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Despite clear indications of interleukin-1 (IL-1) action on Sertoli and germ cells, previous studies failed to detect IL-1 receptors (IL-1R) within the seminiferous tubules. Here, we investigated the existence of the type I signaling receptor (IL-1RI) and the type II decoy receptor (IL-1RII) mRNAs within the testis. Polymerase chain reaction analysis showed the presence of both receptor mRNAs in isolated rat, mouse, and human somatic testicular cells (macrophages, Leydig, Sertoli, and peritubular cells). While also present in rat and mouse isolated pachytene spermatocytes and early spermatids, these receptor mRNAs were not found in human germ cells. The distribution of both IL-1R mRNAs was then examined in adult rat and mouse testis using light and electron microscopic in situ hybridization. No IL-1RI signal was detected in rat testis. In mouse testis, we did not find any signal for IL-1RII. In contrast, IL-1RI mRNA was detected in a wide variety of mouse testicular cells. Strong expression was observed in the rete testis area and high expression was seen over the epithelium of the epididymal duct and in interstitial cells, while lower labeling was detected in peritubular and Sertoli cells and in all germ cell types from spermatogonia to early spermatids; no signal was seen in late spermatids. That the IL-IR was also strongly expressed in the interstitium, the rete testis and efferent duct areas, and the epididymis was established using an autoradiography technique. Overall, our study strongly supports the hypothesis that IL-1 is a regulator of testicular function of prime importance.

Objectives: To raise awareness of blood pressure, measured by number of countries involved, number of people screened, and number of people who have untreated or inadequately treated hypertension. Methods: An opportunistic cross-sectional survey of volunteers aged at least 18 years was carried out in May 2017. Blood pressure measurement, the definition of hypertension and statistical analysis followed the standard May measurement month protocol. Eighteen countries in Latin America and the Caribbean participated in the campaign, providing us with a wide sample for characterization. Results: During May measurement month 2017 in Latin America and the Caribbean, 105 246 individuals were screened. Participants who had cardiovascular disease, 2245 (2.3%) had a prior myocardial infarction, and 1711 (1.6%) a previous stroke, additionally 6760 (6.4%) individuals were diabetic, 7014 (6.7%) current smokers and 9262 (8.8%) reported alcohol intake once or more per week. Mean SBP was 122.7 mmHg and DBP was 75.6 mmHg. After imputation, 42 328 participants (40,4%) were found to be hypertensive. Conclusion: The high numbers of participants detected with hypertension and the relatively large proportion of participants on antihypertensive treatment but with uncontrolled hypertension reinforces the importance of this annual event in our continent, to raise awareness of the prevention of cardiovascular events.

Several of the luminal endothelial glycocalyx functions are exerted via interactions with glycosidic components and sugar binding proteins with lectinic activity. One important example is the mannose receptor (MR). The MR has been detected in cell types that mediate the phagocytosis and pinocytosis of particles and solutes containing mannose. Using isolated constant pressurized rat mesenteric arteries (RMA), we evaluated the effects of a mannose polymer in the vascular tone. RMA were pre-contracted with 10 micromol/L phenylephrine and carbohydrates were perfused at 20 microliters/min. Perfusion of free D-mannose (1 nmol/L to 100 micromol/L) induced a concentration-dependent vasodilation of pre-contracted RMA. Perfusion of mannose polymer (1 nmol/L to 100 micromol/L) induced a larger effect in a concentration-dependent vasodilation. Mannose polymer's maximum effect reached a 96 percent of basal diameter; this significant vasodilation was not nitric oxide (NO) or cyclooxygenase (COX) dependent effect. We corroborated the binding of the mannose polymer to the endothelial lumen, by perfusion of a fluorescently labeled mannose polymer; and also, we detected a significant level of MR mRNA in whole mesenteric arteries. With all these, we proposed a novel effect of a MR in the regulation of vascular tone.

Introduction: Growing availability of advanced imaging studies (AdIS) has resulted in increasing use of studies other than non-contrast CT (NCCT) in the evaluation of acute ischemic stroke (AIS) patients. The diagnosis of AIS is mainly clinical, and thrombolysis in patients with stroke mimics is generally considered to be safe. However, the need for diagnostic certainty and timely detection of large vessel occlusion (LVO) may incline physicians to perform more AdIS. Hypothesis: Performing pre-treatment AdIS in all patients with AIS will prolong DNT without conferring clear benefits regarding treatment decisions. Methods: We reviewed a prospective registry of AIS patients arriving at the Neurologic Emergency Department. We obtained additional information from the patients’ clinical records, and all pertinent imaging studies were reviewed to confirm diagnosis and site of arterial occlusion. Results: We analyzed 128 AIS patients treated with IV thrombolysis. Mean Door to-Needle-Time (DNT) was 83 min. Only 46% of patients were thrombolysed in the first 60 minutes after arrival. AdIS were performed in 60 patients (48%) They were equally performed among patients with NIHSS scores below and above 10 points, a possible cutoff for the presence of LVO. They also were performed equally in patients with clinically mild, and severe strokes, when the clinical diagnosis of AIS was not in doubt. On bivariate analysis, factors associated with DNT<60 minutes were: female sex, posterior circulation stroke and whether only NCCT was performed. Exclusive use of NCCT was associated with a higher percentage of DNT<60 minutes (59 vs 34%, p=0.005). On multivariable analysis, NCCT use was independently associated with DNT<60 min (OR= 2.92, p<0.007) Regarding different imaging studies, DNT means were as follows: NCCT: 69 min, CTA:79 min, CTP: 125 min, MRI 108 min (Difference between groups p=0.007). No patients were excluded from thrombolytic treatment based on AdIS results. Conclusions: The pre-thrombolysis performance of AdIS carries the risk of prolonging DNT and lowering the possibility of benefit for AIS patients. Selection of patients for specific studies and deferring AdIS until after initiating alteplase should be pursued.

Background Internuclear ophthalmoplegia (INO) is an eye movement disorder caused by a lesion in the medial longitudinal fasciculus (MLF) located in the midbrain. Adduction paralysis of both eyes and bilateral abduction nystagmus are the main features of INO [ 1 ] . Case presentation A 29-year-old Hispanic woman was admitted to the emergency department complaining of an intense holocranial headache lasting 9 days, associated with nausea and vomiting. She was discharged home with resolution of the headache but persistence of symptoms. However, she subsequently developed horizontal diplopia and gait abnormalities. She was readmitted to hospital because of anomalous eye movements and conjugate gaze palsy, manifested as bilateral INO. Magnetic resonance angiography (MRA) findings were consistent with dissection of the left V4 vertebral artery with multiple brain infarcts in the superior cerebellar artery territory, comprising both MLF tracts. Conclusions In young adults, bilateral INO is normally caused by demyelinating disease. In other patients, common causes include trauma, infections and autoimmune diseases with neurological symptoms. Vascular disease is implicated in over a third of cases. LEARNING POINTS A vascular aetiology should be suspected when internuclear ophthalmoplegia (INO) presents with an intense headache. Almost a third of patients with bilateral INO have an identified vascular cause. Magnetic resonance imaging is the gold standard for investigating INO

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