Clinical, biological and radiological spectrum of newly diagnosed pulmonary tuberculosis

The aim of the present study was to describe the clinical, biological and the chest-X ray presentations of newly diagnosed pulmonary tuberculosis. A retrospective study of 200 patients was performed from January to October 2004 in the respiratory diseases unit of Dakar's University Teaching Hospital. Among the 200 cases, 140 (70%) were male, giving a sex ratio of 2.3. The mean age of our patients was 35.5 years (range: 14-81 years). The group age of 20 to 39 years was the most affected (55,5% of patients). The median diagnostic delay was 4 months (range: 7 days to 2 years). Haemoptysis revealed the disease in 27% of cases. The chest X-ray showed bilateral lesions in 65% of cases. When they were unilateral, the right side was the most concerned. Of the 200 patients, the lesions interested all parts of at least one lung in 106 (53%). Among our patients, 153 (76.5%) had cavitations and 145 (72.5%) had infiltrates. A pleural effusion was associated to the lung lesions in 10% of the patients. Biologically, we reported 80% cases (n=160) of hypochromic microcytic anaemia. Of the 27 HIV tests done, 18 (66.7%) were positive all for HIV1. Delay in the diagnosis of pulmonary tuberculosis was very long and our data illustrate the need for improved education of the community and event of healthcare workers about the benefit of early diagnosis of tuberculosis.     

Oxidative status of <Emphasis Type="Italic">Matricaria chamomilla</Emphasis> plants related to cadmium and copper uptake

Cadmium (Cd) and copper (Cu) uptake by the plants of Matricaria chamomilla and relation to activities of guaiacol peroxidase (GPX, EC 1.11.1.7), catalase (CAT, EC 1.11.1.6) and glutathione reductase (GR, EC 1.6.4.2) up to 7 days of exposure to 3, 60 and 120 microM Cd or Cu was studied. Cd content in rosettes was ca. 10-fold higher in comparison to Cu while Cu was preferentially accumulated in the roots. In line with this observation, increase of CAT and GPX activity was similar in rosettes of Cd and Cu-treated plants, indicating non-redox active properties of Cd and low Cu accumulation. In the roots, Cu showed strong pro-oxidant effect, as judged from extreme stimulation of CAT and GPX, followed by increase of hydrogen peroxide and malondialdehyde. However, GPX seemed to be more important for alleviation of oxidative stress (ca. 93-250-fold higher activity in 120 microM Cu-treated roots). Cd had substantially lower influences and stimulated GR activity more than Cu. Activities of hydrogen peroxide-scavenging enzymes in relation to its accumulation are also discussed.     

基于大黄不同炮制方法和煎煮时间治疗慢性肾衰竭患者的理论探讨

中药大黄在慢性肾衰竭（CRF）患者的治疗中发挥着重要的作用,能有效延缓肾脏病的进展。通过讨论大黄通腑降浊在慢性肾衰竭的运用,探讨大黄治疗CRF的作用机制,大黄不同炮制方法和煎煮时间对有效成分及功效的影响,名老中医使用大黄治疗CRF的经验,大黄对CRF肾小球硬化信号通路的影响。生大黄、熟大黄、酒大黄、大黄炭哪一种是治疗CRF的最佳药物;不同炮制方法和煎煮时间对大黄有效成分的影响;煎煮多长时间才能发挥最大疗效;大黄治疗CRF的作用机制。现研究大黄不同炮制品不同煎煮时间有效成分的变化规律和大黄不同炮制品不同煎煮时间对CRF大鼠转化生长因子-β1/P13K/Akt信号旁路的影响,为大黄的临床应用提供理论依据。     

Regulatory effects of miR-155 and miR-146a on repolarization and inflammatory cytokine secretion in human alveolar macrophages in vitro

Macrophages play an important role in inflammatory responses; however, miRNA-mediated repolarization of macrophages is essential for fulfilling this function. To clarify a series of changes at the RNA level in alveolar macrophages under normal and inflammatory conditions, bronchial alveolar lavage liquid (BALF) was collected from healthy volunteers or patients with pneumonia. This approach, which differs from that used in previously, provides more accurate information about the states of macrophages in different lung microenvironments. In this study, the density plots of macrophage subtypes (M1 and M2) in the BALF of healthy volunteers differed from that of the patients with pneumonia. The M2 subtype dominated in healthy volunteers and was rapidly repolarized to M1 in response to miRNA-mediated gene regulation. Differential miRNA expression in the two macrophage subtypes revealed lower expression of miR-155 and MIR-146a in patients with pneumonia compared with healthy volunteers; this may be related to inflammation and the use of anti-inflammatory drugs. We also found increased TNF-α and IL-6 expression at the RNA level, while macrophage galactose-type C-type lectin 1 (MGL-1) expression decreased with downregulation of miR-155 and miR-146a expression. These results indicate that the gene regulation mediated by miR-155 and miR-146a contributes to human alveolar macrophage phenotype repolarization, thus leading to an early switch from pro-inflammatory to anti-inflammatory cytokine production.     

An Internet-Based Intervention for Depression in Primary Care in Spain: A Randomized Controlled Trial

BackgroundDepression is the most prevalent cause of illness-induced disability worldwide. Face-to-face psychotherapeutic interventions for depression can be challenging, so there is a need for other alternatives that allow these interventions to be offered. One feasible alternative is Internet-based psychological interventions. This is the first randomized controlled trial (RCT) on the effectiveness of an Internet-based intervention on depression in primary health care in Spain.ObjectiveOur aim was to compare the effectiveness of a low-intensity therapist-guided (LITG) Internet-based program and a completely self-guided (CSG) Internet-based program with improved treatment as usual (iTAU) care for depression.MethodsMulticenter, three-arm, parallel, RCT design, carried out between November 2012 and January 2014, with a follow-up of 15 months. In total, 296 adults from primary care settings in four Spanish regions, with mild or moderate major depression, were randomized to LITG (n=96), CSG (n=98), or iTAU (n=102). Research completers at follow-up were 63.5%. The intervention was Smiling is Fun, an Internet program based on cognitive behavioral therapy. All patients received iTAU by their general practitioners. Moreover, LITG received Smiling is Fun and the possibility of psychotherapeutic support on request by email, whereas CSG received only Smiling is Fun. The main outcome was the Beck Depression Inventory-II at 3 months from baseline. Mixed-effects multilevel analysis for repeated measures were undertaken.ResultsThere was no benefit for either CSG [(B coefficient=-1.15; P=.444)] or LITG [(B=-0.71; P=.634)] compared to iTAU, at 3 months. There were differences at 6 months [iTAU vs CSG (B=-4.22; P=.007); iTAU vs LITG (B=-4.34; P=.005)] and 15 months [iTAU vs CSG (B=-5.10; P=.001); iTAU vs LITG (B=-4.62; P=.002)]. There were no differences between CSG and LITG at any time. Adjusted and intention-to-treat models confirmed these findings.ConclusionsAn Internet-based intervention for depression combined with iTAU conferred a benefit over iTAU alone in the Spanish primary health care system.

Trial Registration

Clinicaltrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01611818","term_id":"NCT01611818"}}NCT01611818; https://register.clinicaltrials.gov/prs/app/action/SelectProtocol? selectaction=Edit&uid=U0001NPQ&ts=2&cx=gctdh2&sid=S0003KJ6 (Archived by WebCite at http://www.webcitation.org/6jbsUvUDz)     

Stereological examination of curcumin’s effects on hippocampal damage caused by the anti-epileptic drugs phenobarbital and valproic acid in the developing rat brain

The anti-epileptic drugs phenobarbital and valproic acid have an extremely strong negative effect on cognitive processes such as learning and memory in the developing brain. We examined whether or not curcumin has protective effects on neuronal injury caused by these drugs in the developing rat brain. Young male Wistar rats were studied in two groups, a 7 days old and a 14 days old group (35 rats in each). Both groups were then divided into 7 sub-groups as the control, curcumin, dimethylsulfoxide, phenobarbital, valproic acid, phenobarbital + curcumin, and valproic acid + curcumin groups (n = 5 in each group). At 24 h after the intraperitoneal injection of the compounds, the rats were sacrificed, and the hippocampal tissue was subjected to stereological analysis with the optical fractionation method. Total numbers of neurons in the hippocampus of the 7 days old and 14 days old rats were calculated. It was found that treatment with phenobarbital resulted in a loss of 43% of the neurons, and valproic acid induced a loss of 57% of the neurons in the 7 days old rats. Curcumin prevented this loss significantly with only 19% in the phenobarbital group and 41% in the valproic acid group. In the 14 days old rat groups, phenobarbital was found to reduce the number of neurons by 30%, and valproic acid reduced it by 38%. Curcumin treatment limited neuronal loss to 3% in the phenobarbital + curcumin group and 10% in the valproic acid + curcumin group. These data strongly indicate that curcumin is a protective agent and prevents hippocampal neuronal damage induced by phenobarbital and valproic acid treatment.     

Suppressive therapy with levothyroxine for euthyroid diffuse and nodular goiter.

In this study, 35 patients with euthyroid diffuse goiter and 35 patients with euthyroid nodular goiter were treated with Levothyroxine (L-T4) for six months. The aim was to evaluate the efficacy of treatment on thyroid and nodule volumes and to evaluate the correlation between volume changes and thyroglobulin levels. Serum thyroid hormones, TSH, thyroglobulin, thyroid and nodule volumes were measured at the initial visit and after 6 months. Radioactive iodine uptakes of the thyroid gland were evaluated before treatment. The mean decrease of thyroid volume at six months was about 20% (20.4 +/- 8.8 ml vs. 16 +/- 7.9 ml, P<0.001) in patients with diffuse goiter. All patients with diffuse goiter showed some decrement in their goiter sizes. Thyroid nodules, in response to thyroid hormone treatment, showed a variable behavior. A reduction of 50% or more in volume was detected in 31% (11/35) of the patients. 54% of the patients (19/35) showed a 10-49% decrease in nodule volume. Five of the patients were found to be insensitive to the therapy. Their nodule volumes either increased or did not change during therapy. Free T4 and free T3 levels increased and TSH levels decreased with L-T4 treatment in all patient groups. Patients with higher TSH levels (within normal limits) showed more volume reduction in the diffuse goiter group. No uniform correlation was found between volume changes and thyroglobulin levels in either of the patient groups. In conclusion, suppressive thyroxine treatment is effective in reducing the size of the goiter, and nodules and thyroglobulin levels cannot be taken as an indicator of the efficacy of L-T4 therapy.     

Longitudinal occlusal changes from primary to permanent dentition in children with normal primary occlusion.

This purpose of this research was to examine the stability of normal occlusion during the transition from primary to permanent dentition. The sample consisted of 128 children (83 boys and 45 girls) 4.5 to 5.5 years old with normal occlusion in the primary dentition. The subjects were reexamined at 12.5 to 13.5 years. None had received orthodontic treatment. Although all the subjects had normal occlusion in the primary dentition, 72.7% (73.5% boys and 71.1% girls) had developed anomalies following eruption of the permanent teeth. These anomalies included crowding, Class II Division 1 or Class II Division 2 malocclusion, mesial occlusion complex, lateral crossbite, anterior crossbite, premature tooth loss, openbite or other anomalies.     

An infection-based model of neurodevelopmental damage

Perinatal exposure to infectious agents and toxins is linked to the pathogenesis of neuropsychiatric disorders, but the mechanisms by which environmental triggers interact with developing immune and neural elements to create neurodevelopmental disturbances are poorly understood. We describe a model for investigating disorders of central nervous system development based on neonatal rat infection with Borna disease virus, a neurotropic noncytolytic RNA virus. Infection results in abnormal righting reflexes, hyperactivity, inhibition of open-field exploration, and stereotypic behaviors. Architecture is markedly disrupted in hippocampus and cerebellum, with reduction in granule and Purkinje cell numbers. Neurons are lost predominantly by apoptosis, as supported by increased mRNA levels for pro-apoptotic products (Fas, caspase-1), decreased mRNA levels for the anti-apoptotic bcl-x, and in situ labeling of fragmented DNA. Although inflammatory infiltrates are observed transiently in frontal cortex, glial activation (microgliosis > astrocytosis) is prominent throughout the brain and persists for several weeks in concert with increased levels of proinflammatory cytokine mRNAs (interleukins 1alpha, 1beta, and 6 and tumor necrosis factor alpha) and progressive hippocampal and cerebellar damage. The resemblance of these functional and neuropathologic abnormalities to human neurodevelopmental disorders suggests the utility of this model for defining cellular, biochemical, histologic, and functional outcomes of interactions of environmental influences with the developing central nervous system.