Background Myocardial infarction (MI) induces remodeling in stellate ganglion neurons (SGNs). Objective We investigated whether infarct site has any impact on the laterality of morphological changes or neuropeptide expression in stellate ganglia. Methods Yorkshire pigs underwent left circumflex artery (LCX, n=6) or right coronary artery (RCA, n=6) occlusion, to create left and right-sided MI, respectively (control: n=10). 5±1 weeks post-MI, left and right stellate ganglia (LSG and RSG, respectively) were collected to determine neuronal size, tyrosine hydroxylase (TH) and neuropeptide Y (NPY) immunoreactivity. Results Compared to control, LCX and RCA MI increased mean neuronal size in the LSG (451±25μm2 vs. 650±34μm2 vs. 577±55 μm2, respectively, p=0.0012); and RSG (433±22 μm2 vs. 646±42 μm2 vs. 530±41μm2, respectively, p=0.002). TH-immunoreactivity was present in the majority of SGNs. Both LCX and RCA MI were associated with significant decrease in the percentage of TH-negative SGNs; from 2.58±0.2% in controls to 1.26±0.3% and 0.7±0.3% in LCX and RCA MI respectively for LSG (p=0.001); and from 3.02±0.4 in controls to 1.36±0.3% and 0.68±0.2% in LCX and RCA MI respectively for RSG (p=0.002). Both TH-negative and TH-positive neurons increased in size following LCX and RCA MI. Neuropeptide Y immunoreactivity was also significantly increased by LCX and RCA MI in both ganglia. Conclusions Left and right-sided MI equally induced morphologic and neurochemical changes in LSG and RSG neurons, independent of infarct site. These data indicate that afferent signals transduced following MI result in bilateral changes, and provide a rationale for bilateral interventions targeting the sympathetic chain for arrhythmia modulation.

Anecdotal evidence suggests that the prevalence of both scabies and head lice is increasing and also that both conditions are becoming refractory to pesticide treatment. Using information obtained from the Office of National Statistics, Royal College of General Practitioners Weekly Returns Service, Department of Health, local surveys of school children from Bristol and drug sales of insecticides, we have confirmed that there has been a rise in the prevalence of both conditions. We have shown that scabies is significantly more prevalent in urbanized areas (P < 0.00001), north of the country (P < 0.000001), in children and women (P < 0.000001) and commoner in the winter compared to the summer. Scabies was also shown to have a cyclical rise in incidence roughly every 20 years. Head lice were shown to be significantly more prevalent in children and mothers (P < 0.000001) though both conditions were seen in all age groups. Head lice were also less common during the summer. Host behaviour patterns, asymptomatic carriage, drug resistance and tourism from countries or districts with a higher incidence may be important factors in the currently high prevalence of both scabies and head lice.

Colophony is a complex mixture of over 100 compounds derived from pine trees. It has countless applications at home and at work and exposure to colophony and modified-colophony is universal. It is the oxidation products of unmodified and modified colophony and some of the new resin acids synthesized during modification that are the principle allergens in colophony. The neutral fraction may account for a small % of positive reactions. When screening for allergy using unmodified gum rosin, allergy to modified rosin will not be revealed. When patients react to both materials, it is probably due to unmodified colophony present in both, rather than a cross-reaction. Relevant positive reactions may be missed if only colophony 20% pet. is relied upon as the screening material.

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The data suggest head lice resistance is present in many parts of England to over-the-counter products containing synthetic insecticides (permethrin, phenothrin and malathion). They further suggest that resistance is starting to develop to carbaryl in head lice in Leeds and that extensive use of this product would lead to significant resistance.

Ustekinumab is a novel biologic agent for psoriasis. When used in everyday clinical practice it demonstrates high levels of short-term therapeutic efficacy with an acceptable short-term safety profile.