A novel SPECT-based approach reveals early mechanisms of central and peripheral inflammation after cerebral ischemia

Inflammation that develops in the brain and peripheral organs after stroke contributes profoundly to poor outcome of patients. However, mechanisms through which inflammation impacts on brain injury and overall outcome are improperly understood, in part because the earliest inflammatory events after brain injury are not revealed by current imaging tools. Here, we show that single-photon emission computed tomography (NanoSPECT/CT Plus) allows visualization of blood brain barrier (BBB) injury after experimental stroke well before changes can be detected with magnetic resonance imaging (MRI). Early 99mTc-DTPA (diethylene triamine pentaacetic acid) signal changes predict infarct development and systemic inflammation preceding experimental stroke leads to very early perfusion deficits and increased BBB injury within 2 hours after the onset of ischemia. Acute brain injury also leads to peripheral inflammation and immunosuppression, which contribute to poor outcome of stroke patients. The SPECT imaging revealed early (within 2 hours) changes in perfusion, barrier function and inflammation in the lungs and the gut after experimental stroke, with good predictive value for the development of histopathologic changes at later time points. Collectively, visualization of early inflammatory changes after stroke could open new translational research avenues to elucidate the interactions between central and peripheral inflammation and to evaluate in vivo ‘multi-system'' effects of putative anti-inflammatory treatments.     

Systematic review with meta-analysis: Stress-management interventions for patients with irritable bowel syndrome

Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder of unknown pathological origin that is associated with psychological distress and reduced health-related quality of life (HRQoL). We investigated the effects of stress-management for adults with IBS on typical symptoms, HRQoL and mental health. With predefined criteria (patients: adults with IBS; intervention: stress-management; control: care as usual or waitlist; outcome: patient-relevant; study-type: controlled trials), we registered the study with PROSPERO (168030) and searched the main medical databases. Two researchers independently reviewed the publications and assessed the risk of bias using the Scottish Intercollegiate Guidelines Network checklist. We performed meta-analysis with homogeneous trials of acceptable quality. After screening 6656 publications, ten suitable randomized trials of acceptable (n = 5) or low methodological quality (n = 5) involving 587 patients were identified. Our meta-analysis showed no effect of stress-management on IBS severity 1–2 months after the intervention (Hedges' g = −0.23, 95%-CI = −0.84 to −0.38, I² = 86.1%), and after 3–12 months (Hedges' g = −0.77, 95%-CI = −1.77 to −0.23, I² = 93.3%). One trial found a short-term reduction of symptoms, and one trial found symptom relief in the long-term (at 6 months). One of two studies that examined HRQoL found an improvement (after 2 months). One of two studies that examined depression and anxiety found a reduction of these symptoms (after 3 weeks). Stress-management may be beneficial for patients with IBS regarding the short-term reduction of bowel and mental health symptoms, whereas long-term benefits are unclear. Good quality RCTs with more than 6 months follow-up are needed.     

Unusual clinical manifestation of virus-associated hemophagocytic syndrome

A 22-year-old man presented with bilateral painless cervical lymphadenomegaly, difficulties in nasal breathing and bilateral conductive hearing loss. Rhinoscopy and computer tomography disclosed mucosal polyps in the nasal cavity and a polypoid soft mass almost completely filling the whole nasal cavity and the paranasal sinuses. Thoracic and abdominal computer tomography showed mild hepatosplenomegaly and a solitary round lesion in the right lung. No fever or abnormal laboratory parameters were detected. The biopsy from the nasal polypoid lesions and from the cervical lymph nodes showed extensive proliferation of histologically benign erythrophagocytic histiocytes. The diagnosis of virus (Epstein-Barr virus)-associated hemophagocytic histiocytosis was confirmed by immunohistochemical reactions, by polymerase chain reaction, and by Epstein-Barr-Encodes (Early)-RNA in situ hybridization. This case illustrates an unusual clinical manifestation of virus-associated hemophagocytic histiocytosis presenting as mucosal polyps of the upper respiratory tract.     

Mixed odontogenic tumors in children and adolescents

Mixed odontogenic tumors in the jaws of children and adolescents usually cause dentition anomalies. The typical forms of these are ameloblastic fibroma, ameloblastic fibroodontoma, complex odontoma and compound odontoma. In the present study mixed odontogenic tumor cases are presented in patients under 20 years of age. All of them were associated with tooth eruption disturbances. Further aim of this study was to discuss the nature and interrelationships of this group of lesions. Ameloblastic fibromas (AFs) are true, mixed, soft tissue neoplasms, deriving from the proliferation of both odontogenic epithelium and mesenchyma. They have a potential to both recurrence and malignant transformation. Ameloblastic fibroodontomas (AFOs) may be regarded as hamartomas, which exhibit epithelial, mesenchymal and abundant hard tissue components of the developing teeth. Odontomas are calcifying benign hamartomas, and represent the most common type of odontogenic jaw tumors among patients less than 20y, having complex and compound variants. Complex odontomas (CXOs) are built up from amorphous hard tissue elements, and generally occur in the premolar or molar regions of the maxilla. Compound odontomas (CDOs) usually appear in the maxilla, in the region of the incisors and canines, and contain small, radio-opaque structures reminiscent of rudimentary teeth. Early diagnosis and treatment of mixed odontogenic jaw tumors in children may prevent the serious orthodontic complications and jaw deformations.     

Role of nitric oxide (NO) metabolism and inflammatory mediators in childhood obesity

Objective and design  

The role of NO and adipocytokines in childhood obesity was studied, supposing that obesity provokes inflammation. Children were admitted to the pediatric clinic for a regular check up because of obesity.     

Taste reactivity deficit in anorexia nervosa

Aim: Anorexia nervosa is a complex psychiatric disorder posing a rapidly increasing burden on modern societies. Our purpose was to clarify perceptual‐motivational aspects of gustatory disturbances in the disease. Methods: A taste reactivity test, with the use of all five primary qualities in two concentrations, was performed in restrictive‐type anorexic patients, and their hedonic evaluations were compared to those of age‐matched healthy control subjects. Results: The patients gave significantly lower pleasantness scores for pleasant taste stimuli compared with controls. The differences were the greatest for the lower concentration sucrose, umami and sodium chloride. Ratings given for the aversive taste stimuli were similar in both experimental groups. Conclusion: Our findings contribute to a better understanding of complex symptoms of anorexia nervosa, and may also help to develop more effective cognitive‐behavioral therapies.