Structural brain changes are associated with response of negative symptoms to prefrontal repetitive transcranial magnetic stimulation in patients with schizophrenia.

Impaired neural plasticity may be a core pathophysiological process underlying the symptomatology of schizophrenia. Plasticity-enhancing interventions, including repetitive transcranial magnetic stimulation (rTMS), may improve difficult-to-treat symptoms; however, efficacy in large clinical trials appears limited. The high variability of rTMS-related treatment response may be related to a comparably large variation in the ability to generate plastic neural changes. The aim of the present study was to determine whether negative symptom improvement in schizophrenia patients receiving rTMS to the left dorsolateral prefrontal cortex (DLPFC) was related to rTMS-related brain volume changes. A total of 73 schizophrenia patients with predominant negative symptoms were randomized to an active (n=34) or sham (n=39) 10-Hz rTMS intervention applied 5 days per week for 3 weeks to the left DLPFC. Local brain volume changes measured by deformation-based morphometry were correlated with changes in negative symptom severity using a repeated-measures analysis of covariance design. Volume gains in the left hippocampal, parahippocampal and precuneal cortices predicted negative symptom improvement in the active rTMS group (all r⩽-0.441, all P⩽0.009), but not the sham rTMS group (all r⩽0.211, all P⩾0.198). Further analyses comparing negative symptom responders (⩾20% improvement) and non-responders supported the primary analysis, again only in the active rTMS group (F(9, 207)=2.72, P=0.005, partial η 2=0.106). Heterogeneity in clinical response of negative symptoms in schizophrenia to prefrontal high-frequency rTMS may be related to variability in capacity for structural plasticity, particularly in the left hippocampal region and the precuneus.

CHACO outreach project: the development of a primary health care-based medical genetic service in an Argentinean province.

Dissemination of knowledge in genetics to be applied in medicine has created a growing need for capacity building in health care workers. The CAPABILITY ARGENTINA outreach project protocol was designed as a model to introduce genetics in areas without genetic services. Our aim was for genetic health care to become part of primary care in an Argentine province lacking genetic services. The program was innovative as professionals from the referral center (Garrahan Hospital S.A.M.I.C.) traveled to remote areas to train professionals through problem-based education. A logical framework was designed for a local needs assessment. Teaching materials (Powerpoint presentations, printed syllabus, and CD) and a web page were developed. A demonstration project was carried out in the Province of Chaco, Argentina. A total of 485 health workers were trained. The number of consultations increased significantly in participating areas comparing before and after the training period. To support this increase, a complementary project was set up from a public hospital sponsored from within Argentina to build a cytogenetic laboratory in the capital of the Province of Chaco. The model was improved for reproduction in other areas in Argentina. CAPABILITY ARGENTINA is a capacity building model for training of primary care professionals in genetics that may be applied to other medical specialties. The outcomes of the programme have a direct impact on clinical practice.

Studies on the effects of phosphine on Salmonella enterica serotype Enteritidis in culture medium and in black pepper (Piper nigrum).

The effect of phosphine on Salmonella enterica serotype Enteritidis inoculated in culture medium and in black pepper grains (Piper nigrum), as well as on the reduction of the microbial load of the dried and moisturized product, was verified. The postfumigation effect was verified in inoculated samples with 0.92 and 0.97 water activity (a(w)) exposed to 6 g/m(3) phosphine for 72 h, dried to 0.67 a(w), and stored for 24, 48, and 72 h. No decreases were observed in Salmonella Enteritidis populations in culture medium when fumigant concentrations up to 6 g/m(3) were applied for 48 h at 35°C. However, the colonies showed reductions in size and atypical coloration as the phosphine concentration increased. No reduction in Salmonella counts occurred on the inoculated dried samples after fumigation. On the other hand, when phosphine at concentrations of 6 g/m(3) was applied on moisturized black pepper for 72 h, decreases in Salmonella counts of around 80% were observed. The counts of total aerobic mesophilic bacterium populations of the dried and moisturized black pepper were not affected by the fumigant treatment. The results of the postfumigation studies indicated that Salmonella Enteritidis was absent in the fumigated grains after drying and storage for 72 h, indicating a promising application for this technique. It was concluded that for Salmonella Enteritidis control, phosphine fumigation could be applied to black pepper grains before drying and the producers should rigidly follow good agricultural practices, mainly during the drying process, in order to avoid product recontamination. Additional work is needed to confirm the findings with more Salmonella serotypes and strains.

Incidence and growth of Listeria monocytogenes in persimmon (Diospyros kaki) fruit.

The incidence of Listeria monocytogenes on persimmon (Diospyros kaki) surface of 'Fuyu' and 'Rama Forte' was evaluated during a 5-month-period (from March to July) of two seasons periods (years 2005 and 2006). The fruits were collected in wholesale and street markets and retail in Sao Paulo and Campinas City, Brazil. A total of 582 fruits were analyzed using the Bax System which is based on the Polymerase Chain Reaction. The ability of this pathogen to grow on the peel and pulp of the two persimmon varieties was also verified at different incubation periods at the temperatures of 10, 20 and 30 degrees C. The growth parameters were obtained by modeling the experimental data using the Gompertz function. The incidence survey showed the absence of L. monocytogenes. The growth curves showed that L. monocytogenes can grow on the peel as well as in the pulp of the two persimmon varieties studied incubated at 10, 20 and 30 degrees C and that low temperatures can reduce the generation rate but does not inhibit its growth.

Fumonisins in Brazilian corn-based foods for infant consumption.

A survey of 196 samples of corn-based infant foods from 13 cities of Sao Paulo State, Brazil, was carried out to investigate the fumonisin contamination in the products. Based on their ingredients, the products were divided into seven groups: infant cereal designated as types A-D, corn meal, corn starch and instant cereal baby food. Although certain infant food samples were free of fumonisin contamination (<20 microg kg(-1); corn starch and infant cereals of type A, B and D), contamination levels in the other products (corn meal, instant corn-based baby food and cereal type C) were of concern, particularly those in corn meal. All samples in these categories contained fumonisins. The mean level for total fumonisins (FB1 + FB2 + FB3) in corn meal was 2242 microg kg(-1) (maximum 8039 microg kg(-1)), in instant corn-based baby food was 437 (maximum 1096) microg kg(-1) and in infant cereal type C was 664 (maximum 1753) microg kg(-1).

Gross anatomic organization of the capybara's (Hydrochaeris hydrochaeris) brachial plexus.

The innervation of the capybara thoracic limb was characterized. The following nerves were observed constituting the right and left brachial plexus: n. dorsalis scapulae (C4 and C5; C4, C5 and C6) which innervates the m. serratus ventralis cervicis and m. rhomboideus; n. suprascapularis (C4, C5 and C6; C5, C6 and C7) supplying the m. supraspinatus and the m. infraspinatus; cranial and caudal nn. subscapulares (C5 and C6; C5, C6 and C7) innervating the m. subscapularis; n. axillaris (C5 and C6; C6, C7 and C8) which supplies the m. triceps brachii (caput mediale); n. radialis (C6, C7, C8 and T1; C6, C7 and C8) which innervates the m. triceps brachii (caput longum and caput mediale) and the m. extensor carpi radialis, m. extensor digitorum communis, m. extensor digitorum lateralis; n. medianus joined to the n. musculocutaneus (C6, C7, C8 and T1; C6, C7 and C8) supplying the m. biceps brachii, m. flexor carpi radialis and m. coracobrachialis; n. ulnaris (C6, C7, C8 and T1; C6, C7 and C8) leading to the m. flexor carpi radialis, the m. flexor carpi ulnaris and the m. flexor digitorum superficialis; n. thoracodorsalis (C6, C7, C8 and T1; C6, C7 and C8) supplying the m. latissimus dorsi; n. thoracicus lateralis (C8, T1; C7, C8, T1) which innervates m. pectoralis profundus (caudal portion); n. thoracicus longus (C6, C7; C7, C8) which is distributed to the m. serratus ventralis thoracis. A communication between the n. radialis and n. ulnaris was observed at the left brachial plexus.

Double aortic arch in a dog (Canis familiaris): a case report.

We herein report a case of a double aortic arch in a 10-week-old male dog of no defined race, which presented episodes of regurgitation at the time of weaning. This vascular malformation was characterized by the persistence of two aortic arches, right and left, of varying dimensions. The right aortic arch was observed to be larger. During post mortem examination the vessels of the animal were injected with coloured latex bi-centrifuged CIS 1-4 polisopreno which revealed the patency of the two aortic arches. Concomitantly, dilation of the cranial oesophagus causing constriction was observed, indicating megaesophagus. Apart from the constriction, the oesophagus presented normal morphometric parameters in relation to its dimensions.

Replacement of the ascending aorta and aortic arch with bovine pericardial grafts. A preliminary report.

Bovine pericardial (BP) grafts have been clinical use at Biocor Hospital since 1989 for replacement or repair of the ascending aorta (AsAo) and initial segment of the aortic arch (AoAr). The main advantages of BP grafts that have justified their clinical application are much easier surgical technique, perfect hemostasis and low cost. From Feb/89 to Feb/94, 88 BP grafts were implanted in the AsAo or the AoAr. There were 33 valved conduits, 47 non-valved conduits and 8 patches. The main indication for the procedure was acute dissection of the aorta, accounting for 50% of the cases. The total hospital mortality was 20.4%. Follow-up was obtained in all but two patients. Patients who survived 2 or more years postoperatively (n = 31) underwent either an echocardiographic or an angiographic study in order to access the behavior of the graft, which was perfect in all of them. The current follow-up is short and complications such as calcification may still develop. However the present study has clearly shown the superior handling and better hemostasis of BP grafts compared to the classical Dacron prosthesis.

[Secondary sternotomy in pediatric heart surgery]. / Esternorrafia secundária em cirurgia cardíaca pediátrica.

PURPOSE: To analyze the results observed in children who underwent surgical correction of congenital anomalies, in whom the sternotomy was left open to avoid postoperative heart compression. METHODS: Fourteen children with mean age of 11 months, with different kind of congenital malformations who underwent definitive correction were submitted to the technique of delayed sternal closure. The indication was: hemodynamic instability due to sternal approximation (8), uncontrolled bleeding (4) and preventive (2). In all patients a bovine pericardial patch was sutured to the skin edges allowing a good decompression of the heart. RESULTS: Among the 14 children, two died in the immediate postoperative period, before the secondary sternal closure. There were two other deaths in the remaining 12 children who underwent sternal approximation, one due to acute pneumothorax and the other due to low cardiac output. The incision was closed after hemodynamic stabilization was achieved, and happened usually around the 3rd postoperative day. There were no cases of mediastinal infection. CONCLUSION: The technique of delayed sternal closure is an important approach in pediatric cardiac surgery and can be life saving. In our experience a bovine pericardial patch proved to be effective in decompressing the heart and also in protecting the mediastinal cavity.

[Surgery for Wolff-Parkinson-White syndrome in the first year of life]. / Cirurgia para síndrome de Wolff-Parkinson-White no 1. ano de vida.

A case of surgical treatment for reentrant atrioventricular tachycardia in a 7 months old child is reported. Episodes of tachycardia were repetitive and long-lasting, often leading to signs of hemodynamic impairement, and were not controlled by antiarrhythmic drugs. The electrophysiologic study showed a circus-movement tachycardia utilizing a concealed accessory pathway located at the anterior septal aspect of tricuspid anulus. The child underwent successful surgical treatment by the endocardial technique. Few minutes after weaning from extracorporeal circulation, developed T wave inversion followed by acute right ventricular dysfunction and ventricular fibrillation. Others ischemic like episodes, maybe as a result of coronary artery spasm, occurring in the next 6 hours were successfully treated with isosorbide dinitrate. At 18 months follow-up, the child is free of tachycardia and has normal atrioventricular conduction.

Logistic analysis of the defense reaction induced by electrical stimulation of the rat mesencephalic tectum.

Subliminal and threshold functions of behavioral output to electrical stimulation of the rat mesencephalic tectum were fitted using the logistic model. The results suggest the existence of isotopic albeit anisotropic freezing and flight mechanisms in the dorsal periaqueductal gray and deep layers of the superior colliculus. Moreover, the marked parallelism of immobility and running threshold functions indicates the probable coupling of these mechanisms through a kind of negative feedback. Finally, the good fitting to the model suggests that the behavioral output to electrical stimulation of these areas follows a logistic function of the logarithm of the stimulus intensity.

Cardiovascular change in response to prolonged defense area stimulation in freely moving rats.

The mean blood pressure and heart rate of freely moving rats were directly recorded over a 1-min period of electrical stimulation of the periaqueductal gray with intensities that induced freezing behavior, intense flight or no behavioral changes. Blood pressure and heart rate increased only when flight was induced and only during the first 15 s of stimulation. These cardiovascular changes suggest that homeostatic mechanisms act during the defense reaction and are markedly inhibited only at the beginning of the stimuli that induce the flight response, this inhibition quickly undergoing attenuation. These data do not suggest that activation of defense area, per se, contributes to the development of primary hypertension.

Cardiovascular change in response to prolonged defense area stimulation in freely moving rats

The mean blood pressure and heart rate of freely moving rats were directly recorded over a 1-min period of electrical stimulation of the periaqueductal gray with intensities that induced freezing behavior, intense flight or no behavioral changes. Blood pressure and heart rate increased only when flight was induced and only during the first 15 s of stimulation. These cardiovascular changes suggest that homeostatic mechanisms act during the defense reaction and are markedly inhibited only at the beginning of the stimuli that induce the flight response, this inhibition quickly undergoing attenuation. Thes data do not suggest that activation of defense area, per se, contributes to the development of primary hypertension

ATP uptake by mouse lymphoma cells.

Mouse lymphoma cells were shown to be unresponsive to prostaglandin E1 in terms of cAMP production. The endogenous ATP concentration was shown to be low. Addition of ATP in the presence of IMBX into the incubation medium resulted in elevation of the intracellular pool of ATP and the cells responded to PGE1 by increasing cAMP production. The ATP effect is specific and cannot be substituted by GTP. ATP analogue (AMP-PCP) can, however, produce a similar effect to ATP. The intracellular ATP concentration can be lowered by incubation with iodoacetate and potassium cyanide. This caused a drastic decrease of the cAMP level. Ethionine on the other hand had no effect on the intracellular ATP level.