Veillonella parvula spondylodiscitis.

OBJECTIVES: Veillonella parvula is an anaerobic Gram-negative coccus rarely involved in bone and joint infections. PATIENTS AND METHOD: We report the case of a Veillonella parvula vertebral osteomyelitis (VO) in a female patient without any risk factor. RESULTS: The 35-year-old patient was immunocompetent and presented with Veillonella parvula VO. She was admitted to hospital for inflammatory lower back pain. The discovertebral sample was positive for Veillonella parvula. Literature data on Veillonella VO is scarce. Reported cases usually occurred in immunocompromised patients. Diagnosis delay can be up to four months. Patients are usually afebrile. Outcome with antimicrobial treatment alone is favorable in half of cases. Other patients must undergo surgery. CONCLUSIONS: Veillonella VO may occur in immunocompetent patients and have a clinical spectrum of mechanical lower back pain.

Tocilizumab in glucocorticoid-naïve large-vessel vasculitis.

Glucocorticoids (GC) are the mainstay of treatment of large-vessel vasculitis (LVV), but a sizeable number of patients relapse upon tapering the GC dose or after discontinuation of GC therapy. In addition, GC cause numerous adverse events. Therefore, in patients with longstanding disease and in those at risk for GC-related adverse events, the use of alternative therapeutic agents should be considered. Interleukin-6 (IL-6) is a key player in the pathogenesis of LVV. Preliminary data suggest the efficacy of the IL-6 receptor inhibitor tocilizumab (TCZ) in patients with LVV. We report 2 treatment-naïve patients with a recent diagnosis of LVV who received monthly TCZ infusions (8 mg/kg body weight) for 6 consecutive months as monotherapy because of relative contraindications and patients' reluctance to take GC. In both cases we observed a complete clinical response and normalisation of inflammatory markers as well as a decrease in vascular FDG uptake and SUV ratio on fluorodeoxyglucose positron emission/computerised tomography. Serum IL-6 and soluble IL-6 receptor (sIL-6R) levels rose in both patients after TCZ therapy. TCZ may be an effective alternative to GC treatment for LVV patients at risk for GC-related adverse events. Larger studies are required to confirm our findings.

Uremic vagal neuropathy: has parathyroid hormone a pathogenetic role?

Cardiac vagal reflexes were investigated in 19 dialysis patients, with the aim of verifying whether parathyroid hormone, proposed as an important uremic neurotoxin, plays a role in the development of uremic vagal neuropathy. The results indicate that parasympathetic control of heart function is frequently impaired in uremics. Plasma parathyroid hormone levels were significantly correlated with the time on dialysis. However, a correlation between autonomic disturbances and plasma parathyroid hormone concentrations was not found in this study.

Carbon tetrachloride-induced pharmacokinetic changes of diazepam in rats are reduced by a stable analogue of prostaglandin E2 : FCE 20700.

Rats, given CC14 (6670 mg/Kg, sc), exhibited a significant increase in SGPT (425.7 +/- 51.3 mU/ml), together with impaired pharmacokinetics of intravenous diazepam (t beta 1/2: 53.87 h; AUC: 101.05 micrograms/ml/h) when compared with saline treated animal (SGPT: 33.6 +/- 3.8 mU/ml; t beta 1/2: 2.087 h; AUC: 1.37 micrograms/ml/h). FCE 20700 (5 micrograms/ml, sc) did not change, by itself, either SGPT or diazepam pharmacokinetic parameters, but significantly antagonized the changes induced by CC14 (SGPT: 45.3 +/- 5.3 mU/ml; t beta 1/2: 0.167 h; AUC: 2.426 micrograms/ml/h). Further support to this cytoprotective effects was given by histological examination of the livers. Data indicate that this new prostaglandin E2 derivative might be useful in patients with liver failure.

Effect of intracerebroventricular injection of pentagastrin on rat drinking behavior.

Intracerebroventricular (icv) injection of pentagastrin showed a powerful, dose dependent antidipsogenic effect in the rat. Drinking behavior stimulated by 48 h water deprivation was inhibited by 2000 ng of pentagastrin which also blocked, at lower doses, water intake induced by icv injection of angiotensin II (100 ng) and carbachol (150 ng). Pentagastrin was less effective on food intake stimulated by 24 h starvation. The antidipsogenic effect was not a consequence of behavioral alteration. It is suggested that gastrin-like peptides in the brain may play a role in the regulation drinking, acting as thirst inhibitors.

The calcium antagonist nimodipine increases beta-endorphin release from rat hypophysis through an action on adrenal glands. An "in vivo" and "in vitro" study.

Intravenous injection of nimodipine (1, 10 and 100 micrograms/Kg) raised plasma ACTH and beta-endorphin (beta-EP) level and reduced pituitary beta-EP content, in the rat. These effects were sharp and short-lasting. Nimodipine (10(-8), 10(-7), 10(-6) M) did not change basal and hypothalamic extract stimulated beta-EP release from pituitary tissue in vitro. Basal release of corticosterone from adrenal glands, superfused in vitro with the calcium antagonist (10(-7) - 10(-6) M), was not modified. However, ACTH-induced release was strongly reduced. Since glucocorticoids feedback regulates biosynthesis and cleavage of pro-opiocortin, nimodipine, which reduces adrenal gland responsiveness to ACTH, might reflexly increase beta-EP release from hypophysis.

[Action of various bacterial endotoxins on pleurisy and pulmonary edema induced by thiourea]. / Azione di alcune endotossine batteriche sulla pleurite e l'edema polmonare da tiourea.

Administration of E. coli LPS prior to 3.5 mg/Kg dose of thiourea has been reported to protect rats against pulmonary edema and pleural effusion. However, LPS of Shigella sonnei (either in phase I or II) did not show any protective effect. These data might suggest a different mechanism of endotoxins on membranes.