RESUMO
Tuberculosis (TB) is still one of the most frequent infectious diseases worldwide. Until the 1990s, Western European countries showed a low frequency of TB infection, but the rise of immigration has led to a rapid increase in its occurrence. In the elderly, TB is emerging as a significant health problem (age-related decline of the cell-mediated immunity, associated illnesses, use of immunosuppressive drugs, malnutrition, poor life conditions), although its detection and diagnosis is not easy also considering its subclinical presentation. Almost 70% of all TB infections in Italy are found in the lungs; 50% of the extrapulmonary infections affect lymph nodes. Due to the low incidence of superficial tuberculous lymphadenitis without pulmonary manifestations, the possibility of a TB aetiology is often not taken into consideration in the differential diagnosis of lymphadenopathy, resulting in significant delay of appropriate treatment. Herein, we describe the case of a 78-year-old male with nocturnal fever, weakness, night sweats, loss of weight and decay in general condition. The patient had a past medical history of prostate adenocarcinoma treated with hormone therapy. The past medical history in association with clinical findings and laboratory data (anaemia, high titers of fibrinogen and reactive C-protein) led to the suspect of metastatic adenocarcinoma. Only histological and molecular biology findings allowed us to make a correct diagnosis of TB.
Assuntos
Tuberculose dos Linfonodos/patologia , Adenocarcinoma/complicações , Idoso , Antituberculosos/uso terapêutico , Diagnóstico Diferencial , Humanos , Masculino , Metástase Neoplásica/patologia , Neoplasias da Próstata/complicações , Tuberculose dos Linfonodos/complicações , Tuberculose dos Linfonodos/fisiopatologiaRESUMO
The behavioral response of planaria to the exposure to selective opioid agonists was studied. The mu agonist [d-ala2, N-methyl-Phe4,Gly5-ol]enkephalin (DAMGO) and the 6 agonist [D-Pen2, D-Pen5]enkephalin (DPDPE) failed to alter motor activity at all doses tested. Low doses of the selective kappa agonist (+/-)-trans-U-50-trans-3,4-dichloro-N-methyl-N[2-(1-pyrrodinyl)-cyclohexyl]benzene acetamide methasulphonate (U50, 488) and bremazocine-HCl increased motor activity leading to C-like position (CLP) and screw-like hyperkinesia (SLH). These changes were identical to those seen previously with the exposure to D2 or D1 dopamine receptor agonists, respectively. Higher doses of kappa agonists produced the enhancement of CLP and SLH together with robust snake-like movements (SLM). This latter response, that was typical of stimulation of kappa opioid receptors, was blocked by co-exposure to naloxone or the selective kappa antagonist Nor-binaltorphimine (Nor-BNI). Finally, co-exposure to sulpiride or SH-23390 respectively blocked the CLP or SLH response produced by U50,488 or bremazocine. Our data indicate the presence of kappa opioid receptors in planaria and suggest the functional interaction between the opioid and dopamine system in this simple animal model.
Assuntos
Dopamina/fisiologia , Planárias/fisiologia , Receptores Opioides kappa/fisiologia , (trans)-Isômero de 3,4-dicloro-N-metil-N-(2-(1-pirrolidinil)-ciclo-hexil)-benzenoacetamida/farmacologia , Animais , Benzomorfanos/farmacologia , Antagonistas de Dopamina/farmacologia , Ala(2)-MePhe(4)-Gly(5)-Encefalina/farmacologia , D-Penicilina (2,5)-Encefalina/farmacologia , Atividade Motora/efeitos dos fármacos , Antagonistas de Entorpecentes , Planárias/efeitos dos fármacos , Receptores Opioides/agonistas , Receptores Opioides/fisiologia , Receptores Opioides kappa/agonistas , Receptores Opioides kappa/antagonistas & inibidores , Sulpirida/farmacologiaRESUMO
Morpho-functional and behavioral effects of exposure to 6-hydroxydopamine (OHDA)-HCI (24 microg/ml per day for 24 h and 7 days) were studied in planarias (Dugesia gonocephala s.l.). Exposure to 6-OHDA-HC1 for 24 h produced hypokinesia of the specimens. These behavioral changes were more pronounced, leading to complete immobility, after 7 days of exposure to the neurotoxin. Moreover, specimens exposed to 6-OHDA-HCI for 24 h and 7 days failed to show any behavioral response to nomifensine, thus furnishing evidence of the damage of presynaptic dopamine terminals. Exposure to 6-OHDA-HCl for 24 h significantly reduced cathecolamine content in neuropil region, as demonstrated by histochemistry, and electron-dense presynaptic vesicles, as observed on electron microscopy examination. All these alterations were significantly more pronounced and were accompanied by swelling and strong increase of electron-density in cytoplasm of numerous neurons after exposure to the neurotoxin for 7 days. This appears to be the first demonstration of the neurotoxic effects of 6-OHDA-HCI in flatworms.
Assuntos
Comportamento Animal/efeitos dos fármacos , Hipocinesia/induzido quimicamente , Lobo Óptico de Animais não Mamíferos/efeitos dos fármacos , Oxidopamina/toxicidade , Planárias/efeitos dos fármacos , Simpatolíticos/toxicidade , Animais , Catecolaminas/análise , Inibidores da Captação de Dopamina/uso terapêutico , Hipocinesia/tratamento farmacológico , Atividade Motora/efeitos dos fármacos , Atividade Motora/fisiologia , Neurópilo/química , Neurópilo/efeitos dos fármacos , Nomifensina/uso terapêutico , Lobo Óptico de Animais não Mamíferos/patologia , Lobo Óptico de Animais não Mamíferos/fisiologia , Planárias/citologia , Vesículas Sinápticas/efeitos dos fármacos , Vesículas Sinápticas/ultraestruturaRESUMO
Hydra feeding response is a very primitive olfactory-like behavior present in a multicellular organism. We investigated the role of nitric oxide (NO) in the induction and control of hydra feeding response. Under basal conditions, hydra specimens produce detectable amounts of nitrite (NO2-), the breakdown product of NO. When hydra were incubated with reduced glutathione (GSH), the typical activator of feeding response, an increase of basal NO production was observed. This effect was inhibited by glutamic or alpha-aminoadipic acids, two GSH antagonists, which block GSH-induced feeding response, and by the NO synthase (NOS) inhibitor L-NAME. Moreover, we found that hydra possess a calcium-dependent (but calmodulin-independent) NOS isoform. By using exogenous NO donors and NOS inhibitors, we demonstrated that NO stimulus can participate both in triggering tentacular movements and in recruiting neighbor tentacles during hydra feeding response. By using dbt2-cGMP, an analog to cGMP, we observed that the NO effect was independent of cGMP pathway. Our results strongly implicate NO involvement in hydra very primitive feeding behavior, thus confirming its preservation throughout evolution.
Assuntos
Hydra/fisiologia , Óxido Nítrico/fisiologia , Condutos Olfatórios/fisiologia , Animais , Cálcio/fisiologia , Calmodulina/fisiologia , GMP Cíclico/fisiologia , Espectroscopia de Ressonância de Spin Eletrônica , Inibidores Enzimáticos/farmacologia , Comportamento Alimentar/efeitos dos fármacos , Molsidomina/análogos & derivados , Molsidomina/farmacologia , NG-Nitroarginina Metil Éster/farmacologia , Óxido Nítrico/antagonistas & inibidores , Óxido Nítrico Sintase/antagonistas & inibidores , Óxido Nítrico Sintase/metabolismo , Nitritos/metabolismo , Nitroprussiato/farmacologiaRESUMO
Acute high dose treatment with cocaine in planaria has been shown to produce hyperkinesia followed by immobilization, thus suggesting progressive neuronal dopamine (DA) depletion. On the contrary, treatment with low doses of cocaine inhibits motor activity in planaria, without producing hyperkinesias. Here we investigated the morpho-functional changes of the DA presynaptic terminals following cocaine treatment in planaria (acute high dose and chronic low dose). Neuronal DA content was determined by means of histochemical methods, and nerve cell ultrastructure was examined by electron microscopy. The effects of cocaine were compared to those of L-dopa, reserpine (used as positive and negative controls, respectively) and normal untreated specimens. Presynaptic vesicles and DA content were significantly reduced by chronic low-dose cocaine treatment. These effects were even more robust when the drug was acutely administered at high dose. Thus, depletion of DA vesicles is produced by cocaine in planaria, as well as in mammals. The behavioral effects of chronic low-dose treatment with cocaine, however, suggest that the drug acts not only as a DA reuptake blocker, but also as a direct agonist on presynaptic DA receptors. Acute high-dose administration of cocaine also produced signs of neuronal suffering, thus providing evidence for a direct neurotoxic effect of the drug.
Assuntos
Cocaína/farmacologia , Neurônios/efeitos dos fármacos , Planárias/fisiologia , Animais , Catecolaminas/análise , Cocaína/administração & dosagem , Levodopa/farmacologia , Microscopia Eletrônica , Movimento/efeitos dos fármacos , Neurônios/ultraestrutura , Estimulação Física , Planárias/efeitos dos fármacos , Reserpina/farmacologia , Vesículas Sinápticas/efeitos dos fármacos , Vesículas Sinápticas/ultraestruturaRESUMO
Physiological aging in older women it is not necessarily the cause of a change in their sexual attitudes. The organic changes, during concomitant illness, is often known to be the cause of sexual dysfunction, when present. Psychosocial factors are also very important in determining sexual dysfunction. Successful management of sexual dysfunction in older women is totally dependent on clinical history, physical examination of genitalia, personal interview. A multidisciplinary team approach is required for otimal management of sexual problems in elderly women.