Cognitive reserve mediates the severity of certain neuropsychological deficits related to cocaine use disorder.

The concept of cognitive reserve (CR) is being considered in the field of substance use disorder (SUD) by observing that there are individuals whose brain alterations are not related to the cognitive symptomatology they present. Our aims were to characterise the possible neuropsychological deficits in a sample of subjects with SUD compared to healthy controls and to determine whether the degree of CR is a mediator in the cognitive functioning of these patients. To perform these objectives, the study involved a sample of subjects with SUD in outpatient treatment and a healthy control group. A CR questionnaire and a comprehensive neuropsychological assessment were administered, and we also collected data related to drug consumption and psychological well-being. The SUD group showed poorer performance compared to the control group in several cognitive domains (attention, declarative memory, executive functions and emotional perception), as well as in psychological comfort. Interestingly, we observed that the deficits found in attention and processing speed were highly mediated by the CR level of the participants, an effect that we did not observe in the rest of the variables registered. Our results suggest that long-term drug consumption leads to cognitive deficits and affects the psychological well-being of the subjects. Moreover, the CR should be taken into account during the assessment and rehabilitation of patients with SUD due to its protective role against certain neuropsychological deficits.

Mechanism of action of trabectedin in desmoplastic small round cell tumor cells.

BACKGROUND: Desmoplastic small round cell tumor (DSRCT) is a rare and highly aggressive disease, that can be described as a member of the family of small round blue cell tumors. The molecular diagnostic marker is the t(11;22)(p13;q12) translocation, which creates an aberrant transcription factor, EWS-WT1, that underlies the oncogenesis of DSRCT. Current treatments are not very effective so new active drugs are needed. Trabectedin, now used as a single agent for the treatment of soft tissue sarcoma, was reported to be active in some pre-treated DSRCT patients. Using JN-DSRCT-1, a cell line derived from DSRCT expressing the EWS-WT1 fusion protein, we investigated the ability of trabectedin to modify the function of the chimeric protein, as in other sarcomas expressing fusion proteins. After detailed characterization of the EWS-WT1 transcripts structure, we investigated the mode of action of trabectedin, looking at the expression and function of the oncogenic chimera. METHODS: We characterized JN-DSRCT-1 cells using cellular approaches (FISH, Clonogenicity assay) and molecular approaches (Sanger sequencing, ChIP, GEP). RESULTS: JN-DSRCT-1 cells were sensitive to trabectedin at nanomolar concentrations. The cell line expresses different variants of EWS-WT1, some already identified in patients. EWS-WT1 mRNA expression was affected by trabectedin and chimeric protein binding on its target gene promoters was reduced. Expression profiling indicated that trabectedin affects the expression of genes involved in cell proliferation and apoptosis. CONCLUSIONS: The JN-DSRCT-1 cell line, in vitro, is sensitive to trabectedin: after drug exposure, EWS-WT1 chimera expression decreases as well as binding on its target promoters. Probably the heterogeneity of chimera transcripts is an obstacle to precisely defining the molecular mode of action of drugs, calling for further cellular models of DSRCT, possibly growing in vivo too, to mimic the biological complexity of this disease.

Towards a better understanding of Apis mellifera and Varroa destructor microbiomes: introducing 'phyloh' as a novel phylogenetic diversity analysis tool.

The study of diversity in biological communities is an intriguing field. Huge amount of data are nowadays available (provided by the innovative DNA sequencing techniques), and management, analysis and display of results are not trivial. Here, we propose for the first time the use of phylogenetic entropy as a measure of bacterial diversity in studies of microbial community structure. We then compared our new method (i.e. the web tool phyloh) for partitioning phylogenetic diversity with the traditional approach in diversity analyses of bacteria communities. We tested phyloh to characterize microbiome in the honeybee (Apis mellifera, Insecta: Hymenoptera) and its parasitic mite varroa (Varroa destructor, Arachnida: Parasitiformes). The rationale is that the comparative analysis of honeybee and varroa microbiomes could open new perspectives concerning the role of the parasites on honeybee colonies health. Our results showed a dramatic change of the honeybee microbiome when varroa occurs, suggesting that this parasite is able to influence host microbiome. Among the different approaches used, only the entropy method, in conjunction with phylogenetic constraint as implemented in phyloh, was able to discriminate varroa microbiome from that of parasitized honeybees. In conclusion, we foresee that the use of phylogenetic entropy could become a new standard in the analyses of community structure, in particular to prove the contribution of each biological entity to the overall diversity.

Goji berries (Lycium barbarum): risk of allergic reactions in individuals with food allergy.

BACKGROUND: New foods are frequently introduced in Western diets for their healthy properties; however, they may produce adverse effects. OBJECTIVE: After attending a patient who experienced an allergic reaction to Goji berries, we evaluated the allergenic potential of this food in plant food-allergic individuals, a group that is considered to be at high risk of experiencing a reaction. METHODS: We recruited 30 additional plant food-allergic individuals in Spain during 3 months in 2010. Four patients reported symptoms on intake, 6 tolerated the berries, and 20 had never tried Goji berries. Patients underwent skin prick tests with Goji berries, as well as with peach peel and plant food panallergens as markers of cross-reactivity between unrelated foods. We carried out in vitro tests in symptomatic patients. RESULTS: Skin tests to Goji berries were positive in 24 patients (77%): 5 symptomatic patients and 19 asymptomatic patients. Positivity to Goji berries was associated with positivity to peach peel and to the panallergen nonspecific lipid transfer protein (LTP). Nearly half of the patients reported symptoms (45%), but 89% of the skin test-positive patients had never eaten Goji berries. We detected specific immunoglobulin E to Goji berries in all cases, and several individuals recognized 2 protein bands in the immunoblot. Addition of LTP to sera mostly inhibited immunoglobulin E binding to an LTP-like band, suggesting a role for this panallergen in sensitization to Goji berries. CONCLUSIONS: Our results demonstrate the allergenic potential of Goji berries in high-risk individuals, which is probably due to cross-reactivity with LTP from other foods. The risks of Goji berries should be taken into consideration in individuals with food allergy, especially those who are allergic to LTP.

Evolutionary patterns of the mitochondrial genome in Metazoa: exploring the role of mutation and selection in mitochondrial protein coding genes.

The mitochondrial genome is a fundamental component of the eukaryotic domain of life, encoding for several important subunits of the Respiratory Chain, the main energy production system in cells. The processes by means of which mtDNA replicates, expresses itself and evolves have been explored over the years, although various aspects are still debated. In this review, we present several key points in modern research on the role of evolutionary forces in affecting mitochondrial genomes in Metazoa. In particular, we assemble the main data on their evolution, describing the contributions of mutational pressure, purifying and adaptive selection, and how they are related. We also provide data on the evolutionary fate of the mitochondrial synonymous variation, related to the non-synonymous variation, in comparison with the pattern detected in the nucleus. Elevated mutational pressure characterises the evolution of the mitochondrial synonymous variation, whereas purging selection, physiologically due to phenomena such as cell atresia and intracellular mtDNA selection, guarantees coding sequence functionality. This enables mitochondrial adaptive mutations to emerge and fix in the population, promoting mito-nuclear coevolution.

Independent adaptation to riverine habitats allowed survival of ancient cetacean lineages.

The four species of "river dolphins" are associated with six separate great river systems on three subcontinents and have been grouped for more than a century into a single taxon based on their similar appearance. However, several morphologists recently questioned the monophyly of that group. By using phylogenetic analyses of nucleotide sequences from three mitochondrial and two nuclear genes, we demonstrate with statistical significance that extant river dolphins are not monophyletic and suggest that they are relict species whose adaptation to riverine habitats incidentally insured their survival against major environmental changes in the marine ecosystem or the emergence of Delphinidae.

Lectin histochemistry of lipofuscin and certain ceroid pigments.

Little is known at present about the saccharide components of lipofuscin (age pigment) and ceroid pigments in situ. The purpose of this study was, therefore, to study in detail the lectin reactivities of lipofuscin in neurons and cardiac myocytes of old humans and rats. In addition, those of diverse ceroid pigments found in human aortic atheromas, in the livers of choline-deficient rats, in the uteri of vitamin E-deficient rats and in the crushed epididymal fat pad of rats, are included. Cryostat and deparaffinized sections from all these tissues were either extracted with a solvent mixture of chloroform-methanol-water (10:10:3, v/v) and incubated with 7 different biotinylated lectins or left untreated. Delipidation was done in order to study whether it was possible to discriminate between the saccharide moieties of glycolipids and glycoproteins of lipofuscin and ceroid pigments in situ. Other similarly treated sections were used to study the autofluorescence, sudanophilia, acid-fastness and reactivity to PAS. The frequency and intensity of lectin binding and standard histochemical properties of all the pigments were evaluated semi-quantitatively and blind. The results indicated that mannose was in general the most consistently detected sugar residue in lipofuscin granules of humans and rats, and that this pigment may also contain acetylglucosamine, acetylgalactosamine, sialic acid, galactose and fucose. However, notable differences were found not only in the lipofuscin saccharide components of different cell types of humans and rats, but also in those in the same type of cells in both species. Although mannose was not detected in the hepatic ceroid of choline-deficient rats, this saccharide moiety was almost always present in the other ceroid pigments. Each of the ceroids also contained other types of saccharides although the frequency of the latter varied between different ceroid pigments. While lipofuscin and each of the ceroid pigments showed somewhat different lectin binding patterns, the variability in the frequency of reactivity to lectins suggests that these patterns may not be permanent but transient. In this sense, it appears that lectin histochemistry may not allow these pigments to be differentiated. Furthermore, the extractive procedures used in this study did not enable us to determine whether the saccharides detected in the pigments in situ corresponded to glycolipids or glycoproteins.

[Non-palpable lesions of the breast: identification, localization, significance]. / Lesioni non palpabili della mammella: rilevamento, localizzazione, significato.

The authors report the diagnostic protocol used in the Breast Disease Unit of the 1st Surgical Department - University of Rome "La Sapienza" - (1987-1990) as well as the techniques for identifying and localizing nonpalpable lesions of the breast. Mammographic screening in women over 40 years, ultrasonography in women under 40 years, X-ray and ultrasound-guided fine needle aspiration and stereotactic guide wire placement with excisional biopsy, resulted to be diagnostic in 79 cases of carcinoma of the breast (2.0%) of which 13 (16.4%) were nonpalpable lesions. Moreover, the importance of nonpalpable lesions is discussed, pointing out how "very early" diagnosis of carcinoma of the breast plays a fundamental role with respect to both prognosis and treatment. The very early diagnosis of a "minimal" carcinoma ensures a significant increase in survival as well as more conservative surgical procedures that offer a better quality of life being less psychologically traumatic.

Acute pelvic inflammatory disease after surgical sterilization.

STUDY OBJECTIVE: Physicians are very cognizant of the possibility of pregnancy after surgical sterilization, but the potential for acute pelvic inflammatory disease (PID) is thought to be rare. This study was undertaken to determine if upper tract PID occurred more frequently than previously reported in patients remote from surgical sterilization. DESIGN: Retrospective review of hospitalized patients with the primary discharge diagnosis of PID. SETTING: Urban, university hospital. PARTICIPANTS: Three hundred sixty-four hospitalized patients with the primary discharge diagnosis of PID over a six-year study period. MEASUREMENTS AND MAIN RESULTS: Patients' age; gynecologic histories and diagnoses; and laboratory, clinical, and surgical findings were noted. Twenty-three cases of acute PID were identified in 21 patients previously sterilized (6%). Nine of the 23 cases had systemic toxicity warranting surgical evaluation; 18 of the 23 cases were admitted from the emergency department. Mean statistical characteristics of the study group were age, 27.3 +/- 0.8 (SE) years; time interval from sterilization, 49.8 +/- 7.4 months; WBC 15,000 +/- 1,200; and temperature, 38.0 +/- 0.2 C. CONCLUSION: We conclude that acute PID may occur more frequently than previously reported in patients with prior surgical sterilization. An increased awareness of this entity is warranted.

PIP: This study was undertaken to determine if upper tract pelvic inflammatory disease (PID) occurred more frequently than previously reported in patients who underwent surgical sterilization far in the past. This retrospective review of hospitalized patients with a primary discharge diagnosis of PID took place in an urban university hospital with participants being 364 hospitalized patients studied over a 6-year period. Patients' age, gynecologic histories and diagnoses, and laboratory, clinical, and surgical findings were noted. 23 cases of acute PID were identified in 21 patients previously sterilized (6%). 9 of the 23 had systemic toxicity warranting surgical evaluation. 18 of 23 cases were admitted from the emergency department. The mean statistical characteristics of the study group were age (27.3 +or- 9.8 [SE]), time interval from sterilization (49.8 +or- 7.4 months), WBC (15.000 +or- 1200), and temperature (38.0 +or- 0.2 degrees Celsius). The authors conclude that PID may occur more frequently than previously reported in patients with prior surgical sterilization. An increased awareness of this entity is warranted.

In vitro use of arthroscopic irrigation tubing for rapid fluid administration.

The in vitro use of arthroscopic irrigation tubing (AIT) to achieve intravenous flow rates superior to those of previously reported studies are described. Using AIT with a peripheral type of 12 GA. catheter, flow rates of 934 cc/min with gravity and 1,928 cc/min with pressure were achieved. AIT connected to a 12 FR. central-type catheter yielded flow rates in excess of 2,000 cc and 3,000 cc/min with gravity and pressure, respectively. Such a delivery system may be lifesaving in situations where there are limited venous access sites or when there is a need for rapid volume resuscitation with limited personnel.

Rapid cooling in classic heatstroke: effect on mortality rates.

The case records of 39 patients with classic (non-exertional) heatstroke presenting to an urban emergency department were reviewed. Eight of 39 patients died. Rapid cooling, defined as a rectal temperature of less than or equal to 38.9 degrees C (102 degrees F) within an hour of presentation, was achieved in 27 of 39 patients. Twelve patients had a temperature greater than or equal to 38.9 degrees C (102 degrees F) after one hour of treatment in the emergency department. The rate of mortality in the rapid cooling group was four of 27 (15%), while in the delayed cooling group, the mortality rate was four of 12 (33%) (P = 0.18). Factors such as advanced age, hypotension, altered coagulation status, and the necessity for endotracheal intubation on presentation dictated a poor outcome despite successful cooling measures.

Closed reduction of anterior subcoracoid shoulder dislocation. Evaluation of an external rotation method.

We prospectively evaluated an external rotation method for closed reduction of acute anterior shoulder dislocations that had been described recently. Seventy-eight of 100 consecutive emergency patients who presented with anterior shoulder dislocations experienced successful reduction using this external rotation method. The method proved to be easy to perform and relatively safe. Based on our findings, we recommend that it be included in the physician's armamentarium for initial closed reduction of anterior shoulder dislocation.

Ventilatory status early after head injury.

The ventilatory status of patients within the first few hours following head injury has not been well established. We prospectively studied 63 patients who presented to an urban trauma center with varying severity of head injury to determine whether any trend toward hypo- or hyperventilation existed within the first two hours following injury. Arterial blood gas analysis done on emergency presentation showed that 14 patients with severe head injury (Glasgow coma scale less than or equal to 4) had mean pH values of 7.29 and mean PaCO2 of 41.86 torr. Twenty patients categorized as moderate head injury (GCS = 5-11) had mean pH values of 7.38 with a mean PaCO2 of 34.1 torr. Twenty-nine patients with GCS greater than or equal to 12 had mean pH and PaCO2 values of 7.4 and 31.8 torr, respectively. These differences in pH and PaCO2 were statistically significant between the GCS groups with mild and severe head injury (P less than or equal to .01 pH), (P = .05 PCO2), and could not be explained on the basis of hypoxemia, blood alcohol level, hypotension, or associated chest injury. It is concluded that patients with severe craniocerebral trauma show an early trend toward hypercapnea and acidosis. Immediate control of airway and assisted ventilation is necessary in order to reduce PaCO2 to optimal levels in patients with severe head injury.

Emergency presentation of subdural hematoma: a review of 85 cases diagnosed by computerized tomography.

The emergency presentations of 85 patients diagnosed by computerized axial tomography (CT) as having subdural hematomas (SDH) were retrospectively reviewed to identify factors contributing to an early or delayed diagnosis. Sixty-one of 85 patients (72%) were diagnosed within 24 hours of presentation. Forty-five of 57 (79%) with definite history or signs of cranial trauma were diagnosed within 24 hours, while only 16 of 28 (57%) without historical or physical evidence of trauma were diagnosed promptly. Focal neurologic signs were present in 32 of 57 patients (56%) with head trauma and 24 of these patients (75%) had an early CT scan. Twenty-two of 50 patients (44%) with head trauma had skull fractures, but the presence or absence of skull fracture alone did not serve to hasten the diagnosis in this group. In patients without head trauma, 14 of 28 (50%) had focal neurologic signs, with eight of 14 (57%) undergoing CT scan within 24 hours. No patient in this group had an abnormal skull series. Thus despite the immediate availability of CT scanning, a significant number of patients, especially those without history or evidence of head trauma, had a delay in diagnosis exceeding 24 hours. The presence of a focal neurologic sign is a more sensitive indicator of the presence of SDH than is a positive skull series.