Cranial neuropathies in granulomatosis with polyangiitis (Wegener's): a case-based review.

The purpose of this case-based review is to highlight cranial nerve involvement in granulomatosis with polyangiitis (Wegener's). In this disease, cranial nerve involvement may be less frequent than other neurological manifestations, but often goes unrecognized by physicians as a sign of the disease, and its prevalence and importance is likely underestimated. Awareness of this aspect of the disease is necessary to make the proper diagnosis rapidly, as it can be a major feature of a patient's presentation. We also briefly discuss the known pathogenic mechanisms, which could be important when selecting the best therapeutic option.

Post-mortem β-hydroxybutyrate determination in synovial fluid.

β-hydroxybutyrate concentrations were determined in blood and synovial fluid in a series of medico-legal cases including hypothermia fatalities, individuals found dead in a cold environment and non-hypothermia cases with various, non-traumatic causes of death. Hypothermia was considered to be the cause of death according to circumstantial elements indicating exposure to cold, autopsy findings, biochemical investigation results and exclusion of other causes of death. The intention of this study was to characterize β-hydroxybutyrate distribution in synovial fluid and assess its usefulness for the postmortem diagnosis of antemortem abnormalities in blood β-hydroxybutyrate levels. Unenhanced CT scans, autopsies, histology, neuropathology, toxicology, and biochemistry were systematically performed. Within the limited number of subjects included in the study, the results indicate that abnormalities in antemortem β-hydroxybutyrate blood levels, as may be observed in hypothermia fatalities, are reflected in postmortem synovial fluid values. These preliminary findings notwithstanding, synovial fluid analysis to determine β-hydroxybutyrate is unlikely to be generally applied due to the more invasive collection technique it requires and could be limited to special cases in which biological fluids systematically collected upon autopsy are unavailable.

Detection of smuggled cocaine in cargo using MDCT.

OBJECTIVE: Smuggling dissolved drugs, especially cocaine, in bottled liquids is an ongoing problem at borders. Common fluoroscopy of packages at the border cannot detect contaminated liquids. The objective of our study was to develop an MDCT screening method to detect cocaine-containing vessels that are hidden between uncontaminated ones in a shipment. MATERIALS AND METHODS: Studies were performed on three wine bottles containing cocaine solutions that were confiscated at the Swiss border. Reference values were obtained by scans of different sorts of commercially available wine and aqueous solutions of dissolved sugar. All bottles were scanned using MDCT, and data evaluation was performed by measuring the mean peak of Hounsfield units. To verify the method, simulated testing was performed. RESULTS: Using measurements of the mean peak of Hounsfield units enables the detection of dissolved cocaine in wine bottles in a noninvasive and rapid fashion. Increasing opacity corresponds well with the concentration of dissolved cocaine. Simulated testing showed that it is possible to distinguish between cocaine-contaminated and uncontaminated wine bottles. CONCLUSION: The described method is an efficacious screening method to detect cocaine-contaminated bottles that are hidden between untreated bottles in cargo. The noninvasive examination of cargo allows a questionable delivery to be tracked without arousing the suspicion of the smugglers.

Un peuple réfractaire à l'industrie ?: fabriques et ouvriers dans les montagnes valaisannes

L'image que l'on associe traditionnellement au Valais ressort plutôt de ses paysages alpins ou de ses agriculteurs de montagne que de ses industries. Celles-ci forment pourtant un maillon essentiel dans l'histoire du développement du canton.Au Moyen Age déjà, la prospection du fer, du plomb et surtout de l'argent donnait lieu a de sévères concurrences. Mais c'est l'arrivée des grandes industries chimiques et métallurgiques, vers 1900, qui a provoqué la reconversion en masse de centaines de paysans en ouvriers d'usines.Dans la complexité d'un marché devenu mondial, ces industries ont dû évoluer, certaines ont disparu, d'autres sont en passe de l'être.C'est ce regard sur un Valais méconnu qu'une dizaine d'historiens, avec l'oeil complice de plusieurs photographes, proposent à votre lecture.

UV irradiation of human keratinocytes activates the inflammasome

Human keratinocytes represent a potent source of the pro-inflammatory cytokines pro-interleukin(IL)-1α and -β. ProIL-1β requires processing by caspase-1 (IL-1β-converting enzyme, ICE) for activation and receptor binding. ProIL-1α and -β lack a signal peptide and leave the cell via the alternative secretion pathway, which is independent of the classical ER/Golgi pathway. Both cytokines are stored in the cytoplasm and can be activated and released upon UV irradiation. In macrophages maturation of proIL-1β requires the activation of inflammasomes, innate multiprotein immune complexes, which are essential for the activation of caspase-1 and thereby for processing of proIL-1β. However, the intracellular pathways, which are responsible for activation of proIL-1β and secretion of IL-1β in keratinocytes, are unknown. We show that human keratinocytes express inflammasome proteins in vitro and in vivo. UVB irradiation of keratinocytes results in an increase of cytoplasmic Ca2+ from intracellular stores. This shift is required for inflammasome-dependent activation of caspase-1 and subsequent processing of proIL-1β and secretion of IL-1β. In contrast to macrophages, caspase-1 cannot activate proIL-18 in keratinocytes, although secretion of this cytokine is also induced by UVB irradiation. In vivo, caspase-1 is also essential for UVB-induced inflammation in the skin, since caspase-1 knockout mice showed a strongly reduced inflammatory response after UVB irradiation. Our results suggest that keratinocytes are important immuno-competent cells under physiological and pathological conditions.

Resposta fisiológica de clone de café Conilon sensível à deficiência hídrica enxertado em porta-enxerto tolerante

O objetivo deste trabalho foi determinar alterações fisiológicas e de tolerância à seca em clones de café Conilon (Coffea canephora) contrastantes quanto à sensibilidade ao deficit hídrico. Foram avaliadas as enxertias recíprocas entre os clones 109A, sensível ao deficit hídrico, e 120, tolerante - 120/109A, 120/120, 109A/120, 109A/109A -, além de seus respectivos pés-francos. As plantas foram cultivadas em vasos de 12 L em casa de vegetação. Após seis meses, metade das plantas foi submetida ao deficit hídrico por meio da suspensão da irrigação, até que as folhas atingissem o potencial hídrico de antemanhã de -3,0 MPa. Quando o clone 120 foi usado como porta-enxerto, as plantas apresentaram sistema radicular mais profundo, mas com menor massa, retardaram por mais tempo a desidratação celular das folhas e apresentaram maior eficiência no uso da água. Sob seca severa, os teores de amido e sacarose decresceram em todos os tratamentos, enquanto os teores de glicose, frutose, aminoácidos totais e prolina aumentaram, particularmente nos tratamentos 109A pé-franco, 109A/109A e 120/109A. Essas plantas apresentaram menor eficiência no uso da água. O acúmulo de solutos não foi associado à tolerância à seca. O uso de porta-enxertos tolerantes à seca contribui para a maior tolerância das plantas ao deficit hídrico.

Consolidation with Radioimmunotherapy May Prolong Survival in First Remission of Mantle Cell Lymphoma Patients Uneligible for Stem Cell Transplantation, An Analysis of the International RIT-Network

Background: Mantle cell lymphoma (MCL) is a rare subtype (3-9%) of Non Hodgkin Lymphoma (NHL) with a relatively poor prognosis (5-year survival < 40%). Although consolidation of first remission with autologous stem cell transplantation (ASCT) is regarded as "golden standard", less than half of the patients may be subjected to this intensive treatment due to advanced age and co-morbidities. Standard-dose non-myeloablative radioimmunotherapy (RIT) seems to be a very efficient approach for treatment of certain NHL. However, there are almost no data available on the efficacy and safety of RIT in MCL. Methods and Patients: In the RIT-Network, a web-based international registry collecting real observational data from RIT-treated patients, 115 MCL patients treated with ibritumomab tiuxetan were recorded. Most of the patients were elderly males with advanced stage of the disease: median age - 63 (range 31-78); males - 70.4%, stage III/IV - 92%. RIT (i.e. application of ibritumomab tiuxetan) was a part of the first line therapy in 48 pts. (43%). Further 38 pts. (33%) received ibritumomab tiuxetan after two previous chemotherapy regimens, and 33 pts. (24%) after completing 3-8 lines. In 75 cases RIT was applied as a consolidation of chemotherapy induced response; the rest of the patients received ibritumomab tiuxetan because of relapse/refractory disease. At the moment follow up data are available for 74 MCL patients. Results: After RIT the patients achieved high response rate: CR 60.8%, PR 25.7%, and SD 2.7%. Only 10.8% of the patients progressed. For survival analysis many data had to be censored since the documentation had not been completed yet. The projected 3-year overall survival (OAS, fig.1 - image 001.gif) after radioimmunotherapy was 72% for pts. subjected to RIT consolidation versus 29% for those treated in relapse/refractory disease (p=0.03). RIT was feasible for almost all patients; only 3 procedure-related deaths were reported in the whole group. The main adverse event was hematological toxicity (grade III/IV cytopenias) showing a median time of recovery of Hb, WBC and Plt of 45, 40 and 38 days respectively. Conclusion: Standard-dose non-myeloablative RIT is a feasible and safe treatment modality, even for elderly MCL pts. Consolidation radioimmunotherapy with ibritumomab tiuxetan may prolong survival of patients who achieved clinical response after chemotherapy. Therefore, this consolidation approach should be considered as a treatment strategy for those, who are not eligible for ASCT. RIT also has a potential role as a palliation therapy in relapsing/resistant cases.

Manejo de míldio no cultivo protegido de videira de mesa 'BRS Clara'

O objetivo deste trabalho foi avaliar a eficiência da cobertura de plástico e da tela antigranizo associadas, ou não, a programas de aplicação de fungicidas, no controle de míldio na cultivar de uva de mesa BRS Clara, sob condições de produção das safras normal e temporã do norte do Paraná, e analisar a influência de variáveis micrometeorológicas no progresso da doença. Foram conduzidos experimentos em duas safras normais (setembro a dezembro) e duas safras temporãs (janeiro a maio) nos anos 2008 e 2009. O delineamento experimental foi de blocos ao acaso, com sete tratamentos e quatro repetições: cobertura com tela antigranizo sem uso de fungicidas para controle de míldio ou com uso de fungicidas (padrão do produtor); cobertura de plástico sem uso de fungicidas ou com fungicidas apenas para oídio; cobertura de plástico com 25 ou 50% das aplicações de fungicidas padrão; e cobertura de plástico com tratamento de fosfito e cobre. A cobertura de plástico permite reduzir o número de pulverizações de fungicidas em até 75% em relação à tela antigranizo. A severidade da doença apresenta alta correlação positiva com o número de horas diárias de molhamento foliar e com a umidade relativa do ar maior que 90%. Sob tela antigranizo, a severidade da doença também se correlaciona com a intensidade de chuva

Suplementos para ovinos mantidos em pastos de capim-marandu

O objetivo deste trabalho foi avaliar o efeito da suplementação na resposta produtiva, no pH e no nitrogênio amoniacal ruminal, e no custo de produção de ovinos em pastagem de capim-marandu no período da seca. O experimento teve a duração de 84 dias. Utilizaram-se 20 cordeiros não castrados com idade e peso corporal inicial médios de quatro meses e 24,20 kg, respectivamente, para avaliação do desenvolvimento, distribuídos em cada um dos tratamentos que são os suplementos, mineral, energético, proteico e múltiplo, com cinco animais por tatamento, em área de 0,1 ha. Para avaliação dos parâmetros nutricionais, foram utilizados quatro ovinos fistulados no rúmen com 12 meses e 55 kg de peso corporal foram distribuídos em quatro piquetes de 0,1 ha. Avaliaram-se os suplementos mineral, energético, múltiplo e proteico. Os ganhos de peso foram de 0,017, -0,008, 0,024 e 0,077 kg por dia para os suplementos mineral, energético, múltiplo e proteico, respectivamente. Quatro horas após suplementação, os valores de pH ruminal foram de 6,30, 6,40, 6,18 e 6,24 para os suplementos mineral, energético, múltiplo e proteico, respectivamente. Os valores para nitrogênio amoniacal do líquido ruminal foram de 10,57, 7,36, 21,58 e 24,50 mg dL-1 para os suplementos mineral, energético, múltiplo e proteico, respectivamente. Os suplementos mineral e proteico produziram o ganho de peso com o menor custo. O uso de suplemento energético para cordeiros submetidos à forragem com baixo teor de proteína reduz o ganho de peso.