Reflex time in relation to age and behavioral status studied in postnatal growing rats

1. The central nervous system of neonatal albino rats showed age specific functional parameters, some of them are comparable with those of human prematures. 2. The reflex times (RT) of the lid closure reflex and of the withdrawal reflex of the foreleg, hindleg and tail were measured during the behavioral states quite sleep, active sleep, and wakefulness of rats between 1st and 20th postnatal day. 3. The RT of the investigated reflexes decreased with age in different degrees. 4. The RT was found to be different in the behavioral states; with increasing age the RT becomes longer in active sleep than in the other states. 5. The reflex time measurement of withdrawal reflexes during different behavioral states should be proved for its applicability as a test for normal brain development in humans newborns.     

Metabolic syndrome and the decreased levels of uric acid by leflunomide favor redox imbalance in patients with rheumatoid arthritis

Oxidative stress plays a role in the pathophysiology of rheumatoid arthritis (RA). The aim of the present study was to verify the influence of metabolic syndrome (MetS) and disease-modifying antirheumatic drugs on nitrosative and oxidative biomarkers in patients with RA. A total of 177 patients with RA and 150 healthy volunteers participated in this study, which measured lipid hydroperoxides, advanced oxidation protein products (AOPP), nitric oxide metabolites (NOx), carbonyl protein, total radical-trapping antioxidant parameter (TRAP), uric acid (UA), and C-reactive protein (CRP). NOx and the NOx/TRAP ratio were significantly increased in RA, while no significant differences in lipid hydroperoxides, AOPP, UA, and TRAP levels were found between both groups. Treatment with leflunomide was associated with increased levels of carbonyl protein, and lowered levels in TRAP and UA, while the NOx/TRAP ratio further increased. NOx and the NOx/TRAP ratio were significantly higher in women than in men, while TRAP and UA were significantly lower in women. MetS was accompanied by increased AOPP and UA levels. RA was best predicted by increased NOx/TRAP ratio, CRP, and BMI. In conclusion, our data demonstrated that NOx and NOx/TRAP are strongly associated with RA physiopathology. Our findings suggest that inhibition of iNOS may become an interesting therapeutic approach for the treatment of RA. In addition, the presence of MetS and a decrease in levels of UA by leflunomide favor redox imbalance in RA patients. More studies are needed to evaluate the impact of antioxidant capacity reduction on RA progression.     

Can we distinguish respiratory viral infections based on clinical features? A prospective pediatric cohort compared to systematic literature review

Studies have shown that the predictive value of “clinical diagnoses” of influenza and other respiratory viral infections is low, especially in children. In routine care, pediatricians often resort to clinical diagnoses, even in the absence of robust evidence‐based criteria. We used a dual approach to identify clinical characteristics that may help to differentiate infections with common pathogens including influenza, respiratory syncytial virus, adenovirus, metapneumovirus, rhinovirus, bocavirus‐1, coronaviruses, or parainfluenza virus: (a) systematic review and meta‐analysis of 47 clinical studies published in Medline (June 1996 to March 2017, PROSPERO registration number: CRD42017059557) comprising 49 858 individuals and (b) data‐driven analysis of an inception cohort of 6073 children with ILI (aged 0‐18 years, 56% male, December 2009 to March 2015) examined at the point of care in addition to blinded PCR testing. We determined pooled odds ratios for the literature analysis and compared these to odds ratios based on the clinical cohort dataset. This combined analysis suggested significant associations between influenza and fever or headache, as well as between respiratory syncytial virus infection and cough, dyspnea, and wheezing. Similarly, literature and cohort data agreed on significant associations between HMPV infection and cough, as well as adenovirus infection and fever. Importantly, none of the abovementioned features were unique to any particular pathogen but were also observed in association with other respiratory viruses. In summary, our “real‐world” dataset confirmed published literature trends, but no individual feature allows any particular type of viral infection to be ruled in or ruled out. For the time being, laboratory confirmation remains essential. More research is needed to develop scientifically validated decision models to inform best practice guidelines and targeted diagnostic algorithms.     

Apparent diffusion coefficient in vasogenic edema and reactive astrogliosis

Introduction Distinguishing between vasogenic edema and reactive astrogliosis may be difficult in some instances. This study was performed to test the hypothesis that diffusion-weighted (DW) imaging with apparent diffusion coefficient (ADC) maps can be used to differentiate these two types of changes. Methods The study population included 11 patients with perilesional vasogenic edema and 11 patients with gliosis examined with conventional MR imaging and DW imaging. The signal intensities of conventional pulse sequences and ADC values were calculated in regions of interest placed in the hyperintense edematous or gliotic regions and compared with those of normal-appearing white matter. Signal intensity ratios and ADC values in gliosis were compared with those in vasogenic edema using the Mann-Whitney U-test. Results While considerable overlap was present for signal intensity ratios on conventional MR images, areas of gliosis demonstrated significantly higher ADC values (1.76 ± 0.09 × 10⁻³ mm²/s) than areas of vasogenic edema (1.35 ± 0.06 × 10⁻³ mm²/s; P < 0.0001) without overlap. Conclusion ADC values are helpful in differentiating reactive gliosis from vasogenic edema.     

Pilocytic Astrocytoma with subarachnoidal spread

Summary Pilocytic Astrocytomas (WHO I) are histopathologically tumors of glial origin occurring predominantly in childhood and adolescence. Normally, they are characterized by a benign clinical course, with a long overall survival time and a high rate of complete remission. The rare case of pilocytic astrocytoma, primarily located in the third ventricular region, with generalized subarachnoidal spread is described. In the 10 years of follow-up, the histopathologic findings of the seedings remained those of a typical pilocytic astrocytoma; tumor progression did not occur.      

Increased lipid and protein oxidation and lowered anti-oxidant defenses in systemic lupus erythematosus are associated with severity of illness,autoimmunity, increased adhesion molecules,and Th1 and Th17 immune shift

This study investigated nitro-oxidative stress in patients with systemic lupus erythematosus (SLE) in association with disease activity, immune-inflammatory biomarkers, and adhesion molecules. Two-hundred-four patients with SLE and 256 healthy volunteers were enrolled in this case-control study, which measured nitro-oxidative stress biomarkers, including lipid peroxides (LOOH), advanced oxidation protein products (AOPPs), nitric oxide metabolites (NO_x), sulfhydryl (?SH) groups, products of deoxyribonucleic acid (DNA)/ribonucleic acid (RNA) oxidative degradation, and total radical-trapping anti-oxidant parameter (TRAP). Also measured were anti-nuclear antibodies (ANAs), antibodies against double-stranded DNA (dsDNA), plasma levels of diverse cytokines, C-reactive protein, and adhesion molecules. LOOH (p < 0.001) and AOPP (p < 0.001) were significantly higher, while TRAP was significantly lower (p < 0.001) in SLE patients than in controls. AOPP and LOOH were significantly and positively associated with SLE disease activity index (SLEDAI) scores, anti-nuclear antibodies, and antibodies against double-stranded DNA (anti-dsDNA) levels, while TRAP was significantly and inversely correlated with SLEDAI, ANA, and dsDNA antibody levels. There were significant positive associations between AOPP and LOOH and immune-inflammatory markers, indicating T helper (Th)-17 and Th1 bias and Th1 + Th17/Th2 ratio (p = 0.002 and p = 0.001, respectively). AOPP and LOOH (positively) and TRAP (inversely) were associated with adhesion molecule expression. A model predicting SLE was computed showing that, using LOOH, AOPP, NO_x, adhesion molecules, and body mass index, 94.2% of the patients were correctly classified with a specificity of 91.5%. Increased nitro-oxidative stress takes part in the (auto)immune pathophysiology of SLE and modulates severity of illness and adhesion molecule expression.     

Serological, epidemiological and molecular aspects of hepatitis C virus infection in a population from Londrina, PR, Brazil, 2001-2002

Serological, epidemiological and molecular aspects of hepatitis C virus (HCV) infection were evaluated in 183 subjects from Londrina, Paraná, Brazil, and adjacent areas. Serum samples which tested anti-HCV positive by microparticle enzyme immunoassay (MEIA) obtained from eight patients with chronic hepatitis C, 48 blood donors, and 127 patients infected with the human immunodeficiency virus (HIV) were submitted to another enzyme immunoassay (ELISA) and to the polymerase chain reaction (PCR). About 78.7% of samples were also reactive by ELISA, with the greater proportion (70.8%) of discordant results verified among blood donors. A similar finding was observed for HCV-RNA detection by PCR, with 111/165 (67.3%) positive samples, with higher rates among HIV-positive subjects and patients with chronic hepatitis than among blood donors. Sixty-one PCR-positive samples were submitted to HCV genotyping, with 77.1, 21.3 and 1.6% of the samples identified as types 1, 3 and 2, respectively. Finally, analysis of some risk factors associated with HCV infection showed that intravenous drug use was the most common risk factor among HIV/HCV co-infected patients, while blood transfusion was the most important risk factor in the group without HIV infection. The present study contributed to the knowledge regarding risk factors associated with HCV infection and the distribution of HCV genotypes in the population evaluated.     

Inzidenz des Postmyelographiesyndroms (PMS) und postmyelographischer Beschwerden nach lumbaler Punktion mit der bleistiftförmigen Nadel nach Sprotte im Vergleich zur Nadel nach Quincke

Zusammenfassung Die Myelographie zusammen mit der Postmyelographie-CT ist eine wichtige Untersuchungsmethode in der pr?operativen Diagnostik. Bei nahezu der H?lfte der Patienten k?nnen postpunktionelle Beschwerden bis zu einem Postmyelographie-Syndrom (PMS) auftreten. Pathophysiologisch kann dies durch ein Punktionsleck mit anschlie?endem Liquorverlust erkl?rt werden. Ziel der Studie ist es, den Einflu? zweier Nadeltypen (21 G Nadel nach Sprotte vs 22 G Nadel nach Quincke) auf die Inzidenz postpunktioneller Beschwerden zu überprüfen. In einer prospektiven randomisierten Studie wurden bei 412 Patienten nach lumbaler intrathekaler Kontrastmittelapplikation (Iotrolan, Fa. Schering) die H?ufigkeit des PMS und postpunktioneller Nebenwirkungen in Abh?ngigkeit vom verwendeten Nadeltyp untersucht. Die H?ufigkeit postpunktioneller Beschwerden nach lumbaler Punktion mit der bleistiftf?rmigen Nadel nach Sprotte im Vergleich zur geschliffenen Nadel nach Quincke lag deutlich niedriger (Kopfschmerzen: 6,3 % vs 18,9 %, p < 0,0001; Kofschmerzen für mindestens drei Tage: 0,5 % vs 7,8 %, p < 0,0001; Kopfschmerzen für mindestens 5 Tage: 0 % vs 2,4 %, p = 0,0305; übelkeit: 0 % vs 4,9 %, p = 0,0009; Erbrechen: 0 % vs 4,9 %, p = 0,0009; Schwindel: 0 % vs 3,4 %, p = 0,0074; Nackensteife: 0 % vs 3,4 %, p = 0,0074; PMS: 0 % vs 3,4 %, p = 0,0074). Die Temperatur des Kontrastmittels beeinflu?te die postmyelographischen Beschwerden nicht. Schlu?folgerung: Die Inzidenz des PMS und postpunktioneller Beschwerden kann durch den Einsatz einer „atraumatischen“Nadel nach Sprotte deutlich gesenkt werden. Eingegangen am 22. August 1996 Angenommen am 30. August 1996