A revision of the genus Boroecia Poulsen 1973 (Ostracoda, Halocypridae) with the descriptions of three new species.

The halocyprid ostracod genus Boroecia Poulsen, 1973 is described in detail and Boroecia borealis (Sars, 1866) is nominated as type species. We unravel several taxonomic confusions and uncertainties in the earlier literature that had their origins in the classification of Boroecia maxima and Boroecia antipoda (Müller, 1906) as subspecies of Boroecia borealis. Three new species are described, B. alaska n. sp., and B. danae n. sp. from the Pacific and B. hopcrofti n. sp. from the high Arctic, bringing the total number of species in the genus to six. Five of the species are described in detail, the only exception is Boroecia maxima (Brady Norman, 1896), for which there is already a full description in the literature. Comparative illustrations are provided for all the species together with standardised meristic data. A key to the identity all six species is included.

An immediate effect of PNF specific mobilization on the angle of trunk rotation and the Trunk-Pelvis-Hip Angle range of motion in adolescent girls with double idiopathic scoliosis-a pilot study.

BACKGROUND: Impairment of spine rotation is a key concept in several theories explaining the pathogenesis and progression of scoliosis. In previous studies, a more limited range of motion in scoliotic girls compared to their non-scoliotic peers was noted. The Trunk-Pelvis-Hip Angle measurement is a test used to assess the range of motion in the trunk-pelvis-hip complex in the transverse plane. The aim of this study was to assess an immediate effect of Proprioceptive Neuromuscular Facilitation specific mobilization (mPNF) on the angle of trunk rotation and Trunk-Pelvis-Hip Angle range of motion in adolescent girls with double scoliosis. METHODS: The study was conducted on 83 girls aged 10 to 17 years (mean 13.7 ± 1.9) with double idiopathic scoliosis consisting of a right-sided thoracic curve (mean 25.1° ± 13.9°) and a left-sided thoracolumbar or lumbar curve (mean 20.8° ± 11.4°). The angle of trunk rotation and Trunk-Pelvis-Hip Angle were measured at baseline and after PNF mobilization. Bilateral lower limb patterns of Proprioceptive Neuromuscular Facilitation were used in combination with the "contract-relax" technique and stimulation of asymmetrical breathing. In the statistical analysis, the SAS rel. 13.2 software was used. Preliminary statistical analysis was performed using descriptive statistics. According to Shapiro-Wilk criterion of normality, the Wilcoxon test was used to compare paired samples. Next, the data was analyzed using multivariate GLM models. RESULTS: In adolescent girls with double scoliosis, significant differences between the left and right side of the body concerning the Trunk-Pelvis-Hip Angle ranges were noted. A single, unilateral PNF mobilization significantly decreased the angle of trunk rotation in the thoracic (p < 0.001) and lumbar spine (p < 0.001). Unilateral PNF mobilization also increased the Trunk-Pelvis-Hip Angle ranges on the left (p < 0.001) and right (p < 0.001) side significantly. CONCLUSIONS: Unilateral PNF mobilization led to a decrease in the angle of trunk rotation, improvement in the range of motion, and the symmetry of mobility in the transverse plane in the trunk-pelvis-hip complex in adolescent girls with double idiopathic scoliosis. The effects should be treated only as immediate. Further studies are required to determine long-term effects of PNF mobilization on the spinal alignment. TRIAL REGISTRATION: ISRCTN11750900.

Serum and ascitic fluid serotonin levels and 5-hydroxyindoleacetic acid urine excretion in the liver of cirrhotic patients with encephalopathy.

PURPOSE: The excess and deficit of serotonin can be the cause of somatic and mental disorders. The aim of this study was to evaluate serotonin levels in blood and ascitic fluid as well as excretion of 5-hydroxyindoleacetic acid (5-HIAA) in urine in patients with hepatic encephalopathy (HE). MATERIAL AND METHODS: The study included 75 alcoholic cirrhotic patients divided into 3 groups (HE1, HE2, HE3), 25 patients each, with grade 1, 2 and 3 of hepatic encephalopathy according to West-Haven classification. The control group (C) included 25 clinically healthy volunteers. Venous blood and ascitic fluid were collected in fasting. On the same day a 24-hour urine collection was performed. Immunoenzymatic method was used to determine the serotonin level in serum and ascitic fluid, and 5-HIAA in urine (IBL-RE-59121, RE-59131). RESULTS: In the control group, mean serum serotonin level (ng/ml) was 155.5 ± 38.1 and in the 3 study groups: HE1 - 175.2 ± 32.4 (NS), HE2 - 137.2 ± 28.6 (NS), HE3 - 108.3 ± 46.3 (p<0.001). Serotonin concentration in ascitic fluid was on the average about 25% of its level in serum. The excretion of 5-HIAA in urine (mg/24h) in all groups, was: C - 5.9 ± 2.1, HE1 - 5.8 ± 1.8 (NS), HE2 - 4.8 ± 1.2(NS), HE3 - 4.3 ± 1.3 (p<0.05). CONCLUSION: The results of our study indicate that serum and ascitic fluid level of serotonin and urine excretion of 5-HIAA depends on the grade of hepatic encephalopathy. In patients with severe hepatic encephalopathy serotonin concentration in blood is decreased which can affect some clinical manifestation of this disease.

Troublesome tinnitus in children: epidemiology, audiological profile, and preliminary results of treatment.

Introduction. Although tinnitus often has a significant impact on individual's life, there are still few reports relating to tinnitus in children. In our tinnitus clinic, children with distressing tinnitus constitute about 0,5% of all our patients. Objectives. The aim of this study was to analyse children with troublesome tinnitus as regards epidemiology, audiological profile, and preliminary effects of the therapy. Methods. A retrospective study was carried out involving the cases of 143 children consulted in our Tinnitus Clinic in 2009. The selected group with troublesome tinnitus was evaluated and classified for proper category of Tinnitus Retraining Therapy (TRT). Results. The study showed that 41.3% of the children suffered from bothersome tinnitus. In this group 44.1% of the patients demonstrated normal hearing. The success of the therapy after 6 months was estimated on 81.4% of significant improvement. Conclusions. It is recommended that a questionnaire include an inquiry about the presence of tinnitus during hearing screening tests.

Internal validation of a telemedical system for monitoring patients with chronic respiratory diseases.

One of the most promising and innovative developments in medicine are telemedical systems. The system PulmoTel 2010 and its internal validation are presented, focusing on the system architecture, hardware, software and communication solutions. PulmoTel 2010 consists of a distant server managing users and medical devices, as well as data transmission, processing, storage and presentation. The server cooperates with home units used by patients, capable of performing lung function tests. All the elements communicate via the Internet, however other media, as wire and mobile telephony, can be additionally applied in regions with a less developed infrastructure. Internal validation of the system was performed using data generated by application simulating features of a home unit. It demonstrated an appropriate operation of the overall system and fulfillment of the main objectives of the project.

Actin reorganization in CHO AA8 cells undergoing mitotic catastrophe and apoptosis induced by doxorubicin.

Doxorubicin (DOX) is a drug widely used in cancer chemotherapy. Although it has been proven that DOX kills tumor cells, the triggered modes of cell death are not fully understood. There is some evidence that, depending on the dose of DOX, the treated cells undergo senescence, mitotic catastrophe, apoptosis or necrosis. The aim of this study was to assess the type of CHO AA8 cell death induced with different DOX doses. In this context, we also assessed organization and distribution of F-actin, which integrity was suggested to be indispensable for apoptosis. Following treatment with 0.5 and 1 microM DOX, the giant multinucleated cells with extended network of fine microfilaments appeared. Notably, in the nuclei of the enlarged cells microscopy and cytometric analysis showed the presence of F-actin. DOX (2.5 microM) caused the appearance of the giant cells and with apoptotic features and signs of autophagy vacuolization. Flow cytometric studies indicated a dose-dependent increase in the number of TUNEL-positive cells and cells stained with both Annexin V and PI. Cell cycle analysis revealed the increase in the hyperploid DNA content. Our results suggest that treatment of CHO AA8 cells with different DOX doses caused mitotic catastrophe that was followed by apoptosis with signs of autophagy. The increase in F-actin content in the nuclei of the dying cells was evident. We hypothesize that in CHO AA8 cells F-actin may be involved in chromatin reorganization undergoing cell death.

Strokes in paroxysmal atrial fibrillation have more favorable outcome than in permanent atrial fibrillation.

OBJECTIVE: Our aim was to compare the course of IS due to ptAF and pxAF. METHODS: A prospective, single-center study was conducted in patients with AF and acute IS with 6-month follow-up. RESULTS: We included 178 patients: 70 (39%) with pxAF and 108 (61%) with ptAF. Compared with patients with ptAF, patients with pxAF more often presented with subcortical, mainly lacunar strokes (21% vs 8%, P = 0.01) and were less frequently dependent at discharge (16% vs 42%, P < 0.001) and after 6 months (16% vs 20%, P < 0.001). Strokes in patients with pxAF were more frequently categorized as non-cardioembolic (35% vs 18%, P = 0.01). In the multivariate analysis, after adjustment for confounding factors (diabetes, chronic heart failure, high risk of thromboembolism and lack of prestroke anticoagulation), ptAF was an important risk factor for unfavorable short-term (OR 5.4; P < 0.01) and long-term outcomes (OR 2.6, P = 0.01) of IS. In all patients with AF, the occurrence of non-cardioembolic stroke was related to a reduced risk of dependence or death in short-term outcome (OR 0.4, P = 0.04) and marginally influenced long-term outcome (OR 0.49, P = 0.09). CONCLUSIONS: The present study suggests that, compared with patients with ptAF, ISs in patients with pxAF have better outcomes.

Correlation between Different PBL Assessment Components and the Final Mark for MB ChB III at a Rural South African University

Problem-based learning (PBL) is now an accepted component of many medical school programmes worldwide. Our university also follows the PBL `SPICES' model for MB ChB III. The assessment modalities used are the modified essay questions (MEQ); objective structured practical examination (OSPE); individualised process assessment (IPA) and tutorial continuous assessment (TUT). This study was done to compare the students' performances in individual assessment components with the final mark to determine the correlation between these parameters. Materials and methods. The study was retrospective; descriptive and analytical; based on the integrated marks of all the MB ChB III students at Walter Sisulu University (WSU) in 2007. Assessment marks were stratified according to blocks and different types of assessment (MEQ; TUT; OSPE; IPA). Regression analysis was used to compute and scrutinise these vis-a-vis their correspondence with the final marks for each block.Results. Three hundred and seventy-nine block assessment marks of 96 students from 4 blocks of MB ChB III were analysed and the correlation between the assessment components and final mark were compared. Regression analysis showed good correlation when analysing the assessment modality versus the final mark for the MEQs (r=0.93; 0.93; 0.94; 0.96); followed by OSPEs (r=0.71; 0.70; 0.76; 0.77) and IPAs (r=0.62; 0.51; 0.68; 0.77). However; correlation was not significant with the TUT. Conclusion. There was good correlation between the students' performance in the majority of assessment modalities and the final mark in the different blocks of the MB ChB III examination. There may be a need to make tutorial assessment methods more objective; partly by additional tutor training

Hyperthermia-induced reorganization of microtubules and microfilaments and cell killing in CHO AA8 cell line.

The aim of this study was to elucidate the effects of hyperthermic treatment on cell morphology and the cytoskeleton in CHO AA8 cell line. The effects of exposure to elevated temperature were analyzed in CHO AA8 cell line by fluorescence microscopy and flow cytometry. The 30 min, at 44.5 degrees C heat shock treatment resulted in the collapse of microtubules (MTs) and microfilaments (MFs) around the nucleus followed by their recovery 24 h after heating. The initial collapse of these cytoskeletal systems, observed 15 min after treatment, was accompanied by the appearance of cells with reduction of volume, shrunken cytoplasm and condensed chromatin. 24 h afterwards, there was the increase in the number of cells with restored and extended MT and MF cytoskeletons. Most of them were larger in size compared to the control cells and had multiple nuclei. 48 h after heat shock the highest number of the giant cells with alternation in nuclear morphology was seen. Flow cytometry analysis revealed the increase in the number of cells with externalized phosphatidylserine 24 h and 48 h after hyperthermic treatment. These results suggest that following heat shock, CHO AA8 cells undergo mitotic catastrophe that presumably represents one of the events resulting in apoptosis.

Changes in open-field activity and novelty-seeking behavior in periadolescent rats neonatally treated with monosodium glutamate.

Monosodium glutamate (MSG) treatment of neonatal rodents leads to degeneration of the neurons in the arcuate nucleus, inner retinal layers and various other brain areas. It also causes various changes in the motor activity, sensory performance and learning abilities. We have previously shown that MSG treatment delays the appearance of some reflexes during neurobehavioral development and leads to temporary changes in reflex performance and motor coordination. Investigation of novelty-seeking behavior is of growing importance for its relationship with sensitivity to psychomotor stimulants. Perinatal administration of numerous toxic agents has been shown to influence novelty-seeking behavior in rats, but little is known about the influence of neonatal MSG treatment on the novelty-seeking behavior. The aim of the present study was to compare changes in locomotor, spontaneous exploratory and novelty-seeking behavior in periadolescent rats neonatally treated with MSG. Newborn rats were treated with 4 mg/g MSG subcutaneously on postnatal days 1, 3, 5, 7 and 9. Open-field behavior was tested at 2, 3, 4, 6 and 8 weeks of age. We found that MSG administration led to only temporary increases in locomotor behavior, which was more pronounced during the first few postnatal weeks, followed by a subtle hypoactivity at 2 months of age. Novelty-seeking was tested in four 5-min trials at 3 weeks of age. Trial 1 was in an empty open-field, two identical objects were placed in the arena during trial 2 and 3, and one of them was replaced to a novel object during trial 4. We found that the behavioral pattern of MSG-treated rats was the opposite in all tested signs in the novelty exploration test compared to control pups. In summary, our present study shows that neonatal MSG treatment leads to early temporary changes in the locomotor activity followed by hypoactivity at 2 months of age. Furthermore, MSG-treated rats show a markedly disturbed novelty-seeking behavior represented by altered activity when subjected to a novel object.

Expression of p53 and its homolog, p73, in HPV DNA positive oesophageal squamous cell carcinomas.

Several studies have detected human papilloma virus (HPV) DNA in squamous cell carcinoma of the oesophagus (OSCC). In this study, we analysed OSCC specimens from 114 patients for the presence of HPV DNA, and p53 and p73 expression. HPV DNA was detected in 44.7% of cases, with the low risk HPV11 occurring most frequently. p53 and p73 expression was detected in 70% and 61.4% of cases, respectively. There was no correlation between expression of p53, p73 or HPV infection and tumour grade, or between p53 expression and the presence of HPV DNA. There was, however, significant correlation between p73 expression and the presence of HPV DNA (p<0.01) and p53 and p73 co-expression (p<0.001), as well as co-expression of p53 and p73 with HPV status (p<0.05). These data support previous studies suggesting a role for HPV infection in OSCC and also indicate that HPV infection and p53 and p73 overexpression are not mutually exclusive. In addition, the data implicate a role for p73 in OSCC and suggest a complex interaction between p53, p73 and HPV in the aetiology of the disease.

Self-induced vomiting -- risk for oesophageal cancer?

BACKGROUND: Chronic inflammation of the oesophagus is considered a precursor condition for the development of oesophageal cancer. Identification of the causes of chronic oesophageal irritation is therefore relevant in developing preventive measures. Self-induced vomiting is a cultural practice among the black population of South Africa, particularly those living in the Transkei, a region reported to have one of the highest incidences of oesophageal cancer worldwide. METHODS: We retrospectively examined the association between the practice of self-induced vomiting and the development of cytological features of inflammation in 478 self-selected subjects living in Transkei who underwent early screening for oesophageal cancer. Screening involved brush biopsy, cytological investigation and a questionnaire interview. RESULTS: The prevalence of self-induced vomiting was 80.5% and 79.1% in males and females, respectively, and this was stable across all ages. Furthermore, self-induced vomiting was found to be significantly and independently associated with oesophageal chronic inflammation (odds ratio 1.83, 95% confidence interval: 1.13 - 2.96, p = 0.013). CONCLUSION: While the association between the cultural practice of self-induced vomiting and oesophageal cancer has previously been hypothesised, this is the first study to report on an association between this practice and oesophageal chronic inflammation. Further studies that take into account the method used, frequency and duration of vomiting, age of commencement and fasting state of subjects practicing self-induced vomiting coupled with accurate indicators of inflammation are needed to elucidate the role of self-induced vomiting in oesophageal pathogenesis.

Influence of the therapy with pergolide mesylate plus L-DOPA and with L-DOPA alone on serum cGMP level in PD patients.

The aim of our study was to investigate serum cGMP level in patients treated with L-DOPA alone and L-DOPA with pergolide mesylate (PM) and to compare the obtained values with age-matched healthy subjects. PD patients treated with L-DOPA or with PM + L-DOPA had significantly higher cGMP levels in serum as compared to control. Moreover, cGMP level was significantly higher after treatment with PM + L-DOPA then L-DOPA alone. We did not observed significant differences in UPDRS scores between both PD groups. Our data suggest that changes in serum cGMP level in PD patients are related with PM + L-DOPA or L-DOPA alone therapy.

Pergolide mesylate, a dopaminergic receptor agonist, applied with L-DOPA enhances serum antioxidant enzyme activity in Parkinson disease.

The aim of this study was to compare patients with Parkinson disease (PD) patients treated with pergolide mesylate (PM), a dopaminergic receptor agonist, together with L-DOPA and those these treated with L-DOPA alone on the concentration of free radicals (FR), glutathione, and the activity of superoxide dismutase (SOD) and catalase in the serum. The study was carried out using 16 age-matched control subjects, 16 PD patients treated with L-DOPA at a dose of 1 to 1.5 g daily, and 16 PD patients treated with L-DOPA 1 to 1.5 g daily with PM 0.75 to 1.25 mg daily. The mean duration of treatment of PD was 6 years (range, 2-8 years) with l-DOPA, and 2 years with PM + L-DOPA or L-DOPA alone. Although there was no significant difference in lipid peroxidation products among the 3 groups, patients treated with L-DOPA showed high levels of FR as determined by dichlorofluorescein. Although catalase and SOD activities were elevated in both groups of PD patients, additional treatment with PM further enhanced catalase activity compared with those treated with l-DOPA alone. Interestingly, patients treated with PM + L-DOPA showed a significantly increased level of glutathione compared with those treated with L-DOPA alone. Collectively, these data suggest that PM + L-DOPA is a more efficient therapy in maintaining an antioxidative defense in PD patients compared with treatment with L-DOPA alone.

Human papillomavirus associated with oesophageal cancer.

AIM: To study the prevalence and the different types of human papillomavirus (HPV) in patients with oesophageal cancer from a high risk area of South Africa (Transkei). METHODS: DNA samples from 50 paraffin wax embedded tissue sections were analysed by nested polymerase chain reaction (PCR) using the degenerate HPV L1 consensus primer pairs MY09/MY11 and GP5+/GP6+. Positive PCR samples were subjected to DNA sequence analysis. RESULTS: HPV DNA was detected in 23 of the 50 samples. Sequence analysis revealed that most patients (11) harboured DNA to HPV type 11, whereas other types included DNA HPV type 39 (seven patients), type 16 (two patients), and type 52 (one patient). HPV type 39 has not previously been shown to be associated with oesophageal cancer. In contrast to earlier studies that have found HPV type 16 to be more frequently associated with oesophageal cancer, HPV type 11 was the predominant subtype in this study. CONCLUSIONS: The high frequency of occurrence of HPV in oesophageal tumours (23 of 50 patients; 46%) implicates HPV as one of the possible aetiological factors in this disease. The finding that the low risk HPV subtypes predominate indicates that transformation may be effected via the E6 and E7 proteins.

Second messenger systems in the action of LH and oxytocin on porcine endometrial cells in vitro.

LH/hCG as well as oxytocin receptors are present in the porcine endometrium. Oxytocin increases phosphatidylinositol hydrolysis in this tissue, but its action on adenylate cyclase activity is disputed. The second messenger system responding to LH/hCG in endometrial cells has not been established. In this study, we investigated the involvement of protein kinase A and C signaling mechanisms in the action of LH on porcine endometrial cells in vitro. The possibility of cAMP accumulation after treatment of endometrial cells with oxytocin was also investigated. Endometrial tissue was obtained from gilts during Days 12-15 of the estrous cycle. To study the adenylate cyclase system, endometrial cells were cultured for 48 h and then incubated with different doses of LH or oxytocin for 15, 30, 60, and 180 min. To study the phospholipase C system, dispersed cells were first labeled with myo-[3H]inositol and then treated with increasing doses of LH or 100 nM of oxytocin for 30 min. Time- and dose-dependent effect of LH and oxytocin on cAMP concentration was observed. After 30 min of incubation only the highest dose of LH (100 ng/ml) was able to increase cAMP concentration in medium (P < 0.05). Longer periods (1 and 3 h) caused increased cAMP accumulation after treatment with 10 and 100 ng/ml of LH (P < 0.001). Oxytocin-stimulated cAMP concentration was observed after 1 h when only the highest dose (1000 nM) of hormone was used (P < 0.01) and after 3 h of incubation with doses of 10-1000 nM (P < 0.01). LH (10 and 100 ng/ml) increased inositol phosphates (IPs) accumulation in endometrial cells after 30 min of incubation (P < 0.01). Oxytocin involvement in IPs synthesis was more apparent than was LH (P < 0.001 versus P < 0.01). This is the first demonstration that LH receptor signaling leads to increased cAMP generation as well as IPs turnover in porcine endometrium. Oxytocin-dependent cAMP production in endometrial cells of swine was found after longer periods (3 h) of incubation. Our observations lead to the conclusion that both protein kinase A and C second messenger systems are involved in LH action and that oxytocin is able to stimulate adenylate cyclase activity in porcine endometrial cells.

Changes in tumor necrosis factor-alpha system and insulin sensitivity during an exercise training program in obese women with normal and impaired glucose tolerance.

OBJECTIVE: Tumor necrosis factor-alpha (TNFalpha) plays an important role in the pathogenesis of insulin resistance and type 2 diabetes. Plasma levels of the soluble (s) fractions of TNFalpha receptors, especially sTNFR2, are good indicators of TNFalpha system activation in obesity. The aim of the present study was to assess the effect of exercise training on the TNFalpha system and to evaluate the relationship with changes in insulin sensitivity. DESIGN AND METHODS: Sixteen obese women (body mass index (BMI)>27.8 kg/m(2)), 8 with normal (NGT) and 8 with impaired glucose tolerance (IGT), participated in an exercise training program which lasted for 12 weeks and included exercise performed on a bicycle ergometer at an individual intensity of 70% maximal heart rate, for 30 min, 5 days a week. Anthropometrical measurements and blood biochemical analyses were performed, and plasma TNFalpha, sTNFR1 and sTNFR2 levels were assessed. Insulin sensitivity was evaluated using the hyperinsulinemic euglycemic clamp technique (insulin infusion: 50 mU x kg(-1)xh(-1)). RESULTS: At baseline, despite similar anthropometrical parameters, IGT subjects were markedly more insulin resistant and had higher TNFalpha and sTNFR2 concentrations. Exercise training increased insulin sensitivity and decreased TNFalpha and sTNFR2 levels, while sTNFR1 remained unchanged. The decrease in sTNFR2 was significantly related to the increase in insulin sensitivity; that relationship remained significant after adjustment for the concurrent changes in BMI, waist circumference, percentage of body fat, plasma glucose, insulin and free fatty acids. CONCLUSIONS: Regular physical exercise decreases TNFalpha system activity and that decrease may be responsible for the concurrent increase in insulin sensitivity.

Nongonadal LH/hCG receptors in pig: functional importance and parallels to human.

Luteinizing hormone (LH) and human chorionic gonadotropin (hCG) share a common receptor in gonadal cells; however, the presence of these receptors has also been detected in several nongonadal but reproduction-associated tissues of pig, human, and other species. There are no data about the ontogeny of the human LH/hCG receptor. The expression of the porcine LH receptor gene in the uterus starts about 10 days after the appearance of this gene in gonads. LH/hCG receptors were found in uterus (myometrium, endometrium), oviduct, cervix, fetal membranes, and umbilical cord in humans and pigs. The main role of LH/hCG receptors in myometrium is stimulation of growth and hyperplasia and relaxation of uterine motility. hCG also increases blood flow in the uterine artery. LH and hCG can increase production of prostaglandins in endometrium, oviduct, and blood vessels. It is suggested that the preovulatory surge of LH plays an important role in controlling oviductal contractions. Human and pig mammary glands also possess LH/hCG receptors through which gonadotropins can affect the metabolism of steroid hormones in this tissue and may play an inhibitory role in mammary carcinogenesis and in the growth of breast tumors.

[Sleep disorders as a risk factors for stroke]. / Zwiazane ze snem zaburzenia oddychania jako czynnik ryzyka udaru mózgu.

Sleep-disordered breathing seems to play a role in pathogenesis of stroke: for example, it was showed that snoring is a risk factor for stroke. Sleep disorders and sleep-disordered breathing increase the risk for stroke, probably by influencing systemic and cerebral blood circulation, causing hypoxaemia during night. This theory is supported by the fact of higher prevalence of stroke in the morning. During REM sleep there is a higher requirement for oxygen; as most sleep apnoeas occur during REM, it is possible that there is a relative hypoxaemia during this sleep stage. Stroke, including hemispheric stroke, can cause or aggravate the pre-existing sleep-disordered breathing. There are contradictory data in the literature regarding the influence of stroke on sleep architecture. Sleep disorders are associated with poorer stroke outcome, so their detection and treatment can be important in secondary stroke prophylaxis and will improve the patient's functioning and quality of life.

[Aspergillus spondylodiscitis]. / Spondylodiscite aspergillaire.

Four weeks after an Amanita phalloides poisoning, a 29-year-old man presented an ocular aspergillosis. One month later he developed a bilateral L5-S1 radicular syndrome. The diagnosis of aspergillar spondylodiscities was established on the basis of x-ray, CT-scan, MRI and pathology findings. Clinical and radiological improvement was obtained with fluconazole.