Spatiotemporal Mapping Reveals Regional Gastrointestinal Dysfunction in mdx Dystrophic Mice Ameliorated by Oral L-arginine Supplementation

Background/Aims@#Patients with Duchenne muscular dystrophy exhibit significant, ongoing impairments in gastrointestinal (GI) function likely resulting from dysregulated nitric oxide production. Compounds increasing neuronal nitric oxide synthase expression and/or activity could improve GI dysfunction and enhance quality of life for dystrophic patients. We used video imaging and spatiotemporal mapping to identify GI dysfunction in mdx dystrophic mice and determine whether dietary intervention to enhance nitric oxide could alleviate aberrant colonic activity in muscular dystrophy. @*Methods@#Four-week-old male C57BL/10 and mdx mice received a specialized diet either with no supplementation (control) or supplemented (1 g/kg/day) with L-alanine, L-arginine, or L-citrulline for 8 weeks. At the conclusion of treatment, mice were sacrificed by cervical dislocation and colon motility examined by spatiotemporal (ST) mapping ex vivo. @*Results@#ST mapping identified increased contraction number in the mid and distal colon of mdx mice on control and L-alanine supplemented diets relative to C57BL/10 mice (P < 0.05). Administration of either L-arginine or L-citrulline attenuated contraction number in distal colons of mdx mice relative to C57BL/10 mice. @*Conclusions@#GI dysfunction in Duchenne muscular dystrophy has been sadly neglected as an issue affecting quality of life. ST mapping identified regional GI dysfunction in the mdx dystrophic mouse. Dietary interventions to increase nitric oxide signaling in the GI tract reduced the number of colonic contractions and alleviated colonic constriction at rest. These findings in mdx mice reveal that L-arginine can improve colonic motility and has potential therapeutic relevance for alleviating GI discomfort, improving clinical care, and enhancing quality of life in Duchenne muscular dystrophy.

The epidemiology of respiratory disease in Zimbabwe

This review of the burden of respiratory diseases in children and adult Zimbabweans is based on limited available literature and highlights a need for more descriptive epidemio- logical studies. In children; the commonest reported causes of respiratory mortality were acute pyogenic pneumonia; Pneumocystis carinii pneumonia; and tuberculosis; with different patterns of diseases evident between HIV-positive and HIV-negative children. Asthma and other atopic conditions are common but under-reported due to a predomi- nance of publication on HIV-related subjects. In adults; exposure to indoor air pollution due to burning of biomass fuels is probably associated with acute respiratory infections; asthma; chronic obstructive pulmonary disease; lung cancer; and nasopharyngeal and laryngeal cancers in Zimbabwe as in other regions. These conditions also have other common risk factors including malnutrition and tobacco smoking but the prevalence rates of these conditions and their associations with risk factors are not known. In adults with chronic cough; tuberculosis is the most common diagnosis among HIV infected adults but lower respiratory tract infections and asthma were more common among HIV- negative patients. Factors associated with tobacco smoking in Zimbabwe are discussed

Resucitación cardiopulmonar en pacientes hospitalizados / Cardiopulmonary resuscitation in hospitalized patients

Antecedentes: La introducción de la reanimación cardiopulmonar (RCP) en pacientes ambulatorios ha demostrado ser de utilidad, mientras que en pacientes hospitalizados los resultados han sido poco satisfactorios. El objetivo de nuestro trabajo fue identificar variables pronósticas que puedan afectar los resultados inmediato y final de la RCP para hacer un uso más racional de éste procedimiento. Materiales y métodos: Fueron estudiados prospectivamente todos los pacientes internados que tuvieron paro cardio-respiratorio (PCR) y recibieron RCP en un hospital de la comunidad y se analizaron 9 variables que pudieran influir en los resultados. Se hizo el análisis estadístico con el test de Chi-Cuadrado. Resultados: Se analizaron 127 casos de PCR, 54 (43 por ciento) fueron resucitados exitosamente; 20 (16 por ciento) sobrevivieron el alta de la Unidad de Cuidados Intensivos (UCI) y 14 (11 por ciento) permanecieron vivos a los 3 meses del PCR, sólo 12 (9 por ciento) fueron dados de alta del Hospital. Los factores pronósticos favorables que se identificaron fueon los siguientes: la localización del PCR, la corta duración de la RCP, un ritmo inicial diferente de la asistolia, la ausencia de falla orgánica previa y un tiempo breve de internación pre-RCP. Conclusiones: Nuestro trabajo confirma que el resultado de la RCP en pacientes hospitalizados es pobre. La identificación de los factores pronósticos permiten un uso más racional de la RCP. El mayor número de éxitos de este procedimiento fue obtenido fuera del área de cuidado crítico, con lo que se reafirma la necesidad de contar con un equipo entrenado en esta técnica que pueda operar las 24 horas en todas las áreas del hospital