Mating-induced analgesia is dependent of copulatory male pattern in high- and low- yawning male rats

Mating behavior in rodents can modulate pain sensations in both sexes. In males, the execution of mounts, intromissions, and ejaculations induced a progressive increase in their vocalization thresholds induced by tail shocks and other types of noxious stimuli. We selectively inbred two sublines from Sprague-Dawley (SD) rats that differed in their spontaneous yawning frequency. The high-yawning (HY) subline had a mean of 20 yawns/h and a different pattern of sexual behavior characterized by longer interintromission intervals and more sexual bouts that delayed ejaculation. The low-yawning (LY) subline and SD rats yawned as a mean 2 and 1 yawns/h, respectively. So, we determine mating-induced analgesia in HY, LY, and SD male rats by measuring vocalization thresholds in response to noxious electric tail shocks. Our results showed that the magnitude of mating-induced analgesia was lower in HY and LY rats with respect to SD rats. When the rats performed different components of male sexual pattern, both sublines exhibited a significantly lower increase in their vocalization thresholds with respect to SD rats-being sublines less responsive regarding mating-induced analgesia. Pain modulation mechanisms depend on responses to stress, so the low levels of analgesia obtained in the yawning sublines may be due either to differences in their response to stress in other paradigms, or to atypical performance of male sexual behavior during mating, an event which as a stressful event in rats. Therefore, the yawning sublines are a suitable model for analyzing how a different temporal pattern in the display of male sexual behavior affects analgesia mechanisms. Our results concur with Wistar rats with different endophenotypes that could apply to humans as well.

Common and differential dimensions of personal identity between psychosis and depression: The relevance of gender and depressive mood

Disturbances in personal identity are recognized in psychosis and depression. However, it is unknown whether these disruptions share common processes across clinical groups, or whether there are unique alterations by group or between men and women within each clinical group. To advance on this question, we compared personal identity dimensions in psychosis and depression and investigated the effects of gender and depressive mood. This study assessed dimensions of personal identity using the repertory grid technique among 85 outpatients with psychosis, 85 outpatients with depressive disorders and 85 healthy controls who were matched by age. Data regarding depressive mood and general functioning was also collected. Results showed that self-discrepancies were higher in psychosis and depression than in controls, and were associated with depressive mood. Interpersonal dichotomous thinking was more prevalent in women in both clinical groups. Women with psychosis showed higher ideal-others discrepancy and had a more complex structure of personal identity than their male counterparts. To conclude, alterations in self-ideal and self-others discrepancies may be transdiagnostic dimensions related to depressive mood. Interpersonal dichotomous thinking may also be a common dimensional characteristic in psychosis and depression but more specific to women. Finally, critical views of others and a higher complexity of personal identity may be more specific to women than men with psychosis. Our results are consistent with other studies pointing to the need for person-focused treatments promoting the recovery of a full sense of personal identity, rather than just focusing on specific thoughts and feelings.

Double blinded, vehicle controlled, crossover study on the efficacy of a topical endocannabinoid membrane transporter inhibitor in atopic Beagles

The endocannabinoid system is important for skin homeostasis and alterations are linked to inflammatory diseases like atopic dermatitis (AD). Importantly, activation of cannabinoid receptor CB2 decreases pruritus and inflammation in mouse models. Reduction of inactivation of endogenous cannabinoids could, therefore, be a therapeutic option for AD. Dogs spontaneously develop AD, which closely mimics the human disease making them suitable to test new therapies. Our study aimed to test the effects of a topical endocannabinoid membrane transporter inhibitor (WOL067-531, 1% gel) on pruritus and dermatitis in a canine model of AD. Nineteen Beagles allergic to dust mites (DM) were randomized to receive either active ingredient or vehicle on inguinal area while challenged epicutaneously with DM twice weekly for 28 days. Treatment was administered twice daily and started after three challenges (day 8). Dermatitis and pruritus were scored weekly by personnel blinded to treatment allocation. Dermatitis was scored using a validated scoring system and pruritus was scored using camera recordings. After a 4-week washout, dogs were crossed over and the study was repeated. On days 15 and 22, dermatitis scores were significantly increased after DM challenge in the vehicle group (16.34, p = 0.0089 and 7.42, p = 0.04845, respectively) but not in the active ingredient group (p = 0.3177 and p = 0.3190, respectively). Significant decrease on pruritus both on inguinal area and overall (p = 0.048 and p = 0.032, respectively) occurred in the active ingredient group. No adverse effects were noted. In conclusion, the newly developed topical endocannabinoid membrane transporter inhibitor (WOL067-531) minimized allergic flares and pruritus in a canine model of AD.

The Neural Signals of the Superior Ovarian Nerve Modulate in an Asymmetric Way the Ovarian Steroidogenic Response to the Vasoactive Intestinal Peptide

The superior ovarian nerve (SON) provides neuropeptide-Y, norepinephrine and vasoactive intestinal peptide (VIP) to the ovaries. Ovarian steroidogenesis is modulated by the SON. In the cyclic rat, the acute steroidogenic response to ovarian microinjection of VIP is asymmetric and varies during the estrous cycle. In the present study, we analyze whether the differential effects of VIP in each ovary are modulated by the neural signals arriving through the SON. Cyclic female rats were submitted on diestrus-1, diestrus-2, proestrus, or estrus to a unilateral section of the SON, and immediately afterward, the denervated ovary was either microinjected or not with VIP. Animals were sacrificed 1 h after treatment. The injection of VIP into the left denervated ovary performed on diestrus-1 decreased progesterone levels in comparison with the left SON sectioning group; similar effects were observed on proestrus when VIP was injected into either of the denervated ovaries. Compared to the left SON sectioning group, VIP treatment into the left denervated ovary on diestrus-2 or proestrus decreased testosterone levels, whereas on diestrus-1, proestrus or estrus, the same treatment resulted in higher estradiol levels. Compared to the right SON sectioning group, VIP injected into the right denervated ovary yielded higher testosterone levels on diestrus-1 and estrus and lower testosterone levels on proestrus. VIP injection into the right denervated ovary increased estradiol levels on diestrus-2 or estrus while decreasing them on proestrus. Our results indicate that in the adult cyclic rat, the set neural signals arriving to the ovaries through the SON asymmetrically modulate the role of VIP on steroid hormone secretion, depending on the endocrine status of the animal. The results also support the hypothesis that the left and right ovary respond differently to the VIPergic stimulus.

Follicular Development and Secretion of Ovarian Hormones during the Juvenile and Adult Reproductive Lives of the Myelin Mutant taiep Rat: An Animal Model of Demyelinating Diseases

Infertility and reproductive problems have been reported in women with several neurological disorders, for example, demyelination. However, the physiology of such problems has remained unknown so far. The taiep rats are an animal neurological model that initially shows a hypomyelination followed by a progressive demyelination of the central nervous system. This animal has reproductive problems, and the aim of this work is to characterize the follicular development, secretion of ovarian hormones, and presence of noradrenaline in the ovaries of the female taiep rats in the juvenile and adult stages. The taiep rats have low body weight (approximately 19% less than that of SD rats), a delay of 4 days in the age of vaginal opening, and an irregularity in the estrous cycle by the absence or prolongation of some estral cycle stage. In the juvenile stage, we observed a decrease of approximately 44% in the total number of follicles with a 15% increase of atresia and an 80% decrease in the fluorescence intensity of catecholamines in the ovaries, with a 21% increment in plasma concentrations of testosterone. In the adult stage, we observed follicular cysts and a 50% decrease in fluorescence intensity of catecholamines in the ovaries, with changes in the secretion of ovarian hormones, an increase of 20 times in progesterone, and a decrement of a half in estradiol. The demyelination in taiep rats affects follicular development and steroidogenesis in the early stages of the animal's life, and this is maintained until adulthood.

Hemi-ovariectomies promote a decrease in the dendritic lengths of CA1 and CA3 neurons: A dimorphic effect of the cerebral hemispheres

Certain structures of the central nervous system (CNS) are morphologically and functionally related to the ovaries. Ovariectomy has been used to study the functional role of the ovaries in the CNS, as well as the role of the CNS on the reproductive system. In the present study, the effects of left and right hemi-ovariectomy on the morphology of pyramidal neurons from the CA1 and CA3 regions of the ventral hippocampus were studied. During the estrus phase, female Long-Evans rats underwent either left and right hemi-ovariectomies or left and right sham surgeries. Three estrous cycles later, the animals were sacrificed, and their brains were processed in Golgi-Cox stain and analyzed by the Sholl method to calculate the dendritic length of the CA1 and CA3 neurons of the left and right hemispheres. The results indicate that the dendritic lengths of the basilar and apical arbors of the CA1 neurons from the left hemisphere were shorter after both left and right hemi-ovariectomy, while the CA1 neurons from the right hemisphere were not affected by either procedure. However, the basilar dendritic arbors of the CA3 neurons from both hemispheres were affected by right hemi-ovariectomy. The spine density only decreased in the apical arbors in the CA3 neurons from the left hemisphere of rats that underwent right hemi-ovariectomy. This study's results indicate that hemi-ovariectomy in adult rats changes in the morphology of the CA1 and CA3 pyramidal neurons in the ventral hippocampus and that there are dimorphic responses between the hemispheres.

Unilaterally blocking the muscarinic receptors in the suprachiasmatic nucleus in proestrus rats prevents pre-ovulatory LH secretion and ovulation

BACKGROUND

The suprachiasmatic nucleus (SCN) and the cholinergic system of various regions of the hypothalamus participate in the regulation of gonadotropin-releasing hormone (GnRH) and gonadotropin secretion, which are necessary for the occurrence of ovulation. In the present study, our goal was to analyse the effects of unilaterally blocking the muscarinic receptors in the SCN on ovulation and steroid secretion.

METHODS

Cyclic rats were randomly allotted to one of the experimental groups. Groups of 8-14 rats were anaesthetized and microinjected with 0.3 μl of saline or a solution of atropine (62.5 ng in 0.3 μl of saline) into the left or right SCN at 09.00 or 19.00 h during diestrus-1 or on the proestrus day. The rats were euthanized on the predicted day of oestrus, and evaluated ovulation and levels of progesterone and oestradiol. Other groups of 10 rats were microinjected with atropine into the left or right SCNs at 09.00 h on the proestrus day, were euthanized eight h later, and luteinizing hormone (LH) was measured.

RESULTS

At 09.00 or 19.00 h during diestrus-1, atropine microinjections into the SCNs on either side did not modify ovulation. The atropine microinjections performed at 09.00 h of proestrus into either side of the SCN blocked ovulation (right SCN: 1/9 ovulated vs. 9/10 in the saline group; left SCN: 8/14 ovulated vs. 10/10 in the saline group). The LH levels at 17.00 h in the rats that were microinjected with atropine at 09.00 h of proestrus were lower than those of the controls. In the non-ovulating atropine-treated rats, the injection of synthetic LH-releasing hormone (LHRH) restored ovulation. Atropine treatment at 19.00 h of proestrus on either side of the SCN did not modify ovulation, while the progesterone and oestradiol levels were lower.

CONCLUSION

Based on the present results, we suggest that the cholinergic neural information arriving on either side of the SCN is necessary for the pre-ovulatory secretion of LH to induce ovulation. Additionally, the regulation of progesterone and oestradiol secretion by the cholinergic innervation of the SCN varies with the time of day, the day of the cycle, and the affected SCN.

In the pubertal rat, the regulation of ovarian function involves the synergic participation of the sensory and sympathetic innervations that arrive at the gonad

BACKGROUND

The present study investigates sectioning the superior ovarian nerve (SON) in rats with functional sensorial denervation induced by capsaicin administration at birth and the effects on the establishment of puberty, ovulation, serum progesterone, and estradiol concentrations.

METHODS

The animals were allotted randomly to one of the following experimental groups. Groups of 8-10 rats were injected at birth with capsaicin or vehicle, and on day 20 or 28 of life, they were submitted to a sham operation (SO). Other groups of 8-10 rats were injected at birth with capsaicin or vehicle, and on day 20 or 28 of life, they were submitted to the uni-or bilateral SON sectioning. The animals were killed at the first estrus. Serum concentration of progesterone (ng/ml) and estradiol (pg/ml) were measured using a radioimmunoassay.

RESULTS

Animals treated with capsaicin and subjected at 20 days of life to the left or bilateral section of SON had a delayed age of vaginal opening. Furthermore, animals with a lack of sensory information and subjected to a SO at 28 days of life had the same delay in the age of vaginal opening. Animals with sensorial innervation intact, subjected to unilateral section of the SON at 20 or 28 days of age, showed diminished ovulation rate and number of ova shed by the denervated ovary. In animals with sensorial denervation, the uni-or bilateral sectioning of the SON did not result in changes in ovulation. Progesterone and estradiol levels were different depending on the age of the animal in which the SON section was performed.

CONCLUSIONS

Based on the present results, we suggest that sympathetic innervation regulates ovulation and the secretion of steroid hormones and that the sensory fibers modulate the sympathetic innervation action on ovarian functions.

Effect of canagliflozin on serum uric acid in patients with type 2 diabetes mellitus

Hyperuricaemia is associated with an increased risk of gout, kidney stones and cardiovascular disease. The present post hoc analysis of pooled data from four placebo-controlled phase III studies assessed the effect of canagliflozin, a sodium-glucose co-transporter 2 inhibitor, on serum uric acid levels in patients with type 2 diabetes mellitus (T2DM) and in a subset of patients with hyperuricaemia [defined as baseline serum uric acid ≥475 µmol/l (∼8 mg/dl)]. At week 26, canagliflozin 100 and 300 mg were associated with a ∼13% reduction in serum uric acid compared with placebo. In the subset of patients with hyperuricaemia, placebo-subtracted percent reductions in serum uric acid were similar to those in the overall cohort. More patients in the hyperuricaemic group achieved a serum uric acid level of <360 µmol/l (∼6 mg/dl) with both canagliflozin 100 mg (23.5%) and 300 mg (32.4%) compared with placebo (3.1%). Incidences of gout and kidney stones were low and similar across groups. In conclusion, canagliflozin treatment decreased serum uric acid in patients with T2DM, including those with baseline hyperuricaemia.

Asymmetric steroidogenic response by the ovaries to the vasoactive intestinal peptide

In vitro the vasoactive intestinal peptide (VIP) stimulates progesterone, androgens, and estradiol secretion, and the effects are time-dependent. The present study analyzed the acute (1 h) and sub-acute (24 h) effects of unilateral injection of VIP into the ovarian bursa on each day of the estrous cycle on progesterone, testosterone, and estradiol serum levels. Cyclic 60-day-old virgin female rats on diestrus-1, diestrus-2, proestrus, or estrus were injected with saline or VIP 10(-6) M into the left or right ovarian bursa. One hour after saline injection on each day of estrus cycle, progesterone levels were higher than in control animals. The acute effects of saline solution on testosterone and estradiol levels were asymmetric and varied during the estrous cycle. In comparison with saline groups, the effects of VIPergic stimulation on progesterone, testosterone, and estradiol serum levels depend on the time elapsed between treatment and autopsy and vary during the estrous cycle. An acute asymmetric response from the ovaries to the VIP was observed at diestrus-1, diestrus-2, and proestrus on progesterone and estradiol levels. The asymmetries on testosterone levels were observed at diestrus-1, diestrus-2, and estrus days. The present results suggest that in the cyclic rat, each ovary has different sensitivities to VIPergic stimulation which depends on the endocrine status of the animal.

The effects of sensorial denervation on the ovarian function, by the local administration of capsaicin, depend on the day of the oestrous cycle when the treatment was performed

There is evidence that sensory innervation plays a role in the regulation of puberty. The present study investigates the effects of functional sensorial desensitisation induced by capsaicin administration to adult female rats in the days of diestrus 1, diestrus 2, pro-oestrus or oestrus on ovulation and serum oestradiol and progesterone concentration. The animals were allotted at random to one of the following groups: (1) animals with capsaicin administration into the bursa ovarica (local administration) (2) animals with vehicle administration into the bursa ovarica and (3) untreated animals group. The animals treated were killed on the day of oestrus after three consecutive 4-day oestrous cycles. No differences were observed in oestrous cyclicity or the average number of ova shed between the sensorial desensitisation animals and the vehicle-treated groups. Capsaicin administration resulted in a significant increase in the intra-ovarian noradrenaline levels in the day of diestrus 2 and pro-oestrus. Serum oestradiol and progesterone concentrations were different, depending on the day of the oestrous cycle in which the treatment was performed. These results suggest that in adult normal female rats, ovarian sensorial innervations participate together with the sympathetic innervation in the ovarian function regulating the hormone secretion and this participation varies along the oestrous cycle.

Lack of sensorial innervation in the newborn female rats affects the activity of hypothalamic monoaminergic system and steroid hormone secretion during puberty

There is evidence that sensory innervation plays a role regulating ovarian functions, including fertility.Since sensory denervation by means of capsaicin in newborn female rats results in a lower response togonadotropins, the present study analyzed the effects that sensory denervation by means of capsaicin in neonatal rats has on the concentration of monoamines in the anterior(AH) and medium (MH) hypothalamus, and on steroid hormone levels in serum. Groups of newborn female rats were injected subcutaneously with capsaicin and killed at 10, 20, and 30 days of age and on the first vaginal estrous.The concentrations of noradrenaline, dopamine, serotonin(5-HT), and their metabolites in the AH and MH were measured using HPLC, and the levels of estradiol (E),progesterone (P), testosterone (T), FSH, and luteinizing hormone using radioimmunoanalysis. The results show thatat 20 days of age, capsaicin-treated rats have lowernoradrenergic and serotonergic activities in the AH, and that the dopaminergic activity was lower in the MH. These results suggest that the sensorial system connections within the monoaminergic systems of the AH and MH are different.Capsaicin-treated animals had lower T, E, and P levels than in the control group, suggesting that the lower activity in the AH monoaminergic system and lower hormonesecretion could be explained by the blockade of information mediated by the sensory innervation (probably substance P), mainly between the ovary and the AH.

Effects on steroid hormones secretion resulting from the acute stimulation of sectioning the superior ovarian nerve to pre-pubertal rats

In the adult rat, neural signals arriving to the ovary via the superior ovarian nerve (SON) modulate progesterone (P4), testosterone (T) and estradiol (E2) secretion. The aims of the present study were to analyze if the SON in the pre-pubertal rat also modulates ovarian hormone secretion and the release of follicle stimulating hormone (FSH) and luteinizing (LH) hormone. P4, T, E2, FSH and LH serum levels were measured 30 or 60 minutes after sectioning the SON of pre-pubertal female rats. Our results indicate that the effects on hormone levels resulting from unilaterally or bilaterally sectioning the SON depends on the analyzed hormone, and the time lapse between surgery and autopsy, and that the treatment yielded asymmetric results. The results also suggest that in the pre-pubertal rat the neural signals arriving to the ovaries via the SON regulate the enzymes participating in P4, T and E2 synthesis in a non-parallel way, indicating that the mechanisms regulating the synthesis of each hormone are not regulated by the same signals. Also, that the changes in the steroids hormones are not explained exclusively by the modifications in gonadotropins secretion. The observed differences in hormone levels between rats sacrificed 30 and 60 min after surgery reflect the onset of the compensatory systems regulating hormones secretion.

Effects of acute unilateral ovariectomy to pre-pubertal rats on steroid hormones secretion and compensatory ovarian responses

In the present study we analyzed the existence of asymmetry in the secretion of steroid hormones in pre-pubertal female rats treated with unilateral ovariectomy (ULO) or unilateral perforation of the abdominal wall (sham-surgery). Treated rats were sacrificed at different times after surgery. Since sham-surgery had an apparent effect on the age of first vaginal estrous (FVE) and serum levels hormone, the results of the sham surgery groups were used to assess the effects of their respective surgery treatment groups. On the day of FVE, compensatory ovulation (CO) and compensatory ovarian hypertrophy (COH) were similar in animals with ULO, regardless of the ovary remaining in situ. In ULO treated animals, progesterone (P4) levels were higher than in animals with sham-surgery one hour after treatment but lower in rats sacrificed at FEV. Left-ULO resulted in lower testosterone (T) concentration 48 and 72 hours after surgery. In rats with Right-ULO lower T concentrations were observed in rats sacrificed one or 72 hours after surgery, and at FVE. ULO (left or right) resulted in lower estradiol (E2) concentrations one or 72 hours after treatment. In rats with Left-ULO, E2 levels were higher 48 hours after surgery and at FVE. Left-ULO resulted in higher levels of follicle stimulating hormone (FSH) five hours after surgery and at FVE. FSH levels were higher in rats with Right-ULO sacrificed on FVE. The present results suggest that in the pre-pubertal rat both ovaries have similar capacities to secrete P4, and that the right ovary has a higher capacity to secrete E2. Taken together, the present results support the idea that the effects of ULO result from the decrease in glandular tissue and changes in the neural information arising from the ovary.

[Cholecystolithotomy: first middle-long term results of our series]

Cholelithiasis in children is an infrequent disease whose incidence has increased over the last few decades. It has its own typical characteristics, different from those present in adults. Laparoscopic cholecystectomy has become the treatment of choice for symptomatic cases, still its connection with right-sided colon cancer and other diseases associated with the procedure has led to recommend it with some reservation. Though several authors adopted cholecystotomy as a therapeutic option in recent years, its use remains controversial. Our indication criteria for this technique are presented herewith, as well as long- and medium-term results (mean follow-up of 10 years) of our series, previously reported in 2003, and a new case added later in 2006.

MATERIALS AND METHODS

Since 2003, a prospective study of 15 patients from our previous series and a new patient added afterwards is being carried out, including: 1) Medical history checking for symptoms connected with biliary conditions. 2) DIAGNOSTIC TESTS: laboratory tests and ultrasonography.

RESULTS

Out of our 16 patients: A girl relapsed a few months later and underwent cholecystectomy, but whether it was a true relapse or a missed gallstone was not established. A patient with a history of recurrent abdominal pain has shown no improvement in his symptoms even though his tests are normal. Two patients have been lost for our study, but showed normal tests for 5 and 7 years respectively. Our 11 remaining patients show no symptoms as well as normal laboratory and imaging tests. A new patient joined our study in 2006, showing normal tests to date and no postsurgical complications.

CONCLUSIONS

Based on our experience, cholecystotomy has proved to be a complication-free, safe and easy procedure with a virtually nonexistent relapse rate in the long and medium term for patients in the pediatric age group presenting with single or double cholelithiasis, unchanged for 1-2 years with no size increase, no apparent etiology, no complications and a normal bile duct.

Cognitive-behavioral therapy for chronic psychosis

Cognitive-behavioral therapy (CBT) has been used in recent years as an intervention for chronic psychoses, generally as a complement to the pharmacological treatment. This fact has motivated controlled studies that analyze the efficiency of this type of interventions. That is why this bibliographical review has aimed to analyze the most relevant studies up-to-date. Those works having a controlled and random design, that assured the requirements of reliability and validity, were included. The studies show encouraging results, because they support the efficiency of CBT as a measurement of treatment. Nevertheless, more investigations that support this information are still required.

Trombosis venosa cerebral neonatal. Diagnóstico por angiorresonancia magnética

Neonatal cerebral venous thrombosis (NCVT) is a rare, severe neuropathology of multiple etiology and variable clinical presentation. We describe the case of a 25-day-old infant that presented with a tonic convulsion. Ultrasound examination showed tetraventricular hemorrhage. Magnetic resonance imaging (MRI) showed the presence of acute thrombosis of the deep and superficial venous systems associated to a hemorrhagic infarct of the left thalamus. Coagulation study revealed a deficit of protein C. Thrombosis of deep cerebral veins must be ruled out as a cause of a neonatal convulsive crisis. The presence of a hemorrhagic thalamic lesion supports the diagnosis of NCVT, which must in turn be confirmed by magnetic resonance angiography (MRA).

Effects of capsaicin treatment on the regulation of ovarian compensatory hypertrophy and compensatory ovulation

The present study investigates the effects of functional sensorial denervation, induced by administering capsaicin to hemiovariectomized adult female rats in each day of the estrus cycle, on ovulation and serum concentrations of estrogen and progesterone. The results indicate that the establishment of compensatory ovarian hypertrophy (COH) and compensatory ovulation (CO) depends on both the day of the estrous cycle when sensorial denervation was performed and on which ovary was extirpated. These results support the now accepted notion that the response of the ovaries to denervation is asymmetrical. The results seem to suggest that this asymmetric response is mediated by some specific neu-ral information that is registered in the ovary and sent to the CNS, that such information plays a role modulating the reactivity of the ovarian compartments to gonadotropins, and that the frequency of this signal varies along the estrus cycle.

Adhesive small bowel obstruction: predictive value of oral contrast administration on the need for surgery

INTRODUCTION

adhesive small bowel obstruction (SBO) is a common cause of hospital admission. Nonoperative management is initially recommended unless there is suspicion of strangulation, but its optimal duration is controversial. The aims of our study was to evaluate the usefulness of radiographic small bowel examination with contrast medium to predict the need for surgery in SBO.

MATERIAL AND METHODS

this prospective study carried out from January 1999 to December 2001, included 100 patients with clinical and radiological criteria of adhesive SBO. We described the past medical history, as well as clinical picture, blood tests and radiological findings in these patients. Fifty cubic centimeters of 5% barium suspension were given orally, and plain abdominal radiographs were taken at 4, 8, 16, and 24 hours afterwards. A liquid diet was given as soon as the contrast medium appeared in the right colon. Otherwise, surgical intervention was considered based on the outcome of the patient and the criteria of the emergency surgical team.

RESULTS

in 70 patients, barium contrast appeared in the right colon, and a liquid diet was tolerated by 69 of them (98.6%). Mean hospitalization time for this group was 43 +/- 17 hours. In the remaining 30 patients, no evidence of barium contrast in the right colon was seen, and 25 of them underwent surgery (75%), while the other 5 tolerated a liquid diet. Mean hospitalization time for this second group of patients was 13.8 +/- 11 days. Sensitivity, specificity, positive predictive value, and negative predictive value for the absence of contrast medium in the right colon within 24 hours as a predictor of surgery were 93, 96, 98 and 83%, respectively. There was a statistical significant relationship (p < 0.01) between the "Presence of contrast medium in the right colon" and "Oral diet tolerance". Only the variable "Number of previous surgical interventions" tended to reach statistical significance (p = 0.07). Tolerance of liquid diet was more likely when patients had more than one previous abdominal surgery.

CONCLUSIONS

early oral administration of a radiological contrast medium in patients with adhesive SBO can effectively predict the need for a surgical procedure. It can shorten not only hospital stay, but also the potential morbidity of late surgery, secondary to a prolonged and unsuccessful nonoperative treatment.

The effects of superior ovarian nerve sectioning on ovulation in the guinea pig

The effects on spontaneous ovulation associated with the unilateral or bilateral sectioning of the superior ovarian nerves (SON) were analyzed in guinea pigs at different time intervals of the estrous cycle. Day 1 of the estrous cycle was defined as the day when the animal presents complete loss of the vaginal membrane (open vagina). Subsequent phases of the cycle were determined by counting the days after Day 1. All animals were autopsied on the fifth day of the estrous cycle after surgery. Sectioning the right, left, or both SONs on day 5 (early luteal phase) resulted in a significant increase in the number of fresh corpora lutea. Ovulation increased significantly when the left SON (L-SON) was sectioned during late follicular phase (day 1) and medium luteal phase (day 8). When surgery was performed on days 1 or 8, neither sectioning the right SON (R-SON) nor sectioning the SON bilaterally had an apparent effect on ovulation rates. Similarly, ovulation rates were not affected when unilateral (right or left) or bilateral sectioning of the SON was performed during late luteal phase two (day 12). Unilateral or bilateral sectioning of the SON performed during the early luteal phase (day 5) was associated with a significant decrease in uterine weight. A comparable effect was observed when the L-SON was sectioned during late follicular phase (day 1), or medium luteal phase (day 8). No effects on uterine weight were observed when unilateral or bilateral sectioning of the SON was performed during late luteal phase. Our results suggest that in the guinea pig the SON modulates ovulation, and that the degree of modulation varies along the estrous cycle. The strongest influence of the SONs on ovulation occurs during early luteal phase, and decrease thereafter, being absent by late luteal phase. In addition, sectioning the left or the right SON caused different responses by the ovaries of adult guinea pigs. This paper discusses the mechanisms by which ovulation increased when the SON was surgically cut.

Effects of functional peripheral sympathetic denervation induced by guanethidine on follicular development and ovulation of the adult female guinea pig

The present study investigates the effects of functional sympathetic peripheral denervation induced by guanethidine sulphate (GTD) to adult female guinea pigs in the follicular (FPh) or luteal phases (LPh) on their oestrous cyclicity and ovulation. No differences were observed in oestrous cyclicity or the average number of corpora lutea present in the ovaries between the control and denervated animals. Guanethidine sulphate administration resulted in a significant decrease in ovarian norepinephrine content, higher for the left ovary than for the right one. Serum oestrogen and progesterone concentrations, the mean of follicles, and its diameter were different, depending on the oestral cycle in which the treatment was performed. These results suggest that in adult normal female guinea pigs, ovarian innervation participates in the regulation of follicular development in an inhibitory way.

[Intrathecal perfusion pump with baclofen in generalized dystonia]

OBJECTIVES

We show the effectiveness of treatment with continuous intrathecal baclofen infusion in a case of hereditary generalized dystonia refractory to anticholinergics, tetrabenazine, pimozide, L-dopa, benzodiazepines and thalamotomy.

CLINICAL CASE

A 26 years old female patient, when she was 11 years old began with torsion dystonia in her left feet, that progressively worsened to involve her entire body. She had painful spasms. She had four brothers, three of them with dystonia and one healthy. Her uncle grandfather had similar symptoms. Complementary explorations to reject secondary origin was negatives. She was treated with high and progressive dosages of anticholinergics, pimozide, tetrabenazine, benzodiazepines, L-dopa and thalamotomy without improvement. Underwent intrathecal baclofen test dosing, we used 25, 50, 100 micrograms/day, the last one with improvement during 10 hours. A pump was inserted with an initial dose of 220 micrograms/day. After pump insertion, baclofen dosage was gradually increased to 450 micrograms/day. She had a great improvement in right part of her body and less in her left body. Painful spasms had disappeared.

CONCLUSION

We propose continuous baclofen intrathecal infusion pump for patients with severe torsion dystonia that not response to ordinal treatment.

[Chemical composition and digestibility of the protein of 20 ecotypes of Pijiguao (Bactris gassipaes) of the Venezuelan Amazon]

Precooked flour (80 degrees C x 3 hours) from the pulp of 20 ecotypes of Pijiguao cultivated in the Amazon area of Venezuela and dried at 80 degrees C for 3 hours was manufactured for the purpose of developing an alternative method of conservation of the fruit for human consumption and for the purpose of contributing to the study of the germoplasm through the assessment of its chemical characterization by applying the AOAC methods. The results showed a wide statistical variability (p < 0.05) among the ecotypes in relation to the fat content (5.13%-17.30%), protein content (5.00%-8.30%), starch content (29.13%-56.40%), and dietetic fiber content (8.10%-21.00%). Likewise, significant differences in the carotenoid content (3.46-40.06 mg/100 g) and the vitamin C content (6.60 to 51.60 mg/100 g) were also detected. The digestibility "in vitro" of the protein was high (88.10%-91.90%). In addition color was analyzed in a tristimulus color meter and the data varied between L = 65.07 to 81.84; a = 0.18 to 13.96 y b = 18.30 to 38.82. Orange, yellow, and beige were observed Pijiguao precooked flour is a potential source of dietetic carotenoids, vitamin C, fat, and starch.

Evaluation of institutional cancer registries in Colombia

The four primary objectives of this descriptive study were to: 1) design a quality-measurement instrument for institutional cancer registries (ICRs), 2) evaluate the existing ICRs in Colombia with the designed instrument, 3) categorize the different registries according to their quality and prioritize efforts that will efficiently promote better registries with the limited resources available, and 4) determine the institution with the greatest likelihood of successfully establishing Colombia's second population-based cancer registry. In 1990 the National Cancer Institute of Colombia developed 13 institution-based cancer registries in different Colombian cities in order to promote the collection of data from a large group of cancer diagnostic and treatment centers. During the first half of 1997, this evaluation reviewed 12 registries; one of the original 13 no longer existed. All of the Colombian institutions (hospitals) that maintain institution-based cancer registries were included in the study. At each institution, a brief survey was administered to the hospital director, the registry coordinator, and the registrar (data manager). Researchers investigated the institutions by looking at six domains that are in standard use internationally. Within each domain, questions were developed and selected through the Delphi method. Each domain and each question were assigned weights through a consensus process. In most cases, two interviewers went to each site to collect the information. The university hospitals in Cali, Pereira, and Medellín had substantially higher scores, reflecting a good level of performance. Four of the 12 institutions had almost no cancer registry work going on. Five of the 12 hospital directors considered that the information provided by the cancer registries influenced their administrative decisions. Three of the registries had patient survival data. Four of the institutions allocated specific resources to operate their cancer registries; in the other 8 hospitals there was no clear budget allocation. Seven of the hospital directors could not identify five or more objectives of a cancer registry. Data management was usually poor and resources insufficient at most of the institutions. In summary, the cancer registry system in Colombia varies greatly from institution to institution. A few of the hospitals do a good job while others have neglected the registries. The high, identical total scores for Pereira and Medellín suggest they would be good locations to establish new population-based cancer registries similar to the existing one in Cali. However, the overall characteristics in Pereira may provide a more appropriate environment for the second registry, with Medellín as an alternative.

[Sotos syndrome associated with focal dystonia]

INTRODUCTION

Sotos syndrome is a form of infantile gigantism characterized by excessive body size from the time of birth, particular facies, acromegalic changes and signs of non-progressive cerebral involvement. The etiology is unknown. Diagnosis is based on somatometric data and the particular phenotype traits. Biochemical and endocrine studies are normal. Torticollis is a focal dystonia and therefore more common in adults.

CLINICAL CASE

A 20 year old woman with macrosomic features since birth presented with: weight 104 kg, height 182 cm; prognathism, hypertelorism, a broad over hanging forehead with a high hair line; large ears, hands and feet; torticollis towards the right with elevation and anteroversion of the right shoulder which caused symptomatic scoliosis. She was bradypsychic and rather slow in speech. The complementary tests done (cerebral and cervical CT and MR, bone gammography, evoked potentials, EMG-ENG, sural nerve biopsy, biopsy of skin and muscle, EEG and hormone and biochemistry studies) were normal. The torticollis was treated with botulinus toxin and improved considerably, as did the scoliosis.

CONCLUSIONS

To date, dystonia has not been described in association with Sotos syndrome. This may be a causal association, or even perhaps hereditary, since the patient's mother had dystonia (in the form of blepharospasm).

Fine needle aspiration of thyroid nodules in a rural setting

PURPOSE

The purpose of this study was to evaluate the applicability of fine needle aspiration biopsy (FNAB) of thyroid nodules in rural practices with smaller patient numbers, to assess the effect of these numbers on the results, and to establish the level of accuracy of the procedure in this setting.

PATIENTS AND METHODS

We retrieved all thyroid FNAB reports identified as being performed by a single practitioner in a referral endocrine practice in Rapid City, South Dakota, between September 30, 1987, and September 30, 1991. Biopsy results are separated by year to establish correlations with the number of biopsies and outcomes. Follow-up pathology reports were obtained for all patients known to have undergone surgery.

RESULTS

A total of 189 FNABs in 165 patients were available for review from a 4-year period. The number of FNABs increased progressively from 28 per year to 65 per year during the 4-year course of the study. The incidence of inadequate specimens decreased inversely from 18% to 6% with the increase in the number of FNABs. The percentage of surgical interventions in which malignancy was found increased from 23% to 50% over the same period. Analysis of the results suggests that accuracy and specificity are comparable to results from larger centers.

CONCLUSIONS

FNAB of thyroid nodules can substantially reduce surgical intervention and increase the yield of malignancy without excessive loss of accuracy even in rural areas with small numbers of patients. Improved results as the number of biopsies increased to 50 or more per year suggest benefits from concentrating biopsies with as few operators as practical.

Candida arthritis in adult patients who are not intravenous drug addicts: report of three cases and review of the literature

Candida species are an uncommon cause of infectious arthritis, although the frequency has increased during recent years. Three cases of septic arthritis caused by Candida species are reported, and the literature is reviewed. The first patient developed a popliteal cyst infected by Candida albicans after multiple intravenous antibiotic treatments. The second patient had acute myelogenous leukemia and experienced knee arthritis after chemotherapy, and the third suffered oligoarthritis after a second heart transplantation. All patients received treatment with a standard dose of intravenous amphotericin B. Responses were achieved only in the first two cases; the third patient died despite therapy. Thirty-six previously reported Candida arthritis cases are reviewed, and epidemiologic, diagnostic, therapeutic, and prognostic features are analyzed. Cases are divided into two categories: direct inoculation of fungus and hematogenously disseminated disease; these two categories are compared in terms of sex, age, pathogen species, treatment, and survival. Arthritis induced through direct inoculation of fungus is seen in older individuals, is more frequently produced by species other than C albicans (Candida parapsilosis especially), and has a better prognosis than arthritis caused by disseminated candidiasis. Arthritis can be resolved even in the persistence of the systemic disease. It is believed that the first case of Baker's cyst infected by C albicans and the first case of Candida arthritis in a heart transplant patient are reported here.

Floor/shoe slip resistance measurement

A variety of slip measurement devices exist that provide estimates of both static and dynamic coefficient-of-friction (COF) values between one's shoes and the floor. Unfortunately, different shoe sole/heel materials, floor conditions, and contaminants will affect the tests in ways that result in widely varying COF estimates. This paper reviews the basic physics of such tests and describes a set of experiments to determine the static and dynamic COF values under operating conditions known to exist in different jobs. The results define a set of conditions wherein low (hazardous) COF values would exist (e.g., hard Neolite shoe material in contact with a wet, smooth walking surface). The results also question the use of light-load testing devices and static and slow speed reference COF values in the literature.

Selective expansion of T cells bearing the gamma/delta receptor and expressing an unusual repertoire in the synovial membrane of patients with rheumatoid arthritis

In a study of 7 patients with rheumatoid arthritis (RA), we characterized the T cell population present in the synovial membrane, thought to be the location where T cells trigger the disease. Synovial membrane lymphocytes from the RA patients were found to have a selective expansion of gamma/delta T cells (8.8% in synovial membrane versus 4% in peripheral blood). Expansion of the gamma/delta T cell subset was not found in the synovial membrane of patients with osteoarthritis. We characterized the gamma/delta T cell repertoire using monoclonal antibodies Ti gamma A, BB3, and delta TCS1, which recognize the gene products encoded by V gamma 9, V delta 2, and V delta 1-J delta 1, respectively. The majority of the synovial gamma/delta T cells did not express the repertoire encoded by these genes, which is found in nearly 100% of the peripheral blood gamma/delta T cells of healthy volunteer donors and in the thymus at early stages of development. We conclude that the synovial membrane of patients with RA displays a selective expansion of a specific population of gamma/delta T cells expressing a clonotypic receptor not yet serologically defined, which might be implicated in the development of the disease.

Enterotoxins and adhesins of enterotoxigenic Escherichia coli: are they risk factors for acute diarrhea in the community?

A cohort of 228 Mexican children less than 5 years old was followed during the enterotoxigenic Escherichia coli(ETEC) season. The incidence of ETEC diarrhea-associated and asymptomatic infections was determined, and E. coli strains isolated from stool samples were tested for heat-labile and heat-stable toxins and for expression of colonization factor antigens (CFA). Of the children, 61% had at least one ETEC infection. Children with ETEC isolated from stools were more likely to have diarrhea than were ETEC-free age-matched control children (odds ratio [OR] = 4.5; 95% confidence interval [CI] = 2.9-7.0). Strains carrying CFA/IV, CFA/I, or CFA/II were found in 23%, 18%, and 5% of ETEC infections, respectively. The risk of having diarrhea associated with a CFA-expressing versus a CFA-negative ETEC strain was the same (age-adjusted OR = 0.8; 95% CI = 0.4-1.6). These data should be considered in the development of a diarrhea vaccine containing only CFAs.

Salt-sensitive blood pressure and exaggerated vascular reactivity in the hypertension of diabetes mellitus

PURPOSE

This study evaluates the effects of dietary salt restriction and loading on blood pressure in normotensive and hypertensive patients with non-insulin-dependent diabetes mellitus (NIDDM). Salt sensitivity of blood pressure responses is compared to vascular reactivity to infused angiotensin II on the two sodium diets.

PATIENTS AND METHODS

We studied 19 patients with NIDDM (seven normotensive, 12 hypertensive) and seven nondiabetic control subjects under metabolic balance after 6 days on a constant low- (20 mEq) sodium diet and again after 6 days on a high- (250 mEq) sodium diet. Salt sensitivity of blood pressure was determined by the increment in integrated 24-hour blood pressure values on changing from the low- to the high-sodium diet. Blood pressure and plasma aldosterone responses to a graded-dose infusion of angiotensin II were also examined on both sodium diets.

RESULTS

Eight of 12 hypertensive patients with NIDDM displayed salt-sensitive blood pressure responses, whereas none of the normotensive patients with NIDDM or control subjects were salt-sensitive. Patients with NIDDM also had augmented blood pressure responses to infused angiotensin II on both sodium diets when compared to control subjects. Whereas controls had reduced vascular responses to angiotensin II on the low-sodium diet, these responses were not decreased in patients with NIDDM. Patients with NIDDM also retained more sodium on the high-sodium diet than did the control subjects.

CONCLUSION

Hypertension in patients with NIDDM is frequently salt-sensitive, which may be due to sodium retention and enhanced vascular reactivity to angiotensin II. Since sodium restriction does not normally reduce vascular reactivity to angiotensin II in NIDDM, salt-restricted diets may be less effective in blood pressure control in hypertensive NIDDM.