Localisation régionale et subcellulaire du récepteur EphA7 dans l'hippocampe et le cervelet du rat adulte

EphA7 est un membre de la famille des récepteurs à tyrosine kinase, Eph, qui assume plusieurs rôles durant le développement du système nerveux central. Par ailleurs, il continue d’être fortement exprimé dans le cerveau adulte, notamment dans les régions reconnues pour leur grande plasticité synaptique, telles que l’hippocampe et le cervelet. Par hybridation in situ, nous avons cartographié la distribution de l’ARNm d’EphA7 dans le cerveau de rats et souris adultes. Les couches pyramidales du CA1 et CA3 et granulaire du gyrus dentelé de la formation de l’hippocampe ont montré le plus fort marquage. Un niveau d’ARNm d’EphA7 plus modéré a été observé dans l’habenula, le striatum, l’amygdale, le cervelet et le cortex cingulaire, piriforme et entorhinal. Quant à la protéine détectée par immunohistochimie, elle était fortement exprimée dans le neuropile de l’hippocampe et la couche des cellules de Purkinje du cervelet. En microscopie électronique, dans toutes les couches de l’hippocampe et du cervelet examinées, des épines dendritiques, des dendrites, des axones non-myélinisés, des terminaisons axonales et quelquefois des prolongements astrocytaires constituaient les éléments immunopositifs. Comme on pouvait déjà le voir en microscopie photonique, les corps cellulaires des cellules pyramidales et granulaires de l’hippocampe ainsi que des cellules de Purkinje du cervelet montraient aussi du marquage, surtout intracellulaire. L’analyse quantitative a révélé la localisation préférentielle d’EphA7 dans des dendrites et épines dendritiques. La majorité des épines marquées formaient des synapses asymétriques (excitatrices) avec des terminaisons axonales non marquées. La double localisation préférentielle d’EphA7 dans les dendrites ainsi que les densités post-synaptiques des épines dendritiques est compatible avec l’hypothèse d’un rôle d’EphA7 dans le maintien ou la fonction de certaines synapses du SNC adulte.

Études structurales par résonance magnétique nucléaire du ribozyme VS de Neurospora

Le ribozyme VS de Neurospora catalyse des réactions de clivage et de ligation d’un lien phosphodiester spécifique essentielles à son cycle de réplication. Il est formé de six régions hélicales (I à VI), qui se divisent en deux domaines, soit le substrat (SLI) et le domaine catalytique (tiges II à VI). Ce dernier comprend deux jonctions à trois voies qui permettent de reconnaître le substrat en tige-boucle de façon spécifique. Ce mode de reconnaissance unique pourrait être exploité pour cibler des ARN repliés pour diverses applications. Bien que le ribozyme VS ait été caractérisé biochimiquement de façon exhaustive, aucune structure à haute résolution du ribozyme complet n’a encore été publiée, ce qui limite la compréhension des mécanismes inhérents à son fonctionnement. Précédemment, une approche de divide-and-conquer a été initiée afin d’étudier la structure des sous-domaines importants du ribozyme VS par spectroscopie de résonance magnétique nucléaire (RMN) mais doit être complétée. Dans le cadre de cette thèse, les structures de la boucle A730 et des jonctions III-IV-V et II-III-VI ont été déterminées par spectroscopie RMN hétéronucléaire. De plus, une approche de spectroscopie RMN a été développée pour la localisation des ions divalents, tandis que diverses approches de marquage isotopique ont été implémentées pour l’étude d’ARN de plus grandes tailles. Les structures RMN de la boucle A730 et des deux jonctions à trois voies révèlent que ces sous-domaines sont bien définis, qu’ils sont formés de plusieurs éléments structuraux récurrents (U-turn, S-turn, triplets de bases et empilement coaxial) et qu’ils contiennent plusieurs sites de liaison de métaux. En outre, un modèle du site actif du ribozyme VS a été construit sur la base des similarités identifiées entre les sites actifs des ribozymes VS et hairpin. Dans l’ensemble, ces études contribuent de façon significative à la compréhension de l’architecture globale du ribozyme VS. De plus, elles permettront de construire un modèle à haute résolution du ribozyme VS tout en favorisant de futures études d’ingénierie.

Quantitative functional MRI of the Cerebrovascular Reactivity to CO2

Le dioxyde de carbone (CO2) est un résidu naturel du métabolisme cellulaire, la troisième substance la plus abondante du sang, et un important agent vasoactif. À la moindre variation de la teneur en CO2 du sang, la résistance du système vasculaire cérébral et la perfusion tissulaire cérébrale subissent des changements globaux. Bien que les mécanismes exacts qui sous-tendent cet effet restent à être élucidés, le phénomène a été largement exploité dans les études de réactivité vasculaire cérébrale (RVC). Une voie prometteuse pour l’évaluation de la fonction vasculaire cérébrale est la cartographie de la RVC de manière non-invasive grâce à l’utilisation de l’Imagerie par Résonance Magnétique fonctionnelle (IRMf). Des mesures quantitatives et non-invasives de de la RVC peuvent être obtenus avec l’utilisation de différentes techniques telles que la manipu- lation du contenu artériel en CO2 (PaCO2) combinée à la technique de marquage de spin artériel (Arterial Spin Labeling, ASL), qui permet de mesurer les changements de la perfusion cérébrale provoqués par les stimuli vasculaires. Toutefois, les préoccupations liées à la sensibilité et la fiabilité des mesures de la RVC limitent de nos jours l’adoption plus large de ces méthodes modernes de IRMf. J’ai considéré qu’une analyse approfondie ainsi que l’amélioration des méthodes disponibles pourraient apporter une contribution précieuse dans le domaine du génie biomédical, de même qu’aider à faire progresser le développement de nouveaux outils d’imagerie de diagnostique. Dans cette thèse je présente une série d’études où j’examine l’impact des méthodes alternatives de stimulation/imagerie vasculaire sur les mesures de la RVC et les moyens d’améliorer la sensibilité et la fiabilité de telles méthodes. J’ai aussi inclus dans cette thèse un manuscrit théorique où j’examine la possible contribution d’un facteur méconnu dans le phénomène de la RVC : les variations de la pression osmotique du sang induites par les produits de la dissolution du CO2. Outre l’introduction générale (Chapitre 1) et les conclusions (Chapitre 6), cette thèse comporte 4 autres chapitres, au long des quels cinq différentes études sont présentées sous forme d’articles scientifiques qui ont été acceptés à des fins de publication dans différentes revues scientifiques. Chaque chapitre débute par sa propre introduction, qui consiste en une description plus détaillée du contexte motivant le(s) manuscrit(s) associé(s) et un bref résumé des résultats transmis. Un compte rendu détaillé des méthodes et des résultats peut être trouvé dans le(s) dit(s) manuscrit(s). Dans l’étude qui compose le Chapitre 2, je compare la sensibilité des deux techniques ASL de pointe et je démontre que la dernière implémentation de l’ASL continue, la pCASL, offre des mesures plus robustes de la RVC en comparaison à d’autres méthodes pulsés plus âgées. Dans le Chapitre 3, je compare les mesures de la RVC obtenues par pCASL avec l’utilisation de quatre méthodes respiratoires différentes pour manipuler le CO2 artérielle (PaCO2) et je démontre que les résultats peuvent varier de manière significative lorsque les manipulations ne sont pas conçues pour fonctionner dans l’intervalle linéaire de la courbe dose-réponse du CO2. Le Chapitre 4 comprend deux études complémentaires visant à déterminer le niveau de reproductibilité qui peut être obtenu en utilisant des méthodes plus récentes pour la mesure de la RVC. La première étude a abouti à la mise au point technique d’un appareil qui permet des manipulations respiratoires du CO2 de manière simple, sécuritaire et robuste. La méthode respiratoire améliorée a été utilisée dans la seconde étude – de neuro-imagerie – où la sensibilité et la reproductibilité de la RVC, mesurée par pCASL, ont été examinées. La technique d’imagerie pCASL a pu détecter des réponses de perfusion induites par la variation du CO2 dans environ 90% du cortex cérébral humain et la reproductibilité de ces mesures était comparable à celle d’autres mesures hémodynamiques déjà adoptées dans la pratique clinique. Enfin, dans le Chapitre 5, je présente un modèle mathématique qui décrit la RVC en termes de changements du PaCO2 liés à l’osmolarité du sang. Les réponses prédites par ce modèle correspondent étroitement aux changements hémodynamiques mesurés avec pCASL ; suggérant une contribution supplémentaire à la réactivité du système vasculaire cérébral en lien avec le CO2.

STUDIES ON THE QUALITY AND PROCESS CONTROL FACTORS DURING THE PRODUCTION AND STORAGE OF SALTED DRIED FISH PRODUCTS

In this study the quality and process control factors during the production and storage of salted dried fish products. The study reveals that quantity of dry fish production in the state is decreasing and dry fish processing industry should be encouraged by central and state governments. The dry and wet salting may be carried out to a period of 4 to 8 hours respectively and time may depend on temperature, size, and concentration of medium. Demand is an unavoidable factor for sale of fish. The packed dry salted lots kept at room temperature are useful only for 20 days. The refrigerator- stored lots had more storage life and nutritional content are good up to 3 months. The cold storage stored dry salted lot had more storage life than the wet salted lot. The use of preservatives in salting is encouraged to reduce pH. The low temperature preservation maintains the nutritional value and quality for long period. It further encourages the labeling of nutritional value of dry fish as in tinned products.

On infinite graphs and related matrices

This thesis Entitled On Infinite graphs and related matrices.ln the last two decades (iraph theory has captured wide attraction as a Mathematical model for any system involving a binary relation. The theory is intimately related to many other branches of Mathematics including Matrix Theory Group theory. Probability. Topology and Combinatorics . and has applications in many other disciplines..Any sort of study on infinite graphs naturally involves an attempt to extend the well known results on the much familiar finite graphs. A graph is completely determined by either its adjacencies or its incidences. A matrix can convey this information completely. This makes a proper labelling of the vertices. edges and any other elements considered, an inevitable process. Many types of labelling of finite graphs as Cordial labelling, Egyptian labelling, Arithmetic labeling and Magical labelling are available in the literature. The number of matrices associated with a finite graph are too many For a study ofthis type to be exhaustive. A large number of theorems have been established by various authors for finite matrices. The extension of these results to infinite matrices associated with infinite graphs is neither obvious nor always possible due to convergence problems. In this thesis our attempt is to obtain theorems of a similar nature on infinite graphs and infinite matrices. We consider the three most commonly used matrices or operators, namely, the adjacency matrix

Investigations on novel polymer nano composites and bio-compatible manganese doped ZnS nanocrystals for photonic and bio-imaging applications

Fluorescence is a powerful tool in biological research, the relevance of which relies greatly on the availability of sensitive and selective fluorescent probes. Nanometer sized fluorescent semiconductor materials have attracted considerable attention in recent years due to the high luminescence intensity, low photobleaching, large Stokes’ shift and high photochemical stability. The optical and spectroscopic features of nanoparticles make them very convincing alternatives to traditional fluorophores in a range of applications. Efficient surface capping agents make these nanocrystals bio-compatible. They can provide a novel platform on which many biomolecules such as DNA, RNA and proteins can be covalently linked. In the second phase of the present work, bio-compatible, fluorescent, manganese doped ZnS (ZnS:Mn) nanocrystals suitable for bioimaging applications have been developed and their cytocompatibility has been assessed. Functionalization of ZnS:Mn nanocrystals by safe materials results in considerable reduction of toxicity and allows conjugation with specific biomolecules. The highly fluorescent, bio-compatible and water- dispersible ZnS:Mn nanocrystals are found to be ideal fluorescent probes for biological labeling

Primary hemocyte culture of Penaeus monodon as an in vitro model for white spot syndrome virus titration, viral and immune related gene expression and cytotoxicity assays

Immortal cell lines have not yet been reported from Penaeus monodon, which delimits the prospects of investigating the associated viral pathogens especially white spot syndrome virus (WSSV). In this context, a method of developing primary hemocyte culture from this crustacean has been standardized by employing modified double strength Leibovitz-15 (L-15) growth medium supplemented with 2% glucose, MEM vitamins (1 ), tryptose phosphate broth (2.95 g l 1), 20% FBS, N-phenylthiourea (0.2 mM), 0.06 lgml 1 chloramphenicol, 100 lgml 1 streptomycin and 100 IU ml 1 penicillin and hemolymph drawn from shrimp grown under a bio-secured recirculating aquaculture system (RAS). In this medium the hemocytes remained viable up to 8 days. 5-Bromo-20-deoxyuridine (BrdU) labeling assay revealed its incorporation in 22 ± 7% of cells at 24 h. Susceptibility of the cells to WSSV was confirmed by immunofluoresence assay using a monoclonal antibody against 28 kDa envelope protein of WSSV. A convenient method for determining virus titer as MTT50/ml was standardized employing the primary hemocyte culture. Expression of viral genes and cellular immune genes were also investigated. The cell culture could be demonstrated for determining toxicity of a management chemical (benzalkonium chloride) by determining its IC50. The primary hemocyte culture could serve as a model for WSSV titration and viral and cellular immune related gene expression and also for investigations on cytotoxicity of aquaculture drugs and chemicals

Development of a cell culture system from the ovarian tissue of African catfish Clarias gariepinus

A growth medium with Leibovitz-15 L-15.as the base, supplemented with foetal bovine serum 10% vrv., fish muscle extract 10% vrv., prawn muscle extract 10% vrv., lectin concanavalin A. 0.02 mg mly1., lipopolysaccharide 0.02 mg mly1., glucose D 0.2 mg mly1., ovary extract 0.5% vrv.and prawn haemolymph 0.5%. has been formulated with 354"10 mOsm for the development and maintenance of a cell culture system from the ovarian tissue of African catfish, Clarias gariepinus. For its subculturing, a cell dissociationrextracting solution, composed of equal portions of trypsin phosphate versene glucose TPVG. containing 0.0125% wrv.trypsin and 25% vrv.non-enzymatic cell dissociation solution 1 and 2, has also been developed with which the cell culture can be passaged 15 times after which they cease to multiply and consequently perish. The cell cultures can be maintained for 12–15 days without fluid change between the passages. This is the first report of a cell culture system from the ovarian tissues of African catfish

Design and study of self-assembled functional organic and hybrid systems for biological applications

The focus of self-assembly as a strategy for the synthesis has been confined largely to molecules, because of the importance of manipulating the structure of matter at the molecular scale. We have investigated the influence of temperature and pH, in addition to the concentration of the capping agent used for the formation of the nano-bio conjugates. For example, the formation of the narrower size distribution of the nanoparticles was observed with the increase in the concentration of the protein, which supports the fact that γ-globulin acts both as a controller of nucleation as well as stabiliser. As analyzed through various photophysical, biophysical and microscopic techniques such as TEM, AFM, C-AFM, SEM, DLS, OPM, CD and FTIR, we observed that the initial photoactivation of γ-globulin at pH 12 for 3 h resulted in small protein fibres of ca. Further irradiation for 24 h, led to the formation of selfassembled long fibres of the protein of ca. 5-6 nm and observation of surface plasmon resonance band at around 520 nm with the concomitant quenching of luminescence intensity at 680 nm. The observation of light triggered self-assembly of the protein and its effect on controlling the fate of the anchored nanoparticles can be compared with the naturally occurring process such as photomorphogenesis.Furthermore,our approach offers a way to understand the role played by the self-assembly of the protein in ordering and knock out of the metal nanoparticles and also in the design of nano-biohybrid materials for medicinal and optoelectronic applications. Investigation of the potential applications of NIR absorbing and water soluble squaraine dyes 1-3 for protein labeling and anti-amyloid agents forms the subject matter of the third chapter of the thesis. The study of their interactions with various proteins revealed that 1-3 showed unique interactions towards serum albumins as well as lysozyme. 69%, 71% and 49% in the absorption spectra as well as significant quenching in the fluorescence intensity of the dyes 1-3, respectively. Half-reciprocal analysis of the absorption data and isothermal titration calorimetric (ITC) analysis of the titration experiments gave a 1:1 stoichiometry for the complexes formed between the lysozyme and squaraine dyes with association constants (Kass) in the range 104-105 M-1. We have determined the changes in the free energy (ΔG) for the complex formation and the values are found to be -30.78, -32.31 and -28.58 kJmol-1, respectively for the dyes 1, 2 and 3. Furthermore, we have observed a strong induced CD (ICD) signal corresponding to the squaraine chromophore in the case of the halogenated squaraine dyes 2 and 3 at 636 and 637 nm confirming the complex formation in these cases. To understand the nature of interaction of the squaraine dyes 1-3 with lysozyme, we have investigated the interaction of dyes 1-3 with different amino acids. These results indicated that the dyes 1-3 showed significant interactions with cysteine and glutamic acid which are present in the side chains of lysozyme. In addition the temperature dependent studies have revealed that the interaction of the dye and the lysozyme are irreversible. Furthermore, we have investigated the interactions of these NIR dyes 1-3 with β- amyloid fibres derived from lysozyme to evaluate their potential as inhibitors of this biologically important protein aggregation. These β-amyloid fibrils were insoluble protein aggregates that have been associated with a range of neurodegenerative diseases, including Huntington, Alzheimer’s, Parkinson’s, and Creutzfeldt-Jakob diseases. We have synthesized amyloid fibres from lysozyme through its incubation in acidic solution below pH 4 and by allowing to form amyloid fibres at elevated temperature. To quantify the binding affinities of the squaraine dyes 1-3 with β-amyloids, we have carried out the isothermal titration calorimetric (ITC) measurements. The association constants were determined and are found to be 1.2 × 105, 3.6× 105 and 3.2 × 105 M-1 for the dyes, 1-3, respectively. To gain more insights into the amyloid inhibiting nature of the squaraine dyes under investigations, we have carried out thioflavin assay, CD, isothermal titration calorimetry and microscopic analysis. The addition of the dyes 1-3 (5μM) led to the complete quenching in the apparent thioflavin fluorescence, thereby indicating the destabilization of β-amyloid fibres in the presence of the squaraine dyes. Further, the inhibition of the amyloid fibres by the squaraine dyes 1-3, has been evidenced though the DLS, TEM AFM and SAED, wherein we observed the complete destabilization of the amyloid fibre and transformation of the fibre into spherical particles of ca. These results demonstrate the fact that the squaraine dyes 1-3 can act as protein labeling agents as well as the inhibitors of the protein amyloidogenesis. The last chapter of the thesis describes the synthesis and investigation of selfassembly as well as bio-imaging aspects of a few novel tetraphenylethene conjugates 4-6.Expectedly, these conjugates showed significant solvatochromism and exhibited a hypsochromic shift (negative solvatochromism) as the solvent polarity increased, and these observations were justified though theoretical studies employing the B3LYP/6-31g method. We have investigated the self-assembly properties of these D-A conjugates though variation in the percentage of water in acetonitrile solution due to the formation of nanoaggregates. Further the contour map of the observed fluorescence intensity as a function of the fluorescence excitation and emission wavelength confirmed the formation of J-type aggregates in these cases. To have a better understanding of the type of self-assemblies formed from the TPE conjugates 4-6, we have carried out the morphological analysis through various microscopic techniques such as DLS, SEM and TEM. 70%, we observed rod shape architectures having ~ 780 nm in diameter and ~ 12 μM in length as evidenced through TEM and SEM analysis. We have made similar observations with the dodecyl conjugate 5 at ca. 70% and 50% water/acetonitrile mixtures, the aggregates formed from 4 and 5 were found to be highly crystalline and such structures were transformed to amorphous nature as the water fraction was increased to 99%. To evaluate the potential of the conjugate as bio-imaging agents, we have carried out their in vitro cytotoxicity and cellular uptake studies though MTT assay, flow cytometric and confocal laser scanning microscopic techniques. Thus nanoparticle of these conjugates which exhibited efficient emission, large stoke shift, good stability, biocompatibility and excellent cellular imaging properties can have potential applications for tracking cells as well as in cell-based therapies. In summary we have synthesized novel functional organic chromophores and have studied systematic investigation of self-assembly of these synthetic and biological building blocks under a variety of conditions. The investigation of interaction of water soluble NIR squaraine dyes with lysozyme indicates that these dyes can act as the protein labeling agents and the efficiency of inhibition of β-amyloid indicate, thereby their potential as anti-amyloid agents.

Information needs for a purchase of fairtrade coffee

This research investigates what information German Fairtrade coffee consumers search for during pre-purchase information seeking and to what extent information is retrieved. Furthermore, the sequence of the information search as well as the degree of cognitive involvement is highlighted. The role of labeling, the importance of additional ethical information and its quality in terms of concreteness as well as the importance of product price and organic origin are addressed. A set of information relevant to Fairtrade consumers was tested by means of the Information Display Matrix (IDM) method with 389 Fairtrade consumers. Results show that prior to purchase, information on product packages plays an important role and is retrieved rather extensively, but search strategies that reduce the information processing effort are applied as well. Furthermore, general information is preferred over specific information. Results of two regression analyses indicate that purchase decisions are related to search behavior variables rather than to socio-demographic variables and purchase motives. In order to match product information with consumers’ needs, marketers should offer information that is reduced to the central aspects of Fairtrade.

On-the-Fly Maintenance of Series-Parallel Relationships in Fork-Join Multithreaded Programs

A key capability of data-race detectors is to determine whether one thread executes logically in parallel with another or whether the threads must operate in series. This paper provides two algorithms, one serial and one parallel, to maintain series-parallel (SP) relationships "on the fly" for fork-join multithreaded programs. The serial SP-order algorithm runs in O(1) amortized time per operation. In contrast, the previously best algorithm requires a time per operation that is proportional to Tarjan’s functional inverse of Ackermann’s function. SP-order employs an order-maintenance data structure that allows us to implement a more efficient "English-Hebrew" labeling scheme than was used in earlier race detectors, which immediately yields an improved determinacy-race detector. In particular, any fork-join program running in T₁ time on a single processor can be checked on the fly for determinacy races in O(T₁) time. Corresponding improved bounds can also be obtained for more sophisticated data-race detectors, for example, those that use locks. By combining SP-order with Feng and Leiserson’s serial SP-bags algorithm, we obtain a parallel SP-maintenance algorithm, called SP-hybrid. Suppose that a fork-join program has n threads, T₁ work, and a critical-path length of T[subscript ∞]. When executed on P processors, we prove that SP-hybrid runs in O((T₁/P + PT[subscript ∞]) lg n) expected time. To understand this bound, consider that the original program obtains linear speed-up over a 1-processor execution when P = O(T₁/T[subscript ∞]). In contrast, SP-hybrid obtains linear speed-up when P = O(√T₁/T[subscript ∞]), but the work is increased by a factor of O(lg n).

Targeted Stimuli-Responsive Dextran Conjugates for Doxorubicin Delivery to Hepatocytes

A targeted, stimuli-responsive, polymeric drug delivery vehicle is being developed in our lab to help alleviate severe side-effects caused by narrow therapeutic window drugs. Targeting specific cell types or organs via proteins, specifically, lectin-mediated targeting holds potential due to the high specificity and affinity of receptor-ligand interactions, rapid internalization, and relative ease of processing. Dextran, a commercially available, biodegradable polymer has been conjugated to doxorubicin and galactosamine to target hepatocytes in a three-step, one-pot synthesis. The loading of doxorubicin and galactose on the conjugates was determined by absorbance at 485 nm and elemental analysis, respectively. Conjugation efficiency based on the amount loaded of each reactant varies from 20% to 50% for doxorubicin and from 2% to 20% for galactosamine. Doxorubicin has also been attached to dextran through an acid-labile hydrazide bond. Doxorubicin acts by intercalating with DNA in the nuclei of cells. The fluorescence of doxorubicin is quenched when it binds to DNA. This allows a fluorescence-based cell-free assay to evaluate the efficacy of the polymer conjugates where we measure the fluorescence of doxorubicin and the conjugates in increasing concentrations of calf thymus DNA. Fluorescence quenching indicates that our conjugates can bind to DNA. The degree of binding increases with polymer molecular weight and substitution of doxorubicin. In cell culture experiments with hepatocytes, the relative uptake of polymer conjugates was evaluated using flow cytometry, and the killing efficiency was determined using the MTT cell proliferation assay. We have found that conjugate uptake is much lower than that of free doxorubicin. Lower uptake of conjugates may increase the maximum dose of drug tolerated by the body. Also, non-galactosylated conjugate uptake is lower than that of the galactosylated conjugate. Microscopy indicates that doxorubicin localizes almost exclusively at the nucleus, whereas the conjugates are present throughout the cell. Doxorubicin linked to dextran through a hydrazide bond was used to achieve improved killing efficiency. Following uptake, the doxorubicin dissociates from the polymer in an endosomal compartment and diffuses to the nucleus. The LC₅₀ of covalently linked doxorubicin is 7.4 μg/mL, whereas that of hydrazide linked doxorubicin is 4.4 μg/mL.

Seguridad de los antipsicoticos en embarazo en pacientes con psicosis. Revisión sistemática

Enfermedades mentales de tipo psicótico en gestantes se han asociado con mayor número de resultados negativos. Los síntomas psicóticos durante el embarazo se presentan aproximadamente 7.1 por 100.000 casos. Dentro de las consecuencias se incluye mayor riesgo de parto pretérmino, bajo peso al nacer, alteraciones placentarias, malformaciones congénitas de predominio cardiovascular y mayor tasa de muertes perinatales. Como abordaje terapéutico son frecuentes los antipsicóticos de primera generación, aceptados como seguros pero en menor grado se han considerados los antipsicóticos de segunda generación pues ha sido escasamente evaluada su seguridad durante la gestación. Aún existe controversia sobre los potenciales efectos secundarios de algunos antipsicóticos dado los resultados contradictorios. Métodos: Revisión sistemática de la literatura de artículos que proporcionaron mejor evidencia para determinar cuáles antipsicóticos de elección durante la gestación en pacientes con esquizofrenia de acuerdo a su perfil de seguridad. Se evaluó calidad metodológica reconociendo particularidades y resultados de los estudios incluidos. Resultados: De 39 estudios seleccionados, cinco fueron incluidos en esta revisión, clasificándose como nivel de evidencia IIa y evaluados según su calidad metodológica con escala NOS. Se evaluó paso placentario de antipsicóticos, malformaciones fetales, complicaciones obstétricas como parto pretérmino, bajo y alto peso fetal, complicaciones respiratorias, diabetes gestacional, aborto espontáneo, entre otros. Discusión: Se debe sopesar el riesgo-beneficio, la significancia estadística, la significancia clínica y las particularidades de las pacientes a tratar. Conclusión: Los estudios analizados evaluaron diferentes medicamentos antipsicóticos, dificultando consolidación de información en especial en conclusiones solidas ante algunas premisas como fármacos de elección.

Archivo digital de imágenes diagnósticas enfocado a tórax y abdomen de Fundación Cardioinfantil – Instituto de Cardiología

Introducción: El desarrollo del archivo docente de imágenes diagnósticas, permite al Departamento de Imágenes compartir y difundir el conocimiento de la colección de casos e imágenes radiológicas reales con mayor rapidez y facilidad en el acceso a las mismas por parte de todo el personal de la Clínica Fundación Cardio-Infantil – Instituto de Cardiología, a través por portal web “e-cardio”, contribuyendo así en la formación académica del personal médico, técnico y administrativo. Metodología: Este trabajo no responde a ningún tipo de estudio epidemiológico, sino a una colección de imágenes y reseñas radiológicas de casos de patología torácica y cardiovascular, procedentes de pacientes de la Fundación Cardioinfantil – Instituto de Cardiología, con el fin de conformar un archivo digital docente. Resultados: Se recolectaron 1.148 radiografías impresas, previamente rotuladas según el Index for Radiological Diagnoses 4 edición y de archivos individuales 3.512 imágenes. Utilizando los criterios de inclusión y exclusión, se realizó la selección de imágenes para continuar el procedimiento. Se descartaron 278 radiografías impresas por no tener rotulo, estar en mal estado general, o rotulación incorrecta. En el caso de los archivos digitales, se descartaron 1435 imágenes, utilizando el mismo procedimiento. Conclusión: Iniciar la conformación y montaje del primer archivo docente de la Clínica Fundación Cardioinfantil – Instituto de Cardiología. Motivar a los profesionales médicos de la Clínica Fundación Cardio Infantil, y especialmente a los residentes de Radiología, para que estén en un proceso de aprendizaje continúo, fortaleciendo su autoevaluación, y todo ello para beneficio final de los pacientes y de la misma Institución.

Descripción del comportamiento basal y transoperatorio de los nivels de NIRS cerebral en pacientes con cardiopatias congenitas cianosantes sometidos a cirugia paliativa o correctiva y su correlación con las variables fisiologicas determinantes del flujo sanguineo cerebral

La lesión neurológica es un riesgo latente en pacientes sometidos a cirugía cardiaca, en cirugía para corrección de cardiopatías congénitas puede tener una incidencia tan alta como del 26%, por lo cual es necesario contar con herramientas cada vez más acertadas y que puedan ayudar a disminuir esta incidencia; la saturación regional cerebral medida por NIRS constituye una herramienta válida, que permite una evaluación continua y de forma no invasiva, que puede servir para este fin. El presente estudio pretende determinar una asociación entre los niveles de saturación regional de oxígeno cerebral en los pacientes con cardiopatías congénitas cianosantes y las variables fisiológicas determinantes del aporte de oxígeno, asumiendo una hipoxemia crónica para estos pacientes. Se realizó un estudio de correlación para estas variables, para lo cual se evaluaron de forma sistemática estas en pacientes sometidos a cirugía cardiaca en la Fundación Cardioinfantil Instituto de Cardiología, que cumplían con los criterios de inclusión, hasta completar una muestra de 31 pacientes, en los cuales no se realizó ninguna intervención, catalogándolo como riesgo menor que el mínimo, cumpliendo con los criterios de Helsinki.Se encontró una correlación significativa entre los valores de NIRS cerebral con los contenidos arteriales, capilares y venoso de oxígeno en el análisis bivariado, encontrándose para estos pacientes niveles más bajos de estos contenidos como también para el consumo de oxígeno, no se encontró asociación significativa con la saturación arterial ni venosa de oxígeno, parece existir una relación significativa entre los niveles más bajos de NIRS con el resultado neurológico, estos hallazgos sin embargo no fueron significativos en el análisis multivariado.