Methylmercury interferes with glucocorticoid receptor: Potential role in the mediation of developmental neurotoxicity.

Methylmercury (MeHg) is a widespread environmental contaminant with established developmental neurotoxic effects. Computational models have identified glucocorticoid receptor (GR) signaling to be a key mediator behind the birth defects induced by Hg, but the mechanisms were not elucidated. Using molecular dynamics simulations, we found that MeHg can bind to the GR protein at Cys736 (located close to the ligand binding site) and distort the conformation of the ligand binging site. To assess the functional consequences of MeHg interaction with GR, we used a human cell line expressing a luciferase reporter system (HeLa AZ-GR). We found that 100 nM MeHg does not have any significant effect on GR activity alone, but the transactivation of gene expression by GR upon Dex (a synthetic GR agonist) administration was reduced in cells pre-treated with MeHg. Similar effects were found in transgenic zebrafish larvae expressing a GR reporter system (SR4G). Next we asked whether the effects of developmental exposure to MeHg are mediated by the effects on GR. Using a mutant zebrafish line carrying a loss-of-function mutation in the GR (grS357) we could show that the effects of developmental exposure to 2.5 nM MeHg are mitigated in absence of functional GR signaling. Taken together, our data indicate that inhibition of GR signaling may have a role in the developmental neurotoxic effects of MeHg.

The prevalence of pathological gambling in Romanian teenagers.

BACKGROUND: The liberalization of teenagers' way of life strikingly increased in Romania after 1989; this includes gambling. The goal of our study is to analyze the different aspects of gambling in some teenager communities in Romania. METHODS: The study included 500 school-teenagers from 3 different Romanian districts (Cluj, Salaj and Bacau). Of these 217 (43.40%) were males and 283 (56.60%) females. Median age was 16 years old (range 14-19). A structural questionnaire was applied to the teenagers consisting in "The 20 questions of the American Anonymous Gambling Association". Other 20 questions about their age, gender, family, income, school, toxic abuse, gambling preferences, the frequency and the amount of money they use in gambling were also proposed. RESULTS: The results of the study were as it follows: 34 (6.8%) of the tested teenagers were pathological gamblers, 28 (82.36%) males and 6 (17.64%) females, with a ratio F:M of 1:4.6. The average age of starting gambling was 13.25 1.51 years old. The majority (82.35%) prefers group gambling and only 17.64% prefer individual gambling. Of these, 47.5% of them gamble very often (almost every day) and 38.2% gamble often (once a week). The most frequent gambling was: pool (55.88%), poker (35.29%), bingo (32.35%), and basketball on a bet (5.88%), black-jack, roulette and craps (2.94% each). Gambling was the reason for school absenteeism and modest results at school in 64.70% and 52.94% of all the teenagers respectively. CONCLUSIONS: The results of the study revealed very concerning aspects of the increased incidence of gambling among Romanian teenagers, compared to the UK (6% of them are gambling).

Hospice inpatient care: an overview of NHO's 1995 inpatient survey results.

Hospice inpatient care is currently provided through a variety of arrangements, including freestanding facilities, dedicated units, and contracted beds, but lack of standard definitions of the various types of arrangements has led to confusion about the number and type of facilities actually in operation. This study identified a total of 97 freestanding facilities and dedicated hospice units with a total of 1,165 beds. Fifty-six percent were freestanding facilities; the balance were units located within other facilities, primarily hospitals. Forty-six percent of the units provided mainly acute hospice care, 17% provided mainly residential care, and the balance mixed acute and residential care. Seventy-seven of these facilities were operational in 1994, and these were classified into five facility types. Length of stay for the acute level of care averaged 9.7 days with a median of 6.8 days for the 36 reporting facilities. Length of stay for residential care averaged 33.2 days with a median of 30 days for the 22 reporting facilities. Bed size, total inpatient days of care, average daily census, occupancy rate, and charges are also reported by facility type.

A comparative study of hospice services in the United States.

In order to document the implementation of the hospice concept in the United States, 24 hospices, in operation at least one year and serving at least 100 patients, were selected from the National Hospice Organization roster to participate in a survey of organization, staffing, funding, services and population served. All of the hospices offered both home care and bereavement programs but only 41.7 per cent provided an inpatient program. Ten of the hospices were institutionally based, usually in a hospital. Inpatient services were associated with institutional affliations. The average profile of patients admitted to hospice was a 60-year-old White (89 per cent), female (54.3 per cent) cancer patient (94.5 per cent) whose spouse was primary care giver (63.8 per cent). Hospices provided a wide variety of both medical and social services provided by volunteers as well as paid staff. It appears that two divergent types of hospices are developing: 1) independent, heavily volunteer hospices with a variety of professional staff delivering a wide array of social/psychological services with unstable funding; and 2) institutionally based hospices providing both inpatient and home care, greater variety of medical/nursing services, less variety of social/psychological services, using fewer types of volunteers and paid staff, and not experiencing funding problems.

[The Oradea study regarding the epidemiology factors in ischemic cardiopathy]. / Studiul Oradea privind depistarea si epidemiologia factorilor de risc în cardiopatia ischemia. I) Hipercolesterolemia.

Cholesterolemia in a population of 100482 inhabitants of the Bihor district, subjected to screening for the risk factors in ischemic cardiopathy were studied. Together with hyperlipidemias other risk factors were detected: arterial hypertension, obesity, diabetes mellitus, smoking, ischemic alterations of the electrocardiogram, the influence of the noxious agents present at the working place, of the blood groups and disturbances of the menstrual cycle. The mean cholesteremia is of 205 ± 43.7 mgr% (M = 207 ± 43.7 mgr%; F = 204 ± 43.5 mgr%). The prevalence of cholesterolemia, in comparison with the higher normal limits in each age group over 15 years of age, is in the entire studied series, of 13.5%. The population in whom cholesterolemia exceeds 250 mgr% represents 13.92%.

[Current possibilities of optimizing emergency tetanus immunization]. / Posibilitati actuale de optimizare a imunizarii antitetanice de urgenta.

Retrospective analysis of the tetanus cases, admitted over a six year period, shows the high risks involved by the insufficient immunoprotection. The failure of emergency immunization, with its effects on the incidence and evolution of the disease, may be accounted for by : the difficulty in establishing the vaccination past history, probable decrease of protection with time due to basal immunization, inconstant response to the booster dose, immunodepressive side effects, the drawbacks of antitoxic serum. With reference to their own experience and the published data concerning the methods applied for obtaining a more rapid response to anatoxin and possible optimizing of the protective titre concurrent with the incubation period of tetanus. Experimental investigations have demonstrated the superiority of repeated, multifocal inoculations for obtaining an earlier antitoxic immunity.

[Comparative evaluation of risk factors in acute generalized tetanus]. / Evaluare comparata a factorilor de risc în tetanosul acut generalizat

The investigations included a group of 26 patients with acute generalized tetanus, cared for in the Clinic according to a unitary method. A number of 17 prognostic, clinical and laboratory criteria were analyzed from the viewpoint of the pathogenic and clinicoevolutive incidence and significance. According to the severity, lethal course of the disease the following sequence was established in order of gravity: serum sickness, kypokaliemia, hyperpyruvicemia greater than an incubation of less 6 days, invasion within less than 24 hours, hyperlactacidemia greater than age over 60 years, persistent hypertension and tachycardia, hyperazoltemia, hyperglycemia, frequent paroxysmal contractions (before sedation) greater than late admission to hospital, associated cardiopulmonary pathology, hyponatriemia insufficient dressing of the wound and rural environment. The importance of the biological indices is emphasized, both as elements of prognosis and as orientative criteria for the treatment of the case.

[Fuctional-metabolic disorders in typhoid infection]. / Tulburari fuctional-metabolice in infectia tifica

The complex biologic investigation of thyphoid fever is dictated by the necessity of instituting a pathogenetic therapy, especially in the toxic and complex forms. Performing 178 fuctional-metabolic tests in 50 cases of typhoid fever (of which 10 severe and complicated forms), the authors established the prognostic value energy deficiency (approximately P), lactate, alkaline reserve and GPT. Azotemia is only characteristic in the forms with renal involvement, and the other transaminases may be positive even whe the liver is not enlarged. In one case of repeated digestive hemorrhage no evidence could be found of the mechanism of consumption coagulopathy.