Cancer pain management in developing countries: a mosaic of complex issues resulting in inadequate analgesia

OBJECTIVE: To determine the prevalence of suicidal ideation and the symptomatic profile as well as to identify the sociodemographic characteristics highlighting female adolescents with the highest scores on suicidal ideation in adolescents living in Mexico City: students and suicidal patients. MATERIAL AND METHODS: A cross-sectional and ex-post-facto study was carried out in order to analyze information from two samples: 1,712 junior and junior high school women students (representative student sample in Mexico City), and 30 adolescents inpatient hospitalized for her suicide attempts (clinical sample). RESULTS: Prevalence of presence as well as persistence of suicidal ideation were higher in the clinical sample, nevertheless 11.8% of the school sample had everyone of the symptoms in a range of 1 to 7 days. The most persistent of the ideation symptoms was: "My family would be better if I were dead"; and in the clinical sample it was "I thought about killing myself". Finally, the sociodemographic characteristics that best matched the student girls having the highest scores in suicidal ideation were: to be on junior high school, to get low grades, to acknowledge school performance as bad and to have interrupted her studies. The characteristics that highlight the girls with a first attempt were analyzed in the clinic sample in comparison with those ones with two or more attempts. It was significant that girls in the second group were living only with one parent and they thought in the last attempt that their dead would be possible or certain. CONCLUSIONS: The prevalence of suicidal ideation was important in the school sample. If it is considered that this psychological construct has a strong association with suicidal attempt, and multiple suicide conduct, then is a priority to detect adolescents in risk and to make preventive efforts, considering the sociodemographic characteristics that configurate in risk for suicidal ideation.     

Regional and cellular expression of glial (GLT1) and neuronal (EAAC1) glutamate transporter proteins in ovine fetal brain

Glutamate transport is a primary mechanism for regulating extracellular levels of glutamate which can have either neurotrophic or neurotoxic effects in the developing brain, depending on its concentration. Using immunoblotting and immunocytochemistry, we tested the hypotheses that expression of neuronal and glial glutamate transporter proteins was regionally and temporally regulated in the developing ovine brain and that expression of the glial isoform early in development was not cell-type specific. Immunoblots for the neuronal glutamate transporter EAAC1 revealed a major band of immunoreactivity at 69,000 nmol. wt, whereas glial glutamate transporter-1 (GLT1) immunoreactivity was observed as 73,000 and 146,000 mol. wt proteins. EAAC1 and GLT1 are regulated differently during development, with EAAC1 immunoreactivity being most abundant at 60 and 71 days completed gestation (term=145 days) and dissipating thereafter, while GLT1 immunoreactivity was most abundant at 136 days gestation. By immunocytochemistry EAAC1 expression is neuronal throughout gestation with intense labelling of dendrites within the telencephalon evident at 60 days. Neuropil, neuronal cell bodies and processes are EAAC1-immunoreactive throughout gestation with no evidence of astrocytic or oligodendroglial immunoreactivity. In contrast, GLT1 is expressed by neuronal and non-neuronal cell types during midgestation with astrocyte selectivity developing by 136 days. During midgestation, GLT1 is transiently expressed in neurons of the subplate, cranial nerve nuclei, basal ganglia, and cerebellar cortex. The major finding of this study, that GLT1 is transiently expressed in various neuronal populations at midgestation demonstrates that the cell-type specificity of the GLT1 phenotype is developmentally regulated and depends on brain maturity.     

Bupropion and desipramine increase dopamine transporter mRNA expression in the ventral tegmental area/substantia nigra of rat brain

The homeobox gene Otx2 is a mouse cognate of the Drosophila orthodenticle gene, which is required for development of the brain, rostral to rhombomere three. We have investigated the mechanisms involved in this neural function and specifically the requirement for Otx2 in the visceral endoderm and the neuroectoderm using chimeric analysis in mice and explant recombination assay. Analyses of chimeric embryos composed of more than 90% of Otx2-/- ES cells identified an essential function for Otx2 in the visceral endoderm for induction of the forebrain and midbrain. The chimeric studies also demonstrated that an anterior neural plate can form without expressing Otx2. However, in the absence of Otx2, expression of important regulatory genes, such as Hesx1/Rpx, Six3, Pax2, Wnt1 and En, fail to be initiated or maintained in the neural plate. Using explant-recombination assay, we could further demonstrate that Otx2 is required in the neuroectodem for expression of En. Altogether, these results demonstrate that Otx2 is first required in the visceral endoderm for the induction, and subsequently in the neuroectoderm for the specification of forebrain and midbrain territories.     

Reconstructive memory bias in recall of neuropsychological symptomatology

Several hypotheses have been advanced in recent years to understand difficulties in agrammatic patients. Some of them are of a structural kind, as the deficiency is said to lie in some of the linguistic system components. Others are of a functional type, as it is stated that the problem of these patients lies in the loss of processing capacity. Using the existence of a syntactic type of structure in Spanish, that active sentences do not follow the canonical S-V-O order, we will try to prove in this article whether agrammatic patients' problems are due to memory span loss or to one of the syntactic process mechanisms. To this end, the performances of three groups of patients are contrasted. Agrammatic, anomic, and normal Spanish speakers are given several tasks of sentence-picture matching and tests of memory span. Results show that agrammatic patients have specific difficulties processing certain syntactical structures; however, their memory deficiencies are not more pronounced than in other patients. It can be concluded, therefore, that the deficiencies of agrammatic patients are of a structural character rather than due to memory span loss.     

Integrated MRI assessment of regional function and perfusion in canine myocardial infarction

A single integrated examination using regional measurements of perfusion from contrast-enhanced MRI and three-dimensional (3D) strain from tissue-tagged MRI was developed to differentiate infarcted myocardium from adjacent tissue with functional abnormalities. Ten dogs were studied at baseline and 10 days after a 2-hour occlusion of the left anterior descending coronary artery (LAD). Strain was determined using a 3D finite element model. Two-dimensional measurements of hypoenhancing regions were highly correlated with myocardial viability (r = 0.96). Signal intensity versus time curves obtained from contrast-enhanced MRI were used for quantitative perfusion analysis. The remote and adjacent noninfarcted tissue of the dogs with LAD occlusion, as well as the infarcted tissue, exhibited abnormal deformation patterns as compared to normal dogs (positive predictive value (PPV) of strain determination of infarction = 66%). Integration of contrast-enhanced MRI results with 3D strain analysis enabled the delineation of the myocardial infarction (PPV = 100%) from functionally compromised myocardium. This integrated cardiac examination shows promise for noninvasive serial assessment of potentially jeopardized noninfarcted myocardium to study the process of infarct remodeling and expansion.     

Molecular heterogeneity of the L-1 metallo-beta-lactamase family from Stenotrophomonas maltophilia

We have determined the nucleotide sequence of the blaS gene encoding the carbapenem-hydrolyzing L-1 beta-lactamase from Stenotrophomonas maltophilia GN12873. Analysis of the DNA and deduced amino acid sequences identified a product of 290 amino acids. Comparisons of the L-1 amino acid sequence with those of other zinc beta-lactamases showed 88.6% identity with the L-1 enzyme from S. maltophilia IID1275 and less than 20% identity with other class B metalloenzymes.     

Protein organization on the PHA inclusion cytoplasmic boundary

Biotransformation of ethanol by liver nuclei was studied. The formation of acetaldehyde was determined by GC/FID. The 1-hydroxyethyl (1HEt) formation was established by spin trapping of the radical with N-t-butyl-alpha-phenylnitrone (PBN) followed by GC/MS. Liver nuclei, free of endoplasmic reticulum, cytosol or mitochondria, were able to biotransform ethanol to acetaldehyde in the presence of NADPH under air. Only 22% activity was observed in the absence of the cofactor. Twenty-six percent of the NADPH-dependent activity and 47% of the NADPH-independent activity were observable under nitrogen. Aerobic biotransformation was inhibited by CO, SKF 525A, 4-methylpyrazole and by diethyldithiocarbamate. This suggests that CYP2E1 is involved in the process. However, the formation of acetaldehyde was able to proceed under a pure CO atmosphere. The lack of inhibitory effects of 2-mercapto-1-methylimidazol and thiobenzamide excludes the potential participation of the NADPH flavin monooxigenase system. The formation of hydroxyl radicals in the process is suggested by the partial inhibitory effect of 5 mM mannitol and 5 mM sodium benzoate and by the fact that the 1HEt was detected. The NADPH-dependent anaerobic ethanol biotransformation pathway was stimulated by FAD and inhibited to some extent by iron chelators. The relevance of a liver nuclear ethanol biotransformation, generating reactive metabolites, such as acetaldehyde and free radicals, nearby DNA, nuclear proteins and lipids is discussed.