Infectious endocarditis from Streptococcus bovis associated with colonic carcinoma: case report and literature review Endocardite infecciosa por Streptococcus bovis associada com carcinoma cólico: relato de caso e revisão da literatura

BACKGROUND: Many studies in the literature have warned of the need for investigation of colonic lesions among patients, especially elderly ones, who have bacteremia and/or endocarditis from Streptococcus bovis. Bacteremia and infectious endocarditis from Streptococcus bovis may be related to the presence of neoplastic lesions in the large intestine and hepatic disease. AIM: This report describes a patient who presented infectious endocarditis from Streptococcus bovis associated with colonic carcinoma and tubular-villous adenomas. CONCLUSIONS: The finding of this bacterium among patients with septicemia and/or endocarditis is also related to the presence of villous or tubular-villous adenomas in the large intestine. For this reason, complete and detailed investigation of the large intestine must be performed in patients with infectious endocarditis, even in the absence of intestinal symptoms. An increased incidence of this condition or hepatic dysfunction has been reported among patients with infectious endocarditis from Streptococcus bovis. Patients with infectious endocarditis from Streptococcus bovis and normal colonoscopy may be included in the group at risk for developing colonic cancer. The knowledge that there is an association between endocarditis from Streptococcus bovis and carcinoma of the colon has important clinical implications. If the lesion can be discovered at an early stage, curative resection may become possible.<br>RACIONAL: Diferentes estudos na literatura têm alertado para a necessidade de investigação de lesões cólicas entre doentes, especialmente nos mais idosos, que apresentem bacteremia e/ou endocardite por Streptococcus bovis. A bacteremia e a endocardite infecciosa por S. bovis pode estar relacionada à presença de lesões neoplásicas do intestino grosso e a doença hepática. OBJETIVO: Descrição do caso de doente com endocardite infecciosa por S. bovis associada a carcinoma cólico e adenomas túbulo-vilosos. CONCLUSÕES: A detecção da bactéria nos pacientes com bacteremia e/ou endocardite também está relacionada com a presença de adenomas vilosos ou túbulo-vilosos no intestino grosso. A investigação minuciosa e completa do intestino grosso em doentes com endocardite infecciosa, mesmo na ausência de sintomas intestinais, deve ser realizada. O aumento da incidência da doença ou de disfunção hepática está sendo notado entre os pacientes com endocardite infecciosa por S. bovis. Doentes com endocardite infecciosa por S. bovis e colonoscopia normal podem ser incluídos em grupo de risco para o desenvolvimento de câncer cólico. O conhecimento desta associação entre endocardite por S. bovis e carcinoma de cólon tem aplicações clínicas importantes, pois se a lesão for descoberta num estádio inicial, a extirpação curativa pode ser possível

Regional-Specific Effects of Ovarian Hormone Loss on Synaptic Plasticity in Adult Human APOE Targeted Replacement Mice

The human apolipoprotein ε4 allele (APOE4) has been implicated as one of the strongest genetic risk factors associated with Alzheimer’s disease (AD) and in influencing normal cognitive functioning. Previous studies have demonstrated that mice expressing human apoE4 display deficits in behavioral and neurophysiological outcomes compared to those with apoE3. Ovarian hormones have also been shown to be important in modulating synaptic processes underlying cognitive function, yet little is known about how their effects are influenced by apoE. In the current study, female adult human APOE targeted replacement (TR) mice were utilized to examine the effects of human APOE genotype and long-term ovarian hormone loss on synaptic plasticity in limbic regions by measuring dendritic spine density and electrophysiological function. No significant genotype differences were observed on any outcomes within intact mice. However, there was a significant main effect of genotype on total spine density in apical dendrites in the hippocampus, with post-hoc t-tests revealing a significant reduction in spine density in apoE3 ovariectomized (OVX) mice compared to sham operated mice. There was also a significant main effect of OVX on the magnitude of LTP, with post-hoc t-tests revealing a decrease in apoE3 OVX mice relative to sham. In contrast, apoE4 OVX mice showed increased synaptic activity relative to sham. In the lateral amygdala, there was a significant increase in total spine density in apoE4 OVX mice relative to sham. This increase in spine density was consistent with a significant increase in spontaneous excitatory activity in apoE4 OVX mice. These findings suggest that ovarian hormones differentially modulate synaptic integrity in an apoE-dependent manner within brain regions that are susceptible to neurophysiological dysfunction associated with AD