[Ultrasound examination of the liver in HELLP syndrome]

A 33-year-old multiparous woman in the 34th gestational week presented with severe upper abdominal pain, nausea and vomiting. Clinical examination revealed severe epigastric tenderness. Abdominal ultrasound examination showed geographical areas with increased echogenicity in the right lobe of the liver. Through haematological examination, we found severe thrombocytopenia and fibrinolysis. The diagnosis of HELLP syndrome was suspected and a caesarean section was performed. We suggest that obstetrical patients with upper abdominal pain and abnormal liver sonography should immediately be haematologically investigated to exclude the life-threatening condition of the HELLP syndrome.

Synovectomy and radial head excision in rheumatoid arthritis. 11 patients followed for 14 years

A radial head excision and partial synovectomy of the elbow through a lateral approach was performed in 24 patients suffering from rheumatoid arthritis. At follow-up examination of 11 patients (12 elbows) 14 years postoperatively, 10 patients were still satisfied with pain reduction and improved elbow motion. 2 elbows had been reoperated on. Radiographic destruction, assessed by the Larsen index, was, on average, 2.9 preoperatively and 3.8 at follow-up.

Sleep patterns are disturbed in cats infected with feline immunodeficiency virus

Human immunodeficiency virus (HIV)-related sleep disturbances have been reported early in AIDS. Likewise, the feline immunodeficiency virus (FIV), a natural lentivirus pathogen of cats, produces a similar immunodeficiency syndrome with neurological sequelae. To identify the neurophysiological substrate of FIV infection in brain, pathogen-free cats were infected with the Maryland strain of FIV. Eight weeks after inoculation, all FIV-infected cats seroconverted and virus was detected in the cerebrospinal fluid and in the mononuclear cells of peripheral blood. Ten to 12 months after the FIV inoculation, inoculated and control cats were surgically implanted with electrodes to record the sleep/wake cycle. These sleep recordings were obtained under conditions controlling for environmental variables and instrumental adaptation. FIV-infected cats spent 50% more time awake than the sham-inoculated controls and exhibited many more sleep/waking stage shifts--i.e., 40% more than controls. In addition, FIV-infected cats showed approximately 30% of rapid eye movement (REM) sleep reduction compared to controls. The latency to sleep and REM sleep onset was also significantly delayed in FIV-infected cats. In addition, a remarkable increase in cortically recorded spindle activity (8-13 Hz) was observed during slow-wave sleep in some infected subjects, similar to changes described in HIV-infected humans. Moreover, infected cats exhibited no overt signs of systemic morbidity, such as hyperpyrexia or body weight loss. These results indicate that FIV-infected cats exhibit sleep abnormalities similar to the sleep disturbances previously described in AIDS patients and further support the feline preparation as a valuable animal model of HIV infection of the central nervous system.

Intraventricular administration of a FIV-envelope protein induces sleep architecture changes in rats

Fifteen adult male Sprague-Dawley rats were implanted with a set of electrodes for standard sleep recordings. A stainless steel cannula was also implanted into the lateral ventricle of these rats. Fifteen additional rats were implanted with a cannula alone. Rats with electrodes were habituated for 3 days or more to the recording environment, then placed into 3 groups (n = 5). One group received saline (i.c.v.), while the other two groups received either the feline immunodeficiency virus envelope glycoprotein (FIV SU-Env) or a fragment of the Epstein-Barr virus envelope glycoprotein (EB gp105). Rats were then recorded for electrographic sleep-wake cycle evaluation for the following 4 h. Core temperature was assessed through a thermistor probe inserted into the rectum, immediately before and 1, 2, 3 and 4 h after the i.c.v. treatment condition. Results demonstrated that compared to saline, FIV SU-Env increased wakefulness and decreased REM sleep throughout the 4 h of recording. Likewise, FIV SU-Env decreased SWS2 for 2 h. In addition, EB gp105 administration elicited minor modifications of the sleep-wake cycle, causing only a transient reduction of REM sleep in the first hour of recording. None of the treatments altered body temperature. These findings strongly support and extend studies in FIV-infected cats in which we have found similar sleep abnormalities. In addition, these results are consistent with the hypothesis that the FIV SU-Env proteins are responsible for these neurological disturbances.(ABSTRACT TRUNCATED AT 250 WORDS)