Thrombotic Thrombocytopenic Purpura and Relapes: Why do case series differ?

We examined the retrospective case series of the Itallan Cooperative Group to determine the incidence of relapes in TTP patients. Of 60 patients who have crossed the 10-year threshold from the first episode, Only 9 (15%) relapsed during that period, a figure far lower than that reported recently. Such difference is hardly explainable on the basis of our current knowledge of the biological behaviour of TTP. Furthermore, we unsuccessfully analyzed the treatment performed in each of our relapsed patients, in search of some element that could retrospectively predict the subsequent relapse     

Test‐retest reliability of the default mode network in a multi‐centric fMRI study of healthy elderly: Effects of data‐driven physiological noise correction techniques

Understanding how to reduce the influence of physiological noise in resting state fMRI data is important for the interpretation of functional brain connectivity. Limited data is currently available to assess the performance of physiological noise correction techniques, in particular when evaluating longitudinal changes in the default mode network (DMN) of healthy elderly participants. In this 3T harmonized multisite fMRI study, we investigated how different retrospective physiological noise correction (rPNC) methods influence the within‐site test‐retest reliability and the across‐site reproducibility consistency of DMN‐derived measurements across 13 MRI sites. Elderly participants were scanned twice at least a week apart (five participants per site). The rPNC methods were: none (NPC), Tissue‐based regression, PESTICA and FSL‐FIX. The DMN at the single subject level was robustly identified using ICA methods in all rPNC conditions. The methods significantly affected the mean z‐scores and, albeit less markedly, the cluster‐size in the DMN; in particular, FSL‐FIX tended to increase the DMN z‐scores compared to others. Within‐site test‐retest reliability was consistent across sites, with no differences across rPNC methods. The absolute percent errors were in the range of 5–11% for DMN z‐scores and cluster‐size reliability. DMN pattern overlap was in the range 60–65%. In particular, no rPNC method showed a significant reliability improvement relative to NPC. However, FSL‐FIX and Tissue‐based physiological correction methods showed both similar and significant improvements of reproducibility consistency across the consortium (ICC = 0.67) for the DMN z‐scores relative to NPC. Overall these findings support the use of rPNC methods like tissue‐based or FSL‐FIX to characterize multisite longitudinal changes of intrinsic functional connectivity. Hum Brain Mapp 37:2114–2132, 2016. © 2016 Wiley Periodicals, Inc.     

Microflora associated with successful and failed orthodontic mini-implants

Objectives: Mini-implants are used for orthodontic bone anchorage. The reasons for a potential instability or loss of the mini-implants during treatment are multiple. Among other factors, colonization of implants with pathogenic bacteria is discussed. Therefore, the microflora associated with successful and failed mini-implants has been screened.
Material and methods: A total of 76 mini-implants collected from 25 patients were observed during regular orthodontic treatment. Bacterial samples of eight failed and – exemplarily – four successful (control) cases were subjected to a universal Bacteria -directed real-time quantitative polymerase chain reaction for quantification in combination with a microarray-based identification of 20 selected species.
Results: The failure rate in the present investigation was 10.5%. The bacterial analysis did not reveal any major difference in the total amount or species composition between control and failed mini-implants. However, Actinomyces viscosus was found in four (100%) and Campylobacter gracilis in three (75%) stable controls, whereas both species were rarely found (12.5%) in failed implants.
Conclusions: In the present study, the peri-implant sulcus surrounding failed orthodontic mini-implants did not show a specific aggressive bacterial flora.     

Slug (SNAI2) down-regulation by RNA interference facilitates apoptosis and inhibits invasive growth in neuroblastoma preclinical models

PURPOSE: We assessed the relevance of Slug (SNAI2) for apoptosis resistance and invasion potential of neuroblastoma cells in vitro and in vivo. EXPERIMENTAL DESIGN: We evaluated the effect of imatinib mesylate on invasion and analyzed the genes modulated by imatinib mesylate treatment in neuroblastoma cells. Slug expression, inhibited by imatinib mesylate treatment, was knocked down in neuroblastoma cells by RNA interference, and the effects on invasion and apoptosis were evaluated in vitro. A pseudometastatic model of neuroblastoma in severe combined immunodeficient mice was used to assess the effects of Slug silencing alone or in combination with imatinib mesylate treatment on metastasis development. RESULTS: Microarray analysis revealed that several genes, including Slug, were down-regulated by imatinib mesylate. Slug expression was detectable in 8 of 10 human neuroblastoma cell lines. Two Slug-expressing cell lines were infected with a vector encoding a microRNA to Slug mRNA. Infected cells with reduced levels of Slug were tested for the expression of apoptosis-related genes (p53, Bax, and Bcl-2) identified previously as Slug targets. Bcl-2 was down-regulated in Slug-interfered cells. Slug down-regulation increased sensitivity to apoptosis induced by imatinib mesylate, etoposide, or doxorubicin. Invasion of Slug-silenced cells was reduced in vitro. Animals injected with Slug-silenced cells had fewer tumors than controls and the inhibition of tumor growth was even higher in animals treated with imatinib mesylate. CONCLUSIONS: Slug down-regulation facilitates apoptosis induced by proapoptotic drugs in neuroblastoma cells and decreases their invasion capability in vitro and in vivo. Slug inhibition, possibly combined with imatinib mesylate, may represent a novel strategy for treatment of metastatic neuroblastoma.     

Role of serotonin(2C) receptors in the control of brain dopaminergic function

There is substantial evidence that the functional status of mesocorticolimbic dopaminergic (DA) system originating in the ventral tegmental area (VTA) is under a phasic and tonic inhibitory control by the serotonergic system, which acts by stimulating serotonin(2C) (5-HT(2C)) receptor subtypes. This assertion is based upon a number of electrophysiological and biochemical data showing that 5-HT(2C) receptor agonists decrease, while 5-HT(2C) receptor antagonists enhance mesocorticolimbic DA function. On the other hand, it does not seem that 5-HT(2C) receptors play a relevant role in the control of nigrostriatal DA system originating in the substantia nigra pars compacta (SNc). The authors of this article review the most relevant data regarding the role of 5-HT(2C) receptors in the control of brain DA function and underline the importance of this subject in the search of new therapies for neuropsychiatric disorders such as depression, schizophrenia, drug addiction, and Parkinson's disease.     

Anaphylactic reactions to tolperisone (Mydocalm)

Four patients with anaphylaxis attributed to the intake of the centrally acting muscle relaxant tolperisone hydrochloride (Mydocalm) were observed at the Emergency Department of the Geneva University Hospital between November 2001 and March 2003. All patients were middle-aged women who took tolperisone for chronic muscular pain. All reactions occurred within an hour after oral intake of this drug frequently prescribed in Switzerland. The severity of anaphylaxis ranged from urticarial reactions to shock with arterial hypotension. Prick-to-prick skin testing performed in one patient with a tablet of tolperisone diluted in water was negative. Its globally restricted commercialisation may explain the lack of reports on such adverse effects in the MedLine database. Anaphylactic reactions to this drug, however, are mentioned in other sources such as the Swiss Drug Compendium and the WHO drug reaction database. Together, these findings suggest that anaphylaxis to tolperisone is not uncommon and should be known to physicians in countries where this drug is available.