RESUMO
Además del sistema ABO, los subgrupos del mismo revisten gran importancia en inmunohematología, Los subgrupos A difieren tanto en el número de sitios antigénicos como en la configuración del antígeno eritrocitario. Los principales, A1 y A2 se diferencian en que los eritrocitos A1 son aglutinados por el anticuerpo Anti-A1 humano o por la Lectina Anti-A1 (Dolichos biflorus), y los eritrocitos A2 son aglutinados por la Lectina Anti-H (Ulex europaeus). MATERIALES Y MÉTODOS: se realizó un estudio descriptivo, de Corte Transversal, Se analizó los registros tanto físico y electrónico del Banco de Sangre, se incluyeron todos los donadores efectivos, mismos que fueron tipificados por el laboratorio de inmunohematología en el periodo de mayo a julio del 2018. Método empleado, aglutinación en tubo y en micro placa. RESULTADOS: en un total de 1599 donantes, se determinó que el grupo O tiene mayor frecuencia con un 84% y el menos frecuente fue el AB con un 0,66%. Según el grupo sanguíneo A y AB tenemos las siguientes frecuencias: A1 que representa el (73.3%), A2 el (15.9%), Aint el (5.65%), A1 B el (3.60%) y A2 B el (1.55%). La importancia clínica se basa en que algunas personas del grupo A2 transfundidas con A1 , pueden producir Anti-A1 que es un anticuerpo natural irregular activo a 22 ºC, pero en ocasiones está activo a 37ºC causando una reacción transfusional extravascular, por lo que, si no se cuenta con eritrocitos A2 , se recomienda transfundir eritrocitos grupo O.
In addition to the ABO system, its subgroups review great importance in Immunohematology. Subgroups A differ both in the number of antigenic sites and in the configuration of the erythrocyte antigen. The main ones, A1 and A2 differ in that A1 erythrocytes are agglutinated by human Anti-A1 antibody or by Anti-A1 Lectin (Dolichos biflorus), and A2 erythrocytes are agglutinated by Anti-H Lectin (Ulex europaeus). MATERIALS AND METHODS: a descriptive, cross-sectional study was conducted. The physical and electronic records of the Blood Bank were analyzed, all effective donors were included, which were typified by the Immunohematology Laboratory in the period of May. to July 2018. Method used, agglutination in tube and in microplate. RESULTS: in a total of 1599 protocols, it was determined that group O has the highest frequency with 84% and the least frequent was the AB with 0.66%. According to blood group A and AB we have the following frequencies: A1 representing (73.3%), A2 (15.9%), Aint (5.65%), A1B (3.60%) and A2B (1.55%). The clinical importance is based on the fact that some people in group A2 transfused with A1, can produce Anti-A1 which is an irregular natural antibody active at 22 ° C but sometimes it is active at 37 °C causing an extravascular transfusion reaction, so if A2 erythrocytes are not available, it is recommended to transfuse group O erythrocytes.
Assuntos
Bancos de Sangue , Aglutinação , Eritrócitos , Registros , Ulex , LaboratóriosRESUMO
Cognitive impairment is highly prevalent among individuals with late-life depression (LLD) and tends to persist even after successful treatment. The biological mechanisms underlying cognitive impairment in LLD are complex and likely involve abnormalities in multiple pathways, or 'cascades,' reflected in specific biomarkers. Our aim was to evaluate peripheral (blood-based) evidence for biological pathways associated with cognitive impairment in older adults with LLD. To this end, we used a data-driven comprehensive proteomic analysis (multiplex immunoassay including 242 proteins), along with measures of structural brain abnormalities (gray matter atrophy and white matter hyperintensity volume via magnetic resonance imaging), and brain amyloid-ß (Aß) deposition (PiB-positron emission tomography). We analyzed data from 80 older adults with remitted major depression (36 with mild cognitive impairment (LLD+MCI) and 44 with normal cognitive (LLD+NC)) function. LLD+MCI was associated with differential expression of 24 proteins (P<0.05 and q-value <0.30) related mainly to the regulation of immune-inflammatory activity, intracellular signaling, cell survival and protein and lipid homeostasis. Individuals with LLD+MCI also showed greater white matter hyperintensity burden compared with LLD+NC (P=0.015). We observed no differences in gray matter volume or brain Aß deposition between groups. Machine learning analysis showed that a group of three proteins (Apo AI, IL-12 and stem cell factor) yielded accuracy of 81.3%, sensitivity of 75% and specificity of 86.4% in discriminating participants with MCI from those with NC function (with an averaged cross-validation accuracy of 76.3%, sensitivity of 69.4% and specificity of 81.8% with nested cross-validation considering the model selection bias). Cognitive impairment in LLD seems to be related to greater cerebrovascular disease along with abnormalities in immune-inflammatory control, cell survival, intracellular signaling, protein and lipid homeostasis, and clotting processes. These results suggest that individuals with LLD and cognitive impairment may be more vulnerable to accelerated brain aging and shed light on possible mediators of their elevated risk for progression to dementia.
Assuntos
Biomarcadores/sangue , Encéfalo/patologia , Transtornos Cognitivos/etiologia , Depressão , Proteínas/metabolismo , Idoso , Idoso de 80 Anos ou mais , Compostos de Anilina , Benzotiazóis/farmacocinética , Encéfalo/diagnóstico por imagem , Depressão/sangue , Depressão/complicações , Depressão/patologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Aprendizado de Máquina , Imageamento por Ressonância Magnética , Masculino , Testes Neuropsicológicos , Tomografia por Emissão de Pósitrons , Proteômica/métodos , Escalas de Graduação Psiquiátrica , TiazóisRESUMO
Studies conducted in industrialized countries have shown that elderly demented subjects have increased risk of car accidents. However, there is no information about the effect of dementia on driving habits in non-industrialized countries. The number of motor vehicle crashes (MVC) and abnormal driving behaviours (ADB) (e.g. not recognizing traffic lights, driving in the middle of the road, etc.) were assessed with a semi-structured interview in 56 demented subjects and 31 elderly controls, all of whom were active drivers, at the Regional Registry of Dementia in Mendoza. Detailed neurological, psychiatric and neuropsychological examinations were also conducted on each subject. The presence of dementia and sex (male) predicted ADB, MVC and number of MVC (two or more). Among demented patients, ADB and MVC were associated with sex (male) and number of MVC was associated with sex (male) and Blessed Dementia Rating Scale for activities of daily living scores. Neither ADB, MCV, or number of MVC were associated with education level, or with cognitive or psychiatric measures. These findings showed that in developing countries, dementia has a significant contribution to MVC and ADB, as occurs in industrialized nations. Consequently, legislation to curb the risk of accidents caused by demented patients should be implemented. Furthermore, physicians must encourage demented patients (or their families) to discontinue driving, even those with mild dementia syndrome.
Assuntos
Acidentes de Trânsito/psicologia , Condução de Veículo/psicologia , Demência/psicologia , Acidentes de Trânsito/estatística & dados numéricos , Idoso , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/psicologia , Argentina/epidemiologia , Condução de Veículo/estatística & dados numéricos , Demência/epidemiologia , Demência Vascular/diagnóstico , Demência Vascular/psicologia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Testes Neuropsicológicos , Projetos Piloto , Escalas de Graduação Psiquiátrica , Fatores de RiscoRESUMO
We examined the clinical characteristics of six right-handed patients who developed speech motor control disorders after human immunodeficiency virus (HIV) infection. They exhibited an ataxic dysarthria, characterized by irregular articulatory breakdowns in consonant and vowel timing; were slow in timed decision-making tasks; and had impaired procedural learning. Other aspects of the neurologic examination revealed signs of diffuse CNS involvement including action-intention tremors, ataxic gait, and release signs. None developed HIV-associated dementia during 1 year of follow-up. Motor speech control disorder appears to be related to a cerebellar dysfunction.
Assuntos
Infecções por HIV/complicações , Distúrbios da Fala/etiologia , Adulto , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Humanos , Masculino , Atividade Motora , Testes Neuropsicológicos , Distúrbios da Fala/fisiopatologiaRESUMO
We evaluated the reliability of clinical diagnoses using the recently standardized criteria for the diagnosis of vascular dementia (VaD) developed by the National Institute of Neurological Disorders and Stroke (NINDS) and the Association Internationale pour la Recherche et l'Enseignement en Neurosciences (AIREN). Two neurologists and two psychiatrists independently reviewed clinical data abstracted from those of 42 demented subjects participating in a longitudinal study of dementia at the University of Pittsburgh. For each patient we abstracted the clinical data on a standardized form. Each physician diagnosed each case according to the NINDS-AIREN criteria, using both clinical information and MRIs. We calculated the interrater agreement for all two-way combinations of clinicians with kappa statistics, which ranged from 0.46 (moderate agreement) to 0.72 (substantial agreement). The moderate reliability observed in this study may be attributable to patient-, clinician-, or criteria-centered sources of variance.
Assuntos
Demência Vascular/diagnóstico , National Institutes of Health (U.S.) , Idoso , Associação , Demência Vascular/epidemiologia , Feminino , Humanos , Cooperação Internacional , Masculino , Neurociências , Variações Dependentes do Observador , Estados UnidosRESUMO
OBJECTIVE: We describe the sampling, initial evaluation, and final diagnostic classification of subjects enrolled in a natural history study of Alzheimer's disease (AD). DESIGN: Volunteer cohort study. SETTING: Multidisciplinary behavioral neurology research clinic. PATIENTS OR OTHER PARTICIPANTS: Three-hundred nineteen individuals were enrolled in the Alzheimer Research Program between March 1983 and March 1988. Of these, 204 were originally classified with AD, 102 were normal elderly control subjects, and 13 were considered special cases. MAIN OUTCOME MEASURES: Final consensus clinical diagnosis, final neuropathologic diagnosis, and death. RESULTS: Of the 204 patients enrolled in the study, re-review after as many as 5 years of follow-up resulted in a final clinical classification of 188 with probable AD. Seven patients were believed to have a significant vascular component to the dementia, three were found to have developed depression, and six were excluded on other clinical grounds. Neuropathologic examination of 50 brains indicated definite AD in 43. After removing these seven misdiagnosed patients, the final group of probable/definite AD totaled 181 individuals. Accuracy of the baseline clinical diagnosis relative to neuropathology was 86%, and when follow-up clinical data were considered, 91.4%. Detailed neuropsychological testing yielded high sensitivity (0.988) and specificity (0.983) to dementia. Analyses of survival time from study entry until death revealed that older patients were significantly more likely to die during follow-up, but neither sex, years of education, nor pattern of cognitive impairment were related to survival. CONCLUSIONS: These data provide the descriptive basis for future studies of this cohort. They indicate that longitudinal follow-up of demented cases increases accuracy of diagnosis, and that detailed cognitive testing aids in early classification.
Assuntos
Doença de Alzheimer/diagnóstico , Idoso , Doença de Alzheimer/complicações , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/fisiopatologia , Estudos de Coortes , Feminino , Humanos , Masculino , Transtornos Mentais/complicações , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Sistema Nervoso/fisiopatologia , Doenças do Sistema Nervoso/complicações , Doenças do Sistema Nervoso/epidemiologia , Testes NeuropsicológicosRESUMO
We examined the relationship between unawareness of cognitive deficits and psychiatric and neuropsychological manifestations in 181 patients with probable Alzheimer's disease (AD). Patients unaware of their cognitive deficits were more cognitively impaired, as measured by the Mini-Mental State Examination, and had a specific defect in 'frontal/executive' functions. The presence of major depression, delusions and hallucinations was no more likely among patients who were aware of their cognitive impairment than among those who were not. These findings have important implications for the understanding of anosognosia and deficit awareness in dementia.
Assuntos
Agnosia/psicologia , Doença de Alzheimer/psicologia , Conscientização , Transtornos Cognitivos/psicologia , Idoso , Idoso de 80 Anos ou mais , Agnosia/diagnóstico , Doença de Alzheimer/diagnóstico , Transtornos Cognitivos/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos/estatística & dados numéricos , Escalas de Graduação Psiquiátrica , Psicometria , Valores de Referência , Papel do DoenteRESUMO
This study presents a structural and clinical description of a patient with dementia of motor neuron disease (D-MND), and compares and contrasts the neuropsychological characteristics of this patient with those of a group of patients with Alzheimer's disease (AD) matched by severity of dementia. The D-MND patient as well as the AD patients performed abnormally on all tasks that assessed executive/frontal functions. However, the D-MND patient tended to be more impaired than AD patients on tasks that required high speed decisions and on shifting from one strategy to another. Deficits in memory, language, and lexical-semantic abilities were also apparent in this patient. The co-occurrence of signs and symptoms characteristics of 'subcortical' dementia with those of 'cortical' dementia suggest that the executive system dysfunction may be secondary to subcortical pathology.