[Epidemiology of epilepsy in sub-Saharan Africa: a review]

Epilepsy is, above all tropical, moreover, very african in its frequency and gravity. Data on the prevalence of epilepsy shows it to be two or three times more prevalent in tropical zones than in industrialized countries in non tropical areas, however it is rare to find data on the incidence and prognosis of epilepsy in sub-Saharan Africa. It is difficult to determine the relative contribution of each of the causes of epilepsy. Only a few case-control studies have been carried out in sub-Saharan Africa. Infectious diseases, in particular parasitic diseases such as neurocysticercosis or cerebral malaria, seem to be the cause of the majority of the cases of epilepsy. However it is necessary to do additional epidemiological studies to determine the etiologies of epilepsy more precisely in sub-Saharan Africa.

[Pilot training experience in lip-reading skills for nurses in intensive care units]

In the intensive care unit (ICU) of Mestre hospital (Italy) a research was carried out to analyse the possibility to improve nurses' lip-reading skills.

METHODS

A specialized speech therapist organized a 20 hour training course for 34 health workers in ICU.

RESULTS

The participants had a lip-reading test at the beginning and at the end of the course and six months later. The final test revealed that participants could recognize a greater number of typical words in ICU in comparison to the initial test. Yet, after 6 months the skill decreased to the level shown at the beginning of the course. On the other hand, the trend shows that some participants' skill did not decrease. Neither the starting level nor intermediate stage are conditioned by sex, age, profession, and experience. In order to measure clinic efficacy, the participants had another test to understand if improved lip-reading skill could influence the following variables: word comprehension, nurse attitude to communication toward non-speaking people, patient emotional status and nurse emotional status. The training course seems to have had good effects on nurses' attitudes towards their patients and on their communication. Yet, study results do not show if increased lip-reading skills have real positive effects on ICU communication and whether this method is better than usual communication methods (e.g. mimic or alphabetic board).

[Gas in hepatic veins associated with tunneled femoral hemodialysis catheter]

We report the case of a female patient admitted for acute renal failure who required hemodialysis treatment using a tunneled femoral catheter. Abdominal ultrasound showed isolated gas in the hepatic veins. It was related to manipulation of the catheter, which allowed the passage of gas bubbles from the inferior vena cava into the hepatic veins.

Molecular phylogeny and taxonomic revision of Chlamydomonas (Chlorophyta). I. Emendation of Chlamydomonas Ehrenberg and Chloromonas Gobi, and description of Oogamochlamys gen. nov. and Lobochlamys gen. nov

The genus Chlamydomonas (including Chloromonas) is one of the largest green algal genera comprising more than 600 species. To initiate a comprehensive analysis of the phylogeny and systematics of the genus, we determined nuclear-encoded SSU rRNA sequences from 32 strains of Chlamydomonas, Chloromonas and Chlorogonium with emphasis on oogamous taxa and related strains, and incorporated these into global molecular phylogenetic analyses of 132 strains of Chlorophyceae. In addition, we studied the morphology and reproduction of oogamous and related strains by light microscopy. We recognize and designate 18 monophyletic lineages (clades) within the Chlorophyceae, 11 of which are confined to the CW (basal bodies displaced clockwise) subgroup. The majority of clades recognized within the Chlorophyceae do not correspond to any of the traditional classification systems, which are still largely based on the organization level. Strains assigned to Chlamydomonas and Chloromonas were found in seven different clades confirming the polyphyly of the two genera as presently conceived. To initiate the taxonomic revision of Chlamydomonas, C. reinhardtii is proposed as the conserved type of the genus. In consequence, species in clades other than the clade containing C. reinhardtii must be transferred to other genera, a process initiated in this contribution. The oogamous strains studied represent a monophyletic lineage, which is described as Oogamochlamys gen. nov. comprising three species (O. gigantea, O. zimbabwiensis and O. ettlii spec. nov.). The sister clade to Oogamochlamys consists of isogamous strains characterized by chloroplasts with incisions and is described as Lobochlamys gen. nov. with two species (L. culleus and L. segnis). Another clade is characterized by asteroid or perforated, parietal chloroplasts and contains the type species of Chloromonas (C. reticulata). Thus, the polyphyletic Chloromonas (traditionally defined as "Chlamydomonas without pyrenoids") can be legitimized as a monophyletic genus by restriction to this clade and is here emended on the basis of chloroplast characters (the clade contains strains with or without pyrenoids thus rejecting the character "absence of pyrenoids").

Mesostigmatophyceae, a new class of streptophyte green algae revealed by SSU rRNA sequence comparisons

Complete nuclear-encoded SSU rRNA sequences have been obtained from three taxa of streptophyte green algae (Klebsormidium nitens, Nitella capillaris, Chaetosphaeridium globosum) and two strains of the scaly green flagellate Mesostigma viride. Phylogenetic analyses of 70 taxa of Viridiplantae (Chlorophyta and Streptophyta) and 57 taxa of streptophyte green algae and embryophyte plants using distance, parsimony and likelihood methods revealed a novel monophyletic lineage among the Streptophyta comprising the genera Mesostigma and Chaetosphaeridium. This lineage is described here as the Mesostigmatophyceae classis nova. Our analyses demonstrate that (1) scaly green flagellates (prasinophytes) are polyphyletic, (2) a scaly green flagellate is a member of the Streptophyta and forms a clade with the oogamous, filamentous Chaetosphaeridium to the exclusion of all other known streptophyte green algae, (3) a previously published SSU rRNA sequence of Chaetosphaeridium (AF113506) is chimeric and contains part of a fungal SSU rRNA, and (4) the phylogenetic relationships between the Mesostigmatophyceae and other streptophyte green algae remain unresolved by SSU rRNA sequence comparisons.

Phage typing, an accessible and useful method in the epidemiological surveillance of diphtheria

Within the framework of the measures for diphtheria prevention and control, phage typing of isolates is useful for epidemiological investigations in a disease focus and in general population. The identification of asymptomatic carriers of toxigenic C.diphtheriae and its eradication decrease the transmission rate of the disease. The study of the circulating phage types (6058) enabled us to demonstrate the frequency and distribution of the different phage types, toxigenic and nontoxigenic in Romania. With the current knowledge of the circulating phage types it can be concluded that imported cases of diphtheria have not occurred so far. The Romanian phage typing schemes are able to type isolates from overseas, sometimes through phage adaptation methods. Our phage typing schemes are also able to demonstrate any modifications in the phage sensitivity patterns of diphtheria.

Circadian rhythms of plasma corticosterone at different times after induction of diabetes. Responses to corticoadrenal stimulation in light and dark phases

In this study we have tried to determine the effects of streptozotocin-induced (50 mg/kg) diabetes (15 and 30 day duration) on circadian rhythms of plasma corticosterone concentrations and on the responsiveness of the adrenal glands to exogenously administered ACTH at the time of maximum and minimum levels of plasma corticosterone. Rats were kept under controlled lighting 12h light/12h dark (12L/12D) and fed ad libitum. The corticosteroid circadian pattern in control (C) rats is characterized as one in which peak corticosterone concentrations occur at the beginning of the dark phase (activity period), with a decrease over the remainder of the 24h period. Circadian rhythmicity of plasma corticosterone concentration was absent in the diabetic rats 15 days after induction (D15 rats), with higher mean levels than the C. However, in the diabetic rats 30 days after induction (D30 rats) there is a recovery of this rhythm with similar acrophase and amplitude to the C rats. One hour after stimulation by ACTH (5 IU/kg) at the time of maximum and minimum levels of plasma corticosterone, the C rats showed similar plasma corticosterone levels. In the D15 rats, levels of corticosterone in the light phase one hour after ACTH administration were higher than in the dark phase; being lower than C in this phase. The loss of capacity to respond during the dark phase may be due to adrenal blunting in this phase with high levels of plasma corticosterone. In D30 rats, there is a more noticeable loss of capacity for adrenal response in the light than in the dark phase, with values lower than C and D15 rats in both phases. These findings suggest that the duration of diabetes has a significant role in both plasma corticosterone rhythms and adrenal sensitivity to ACTH administration.

[Treatises on social hygiene (1784-1797) by Filippo Baldini, physician at the court of Naples: medical culture and service to the king]

The career of Filippo Baldini, physician at the Neapolitan court, demonstrates the development of prophylaxis and public hygiene throughout the eighteenth-century. It gives one an opportunity to observe the deep connections between medicine and the contemporaneous governmental policy.

Prevalence and correlates of herpes simplex infections. The population-based AIDS in Multiethnic Neighborhoods Study

OBJECTIVE

To examine the extent and correlates of infection with herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in an inner-city community, we studied the prevalence of antibodies to these viruses and their association with risk behaviors in a representative sample of unmarried white, black, and Hispanic adults living in San Francisco, Calif.

DESIGN

Cross-sectional, community-based, random household survey.

PARTICIPANTS

In 1988 and 1989, we surveyed 1770 unmarried men and women aged 20 to 44 years from three San Francisco neighborhoods of varying geographic and cultural characteristics.

MAIN OUTCOME MEASURES

HSV-1 and HSV-2 antibodies based on an immunodot assay using type-specific glycoproteins gG-1 and gG-2.

RESULTS

Of blood samples from 1212 participants available for testing, 750 (62%) had HSV-1 antibodies and 400 (33%) had HSV-2 antibodies. After controlling for other variables, HSV-1 antibody was significantly correlated (P less than .05) with older age (in heterosexual men, women, and homosexually active men), less education (in heterosexual men and women), and Hispanic (especially those not born in the United States) or black race. HSV-2 antibody was significantly correlated (P less than .05) with female gender, number of lifetime sexual partners and older age (in heterosexual men and women), and low levels of education and black or Hispanic race (in women). Among those with antibody to HSV-2, only 28 (19%) of 149 men and 32 (13%) of 251 women reported a history of genital herpes. However, most men (62%) and women (84%) who reported a history of genital herpes had HSV-2 antibodies. We observed a similar pattern (low sensitivity and moderate specificity) for a history of facial herpes and the presence of HSV-1 antibodies. After controlling for other variables, HSV-2 antibodies were associated with a lower frequency of HSV-1 antibodies among homosexual men infected with the human immunodeficiency virus.

CONCLUSIONS

HSV-1 antibodies were found in nearly two thirds of single urban adults and were most common among Hispanics not born in the United States. HSV-2 antibodies were found in one third of this population and were associated with risk behaviors for sexually transmitted diseases. For both facial and genital herpes infections, self-reporting of infection was very insensitive and moderately specific.

Risk for AIDS in multiethnic neighborhoods in San Francisco, California. The population-based AMEN Study

To examine the actual and potential spread of human immunodeficiency virus (HIV) from an acquired immunodeficiency syndrome (AIDS) epicenter to surrounding neighborhoods, we studied the prevalence of the viral infection and AIDS risk behaviors from 1988 to 1989 in a representative sample of unmarried whites, African Americans, and Hispanics living in San Francisco. We surveyed 1,770 single men and women aged 20 to 44 years (a 64% response rate) in a random household sample drawn from 3 neighborhoods of varying geographic and cultural proximity to the Castro District where the San Francisco epidemic began. Of 1,369 with blood tests, 69 (5%) had HIV antibodies; all but 5 of these reported either homosexual activity (32% HIV-positive; 95% confidence interval [CI] = 23%, 41%), injection drug use (5% HIV-positive; CI = 1%, 14%), or both (59% HIV-positive; CI 42%, 74%). Homosexual activity was more common among white men than among African-American or Hispanic men, but the proportion of those infected was similar in the 3 races. Both the prevalence of homosexually active men and the proportion infected were much lower in the 2 more outlying neighborhoods. Risk behaviors in the past year for acquiring HIV heterosexually--sex with an HIV-infected person or homosexually active man or injection drug user, unprotected sexual intercourse with more than 4 partners, and (as a proxy) having a sexually transmitted disease--were assessed in 1,573 neighborhood residents who were themselves neither homosexually active men nor injection drug users. The prevalence of reporting at least 1 of these risk behaviors was 12% overall, and race-gender estimates ranged from 5% among Hispanic women to 21% among white women. We conclude that in San Francisco, infection with HIV is rare among people who are neither homosexually active nor injection drug users, but the potential for the use spread of infection is substantial, as 12% of this group reported important risk behaviors for acquiring the virus heterosexually.

Growth and rosmarinic acid production in cell suspension cultures of Salvia officinalis L

Rosmarinic acid (RA) is a natural antioxidant produced by cell suspension cultures of sage (Salvia officinalis L.). The growth and production of RA by these cells can be modified by the type of culture medium. Production can be increased 10-fold to attain 6.4 g.1(-1) under optimal conditions. Investigation of kinetics showed that a change in the medium caused shifts in peaks of growth and production, and modifications of the cell metabolism. RA production can be correlated with growth or begins only when growth has stopped.

Condom use in multi-ethnic neighborhoods of San Francisco: the population-based AMEN (AIDS in Multi-Ethnic Neighborhoods) Study

We examined the prevalence and correlates of condom use in a community-based sample of unmarried heterosexual and gay/bisexual Whites, Blacks, and Hispanics (aged 20 to 44 years) in San Francisco (n = 1229). Only 9% of heterosexual males reported always using condoms, and fewer of those with multiple sexual partners (6%) reported always using condoms compared with those in monogamous relationships (12%). Much higher proportions of gay/bisexual men reported always using condoms (48%). Racial differences in condom use were observed only among women. Sexual communication and the sexual enjoyment value of condoms were consistent correlates of condom use across gender and sexual orientation, while other condom-related beliefs were significant predictors of condom use only for men. In general, condom promotion programs should build sexual communication skills, teach people how to enhance enjoyment with condoms, and reduce psychological barriers to condom acquisition and use.

Effect of alcohol treatment on sexual behaviour of male rats

The effect of chronic alcohol treatment on sexual parameters of the male rats was studied. The results showed that the ingestion of cognac leads to significant alterations in the sexual behaviour of the male rat. Sexual parameters indicated that sexual behaviour is drastically affected by cognac consumption. The parameters affected were the number of ejaculation; initial latency, ejaculation latencies and neuromotor activities which showed significant variation (P less than 0.01). Further, mounts without, with and total intromissions and refractory periods were significantly affected by alcohol consumption. In addition, the percentage of tests during which an ejaculation was observed was significantly reduced (P less than 0.01) in the alcohol-treated males when compared with control groups.

Insulin stimulation of water intake in humans

Drinking response to the intravenous administration of insulin (0.1 U/kg) was studied in 15 volunteers (eight males and seven females). Water intake was significantly higher after insulin than after saline administration during the 90-min period studied. Plasma glucose decreased significantly in individuals receiving insulin and the time of the maximum decrease (30 min) was concurrent with the beginning of water intake. Haematocrit values in the insulin-treated group were also significantly higher at that time. Plasma renin activity (PRA) after insulin administration was higher than under basal conditions or after saline injection. On the other hand, psychological responses indicated that insulin probably elicits thirst prior to the hunger which appears with hypoglycaemia. A possible role of endogenous insulin in meal-related thirst is hypothesized.

Normalization of the altered liver function tests after islet transplantation in diabetic rats

The purpose of our study was to determine if streptozotocin induced diabetes (SID) in rats produces alterations in hepatic function, as described in poorly controlled diabetic patients, and if islet transplantation (islet-Tx) would subsequently ameliorate this status. Hepatocellular dysfunction was evaluated by the aspartate aminotransferase (SGOT) and the alanine aminotransferase (SGPT) activities in plasma. For the evaluation of cholestasis the plasma alkaline phosphatase (APase) activity was used. These determinations were performed in normal, SID, SID with Islet-Tx, and SID Wistar rats with sham-Tx. Also, glucose was measured in plasma samples, as well as histological studies of the liver were performed. More than 1,000 isogeneic islets (islet-Tx group) or non viable insular tissue (sham-Tx group) were transplanted via mesenteric ileal vein three weeks after SID. The results showed that SID in rats produces alterations in the hepatic function as well as in the structure of the hepatocytes, and the normalization of carbohydrate metabolism by islet transplantation restores normal hepatic function and morphology.

Islet transplantation restores normal serum amylase levels in diabetic rats

Diabetes is associated with a diminution in exocrine pancreatic function. The goal of our study was to investigate whether the altered exocrine pancreatic function of streptozotocin-induced diabetic rats could be ameliorated by islet transplantation. Diabetic rats received either more than 1,000 syngeneic islets intraportally (islet transplantation group) or pancreatic, nonviable insular tissue (sham transplantation group). Plasma amylase and insulin levels in diabetic rats were significantly lower than in normal rats. The exocrine pancreas of streptozotocin-induced diabetic rats showed alterations (decrease of zymogen granules, diminution of endoplasmic reticulum, clusters of ribosomes without organization) in the structure of acinar cells at the electron microscopic level. After islet transplantation, plasma glucose levels were restored to normal values, and those of amylase and insulin gradually increased to normal values. A positive correlation between plasma levels of amylase and insulin was found. Three months after islet transplantation, the islet-transplanted rats did not show morphologic alterations of the acinar cells which were still found in the sham-transplanted rats. It is concluded that alterations of exocrine pancreas in streptozotocin-induced diabetic rats are ameliorated by islet transplantation.