Acute Enterovirus Encephalitis as a Cause for Isolated Visual and Auditory Hallucinations in a 22-Year-Old Patient.

Viral encephalitis often presents with severe illness, headache, fever, behavioral changes, altered level of consciousness, and focal neurologic deficits. One of the most feared kind of virus encephalitis is herpes simplex encephalitis; however, other central virus infections are also capable of presenting with psychiatric symptoms. Here, we report the case of a 22-year-old woman with first time visual and auditory hallucinations due to an acute enterovirus encephalitis with no cerebrospinal fluid abnormalities but a positive PCR result for enterovirus (ECHO). During treatment, the symptoms deteriorated, and she hat to be shifted to the sheltered ward because of imperative suicidal auditory hallucinations. Under treatment with risperidone and olanzapine, symptoms suddenly stopped and did not reoccur under subsequent reduction of the antipsychotic medication.

Behavioural change in Prader-Willi syndrome during COVID-19 pandemic.

BACKGROUND: Prader-Willi syndrome (PWS) is a rare genetic disorder that in many cases is associated with mental health disorders, in addition to characteristic symptoms such as hyperphagia. The current Sars-CoV-2 coronavirus pandemic has led to massive restrictions in health care and social life worldwide. People with PWS represent a particularly vulnerable population group to these restrictions, with unknown impact on their mental health. METHODS: We conducted an online questionnaire to assess the impact of the restrictions associated with the COVID-19 pandemic on the mental health of people with PWS. RESULTS: One hundred and eight caregivers completed the survey about individuals with PWS. Individuals with PWS > 6 years (n = 89) were included for evaluation with regard to psychopathological change. Respondents frequently reported an increase in psychopathological symptoms associated with PWS during the lockdown, with 51.7% reporting increased temper outbursts, 43.8% showing signs of sadness, 38.2% being anxious, 55.0% more irritable, and 39.3% showing more food seeking behaviour. Adjusted for the type of accommodation food seeking behaviour and irritability is increased to a significantly lesser extent in people with PWS accommodated in specialised care facilities compared with those living in their family home. No significant difference could be found between the sexes. CONCLUSION: The COVID-19 pandemic has had a significant effect on the mental health of individuals with PWS, evidenced by an increase in behaviours associated with PWS, including temper outbursts, food-seeking, and irritability, which again underlines their need for specialised care. Individuals living with their families were particularly vulnerable, indicating that they and their families are in special need of support.

Botulinum toxin therapy of bipolar depression: A case series.

We and others have recently found that botulinum toxin injected into the brow muscles has significant antidepressant properties as compared to placebo in randomized controlled trials in patients with major depressive disorder. However, data for the treatment of bipolar depression with botulinum toxin is lacking. We report here six patients with bipolar disorder experiencing moderate to severe depressive episodes who were treated on a compassionate basis with botulinum toxin given their persistent depressive symptoms and adverse side effects from medications. Four of six patients with bipolar depression experienced a remission following treatment with botulinum toxin, and the other two patients experienced a reduction of depressive symptoms. When the effect of botulinum toxin on the frown muscles began to wear off, depressive symptoms returned and retreatment with botulinum toxin provided successful relief of depressive symptoms again.

E-Cadherin and EpCAM expression by NSCLC tumour cells associate with normal fibroblast activation through a pathway initiated by integrin αvß6 and maintained through TGFß signalling.

Fibroblasts in the tumour stroma (cancer-associated fibroblasts) influence tumour progression and response to therapeutics; little is known about the mechanisms through which the tumour cell co-opts a normal fibroblast. To study the activation of fibroblasts by tumour cells, a panel of non-small cell lung cancer (NSCLC) cell lines and normal human dermal fibroblasts were co-cultured. A subset of the NSCLC cells induced an activated cancer-associated fibroblast-like fibroblast phenotype defined by induction of fibroblast α-smooth muscle actin expression. Tumour cells that activated fibroblasts were associated with E-Cadherin and EpCAM expression and expression of integrin αvß6. Co-culture of activating tumour cells with fibroblasts resulted in induction of transcripts associated with tumour cell invasion and growth, TGFß1 and TGFBR1, SERPINE-1, BMP6, SPHK1 and MMP9. Fibroblast activation was inhibited by an αvß6/8 integrin blocking antibody (264RAD) and a small molecule inhibitor of the TGF-beta type I receptor activin-like kinase (ALK5) (SB431542), demonstrating that transactivation of the TGFß pathway initiates fibroblast activation. Both integrin and ALK5 antagonists inhibited initiation. Only ALK5 was effective when added after 3 days of co-culture. This suggests that although activation is αvß6-dependent, once fibroblasts are activated alternative TGFß pathway regulators maintain an activation loop. In co-culture activating cells had reduced sensitivity to selumetinib, AZD8931 and afatinib compared with mono-culture. In contrast, non-activating cells were insensitive to selumetinib and AZD8931 in both mono-culture and co-culture. In conclusion NSCLC cell lines, positive for E-Cadherin, EpCAM and αvß6 expression, activate normal fibroblasts through avß6/TGFß signalling in vitro, and influence both gene expression and response to therapeutic agents.

A human monoclonal antibody 264RAD targeting αvß6 integrin reduces tumour growth and metastasis, and modulates key biomarkers in vivo.

αvß6 integrin expression is upregulated on a wide range of epithelial tumours, and is thought to play a role in modulating tumour growth. Here we describe a human therapeutic antibody 264RAD, which binds and inhibits αvß6 integrin function. 264RAD cross-reacts with human, mouse and cynomolgus monkey αvß6, and inhibits binding to all ligands including the latency-associated peptide of TGF-ß. Screening across a range of integrins revealed that 264RAD also binds and inhibits the related integrin αvß8, but not the integrins α5ß1, αvß3, αvß5 and α4ß1. In vitro 264RAD inhibited invasion of VB6 and Detroit 562 cells in a Matrigel invasion assay and αvß6 mediated production of matrix metalloproteinase-9 in Calu-3 cells. It inhibited TGF-ß-mediated activation of dermal skin fibroblasts by preventing local activation of TGF-ß by NCI-H358 tumour cells in a tumour cell-fibroblast co-culture assay. In vivo 264RAD showed dose-dependent inhibition of Detroit 562 tumour growth, regressing established tumours when dosed at 20 mg/kg once weekly. The reduction in growth associated with 264RAD was related to a dose-dependent inhibition of Ki67 and phospho-ERK and a reduction of αvß6 expression in the tumour cells, coupled to a reduction in fibronectin and alpha smooth muscle actin expression in stromal fibroblasts. 264RAD also reduced the growth and metastasis of orthotopic 4T1 tumours. At 20 mg/kg growth of both the primary tumour and the number of metastatic deposits in lung were reduced. The data support the conclusion that 264RAD is a potent inhibitor of αvß6 integrin, with some activity against αvß8 integrin, that reduces both tumour growth and metastasis.

Allelochemicals released in soil following incorporation of rapeseed (Brassica napus) green manures.

Plant-derived allelochemicals such as those produced by glucosinolate hydrolysis in Brassica napus, or rapeseed, are viable alternatives to synthetic compounds for the control of soil-borne plant pests. However, allelochemical production and residence times in field soils have not been determined. Soil samples were taken at 0-7.5 and 7.5-15 cm during a period of 3 weeks following plow-down of two winter rapeseed cultivars (Humus and Dwarf Essex). Soil samples were extracted with dichloromethane and analyzed using gas chromatography. Nine glucosinolate degradation products were identified-five isothiocyanates, three nitriles, and one oxazolidinethione. Maximum concentrations were observed 30 h after plow-down. Compounds derived from 2-phenylethyl glucosinolate, the principal glucosinolate in rapeseed roots, dominated the profile of degradation products. Shoot glucosinolates left few traces. This indicates that rapeseed roots may be a more important source of toxic fumigants than above-ground parts of the plant.

Criteria used by clinicians to differentiate sinusitis from viral upper respiratory tract infection.

BACKGROUND: Acute sinusitis and upper respiratory tract infections (URIs) share many common symptoms and signs. Objective criteria have been identified that are valid for distinguishing between these two clinical problems. The objective of this study was to determine how often clinicians use these validated criteria and how often they rely on clinical cues that are less valuable for differentiating sinusitis from URI. METHODS: We performed a retrospective review of 734 patients with a diagnosis of acute sinusitis (n = 367) or URI (n = 367) at a family practice residency training site over a 3-year period. Charts were reviewed to ascertain patient demographics, past history, current symptoms, physical findings, and treatment prescribed. RESULTS: Patients with sinusitis were likely to be older, female, smokers, have a history of allergic rhinitis, and have longer symptom durations. Complaints of sinus pressure or discolored nasal discharge and the finding of sinus tenderness were strongly associated with the diagnosis of sinusitis. In multivariate analysis, eight factors were independently associated with the diagnosis of sinusitis. Four clinical cues alone (sinus tenderness, sinus pressure, postnasal drainage, and discolored nasal discharge) were highly associated with the diagnosis of sinusitis and explained 60% of the variation in the diagnosis between sinusitis and URI. CONCLUSIONS: Physicians tend to rely on four factors to differentiate sinusitis from URIs. Only one of these has been shown to be a reliable predictor of acute sinusitis. This use of unreliable criteria may lead to misdiagnoses and inappropriate prescriptions for antibiotics.

In vitro hydroxylation of bentazon by microsomes from naphthalic anhydride-treated corn shoots.

In vitro metabolism of the herbicide bentazon was studied in microsomal membranes isolated from 6-day-old etiolated corn shoots. Microsomes isolated from shoots of nontreated seeds did not metabolize bentazon when assayed with NADPH or peroxides. However, microsomes isolated from shoots of seeds pretreated with naphthalic anhydride formed a single bentazon metabolite when provided with NADPH. The metabolite was identified as 6-hydroxybentazon, the major phase I metabolite produced in vivo. In vitro formation of this metabolite was strongly inhibited by carbon monoxide, nitrogen, and tetcyclacis (10 microM). The results suggest that aryl hydroxylation of bentazon in corn shoots is catalyzed by a cytochrome P-450 (E.C. 1.14.14.1) and that a seed pretreatment with naphthalic anhydride is necessary for recovery of activity in vitro.

Induction of glutathione s-transferase isozymes in sorghum by herbicide antidotes.

Certain chemicals referred to as herbicide antidotes protect sorghum from injury by chloroacetanilide herbicides such as metolachlor. The effect of herbicide antidotes on the glutathione S-transferase isozyme complement of etiolated sorghum (Sorghum bicolor [L.] Moench) shoots was examined. Elution profiles of glutathione S-transferase isozymes from untreated and antidote-treated seedlings were generated by fast protein liquid chromatography utilizing an anion exchange (Mono Q) column. In untreated seedlings, there were two glutathione S-transferase isozymes, a major isozyme which exhibited activity toward 1-chloro-2,4-dinitrobenzene and a minor isozyme which exhibited activity toward metolachlor. Treating sorghum seedlings with various antidotes (flurazole, oxabetrinil, CGA-133205, naphthalic anhydride, dichlormid) resulted in the appearance of four to five additional glutathione S-transferase isozymes (de-pending on the particular antidote) which exhibited activity toward metolachlor as a substrate and little or no activity with 1-chloro-2,4-dinitrobenzene. Treating etiolated sorghum shoots with metolachlor was also found to induce at least four isozymes which exhibited activity toward the herbicide. An increase in glutathione S-transferase activity, measured with metolachlor as substrate, was detected within 4 h after treatment with 30 micromolar oxabetrinil, but 36 hours were required for maximum expression of activity. Addition of either the transcription inhibitor cordycepin or the translation inhibitor cycloheximide inhibited the appearance of glutathione S-transferase activity measured with metolachlor as substrate. The results are consistent with the hypothesis that antidotes confer protection against metolachlor injury in sorghum by inducing the de novo synthesis of glutathione S-transferase isozymes which catalyze the detoxification of the herbicide.