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A celiac disease update review and a case report are presented, especially concerning a Clinical Pathology Laboratory approach. Implemented basic research, case finding strategy and information technologies are the key tools for a better understanding of the multi-etiological features of this disease. By these tools it will be achieved appropriateness in diagnosing and monitoring of the related clinical pictures.
Thirty healthy individuals with no history of cardiovascular disease were studied to determine the electrocardiographic effects of maximal exercise immediately followed by ingestion of ice water. The subjects were subgrouped according to their training into (A) high (N = 5), (B) moderate (N = 14) and (C) low (N = 11) levels. Electrocardiograms (ECGs) were taken at rest and at rest with ingestion of ice water followed by maximal stress tests. Maximal stress tests were repeated followed by ingestion of ice water at the beginning of and at 2, 3, 6 and 9 minutes of recuperation. The stress test combining maximal effort and ice water ingestion was positive in all members of Group A, in 4 from Group B and in 1 from Group C. A stress test associating maximal effort with ice water ingestion is a useful method of detecting subjects susceptible to changes in ECG which appear to be secondary to coronary spasm. It has a low cost it is simple to perform and represents minimal risk.
Patients with pulmonary atresia and intact ventricular septum have a poor prognosis with or without conventional surgical treatment. The best results of surgical treatment are obtained in those cases with a mild underdeveloped right ventricle and minor sinusoidal communication in the absence of important dysfunction of the tricuspid valve. We present five cases of pulmonary atresia with intact ventricular septum associated with dysfunction of the tricuspid valve. On the basis of radiographic, electrocardiographic and hemodynamic findings, this group of patients could not be distinguished from others without dysplasia of the tricuspid valve. Echocardiographic and angiocardiographic studies are mandatory in the differential diagnosis. A combination of systemic-pulmonary artery anastomosis associated with pulmonary valvotomy, when possible, and reconstruction of the right ventricular outflow tract are indicated for surgical solution of these malformations. However, tricuspid valve replacement is indicated in some cases.
The clinical presentation and long-term follow-up of 14 cases of tricuspid atresia associated with pulmonary atresia were reviewed. The electrocardiograms, hemodynamic findings and a definition of anatomic types were outlined in order to facilitate therapeutic decisions. In these types of tricuspid atresia the clinical presentation depends on the patent ductus. Despite the caliber of the ductus arteriosus, the poor tolerance to the malformation is frequent and the clinical presentation is similar to those malformations with decreased pulmonary blood flow (cyanosis since birth and hypoxic spells). In considering the age of these patients, the modified Blalock-Taussig anastomosis is the initial procedure. The Fontan procedure should be considered carefully as an alternative in older children.
Pulmonary atresia with intact ventricular septum represents a congenital cardiac lesion for which the prognosis depends on the patency of the ductus arteriosus. Nine children with pulmonary atresia and intact ventricular septum underwent echocardiographic studies before cardiac catheterization trying to visualize the anatomy of the outflow tract of the right ventricle, the dimension of the ventricular cavity, the characteristics of the tricuspid valve and finally the size and integrity of the interventricular septum. Using Doppler ultrasound it was possible to evaluate the function of the tricuspid valve and the patency of the ductus arteriosus. The results obtained were correlated with the angiographic and anatomic studies. We concluded that noninvasive assessment of this malformation permits an excellent correlation with the angiographic and anatomic studies.
The effects of the kappa-opioid receptor agonists tifluadom, bremazocine and U-50,488 on locomotor activity (test: toggle-floor box) and memory (test: passive avoidance) were assessed in C57BL/6 (C57) and DB/2 (DBA) mice. The drugs administration resulted in activity depression in both strains, the effect was higher in DBA mice and was enhanced by pretreatment with haloperidol and with muscimol. Memory impairment was observed in DBA mice following posttraining administration of all drugs. This effect was enhanced by immobilization stress and decreased by familiarization with the apparatus. Memory improvement was evident in C57 mice (U-50,488 experiments). In a research carried out with CD1 mice, amygdaloid lesions decreased the memory impairing effect of U-50,488. The results are compared with those previously obtained with mu agonists and, as concerns memory, are discussed in terms of the involvement of emotional factors in mice responses to kappa agonists administration.
The opioid benzodiazepine, tifluadom, and the benzodiazepine tranquilizer, diazepam, were compared for their influence on morphine and scopolamine-induced locomotor stimulation in mice. Diazepam enhanced drug-induced hyperactivity, while tifluadom had no effect or reduced locomotor activity. The results demonstrate that tifluadom, a benzodiazepine compound possessing opiate-like analgesic properties, is devoid of either benzodiazepine or morphine-like effects in activity tests.
The level of opioid peptides: beta-endorphin and dynorphin, binding to the mu and kappa opioid receptors and the analgesic response of those endogenous opioid systems to stress were investigated in two strains of mice: C57BL/6 (C57) and DBA/2 (DBA). The nociceptive threshold of DBA mice was higher than that of C57 mice. KD values for spinal mu receptors were lower in C57, while KD for cerebral kappa receptors were higher in this strain. DBA mice have significantly higher concentrations of dynorphin in the hypothalamus and neurointermediate lobe of the pituitary. Stress-induced analgesia was much greater in C57 than in DBA mice. In the hypothalamus both stress procedures depressed the concentrations of beta-endorphin in C57, and dynorphin in DBA mice. The level of beta-endorphin increased in the neurointermediate lobe in C57 and in anterior lobe of the pituitary in DBA mice. In the spinal cord both stress procedures depressed the dynorphin level. The above data indicate that C57 and DBA mice differ in the endogenous opioid peptide content, stress-induced alteration and opioid receptor affinity, the effects which might correlate with their different responses to environmental factors and pharmacological agents.
Pulmonary atresia with intact ventricular septum is an uncommon congenital cardiac anomaly which very often present varying degrees of downward displacement and dysplasia of the tricuspid valve. We describe a case of pulmonary atresia and intact ventricular septum associated with Ebstein's malformation of the tricuspid valve first diagnosed with echocardiography and confirmed by angiocardiography and anatomic studies.
The tail-flick latency, measured using radiant heat as a noxious stimulus, was significantly shorter in C57BL/6 than in DBA/2J mice, while no significant interstrain differences were observed in the hot-plate test. The experiments in which the animals' tail was painted indicated that the difference in the tail-flick latency between strains was caused by the difference in the color of animal's coat.
The tail-flick latency, measured using radiant heat as a noxious stimulus, was significantly shorter in C57BL/6 than in DBA/2J mice, while no significant interstrain differences were observed in the hot-plate test. The experiments in which the animals' tail was painted indicated that the difference in the tail-flick latency between strains was caused by the difference in the color of animal's coat.
The effects of amineptine and cocaine on locomotor activity were studied in two sets of experiments, by using C57BL/6 mice. In a first set, activity enhancements were evident following acute administration of both drugs. In addition to that the effects of amineptine were additive with those of cocaine. In a second set of experiments, mice developed tolerance to the stimulatory effects of both amineptine and cocaine, and a clear cross-tolerance effect was evident in mice chronically injected with these drugs. The results are discussed in terms of the involvement of dopaminergic mechanisms in the activity stimulating action of amineptine.
In C57BL/6 mice caffeine antagonized morphine-induced hyperactivity. This effect was most evident when caffeine was used in doses that slightly increased locomotor activity. Given at the same dose caffeine did not affect morphine-induced analgesia. Two possibilities of explanation of this effect are discussed: action of caffeine on dopaminergic mechanisms responsible for morphine-induced running fit through its effect on cyclic AMP level, and a direct action of caffeine on delta opiate receptors involved in the stimulatory effect of morphine.
Clonidine, 0.25 and 0.5 mg/kg, depressed significantly the running fit induced by 10 or 20 mg/kg of morphine in C57BL/6 mice, but did not affect morphine analgesia measured by the "hot plate" test. The results confirm the hypothesis that different mechanisms are involved in the two types of response to morphine, and the running fit response is mediated via a noradrenergic mechanism of action.
The main aim of this study was to investigate the interaction between the effects of caffeine and cocaine on memory consolidation in mice. For this purpose, CD1 mice were used; they were injected intraperitoneally and tested in a one-trial inhibitory avoidance task. The apparatus consisted of two compartments, one lighted and the other in darkness. On the training day, the animal had to go from the lighted to the dark compartment, where it received an electric shock. On the test day, carried out in our experiments 24 hours later, the time the animal waited to enter the dark compartment is the measure of its retention (for further details, see Methods). Three sets of experiments were carried out. In a first set, immediately posttraining, caffeine (0.25, 0.5 and 1 mg/kg) or cocaine (1, 2.5 and 5 mg/kg) administrations enhanced the memory consolidation of mice. In a second set, the D2 dopamine receptor antagonist, (-)-sulpiride, antagonized the enhancing effect of caffeine on memory. In a third set, a clear interaction between caffeine and cocaine was evident. The results are interpreted in terms of interaction of the drugs used with the dopaminergic system.