was higher while CPP and compliance were lower whenever the basal cisterns were effaced in cases of cerebral oedema with Marshall III and IV. In comparison, the study revealed lower ICP, higher mean CPP and better mean cerebral compliance if the basal cisterns were opened or the post operative CT brain scan showed Marshall I and II. These findings suggested the surgical evacuation of clots to reduce the mass volume and restoration of brain anatomy may reduce vascular engorgement and cerebral oedema, therefore preventing intracranial hypertension, and improving cerebral perfusion pressure and cerebral compliance. Nevertheless the study did not find any significant relationship between midline shifts and mean ICP, CPP or cerebral compliance even though lower ICP, higher CPP and compliance were frequently observed when the midline shift was less than 0.5 cm. As the majority of our patients had multiple and diffuse brain injuries, the absence of midline shift did not necessarily mean lower ICP as the pathology was bilateral and even when after excluding the multiple lesions, the result remained insignificant. We assumed that the CT brain scan obtained after evacuation of the mass lesion to assess the state basal cistern and classify the diffuse oedema may prognosticate the intracranial pressure and cerebral perfusion pressure

Multiple cerebral cavernous malformations in a pediatric patient with Turner syndrome

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Nicholas T. Gamboa, B.S.

2017-12-01

Full Text Available Turner syndrome (TS; 45,X0 is a relatively common chromosomal disorder that is associated with characteristic phenotypic stigmata: short stature, webbed neck, broad (“shield” chest with widely spaced nipples, cubitus valgus, ovarian dysgenesis (“streak ovary”, primary amenorrhea, renal anomalies, lymphedema of the hands or feet, and various vascular abnormalities. Abnormalities of the cardiovascular system are commonly reported in patient with TS, and vascular anomalies affecting various other organ systems are also frequently reported. To date, however, few reports of intracranial vascular malformations exist. The authors report the case of a patient with TS who was found to have multiple cerebral cavernous malformations on imaging.

A GEOGRAFIA DOS TRANSPORTES NA ORGANIZAÇÃO DO ESPAÇO URBANO: mobilidade e acidentes de trânsito

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Luiz Andrei Gonçalves Pereira

2012-06-01

Full Text Available A Geografia trabalha várias temáticas, e dentre elas, os meios de transportes, que são responsáveis pela organização da estrutura espacial das redes e dos fluxos de mercadorias, pessoas e informações pelos diversos territórios. Nesse sentido, o objetivo desta pesquisa é analisar as políticas de mobilidade na organização do espaço urbano, sob a perspectiva da Geografia dos Transportes, tendo os acidentes de trânsito como uma externalidade no processo de planejamento urbano e um grave problema socioeconômico na cidade de Uberlândia. Assim, na operacionalização do mesmo, foram realizados alguns procedimentos metodológicos, tais como estudos bibliográficos e coleta dos dados em fontes secundárias de instituições governamentais para análise dos acidentes, no período de 2006 a 2009. Na organização do espaço urbano, a Geografia dos Transportes é uma disciplina importante para a compreensão da política de mobilidade urbana. O Estatuto da Cidade regulamentou os artigos 182 e 183 da Constituição Federal e estabeleceu diretrizes gerais para a política urbana brasileira e o Plano Diretor é um instrumento que traça as diretrizes gerais para o planejamento municipal. Os acidentes de trânsito podem ser considerados externalidades negativas nesse espaço urbano organizado, uma vez que extrapolam a política de planejamento e resultam em problemas econômicos e sociais para a população uberlandense. Em suma, as estatísticas dos acidentes de trânsito ainda assustam, e por esse motivo, o Brasil, Minas Gerais e Uberlândia precisam urgente de uma política de mobilidade inclusiva e sustentável, que garanta qualidade de vida à população, principalmente nas áreas urbanas.

Chronic Supplementation of Paeonol Combined with Danshensu for the Improvement of Vascular Reactivity in the Cerebral Basilar Artery of Diabetic Rats

Science.gov (United States)

Hu, Jing; Li, Ya-Ling; Li, Zi-Lin; Li, Hua; Zhou, Xuan-Xuan; Qiu, Peng-Cheng; Yang, Qian; Wang, Si-Wang

2012-01-01

One of the leading causes of death in the world is cerebrovascular disease. Numerous Chinese traditional medicines, such as Cortex Moutan (root bark of Paeonia suffruticosa Andrew) and Radix Salviae miltiorrhizae (root and rhizome of Salvia miltiorrhiza Bunge), protect against cerebrovascular diseases and exhibit anti-atherosclerotic effects. Traditional medicines have been routinely used for a long time in China. In addition, these two herbs are prescribed together in clinical practice. Therefore, the pharmacodynamic interactions between the active constituents of these two herbs, which are paeonol (Pae) and danshensu (DSS), should be particularly studied. The study of Pae and DSS can provide substantial foundations in understanding their mechanisms and empirical evidence to support clinical practice. This study investigated the effects and possible mechanisms of the pharmacodynamic interaction between Pae and DSS on cerebrovascular malfunctioning in diabetes. Experimental diabetes was induced in rats, which was then treated with Pae, DSS, and Pae + DSS for eight weeks. Afterward, cerebral arteries from all groups were isolated and equilibrated in an organ bath with Krebs buffer and ring tension. Effects of Pae, DSS, and Pae + DSS were observed on vessel relaxation with or without endothelium as well as on the basal tonus of vessels from normal and diabetic rats. Indexes about oxidative stress were also determined. We report that the cerebral arteries from diabetic rats show decreased vascular reactivity to acetylcholine (ACh) which was corrected in Pae, DSS, and Pae + DSS treated groups. Furthermore, phenylephrine (PE)-induced contraction response decreased in the treated groups. Phenylephrine and CaCl2-induced vasoconstrictions are partially inhibited in the three treated groups under Ca2+-free medium. Pre-incubated with tetraethylammonium, a non-selective K+ channel blocker, the antagonized relaxation responses increased in DSS and Pae + DSS treated diabetic

Acidente de trabalho, com material biológico, em profissionais de saúde de hospitais públicos do Distrito Federal, Brasil, 2002/2003

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Caixeta Roberta de Betânia

2005-01-01

Full Text Available Foi estudada a ocorrência de acidente de trabalho em profissionais de saúde no período de 2002/2003 e a influência das medidas de biossegurança e aceitação de quimioprofilaxia frente ao risco de transmissão ocupacional do HIV. Avaliou-se 570 profissionais de saúde de seis hospitais públicos, selecionados aleatoriamente, do conjunto de hospitais do Distrito Federal, Brasil. Esses profissionais foram questionados quanto ao conhecimento sobre biossegurança, ocorrência de acidente de trabalho, aceitação da quimioprofilaxia e teste sorológico anti-HIV. Entre os profissionais avaliados, o coeficiente de acidentabilidade foi de 39,1 e mostrou-se inversamente proporcional ao porte do hospital. Dentistas, médicos e técnicos de laboratório acidentaram-se mais, em contrapartida aos farmacêuticos e enfermeiros. As situações relacionadas ao acidente de trabalho com maior aceitação e adesão ao uso da quimioprofilaxia foram sorologia positiva e carga viral intensa do paciente-fonte (99,6-99,0%, em contraposição à sorologia negativa do paciente-fonte e acidente de pequena proporção (36,8-55,6%. O conhecimento dos profissionais de saúde sobre o conceito e as normas de biossegurança, a disponibilidade destas na unidade de trabalho e a realização de treinamento em biossegurança não influenciaram positivamente no coeficiente de acidentabilidade de trabalho.

Acidentes perfurocortantes e medidas preventivas para hepatite B adotadas por profissionais de Enfermagem nos serviços de urgência e emergência de Teresina, Piauí

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Telma Maria Evangelista de Araújo

Full Text Available Objetivos analisar a ocorrência de acidentes perfurocortantes e as medidas preventivas associadas à hepatite B entre profissionais de Enfermagem em serviços de urgência e emergência. Métodos estudo transversal analítico com aplicação de questionário a 317 participantes de cinco hospitais públicos de Teresina, PI, em 2010. Resultados 152 (47,9% referiram ter sofrido acidente perfurocortante; entre as categorias, 27,3% dos Enfermeiros, 48,2% dos Auxiliares, 52,6% dos Técnicos de Enfermagem. A chance de um profissional de nível médio (Auxiliar ou Técnico sofrer um acidente perfurocortante é de 2,8 (1,38-5,67 vezes maior que o de nível superior (Enfermeiros. A agulha foi o instrumento causador mais frequente (77,0%. A não notificação do acidente foi expressiva entre Técnicos (67,0%, Auxiliares (70,0% e Enfermeiros (75,0%, assim como a não adoção de medidas profiláticas pós-exposição (84,9%, em média. As três categorias profissionais referiram uso de luvas como o EPI mais utilizado. Os Auxiliares de Enfermagem apresentaram o menor percentual (47,0% de esquema vacinal completo para hepatite B. Discussão um percentual expressivo de profissionais de Enfermagem sofreu acidente perfurocortante no trabalho com baixa adoção de medidas preventivas e profiláticas, reforçando a necessidade de fortalecimento de estratégias que visem à saúde do trabalhador no âmbito hospitalar.

Modeling Cerebral Blood Flow Control During Posture Change from Sitting to Standing

DEFF Research Database (Denmark)

Olufsen, Mette; Tran, Hien; Ottesen, Johnny T.

2004-01-01

, the heart, and venous valves. We use physiologically based control mechanisms to describe the regulation of cerebral blood velocity and arterial pressure in response to orthostatic hypotension resulting from postural change. Beyond active control mechanisms we also have to include certain passive non......Hypertension, decreased cerebral blood flow, and diminished cerebral blood flow regulation, are among the first signs indicating the presence of cerebral vascular disease. In this paper, we will present a mathematical model that can predict blood flow and pressure during posture change from sitting......-linearities in some of the compliance-pressure and resistance-pressure relationships. Futhermore, an acurate and physiologically based submodel, describing the dynamics of how gravity effects the blood distribution during suspine changes, is included. To justify the fidelity of our mathematical model and control...

Cerebral and extracerebral vasoreactivity in symptomatic lacunar stroke patients: a case-control study.

Science.gov (United States)

Deplanque, Dominique; Lavallee, Philippa C; Labreuche, Julien; Gongora-Rivera, Fernando; Jaramillo, Arturo; Brenner, David; Abboud, Halim; Klein, Isabelle F; Touboul, Pierre-Jean; Vicaut, Eric; Amarenco, Pierre

2013-08-01

Whether cerebral artery endothelial dysfunction is a key factor of symptomatic lacunar stroke and cerebral small vessel disease remains unclear. Cerebral and extracerebral vasoreactivity were measured in 81 patients with recent symptomatic lacunar stroke and in 81 control subjects matched for main vascular risk factors. Cerebral vasoreactivity and carotid endothelial-dependent vasodilation were measured after five-minutes of carbon dioxide-induced hypercapnia. Brachial endothelial-dependent vasodilation was assessed after hyperemia induced by deflating a cuff around the forearm previously inflated to 200 mmHg for four-minutes. Carotid and brachial endothelial-independent vasodilation were measured five-minutes after administration of sublingual nitroglycerin 300 μg. Brain magnetic resonance imaging were analyzed in lacunar stroke patients. One-month after stroke onset, patients had more severely impaired cerebral vasoreactivitys than matched controls (mean ± standard deviation, 14·4 ± 12·1% vs. 19·4 ± 17·4%; P = 0·049). Severe alterations of both carotid and brachial endothelial-dependent and at a lesser degree of carotid and brachial endothelial-independent vasodilation were observed in both groups. After adjustment for confounders, subjects with a cerebral vasoreactivity value in the two lower tertiles (≤19·6%) were more likely to have had a symptomatic lacunar stroke (adjusted odds ratio, 3·78; 95% confidence interval, 1·42 to 10·08; P = 0·008). Only alteration of brachial endothelial-independent vasodilation correlated with parenchymal abnormalities, namely microbleeds and leukoaraiosis. While abnormalities in extracerebral vasoreactivity seem related to vascular risk factors, the severity of endothelial dysfunction in cerebral arteries may be determinant in the occurrence of symptomatic lacunar stroke in patients with small vessel disease. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke

Vascular Care in Patients With Alzheimer Disease With Cerebrovascular Lesions Slows Progression of White Matter Lesions on MRI The Evaluation of Vascular Care in Alzheimer's Disease (EVA) Study

NARCIS (Netherlands)

Richard, Edo; Gouw, Alida A.; Scheltens, Philip; van Gool, Willem A.

2010-01-01

Background and Purpose-White matter lesions (WMLs) and cerebral infarcts are common findings in Alzheimer disease and may contribute to dementia severity. WMLs and lacunar infarcts may provide a potential target for intervention strategies. This study assessed whether multicomponent vascular care in

Superficial temporal artery calcification in patients with end-stage renal disease: Association with vascular risk factors and ischemic cerebrovascular disease

International Nuclear Information System (INIS)

Anwar, Zeeshan; Zan, Elcin; Carone, Marco; Ozturk, Arzu; Sozio, Stephen M; Yousem, David M

2011-01-01

Extracranial superficial temporal artery (STA) calcification is an unusual finding seen in patients with chronic kidney disease and has unknown ramifications with respect to intracranial ischemic disease. We sought to determine the association between the risk factors for vascular calcification and this rare phenomenon, in patients with chronic renal failure, and to assess the coexistence of cerebral ischemia. Medical records and laboratory data on risk factors for vascular calcification were retrospectively retrieved for 453 patients with a discharge diagnosis of end-stage renal disease (ESRD). CT head examinations were reviewed to identify and associate STA calcification with 1) risk factors for the vascular calcification, 2) intracranial artery calcification, and 3) cerebral ischemia (white matter and/or cortical ischemic changes). STA calcification was present in 9.9% (45/453) of the studied cohort. The prevalence of cerebral ischemia was 24.4% (11/45) in patients with STA calcification and 9.3% (38/408) in patients without it. Diabetes mellitus (OR: 2.56, 95% CI: 1.059-6.208; P=0.037) was independently associated with the risk of STA calcification. The risk of cerebral ischemia, however, was not related to STA calcification (P=0.221). The presence of diabetes mellitus is important in describing the risk of STA calcification in patients with ESRD, whereas age, gender, hypertension, serum calcium, serum phosphate, or serum hemoglobin levels are not. The risk of cerebral ischemia is not related to STA calcification but has the strongest association with diabetes mellitus

Predictors of short-term outcome in patients with acute middle cerebral artery occlusion: unsuitability of fluid-attenuated inversion recovery vascular hyperintensity scores

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Chan-chan Li

2018-01-01

Full Text Available Fluid-attenuated inversion recovery (FLAIR vascular hyperintensity (FVH is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the present study was to assess a FVH score and explore its relationship with clinical outcomes. Patients with acute ischemic stroke due to middle cerebral artery M1 occlusion underwent magnetic resonance imaging and were followed up at 10 days (National Institutes of Health Stroke Scale and 90 days (modified Rankin Scale to determine short-term clinical outcomes. Effective collateral circulation indirectly improved recovery of neurological function and short-term clinical outcome by extending the size of the pial penumbra and reducing infarct lesions. FVH score showed no correlation with 90-day functional clinical outcome and was not sufficient as an independent predictor of short-term clinical outcome.

Protective effects of D-Limonene against transient cerebral ischemia in stroke-prone spontaneously hypertensive rats.

Science.gov (United States)

Wang, Xifeng; Li, Gang; Shen, Wei

2018-01-01

Stroke is a leading cause of disability and death world-wide and there is currently a lack of effective treatments for acute stroke. D-Limonene is a common natural monocyclic monoterpene possessing various activities. The present study aimed to evaluate the therapeutic efficacy of D-limonene against ischemia-associated cerebral injury in hypertensive SHRsp rats. Although systolic blood pressure was not altered by ischemia, D-Limonene decreased the systolic blood pressure of SHRsp rats following stroke. Induction of stroke resulted in increased escape latency time, decreased time spent in the target quadrant in the probe trial, decreased capacity to distinguish between familiar objects and novel objects, and increased sensory neglect in the SHRsp rat, however these symptoms were significantly inhibited by D-limonene. D-limonene also decreased the cerebral infarct size in the SHRsp rats following stroke. D-Limonene markedly decreased the mRNA expression of interleukin-1β, monocyte chemoattractant protein-1 and cyclooxygenase-2 in SHRsp rats following stroke. The mRNA expression of vascular endothelial growth factor in the brain of SHRsp rats following stroke was significantly increased by D-Limonene. D-Limonene increased the activities of superoxide dismutase and catalase, decreased the malondialdehyde level, increased glutathione content and reduced the DHE-staining in SHRsp rats following stroke. Overall, inhibition of cerebral inflammation, vascular remodeling and antioxidant activities of D-Limonene may be involved in the protective effects against ischemia-induced damage in SHRsp rats. The present study identified D-Limonene as a potential therapeutic candidate for treatment of stroke-associated cerebral and vascular damage under conditions of hypertension.

Normal Control Study of Cerebral Blood Flow by 99mTc HM-PAO SPECT

International Nuclear Information System (INIS)

Koong, Sung Soo; Moon, Dae Hyuk; Lee, Bum Woo; Lee, Kyung Han

1989-01-01

Regional cerebral perfusion was evaluated in 15 normal controls by single photon emission computed tomography using 99m Tc HM-PAO. For quantitative analysis, 13 pairs of homologous region of interest (ROI) were drawn on three transverse slices matching the vascular territories and cerebral cortices, and normal values of 3 semiquantitative indices including 'Right to left ratio' (R/L ratio), 'Regional index' (RI), and 'Region to cerebellum ratio (R/cbll ratio) were calculated. Mean values of R/L ratios of homologous regions were ranged from 0.985 to 1.023, and mean ± 2 s.d. of all regions did not exceed 11% of mean. Significant difference of Rls (mean count per voxel of a ROI/mean count per voxel of total ROls) between regions were found (p<0.001) with highest values in occipital cortex and cerebellum. After attenuation correction, Rls in deep gray, cranial portion of anterior cerebral artery and vascular territories in the 2nd slice increased significantly (p<0.05-0.001) hut vise versa in other ROIs. Region to cerebellum ratios also showed regional difference similar to Rls.

Vascular Contributions to Cognitive Impairment and Dementia

Science.gov (United States)

Gorelick, Philip B.; Scuteri, Angelo; Black, Sandra E.; DeCarli, Charles; Greenberg, Steven M.; Iadecola, Costantino; Launer, Lenore J.; Laurent, Stephane; Lopez, Oscar L.; Nyenhuis, David; Petersen, Ronald C.; Schneider, Julie A.; Tzourio, Christophe; Arnett, Donna K.; Bennett, David A.; Chui, Helena C.; Higashida, Randall T.; Lindquist, Ruth; Nilsson, Peter M.; Roman, Gustavo C.; Sellke, Frank W.; Seshadri, Sudha

2013-01-01

Background and Purpose This scientific statement provides an overview of the evidence on vascular contributions to cognitive impairment and dementia. Vascular contributions to cognitive impairment and dementia of later life are common. Definitions of vascular cognitive impairment (VCI), neuropathology, basic science and pathophysiological aspects, role of neuroimaging and vascular and other associated risk factors, and potential opportunities for prevention and treatment are reviewed. This statement serves as an overall guide for practitioners to gain a better understanding of VCI and dementia, prevention, and treatment. Methods Writing group members were nominated by the writing group co-chairs on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council Scientific Statement Oversight Committee, the Council on Epidemiology and Prevention, and the Manuscript Oversight Committee. The writing group used systematic literature reviews (primarily covering publications from 1990 to May 1, 2010), previously published guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and, when appropriate, formulate recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on the recommendations and approved the final version of this document. After peer review by the American Heart Association, as well as review by the Stroke Council leadership, Council on Epidemiology and Prevention Council, and Scientific Statements Oversight Committee, the statement was approved by the American Heart Association Science Advisory and Coordinating Committee. Results The construct of VCI has been introduced to capture the entire spectrum of cognitive disorders associated with all forms of cerebral vascular brain injury—not solely stroke—ranging from mild cognitive impairment through fully developed

Motociclistas de entrega: algumas características dos acidentes de trânsito na região sul do Brasil Motorcycle couriers: characteristics of traffic accidents in southern Brazil

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Dorotéia Fátima Pelissari de Paula Soares

2011-09-01

Full Text Available OBJETIVO: conhecer características dos acidentes de trânsito ocorridos com motoboys nos municípios de Londrina e Maringá, Estado do Paraná. MÉTODOS: Foram considerados 327 motoboys que relataram, em 2005/2006, acidentes de motocicleta nos 12 meses anteriores à pesquisa (147 de Londrina e 180 de Maringá. RESULTADOS: Dos entrevistados, 39,6% relataram mais de um acidente de trânsito. Os acidentes foram percebidos como graves por 21,4% dos motoboys e 56,3% relataram conhecer motoboy afastado do trabalho por acidente. A maioria dos acidentes (82,9% ocorreu durante o trabalho. Foram observadas diferenças significativas, entre os municípios, para condições climáticas (p=0,013, período do dia (p=0,002, atendimento pré-hospitalar (p=0,032 e necessidade de internação hospitalar (pOBJECTIVE: This study aimed at understanding characteristics of traffic accidents with motorcycle couriers in the cities of Londrina and Maringá, in the State of Paraná (Brazil. METHODS: A total of 327 couriers who reported, in 2005/2006, motorcycle accident in the previous 12 months took part in the study (147 in Londrina and 180 in Maringá. RESULTS: Of all the interviewed, 39.6% reported more than one traffic accident. The accidents were perceived as serious by 21.4% of them and 56.3% reported knowing a convalescing courier due to a traffic accident. Most injuries (82.9% occurred during work hours. Significant differences were observed between the cities concerning climatic conditions (p=0.013, time of the day (p=0.002, pre-hospital care (p=0.032 and hospital admission (p<0.001. CONCLUSION: The high incidence and the recurrence of traffic accidents highlight the susceptibility of motorcycle couriers to these events and the need for strategies and specific prevention policies.

Microcephalic osteodysplastic primordial dwarfism type II (MOPD II) with multiple vascular complications misdiagnosed as Dubowitz syndrome.

Science.gov (United States)

Dieks, Jana-Katharina; Baumer, Alessandra; Wilichowski, Ekkehard; Rauch, Anita; Sigler, Matthias

2014-09-01

To date, the genetic basis of Dubowitz syndrome (short stature, microcephaly, facial abnormalities, eczema) is unknown and vascular complications are not known to be associated with this syndrome. In microcephalic osteodysplastic primordial dwarfism type II (MOPD II; disproportionate short statue, microcephaly, facial abnormalities), however, cerebral aneurysms and other vascular abnormalities are frequent complications. MOPD II is a genetic disorder caused by mutations in the pericentrin (PCNT) gene (21q22). We report on a patient who came to our attention as a 22-year-old with subarachnoid bleeding due to a ruptured cranial aneurysm. Until then, the patient was thought and published to have Dubowitz syndrome; previously, he was treated with coronary bypass surgery for extensive coronary angiopathy. Consecutive genetic testing revealed MOPD II. After clinical stabilization, the patient was discharged to a specialized rehabilitation center where he died due to re-rupture of a cranial aneurysm. In patients with short stature-especially when clinical features are accompanied by vascular complications-MOPD II should be considered as a differential diagnosis leading to consecutive genetic testing. After detection of mutations in the PCNT gene, a full vascular status including cerebral imaging and cardiac evaluation needs to be determined in order to analyze vascular abnormalities and initiate prophylactic treatment.

Neuroradiological findings in vascular dementia

Energy Technology Data Exchange (ETDEWEB)

Guermazi, Ali; Miaux, Yves; Suhy, Joyce; Pauls, Jon; Lopez, Ria [Synarc, Inc., Department of Radiology Services, San Francisco, CA (United States); Rovira-Canellas, Alex [Hospital General Universitari Vall d' Hebron, Unita de Resonancia Magnetica, Barcelona (Spain); Posner, Holly [Eisai, Inc., Teaneck, NJ (United States)

2007-01-15

There are multiple diagnostic criteria for vascular dementia (VaD) that may define different populations. Utilizing the criteria of the National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) has provided improved consistency in the diagnosis of VaD. The criteria include a table listing brain imaging lesions associated with VaD. The different neuroradiological aspects of the criteria are reviewed based on the imaging data from an ongoing large-scale clinical trial testing a new treatment for VaD. The NINDS-AIREN criteria were applied by a centralized imaging rater to determine eligibility for enrollment in 1,202 patients using brain CT or MRI. Based on the above data set, the neuroradiological features that are associated with VaD and that can result from cerebral small-vessel disease with extensive leukoencephalopathy or lacunae (basal ganglia or frontal white matter), or may be the consequence of single strategically located infarcts or multiple infarcts in large-vessel territories, are illustrated. These features may also be the consequence of global cerebral hypoperfusion, intracerebral hemorrhage, or other mechanisms such as genetically determined arteriopathies. Neuroimaging confirmation of cerebrovascular disease in VaD provides information about the topography and severity of vascular lesions. Neuroimaging may also assist with the differential diagnosis of dementia associated with normal pressure hydrocephalus, chronic subdural hematoma, arteriovenous malformation or tumoral diseases. (orig.)

Assessment of cerebral circulation in normal fetuses by three-dimensional power Doppler ultrasonography

International Nuclear Information System (INIS)

Milani, Hérbene José Figuinha; Sá Barreto, Enoch Quinderé de; Araujo Júnior, Edward; Haratz, Karina Krajden; Rolo, Liliam Cristine; Nardozza, Luciano Marcondes Machado; Moron, Antonio Fernandes

2012-01-01

Objective: To assess the three-dimensional power Doppler ultrasonography (3D power Doppler) vascular indices in the middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) territories. Methods: A cross-sectional study was carried out on 111 normal pregnancies between 26 and 34 weeks. The MCA, ACA and PCA territories closest to the transducer were scanned and volumes were calculated by using the VOCAL (Virtual Organ Computer-aided Analysis) program. The 3D power Doppler indices – vascularization index (VI), flow index (FI) and vascularization-flow index (VFI) were calculated. Scatter graphs, Pearson correlation coefficients (r) and linear regression models were used. Results: Only the FI-MCA (r = 0.38 and p < 0.001), VFI-MCA (r = 0.23 and p = 0.016) and FI-PCA (r = 0.191 and p = 0.040) had a low correlation with gestational age. The other 3D power Doppler indices VI-MCA (r = 0.153 and p = 0.150), VI-ACA (r = 0.105 and p = 0.271), FI-ACA (r = 0.154 and p = 0.106), VFI-ACA (r = 0.134 and p = 0.161), VI-PCA (r = 0.105 and p = 0.270) and VFI-PCA (r = 0.126 and p = 0.180) showed no statistically significant correlation with gestational. Conclusion: It was observed a low correlation between gestational age and the FI-MCA, VFI-MCA and FI-PCA.

The development of cerebral amyloid angiopathy in cerebral vessels. A review with illustrations based upon own investigated post mortem cases.

Science.gov (United States)

Mendel, T A; Wierzba-Bobrowicz, T; Lewandowska, E; Stępień, T; Szpak, G M

2013-12-01

The process of β-amyloid accumulation in cerebral vessels is presented. Cerebral amyloid angiopathy (CAA) was confirmed during an autopsy. It was diagnosed according to the Boston criteria. Cerebral amyloid angiopathy can involve all kinds of cerebral vessels (cortical and leptomeningeal arterioles, capillaries and veins). The development of CAA is a progressive process. β-amyloid appears first in the tunica media, surrounding smooth muscle cells, and in the adventitia. β-amyloid is progressively accumulated, causing a gradual loss of smooth muscle cells in the vessel wall and finally replacing them. Then, the detachment and delamination of the outer part of the tunica media results in the "double barrel" appearance, fibrinoid necrosis, and microaneurysm formation. Microbleeding with perivascular deposition of erythrocytes and blood breakdown products can also occur. β-amyloid can also be deposited in the surrounding of the affected vessels of the brain parenchyma, known as "dysphoric CAA". Ultrastructurally, when deposits of amyloid fibers were localized in or outside the arteriolar wall, the degenerating vascular smooth muscle cells were observed. In the Institute of Psychiatry and Neurology the study was carried out in a group of 48 patients who died due to intracerebral hemorrhage caused by sporadic CAA.

A desproteção social dos trabalhadores rurais nos acidentes de trabalho = The social don’t protection of the agricultural workers in the works accidents

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Schlindwein, Vanderleia de Lurdes Dal Castel

2011-01-01

Full Text Available Este artigo é uma pesquisa de cunho qualitativo que buscou investigar os vários ângulos que contribuem para a desproteção social dos trabalhadores rurais no acesso ao sistema de proteção social brasileiro, nos processos de adoecimento e acidentes no trabalho, situação que expõe o trabalhador e sua família a diferentes formas de violências e precarização das condições de vida, saúde e trabalho. Para desvelar esses caminhos, nem sempre visíveis, foram realizadas entrevistas qualitativas com profissionais da Previdência Social, na região nordeste do Estado do Rio Grande do Sul. Os depoimentos revelam os obstáculos institucionais que dificultam o encaminhamento e reconhecimento do auxílio doença e acidente junto ao Instituto Nacional de Seguridade Social (INSS, até os entraves de reconhecimento do nexo causal do trabalho com o acidente

U0126 attenuates cerebral vasoconstriction and improves long-term neurologic outcome after stroke in female rats

DEFF Research Database (Denmark)

Ahnstedt, Hilda; Mostajeran, Maryam; Blixt, Frank W

2015-01-01

, responses to this treatment in females and long-term effects on outcome are not known. Initial experiments used in vitro organ culture of cerebral arteries, confirming ERK1/2 activation and increased ETB receptor-mediated vasoconstriction in female cerebral arteries. Transient middle cerebral artery......-mediated contraction was studied with myograph and protein expression with immunohistochemistry. In vitro organ culture and tMCAO resulted in vascular ETB receptor upregulation and activation of ERK1/2 that was prevented by U0126. Although no effect on infarct size, U0126 improved the long-term neurologic function...

MRI in human immunodeficiency virus-associated cerebral vasculitis

International Nuclear Information System (INIS)

Berkefeld, J.; Lanfermann, H.

2000-01-01

Cerebral ischaemia caused by inflammatory vasculopathies has been described as complication of human immunodeficiency virus (HIV) infection. Imaging studies have shown ischaemic lesions and changes of the vascular lumen, but did not allow demonstration of abnormalities within the vessel wall itself. Two HIV-infected men presented with symptoms of a transient ischaemic attack. Initial MRI of the first showed no infarct; in the second two small lacunar lesions were detected. In both cases, multiplanar 3-mm slice contrast-enhanced T1-weighted images showed aneurysmal dilatation, with thickening and contrast enhancement of the wall of the internal carotid and middle cerebral (MCA) arteries. These findings were interpreted as indicating cerebral vasculitis. In the first patient the vasculopathy progressed to carotid artery occlusion, and he developed an infarct in the MCA territory, but then remained neurologically stable. In the second patient varicella zoster virus (VZV) infection was the probable cause of vasculitis. The clinical deficits and vasculitic MRI changes regressed with antiviral and immunosuppressive therapy. (orig.)

MRI in human immunodeficiency virus-associated cerebral vasculitis

Energy Technology Data Exchange (ETDEWEB)

Berkefeld, J.; Lanfermann, H. [Frankfurt Univ. (Germany). Abt. fuer Neuroradiologie; Enzensberger, W. [Klinik fuer Neurologie, Klinikum der Johann Wolfgang Goethe-Univ. Frankfurt am Main (Germany)

2000-07-01

Cerebral ischaemia caused by inflammatory vasculopathies has been described as complication of human immunodeficiency virus (HIV) infection. Imaging studies have shown ischaemic lesions and changes of the vascular lumen, but did not allow demonstration of abnormalities within the vessel wall itself. Two HIV-infected men presented with symptoms of a transient ischaemic attack. Initial MRI of the first showed no infarct; in the second two small lacunar lesions were detected. In both cases, multiplanar 3-mm slice contrast-enhanced T1-weighted images showed aneurysmal dilatation, with thickening and contrast enhancement of the wall of the internal carotid and middle cerebral (MCA) arteries. These findings were interpreted as indicating cerebral vasculitis. In the first patient the vasculopathy progressed to carotid artery occlusion, and he developed an infarct in the MCA territory, but then remained neurologically stable. In the second patient varicella zoster virus (VZV) infection was the probable cause of vasculitis. The clinical deficits and vasculitic MRI changes regressed with antiviral and immunosuppressive therapy. (orig.)

Avaliação dos riscos de acidentes em atividades de poda de árvores na arborização urbana do distrito federal

OpenAIRE

Fiedler,Nilton César; Sone,Eduardo Hideki; Vale,Ailton Teixeira do; Juvêncio,José de Fátima; Minette,Luciano José

2006-01-01

Esta pesquisa teve por objetivo avaliar os riscos de acidentes em atividades de poda de árvores na arborização urbana do Distrito Federal. A coleta de dados foi feita com a aplicação de um questionário em forma de entrevista individual. Responderam ao questionário 94% dos funcionários, sendo 92% do total dos operadores de motosserra e 95% do total de auxiliares. Além disso, foi realizada uma avaliação qualitativa do risco de acidentes nas máquinas e equipamentos de poda e nos veículos de tran...

Arterial vascularization of the pineal gland.

Science.gov (United States)

Kahilogullari, Gokmen; Ugur, Hasan Caglar; Comert, Ayhan; Brohi, Recep Ali; Ozgural, Onur; Ozdemir, Mevci; Karahan, Suleyman Tuna

2013-10-01

The arterial vascularization of the pineal gland (PG) remains a debatable subject. This study aims to provide detailed information about the arterial vascularization of the PG. Thirty adult human brains were obtained from routine autopsies. Cerebral arteries were separately cannulated and injected with colored latex. The dissections were carried out using a surgical microscope. The diameters of the branches supplying the PG at their origin and vascularization areas of the branches of the arteries were investigated. The main artery of the PG was the lateral pineal artery, and it originated from the posterior circulation. The other arteries included the medial pineal artery from the posterior circulation and the rostral pineal artery mainly from the anterior circulation. Posteromedial choroidal artery was an important artery that branched to the PG. The arterial supply to the PG was studied comprehensively considering the debate and inadequacy of previously published studies on this issue available in the literature. This anatomical knowledge may be helpful for surgical treatment of pathologies of the PG, especially in children who develop more pathology in this region than adults.

Representações sociais sobre o acidente de trabalho em saúde

OpenAIRE

Medeiros Júnior, Antônio

2005-01-01

O presente estudo objetivou identificar os elementos representacionais sobre o acidente de trabalho em saúde, além de investigar os tipos mais freqüentes ocorridos em um hospital universitário, buscando compreender os elementos cognitivos, afetivos e sociais, subjacentes ao processo de trabalho em saúde. O foco de análise foi dirigido para 470 trabalhadores dos níveis de apoio, médio e superior deste hospital, à luz do suporte teórico-metodológico da Teoria das Representações Sociais. Para co...

Assessing regional cerebral blood flow in depression using 320-slice computed tomography.

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Yiming Wang

Full Text Available While there is evidence that the development and course of major depressive disorder (MDD symptomatology is associated with vascular disease, and that there are changes in energy utilization in the disorder, the extent to which cerebral blood flow is changed in this condition is not clear. This study utilized a novel imaging technique previously used in coronary and stroke patients, 320-slice Computed-Tomography (CT, to assess regional cerebral blood flow (rCBF in those with MDD and examine the pattern of regional cerebral perfusion. Thirty nine participants with depressive symptoms (Hamilton Depression Rating Scale 24 (HAMD24 score > 20, and Self-Rating Depression Scale (SDS score > 53 and 41 healthy volunteers were studied. For all subjects, 3 ml of venous blood was collected to assess hematological parameters. Transcranial Doppler (TCD ultrasound was utilized to measure parameters of cerebral artery rCBFV and analyse the Pulsatility Index (PI. 16 subjects (8 =  MDD; 8 =  healthy also had rCBF measured in different cerebral artery regions using 320-slice CT. Differences among groups were analyzed using ANOVA and Pearson's tests were employed in our statistical analyses. Compared with the control group, whole blood viscosity (including high\\middle\\low shear rateand hematocrit (HCT were significantly increased in the MDD group. PI values in different cerebral artery regions and parameters of rCBFV in the cerebral arteries were decreased in depressive participants, and there was a positive relationship between rCBFV and the corresponding vascular rCBF in both gray and white matter. rCBF of the left gray matter was lower than that of the right in MDD. Major depression is characterized by a wide range of CBF impairments and prominent changes in gray matter blood flow. 320-slice CT appears to be a valid and promising tool for measuring rCBF, and could thus be employed in psychiatric settings for biomarker and treatment response purposes.

Idade avançada e incidência de fibrilação atrial em pós-operatório de troca valvar aórtica

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Fernando Pivatto Júnior

2014-03-01

Full Text Available Objetivo: Descrever, em idosos, a correlação entre faixa etária e ocorrência de fibrilação atrial após cirurgia por estenose aórtica, além de avaliar a influência da ocorrência de fibrilação atrial na incidência de acidente vascular cerebral, tempo de internação e mortalidade hospitalar. Métodos: Estudo transversal retrospectivo incluindo pacientes com idade > 70 anos submetidos à cirurgia de troca valvar aórtica isolada. Resultados: Foram estudados 348 pacientes com idade média de 76,8±4,6 anos. A incidência de fibrilação atrial no pós-operatório foi 32,8% (n=114, sendo superior nos pacientes > 80 anos (42,9 vs. 28,8% 70-79 anos, P=0,017 e havendo significância estatística limítrofe (P=0,055 para tendência linear na correlação idade e incidência de fibrilação atrial. Verificou-se significativo maior tempo de internação na Unidade de Terapia Intensiva e hospitalar total, porém, não se observou maior taxa de acidente vascular cerebral ou de mortalidade hospitalar decorrente da fibrilação atrial. Conclusão: A incidência de fibrilação atrial no pós-operatório de cirurgia para estenose valvar aórtica em pacientes idosos com > 70 anos foi elevada e linearmente correlacionada ao avanço da idade, especialmente após 80 anos, causando aumento dos tempos de internação total e em Unidade de Terapia Intensiva, sem aumento significativo da morbimortalidade. O conhecimento desses dados é importante para evidenciar a necessidade de medidas profiláticas e de tratamento precoce dessa arritmia nesse subgrupo.

123I-IMP-SPECT in vascular dementia

International Nuclear Information System (INIS)

Namura, Yasuhiro; Miyoshi, Toshihiko; Shio, Hideo; Yamaguchi, Shinya; Kimura, Jun

1990-01-01

Cerebral blood flow (CBF) was studied by N-isopropyl-p- 123 I-iodoamphetamine (IMP)-single photon emission computed tomography (SPECT) in patients with vascular dementia. Patients were divided by CT/MRI findings into multiple or localized type and cortical or subcortical type. Of patients with multiple lesions in the cortex, the reduction of CBF was noted in several cortex corresponding to CT/MRI findings. Patients in this group had a high incidence of aphasia, agraphia, dyscalculia, and amnesia. Patients with multiple lesions in the white matter and basal ganglia were subdivided into 3 groups by clinical manifestations. CBF in those with dementia showed generalized reduction in all cerebral cortex and especially in bilateral frontal regions. CBF in those with slightly impaired mentality was almost normal. In another group with pseudobulbar palsy and/or extrapyramidal sings, CBF was reduced intermediately only in bilateral frontal regions. Typical symptoms in demented patients were apathy, emotional lability, and forgetfulness. In those with the localized type, CBF was reduced in cerebral cortical areas correlating with the impaired mental functions. (author)

Sleep Apnea, Sleep Duration and Brain MRI Markers of Cerebral Vascular Disease and Alzheimer's Disease: The Atherosclerosis Risk in Communities Study (ARIC).

Science.gov (United States)

Lutsey, Pamela L; Norby, Faye L; Gottesman, Rebecca F; Mosley, Thomas; MacLehose, Richard F; Punjabi, Naresh M; Shahar, Eyal; Jack, Clifford R; Alonso, Alvaro

2016-01-01

A growing body of literature has suggested that obstructive sleep apnea (OSA) and habitual short sleep duration are linked to poor cognitive function. Neuroimaging studies may provide insight into this relation. We tested the hypotheses that OSA and habitual short sleep duration, measured at ages 54-73 years, would be associated with adverse brain morphology at ages 67-89 years. Included in this analysis are 312 ARIC study participants who underwent in-home overnight polysomnography in 1996-1998 and brain MRI scans about 15 years later (2012-2013). Sleep apnea was quantified by the apnea-hypopnea index and categorized as moderate/severe (≥15.0 events/hour), mild (5.0-14.9 events/hour), or normal (sleep duration was categorized, in hours, as sleep study participants were 61.7 (SD: 5.0) years old and 54% female; 19% had moderate/severe sleep apnea. MRI imaging took place 14.8 (SD: 1.0) years later, when participants were 76.5 (SD: 5.2) years old. In multivariable models which accounted for body mass index, neither OSA nor abnormal sleep duration were statistically significantly associated with odds of cerebral infarcts, WMH brain volumes or regional brain volumes. In this community-based sample, mid-life OSA and habitually short sleep duration were not associated with later-life cerebral markers of vascular dementia and Alzheimer's disease. However, selection bias may have influenced our results and the modest sample size led to relatively imprecise associations.

Evaluation of computer tomography in cerebro-vascular disease (Strokes)

International Nuclear Information System (INIS)

Lee, Young Sik; Baek, Seung Yon; Rhee, Chung Sik; Kim, Hee Seup

1984-01-01

Most of cerebrovascular disease are composed of vascular occulusive changes and hemorrhage. Now a day, the computed tomography is the best way for evaluation of cerebrovascular disease including detection of nature, location, and associated changes. This study includes evaluation of computed tomography of 70 patients with cerebrovascular disease during the period of 10 months from April. 1983 to Feb. 1984 in Department of Radiology, Ewha Womans University Hospital. The results were as follows: 1. Age distribution of the total 70 patients was broad ranging from 25 years to 79 years. 78.6% of patients were over the age of 50. The male and female sex ratio was 1.4:1. 2. 4 out of 70 patients were normal and 66 patients revealed abnormal on C.T. findings; those were intracranial hemorrhage (28 patients), cerebral infarction (34 patients) and brain atrophy (4 patients). 3. In cases of cerebral infarction, the cerebral hemisphere was most common site of lesion (28 cases), and next was basal ganglia (2 cases). Most of the infarcts in cerebral hemisphere were located in the parietal and temporal lobes. 4. In cases of intracranial hemorrhage, the basal ganglia was most common site of lesion (15 cases). The next common site was cerebral hemisphere (9 cases). 6 patients of all intracranial hemorrhage were combined with intraventricular hemorrhage. Ratio of right and left was 2:3. 5. In patients with motor weakness or hemiparesis, more common findings on CT scan were cerebral infarction. In case with hemiplegia, more common CT findings were intracerebral hemorrhage. 6. Of the 40 cases thought to be cerebral infarction initially by clinical findings and spinal tap. 8 cases (20.0%) were proved to be cerebral hemorrhage by the CT scan. However, of the 22 cases thought to be cerebral hemorrhage, initially, only two cases (9.0%) were cerebral infarction

Cenários típicos de lesões decorrentes de acidentes de trabalho na indústria madeireira Scenarios of typical occupational injuries in lumber industry

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Vidal de Souza

2002-12-01

Full Text Available OBJETIVO: Descrever os cenários das lesões decorrentes de acidentes de trabalho na indústria madeireira. MÉTODOS: Foram identificados todos os acidentes típicos entre janeiro de 1997 e janeiro de 1999, notificados a um dos postos do Instituto Nacional de Seguro Social, localizado em Lages, Santa Catarina. Trata-se de um estudo transversal descritivo em que foram analisadas 254 Comunicações de Acidentes de Trabalho (CAT. Aplicou-se análise multivariada com Análise Fatorial de Correspondência Múltipla (AFCM, Classificação Hierárquica de Ascendência (CHA e Classificação Não Hierárquica de Partição (CNHP para a identificação dos cenários típicos de lesões decorrentes de acidentes. RESULTADOS: Cinco cenários de lesões decorrentes de acidentes foram agrupados: 1 queda do trabalhador, 40 casos; 2 sobreesforço ao erguer ou empurrar um objeto, 5 casos; 3 objetos ou peças que tenham caído ou saltado de máquinas em movimento, 76 casos; 4 esmagamento de partes moles, 56 casos; e 5 contato com serras em movimento, 77 casos. CONCLUSÕES: A utilização de análise multivariada permitiu definir as lesões mais típicas relacionadas a determinados tipos de acidentes, bem como apreender as circunstâncias em que ocorreram.OBJECTIVE: To describe the scenarios of typical occupational injuries in lumber industry. METHODS: All occupational injuries reported to a INSS (National Institute of Social Security center in Lages, SC, Brazil from January 1997 to January 1999 were identified. A descriptive cross-sectional study was carried out and 254 injury report forms were analyzed. Multivariate analysis was conducted using Factorial Analysis of Correspondence (FAC, Hierarchical Ascendant Classification (HAC and Partition to identify the scenarios of typical occupational injuries. RESULTS: There were identified five scenarios of occupational injuries: 1 workers' falls (40 reports; 2 overexertion in lifting or pushing objects (5 reports; 3

Cerebrovascular endothelin-1 hyper-reactivity is associated with transient receptor potential canonical channels 1 and 6 activation and delayed cerebral hypoperfusion after forebrain ischaemia in rats

DEFF Research Database (Denmark)

Johansson, S E; Andersen, X E D R; Hansen, R H

2015-01-01

. METHODS: Experimental forebrain ischaemia was induced in Wistar male rats by a two-vessel occlusion model, and the cerebral blood flow was measured by magnetic resonance imaging two days after reperfusion. In vitro vasoreactivity studies, immunofluorescence and quantitative PCR were performed on cerebral...... in the vascular smooth muscle cells was enhanced and correlated with decreased cerebral blood flow two days after forebrain ischaemia. Furthermore, under conditions when voltage-dependent calcium channels were inhibited, endothelin-1-induced cerebrovascular contraction was enhanced and this enhancement...... was presumably mediated by Ca(2+) influx via upregulated transient receptor potential canonical channels 1 and 6. CONCLUSIONS: Our data demonstrates that endothelin-1-mediated influx of extracellular Ca(2+) activates transient receptor potential canonical channels 1 and 6 in cerebral vascular smooth muscle cells...

Fístula traqueoesofágica como complicação tardia de traqueostomia

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COELHO MARLOS DE SOUZA

2001-01-01

Full Text Available A fístula traqueoesofágica como complicação tardia de traqueostomia é uma ocorrência rara, com incidência menor do que 1%, mas que deve ser conhecida, diagnosticada e tratada rapidamente, para que se evite evolução desfavorável. Relata-se o caso de uma mulher de 41 anos que permaneceu com traqueostomia prolongada, devido a acidente vascular cerebral. Após a alta hospitalar, apresentou insuficiência respiratória aguda e observou-se a saída de material da sonda nasogástrica traqueostomia. O diagnóstico de fístula traqueoesofágica foi feito por exame endoscópico e a paciente foi submetida a uma traqueoplastia, com boa evolução.

Microcephalic osteodysplastic primordial dwarfism type II (MOPD II) with multiple vascular complications misdiagnosed as Dubowitz syndrome

OpenAIRE

Dieks, Jana-Katharina; Baumer, Alessandra; Wilichowski, Ekkehard; Rauch, Anita; Sigler, Matthias

2014-01-01

To date, the genetic basis of Dubowitz syndrome (short stature, microcephaly, facial abnormalities, eczema) is unknown and vascular complications are not known to be associated with this syndrome. In microcephalic osteodysplastic primordial dwarfism type II (MOPD II; disproportionate short statue, microcephaly, facial abnormalities), however, cerebral aneurysms and other vascular abnormalities are frequent complications. MOPD II is a genetic disorder caused by mutations in the pericentrin (PC...

Análise de conceito do resultado de enfermagem Mobilidade em pacientes com acidente vascular cerebral

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Rafaella Pessoa Moreira

2014-06-01

Full Text Available O objetivo foi realizar análise do conceito do resultado de enfermagem Mobilidade em paciente com AVC. Realizou-se revisão integrativa da literatura, por meio de acesso on-line às bases: Scopus, Pubmed, Cinahl, Cochrane e Lilacs, usando-se os descritores: mobility, stroke, nursing e sinonímias nas línguas portuguesa e espanhola. Identificaram-se 1.521 artigos de que, após seleção criteriosa, resultaram 49. Destacam-se artigos publicados no Canadá (26,7%, a partir de 2001 (95,9%, por fisioterapeutas (34,6%, em unidades de reabilitação (61,5%. Atributos identificados para Mobilidade: andar, ficar em pé, sentar, colocar a perna de um lado para outro, virar-se, iniciar e parar a locomoção, subir escadas, função motora, transferência e habilidade motora. Também foi construído caso modelo, caso contrário e identificados antecedentes: controle postural e equilíbrio; e consequentes: realiza tarefas no interior e exterior da casa e deambula sem dificuldade. Os conceitos do resultado Mobilidade encontrados nesta pesquisa precisam ser validados com especialistas na área e na prática clínica.

Evaluation of cerebral blood flow, cerebral metabolism and cerebral function by magnetic resonance imaging

International Nuclear Information System (INIS)

Tanaka, Chuzo; Higuchi, Toshihiro; Umeda, Masahiro; Naruse, Shoji; Horikawa, Yoshiharu; Ueda, Satoshi; Furuya, Seiichi.

1995-01-01

The magnetic resonance (MR) method has the unique potentiality of detecting cerebral metabolites, cerebral blood flow and brain functions in a noninvasive fashion. We have developed several MR techniques to detect these cerebral parameters with the use of clinical MRI scanners. By modifying the MR spectroscopy (MRS) technique, both 31 P- and 1 H-MRS data can be obtained from multiple, localized regions (multi-voxel method) of the brain, and the distribution of each metabolite in the brain can be readily visualized by metabolite mapping. The use of diffusion weighted images (DWI) permits visualization of the anisotropy of water diffusion in white matter, and based on the difference of diffusion coefficiency, the differential diagnosis between epidermoid tumor and arachnoid cyst can be made. By employing dynamic-MRI (Dyn-MRI) with Gd-DTPA administration, it is possible to examine the difference in blood circulation between brain tumor tissue and normal tissue, as well as among different types of brain tumors. By using magnetization transfer contrast (MTC) imaging, it has become possible to detect brain tumors, and with a small dose of Gd-DTPA, to visualize the vascular system. Functional MRI (fMRI) visualizes the activated brain by using conventional gradient echo technique on conventional MRI scanners. This method has the unique characteristic of detecting a brain function with high spatial and temporal resolution by using the intrinsic substance. Moreover, the localization of motor and sensory areas was detected by noninvasive means within few minutes. The fMRI procedure will be used in the future to analyze the higher and complex brain functions. In conclusion, multi-modality MR is a powerful technique that is useful for investigating the pathogenesis of many diseases, and provides a noninvasive analytic modality for studying brain function. (author)

Transcephalic electrical impedance in the study of cerebral circulation in a juvenile pig model.

Science.gov (United States)

Grönlund, J; Bartocci, M; Kääpä, P; Jahnukainen, T; Rautanen, M; Halkola, L; Välimäki, I

1997-11-01

Transcephalic electrical impedance offers a technique for non-invasive, cot-side monitoring of neonatal cerebral circulation but the exact nature of the signal is somewhat ambiguous. The impedance signal is examined in an animal project where the ventilator settings are adjusted (20 min-1-10 min-1-40 min-1 for 10 min periods each) to produce circulatory changes. Six juvenile pigs are intubated, and ECG, arterial blood pressure, carotid flow (CF) by electromagnetic flowmeter and impedance are continuously monitored and stored on analogue tape. Cardiac output by thermodilution, blood oxygen (pO2) and carbon dioxide (pCO2) tensions are measured. ECG is converted to heart rate, mean blood pressure is integrated, and the high-frequency (1.50-4.00 Hz) component of the impedance signal delta Z is computed using autoregressive spectral estimation. Stroke volume, peripheral vascular resistance (PVR) and cerebral vascular resistance (CVR) are calculated. pCO2 and CF increase and pO2 decreases during hypoventilation. CF correlates positively with cardiac output, stroke volume, delta Z and pCO2, and negatively with pO2 and CVR. delta Z correlates positively with heart rate and cardiac output, and negatively with PVR and CVR. It is concluded that the impedance signal is related to the amount of blood transmitted to the brain by every beat of the heart, depending on the changes in both the systemic circulation and the cerebral vascular compliance.

[The magneto-, photo- and laser therapy of headaches in patients with vascular brain lesions].

Science.gov (United States)

Troshin, V D; Miasnikov, I G; Belousova, T E

1994-01-01

To manage vascular cephalalgia, a combined approach is proposed: segmentally oriented magnetic, photo- and photomagnetic therapy plus intravenous laser treatment. The effect was directly correlated with cerebral hemodynamic condition, damage to vegetative innervation segmental-peripheral link and physiotherapeutic factors.

l-arginine and l-NMMA for assessing cerebral endothelial dysfunction in ischaemic cerebrovascular disease

DEFF Research Database (Denmark)

Karlsson, William K; Sørensen, Caspar G; Kruuse, Christina

2017-01-01

Endothelial dysfunction (ED), in particular cerebral ED, may be an essential biomarker for ischaemic cerebrovascular disease. However, there is no consensus on methods to best estimate cerebral ED. In this systematic review, we evaluate the use of l-arginine and NG -monomethyl-l-arginine (l......-NMMA) for assessment of cerebral ED. A systematic search of PubMed, EMBASE and the Cochrane Library was done. We included studies investigating cerebrovascular response to l-arginine or l-NMMA in human subjects with vascular risk factors or ischaemic cerebrovascular disease. Seven studies (315 subjects) were eligible...... cerebrovascular disease. Inconsistencies in results were most likely due to variations in methods and included subject populations. In order to use cerebral ED as a prognostic marker, further studies are required to evaluate the association to cerebrovascular disease....

Acidentes de trabalho: uma expressão da violência social Occupational accidents: an expression of social violence

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Jorge M. H. Machado

1994-01-01

Full Text Available O objetivo principal deste estudo é relacionar violência e processo de trabalho. Tem como pressuposto que o elevado índice de acidentes de trabalho existente no Brasil caracteriza uma forma de violência estrutural nos locais de trabalho. Este quadro é situado no contexto internacional, a partir de dados de diversos setores econômicos. Discutem-se as informações provenientes dos registros da Previdência Social e dos atestados de óbito. Em aparente contraste com os dados internacionais, as estatísticas brasileiras mostram que os acidentes resultantes de atividades externas às empresas, em particular os de trânsito, são as maiores causas de morte no trabalho. São examinadas também questões relativas à qualidade dos registros e à classificação dos diversos tipos de acidente.The main objective of this study is to underscore the link between violence and the work process. Brazil is presently characterized by a very high level of occupational accidents, which amount to a form of structural violence in the workplace. The study considers the situation in the international context, with a brief analysis of different data in a variety of economic sectors. Brazilian data on occupational accidents obtained from National Social Welfare System records and death certificate archives are also discussed. In apparent contrast to international data, the Brazilian records demonstrate that outdoor activities, and in particular traffic accidents, are the major causes of death at work. Problems relating to the quality of data and to the classification of different types of accidents are also examined.

Escalas para avaliação da sobrecarga de cuidadores de pacientes com Acidente Vascular Encefálico Escalas para evaluación de la sobrecarga de cuidadores de pacientes con Accidente Vascular Encefálico Scales for evaluation of the overload of caregivers of patients with Stroke

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Ana Railka de Souza Oliveira

2012-10-01

Full Text Available O objetivo do estudo foi avaliar as escalas disponíveis na literatura para medir a sobrecarga de cuidadores de pacientes acometidos por acidente vascular encefálico. Realizou-se uma revisão bibliográfica nas três bases de dados: LILACS, CINAHL e SCOPUS. Selecionaram-se 23 trabalhos e identificaram-se 24 diferentes escalas. Destas, as mais citadas foram o Caregiver Strain Index, a Caregiver Burden Scale, a Caregiver Reaction Assessment, o Sense of Competence Questionnaire, a Relatives Stress Scale e a Zarit Burden Interview. O uso de escalas para mensurar a sobrecarga é uma ferramenta importante para avaliar o contexto no qual está inserido o cuidador, entretanto é mais fidedigno quando associado a outros instrumentos de mensuração. Portanto, é fundamental pesquisas de validação de escalas para essa população.El objetivo de esto estudio fue evaluar las escalas disponibles en literatura para evaluar la sobrecarga de cuidadores de pacientes acometidos por accidente vascular encefálico. Una revisión bibliográfica fue desarrollada en tres bases de datos: LILAS, CINAHL y SCOPUS. En 23 trabajos seleccionados, 24 diferentes escalas fueron identificadas, siendo las principales: el Caregiver Strain Index, la Caregiver Burden Scale, el Caregiver Reaction Assessment, el Sense of Competence Questionnaire, la Relatives Stress Scale y la Zarit Burden Interview. El uso de escalas para mensurar sobrecarga es una herramienta importante en el contexto donde se inserta el cuidador. Es más confiable utilizar más que uno instrumento de mensuración. Por esto, la validación de escalas es importante para esta población.The objective of the study was to evaluate the available productions in literature about scales to measure the overload of caregivers of patients with stroke. It was carried out a bibliographical revision in three databases: LILACS, CINAHL and SCOPUS. In 23 works, 24 different scales were identified, and the most cited were: the

Effects of acetazolamide on the micro- and macro-vascular cerebral hemodynamics: A diffuse optical and transcranial doppler ultrasound study

OpenAIRE

Zirak P.; Delgado-Mederos R.; Marti-Fabregas J.; Durduran T.

2010-01-01

Acetazolamide (ACZ) was used to stimulate the cerebral vasculature on ten healthy volunteers to assess the cerebral vasomotor reactivity (CVR). We have combined near infrared spectroscopy (NIRS), diffuse correlation spectroscopy (DCS) and transcranial Doppler (TCD) technologies to non-invasively assess CVR in real-time by measuring oxy- and deoxy-hemoglobin concentrations, using NIRS, local cerebral blood flow (CBF), using DCS, and blood flow velocity (CBFV) in the middle cerebral artery, usi...

Acidentes do trabalho em pescadores artesanais da região do Médio Rio Araguaia, Tocantins, Brasil Work-related accidents in traditional fishermen from the Medium Araguaia River region, Tocantins, Brazil

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Domingos Garrone Neto

2005-06-01

Full Text Available Este é um estudo transversal, com componente retrospectivo, investigando a ocorrência de acidentes do trabalho entre pescadores profissionais artesanais da região do médio Rio Araguaia, Tocantins, Brasil. Entre junho e agosto de 2002, foram entrevistados pescadores do Município de Araguacema, com respeito à organização de suas atividades de trabalho e à ocorrência de acidentes do trabalho nos últimos seis meses. Dos 92 pescadores que participaram do estudo, 56 relataram ter sofrido acidente. A proporção de incidência de acidentes obtida foi de 82,6% ao ano. Cerca de 95,7% dos entrevistados referiram não contribuir regularmente para a Previdência Social e não estarem cientes sobre seus direitos e deveres previdenciários. Entre os pescadores que referiram acidentes, essa proporção foi de 98,2%. Aproximadamente 23,0% dos pescadores estudados relataram possuir outra atividade laboral paralela, principalmente como pedreiro (47,6% e guia de pesca (23,9%. As injúrias por animais do ambiente aquático foram a principal causa de acidente relatada pelos pescadores, perfazendo cerca de 86,0% dos casos. Percebe-se, diante dos resultados, que os acidentes por animais do ambiente aquático são um importante agravo à saúde, provocando, em alguns casos, incapacidade temporária para o trabalho.This is a cross-sectional study of work-related accidents among traditional fishermen in the Medium Araguaia River region of Tocantins, Brazil. From June to August 2002, fishermen from the Municipality of Araguacema were interviewed about the organization of their work activities and work-related accidents during the previous six months. Of the 92 participating fishermen, 56 reported having suffered a work-related accident (annual incidence was 82.6%. Some 95.7% of those interviewed did not regularly pay social security insurance as self-employed workers and were not aware of their social rights and duties. For fishermen reporting accidents, this

Functional Magnetic Resonance Imaging in the Presurgical Evaluation of Brain Vascular Malformations

International Nuclear Information System (INIS)

Montes, Natalia; Herrera, Diego A; Vargas Sergio A

2010-01-01

Objective: To describe our experience in presurgical evaluation of intracranial vascular malformations by means of functional magnetic resonance (fMRI). Method: To evaluate eight patients with cerebral vascular malformations (seven arterio-venous malformation [AVM ] and one cavernous malformation) to send to the eloquent cortex with RMf pre-surgical mapping is assessed. Used a technique that is dependent on the level of oxygen (BOLD) to locate these areas in the cerebral vascular malformation, by applying different paradigms. Results: We found one AVM at the right temporal lobe with activation of the parahipocampal gyrus at the contralateral side using a memory paradigm; another patient with an AVM at the right mesotemporal lobe showed activation of visual and spatial memory of the contralateral hippocampus and parahippocampus. One patient with an AVM at the left parietal lobe without compromise of sensorial and motor cortex; a cavernous malformation at the left angular gyrus with hemispheric language dominance in that side; one right thalamic AVM, one periventricular AVM bilateral language dominance; one left occipital AVM with decreased activation in visual association cortex; one temporoccipital AVM with left language dominance and neurovascular uncoupling. Conclusion: fMRI can delineate anatomically the relationship between the lesion and eloquent cortex, providing useful information for presurgical planning and allowing risk estimation of intervention.

A study of cerebral circulation, metabolism and MRI findings in patients with chronic cerebral circulatory insufficiency

International Nuclear Information System (INIS)

Kondo, Susumu

1995-01-01

Chronic cerebral circulatory insufficiency (CCCI) is a recently proposed clinical entity characterized by symptoms such as dizziness, a feeling of heavy-headedness or vague numbness without any neurological signs or organic vascular lesions on CT. In order to elucidate its pathogenesis, ultrasonic quantitative blood flow measurement system, positron emission tomography (PET) and MRI were employed to study three groups of subjects: 60 subjects with CCCI (group A), 44 subjects with risk factors for cerebrovascular disease but without neurological abnormalities (group B), and 40 normal healthy volunteers (group C). The results are summarized as follows: Mean common carotid blood flow decreased with age in all groups. Common carotid blood flow was lowest in group A and second lowest in group B in every decade of patient age. PET study revealed that CBF and CMRO 2 in all regions examined were significantly lower in group A than in group C. The incidence of MR signal abnormalities in the white matter increased with age. Group A had the highest incidence, and group C had the lowest. Reduction in mean common carotid blood flow and cerebral blood flow was associated with increasing incidence and severity of MR signal abnormalities. These findings indicate that CCCI is a pathologic condition closely related to diffuse cerebral low perfusion resulting from cerebral arteriosclerosis. The symptoms seen in this condition, which are apt to be taken lightly, may warn of impending ischemic stroke. (author)

Acidentes e violências entre mulheres atendidas em Serviços de Emergência Sentinela - Brasil, 2009 Accidents and violence among women attended in Sentinel Emergency Services - Brazil, 2009

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Celeste de Souza Rodrigues

2012-09-01

Full Text Available As causas externas afetam de maneira desigual as populações humanas. O presente artigo tem como objetivo analisar os atendimentos de emergência em mulheres vítimas de acidentes e violências. Foram analisados dados do inquérito de Vigilância de Violências e Acidentes em 74 Unidades de Emergência de 23 capitais e no Distrito Federal em 2009. Analisaram-se 6.965 atendimentos de mulheres adultas comparando-se as faixas de 20-39 e 40-59 anos, em relação a ocorrência de acidentes e violências. Os acidentes foram mais frequentes em mulheres jovens (20 a 39 anos, de cor negra e com escolaridade maior que 9 anos de estudo. A ocorrência de violência também foi predominante em mulheres jovens e negras, porém com menor escolaridade. Entre os acidentes predominaram as quedas (38,6%, seguidas de acidentes de transporte. As violências foram mais frequentes no domicílio (p Accidents from external causes affect the human population in different ways. This article seeks to analyze emergency care for women who are victims of accidents and violence. Data from the Surveillance System for Violence and Accidents were analyzed. This study was carried out in 74 emergency units of 23 state capitals and the Federal District in 2009 and included 6,965 women aged from 20-59 years. The age groups of 20-39 and 40-59 years were compared for the occurrence of accidents and violence. Accidents were more frequent among young black women (20-39 years with more than nine years of schooling. The occurrence of violence was also prevalent in young black women but with less schooling. Falls were the most frequent accidents (38.6%, followed by traffic accidents. The occurrence of violence was more frequent in the home (p <0.000 and the mention of alcohol abuse among victims of violence was predominant. The most frequent type of violence was aggression (84.6%, in which the aggressor was male (79.1% and identified as an intimate partner (44.1%. It is increasingly

[Neuroradiological pattern of peripartum cerebro vascular disease medicating transfer to determine care unit].

Science.gov (United States)

Lakhdar, Rim; Baffoun, Nader; Hammami, Nadia; Nagi, Sonia; Baccar, Kamel; Drissi, Syrine; Kaddour, Chokri

2012-03-01

Pregnancy and puerperium are considered a period of a high risk of stroke responsible in a part of the morbidity and mortality in women. Imaging is the pivotal tool to diagnostics and care. To investigate the clinical and imaging features cerebrovascular complications during pregnancy and in post partum period. We report a retrospective analysis of forty four patients (November 2002 - October 2010) admitted in the intensive car department of the national institute of neurology for cerebro-vascular complications during pregnancy and in post partum period. Cerebro-vascular imaging modalities included cerebral computed tomography (CCT) with and without contrast in 94% of cases, magnetic resonance imaging (MRI) in 30.6% of cases completed by venous angiography MRI in 27.2% of cases and angiography MRI of Willis polygon in 11.3% of cases and by cerebral angiography in 13.6% of cases. Posterior reversible encephalopathy syndrome (PRES) is diagnosed in 61.4 % of cases followed by meningo-cerebral haemorrhage (MCH) in 29.5% and finally cerebral venous thrombosis (CVT) and arterial ischemia in 4.5% of cases each one. The cerebro-vascular complications are revelled in 86.3 % of the cases during the postpartum and were associated with the eclampsia or preeclampsia in 90.9 % of the cases (n=40). CCT showed typical lesions of PRES in 23 patients. It confirms the presence of hematoma in the 13 patients with MCH and find hypodense lesion in one case with ischemic stroke. CCT show direct (delta sign) and indirect signs of CVT. MRI confirms the diagnostic of PRES, when done (11 of 12 cases) and show cortical sub cortical hyper signal on T2 and FLAIR and hypo signal on T1 sequences. MRI was normal in one case. It shows hemorrhagic lesion in the 2 cases of MCH, thrombosis in the cases of CVT and ischemic lesion in the cases of ischemic stroke. CCT and MRI done within 48 hours from admission were decisive for early diagnostic and for fast and adequate care. Early recognition of stroke

Traumatismos vasculares revisão de 5 anos Vascular Trauma a five year review

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Luís F. Antunes

2011-06-01

Full Text Available O presente trabalho pretende avaliar a casuística dos traumatismos vasculares agudos admitidos no Serviço de Cirurgia Vascular dos Hospitais da Universidade de Coimbra (HUC durante o período de 5 anos, compreendido entre Julho de 2004 e Junho de 2009. Foram avaliados 97 doentes, sendo a principal causa de traumatismo as lesões iatrogénicas, seguida dos acidentes de viação. No grupo de doentes não relacionados com procedimentos coronários percutâneos verificou-se que no membro superior as artérias umeral e radial foram as mais afectadas, enquanto no membro inferior foram as artérias femoral superficial e poplítea. A isquémia aguda foi a principal forma de apresentação. Relativamente ao tratamento deste grupo de doentes, a RATT (ressecção e anastomose topo-topo e o enxerto foram os mais utlizados no membro superior, enquanto a trombectomia e o bypass foram as técnicas mais aplicadas a nível do membro inferior. Não houve mortalidade mas a morbilidade foi elevada, predominando as lesões neurológicas nos traumatismos do membro superior, e a amputação nos do membro inferior. Os resultados deste trabalho foram concordantes com o que está publicado na literatura em que se demonstra um aumento progressivo dos traumatismos de origem iatrogénica.This review intended to evaluate the series of acute vascular trauma in the Vascular Surgery Service of the Coimbra University Hospital in the period between July 2004 and June 2009. A total of 97 patients were evaluated with iatrogenic lesions being the main cause of trauma injuries, followed by traffic accidents. In group of patients not related with percutaneous coronary angioplasty, it was found that brachial and radial arteries were the most affected in upper limb, while in the lower limb were the superficial femoral and popliteal arteries. The main clinical manifestation was acute ischemic limb. In this group, resection with end-to-end anastomosis and grafts were the main treatment

O contributo das ciências sociais para a análise de acidentes maiores: dois modelos em confronto The contribution of social sciences to analysis of major accidents: two models in comparison

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João Areosa

2012-07-01

Full Text Available Os acidentes maiores são um problema social relevante, dado que podem afetar alguns pilares importantes das sociedades contemporâneas, como as populações, as infraestruturas ou as próprias organizações onde estes eventos ocorrerem. Este tipo de acidentes surge em organizações de alto-risco, onde interagem, entre outros, aspetos de natureza técnica, tecnológica, social e organizacional. Neste artigo confrontamos a perspetiva das organizações de alta fiabilidade e a teoria dos acidentes normais, explorando as principais virtudes e limites de cada um destes modelos. Iremos verificar que o seu modo de compreender os acidentes, bem como as formas de prevenção propostas são parcialmente antagónicos.Major accidents are a relevant social problem, because they can affect certain important pillars of contemporary societies such as population, infrastructures, and the very organizations in which the events occurred. Major accidents arise in high-risk organizations, where technical, technological, social, and organizational factors interact. In this paper we confront the theory of High Reliability Organizations (HRO and the Normal Accidents Theory (NAT, exploring the virtues and limitations of each model.

Cerebral microbleeds in a neonatal rat model.

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Brianna Carusillo Theriault

Full Text Available In adult humans, cerebral microbleeds play important roles in neurodegenerative diseases but in neonates, the consequences of cerebral microbleeds are unknown. In rats, a single pro-angiogenic stimulus in utero predisposes to cerebral microbleeds after birth at term, a time when late oligodendrocyte progenitors (pre-oligodendrocytes dominate in the rat brain. We hypothesized that two independent pro-angiogenic stimuli in utero would be associated with a high likelihood of perinatal microbleeds that would be severely damaging to white matter.Pregnant Wistar rats were subjected to intrauterine ischemia (IUI and low-dose maternal lipopolysaccharide (mLPS at embryonic day (E 19. Pups were born vaginally or abdominally at E21-22. Brains were evaluated for angiogenic markers, microhemorrhages, myelination and axonal development. Neurological function was assessed out to 6 weeks.mRNA (Vegf, Cd31, Mmp2, Mmp9, Timp1, Timp2 and protein (CD31, MMP2, MMP9 for angiogenic markers, in situ proteolytic activity, and collagen IV immunoreactivity were altered, consistent with an angiogenic response. Vaginally delivered pups exposed to prenatal IUI+mLPS had spontaneous cerebral microbleeds, abnormal neurological function, and dysmorphic, hypomyelinated white matter and axonopathy. Pups exposed to the same pro-angiogenic stimuli in utero but delivered abdominally had minimal cerebral microbleeds, preserved myelination and axonal development, and neurological function similar to naïve controls.In rats, pro-angiogenic stimuli in utero can predispose to vascular fragility and lead to cerebral microbleeds. The study of microbleeds in the neonatal rat brain at full gestation may give insights into the consequences of microbleeds in human preterm infants during critical periods of white matter development.

Study on the change and relationship between plasma D-dimer and homocysteine levels in patients with acute cerebral vascular accident

International Nuclear Information System (INIS)

Lu Ye; Pan Xiangtao; Yan Min

2009-01-01

Objective: To study the clinical significance of the changes and the relationships between plasma D-dimer (D-D) and Homocysteine (Hcy) expression in patients with acute cerebral infarction and acute cerebral hemorrhage. Methods: Plasma D-D (with ELISA) and Hcy (with CLIA) levels were measured in 397 patients with cerebral infarction, 122 patients with cerebral hemorrhage and 30 controls.Results 1) The mean level of the plasma D-D and Hcy in patients with acute cerebral infarction was 5.20±0.92μg/L and 21.23±13.54 μmol/L respectively, which was significant higher than that in controls and patients with acute cerebral hemorrhage. 2) Higher expressing of D-D and Hcy was found in 101 (25.4%) and 140 (35.3%) cases of acute cerebral infarction patients. The data in acute cerebral hemorrhage group was 17 (13.9%) and 27 (22.1%) respectively. There was significant difference between two groups, P<0.01. 3) There was not correlations with the expression level of D-D and Hcy in patients with acute cerebral infarction and patients with acute cerebral hemorrhage. 4) The expressing level of the Plasma D-D in acute cerebral infarction patients was not significant difference in both age and sex. The expressing level of Hcy in male was higher than that in female. There was not significant difference in the expressing level of Hcy in different age. Conclusion: The levels of plasma D-D and Hcy in patients with acute cerebral infarction significantly in creased, but there were not correlations between the levels of the two parameters. (authors)

Egas Moniz: 90 Years (1927-2017) from Cerebral Angiography.

Science.gov (United States)

Artico, Marco; Spoletini, Marialuisa; Fumagalli, Lorenzo; Biagioni, Francesca; Ryskalin, Larisa; Fornai, Francesco; Salvati, Maurizio; Frati, Alessandro; Pastore, Francesco Saverio; Taurone, Samanta

2017-01-01

In June 2017 we celebrate the 90th anniversary of the pioneer discovery of cerebral angiography, the seminal imaging technique used for visualizing cerebral blood vessels and vascular alterations as well as other intracranial disorders. Egas Moniz (1874-1955) was the first to describe the use of this revolutionary technique which, until 1975 (when computed tomography, CT, scan was introduced in the clinical practice), was the sole diagnostic tool to provide an imaging of cerebral vessels and therefore alterations due to intracranial pathology. Moniz introduced in the clinical practice this fundamental and important diagnostic tool. The present contribution wishes to pay a tribute to the Portuguese neurosurgeon, who was also a distinguished neurologist and statesman. Despite his tremendous contribution in modern brain imaging, Egas Moniz was awarded the Nobel Prize in Physiology or Medicine in 1949 for prefrontal leucotomy, the neurosurgical intervention nowadays unacceptable, but should rather be remembered for his key contribution to modern brain imaging.

Clinical and imaging characteristics of the vascular dementia. Preliminary studies

International Nuclear Information System (INIS)

Gomez Viera, Nelson; Rivero Arias, Edmundo; Perez Nellar, Jesus; Begueria Santos, Ramon; Arias Sifontes, William; Raiteris Flores, Juan

1997-01-01

A descriptive prospective study was carried out in 41 patients presenting with vascular dementia from Habana Vieja municipality, Havana City, in order to know some of the clinical and imaging characteristics of this disease. The main risk factors observed were the history of cerebrovascular disease and arterial hypertension. Depression, sleeping disorders and focal and pseudo bulbar neurologic signs were the most frequent clinical findings. Folstein neuropsychological test evidenced an important disorder of attention, calculation, the evocation memory and orientation. According to this test, 29 % of the patients had a severe dementia and nearly 50 % showed a severe handicap. The most frequent imaging findings observed in the computerized axial tomography of the cranium were cerebral atrophy, and single or multiple infarctions. Multiple cerebral infarctions, the lacunar status, subcortical encephalopathy of Binswanger, and single infarction located in cerebral areas related to cognition were considered as possible psychopathological mechanisms associated with the disease

Occult cerebral vascular malformation: High-field (2.0 T) MR imaging and comparison with CT

International Nuclear Information System (INIS)

Chang, Kee Hyun; Chung, Jin Wook; Han, Moon Hee; Kang, Heung Sik; Han, Man Chung; Kim, Chu Wan

1989-01-01

Extensive experience with CT has led to the recognition of criteria for the diagnosis of occult cerebral vascular malformation. MR demonstrated all lesions as hemorrhage foci. The most common and typical MR findings of OVCM was circumscribed thick hypointense rim on T2-weighted images (T2-Wls) representing hemosiderin deposit with various central intensities suggesting the presence of hematomas in different stages (11 lesions). Among these. the recurrent hemorrhage in small amount produced the characteristic 'a bunch of grape' appearance. But, small OCVM less than 1 cm in diameter was identified as a small homogeneous hypointense nodule on T2-Wls with sharp (6 lesions) or fade-out (1 lesions) border. There were 2 lesions showing atypical findings such as dense hemosiderin rin with central lacuma or bilobed subacute hematoma. As the associated MR findings which strongly suggest the diagnosis of OCVM signal void due to feeding or draining vessels was found in 4, lesions and the surrounding focal cortical atrophy or leukomalacia in 2 lesions. The predilection site of OCVM was subcortical (8 lesions) and periventricular (6 cases) location. CT depicted 16 of the 20 lesions, but missed 4 lesions of small OCVM. CT alone did not permit definitive diagnosis of OCVM is most cases. Fifteen lesions demonstrated on CT contained somewhat hyperdense area in central or peripheral locations. Peripheral hyperdense area corresponded to the dense hemosiderin deposit on MR and central one to the hematoma formed by recent hemorrhage. Low density area on CT usually corresponded to liquefied subacute hematoma on MR

sup 123 I-IMP-SPECT in vascular dementia

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Namura, Yasuhiro; Miyoshi, Toshihiko; Shio, Hideo; Yamaguchi, Shinya; Kimura, Jun (Kyoto Univ. (Japan). Hospital)

1990-12-01

Cerebral blood flow (CBF) was studied by N-isopropyl-p-{sup 123}I-iodoamphetamine (IMP)-single photon emission computed tomography (SPECT) in patients with vascular dementia. Patients were divided by CT/MRI findings into multiple or localized type and cortical or subcortical type. Of patients with multiple lesions in the cortex, the reduction of CBF was noted in several cortex corresponding to CT/MRI findings. Patients in this group had a high incidence of aphasia, agraphia, dyscalculia, and amnesia. Patients with multiple lesions in the white matter and basal ganglia were subdivided into 3 groups by clinical manifestations. CBF in those with dementia showed generalized reduction in all cerebral cortex and especially in bilateral frontal regions. CBF in those with slightly impaired mentality was almost normal. In another group with pseudobulbar palsy and/or extrapyramidal sings, CBF was reduced intermediately only in bilateral frontal regions. Typical symptoms in demented patients were apathy, emotional lability, and forgetfulness. In those with the localized type, CBF was reduced in cerebral cortical areas correlating with the impaired mental functions. (author).

Enhanced expressions of microvascular smooth muscle receptors after focal cerebral ischemia occur via the MAPK MEK/ERK pathway

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Edvinsson Lars

2008-09-01

Full Text Available Abstract Background MEK1/2 is a serine/threonine protein that phosphorylates extracellular signal-regulated kinase (ERK1/2. Cerebral ischemia results in enhanced expression of cerebrovascular contractile receptors in the middle cerebral artery (MCA leading to the ischemic region. Here we explored the role of the MEK/ERK pathway in receptor expression following ischemic brain injury using the specific MEK1 inhibitor U0126. Methods and result Rats were subjected to a 2-h middle cerebral artery occlusion (MCAO followed by reperfusion for 48-h and the ischemic area was calculated. The expression of phosphorylated ERK1/2 and Elk-1, and of endothelin ETA and ETB, angiotensin AT1, and 5-hydroxytryptamine 5-HT1B receptors were analyzed with immunohistochemistry using confocal microscopy in cerebral arteries, microvessels and in brain tissue. The expression of endothelin ETB receptor was analyzed by quantitative Western blot. We demonstrate that there is an increase in the number of contractile smooth muscle receptors in the MCA and in micro- vessels within the ischemic region. The enhanced expression occurs in the smooth muscle cells as verified by co-localization studies. This receptor upregulation is furthermore associated with enhanced expression of pERK1/2 and of transcription factor pElk-1 in the vascular smooth muscle cells. Blockade of transcription with the MEK1 inhibitor U0126, given at the onset of reperfusion or as late as 6 hours after the insult, reduced transcription (pERK1/2 and pElk-1, the enhanced vascular receptor expression, and attenuated the cerebral infarct and improved neurology score. Conclusion Our results show that MCAO results in upregulation of cerebrovascular ETB, AT1 and 5-HT1B receptors. Blockade of this event with a MEK1 inhibitor as late as 6 h after the insult reduced the enhanced vascular receptor expression and the associated cerebral infarction.

Transtorno de estresse pós-traumático em vítimas de acidentes rodoviários graves: análise de fatores preditores

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Tânia Sofia Fernandes Pires

2013-01-01

Full Text Available CONTEXTO: Os acidentes rodoviários são acontecimentos potencialmente traumáticos que podem originar transtornos psicológicos, designadamente transtorno de estresse pós-traumático (TEPT. Os estudos são controversos quanto ao poder preditivo da dissociação peritraumática e os sintomas de transtorno de estresse agudo (TEA para predizer TEPT, mas referem que as mulheres reportam mais sintomas de transtorno pós-exposição traumática. OBJETIVO: Analisar o contributo da dissociação peritraumática, dos sintomas de TEA e do gênero para predizer TEPT quatro meses após o acidente. MÉTODO: Cento e vinte e quatro homens e mulheres, vítimas de acidentes graves, avaliados no hospital (t1 e reavaliados quatro meses depois (t2. RESULTADOS: Entre os participantes, 64,5% apresentam TEA (t1 e 58,9%, TEPT (t2. Os sintomas de dissociação peritraumática e TEA correlacionam-se positivamente com os sintomas de TEPT. As mulheres reportam mais dissociação peritraumática, TEA e TEPT. A dissociação peritraumática, o TEA e o gênero (feminino explicam 26,8% da variância de TEPT, sendo o contributo do gênero marginalmente significativo. CONCLUSÕES: O número de vítimas com sintomas de TEPT após acidente grave é elevado e os sintomas peritraumáticos são preditores de TEPT, sugerindo a necessidade de considerar os sintomas iniciais na prevenção de transtorno posterior.

Cerebral angiography with prospective ECG triggering preliminary study of dual-source CT

International Nuclear Information System (INIS)

Xue Yuejun; Qian Nong; Shao Yanhui; Pan Changjie; Rong Weiliang; Xu Yiqun

2012-01-01

Objective: To study the image quality and radiation dose in dual-source CT cerebral angiography with prospective ECG-triggered sequence mode (step-and-shoot, SAS). Methods: A total of forty-three patients with clinically suspected cerebral vascular disease underwent cerebral CT angiography with prospective ECG-triggering (step-and-shoot, SAS). Data acquisition was at 60% R-R interval of the ECG presentation mode. The post-processing included maximum intensity projection (MIP), multiplanar reformation (MPR) and volume rendering (VR). The CTA image quality, radiation dose and rates of excellent images were evaluated. Results: The CTA image quality score was 4.72 ± 0.50 and 97.7% (42/43) patients had excellent CTA images. The average effective dose of SAS-CTA was (0.22 ± 0.01)mSv, which was lower by 76.31% than that of DE-CTA. Conclusions: Prospective ECG-triggering sequence could be used in cerebral angiography with a significant reduction in radiation dose and diagnostic image quality. (authors)

Dietary and plant polyphenols exert neuroprotective effects and improve cognitive function in cerebral ischemia

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Cerebral ischemia is caused by an interruption of blood flow to the brain which generally leads to irreversible brain damage. Ischemic injury is associated with vascular leakage, inflammation, tissue injury, and cell death. Cellular changes associated with ischemia include impairment of metabolism, ...

An investigation of cerebral magnetic resonance angiography, 5

International Nuclear Information System (INIS)

Takeda, Sadanori; Sadamoto, Kazuhiko; Ohue, Shiro; Todo, Hirooki; Sakaki, Saburo.

1992-01-01

A number of studies of MR angiography (MRA) as a noninvasive screening method for vascular diseases have been reported recently. Almost all of them were investigated using high tesla magnets (1.5 tesla). We have been investigating three-dimensional MRA using a medium tesla (0.5 tesla) system (HITACHI G-50). The purpose of this study is to evaluate the usefulness of 3-D MRA for the screening of cerebral aneurysms. Twenty patients with 25 cerebral aneurysms were included in this study. The sizes of the aneurysms ranged from 2 to 35 mm. Twenty-three aneurysms were located on the anterior circulation, and 2 on the posterior circulation. MR angiography was performed with a gradient-echo sequence at a TR of 50 msec, a TE of 16 msec, and a flip angle of 25 degrees. The imaging volumes ranged in thickness from 48 to 64 mm, with 32 partitions. We used a sequence-subtraction technique composed of rephased and dephased sequences; it provides a good visualization of the main cerebral arteries. Cerebral aneurysms were detected on 3-D MRA in 23 lesions (92%). We consider that 0.5 tesla 3-D MRA could be useful for the screening of nonruptured aneurysms. (author)

Pathophysiology of the vascular wall and its relevance for cerebrovascular disorders in aged rodents.

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Popa-Wagner, A; Pirici, D; Petcu, E B; Mogoanta, L; Buga, A-M; Rosen, C L; Leon, R; Huber, J

2010-08-01

Chronic hypertension and cerebral amyloid angiopathy (CAA) are the main pathologies which can induce the rupture of cerebral vessels and intracerebral hemorrhages, as a result of degenerative changes in the vascular wall. A lot of progress has been made in this direction since the successful creation of the first mouse model for the study of Alzheimer's disease (AD), as the spectrum of AD pathology includes a plethora of changes found in pure cerebrovascular diseases. We describe here some of these mouse models having important vascular changes that parallel human AD pathology, and more importantly, we show how these models have helped us understand more about the mechanisms that lead to CAA formation. An important cellular event associated with reduced structural and functional recovery after stroke in aged animals is the early formation of a scar in the infarcted region that impairs subsequent neural recovery and repair. We review recent evidence showing that the rapid formation of the glial scar following stroke in aged rats is associated with premature cellular proliferation that originates primarily from the walls of capillaries in the corpus callosum adjacent to the infarcted region. After stroke several vascular mechanisms are turned-on immediately to protect the brain from further damage and help subsequent neuroregeneration and functional recovery. Although does occur after stroke, vasculogenesis is overshadowed in its protective/restorative role by the angiogenesis and arteriogenesis. Understanding the basic mechanisms underlying functional recovery after cerebral stroke in aging subjects is likely to yield new insights into the treatment of brain injury in the clinic.

Anastomose arterial extra-intracraniana para tratamento de paciente com isquemia cerebral refratária ao manejo clínico

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Falavigna Asdrubal

2004-01-01

Full Text Available A anastomose extra-intracraniana pode ser utilizada em casos selecionados de insuficiência vascular encefálica refratária ao tratamento clínico. Descrevemos um caso de isquemia encefálica em território de artéria cerebral média direita devida à oclusão da artéria carótida interna homolateral com conseqüente redução da perfusão e reserva vascular nos hemisférios frontal e parietal. Apesar do tratamento clínico, a melhora do déficit motor estava relacionada diretamente com a manutenção de níveis tensionais sistêmicos elevados pelo uso de vasopressor. Após anastomose extra-intracraniana término-lateral entre as artérias temporal superficial e cerebral média direita, houve melhora significativa da perfusão cerebral com remissão do déficit motor.

FLAIR vascular hyperintensities and 4D MR angiograms for the estimation of collateral blood flow in anterior cerebral artery ischemia.

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Matthias Gawlitza

Full Text Available To assess FLAIR vascular hyperintensities (FVH and dynamic (4D angiograms derived from perfusion raw data as proposed magnetic resonance (MR imaging markers of leptomeningeal collateral circulation in patients with ischemia in the territory of the anterior cerebral artery (ACA.Forty patients from two tertiary care university hospitals were included. Infarct volumes and perfusion deficits were manually measured on DWI images and TTP maps, respectively. FVH and collateral flow on 4D MR angiograms were assessed and graded as previously specified.Forty-one hemispheres were affected. Mean DWI lesion volume was 8.2 (± 13.9; range 0-76.9 ml, mean TTP lesion volume was 24.5 (± 17.2, range 0-76.7 ml. FVH were observed in 26/41 (63.4% hemispheres. Significant correlations were detected between FVH and TTP lesion volume (ρ = 0.4; P<0.01 absolute (ρ = 0.37; P<0.05 and relative mismatch volume (ρ = 0.35; P<0.05. The modified ASITN/SIR score correlated inversely with DWI lesion volume (ρ = -0.58; P<0.01 and positively with relative mismatch (ρ = 0.29; P< 0.05. ANOVA of the ASITN/SIR score revealed significant inter-group differences for DWI (P<0.001 and TTP lesion volumes (P<0.05. No correlation was observed between FVH scores and modified ASITH/SIR scores (ρ = -0.16; P = 0.32.FVH and flow patterns on 4D MR angiograms are markers of perfusion deficits and tissue at risk. As both methods did not show a correlation between each other, they seem to provide complimentary instead of redundant information. Previously shown evidence for the meaning of these specific MR signs in internal carotid and middle cerebral artery stroke seems to be transferrable to ischemic stroke in the ACA territory.

Affinity proteomics reveals elevated muscle proteins in plasma of children with cerebral malaria.

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Julie Bachmann

2014-04-01

Full Text Available Systemic inflammation and sequestration of parasitized erythrocytes are central processes in the pathophysiology of severe Plasmodium falciparum childhood malaria. However, it is still not understood why some children are more at risks to develop malaria complications than others. To identify human proteins in plasma related to childhood malaria syndromes, multiplex antibody suspension bead arrays were employed. Out of the 1,015 proteins analyzed in plasma from more than 700 children, 41 differed between malaria infected children and community controls, whereas 13 discriminated uncomplicated malaria from severe malaria syndromes. Markers of oxidative stress were found related to severe malaria anemia while markers of endothelial activation, platelet adhesion and muscular damage were identified in relation to children with cerebral malaria. These findings suggest the presence of generalized vascular inflammation, vascular wall modulations, activation of endothelium and unbalanced glucose metabolism in severe malaria. The increased levels of specific muscle proteins in plasma implicate potential muscle damage and microvasculature lesions during the course of cerebral malaria.