Stylosanthes cv. Campo Grande silage and concentrate levels in diets for beef cattle

The objective of this study was to evaluate the ruminal and intestinal digestion, the ruminal fermentation and the performance of beef cattle fed diets containing Stylosanthes silage (StS) and corn silage (CS). The treatments consisted of diets containing StS with different concentrate levels, based on dry matter (DM) (g/kg): 200 (StS-200), 400 (StS-400), 60 (StS-600), and a Control treatment with 600 g/kg CS and 400 g/kg concentrate (CS-400). In Experiment 1, 32 Nellore bulls, 364.28 ± 2.82 kg bodyweight, were distributed in a complete randomised design with eight replicates. Four Holstein × Zebu bulls (average bodyweight of 429 ± 15 kg) were used in Experiment 2, distributed in a 4 × 4 Latin square design. Nutrient intake was similar between StS-400 and CS-400 (P > 0.05), however, only StS-600 showed the same intake of total digestible nutrients as CS-400 (P < 0.05). Only the animals fed the StS-600 diet had similar (P > 0.05) average daily gain of carcass in comparison with those fed the Control diet. The StS-200 and StS-400 diets showed lower (P < 0.05) total tract digestibility of DM and crude protein than CS-400 (P < 0.05). Ruminal pH values of StS-200 and SE-400 were higher (P < 0.05) than in CS-400. The StS-600 diet showed a similar productive performance to CS in diets with 600 g/kg of concentrate, highlighting the potential use of this legume in diets for beef cattle in tropical conditions.

Molluscicidal activities of six species of Bignoniaceae from north–eastern Brazil, as measured againstBiomphalaria glabrataunder laboratory conditions

The molluscicidal profile and brine-shrimp bio-activity of the ethanolic extracts of plants from the Bignoniaceae family were determined. The six extracts investigated were of the stems of Melloa quadrivalvis and Tabebuia aurea, and whole plants of Adenocalymma comosum, Arrabidaea parviflora, Cuspidaria argentea and Clytostoma binatum. When tested in the laboratory, with Biomphalaria glabrata as the test snail, all six extracts gave median lethal concentrations (9-54 microg/ml) that fell well below the upper threshold, of 100 mug/ml, set for a potential molluscicide by the World Health Organization.

Immunogenicity of a recombinant hepatitis B vaccine (Euvax-B) in haemodialysis patients and staff

Hepatitis B vaccine is the most effective strategy for preventing the transmission of hepatitis B virus (HBV) in haemodialysis centers. Nevertheless, lower vaccine responses have been reported in haemodialysis patients as compared with healthy subjects. This study examines the response to Euvax-B in Brazilian haemodialysis patients and staff. A total of 102 eligible patients (n = 42) and staff members (n = 60) consented to be studied. Patients were immunized intramuscularly with four doses of 40 microg of Euvax-B vaccine at 0, 1, 2 and 6 months. In staff members, the vaccine was administered in three doses of 20 microg at 0, 1, and 6 months. Post-vaccine samples were taken from all subjects I month after each dose. The vaccine response was determined by measuring antibody to the hepatitis B surface antigen (anti-HBs) levels using ELISA. Subjects with anti-HBs titres equal to or higher than 10 UI/L were considered immune protected. Of the haemodialysis patients who received four doses of hepatitis B vaccine, 89.5% responded to Euvax-B vaccine. The geometric mean of anti-HBs titres was 322.8 IU/L (95% CI: 317.7-328). Among staff members, 93.3% reached anti-HBs protective titres after the third vaccine dose. The geometric mean of anti-HBs titres was 2,209 IU/L (Cl: 2,198-2,219). Age, male gender and body mass index were not associated with vaccine response in either group. This study showed a good immunogenicity response to Euvax-B in haemodialysis patients and staff.

Hepatitis C prevalence and risk factors in hemodialysis patients in Central Brazil: a survey by polymerase chain reaction and serological methods

An hemodialysis population in Central Brazil was screened by polymerase chain reaction (PCR) and serological methods to assess the prevalence of hepatitis C virus (HCV) infection and to investigate associated risk factors. All hemodialysis patients (n=428) were interviewed in eight dialysis units in Goiânia city. Blood samples were collected and serum samples screened for anti-HCV antibodies by an enzyme-linked immunosorbent assay (ELISA). Positive samples were retested for confirmation with a line immunoassay (LIA). All samples were also tested for HCV RNA by the PCR. An overall prevalence of 46.7% (CI 95%: 42-51.5) was found, ranging from 20.7% (CI 95%: 8.8-38.1) to 90.4% (CI 95%: 79.9-96.4) depending on the dialysis unit. Of the 428 patients, 185 were found to be seropositive by ELISA, and 167 were confirmed positive by LIA, resulting in an anti-HCV prevalence of 39%. A total of 131 patients were HCV RNA-positive. HCV viremia was present in 63.5% of the anti-HCV-positive patients and in 10.3% of the anti-HCV-negative patients. Univariate analysis of risk factors showed that the number of previous blood transfusions, transfusion of blood before mandatory screening for anti-HCV, length of time on hemodialysis, and treatment in multiple units were associated with HCV positivity. However, multivariate analysis revealed that blood transfusion before screening for anti-HCV and length of time on hemodialysis were significantly associated with HCV infection in this population. These data suggest that nosocomial transmission may play a role in the spread of HCV in the dialysis units studied. In addition to anti-HCV screening, HCV RNA detection is necessary for the diagnosis of HCV infection in hemodialysis patients.

16α,17α-Epoxy-20-oxopregn-5-en-3β-yl acetate

The title compound, C23H32O4, has a 3beta configuration, with the epoxy O atom at 16alpha,17alpha. Rings A and C have slightly distorted chair conformations. Because of the presence of the C5=C6 double bond, ring B assumes an 8beta,9alpha-half-chair conformation slightly distorted towards an 8beta-sofa. Ring D has a conformation close to a 14alpha-envelope. The acetoxy and acetyl substituents are twisted with respect to the average molecular plane of the steroid. The conformation of the molecule is compared with that given by a quantum chemistry calculation using the RHF-AM1 (RHF = Roothaan Hartree-Fock) Hamiltonian model. Cohesion of the crystal can be attributed to van der Waals interactions and weak intermolecular C-H.O interactions, which link the molecules head-to-tail along [101].

Genotyping of group A rotavirus samples from Brazilian children by probe hybridization

The G genotyping of 74 group A rotavirus samples was done by RNA-DNA hybridization (dot-blot) using oligonucleotide probes for the VP7 gene region of the human rotavirus serotypes/genotypes 1, 2, 3 and 4. Thirty-one samples could be genotyped by dot-blot showing the following results: G1 = 16, G4 = 6, G3 = 5, and G2 = 4. The data show circulation of genotypes G1-G4 and the predominance of G1. The knowledge of genotypes provides important information concerning rotavirus circulation in Central Brazil.

Hepatitis B virus: genotypes and subtypes in Brazilian hemodialysis patients

There are no data concerning the genotypic analysis of hepatitis B virus (HBV) infection in Brazilian dialysis centers. Serum samples from all hemodialysis patients (n = 282) in Goiânia City, Central Brazil, were tested for hepatitis B surface antigen (HBsAg). An overall prevalence of 12.0% was found, ranging from 0 to 33.3% depending on dialysis centers. Positive samples (n = 34) were submitted to serological subtyping by monoclonal ELISA and HBV DNA detection by polymerase chain reaction (PCR). Among 30 PCR-positive samples, 26 were genotyped by use of the line probe assay technology (INNO-LiPA HBV, Innogenetics, Gent, Belgium). HBV genotypes A (50. 0%) and D (46.2%) were the most frequently found whereas genotype F (3.8%) was rare in this population. Serological subtypes adw2 (44. 1%) and ayw3 (41.2%) were dominant. By contrast, adw4 and ayw2 were found at a low frequency (2.9%). A correlation was observed in the distribution of genotypes and subtypes by dialysis center. Genotype D and subtype ayw3 were predominant in 2 hemodialysis centers whereas genotype A and subtype adw2 were predominant in the others. The findings of high HBsAg prevalence rates restricted to certain dialysis centers and the data obtained through genotyping and serological subtyping suggest HBV nosocomial transmission in these hemodialysis centers.

Hepatitis C virus prevalence among an immigrant community to the southern Amazon, Brazil

A community-based random survey was conducted in a southern Brazilian Amazonian county aiming to investigate hepatitis C virus (HCV) infection prevalence and the association of demographic variables and lifestyle behaviours. Seven hundred eighty individuals were serologically screened with a third generation enzyme-linked immunosorbent assay to detect anti-HCV antibodies between 1994/1995. Positive samples were retested for confirmation with a line immunoassay (LIA, Inno-LIA HCV Ab III). Most of these subjects were low income and came from southern Brazilian states (65.8). Two point four percent (IC 95% 1.2%- 4.6%) of the subjects had LIA-confirmed anti-HCV antibodies reactivity. The age-specific prevalence of HCV antibodies slightly increased with age, with the highest prevalence after the age of 40 years. The results of multivariate analysis indicate a strong association between HCV antibodies and previous surgery and history of intravenous drug use. There were no apparent association with gender, hepatitis B virus markers, blood transfusion, and sexual activity. Mean time living in Amazon did not differ between confirmed and negative anti-HCV individuals. The present data point out an intermediate endemicity of HCV infection among this immigrant community to the Amazon region and that few HCV infected participants presented known risk factors.

[Varicella: clinical aspects and prevention]

OBJECTIVE: To present, in practical form and updated terms, the clinical aspects of the varicella and its prevention using either vaccination or isolation precautions. METHOD: Review of the literature using MEDLINE and LILACS referring to the last 10 years; presentation of the most recent aspects in the literature as well as reference to the author's professional experience in the area. RESULTS: Current aspects of the clinic and treatment of this disease are analyzed. The vaccine is examined in relation to the soroconversion and safety. The technique of application of the vaccine is presented, considering its indication for healthy children, adults, seniors and high risk patients. Among these, we consider those with leukemia, solid tumors, nephrotic syndrome, AIDS, and those transplanted. The application of the vaccine is analyzed in relation to contacts, personal in the health area and people in closed communities. Precautions, contraindication, production and types of vaccines are analyzed. The association and combination of vaccines, as well as their current indications are carefully discussed. As a nosocomial infection, varicella requires much attention due to its very easy dissemination. Recommended procedures are indicated for both hospitalized and contact cases of varicella or zoster. CONCLUSIONS: The appropriate knowledge of the clinic, treatment and preventive procedures in cases of varicella is mostly important for the pediatrician, especially with the introduction of its vaccine in our country.

Hepatitis B virus infection profile in central Brazilian hemodialysis population

Hepatitis B has proved to be a major health hazard in hemodialysis patients. In order to investigate the hepatitis B virus (HBV) infection profile in the hemodialysis population of Goiânia city--Central Brazil, all dialysis patients (N = 282) were studied. The prevalence of any HBV marker (HBsAg, anti-HBs, and anti-HBc) was 56.7% (95% CI: 51.1-62.7), ranging from 33.3% to 77.7% depending on dialysis unit. HBV-DNA was detected in 67.6% and 88.2% of the HBsAg-positive serum samples, in 91.3% and 100% of the HBsAg/HBeAg-positive samples, and in 18.2% and 63.6% of the HBsAg/anti-HBe-reactive sera by hybridization and PCR, respectively. The length of time on hemodialysis was significantly associated with HBV seropositivity. Only 10% of the patients reported received hepatitis B vaccination. The findings of a high HBV infection prevalence in this population and the increased risk for HBV infection on long-term hemodialysis suggest the environmental transmission, emphasizing the urgent need to evaluate strategies of control and prevention followed in these units.

[Seroepidemiology for the hepatitis B virus (HBV) in pregnant women/parturients and its transmission to newborns in Goiânia, GO]

In order to detect hepatitis B virus (HBV), 1459 serum samples from pregnant/parturient women were collected at two public hospitals in Goiânia, GO. These samples were tested by enzyme linked immunosorbent assay for HBsAg and anti-HBs. 109 (7.5%) serum samples were positive. Eight (0.5%) sera were positive for HBsAg and 101 (7.0%) for anti-HBs. Viral positivity for both HBsAg and anti-HBs were observed in women which age ranged from 15 to 30 years. Four newborns from HBsAg positive mothers were submitted to the treatment with HBV vaccine (Engerix B) and with hyperimmune gammaglobulin (HBIG, Abbott Laboratories, Brazil). Cord blood from one of the newborns was positive for HBsAg. A positive association was found between hepatitis B and sexually transmitted infections and blood transfusion. These results emphasize the need for prenatal screening for HBV in pregnant women and treatment of the newborns from AgHBs-positive mothers.

Short report: prevalence of hepatitis C viral antibody among Brazilian children, adolescents, and street youths

The prevalence of hepatitis C antibodies (anti-HCV) was investigated in 1,378 central Brazilian children, students, and street youths (homeless adolescents without family links or adolescents working in poorly paid activities). Sera were tested with a second generation enzyme-linked immunosorbent assay, and positive samples were retested by a confirmatory assay (line immunoassay). All children attending day care centers were anti-HCV negative. Only one (0.2%) adolescent was positive in the student group. However, higher positivity was found in street youths; four (1.0%) living at home and three (3.0%) living in the streets and anti-HCV antibodies. Among these, the prevalence of anti-HCV increased significantly with age from 0% in the 9-12-year-old group to 6.9% in the 17-20-year-old group. Risk factors including blood transfusion, tattooing, intravenous drug use, and sexual intercourse with multiple partners were significantly associated with the presence of anti-HCV in street youths. These results indicate that apparently healthy children and adolescents attending day care centers or primary schools in central Brazil have a low exposure to HCV infection, but street youths in the same area are at risk for infection with this virus.

Risk factors and prevalence of antibodies against hepatitis A virus (HAV) in children from day-care centers, in Goiania, Brazil

A seroepidemiologic survey about hepatitis A virus (HAV) infection was carried out in a group comprising 310 children, ranging in age from 3 months to 9 years, from day-care centers, in Goiania, a middle sized city in the central region of Brazil. The biomarkers employed in the investigation of previous infection include total IgG and IgM anti-HAV antibodies, and for the detection of more recent infection, IgM anti-HAV antibodies were analyzed. The study was performed in 1991 and 1992. According to the results, 69.7% of the children presented total IgG/IgM anti-HAV antibodies, with 60% of the group in the age range of 1 to 3 years. Among 10 day-care centers analyzed, the prevalence of the biomarker IgM anti-HAV was 3.2%, with an uniform distribution of the cases in the group of children ranging in age from 1 to 4 years. Multivariate analysis was performed to investigate the sociodemographic factors that could influence the results. It was verified that the risk for the infection increased with the length of the attendance in the day-care centers, i.e., the risk for children with attendance of one year or more was 4.7 times higher, when compared with children with one month attendance (CI 95% 2.3-9.9). According to the results, hepatitis A is an endemic infection in day-care centers in the study area. The length of attendance in the day-care settings was demonstrated to be a risk factor for the HAV infection. Such findings suggest that if hepatitis A vaccination becomes available as a routine policy in our region, the target group should be children under one year. Moreover, those children should receive the vaccine before they start to attend the day-care centers.

[Seroepidemiology of hepatitis A virus infection in street children of Goiânia-Goiás]

A cross-sectional study was performed to determine the age-prevalence of hepatitis A virus (HAV) among street youth from Goiania city--Central Brazil, and to determine if any risk factors could be identified. The surveys were conducted between 1991/1992. The street youth were 397 individuals aged 7 to 21 years old living in institutions and teenagers working at streets. Then, 313 adolescents working at streets and with family links, and 84 institutionalized ones without family were screened for antibodies against HAV. Prevalences ranged from 80.0% to 92.2% to total anti-HAV and there was not a statistically significant trend of positivity with age in this group. Univariate analysis for risk factors associated with HAV infection was performed with no statistically significant difference for adolescents working at streets and living with parents, and street youth with family links. Economic variables were not statistically associated with seropositivity, probable due to homogeneous characteristics of the group. This study disclosed that street youth have a high rate of HAV infection. These findings do not suggest differences between subgroups of populations in acquiring immunity to HVA. The public health implication and the need of screening other subgroups of population of the same city were suggested in order to discuss vaccine strategy in underdeveloped countries.

Anti-HCV related to HCV PCR and risk factors analysis in a blood donor population of central Brazil

Data concerning HCV infection in Central Brazil are rare. Upon testing 2,350 voluntary blood donors from this region, we found anti-HCV prevalence rates of 2.2% by a second generation ELISA and 1.4% after confirmation by a line immunoassay. Antibodies against core, NS4, and NS5 antigens of HCV were detected in 81.8%, 72.7%, and 57.5%, respectively, of the positive samples in the line immunoassay. HCV viremia was present in 76.6% of the anti-HCV-positive blood donors. A relation was observed between PCR positivity and serum reactivity in recognizing different HCV antigens in the line immunoassay. The majority of the positive donors had history of previous parenteral exposure. While the combination of ALT > 50 IU/l and anti-HBc positivity do not appear to be good surrogate markers for HCV infection, the use of both ALT anti-HCV tests is indicated in the screening of Brazilian blood donors.

[Haemophilus influenzae type b infections and its prevention by vaccines]

Haemophilus influenzae type b (Hib) infections and its prevention by vaccines are reviewed. Its prevalence is underestimated, due to technical pitfalls in the laboratory and to the difficulties of diagnosing respiratory infections, chiefly pneumonia. Taking into account all infections (respiratory, meningitis and others), Hib is probably the most important pathogen, compared to S. pneumoniae and N. meningitidis. The incidence of Hib meningitis in Brazil is presented and risk factors are discussed, as well as the preventive alternatives. The different Hib vaccines are analyzed and schedules of immunization with two of them (PRP-T and HbOC) are presented. Possible eradication of Hib diseases is discussed.

[Serologic screening for hepatitis B in health professionals in the city of Goiânia-Goiás]

Markers for hepatitis B virus in health care workers were analysed in 625 employees of three institutions in Goiânia city. The virus prevalence was 23.4% related to different markers (AgHBs, anit-HBs and anti-HBc). Among the positive individuals, 1.3% presented acute infection, 1.0% were virus carriers and 21.1% presented only anti-HBs and 32.6% only anti-HBc as markers. There were 19 reports of virus vaccination. Eight of them seroconverted for anti-HBs and 6 were positive for both anti-HBc and anti-HBs. Higher prevalence rates were found above 30 year of age (p < 0.05). The male and female prevalence rates were 29.5% and 21.1% (p < 0.05) respectively. The virus prevalence rates among blood and patient contacts were 25.9% (p < 0.05) and the highest prevalence was found in persons followed up for at least ten years (p < 0.05). The greatest risk section has shown to be hemodialysis unit personnel with a percentual of 77% (p < 0.05).

Quality assurance of a diarrhoea control programme in northeastern Brazil

In this study quality assurance methods were used in an evaluation of a programme for Control of Diarrhoeal Diseases (CDD) in northeastern Brazil. Seventy-eight randomly selected public primary care facilities in four states were assessed by trained surveyors. Problems observed in the facilities were lack of information on target population and coverage, lack of equipment to permit rehydration in the premises, and frequent unavailability of trained professionals. Health workers showed deficiencies in history taking, physical examination and knowledge on diarrhoea management. Many caretakers had difficulties in recalling information given to them in the health facilities. Eighty-four percent of the cases were treated with oral rehydration, but 90% were sent home immediately and not kept in the facilities to practice rehydration under guidance as recommended by the national CDD programme. An overuse of the medical treatment was observed. More than two-thirds of health professionals gave wrong indications for use of antibiotics. The study showed that oral rehydration therapy is well established in the government health services in the region but that the CDD programme needs to take early action to correct deficiencies in logistics, case management and health education.

[Rotavirus and adenovirus in 0- to 5-year-old children hospitalized with or without gastroenteritis in Goiâna, GO, Brazil]

In order to detect rotavirus and adenovirus 557 feces samples from hospitalized children (0-5 years of age) were analysed from June 1987 to July 1990 in Goiânia city. Two hundred and ninety one samples were from children with diarrhoea and 266 were from children without diarrhoea. Amongst this later group, 64 samples were from children from the nursery. Two hundred and sixty one out of 557 samples were analysed by immunoelectron microscopy (IEM), polyacrylamide gel electrophoresis (SDS-PAGE) and enzymatic immunoassay for rotavirus and adenovirus (EIARA) whereas the rest (296 samples) were analysed by SDS-PAGE and EIARA. Positivity of rotavirus and adenovirus was 17.2% and 2.1% respectively. Concerning rotavirus and adenovirus there was 29.2% and 2.4% positivity within the group with diarrhoea and 4.1% and 1.5% positivity amongst children without diarrhoea (p < 0.05). Rotavirus were more prevalent amongst children which age ranged from 1 to 11 months of age. No newborn child from the nursery was positive for rotavirus. Adenovirus were detected amongst children from 1 to 3 years of age. Rotavirus circulation peak occurred between May and August (p < 0.05) and no positive case was detected from December to February. Two hundred out of 291 diarrheic samples were also studied concerning bacteria and pathogenic parasites and equal percentages (17.0%) were found for both rotavirus and pathogenic bacteria. Eighty nine samples of rotavirus were detected by SDS-PAGE and 86 of these (96.6%) belonged to the subgroup II with 13 different electrophoretic patterns. Predominance of a given electrophoretic profile was observed in each year of the study.

[The occurrence of rotaviruses and adenoviruses in children up to 11 years old without diarrheal symptomatology in Goiânia, Goiás]

Three hundred and eighty-five children without a diagnosis of diarrhoeal illness had faecal specimens collected in order to detect rotavirus infection. The survey was conducted in Goiânia city--central Brazil and the children aged 0-11 years old were recruited (268 in day care centers and 117 from a local outpatient clinic--Hospital Lucio Rebelo). Detection of rotavirus was done by polyacrylamide gel electrophoresis (PAGE-SDS), and 89 specimens were also analyzed by commercial enzyme immunoassays for rotavirus and adenovirus (EIARA). Rotaviruses and adenoviruses were only detected among the children attending the outpatient clinic. Prevalence rates of rotavirus and adenovirus excretion were of 1.7% and 1.6%, respectively. Both viruses were found among children from 1 to 2 years old.

Management of childhood diarrhoea at the household level: a population-based survey in north-east Brazil

The management of childhood diarrhoea at the household level was studied in a population-based survey in four states in north-east Brazil. Of a representative sample of 6524 children under 5 years of age, 982 (15.1%) had diarrhoea on the day of the interview or had had diarrhoea at some time during the previous 15 days. A total of 66% of the children were not taken for treatment, while government health services were used by 14%, private doctors by 1%, and traditional healers (rezadeiras) by 24%. Oral rehydration therapy was given to 24.3% of the children as follows: solutions of oral rehydration salts (ORS) were received by 6.8%, salt-and-sugar solutions by 14.7%, and solutions of commercial ORS brands by 4.3%. Although 95% of the caretakers knew about rehydration solutions, only 18% prepared them correctly, the most common error being the use of insufficient water. Of the rehydration solutions used, 39% had a sodium concentration that was potentially dangerous (greater than 120 mmol/l), and 8% had a sodium concentration that was very low. Of those solutions prepared using ORS, 38% had too high a sodium concentration, while 14% of the salt-and-sugar solutions prepared using either the "scoop-and-pinch" approach or a plastic spoon were too concentrated. However, potentially the most dangerous were the salt-and-sugar solutions prepared using nonstandard recipes. More than half of these had an unacceptably high sodium concentration or osmolarity.

Mill Hill strain of parainfluenza 1 virus is a potent human interferon inducer

The interferon (IFN)-inducing capacities of the widely used Cantell strain of Sendai and the Mill Hill strain of parainfluenza 1 were compared. The Mill Hill strain proved to be a more potent inducer of IFN than the Cantell strain when tested in human peripheral blood leukocytes and amniotic membrane cultures. The Mill Hill strain did not produce defective particles readily, nor did these particles appear necessary for IFN induction. The Mill Hill strain of parainfluenza 1 virus appears superior to the Cantell strain of Sendai virus for the production of natural human IFN.

[Presence of rotavirus and adenovirus in fecal samples of children with gastroenteritis, in the city of Goyania]

In an attempt to detect rotavirus and adenovirus prevalence among other enteropathogens (bacteria and parasites) in diarrhoea, three hundred fecal samples originating from children living in Goiânia city (Goiás state, Brazil) were analysed. Rotavirus was found to be the only pathogen in 47 cases, and associated with other infectious agents in 21 cases. 97.0% positive samples of rotavirus showed an electrophoretic pattern characteristic of subgroup II. Adenovirus was found in 7 cases, and associated with other microorganisms in 1 case. Three methods were applied for virological analyses: enzyme immunoassay for rotavirus and adenovirus (EIARA), polyacrylamide gel electrophoresis (PAGE) and immunoelectron microscopy (IEM). The concordance among the three methods was 92.8%, PAGE and EIARA agreed in 95.8%, and IEM and EIARA agreed in 100.0%.

[Collapse of the aortic valve in dilated myocardiopathies: echocardiographic study]

In order to clarify the early systolic partial closure (notching) of aortic valve in patients (pts) with dilated cardiomyopathy (DC), authors (AA) evaluated the M-mode echocardiograms corresponding to 41 pts with DC. Pts were separated in two groups, according to the presence of systolic notching: group A (18 pts) presenting systolic notching; group B (23 pts) in which no systolic notching was observed. For each group, the same echocardiographic parameters were evaluated related to aortic root, left atrium, left ventricule (LV), aortic valve and mitral valve. Both groups were compared statistically. Results--Group A presented a reduced motion of aortic root and greater initial maximal aortic cuspids separation. AA therefore conclude that in pts with DC the systolic notching has no eventual relation with mitral regurgitation. In this setting no conclusions about LV function can be inferred, and it is suggested that systolic notching may bear some relation with differences in the distribution of transvalvular aortic flow.

Frontofacionasal dysplasia: evidence for autosomal recessive inheritance

We report on a 2-month-old girl whose parents are first cousins. The patient has severe craniofacial anomalies characterized by: encephalocele, hypertelorism, midface hypoplasia, hypoplasia of frontal bone on the left side, malformed left eye, absent inner eyelashes, irregular S-shaped palpebral fissures, deformed nostrils, hypoplastic right nasal wing and cleft lip, and clefts of premaxilla, palate and uvula. No other malformations were observed. This association of anomalies suggests the diagnosis of frontofacionasal dysplasia. Parental consanguinity suggests autosomal recessive inheritance.

Familial occurrence of bifid femur and monodactylous ectrodactyly

Two brothers each had one normal upper limb; one had tridactylous ectrodactyly of one hand with normal forearm bones; the other had monodactyly of one hand with absent ipsilateral ulna. Both had monodactyly of the feet, absence of the tibiae, and unilateral bifurcation of the femur. A sister of the paternal grandfather was purportedly similarly affected. Since her parents and the father and paternal grandfather of the affected boys were normal, the pattern of inheritance of the trait in this family is presently unclear.