Electrophysiological evidence for a defect in the processing of temporal sound patterns in multiple sclerosis

OBJECTIVES: To assess the processing of spectrotemporal sound patterns in multiple sclerosis by using auditory evoked potentials (AEPs) to complex harmonic tones. METHODS: 22 patients with definite multiple sclerosis but mild disability and no auditory complaints were compared with 15 normal controls. Short latency AEPs were recorded using standard methods. Long latency AEPs were recorded to synthesised musical instrument tones, at onset every two seconds, at abrupt frequency changes every two seconds, and at the end of a two second period of 16/s frequency changes. The subjects were inattentive but awake, reading irrelevant material. RESULTS: Short latency AEPs were abnormal in only 4 of 22 patients, whereas long latency AEPs were abnormal to one or more stimuli in 17 of 22. No significant latency prolongation was seen in response to onset and infrequent frequency changes (P1, N1, P2) but the potentials at the end of 16/s frequency modulations, particularly the P2 peaking approximately 200 ms after the next expected change, were significantly delayed. CONCLUSION: The delayed responses appear to be a mild disorder in the processing of change in temporal sound patterns. The delay may be conceived of as extra time taken to compare the incoming sound with the contents of a temporally ordered sensory memory store (the long auditory store or echoic memory), which generates a response when the next expected frequency change fails to occur. The defect cannot be ascribed to lesions of the afferent pathways and so may be due to disseminated brain lesions visible or invisible on magnetic resonance imaging.     

Visual hallucinations induced by the combination of prolintane and diphenhydramine

The case of a young man is presented who developed visual hallucinations following two months of concomitant use of prolintane and diphenhydramine at therapeutic dosages. An increase in dopaminergic brain activity is proposed as the causal mechanism for hallucinations--whereas prolintane can induce the release of dopamine at the synaptic cleft, diphenhydramine can act inhibiting the reuptake of dopamine and inducing a potentiation of its effects. The psychiatric complications appearing two months after starting the use of both drugs could be attributed to a phenomenon of pharmacological kindling.     

Infectious factors in acute acalculous cholecystitis

BACKGROUND/AIMS: The infection is shown as a secondary phenomenon in lithiasic acute cholecystitis. However, its importance in acute gallbladder inflammation without lithiasis has not been sufficiently clarified. In this context, we tried to investigate this issue by resorting to animal research. Similarly we studied the repercussions of Diclofenac (NSAID) in bacteriological features of the bile in the operated animals. METHODOLOGY: We provoked acute cholecystitis in pigs by the ligature of biliary pedicle associated to the gallbladder introduction of "Lysophosphatidylcoline". Two series of animals were used: P1 (pigs not treated with Diclofenac) with 17 pigs and P2 (pigs treated with Diclofenac) with 23. In the latter group we associated the administration of Diclofenac given before the production of acute cholecystitis and administered for 4 days. The microbiology of the bile was studied in 34 pigs. The following parameters were valorized: histological gallbladder lesions and microorganisms in bacteriological examination of the bile. RESULTS: Severe lesions of acute cholecystitis were registered in 82.3% of the animals. Positive bile cultures were registered in 64.1% of group P1 and 65.5% in the group P2. The simultaneous administration of Diclofenac in the P2 group did not cause a regression of gallbladder lesions or in microbial agents in the bile in relation to the first group (P = 0.649, and P = 0.781, respectively). CONCLUSIONS: Our investigations allow us to conclude by valorization the infection factor in acute acalculous cholecystitis. On the other hand, the absence of repercussion of Diclofenac in acute acalculous cholecystitis was demonstrated not only in histological gallbladder lesions, but also in bile infection.     

Women undergoing investigation of sexual abuse in the metropolitan area of Porto Alegre, Brazil: a retrospective study

This is a retrospective study of 1,063 examinations performed on women at the Institute for Forensic Medicine in the city of Porto Alegre, RS, Brazil, between January 1998 and December 1999, as part of an investigation of charges of sexual abuse. Most women were white (83.9% - 892), single (89.1% - 947), and were between 11 and 20 years of age (59% - 627); 40% (425) were 14 years old or younger. There was evidence of previous sexual contact in 57% (606) of the patients; 37% (393) were virgins. Evidence of recent sexual intercourse was found in 287 (27%) cases, including presence of sperm in the vagina (18% - 191), recent rupture of the hymen (7% - 74), and pregnancy (2% - 21). Physical violence was evident in 30% (319) of all cases. In cases where information regarding the perpetrator was available (39% - 415), 25% (105) consisted of family members. Further studies should be carried out in order to assess the incidence of sexual violence by family members.     

Statins for primary and secondary prevention of coronary heart disease. A scientific review.

Cardiovascular disease has an elevated prevalence in the general population, with increasing incidence with advancing age. Epidemiological studies clearly show that higher concentrations of serum lipids (especially cholesterol) constitute a major individual risk factor, and that their treatment reduces the incidence of cardiovascular disease, especially coronary heart disease (CHD). The best evidence supporting the importance of hypercholesterolemia as a major risk factor for CHD arises from large randomized controlled trials (RCTs), which show that by lowering total cholesterol and low-density lipoprotein concentrations, and increasing high-density lipoprotein concentrations, coronary event rates and cardiovascular mortality are diminished. Also, hyperlipidemia is frequently found in patients suffering from premature CHD and, in most cases, has a familial genetic component. The benefit from lowering cholesterol is found in primary prevention (patients with hypercholesterolemia but no known CHD), as well as in secondary prevention (patients with known CHD, in whom the aim is to improve prognosis). The main objective of this paper is to present and discuss the most valid, important and applicable scientific evidence on the primary and secondary prevention of coronary heart disease using statins. We have based our discussion on large RCTs that studied clinically relevant outcomes (mortality, morbidity, event rates, etc.), published over the last 10 years, as well as on systematic reviews and/or meta-analyses of RCTs published over the last 5 years. Both types of evidence were selected from secondary scientific sources. We conclude with practical evidence-based recommendations on the selection of patients for primary and secondary prevention with statins.     

谷氨酸脱羧酶抑制剂L-苹果酸对小鼠学习记忆的影响

跳台法和Y迷宫法试验表明,小鼠po L-苹果酸600mg·kg^-1连续5d后对记忆的获得、巩固和再现均有明显的改善作用,并能促进空间辨别学习能力;L-苹果酸改善记忆的作用能被NMDA受体拮抗剂氯胺酮所拮抗。脑内游离氨基酸测定显示,L-苹果酸可明显降低小鼠脑内GABA水平,提高Glu/GABA比值。实验结果表明,脑内GABA水平下降,Glu/GABA比值升高对学习记忆有正性调节作用。