Effectiveness,Safety and Applicability of Wii Therapy in Patients with Chronic Obstructive Pulmonary Diseases

Aim： We investigated the applicability, effectiveness and safety of Wii Therapy to improve trunk flexibility and reduce symptoms in COPD （chronic obstructive pulmonary disease） patients. Methodology： Case reports of 13 COPD patients from the PR （Pulmonary Rehabilitation） program. They performed 10 sessions of Wii therapy, 2 times/week. The patients were randomized into two groups： Group A （5 tennis sessions after 5 bowling sessions） and Group B （10 tennis and bowling sessions, both associated in the same sessions）. We analyzed the trunk forward flexibility, dyspnea by Modified Borg Scale Dyspnea index, COPD symptoms by COPD Assessment Test--CAT and the psychological responses by Subjective Experiences Scale. Results： After Wii Therapy, we observed a positive evolution in trunk forward-flexibility, especially in Group B （A = 73.57 ± 11.07; B = 80.83 ± 19.85, no significant）. Despite the positive developments of symptoms by the Borg Scale-Dyspnea index （A = 0 vs. B = 0.5） and CAT （A = 11.14 ± 4.01 vs. B = 10.33± 2.33）, Group A performed better than Group B. The psychological responses observed were positive experiences for both groups. Conclusion： Wii Therapy focuses only on the individual＇s movement can be used as a complement to PR. This therapy was effective, safe and easy to apply, in addition to being a resource that provides fun for the patient.     

Chitosan Iron(III) Reduces Phosphorus Levels in Alloxan Diabetes‐Induced Rats with Signs of Renal Failure Development

Abstract: This study evaluates the effect of complex cross‐linked chitosan iron‐(III) (CH‐FeCL) polymer as phosphate binder in renal failure induced by alloxan (150 mg/kg, i.p.) in rats. The animals (male and female) were divided into four groups and received the treatment once a day for 15 days: (i) control group, which received a single injection of saline (3 ml/kg, i.p.) and normal diet; (ii) alloxan group, which received only a dose of alloxan and normal diet; (iii) phosphate (PO4) group, which received diet supplemented with phosphate 1.2%; and (iv) CH‐FeCL group, which received diet supplemented with phosphate 1.2% + CH‐FeCL 0.5% (0.054% Fe elemental). It was observed that the CH‐FeCL treatment did not alter body‐weight, relative weight of the organs and haematological parameters in the treated and control groups for both sexes. However, a decrease in serum phosphorus level of the CH‐FeCL group was observed after 15 days, compared with the phosphate group in both sexes. The serum iron concentration of the CH‐FeCL group did not differ from the control group in either sex. CH‐FeCL polymer decreases intestinal phosphate absorption in rats with renal failure and is promising for the treatment of phosphate retention in patients with renal failure.     

Micrometastases from HBP malignancies and metastatic cancer

Despite advances in early diagnosis and surgical treatment, the prognosis for patients with primary malignant tumors of the hepatobiliary tract and pancreas has not changed markedly over the last decades. Early metastatic relapse after complete resection indicates the presence of disseminated tumor cells undetectable by current tumor staging methods. Sensitive immunohistocytochemical and nucleic acid‐based assays have been developed to detect single tumor cells present in lymph nodes, bone marrow, or blood. Standardization of the current occult tumor cell detection protocols are needed before “micrometastatic” tumor staging can be used in clinical practice. We present an overview of recent studies on the frequency and prognostic value of occult disseminated tumor cells in the lymph nodes, bone marrow, and blood of patients with hepatopancreatobiliary malignancies and metastatic colorectal cancer identified by immunohistocytochemistry or nucleic acid‐based assays.     

Effects of L-2-Hydroxyglutaric Acid on Various Parameters of the Glutamatergic System in Cerebral Cortex of Rats

L-2-Hydroxyglutaric acid (LGA) accumulates and is the biochemical hallmark of the neurometabolic disorder L-2-hydroxyglutaric aciduria (LHGA). Although this disease is predominantly characterized by severe neurological findings and pronounced cerebral atrophy, the pathomechanisms of brain injury are virtually unknown. In the present study, we investigated the effect of LGA (0.1–1 mM) on various parameters of the glutamatergic system, namely the basal and potassium-induced release of L-[³H]glutamate by synaptosomal preparations, Na⁺-dependent L-[³H]glutamate uptake by synaptosomal preparations and Na⁺-independent L-[³H]glutamate uptake by synaptic vesicles, as well as of L-[³H]glutamate binding to synaptic plasma membranes from cerebral cortex of male adult Wistar rats. We observed that LGA significantly increased L-[³H]glutamate uptake into synaptosomes and synaptic vesicles, without altering synaptosomal glutamate release and glutamate binding to synaptic plasma membranes. Although more comprehensive studies are necessary to evaluate the exact role of LGA on neurotransmission, our findings do not support a direct excitotoxic action for LGA. Therefore, other abnormalities should be searched for to explain neurodegeneration of LHGA.     

Efficiency of inhaled nitric oxide as rescue therapy during severe ARDS: Survival and factors associated with the first response

PURPOSE: The purpose of this study was to determine if the response to inhaled nitric oxide (NO) as salvage therapy is an independent factor for survival in adult respiratory distress syndrome (ARDS) patients and to identify the factors that predict the response to inhaled NO during ARDS. MATERIALS AND METHODS: This was a multicenter, 2-year retrospective, clinical study in five university surgical or medical intensive care units, including all consecutive patients with ARDS in whom inhaled NO was tried. Clinical data (medical history, diagnoses), general severity scores (SAPS II, OSF), biological data, radiological and hemodynamic data at admission, at the beginning of the ARDS, and under treatment with inhaled NO were recorded. The NO response was defined as the variation of PaO2/Fio2 ratio before initiation and after 30 minutes of NO inhalation (VarPaO2/FiO2). RESULTS: Ninety-three patients aged 49 +/- 18 years were studied. Mean SAPS II was 45 +/- 16. Before the beginning of inhaled NO, PaO2/Fio2 ratio was 95 +/- 53 mm Hg and lung injury score 2.7 + 0.3. VarPao2/Fio2 when NO was started (11 +/- 4 ppm) was 26 +/- 44.5 mm Hg (median 17 mm Hg). Intensive care unit mortality was 74%. None of the parameters studied were predictors of response to inhaled NO, although there was a tendency for the youngest patients with the more severe hypoxemia to have a better response. Response to first inhaled NO test (VarPaO2/FiO2) was univariately associated with survival (Survivors: 45 +/- 44 mm Hg vs. Nonsurvivors: 20 +/- 43 mm Hg, P = .01), but this difference disappeared after adjusting for other prognostic factors (P = .16) selected by multivariate analysis. Finally, inhaled NO was continued for more than 1 day for 75 patients, and definitively stopped for 18 patients. Intensive care unit mortality (73% vs. 78%) was not different between these groups (P = .25, Log-rank test). CONCLUSIONS: We conclude that (1) efficacy of inhaled NO in improving oxygenation was moderate and difficult to predict, (2) response to first NO inhalation was not associated with prognosis, and (3) treatment of the most severe ARDS patients with inhaled NO did not influenced their intensive care unit survival.     

Vaccinia viruses isolated from cutaneous disease in horses are highly virulent for rabbits

Two genotypically distinct Vaccinia viruses (VACV), named P1V and P2V, were isolated from an outbreak of cutaneous disease in horses in Southern Brazil. We herein investigated the susceptibility of rabbits, a proposed animal model, to P1V and P2V infection. Groups of weanling rabbits were inoculated intranasally (IN) with P1V or P2V at low (10^2.5 TCID₅₀), medium (10^4.5TCID₅₀), or high titer (10^6.5TCID₅₀). Rabbits inoculated with medium and high titers shed virus in nasal secretions and developed serous to hemorrhagic nasal discharge and severe respiratory distress, followed by progressive apathy and high lethality. Clinical signs appeared around days 3-6 post-inoculation (pi) and lasted up to the day of death or euthanasia (around days 5-10). Virus shedding and clinical signs were less frequent in rabbits inoculated with low virus titers. Viremia was detected in all groups, with different frequencies. Viral DNA was detected in the feces of a few animals inoculated with P1V and P2V, low titer, and with P2V at high titer. Gross necropsy findings and histological examination showed diffuse interstitial fibrousing pneumonia with necrosuppurative bronchopneumonia and intestinal liquid content. Neutralizing antibodies were detected in all inoculated animals surviving beyond day 9pi. These results show that rabbits are highly susceptible to VACV isolated from horses, and develop severe respiratory and systemic disease upon IN inoculation. Thus, rabbits may be used to study selected aspects of VACV infection and disease.     

Copy number of chromosome 17 but not HER2 amplification predicts clinical outcome of patients with pancreatic ductal adenocarcinoma.

PURPOSE: To determine the frequency and the potential clinical use of HER2 (17q21) gene amplification and chromosome 17 aneuploidy in pancreatic ductal adenocarcinoma (PDAC). MATERIALS AND METHODS: Serial tissue sections of 50 resected PDACs were analyzed with chromogenic in situ hybridization using locus-specific HER2 probes and centromeric probes for chromosome 17. Centromeric probes for chromosome 7 and 8 were hybridized to confirm ploidy levels. Expression of HER2 protein was assessed by immunohistochemistry. Correlations of experimental findings with clinical and follow-up data were tested. RESULTS: The HER2 gene locus was frequently (24%) amplified in PDAC and the rate of overexpression (2+ and 3+) was 10%, but no prognostic significance was found. Copy number analysis of chromosomes 7, 8, and 17 revealed disomic (40%), trisomic (36%), and hypertetrasomic (24%) tumors. Compared with patients with disomic tumors, patients with hypertetrasomic tumors exhibited a significantly decreased relapse-free and overall survival (5.0 v 13.0 months, P = .0144 and 7.0 v 20.0 months, P = .0099, respectively). Multivariate analysis confirmed the independent prognostic significance of hypertetrasomy. CONCLUSION: Tumor ploidy levels correlate with prognosis of PDAC patients, indicating characteristic biologic properties of PDAC with high chromosomal instability. In contrast, no prognostic influence on patient outcome was found for the amplification of the HER2 oncogene or p185(HER2) overexpression. Therefore, evaluation of ploidy levels offers new opportunities for patient stratification in clinical trials and enables novel approaches to study the well-known aggressiveness of PDAC.     

Interrelationship between radiologic findings and prognosis of epilepsy in children with neurocysticercosis

INTRODUCTION: Epileptic manifestations of Neurocysticercosis (NC) appear to depend on number and localization of the cysts. The objective of this study was to investigate the relationship between CT findings, number of parasites and the evolutive stage of the cysts, and the prognosis of epilepsy in children with NC. METHOD: We studied 28 patients with the parenchymal form of NC, considering: epilepsy duration; seizure frequency before and after AED treatment; seizure control; number of AED and recurrence after AED withdrawal. Clinical information was crossed with the number of lesions and disease activity in univariate comparison. RESULTS: The analysis of the clinical data in relation to the number of lesions and disease activity showed no statistical difference among the variables (p>0.05). CONCLUSION: We conclude that the course of epilepsy due to NC in childhood cannot be based exclusively on the number or stage of the parasites.