Time-dependent changes in distribution of basic fibroblast growth factor immunoreactive cells in hippocampus after kainic acid injection in rat pups

Five-day-old Wistar albino rats were injected with kainic acid (KA) or saline i.p. to investigate time-dependent alterations in morphology and number of basic fibroblast growth factor (bFGF) immunoreactive (-ir) astrocytes and neurons in hippocampus at 15, 30, and 90 days after the injections. Sections were stained with cresyl violet for morphological evaluation and bFGF immunohistochemistry was used for quantitative evaluation of bFGF-ir cell density. Fifteen days after KA injection, there was gliosis but no neuronal loss although disorganization in CA1, CA3, CA4 pyramidal layers and neuronal loss were evident 30 and 90 days after the injection. KA injected rats demonstrated significantly increased number of bFGF-ir astrocytes throughout the hippocampus and pyramidal neurons in CA2 after 15 days and decreased number of bFGF-ir cells after 30 and 90 days. The decrease in the number of bFGF-ir astroglia and neurons in long term after KA injection may indicate a decrease in the production of bFGF and/or number of bFGF-ir cells suggesting that protective effects of bFGF may be altered during epileptogenesis in hippocampus.     

Antigen-induced T-cell changes: Modulation by pharmacologic agents

To determine the effect of pharmacologic modulation of alterations of peripheral blood T-cell subsets caused by antigen-induced bronchoconstriction, we administered albuterol immediately after antigen-induced bronchoconstriction in a double-blind to protocol to 12 atopic asthmatic subjects. We also administered cromolyn sodium before antigen to 7 of the same subjects. Peripheral blood T-cell subset composition (CD4, CD8, la) of a highly purified T-cell preparation was determined before, 24, 48, 72, and 168 h after bronchoconstriction. We found that placebo inhalation immediately after antigen-induced bronchoconstriction did not affect subsequent peripheral blood T-cell subset changes (decrease in CD4+ and increase in Ia+ T lymphocytes). In contrast, inhaled albuterol abolished these T-cell subset changes. Although cromolyn sodium significantly decreased the severity of antigen-induced bronchoconstriction, it did not affect T-cell subset composition changes at the dosage used. We conclude that albuterol can ablate T-cell subset changes associated with antigen-induced bronchoconstriction. Cromolyn sodium ameliorates bronchoconstriction, but has no affect on T-cell subset composition changes. This implies that T-cell changes and bronchoconstriction caused by antigen inhalation are mediated through different pathways.     

The effects of the addition of motor imagery to home exercises on pain,disability and psychosocial parameters in patients undergoing lumbar spinal surgery: A randomized controlled trial

ContextPatients who have suffered from persistent symptoms often undergo lumbar spinal surgery (LSS). Motor imagery should be added to postoperative home exercises to reduce patient complaints.ObjectiveThe aim of this study was to compare the effects of home exercise plus motor imagery and only home exercise in patients undergoing LSS.DesignA randomized controlled study.SettingsThis study was designed by researchers at Dokuz Eylul University.ParticipantsThirty-seven patients undergoing LSS were randomized to motor imagery group (n = 19) and control group (n = 18).Main outcome measuresPain was measured by Visual Analogue Scale, disability related to low back pain by Oswestry Disability Index, pain-related fear by Tampa Scale of Kinesiophobia, depression by Beck Depression Inventory, quality of life by World Health Organization Quality of Life Scale-Short Form (WHOQOL-BREF). All assessments were repeated in the preoperative period, three weeks after and six weeks after the surgery.InterventionsMotor imagery group underwent home exercise plus motor imagery program applied by voice recording. Control group underwent only home exercise program. Exercise program compliance was monitored by exercise diary and telephone calls once every week.ResultsThere was a significant improvement in pain at rest and during activity, disability, kinesiophobia, depression, physical health and psychological sub-parameters of WHOQOL-BREF between preoperative period, and the third week and sixth week in both groups (p < 0.05). When comparing groups for gain scores, there was a more significant improvement in pain during activity in motor imagery group (p < 0.05). Motor imagery should be addressed as an effective treatment after LSS.     

Strengthening Surgical Services at the Soum (First-referral) Hospital: The WHO Emergency and Essential Surgical Care (EESC) Program in Mongolia

Background

Provision of surgical care continues to receive little attention and funding despite the growing burden of surgical disease worldwide. In 2004, The World Health Organization (WHO) established the Emergency and Essential Surgical Care (EESC) program, which was designed to strengthen surgical services at the first-referral hospital. There are limited data documenting the implementation and scale-up of such services. We describe the nationwide implementation of the EESC program in Mongolia over a 6?year period.

Methods

Surgical services were increased in rural areas of Mongolia using the WHO Integrated Management of Emergency and Essential Surgical Care (IMEESC) toolkit from 2004 to 2010. Fund of knowledge tests and program evaluation was done to measure uptake, response, and perceived importance of the program. Two years after the pilot sites were launched, programmatic impact on short-term process measures was evaluated using the WHO Monitoring and Evaluation form.

Results

The program was implemented in 14 aimags/provinces (66.67?%) and 178 soum hospitals (52.66?%). Fund of knowledge scores increased from 47.72?% (95?% confidence interval (CI) 40.7–54.7) to 77.9?% (95?% CI 70.1–85.7, p?=?0.0001) after the training program. 1?year post-training, there was a 57.1?% increase in the availability of emergency rooms, 59.1?% increase in the supply of emergency kits, a 73.64?% increase in the recording of emergency care cases, and a 46.66?% increase in the provision of facility and instrument usage instructions at the pilot sites.

Conclusions

The EESC program was successfully implemented and scaled up at a national level with improvements in short-term process measures.     

Severe Hyponatremia after Colonoscopy Preparation in a Patient with the Acquired Immune Deficiency Syndrome

Disseminated infections with cytomegalovirus have become an increasingly important cause of morbidity and mortality in patients with the acquired immune deficiency syndrome. Herein we describe a male homosexual with the acquired immune deficiency syndrome who became severely hyponatremic during bowel preparation for colonoscopy. Biochemical evidence of adrenal insufficiency and clinical evidence for cytomegalovirus colitis was found. We propose that the patient had clinically significant cytomegalovirus adrenalitis. A random urinary sodium concentration is suggested as a potential screening test before bowel preparation in such patients.