Mechanisms of Brain Injury in Bacterial Meningitis: Workshop Summary

Morbidity and mortality associated with bacterial meningitis remain high, although antibiotic therapy has improved during recent decades. The major intracranial complications of bacterial meningitis are cerebrovascular arterial and venous involvement, brain edema, and hydrocephalus with a subsequent increase of intracranial pressure. Experiments in animal models and cell culture systems have focused on the pathogenesis and pathophysiology of bacterial meningitis in an attempt to identify the bacterial and/or host factors responsible for brain injury during the course of infection. An international workshop entitled "Bacterial Meningitis: Mechanisms of Brain Injury” was organized by the Department of Neurology at the University of Munich and was held in Eibsee, Germany, in June 1993. This conference provided a forum for the exchange of current information on bacterial meningitis, including data on the clinical spectrum of complications, the associated morphological alterations, the role of soluble inflammatory mediators (in particular cytokines) and of leukocyte-endothelial cell interactions in tissue injury, and the molecular mechanisms of neuronal injury, with potential mediators such as reactive oxygen species, reactive nitrogen species, and excitatory amino acids. It is hoped that a better understanding of the pathophysiological events that take place during bacterial meningitis will lead to the development of new therapeutic regimen

The Foundations of Human Pro-Social Behaviour: Some Economic Aspects

Pro-social behaviour has an economic foundation. Income rate, social discount rates, incentives and welfare motives force agents to act pro-socially. Pro-social behaviour is realized through the institution of social responsibility, which includes non-market coordination mechanism, altruism, social capital and trust. The nature of the institute of social responsibility and its components are described in the first part of the paper. The second part describes the conditions that promote pro-social behaviour and reflect the main features of the institute of social responsibility. In the third part we tested the hypothesis of the second part on the basis of a comparative analysis of pro-social behaviour in Russia and OECD countries. In the fourth part we summed up the conclusions of the study. The study found a direct connection between the pro-social behaviour, the level of trust, volunteer and charitable activities. For empirical testing of theoretical hypotheses we use sociological surveys data of WVS (2010-2014), ESS (2012). In this paper we evaluated the pro-social behaviour in Russia in comparison with OECD countries. We used the following indicators: positive expectations for the future, trust, participation in volunteer activities and charity. We found that pro-social activity is poorly implemented in Russia. The low level of per capita income, low level of interpersonal trust, weak development of volunteer and charitable activities and pessimistic expectations of the future - these are the key factors that reduce pro-social activity in Russia

823-2 The ratio of early diastolic mitral flow velocity to early diastolic mitral annular velocity predicts prognosis in patients with chronic congestive heart failure

Arquitectes: Lluís Clotet, Òscar Tusquets Blanca, Carlos DíazProposta d'alçats i seccions del convent dels Àngels.Digitalitzat per Tecnodo

Surgery of secondary mitral insufficiency in patients with impaired left ventricular function

<p>Abstract</p> <p>Background</p> <p>Secondary mitral insufficiency (SMI) is an indicator of a poor prognosis in patients with ischemic and dilated cardiomyopathies. Numerous studies corroborated that mitral valve (MV) surgery improves survival and may be an alternative to heart transplantation in this group of patients.</p> <p>The aim of the study was to retrospectively analyze the early and mid-term clinical results after MV repair resp. replacement in patients with moderate-severe to severe SMI and left ventricular ejection fraction (LVEF) below 35%.</p> <p>Methods</p> <p>We investigated 40 patients with poor LVEF (mean, 28 ± 5%) and SMI who underwent MV repair (n = 26) resp. replacement (n = 14) at the University Hospital Muenster from January 1994 to December 2005. All patients were on maximized heart failure medication. 6 pts. had prior coronary artery bypass grafts (CABG). Twenty-seven patients were in New York Heart Association (NYHA) class III and 13 were in class IV. Eight patients were initially considered for transplantation. During the operation, 14 pts had CABG for incidental disease and 8 had tricuspid valve repair. Follow-up included echocardiography, ECG, and physician's examination and was completed in 90% among survivors. Additionally, the late results were compared with the survival after orthotope heart transplantation (oHTX) in adults with ischemic or dilated cardiomyopathies matched to the same age and time period (148 patients).</p> <p>Results</p> <p>Three operative deaths (7.5%) occurred as a result of left ventricular failure in one and multiorgan failure in two patients. There were 14 late deaths, 2 to 67 months after MV procedure. Progress of heart failure was the main cause of death. 18 patients who were still alive took part on the follow-up examination. At a mean follow-up of 50 ± 34 (2–112) months the NYHA class improved significantly from 3.2 ± 0.5 to 2.2 ± 0.4 (p < 0.001). The LVEF improved significantly from 29 ± 5% to 39 ± 16 (p < 0.05). There were no differences in survival after MV repair or replacement. The 1-, 3-, 5-year survival rates in the study group were 80%, 58% and 55% respectively. In the group of patients after oHTX the survival was accordingly 72%, 68%, 66% (p > 0.05).</p> <p>Conclusion</p> <p>High risk mitral valve surgery in patients with cardiomyopathy and SMI offers a real mid-term alternative method of treatment of patients in drug refractory heart failure with similar survival in comparison to heart transplantation.</p

Aortic dissection associated with cogans's syndrome: deleterious loss of vascular structural integrity is associated with GM-CSF overstimulation in macrophages and smooth muscle cells

<p>Abstract</p> <p>Background</p> <p>Cogan's syndrome is a rare disorder of unknown origin characterized by inflammatory ocular disease and vestibuloauditory symptoms. Systemic vasculitis is found in about 10% of cases.</p> <p>Case presentation</p> <p>A 46-year-old female with Cogans's syndrome and a history of arterial hypertension presented with severe chest pain caused by an aneurysm of the ascending aorta with a dissection membrane located a few centimeters distal from the aortic root. After surgery, histopathological analysis revealed that vascular matrix integrity and expression of the major matrix molecules was characterized by elastolysis and collagenolysis and thus a dramatic loss of structural integrity. Remarkably, exceeding matrix deterioration was associated with massively increased levels of granulocyte macrophage colony stimulating factor (GM-CSF).</p> <p>Conclusion</p> <p>Our data suggest that the persistently increased secretion of the inflammatory mediator GM-CSF by resident inflammatory cells but also by SMC may be the trigger of aortic wall structural deterioration.</p