Children's (in)dependent mobility in Portugal

OBJECTIVES

To characterize children's independent mobility in Portugal, by studying the influence of age, sex, school type (primary/secondary) and location (urban/rural). To explore associations between mobility licences and children's actual independent mobility.

DESIGN

Cross-sectional study of 1099 children between 8 and 15 years of age and their parents. Children attended primary (n=660, 49% boys, 69% urban) and secondary (n=439, 43% boys, 72% urban) schools.

METHODS

The Portuguese version of the child independent mobility survey (Policy Studies Institute, London) was completed. Parents reported the mobility licences granted to their children. Children reported their independent mobility on school journeys and on weekends. Differences were examined in mobility licences and independent mobility by sex, urban/rural setting and primary/secondary schools. Multiple logistic regression models examined the associations between different variables and actual independent mobility.

RESULTS

Secondary school children are granted more licences and have greater levels of independent mobility than primary school children. Only 21% of primary school children and 45% of secondary school children come home from school actively and independently. Overall, sex does not influence the licences granted to children in Portugal but boys have greater levels of independent mobility during the weekends than girls. Children in rural settings report engaging in more activities during the weekend. The number of mobility licences granted to the child was identified as predictor for actual independent mobility on school days and during the weekend.

CONCLUSIONS

Portuguese children lack independent mobility. Complementary qualitative research will be important to inform about the better practices to tackle this problem.

Rumen morphometrics and the effect of digesta pH and volume on volatile fatty acid absorption

The effects of rumen digesta volume and pH on VFA absorption and its relation to rumen wall morphology were evaluated. Nine rumen cannulated cows formed 3 groups based on desired variation in rumen morphology: The High group was formed by Holsteins yielding 25.9 kg milk/d and fed on a high-grain total mixed ration (TMR); the Medium group by Holstein-Zebu crossbreds yielding 12.3 kg milk/d and fed on corn silage, tropical pasture, and a commercial concentrate; and the Dry group by nonlactating grazing Jerseys fed exclusively on tropical pasture. Within each group, a sequence of 3 ruminal conditions was induced on each cow in 3 × 3 Latin Squares, with 7-d periods: high digesta volume and high pH (HVHP), low volume and high pH (LVHP), and low volume and low pH (LVLP). Rumen mucosa was biopsied on the first day of Period 1. Ruminal morphometric variables evaluated were mitotic index, absorptive surface and papillae number per square centimeter of wall, area per papillae, papillae area as a percentage of absorptive surface, and epithelium, keratinized layer, and nonkeratinized layer thickness. There was marked variation in rumen morphology among the groups of cows. Grazing Jerseys had decreased rumen wall absorptive surface area and basal cells mitotic index, and increased thickness of the epithelium and of the keratin layer compared with cows receiving concentrates. Mean rumen pH throughout the 4 h sampling period was: 6.78 for HVHP, 7.08 for LVHP, and 5.90 for LVLP (P < 0.01). The capacity of the rumen wall to absorb VFA was estimated by the Valerate/CrEDTA technique. The fractional exponential decay rate for the ratio of valeric acid to Cr (k Val/Cr) was determined by rumen digesta sampling at 20-min intervals during 4 h, after the mixing of markers and the return of the evacuated ruminal content. The k Val/Cr values for treatments HVHP, LVHP, and LVLP were, respectively: 19.6, 23.9, and 35.0 %/h (SEM = 2.01; P = 0.21 for contrast HVHP vs. LVHP and P < 0.01 for contrast LVHP vs. LVLP). The k Val/Cr was faster under low pH, but decreasing digesta volume under high pH did not elicit such a response. The correlation between the absorptive surface area per square centimeter of rumen wall and the mean of the 3 k Val/Cr values of each cow was 0.90 (P < 0.01). Cows capable of maintaining a less-acidic rumen environment had greater inflow of water into the digestive cavity, had a more developed rumen mucosa, and were more efficient VFA absorbers.

Suplementação de vacas leiteiras com homeopatia: desempenho e digestibilidade

Avaliou-se o efeito da suplementação de uma combinação homeopática sobre o desempenho e a digestibilidade de nutrientes em vacas leiteiras. Trinta e duas vacas Holandesas foram blocadas em pares e aleatoriamente alocadas a um de dois tratamentos por 63 dias, posterior a um período de padronização de 14 dias. Variáveis mensuradas no final da padronização ajustaram medidas semanais da mesma variável no modelo de análise estatística. Os tratamentos foram: Suplementação diária com 150 gramas de uma combinação homeopática (Hypothalamus, 10-30; Colibacilinum, 10-30; Streptococus Beta Hemolyticum, 10-60; Streptococus Uberis, 10-60; Phytolacca, 10-60; Calcium Phosphoricum, 10-30; Natrum Muriaticum, 10-60; Urtica Urens, 10-30; Silicea Terra, 10-400) em veículo mineral, ou 150 gramas do mesmo veículo mineral (controle). A suplementação com homeopatia aumentou o teor de proteína no leite de 3,09 para 3,19% (P=0,01) e tendeu a aumentar a secreção diária de proteína de 0,737 para 0,776kg (P=0,10). A queda na digestibilidade da fibra e da matéria orgânica (P=0,10), e a similaridade na relação entre alantoína e creatinina na urina (P=0,32), sugerem que houve aumento na eficiência de síntese de proteína microbiana no rúmen. Apesar de o mecanismo não ter sido elucidado, a combinação homeopática aumentou o teor de proteína do leite.

Suplementação de vacas leiteiras com homeopatia: células somáticas do leite, cortisol e imunidade

Avaliou-se o efeito da suplementação de uma combinação homeopática sobre a contagem de células somáticas do leite (CCS), o teor sanguíneo de cortisol e a resposta de anticorpos neutralizantes antivírus da raiva de vacas leiteiras. Trinta e duas vacas Holandesas em lactação foram blocadas em pares e aleatoriamente alocadas a um de dois tratamentos por 63 dias, posterior a um período de padronização de 14 dias. A CCS mensurada no final da padronização ajustou os valores semanais de CCS no modelo de análise estatística. Os tratamentos foram: 150 gramas de uma combinação homeopática (Hypothalamus, 10-30; Colibacilinum, 10-30; Streptococus Beta Hemolyticum, 10-60; Streptococus Uberis, 10-60; Phytolacca, 10-60; Calcium Phosphoricum, 10-30; Natrum Muriaticum, 10-60; Urtica Urens, 10-30; Silicea Terra, 10-400) em veículo mineral, ou 150 gramas do mesmo veículo mineral (controle). A homeopatia tendeu a aumentar a CCS de 124 para 222 x1.000 células mL-1 (P=0,09) e a CCS linearizada (P=0,08). Não foram detectados efeitos de tratamento sobre a concentração sérica de cortisol após estresse induzido por aspiração percutânea do saco ventral do rúmen (P=0,59) ou sobre o título de anticorpos neutralizantes em resposta à vacinação antivírus da raiva (P=0,40). A suplementação com homeopatia tendeu a aumentar a CCS de vacas com baixa CCS.

Pre–release training of juvenile little owls Athene noctua to avoid predation

Anti–predator training of juvenile little owls was tested in a sample of recovered owls raised in captivity in Brinzal Owl Rescue Center (Madrid, Spain). Mortality caused by predators has been described previously in released individuals. Nine little owls were conditioned during their development to a naturalized goshawk and a large live rat, whose presence was paired to the owl’s alarm call. All nine owls and seven non–trained individuals were then released during the late summer and autumn and radio–tracked for six weeks to test their survival. In total 71.4% of the trained owls survived while only the 33.3% of the untrained group were alive at the end of week six. The only cause of death that was detected was predation. Antipredator training, therefore, seems to be beneficial in maximizing survival after the release of juvenile little owls.

Inhibitors of the mitochondrial electron transport chain and de novo pyrimidine biosynthesis as antimalarials: The present status

Malaria is a major worldwide public health threat with worrying social and economic burdens due to the rapid emergence of multidrug-resistant Plasmodium falciparum strains. As a result, there is an urgent need to find novel drugs that might overcome clinical resistance to marketed antimalarials. In recent years, the mitochondrial electron transport chain (mtETC) has been explored for the development of new antimalarials. Type II NADH:quinone oxidoreductase (PfNDH2), succinate dehydrogenase (SDH) and cytochrome bc1 have become a major focus of those efforts, leading to several studies of its biochemistry and the design of potent inhibitors. Furthermore, de novo pyrimidine biosynthesis in malaria parasites, particularly dihydroorotate dehydrogenase (PfDHODH), is also receiving increasing attention. The enzymes involved in the mtETC are valuable targets in malaria chemotherapy, not only because they play a critical role in metabolic pathways of P. falciparum, but also because they differ significantly from the analogous mammalian system. Inhibition of such enzymes results in the shutdown of mitochondrial electron flow, leading to the arrest of pyrimidine biosynthesis and consequent parasite death. In this review, we aim to outline recent advances in the inhibition of mitochondrial metabolic pathways, highlighting the major classes of known inhibitors and those that are currently being developed.

Biocorrosion and biofilm formation in a nutrient limited heating system subjected to alternating microaerophilic conditions

Severe biofilm formation and biocorrosion have been observed in heating systems even when the water quality complied with existing standards. The coupling between water chemistry, biofilm formation, species composition, and biocorrosion in a heating system was investigated by adding low concentrations of nutrients and oxygen under continuous and alternating dosing regimes. Molecular analysis of 16S rRNA gene fragments demonstrated that the amendments did not cause changes in the overall bacterial community composition. The combined alternating dosing of nutrients and oxygen caused increased rates of pitting (bio-) corrosion. Detection of bacteria involved in sulfide production and oxidation by retrieval of the functional dsrAB and apsA genes revealed the presence of Gram-positive sulfate- and sulfite-reducers and an unknown sulfur-oxidizer. Therefore, to control biocorrosion, sources of oxygen and nutrients must be limited, since the effect of the alternating operational conditions apparently is more important than the presence of potentially corrosive biofilm bacteria.

Parents-child role reversal in trilogue play: case studies of trajectories from pregnancy to toddlerhood

Role reversal, whereby a child attempts to meet her parent's adult needs for parenting, intimacy, or companionship, has been identified as a risk factor for developmental disturbances. It has been defined from diverse perspectives as a child attachment strategy, a parent - toddler relational disturbance, and a boundary disturbance between parents and child. The recently discovered infant's triangular capacity, namely the sharing of her attention and affects with both parents, allows one to analyse the infant's contribution to early family dynamics. Role reversal was detected in 4 out of 45 father - mother - infant interactions observed in trilogue play from pregnancy to toddlerhood. The developmental trajectories towards role reversal are explored by means of case analyses. Results are compared with cases of problematic triangulation encountered in the same sample. In role reversal, family interactions are rigidly organized around a "two against one" coalition, whereby the normative hierarchy between parents and child is reversed. The child's triangular capacity is overactivated, controlling the tension between her parents by provocation - animation strategies.

296 LEUKEMIA INHIBITORY FACTOR INFLUENCES SHEEP OOCYTE PARTHENOGENETIC DEVELOPMENT DURING THE TRANSITION FROM GERMINAL VESICLE TO EARLY PRONUCLEAR STAGE

Leukemia inhibitory factor (LIF) is an indispensable cytokine for female fertility. The influence of LIF on embryo development and particularly implantation has been recently confirmed; however, the effect of this cytokine on the oocyte has not been studied. The presence of LIF in human follicular fluid implies its possible role in the acquisition of oocyte competence. Furthermore, the up-regulation of LIF by steroid hormones in sheep makes entirely feasible the hypothesis that ovulatory estradiol peak plays a role in the preparation of female gamete for fertilization. With this in mind, we studied the effect of LIF during in vitro development of sheep oocytes mimicking the physiological expression of LIF induced by the ovulatory peak of estradiol in mice. GV stage oocytes matured and chemically activated in the presence of LIF and anti-LIF antibody were cultured to the blastocyst stage in our standard media. To eliminate the effect of the putative presence of LIF in heat inactivated fetal calf serum used for oocyte maturation, aliquots of LIF were treated at 56°C for 30 min and added to the maturation medium. The proportion of embryos that reached the blastocyst stage in vitro was significantly higher (P < 0.001) for oocytes matured and activated with LIF (36/93; 39%) than for the group incubated with antibody against LIF (6/68; 9%). The significant effect of anti-LIF antibody (P < 0.001) was also observed when compared with blastocysts developed from the control group of oocytes matured without LIF addition (31/106; 29%). Although the beneficial influence of LIF treatment on embryo development demonstrated with those preliminary data was not confirmed statistically, due to low number of oocytes involved, the proportion of embryos reaching the blastocyst stage in vitro was about 10% higher for those incubated with LIF than for either those cultured without the cytokine or those, matured in the presence of heat-treated LIF (15/55; 27%); however, the rate of blastocyst development appeared very similar to that of the control group. This study revealed for the first time a role of LIF in determining oocyte competence. Further investigation to determine how LIF achieves its effects on the oocyte are ongoing in our laboratory. This work was supported by FIRB RBNE01HPMX, COFIN 2002074357, COFIN 2003073943 002, and British Council 2004.

[HIV, HPV, and syphilis prevalence in a women's penitentiary in the city of São Paulo, 1997-1998]

Incarcerated women as a group are particularly vulnerable to infections. The lack of public programs for prevention, early diagnosis, and treatment contribute to the increase in the incidence and prevalence of diseases in general and especially sexually transmitted diseases. This article aims to estimate the prevalence of infection by the human immunodeficiency virus (HIV), human papillomavirus (HPV), and syphilis among inmates at the Women's Penitentiary in the State capital of São Paulo, Brazil. All inmates were invited to participate in the study, which was divided into two stages: 1. STD/AIDS preventive workshops including interviews and 2. laboratory tests. The interview covered knowledge of STD/AIDS, risk behavior, and individual reproductive health history. A total of 262 women, with a mean age of 32.4 years and limited schooling, participated in more than one stage of the study. Prevalence rates were 14.5% for HIV, 16.3% for high-oncogenic-risk HPV probes, 4.8% for low-oncogenic-risk HPV probes, and 5.7% for syphilis. The authors conclude that STD/HIV constitute a serious health problem in the prison system, requiring urgent preventive measures.

Effects of presynchronization and bovine somatotropin on pregnancy rates to a timed artificial insemination protocol in lactating dairy cows

The objective was to examine the effects of presynchronization and bovine somatotropin (bST) on pregnancy rates to a timed artificial insemination protocol in lactating dairy cows. Lactating Holstein cows (n = 543) were assigned randomly in a 2 x 3 factorial experiment in which cows received a presynchronization treatment or not, and were treated with bST (500 mg) at 63 +/- 3, 73 +/- 3, or 147 +/- 3 d postpartum. The latter group was used as a control. Presynchronization treatment consisted of two injections of PGF2alpha (25 mg) given 14 d apart, with the second injection of PGF2alpha being administered 12 d before initiation of the timed artificial insemination protocol. All cows received GnRH (100 microg) at 63 +/- 3 d postpartum, an injection of PGF2alpha (40 mg) 7 d later, a GnRH injection at 48 h after PGF2alpha and were inseminated 16 to 20 h later. Cows were resynchronized if determined to be nonpregnant at ultrasonography at 32 d after insemination with a GnRH injection (100 microg), an injection of PGF2alpha (40 mg) 7 d later, and a GnRH injection at 48 h after PGF2alpha and were inseminated 16 to 20 h later. Cows were examined for pregnancy at 32 d and reexamined at 74 d after insemination. No differences in pregnancy rates were observed between cows receiving bST treatment at 63 +/- 3 d postpartum or at 73 +/- 3 d postpartum. An interaction between presynchronization and bST treatment indicated that pregnancy rates were increased for cows treated with bST when cows were presynchronized. When anestrous cows were excluded from the analyses, both an effect of bST and of presynchronization were observed, indicating that bST increased pregnancy rates regardless of presynchronization treatment and that presynchronization also increased pregnancy rates independently of bST treatment. Presynchronization and bST treatment may be used to increase first-service pregnancy rates to a timed artificial insemination protocol.

CK-19 expression by RT-PCR in the peripheral blood of breast cancer patients correlates with response to chemotherapy

BACKGROUND

The recent introduction of sensitive RT-PCR-based techniques for the detection of epithelial antigen expression, such as CK-19, in the peripheral blood and bone marrow of breast cancer patients may provide an opportunity to evaluate tumor response at the molecular level, even in the absence of measurable disease while patients are still receiving chemotherapy.

METHODS

We studied serially collected blood samples of 53 patients with breast cancer before, during, and after adjuvant, neoadjuvant, and palliative chemotherapy to evaluate its effects on the expression of CK-19 measured by RT-PCR.

RESULTS

The percentage of CK-19 RT-PCR positivity decreased consistently from 43% (23/53) before chemotherapy to 14.3% (7/49), and to 18.9% (7/37) after 3 and 6 cycles, respectively (chi-square for linear trend = 7.948; p = 0.0048). Furthermore, there was a significant correlation between a negative CK-19 at three months and the response to chemotherapy (p = 0.024).

CONCLUSION

We conclude that RT-PCR negativity for CK-19 expression at 3 months after the beginning of chemotherapy correlates with tumor response and, as treatment progresses, there is a significant trend for the occurrence of more negative RT-PCR results. Further studies are needed to confirm if this technique can be useful to assess response to chemotherapy in patients without measurable disease and if negativation of CK-19 expression while on chemotherapy is of prognostic significance.

[Psychiatric manifestations of a new variant of Creutzfeldt-Jakob disease. Apropos of a case]

The new variant of Creutzfeldt-Jakob disease (nvCJD) was first described in the UK in 1996 (16). The nvCJD differs from sporadic, genetic and iatrogenic CJD. Creutzfeldt-Jakob disease is closely associated with an abnormal isoform PrPSc of a cell-surface glycoprotein, prion protein (14). Molecular analysis suggests that nvCJD is caused by the same prion strain as bovine spongiform encephalopathy (BSE) (4, 10). To the end of September 2000, there have been 82 cases of nvCJD in the UK. We report the second French case of nvCJD to our knowledge (5, 13).

CASE REPORT

This 36 year old woman was referred by a local general practitioner with a 6 month history of psychiatric symptoms of major depressive disorder. According to her family, the patient had suffered from personality change for several months before the onset of depression including apathy, emotional lability, infantile affect. There was no history of health problems. As she was admitted to the psychiatric department of our hospital in Paris suburbs, she presented a major depressive disorder. There were no specific psychiatric features allowing distinction from common depressive disorders, except a marked emotional lability. The patient's condition progressed rapidly within the following days. She presented memory impairment and disorientation. Drug treatments, clomipramine (125 mg/day) and venlafaxine (200 mg/day), were used with no benefit. She presented subsequently transient delusions and auditory hallucinations, fleeting for some hours. The predominant delusional themes were somatic type and pregnancy. The delusions were concomitant with delusions of the onset of cognitive impairment. The patient tested negative for the P 14.3.3 protein in the CSF. Computed tomography scan of the brain did not show any relevant abnormality. The electroencephalogram showed non specific slow wave activity. The neurological symptoms developed 7 months after the onset of depressive symptoms including ataxia, myoclonus, excessive daytime drowsiness, headache. After the onset of neurological symptoms, the illness progressed rapidly over the next 2 months with cognitive impairment, particularly memory impairment, myoclonus, ataxia, incontinence of urine and progressive immobility leading to dependency. CSF tests were negative. She was referred to a neurology department where the diagnosis was confirmed by brain biopsy (detailed elsewhere). The patient died in a state of akinetic mutism.

DISCUSSION

The clinical features of our patient were consistent with previous descriptions of nvCJD, mainly those of the National CJD Surveillance Unit studies (17): early psychiatric symptoms, prolonged duration of illness (median: 14 months), earlier age at death, compared with sporadic CJD. Psychiatric symptoms occur in the clinical course in about a third of cases of sporadic CJD (3). In contrast, of the 35 cases that have died of nvCJD identified in the study by Will et al. (17), 34 suffered from early and prominent psychiatric symptoms, mainly depression and anxiety. In most of the patients, the first symptoms were psychiatric. Drug treatment was used in most cases, some patients had a transient improvement (18). The patient without psychiatric symptoms reported by the NCJDSU (17) was emotionally labile. Infantile affect and emotional lability, found in our patient, are frequently reported in other studies (1, 18). Schizophreniform disorders have been described during the clinical course, with auditory and visual hallucinations and paranoid delusions (17, 18). The insomnia and excessive daytime drowsiness our patient presented have been described in similar cases (18). Investigations are important to rule out alternative diagnoses. EEG records do not show periodic triphasic complexes as in sporadic CJD. The P 14.3.3 protein in the CSF is positive in half the cases of nvCJD (17). First neurological symptoms developed 6 months after the onset of psychiatric symptoms including ataxia, myoclonus and persistent painful sensory symptoms (17, 18). In most of the cases, MRI brain scans show bilateral pulvinar high signal (17), found subsequently in our patient and detailed elsewhere (13). The terminal stages are progressive cognitive impairment, helplessness and akinetic mutism.

CONCLUSION

The first symptoms of this patient were purely psychiatric and difficult to distinguish from common psychiatric disorders. Clinical surveillance of human prion disease is crucial in France, as in UK. The link with BSE has dramatically highlighted the need for neurological and neuropsychological precise investigations.

Acyloxymethyl as a drug protecting group. Part 7: Tertiary sulfonamidomethyl ester prodrugs of benzylpenicillin: chemical hydrolysis and anti-bacterial activity

Tertiary sulfonamidomethyl esters of benzylpenicillin (4) were synthesised and evaluated as a new class of potential prodrugs for beta-lactam antibiotics. Their hydrolysis in aqueous buffers was studied by HPLC and reveal a U-shaped pH rate profile with a pH-independent process extending from ca. pH 2 to ca. pH 10. This pathway is characterised by kinetic data that are consistent with a unimolecular mechanism involving rate-limiting iminium ion formation and penicillinoate expulsion. Benzylpenicillin and the corresponding sulfonamide are the ultimate products detected and isolated, indicating that beta-lactam ring opening is much slower than ester hydrolysis. As expected from the high reactivity, benzylpenicillin esters (4) displayed similar in vitro antibacterial activity to benzylpenicillin itself. Compared to the benzylpenicillin derivatives, sulfonamidomethyl esters of benzoic, clofibric and valproic acids display a much higher stability, giving rise to a Brønsted beta1g value of -0.96 and suggesting that tertiary sulfonamidomethyl esters may be useful prodrugs for carboxylic acid drugs with pKa > 4.

Acyloxymethyl as a drug protecting group. Part 6: N-acyloxymethyl- and N-[(aminocarbonyloxy)methyl]sulfonamides as prodrugs of agents containing a secondary sulfonamide group

Tertiary N-acyloxymethyl- and N-[(aminocarbonyloxy)methyl]sulfonamides were synthesised and evaluated as novel classes of potential prodrugs of agents containing a secondary sulfonamide group. The chemical and plasma hydrolyses of the title compounds were studied by HPLC. Tertiary N-acyloxymethylsulfonamides are slowly and quantitatively hydrolysed to the parent sulfonamide in pH 7.4 phosphate buffer, with half-lives ranging from 20 h, for 7d, to 30 days, for 7g. Quantitative formation of the parent sulfonamide also occurs in human plasma, the half-lives being within 0.2-2.0 min for some substrates. The rapid rate of hydrolysis can be ascribed to plasma cholinesterase, as indicated by the complete inhibition observed at [eserine] = 0.10 mM. These results suggest that tertiary N-acyloxymethylsulfonamides are potentially useful prodrugs for agents containing a secondary sulfonamide group, especially with pKa < 8, combining a high stability in aqueous media with a high rate of plasma activation. In contrast, N-[(aminocarbonyloxy)methyl]sulfonamides 7h-j do not liberate the parent sulfonamide either in aqueous buffers or in human plasma and thus appear to be unsuitable for development as sulfonamide prodrugs.

Low-dose quinine for treatment of Plasmodium falciparum malaria in Guinea-Bissau

The recommended dose of 10 mg quinine/kg bodyweight 3 times a day for 7 days for treatment of malaria is so high that many patients experience cinchonism. We have earlier obtained good results with 7 days' treatment with 20 mg Quinimax/kg bodyweight divided into 2 daily doses. In order to identify the lowest effective dose, children with symptomatic malaria were treated with quinine twice a day for 7 days. They were assigned to 1 of 3 groups treated daily with 10 mg/kg, 15 mg/kg, or 20 mg/kg bodyweight, respectively; 42, 46, and 34 children, respectively, received treatment and completed 5 weeks of follow-up. The cumulative percentages of all children with parasitaemia during follow-up on day 28 or before were 33%, 13% and 12%, respectively. Treatment with 10 mg quinine salt/kg daily for 7 days gave a significantly higher rate of recrudescence than did treatment with 15 or 20 mg/kg daily. Thus at least 15 mg of quinine salt/kg bodyweight daily should be recommended for treatment of symptomatic Plasmodium falciparum malaria in Guinea-Bissau.

Comparison of 3, 5 and 7 days' treatment with Quinimax for falciparum malaria in Guinea-Bissau

For treatment of malaria, the World Health Organization recommends 10 mg of quinine per kg body-weight 3 times a day for at least 7 d. In Guinea-Bissau, as in several other African countries, a 3 d treatment regimen (10 mg/kg twice daily) is currently used. We therefore compared the 3 d treatment period with periods of 5 and 7 d. A total of 145 children with clinical malaria due to monoinfection with Plasmodium falciparum, with > or = 20 parasites per 200 leucocytes, were treated with intramuscular Quinimax 10 mg per kg body-weight twice daily for 3, 5 or 7 d. The children were then examined once weekly for 4 weeks. Following the 3 d treatment regimen, 34 of 43 children (79%) had parasitaemia on day 28 or before; following the 5 d treatment regimen, 36 of 40 children (90%) did so; and following the 7 d treatment regimen, 7 of 62 children (11%) were parasitaemic at that time. This study thus suggests that the currently recommended 3 d Quinimax treatment regimen in Guinea-Bissau for moderate and severe malaria is not effective.

Cold: a risk factor for stroke?

A retrospective study was performed to investigate seasonal variation in stroke incidence and to evaluate the hypothesis that cold might be a risk factor. Data were obtained from the central registry of the Hospital de S. João, Porto, Portugal, concerning 4048 patients consecutively admitted for cerebrovascular disease during a period of 33 months. Monthly admissions for stroke and its subtypes were related to mean values of ambient temperature using linear correlation. There was a strong inverse correlation between average temperature and total admissions for cerebrovascular disease (r = -0.72, P < 0.00005), intracerebral haemorrhage (r = -0.66, P < 0.00005), ischaemic stroke (r = -0.46, P = 0.007) and transient ischaemic attack (r = -0.41, P = 0.017). These correlations were independent of any seasonal variation in the number of hospital admissions due to all causes. No relation was found between temperature and subarachnoid haemorrhage. The rhythmometric analysis showed the presence of a statistically significant rhythm with an acrophase in the coldest months. These results support the hypothesis of stroke being a chronorisk disease to which cold might represent a triggering factor.

Short-term memory and cognitive variability in adult fragile X females

We investigated the possibility that adult fragile X [fra(X)] heterozygotes have a distinct or specific cognitive profile, with a particular focus on visuospatial and/or memory deficits. With a sample of 13 adult fra(X) female carriers (2 fra(X) positive) and age-matched control women, we performed 2 tests: Wechsler Adult Intelligence Scale-Revised (WAIS-R) and the Revised Visual Retention Test (RVRT). An identifiable cognitive profile was not evident in the study group, but significant differences were evident in RVRT performance in number correct and number of errors when compared to controls and normative data. The combination of the WAIS-R and RVRT data suggests that the short-term memory component of the tasks may be of more significance than visuospatial performance in the deficits observed.

Efficacy of ivermectin against the bloodsucking insect, Rhodnius prolixus (Hemiptera, Triatominae)

Ivermectin (0.2 mg/kg body weight) caused a high mortality in nymphs and adults of Rhodnius prolixus following a single meal in mice sub-cutaneously injected with the drug. This effect was more evident in nymphs of 1st-and 2nd-instar than in older nymphs and adults. Third-instar nymphs presented a high mortality when fed on mice treated with ivermectin 24 and 48 hours previously, while mortality was significantly reduced in nymphs fed on mice treated 72 hours before. Surviving 3rd-instar nymphs did not molt. When adult females were fed once on mice treated for 24 hours with ivermectin there was a considerable reduction in egg production. This inhibition was not reversed by a second feeding on normal mice. We concluded that sub-lethal doses of ivermectin caused toxic effects interfering in the neuro-endocrine control of development and reproduction of this bloodsucking insect.