Reversible cerebral arteriopathy associated with the administration of ergot derivatives

Three cases of intracranial arteriopathy associated with the administration of ergot derivatives are reported. In the first case, excessive doses of dihydroergotamine and of ergotamine tartrate seemed to be the cause, but simultaneous treatment with an antibiotic and the existence of a cytomegalovirus infection could have favoured the arteriopathic process. The second patient also received excessive doses of these two drugs, but in addition she was taking oestrogen and progesteron containing contraceptives. In the third case, an intravenous injection of methylergometrine in a dose of 0.2 mg seemed to have initiated the arteriopathy. Arteriograms were comparable in all three cases, with segmental stenosis of several cerebral arteries, whereas internal carotid and vertebral arteries remained normal. In the first case a control cerebral arteriography was normal one month later. These findings suggest that widespread cerebral arteriopathy can appear in subjects who chronically abuse ergotamine tartrate.     

Elastase in gingival crevicular fluid from smokers and non-smokers with chronic inflammatory periodontal disease

OBJECTIVE: To compare elastase concentrations in gingival crevicular fluid (GCF) from individual sites of smokers and non-smokers.
MATERIALS AND METHODS: Twelve pairs of smokers and non-smokers with untreated, moderate to advanced chronic inflammatory periodontal disease were matched for gender, age, ethnicity and the clinical and radio-graphic extent of disease. Durapore filter strip samples were collected over 30 s from two mesiopalatal sites on upper left posterior teeth. Samples were analysed for: I) polymorphonuclear neutrophil leucocyte (PMNL) cell counts; 2) PMNL elastase-αI-antitrypsin complex in the GCF supernatant by ELISA; and 3) functional elastase, free or bound to α2-macroglobulin, estimated from activity against N-tert-butoxycarbonyI-alanyl-prolyl-nor-valylg-chlorothiobenzyl ester in supernatant and lysates of GCF PMNLs.
RESULTS: There were no differences in disease parameters between groups except that bleeding on probing was less extensive in smokers (P< 0.001). Cell counts and elastase content of crevicular PMNLs showed no differences between groups. Lower concentrations of elastase were found in GCF supernatants from smokers than non-smokers. This difference was observed for functional elastase (mean [s.d.] = 30.21 [17.60] against 73.77 [75.26] ng μI^-1, P <0.05) and elastase complexed with αl-antitrypsin (8.97 [6.54] ng μl^-1 against 25.71 [22.07] ng μI^-1, P < 0.001).
CONCLUSIONS: Smokers have lower elastase concentrations in GCF than non-smokers. Further investigation is required to elucidate the underlying cause and its relationship with periodontal disease.     

What are the information needs of Chinese breast cancer patients receiving chemotherapy?

Cancer patients demand information, not only to assist them to understand the disease and its treatment, but also to allow them to interpret the aversive events and action taken, so that the threat inherent from the diagnosis becomes lessened. With the goal of studying the information needs of women with breast cancer who were receiving chemotherapy, 51 patients were invited to complete a self-administered questionnaire at the beginning and again at half way through their chemotherapy treatment. The results showed that for these patients the cancer and its spread, the side effects of chemotherapy and the management of the side effects were the priority information needs in the early stages and following chemotherapy. Among 52 questions, only six items were revealed to have significant difference when compared with the Time 1 and Time 2 measures. The results reflect that over time information needs for this group of patients was relatively stable. Marital status and subscale of disease was found significant difference at the first and second time points. The findings indicate that there is a need for the provision of a family-centered education program that addresses patient's information needs, cultural sensitivity, the use of building up and ongoing.     

Genetic relatedness of indigenous ethnic groups in northern Borneo to neighboring populations from Southeast Asia,as inferred from genome‐wide SNP data

The region of northern Borneo is home to the current state of Sabah, Malaysia. It is located closest to the southern Philippine islands and may have served as a viaduct for ancient human migration onto or off of Borneo Island. In this study, five indigenous ethnic groups from Sabah were subjected to genome‐wide SNP genotyping. These individuals represent the “North Borneo”‐speaking group of the great Austronesian family. They have traditionally resided in the inland region of Sabah. The dataset was merged with public datasets, and the genetic relatedness of these groups to neighboring populations from the islands of Southeast Asia, mainland Southeast Asia and southern China was inferred. Genetic structure analysis revealed that these groups formed a genetic cluster that was independent of the clusters of neighboring populations. Additionally, these groups exhibited near‐absolute proportions of a genetic component that is also common among Austronesians from Taiwan and the Philippines. They showed no genetic admixture with Austro‐Melanesian populations. Furthermore, phylogenetic analysis showed that they are closely related to non–Austro‐Melansian Filipinos as well as to Taiwan natives but are distantly related to populations from mainland Southeast Asia. Relatively lower heterozygosity and higher pairwise genetic differentiation index (F_ST) values than those of nearby populations indicate that these groups might have experienced genetic drift in the past, resulting in their differentiation from other Austronesians. Subsequent formal testing suggested that these populations have received no gene flow from neighboring populations. Taken together, these results imply that the indigenous ethnic groups of northern Borneo shared a common ancestor with Taiwan natives and non–Austro‐Melanesian Filipinos and then isolated themselves on the inland of Sabah. This isolation presumably led to no admixture with other populations, and these individuals therefore underwent strong genetic differentiation. This report contributes to addressing the paucity of genetic data on representatives from this strategic region of ancient human migration event(s).     

Functional outcomes following surgical management of pain,exposure or extrusion following a suburethral tape insertion for urinary stress incontinence

Introduction and hypothesis

Surgical revision of a tape inserted for urinary stress incontinence may be indicated for pain, or tape exposure or extrusion. This study assesses the clinical outcomes of revision surgery.

Methods

A retrospective review of 47 consecutive women who underwent surgical revision for the indications of pain, tape exposure or tape extrusion.

Results

Forty-seven women underwent revision. 29 women (62 %) had initial tape placement at another institution. Mean interval between placement and revision was 30 months. 39 women (83 %) had an identifiable tape exposure or extrusion with or without pain, while 8 women (17 %) presented with pain alone. 11 (23 %) of the tapes were infected clinically and histologically at revision, 10 of the 11 (90 %) being of a multifilament type. In 23 (49 %) cases, the revision aimed to completely remove the tape. Partial excision 24 (51 %) was reserved for localised exposures or extrusions where infection was not suspected. A concomitant continence procedure was performed in 9(19 %) at the time of tape revision. None of these 9 women has experienced recurrent stress urinary incontinence (SUI) compared with 11 out of 38 women (29 %) requiring further stress incontinence surgery when no continence procedure was performed (Fisher’s exact p?=?0.092). Eight out of 47 underwent revision surgery for pain with no identifiable exposure or extrusion; pain subsequently resolved in all 8 women.

Conclusions

Excision is an effective treatment for tape exposure and pain whether infection is present or not. Tapes of a multifilament type are strongly associated with infection. When infection is present, complete sling removal is necessary. A concomitant procedure to prevent recurrent SUI should be considered if tape excision is planned and infection is not suspected.     

Is there any relationship between serum and urine neopterin and serum interferon‐γ levels in the activity of Behcet's disease?

Background  Behcet's disease (BD) is a chronic, inflammatory, multisystem vasculitic disorder. There is no reliable laboratory marker that indicates disease activity. Neopterin is an immunological marker of cellular immune activation, which is secreted by monocytes/macrophages as a result of interferon-gamma (IFN-γ) secretion by activated T lymphocytes.
Objective  We aimed to investigate serum and urine neopterin levels in BD patients.
Methods  Forty-five patients who were diagnosed according to the criteria of the International Study Group for BD and 45 age- and sex-matched healthy controls were enrolled in the study. Disease activity was considered by clinical findings. Serum and urine neopterin levels and serum IFN-γ levels were measured.
Results  The mean values of serum and urine neopterin levels were 12.68 ± 4.87 nmol/L and 167.53 ± 148.73 µmol/mol creatinine, respectively, in BD patients ( P =  0.000 and P  = 0.008, respectively), which were statistically significantly different from the control group. However, there was no significant statistical difference between serum and urine neopterin levels of the clinically active and inactive patients. It was also found that the mean value of serum IFN-γ levels was higher in healthy controls than in BD patients ( P =  0.000).
Conclusions  We conclude that serum and urinary neopterin measurement can not be used as a reliable laboratory marker as the BD patients' serum and urinary neopterin levels do not increase in the active stage even though these levels increase when compared to healthy controls.     

Moderate traumatic brain injury is linked to acute behaviour deficits and long term mitochondrial alterations

Traumatic brain injury (TBI) remains one of the leading causes of death and disability worldwide. Mild TBI may lead to neuropsychiatric sequelae, including memory loss and motor impairment. Mitochondrial dysfunction and oxidative stress have a contributory role in several neurological disorders; however, their association with mitophagy in mild TBI is unclear. TBI was induced in female Sprague Dawley (SD) rats using a New York University Impactor (10 g, impactor head 2.5 mm diameter, weight drop 50 mm) and compared to sham surgery controls. The novel object recognition and error ladder tests were performed at 24 hours and for 6 weeks post injury, and the brains were examined histologically to confirm the extent of injury. Mitochondria manganese superoxide dismutase (MnSOD) and the oxidative phosphorylation (OXPHOS) complexes I‐V (CI‐CV), as well as mitophagy markers, dynamin related protein 1 (DRP‐1), LC3A/B and PTEN‐induced putative kinase 1 (PINK‐1), were measured in the penumbra by western blot. At 24 hours sham rats performed as expected on a novel object recognition test while TBI rats showed cognitive deficits at the early time points. TBI rats also showed more early motor deficits on a horizontal ladder, compared with the sham rats. MnSOD, OXPHOS CI, CIII and CV protein levels were significantly lower in the TBI group at 24 hours. DRP‐1, LC3A/B I and II, and PINK‐1 were increased at 6 weeks suggesting abnormal mitophagy. Moderate TBI caused immediate cognitive and mild motor functional deficits in the rats that did not persist. Reduced antioxidative capacity and possibly compromised mitochondrial function may affect the long term functional recovery.