Usefulness of ultrasonography in the assessment of peripheral enthesis in spondyloarthritis.

Enthesitis is one of the characteristic etiopathogenic manifestations of spondyloarthritis. However, in clinical practice, its presence often goes unnoticed because of the lack of precision and sensitivity of physical examination to detect it. Viable, valid and reliable imaging tests are needed for early diagnosis, as well as a good sensitivity to change to monitor therapeutic response. In this paper we review the most relevant aspects of current knowledge of the enthesis and discusses the validity of ultrasound for assessing enthesitis in spondyloarthritis and its sensitivity to change to monitor therapeutic response.

Mitochondrial function and nitric oxide production in hippocampus and cerebral cortex of rats exposed to enriched environment.

Male rats (21days) were assigned to enriched environment (EE) or to standard environment (SE) for 1year. Oxygen consumption and the sensitivity to calcium induced mitochondrial permeability transition (MPT), through mitochondrial membrane potential (DeltaPsi(m)) and swelling, were determined in isolated hippocampal and cerebral cortex mitochondria. Mitochondrial H(2)O(2) production rate, and NOS activity and expression associated with mitochondrial membranes were also assayed. Results showed that state 3 respiratory rate was increased by 80% in cerebral cortex mitochondria from EE rats and no changes were observed in hippocampal mitochondria after EE exposure. Calcium induced-swelling was 40% and 53% lower in hippocampal and cerebral cortex mitochondria from EE rats, as compared with SE rats. Calcium loading induced membrane depolarization in cerebral cortex mitochondria from EE rats but did not affect mitochondrial DeltaPsi(m) in hippocampal mitochondria from EE animals, probably due to decreased H(2)O(2) formation. NO production associated to mitochondrial membranes was increased by 195% in cerebral cortex mitochondria but decreased by 47% in hippocampal mitochondria from EE rats, as compared with SE rats. Western blot analysis from nNOS protein expression associated to mitochondrial samples revealed a similar pattern. Our results suggest that in hippocampus and cerebral cortex, EE exposure protects mitochondria against calcium-induced MPT maintaining a convenient membrane potential, which assures a continuous energy supply.

Evaluation of immune responses raised against Tc13 antigens of Trypanosoma cruzi in the outcome of murine experimental infection.

We have previously reported that genetic immunization with Tc13Tul antigen of Trypanosoma cruzi, the aetiological agent of Chagas' disease, triggers harmful effects and non-protective immune responses. In order to confirm the role of Tc13 antigens during T. cruzi infection, herein we studied the humoral and cellular immune responses to the Tc13Tul molecule and its EPKSA C-terminal portion in BALB/c T. cruzi-infected mice or mice immunized with recombinant Tc13Tul. Analysis of the antibody response showed that B-cell epitopes that stimulate a sustained IgM production along the infection and high levels of IgG in the acute phase are mainly located at the Tc13 N- and C-terminal domains, respectively. DTH assays showed that T-cell epitopes are mainly at the Tc13 N-terminal segment and that they do not elicit an efficient memory response. Recombinant Tc13Tul did not induce IFN-gamma secretion in either infected or immunized mice. However, a putative CD8+Tc13Tul-derived peptide was found to elicit IFN-gamma production in chronically infected animals. Immunization with recombinant Tc13Tul did not induce pathology in tissues and neither did it protect against the infection. Our results show that in the outcome of T. cruzi infection the Tc13 family protein mainly triggers non-protective immune responses.

Exposure to enriched environments increases brain nitric oxide synthase and improves cognitive performance in prepubertal but not in young rats.

Rats were randomly assigned to enriched (EE) or standard environments (SE) at 21 or 73 days of age, for 17 days. Half of the rats of each rearing condition were trained in a radial maze (RM). At 38 days (pre-pubertal) or 90 days (young), rats were sacrificed and brain cytosolic and mitochondrial nitric oxide synthase (mtNOS) activity was assayed. Western blot analysis of brain mtNOS was conducted. In the pre-pubertal group, EE rats improved their performance in the RM while SE rats did not. In the young group, SE and EE rats showed a random performance in the RM. In SE pre-pubertal rats, training increased brain cytosolic NOS and mtNOS activity by 68% and 82%. In EE non-trained pre-pubertal rats, brain cytosolic NOS and mtNOS activity increased by 80% and 60%, as compared with SE non-trained pre-pubertal rats. In EE pre-pubertal rats that were trained, brain cytosolic NOS and mtNOS activity increased by 70% and 90%, as compared with SE pre-pubertal rats that were not trained. A higher protein expression of brain mtNOS was found in EE rats, as compared with SE animals. Mitochondrial complex I activity was higher in EE than in SE rats. Training had no effect on complex I activity neither in SE nor in EE rats. In young rats, no significant differences in enzyme activities were found between EE and SE rats. These results support the hypothesis that brief exposure to EE and training produce effects on behavioral performance and on biochemical parameters in an age-dependent manner.

Extensive enriched environments protect old rats from the aging dependent impairment of spatial cognition, synaptic plasticity and nitric oxide production.

In aged rodents, neuronal plasticity decreases while spatial learning and working memory (WM) deficits increase. As it is well known, rats reared in enriched environments (EE) show better cognitive performances and an increased neuronal plasticity than rats reared in standard environments (SE). We hypothesized that EE could preserve the aged animals from cognitive impairment through NO dependent mechanisms of neuronal plasticity. WM performance and plasticity were measured in 27-month-old rats from EE and SE. EE animals showed a better spatial WM performance (66% increase) than SE ones. Cytosolic NOS activity was 128 and 155% higher in EE male and female rats, respectively. Mitochondrial NOS activity and expression were also significantly higher in EE male and female rats. Mitochondrial NOS protein expression was higher in brain submitochondrial membranes from EE reared rats. Complex I activity was 70-80% increased in EE as compared to SE rats. A significant increase in the area of NADPH-d reactive neurons was observed in the parietotemporal cortex and CA1 hippocampal region of EE animals.

Immunological and pathological responses in BALB/c mice induced by genetic administration of Tc 13 Tul antigen of Trypanosoma cruzi.

Tc13 is a trans-sialidase family protein of Trypanosoma cruzi, the aetiological agent of Chagas' disease. Recently, in vitro studies had suggested that Tc13 might participate in the pathogenesis of the disease. In order to study the role of Tc13 antigens in an in vivo model, we administered plasmid DNA encoding a Tc13 antigen from the Tulahuén strain (Tc13 Tul) to BALB/c mice and evaluated the immunological and pathological manifestations as well as the capacity of this antigen to confer protection against T. cruzi infection. Tc13 Tul immunization did not elicit a detectable humoral immune response but induced specific memory T-cells with no capacity to produce IFN-gamma. Five months after DNA-immunization with Tc13 Tul, signs of hepatotoxicity and reactive changes in the heart, liver and spleen were observed in 40-80% of mice. When Tc13 Tul DNA-immunized animals were challenged with trypomastigotes, a significant decrease in parasitaemia in early and late acute phase was observed without modification in the survival rate. Surprisingly, Tc13 Tul-immunized mice chronically infected with T. cruzi showed a decrease in the severity of heart damage. We conclude that, in BALB/c mice, genetic immunization with Tc13 Tul mainly induces immune responses associated with pathology.

PET/CT fusion scan in lung cancer: current recommendations and innovations.

Combined fluorodeoxyglucose-positron emission tomography (PET)/ computed tomography (CT) imaging has the potential to become the new standard imaging modality for the staging and restaging of patients with lung cancer. PET/CT is superior to PET alone, CT alone, and visual correlation of both techniques separately. In particular, it improves T3 and T4 staging and delineation of tumors associated with atelectasis. CT contrast media enhancement is probably only still needed when a substantial mediastinal tumor component is present and delineation of tumor from vascular structures is relevant. PET/CT is very accurate in detecting mediastinal nodal disease, but false-positive results are sufficiently frequent to require sampling in some positive cases. Whole-body PET/CT is the most sensitive technique for detecting extracranial metastatic disease, unexpected additional primary malignancies, and recurrence. Innovations include therapy monitoring, prognostic information, evaluation of small-cell lung cancer, its use for radiotherapy planning, and four-dimensional respiratory gating acquisition.

[Estimate of hypothyroidism prevalence in Lleida, Spain, based on thyroid hormone prescription]. / Estimación de la prevalencia de hipotiroidismo en lleida a partir de la prescripción de hormonas tiroideas.

BACKGROUND: Hypothyroidism is a common disease sometimes showing no specific symptoms, thus being difficult to diagnose. This study is aimed at estimating the prevalence of hypothyroidism in Lleida by way of thyroid hormone prescriptions and comparing the results with those from other regions. METHODS: A retrospective observational study. A total of 2,854 individuals undergoing thyroid hormone treatment through Social Insurance prescriptions. Moths of October-December 2001. VARIABLES: age, sex and healthcare region. RESULT: The prevalence of hypothyroidism for 2001 is 8.4 cases per 1000 inhabitants/day (IC 95%: 9.23-7.47). Average age: 60 (DS <:16.6). Age spread: 2.4@1000 among males and 12.4@1000 among females. By age groups: Under age 15:3., 6@1000, 15-64 age group, 6.8@1000 and those over age 64, 12.5@1000. The highest figures were found in the rural areas (Seu d'Urgell: 10.5@1000), and the lowest in urban areas (Example: 5.8@1000, Balafia: 5.4@1000) CONCLUSIONS: Hypothyroidism under treatment figure is, as in other studies, higher among females and predominant among those over 64 years of age. We however found prevalence values lower than the data from a prior populational study for the same region, indicating a possible underdiagnosing of this disease.

[Health risks of genetically modified foods: a literature review]. / Riesgos sobre la salud de los alimentos modificados genéticamente: una revisión bibliográfica.

In 1999, there has been much concern on the safety of genetically modified (GM) foods, an important and complex area of safety research, which demands rigorous standards. Various groups, including consumers and environmental Non Governmental Organizations (NGO) have suggested that all GM foods should be subjected to long-term animal feeding studies before approval for human consumption. The main goal of this review has been to know which is the state-of-the art regarding to the potential adverse effects of GM foods. Two databases, MEDLINE and TOXLINE, as well as a number of URL from INTERNET were used for references. Although commentaries, general news and letters to the Editor have been frequently published in reputable journals, papers about experimental studies on the safety of GM foods are surprisingly very scant. If data on toxicological assessment of GM foods have been obtained, these have not been reported in scientific journals and subjected to the scientific judgement.

[The prevalence of antithyroid antibodies in Lleida]. / Prevalencia de anticuerpos antitiroideos en Lleida.

OBJECTIVE: To evaluate the prevalence of autoimmune thyroid antibody, goiter and levels of ioduria in the region of Lleida. METHODS: Cross-sectional study on a randomized sample of 601 individuals above 6 years old. Examination and palpation of thyroid gland, TSH, T4, FT4, T3, peroxidase antibodies, thyroglobulin antibodies, and ioduria. RESULTS: The prevalence of positive peroxidase antibodies was 3.4% (IC 95%: 0.9-5.9), and that of positive thyroglobulin antibodies 9.7% (IC 95%: 6.5-12.9). Palpable goiter was found in 18.3% of individuals, and visible goiter in 13.3%. The mean ioduria was 120.2 +/- 68 mg/l. The mean TSH value was higher in the individuals with thyroid autoimmunity (3.4 +/- 2.4 mU/l) than in the rest (1.6 +/- 1.2 mU/l) the difference was significant. CONCLUSIONS: Although cases of hypothyroidism are common in populations with iodine deficiency, in regions with adequate iodine intake justifies monitoring for hypothyroidism in these populations as well.

[The prevalence of thyroid functional disorders in the province of Lleida]. / Prevalencia de trastorno de la función tiroidea en la provincia de Lleida.

OBJECTIVE: To assess the prevalence of thyroidal disorders in our area using a representative sample of the population in terms of age and distribution by sex. DESIGN: Descriptive observational transversal study. SETTING: Six areas from the province of Lleida including its capital. PARTICIPANTS: All the inhabitants older than 6 and living in the region during the time of the study. MEASUREMENTS AND MAIN RESULTS: The study was carried out using a representative sample of the population. Several demographic and clinical parameters that are considered to be related to thyroidal disorders were gathered. A blood sample was performed to measure thyrotropin and thyroidal hormones (total T3, free T3 and free T4) and antithyroidal antibodies. 4 diagnostic categories were defined: overt hypothyroidism, subclinical hypothyroidism, overt hyperthyroidism and subclinical hyperthyroidism. Blood samples from 401 individuals were analyzed. The prevalence of hyperthyroidism has been 5.6% +/- 2.3% of which 4.6% +/- 2.1% corresponds to subclinical hyperthyroidism. The prevalence of hypothyroidism has been 3.48% +/- 1.7% with 1.24% of overt condition and 2.23% of subclinical. We have not found statistical significance by sex in hyperthyroidism while the prevalence of hypothyroidism is significantly higher among women. 42.8% of hypothyroidism showed positive values for antithyroidal antibodies. CONCLUSIONS: The prevalence of thyroidal disorders in the studied area is similar to those other regions with an adequate iodine intake. Hypothyroidism has diminished in the last years. Hyperthyroidism has not changed. Data about prevalence of thyroidal disorders will have increased value in the future if strategies such as screening and treatment of subclinical disorders prove to be beneficial.

[Myocardial cell response to Trypanosoma cruzi infection]. / Respuesta de las células musculares cardíacas a la infeccion con Trypanosoma cruzi.

The aim of this study is to establish the response of cardiac myocytes to the infection with Trypanosoma cruzi. The role of myocardial cell proliferation on heart remodelation and the ability of these cells to produce nitric oxide and control intracellular parasite growth during T. cruzi infection were evaluated. The presence of proliferating cell nuclear antigen (PCNA) was determined in myocardial cells of Wistar rats infected with T. cruzi, resulting in a significant increase of PCNA+ labelling in all stages of disease. The ability of myocardial cells to control growth of intracellular parasites and the production of nitric oxide were evaluated in cultures of cardiac myocytes obtained from neonatal rats. Different combinations of cytokines were added to culture media. The number of cardiac cells displaying intracellular amastigotes was lower in cultures supplemented with IL-1b, TNF-a and IFN-g than with other cytokine combinations and controls. The addition of cytokines resulted also in an increase of nitric oxide production in both infected and non-infected controls. These results demonstrate that myocardial cells participate actively in the response of the heart to the infection with T. cruzi.

Implicacion de la via colinergica muscarinica en la memoria de trabajo espacial / Implication of muscarinic cholinergic neurotransmissionon spatial working memory

Ratas macho de la cepa Wistar, entrenadas en una tarea de alternancia en un laberinto en T (memoria de trabajo) y en una discriminación de claves visuales y tactiles (memoria asociativa) fueron tratadas por vía sistémica, con dos bloqueantes de la neurotransmisión colinérgica muscarinica (escopolamina y atropina), en un rango de dosis entre 0,1 y 3,0 mg/kg. Ambos antagonistas colinergicos indujeron un aumento significativo de los errores (p < 0,05), aunque las dosis requeridas para ello fueron diferentes: 1,0 y 3,0 mg/kg para la atropina, y 0,6 y 1,0 mg/kg para la escopolamina. Estas diferencias podrian ser atribuidas, en primera instancia, a la mayor penetración de la escopolamina a través de la barrera hemato-encefálica. Ninguna de las dosis de atropina o escopolamina empleadas modificó significativamente la ejecución de la tarea de memoria asociativa. LaN-Metil-escopolamina, un análogo cuaternario de la escopolamina y por ende de menor penetración al SNC ante su administración sistémica, no produjo efectos significativos sobre el rendimiento en ninguna de las dos tareas. Ello sugiere que las acciones desarrolladas por la escopolamina y por extensión las observadas con atropina, son de naturaleza central. Finalmente se examina-ron tambien los posibles efectos de la manipulación de la demora y de la cantidad de recompensa, sobre el rendimiento en MT espacial.

Burn injuries following explosion of car heaters.

We report four cases of burn injuries inflicted by hot coolant after the explosion of the heating unit in four motor-vehicles of the same make and version, in similar circumstances while the patients were driving their cars. Burns of this type can cause considerable morbidity with an accompanying high risk of a traffic accident.

[Current situation of goiter endemic and iodine intake in the population of the Pyrenees and the Segrià region of Lleida]. / Situación actual de la endemia de bocio y del consumo de yodo en la población del Pirineo y de la comarca del Segrià de Lleida.

OBJECTIVE: To assess the prevalence of goiter in five areas of the Pyrineans and in the region of Segrià in Lleida. DESIGN: Transversal descriptive study. SETTING: Five Pyrinean's regions and Segrià. PATIENTS: Randomised selection of a sample of 601 subjects from the population over 6 years old. MEASUREMENTS: The field work, which was preceded by an informative campaign in the media, was carried out from October of 1994 through February of 1995. Survey with a personal interview, blood pressure, weight, height, goiter palpation, blood analysis with thyroidal hormones and urine analysis with the iodine/creatine ratio determination. RESULTS: The prevalence of goiter was 18.3% which was higher among women, the ratio being 3.7/1 (women/men). No significant differences were found in regard to geographic distribution. Mean iodinuria was 120 micrograms/l, though it was below 50 in 11.1% subjects. The prevalence of goiter has been founded to be related to age, increasing from the age of 45 onwards. Higher percentage of goiter was found among individuals with a family history of the disease and women who have had children. The prevalence of hypothyroidism was 3.4%. CONCLUSIONS: We have found a medium degree of goiter's endemia in the study area, the mean iodinuria in the population is in normal range. The women with children have a higher prevalence of goiter probably due to a lack of sufficient iodine intake being a subgroup at risk.

[Prevalence of tobacco dependence in 6 counties of Lleida]. / Prevalencia de tabaquismo en 6 comarcas de Lleida.

OBJECTIVE: To find the prevalence of tobacco dependency in the population of six counties in Lleida and in patients with chronic diseases or vascular risk factors. DESIGN: Cross-sectional study. A descriptive analysis of the data. SETTING: Six counties in Lleida: 5 Pyrenean counties with a rural population and the Segrià county with an urban population. PARTICIPANTS: A personal questionnaire covering 900 people over 15 (95% CI, 4% accuracy), chosen by randomised sampling, stratified for urban or rural, from the Municipal Rolls. MEASUREMENTS AND MAIN RESULTS: 543 individuals took part. Prevalence of tobacco dependency was 19.7%, higher in men (27.7%) than in women (12%) (p < 0.05). However, among the young there were no difference between the sexes. CONCLUSIONS: We found a low, in comparison with other studies, percentage of smokers in our sample, with a high prevalence of ex-smokers among patients with ictus or Coronary Disease. However, the high prevalence of smokers among the individuals with some cardiovascular risk factor points to the need to redouble efforts in health education on tobacco.

Bloqueo colinérgico: su efecto sobre el componente atencional de la memoria de trabajo espacial / Cholinergic blockade: its effect on attentional component of spatial working memory

Ratas macho de la cepa Wistar, entrenadas en una tarea de alternancia espacial en un laberinto en T (memoria de trabajo) y en una discriminación de claves visuales y táctiles (memoria asociativa) fueron tratadas por vía sistémica, con dos bloqueantes de la neurotransmisión colinérgica muscarínica (escopolamina y atropina), en un rango de dosis entre 0,1 y 3,0 mg/kg. Ambos antagonistas colinérgicos indujeron un aumento significativo de los errores (p = < 0,05), aunque las dosis requeridas para ello fueron diferentes: 1,0 y 3,0 mg/kg para la atropina, y 0,6 y 1,0 mg/kg para la escopolamina. Estas diferencias podrían ser atribuidas, en primera instancia, a la mayor penetración de la escopolamina a través de la barrera hemato encefálica. Ninguna de las dosis de atropina o escopolamina empleadas modificó significativamente la ejecución de la tarea de memoria asociativa. La N-Metilescopolamina, un análogo cuaternario de la escopolamina y por ende de menor penetración al SNC ante su administración sistémica, no produjo efectos significativos sobre el rendimiento en ninguna de las dos tarea. Ello sugiere que las acciones desarrolladas por la escopolamina y por extensión las observadas con atropina, son de naturaleza central. Finalmente se examinaron también los posibles efectos de la manipulación de la demora y de la cantidad de recompensa, sobre el rendimiento en MT espacial, en relación con el componen-te atencional requerido por la tarea.