Aberrant functional network connectivity in psychopathy from a large (N = 985) forensic sample.

Psychopathy is a personality disorder characterized by antisocial behavior, lack of remorse and empathy, and impaired decision making. The disproportionate amount of crime committed by psychopaths has severe emotional and economic impacts on society. Here we examine the neural correlates associated with psychopathy to improve early assessment and perhaps inform treatments for this condition. Previous resting-state functional magnetic resonance imaging (fMRI) studies in psychopathy have primarily focused on regions of interest. This study examines whole-brain functional connectivity and its association to psychopathic traits. Psychopathy was hypothesized to be characterized by aberrant functional network connectivity (FNC) in several limbic/paralimbic networks. Group-independent component and regression analyses were applied to a data set of resting-state fMRI from 985 incarcerated adult males. We identified resting-state networks (RSNs), estimated FNC between RSNs, and tested their association to psychopathy factors and total summary scores (Factor 1, interpersonal/affective; Factor 2, lifestyle/antisocial). Factor 1 scores showed both increased and reduced functional connectivity between RSNs from seven brain domains (sensorimotor, cerebellar, visual, salience, default mode, executive control, and attentional). Consistent with hypotheses, RSNs from the paralimbic system-insula, anterior and posterior cingulate cortex, amygdala, orbital frontal cortex, and superior temporal gyrus-were related to Factor 1 scores. No significant FNC associations were found with Factor 2 and total PCL-R scores. In summary, results suggest that the affective and interpersonal symptoms of psychopathy (Factor 1) are associated with aberrant connectivity in multiple brain networks, including paralimbic regions.

Gender differences in hypertension and kidney disease.

Gender differences exist in hypertension, the prevalence of several renal diseases, progression of established renal disease, and within the ESRD program, including renal transplantation. Sex hormones play key roles in the pathogenesis and outcome of disease processes. Observational data suggest gender differences in the prevalence and outcome of several renal diseases. The molecular mechanisms associated with physiologic phenomena needed to explain gender differences in renal disorders, however, remain largely obscure. The interaction of psychosocial, economic, medical, and genetic differences associated with discrepancies between the genders in the process of receiving a renal transplant and sustaining graft function are currently unclear. Additional studies are needed in these and other areas to explain gender differences in the incidence, prevalence, and outcome of renal disease.

Nodular glomerulosclerosis with anti-glomerular basement membrane-like glomerulonephritis; a distinct pattern of kidney injury observed in smokers.

BACKGROUND: Cigarette smoking has recently been recognized as a risk factor for developing nodular glomerulosclerosis and has also been frequently encountered in patients with anti-glomerular basement membrane (anti-GBM) disease. However, the concurrent presence of both patterns of glomerular injury has not been previously reported. MATERIAL AND METHODS: In this article, we describe three patients with non-diabetic nodular glomerulosclerosis, anti-GBM-like glomerulonephritis (GN) and a history of heavy smoking. RESULTS: Our cohort included three patients, of which two were men (53 and 77 years old) and one a 28-year-old woman. None of the patients had a history of diabetes mellitus but all of them were heavy smokers who presented with renal insufficiency and proteinuria. Nodular glomerulosclerosis and occasional small, non-circumferential crescents in different stages of development were found on kidney biopsy. Immunofluorescence microscopy studies showed intense linear IgG staining along the glomerular basement membranes in the absence of granular immune-type deposits. Electron microscopy evaluation revealed prominent endothelial cell injury without detectable electron-dense deposits. One patient was dialysis-dependent a few months post-biopsy while the other two patients maintained their kidney function 18 and 24 months post-biopsy but without a significant improvement of serum creatinine. CONCLUSIONS: The combination of nodular glomerulosclerosis and anti-GBM-like GN appears to be a distinct pattern of injury observed in a small subset of heavy smokers. Although this pattern of glomerular injury might be less aggressive than the typical anti-GBM GN, it does not appear to carry a favorable prognosis.

Tuberculosis intestinal, absceso y pancreatitis necrohemorrágica, a propósito de un caso, hospital Juan Pablo Pina, San Cristóbal, 1994 / Intestinal tuberculosis, abscess and neurohemorrhagic pancreatitis, about a case at the Juan Pablo Pina Hospital, San Cristobal, 1994

Presentamos el caso de una paciente con tuberculosis intestinal y un absceso de la cabeza y cuello del páncreas acompañado de áreas necrohemorrágicas. Se señala la importancia de la evaluación clínica y más aún, cuando no todos los estudios complentarios están disponibles, así como la importancia de la biopsia de los distintos hallazgos intrabdominales cuando se está ante un cuadro de complicaciones múltiples que podrían involucrar entidades primarias o secundarias agravantes de la enfermedad. Se enfatiza además el manejo de la complicación principal del caso a través del drenaje, la necrosectomía pancreática y el lavado continuo de la cavidad abdominal a través de drenes rígidos como recurso auxiliar disponible al momento de intervenir la paciente