Medical management of AIDS patients. Kaposi's sarcoma.

Kaposi's sarcoma (KS) presents with variable severity in the context of HIV infection. Various therapeutic approaches can be taken, and these are determined by the extent and location of KS lesions and the severity of tumor-related symptoms. New insights into the pathogenesis of KS lesions may provide innovative treatment strategies and a more rational basis for the control of this neoplasm.     

The relationship between neuroleptic dosage and cognitive functioning in chronic schizophrenic patients

A review of the effects of phenothiazines on cognitive function suggests that phenothiazine derivatives facilitate performance on tests of cognitive function, at least in subjects who are thought disordered. Drug effects frequently depend on the dose administered, however, and the response to various doses of some drugs (e.g., antidepressants) is frequently nonlinear. In our study, 23 hospitalized males with chronic psychotic disorders, and stabilized on dosages of neuroleptics with chlorpromazine equivalents of from 50 to 7,200 milligrams daily, were tested in the morning and in the evening of the same day with the Mini-Mental State examination [1]. Cognitive functioning was positively correlated (+0.49) with dosage, but the relationship was curvilinear. Functioning improved with increasing dose up to a dose of about 2,000 milligrams daily; beyond that dosage (and up to 7,200 milligrams daily) functioning plateaued. Scores on same-day retest were essentially unchanged regardless of dose. The implication of these findings for the management of chronic psychotic patients is discussed.     

Nerve growth factor induces the expression of functional FSH receptors in newly formed follicles of the rat ovary

The neurotrophin nerve growth factor (NGF) and its two membrane-anchored receptors are expressed in the developing ovary before the organization of the first primordial follicles. In the absence of NGF, the growth of primordial follicles is retarded, indicating that NGF contributes to facilitating early follicular development. The present experiments were undertaken to determine whether NGF can also be involved in the differentiation process by which ovarian follicles become responsive to gonadotropins. Treatment of 2-d-old rat ovaries in organ culture with NGF increased FSH receptor (FSHR) mRNA within 8 h of exposure. This effect was cAMP-independent but additive to the cAMP-mediated increase in FSHR gene expression induced by either forskolin or vasoactive intestinal peptide, a neurotransmitter previously shown to induce FSHR formation in neonatal rat ovaries. After NGF treatment, the ovary acquired the capacity of responding to FSH with cAMP formation and preantral follicular growth, indicating that exposure to the neurotrophin resulted in the formation of biologically active FSHRs. Quantitative measurement of FSHR mRNA demonstrated that the content of FSHR mRNA is reduced in the ovaries of mice carrying a null mutation of the NGF gene. These results indicate that one of the functions of NGF in the developing ovary is to facilitate the differentiation process by which early growing follicles become gonadotropin-dependent during postnatal life, and that it does so by increasing the synthesis of FSHRs.     

Colecistectomía laparoscópica en pacientes mayores de 80 años

Introduction

The increasing aging of the population also increases the prevalence of symptomatic gallbladder diseases. It is important to analyse their surgical treatment in the elderly.

Methods

All the laparoscopic cholecystectomies performed in our surgery department on patients aged 80 years-old or over from 1992 to 2007 were included in this study.

Results

Laparoscopic cholecystectomy was performed on 133 patients 80 years-old and over, with 63% of them women, and an average age of 83.23 years. Biliary colic (29%) and acute pancreatitis (44%) were the main reasons for surgery. Associated diseases were found in 73% of them. Only 7.5% needed urgent surgery, even although 71% were admitted urgently. There were 13.5% conversions to open surgery, 17% morbidity and 2.3% mortality.

Conclusions

Laparoscopic cholecystectomy can be recommended in symptomatic gallbladder disease in the elderly.     

EULID Project: European Living Donation and Public Health

The choice of transplantation from a living donor offers advantages over a deceased donor. However, it also carries disadvantages related to donor risks in terms of health and safety. Furthermore, there are several controversial ethical aspects to be taken into account. Several national and international institutions and the scientific community have stated standards that have great influence on professional codes and legislations. Living organ donation and transplantation are to some extent regulated by parliamentary acts in most European countries. It is necessary to take a step forward to develop a legal framework to regulate all of these processes to guarantee the quality and to prevent illegal and nonethical practices. It is also necessary to develop and implement living donor protection practices not only in terms of physical health, but also to minimize potential impacts on the psychological, social, and economic spheres. Finally, an additional effort should be made to create a database model with recommendations for registration practices as part of the standardized follow-up care for the living donor. The European Living Donation (EULID) project's (http://www.eulivingdonor.eu/) main objective was to contribute to a European consensus to set standards and recommendations about legal, ethical, and living donor protection practices to guarantee the health and safety of living donors.