Specific immediate early gene expression induced by high doses of salicylate in the cochlear nucleus and inferior colliculus of the rat / Expressão específica de genes precoces imediatos induzida por doses elevadas de salicilato no núcleo coclear e colículo inferior de rato

Abstract Introduction: Salicylate at high doses induces tinnitus in humans and experimental animals. However, the mechanisms and loci of action of salicylate in inducing tinnitus are still not well known. The expression of Immediate Early Genes (IEG) is traditionally associated with long-term neuronal modifications but it is still not clear how and where IEGs are activated in animal models of tinnitus. Objectives: Here we investigated the expression of c-fos and Egr-1, two IEGs, in the Dorsal Cochlear Nucleus (DCN), the Inferior Colliculus (IC), and the Posterior Ventral Cochlear Nucleus (pVCN) of rats. Methods: Rats were treated with doses known to induce tinnitus in rats (300 mg/kg i.p. daily, for 3 days), and c-fos and Egr-1 protein expressions were analyzed using western blot and immunocytochemistry. Results: After administration of salicylate, c-fos protein expression increased significantly in the DCN, pVCN and IC when assayed by western blot. Immunohistochemistry staining showed a more intense labeling of c-fos in the DCN, pVCN and IC and a significant increase in c-fos positive nuclei in the pVCN and IC. We did not detect increased Egr-1 expression in any of these areas. Conclusion: Our data show that a high dose of salicylate activates neurons in the DCN, pVCN and IC. The expression of these genes by high doses of salicylate strongly suggests that plastic changes in these areas are involved in the genesis of tinnitus.

Resumo Introdução: Salicilato em doses elevadas induz zumbido nos seres humanos e em animais experimentais. No entanto, os mecanismos e loci de ação do salicilato na indução de zumbido ainda não são bem conhecidos. A expressão dos genes precoces imediatos (GPIs) está tradicionalmente associada a alterações neuronais em longo prazo, mas ainda não está claro como e onde os GPIs são ativados em modelos animais de zumbido. Objetivos: No presente estudo investigamos a expressão de c-fos e Egr-1, dois GPIs, no núcleo coclear dorsal (NCD), colículo inferior (CI) e núcleo coclear ventral posterior (NCVp) de ratos. Métodos: Os ratos foram tratados com doses que, conhecidamente, induzem zumbido em ratos (300 mg/kg IP/dia, por três dias) e as expressões das proteínas c-fos e Egr-1 foram analisadas por meio de Western blot e imunoistoquímica. Resultados: Após a administração de salicilato, a expressão da proteína c-fos aumentou significativamente no NCD, NCVp e CI, quando analisados por Western blot. A coloração imunoistoquímica mostrou uma marcação mais intensa de c-fos no NCD, NCVp e CI e um aumento significativo de núcleos positivos de c-fos no NCVp e CI. Não detectamos aumento da expressão de Egr-1 em qualquer dessas áreas. Conclusão: Nossos dados mostram que uma dose alta de salicilato ativa neurônios no NCD, NCVp e CI. A expressão desses genes por doses altas de salicilato sugere que as alterações plásticas nessas áreas estão envolvidas na gênese do zumbido.

Helicobacter pylori infection and thrombocytopenia: A single-institution experience in Mexico / Infección por Helicobacter pylori y trombocitopenia: Experiencia en una sola institución mexicana

The association between gastrointestinal H. pylori infection and thrombocytopenia was studied in a single institution in Mexico, over a 5-year period. In 99 individuals with H. pylori infection, the prevalence of thrombocytopenia was 14%, whereas in 23 consecutive patients with chronic refractory thrombocytopenic purpura, the prevalence of H. pylori infection was 60%, this figure being similar to that informed in the general population of Mexico (66%); the association between thrombocytopenia and H. pylori infection was not significant. In 14 patients who were found to have both thrombocytopenia and H. pylori infection, eradication treatment was given and the platelet count recovered in three. It is not still clear if detection of H. pylori infection should be routinely included in the initial workup of chronic thrombocytopenia.

Se investigó la asociación entre infección del tubo digestivo por H. pylori y trombocitopenia en una sola institución en México, en un periodo de cinco años. En 99 individuos infectados por H. pylori, la prevalencia de trombocitopenia fue de 14%; por otro lado, en 23 pacientes consecutivos con púrpura trombocitopénica crónica refractaria, la prevalencia de infección por H. pylori fue de 60%, cifra similar a la descrita para la población general de nuestro país, de alrededor de 66%; en consecuencia, la asociación entre trombocitopenia e infección por H. pylori no fue significativa. En 14 pacientes en quienes coexistieron púrpura trombocitopénica e infección por H. pylori, se administró tratamiento de erradicación de la bacteria y la cuenta de plaquetas se normalizó en tres. Los datos apoyan otras publicaciones que muestran falta de asociación entre estas variables y son insuficientes para recomendar si es prudente o no investigar la infección por H. pylori en el estudio inicial de todos los pacientes con púrpura trombocitopénica.

Efficacy of Two Triple Eradication Regimens in Children with Helicobacter pylori Infection

Triple therapy with bismuth subsalicylate, amoxicillin, metronidazole (BAM) or with omeprazole, amoxicillin, clarithromycin (OAC) has been commonly used for the eradication of Helicobacter pylori infection. We compared the efficacy of these triple therapies in children with H. pylori infection. We retrospectively analyzed results in 233 children with H. pylori infection and treated with OAC (n=141) or BAM (n=92). Overall eradication rates of triple therapy with OAC and BAM were 74% and 85%, respectively, which showed no statistical difference. Our study showed that the triple therapy with BAM was more effective for the first-line eradication of H. pylori infection in Korean children, but has no statistical difference with OAC regimen.

Efficacy of Two Triple Eradication Regimens in Children with Helicobacter pylori Infection

Triple therapy with bismuth subsalicylate, amoxicillin, metronidazole (BAM) or with omeprazole, amoxicillin, clarithromycin (OAC) has been commonly used for the eradication of Helicobacter pylori infection. We compared the efficacy of these triple therapies in children with H. pylori infection. We retrospectively analyzed results in 233 children with H. pylori infection and treated with OAC (n=141) or BAM (n=92). Overall eradication rates of triple therapy with OAC and BAM were 74% and 85%, respectively, which showed no statistical difference. Our study showed that the triple therapy with BAM was more effective for the first-line eradication of H. pylori infection in Korean children, but has no statistical difference with OAC regimen.

Investigation of an epidemic of Reye's syndrome in northern region of India.

OBJECTIVE: To determine the extent, epidemiological and clinical features of an epidemic of non-inflammatory encephalopathy in northern region of India. DESIGN: Surveillance of referred cases having unconsciousness after a short bout of fever during October and November 1997. Case control study in 7 most affected villages. METHODS: Active case finding was done to assess the extent and severity of the epidemic by interviewing health professionals and by reviewing mortality records in 10 districts of Haryana, Punjab and Chandigarh. A house to house survey was conducted in seven most affected villages. A case was defined as any child of less than 15 years of age, who had prodromal fever followed by vomiting and unconsciousness with subsequent recovery or death. Two age and sex matched controls who had fever without unconsciousness were taken for each case, one from nearby house and another staying furthest from the affected house. These groups were compared for various epidemiologic factors, clinical features and treatment pattern. Residual medicines used by affected patients were tested for presence of salicylate. Local village practitioners were interviewed for their knowledge and attitude towards use of aspirin in a febrile child. RESULTS: Information regarding 129 affected children (M: F=1 : 1) could be obtained. Age ranged between 1 to 12 years (mean 5.8 years). Most were from rural or semi-suburban areas. Attack rate was 5.4/1000 and case fatality rate was 72%. Multiple sibs were affected in 9.3%. History of fever was reported by 83%, vomiting preceding unconsciousness by 83% and abnormal behavior by 65%. Abnormal posturing was reported in 55%. Seventeen (61%) of 28 samples had IgM antibodies in serum/CSF against measles. Twelve (36%) of 33 serum samples tested positive for Varicella zoster virus. None gave history of aspirin intake and 10 samples of residual drugs did not contain salicylate. However, 6 out of 19 blood samples taken from affected patients contained salicylate. Environmental factors were in favor of Japanese encephalitis (JE) but brain biopsy and serology disproved it. Based on earlier report of JE from this area, the cases in present epidemic were being reported as JE before this study was undertaken. Intensive fogging with malathion was being undertaken as antimosquito measure, specially around the affected houses. Local village practitioners (n = 37) were unaware of contraindications of aspirin in a febrile child. CONCLUSION: Measles and varicella zoster emerged as the probable etiologies for the viral prodrome precipitating these cases of Reye's syndrome. Aspirin might have a contributory role. Malathion is another putative cofactor.

Relación de los factores de riesgo: estado de nutrición y nivel de hábitos de higiene personal con la frecuencia de Verruga Vulgar, y efecto del tratamiento con el Acido Salicílico; en estudiantes del C.E Julio C. Tello del pueblo joven Ciudad Blanca-Paucarpata, Arequipa setiembre de 1994

La Verruga Vulgar Pápula Dérmica, es un problema de salud a nivel mundial, tanto por su contagiosidad como por el aspecto de las lesiones cutáneas. El siguiente estudio se realizó en los estudiantes del nivel primario y secundario, del turno de mañana y tarde, del C.E Julio C. Tello; para determinar la presencia de verruga vulgar y su relación con los factores de riesgo: estado de nutrición y nivel de hábitos de higiene personal, así como comparar el efecto terapéutico del ácido salicílico con un placebo. Consta de dos partes: la primera parte de tipo transversal, pseudoretrospectivo y analítico; la segunda parte de tipo longitudinal, prospectivo y experimental. Se formó el grupo de casos y el grupo control; para encontrar el nivel de habitos de higiene personal en el sistema vigesimal, el estado de nutrición en desviaciones estandard; y relacionarlo con la frecuencia de lesiones de verruga vulgar. Luego se seleccionó 134 estudiantes con verruga vulgar; para formar el grupo experimental y grupo control experimental. Se midió las lesiones de verruga vulgar. Aplicamos tratamiento con ácido salicílico al 26 por ciento en solución de colodion y placebo; durante 15 días por una sola vez al día. Después de una semana de terminar el tratamiento se evaluó el efecto terapéutico. La frecuencia de verruga vulgar fue de 11.63 por ciento; con las siguientes características: es más frecuente; relativamente el sexo masculino con 11.74 por ciento, el grupo etáreo de 8-10 años con 32.6 por ciento, en mano con 71.73 por ciento, el estudiante con una sola lesión con 37.71 por ciento. Solo presentan desnutrición crónica 30.29 por ciento de estudiantes con verruga vulgar, siendo indirecta la relación entre el estado de desnutrición y la frecuencia de lesiones de verruga vulgar, (p<0.05). Presentan nivel de hábitos de higiene personal deficiente 52 por ciento de estudiantes con verrugavulgar, siendo indirecta la relación entre el nivel de hábitos de higiene personal y la frecuencia de lesiones de verruga vulgar, (p<0.001). El efecto terapéutico del ácido salicílico es mejor que el placebo; según el número de estudiantes, número de lesiones, el diámetro y la altura de las lesiones; en todos los casos (p<0.001). Que los profesores pongan más énfasis en la enseñanza sobre la importancia de la higiene personal, se aumente la cobertura del PRONAA en los centros educativos; realizar más estudios sobre el tratamiento de la verruga vulgar con ácido salicílico