Melanocortin-4 receptor activation stimulates hypothalamic brain-derived neurotrophic factor release to regulate food intake, body temperature and cardiovascular function.

In the present study, we aimed to investigate the neuromodulatory role played by hypothalamic brain-derived neurotrophic factor (BDNF) in the regulation of acute cardiovascular and feeding responses to melanocortin-4 receptor (MC4R) activation. In vitro, a selective MC4R agonist, MK1, stimulated BDNF release from isolated rat hypothalami and this effect was blocked by preincubation with the MC3/4R antagonist SHU-9119. In vivo, peripheral administration of MK1 decreased food intake in rats and this effect was blocked by pretreatment with an anti-BDNF antibody administered into the third ventricle. When anorexia was induced with the cannabinoid-1 receptor (CB1R) antagonist AM251, the anti-BDNF antibody did not prevent the reduction in food intake. Peripheral administration of MK1 also increased mean arterial pressure, heart rate and body temperature. These effects were prevented by pretreatment with the anti-BDNF antibody whereas the intracerebroventricular administration of BDNF caused changes similar to those of MK1. These findings demonstrate for the first time that activation of MC4R leads to an acute release of BDNF in the hypothalamus. This release is a prerequisite for MC4R-induced effects on appetite, body temperature and cardiovascular function. By contrast, CB1R antagonist-mediated anorexia is independent of the MC4R/BDNF pathway. Overall, these results show that BDNF is an important downstream mediator of the MC4R pathway.

[Analysis of pediatric home care services of the Assistance Publique--Hôpitaux de Paris]. / Analyse de l'activité de l'hospitalisation à domicile pédiatrique de l'Assistance Publique--Hôpitaux de Paris.

BACKGROUND: The Home Health Care services for children in Paris was recently established and it is interesting to analyse the first results of their activities. POPULATION AND METHODS: A random sample (n = 157) of the 418 children admitted to home health care in the Assistance publique-Hôpitaux de Paris (HAD-P) in 1991 has been studied; only one episode of care was analyzed for each child. The data analysed included sociodemographic characteristics of the children, their clinical diagnosis and the care received. RESULTS: More than half of the children presented chronic diseases. Follow-up of newborn children was the main reason for admitting children with acute conditions. Housing and socioeconomic conditions were poor for a significant number of children. A seasonal pattern was found, with higher activity in the beginning and in the end of the year. CONCLUSIONS: More efforts are needed to develop complementarity between hospital-based and home health care services, beginning with improved communication of detailed information regarding home health care objectives and conditions.

[Esophageal leiomyomas. Apropos of 16 cases]. / Les léiomyomes de l'oesophage. A propos de 16 cas.

16 cases of oesophageal leiomyomas are reported; diagnostic difficulties and important surgical consequences are discussed. The surgical procedures must be as soon as possible, and should be enucleation of the lesion. The results are excellent. In three cases postoperative oesophageal spasms and retrosternal pains needed secondary medical treatment.