Potentiation of the depressant effect of alcohol by flunitrazepam in rats: an electrocorticographic, respiratory and electrocardiographic study

Alcohol, a widely commercialized psychotropic drug, and the benzodiazepine Flunitrazepam, an anxiolytic widely prescribed for patients with anxiety and insomnia problems, are well known drugs and both act on the central nervous system. The misuse and the association of these two drugs are public health concerns in several countries and could cause momentary, long-lasting and even lethal neurophysiological problems due to the potentiation of their adverse effects in synergy. The present study observed the result of the association of these drugs on electrophysiological responses in the brain, heart, and respiratory rate in Wistar rats. 8 experimental groups were determined: control, one alcohol group (20% at a dose of 1 ml/100 g VO), three Flunitrazepam groups (doses 0.1; 0.2 and 0.3 mg/kg) and three alcohol-Flunitrazepam groups (20% at a dose of 1 ml/100 g VO of alcohol, combined with 0.1; 0.2 and 0.3 mg/kg of Flunitrazepam, respectively). The results showed that there was a more pronounced reduction in alpha and theta wave power in the alcohol-Flunitrazepam groups, a decrease in the power of beta oscillations and greater sedation. There was a progressive decrease in respiratory rate linked to the increase of Flunitrazepam dose in the alcohol-Flunitrazepam associated administration. It was observed alteration in heart rate and Q-T interval in high doses of Flunitrazepam. Therefore, we conclude that the association alcohol-Flunitrazepam presented deepening of depressant synergistic effects according to the increase in the dose of the benzodiazepine, and this could cause alterations in low frequency brain oscillations, breathing, and hemodynamics of the patient.

Impact of an IUCN national Red List of threatened flora on scientific attention

Red Lists are thought to attract attention to the conservation of threatened species. Determining the impact of these lists on the attention of scientists is a matter of consequence for biodiversity conservation. We evaluated trends in mentions of Brazilian angiosperm plants in the biodiversity conservation literature and tested the effect of the Red List of Brazilian Flora (RLBF) publication on these mentions. We collected mentions in the literature available in Google Scholar from the years 1990-2020, for 2449 Brazilian angiosperm species assessed in different IUCN categories. We used a Bayesian structural time-series method to test the effect of the RLBF publication on the number of mentions for the set of species in the IUCN categories, angiosperm families, and plants of commercial interest. The results showed a gap in mentions for many threatened and Data Deficient species in the scientific literature. We also found that the mentions were biased toward species of commercial interest and were unrelated to their threat status. Publication of the RLBF positively affected the number of mentions for IUCN threat categories and for more than half of the angiosperm families. These results were obtained after a few species of commercial interest were excluded from each treated group. This study suggests that the Red List assessments are essential to determine priorities for resource allocation to scientific activities. However, this effect was not sufficient to reduce the bias in scientific attention. Our findings support the need to stimulate more effective programs to fund research on threatened plant species.

Translational evaluation of training structures in equivalence-based instruction

We used a laboratory preparation to evaluate the claim that equivalence-based instruction (EBI) is an efficient form of instruction due to eliminating the need for emergent relations to be taught. Three groups of college students received training to establish 3 stimulus classes with 4 members in each class. Two groups received either a linear series (EBI-LS) or a 1-to-many training structure (EBI-OTM group). A control group received complete instruction (CI) that targeted all possible relations between the members of each class. The EBI-OTM group required fewer trials to complete instruction compared to CI, whereas EBI-LS did not. The EBI-OTM and the CI groups performed equally well on a posttest that followed initial attainment of the mastery criterion, whereas the EBI-LS group performed more poorly than the other 2. The groups' performance on a function transfer test did not differ. The results support the claim that compared to CI, EBI is an efficient form of instruction when it follows an OTM structure. However, they also suggest this efficiency advantage cannot be attributed to the fewer relations that need to be taught in EBI, as the EBI-OTM and the EBI-LS groups were trained on the same number of relations.

The effects of stimulus pairings on autistic children's vocalizations: Comparing forward and backward pairings

In a procedure known as stimulus-stimulus pairing (Yoon and Bennett, 2000), the experimenter pairs a target sound (e.g., "bah") with a child's preferred item (e.g., a toy). Even though the stimulus pairings proceed independently of the child's behavior, this procedure has proved capable of increasing imitation of the target sound in developmentally delayed children (Shillingsburg et al., 2015). The underlying behavioral processes remain poorly known, however, and few systematic variations of the basic procedure have been published. In the present experiment, with autistic children as participants, (a) we compared the effects of forward versus backward pairings on the imitation of target sounds, and (b) we evaluated formally the relation between the children's preexisting verbal repertoires and the efficacy of the pairing procedure. As is often reported in the Pavlovian literature, backward pairings promoted lower levels of conditional responding than forward pairings. Also, we found a negative relation between a child's verbal level and pairing efficacy: children with the lower scores on the Behavioral Language Assessment Form (Sundberg and Partington, 1998) exhibited more conditioning. These findings confirm in a single study what has been so far only suspected informally.

Review of the Pollination System by Small Diverse Insects

Many studies have evaluated and categorized the pollination systems of plants in different regions. These studies resulted in the definition of new pollination systems, such as that by small diverse insects (SDI). Although SDI systems are frequent in tropical communities, we know little about the species of plants and pollinators that compose these systems. This study synthesized knowledge of SDI systems through a systematic review of the literature, in order to characterize the composition of plants and pollinator species related to this pollination system. Most studies of SDI systems were carried out in tropical rainforest communities, and used a variety of terminologies and concepts. We found 362 plant species assigned to the SDI system, distributed in 76 families and 35 orders. These species are mainly trees and have inconspicuous greenish flowers, and most are hermaphroditic or dioecious. Few studies provided information on the composition of pollinators, which encompassed small and large insects; beetles, wasp, flies, and bees were the most frequent groups. We suggest adoption of the term "pollination system by diverse insects" instead of "small diverse insects." We discuss conceptual aspects and questions for studies with this pollination system.

Bees, birds and yellow flowers: pollinator-dependent convergent evolution of UV patterns

Colour is one of the most obvious advertisements of flowers, and occurs in a huge diversity among the angiosperms. Flower colour is responsible for attraction from a distance, whereas contrasting colour patterns within flowers aid orientation of flower visitors after approaching the flowers. Due to the striking differences in colour vision systems and neural processing across animal taxa, flower colours evoke specific behavioural responses by different flower visitors. We tested whether and how yellow flowers differ in their spectral reflectance depending on the main pollinator. We focused on bees and birds and examined whether the presence or absence of the widespread UV reflectance pattern of yellow flowers predicts the main pollinator. Most bee-pollinated flowers displayed a pattern with UV-absorbing centres and UV-reflecting peripheries, whereas the majority of bird-pollinated flowers are entirely UV- absorbing. In choice experiments we found that bees did not show consistent preferences for any colour or pattern types. However, all tested bee species made their first antennal contact preferably at the UV-absorbing area of the artificial flower, irrespective of its spatial position within the flower. The appearance of UV patterns within flowers is the main difference in spectral reflectance between yellow bee- and bird-pollinated flowers, and affects the foraging behaviour of flower visitors. The results support the hypothesis that flower colours and the visual capabilities of their efficient pollinators are adapted to each other.

Collagen type IV-related nephropathies in Portugal: pathogenic COL4A5 mutations and clinical characterization of 22 families

Alport syndrome (AS) is caused by pathogenic mutations in the genes encoding α3, α4 or α5 chains of collagen IV (COL4A3/COL4A4/COL4A5), resulting in hematuria, chronic renal failure (CRF), sensorineural hearing loss (SNHL) and ocular abnormalities. Mutations in the X-linked COL4A5 gene have been identified in 85% of the families (XLAS). In this study, 22 of 60 probands (37%) of unrelated Portuguese families, with clinical diagnosis of AS and no evidence of autosomal inheritance, had pathogenic COL4A5 mutations detected by Sanger sequencing and/or multiplex-ligation probe amplification, of which 12 (57%) are novel. Males had more severe and earlier renal and extrarenal complications, but microscopic hematuria was a constant finding irrespective of gender. Nonsense and splice site mutations, as well as small and large deletions, were associated with younger age of onset of SNHL in males, and with higher risk of CRF and SNHL in females. Pathogenic COL4A3 or COL4A4 mutations were subsequently identified in more than half of the families without a pathogenic mutation in COL4A5. The lower than expected prevalence of XLAS in Portuguese families warrants the use of next-generation sequencing for simultaneous COL4A3/COL4A4/COL4A5 analysis, as first-tier approach to the genetic diagnosis of collagen type IV-related nephropathies.

Maspin expression in carcinoma ex pleomorphic adenoma

AIMS

To investigate the presence and distribution of the protein maspin in carcinoma ex pleomorphic adenoma (CXPA).

METHODS

Maspin expression was studied by means of immunohistochemistry in 16 cases of CXPA, using the labelled polymer method.

RESULTS

According to the extent of invasion, the tumours were subdivided into: intracapsular (five cases), minimally invasive (four cases), and invasive (seven cases). Twelve patients had carcinoma with only epithelial differentiation, whereas four had a malignant myoepithelial component. Non-luminal cells in the duct-like structures of the remnant pleomorphic adenoma were strongly positive for maspin, whereas only a few luminal cells were immunopositive. A few positive cells were seen in the frequent hypocellular and hyalinised areas. Maspin was abundantly expressed, mainly in non-luminal cells, in transitional areas of CXPA with only epithelial differentiation. In frankly carcinomatous areas there was a gradual decrease in maspin expression. Almost all cells were maspin positive in CXPA with a myoepithelial component. When present, luminal cells were in general negative for maspin.

CONCLUSIONS

When only epithelial cells undergo malignant transformation, maspin expression is gradually lost. In cases with a myoepithelial component, maspin expression is high, and this might be related to the tumour suppressor activity attributed to this cell.

Carcinoma ex pleomorphic adenoma (CXPA): immunoprofile of the cells involved in carcinomatous progression

AIMS

To characterize the cellular component in pleomorphic adenoma (PA) that undergoes malignant transformation in carcinoma ex pleomorphic adenoma (CXPA).

METHODS AND RESULTS

A panel of antibodies against cytoskeletal proteins was applied in 16 cases of CXPA: intracapsular carcinoma (five cases), minimally invasive (four cases) and frankly invasive (seven cases). The CXPAs were classified into two main groups according to their predominant cellular component as detected by the panel of antibodies: (i) carcinomas with only epithelial differentiation (75% of the cases), and (ii) carcinomas with a myoepithelial component (25%). CXPA with only epithelial differentiation showed two types of malignant areas in the part of the tumour that was confined by the PA capsule: (i) intraductal carcinoma areas characterized by ductal structures containing both benign myoepithelial cells positive for alpha-smooth muscle actin (alpha-SMA), vimentin and cytokeratin (CK)14 and proliferating atypical luminal cells reactive for CK7, CK8 and CK19, and (ii) carcinoma areas composed only of epithelial cells reactive for CK7, CK8 and CK19. In the latter, the cells presented morphological and immunohistochemical characteristics similar to those found in areas of invasive carcinoma outside the PA capsule. CXPAs with a myoepithelial component were composed mainly or exclusively of cells that expressed vimentin and alpha-SMA. In this group, ductal structures reminiscent of PA filled by malignant cells were not identified.

CONCLUSION

Most CXPAs consist only of epithelial cells that have an immunoprofile comparable to ductal luminal cells of PA. These malignant luminal cells arise in the duct-like structures as intraductal carcinoma and probably only at this early stage of development should the lesion be considered as a non-invasive carcinoma.

Primary antiphospholipid syndrome presented by total infarction of right kidney with nephrotic syndrome

We report the case of a young woman with primary antiphospholipid syndrome (APS), which presented with acute renal failure, hypoproteinemia, hypoalbuminemia and nephrotic proteinuria. Investigations showed total infarction of right kidney by extensive arterial and vein thrombosis and presence of anticardiolipin antibodies IgG isotype (anti-beta2-glycoprotein I-positive). She was submitted to right nefrectomy and initiated anticoagulant therapy. After nefrectomy, the postoperative period was marked by the development of arterial hypertension and persistence of nephrotic syndrome. Hypertension was treated with antihypertensive drugs (IECA, beta-blocker and calcium antagonist). As the nephrotic syndrome persisted despite anticoagulant and antihypertensive therapy, the patient was treated with oral corticosteroids. Her renal function improved, hypoproteinemia and hypoalbuminemia corrected to normal values and proteinuria decreased to subnephrotic value. We discuss the unusual presentation of this case of primary antiphospholipid syndrome with total unilateral renal thrombosis and nephrotic syndrome that respond to anticoagulant, antihypertensive and corticosteroid therapy.

[Hepatitis B virus markers in peripheral blood mononuclear cells]

Recent studies have shown tropism of the hepatitis B virus (HBV) by peripheral blood mononuclear cells (PBMC). The consequences of this phenomenon and their clinical use are not yet clear, however. Seventy-nine patients were studied between March 1989 and October 1990. Sixty-nine patients had chronic liver disease with histological evaluations, and 10 were vaccinated for HBV. The following markers were determined: serum: HBsAg, HBeAg, anti-HBe, antitotal-HBc, anti-HBs, anti-HCV, HBV-DNA; lysated PMBC cells: HBsAg, HBeAg. Hepatic tissue: HBsAg, HBcAg. Four groups were formed according to serology. Group I--positive HBsAg patients (n = 25) HBsAg was observed in the lysated of PBMC in 19 (76%) of the patients. HBeAg in PBMC was detected in 8 (32%), all of them showed evidence of viral replication (presence of HBcAg and/or HBV-DNA in the serum HBcAg in the tissue). Group II--antitotal HBc/anti-HBs positive (n = 14), HBsAg in PBMC was found in 5 (36%) and HBeAg in 1 (7.0%). In this patient replication markers in the serum and in the tissue (HBV-DNA, HBcAg) was also present. Three patients out of 9 anti-HBs positive had HBsAg in PBMC. Group III--seronegative patients for HBV. HBsAg was present in PBMC in 2 (6.6%) of the patients, but was absent in all of them. There was concomitant presence of HBsAg in MN and the hepatic tissue in 1 patient. Replication markers were not observed in the group. Group IV--10 asymptomatic individuals vaccinated for HBV. Except anti-HBs in serum, no other HBV marker could be identified in serum or in PBMC.(ABSTRACT TRUNCATED AT 250 WORDS)

[Emphysematous cholecystitis]

Emphysematous cholecystitis (EC) is a rare and dramatic disease that requires prompt therapeutic procedures. The authors report a case of a 70-year-old-woman, admitted to the Intensive Care Unit for Infectious Diseases of the Santa Maria Hospital, with the diagnosis of EC. The literature on EC is also reviewed.

[Sarcoidosis as a cause of febrile++ syndrome of unknown origin. Retrospective study of 8 cases]

The authors report the results of a retrospective study of patients admitted to the Department of Infectious Diseases of Santa Maria Hospital with the diagnosis of sarcoidosis, from June 1982 to August 1991. Seven out of eight patients, were admitted due to fever of unknown origin. The results are discussed and the literature on sarcoidosis is also reviewed.

[Febrile coma and disseminated intravascular coagulation following heat stroke]

A clinical case that occurred in a 42 years old female and which fulfils the diagnostic criteria for the entity described as Heat Stroke is presented. In this case, besides the usual manifestations of hyperpyrexia without sweating along with consciousness disorders, features of consumptive coagulopathy, rhabdomyolysis and well marked laboratory liver dysfunction have also been found. The severity of this situation and its less common occurrence in temperate climates, together with the uncertainty in establishing the diagnosis, namely when infection is suspected--in the present case the initial diagnosis was Sepsis, which led to patient's admission in an infectious diseases intensive care unit--motivate the authors to make this report. Furthermore, they consider this case to be a good example of the varied clinical and laboratory manifestations and possible severe complications that Heat Stroke may display.

The relationship of education to critical thinking ability and values among nurses: socialization into professional nursing

Exposure to faculty is assumed to positively influence critical thinking ability and professional values; therefore, faculty must be assumed to be superior in these characteristics. As a first step toward testing these assumptions, this study used a cross-sectional survey technique to compare critical thinking ability and values in ADN-prepared (n = 32) and BSN-prepared (n = 32) registered nurses, nursing faculty (n = 32), and sophomore college students (n = 32) beginning a baccalaureate degree program in nursing. The critical thinking ability of faculty was not significantly higher than that of sophomore nursing students when the influence of age was controlled statistically. The values of all three groups of nurses were strikingly similar, although faculty valued achievement most highly (P = .0001), while sophomore students valued goal orientation most highly (P = .001). All subjects valued support highly, but only sophomore students valued benevolence highly.

Historical roots and future perspectives related to nursing ethics

This article traces the evolution of the development and the refinement of the professional code from concerns about the ethical conduct of nurses to its present state as a professional code for all nurses. The importance and the relationship of the Ethics Committee of the American Nurses' Association (ANA) to the development of the code and other ANA programs and structural units is also presented. The recognized need for a code of ethics to establish nursing as a profession has been present throughout the evolution of the professional nursing organization. A distinction between ethical conduct of nurses and a code of ethics for professional nurses has been made by nursing leaders. The code has been refined to reflect nursing's changing relationship to society and the societal concerns of the times.

Ethical issues in the behavioral treatment of children and adolescents

This article addresses a need to assess the acceptibility and evaluation of behavioral treatment as it is applied in child and adolescent inpatient settings. The choice of when and how to use behavioral interventions and the implications of these choices may present the nurse with certain ethical dilemmas related to ethical principles of autonomy, beneficence, and maleficence. In addition, the inpatient milieu structure is examined relative to possible ethical dilemmas.

Second operation for repair of biliary atresia

In our experience with biliary atresia, there are few cases amenable to reoperation for recurrent jaundice. All authors would agree that specific conditions such as complete bile flow recovery from the first operation followed by early recurrence should be an unquestionable case for revision of the anastomosis, inasmuch as no biologic signs of ongoing cholangitis can be traced. The same decision would apply to the problem of bile leakage after hepatoportocholecystostomy. In other cases, however, one should be aware that these reoperations expose the child to ascitis, poor healing of the abdominal wound, liver failure, and also bring with the decision to reoperate undue hopes to the parents of the child. Moreover, if the child should be a future candidate for liver transplantation, it may be wiser to avoid useless laparotomies and abdominal dissections that are known to complicate the task of hepatectomy.

Banding patterns of the chromosomes of Cebus apella: unstable chromosomes and pericentric inversion

Quinacrine- and Giemsa-banding studies of the chromosomes of Cebus paella permitted to establish a pattern for the species and revealed an extreme chromosome unstability in the specimens studied. The male showed a pericentric inversion in one of its chromosomes, while the female turned out to have four different cell lines, with multiple structural changes involving several pericentric inversions and one deletion. Comparison with previously reported results indicates the existence of a marked intra- and interspecific chromosome variability.

Banding patterns of the chromosomes of Cebus albifrons. Comparative study with Cebur apella

Quinacrine- and Giemsa-banding studies of the chromosomes of Cebus albifrons permitted to obtain a pattern that characterizes the species. The topography of the bands has been compared with that of Cebus apella. Each chromosome pair of C. albifrons has a homologue in C. apella. The differences between the two karyotypes are the result of five pericentric inversions.

Behavior modification approach in a partial day treatment center

Since the beginning of the program in September 1970, we have found that a combined behavioral program of individual therapy, home intervention, and group therapy to be the most effective for maintaining a person in his community. In addition, we have not seen a need for a full eight-hour day in the clinic. Rather, we operate on the principle that it is more adaptive to keep a patient functioning in the community (natural environment) with support from us. For the extremely or severely disorganized person, we have found the application of behavior modification principles to be the most useful in the terms of establishing and maintaining adaptive behaviors, of interruptin and decreasing maladaptive behaviors and of offering support and guidance (generalization) to patients and families. We have also increased the amount of individual therapy and intensified the home intervention program. These changes have been based upon subjective data as well as objective data (change in patient behavior while receiving and following a particular mode of therapy). The program has undergone many changes since its inception. We have found the behavior modification modality to be effective for establishing a program that patients can generalize to their community setting. Our constant thrust is to utilize already existing agencies in the community and to optimally assist the patient so that he may remain in his community. We have gone from an eclectic program to a systematic behavior modification program. The present behavioral program has been demonstrated to be an effective modality for the training of personnel. We are grateful to our staff for their cooperation and suggestions in making the program successful. In addition, we are indebted to our late Director, Curtis W; Gifford--a loyal and dedicated friend. We particularly appreciate his administrative skills and encouragement in developing an autonomous program.