What is the effect of Tribulus terrestris on testicular morphology and sperm production? An experimental study in the rat model.

The objective of this study was to investigate whether treatment with Tribulus terrestris (Tt) has any impact on the testicular morphology and function in a rodent model. Twenty male rats were divided into a control group and a group receiving 100 mg kg-1 body weight of Tt supplementation. After 40 days of experiment, the animals were submitted to euthanasia; epididymal tail spermatozoa were collected; and spermatozoa concentration, motility, and viability were analyzed. In addition, testicles were collected and processed for histomorphometrical analyses. Data were compared using the Student's t-test and considered significant when P < 0.05. Spermatozoa concentration, motility, and viability showed no difference between the groups. Further, testicular weight and volume, seminiferous tubule diameter, tunica propria surface density, seminiferous epithelium surface density, and intertubular compartment surface density were statistically similar between the groups. However, seminiferous epithelium height and tubular lumen surface density were augmented in animals treated with Tt. Treatment with Tt does not cause a major impact on testicular morphology, promoting only subtle modifications. No difference on spermatozoa parameters was observed.

Pediatric Organ and Tissue Donation-A 10-Year Retrospective Study in Portugal.

Organ and tissue donation can transform lives. One donor can ensure the survival of up to 8 people through their organs and improve the quality of life for dozens more through tissue donation. Portugal has an excellent transplantation rate, but deaths still occur while waiting for an organ. The study aimed to analyze pediatric organ and tissue donors nationally and evaluate brain deaths in a pediatric intensive care unit (PICU) over the past 10 years to identify any potential lost donors. We conducted a retrospective descriptive study of pediatric organ and tissue donors and diagnosed brain deaths from January 2011 to December 2021. Demographic and clinical data were analyzed, including those provided by the National Transplant Coordination. Over the past 10 years in Portugal, 121 pediatric donors (11.7 per million population) were collected, and 569 organs and tissues were collected. During the same period in the PICU, there were 125 deaths, including 20 brain deaths. Of this group, 4 were organ and tissue donors. In the non-donor group (n = 16), a potential lost donor case stands out. Pediatric specialists need to be more familiar with the donation process, which would enable the identification and optimization of all potential donors, thus minimizing the number of potentially lost organs.

Does treatment with dutasteride or finasteride has impact on renal morphology? Experimental study.

PURPOSE: To investigate whether renal modifications occur following treatment with dutasteride or finasteride. METHODS: Twenty-four male rats were divided into three groups: control (that received distilled water), dutasteride (0.5 mg/kg/day), and finasteride (5 mg/kg/day) groups. All administrations were given by gavage for 40 consecutive days. After inducing euthanasia, blood was collected for urea and creatinine analyses, and both the kidneys were collected for stereological analyses of kidney morphology. RESULTS: Serum urea and creatinine levels were increased in both the finasteride and the dutasteride groups compared with those in the control group. In addition, kidney weight, kidney volume, cortical volume, glomerular volumetric density, and mean glomerular volume were reduced in both treatment groups. Finally, the number of glomeruli per kidney was reduced by 26.8% in the finasteride group and by 51.6% in the dutasteride group compared with that in the control group. CONCLUSIONS: The 5-ARIs finasteride and dutasteride promoted morphological and functional damages in rat kidneys. In addition, rats in the dutasteride group showed more severe renal modifications than those in the finasteride group.

Does treatment with dutasteride or finasteride has impact on renal morphology? Experimental study

ABSTRACT Purpose: To investigate whether renal modifications occur following treatment with dutasteride or finasteride. Methods: Twenty-four male rats were divided into three groups: control (that received distilled water), dutasteride (0.5 mg/kg/day), and finasteride (5 mg/kg/day) groups. All administrations were given by gavage for 40 consecutive days. After inducing euthanasia, blood was collected for urea and creatinine analyses, and both the kidneys were collected for stereological analyses of kidney morphology. Results: Serum urea and creatinine levels were increased in both the finasteride and the dutasteride groups compared with those in the control group. In addition, kidney weight, kidney volume, cortical volume, glomerular volumetric density, and mean glomerular volume were reduced in both treatment groups. Finally, the number of glomeruli per kidney was reduced by 26.8% in the finasteride group and by 51.6% in the dutasteride group compared with that in the control group. Conclusions: The 5-ARIs finasteride and dutasteride promoted morphological and functional damages in rat kidneys. In addition, rats in the dutasteride group showed more severe renal modifications than those in the finasteride group.

Catatonia em um adolescente após uso de mefedrona como droga recreativa / Catatonia in a teenager after use of mephedrone as a recreational drug

Objetivos: Os autores relatam um caso de catatonia secundária à exposição a mefedrona, um derivado semissintético do alcalóide catinona, e fazem uma revisão da literatura sobre essa substância que vem sendo usada crescentemente como droga recreativa.Descrição do caso: Um adolescente de 14 anos foi levado ao serviço de emergência por apresentar quadro de agitação psicomotora grave com auto e heteroagressividade seguido de estupor, mutismo e acinesia. Ao exame na admissão apresentava-se sem resposta a estímulos. A investigação complementar não mostrou alterações relevantes. Durante a hospitalização apresentou dois episódios de agitação psicomotora grave e no restante do tempo manteve estado pseudocomatoso. Após ser conhecido o consumo de mefedrona previamente ao início do quadro, e perante a hipótese diagnóstica de catatonia, iniciou-se com lorazepam, com o que o paciente apresentou recuperação rápida ecompleta.Conclusões: Segundo a bibliografia consultada, este é o primeiro relato publicado de catatonia associada ao consumo de mefedrona. O caso ilustra uma manifestação psiquiátrica grave secundária à exposição a essa droga recreativa, facilmente adquirida pelos adolescentes apesar de já terem sido descritos casos fatais associados ao seu consumo.

Aims: The authors report a case of catatonia secondary to exposure to mephedrone, a semisynthetic derivativeof the alkaloid cathinone, and review the literature on this substance that has been increasingly used as a recreational drug.Case description: A 14 year old boy was taken to the emergency room presenting severe psychomotor agitation with self and heteroaggressiveness followed by stupor, mutism and akinesia. On the admission examination the patient was unresponsive to stimuli. Complementary examination showed no significant changes. During hospitalization he had two episodes of severe psychomotor agitation and in the rest of the time he kept a pseudo-comatose state. After knowledge on the consumption of mephedrone prior to the onset of symptoms and facing the diagnostic hypothesis of catatonia, lorazepam was started, after which the patient showed rapid and complete recovery.Conclusions: According to the reviewed literature, this is the first published report of catatonia associated with consumption of mephedrone. The case illustrates a severe psychiatric manifestation secondary to exposure to this recreational drug, easily acquired by adolescents despite fatalities associated with its consumption have already been described.

Factors associated with health-related quality of life changes in survivors to pediatric intensive care.

OBJECTIVE: To determine predictors of change in the health-related quality of life in survivors to pediatric intensive care, based on preadmission health status, demographic characteristics, and physiological variables. DESIGN: Prospective evaluation of health-related quality of life at PICU admission and after 6 months. SETTING: Three PICUs at tertiary hospitals. PATIENTS: Children aged ≥ 6 yrs admitted to the PICUs between May 2002 and June 2004. INTERVENTIONS: Health Utilities Index Mark 3 questionnaire was administered to a child proxy by direct interview at admission and by telephone interview at follow-up. MEASUREMENTS AND MAIN RESULTS: From the 517 eligible admissions, 44 (8.5%) children died in the PICU and 252 had a follow-up assessment. From a list of 115 analyzed variables, 29 (25%) and 30 (26%) were selected (p < .10) for a multivariable model predicting improvement and deterioration of the health-related quality of life, respectively. In the final models, only mechanical ventilation, preadmission global score of Health Utilities Index Mark 3, and preadmission Health Utilities Index Mark 3 pain attribute were associated with improvement; and main diagnostic group, preadmission Health Utilities Index Mark 3 emotion attribute, and preadmission Health Utilities Index Mark 3 pain attribute were associated with deterioration in the health-related quality of life. CONCLUSIONS: The most common variables used to compute probability of death algorithms were not capable of predicting health-related quality of life in survivors to pediatric intensive care. The preadmission health-related quality of life and trauma admissions are important variables to predict change in the health-related quality of life of children surviving to pediatric intensive care.

[Cardiac arrest in the pediatric population]. / Paragem cardíaca em idade pediátrica.

A case of cardiac arrest in a ten year old child that was successfully resuscitated is here presented. The etiological investigation showed an Hypertrophic Cardiomyopathy (HCM). An Implantable Cardioverter Defibrillator (ICD) was placed for secondary profilaxy of Sudden Death (SD). Sudden Death in paediatric age is a rare accident with bad prognosis (survival with no sequel inferior to 5%) and with huge social impact. Hypertrophic Cardiomyopathy is a recognised cause of Sudden Death where prevention is possible. This report is important to enhance the question about the need and form of strategies to prevent sudden death of cardiac origin in pediatric age.

[Lúpus erythematosus]. / Lúpus Eritematoso Sistémico.

Systemic Lúpus Erythematosus (SLE) is an auto-imune disorder, with multiple organ involvement, characterized by vascular and connective tissue inflammation, as well as antinuclear antibodies (ANA). We report a case of a black teenager with a past of arthritis of knees, fever and astenia during the year previous to this admission. She was admitted to the Pediatric Intensive Care Unit (PICU) for bilateral Streptococcus pneumoniae pneumonia complicated by pleural effusion. She also had generalized edema and macroscopic hematúria. She was started on antibiotics, with improvement. The studies were compatible with active SLE, poliserositis, nephrotic proteinúria, lupic nephritis class IV and serious anemia. During the admission, she had symptomatic hypertension with tonic-clonic seizure. She was transferred to Italy, clinically stable, medicated with steroids, anti-hypertensive and anti-convulsant drugs.

Methadone intoxication in a child: toxic encephalopathy?

Methadone is used in the treatment of opioid addiction. Acute intoxication can lead to severe consequences and can even be lethal. In several case reports and small series, a presumably toxic leukoencephalopathy is described resulting from inhalation of heroin. We present the case of a 3-year-old boy who ingested methadone accidentally. In a coma with acute obstructive hydrocephalus owing to massive cerebellar edema and supratentorial lesions, he was successfully treated with methylprednisolone and cerebrospinal fluid external drainage. To our knowledge, this is the first report of an encephalopathy associated with synthetic opioid intoxication.