Cytological features of chronic follicular cervicitis in liquid-based specimens: a potential diagnostic pitfall

A review of negative split-sample cervical cytology cases revealed five cases reported as chronic follicular cervicitis. These cases showed characteristic morphological features in conventional smears with lymphoid cells, plasma cells and tingible body macrophages smeared across the slides. This contrasts with the presentation of ThinPrep samples (Cytic Corporation, Boxburgh, MA, USA), where cells were observed aggregated in clumps. The different presentation noted in liquid-based samples may require careful microscopic evaluation at high-power magnification.     

Substance use disorders: a comprehensive update of classification,epidemiology, neurobiology,clinical aspects,treatment and prevention

Substance use disorders (SUDs) are highly prevalent and exact a large toll on individuals’ health, well-being, and social functioning. Long-lasting changes in brain networks involved in reward, executive function, stress reactivity, mood, and self-awareness underlie the intense drive to consume substances and the inability to control this urge in a person who suffers from addiction (moderate or severe SUD). Biological (including genetics and developmental life stages) and social (including adverse childhood experiences) determinants of health are recognized factors that contribute to vulnerability for or resilience against developing a SUD. Consequently, prevention strategies that target social risk factors can improve outcomes and, when deployed in childhood and adolescence, can decrease the risk for these disorders. SUDs are treatable, and evidence of clinically significant benefit exists for medications (in opioid, nicotine and alcohol use disorders), behavioral therapies (in all SUDs), and neuromodulation (in nicotine use disorder). Treatment of SUDs should be considered within the context of a Chronic Care Model, with the intensity of intervention adjusted to the severity of the disorder and with the concomitant treatment of comorbid psychiatric and physical conditions. Involvement of health care providers in detection and management of SUDs, including referral of severe cases to specialized care, offers sustainable models of care that can be further expanded with the use of telehealth. Despite advances in our understanding and management of SUDs, individuals with these conditions continue to be stigmatized and, in some countries, incarcerated, highlighting the need to dismantle policies that perpetuate their criminalization and instead develop policies to ensure support and access to prevention and treatment.     

Long-Term Drug Treatment of Obesity in a Private Practice Setting

ATKINSON, RICHARD L, ROY C BLANK, DONALD SCHUMACHER, NIKHIL V DHURANDHAR, DOUGLAS L RITCH. Long-term drug treatment of obesity in a private practice setting. This study evaluated the long-term efficacy and safety of the combination of phentermine and fenfluramine for the treatment of obesity in a private practice setting. A total of 1388 consecutive, qualified patients presenting to a private general internal medicine practice in Charlotte, NC, were enrolled with eligibility criteria including: age 18 years to 60 years, 20% over “desirable” bodyweight or body mass index <27, no serious medical or psychiatric disease, and no contraindications to drug therapy. Patients were instructed in diet, exercise, and behavior modification techniques and received phentermine (15 mg/day to 30 mg/day) and fenfluramine (20 mg/day to 60 mg/day) continuously for over 3 years. Average duration of treatment was 15. 9 months, and average weight loss at the last visit was 11. 6 kg, or 11. 7% of initial bodyweight. For patients completing 1 year of drug treatment, mean weight loss was 16. 5 kg, or 16% of initial weight. Weight loss persisted for 2 years, but partial regain was seen at 3 years. The dropout rates were 18% at 6 months, 39% at 1 year, 68% at 2 years, and 78% at 3 years. At 1 year, blood pressure of hypertensive patients fell from 151/95 mm Hg to 127/78 mm Hg, and serum cholesterol and triglycerides of hyperlipidemic patients fell by 0. 750 mmol/L (29 mg/dL) and 0. 937 mmol/L (83 mg/dL), respectively. Adverse events were modest. We conclude that, in a private practice setting, long-term treatment of obesity with the combination of phentermine, fenfluramine, and a weight maintenance program is generally safe and effective. More research is needed to determine efficacy and safety for longer than 3 years.     

Cutaneous zygomycosis caused byAbsidia corymbifera in a leukemic patient

A case of cutaneous zygomycosis caused byAbsidia coryabifera in a leukemic patient submitted to chemotherapy is reported. The lesion was located on the little finger of the right hand and probably resulted from a latent osteomyelitis. It progressed to form extensive necrotic area. No systemic infection was detected and the lesion did not appear to be associated with any trauma.     

Coprecipitating IgG asymmetric antibodies: A possible role for Fab glycosylation,and speculations on their formation and functions in disease

IgG asymmetric antibodies are synthesized by the same cellular clones as the symmetric ones but appear in the immune response in different proportions. The evidence suggests that they are caused by asymmetric glycosylation on some IgG molecules in the Fab region. The cause of this is unknown but it could be speculated that there are cellular factors that induce glycosyl transferases or cause the molecule to be more accessible to glycosylation. The production of asymmetric antibodies can be modified by the physical status (soluble or particulate) of the antigen used as immunogen by the number and frequency of stimulation, and by physiological factors such as the ones secreted by the placenta and by lymphocytes that express progesterone receptors in response to hormone. An increase of these antibodies can be beneficial or harmful to the host, depending on the situation in which they act and the character of self or non-self of the antigens recognized. Editors note—Many of the ideas proposed in this article are very speculative, but it was thought appropriate to publish it in order to stimulate further discussion of the subject. It is an interesting role for Fab glycosylation that is proposed by Professor Margni. The ideas discussed are not necessarily those held by the Editorial Board or the reviewers, who felt that the evidence for many of the deductions made was very limited. It was also emphasized by the reviewers that the author's case would be substantially improved if more corroborative evidence was available from other groups. The Editors would welcome any comments on the subject for publication in future issues of the journal.     

Biotechnological challenges of bioartificial kidney engineering

With the world-wide increase of patients with renal failure, the development of functional renal replacement therapies have gained significant interest and novel technologies are rapidly evolving. Currently used renal replacement therapies insufficiently remove accumulating waste products, resulting in the uremic syndrome. A more preferred treatment option is kidney transplantation, but the shortage of donor organs and the increasing number of patients waiting for a transplant warrant the development of novel technologies. The bioartificial kidney (BAK) is such promising biotechnological approach to replace essential renal functions together with the active secretion of waste products. The development of the BAK requires a multidisciplinary approach and evolves at the intersection of regenerative medicine and renal replacement therapy. Here we provide a concise review embracing a compact historical overview of bioartificial kidney development and highlighting the current state-of-the-art, including implementation of living-membranes and the relevance of extracellular matrices. We focus further on the choice of relevant renal epithelial cell lines versus the use of stem cells and co-cultures that need to be implemented in a suitable device. Moreover, the future of the BAK in regenerative nephrology is discussed.     

花生幼苗对重复干旱胁迫的生理响应

防雨棚内设盆栽试验,设置对照(Control,75%田间持水量)、干旱胁迫(D,35%)、重复干旱胁迫(D_D,35%)3个处理,探讨花生幼苗对预干旱胁迫的适应和记忆响应,分析预干旱对缓解重复干旱胁迫危害的生理作用。结果表明,与干旱胁迫处理相比,重复干旱胁迫提高了叶片的相对含水量,减少脯氨酸的积累,降低MDA和O·_2~-含量;抗氧化酶SOD、CAT活性降低,其中POD活性降低最为明显,并在复水后恢复到与对照相同水平或低于对照。与正常水分的对照相比,干旱胁迫显著降低叶片光合速率(P_N)、最大光合势能(P_C)、最大光量子产量(Y_Q),但重复干旱处理在重复干旱胁迫时期和复水后P_N、P_C和Y_Q均高于干旱处理。预干旱胁迫导致光合和气孔导度滞后面积、滞后率(H_P和H_g)增加,经过预干旱胁迫后,重复干旱显著降低光合和气孔导度滞后面积和滞后率。预干旱胁迫提高植株在重复干旱胁迫下叶片含水量,减轻重复干旱对植株造成的生理伤害,在光合作用上提高对重复干旱的抵御能力,并在复水后快速恢复到正常水分条件下植株生长水平,减少干旱对植株的不利影响。因此,预干旱胁迫促使花生幼苗具备适应或可记忆初始胁迫的能力,重复干旱胁迫时表现更为迅速和强烈的生理防御和快速的生理恢复机制。     

On the effects of Dikonirt (sodium salt of 2.4-Dichlorophenoxi-acetic acid) on the mortality and reproduction of Daphnia magna

The effects of sodium salt of 2.4-Dichlorophenoxi-acetic acid (2.4-D-Na) on the mortality and reproduction ofDaphnia magna have been tested.The mortality tests were performed in experiments with duration time of 24, 48 and 96 h at the temperatures of 15 and 20 °C. The toxic effect increased by 11–16 regarding 47% with increasing of temperature and exposure time.This herbicide (Dikonirt) affected adversely the reproduction of daphnids at concentration lower than tenth of LC₅₀ value.     

The modification of cortical reorganization and chronic pain by sensory feedback

Recent neuroscientific evidence has revealed that the adult brain is capable of substantial plastic change in areas such as the primary somatosensory cortex that were formerly thought to be modifiable only during early experience. We discuss research on phantom limb pain as well as chronic back pain that revealed functional reorganization in both the somatosensory and the motor system in these chronic pain states. In phantom limb pain patients, cortical reorganization is correlated with the amount of phantom limb pain; in low back pain patients the amount of reorganizational change increases with chronicity. We present a model of the development of chronic pain that assumes an important role of somatosensory pain memories. In phantom limb pain, we propose that those patients who experienced intense pain prior to the amputation will later likely develop enhanced cortical reorganization and phantom limb pain. We show that cortical plasticity related to chronic pain can be reduced by behavioral interventions that provide feedback to the brain areas that were altered by somatosensory pain memories.     

Chronic wasting disease: Fingerprinting the culprit in risk assessments

Transmissible spongiform encephalopathies (prion diseases) in animals may be associated with a zoonotic risk potential for humans as shown by the occurrence of variant Creutzfeldt-Jakob disease in the wake of the bovine spongiform encephalopathy epidemic. Thus, the increasing exposure of humans in North America to cervid prions of chronic wasting disease (CWD) in elk and deer has prompted comprehensive risk assessments. The susceptibility of humans to CWD infections is currently under investigation in different studies using macaques as primate models. The necessity for such studies was recently reinforced when disease-associated prion protein and its seeding activity were detected in muscles of clinically inconspicuous CWD-infected white-tailed deer (WTD). Increasing evidence points to the existence of different CWD strains and CWD prions may also change or newly emerge over time. Therefore, CWD isolates examined in macaques should be characterized as precisely as possible for their molecular identity. On this basis other CWD field samples collected in the past, present or future could be systematically compared with macaque-tested inocula in order to assess whether they are covered by the ongoing risk assessments in primates. CWD typing by Fourier transform-infrared spectroscopy of pathological prion protein may provide a method of choice for this purpose.