Role of toll-like receptor 7 (TLR7) in voluntary alcohol consumption.

Overactivation of neuroimmune signaling has been linked to excessive ethanol consumption. Toll-like receptors (TLRs) are a major component of innate immune signaling and initiate anti- and pro-inflammatory responses via intracellular signal transduction cascades. TLR7 is upregulated in post-mortem brain tissue from humans with alcohol use disorder (AUD) and animals with prior exposure to ethanol. Despite this evidence, the role of TLR7 in the regulation of voluntary ethanol consumption has not been studied. We test the hypothesis that TLR7 activation regulates voluntary ethanol drinking behavior by administering a TLR7 agonist (R848) during an intermittent access drinking procedure in mice. Acute activation of TLR7 reduced ethanol intake, preference, and total fluid intake due, at least in part, to an acute sickness response. However, chronic pre-treatment with R848 resulted in tolerance to the adverse effects of the drug and a subsequent increase in ethanol consumption. To determine the molecular machinery that mediates these behavioral changes, we evaluated gene expression after acute and chronic TLR7 activation. We found that acute TLR7 activation produces brain region specific changes in expression of immune pathway genes, whereas chronic TLR7 activation causes downregulation of TLRs and blunted cytokine induction, suggesting molecular tolerance. Our results demonstrate a novel role for TLR7 signaling in regulating voluntary ethanol consumption. Taken together, our findings suggest TLR7 may be a viable target for development of therapies to treat AUD.

Study of clitoral hood anatomy in the pediatric population.

INTRODUCTION AND AIMS: Pediatric female genitalia size and morphology have not previously been well described. The aims of this study were to create a standard reference for the anterior vulval structures, and examine the relationship between the clitoral hood and labia minora. METHOD: Female patients between 0 and 16 years of age, and with normal external genitalia had the following measurements taken: length of clitoral hood, length of sides of clitoral hood, clitoral diameter, apex of clitoral hood to base of pubic symphysis, apex of clitoral hood to urethral orifice, distance of clitoral hood to labia majora, and length and depth of labia minora. Qualitative descriptors of the clitoral hood and labia were recorded. Patients were grouped into age ranges for analysis: 0-3 years, 4-8 years, 9-12 years, and 13-16 years. RESULTS: Fifty-eight girls were examined. There was a linear relationship between age and genital structure size. In the majority of patients, the labia minora converged under the clitoral glans, separate to the clitoral hood. Four shapes of clitoral hood were observed: horseshoe, trumpet, coffee bean, and tent. DISCUSSION: This study observed great variation in size and morphology of pediatric female genitalia, which is in keeping with other studies. The study was limited by ability to recruit older patients to the study (girls aged 11-16 years) and, therefore, there were lower numbers in this age category. However, the trends that were observed were present in both younger and older girls. CONCLUSION: External genitalia size and morphology are varied in the pediatric female population. The clitoral hood and labia minora were observed to be distinctly separate structures. This study provides a reference for surgeons undertaking genital reconstruction procedures. The study demonstrated that the clitoral hood and labia minora are anatomically distinct structures.

Neurodevelopmental screen in the school entrant medical examination as a predictor of coordination and communication difficulties.

A neurodevelopmental screen in the medical examination of 3750 school entrants with a mean age of 5 years 4 months was validated as a predictor of coordination and communication difficulties. Class teachers of 6, 7, and 8 year olds completed a questionnaire about motor and communication success and difficulty in school activities. Below average ratings on the neurodevelopmental screen were associated with later problems in school activities. The findings, reported to all head teachers, suggest some approaches to intervention in school. The neurodevelopmental screen contributes to early assessment of special education needs of clumsy children.

Effect of extramural experiences on dental students' attitudes.

This study was designed to determine the effect of a set of community dentistry extramural experiences on student attitudes. The experiences involved one or more of four underserved or special populations: the mentally retarded, the mentally ill, correctional center inmates, and indigent children. Comparison of student responses to attitude questionnaires before and after the extramural experiences showed both positive and negative changes in attitude.

Treatment of correctional center inmates at a public health department: a cooperative venture.

Minimum security correctional institutions in North Carolina are small units with no in-house dental facilities. Dental care for inmates of these institutions traditionally has been provided at larger correctional institutions each of which is responsible for the dental treatment of inmates of many smaller units. Services provided are therefore necessarily limited. This paper describes and evaluates an innovative program designed to provide high quality, cost-effective dental care for minimum security correctional center inmates at a nearby county health department clinic. The program is a cooperative effort sponsored by the North Carolina Department of Corrections, the University of North Carolina School of Dentistry, and the Orange County (N.C.) Health Department and is funded in part by a grant from the Robert Wood Johnson Foundation.