Wilkie Syndrome behind Crohn Disease? Superior Mesenteric Artery Syndrome Mimicking and Complicating Crohn Disease of the Upper Gastrointestinal Tract.

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Influence of normal mammary epithelium on breast cancer progression: the protective role of early pregnancy

AIMS AND BACKGROUND: The microenvironment has a well recognized role in breast cancer progression. Despite different theories, the mechanism of early pregnancy protection in mammary carcinogenesis is unknown. Since pregnancy is responsible for mammary gland differentiation, we tested the hypothesis that differentiated mammary epithelial cells may inhibit breast cancer progression. In other words, the protective role of early pregnancy could be due to the inhibitory influences of the more differentiated mammary tissue. METHODS: In order to test our hypothesis, we used 30 female Balb/c nude mice and MCF-7 cells of breast adenocarcinoma. The female mice were divided into two test groups, group I (GI) and group II (GII), and a control group. In GII, the animals were submitted to epithelial removal in the left fourth inguinal mammary gland at 3 weeks of age. Both groups were given continuous hormonal treatment to simulate the pregnancy development of the mammary gland. Two million MCF-7 cells were then injected into the fourth inguinal mammary gland (GI) or in the respective cleared mammary fat pad (GII). Five weeks later the mice were sacrificed and their tumors removed. Tumor development rates and tumor volumes were determined and proliferation and apoptosis were evaluated by immunohistochemistry. RESULTS: Tumors of GII mice had a larger mean volume than those of GI mice (P = 0.001, Mann-Whitney U-test) and an apparent increase in proliferation, demonstrated by a higher staining intensity for proliferating cell nuclear antigen (PCNA). As tumors presented caspase 8 staining, there may be apoptotic activation involved in cell death, mainly through an extrinsic pathway. CONCLUSIONS: These results suggest that a differentiated intact mammary gland may have an inhibitory influence on mammary tumor growth in mice

Single Fetal Death in Twin Pregnancy. What Will Be the Problems to the Surviving Co-Sib?

Na gravidez bigemelar, a morte de um dos fetos no segundo e terceiro trimestre é uma complicação rara, variando a taxa de incidência entre 2,6 e 6,8%. Este acontecimento determina um aumento das taxas de morbilidade e mortalidade perinatal para o gémeo sobrevivente, especialmente em gravidezes monocoriónicas, quando a morte fetal é devida à síndroma de tranfusão feto-fetal. Para alguns autores o atraso de crescimento intrauterino e a prematuridade são os principais factores de risco para o aumento da morbilidade e mortalidade do gémeo sobrevivente. A patofisiologia de instalação dos distúrbios cerebrais no gémeo sobrevivente após a morte do feto irmão não está definida, nem o intervalo de tempo que medeia entre a morte e o estabelecimento das lesões. Também não existe um protocolo definitivo de seguimento destas gravidezes e, posteriormente, do gémeo sobrevivente. No período de 1 de Setembro de 1994 a 31 de Dezembro de 1998, foram seguidas, na consulta de Gravidez Múltipla da Maternidade Dr. Alfredo da Costa, 235 gravidezes bigemelares. Em nove casos (3,8%) ocorreu morte de um dos fetos com idade gestacional acima das 13 semanas. Em cinco das nove gravidezes foi conhecida a causa de morte, quatro das quais foram atribuídas à síndroma de tranfusão feto-fetal. A taxa de prematuridade do gémeo sobrevivente foi de 44,4% (4/9) e a de mortalidade de 11,1%(1/9). A taxa de morbilidade neonatal foi de 62,5% (5/8), na maioria dos casos por complicações inerentes à prematuridade. A taxa de morbilidade neurológica foi de 37,5% (3/8). A taxa de lesões neurológicas major foi de 25% (2/8) e ocorreu em recém-nascidos de termo. A síndroma de transfusão feto-fetal, como causa de morte fetal, associou-se aos casos com pior prognóstico no que se referiu ao gémeo sobrevivente.O crescimento do gémeo sobrevivente parece depender das lesões provocadas pela morte do feto irmão. Os autores finalizam com uma proposta de atitudes obstétricas e pediátricas em relação ao gémeo sobrevivente

Allergic conjunctivitis and conjunctival provocation tests in atopic dogs.

INTRODUCTION: Canine atopic dermatitis (cAD) is a very common disease, but little is known about eye involvement. The conjunctival provocation test (CPT) is used in human to study the ocular response to allergenic stimuli and to evaluate anti-allergic therapy. To our knowledge it has not been used in dogs. OBJECTIVES: To evaluate the prevalence of ocular signs in a population of atopic dogs and relate these with clinical cAD scores; and the usefulness of CPT for dust mites in atopic dogs with itchy eyes. PROCEDURES: Sixty cAD patients were evaluated for (i) ocular signs of allergic conjunctivitis including conjunctival hyperemia, chemosis, epiphora, ocular discharge, pruritus and corneal involvement, graded 0 to 3 according to severity, and (2) cAD Extent and Severity Index (CADESI-03). Additionally, CPTs for Dermatophagoides farinae (n = 12) and Dermatophagoides pteronyssinus (n = 12) were performed in sensitized atopic dogs and 24 control dogs. RESULTS: Periocular and ocular signs of allergy were present in 60% (36/60) of cases. Conjunctival hyperemia (90%) was the most common sign. Severity of ocular signs was significantly correlated with eye pruritus (r(s)  = 0.690, P = <0.001) and skin lesions score for head region (r(s) = 0.261, P = 0.04). A highly significant difference (P < 0.001, Fisher test) was found in CPTs between the test and the control groups. CONCLUSION:  Allergic conjunctivitis signs associated with cAD seem under valuated so these patients would benefit from an ophthalmologic evaluation. Furthermore, we found CPT to be a reliable, easy to perform and safe test for the etiologic diagnosis of allergic conjunctivitis in the dog

Drug Provocation Tests to Betalactam Antibiotics: Experience in a Paediatric Setting

Background: Few studies have been performed in children withs uspected betalactam allergy.We aimed to assess the role of the drug provocation test(DPT)with betalactams in a paediatric setting and to study the association between allergy to betalactam antibiotics and other allergic diseases. Methods:We included all the patients under 15 years old who were consecutively referred to the Immunoallergy Department, Dona Estefânia Hospital,Portugal(January 2002 to April 2008)for a compatible history of allergic reaction to betalactam. All were submitted to a DPT.Children were proposed to performs kintests(ST)to betalactam antibiotics followed by DPT. If they decline ST,a DPT with the culprit drug was performed. Results: We studied 161 children,60%were boys,with a median age of 5years old at the time of the DPT.Thirty-three patients(20.5%)had an immediate reaction and 33(20.5%)a non-immediate reaction. These verity of there porte dreactions was low in most cases. Skin tests to betalactams were performed in 47 children and were positive in 8.DPT was positive inonlyone(3.4%)of the patients skin tested and in 11(13.4%)of those not skin tested. These verity of the DPT reaction was low.Asthma and food allergy were associated with a positive DPT in the later group. Conclusions: DPT seems a safe procedure even in the absence of ST in non-severe cases. This could be a practical optionin infants and pre-school children,where ST are painful and difficult to perform.Additional caution should be taken in children with asthma and food allergy

Behavioural stress responses predict environmental perception in European sea bass (Dicentrarchus labrax)

Individual variation in the response to environmental challenges depends partly on innate reaction norms, partly on experience-based cognitive/emotional evaluations that individuals make of the situation. The goal of this study was to investigate whether pre-existing differences in behaviour predict the outcome of such assessment of environmental cues, using a conditioned place preference/avoidance (CPP/CPA) paradigm. A comparative vertebrate model (European sea bass, Dicentrarchus labrax) was used, and ninety juvenile individuals were initially screened for behavioural reactivity using a net restraining test. Thereafter each individual was tested in a choice tank using net chasing as aversive stimulus or exposure to familiar conspecifics as appetitive stimulus in the preferred or non preferred side respectively (called hereafter stimulation side). Locomotor behaviour (i.e. time spent, distance travelled and swimming speed in each tank side) of each individual was recorded and analysed with video software. The results showed that fish which were previously exposed to appetitive stimulus increased significantly the time spent on the stimulation side, while aversive stimulus led to a strong decrease in time spent on the stimulation side. Moreover, this study showed clearly that proactive fish were characterised by a stronger preference for the social stimulus and when placed in a putative aversive environment showed a lower physiological stress responses than reactive fish. In conclusion, this study showed for the first time in sea bass, that the CPP/CPA paradigm can be used to assess the valence (positive vs. negative) that fish attribute to different stimuli and that individual behavioural traits is predictive of how stimuli are perceived and thus of the magnitude of preference or avoidance behaviour.European Commission [265957]; Portuguese Fundacao para a Ciencia e Tecnologia (FCT) [FRH/BPD/72952/2010]; FCT [SFRH/BD/80029/2011

Mesotelioma Maligno Primário do Peritoneu Associado a Carcinoma de Células Renais. Revisão Concisa

O Mesotelioma peritoneal maligno é um tumor maligno relacionado frequentemente com exposição prolongada a fibras de amianto, de mau prognóstico, de diagnóstico geralmente tardio, face à pouca expressão clínica na fase inicial da doença. Como o mesotelioma evolui geralmente só na cavidade peritoneal, doentes seleccionados poderão ter maior sobrevivência se for possível a peritonectomia extensa e quimioterapia hipertérmica intraperitoneal intraoperatória. Os autores referem a sincronicidade ainda não descrita, de mesotelioma peritoneal maligno primário e carcinoma de Grawitz. São revistos concisamente: a clínica destes tumores, síndromes paraneoplásicos (disfunção bioquímica hepática, emagrecimento extremo); etiopatogenia da acção cancerígena das fibras de amianto; mecanismos de disseminação intraperitoneal; avaliação tomodensitométrica; importância da imunohistoquímica no diagnóstico histopatológico; estadiamento; importância do tratamento multidisciplinar destes tumores

Renal Artery Angioplasty

Efectuámos angioplastia transiuminal percutânea (ATP) da artéria renal em 59 doentes hipertensos e houve benefício inicial na tensão arterial em 91,5% e tardio em 79,6%. Obtivemos melhores resultados nas lesões unilaterais (81,4%) do que nas bilaterais (72,7%); nas lesões fora do ostium (82,5%) do que nas do ostium (7 1,4%); nas lesões de origem fibromuscular (88,9%) do que nas de origem aterosclerótica(75%); e nos doentes com idade igual ou inferior a 55 anos (84,8%) do que em doentes com idade superior (71,4%). Estas diferenças não foram contudo significativas. Os bons resultados da ATP da artéria renal na hipertensão renovascular levam-nos a considerar esta forma de intervenção como uma alternativa do seu tratamento