Unlike hypoxia, hypoglycemia does not preferentially destroy GABAergic neurons in developing rat neocortex explants in culture

We tested whether hypoglycemia, like hypoxia, would preferentially destroy GABAergic nerve cells in the neocortex. To this end, rat neocortex explants dissected from 6-day-old rat pups and cultured up to a developmental stage approximately comparable to that of the newborn human neocortex, were exposed to hypoglycemia for different periods. Quantitative light microscopic and immunocytochemical evaluation of the cultures demonstrated that hypoglycemia does not preferentially destroy GABAergic but rather non-GABAergic neurons, a finding quite opposite to what was found after hypoxia. Recent biochemical data from other laboratories which seem to support this difference in neuronal vulnerability are discussed. It is concluded that perinatal hypoglycemia may not form such a serious threat with respect to the genesis of epilepsy as does hypoxia.     

Laboratory diagnosis of pulmonary embolism: value of increased levels of plasma D-dimer and thrombin--antithrombin III complexes

Plasma D-dimer (DD) and thrombin--antithrombin III complex (TAT) were measured with ELISAs in 99 patients investigated by 102 ventilation--perfusion lung scintigraphy because of suspected pulmonary embolism. High-probability lung scan was associated with increased DD (more than 500 ng/ml) and TAT (more than 4.1 ng/ml) levels (sensitivity of 100 and 70%, respectively). The corresponding figures of specificity were 81 and 42%. In the 56 patients with low-probability or indeterminate probability scans, 31 (55%) had DD concentrations of less than 500 ng/ml. These preliminary data suggest that a plasma DD concentration of less than 500 ng/ml might rule out the diagnosis of pulmonary embolism in suspected patients with an inconclusive lung scanning.     

Relevance of 10-min delayed recall in dementia screening

Within the context of early diagnosis of Alzheimer's disease (AD), there is a growing interest in neuropsychological screening tests. Amongst these tests, we focused on the largely used Memory Impairment Screen (MIS). The objective of the present work was to show that adding a 10-min delayed recall to the MIS, improves the test psychometric characteristics in order to detect dementia in the earliest stages. A prospective study was carried out on a cohort of 270 consecutive elderly ambulatory subjects attending the Broca Hospital Memory Clinic: normal controls ( n  = 67), mild cognitive impairment subjects ( n  = 98) and mildly demented patients [ n  = 105, Mini Mental State Examination (MMSE) = 23 ± 4]. This study consisted in testing the advantage of the 10-min delayed recall entitled MIS-D compared with the MIS. At a cut-off score of 6, the MIS-D revealed satisfying psychometric characteristics with a sensitivity of 81% and a specificity of 91%, whilst the MIS alone indicated a sensitivity of 60% and a specificity of 88% in detecting dementia. In demented patients with MMSE score ≥26, MIS-D properties still remained satisfying (sensitivity: 75%, specificity: 92%). MIS-D is a more relevant screening test than MIS alone at very early stages of dementia.     

Validation of the Brazilian-Portuguese Version of the European Community Respiratory Health Survey in Asthma Patients

Background. The European Community Respiratory Health Survey (ECRHS) questionnaire was planned to answer questions about the distribution of asthma. Our objective was to determine the cultural equivalence of the ECRHS into the Brazilian-Portuguese language. Methods. We translated the ECRHS according to international criteria. Results. Small cultural adaptations were necessary. Among the 80 participating patients, the Cronbach indices were higher (0.98-1.00) and the Kappa indices varied from 0.77 to 1.00. Conclusion. The study suggests that the Brazilian version of the ECRHS is conceptually equivalent to the original and similarly reliable and may be used in international studies involving Portuguese-speaking respiratory patients.     

Chronic intestinal pseudo-obstruction: manifestations, natural history and management

Chronic intestinal pseudo-obstruction (CIPO) is a rare pathological condition characterized by a marked derangement of gut propulsive motility mimicking mechanical obstruction, in the absence of any lesion occluding the gut lumen. This disease is often associated with a disabling and potentially life-threatening complications and is still too often unrecognized even in referral centres. As a result, patients receive neither appropriate care nor recognition of their severe health condition. Medical and surgical therapies are often unsatisfactory and long-term outcome turns out to be poor in the vast majority of cases. This article focuses on the main clinical features, the management and long-term outcome of patients affected by CIPO, with particular emphasis on those aspects which remain a matter of debate.