Mapping of glucocorticoid receptor immunoreactive neurons in the rat tel- and diencephalon using a monoclonal antibody against rat liver glucocorticoid receptor

By means of a monoclonal antibody against the rat liver glucocorticoid receptor (GR) in combination with the indirect immunoperoxidase technique it has been possible to demonstrate GR-immunoreactive nerve and glial cell nuclei all over the tel- and diencephalon of the male rat. Strongly GR-immunoreactive nerve cell nuclei were only present in the parvocellular part of the paraventricular hypothalamic nucleus, in the anterior periventricular hypothalamic nucleus, in the ventral part of the mediobasal hypothalamus, and in the CA1 and CA2 subregion of the hippocampal formation. Within the paraventricular hypothalamic nucleus a substantial overlap exists between the GR-immunoreactive area and the CRF-immunoreactive area. Medium to high densities of moderately GR-immunoreactive nerve cell nuclei were present all over the cortical hemispheres. Medium densities of moderately GR-immunoreactive nerve cells were demonstrated in many thalamic nuclei and in the central amygdaloid nucleus. After adrenalectomy the GR immunoreactivity was predominantly located in the pericaryon. Upon acute corticosterone treatment of adrenalectomized male rats, the GR immunoreactivity was again mainly demonstrated in the nerve cell nuclei indicating that corticosterone can translocate GR from the cytoplasm to the cell nuclei. It is suggested that the hypothalamic GR may be involved in the regulation of especially CRF secretion but also in the secretion of other anterior pituitary hormones such as TRH and somatostatin.     

Biochemical responses of the shore crab (Carcinus maenas) in a eutrophic and metal-contaminated coastal system (Óbidos lagoon,Portugal)

A eutrophic and metal-contaminated coastal system (Óbidos lagoon, Portugal) was monitored combining water/sediment quality parameters and Carcinus maenas biomarkers (accumulated metals, oxidative stress and biotransformation responses). Two confined branches (Barrosa and Bom-Sucesso) were surveyed and compared with a reference area. Both crab genders from Barrosa exhibited activation of hepatopancreas CAT, GPx and GST, pointing out this area as the major impacted in the lagoon. Females captured at Barrosa were more vulnerable to peroxidative damage while only males showed decreased EROD activity, reinforcing gender specificities. In general, responses were not directly attributed to metals in hepatopancreas, as supported by Principal Component Analysis (PCA). However, higher metals (Ni, Cu, Cd) and nutrients levels registered in Barrosa water were associated with the observed oxidative stress responses by PCA. Despite the difficulty to establish cause–effect relationships due to the co-occurrence of various stressors and their interactions, the adopted integrated monitoring strategy appears to be promising.     

Assessing the quality of the volume-outcome relationship in uro-oncology

OBJECTIVE

To assess systematically the quality of evidence for the volume‐outcome relationship in uro‐oncology, and thus facilitate the formulating of health policy within this speciality, as ‘Implementation of Improving Outcome Guidance’ has led to centralization of uro‐oncology based on published studies that have supported a ‘higher volume‐better outcome’ relationship, but improved awareness of methodological drawbacks in health service research has questioned the strength of this proposed volume‐outcome relationship.

METHODS

We systematically searched previous relevant reports and extracted all articles from 1980 onwards assessing the volume‐outcome relationship for cystectomy, prostatectomy and nephrectomy at the institution and/or surgeon level. Studies were assessed for their methodological quality using a previously validated rating system. Where possible, meta‐analytical methods were used to calculate overall differences in outcome measures between low and high volume healthcare providers.

RESULTS

In all, 22 studies were included in the final analysis; 19 of these were published in the last 5 years. Only four studies appropriately explored the effect of both the institution and surgeon volume on outcome measures. Mortality and length of stay were the most frequently measured outcomes. The median total quality scores within each of the operation types were 8.5, 9 and 8 for cystectomy, prostatectomy and nephrectomy, respectively (possible maximum score 18). Random‐effects modelling showed a higher risk of mortality in low‐volume institutions than in higher‐volume institutions for both cystectomy and nephrectomy (odds ratio 1.88, 95% confidence interval 1.54–2.29, and 1.28, 1.10–1.49, respectively).

CONCLUSION

The methodological quality of volume‐outcome research as applied to cystectomy, prostatectomy and nephrectomy is only modest at best. Accepting several limitations, pooled analysis confirms a higher‐volume, lower‐mortality relationship for cystectomy and nephrectomy. Future research should focus on the development of a quality framework with a validated scoring system for the bench‐marking of data to improve validity and facilitate rational policy‐making within the speciality of uro‐oncology.     

The use of Urgotul™ in the treatment of partial thickness burns and split‐thickness skin graft donor sites: a prospective control study

The use of paraffin‐impregnated gauze for burns and skin graft donor sites is commonly associated with wound adherence with consequent pain and trauma upon removal. This prospective clinical study was performed to evaluate a new class of lipido‐colloid dressings (Urgotul^?) in promoting healing and in reducing tissue adherence. In a 6‐month period, 25 consecutive patients were recruited. Two separate burn or donor sites on each patient were dressed with tulle‐gras (TG) or Urgotul^? and covered with standard secondary dressings. Objective assessment of wounds by two reviewers, and patients' subjective assessments were recorded. Twenty‐three (92%) patients were followed up for a mean of 3 months. Mean time to complete epithelialisation was 9·6 and 11·9 days for the Urgotul^? and TG sites respectively (P < 0·05). Bleeding was seen in 52% of Urgotul^? sites compared with 100% of the TG sites at first dressing change (P < 0·05). Patients reported ‘moderate pain’ during dressing change in 22% and 57% in the Urgotul^? and TG groups respectively (P < 0·05), with 35% of TG sites being ‘very painful’ requiring extra analgesia. We found that compared with TG, Urgotul^? was associated with faster epithelialisation, less pain and trauma (bleeding) during dressing changes.     

Elastosis perforans serpiginosa in a patient with Down's syndrome

Elastosis perforans serpiginosa is a rare, primary perforating dermatosis, frequently associated with certain genetic diseases and characterized by the transepidermal extrusion of elastic fibers. The present case report describes this dermatosis in a 19-year old female patient with Down's syndrome, who presented with asymptomatic erythematous, keratotic papules in an arciform pattern, located on her right forearm and knee, which had been present for five years. Following histopathological confirmation, treatment with cryotherapy was initiated, resulting in partial remission of the lesions.     

Four cases of Muckle-Wells syndrome within the same family

Muckle-Wells syndrome is a rare autosomal dominant disease that belongs to a group of hereditary febrile syndromes. It is characterized by recurrent and self-limited episodes of fever, urticaria, arthralgia, myalgia and conjunctivitis since childhood, which are related to exposure to cold temperatures. Lately, progressive sensorineural hearing loss occurs. Amyloidosis is the main complication and can be found in about 25% of the cases. It has been demonstrated that there is an association with mutations in the NLRP3 gene, which codifies cryopyrin, a protein responsible for regulating the production of proinflammatory cytokines, such as interleukin-1Beta. The authors report four cases of the disease within a family.     

AIP56: a novel bacterial apoptogenic toxin

Photobacterium damselae subsp. piscicida (Phdp) is a Gram-negative pathogen agent of an important fish septicemia. The key virulence factor of Phdp is the plasmid-encoded exotoxin AIP56, which is secreted by exponentially growing pathogenic strains. AIP56 has 520 amino acids including an N-terminal cleavable signal peptide of 23 amino acid residues, two cysteine residues and a zinc-binding region signature HEXXH that is typical of most zinc metallopeptidases. AIP56 induces in vitro and in vivo selective apoptosis of fish macrophages and neutrophils through a caspase-3 dependent mechanism that also involves caspase-8 and -9. In vivo, the AIP56-induced phagocyte apoptosis progresses to secondary necrosis with release of cytotoxic phagocyte molecules including neutrophil elastase. Fish injected with recombinant AIP56 die with a pathology similar to that seen in the natural infection.     

Highly debilitating natural <Emphasis Type="Italic">Trypanosoma vivax</Emphasis> infections in Brazilian calves: epidemiology,pathology, and probable transplacental transmission

Clinical, epidemiological, and pathological aspects of trypanosomiasis caused by Trypanosoma vivax in calves were reported for the first time in northeast Brazil. Clinical and epidemiological data, packed cell volumes (PCV), and parasitemia were assessed in 150 calves in May 2009 (rainy season—survey 1) and in 153 calves in November 2009 (dry season—survey 2) in three farms (A, B, and C). Prevalence of T. vivax in calves examined in the survey 1 was 63.3%, 65.0%, and 80.0% in farms A, B, and C, respectively. Morbidity varied from 63.3% to 80%, mortality from 15% to 30% and lethality from 23% to 37.5%. In survey 1, for all farms, high parasitemia (from 30.3 to 26.2 × 10⁶ parasites/mL), fever (from 39.8 to 40.3°C), low PCV (from 15.7% to 18.1%), and body score (from 2.5 to 3.5) were detected. Calves showed depression, weight loss, pale mucous membranes, enlarged lymph nodes, edema of the dewlap, cough, coryza, and diarrhea. The animals from farms A and B were treated with diminazene aceturate. Six months after, in survey 2, non-treated calves from farm C showed values for prevalence (81.82), morbidity (81.82), mortality (12.73), and lethality (15.55) similar to those in survey 1 (P > 0.05). Also in survey 2, four calves aging merely 1–3 days old presented high parasitemia levels (from 32 × 10⁶ to 74 × 10⁶ parasites/mL), suggesting transplacental transmission. In conclusion, trypanosomiasis by T. vivax constitutes high prevalent disease for calves raised in Brazilian semiarid and may have transplacental transmission.     

Efficacy of temporal lobe surgery for epilepsy in patients with negative MRI for mesial temporal lobe sclerosis

Epilepsy surgery is a successful treatment for refractory temporal lobe epilepsy (TLE). Reports suggest fewer seizure-free outcomes for patients with TLE and who have a negative brain MRI (nMRI) for mesial temporal sclerosis. Data were collected prospectively from patients with nMRI who underwent temporal lobe surgery for TLE characterized by unilateral ictal temporal lobe seizure onset based on a scalp video electroencephalogram or invasive subdural electrode recordings. A total of 86 patients were followed for at least 24 months after surgery. Outcome was evaluated using the Engel classification. Seizure control was obtained by 55% (47/86) of patients (Class [CL]-I), 27% (23/86) showed significant improvement (CL-II) and 19% (16/86) were deemed surgical failures. Shorter duration of epilepsy, later onset of seizures, and ictal theta rhythm (5-7 Hz) were the most significant predictors of postoperative seizure control. Although hypometabolism on positron emission tomography scan and significant memory disparity (>2.5/8) were not significant prognosticators independently, cumulatively they were predictors for favorable outcome.