Lack of nephrotoxicity following 15-day therapy with high doses of colistin in rats.

BACKGROUND: Recent studies suggest that the incidence and severity of systemic toxicity due to colistin administration appear to be overstated. The objective of this study was to investigate colistin-induced nephrotoxicity in Wistar rats. MATERIAL/METHODS: Eighteen adult Wistar rats were divided into three groups: group I (controls, vehicle, n=6) rats were injected intramuscularly (i.m.) with physiological sodium chloride solution and groups II and III (colistin, n=6 each) rats were treated with colistin at a dose of 150,000 or 300,000 IU/kg body weight per day i.m, respectively. The drug injections were applied for 15 days. Twelve hours after the last injection the rats were sacrificed. The kidneys were quickly removed and blood samples were collected. Microscopic examination of the kidneys and measurements of serum creatinine and blood urea nitrogen concentrations were performed. RESULTS: The mean urea nitrogen concentrations were 5.95+/-0.58, 5.75+/-0.61, and 5.77+/-0.87 mmol/l and the mean serum creatinine concentrations were 45.5+/-1.87, 43+/-1.79, and 44+/-2.19 micromol/l in groups I, II, and III, respectively, without any statistical differences between the groups. Exposure to colistin did not cause any histological change in the kidney structure. CONCLUSIONS: These results suggest that colistin, when administered alone at usual doses, may not cause nephrotoxicity.     

Epidemiology of traumatic comas: a prospective population-based study

Objective : Most studies on patients with severe brain injury (SBI) are based on data from specialized centres. This prospective epidemiologic study included all patients in a defined region with a coma lasting more than 24 hours or leading to a death.

Methods : All patients with a SBI admitted to an emergency department in the region were included during a 1-year period. A data form was completed with initial neurological state, CT scan lesions and associated injuries. Outcome at the end of acute hospitalization was assessed from medical notes.

Results : Two hundred and forty-eight patients were registered. Annual incidence was 8.5/100 000 population. Median age was 41 years. Traffic crashes were the most frequent cause (59%). Falls occurred in 30% (16% from a high level, 14% from one level). Initial GCS was above 8 in 31%, and patients with a neurological deterioration were older (52 vs 32 years). Death occurred in 52% of the cohort. Outcome was related to CT scan diagnosis, delay before eye opening and delay before obeying commands.

Conclusion . This population-based cohort of patients with SBI was different from patients selected in trauma centres. The patients were older, more often injured in falls and their mortality rate remained very high.     

Leiomyoma of kidney: An Indian experience with literature review

INTRODUCTIONLeiomyoma of kidney is an exceptional finding in the urinary tract. Though most of these tumors are detected on autopsy, still it remains a diagnostic challenge.PRESENTATION OF CASEWe report three adult cases of renal leiomyoma in our institute who presented with abdominal mass and haematuria in last 8 years.DISCUSSIONLeiomyoma has been reported in other organs but renal leiomyoma is rare tumour, though in autopsy series they are second in order of frequency among the renal mesenchymal neoplasms, and few cases have been described in the literature. Still no Indian experience is evaluated on this rare site of occurrence.CONCLUSIONConsidering the difficulty of clinical diagnosis of this tumour, strong suspicion is indicated when a patient presents with voluminous, well circumscribed renal lesions.     

Effect of Chronic Periodontitis on Oxidative Status in Patients With Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) and chronic periodontitis (CP) are the most common chronic inflammatory diseases and have remarkable similar pathologies. The aim of this study is to investigate the impact of periodontal status on oxidative stress in patients with RA by evaluating serum oxidative parameters and prolidase levels. Methods: For this cross‐sectional comparative study, the following four groups were composed of 20 individuals each (80 individuals total): 1) RA with CP (RA‐CP group); 2) RA but periodontally healthy (RA‐C group); 3) systemically healthy with CP (CP group); and 4) systemically and periodontally healthy (C group). Demographic, periodontal, rheumatological, and serum oxidative parameters as determined by serum total antioxidant status, total oxidant status, oxidative stress index (OSI), lipid hydroperoxide levels, paraoxonase, arylesterase, and ceruloplasmin activity, prolidase level, and total sulfhydryl groups were evaluated. Results: The OSI values of the RA‐CP group were statistically significantly higher than those of the C group (P <0.05). The prolidase levels of the RA‐C, RA‐CP groups and the CP group were statistically higher than those of the C group (P = 0.001, P = 0.007, and P = 0.001, respectively). Conclusions: Although CP and RA each increase oxidative stress, in a small sample size these effects are only significant when both CP and RA are combined relative to neither exposure. In addition, increased prolidase levels in patients with RA and CP may be related to increased oxidative tissue damage.     

Numerical study of the influence of material parameters on the mechanical behaviour of a rehabilitated edentulous mandible

Objectives

The study dealt with full dental prosthetic reconstruction on four implants. The aim was to analyse the influence of material parameters on the mechanical behaviour of the restored mandible compared to the natural mandible.

Methods

A finite element model of an edentulous mandible with prosthetic rehabilitation was established. Four materials were investigated for the framework of the prosthesis (zirconia, titanium, gold and nickel-titanium (NiTi)), as well as three cortical bone thicknesses. Various muscles were employed to simulate the main stages of mastication. Three distinct phases of mastication were modelled: maximum intercuspation, incisal clench and unilateral molar clench.

Results

The zirconia framework demonstrated the highest stresses and NiTi the weakest. The highest stresses in the framework were obtained during maximum intercuspation. The highest stresses at the bone-implant interface were recorded on the working axial implant during unilateral molar clench and on tilted implants during maximum intercuspation. The influence of the framework's material stiffness on the stresses at the bone-implant interface was insignificant for axial implants (except the right implant during unilateral molar clench) and slightly more significant for tilted implants. Mandibular flexion decreased with an increase of the cortical bone thickness and the stiffness of the prosthetic framework's material.

Conclusions

Among all materials, NiTi allowed a better preservation of the mandibular flexure, during all the mastication stages. Compared to stiffer materials, NiTi also permitted physiological mechanical conditions at the bone/implant interface, in almost all mastication stages.     

SuPAR,a potential inflammatory mediator in psoriasis pathogenesis

Psoriasis is an inflammatory skin disorder that is strongly associated with the metabolic syndrome. The sole reliance on clinical examination to guide prognostication and treatment is insufficient at best; accurate diagnostic and prognostic psoriatic molecular biomarkers are needed. Soluble urokinase plasminogen activator receptor (suPAR) has been implicated in inflammation. The aim of this study is to determine whether suPAR plays a role in the pathogenesis of psoriasis and whether an association exists between suPAR levels, disease severity, and other variables like insulin, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). This study also compares the pattern of uPAR staining in healthy vs psoriatic skin: 39 psoriatic and 30 control subjects were included. Two biopsies (affected and unaffected skin) and one biopsy were taken from psoriasis patients and healthy controls, respectively, with uPAR staining of all skin biopsies. Blood samples from all subjects were obtained to determine suPAR, ESR, CRP, and fasting insulin levels. uPAR staining was prominent in unaffected skin from psoriasis patients and healthy individuals vs weak/absent uPAR staining in psoriatic skin. CRP, ESR and suPAR levels were not significantly elevated in the mild psoriasis group compared to healthy controls. The loss of epidermal uPAR is suggestive of its tentative role in the pathogenesis of psoriasis. Patients with mild–moderate psoriasis possibly lack the powerful association attributed to metabolic syndrome in psoriatic patients. Further studies on larger cohorts are needed to ascertain the validity of the mentioned conclusions.     

Force-velocity relationship on a cycle ergometer and knee-extensor strength indices.

Maximal anaerobic power (Pmax) is often measured on a friction loaded cycle ergometer by means of an all-out exercise against a single braking force or from the force-velocity relationship. The relationship between braking force (F) and peak velocity (V) in cycling is linear: V = V0(1-F/F0) where V0 and F0 correspond to the intercepts with the velocity axis and force axis, respectively. The aim of the present paper was to test the hypothesis that parameter F0 expresses strength ability. The first study (12 male volleyball players) showed significant correlations between F0 and maximal isometric voluntary force (MVF) or maximal isometric rate of force development (MRFD) during isometric knee extension with data expressed either in absolute units (0.66 < r < 0.81, P < 0.01) or related to quadriceps muscle mass kgQ or kgQ2/3 (0.58 < r < 0.82, 0.05 < P < 0.001). In the second study (24 male athletes), F0 was significantly correlated with the peak torques in isokinetic Biodex knee extension at four angular velocities (0, 1.57, 3.14 and 4.19 rad.s-1) with the values expressed in absolute units (0.49 < r < 0.83, 0.05 < P < 0.001). When the results were related to kgQ or kgQ2/3 the correlation coefficients increased with velocity (0.22 < r < 0.69) and were significant (0.05 < P < 0.001) except at 0 rad.s-1. Nevertheless, the interest of the determination of F0 in addition to Pmax is questionable because similar coefficients of correlation were obtained between Pmax and strength performances.     

Parathyroid-hormone-related protein-mediated hypercalcemia in benign congenital mesoblastic nephroma

Parathyroid hormone-related protein (PTHrP) mediated hypercalcemia of malignancy is rare in children, and even more so in the setting of a benign tumor. We report two infants with PTHrP-mediated hypercalcemia secondary to congenital mesoblastic nephroma and their outcome after removal of the benign tumor. Pre-operatively hypercalcemia was corrected with saline hydration, furosemide, calcitonin and/ or pamidronate. Following resection of the tumor serum PTHrP normalized. Immunohistochemical staining of tumor cells was positive for PTHrP. Post-operatively the infants developed elevated serum parathyroid hormone with low- normal serum Ca and P, and undetectable urinary Ca and P, probably due to their movement into bone. Children needed treatment with calcitriol, Ca and P supplementation for 6-12 weeks until PTH normalized and urinary Ca and P were detected, suggesting bone replenishment. We conclude that benign congenital mesoblastic nephroma can secrete PTHrP that can cause severe hypercalcemia; and following excision one should anticipate the development of a transient modified “hungry bone”-like condition requiring Ca, P and calcitriol therapy for several weeks accompanied by careful monitoring of mineral homeostasis.