The 16α-hydroxylated Bile Acid, Pythocholic Acid Decreases Food Intake and Increases Oleoylethanolamide in Male Mice

Modulation of bile acid (BA) structure is a potential strategy for obesity and metabolic disease treatment. BAs act not only as signaling molecules involved in energy expenditure and glucose homeostasis, but also as regulators of food intake. The structure of BAs, particularly the position of the hydroxyl groups of BAs, impacts food intake partly by intestinal effects: (1) modulating the activity of N-acyl phosphatidylethanolamine phospholipase D, which produces the anorexigenic bioactive lipid oleoylethanolamide (OEA) or (2) regulating lipid absorption and the gastric emptying-satiation pathway. We hypothesized that 16α-hydroxylated BAs uniquely regulate food intake because of the long intermeal intervals in snake species in which these BAs are abundant. However, the effects of 16α-hydroxylated BAs in mammals are completely unknown because they are not naturally found in mammals. To test the effect of 16α-hydroxylated BAs on food intake, we isolated the 16α-hydroxylated BA pythocholic acid from ball pythons (Python regius). Pythocholic acid or deoxycholic acid (DCA) was given by oral gavage in mice. DCA is known to increase N-acyl phosphatidylethanolamine phospholipase D activity better than other mammalian BAs. We evaluated food intake, OEA levels, and gastric emptying in mice. We successfully isolated pythocholic acid from ball pythons for experimental use. Pythocholic acid treatment significantly decreased food intake in comparison to DCA treatment, and this was associated with increased jejunal OEA, but resulted in no change in gastric emptying or lipid absorption. The exogenous BA pythocholic acid is a novel regulator of food intake and the satiety signal for OEA in the mouse intestine.

Cortical inhibition on TMS-EEG: interstimulus interval effect on short-interval paired-pulse

In mental disorders, paired-pulse (PP) transcranial magnetic stimulation and electroencephalography (TMS-EEG) recordings usage is increasing to directly evaluate the cortical inhibition of motor and nonmotor regions. One of the most common measures to assess the inhibition is the short-interval cortical inhibition (SICI), which depends on the interstimulus interval (ISI). This measure has been widely used in the motor cortex. However, the number of studies that evaluate other nonmotor regions, such as the dorsolateral prefrontal cortex (DLPFC), are increasing and there is still little knowledge on how the ISI affects those areas.In this pilot study, six subjects underwent a SICI protocol over the DLPFC using ISI values of 2 and 4ms with the aim of comparing them. TMS-EEG signals for both ISIs were characterized regarding the amplitude and latency of the TMS-evoked potentials (TEP) P60 and N100. Whereas the variation of cortical inhibition between ISIs is almost significant for N100, with higher inhibition for an ISI of 2ms, for TEP P60 the variation was not appreciable. Findings are in accordance with the ones in the state-of-the-art obtained in the motor cortex and suggest that a greater inhibition is likely to be produced with an ISI of 2ms.Clinical relevance- This pilot study indicates that cortical inhibition might be better assessed when DLPFC is stimulated with an ISI of 2ms in the SICI protocol.

A41 FONTAN ASSOCIATED LIVER DISEASE: THE ROLE OF TRANSIENT ELASTOGRAPHY IN CHILDREN AND ADOLESCENTS

Background

Non-invasive assessment of Fontan Associated Liver Disease (FALD) is of interest, but studies have yielded inconsistent results about the correlation of severity of disease with laboratory values and imaging. Transient elastography (TE) is a non-invasive imaging modality used commonly for liver stiffness measurement (LSM) and in Fontan patients it is hypothesized to reflect not only liver fibrosis but also venous congestion.

Purpose

To better define the potential role of TE for non-invasive assessment of the severity of FALD.

Method

This was a retrospective study conducted on patients’ medical records at CHU Sainte-Justine Hospital. Patients less than 18 years of age with FALD who had at undergone at least one LSM by TE between 1998-2021 were included. The relationship between LSM and liver function tests, hepatic ultrasound findings (including a cirrhosis score), cardiac catheterization results and histological fibrosis scores were analyzed. The impact of interventions during cardiac catherization on LSM were also studied.

Result(s)

A total of 54 patients (36 boys and 18 girls) with FALD were studied. Median age at Fontan surgery was 4.6 years (IQR 4.0 ─ 5.4 years). Higher LSM values significantly correlated with longer time from Fontan, higher total and direct bilirubin and GGT levels, higher INR, longer APTT, lower Factor V, and lower absolute lymphocyte count. Greater LSM was also significantly associated with the presence of heterogenous parenchymal echogenicity, irregular liver contours and greater ultrasonographic cirrhosis scores. Higher TE values were significantly correlated with higher wedged hepatic venous pressure and Fontan pressure. After catherization interventions that addressed stenoses, there was a statistically significant reduction in mean LSM (24.9±3.63 kPa vs 15.8±4.6 kPa, p=0.005). After closure of significant pulmonary collaterals, mean LSM tended to increase, but this difference did not reach statistical significance (19.1±1.9 kPa vs 24.6±3.5 kPa, p=0.2). At liver biopsy, significant direct correlation was found between LSM and the grade of sinusoidal fibrosis and LSM. TE with values >20 kPa were found to have higher grades of sinusoidal fibrosis, while values <20kPa had higher grades of sinusoidal dilatation.

Conclusion(s)

This study showed that TE allows to identify patients with higher cholestatic parameters, more severe liver fibrosis at biopsy and sonographic signs suggestive of cirrhosis. Moreover, it confirmed that liver congestion significantly contributes to LSM values. Interestingly, catheter interventions addressing pulmonary stenoses led to the improvement of TE measurements, giving hope for the reduction of hepatic venous congestion in these patients, which might have an effect on their FALD. Finally, the LSM threshold of 20 kPa could be useful clinically as a value above which fibrosis is likely to be significant, while if below could indicate a greater contribution from hepatic congestion.

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Chronic obstructive pulmonary disease in severe mental illness: A timely diagnosis to advance the process of quitting smoking

Background

This study has two main objectives: to describe the prevalence of undetected chronic obstructive pulmonary disease (COPD) in a clinical sample of smokers with severe mental illness (SMI), and to assess the value of the Tobacco Intensive Motivational Estimated Risk tool, which informs smokers of their respiratory risk and uses brief text messages to reinforce intervention.

Method

A multicenter, randomized, open-label, and active-controlled clinical trial, with a 12-month follow-up. Outpatients with schizophrenia (SZ) and bipolar disorder were randomized either to the experimental group—studied by spirometry and informed of their calculated lung age and degree of obstruction (if any)—or to the active control group, who followed the 5 A’s intervention.

Results

The study sample consisted of 160 patients (71.9% SZ), 78.1% of whom completed the 12-month follow-up. Of the patients who completed the spirometry test, 23.9% showed evidence of COPD (77.8% in moderate or severe stages). TIMER was associated with a significant reduction in tobacco use at week 12 and in the long term, 21.9% of patients reduced consumption and 14.6% at least halved it. At week 48, six patients (7.3%) allocated to the experimental group achieved the seven-day smoking abstinence confirmed by CO (primary outcome in terms of efficacy), compared to three (3.8%) in the control group.

Conclusion

In this clinical pilot trial, one in four outpatients with an SMI who smoked had undiagnosed COPD. An intensive intervention tool favors the early detection of COPD and maintains its efficacy to quit smoking, compared with the standard 5 A’s intervention.

[Peri-ictal electrocardiographic alterations in paediatric epilepsy patients. A prospective study]

INTRODUCTION

Epileptic seizures can be associated with peri-ictal heart rhythm disorders and even sudden death (SUDEP). Few paediatric studies have been conducted on the subject.

AIM

To determine heart rhythm disorders in paediatric patients with epilepsy who were studied with video-electroencephalogram (video-EEG).

METHODS

Prospective, observational study in patients under 18 years of age admitted for video-EEG at the Hospital Clinico Red de Salud UC-Christus, Santiago, Chile. A neurological and cardiological evaluation and electrocardiogram (ECG) were performed, in addition to a Holter ECG simultaneously with the video-EEG.

RESULTS

Twenty-five patients were studied, 12 with refractory epilepsies, 23/25 focal and 20 on polytherapy. Altogether 768 hours of video-EEG were recorded, including 281 seizures in 15 patients: 157 clinical and 103 generalised. There were no serious arrhythmias, only non-specific or probably benign disorders, mainly incomplete right bundle branch block in 11 patients, which were more frequent in refractory epilepsies (p<0.036). Heart rate variation occurred mainly in seizures >30 seconds. No patient presented SUDEP.

CONCLUSIONS

This is the first prospective study, with a new technique, using video-EEG and Holter ECG simultaneously in paediatrics. Despite the high number of seizures and refractory patients, we found no serious heart rhythm disorders, consistent with the clinical evaluation. Right bundle branch block is considered a non-pathological cardiological finding, but was highly prevalent in our sample compared to the normal population, especially in refractory epilepsy. Given that this is a serious event in epilepsy, it is important to further investigate such studies to assess preventive measures.

Dorsolateral prefrontal N-acetyl-aspartate concentration in male patients with chronic schizophrenia and with chronic bipolar disorder

Objectives

A study of N-acetyl-aspartate (NAA) can provide data of interest about cortical alterations in psychotic illnesses. Although a decreased NAA level in the cerebral cortex is a replicated finding in chronic schizophrenia, the data are less consistent for bipolar disease. On the other hand, it is likely that NAA values in schizophrenia may differ in men and women.

Methods

We used proton magnetic resonance spectroscopy (1H MRS) to examine NAA levels in the prefrontal cortex in two groups of male patients, one with schizophrenia (n = 11) and the other with bipolar disorder (n = 13) of similar duration, and compared them to a sample of healthy control males (n = 10). Additionally, we compared the degree of structural deviations from normal volumes of gray matter (GM) and cerebrospinal fluid (CSF) in the dorsolateral prefrontal cortex.

Results

Compared to controls, schizophrenia and bipolar patients presented decreased NAA to creatine ratios, while only the schizophrenia group showed an increase in CSF in the dorsolateral prefrontal region. There were no differences in choline to creatine ratios among the groups.

Conclusions

These data suggest that the decrease in NAA in the prefrontal region may be similar in schizophrenia and bipolar disorder, at least in the chronic state. However, cortical CSF may be markedly increased in schizophrenia patients.

Glucocorticoid and inflammatory reactivity to a repeated physiological stressor in insomnia disorder

Despite known associations of insomnia disorder with alterations in cytokine and glucocorticoid (GC) production, neither the sensitivity of immune cells to a GC signal nor the reactivity of the hypothalamus-pituitary-adrenal (HPA) axis and inflammatory system to stress, or adaptation of these systems to repeated stress have been assessed in patients with insomnia. To investigate potential dysregulation in stress reactivity and adaptation to repeated exposure, a physiological stressor (the cold pressor test; CPT) was repeatedly administered to N = 20 participants with insomnia disorder (based on DSM-V, 18 females, age 30 ± 2.5 years) and N = 20 sex-matched healthy controls following an at-home actigraphy and in-laboratory PSG. HPA and inflammatory markers (serum cortisol, plasma interleukin [IL]-6) were measured at baseline/resting levels and following each of the three CPTs. In addition, sensitivity of monocytes to the synthetic GC dexamethasone was assessed in-vitro at baseline levels in order to examine the cortisol-IL-6 interplay at the cell level. Compared to healthy controls, individuals with insomnia disorder exhibited shorter sleep duration as assessed by actigraphy and PSG (p ≤ 0.05). HPA, but not inflammatory reactivity to the repeated CPT challenge was greater in insomnia disorder (p ≤ 0.05 for group effect), due to greater cortisol responses to the initial CPT (p ≤ 0.05). There were no between-group differences in the ability of the HPA to adapt to stress repetition nor in basal/resting levels of cortisol, IL-6, and GC sensitivity. These findings suggest that insomnia disorder potentiates HPA axis reactivity to initial/novel stressors, which may constitute a pathway underlying adverse health consequences in the long term.

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Insomnia disorder potentiates HPA, but not inflammatory reactivity to a novel stressor.

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The ability of the HPA axis to adapt to the repeated exposure to the same stressor is unchanged in insomnia.

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Basal/resting levels of cortisol, IL-6, and their interplay at cell level (i.e., GC sensitivity of monocytes) are unchanged in insomnia.

Updating national standards for drinking-water: a Philippine experience

The latest version of the Philippine National Standards for Drinking-Water (PNSDW) was issued in 2007 by the Department of Health (DOH). Due to several issues and concerns, the DOH decided to make an update which is relevant and necessary to meet the needs of the stakeholders. As an output, the water quality parameters are now categorized into mandatory, primary, and secondary. The ten mandatory parameters are core parameters which all water service providers nationwide are obligated to test. These include thermotolerant coliforms or Escherichia coli, arsenic, cadmium, lead, nitrate, color, turbidity, pH, total dissolved solids, and disinfectant residual. The 55 primary parameters are site-specific and can be adopted as enforceable parameters when developing new water sources or when the existing source is at high risk of contamination. The 11 secondary parameters include operational parameters and those that affect the esthetic quality of drinking-water. In addition, the updated PNSDW include new sections: (1) reporting and interpretation of results and corrective actions; (2) emergency drinking-water parameters; (3) proposed Sustainable Development Goal parameters; and (4) standards for other drinking-water sources. The lessons learned and insights gained from the updating of standards are likewise incorporated in this paper.

Novel measure of the weigh distribution balance on the brain network: graph complexity applied to schizophrenia

The aim of this study was to assess brain complexity dynamics in schizophrenia (SCH) patients during an auditory oddball task. For this task, we applied a novel graph measure based on the balance of the node weights distribution. Previous studies applied complexity parameters that were strongly dependent on network topology. This could bias the results, as well as making correction techniques, such as surrogating process, necessary. In the present study, we applied a novel graph complexity measure derived from the information theory: Shannon Graph Complexity (SGC). Complexity patterns from electroencephalographic recordings of 20 healthy controls and 20 SCH patients during an auditory oddball task were analyzed. Results showed a significantly more pronounced decrease of SGC for controls than for SCH patients during the cognitive task. These findings suggest an important change in the brain configuration towards a more balanced network, mainly in the connections related to long-range interactions. Since these changes are significantly more pronounced in controls, a deficit in the neural network reorganization can be associated with SCH. In addition, an accuracy of 72.5% was obtained using a receiver operating characteristic curve with a leave-one-out cross-validation procedure. The independence of network topology has been demonstrated by the novel complexity measure proposed in this study, therefore, it complements traditional graph measures as a means to characterize brain networks.

Aromaticity introduced by antiferromagnetic ligand mediated metal–metal interactions. Insights from the induced magnetic response in [Cu6(dmPz)6(OH)6]

Ligand-mediated antiferromagnetic coupling induces aromatic-ring behavior.

Analysis of the non-stationarity of neural activity during an auditory oddball task in schizophrenia

The aim of this study was to characterize brain dynamics during an auditory oddball task. For this purpose, a measure of the non-stationarity of a given time-frequency representation (TFR) was applied to electroencephalographic (EEG) signals. EEG activity was acquired from 20 schizophrenic (SCH) patients and 20 healthy controls while they underwent a three-stimulus auditory oddball task. The Degree of Stationarity (DS), a measure of the non-stationarity of the TFR, was computed using the continuous wavelet transform. DS was calculated for both the baseline [-300 0] ms and active task [150 550] ms windows of a P300 auditory oddball task. Results showed a statistically significant increase (p<;0.05) in non-stationarity for controls during the cognitive task in the central region, while less widespread statistically significant differences were obtained for SCH patients, especially in the beta-2 and gamma bands. Our findings support the relevance of DS as a means to study cerebral processing in SCH. Furthermore, the lack of statistically significant changes in DS for SCH patients suggests an abnormal reorganization of neural dynamics during an oddball task.

Personality traits in patients with cluster headache: a comparison with migraine patients

Background

Cluster headache (CH) has been associated with certain personality traits and lifestyle features, but there are few studies assessing personality profiles in CH. We aimed to analyze personality traits in patients with CH, and to compare them with those found in migraine.

Methods

We included all consecutive patients with CH attending 5 outpatient offices between January and December 2013. Personality traits were evaluated using the Salamanca screening test, a validated inventory assessing 11 personality traits grouped in 3 clusters. We analyzed the test results in this population, and compared them with those of a migraine population previously assessed with the same test.

Results

Eighty patients with CH (75 men, 5 women; mean age, 43.2 ± 9.9 years) were recruited. The reference population consisted of 164 migraine patients (30 men, 134 women; mean age 36.4 ± 12.7 years). In CH patients, the most frequent personality traits were anancastic (52.5 %), anxious (47.5 %), histrionic (45 %), schizoid (42.5 %), impulsive (32.5 %) and paranoid (30 %). When compared to migraine patients, paranoid (p < 0.001; χ2 test), and schizoid traits (p = 0.007; χ2 test) were significantly more prevalent in CH patients. In logistic regression analysis the paranoid trait was significantly associated with CH (p = 0.001; OR: 3.27, 95 % CI [1.66–6.43]).

Conclusion

According to the Salamanca screening test, personality traits included in cluster A (odd or eccentric disorders) are more prevalent in CH patients than in a population of migraineurs. Larger studies are needed to determine whether certain personality traits are related to CH.

Characterization of thymus atrophy in calves with subclinical BVD challenged with BHV-1

Since the thymus is a target organ for the bovine viral diarrhea virus (BVDV), our experiment aimed to understand its relationship with the immunosuppressive effect by studying the consequences of a previous infection with BVDV on the thymus of calves challenged with bovine herpesvirus 1.1 (BHV-1). For this purpose, 12 animals were inoculated intranasally with non-cytopathic BVDV-1; 12 days later, 10 of them were coinfected intranasally with BHV-1. These animals were euthanized in batches of two at 0, 1, 2, 4, 7 or 14 dpi with BHV-1. Another 10 calves were inoculated solely with BHV-1 and euthanized in batches of two at 1, 2, 4, 7 or 14 dpi with BHV-1; two uninoculated calves were used as negative controls. Thymus samples from these animals were processed for viral detection and histopathological, immunohistochemical, and ultrastructural studies focused on BVDV/BHV-1 antigens, cortex:medulla ratio, apoptosis (TUNEL and caspase-3), collagen deposition, and factor VIII endothelial detection. Our study revealed the immunohistochemical presence of BVDV antigen in all animals in the BVDV-infected group, unlike BHV-1 detection, which was observed in animals in both infection groups only by molecular techniques. BVDV-preinfected animals showed severe atrophic changes associated with reduced cortex:medulla ratio, higher presence of cortical apoptosis, and increased collagen deposition and vascularization. However, calves solely infected with BHV-1 did not show atrophic changes. These findings could affect not only the numbers of circulating and local mature T cells but also the T cell-mediated immunity, which seems to be impaired during infections with this virus, thus favoring pathogenic effects during secondary infections.

The first report of a microdiverse anammox bacteria community in waters of Colombian Pacific, a transition area between prominent oxygen minimum zones of the eastern tropical Pacific

Anaerobic ammonium oxidizers contribute to the removal of fixed nitrogen in oxygen-deficient marine ecosystems such as oxygen minimum zones (OMZ). Here we surveyed for the first time the occurrence and diversity of anammox bacteria in the Colombian Pacific, a transition area between the prominent South and North Pacific OMZs. Anammox bacteria were detected in the coastal and oceanic areas of the Colombian Pacific in low oxygen (< 22 μM), high nitrate (25–35 μM) and low nitrite (< 0.07 μM), and ammonium (< 1 μM) waters. In these waters, anammox bacteria were rich [∼ 7 operational taxonomic units (OTUs), 98% cut-off) and microdiverse (Shannon index H′ < 1.24), in comparison with the observed at the prominent OMZ of the Eastern Tropical South Pacific, Arabian Sea and Black Sea. Anammox bacteria-like sequences from the Colombian Pacific were grouped together with sequences retrieved from the distinct OMZ's marine subclusters (Peru, Northern Chile and Arabian Sea) within Candidatus ‘Scalindua spp’. Moreover, some anammox bacteria OTUs shared a low similarity with environmental phylotypes (86–94%). Our results indicated that a microdiverse anammox community inhabits the Colombian Pacific, generating new questions about the ecological and biogeochemical differences influencing its community structure.

Effects of Preinfection With Bovine Viral Diarrhea Virus on Immune Cells From the Lungs of Calves Inoculated With Bovine Herpesvirus 1.1

The aim of this work was to study the interstitial aggregates of immune cells observed in pulmonary parenchyma of calves preinfected with bovine viral diarrhea virus and challenged later with bovine herpesvirus 1. In addition, the intent of this research was to clarify the role of bovine viral diarrhea virus in local cell-mediated immunity and potentially in predisposing animals to bovine respiratory disease complex. Twelve Friesian calves, aged 8 to 9 months, were inoculated with noncytopathic bovine viral diarrhea virus genotype 1. Ten were subsequently challenged with bovine herpesvirus 1 and euthanized at 1, 2, 4, 7, or 14 days postinoculation. The other 2 calves were euthanized prior to the second inoculation. Another cohort of 10 calves was inoculated only with bovine herpesvirus 1 and then were euthanized at the same time points. Two calves were not inoculated with any agent and were used as negative controls. Pulmonary lesions were evaluated in all animals, while quantitative and biosynthetic changes in immune cells were concurrently examined immunohistochemically to compare coinfected calves and calves challenged only with bovine herpesvirus 1. Calves preinfected with bovine viral diarrhea virus demonstrated moderate respiratory clinical signs and histopathologic evidence of interstitial pneumonia with aggregates of mononuclear cells, which predominated at 4 days postinoculation. Furthermore, this group of animals was noted to have a suppression of interleukin-10 and associated alterations in the Th1-driven cytokine response in the lungs, as well as inhibition of the response of CD8+ and CD4+ T lymphocytes against bovine herpesvirus 1. These findings suggest that bovine viral diarrhea virus preinfection could affect the regulation of the immune response as modulated by regulatory T cells, as well as impair local cell-mediated immunity to secondary respiratory pathogens.

A simplified indication of metabolic syndrome to recognize subjects with a moderate risk to develop type 2 diabetes mellitus in a large Italian sample

To propose a simplified tool to recognize subjects with a moderate risk to develop type 2 diabetes mellitus (Type 2 DM): this method would take into account only variables from metabolic syndrome definitions which are cheaply assessable. A total of 3,003 employees without diabetes in Italy who attended one annual health examination between 2009 and 2012 were enrolled in this cross-sectional study. A questionnaire was administered along with the annual health examination to record personal and familiar anamnesis. To identify Type 2 DM-prone individuals, the diabetes predictive model by Stern MP et al. was used. Then a multiple logistic regression model was developed using the predicted probability 20%+ of developing Type 2 DM as the outcome variable and a panel of easily measurable continuous baseline characteristics as explanatory variables (waist circumference, WC; body mass index, BMI; and systolic blood pressure, SBP). The optimism-adjusted area under the curve of the proposed model receiver-operating characteristic (ROC) is 0.90. The effects of the explanatory variables on the presumed Type 2 DM risk are summarized by the following adjusted odds ratio values: 2.65 for SBP (P < 0.001), 2.01 for WC (P = 0.04) and 4.64 for BMI (P < 0.001). The satisfactory ROC of the proposed model suggests the importance of simple assessments in the prognostic information on Type 2 DM risk. Such ease of use may be particularly relevant in populations facing the transition from traditional to industrial food who do not have a sophisticated health service yet.

Therapeutic Effects of Policosanol and Atorvastatin against Global Brain Ischaemia-Reperfusion Injury in Gerbils

Stroke is the third cause of death and the first of permanent adult disability. Pretreatment with policosanol and atorvastatin has been effective in experimental models of cerebral ischaemia in rodents. The objective was to compare the therapeutic effects of policosanol and atorvastatin in a model of global cerebral ischaemia in gerbils. Gerbils were distributed into seven groups, a negative control and six with ischaemia-reperfusion-induced global cerebral ischemia (one vehicle positive control, two policosanol (100 and 200 mg/kg), two atorvastatin (10 and 20 mg/kg) and one aspirin (60 mg/kg) group). Treatments were given 4 h after ischaemia induction. Effects on ischemia-reperfusion-induced symptoms, hyperlocomotion, damage of pyramidal hipoccampal neurons and increased plasma oxidative markers were investigated. Positive, not negative controls, exhibited clinical symptoms, hyperlocomotion, neuronal damage and increased plasma oxidative markers. Policosanol (100 and 200 mg/kg) reduced significantly ischemia-reperfusion-induced symptoms, the frequency of symptomatic animals, histological scores of neuronal damage and plasma oxidative markers as compared with the positive control group. Atorvastatin (10 and 20 mg/kg) decreased significantly the symptoms and histological scores, but unchanged the frequency of symptomatic gerbils and oxidative variables. Only the highest dose of policosanol (200 mg/kg) and atorvastatin (20 mg/kg) reduced significantly ischemia reperfusion-induced hyperlocomotion, policosanol being the most effective. Aspirin 60 mg/kg lowered significantly symptom score, the rate of symptomatic gerbils and hyperlocomotion versus the positive controls, but failed to modify oxidative parameters. In conclusion, postreperfusion treatment with policosanol and atorvastatin was effective for ameliorating symptoms, hyperlocomotion and neurological damage of hippocampal CA1 neurons in gerbils with ischemia-reperfusion-induced global cerebral ischemia, but only policosanol reduced increased plasma oxidative variables.

Porcine and rodent infection withTrichinella, in the Sierra Grande area of Río Negro province, Argentina

In 2000, two cases of human trichinellosis were detected in the Sierra Grande area of Rio Negro province, Argentina. As part of an investigation of the aetiology of these cases, 300 pigs slaughtered for consumption in the area between 2000 and 2002 were checked for Trichinella infection, by artificial digestion of a muscle sample. Twelve (5.6%) - four (7.3%) of the 55 checked in 2000, five (4.8%) of the 105 investigated in 2001, and three (2.1%) of the 140 investigated in 2002 - were found infected. Blood samples were collected from other pigs aged > 6 months old, so that sera could be tested, in ELISA and by western blotting, for anti- Trichinella antibodies. Of the 181 animals checked in the initial serological survey, 36 (19.9%) were found seropositive for Trichinella. When 35 of the seronegative pigs were re-checked 6 months later, three (8.6%) were found to have seroconverted. Four (15.4%) of 26 local rodents, caught in Sherman-type traps, were also found positive when checked for infection by artificial digestion. It appears that about 20% of pigs in the study area are infected each year, this high level of transmission being sustained by a high prevalence of infection in the local rodent populations.

Spatial distribution and cognitive correlates of gamma noise power in schizophrenia

BACKGROUND

Brain activity is less organized in patients with schizophrenia than in healthy controls (HC). Noise power (scalp-recorded electroencephalographic activity unlocked to stimuli) may be of use for studying this disorganization. Method Fifty-four patients with schizophrenia (29 minimally treated and 25 stable treated), 23 first-degree relatives and 27 HC underwent clinical and cognitive assessments and an electroencephalographic recording during an oddball P300 paradigm to calculate noise power magnitude in the gamma band. We used a principal component analysis (PCA) to determine the factor structure of gamma noise power values across electrodes and the clinical and cognitive correlates of the resulting factors.

RESULTS

The PCA revealed three noise power factors, roughly corresponding to the default mode network (DMN), frontal and occipital regions respectively. Patients showed higher gamma noise power loadings in the first factor when compared to HC and first-degree relatives. In the patients, frontal gamma noise factor scores related significantly and inversely to working memory and problem-solving performance. There were no associations with symptoms.

CONCLUSIONS

There is an elevated gamma activity unrelated to task processing over regions coherent with the DMN topography in patients with schizophrenia. The same type of gamma activity over frontal regions is inversely related to performance in tasks with high involvement in these frontal areas. The idea of gamma noise as a possible biological marker for schizophrenia seems promising. Gamma noise might be of use in the study of underlying neurophysiological mechanisms involved in this disease.

Chronic administration of risperidone in a rat model of schizophrenia: a behavioural, morphological and molecular study

In the present work we analyzed the effect of the chronic administration of risperidone (2mg/kg over 65 days) on behavioural, morphological and molecular aspects in an experimental model of schizophrenia obtained by bilateral injection of ibotenic acid into the ventral hippocampus of new-born rats. Our results show that during their adult lives the animals with hippocampal lesions exhibit different alterations, mainly at behavioural level and in the gene expression of dopamine D(2) and 5-HT(2A) receptors. However, at morphological level the study performed on the prefrontal cortex did not reveal any alterations in either the thickness or the number of cells immunoreactive for c-Fos, GFAP, CBP or PV. Overall, risperidone administration elicited a trend towards the recovery of the values previously altered by the hippocampal lesion, approaching the values seen in the animals without lesions. It may be concluded that the administration of risperidone in the schizophrenia model employed helps to improve the altered functions, with no significant negative effects.

Quantification and determination of spread mechanisms of bovine viral diarrhoea virus in blood and tissues from colostrum-deprived calves during an experimental acute infection induced by a non-cytopathic genotype 1 strain

To detect and monitor the sequential changes in virus levels, a reverse transcription quantitative real-time polymerase chain reaction assay using a TaqMan probe was carried out on frozen blood and tissues samples collected from calves experimentally infected with a non-cytopathic Bovine viral diarrhoea virus (BVDV) genotype 1 strain. Blood samples were collected among days 1-14 post-inoculation (p.i). On day 3 p.i, viral RNA was detected in blood samples from six of the eight inoculated animals. Viral RNA was detected in all remaining inoculated animals between 5 and 12 days p.i. The levels of viral RNA increased along the experiment, with a maximal peak between 6 and 9 days p.i. Analysis of virus load in tissues collected from calves euthanized on days 3, 6, 9 and 14 p.i displayed that BVDV was detected on day 3 p.i, being especially abundant in tonsils and ileocaecal valve, highlighting the role of tonsils as the main earliest viral replication sites as well as the principal source for virus spread to other lymphoid tissues and visceral organs. Coinciding with the highest viraemia levels, the highest viral loads were recorded at 9 days p.i. in tonsils, ileal lymph nodes, distal ileum and spleen, showing the main role of these secondary lymphoid organs in the pathogenic mechanisms of BVDV. However, virus levels in the liver and lung increased only towards the end of the infection. This fact could influence in the appearance of bovine respiratory diseases because of the capacity of BVDV for enhancing susceptibility to secondary infections.

Effect of oleic, lauric and myristic acids on phenylephrine-induced contractions of isolated rat vas deferens

D-004, a lipid extract of Roystonea regia fruits that contains oleic, lauric and myristic acids as major components inhibits alpha1-adrenoreceptors-mediated contractile responses in isolated rat vas deferens and prostate trips; no study has demonstrated a similar effect for oleic, lauric or myristic acids individually. Therefore, the effects of D-004 (250 microg/mL), oleic (100 microg/mL), lauric (50 microg/mL) or myristic (25 microg/mL) acids and their combined effects on phenylephrine (PHE: 10(-7)-10(-4) mol/L) induced contractions has been studied. No treatment changed the basal tone of the preparations, but all inhibited PHE-induced contractions. D-004 produced the highest inhibition, followed by lauric acid, which was more effective than myristic and oleic acids against PHE-induced contractions of control group. D-004 and the mixture of the three acids produced similar inhibitions.

Response of proinflammatory and anti-inflammatory cytokines in calves with subclinical bovine viral diarrhea challenged with bovine herpesvirus-1

The aim of this work was to investigate the susceptibility of calves infected with bovine viral diarrhea virus (BVDV) against secondary infections. For this purpose, the profile of cytokines implicated in the immune response of calves experimentally infected with a non-cytopathic strain of BVDV type-1 and challenged with bovine herpesvirus 1.1 (BHV-1.1) was evaluated in comparison with healthy animals challenged only with BHV-1.1. The immune response was measured by serum concentrations of cytokines (IL-1β, TNFα, IFNγ, IL-12, IL-4 and IL-10), acute phase proteins (haptoglobin, serum amyloid A and fibrinogen) and BVDV and BHV-1.1 specific antibodies. BVDV-infected calves displayed a great secretion of TNFα and reduced production of IL-10 following BHV-1 infection, leading to an exacerbation of the inflammatory response and to the development of more intense clinical symptoms and lesions than those observed in healthy animals BHV-1-inoculated. A Th1 immune response, based on IFNγ production and on the absence of significant changes in IL-4 production, was observed in both groups of BHV-1-infected calves. However, whereas the animals inoculated only with BHV-1 presented an IFNγ response from the start of the study and high expression of IL-12, the BVDV-infected calves showed a delay in the IFNγ production and low levels of IL-12. This alteration in the kinetic and magnitude of these cytokines, involved in cytotoxic mechanisms responsible for limiting the spread of secondary pathogens, facilitated the dissemination of BHV-1.1 in BVDV-infected calves.

Characterization of apoptosis pathways (intrinsic and extrinsic) in lymphoid tissues of calves inoculated with non-cytopathic bovine viral diarrhoea virus genotype-1

Previous studies have shown that activation of effector caspase-3 is associated with the apoptosis of lymphocytes occurring during infection with bovine viral diarrhoea virus (BVDV); however, the regulation of the apoptosis pathways that induce cell death via activation of effector caspase-3 has not yet been clarified. The aim of this study was to examine immunohistochemically the expression of cleaved caspase (CCasp)-8 (initiator caspase of the extrinsic pathway), CCasp9 (initiator caspase of the intrinsic pathway) and Bcl-2 (an anti-apoptotic marker) in gut-associated lymphoid tissue (GALT) of the ileum from calves inoculated with a non-cytopathic strain of BVDV genotype-1. CCasp8 had similar expression to that of CCasp3. In interfollicular T-cell areas there was moderate apoptosis and evidence of moderate activation of initiator caspase-8. In B-cell follicles there was marked lymphocyte apoptosis and evidence of intense caspase-8 activation, highlighting the potentially major role of the extrinsic pathway in lymphocyte apoptosis in the GALT during BVDV infection. Additionally, there was a significant decrease in the number of CCasp9(+) cells from the start of the experiment and this was linked to inactivation of caspase-9. Therefore, the intrinsic pathway may play only a minor role in the induction of lymphocyte apoptosis. Finally, the observed overexpression of Bcl-2 protein could play a major role in protecting lymphocytes in the T-cell areas against apoptosis, while low levels of Bcl-2 expression could be associated with the follicular lymphocyte apoptosis occurring during BVDV infection.

[Ultrasound of the Achilles tendon after percutaneous repair]

PURPOSE

To evaluate clinical and ultrasound (US) results following percutaneous repair of the Achilles tendon.

MATERIALS AND METHODS

Thirty-four patients underwent percutaneous Achilles tendon repair between 2004 and 2006. Seventeen patients (11 males and 6 females aged 30 to 59 years) underwent clinical and US follow-up at a mean of 15 months. US evaluation included assessment of the bilateral Achilles tendons with recording of maximum tendon diameter, echotexture, and presence of intratendonous neovascularization on power Doppler US.

RESULTS

On clinical evaluation, all patients were satisfied with the outcome and able to resume their normal level of activity. On US evaluation, there was no tendon discontinuity, and all tendons showed hypoechoic thickening with mean maximal diameter of 13 mm. Focal changes in echotexture were noted in 11 patients, hypoechoic in 5 cases and echogenic in 6 cases. A normal fibrillar echotexture was noted in 5 cases, at more than on eyear after surgery. Intratendonous neovascularization was present in 10 cases, mild in 6 cases, moderate in 2 cases and marked in 2 cases. The degree of neovascularization decreased with increasing postsurgical time.

CONCLUSION

Postsurgical Achilles tendons were characterized on US by hypoechoic thickening and loss of normal fibrillar echotexture. The presence of intratendonous neovascularization probably corresponds to postsurgical scarring that decreases over time.

An original knee arthrodesis technique combining external fixator with Steinman pins direct fixation

INTRODUCTION

Knee arthrodesis may be the last possible option for infected total knee arthroplasty (TKA) patients and in revision cases involving severe bone loss and/or extensor mechanism damages. Success in these situations depends on achieving good fixation assembly stability. We report bone fusion results using a fixation technique combining cross-pinning by two Steinman pins with a single-frame external fixator. Remission of infection at long-term follow-up was an additional criteria assessed for those cases initially treated for sepsis.

HYPOTHESIS

This fixation modality improves fusion rates.

PATIENTS AND METHODS

In six of this series of eight patients (mean age: 59 years), surgery was performed in a context of infection: five cases of infected TKA, and one case of septic arthritis. In the other two cases, arthrodesis was respectively indicated for a severe post-traumatic stiffness compounded by extensor system rupture and for a fracture combined to a complete mechanical implant loosening. In three of the six infection cases, arthrodesis was performed as a single-stage procedure. All patients were operated on using the same technique: primary arthrodesis site stabilization by frontal cross-pinning with two Steinman pins, followed by installation of a sagittal external fixator frame. Results were assessed at a mean 8 year follow-up.

RESULTS

All the arthrodeses showed fusion at a mean 3.5 months (range: 2.5 to 6 months) postoperative delay without reintervention. Weight-bearing was resumed at 2 to 3 months. The external fixator was removed at a mean 5.2 months. No recurrence of infection was observed over a mean follow-up of 8.2 years (range: 1 to 15 years). Three complications occurred: one hematoma, managed surgically; one supracondylar fracture treated orthopedically; and one osteitis, managed by surgical curettage.

DISCUSSION

This knee arthrodesis technique proved effective, with no failures in this short series, especially in cases of primary infection. It is a reproducible means of osteosynthesis, with little subsequent morbidity. Fixation in two orthogonal planes seemed to provide the stability required to achieve bone fusion. This assembly avoids internal fixation, which is never risk-free in a context of primary sepsis.

LEVEL OF EVIDENCE

Level IV. Retrospective study.

Usefulness of sero-surveillance for Trichinella infections in animal populations

In this paper we evaluate serology as a tool to monitor Trichinella-free pig herds. Indoor, industrial-raised fattening pigs in the Netherlands are practically Trichinella-free, and were used as a negative reference cohort. A positive cohort was not available but we used sera from an endemic region in Argentina to model a plausible distribution of serological responses (as OD levels) in positive sera, employing the difference between the endemic sera and the negative Dutch sera. We describe a method for correcting for variation among ELISA plates using on-plate reference sera, and demonstrate how to apply these corrections to a collection of test sera from pig farms. The positive and negative reference distributions can be used to estimate fractions true and false positives, necessary for defining appropriate cutoffs to be used for classifying positive and negative animals. Based on this analysis, the serological test was shown to lack the predictive power required for its large scale deployment. The properties of the serological test were also compared to the conventional digestion assay, which is highly specific but considerably less sensitive.

Clozapine may partially compensate for task-related brain perfusion abnormalities in risperidone-resistant schizophrenia patients

BACKGROUND

Previous reports show different cerebral activity patterns during treatment with clozapine and typical neuroleptics. However, to date no study has directly compared the brain activity patterns while subjects are undergoing treatment with clozapine and other atypical antipsychotics. This comparison is of interest, given the probably different mechanism of action of clozapine in comparison with other atypicals.

OBJECTIVE

To assess the effect of clozapine on perfusion deviations still evident during treatment with risperidone.

METHODS

Here we used hexamethylene-propylenaminoxime single photon emission computed tomography to compare the perfusion patterns observed during the performance of a Stroop test in 10 patients sequentially treated with risperidone and clozapine, owing to a lack of response to the former, and in 10 healthy controls.

RESULTS

Patients on risperidone showed decreased perfusion as compared to controls in the medial prefrontal, middle cingulate and insular regions, as well as increased activities in brain stem and the posterior hippocampus. After receiving clozapine, the same patients showed an even wider prefrontal perfusion deficit and the brain stem was still hyperactive, but the abnormalities in the cingulate cortex, insula and hippocampus had disappeared. Clinical improvement was directly related to an increase in thalamic perfusion.

CONCLUSION

Clozapine may alleviate hyperactivity in the limbic system in schizophrenia and may facilitate activation of the regions involved in cognitive tasks to a greater degree than risperidone, as well as eliciting greater inhibition of the PF region.

Differential clinical, structural and P300 parameters in schizophrenia patients resistant to conventional neuroleptics

Schizophrenia is a heterogeneous clinical condition that may reflect a variety of biological processes. In particular, treatment-resistant (TR) schizophrenia may have a distinct neurobiological substrate. Within the context of clinical data, a simultaneous study with different imaging techniques could help to elucidate differences in cerebral substrates among schizophrenia patients with different responses to treatment. In the present work we used a set of biological data (basal and longitudinal volumetry, and P300 event-related potential measurements) to compare TR and treatment-responsive chronic schizophrenia patients with healthy controls. The TR patients showed higher baseline clinical scores, a more severe basal profile of brain alterations, as well as a different outcome as regards to volume deficits. These data support the notion that biological substrates vary among groups of different psychotic patients, even when they have the same diagnosis, and that those substrates may be related to the response to treatment.

Marked hypofrontality in clozapine-responsive patients

Previous data show that the effects of clozapine on regional brain activity are different from those of other antipsychotic agents. It seemed of interest to study the brain activity patterns after treatment with clozapine, since this drug might correct basal deficits directly related to schizophrenia or instead induce changes that would in some way compensate distant abnormalities. In order to study the activity pattern resulting from clozapine treatment we have used FDG-PET and statistical parametric mapping (SPM) to explore the functional status of patients after chronic treatment with this drug, We compared their metabolic activity with normal controls and neuroleptic-naive (NN) patients, with the aim to identify if a reversion of pre-existing deficits or a induction of different changes was the result of clozapine administration. We compared metabolic patterns in 23 treatment-resistant (TR) patients after 6 months of treatment with clozapine, eighteen healthy subjects, and 17 NN schizophrenia patients. After treatment with clozapine, TR patients showed a clear hypofrontality and caudate hypometabolism in comparison with both the controls and NN patients, and also a lower thalamic activity than the healthy controls. In conclusion, our results support a preferential role for prefrontal regions and their subcortical connections in the mechanism of action of clozapine, resulting in a clearly hypofrontal state as compared to both controls and schizophrenia patients without previous treatment.

Changes in Cortical Volume with Olanzapine in Chronic Schizophrenia

INTRODUCTION

Atypical antipsychotics can affect cortical volume differently from traditional drugs. The study of the outcome of grey matter deficits in schizophrenia with olanzapine may be of particular interest in this context.

METHODS

In this study, we evaluated the changes in the volume of gray matter in the cortex of 11 schizophrenic patients treated with olanzapine and in 11 healthy controls after three years of follow-up. After MR imaging, acquisition data were processed with a volumetric quantification method based on the Talairach atlas. The longitudinal change of volumetric data was corrected for differences in overall brain size.

RESULTS

Patients showed greater reduction than controls in cortical volume in the frontal and parietal regions during follow-up. No relationship was observed between clinical and volumetric changes.

CONCLUSION

Our data suggest that the profile of action of olanzapine on the cortical volume of chronically ill patients may be similar to that of typical antipsychotics. Other explanations, however, cannot be completely discarded for that outcome with our data.