Chronic lead poisoning-- a" forgotten" cause of anemia

We present the case of a female patient with a chronic hypersideremic anemia associated with digestive and neurological symptoms, with a long time ignored toxic history. The diagnose was based on very high levels of lead in serum and urine, very high levels of D-aminolaevulinic acid in the urine, and the presence of basophilic stippling of erythrocytes in the smear of the patient. Lead intoxication was due to ingestion of home-made alcohol (domestic devices made from lead mixtures) and of yogurt preserved in lead-glazed mugs.     

Treatment outcome using prednisone in corticosteroid-responsive primary nephrotic syndrome in children

In children, the nephrotic syndrome is usually corticoid-responsive; approximately 70% of patients experience relapses, frequently triggered by infections. Our paper presents the results obtained using a 4 month prednisone regimen. This retrospective study included 83 children afflicted with nephrotic syndrome over a 10 year span. We analyzed: age at diagnosis, boys/girls ratio, response to corticoid treatment - after one month of prednisone and at the completion of the treatment course, number of relapses and their frequency, complications of prednisone treatment. The median age at diagnosis was 4.8 years, males predominating M:F = 1.5:1. Complete response after 4 weeks of prednisone therapy was noted in 98.79% of cases. We had 116 episodes of relapses during the first year of follow-up, occurring in 67.4% of children (27.9% were frequent relapsers, 11.62% subsequently became corticoid-dependent). Late relapses, after the first year, occurred in 32.55% of cases. We noted mostly mild adverse effects of the prednisone treatment: occurrence of infections during therapy (16.27%), cushingoid facies (37.2%), hirsutism (4.6%), high blood pressure (4.65%), stretch marks (2.32%). In conclusion, the 4 month prednisone treatment regimen is efficient in inducing and maintaining a remission. The incidence of relapses is 32.55%, comparable to the figure cited in larger studies. Serious adverse effects are significantly lower with this regimen compared to other corticoid treatment schemes. Key wo     

Early diagnosis in hypertrophic cardiomyopathy--case report

Disproportionate heart muscle enlargement compared with little or no chamber enlargement are characteristic for hypertrophic cardiomyopathy (HCM). The clinical course of HCM is highly variable. Many patients are asymptomatic or mildly symptomatic and may be relatives of patients with known disease. Unfortunately, the first clinical manifestation of the disease may be sudden death, frequently occurring in children and young adults, often during or after physical exertion. We present 2 cases of HCM who emphasize the variability of clinical and ECG modifications and underline the importance of routine echocardiography in patients with atypical cardiac symptoms in order to identify the disease and prevent high risk for sudden death.     

Quantitative age-related changes in dorsal lateral geniculate nucleus relay neurons of the rat

An ultrastructural and quantitative study of the age-related changes occurring in the relay neurons of the dorsal lateral geniculate nucleus (dLGN) was carried out using male Wistar rats aged 3, 18, 24, and 28 months. Morphometric techniques were used to obtain data regarding cellular activity including soma, nuclear, and nucleolar size. Volume fractions for rough endoplasmic reticulum (RER), mitochondria, and lipofuscin, as well as numbers and sizes of mitochondria and dense bodies (DB) was also calculated. Among the few alterations found in the perikaryon, we can highlight the redistribution and fragmentation of RER and an increase and progressive aggregation of lipofuscin. Quantitative data show a significant decrease in the volume of the soma (-42.77%) and the nucleus (-33.66%), and in the volume fraction of the RER (-18.81%) and mitochondria (-10.16%). A significant increase in lipofuscin (+213.29%), and variations in size and number of mitochondria and dense bodies were also found. Some histophysiological considerations about the findings are discussed. The findings lead to the conclusion that a relative degree of morphological stability is exhibited by relay neurons, although the quantitative data show evident intracellular changes, especially from 24 to 28 months. These changes suggest that accompanying physiological alterations may occur, with putative effects on visual function during ageing.     

Methoctramine analogues inhibit responses to capsaicin and protons in rat dorsal root ganglion neurons

We have investigated the possibility that vanilloid receptors have a binding site for polyamines and determined the consequences of binding to such a site. Whole-cell and single-channel patch-clamp recordings were used to investigate the effect of the tetraamine, methoctramine, and 16 of its analogues on capsaicin and proton induced responses of foetal rat dorsal root ganglion neurons. All but two methoctramine analogues inhibited responses to 10 microM capsaicin with IC50 values in the range of 2-70 microM at a holding potential of -100 mV. Inhibition was generally non-competitive and voltage-dependent. Methoctramine at 10 microM reduced the single channel mean open time (>3-fold), but also increased the mean closed time (1.7-fold). Sustained responses to pH 5.4 were antagonized by methoctramine with similar potency to capsaicin responses. Similar data were obtained with adult rat dorsal root ganglion neurons. These data indicate that methoctramine analogues bind to vanilloid receptors to inhibit their function.     

Stereological changes in the capillary network of the aging dorsal lateral geniculate nucleus

In this work we studied the effect of aging on the capillaries of the dorsal lateral geniculate nucleus in 3-, 18-, 24-, and 28-month-old rats. The parameters analyzed were the capillary profile density, capillary volume fraction, length and surface area per unit volume, and capillary average diameter. The quantitative analysis showed in all parameters an increase between 3 and 18 months, and a significant decrease in capillary volume fraction (-18.75%) and diameter (-5.5%) between 18 and 24 months. No changes from 24 months onwards were observed. The increase observed in capillary profile density and capillary volume fraction between 3 and 18 months may indicate an increase of the capillary network. Furthermore, we observed an increase in the length and surface area per unit volume, which we interpret as an expansion of the exchange surface between blood and nerve tissue. The reduction in the capillary parameters that takes place between 18 and 24 months is slight, and may indicate the onset of decline characteristic of aging.     

Alpha(1)-adrenoceptor-mediated depolarization and beta-mediated hyperpolarization in cultured rat dorsal root ganglion neurones

The effect of excitotoxic injury on the production of monocyte chemoattractant protein-1 (MCP-1) was examined in rat cortico-striatal slice cultures. Treatment with 50 microM N-methyl-D-aspartate (NMDA) for 4 h, which caused severe damage in neurons, induced the production of MCP-1 in astrocytes. Production levels were markedly elevated immediately after the treatment, peaked at 4-8 h, and had decreased to nearly the basal level by 72 h. Since the treatment promoted the release of MCP-1 in the slice cultures, but not in the enriched astrocyte cultures, it is unlikely that NMDA directly acted on the astrocytes. These results suggest that information on neuronal injury induced by NMDA is transmitted to astrocytes to induce the production of MCP-1. Organotypic slice cultures are useful for investigating the inflammatory responses of astrocytes in the process of neuronal injury.     

Current aspects of hemolytic uremic syndrome in children

The authors are approaching the problem of hemolytic uremic syndrome, a common cause of acute renal failure in children. This review present an update about the pathophysiology of typical hemolytic uremic syndrome, useful for understanding the clinical picture and the base for some modern therapeutical models. Concerning the evolution, the authors underline the importance of identifying the risk factors for acute phase, the extrarenal manifestations being considered of vital risk. The atypical hemolytic uremic syndrome still has some uncertainties; the article try to make a synthesis of ethiopathogeneity, clinical manifestations, evolution and therapeutical modern approaches.     

Misogyny in the nursing world? A historical overview

Through history, there have been men and women who have cared for injured warriors, attended to expectant mothers, cared for those most unprotected or attended to the health of children and sick older people. This is a fact which the History of Nursing does not ignore. Nonetheless, it is no less certain that since their origins, surgical practices and therapeutic specialties in the hands of men have enjoyed an enormous social recognition while those treatment practices and care tasks which have women as their main protagonists frequently fall into a forgotten and silent place. Now the question is to what is due such an asymmetric and sexual evaluation of these tasks? How are these differences among men and women and among doctors and nurses expressed and explained? Basically these are viewed through a dense network of images, symbols and social stereotypes which codify their behaviors, regulate their activities, prescribe their expectations and construct their tastes. All this is a subtle, polymorphic strategy for androcentric normalization of feminine reality which, as is to be expected, does not escape being designated as specific roles for female caretakers either. The authors examine the Florence Nightingale model to ascertain whether or not this model is capable to overcome, eliminate or transform some of the androcentric patterns described in the previous article or, to the contrary, whether or not these patterns still persevere and are transmitted to present day, even though only in a deceptive manner.