Memorias en movimiento: testimonios corporales sobre marcas inscritas por el diagnóstico del “trastorno bipolar”

Los diagnósticos clínicos de “trastornos mentales” son categorías que aparecen dentro de un contexto particular, por lo que están cargados de significados y atravesado por una economía política del deseo. De tal manera, el diagnóstico puede marcar a las personas que los portan. Con esta premisa y desde un enfoque de los Estudios de la Cultura, esta investigación busca analizar las formas en que los sujetos diagnosticados con trastorno mental experimentan dicha marca y las narrativas que emergen de tal experiencia. En este estudio se presentan tres narraciones de personas diagnosticadas con trastorno bipolar, considerando que esta última es una categoría problemática, conectada con el ámbito social, médico, familiar, farmacológico y demás. Más que un trastorno, el estado bipolar expresa la complejidad humana, que ha sido marcada psiquiátricamente como una falencia. De ahí la importancia de registrar la manera en que estas experiencias se inscriben en la memoria de las participantes, a partir de su bitácora testimonial oral y corporal/ visual/emocional, que incorpora movimientos dancísticos para el registro visual.

A double-Gerdien instrument for simultaneous bipolar air conductivity measurements on balloon platforms

A bipolar air conductivity instrument is described for use with a standard disposable meteorological radiosonde package. It is intended to provide electrical measurements at cloud boundaries, where the ratio of the bipolar air conductivities is affected by the presence of charged particles. The sensors are two identical Gerdien-type electrodes, which, through a voltage decay method, measure positive and negative air conductivities simultaneously. Voltage decay provides a thermally stable approach and a novel low current leakage electrometer switch is described which initiates the decay sequence. The radiosonde supplies power and telemetry, as well as measuring simultaneous meteorological data. A test flight using a tethered balloon determined positive (σ+) and negative (σ−) conductivities of σ+ = 2.77±0.2 fS m−1 and σ− = 2.82±0.2 fS m−1, respectively, at 400 m aloft, with σ+/σ− = 0.98±0.04.

Neural response to emotional prosody in schizophrenia and in bipolar affective disorder

Background Evidence suggests a reversal of the normal left-lateralised response to speech in schizophrenia. Aims To test the brain's response to emotional prosody in schizophrenia and bipolar disorder. Method BOLD contrast functional magnetic resonance imaging of subjects while they passively listened or attended to sentences that differed in emotional prosody Results Patients with schizophrenia exhibited normal right-lateralisation of the passive response to 'pure' emotional prosody and relative left-lateralisation of the response to unfiltered emotional prosody When attending to emotional prosody, patients with schizophrenia activated the left insula more than healthy controls. When listening passively, patients with bipolar disorder demonstrated less activation of the bilateral superior temporal gyri in response to pure emotional prosody, and greater activation of the left superior temporal gyrus in response to unfiltered emotional prosody In both passive experiments, the patient groups activated different lateral temporal lobe regions. Conclusions Patients with schizophrenia and bipolar disorder may display some left-lateralisation of the normal right-lateralised temporal lobe response to emotional prosody. Declaration of interest R.M. received a studentship from Neuraxis,, and funding from the Neuroscience and Psychiatry Unit, University of Manchester.

Avaliação das quimiocinas e da expressão de seus receptores em células mononucleares de pacientes portadores da doença de Chagas submetidas à infecção in vitro com Trypanosoma cruzi e tratamento com benzonidazol

Atualmente o Brasil apresenta 3 milhões de indivíduos portadores da cardiomiopatia chagásica. Porém, tratamento etiológico com o fármaco Benzonidazol (BZ) na fase crônica da doença ainda não está elucidado. Acredita-se que a recomendação do BZ nessa fase, pode prevenir ou retardar a evolução clínica da cardiomiopatia na Doença Chagas (DC). Assim o objetivo do estudo é avaliar a produção de quimiocinas e expressão de seus receptores em Células mononucleares do sangue periférico - PBMC (de portadores crônicos da doença de Chagas) submetidas in vitro ao tratamento com BZ, após a infecção com T.cruzi. Foram selecionados 11 pacientes na fase crônica da doença. Amostras de sangue desses pacientes foram coletadas para obtenção de PBMC, em que foram cultivadas em placas de cultivo na concentração de 106 células/ml por poço. Após a adesão das células aderentes (principalmente macrófagos), as células não aderentes (principalmente linfócitos) foram removidas e as formas tripomastigotas foram adicionadas ao cultivo para infecção das células aderentes. Subsequente a incubação, as células não aderentes foram adicionadas novamente ao cultivo juntamente com o fármaco Bz (1µg/mL), ficando um co-cultivo de células aderentes infectadas com T.cruzi, células não aderentes e o BZ (C+T+BZ). As placas de cultura foram incubadas por períodos de 24h e 5 dias. Para uma análise fidedigna da ação do BZ nas células aderentes e não aderentes foi necessário a criação dos controles: células (C), células e tripomastigotas (C+T) e células e o BZ (C+BZ). Após o cultivo, foram coletados os sobrenadantes das culturas, para avaliação da produção de quimiocinas (CCL2, CXL9, CXL10, CCL5 e CXCL8) por CBA (Cytometric Bead Array). Posteriormente foi realizada a imunofenotipagem, avaliando a expressão dos receptores CCR3, CCR4, CXCR3, CXCR5, CCR1, CXCR4, CXCR2 e CCR5, em linfócitos T CD3+ e monócitos CD14+. Os resultados obtidos na avaliação dos linfócitos mostraram que o receptor CXCR5 esteve aumentado na condição C+T+BZ; e os receptores CCR4 e CCR1 estavam diminuídos nessa mesma condição. Nos monócitos observamos uma diminuição de CCR4 e um aumento do CCR5 nas mesmas condições. Com relação a dosagem de quimiocinas no sobrenadante, foi evidenciado que CCL2 e CXCL8 apresentaram uma diminuição na condição C+T+BZ. Assim podemos concluir que devido ao caráter inflamatório modulado, que o BZ conduziu, podemos afirmar que o fármaco demonstrou benefícios relevantes na expressão de receptores e na produção de quimiocinas

Avaliação do efeito do benzonidazol sobre linfócitos, de portadores crônicos da doença de Chagas, submetidos experimentalmente à exposição ao Trypanosoma cruzi

O único medicamento disponível para o tratamento da doença de Chagas (DC) no Brasil é o benzonidazol (Bz). O beneficio da medicação aos portadores crônicos da doença ainda demonstra controvérsias, mas seu uso nessa fase pode ter a finalidade de prevenir/retardar a evolução da DC para formas mais graves. Os fenômenos imunológicos que ocorrem após a terapia com o Bz ainda não estão elucidados. Assim, este estudo propôs avaliar o efeito do Bz sobre o perfil imunológico de linfócitos T e a produção de citocinas por células da resposta imune expostas in vitro ao T. cruzi. Amostras de sangue de portadores crônicos da DC foram coletadas para obtenção de células mononucleares de sangue periférico com posterior infecção com tripomastigotas de T. cruzi, seguida de adição do Bz às culturas. Após o tempo de cultivo, os sobrenadantes foram estocados para posterior análise das citocinas IFN-gama, TNF, IL-10, IL-6, IL-4 e IL-2 por CBA e as células foram avaliadas por citometria de fluxo, quanto à expressão das moléculas CD28+ e CTLA-4+ e a produção de citocinas (IL-10 e IFN-gama) em linfócitos T CD4+ e CD8+. Nossos resultados mostraram que o tratamento com o Bz aumentou a expressão da molécula CTLA-4+ em linfócitos T CD8+, indicando que o Bz pode induzir uma modulação da resposta imune e, consequentemente, diminuir a ativação exacerbada dessas células. Além disso, verificamos uma diminuição da produção da citocina IL-10 por linfócitos T CD4+ na presença do Bz. Com relação à produção global de citocinas por células aderentes e não aderentes, observamos que o Bz causou uma diminuição da citocina pró-inflamatória TNF e da citocina anti-inflamatória IL-10, enquanto que as outras citocinas (IFN-gama, IL-6, IL4 e IL-2) permaneceram com níveis elevados de produção na presença desse fármaco. Nossos resultados sugerem que o Bz induz uma regulação da ativação de linfócitos T CD8+ e a produção de citocinas do perfil Th1 modulado por citocinas do perfil Th2, em células de portadores crônicos da DC. Assim, acreditamos que a administração do Bz aos portadores de formas clínicas brandas da DC pode ser benéfica a esses pacientes, visto que o Bz não promoveu um perfil inflamatório exacerbado

Condições orais em Minas Gerais: estudo da Carga Global de Doença e o papel dos serviços de saúde

Introdução: Os agravos orais são um problema de saúde pública devido à suaprevalência na população e as complicações físicas e psicológicas advindas de suas ocorrências. Objetivou-se estimar a carga de doença para as condições orais em Minas Gerais, no período 2004 - 2006, e identificar fatores contextuais e de serviços de saúdeassociados. Métodos: Estudo da Carga de Doença para cárie, edentulismo e doençaperiodontal, por sexo e faixa etária. O indicador usado foi o DALY, que medesimultaneamente o impacto da mortalidade e dos problemas de saúde que afetam a qualidade de vida. A Carga de Doença para condições orais foi analisada em números absolutos e taxas / 1.000 habitantes. Os procedimentos ambulatoriais odontológicos foram organizados em série histórica e examinados por meio de análise descritiva. A associação de fatores contextuais com agravos orais foi analisada com modelagem hierárquica. Resultados: Estimou-se 45.514 YLD para agravos orais, com taxa de 2,4/1.000 habitantes. Estimou-se 18.142 YLD para homens e 27.372 YLD para mulheres (1,9/1.000 e 2,8/1.000, respectivamente). O número de YLD para cárie foi de 8.332, com taxas de 0,4/1.000 para ambos os sexos. Estimou-se 33.888 YLD para edentulismo, com taxa de 2,2/1.000 nas mulheres. Na doença periodontal estimou-se 3.217 YLD, resultando em uma taxa de 0,2/1.000 para ambos os sexos. Observou-se aumento da oferta de alguns procedimentos odontológicos ambulatoriais nas Macrorregionais de Saúde menos favorecidas economicamente. As característicassocioeconômicas associaram-se à incidência de cárie dentária e à prevalência de edentulismo.

Expression of the Rap1 guanine nucleotide exchange factor, MR-GEF, is altered in individuals with bipolar disorder

In the rodent forebrain GABAergic neurons are generated from progenitor cells that express the transcription factors Dlx1 and Dlx2. The Rap-1 guanine nucleotide exchange factor, MR-GEF, is turned on by many of these developing GABAergic neurons. Expression of both Dlx1/2 and MR-GEF is retained in both adult mouse and human forebrain where, in human, decreased Dlx1 expression has been associated with psychosis. Using in situ hybridization studies we show that MR-GEF expression is significantly down-regulated in the forebrain of Dlx1/2 double mutant mice suggesting that MR-GEF and Dlx1/2 form part of a common signalling pathway during GABAergic neuronal development. We therefore compared MR-GEF expression by in situ hybridization in individuals with major psychiatric disorders (schizophrenia, bipolar disorder, major depression) and control individuals. We observed a significant positive correlation between layers II and IV of the dorso-lateral prefrontal cortex (DLPFC) in the percentage of MR-GEF expressing neurons in individuals with bipolar disorder, but not in individuals with schizophrenia, major depressive disorder or in controls. Since MR-GEF encodes a Rap1 GEF able to activate G-protein signalling, we suggest that changes in MR-GEF expression could potentially influence neurotransmission.

Rod bipolar cells in the retina of the capuchin monkey (Cebus apella): Characterization and distribution

Rod bipolar cells in Cebus apella monkey retina were identified by an antibody against the alpha isoform of protein kinase C (PKC alpha). which has been shown to selectively identify rod bipolars in two other primates and various mammals. Vertical sections were used to confirm the identity of these cells by their characteristic morphology of dendrites and axons. Their topographic distribution was assessed in horizontal sections; counts taken along the dorsal, ventral, nasal, and temporal quadrants. The density of rod bipolar cells increased from 500 to 2900 cells/mm(2) at 1 mm from the fovea to reach a peak of 10,000-12,000 cellss/mm(2) at 4 mm, approximately 5 deg of eccentricity, and then gradually decreased toward retinal periphery to values of 5000 cells/mm(2) or less. Rod to rod bipolar density ratio remained between 10 and 20 across most of the retinal extension. The number of rod bipolar cells per retina was 6,360,000 +/- 387,433 (mean +/- S.D., n = 6). The anti-PKC alpha antibody has shown to be a good marker of rod bipolar cells of Cebus, and the cell distribution is similar to that described for other primates. In spite of the difference in the central retina, the density variation of rod bipolar cells in the Cebus and Macaca as well as the convergence from rod to rod bipolar cells are Generally similar, suggesting that both retinae stabilize similar sensitivity (as measured by rod density) and convergence.

Clinical significance of lifetime panic disorder in the course of bipolar disorder type I

Objectives: The aim of the study was to analyze the impact of lifetime panic disorder (PD) diagnosis in a sample of patients with bipolar disorder type I (BPI), evaluating clinical and demographic variables. Methods: Ninety-five outpatients from the Bipolar Disorder Research Program at the Institute of Psychiatry of the University of Sao Paulo Medical School were enrolled. Twenty-seven BPI patients with PD were compared to 68 BPI patients without any anxiety disorders regarding clinical and demographic variables. Results: Compared to BPI patients without any anxiety disorders, patients with BPI + PD presented significantly higher number of mood episodes (18.9 +/- 13.8 vs 8.5 +/- 7.8; P < .001), depressive episodes (10.8 +/- 8.2 vs 4.6 +/- 4,8; P = .001), and manic episodes (7.4 +/- 7.3 vs 3.6 +/- 3.6; P = .008). Patients with BPI + PD had more frequently a depressive episode as their first one compared to BPI patients without anxiety disorders (94.1% vs 57.5%; P = .011). Patients with BPI + PD had more comorbidity with lifetime diagnosis of drug abuse or dependence (33.3% vs 8.8%; P = .010) and eating disorders (29.6% vs 6.0%; P = .004). Conclusions: The higher number of mood episodes in general presented by patients with BPI + PD when compared with BPI patients without any anxiety disorders, along with the higher frequencies of drug misuse and eating disorders, indicates that PD comorbidity is associated with a poorer Course and outcome of BPI. The higher frequency of depression as the onset mood episode and the higher number of manic episodes in the group with PD may have important treatment implications and should be further investigated. (C) 2009 Elsevier Inc. All rights reserved.

Functional and Structural Connectivity Between the Perigenual Anterior Cingulate and Amygdala in Bipolar Disorder

Objective: Abnormalities in the morphology and function of two gray matter structures central to emotional processing, the perigenual anterior cingulate cortex (pACC) and amygdala, have consistently been reported in bipolar disorder (BD). Evidence implicates abnormalities in their connectivity in BD. This study investigates the potential disruptions in pACC-amygdala functional connectivity and associated abnormalities in white matter that provides structural connections between the two brain regions in BD. Methods: Thirty-three individuals with BD and 31 healthy comparison subjects (HC) participated in a scanning session during which functional magnetic resonance imaging (fMRI) during processing of face stimuli and diffusion tensor imaging (DTI) were performed. The strength of pACC-amygdala functional connections was compared between BD and HC groups, and associations between these functional connectivity measures from the fMRI scans and regional fractional anisotropy (FA) from the DTI scans were assessed. Results: Functional connectivity was decreased between the pACC and amygdala in the BD group compared with HC group, during the processing of fearful and happy faces (p < .005). Moreover, a significant positive association between pACC-amygdala functional coupling and FA in ventrofrontal white matter, including the region of the uncinate fasciculus, was identified (p < .005). Conclusion: This study provides evidence for abnormalities in pACC-amygdala functional connectivity during emotional processing in BD. The significant association between pACC-amygdala functional connectivity and the structural integrity of white matter that contains pACC-amygdala connections suggest that disruptions in white matter connectivity may contribute to disturbances in the coordinated responses of the pACC and amygdala during emotional processing in BD.

Abnormal Corpus Callosum Integrity in Bipolar Disorder: A Diffusion Tensor Imaging Study

Objective: Abnormalities in the anterior interhemispheric connections provided by the corpus callosum (CC) have long been implicated in bipolar disorder (BID). In this study, we used complementary diffusion tensor imaging methods to study the structural integrity of the CC and localization of potential abnormalities in BD. Methods: Subjects included 33 participants with BID and 40 healthy comparison participants. Fractional anisotropy (FA) measures were compared between groups with region of interest (ROD methods to investigate the anterior, middle, and posterior CC and voxel-based methods to further localize abnormalities. Results: In ROI-based analyses, FA was significantly decreased in the anterior and middle CC in the BID group (p <.05). Voxel-based analyses similarly localized group differences to the genu, rostral body, and anterior midbody of CC (p <.05, corrected). Conclusion: The findings demonstrate abnormalities in the structural integrity of the anterior CC in BID that might contribute to altered interhemispheric connectivity in this disorder.

Abnormal anterior cingulum integrity in bipolar disorder determined through diffusion tensor imaging

Background Convergent evidence implicates white matter abnormalities in bipolar disorder. The cingulum is an important candidate structure for study in bipolar disorder as it provides substantial white matter connections within the corticolimbic neural system that subserves emotional regulation involved in the disorder. Aims To test the hypothesis that bipolar disorder is associated with abnormal white matter integrity in the cingulum. Method Fractional anisotropy in the anterior and posterior cingulum was compared between 42 participants with bipolar disorder and 42 healthy participants using diffusion tensor imaging. Results Fractional anisotropy was significantly decreased in the anterior cingulum in the bipolar disorder group compared with the healthy group (P=0.003); however, fractional anisotropy in the posterior cingulum did not differ significantly between groups. Conclusions Our findings demonstrate abnormalities in the structural integrity of the anterior cingulum in bipolar disorder. They extend evidence that supports involvement of the neural system comprising the anterior cingulate cortex and its corticolimbic gray matter connection sites in bipolar disorder to implicate abnormalities in the white matter connections within the system provided by the cingulum.

Synthesis of a PEG-bipolar-dimyristoylphosphatidylethanoline

The problem of drug delivery has been of continuous research interest to the biomedical scientific community. The basic problem of drug delivery is to facilitate the transport of medication via the bloodstream to the target organs. This process can be significantly hampered by the hydrophobic nature of most medications. Pharmaceutical compounds and in particular chemotherapeutics (which are a specific area of research at the Cornell Medical Center and the Sloan-Kettering Institute) tend to be extremely hydrophobic. Blood is a hydrophilic environment, so the hydrophobic drugs simply cannot dissolve in the bloodstream. As a result they cannot be transported successfully to the target tissues. For example, Sloan-Kettering possesses compounds that kill cancer cells 100ln vitro, yet those same compounds are virtually inactive in vivo because of their insolubility in the blood. It was our purpose, therefore, to develop an appropriate and successful drug delivery system.