Possible association between the lrrk2 gene and anxiety behavior: a systematic literature review.

Alterations to the LRRK2 gene have been associated with Parkinson's disease and alcohol consumption in animals and humans. Furthermore, these disorders are strongly related to anxiety disorders (ADs). Thus, we investigated how the LRRK2 gene might influence anxiety in humans and mice. We elaborated a systematic review based on the PRISMA Statement of studies that investigated levels of anxiety in animal or human models with alterations in the LRRK2 gene. The search was conducted in the PubMed, Scopus, and Web of Science databases, and in reference lists with descriptors related to ADs and the LRRK2. From the 62 articles assessed for eligibility, 16 were included: 11 conducted in humans and seven, in mice. Lrrk2 KO mice and the LRRK2 G2019S, LRRK2 R1441G, and LRRK2 R1441C variants were addressed. Five articles reported an increase in anxiety levels concerning the LRRK2 variants. Decreased anxiety levels were observed in two articles, one focusing on the LRRK2 G2019S and the other, on the Lrrk2 KO mice. Eight other articles reported no differences in anxiety levels in individuals with Lrrk2 alterations compared to their healthy controls. This study discusses a possible influence between the LRRK2 gene and anxiety, adding information to the existing knowledge respecting the influence of genetics on anxiety.

Anti-Mullerian hormone and its relationship to ovulation response and fertility in timed AI Bos indicus heifers.

This study evaluated the association between plasma anti-Mullerian hormone (AMH) concentration and fertility in Nelore (Bos indicus) heifers submitted to timed artificial insemination (TAI). At the onset of the synchronization protocol, heifers (n = 289) received a subcutaneous P4 ear implant (3 mg) and 2 mg of oestradiol benzoate. Eight days later, the P4 implant was removed and 0.5 mg of oestradiol cypionate, prostaglandin (0.265 mg, i.m.) and equine chorionic gonadotropin (300 UI, i.m.) was administered, and TAI was performed 48 hr after ear implant removal. Ovarian ultrasound evaluations were performed to measure number of ovarian follicles, dominant follicle size and ovulation response. Pregnancy diagnosis was performed by ultrasound 30 days after AI. Heifers with greater circulating AMH had more antral follicles, a smaller dominant follicle near timed ovulation and lower ovulation response to the timed AI protocol compared to heifers with lower circulating AMH. Although AMH and pregnancy outcome had a quadratic-shaped pattern, AMH was not significantly associated with fertility. In conclusion, heifers with lower AMH had larger follicles towards the end of the synchronization protocol and greater ovulation responses, whereas greater circulating AMH was unrelated to conception success.

Chest calcifications beyond the lung parenchyma-A review.

OBJECTIVE: Thoracic calcifications are frequently found in chest radiographs and CTs, occurring in a wide variety of disorders. Although most calcifications are harmless sequelae of previous disease, they provide important information to establish the diagnosis. This article reviews the different types of calcified lesions found in the chest, focusing on lesions outside the lung parenchyma. A location-based approach to the differential diagnosis is used, while providing the reader with diagnostic pearls and discussing the clinical importance of the different types of calcifications. CONCLUSION: Chest calcifications are a common finding in routine chest imaging. Understanding the different etiologies and radiologic manifestations provide the radiologist with the necessary tools to elaborate a differential diagnosis, as well as to correctly differentiate the findings that need further work-up from the ones that can be dismissed.

Effect of induction of ovulation with estradiol benzoate at P4 device removal on ovulation rate and fertility in Bos indicus cows submitted to a TAI protocol.

This study aimed to minimize the number of times cattle need to be confined during protocols for TAI in beef cows treated for induction of ovulation with EB at the time of P4 device removal (P4r). In Experiment 1, cows were treated with P4 plus EB (Day 0; AM) and were allocated to one of three groups at P4r: EB8.5, EB at P4r on Day 8.5 (PM; three confinements); EB9, EB 24 h after P4r on Day 8 (AM; four confinements) and EC8, EC at P4r on Day 8 (AM; positive control; three confinements). At P4r, cows were treated with PGF2a plus eCG. Ultrasonography was performed from D8 to D12. The interval from P4r to ovulation was less in the EB8.5 compared to EB9 and EC8 group. There was no difference in the ovulation rate between groups. The variability of ovulation was greater in the EB8.5 and EC8 compared to EB9 group. In Experiment 2, cows of EC8 and EB9 groups were submitted to TAI 48 to 52 h (AM) or 54 to 58 h (PM) after P4r (D10). Cows of the EB8.5 group were submitted to TAI 38 to 42 h (AM) or 44 to 48 h (PM) after P4r (D10). There was no interaction between treatments and timing of AI and no treatment effect and timing of AI on P/AI. In conclusion, the delay compared to what typically occurs by 10 h of P4r concomitant with EB administration (Day 8.5) reduced the frequency of animal confinement for the TAI protocol without affecting the reproductive efficiency and the flexibility to perform the TAI in suckled beef cows.

Fluoride effects on ectopic bone formation in young and old rats.

This study evaluated the effect of fluoride on bone fluoride levels and on ectopic bone formation in young and old rats. Eighty male Wistar rats were assigned to four groups (n = 20/g), which differed according to the fluoride concentration in their drinking water (0, 5, 15 and 50 mg/l). When half of the rats were 90 days old, demineralized bone matrix (DBM) was implanted. The other rats received DBM implants when they were 365 days old. The animals were killed 28 days after. Fluoride in the femur surface, whole femur and plasma was analyzed with an electrode. The implants were analyzed histomorphometrically. Data were tested for statistically significant differences by ANOVA, Tukey's test, t-test and linear regression (p < 0.05). Increases in plasma, femur surface and whole femur fluoride concentrations were observed as water fluoride levels increased. There was also a trend for increase in plasma and femur fluoride concentrations as age increased. Significant positive correlations were found between plasma and femur surface, plasma and femur and femur surface and femur fluoride concentrations. The morphometric analyses indicated an increase in bone formation for younger rats that received 5 mg/l of fluoride in the drinking water. However, this was not statistically significant. The younger rats that received 50 mg/l of fluoride showed impairment in bone formation. Bone formation was not significantly affected among the older rats. The results suggest that lower doses of fluoride in the drinking water, which slightly increase plasma fluoride levels, may have an anabolic effect on bone formation in younger rats.

Action of Nitroglycerin and amyl nitrite in labile and essential hypertension: hemodynamic differences.

Seventeen patients with labile hypertension received nitroglycerin and 18 received amyl nitrite. Twelve patients with established essential hypertension received nitroglycerin and 12 received amyl nitrite. Nitroglycerin reduced the systolic and mean arterial pressures and cardiac output in both groups, but had no effect on diastolic pressure and total peripheral resistance. Amyl nitrite decreased systolic, diastolic, and mean arterial pressures and peripheral vascular resistance and increased heart rate and cardiac output in labile hypertensives. In established hypertensive patients, amyl nitrite decreased systolic, diastolic, and mean arterial pressures and cardiac output, and had little effect on peripheral vascular resistance. Nitroglycerin reduced arterial pressure in labile and established hypertensives through venodilation and peripheral venous pooling. Amyl nitrite and effects similar to nitroglycerin in established hypertensives; in labile hypertensives it reduced arterial pressure through arterial dilation and a decrease in peripheral vascular resistance.

Ticrynafen: a novel uricosuric antihypertensive natriuretic agent.

Interest in new diuretics with less side effects has led to the synthesis of ticrynafen, an uricosuric diuretic. This agent was compared with hydrochlorothiazide in a crossover design study involving 12 hypertensive men. Both agents significantly decreased mean arterial pressure from 8% to 18% in eight of the 12 patients. In addition to reducing body weight, these diuretics induced reversible changes in BUN and carbon dioxide content (increased) and plasma concentration of potassium and chloride ions (decreased). The most important change in renal function was a 2.5-fold increase in fractional urate clearance by ticrynafen associated with reduction of serum uric acid by 62%. Thus, ticrynafen is a promising therapeutic agent in hypertension, adding a unique uricosuric effect that should improve patient compliance.

Microalbuminuria and renal morphology in the evaluation of subclinical lupus nephritis.

AIM AND METHOD: In an attempt to evaluate subclinical lupus nephropathy, we analyzed the clinical characteristics, determined the albumin excretion rate (AER) by radioimmunoassay and performed renal biopsy in 30 patients with systemic lupus erythematosus (SLE) who had no clinical signs of renal involvement (no urinary sediment abnormalities, absence of proteinuria, serum creatinine <1.3 mg/dl). All biopsies were classified according to a modified classification proposed by the WHO. RESULTS: Fifteen cases (50%) had mesangial glomerulonephritis (MGN) type IIb, 12 had MGN type IIa and 3 patients showed no changes on light microscopy (LM) or on immunofluorescence (IF) (type I). Anti-IgM-fluorescent deposits were found in 83% of the renal biopsies, being associated with less heavily stained deposits of IgG, IgA and C3. Patients with MGN type IIb showed lower mean age when compared to those of MGN type IIa (26.04 years vs. 36.3 years) (p<0.029); those patients also presented disease duration of 4.8 years and their mean AER was 39.9 microg/min. Six of the patients (6 of 15, 40%) showed positive anti-dsDNA antibodies, in contrast to patients with MGN type IIa who did not show positive anti-dsDNA antibodies (p<0.002). The group with abnormal AER presented lower mean age (p<0.029) and lower C3 levels (p<0.0098) when compared to the group with normal AER. CONCLUSION: The results suggest the high prevalence of MGN type IIb and IgM deposits on IF, despite the paucity of clinical and laboratory data on these patients. Furthermore, there is an association between MGN type IIb and positive anti-dsDNA antibodies and a relationship between abnormal AER and low C3 levels. The level of AER could not determine the presence or absence of renal disease on LM or IF in this population.

The clonidine test for the diagnosis of pheochromocytoma: the usefulness of urinary metanephrine measurements.

1. The clonidine suppression of urinary metanephrines as a criterion for the diagnosis of pheochromocytoma is described. Twenty-four patients were divided into 3 groups: Group I, 10 patients with pheochromocytoma (confirmed by tomography and surgery); Group II, 9 patients with suspected pheochromocytoma (clinical evidence plus one mildly elevated value of urinary metanephrines, but with negative tomography); Group III, 5 patients with proven essential hypertension. 2. Urinary metanephrine levels were determined in urine collected before (basal) and 3 h after a single oral dose of clonidine (0.4 or 0.8 mg). 3. Mean basal urinary metanephrine levels were above normal for group I (9.2 +/- 2.2 micrograms/mg creatinine) and group II (2.2 +/- 0.3 micrograms/mg creatinine) but were within the normal range for group III (0.6 +/- 0.1 microgram/mg creatinine). After clonidine administration, urinary metanephrine levels remained elevated for all patients with pheochromocytoma but decreased to within the normal range for all but one patient in group II. The urinary metanephrine levels of group III were not significantly altered by clonidine. 4. These data demonstrate that, when monitored by the clonidine suppression test, urinary metanephrine levels are useful for the diagnosis of pheochromocytoma, permitting the differentiation of affected patients from those exhibiting essential hypertension and increased sympathetic drive.

Kidney transplantation improves the multidimensional quality of life.

INTRODUCTION: Quality of life is affected during any illness, especially chronic diseases, such as renal failure. OBJECTIVE: To evaluate the quality of life after kidney transplantation. METHODS: One hundred patients were interviewed (60 men, 40 women, mean age 36 +/- 10.4 years, median 35 years) from July to October 2000 using the multidimensional questionnaire WHOQL-Bref. RESULTS: Eighty-eight percent of patients were satisfied/very satisfied with their general health condition. Seventy-seven percent manifested a good capacity to carry out daily activities, and 75% considered themselves satisfied with their work capacity. Quality of life was considered "very good" or "good" among 80%, and "neither good nor bad" in 20%. None considered quality of life in general as "bad" or "very bad." Most (87%) were satisfied with their current condition and with themselves after the kidney transplant. CONCLUSION: Patients perceive kidney transplant as capable of improving their quality of life. The most important finding in this study is that the results of the physical and psychological domains did not show any significant difference. It was possible to conclude that the quality of life for most subjects is related to reduction or disappearance of the symptoms caused by the previous disease.

[Benign intrinsic tectal tumors: apropos of 2 cases]. / Tumores intrínsecos benignos da região tectal: considerações a propósito de dois casos.

The introduction of computerized tomography and magnetic resonance imaging led to the knowledge that brain stem tumors are not a homogeneous group with regard to their clinical, pathological and biological features. The classical concept of an uniformly poor prognosis has been modified and some subtypes of tumors are amenable to surgical treatment and long-term survival. The authors report two cases of patients with tumors of the tectal region whose symptoms and CT features were consistent with late-onset aqueductal obstruction. In both cases definitive diagnosis was established by MRI and symptoms resolved after ventriculo-peritoneal shunt implantation. The clinic and pathological features and therapeutical alternatives as well, are discussed.

[Ambulatory follow-up of patients with myelomeningocele in a pediatric hospital]. / Acompanhamento ambulatorial de pacientes com mielomeningocele em um hospital pediátrico.

Myelomeningocele is the most common congenital malformation of the nervous system and despite its complexity and involvement of multiple organs is compatible with long survival. The peculiar characteristics of this malformation expose myelomeningocele patients to acute and chronic care problems with effects in quality of survival. In order to evaluate the quality of the follow-up of spina bifida patients in a pediatric hospital, the authors examined 54 patients attending the neurosurgical outpatient unity of a pediatric hospital. The lack of a multidisciplinary spina bifida clinic in Rio de Janeiro forced the patients to pursuit for complimentary medical and paramedical care outside the hospital with significant effects in the quality of survival. In consequence, only 25% of the patients were able to walk and community ambulation was nearly absent. Only 66.6% had a regular rehabilitation program and nearly 50% had routine orthopedics consultations. Almost half of the patients had no urological referral at all and 75% were incontinent, with recurrent urinary infections ranging 72.2%. The rates of neurosurgical complications were similar to those observed in the literature. We concluded that the quality of survival of patients with neural tube defects is strongly influenced by the adverse socio-economical conditions and the lack of a spina bifida multidisciplinary clinic.

[Myelomeningocele: surgical treatment and results]. / Mielomeningocele: tratamento cirúrgico e resultados.

The authors made a retrospective study of 72 patients with myelomeningocele treated at a pediatric hospital in Rio de Janeiro, Brazil. 65 (90.2%) lesions involved the inferior segments of the spine and 87.5% of the patients needed shunt procedures for hydrocephalus control. Shunt infections in spina bifida cystica patients were more frequent than in any other group of hydrocephalic patients treated at the institution. There was a great incidence of postoperative complications such as wound infections and skin necrosis. 11 (15.3%) patients developed signs and symptoms related to Chiari II malformation. The overall mortality was 8.3%, and in most of the cases, ascribed to the Chiari malformation.

[Intraerythrocytic potassium and diuretic therapy]. / Potássio intra-eritrocitário e diureticoterapia.

Diuretic-induced hypokalemia is one of the most common and important disturbances during antihypertensive therapy. However, it has been suggested that determination of serum potassium levels may not reflect significant changes of its intracellular concentration. This study was performed to evaluate whether there is any change of red cell potassium concentration as compared to serum potassium levels, in ten patients receiving chlorthalidone, 25 mg/day, during 4 weeks. Significant antihypertensive effect was achieved and despite serum potassium levels less than 3.5 mEq/1 occurred in four patients, no significant change in intracellular concentration of potassium was observed in this population with essential hypertension.

[Multicenter comparative study of the effects of benazepril and captopril in mild and moderate systemic hypertension]. / Estudo multicêntrico comparativo entre efeitos do benazepril e captopril na hipertensão arterial sistêmica leve e moderada.

PURPOSE: To evaluate the efficacy and safety of benazepril versus captopril in patients with mild or moderate systemic arterial hypertension (SAH). METHODS: A multicenter, double-blind, randomized trial analyzed 174 patients, mean age of 52 +/- 9 years, 68 (39%) men. After 2 weeks under placebo, 90 patients were treated, during 6 weeks, with 10 mg, once a day, of benazepril (BZ) and 50 mg, twice a day, of captopril (CPT). At week 3, 25 mg of hydrochlorothiazide (HCT) was added if diastolic blood pressure (DBP) was greater than 90 mmHg. Side effects were analyzed as a not related, unlikely, possible, probable and definitive regard to treatment. RESULTS: Systolic (p < 0.001) and DBP (p < 0.0001) reductions were observed in both groups. Additional reduction was observed in both groups when 25 mg of HCT was added in patients with DBP > 90 mmHg at week 3. Heart rate was unchanged. The response to treatment was better at BZ group (74% versus 59% of good and excellent response; p = 0.037). Side effects classified as probable or definitive in relation to the treatment occur in 3 (3%) and 10 (11%), respectively at BZ an CPT groups. Laboratorial changes were not observed during treatment. CONCLUSION: BZ (10 mg) was superior to CPT (50 mg) in patients with discrete and moderate SAH.