Pathological changes in cattle naturally infected by Calicophoron daubneyi adult flukes.

Local host response and parasite distribution were studied in the forestomachs, abomasum, duodenum and regional lymph nodes of cattle suffering from bovine paramphistomosis. The parasites were found attached, by its ventral sucker, to small conical papillae of the rumen and reticulum. Affected papillae, showed morphological changes denoted by very narrow stalks and expanded heads. Histologically, these changes were characterized by epithelial acanthosis-hyperkeratosis of the epithelium. Infiltration of inflammatory cells was often related with the epithelial changes, although it was also found in the duodenal mucosa and submucosa. These cells were arranged as aggregates or follicles but sparse infiltration of eosinophils, globule leukocytes, mast cells or macrophages was also observed in the lamina propria. Tissue damage and inflammatory reaction were more severe in the ruminal atrium, where the largest number of flukes and affected papillae were observed. In contrast, lesions in the ruminal dorsal sac were absent or mild. Statistical correlation between lesion severity and parasite burden was confirmed.

Immunohistochemical study and mRNA cytokine profile of the local immune response in cattle naturally infected with Calicophoron daubneyi.

In order to recognize the local immune response of the definitive host to Calicophoron daubneyi natural infection, an immunohistochemical study was carried out in the reticulum and rumen in 49 naturally infected cattle. The role of cytokines (IL-4 and IL-10 interleukins and IFN-γ) in the activation of specific defence mechanisms was evaluated by reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) assays to study cytokine mRNA expression. In all infected animals, CD3+ T lymphocytes seemed to be the main element of the inflammatory infiltrate in the reticular and ruminal lamina propria at the point of the parasite adhesion. Intraepithelial globule leukocytes also showed immunolabelling for CD3. Most CD3+ cells also expressed CD4 (T cell helper) antigen although sporadic CD8+-cytotoxic lymphocytes were observed. Local expression of IFN-γ was observed in damaged papillae at the site of parasite attachment and in scattered cells in the lamina propria. B cells (CD79αcy+, CD45+ and IgG+) were found constantly in relation to lymphoid aggregates. MAC387 was expressed in squamous epithelium and in macrophages of the lamina propria of affected papillae. Macrophages in this location also stained positively for CD163 and CD68. Intraepithelial Langerhans cells and macrophages located in the lamina propria showed immunopositivity for MHCII in the affected areas. RT-qPCR analysis confirmed a statistical significant increase of IFN-γ, and IL-10 expression (p<0.01) in the rumen associated with the presence of flukes. These findings suggest a predominant Th1 polarized local immune response with the probable involvement of Th regulatory cells in cattle C. daubneyi natural infection.

Local and remote sustained trigger point therapy for exacerbations of chronic low back pain. A randomized, double-blind, controlled, multicenter trial.

STUDY DESIGN: A randomized, double-blind, controlled, multicenter trial was conducted. OBJECTIVES: To assess the efficacy of neuroreflexotherapy in the management of low back pain. SUMMARY AND BACKGROUND DATA: Neuroreflexotherapy consists of temporary implantation of epidermal devices in trigger points in the back and referred tender points in the ear. METHODS: The rheumatology and rehabilitation departments of three teaching hospitals in Madrid recruited 78 patients with chronic low back pain. These patients were randomly assigned to the control group (37 patients) or to the treatment group (41 patients). Patients in the treatment group underwent one neuroreflexotherapeutic intervention. The control group received sham treatment consisting of placement of the same number of epidermal devices within a 5-cm radius of the target zones. Patients from both groups were allowed to continue drug treatment as previously prescribed. The use of medications during the trial was recorded. RESULTS: Patients underwent clinical evaluations on three occasions: within 5 minutes before intervention, within 5 minutes after intervention, and 45 days later. The preintervention assessment was carried out by the physician from each hospital department who included the patient in the study. Each of the two follow-up assessments were carried out independently by two of three physicians who had no connection with the research team. Patients in the treatment group showed immediate lessening of pain compared with the results in patients in the control group. The pain relief was clinically relevant and statistically significant, and it persisted up to the end of the trial. CONCLUSIONS: Neuroreflexotherapy intervention seems to be a simple and effective treatment for rapid amelioration of pain episodes in patients with chronic low back pain. At this time, the duration of pain relief beyond 45 days has not been evaluated.

[Features of Paget's disease of bone in a new high-prevalence focus]. / Características de la enfermedad de Paget del hueso en un nuevo foco de elevada prevalencia.

We report the features of a group of 41 patients with Paget's disease (PD) who were identified in a cross sectional study in the "Sierra de la Cabrera" (Madrid). As the screening test, we used serum alkaline phosphatase quantification, and the diagnosis was confirmed by radiological study. This biochemical parameter shows an excellent diagnostic performance, with a sensitivity of 98% and a specificity of 85%. The prevalence in the population over 40 years of age is 6.37% (95% CI 4.79-7.95) which, comparing it with that from other areas, suggests that this region is a "focus" of PD. 51% of cases had the characteristic symptoms of the disease, bone pain being the most common (44%). We compared the abnormalities in the patients with those of a control group with strictly comparable features, and we found that bone deformity (34%) and a localized increase in skin temperature (27%) were the most discriminative data, while cranial symptoms (26%) were nonspecific. Cataracts and actinic keratosis were associated with PD in the crude analysis (p less than or equal to 0.01). When age was controlled for, the statistical significance of cataracts disappeared, whereas that of actinic keratosis was maintained (odds ratio 4.08, p less than or equal to 0.01). A high family incidence was found, with 15 proven cases (36.5%) in 6 families. Apart from a marked increase in alkaline phosphatase (mean: 407 mU/ml), other abnormalities or biochemical differences with the control were not found. These results suggest an interaction of genetic and environmental factors, and is wholly consistent with the multifactorial etiological hypothesis of PD.

Celozoic myxosporidians (Myxidium spp. and Chloromyxum spp.) of cyprinids from the river Esla (León, NW Spain). II. Population dynamics.

In the analysis of the population dynamics of various celozoic Myxosporidians found in Cyprinids of the river Esla (León, NW Spain) a bimodal seasonality was observed for Myxidium macrocapsulare Auerbach, 1910, Myxidium carinae Alvarez-Pellitero et al., 1983 and Chloromyxum complicatum Alvarez-Pellitero et al., 1983. We did not observe a clear influence of the age and sex of the host on the infections. An apparently positive association was observed for Myxidium carinae and Chloromyxum complicatum in Barbus barbus bocagei, and for Myxidium macrocapsulare and Chloromyxum complicatum in Leuciscus cephalus cabeda, which we consider due probably to ecological factors.

Celozoic myxosporidians (Myxidium spp. and Chloromyxum spp.) of cyprinids from the river Esla (León, NW Spain). I. Description of the species.

In the examination of 417 Cyprinids, belonging to 7 species, caught in the Esla river from April 1977 to December 1979, the following celozoic myxosporidians were found: Myxidium macrocapsulare Auerbach, 1910 in Leuciscus cephalus cabeda and Chondrostoma polylepis polylepis; Myxidium carinae n. sp. in Barbus barbus bocagei; Chloromyxum complicatum n. sp. in B. barbus bocagei and L. cephalus cabeda; Chloromyxum chondrostomi n. sp. in Ch. polylepis polylepis; and Chloromyxum cyprini Fujita, 1927 in B. barbus bocagei. All of them were found in the gall bladder, except Chl. cyprini that also parasitizes the liver. The myxosporidians are described and drawings and photomicrographs are presented. Data on the prevalence and intensity of their infections are also given.

Tuberculous arthritis. Report of a case with multiple joint involvement and periarticular tuberculous abscesses.

We describe a 41-year-old man with an unusual presentation of tuberculous joint disease involving 3 peripheral joints: right knee, wrist and first metatarsophalangeal. Periarticular "cold" tuberculous abscesses were observed in the ulnar aspect of his right hand and on the lateral aspect of his first right metatarsal bone. Mycobacterium tuberculosis was isolated from his knee and both abscesses. Synovial biopsies taken from these 3 joints showed typical tuberculous granulomata. M. tuberculosis was also isolated from 3 urine samples. Neither immunodeficiency, or a predisposing condition for tuberculosis could be demonstrated. Combined surgical and antibiotic treatment was effective.

Histopathological and immunohistochemical study of lambs experimentally infected with Fasciola hepatica and Schistosoma bovis.

The aim of this study was to investigate the cross-resistance between Fasciola hepatica and Schistosoma bovis in lambs assessing parasitologic, gross pathologic, histopathologic and immunohistochemical changes in liver and small intestine. Thirty Castellana breed lambs were divided into five comparable groups and exposed to F. hepatical S. bovis (group F/S), S. bovis/F. hepatica (group S/F), S. bovis (group S) or F. hepatica (group F) and six unexposed lambs were used as non-infected controls (group C). Primary patent infection with F. hepatica induced a lower number of schistosome eggs and a higher number of lymphocytes in intestinal and liver schistosome egg-induced granulomas in group F/S than in the groups S/F and S, liver damage being mainly attributed to F. hepatica. S. bovis infection followed by challenge with F. hepatica particularly increased the severity of the most significant liver alterations (cholangiohepatitis by F. hepatica and mesoendophlebitis by S. bovis) and F. hepatica seemed not to have an influence on established S. bovis infection. In addition, immunohistochemical results suggested that the predominant local immune response in both double-infected groups was different, being mainly a cell-mediated immune response in group F/S and a mucosal response in group S/F.