Glutamate receptors of the A5 region modulate cardiovascular responses evoked from the dorsomedial hypothalamic nucleus and perifornical area

To assess the possible function of glutamate in the interaction between the dorsomedial hypothalamic nucleus-perifornical area (DMH-PeF) and the A5 pontine region (A5), cardiovascular and respiratory changes were studied in response to electrical stimulation of the DMH-PeF (1 ms pulses, 30-50 miA given at 100 Hz for 5 s) before and after the microinjection of kynurenic acid (non-specific glutamate receptor antagonist; 50 nl, 5 nmol), MK-801 (NMDA receptor antagonist; 50 nl, 50 nmol), CNQX (non-NMDA receptor antagonist; 50 nl, 50 nmol) or MCPG (metabotropic glutamate receptor antagonist; 50 nl, 5 nmol) within the A5 region. DMH-PeF electrical stimulation elicited a pressor (p < 0.001) and tachycardic response (p < 0.001) which was accompanied by an inspiratory facilitation characterised by an increase in respiratory rate (p < 0.001) due to a decrease in expiratory time (p < 0.01). Kynurenic acid within the A5 region decreased the tachycardia (p < 0.001) and the intensity of the blood pressure response (p < 0.001) to DMH-PeF stimulation. After the microinjection of MK-801 and CNQX into the A5 region, the magnitude of the tachycardia and the pressor response were decreased (p < 0.05 and p < 0.01; p < 0.001 and p < 0.05, respectively). After MCPG microinjection into the A5 region, a decrease in the tachycardia (p < 0.001) with no changes in the pressor response was observed during DMH-PeF stimulation. The respiratory response elicited by DMH-PeF stimulation was not changed after the microinjection of kynurenic acid, MK-801, CNQX or MCPG within the A5 region. These results suggest that A5 region glutamate receptors play a role in the cardiovascular response elicited from the DMH-PeF. The possible mechanisms involved in these interactions are discussed

Glutamate receptors of the A5 region modulate cardiovascular responses evoked from the dorsomedial hypothalamic nucleus and perifornical area.

To assess the possible function of glutamate in the interaction between the dorsomedial hypothalamic nucleus-perifornical area (DMH-PeF) and the A5 pontine region (A5), cardiovascular and respiratory changes were studied in response to electrical stimulation of the DMH-PeF (1 ms pulses, 30-50 µA given at 100 Hz for 5 s) before and after the microinjection of kynurenic acid (non-specific glutamate receptor antagonist; 50 nl, 5 nmol), MK-801 (NMDA receptor antagonist; 50 nl, 50 nmol), CNQX (non-NMDA receptor antagonist; 50 nl, 50 nmol) or MCPG (metabotropic glutamate receptor antagonist; 50 nl, 5 nmol) within the A5 region. DMH-PeF electrical stimulation elicited a pressor (p < 0.001) and tachycardic response (p < 0.001) which was accompanied by an inspiratory facilitation characterised by an increase in respiratory rate (p < 0.001) due to a decrease in expiratory time (p < 0.01). Kynurenic acid within the A5 region decreased the tachycardia (p < 0.001) and the intensity of the blood pressure response (p < 0.001) to DMH-PeF stimulation. After the microinjection of MK-801 and CNQX into the A5 region, the magnitude of the tachycardia and the pressor response were decreased (p < 0.05 and p < 0.01; p < 0.001 and p < 0.05, respectively). After MCPG microinjection into the A5 region, a decrease in the tachycardia (p < 0.001) with no changes in the pressor response was observed during DMH-PeF stimulation. The respiratory response elicited by DMH-PeF stimulation was not changed after the microinjection of kynurenic acid, MK-801, CNQX or MCPG within the A5 region. These results suggest that A5 region glutamate receptors play a role in the cardiovascular response elicited from the DMH-PeF. The possible mechanisms involved in these interactions are discussed.

[Epidemiology of community-acquired pneumonia in the Health Area I of Navarra]. / Epidemiología de las neumonías adquiridas en la comunidad del Area de Salud I de Navarra.

BACKGROUND: During one year (1988), a protocol study of the community-acquired pneumonias was carried out in patients referred to the Hospital Virgen del Camino in Pamplona (Health Area I or Northern Navarra), so as to have an epidemiological and microbiological knowledge of this disease in this geographic area. METHODS: A clinical protocol, microbiological investigation, 3 blood cultures, Gram stain and sputum culture and serological tests at admission and 20 days later (complement fixing antibodies and indirect immunofluorescence) were carried out. Chest radiographs were carried out on admission, on the third and seventh hospital days and subsequently depending on the evolution. RESULTS: The causative organism was found in 141 of the 225 included patients (62%). Two or more organisms were identified in 19 (8%). In 84 (38%) no microorganism was found. The results for the causative organisms and their frequency were: Pneumococcus 12%, mycoplasma 12%, other bacteria (including Legionella) 11%, Q fever 8%, viruses 7%, and psitaccosis 4%. In 59% of patients there was an underlying disease and 39% developed complications. 4% of patients died. CONCLUSIONS: 22% of the community acquired pneumonias were cared for in the hospital, representing 6% of the admissions to the Internal Medicine Service. The etiologic diagnosis was made in 62% of the community-acquired pneumonias. 23% were of bacterial origin (including Legionella) and 31% were nonbacterial. There was a high incidence of pneumonias caused by Mycoplasma pneumoniae and Coxiella burnetii.

[Community-acquired pneumonia: 573 cases]. / Neumonías de la comunidad: 573 casos.

To evaluate the epidemiology and incidence of community-acquired pneumonia (CAP) a retrospective study of 573 cases which had been diagnosed during a 3 1/2 year period was carried out. There was a male predominance (2.09/1) with mean age of 53.33 years. The diagnostic delay (days) was 1.5. The mean hospital stay was 13.39 days. The most common underlying disease was COLD (27%). 34% of patients had received previous therapy. The most common clinical features were cough, fever, and mucous sputum. The most common radiological pattern was alveolar (81%). There was increased ESR and moderately high GOT and GPT. The microbiological diagnosis was achieved in 35.4%, with positive sputum culture (mostly pneumococcus) in 26.8% an positive blood culture in 5.9%. Ten patients died (1.7%). The following factors predicted a poor prognosis: age 75 years, underlying disease, bilateral radiological involvement and leukocytosis with neutrophilia.

[Computerized axial tomography, ultrasonography and percutaneous drainage in the diagnosis and treatment of pyogenic abscess of the liver]. / La tomografía axial computerizada, la ultrasonografía y el drenaje percutáneo en el diagnóstico y el tratamiento del absceso hepático piógeno.

Pyogenic liver abscesses in 20 adult patients were reviewed to evaluate if computed tomography (CT), ultrasonography (US) and percutaneous catheter drainage have improved prognosis of this disease. The average delay in diagnosis was 16 days. The CT sensitivity was 94% while the US sensitivity was 78%. The response to treatment with open surgery was compared to percutaneous drainage. Eleven patients were surgically drained with complications in 58% of them. Eight were treated with percutaneous drainage and no complication appeared as a result of treatment. One was found at autopsy. Days of hospitalization in surgically drained patients were significantly higher (p less than 0.01) than percutaneous drained patients. Percutaneous catheter drainage is recommended as method of choice for treating patients with pyogenic liver abscesses.