245 resultados para Pacemaker
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Interference with time estimation from concurrent nontemporal processing has been shown to depend on the short-term memory requirements of the concurrent task (Fortin Breton, 1995; Fortin, Rousseau, Bourque, & Kirouac, 1993). In particular, it has been claimed that active processing of information in short-term memory produces interference, whereas simply maintaining information does not. Here, four experiments are reported in which subjects were trained to produce a 2,500-msec interval and then perform concurrent memory tasks. Interference with timing was demonstrated for concurrent memory tasks involving only maintenance. In one experiment, increasing set size in a pitch memory task systematically lengthened temporal production. Two further experiments suggested that this was due to a specific interaction between the short-term memory requirements of the pitch task and those of temporal production. In the final experiment, subjects performed temporal production while concurrently remembering the durations of a set of tones. Interference with interval production was comparable to that produced by the pitch memory task. Results are discussed in terms of a pacemaker-counter model of temporal processing, in which the counter component is supported by short-term memory.
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The mechanisms involved in Atlantic meridional overturning circulation (AMOC) decadal variability and predictability over the last 50 years are analysed in the IPSL–CM5A–LR model using historical and initialised simulations. The initialisation procedure only uses nudging towards sea surface temperature anomalies with a physically based restoring coefficient. When compared to two independent AMOC reconstructions, both the historical and nudged ensemble simulations exhibit skill at reproducing AMOC variations from 1977 onwards, and in particular two maxima occurring respectively around 1978 and 1997. We argue that one source of skill is related to the large Mount Agung volcanic eruption starting in 1963, which reset an internal 20-year variability cycle in the North Atlantic in the model. This cycle involves the East Greenland Current intensity, and advection of active tracers along the subpolar gyre, which leads to an AMOC maximum around 15 years after the Mount Agung eruption. The 1997 maximum occurs approximately 20 years after the former one. The nudged simulations better reproduce this second maximum than the historical simulations. This is due to the initialisation of a cooling of the convection sites in the 1980s under the effect of a persistent North Atlantic oscillation (NAO) positive phase, a feature not captured in the historical simulations. Hence we argue that the 20-year cycle excited by the 1963 Mount Agung eruption together with the NAO forcing both contributed to the 1990s AMOC maximum. These results support the existence of a 20-year cycle in the North Atlantic in the observations. Hindcasts following the CMIP5 protocol are launched from a nudged simulation every 5 years for the 1960–2005 period. They exhibit significant correlation skill score as compared to an independent reconstruction of the AMOC from 4-year lead-time average. This encouraging result is accompanied by increased correlation skills in reproducing the observed 2-m air temperature in the bordering regions of the North Atlantic as compared to non-initialized simulations. To a lesser extent, predicted precipitation tends to correlate with the nudged simulation in the tropical Atlantic. We argue that this skill is due to the initialisation and predictability of the AMOC in the present prediction system. The mechanisms evidenced here support the idea of volcanic eruptions as a pacemaker for internal variability of the AMOC. Together with the existence of a 20-year cycle in the North Atlantic they propose a novel and complementary explanation for the AMOC variations over the last 50 years.
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Ketamine and propofol are two well-known, powerful anesthetic agents, yet at first sight this appears to be their only commonality. Ketamine is a dissociative anesthetic agent, whose main mechanism of action is considered to be N-methyl-D-aspartate (NMDA) antagonism; whereas propofol is a general anesthetic agent, which is assumed to primarily potentiate currents gated by γ-aminobutyric acid type A (GABAA) receptors. However, several experimental observations suggest a closer relationship. First, the effect of ketamine on the electroencephalogram (EEG) is markedly changed in the presence of propofol: on its own ketamine increases θ (4–8 Hz) and decreases α (8–13 Hz) oscillations, whereas ketamine induces a significant shift to beta band frequencies (13–30 Hz) in the presence of propofol. Second, both ketamine and propofol cause inhibition of the inward pacemaker current Ih, by binding to the corresponding hyperpolarization-activated cyclic nucleotide-gated potassium channel 1 (HCN1) subunit. The resulting effect is a hyperpolarization of the neuron’s resting membrane potential. Third, the ability of both ketamine and propofol to induce hypnosis is reduced in HCN1-knockout mice. Here we show that one can theoretically understand the observed spectral changes of the EEG based on HCN1-mediated hyperpolarizations alone, without involving the supposed main mechanisms of action of these drugs through NMDA and GABAA, respectively. On the basis of our successful EEG model we conclude that ketamine and propofol should be antagonistic to each other in their interaction at HCN1 subunits. Such a prediction is in accord with the results of clinical experiment in which it is found that ketamine and propofol interact in an infra-additive manner with respect to the endpoints of hypnosis and immobility.
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In this paper, the teleconnections from the tropical Atlantic to the Indo-Pacific region from inter-annual to centennial time scales will be reviewed. Identified teleconnections and hypotheses on mechanisms at work are reviewed and further explored in a century-long pacemaker coupled ocean-atmosphere simulation ensemble. There is a substantial impact of the tropical Atlantic on the Pacific region at inter-annual time scales. An Atlantic Niño (Niña) event leads to rising (sinking) motion in the Atlantic region, which is compensated by sinking (rising) motion in the central-western Pacific. The sinking (rising) motion in the central-western Pacific induces easterly (westerly) surface wind anomalies just to the west, which alter the thermocline. These perturbations propagate eastward as upwelling (downwelling) Kelvin-waves, where they increase the probability for a La Niña (El Niño) event. Moreover, tropical North Atlantic sea surface temperature anomalies are also able to lead La Niña/El Niño development. At multidecadal time scales, a positive (negative) Atlantic Multidecadal Oscillation leads to a cooling (warming) of the eastern Pacific and a warming (cooling) of the western Pacific and Indian Ocean regions. The physical mechanism for this impact is similar to that at inter-annual time scales. At centennial time scales, the Atlantic warming induces a substantial reduction of the eastern Pacific warming even under CO2 increase and to a strong subsurface cooling.
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The circadian timing system (CTS) is responsible for the generation and synchronization and the suprachiasmatic nucleus (SCN) of the hypothalamus has been described as the major circadian pacemaker in many mammalian species. The internal temporal organization managed by SCN is disturbed with aging bringing many pathological disorders that range from loss of complex cognitive performance to simple physiological functions. Therefore, our aim was perform a comparative study of the morphological aspects and neurochemical composition in the SCN of marmosets (Callithrix jacchus) adults and older using immunohistochemical techniques. We found morphometric and neurochemical changes in th SCN o folder animals in comparison to adults, among these a possible decreased in retinal projection to the SCN of older animals, found through a decline in CTB immunostaining, which can occur due atrophy and/or decreasing of fibers from the retinohypothalamic tract (RHT). The Klüver-Barrera histological technique strongly suggests a decrease in those fibers from RHT. Also, by means of a morphometric study, it is found a atrophy and numerical decline of neurons in SCN of aged animals, investigated by Nissl technique, and immunostaining with NeuN and calbindin. Relative optical density (ROD) analysis were used to evaluate the expression of some neurochemical components in SCN, such as GFAP expression, which was increased in older, result that indirectly reinforces that morphological changes occurs due the aging; the vasoactive intestinal polipeptide (VIP) showed no expression alteration in SCN of older animals; the serotonin (5-HT) was descreased in the dorsomedial portion of the SCN, and neurpeptide Y (NPY) apparently also decrease due to the increase of age. Many of these modifications were seen in other animals, such as rodents, human primates and non-human primates. These data about marmoset comes to add new information of the effect of aging on structures responsibles for the circadian rhytmicity, and that some behavioral changes controlled by th SCN, and founded in aged animals, may be caused by these morphological and neurochemical changes. Although some results have been quantitatively negative, qualitatively all analysis show significant change comparing adult and older animals, perhaps due to a low sampling number. In conclusion, the marmoset presents several morphological and neurochemical changes in the SCN of aged animals compared to adults, which may result in behavioral changes that favor pathology aging related
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The principal zeitgeber for most of species is the light-dark photocycle (LD), though other environment factors as food availability, temperature and social cues may act. Daily adjustment of the circadian pacemaker may result from integration of environmental photic and non-photic cues with homeostatic cues. Characterization of non-photic effects on circadian timing system in diurnal mammals is scarce in relation to nocturnal, especially for ecologically significant cues. Thus, we analyzed the effect of conspecific vocalizations and darkness on circadian activity rhythm (CAR) in the diurnal primate Callithirx jacchus. With this objective 7 male adults were isolated in a room with controlled illumination, temperature (26,8 ± 0,2°C) and humidity (81,6 ± 3,6%), and partial acoustic isolation. Initially they were under LD 12:12 (~300:2 lux), and subsequently under constant illumination (~2 lux). Two pulses of conspecific vocalizations were applied in total darkness, separated by 22 days, at 7:30 h (external time) during 1 h. They induced phase delays at circadian times (CTs) 1 and 10 and predominantly phase advances at CTs 9 and 15. After that, two dark pulses were applied, separated by 14 days, during 1 h at 7:30 h (external time). These pulses induced phase delays at CTs 2, 3 and 18, predominantly phase advances at CTs 8, 10 and 19, and no change at CT 14. However, marmosets CAR showed oscillations in endogenous period and active phase duration influenced by vocalizations from animals outside the experimental room, which interfered on the phase responses to pulses. Furthermore, social masking and relative coordination with colony were observed. Therefore, phase responses obtained in this work cannot be attributed only to pulses. Afterwards, pulses of conspecific vocalizations were applied in total darkness at 19:00 h (external time), during 1 h for 5 consecutive days, and after 21 days, for 30 consecutive days, on attempt to synchronize the CAR. No animal was synchronized by these daily pulses, although oscillations in endogenous period were observed for all. This result may be due to habituation. Other possibility is the absence of social significance of the vocalizations for the animals due to random reproduction, since each vocalization has a function that could be lost by a mixture of sounds. In conclusion, conspecific vocalizations induce social masking and relative coordination in marmosets CAR, acting as weak zeitgeber
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The light, besides the vision stimuli, controls other process completely independent of image formation, such as the synchronization of the organismic circadian rhythms to the enviromental light/dark cycle. In mammals, this adjust occurs through the retinohypothalamic tract, a direct retinal projection to the suprachiasmatic nucleus, considered to be the major circadian pacemaker. Early studies have identified only the suprachiasmatic nucleus as a retinal target in the hypothalamus. However, using more sensitive neuroanatomic tracers, other retinorecipient hypothalamic regions outside to suprachiasmatic nucleus were pointed in a great number of mammalian species. In this study, the retinohypothalamic tract was shown in the rock cavy (Kerodon rupestris), an endemic rodent of the semiarid region of the Brazilian Northeast, using unilateral intravitreal injections of cholera toxin subunit b as a neuronal tracer. The results reveal that in the rock cavy, besides the suprachiasmatic nucleus, several hypothalamic regions receive direct retinal projection, such as the ventrolateral preoptic nucleus, medial and lateral preoptic areas, the supraoptic nucleus and bordering areas, anterior, lateral and rectrochiasmatic hypothalamic areas, and the subparaventricular zone. The results are discussed by comparing with those of the literature, into a functional context
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The retinal projections in mammals usually reach, classically, three major functional systems: the primary visual system, the accessory optic system, and the circadian timing system. But the retinal projections also reach areas classically considered non-visual, one of which groups the neurons of the zona incerta (ZI), target this study. The primary visual system includes thalamic lateral geniculate complex is formed by the dorsal lateral geniculate nucleus, intergeniculate leaflet and the ventral lateral geniculate nucleus and other Components. The accessory optic system is composed of the small nuclei: nuclei terminal dorsal, lateral, medial and the interstitial nucleus of the superior posterior fasciculus. These nuclei are involved in visuo-motor activities. The circadian timing system is comprised of the suprachiasmatic nucleus of the hypothalamus, that act as master circadian pacemaker, entraining pathways and efferents pathways to the efectors, and the intergeniculate leaflet, that seems to act as a modulator of the pacemaker. The retinal projections too reach classically considered non-visual areas, including the zona incerta. This region is localized in the ventral thalamus and has been implicated in various functional properties including nociceptive and somatosensory processing, motor response, sociosexual behaviour, feeding and drinking, in symptoms of neurodegenerative diseases, arousal and attention. It also displays connection with several areas of central nervous system. The aim of this study was characterize the retinal projection in the zona incerta of Callithrix jacchus (sagüi), a primate of the New World through the anterograde axonal transport of the cholera toxin subunit b and analyze the citoarchicteture using Nissl and NeuN, and neurochemical substances such as serotonin, GABA, VIP, VP, GFAP and binding-calcium proteins. The zona incerta showed a different division of the literature in citoarquitetura, both by means of Nissl as neurochemical by NeuN, with a subdivision ventrolateral and dorsomedial. The neurochemical to the other substances corroborate with this subdivision. The GFAP was almost completely negative for the zona incerta, result non evidenced in previous studies yet. The 16 retinal projection in sagüi, unlike other primates and rodents, reached the caudal portion only. This work helps to make further studies are conducted based on this subdivision and the localization of the neurochemical substances associated with possible behaviors that the zona incerta is involved
Correlação entre a qualidade de vida, classe funcional e idade em portadores de marca-passo cardíaco
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OBJETIVO: Avaliar se existe correlação entre qualidade de vida e classe funcional em pacientes no pós-implante de marca-passo cardíaco, e sua relação com idade. MÉTODOS: Investigados 107 pacientes de ambos os sexos (49,5% do sexo feminino e 50,5% do sexo masculino), tempo médio de implante 6,36º ±2,99 meses e média de idade 69,3º ±12,6 anos. Para avaliação da classe funcional, foi utilizada escala proposta por Goldman e para qualidade de vida, questionário AQUAREL associado ao SF-36. Realizada análise estatística pela correlação de Spearman, com significância de 5%. RESULTADOS: Foram observadas correlações negativas entre qualidade de vida e classe funcional: AQUAREL nos três domínios, desconforto no peito (r=-0,197, P=0,042), dispneia (r=-0,508, P =0,000), arritmia (r=-0,271, P=0,005) e, no SF-36 nos oito domínios. em relação à idade, correlação negativa com Capacidade Funcional do SF-36 (r=-0,338, P=0,000) e não se observou correlação com AQUAREL. Entre idade e classe funcional observou-se correlação positiva (r=0,237, P=0,014). CONCLUSÃO: Neste estudo, encontrou-se correlação negativa entre qualidade de vida e classe funcional, evidenciando nesta amostra que os pacientes pertencentes a melhor classe funcional apresentaram melhor qualidade de vida. Conforme maior idade, pior a qualidade de vida em Capacidade Funcional e em classe funcional. Sugere-se, que idade e classe funcional influenciam qualidade de vida e as escalas de classificação funcional podem constituir um dos instrumentos que integram a avaliação e refletem a qualidade de vida em portadores de marca-passo.
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O objetivo foi a padronização de modelo experimental de coração isolado parabiótico em coelhos, testando sua estabilidade e durabilidade, para fins de pesquisa cardiovascular. Foram utilizados 66 coelhos raça Norfolk-2000 divididos em grupo doador do coração isolado e animais suporte, totalizando 33 preparações. Mediante auxilio de bombas peristálticas estabeleceu-se suporte circulatório para o coração isolado mantendo-se fluxo constante(16ml/min.). Um balão intraventricular foi inserido no ventrículo esquerdo, sendo ajustado para gerar pressão diastólica de ± 10mmHg. A freqüência foi fixada em 120 batimentos por minuto mediante o uso de marcapasso. Foram avaliadas variáveis hemodinâmicas, laboratoriais e anatomopatológicas. Das 33 preparações, 13 foram excluídas mediante critérios pré-estabelecidos. Das 20 restantes, 10 cumpriram o tempo máximo do protocolo(180 minutos). Com relação ao animal suporte houve deterioração hemodinâmica progressiva c/ queda da pressão arterial média(89,30±6,09mmHg->47,50±6,35mmHg). Com relação ao corações isolado, das 10 preparações que cumpriram os 180 minutos de protocolo, houve estabilidade hemodinâmica. As variáveis laboratoriais mostraram queda progressiva do sódio, potássio e hemoglobina, sendo compatível com hemodiluição. O exame anatomopatológico mostrou espaçamento maior entre fibras, compatível com edema. O presente modelo mostrou estabilidade e atividade de 100% das preparações em 60 minutos, havendo perdas progressivas chegando a 50% das preparações em atividade em 180 minutos. O presente modelo, dentro das limitações estabelecidas é viável para pesquisas cardiovasculares.
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O presente estudo teve por objetivo padronizar modelo experimental de estimulação cardíaca artificial atrial em coelhos. Foram utilizados 20 coelhos raça Norfolk-2000 de ambos os sexos com peso mínimo de 2200g. Após anestesia endovenosa com pentobarbital(30mg/Kg), foi dissecada a veia jugular externa esquerda e introduzido eletrodo EthiconÒ especialmente preparado, até átrio direito via veia cava esquerda. Foram realizadas leituras dos parâmetros elétricos(ondaP, resistência e limiar de comando) no ato cirúrgico e com 7, 14 e 21 dias denominados M1,M2, M3 e M4 respectivamente. Observamos diferença significativa em todos as variáveis analisadas entre M1 e demais momentos. Os resultados são compatíveis com o que se conhece de estimulação cardíaca artificial em outras espécies animais e no homem. O presente modelo mostrou ser viável para estudos de estimulação cardíaca artificial.
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CONTEXTO: A síndrome de Alport é responsável por aproximadamente 5% dos pacientes com insuficiência renal crônica. Nessa doença, anormalidades no sistema de condução cardíaco são mais freqüentes que na população em geral. OBJETIVO: Relatar caso de síndrome de Alport que desenvolveu bloqueio atrioventricular total durante um transplante renal. RELATO DE CASO: Paciente masculino, 21 anos de idade, com insuficiência renal crônica secundária à síndrome de Alport, foi submetido a transplante renal sob anestesia peridural. Durante o procedimento anestésico-cirúrgico apresentou bloqueio atrioventricular total, que foi tratado rapidamente, e com sucesso, usando-se um marcapasso transcutâneo. O bloqueio simpático extenso pode contribuir para o desenvolvimento de distúrbios no sistema de condução cardíaco, particularmente em pacientes com insuficiência renal crônica em esquema de diálise. Mesmo em pacientes com eletrocardiograma pré-operatório normal e sem distúrbios de condução, graus variáveis de bloqueio atrioventricular, incluindo bloqueio atrioventricular total, podem ocorrer. Nesse caso, o uso de marcapasso transcutâneo é tratamento rápido e efetivo na sala de operação até o final da cirurgia, quando o tratamento definitivo pode ser planejado.
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Although rare, major bleeding is the most important side effect of thrombolytic therapy in acute myocardial infarction (AMI) (Levine et al., 1995). Spontaneous hepatic bleeding in normal liver after thrombolytic administration has rarely been reported in literature. To our knowledge, there are only three cases of hepatic bleeding related to thrombolytic therapy in AMI. In these, the used drugs were anisolylated plasminogen streptokinase activator complex (APSAC) (Garcia-Jiménez et al., 1997; Fox et al., 1991) and rt-PA (Garcia-Jiménez et al., 1997). We report a case of hepatic bleeding after streptokinase followed by units over 60 minutes). The next day, the patient developed third-degree atrioventricular block and a temporary pacemaker was inserted. Twenty-seven hours after streptokinase infusion, the patient complained of refractory chest pain that was interpreted as post-myocardial infarction angina; clotting screen was normal and intravenous heparin was started (80 U/kg followed by 18 U/kg/hour). After four hours of heparin administration, the patient presented abdominal pain and distension, and his blood pressure and hematocrit level dropped. Abdominal ultrasonography revealed free fluid in the peritoneal cavity (about 3,000 mL). A laparotomy disclosed blood in the abdominal cavity with bleeding from the right lateral hepatic segment, which was removed. The remaining abdominal viscera were normal and there was no other evidence of hemorrhage. The partial liver resection presented subcapsular hemorrhage with small parenchymal hemorrhage. Histopathological examination also revealed focal areas of ischemic centrilobular necrosis. The patient died of multiple organ system failure 21 days after admission. Copyright © 2002 By PJD Publications Limited.
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Background and Purpose: The circadian rhythm of melatonin in saliva or plasma, or of the melatonin metabolite 6-sulfatoxymelatonin (a6MTs) in urine, is a defining feature of suprachiasmatic nucleus (SCN) function, the body's endogenous oscillatory pacemaker. The primary objective of this review is to ascertain the clinical benefits and limitations of current methodologies employed for detection and quantification of melatonin in biological fluids and tissues. Data Identification: A search of the English-language literature (Medline) and a systematic review of published articles were carried out. Study Selection: Articles that specified both the methodology for quantifying melatonin and indicated the clinical purpose were chosen for inclusion in the review. Data Extraction: The authors critically evaluated the methodological issues associated with various tools and techniques (e.g. standards, protocols, and procedures). Results of Data Synthesis: Melatonin measurements are useful for evaluating problems related to the onset or offset of sleep and for assessing phase delays or advances of rhythms in entrained individuals. They have also become an important tool for psychiatric diagnosis, their use being recommended for phase typing in patients suffering from sleep and mood disorders. Additionally, there has been a continuous interest in the use of melatonin as a marker for neoplasms of the pineal region. Melatonin decreases such as found with aging are or post pinealectomy can cause alterations in the sleep/wake cycle. The development of sensitive and selective methods for the precise detection of melatonin in tissues and fluids has increasingly been shown to have direct relevance for clinical decision making. Conclusions: Due to melatonin's low concentration, as well as the coexistence of numerous other compounds in the blood, the routine determination of melatonin has been an analytical challenge. The available evidence indicates however that these challenges can be overcome and consequently that evaluation of melatonin's presence and activity can be an accessible and useful tool for clinical diagnosis. © Springer-Verlag 2010.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)