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Search Results: 1 - 10 of 13 matches for " Tonicarlo. "
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Comparison between Different ESI Methods on Refractory Epilepsy Patients Shows a High Sensitivity for Bayesian Model Averaging  [PDF]
Danilo Maziero, Agustin Lage Castellanos, Carlos Ernesto Garrido Salmon, Tonicarlo Rodrigues Velasco
Journal of Biomedical Science and Engineering (JBiSE) , 2014, DOI: 10.4236/jbise.2014.79066
Abstract: Electrical Source Imaging (ESI) is a non-invasive technique of reconstructing brain activities using EEG data. This technique has been applied to evaluate epilepsy patients being evaluated for epilepsy surgery, showing encouraging results for mapping interictal epileptiform discharges (IED). However, ESI is underused in planning epilepsy surgery. This is basically due to the wide availability of methods for solving the electromagnetism inverse problem (e-IP) associated to few studies using EEG setups similar to those most commonly used in clinical setting. In this study, we applied six different methods of solving the e-IP based on IEDs of 20 focal epilepsy patients that presented abnormalities in their MRI. We compared the ESI maps obtained by each method with the location of the abnormality, calculating the Euclidian distances from the center of the lesion to the closest border of the method solution (CL-BM) and also to the solution’s maxima (CL-MM). We also applied a score system in order to allow us to evaluate the sensitivity of each method for temporal and extra temporal patients. In our patients, the Bayesian Model Averaging method had a sensitivity of 86% and the shortest CL-MM. This method also had more restricted solutions that were more representative of epileptogenic activities than those obtained by the other methods.
Eficácia da associa??o de métodos diagnósticos no rastreamento do glaucoma
Costa, Roberta Martins da Silva;Velasco, Tonicarlo Rodrigues;Costa, Laudo Silva;Rodrigues, Maria de Lourdes Veronese;
Arquivos Brasileiros de Oftalmologia , 2004, DOI: 10.1590/S0004-27492004000100007
Abstract: objective: to evaluate the effectiveness of associating diagnostic tests for the detection of patients with glaucoma. method: forty-six eyes with cup/disc ratio >0.4 or disc asymmetry >0.2 were submitted to aplanation tonometry and automated static perimetry (screening and full threshold). the full threshold was adopted as gold standard for glaucoma diagnosis. results: the positive predictive value (pretest probability) of disc parameters was 34.8%. the sensitivity, specificity, positive and negative likelihood ratios of screening perimetry were respectively 75%, 93%, 10.7 and 0.27. using a cutoff of 20 mmhg the sensitivity, specificity, positive and negative likelihood ratios of tonometry were respectively 19%, 90%, 1.9 and 0.9. an abnormal screening test changes the probability of having a pathologic full threshold from 34.8% to 85% and a normal one changes this probability to 12%. the results of tonometry in changing the probability of having a pathologic full threshold were 34.8% to 50% when the test was positive (iop>20 mmhg) and 34.8 to 32% when the test was negative (iop<20 mmhg). conclusion: the results in identifying subjects with glaucoma are better when disc parameters are associated with screening visual field than with tonometry.
Eficácia da associa o de métodos diagnósticos no rastreamento do glaucoma
Costa Roberta Martins da Silva,Velasco Tonicarlo Rodrigues,Costa Laudo Silva,Rodrigues Maria de Lourdes Veronese
Arquivos Brasileiros de Oftalmologia , 2004,
Abstract: OBJETIVO: Estudar a eficácia da associa o de testes diagnósticos na detec o de pacientes com glaucoma. MéTODOS: Quarenta e seis olhos de 46 indivíduos com rela o escava o/disco >0,4 ou com assimetria de escava o >0,2 foram submetidos a tonometria, campimetria de estímulos supraliminares (CES) e limiares (CEL). A sele o dos pacientes foi realizada por meio de oftalmoscopia direta e a campimetria de estímulos liminares foi adotada como padr o-ouro ("gold standard") para o diagnóstico de glaucoma. RESULTADOS: A probabilidade de haver altera es na campimetria de estímulos liminares em olhos com rela o escava o/disco >0,4 foi de 34,8% (valor preditivo positivo). A sensibilidade, especificidade e os "likelihood ratios" positivo e negativo da campimetria de estímulos supraliminares foram, respectivamente, 75%, 93%, 10,7 e 0,27. Para a tonometria esses valores foram respectivamente 19%, 90%, 1,9 e 0,9. A associa o do exame supraliminar com o exame do disco óptico aumentou a probabilidade de haver altera es na campimetria de estímulos liminares de 34,8% para 85% se o primeiro for positivo (alterado) e diminui para 12% se este for negativo (normal). Quando o exame do disco é associado à tonometria, a probabilidade inicial aumenta de 34,8% apenas para 50% se o teste for positivo (PO>20 mmHg) e diminui para 32% se o teste for negativo (PO<20mmHg). CONCLUS O: A eficácia em identificar pacientes com glaucoma foi maior quando a oftalmoscopia direta foi associada ao exame de campimetria de estímulos supraliminares do que quando foi associada à tonometria.
Tratamento farmacológico das psicoses na epilepsia
Guarnieri Ricardo,Hallak Jaime Eduardo Cecílio,Walz Roger,Velasco Tonicarlo Rodrigues
Revista Brasileira de Psiquiatria , 2004,
Abstract: A epilepsia é uma das causas mais comuns de incapacidade funcional. Comorbidades psiquiátricas, como as psicoses, est o freqüentemente associadas à epilepsia. Psicoses na epilepsia (PNE) requerem tratamento farmacológico mais cuidadoso, levando-se em conta a propens o dos antipsicóticos (AP) em provocar crises convulsivas e o risco de intera o farmacocinética com as drogas antiepilépticas (DAE). Após uma breve descri o da classifica o e das principais características clínicas das PNE, foram discutidos alguns aspectos gerais do tratamento farmacológico das PNE e o uso de AP típicos e atípicos, destacando seu potencial para diminuir o limiar epileptogênico (LE), bem como possíveis intera es AP/DAE. Os AP atípicos, à exce o da clozapina, demonstraram exercer menor influência sobre o LE. Quanto às intera es farmacocinéticas, as principais DAE estiveram relacionadas com um aumento importante do metabolismo dos AP. Portanto, apesar do risco para convuls es por AP ser dose-dependente, doses mais elevadas de AP podem ser necessárias no tratamento das PNE.
Ictal and interictal SPECT in patients with frontal lobe epilepsy.- This paper was awarded the ADAC Prize at the Brazilian Congress of Nuclear Medicine, Recife, Brazil, December 1998.
Wichert-Ana, Lauro.,Kato, Mery .,Terra Bustamante, Vera Cristina.,Rodrigues Velasco, Tonicarlo.
Alasbimn Journal , 1999,
Abstract: The frontal lobe seizures present variable clinical and electroencephalographic features that play some difficulties in the presurgical work-up for epilepsy. The aim of the present study is to determine the role of ictal and interictal SPECT in the localization of the epileptogenic zone in frontal lobe epilepsies. We evaluated 13 patients, 6 men and 7 women, with mean age of 16yr, and with medically intractable frontal lobe seizures. All patients were submitted to ictal SPECT and 11 also to interictal scans. Ictal SPECT studies were contributive in 54% of patients, and nonlateralized and nonlocalized, or contralateralized in the remaining patients. Interictal SPECT showed normal perfusion in 45,5% of patients, hypoperfusion localized in the suspected epileptogenic zone in 45,5%, and diffuse findings in the other 9%. We conclude that the sensitivity of ictal and interictal SPECT studies in frontal lobe epilepsies is lower than that for temporal lobe seizures, thus confirming previous data.
Epilepsia do lobo temporal mesial associada à esclerose hipocampal
Andrade-Valen?a, Luciana P. A.;Valen?a, Marcelo Moraes;Velasco, Tonicarlo Rodrigues;Leite, Jo?o Pereira;
Journal of Epilepsy and Clinical Neurophysiology , 2006, DOI: 10.1590/S1676-26492006000100007
Abstract: introduction: mesial temporal lobe epilepsy (mtle) is the most frequent form of partial epilepsy and has been considered a major medical and social problem as a result of its pharmacoresistence to conventional antiepileptic therapy. hippocampal sclerosis is the leading cause of mtle in surgical series and represents 50-70% of the cases. objectives: to review the clinical aspects, histological findings, and the pathogenesis of the mtle associated with the hippocampal sclerosis. results: the relation between hippocampal sclerosis and mtle is well established in the literature, although the accurate mechanism through which hippocampal sclerosis is implicated in the genesis of the epileptic seizures is still not completely understood. conclusions: retrospective studies emphasize the association between hippocampal sclerosis and history of initial precipitating injury, such as epileptic seizures, occurring in early phase of the cerebral development. recent evidences indicate that genetic factors may play a role in the genesis of hippocampal sclerosis.
Papel das sinapses elétricas em crises epilépticas
Do Val-da Silva, Raquel Araujo;Bachiega-Salviano, Graziela Lima;Zanetti, Ana Claudia;Romcy-Pereira, Rodrigo Neves;Velasco, Tonicarlo Rodrigues;Leite, Jo?o Pereira;
Journal of Epilepsy and Clinical Neurophysiology , 2010, DOI: 10.1590/S1676-26492010000400006
Abstract: introduction: in the central nervous system, neuronal communication is accomplished by structures called synapses: electrical or chemical. electrical synapses are formed by the apposition of plasmatic membranes at gap junctions and the interaction of connexin subunits from two neurons. at this site, connexin complexes create intercellular pores that communicate the cytoplasm of adjacent neurons and allow free flow of ions and small molecules. objective: in this review, we will present and discuss recent results showing the possible involvement of electrical synapses in the neuronal hypersynchronization during epileptic seizures. results and conclusion: when a neuron is depolarized, ions flow very rapidly from one cell to the other promoting high neuronal synchrony. more recently, the role of gap junctions in the generation and propagation of epileptic discharges has been investigated using combined approaches of in vivo, in vitro and in silico (computational) models.
Increased Metallothionein I/II Expression in Patients with Temporal Lobe Epilepsy
José Eduardo Peixoto-Santos, Orfa Yineth Galvis-Alonso, Tonicarlo Rodrigues Velasco, Ludmyla Kandratavicius, Jo?o Alberto Assirati, Carlos Gilberto Carlotti, Renata Caldo Scandiuzzi, Luciano Neder Serafini, Jo?o Pereira Leite
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0044709
Abstract: In the central nervous system, zinc is released along with glutamate during neurotransmission and, in excess, can promote neuronal death. Experimental studies have shown that metallothioneins I/II (MT-I/II), which chelate free zinc, can affect seizures and reduce neuronal death after status epilepticus. Our aim was to evaluate the expression of MT-I/II in the hippocampus of patients with temporal lobe epilepsy (TLE). Hippocampi from patients with pharmacoresistant mesial temporal lobe epilepsy (MTLE) and patients with TLE associated with tumor or dysplasia (TLE-TD) were evaluated for expression of MT-I/II, for the vesicular zinc levels, and for neuronal, astroglial, and microglial populations. Compared to control cases, MTLE group displayed widespread increase in MT-I/II expression, astrogliosis, microgliosis and reduced neuronal population. In TLE-TD, the same changes were observed, except that were mainly confined to fascia dentata. Increased vesicular zinc was observed only in the inner molecular layer of MTLE patients, when compared to control cases. Correlation and linear regression analyses indicated an association between increased MT-I/II and increased astrogliosis in TLE. MT-I/II levels did not correlate with any clinical variables, but MTLE patients with secondary generalized seizures (SGS) had less MT-I/II than MTLE patients without SGS. In conclusion, MT-I/II expression was increased in hippocampi from TLE patients and our data suggest that it is associated with astrogliosis and may be associated with different seizure spread patterns.
Epistaxis during a generalized seizure leading to an atypical ictal SPECT finding at the skull base
Wichert-Ana, Lauro;Ferruzzi, Emerson Henklain;Alexandre Jr, Veriano;Velasco, Tonicarlo Rodrigues;Bianchin, Marino Muxfeldt;Terra-Bustamante, Vera Cristina;Kato, Mery;Santos, Antonio Carlos;Azevedo-Marques, Paulo Mazzoncini de;Oliveira, Lucas Ferrari de;Sakamoto, Américo Ceiki;
Journal of Epilepsy and Clinical Neurophysiology , 2006, DOI: 10.1590/S1676-26492006000700007
Abstract: introduction: generalized tonic-clonic seizures (gtcs) are among the most dramatic types of epileptic seizures and may be accompanied by rising blood pressure and pulse rate, physical injuries from falling, muscular convulsions, tongue biting, or aspiration pneumonia. epistaxis is an uncommon complication of generalized seizures and investigations should exclude local or systemic disorders. objective: we aim to report a 29-year-old male patient with medically intractable right temporal lobe epilepsy whose ictal spect showed a conspicuous high extracerebral accumulation of the tracer at the skull base. methods: the tracer 99mtc-ecd was injected during a gtcs complicated by simultaneous epistaxis during a long term video-electroencephalographic monitoring. results: initially, spect images showed an unexpected hot spot at the skull base suggesting pharyngeal or pituitary tumors. clinical history disclosed chronic sinusitis and rare episodes of epistaxis. white and red cells blood count, platelet count, serum biochemistry, coagulation tests, and rest arterial blood pressure were normal. computed tomography and mri excluded sinusoidal expansive or vascular lesions, head trauma, fractures or acute infections. subtracted spect disclosed a focal high concentration of the radiotracer within the left sphenoid sinus, probably related to the nose bleeding. conclusion: this is a singular case of a brain spect artifact secondary to a nasal bleeding during a generalized seizure that was misinterpreted as neoplastic disease. also, this case raises concerns about the pathophysiological relationship among epileptic seizures, nasal bleedings and chronic sinusitis.
Different levels of MT-I/II between patients with MTLE with or without seizure generalization: does hippocampal MT-I/II affects seizure spread, or does seizure spread promotes differential expression of MT-I/II?
Peixoto-Santos, José Eduardo;Galvis-Alonso, Orfa Yineth;Velasco, Tonicarlo R.;Kandratavicius, Ludmyla;Assirati Jr, Jo?o Alberto;Carlotti, Carlos Gilberto;Scandiuzzi, Renata Caldo;Serafini, Luciano Neder;Leite, Jo?o Pereira;
Journal of Epilepsy and Clinical Neurophysiology , 2012, DOI: 10.1590/S1676-26492012000100005
Abstract: in the central nervous system, zinc is released along with glutamate during neurotransmission and, in excess, can promote neuronal death. experimental studies have shown that metallothioneins i/ii (mt-i/ii), which chelate free zinc, can affect seizures and reduce neuronal death after status epilepticus. our aim was to evaluate the expression of mt-i/ii in the hippocampus of patients with temporal lobe epilepsy (tle). hippocampi from patients with pharmacoresistant mesial temporal lobe epilepsy (mtle) were evaluated for expression of mt-i/ii and for neuronal, astroglial, and microglial populations. compared to control cases, mtle group displayed widespread increase in mt-i/ii expression, astrogliosis and reduced neuronal population. mt-i/ii levels did not correlate with any clinical variables, but patients with secondary generalized seizures (sgs) had less mt-i/ii than patients without sgs. in conclusion, mt-i/ii expression was increased in hippocampi from mtle patients and our data suggest that it may be associated with different seizure spread patterns.
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