Oxidative status during late pregnancy and early lactation in dairy cows

In the last few years, the detection of free radical damage and the body's defences against it have become increasingly important in clinical medicine as a complementary tool in the evaluation of metabolic status. The aim of this study was to evaluate, under field conditions, the anti-oxidant status of healthy cows during late pregnancy and lactation onset using two parameters: (1) plasma levels of malondialdehyde (MDA), a degradation product of lipid peroxidation, and (2) total antioxidant status (TAS). Results were compared with those obtained in another group of cows with lesser metabolic demands. We also investigated possible relationships between antioxidant status markers and other relevant blood parameters. Our results confirmed the characteristic metabolic changes associated with late pregnancy and early lactation. MDA and TAS provided an accurate reflection of the internal physiological status of the animal. The data indicated increased lipid peroxidation around parturition, but with wide individual variations that may be attributable not only to the physiological stage but also to unknown factors that will have to be further considered in future studies.

Racial differences in the relation between blood pressure and insulin resistance

BACKGROUND

Insulin resistance and the concomitant compensatory hyperinsulinemia have been implicated in the pathogenesis of hypertension. However, reports on the relation between insulin and blood pressure are inconsistent. This study was designed to investigate the possibility of racial differences in this relation.

METHODS

We studied 116 Pima Indians, 53 whites, and 42 blacks who were normotensive and did not have diabetes; the groups were comparable with respect to mean age (29, 30, and 31 years, respectively) and blood pressure (113/70, 111/68, and 113/68 mm Hg, respectively). Insulin resistance was determined by the euglycemic-hyperinsulinemic clamp technique during low-dose (40 mU per square meter of body-surface area per minute) and high-dose (400 mU per square meter per minute) insulin infusions.

RESULTS

The Pima Indians had higher fasting plasma insulin concentrations than the whites or blacks (176, 138, and 122 pmol per liter, respectively; P = 0.002) and lower rates of whole-body glucose disposal during both the low-dose (12.7, 17.1, and 19.5 mmol per minute; P less than 0.001) and the high-dose (38.0, 43.1, and 45.7 mmol per minute; P less than 0.001) insulin infusions. After adjustment for age, sex, body weight, and percentage of body fat, mean blood pressure (calculated as 1/3 systolic pressure + 2/3 diastolic pressure) was significantly correlated with the fasting plasma insulin concentration (r = 0.42) and the rate of glucose disposal during the low-dose (r = -0.41) and high-dose (r = -0.49) insulin infusions (P less than 0.01 for each) in whites, but not in Pima Indians (r = -0.06, -0.02, and -0.04, respectively) or blacks (r = -0.10, -0.04, and 0.02, respectively).

CONCLUSIONS

The relations between insulinemia, insulin resistance, and blood pressure differ among racial groups and may be mediated by mechanisms active in whites, but not in Pima Indians or blacks.

Nortriptyline versus fluoxetine in the treatment of depression and in short-term recovery after stroke: a placebo-controlled, double-blind study

OBJECTIVE

This study compared nortriptyline and fluoxetine with placebo in the treatment of depression and in recovery from physical and cognitive impairments after stroke.

METHOD

A total of 104 patients with acute stroke enrolled between 1991 and 1997 entered a double-blind randomized study comparing nortriptyline, fluoxetine, and placebo over 12 weeks of treatment. The majority of patients were recruited from a rehabilitation hospital in Des Moines, Iowa, but other enrollment sites were also used. Both depressed and nondepressed patients were enrolled to determine whether improved recovery could be mediated by mechanisms unrelated to depression. Nortriptyline in doses of 25 mg/day gradually increased to 100 mg/day or fluoxetine in doses of 10 mg/day gradually increased to 40 mg/day or identical placebo were given over 12 weeks. Response to treatment of depression for individual patients was defined as a greater-than-50% reduction in scores on the Hamilton Rating Scale for Depression and no longer fulfilling diagnostic criteria for major or minor depression. Improved recovery for a treatment group was defined as a significantly higher mean score from baseline to end of the treatment trial, compared with patients treated with placebo, on measures of impairment in activities of daily living and levels of cognitive and social functioning.

RESULTS

Nortriptyline produced a significantly higher response rate than fluoxetine or placebo in treating poststroke depression, in improving anxiety symptoms, and in improving recovery of activities of daily living as measured by the Functional Independence Measure. There was no effect of nortriptyline or fluoxetine on recovery of cognitive or social functioning among depressed or nondepressed patients. Fluoxetine in increasing doses of 10-40 mg/day led to an average weight loss of 15. 1 pounds (8% of initial body weight) over 12 weeks of treatment that was not seen with nortriptyline or placebo.

CONCLUSIONS

Given the doses of medication used in this study, nortriptyline was superior to fluoxetine in the treatment of poststroke depression. Demonstrating a benefit of antidepressant treatment in recovery from stroke may require the identification of specific subgroups of patients, alternative measurement scales, or the optimal time of treatment.

Plasma malonaldehyde (MDA) and total antioxidant status (TAS) during lactation in dairy cows

Metabolic profiles are widely used to monitor health, reproductive status and nutritional status. In the last few years, the evaluation of oxidative stress has contributed increasingly to our knowledge of the fundamental mechanisms involved in metabolic disorders, especially important in dairy cows, in which lactation imposes great physiological demands on the body's homeostatic mechanisms. The aim of the present study was to evaluate oxidative status in healthy cows during lactation (from lactation onset to peak lactation) using two parameters: (i) plasma levels of malondialdehyde (MDA) and (ii) total antioxidant status (TAS). Our results confirm that nutrition can influence the characteristic metabolic changes occurring between lactation onset and peak lactation. In addition, the combination of MDA and TAS can provide complementary information about the metabolic status of the cow. Thus, the proper metabolic adaptation to the onset of lactation, showed by metabolic profiles, contrasts with the high levels of free radicals which cause lipid peroxidation and high MDA values (68.99+/-33.64 microm/L) which is maintained only for a short period of time. In this moment, the antioxidant system can cope efficiently with lipoperoxide production. The most remarkable fact was the great inter-individual variations observed in MDA that might be studied in further investigations. When the animal reaches peak lactation, metabolic status is stabilized, and this is reflected by antioxidant status with mean values of 28.87+/-5.33 microm/L for MDA and 0.154+/-0.002 mmol/L for TAS values.

Mutation rates at Y chromosome specific microsatellites

A collaborative work was carried out by the Spanish and Portuguese ISFG Working Group (GEP-ISFG) to estimate Y-STR mutation rates. Seventeen Y chromosome STR loci (DYS19, DYS385, DYS389I and II, DYS390, DYS391, DYS392, DYS393, DYS437, DYS438, DYS439, DYS460, DYS461, DYS635 [GATA C4], GATA H4, and GATA A10) were analyzed in a sample of 3,026 father/son pairs. Among 27,029 allele transfers, 54 mutations were observed, with an overall mutation rate across the 17 loci of 1.998 x 10(-3) (95% CI, 1.501 x 10(-3) to 2.606 x 10(-3)). With just one exception, all of the mutations were single-step, and they were observed only once per gametogenesis. Repeat gains were more frequent than losses, longer alleles were found to be more mutable, and the mutation rate seemed to increase with the father's age. Hum Mutat 26(6), 520-528, 2005. (c) 2005 Wiley-Liss, Inc.

Interstitial insulin concentrations determine glucose uptake rates but not insulin resistance in lean and obese men

Insulin action and obesity are both correlated with the density of muscle capillary supply in humans. Since the altered muscle anatomy in the obese might affect interstitial insulin concentrations and reduce insulin action, we have cannulated peripheral lymphatic vessels in lean and obese males, and compared peripheral lymph insulin concentrations with whole body glucose uptake during a euglycemic, hyperinsulinemic clamp. Lymph insulin concentrations in the lower limb averaged only 34% of arterial insulin concentrations during 150 min of insulin infusion. Obese subjects had the highest arterial (P < or = 0.0001) and lymph insulin (P < 0.005) concentrations, but the lowest glucose uptake rates (P < 0.002). In contrast to the initial steep rise then plateau of arterial insulins, both lymph insulin and whole body glucose uptake rates rose slowly and did not consistently reach a plateau. In each individual, the glucose uptake closely correlated with peripheral lymphatic insulin concentrations (mean r2 = 0.95). The coupling between glucose uptake and lymph insulin (glucose uptake/pmol insulin) was much steeper in lean subjects than in the obese (P < or = 0.0001). These results indicate that even if insulin diffusion into tissues is rate limiting for insulin action, a tissue defect rather than an insulin diffusion defect causes insulin resistance in obese subjects.

Advantages of binaural hearing provided through bimodal stimulation via a cochlear implant and a conventional hearing aid: a 6-month comparative study

CONCLUSIONS

Our study data demonstrate the additional benefit derived from continued use of a contralateral hearing aid (HA) post-cochlear implantation for speech recognition ability in quiet and in noise. Postoperative bimodal stimulation is recommended for all subjects who show some speech recognition ability in the contralateral ear as it may offer binaural listening advantages in various listening situations encountered in everyday life.

OBJECTIVES

To assess the benefits derived from bimodal stimulation for experienced HA users implanted with a cochlear implant (CI) (score=20% in disyllabic test). The correlation between pre- and postoperative performance on speech perception measures was examined to determine additional criteria for recommending bimodal stimulation postoperatively.

MATERIAL AND METHODS

A within-subject repeated-measures design was used, with each subject acting as their own control. Assessments were carried out preoperatively in aided monaural and best-aided conditions and at 6 months postoperatively in CI-alone, contralateral HA-alone and bimodal listening conditions. Speech recognition using Spanish words and sentences materials was assessed at conversational level and for soft speech in quiet. Speech comprehension in noise was assessed using word materials at a signal:noise ratio of +10, for coincident speech in noise and for spatially separated speech in noise. Twelve adult native Spanish subjects with a severe-to-profound hearing impairment who were experienced with optimally fitted conventional amplification and who displayed suboptimal speech understanding preoperatively were enrolled in the study. Preoperatively, conventional amplification was worn by five subjects binaurally and by seven monaurally.

RESULTS

Postoperatively, superior speech recognition ability in quiet and in noise for disyllabic words was achieved using bimodal stimulation in comparison to performance for either monaural aided condition. Mean improvement in speech recognition in the bimodal condition was significant over performance in the CI-alone condition for disyllabic words in quiet at 70 (p=0.006) and 55 dB SPL (p=0.028), for disyllabic words in noise at +10 dB with speech and noise spatially separated with the noise source closest to the contralateral HA (S0NHA) (p=0.0005) and when the noise source was closest to the CI ear (S0NCI) (p=0.002). When testing word recognition in noise with speech and noise sources coincident in space, word scores were superior in the bimodal condition relative to the CI-alone condition but this improvement was not significant (p=0.07). The advantages of bimodal stimulation included significant effects of binaural summation in quiet and significant binaural squelch effects in both the S0NHA and S0NCI test conditions. All subjects showed superior performance in the binaural situation postoperatively relative to the best-aided condition preoperatively for one or more test situations.

Exaggerated early insulin release and insulin resistance in a diabetes-prone population: a metabolic comparison of Pima Indians and Caucasians

Pima Indians have the highest reported prevalence rate of noninsulin-dependent diabetes mellitus (NIDDM) in the world, so that metabolic comparisons with caucasians, who have a much lower rate, should provide insights into the pathogenesis of NIDDM. We have compared 81 caucasians with 211 Pima Indian nondiabetic subjects similar in age, sex, degree of obesity, and glucose tolerance. During a hyperinsulinemic euglycemic clamp at physiological insulin concentrations, Pima Indians were 17% more insulin resistant than caucasians after accounting for any differences in degree of obesity (P less than 0.0001). During oral glucose tolerance testing, mean plasma insulin concentrations were 33% higher in the Pimas (P less than 0.0001), but these differences were largely explained by the greater insulin resistance in the Pimas. Insulin clearance did not differ between the races. However, early insulin responses were exaggerated in the Indians and not explained by insulin resistance. After accounting for differences in insulin action, plasma insulin concentrations in Pima Indians were 50% higher than those in caucasians 3-5 min after iv glucose (P less than 0.0001), 38% higher 10 min after the end of a meal (P less than 0.0001), and 20% higher 30 min after an oral glucose load (P less than 0.006). These data suggest that in addition to insulin resistance, Pima Indians have exaggerated early insulin release and either increased beta-cell mass or enhanced beta-cell sensitivity to glucose. The data argue against low or delayed insulin secretion as primary factors leading to NIDDM in Pima Indians and favor insulin resistance as the underlying and initiating cause of the disease.

His bundle electrograms in two cases of Wolff-Parkinson-White (pre-excitation) syndrome

The catheter technic for recording the electrical activity of the specialized conducting system in the human heart showed in two patients studied that ventricular pre-excitation was apparently due to a bypass of the His bundle. Intermediate forms of WPW complexes appeared to be combination beats resulting from the activation of the ventricles through impulses traversing both the His bundle and accessory communications. Preferential iatrogenic activation of an intra-atrial (and perhaps even of an atrioventricular) tract appeared to occur in one of the patients. The patients with the WPW (pre-excitation) syndrome and long histories of paroxysmal arrhythmias were successfully treated with a combination of oral propranolol and implanted (transvenous) demand pacemaker.

Clinicopathological study of 13 cases of squamous cell carcinoma complicating hidradenitis suppurativa

BACKGROUND

To the best of our knowledge, only 52 cases of squamous cell carcinoma (SCC) complicating hidradenitis suppurativa (HS) have been reported since 1958. We describe 13 new cases.

METHODS

We propose a clinical and histological analysis of our cases. We include these results in a review of previously reported cases to analyze a total of 65 patients. In our series of 13 cases, we also investigate the presence of human papillomavirus (HPV) in tumor samples, by polymerase chain reaction (PCR) on paraffin-embedded material.

RESULTS

Malignant transformation affects mainly men with a long-term history of genitoanal HS. Although our cases were 7 well-differentiated carcinomas and 6 verrucous carcinomas, lymphatic and visceral metastasis occurred in 2 and 3 cases, respectively. With PCR, we demonstrated presence of HPV in genitoanal tumoral lesions, principally HPV-16.

CONCLUSION

SCC complicating HS evolves poorly, despite a good histological prognosis. Our results sustain the implication of HPV in the malignant transformation of HS.

Arsenic, cadmium, lead, copper and zinc in cattle from Galicia, NW Spain

Knowledge of trace and toxic metal concentrations in livestock is important for assessing the effects of pollutants on domestic animals and contaminant intakes by humans. Metal levels in cattle have been measured in various countries but not in Spain. In this study, the (wet wt.) concentrations of three toxic elements (arsenic, cadmium, lead) and two trace elements (copper, zinc) were quantified in the liver (Li), kidney (Ki), muscle (M) and blood (Bl) of calves (males and females between 6 and 10 months old) and cows (2-16 years old) from Galicia, NW Spain. For the toxic elements, geometric mean concentrations of arsenic in calves (sexes combined) and cows were 10.8 and 10.2 microg/kg (Li), 11.3 and 15.2 microg/kg (Ki), 3.75 and 4.25 microg/kg (M), 3.23 and 2.92 microg/l (Bl). The corresponding cadmium concentrations were 7.78 and 83.3 microg/kg (Li), 54.3 and 388 microg/kg (Ki), 0.839 and 0.944 microg/kg (M), 0.373 and 0.449 microg/l (Bl). Geometric mean concentrations of lead in calves and cows were similarly low and were 33.0 and 47.5 microg/kg (Li), 38.9 and 58.3 microg/kg (Ki), 6.37 and 12.5 microg/kg (M), 5.47 and 12.2 microg/l (Bl). Sex had almost no effect on the amount of toxic metal accumulated except that kidney cadmium concentrations were significantly higher in females than males. Age did influence accumulation; cadmium and lead (but not arsenic) concentrations in most tissues were significantly greater in cows than female calves. For the trace elements, geometric mean copper levels in calf and cow tissues were 49.9 and 36.6 mg/kg (Li), 4.27 and 3.63 mg/kg (Ki), 0.649 and 1.68 mg/kg (M) and 0.878 and 0.890 mg/l (Bl). The corresponding zinc concentrations were 46.3 and 52.5 mg/kg (Li), 14.2 and 20.7 mg/kg (Ki), 47.3 and 52.5 mg/kg (M) and 2.80 and 2.22 mg/l (Bl). Female calves had significantly higher levels than males of muscle zinc and blood copper and zinc. Female calves accumulated more copper but less zinc in the liver and kidneys compared with cows; this may have been associated with the chronic, low-level cadmium accumulation observed in cows. Overall, the levels of arsenic, cadmium, lead and zinc in cattle in Galicia do not constitute a risk for animal health. However, up to 20% of cattle in some regions in Galicia had levels of copper in the liver that exceeded 150 mg/kg wet wt. These animals may be at risk from copper poisoning.

Toxic and essential metals in liver, kidney and muscle of pigs at slaughter in Galicia, north-west Spain

The aims of the study were to evaluate toxic and essential metal concentrations in meat and offal from pigs in north-west Spain to compare these with reported metal concentrations in pigs in other countries and in cattle in this region, and to relate the observed concentrations to maximum acceptable concentrations. Samples from 63 pigs aged 6 months were randomly collected at slaughter. After acid digestion, levels of metals were determined by ICP-OES and ICP-MS. As regards the toxic metals, mean concentrations in liver, kidney and muscle were 0.073, 0.308 and 0.009 mg kg(-1) fresh weight for cadmium, 0.004, 0.008 and 0.003 mg kg(-1) for lead, 0.013, 0.011 and 0.003 mg kg(-1) for arsenic, and 0.001, 0.002 and 0.001 mg kg(-1) for mercury. These concentrations can be considered low, and in general similar to those reported in similar studies in recent years. In addition, maximum admissible concentrations established by the European Union were not exceeded in any sample. As regards the essential metals, concentrations in liver, kidney and muscle were 14.9, 5.63 and 6.85 mg kg(-1) for copper, 81.3, 28.9 and 42.5 mg kg(-1) for zinc, 195, 51.6 and 26.5 mg kg(-1) for iron; 1.17, 2.51 and 0.656 mg kg(-1) for selenium, 3.32, 1.56 and 1.01 mg kg(-1) for manganese, 0.023, 0.027 and 0.003 mg kg(-1) for cobalt, 0.120, 0.077 and 0.131 mg kg(-1) for chromium, 0.009, 0.027 and 0.026 mg kg(-1) for nickel, and 1.62, 0.683 and 0.140 mg kg(-1) for molybdenum. These concentrations are all within the accepted adequate-safe ranges for this animal species, and in general are in line with those previously reported in the literature.

Interactions between toxic and essential trace metals in cattle from a region with low levels of pollution

Studies on the impacts of pollutant metals and metalloids on livestock have largely focused on animals with relatively high levels of exposure. The impact of low-level environmental contamination, which is more common on agricultural land, is largely unknown. The principal aim of the present study was to examine the effects of low-level environmental contamination on trace metal metabolism in cattle from the rural and relatively uncontaminated region of Galicia (NW Spain). Correlations between toxic (cadmium, lead, and arsenic) and essential trace elements (copper and zinc) were evaluated in the tissues (liver, kidney, and muscle) and blood of 494 cattle from throughout Galicia. Cadmium was the toxic element that had the greatest influence on copper and zinc homeostasis. There was a significant positive association between renal cadmium and zinc residues and a significant negative correlation between kidney cadmium and copper. These interactions are likely to be the result of cadmium-induced effects on metallothionein synthesis. Lead and zinc were positively associated in the kidney, although the mechanism of this interaction is uncertain. Arsenic and copper concentrations were strongly correlated with each other in the liver and may indicate that the high copper levels in animals from copper-rich areas in Galicia interfere with their arsenic excretion. The essential metals copper and zinc were also significantly associated with each other in calves but not in cows.

Epidemiologic study of Guillain-Barré syndrome in children <15 years of age in Latin America

In 1986, surveillance of acute flaccid paralysis (AFP) cases among children <15 years of age was implemented in Latin America as part of the initiative to eradicate poliomyelitis from the Western Hemisphere. Data on AFP, including Guillain-Barré syndrome (GBS), could be analyzed from a regional registry system and from specific GBS studies in seven countries. Between 1989 and 1991, 3112 cases of GBS were reported in Latin America, representing 52% of all nonpolio AFP cases. From the studies in seven countries, a total of 1527 GBS cases (49%) were studied, representing an overall annual incidence rate of 0.91/100,000 children <15 years old. Follow-up investigations showed a persistent muscular weakness at 60 days, 6 months, and 1 year after onset in 61%, 14%, and 10% of children, respectively. This study confirms that with the disappearance of polio, GBS arises as the most common cause of AFP.

Retention in a low-threshold methadone maintenance program

In 370 opioid-dependent patients included consecutively in a low-threshold methadone maintenance program, the effect of different variables on the retention rate was assessed. The variables included the patients' age, sex, family situation, employment status, length of heroin use, current route of drug consumption, previous treatments, current consumption of cocaine, alcohol and benzodiazepines, needle sharing, HIV serostatus and methadone dose. The retention rate after 2 years of methadone maintenance was 72%. Dose of methadone > 80 mg/day, age > 30 years, living with family or stable partner and non-current use of alcohol were significant predictive variables for retention.

Flunitrazepam consumption among heroin addicts admitted for in-patient detoxification

The use of benzodiazepines among 973 heroin addicts admitted for inpatient detoxification over a 10-year period was assessed in a cross-sectional study. A total of 780 (80.2%) patients had a history of benzodiazepine use; 666 (68.5%) were consuming benzodiazepines at the time of admission and 419 (43.1%) on an almost daily basis. Seventy-five (7.7%) patients fulfilled criteria for sedative-hypnotic abuse or dependence. Consumption of benzodiazepines began after subjects had become addicted to heroin. Flunitrazepam was ranked first by 68.4% of patients, followed by clorazepate (13%), and diazepam (12.4%). The prevalence of benzodiazepine use, in particular flunitrazepam, among heroin addicts is very high. Specific abuse liability studies are needed to determine whether pharmacologic reasons exist to explain heroin addicts' preference for this compound.