Giant-cell glioblastoma of childhood associated with HIV-1 and JC virus coinfection

Purpose

John Cunningham (JC) viral DNA sequence has seldom been reported in patients with brain tumors such as high grade gliomas and medulloblastomas, pointing to a role in the etiopathogenesis of such tumors.

Results

We present a unique clinical case of an HIV-positive pediatric patient with multifocal leukoencephalopathy and confirmed JC virus (JCV) infection that developed a giant-cell glioblastoma.

Conclusions

Experimental data with infected primates has previously hypothesized an association of human giant-cell glioblastoma with JCV or progressive multifocal leukoencephalopathy, though such association has not been documented in the literature for humans. Future studies with larger cohorts and molecular pathological analyses are still needed to corroborate the role of the widely spread human neurotropic virus in early transformation and in the development of brain tumors with different histology in the setting of HIV-related severe immunosuppression.     

Month of birth and risk of multiple sclerosis in a Portuguese population

Background

Several studies analyzing the month of birth (MOB) of multiple sclerosis (MS) patients and the risk of the disease have been published; as a whole, MS patients were found to be predominantly born in spring months, leading to the current assumption that MOB is somewhat related to the risk of MS.

Objective

Estimate the risk of MS by MOB in a Portuguese population.

Methods

MS patients sample was obtained from the database of patients attended at our MS clinic and born in the districts of Porto, Braga and Viana do Castelo. The control sample was composed of the live births records in the same time period and geographical area. We applied the Hewitt test for seasonality.

Results

We found 421 patients that satisfied the conditions to enter the study. The rank-sums for successive 6-month segments indicate the July–December period as of higher incidence; however, the corresponding rank-sum (48) was not statistically significant according to the Hewitt test (p > 0.05).

Conclusion

Our data does not support the seasonality hypothesis of MOB as risk factor for MS in Portugal. However we are aware that the analysis of a larger MS sample could shed more light in this issue.     

Effects of unilateral stereotactic posterior striatotomy on harmaline‐induced tremor in rats

Although long known and the most prevalent movement disorder, pathophysiology of essential tremor (ET) remains controversial. The most accepted hypothesis is that it is caused by a dysfunction of the olivocerebellar system. Vilela Filho et al. [2001; Stereotact Funct Neurosurg 77:149–150], however, reported a patient with unilateral hand ET that was completely relieved after a stroke restricted to the contralateral posterior putamen and suggested that ET could be the clinical manifestation of posterior putamen hyperactivity. The present study was designed to evaluate this hypothesis in the most often used model of ET, harmaline‐induced tremor in rats. Fifty‐four male Wistar rats were randomly distributed into three groups: experimental (EG), surgical control (SCG), and pharmacological control (PCG) groups. EG animals underwent stereotactic unilateral posterior striatotomy. SCG rats underwent sham lesion at the same target. PCG served exclusively as controls for harmaline effects. All animals received, postoperatively, intraperitoneal harmaline, and the induced tremor was video‐recorded for later evaluation by a blind observer. Thirteen animals were excluded from the study. Limb tremor was reduced ipsilaterally to the operation in 20 of 21 rats of EG and in two of nine of SCG, being asymmetric in one of 10 of PCG rats. Comparisons between EG × SCG and EG × PCG were statistically significant, but not between SCG × PCG. Limb tremor reduction was greater in anterior than in posterior paws. Lateral lesions yielded better results than medial lesions. These results suggest that the posterior striatum is involved with harmaline‐induced tremor in rats and support the hypothesis presented. © 2013 Wiley Periodicals, Inc.     

New details of assembling bioactive films from dispersions of amphiphilic molecules on titania surfaces

Tailoring the surface properties of materials for biomedical applications is important to avoid clinical complications. Forming thin layers of amphiphilic molecules with apolar regions that facilitate attractive intermolecular interactions, can be a suitable and versatile approach to achieve hydrophobic surface modification and provide functional antibacterial properties. Aiming to correlate layer structure and properties starting from film formation, octadecylphosphonic acid (ODPA) and dimethyloctadecyl (3-trimethoxysilylpropyl) ammonium chloride (DMOAP) layers were adsorbed onto smooth titania surfaces. Then the films were studied by atomic force microscopy (AFM) and X-ray Photoelectron Spectroscopy (XPS), and their interactions with aqueous environments were characterized by contact angle and zeta potential measurements. In addition, antibacterial assays were performed using E. coli and S. mutants to reveal the antibacterial properties effected by the surface modification. Immediately after sputter deposition, titania was hydrophilic; however, after air storage and adsorption of DMOAP or ODPA, an increase in the water contact angle was observed. XPS investigations after layer formation and after antibacterial tests revealed that the attachment of layers assembled from ODPA on titania substrates is considerably stronger and more stable than that observed for DMOAP films. Heat treatment strongly affects DMOAP layers. Furthermore, DMOAP layers are not stable under biological conditions.

Structure–property relationship of amphiphilic molecules on smooth substrates was explored through a multi-step approach and its influence on biological activity.     

Subsyndromal depression: an impact on quality of life?

OBJECTIVE: The objective of this study was to demonstrate the association between quality of life and subsyndromal depression in a primary care clinic in a Brazilian sample. METHODS: This was a cross-sectional study. The cases were divided into three groups according to the severity of depressive symptoms: 1) subjects with major depressive disorder; 2) subjects with subsyndromal depression; 3) subjects without depressive symptoms--controls. The participants completed the World Health Organization Instrument to Assess Quality of Life (WHOQOL-BREF), the Quality of Life--Depression (QLDS), the Centers for Epidemiologic Studies--Depression instrument (CES-D), and the Composite International Diagnostic Interview (CIDI). RESULTS: The sample consisted of 438 primary care users (35.2% of them had subsyndromal depression). The subjects with major depression presented the worst impairment of quality of life, which was measured by the WHOQOL-BREF and the QLDS. The patients with subsyndromal depression had a smaller impact on their quality of life and the subjects without depression presented an even lower impact. The hierarchical linear regression involving demographic variables and the severity of depressive symptoms showed that the severity of depression was the variable with higher correlation with quality of life dimensions, presenting increased variation in the domains (from 9% to 24%). CONCLUSIONS: The results suggest that subsyndromal depression causes impairment of the quality of life in primary care patients of a Brazilian sample.     

Effect of correcting for gestational age at birth on population prevalence of early childhood undernutrition

Background

Postmenstrual and/or gestational age-corrected age (CA) is required to apply child growth standards to children born preterm (< 37 weeks gestational age). Yet, CA is rarely used in epidemiologic studies in low- and middle-income countries (LMICs), which may bias population estimates of childhood undernutrition. To evaluate the effect of accounting for GA in the application of growth standards, we used GA-specific standards at birth (INTERGROWTH-21st newborn size standards) in conjunction with CA for preterm-born children in the application of World Health Organization Child Growth Standards postnatally (referred to as ‘CA’ strategy) versus postnatal age for all children, to estimate mean length-for-age (LAZ) and weight-for-age (WAZ) z scores at 0, 3, 12, 24, and 48-months of age in the 2004 Pelotas (Brazil) Birth Cohort.

Results

At birth (n = 4066), mean LAZ was higher and the prevalence of stunting (LAZ < ?2) was lower using CA versus postnatal age (mean ± SD): ? 0.36 ± 1.19 versus ? 0.67 ± 1.32; and 8.3 versus 11.6%, respectively. Odds ratio (OR) and population attributable risk (PAR) of stunting due to preterm birth were attenuated and changed inferences using CA versus postnatal age at birth [OR, 95% confidence interval (CI): 1.32 (95% CI 0.95, 1.82) vs 14.7 (95% CI 11.7, 18.4); PAR 3.1 vs 42.9%]; differences in inferences persisted at 3-months. At 12, 24, and 48-months, preterm birth was associated with stunting, but ORs/PARs remained attenuated using CA compared to postnatal age. Findings were similar for weight-for-age z scores.

Conclusions

Population-based epidemiologic studies in LMICs in which GA is unused or unavailable may overestimate the prevalence of early childhood undernutrition and inflate the fraction of undernutrition attributable to preterm birth.