Adolescent nicotine exposure promotes adulthood opioid consumption that persists despite adverse consequences and increases the density of insular perineuronal nets.

Adolescence marks a sensitive period for neurodevelopment wherein exposure to drugs of abuse may disrupt maturation and induce persistent changes in neurophysiology which may exacerbate the risk for developing substance use disorders in adulthood. Adolescent nicotine exposure (ANE) enhances motivation to obtain drugs of abuse, particularly opioids, and increases vulnerability for the development of opioid use disorder (OUD). Here, we characterized ANE effects on learning about the adverse consequences of opioid consumption in adulthood in the absence of further nicotine administration. First, we show that ANE engenders punishment resistant fentanyl self-administration in a heterogenous seeking-taking chain schedule of reinforcement at least at the tested dose of fentanyl (0.75 µg/kg). We found that ANE rats consumed significantly more fentanyl and contingent foot shock punishment was less efficacious in limiting fentanyl seeking in ANE rats, relative to nicotine-naïve controls. Next, we demonstrated that ANE limits learning about the deleterious consequences of acute opioid intoxication in adulthood. In a combined conditioned taste avoidance and place preference paradigm we found that ANE resulted in significant reductions in the strength of morphine-induced CTA, and a simultaneous enhancement of CPP at a higher dose that was less capable of driving reinforcement in naïve controls. Finally, we examined the expression of perineuronal nets (PNNs) within insular cortex (IC) and found ANE rats to have increased density of PNNs across the anterior IC and significantly more parvalbumin-labeled IC cells relative to naïve controls. Together, these data lay the framework for a mechanistic explanation of the extreme comorbidity between nicotine use and development of OUDs.

Noise-induced hearing loss in the pre-industrial era: early contributions in De Morbis Artificum by Bernardino Ramazzini (1633-1714).

OBJECTIVE: Noise-induced hearing loss is the most prevalent occupational disease worldwide and is historically associated with the Industrial Revolution. This study analyses early descriptions of this disorder during the pre-industrial period in the work of the Italian physician Bernardino Ramazzini (1633-1714). METHOD: Primary and secondary historical literature were reviewed. RESULTS: Ramazzini described hearing loss in corn millers and in coppersmiths and recognised that this disorder is irreversible and progressive when exposure to noise continues. He also seemed to describe tinnitus. He further suggested the use of earplugs as a preventive measure for these classes of workers. Ramazzini's anatomical and pathological knowledge appears to be based on ancient authors; he did not discuss contemporaneous medical authors' work on hearing function. CONCLUSION: Despite some limitations, Ramazzini's work appears pioneering for his time and represents an important milestone in the history of otolaryngology.

Nicotine limits avoidance conditioning with opioids without interfering with the ability to discriminate an opioid-interoceptive state.

Approximately 90 % of individuals undergoing treatment for opioid use disorder (OUD) report comorbid use of nicotine. As such, further investigation into underlying mechanisms contributing to the extreme comorbidity between nicotine and opioid use are warranted. Nicotine administration significantly escalates self-administration of opioids and this increase in motivational efficacy persists despite contingent punishment of opioid consumption. Additionally, both systemic and intra-insular administration of nicotine produces a rightward shift in the dose-response function in both morphine-induced conditioned place preference and taste avoidance paradigms, particularly at higher doses (5-20 mg/kg). Two possible interpretations arise from these outcomes. One is that nicotine may specifically affect learning about the malaise-inducing effects of morphine thus facilitating acceptance of higher doses of morphine. Another interpretation is that it more generally reduces sensitivity to the interoceptive effects of morphine such that higher doses are needed to produce comparable effects in nicotine-treated, relative to control, rats. To further address these possibilities, we asked whether nicotine administration interfered with the ability to discriminate the morphine interoceptive state, irrespective of its hedonic evaluation, at a dose that is impacted by nicotine in avoidance conditioning paradigms. First, we demonstrated that systemic nicotine pretreatment significantly attenuates taste avoidance induced by a low dose of morphine (3 mg/kg). Next, we used an occasion setting paradigm with this same dose of morphine to test whether systemic nicotine pretreatment interferes with the ability to discriminate between saline- and morphine-induced interoceptive states. Within this task, nicotine had no effect on the ability to effectively discriminate between the interoceptive effects of morphine and saline. Collectively, these data suggest that nicotine may be specifically altering the overall hedonic assessment of morphine perhaps by interfering with learning about its deleterious consequences.

The sponge-bearer suffers from goiter: "The Passion of Christ" (c. 1530) by Fermo Stella.

In the partition of the church of San Bernardino in Caravaggio (Lombardy), Fermo Stella (c. 1490-1562) depicted a cycle of frescoes of "The Passion of Christ". In the central panel, "The Crucifixion" one of the tortures of Christ, the sponge-bearer, shows a large goiter and other signs of hypothyroidism (macroglossia, expressionless face, and puffiness around the eyes), confirming that the Renaissance artists often represented sinful and wicked individuals as affected by thyroid diseases.

Association between seasonal flu vaccination and COVID-19 among healthcare workers.

BACKGROUND: In next fall and winter, SARS-CoV-2 could circulate in parallel with seasonal influenza. The dual epidemics will result in considerable morbidity and mortality; therefore, influenza vaccination may be essential. Recent studies found increased risk of coronavirus in individuals receiving influenza vaccination. AIMS: Our aim is to analyse the association between influenza vaccination and COVID-19 in a population of healthcare workers (HCWs). METHODS: IgG antibodies against SARS-CoV-2 were detected in 3520 HCWs at a large hospital in Northern Italy. For each participant, we collected data on flu immunization status for the last five flu seasons. Logistic regression was used to test associations between seasonal flu vaccination status and a positive serology tests for COVID-19. RESULTS: During the last five flu seasons, 2492 vaccinations were administered. Serology tests were negative for 3196 (91%) HCWs and residents and only 21 (1%) people had an equivocal test (12.0-15.0 AU/mL). Only 128 (4%) people received a diagnosis of COVID-19, with a positive swab test. No flu vaccinations for the last five flu seasons were specifically associated with diagnosis of COVID-19 or with positive results of serology tests. CONCLUSIONS: Flu vaccinations did not appear to be associated with SARS-CoV-2 infection. Influenza vaccination should continue to be recommended for HCWs and for individuals at increased risk for severe illness from respiratory infection.

[First isolation of Histoplasma capsulatum from the urban bat Eumops bonariensis]. / Primer aislamiento de Histoplasma capsulatum de murciélago urbano Eumops bonariensis.

We report the first isolation of Histoplasma capsulatum var. capsulatum from a male bat Eumops bonariensis captured in Buenos Aires city in 2003. The pathogen was recovered from spleen and liver specimens, and was identified by its phenotypic characteristics. PCR with primers 1283, (GTG)5, (GACA)4 and M13 was used to compare both bat isolates with 17 human isolates, 12 from patients residing in Buenos Aires city, and 5 from other countries of the Americas. The profiles obtained with the four primers showed that both bat isolates were identical to each other and closer to Buenos Aires patients than to the other isolates (similarity percentage: 91-100% and 55-97%, respectively). The high genetic relationship between bat isolates and those from patients living in Buenos Aires suggests a common source of infection. This is the first record of E. bonariensis infected with H. capsulatum in the world, and the first isolation of the fungus in the Argentinean Chiroptera population. In the same way as these wild mammals act as reservoir and spread the fungus in the natural environment, infection in urban bats could well be associated with the increase in histoplasmosis clinical cases among immunosuppressed hosts in Buenos Aires city.

Primer aislamiento de Histoplasma capsulatum de murciélago urbano Eumops bonariensis / First isolation of Histoplasma capsulatum from the urban bat Eumops bonariensis

Se comunica el primer aislamiento de Histoplasma capsulatum var. capsulatum de un murciélago macho de la especie Eumops bonariensis, capturado en la ciudad de Buenos Aires en 2003. Los aislamientos fueron recuperados de bazo e hígado e identificados fenotípicamente. Se los comparó por PCR, con 17 aislamientos clínicos, 12 de pacientes residentes en la ciudad de Buenos Aires y cinco de otros países de América, usando los iniciadores 1283, (GTG)5, (GACA)4 y M13. Con los cuatro iniciadores, los perfiles de los aislamientos de murciélago resultaron idénticos entre sí y más relacionados a los de pacientes de Buenos Aires que a los de otros países (porcentaje de similitud: 91-100% y 55-87%, respectivamente). La alta relación genética entre los aislamientos obtenidos del murciélago y de los humanos residentes en Buenos Aires sugiere una fuente común de infección. Este es el primer registro de E. bonariensis infectado con H. capsulatum en el mundo, y el primer aislamiento del hongo en la población de quirópteros de la Argentina. Así como estos mamíferos actúan como reservorio y dispersan el hongo en la naturaleza, la infección en murciélagos urbanos podría asociarse al elevado número de casos de histoplasmosis entre pacientes inmunodeprimidos en la ciudad de Buenos Aires.

We report the first isolation of Histoplasma capsulatum var. capsulatum from a male bat Eumops bonariensis captured in Buenos Aires city in 2003. The pathogen was recovered from spleen and liver specimens, and was identified by its phenotypic characteristics. PCR with primers 1283, (GTG)5, (GACA)4 and M13 was used to compare both bat isolates with 17 human isolates, 12 from patients residing in Buenos Aires city, and 5 from other countries of the Americas. The profiles obtained with the four primers showed that both bat isolates were identical to each other and closer to Buenos Aires patients than to the other isolates (similarity percentage: 91-100% and 55-97%, respectively). The high genetic relationship between bat isolates and those from patients living in Buenos Aires suggests a common source of infection. This is the first record of E. bonariensis infected with H. capsulatum in the world, and the first isolation of the fungus in the Argentinean Chiroptera population. In the same way as these wild mammals act as reservoir and spread the fungus in the natural environment, infection in urban bats could well be associated with the increase in histoplasmosis clinical cases among immunosuppressed hosts in Buenos Aires city.

Primer aislamiento de Histoplasma capsulatum de murciélago urbano Eumops bonariensis. / [First isolation of Histoplasma capsulatum from the urban bat Eumops bonariensis]

We report the first isolation of Histoplasma capsulatum var. capsulatum from a male bat Eumops bonariensis captured in Buenos Aires city in 2003. The pathogen was recovered from spleen and liver specimens, and was identified by its phenotypic characteristics. PCR with primers 1283, (GTG)5, (GACA)4 and M13 was used to compare both bat isolates with 17 human isolates, 12 from patients residing in Buenos Aires city, and 5 from other countries of the Americas. The profiles obtained with the four primers showed that both bat isolates were identical to each other and closer to Buenos Aires patients than to the other isolates (similarity percentage: 91-100

and 55-97

, respectively). The high genetic relationship between bat isolates and those from patients living in Buenos Aires suggests a common source of infection. This is the first record of E. bonariensis infected with H. capsulatum in the world, and the first isolation of the fungus in the Argentinean Chiroptera population. In the same way as these wild mammals act as reservoir and spread the fungus in the natural environment, infection in urban bats could well be associated with the increase in histoplasmosis clinical cases among immunosuppressed hosts in Buenos Aires city.

Anestesia combinada con bloqueos epidurales en pediatría: ventajas, desventajas y complicaciones / Regional and combined anesthesia techniques in children: pros, cons and complications

Antecedentes:Las técnicas de anestecia regional y combinada en pediatría son utilizadas en cirugías de alto impacto aferente o en pacientes con problemas especiales.Objetivos:Evaluación de las ventajas,desventajas y complicaciones de anestecia combinada con bloques epidurales en pediatría.Diseño:Estudio prospectivo,no randomizado.Población:102 pacientes ASA I a III,menores de 17 años.Método:Selección de pacientes con beneficios teóricos de recibir anestecia regional o combinada,por el tipo de estimulación quirúrgica,o por riesgo potencial frente al uso de anestecia general convencional.Resultados:65 bloqueos epidurales lumbares o torácicos(63.7 por ciento)37 caudales (36.3 por ciento)Efectividad 96.1 por ciento.Duración media de los procedimientos quirúrgicos 158 ñ17 min.Edad media 5.9ñ3 años,peso promedio 22.3ñ2 kg.Se registraron complicaciones en 7(6.86 por ciento)pacientes.Conclusiones:las técnicas de anestecia regional o combinada en pediatría permiten un excelente nivel de bloqueo aferente,brindando excelentes condiciones quirúrgicas.Presentan múltiples ventajas,pero no pueden sustituir a ninguna otra metodología anestésica -

Anestesia combinada con bloqueos epidurales en pediatría: ventajas, desventajas y complicaciones / Combined anesthesia with epidural blocks in pediatrics: advantages, disadvantages and complications

Antecedentes:Las técnicas de anestecia regional y combinada en pediatría son utilizadas en cirugías de alto impacto aferente o en pacientes con problemas especiales.Objetivos:Evaluación de las ventajas,desventajas y complicaciones de anestecia combinada con bloques epidurales en pediatría.Diseño:Estudio prospectivo,no randomizado.Población:102 pacientes ASA I a III,menores de 17 años.Método:Selección de pacientes con beneficios teóricos de recibir anestecia regional o combinada,por el tipo de estimulación quirúrgica,o por riesgo potencial frente al uso de anestecia general convencional.Resultados:65 bloqueos epidurales lumbares o torácicos(63.7 por ciento)37 caudales (36.3 por ciento)Efectividad 96.1 por ciento.Duración media de los procedimientos quirúrgicos 158 ñ17 min.Edad media 5.9ñ3 años,peso promedio 22.3ñ2 kg.Se registraron complicaciones en 7(6.86 por ciento)pacientes.Conclusiones:las técnicas de anestecia regional o combinada en pediatría permiten un excelente nivel de bloqueo aferente,brindando excelentes condiciones quirúrgicas.Presentan múltiples ventajas,pero no pueden sustituir a ninguna otra metodología anestésica -

[Rhodococcus equi infections in AIDS: personal cases]. / Sepsi da Rhodococcus equi in corso di AIDS: osservazioni personali.

We report on the occurrence of an uncommon pathogen, Rhodococcus equi (R.e.) in HIV infection. In the period february 1990-July 1991 we performed the diagnosis of R.e. infection (lung, lung-central nervous system) in two infected patients, aged 27 and 31 years, both males, drug addicts, classified as CDC IV. In the first of them an cavitating right bronchopneumonia (bpm) was diagnosed as of tuberculous origin, on the ground of the microscopic demonstration of an acid-fast, gram-positive strain in b.a.l.. A standard antituberculous regimen was uneffective and R.e. was eventually isolated in three blood culture taken shortly before the exitus and at post-mortem examination of the lungs. In the second patient a subclavian right bpm developed without microbiological evidence of any common pathogen. A third-generation cephalosporin course was only partially successful (clinical amelioration, incomplete clearing of radiological findings). After 3 months the patient relapsed and an aseptic meningitis developed. Cultures of blood and csf yielded a R.e. strain; post-mortem examination revealed a diffuse, cavitating bpm. Our personal experience underlines the difficulty in recognizing R.e. infections in compromised host, because of similarity to other entities (i.e. tuberculosis) and the absence of pathognomonic hints.

[Hypotheses on the psychodynamics of the hypnotized]. / Ipotesi sulla psicodinamica dell'ipnotizzato.

The hypnotic process starts when the ties between subject and object (perceptions) are sufficiently slackened. The psychodynamics of hypnosis in the hypnotized are reviewed, highlighting the mental machinery set in motion from the start of the process to its conclusion.

Preoperatorio y anestesia en el feocromocitoma. / Preoperative management and anesthesia in pheochromocytoma

Se presenta una paciente de 12 anos de edad con sintomatologia de hipertension arterial paroxistica. Se diagnostica feocromocitoma. Durante la internacion le fueron practicadas dos anestesias generales, la primera para su estudio arteriografico y la segunda para la reseccion del tumor. El diagnostico y tratamiento de este caso promovio una extensa revision bibliografica sobre feocromocitoma, con especial referencia a la aplicacion de anestesia en esta patologia. Se describe la tecnica anestesica empleada por los autores consistente primordialmente en la asociacion droperidol-fentanil-metoxifluorano y bloqueantes adrenergicos en el preoperatorio.Se describe el metodo de preparacion pre-operatorio, las posibles acciones e interacciones medicamentosas, las complicaciones intra y post-quirurgicas. Asimismo se destaca la importancia del empleo de drogas bloqueantes adrenergicas en los pacientes portadores de esta patologia

Preoperatorio y anestesia en el feocromocitoma. / Preoperative management and anesthesia in pheochromocytoma

Se presenta una paciente de 12 anos de edad con sintomatologia de hipertension arterial paroxistica. Se diagnostica feocromocitoma. Durante la internacion le fueron practicadas dos anestesias generales, la primera para su estudio arteriografico y la segunda para la reseccion del tumor. El diagnostico y tratamiento de este caso promovio una extensa revision bibliografica sobre feocromocitoma, con especial referencia a la aplicacion de anestesia en esta patologia. Se describe la tecnica anestesica empleada por los autores consistente primordialmente en la asociacion droperidol-fentanil-metoxifluorano y bloqueantes adrenergicos en el preoperatorio.Se describe el metodo de preparacion pre-operatorio, las posibles acciones e interacciones medicamentosas, las complicaciones intra y post-quirurgicas. Asimismo se destaca la importancia del empleo de drogas bloqueantes adrenergicas en los pacientes portadores de esta patologia