Years of Life Lost (YLLs) due to drug-related deaths in the Islamic Republic Of Iran (2014-2017): a temporal and geographic pattern / Anos de Vida Perdidos (AVP) devido a mortes relacionadas a drogas na República Islâmica do Irã (2014-2017): um padrão temporal e geográfico

Abstract The present study aimed to measure the mortality burden caused by premature death due to substance abuse in different geographical regions of Iran from 2014-17. In this serial cross-sectional study, the data related to individuals who had died of drug abuse were first collected from two sources (Iranian Ministry of Health and Medical Education and the Iranian Legal Medicine Organization). Then, using the capture-recapture method, the number of drug-related deaths was estimated. The years of life lost (YLLs) for all provinces of Iran was calculated based on age, sex, and year. During these four years, the total number of deaths was 12029. The mean age of the individuals was 37.3±14.1. The mean age of dead people was constant in women and men over this period; however, the mean age of dead women due to substance abuse was lower than that of men. The mean YLLs per dead person was 70131.3329 years for men and 9321.1125 years for women. The potential years of life lost (YLLs) showed an upward trend, which was stronger in women than men. It is necessary to perform more regional overviews for finding differences in the number of YLLs due to substance abuse so that specific regional policies can be adopted.

Resumo O presente estudo teve como objetivo medir a carga de mortalidade causada por morte prematura por abuso de substâncias em diferentes regiões do Irã de 2014-17. Neste estudo transversal serial, os dados relacionados aos indivíduos que morreram por abuso de drogas foram coletados primeiramente em duas fontes (Ministério da Saúde e Educação Médica do Irã e Organização de Medicina Legal do Irã). Em seguida, usando o método de captura-recaptura, estimou-se o número de mortes relacionadas a drogas. Os anos de vida perdidos (AVP) para todas as províncias do Irã foram calculados com base na idade, sexo e ano. Durante quatro anos, o número total de óbitos foi de 12029. A média de idade dos indivíduos foi de 37,3±14,1. A média de idade dos mortos foi constante em mulheres e homens ao longo desse período; entretanto, a média de idade das mulheres mortas por abuso de substâncias foi menor do que a dos homens. O AVP médio por pessoa morta foi de 70131,3329 anos para homens e 9321,1125 anos para mulheres. Os anos potenciais de vida perdidos (APVP) apresentaram tendência ascendente, sendo mais forte nas mulheres do que nos homens. É necessário realizar mais análises regionais para encontrar diferenças no número de AVP devido ao abuso de substâncias.

Homicidios de niñas, niños y adolescentes en el sureste de México, entre 2000 y 2017 / Homicides in children and adolescents in Southeast Mexico, between 2000 and 2017

Resumen Introducción: México atraviesa por un contexto de violencia creciente que incluye el aumento de homicidios y feminicidios a lo largo del territorio nacional. Los estudios existentes presentan vacíos de corte regional y de grupos de edad, en particular, el de 0 a 17 años. El objetivo de este artículo es describir el impacto de la mortalidad por homicidios sobre la población de 0 a 17 años en el sureste mexicano, una de las regiones más sacrificadas en materia de derechos humanos y bienestar social. Metodología: mediante las estadísticas de mortalidad general del Instituto Nacional de Estadística y Geografía, se calcularon las tasas brutas de mortalidad y las tasas específicas por sexo y grupos de edad correspondientes al período 2000-2017. Se estimó el promedio de Años de Vida Perdidos. El tipo de estudio es descriptivo y analiza el efecto de los homicidios en la tendencia de la mortalidad y la esperanza de vida. Resultados: los resultados mostraron que el más alto porcentaje de homicidios lo obtuvieron los hombres de todos los grupos etarios. En términos del promedio de AVP, las mujeres adolescentes del conjunto de 12 a 17 años evidenciaron los mayores incrementos. Conclusiones: las tasas de mortalidad por homicidio se comportaron heterogéneamente; resalta la vigencia y aumento de ataques letales contra niñas, niños y, especialmente, adolescentes.

Abstract Introduction: Mexico is currently facing a context of raising violence that includes the increase of homicides and feminicides in the nation-wide territory. The existent studies present certain gaps regarding regional and age groups information. In particular, those gaps are relevant for population from 0 to 17 years old. That is why this article aims to describe the mortality impacts by means of homicides among that age group in Southeast Mexico. This region is one of the most abandoned in terms of Human Rights and Social Well-Being. Methodology: The article uses the general mortality statistics of the National Institute of Statistics and Geography to calculate the gross mortality rates as well as the specific rates by age and sex groups from 2000 to 2017. Likewise, the average years of life lost are calculated. The study is descriptive and analyzes the impact of homicides within the trend of mortality and life expectancy. Results: A main result shows to the highest percentage of homicides occur among men. However, in terms of the average number of YLL and for the age group 12 to 17 years the largest increases occur among adolescent women. Conclusions: The Southeast region of Mexico presents heterogeneous behavior in homicide mortality rates for the age group 0 to 17 years, highlights the validity and increase of lethal violence against girls, boys and particularly adolescents.

Evaluación de veinte años de Lignum-vitae (Guaiacum sanctum, Zygophyllaceae) en el Parque Nacional Palo Verde de Costa Rica

Introducción: El guayacán real (Guaiacum sanctum; Zygophyllaceae) de Mesoamérica y las Antillas está amenazado en gran parte de su área de distribución. Evaluamos si una población de G. sanctum en el Parque Nacional Palo Verde en Costa Rica es viable a largo plazo. Métodos Usando dos estudios demográficos, uno en 1997 y otro en 2017, estimamos las tasas de supervivencia y fecundidad para cada clase de edad, la tasa de crecimiento poblacional (lambda), y las elasticidades para cada tasa vital, y usamos un modelo determinístico denso-independiente para proyectar la trayectoria a largo plazo de la población. Resultados: Las tasas vitales estimadas durante los últimos 20 años sugieren que esta población está disminuyendo rápidamente, con un lambda estimado de 0.62. Aunque algunas clases de edad aumentaron en abundancias, los renovales son raros y los individuos reclutados en 1997 aún no alcanzaron la madurez reproductiva. Nuestros resultados sugieren que la abundancia actual de G. sanctum dentro del Parque Nacional podría no ser un buen indicador del estado de conservación a largo plazo, y por nuestro análisis de viabilidad poblacional, estimamos que la población estudiada disminuiría a menos del 1 % de su actual abundancia en los próximos 200 años. Conclusiones: El deterioro ecosistémico a escala de paisaje esta afectando la región del Parque Nacional Palo Verde, como la pérdida de dispersores de semillas y la supresión de alteraciones, podría compensar la protección pasiva de G. sanctum dentro de los límites del Parque Nacional. Confiar en la estricta protección dada por la locación de la población dentro del parque podría no ser suficiente para conservar esta población de G. sanctum. Recomendamos incorporar, dentro de un programa de investigación, una protección experimental más proactiva y/o medidas de restauración, posiblemente incluyendo tratamientos de alteraciones.

Introduction: The Lignum-vitae (Guaiacum sanctum; Zygophyllaceae) of Mesoamerica and the Greater Antilles, is threatened over much of its range. We evaluated whether a G. sanctum population in the Palo Verde National Park of Costa Rica is viable in the long term. Methods: Using two demographic studies, one in 1997 and the other in 2017, we estimated survival and fecundity rates for each tree age class, population growth rate (lambda), and vital rates elasticity, and we used a density-independent deterministic population model to project the long-term trend of that population. Results: The estimated vital rates during the last 20 years suggested that this population is rapidly decreasing. Although some age classes increased in abundance, seedlings are rare and the plants that recruited in 1997 have not yet reached reproductive maturity. Our results suggest that the current abundance of G. sanctum within the national park may not be a good indicator of its long-term conservation status, and from our population viability analysis, we estimated that the population we studied would decrease to less than 1 % of its current size within the next 200 years. Conclusions: Landscape-scale ecosystem deterioration affecting the greater PVNP region, such as loss of seed dispersers and suppression of disturbances, may offset the passive protection of G. sanctum within park boundaries. Relying on the overall strict protection afforded by the location of the population within the Palo Verde National Park may not be sufficient to conserve this population of G. sanctum. We recommend that more proactive experimental protection and/or restoration measures, possibly including disturbance treatments, be implemented within a research program.

Arginine Vasopressin-Aquaporin-2 Pathway-Mediated Dehydration Effects of Electroacupuncture in Guinea Pig Model of AVP-Induced Eendolymphatic Hydrops / 中国结合医学杂志

OBJECTIVE@#To investigate the effects of electroacupuncture (EA) on endolymphatic hydrops (EH) and the regulation of arginine vasopressin (AVP)-aquaporin-2 (AQP2) pathway in guinea pigs.@*METHODS@#EH was induced in male guinea pigs by an intraperitoneal injection of AVP. For the treatment, EA was delivered to Baihui (GV 20) and Tinggong (SI 19) acupoints, once per day for 10 consecutive days. In histomorphological studies, cochlear hydrops degree was evaluated by hematoxylin-eosin (HE) staining, and then the ratio of scala media (SM) area to SM + scala vestibuli (SV) area (R value) was calculated. In mechanical studies, a comparison of plasma AVP (p-AVP) concentrations, cyclic adenosine monophosphate (cAMP) levels, vasopressin type 2 receptor (V2R) and AQP2 mRNA expressions in the cochlea were compared among groups.@*RESULTS@#EA significantly reduced cochlear hydrops in guinea pigs (P=0.001). EA significantly attenuated the AVPinduced up-regulation of p-AVP concentrations (P=0.006), cochlear cAMP levels (P=0.003) and AQP2 mRNA expression (P=0.016), and up-regulated the expression of V2R mRNA (P=0.004) in the cochlea.@*CONCLUSIONS@#The dehydrating effect of EA might be associated with its inhibition of AVP-AQP2 pathway activation.

Distres respiratorio agudo post aislamiento percutáneo de venas pulmonares / Post-isolation acute respiratory distress percutaneous pulmonary veins

Resumen Paciente de 48 años con historia de fibrilación auricular paroxística, dislipidemia y antecedente de ablación de vía accesoria (2013). Anti coagulado con Rivaroxaban 20 mg PO. Paciente es llevado a aislamiento percutáneo de venas pulmonares (AVP) con sistema de navegación tridimensional Carto 3. 48 horas post AVP inicia con cuadro de distrés respiratorio agudo que requiere hospitalización en unidad de cuido intensivo, que resuelve con manejo diurético y antiinflamatorio. Describimos la importancia del manejo hídrico en relación al AVP.

Abstract 48 years old male, previous history of paroxysmal atrial fibrillation, hiperlipemia and previous accesory pathway ablation an 2013. Anticoagulated with Rivaroxaban 20mg PO. Patient underwent pulmonary vein insolation (PVI) with Carto 3 tridimensional navigation and mapping system. Discharged on day 1 after PVI, readmitted with acute respiratory distress that required intensive care unit admission that resolves with diuretics and anti-inflammatory management. We describe the role of hydric management related with PVI procedure.

Clinical Observation of Xingpi Yang'er Granule in the Treatment of Primary Nocturnal Enuresis in Chil-dren / 中国药房

OBJECTIVE:To observe the efficacy and safety of Xingpi yang'er granule in the treatment of primary nocturnal en-uresis in children. METHODS:97 children with primary nocturnal enuresis were randomly divided into control group (46 cases) and observation group(51 cases). Control group received Racemic anisodamine tablet 0.5 mg/(kg.d),orally,once a day+Vitamin B1 tablet 10 mg,orally,3 times a day+Oryzanol tablet 10 mg,orally,3 times a day + Meclofenac hydrochloride capsule 0.1 g 30 min before going to bed,orally,once a day. Observation group was additionally received Xingpi yang'er granule 0.4 g for 5-6 years old and 0.6 g for 7-14 years old,3 times a day. They were treated for 4 weeks. Clinical efficacy,kidney Yang deficiency score,wake-up threshold,bladder capacity,bladder volume,BVWI,enuresis frequency,AVP,cAMP,cGMP,cAMP/cGMP be-fore and after treatment,recurrence rate and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total ef-fective rate in observation group was significantly higher than control group(P0.05);after 6 months,the total effective rate recur-rence rate in observation group was significantly lower than control group(P0.05). CONCLUSIONS:Based on conventional treatment,Xingpi yang'er granule shows good efficacy and safety in the treatment of primary nocturnal enuresis in children,which can improve children's kidney Yang deficiency score,wake-up threshold and bladder capacity and serum AVP.

Giant Hepatic Artery Aneurysm Associated with Immunoglobulin G4-Related Disease Successfully Treated Using a Liquid Embolic Agent

No abstract available.

Effect of different cold and hot properties of TCM on thermoregulation of yeast induced fever rats / 国际中医中药杂志

Objective To compare the effect of 4 different cold and hot properties of traditional Chinese medicine (TCM) on body temperature and related factors of yeast induced fever rats,and discuss the thermoregulatory mechanism of cold and hot properties of TCM.Methods 108 male SD rats were randomly divided into a normal group,a yeast-induced group,a R.palmatum treated group,a C.chinensis treated group,a Euodia ruticarpa treated group,and a Alpinia officinarum Hance treated group,with 18 rats in each group.Pyrexia model was induced by injecting yeast suspension subcutaneously on rat.At the 4h,8h and 12h after injection of yeast,the rats were sacrificed,and the blood and hypothalamus were collected.The levels of prostaglandin E2 (PGE2),cyclic adenosine 3',5'-monophosphate (cAMP) and arginine vasopressin (AVP) in hypothalamus and plasma were detected by ELISA assay.Results At the 4h after injection of yeast,the temperature of rats in the model group began to rise,and it reached the peak at 8h,while RheumpalmatumL and Coptis chinensis could significantly reduce the body temperature of yeast-induced rat (P＜ 0.01 or P＜ 0.05).At 8h,the levels of PGE2 and cAMP in hypothalamus increased significantly [respectively (31.55 ± 9.88) pg/mg and (0.17±0.03) pmol/mg] compared with the normal group,while the level of AVP (0.14±0.02) pmol/ml in plasma reduced (P＜0.05).Compared with model group,at 8h RheumpalmatumL and Coptis chinensis could significantly lowered PGE2 [respectively (113.65± 18.60) pg/mg and (127.72 ± 15.75) pg/mg,P＜ 0.01 or P＜0.05],and cAMP [respectively (0.69±0.08) pmol/mg and (0.74±0.10) pmol/mg,P＜0.05] in hypothalamus,and increased AVP levels [respectively (1.08 ± 0.12) pmol/ml and (0.91 ±0.01) pmol/ml,P＜0.05 or P＜0.01] in plasma.Euodia ruticarpa and Alpinia officinarum had no significant effect on both body temperature and the levels of inflammatory factors.Conclusion The two cold property traditional Chinese medicines,R.palmatum and C.chinensis,could significantly reduced the body temperature of yeast-induced rats,which may be related to its effective regulation on levels of PGE2 and cAMP in hypothalamus and AVP in plasma,however,the two hot property traditional Chinese medicine,Euodia ruticarpa and Alpinia officinarum Hance,had no related effects.

Copeptin: A Neuroendocrine Biomarker in Acute Myocardial Infarction.

Copeptin is a novel neuroendocrine peptide recently introduced to the field of acute medicine biomarkers. It is 39 amino acids glycopeptide cosynthesized with arginine vasopressin (AVP) and released together in stoichiometric pattern from the hypothalamus upon stimulation of AVP release. Due to difficulties of AVP assay, copeptin largely replaced it in clinical assay as surrogate biomarker because copeptin has easier and more valid measurement methods. In acute stress condition, copeptin rises and reflects stress level exactly like AVP which was largely known as mediator of non-specific stress conditions beside its prominent role in water homeostasis. Acute myocardial infarction (AMI) is an acute stress state in which plasma copeptin rises. Early identification of AMI is a problem due to the delayed appearance of the cardiospecific troponins which start to rise within 6-9 hours from the onset of chest pain. In the recent years many studies concluded that, when copeptin is combined with cardiac troponins in diagnosis of patients presenting with acute chest pain in early hours, it accelerates early rule in of AMI and rule out of non-MI patients. This review article discusses the biochemical and physiological basics of copeptin beside its clinical diagnostic value in AMI according to results and conclusions of some studies carried out on copeptin in AMI diagnostic field.

Cierre percutáneo del conducto arterioso permeable en niños utilizando el Amplatzer vascular plug II / Percutaneous closure of patent ductus arteriosus in infants using the Amplatzer vascular plug II

El cierre percutáneo del conducto arterioso permeable (CAP) es una modalidad de tratamiento bien establecida. El Amplatzer vascular plug II (AVP II) es un dispositivo oclusor autoexpandible, indicado para oclusiones arteriales o venosas en la vasculatura periférica. Describimos nuestra experiencia clínica inicial en el cierre percutáneo del CAP, utilizando el AVP II en la edad pediátrica. El tamaño del dispositivo fue seleccionado de acuerdo al tamaño y morfología del CAP, con un diámetro mayor al 100% del diámetro mínimo del CAP. Los dispositivos fueron implantados a través de una vaina por vena o arteria femoral. En 18 pacientes, el AVP II se utilizó para oclusión del CAP. La mediana de edad fue 24 meses (intervalo: 6-51) y la media de peso, 10.5 kg (intervalo: 4.8-16.5). El diámetro más estrecho del CAP mostró una mediana de 1.1 mm (intervalo: 0.3-7.0). Se logró el implante exitoso y la oclusión angiográfica en 14 pacientes (77.8%). El tamaño del dispositivo implantado mostró una media de 3.9 ± 2.4 veces el diámetro mínimo del CAP. Dos pacientes fueron enviados a cirugía. Ocurrieron dos embolizaciones. El ecocardiograma transtorácico de 24 horas confirmó oclusión total en 13 casos (72.2%). Durante el periodo de seguimiento no se han reportado complicaciones. El cierre percutáneo de CAP < 2 mm con AVP II es una técnica segura y efectiva, particularmente para oclusión de vasos de pequeño diámetro con bajo flujo.

Percutaneous closure of patent ductus arteriosus (PDA) is a well established treatment modality. The Amplatzer vascular plug II (AVP II) is a self-expandable occluder device, indicated for arterial or venous occlusions in the peripheral vasculature. We describe our initial clinical experience in percutaneous closure of PDA using the AVP II in children. Device size was selected according to the size and morphology of the CAP, with a diameter greater than 100% of the minimum diameter of the CAP. The devices were implanted through a pod femoral vein or artery. In 18 patients, AVP II was used for occlusion of PDA. The median age was 24 months (range 6-51) and mean weight 10.5 kg (range 4.8-16.5). The narrowest diameter of the CAP showed a median of 1.1 mm (range 0.3-7.0). Successful implantation was achieved and angiographic occlusion in 14 patients (77.8%). The size of the implanted device showed a mean of 3.9 ± 2.4 times the minimum diameter of the CAP. Two patients were referred for surgery. There were two embolizations. Transthoracic echocardiography 24 hours confirmed total occlusion in 13 cases (72.2%). During the monitoring period there are no reported complications. Percutaneous closure of PDA < 2 mm AVP II is a safe and effective, particularly for occlusion of small-diameter vessels with low flow.

Carga de enfermedad por meningitis bacteriana, Cuba 2006 / Burden of disease due to bacterial meningitis, Cuba 2006

Introducción: la meningitis bacteriana constituye una preocupación para los médicos y los sistemas de salud en general de cualquier país, así como para los organismos internacionales. Objetivo: estimar las cargas por morbilidad y mortalidad por meningitis bacteriana en Cuba para 2006. Métodos: se utilizaron los datos de mortalidad y de incidencia de la encuesta epidemiológica de la Vigilancia Nacional de Meningitis Bacteriana del Instituto de Medicina Tropical "Pedro Kourí". Los procedimientos de estimación se basaron en las recomendaciones de la Organización Mundial de la Salud con el uso del DISMOD y las hojas de cálculos establecidas al efecto. Resultados: la carga global de meningitis bacteriana se estimó en 3527,26 años de vida ajustados por discapacidad (AVAD), lo que representó la pérdida de 31,3 años por cada 100 000 habitantes. La carga por morbilidad y mortalidad de meningitis bacteriana sin ponderar la secuela resultó 2056,25 años de vida ajustados por discapacidad, 55,9 por ciento correspondió sin agente etiológico identificado, seguida de las originadas por Streptococcus pneumoniae (30,9 por ciento), Neisseria meningitidis (9,5 por ciento) y por Haemophilus influenzae tipo b (3,6 por ciento). La carga por mortalidad fue aproximadamente 2 039 años de vida perdidos (AVP) por muerte prematura, o sea 57,8 por ciento. Los menores de 5 años aportaron la mayor carga global de años de vida ajustados por discapacidad y dentro de ellos S. pneumoniae el que generó la mayor carga. Conclusión: la carga por meningitis bacteriana resultó elevada y corroboró su alta utilidad para evaluar los problemas de salud.

Introduction: bacterial meningitis is a real concern for physicians and general health systems of any country as well as the international bodies. Objective: to estimate burdens of disease from morbidity and mortality caused by bacterial meningitis in Cuba during 2006. Methods: the mortality and the incidence data of the epidemiological survey from the National Surveillance of Bacterial Meningitis of "Pedro Kourí" Institute of Tropical Medicine were used. The estimation methods were based on the WHO recommendations by using the DISMOD and the required Excel spreadsheets. Results: the global burden of bacterial meningitis was estimated at a total of 3527.26 Disability Adjusted Lost Years (DALYs), which accounted for 31.3 years lost per 100 000 inhabitants. Morbidity and mortality burden of bacterial meningitis without sequel weighing was 2056.25 disability adjusted lost years, being the 55.9 percent caused by unidentified agent, followed by S. pneumoniae (30.9 percent), N. meningitidis (9.5 percent) and H influenza type b (3.6 percent). The mortality burden was 2 039 years of life lost from premature death, that is, 57.8 percent of the global burden. Children under five years of age contributed the biggest global burden of disability adjusted lost years, and S. penumoniae generated the biggest burden. Conclusion: the burden of bacterial meningitis was high. Burden of disease is an important measure to assess health problems.

Clinical features and molecular analysis of arginine-vasopressin neurophysin II gene in long-term follow-up patients with idiopathic central diabetes insipidus / Apresentação clínica e análise molecular do gene da arginina-vasopressina neurofisina II de pacientes com diabetes insípido central idiopático com longo seguimento

INTRODUCTION: Central diabetes insipidus (DI) characterized by polyuria, polydipsia and inability to concentrate urine, has different etiologies including genetic, autoimmune, post-traumatic, among other causes. Autosomal dominant central DI presents the clinical feature of a progressive decline of arginine-vasopressin (AVP) secretion. OBJECTIVE: In this study, we characterized the clinical features and sequenced the AVP-NPII gene of seven long-term follow-up patients with idiopathic central DI in an attempt to determine whether a genetic cause would be involved. METHODS: The diagnosis of central DI was established by fluid deprivation test and hyper-tonic saline infusion. For molecular analysis, genomic DNA was extracted and the AVP-NPII gene was amplified by polymerase chain reaction and sequenced. RESULTS: Sequencing analysis revealed a homozygous guanine insertion in the intron 2 (IVS2 +28 InsG) of the AVP-NPII gene in four patients, which represents an alternative gene assembly. No mutation in the code region of the AVP-NPII gene was found. CONCLUSIONS: The homozygous guanine insertion in intron 2 (IVS2 +28 InsG) is unlikely to contribute to the AVP-NPII gene modulation in DI. In addition, the etiology of idiopathic central DI in children may not be apparent even after long-term follow-up, and requires continuous etiological surveillance.

INTRODUÇÃO: O diabetes insípido (DI) central, caracterizado por poliúria, polidipsia e inabilidade em concentrar a urina, apresenta diferentes etiologias, incluindo causas genética, autoimune, pós-traumática, entre outras. O DI central autossômico dominante apresenta a característica clínica de falência progressiva da secreção da arginina-vasopressina (AVP). OBJETIVO: No presente estudo, caracterizou-se a apresentação clínica e sequenciou-se o gene AVP-NPII de sete pacientes com DI central idiopático seguidos de longa data na tentativa de determinar se uma causa genética estava envolvida na etiologia. MÉTODOS: O diagnóstico do DI central foi estabelecido por meio do teste de jejum hídrico e infusão de salina hipertônica. Para a realização da análise molecular, o DNA genômico foi extraído e o gene AVP-NPII foi amplificado pela reação em cadeia da polimerase e, posteriormente, sequenciado. RESULTADOS: A análise do sequenciamento do gene AVP-NPII revelou uma inserção em homozigose de uma guanina no íntron 2 (IVS2 +28 InsG) em quatro pacientes, correspondendo a um arranjo alternativo do gene. Nenhuma mutação da região codificadora do gene AVP-NPII foi encontrada. CONCLUSÕES: A inserção em homozigose de uma guanina no íntron 2 (IVS2 +28 InsG) provavelmente não contribui na modulação do gene AVP-NPII no DI. Adicionalmente, a etiologia do DI central idiopático em crianças pode não se tornar evidente mesmo após um longo período de seguimento, necessitando de contínua vigilância da etiologia.

Water and Sodium Balance of Body Fluid

The maintenance of the osmolality of body fluids within a very narrow physiologic range is possible by water balance mechanisms that control the intake and excretion of water. Main factors of this process are the thirst and antidiuretic hormon arginine vasopressin (AVP), secretion regulated by osmoreceptors in the hypothalamus. Body water is the primary determinant of the osmolality of the extracellular fluid (ECF), disorders of body water homeostasis can be divided into hypo-osmolar disorders, in which there is an excess of body water relative to body solute, and hyperosmolar disorders, in which there is a deficiency of body water relative to body solute. The sodium is the predominant cation in ECF and the volume of ECF is directly proportional to the content of sodium in the body. Disorders of sodium balance, therefore, may be viewed as disorders of ECF volume. This reviews addresses the regulatory mechanisms underlying water and sodium metabolism, the two major determinants of body fluid homeostasis for a good understanding of the pathophysiology and proper management of disorders with disruption of water and sodium balance.

Autosomal dominant familial neurohypophyseal diabetes insipidus caused by a novel mutation in arginine-vasopressin gene in a Brazilian family / Diabetes insípido neuro-hipofisário familial causado por uma nova mutação no gene da arginina-vasopressina em uma família brasileira

Autosomal dominant familial neurohypophyseal diabetes insipidus (adFNDI) is a rare autosomal dominant disorder characterized by polyuria and polydipsia due to deficiency of arginine vasopressin (AVP). More than 50 mutations causing adFNDI have been already reported in the AVP gene. The aim of the present study is to analyze the AVP gene in four generations of one Brazilian kindred with adFNDI. The proband was a 31-year old female with huge hypotonic polyuria (10 L/day) dated from childhood. Molecular analysis included amplification of all exons and exon-intron regions of the AVP gene by PCR and direct sequencing. Sequencing analysis showed a novel point mutation in heterozygous: G88V (GGC>GTC). All affected patients presented the same mutation also in heterozygous, while it was absent in four normal members. We expand the repertoire of mutations in AVP describing the novel G88V mutation in one Brazilian kindred with adFNDI.

Diabetes insípido neuro-hipofisário com herança autossômica dominante (adFNDI) é uma doença autossômica dominante rara, caracterizada por poliúria e polidipsia devido à deficiência de arginina-vasopressina (AVP). Mais de 50 mutações causando adFNDI foram descritas no gene AVP. O objetivo deste estudo foi analisar o gene AVP em quatro gerações de uma família brasileira com DINF. O caso-índice é de uma paciente de 31 anos, com volumosa poliúria hipotônica desde a infância (10 L/dia). A análise molecular incluiu amplificação por PCR e seqüenciamento automático dos éxons e regiões éxon-íntron do gene AVP. A análise do seqüenciamento mostrou uma nova mutação de ponto em heterozigose: G88V (GGC>GTC). Todos os pacientes afetados apresentaram a mesma mutação, que não foi encontrada em quatro indivíduos normais da família. Expandimos a lista de mutações no gene AVP, descrevendo a nova mutação G88V em uma família brasileira com adFNDI.

Role of Endogenous Arginine Vasopressin in Physostigmine Induced Hypothermic Response in Rats / 医学研究杂志

Objective To study the subcutaneous injection of physostigmine (PHY) inducing hypothermic response and its relationship with endogenous arginine vasopressin ( AVP). Methods Core temperature and motor activity were monitored by telemetry in female rats maintained at an ambient temperature of 25℃. Tail skin temperature was measured at 30 min intervals with digital thermometer. The central cholinergic antagonist, scopolamine ( lmg/kg ) and AVP V_1 receptor antagonist were administered during the period of PHY (0. 25mg/kg) induced hypothermia. Plasma AVP concentration was measured at 50 min after administration of PHY. Results Subcutaneous injection of PHY led to a rapid reduction in core temperature concomitant with a marked elevation in the heat loss from the tail. The hypothermic response of PHY was blocked by scopolamine and AVP V1 antagonist. Plasma AVP concentration increased markedly at 50 min after PHY. Conclusion The results suggest that endogenous A VP could be involved in PHY -induced hypothermic processes. This may be a novel mechanisms of action for a reversible anticholinesterase drug ( such as PHY ) - induced hypothermia.

The Clinical Significance of Venous Filling Time through Panretinal Photocoagulation in Proliferative Diabetic Retinopathy

PURPOSE: To verify the clinical correlation between retinopathy progression and the change of venous filling time (VFT), measured before and after panretinal photocoagulation (PRP), in proliferative diabetic retinopathy (PDR) patients. METHODS: We conducted this study on 32 patients (32 eyes) who received PRP for PDR. These patients were subdivided into two groups in accordance with the clinical course of PRP: the stabilized group in which retinal neovascularization was regressed and the progressed group in which retinal neovascularization was continued and a complication, such as vitreous hemorrhage or tractional retinal detachment, was developed within 12 months of laser treatment. Arteriovenous passage time (AVP) and VFT were measured by video fluorescein angiogram (FAG) using scanning laser ophthalmoscope (SLO) before and after PRP. VFT values were assigned by measuring by the time duration from start of venous lamina flow to the fullness of fluorescence on the vascular arch. RESULTS: In the stabilized group, AVP was decreased by 0.20+/-0.89sec and VFT was decreased by 0.30+/-1.69 sec through PRP. In the progressed group, AVP was increased in 0.12+/-1.22 sec and VFT was increased by 0.99+/-1.60 sec through PRP. In both groups, the VFT changes were significant (P=0.04) but the AVP changes were not (P=0.34). CONCLUSIONS: VFT was significantly decreased in the stabilized group and significantly increased in the progressed group after PRP. Accordingly, we suggest that VFT changes after PRP can be utilized as a prognostic indicator for evaluating clinical course of diabetic retinopathy after performing PRP and for monitoring the clinical effect of PRP.

Effect of BCEF0083, bioactive compounds from Entomogenous fungi, on AVP content of hypothalamus, pituitary and expression of glucocorticoid receptor mRNA of hippocampus in chronic unpredictable stress model of depression in rats / 中国临床药理学与治疗学

AIM: To study the effect of bioactive compounds from Entomogenous fungi (BCEF0083), on AVP content of hypothalamus, pituitary and expression of glucocorticoid receptor (GR) mRNA of hippocampus in chronic unpredictable stress model of depression in rats. METHODS: The depression animal model was induced by chronic unpredictable stress. The effect of BCEF0083 on AVP content in hypothalamus and pituitary was tested by radioimmunoassay. RT-PCR was used to test the expression of GR mRNA in hippocampus. RESULTS: BCEF0083 decreased the AVP content of hypothalamus and pituitary in chronic unpredictable stressed rats, and increased the expression of GR mRNA of hippocampus in chronic stressed rats. CONCLUSION: BCEF0083 exhibits antidepressant effect by attenuating the stimulated function of hypothalamus-pituitary-adrenal axis in chronic unpredictable stress model of depression in rats.

The Expression of Aquaporin-2,3,4 in Rats' Endolymphatic Sac and Kidney / 听力学及言语疾病杂志

Objective To confirm the expression of Aquaporin2,3,4(AQP2,3,4,water channel protein) in rats'endolymphatic sacs(ES)and kidneys and to investigate and to compare the effects of anti-diuretic hormone(AVP) and DDAVP([deamino-Cys1,D-Arg8]-Vasopressin,V2-receptor agonist)on the expression of AQP2 in rats' ESs and kidneys.Methods 30 healthy Swards white rats were divided into the negative control,AVP group and dDAVP group respectively.The animals were cardiacally perfused.The temporal bones and kidneys were taken out and sectioned by means of the paraffin-embedded technique.The sections of ESs were labeled with fluorescent antibody by immunohistochemical method,and the kidneys' with avidin-biotin-peroxidase complex method(ABC).The expressions of AQP-2 were confirmed in the ESs of the rats while the different effects of the AVP and DDAVP on the ESs and the kidneys were observed.The slides used were analyzed by the image-analyzer and the subsequent data were statistically studied.Results In the cytomembrane and cytoplasm of ESs' epithelia,the constant and clear fluorescent reaction could be observed in the normal control group with the first antibody of AQP2.Significant feeble fluorescent reaction of the first antibody of AQP-2 was revealed in AVP group and DDAVP group.In comparison with the control group,significant stain was found in AVP group and DDAVP group.Noted were also lower gray(P

Effect of BCPT on AVP content of hypothalamus and pituitary and AVP mRNA of hypothalamus in chronic stress rats / 中国药理学通报

Aim To study the effect of bioactive compounds from paecilomyces tenuipes(BCPT) on AVP content of hypothalamus,pituitary and expression of AVP mRNA of hypothalamus and behaviour in chronic unpredictable stress model of depression in rats.Methods The depression animal model was induced by chronic unpredictable stress.The behaviour of rats was tested in the open field.The effect of BCPT on AVP content in hypothalamus and pituitary was tested by radioimmunoassay.RT-PCR was used to test the expression of AVP mRNA in hypothalamus.Results BCPT could decrease the expression of AVP mRNA of hypothalamus and decrease AVP content of hypothalamus and pituitary in chronic stressed rats obviously.BCPT could increase ambulation and rearing score of chronic stressed rats in the open-field test.Conclusion BCPT exhibited an antidepressant-like effect may in part be associated with the decreasing AVP content of hypothalamus and pituitary,and the expression of AVPmRNA of hypothalamus in chronic unpredictable stress model of depression in rats

Effects of Arginine Vasopressin(AVP) Infusion on the Patients with Catecholamine-dependent Septic Shock / 결핵

BACKGROUND: A decreased level of serum arginine vasopressin(AVP) and an increased sensitivity to an exogenous AVP is expected in patients with septic shock who often require a high infusion rate of catecholamines. The goal of the study was to determine whether an exogenous AVP infusion to the patients with septic shock would achieve a significant decrement in infusion rate of catecholamine vasopressors while maintaining hemodynamic stability and adequate urine output. METHODS: Eight patients with septic shock who require a high infusion rate of norepinephrine had received a trial of 4-hour AVP infusion with simultaneous titration of norepinephrine. Hemodynamic parameters and urine output were monitored during the AVP infusion and the monitoring continued up to 4 hours after the AVP infusion had stopped. RESULTS: Mean arterial pressure showed no significant changes during the study period(p=0.197). Norepinephrine infusion rate significantly decreased with concurrent AVP administration(p=0.001). However, beneficial effects had disappeared after the AVP infusion was stopped. In addition, hourly urine output showed no significant changes throughout the trials(p=0.093). CONCLUSION: Concurrent AVP infusion achieved the catecholamine vasopressor sparing effect in the septic shock patients, but there was no evidence of the improvement of renal function. Further study may be indicated to determine whether AVP infusion would provide an organ-protective effect to the septic shock patients.