Markers of microglia in post-mortem brain samples from patients with Alzheimer's disease: a systematic review.

Neuroinflammation is proposed as one of the mechanisms by which Alzheimer's disease pathology, including amyloid-ß plaques, leads to neuronal death and dysfunction. Increases in the expression of markers of microglia, the main neuroinmmune cell, are widely reported in brains from patients with Alzheimer's disease, but the literature has not yet been systematically reviewed to determine whether this is a consistent pathological feature. A systematic search was conducted in Medline, Embase and PsychINFO for articles published up to 23 February 2017. Papers were included if they quantitatively compared microglia markers in post-mortem brain samples from patients with Alzheimer's disease and aged controls without neurological disease. A total of 113 relevant articles were identified. Consistent increases in markers related to activation, such as major histocompatibility complex II (36/43 studies) and cluster of differentiation 68 (17/21 studies), were identified relative to nonneurological aged controls, whereas other common markers that stain both resting and activated microglia, such as ionized calcium-binding adaptor molecule 1 (10/20 studies) and cluster of differentiation 11b (2/5 studies), were not consistently elevated. Studies of ionized calcium-binding adaptor molecule 1 that used cell counts almost uniformly identified no difference relative to control, indicating that increases in activation occurred without an expansion of the total number of microglia. White matter and cerebellum appeared to be more resistant to these increases than other brain regions. Nine studies were identified that included high pathology controls, patients who remained free of dementia despite Alzheimer's disease pathology. The majority (5/9) of these studies reported higher levels of microglial markers in Alzheimer's disease relative to controls, suggesting that these increases are not solely a consequence of Alzheimer's disease pathology. These results show that increased markers of microglia are a consistent feature of Alzheimer's disease, though this seems to be driven primarily by increases in activation-associated markers, as opposed to markers of all microglia.

A simplified method for anal ultrasonography: assessment of patient satisfaction and the simplicity of the procedure.

BACKGROUND: Anal endosonography reliably visualizes and identifies anal sphincter abnormalities. However, dedicated probes are quite expensive. We evaluated a simple and less-costly procedure for anal endosonography involving the insertion of the endoscope through a disposable anoscope filled with standard ultrasound gel in terms of patient satisfaction and the simplicity of the procedure in comparison with the standard technique in a unit that already had echoendoscopes available. METHODS: The two techniques were used in 35 subjects without anal abnormalities and data on the simplicity of the procedures, patient discomfort, the quality of images, and the time needed to perform the procedures were compared. RESULTS: All the variables under investigation scored significantly better with the modified technique compared to the standard one. No differences in thickness of either the internal or the external anal sphincter were found between the two methods. CONCLUSIONS: This simple and less-costly adaptation of anal ultrasonography allows good quality examinations to be performed with better patient comfort in units with echoendoscopes already available, avoiding the need for a more expensive dedicated probe.

Toxic elements at a disused mine district: Particle size distribution and total concentration in stream sediments and mine tailings.

Heavy metal and metalloid pollution at a disused pyrite mine was investigated. Five solid samples collected in the area (three stream sediments with different soil texture, a background soil sample and a mine tailing) were characterised by mineral and element composition, particle size distribution (by wet and dry sieving and laser diffraction) and total concentration by acid digestion (Mn, Zn, Cu, Pb, Hg, Cd, Sb and As). X-ray and element analyses denoted a common mineralogical and chemical composition of mainly quartz, clinochlore, muscovite, anorthite, and hematite. Particle size distributions of the five samples showed that stream sediments were characterised by larger percentage of sand range classes (2000-60 microm) while background sample and tailing are mainly characterised by gravel particles (>2000 microm). Wet and dry sieving procedures gave different particle size distributions, which can be interpreted by laser diffraction analysis and represented by Rosin-Rammler model. Concentrations of Zn, Cu and Cd were higher in the stream sediments than the tailing and background soil, while Mn, As, Sb and Hg are mainly concentrated in the tailing sample. Metal concentrations in the three stream sediment samples are correlated with both particle size dimensions (D(63.2)) and concentration of geochemical normalizers (iron and aluminium). These correlations are observed also for the pollutants that are mainly concentrated in tailing sample (Mn and As), denoting the importance of surface interactions also for the binding of these elements onto stream sediments.

Sequential extraction of heavy metals in river sediments of an abandoned pyrite mining area: pollution detection and affinity series.

In this paper heavy metal pollution at an abandoned Italian pyrite mine has been investigated by comparing total concentrations and speciation of heavy metals (Fe, Cu, Mn, Zn, Pb and As) in a red mud sample and a river sediment. Acid digestions show that all the investigated heavy metals present larger concentrations in the sediment than in the tailing. A modified Tessier's procedure has been used to discriminate heavy metal bound to organic fraction from those originally present in the mineral sulphide matrix and to detect a possible trend of metal mobilisation from red mud to river sediment. Sequential extractions on bulk and size fractionated samples denote that sediment samples present larger percent concentrations of the investigated heavy metals in the first extractive steps (I-IV) especially in lower dimension size fractionated samples suggesting that heavy metals in the sediment are significantly bound by superficial adsorption mechanisms.

Parotiditis crónica recurrente en el niño / Chronic recurrent parotiditis in children

La Parotiditis crónica recurrente (PCR) en niños es una enfermedad de etiología desconocida y evolución autolimitada caracterizada por episodios de aumento de volumen parotídeos dolorosos asociados a sialectacia parotidea no obstructiva. Su estudio y tratamiento no obedece a criterio único. El objetivo del presente trabajo es revisar nuestra experiencia con el uso de mucolíticos como tratamiento sintomático en los periodos agudos de la enfermedad. Pacientes y MÚtodo: Se estudiaron en forma retrospectiva las características clínicas, estudio de imágenes y respuesta clínica al uso de mucolítico (Bromhexina) en 25 pacientes tratados por parotiditis crónica recurrente entre 1993 y 1999, en el policlínico de cirugía del Hospital Roberto del Río. Resultados: La distribución por gÚnero del grupo en estudio fue de 16 hombres y 9 mujeres, con una relación de 1,8:1. El 92 por ciento se tenía entre 4 a 10 años. El aumento de volumen como síntoma estuvo presente en el total de los casos y al momento de la primera consulta todos los pacientes habían presentado por lo menos 1 episodio antes. Hubo respuesta clínica favorable al uso de mucolíticos en el 100 por ciento de los casos, manifestada como disminución del dolor entre 48 y 96 h luego de comenzada la administración del mucolítico. La Parotiditis crónica inespecífica, como todas las enfermedades crónicas con periodos de reagudización ofrece algunas dificultades para su evaluación y tratamiento. El uso de mucolíticos disminuye el periodo sintomático en relación a los descrito en la literatura y puede ser una buena alternativa terapÚutica.

[Neonatal pseudohypoaldosteronism: when a denied truth can delay a diagnosis]. / Pseudoipoaldosteronismo neonatale: quando una verità negata può ritardare una diagnosi.

A child with neonatal pseudohypoaldosteronism is referred. The diagnosis was delayed and complicated as her parents didn't tell us that her sister had been affected by the same illness. The child was born after premature rupture of membranes at 34 weeks. At birth, her conditions were satisfactory. The general conditions of the child gradually worsened and, though she regularly ate human pastorized bank milk, she didn't gain any weight. After 13 days she appeared dehydrated with marbled dry skin and haloed eyes, hypotonic and hyporeflexic. Her suction became more and more weaker, with frequent regurgitations and vomiting. Laboratory tests pointed out hyponatremia (110 mEq/l) and hyperkalemia (6.8 mEq/l). We were able to establish diagnosis of primary pseudohypoaldosteronism measuring plasma concentrations of aldosterone (> 5000 pg/ml), 17 hydroxyprogesterone (normal) and corticosteroids (normal). The child was then supplemented with sodium chlorure. A gradual improvement of general conditions took place. We assumed that both childrens and mother were affected by a milder form of primary pseudohypoaldosteronism, characterized by an autosomal dominant way of transmission. We found high levels of aldosterone with normal levels of blood salts also in the sister and mother patient's. After the neonatal period, pseudohypoaldosteronism can be only suspected in case of positive family history.

Repeat tear of postoperative meniscus: potential MR imaging signs.

PURPOSE: To determine the usefulness of five magnetic resonance (MR) signs of repeat tears of the postoperative meniscus. MATERIALS AND METHODS: Fat-saturated proton-density-weighted and T2-weighted MR images in 20 patients who had undergone at least two knee surgeries were reviewed. Second-look arthroscopic confirmation of meniscal status was available in all patients. MR images of 39 menisci (10 repeat tears, 11 postoperative menisci without repeat tears, three tears in previously normal menisci, and 15 normal menisci) were evaluated for (a) a linear area of abnormal signal intensity extending to an articular surface on intermediate-weighted images, (b) abnormal meniscal morphology, (c) likelihood of a typical postoperative appearance, (d) fluid extending into the linear area on T2-weighted images, and (e) cartilage defects. Two radiologists rated their confidence on a five-point scale for the presence of these signs and were compared for level of agreement. RESULTS: The intraclass correlation coefficient (range, 0.75-0.91) indicated a high level of agreement. Areas under the receiver operating characteristic curves were large (range, 0.70-0.87) for all five signs, with a line (grade 3 signal intensity) and fluid within a line having the highest areas. These two signs also had the highest statistical scores (chi 2 = 14.12 and 13.30; P < .002; odds ratio, 1.588 and 1.599 for the line and the fluid within the line, respectively). CONCLUSION: The two best MR signs of repeat tear of the postoperative meniscus were the presence of a line and fluid within the line extending to an articular surface.

The effects of photic driving on mood states.

The EEG photic driving response is a sensitive neurophysiological measure. It has been used to assess drug effects, forms of epilepsy, neurological status of Alzheimer's patients, and physiological arousal. Photic driving also impacts the psychological status of a person by producing increased visual imagery and decreased physiological and subjective arousal. In this study, ten volunteers underwent nocturnal polysomnography followed by six daytime testing sessions. The six sessions consisted of the alpha attenuation test, two visual analog scales for mood, the Stanford Sleepiness Scale, photic stimulation, and the multiple sleep latency test. These tests were administered 2 hours upon awakening and every 2 hours thereafter. The mean mood across the six daytime testing sessions was computed for all mood variables pre- and post-photic stimulation. Significant differences were found for the subjective moods "sleepy," "alert," and "effort." However, no significant differences were found for pre- and post-photic driving for "angry," "irritable," "hungry," "tense," "overall," "happy," "sexual," and "sad." Additionally, all participants reported increased visual imagery during photic driving, as measured by their responses to an imagery questionnaire.

Rheumatoid nodules: MR/pathological correlation.

PURPOSE: To demonstrate the signal characteristics of subcutaneous rheumatoid nodules in correlation to their histopathologic features. METHOD: The magnetic resonance imaging (MRI) features of biopsy proven subcutaneous rheumatoid nodules are described in five patients with rheumatoid arthritis established by classic criteria. RESULTS: Two morphologic appearances of rheumatoid nodules were observed on MRI: one predominantly cystic, with enhancing peripheral component; and a second type which is predominantly solid, with uniform enhancement following gadolinium injection. CONCLUSION: Subcutaneous rheumatoid nodules can appear by MR as solid, cystic, or a combination of both components. This closely correlates with their histopathologic evolution.

Median nerve hamartoma: MR imaging using chemical shift techniques.

Magnetic resonance imaging findings of median nerve hamartoma are presented in three patients with palpable wrist masses and median neuropathy. Fat-suppressed T1-weighted images demonstrated adipose tissue separating the neural and fibrous tissue bundles in two of three patients, which results in the distinctive appearance of these tumors on magnetic resonance imaging. Fibrous tissue appeared as enhancing longitudinal bundles within the tumor on gadolinium enhanced fat-suppressed T1-weighted images.

Contracted gallbladder: a cause of false-positive hepatobiliary scan in patients with cystic fibrosis.

Gallbladder nonvisualization on hepatobiliary scintigraphy in cystic fibrosis is generally secondary to cystic duct obstruction from inspissated bile, mucus, or gallstones. We report gallbladder nonvisualization on hepatobiliary imaging in two patients with cystic fibrosis who had contracted gallbladders on ultrasonography. Repeat ultrasonography at 6 months revealed persistent gallbladder contraction. A contracted gallbladder therefore is a potential cause of a false-positive hepatobiliary scan which can be treated with conservative management.

Idiopathic peripheral pulmonary artery stenosis: an unusual cause of ventilation-perfusion mismatch.

Idiopathic peripheral pulmonary artery stenosis is a rare cause of ventilation-perfusion mismatch in adults. We report a 39-yr-old man with this entity. Pulmonary scintigraphy demonstrated findings indistinguishable from pulmonary embolism, and pulmonary angiography was necessary for accurate diagnosis.

Adenocarcinoma of the ovary with fat-fluid level: CT appearance.

A fat-fluid level on CT is reported for biopsy proven undifferentiated adenocarcinoma of the ovary. This uncommon radiographic finding has been described in association with germ cell tumors of the ovary, such as cystic teratomas and immature teratomas, but not in other ovarian histologies. The finding of a fat-fluid level on CT is, therefore, suggestive but not exclusive to cystic teratomas.

Enfermedad por descompresión inadecuada y embolia gaseosa: fisiopatología y experiencia clínica en 31 casos / Decompression sickness and air embolism: physiopathology and experience in 31 cases

Se revisa la fisiopatología de las manifestaciones neurológicas de la enfermedad por descomprensión inadecuada y la embolía gaseosa. Se analiza el comportamiento de los gases en ambientes hiperbáricos y sus mecanismos de daño, el papel del sistema cardiorrespiratorio y las repercusiones sistemáticas con especial énfasis en el sistema nervioso central. A continuación de presentaran 31 casos de ambas patologías en buzos artezanales de Chiloé, Décima Región, manegados por los autores entre abril de 1985 y julio de 1986. Se detallan los elementos clínicos, el tratamiento efectuado y se compara finalmente con otras casuísticas. Ambos accidentes constituyen un problema de salud importante con una muy elevada morbimortalidad

[Nuclear medicine in pneumonology in the light of 9 year's experience at the S. Luigi Gonzaga Hospital]. / Medicina nucleare in pneumologia alla luce di 9 anni di sperimentazioni all'Ospedale S. Luigi Gonzaga.

An attempt is made to draw a picture of the results obtained with nuclear medicine in the pneumological field in the light of 9 years experience. An attempt is also made to identify from among recently introduced techniques (T.A.C., echotomography) which ones might be substituted for radioisotopes and when, and on what occasion they can be used as complementary treatment. It is concluded that nuclear medicine is of absolute value for functional examinations of the respiratory apparatus (perfusors and ventilators) and for lung onconscannning with Ga67 citrate and Bleomycin-Co57 under present circumstances and that in other fields certain morphological scans (bone scans) are still useful by virtue of their cost-benefit ratio.

[Indications for radiotherapy of lung cancer in the light of its clinical reality]. / Indicazioni del trattamento radiante del carcinoma del polmone alla luce della sua realtá clinica.

Reference is made to a large series and the literature in an attempt to single out cases where radiation management is indicated in the curative, palliative and anatalogic treatment of lung cancer, an in association with other therapies. It is pointed out that each case much be examined on its merits in the light of the histological type, the extent of the process, and its possible metastasis. The conclusion is drawn that radiotherapy plays a useful part in the albeit slight increase in survival of lung cancer patients under acceptable general conditions.