Social representations of intellectual disability; a comparison between cultures

OBJECTIVES

People with Intellectual disability consistently appear to be one of the most looked-down upon and repressed subgroups of society in many cultures. The main aim of this study was to compare social representations of intellectual disability in its various aspects between different cultures.

MATERIALS AND METHODS

The study was conducted in four different sites: Beirut-Lebanon, Algiers-Algeria, Tours-France and Namur-Belgium. Participants were asked to complete a questionnaire evaluating social representations of intellectual disability.

RESULTS

A total of 755 participants consented to take part in the study. Gender only affected social representations in the Lebanese population. Overall, Algerians appeared to have the least positive social representations and Lebanon to have more positive attitudes, while France and Belgium tended to have the most favourable representations.

DISCUSSION AND CONCLUSIONS

Findings highlight the imbalance between a European and a non-European country showing the importance of developing tailored interventions to improve general attitudes towards intellectual disability.

Anatomy of the rabbit inner ear using computed tomography and magnetic resonance imaging

Anatomically, the inner ear is a highly complex organ of intricate design, composed of a bony labyrinth that encases the same-shaped membranous labyrinth. It is difficult to study the three-dimensional anatomy of the inner ear because the relevant structures are very small and embedded within the petrous temporal bone, one of the densest bones in the body. The current study aimed to provide a detailed anatomic reference for the normal anatomy of the rabbit's inner ear. As a study model, ten healthy adults New Zealand White rabbit heads were used. Six heads were used for macroscopic evaluation of the bony and membranous labyrinths. The remaining four heads were evaluated radiographically, where 3D images were generated of the bony and membranous labyrinths using data sets from computed tomography (CT) and magnetic resonance imaging (MRI), respectively. The anatomical structures were identified and labelled according to NominaAnatomicaVeterinaria (NAV). Our study revealed that CT and MRI are the optimal cross-sectional imaging modalities for investigating such tiny and often inaccessible inner ear structures. As high-quality scanners are not readily available to veterinarians, the CT and MRI images generated by this research were of lower quality; therefore, high-quality dissections were used to identify/support structures seen in these images. In conclusion, this study provides one of the first investigations that uses multislice CT scans and MRI to study the rabbit's inner ear and its correlation with the corresponding anatomical images. Both anatomical, CT and MRI images will serve as a reference for interpreting pathologies relative to the rabbit's inner ear.

CRP relevance in clinical assessment of chronic spontaneous urticaria Tunisian patients

BACKGROUND

Chronic spontaneous urticaria (CSU) is a common dermatological condition defined by the sudden occurrence of daily wheals and pruritus for at least six weeks. Multifactorial origin is suggested such as oxidative stress. This latter may play a double role as a trigger and remnant agent.

OBJECTIVES

The first aim of this study is to investigate antioxidant status, inflammatory proteins, hematologic counts and clinical assessment in CSU patients. The second aim is to evaluate the effect of a first-line treatment: desloratadine 5 mg/d on these different parameters.

PATIENTS AND METHODS

This study enrolled 30 CSU patients and same number of controls. We assessed the urticaria activity score (UAS), total antioxidant status (TAS), glutathione S-transferase (GST), superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT), albumin, alpha1, alpha2, beta1 beta2, gamma globulins, c-reactive protein (CRP) and hematologic numeration.

RESULTS

At baseline alpha1, alpha2, beta1, beta2, gamma globulins, CRP, SOD activity, leukocytes and basophils were significantly higher in patients versus controls (p < 0.05). TAS, GST, CAT, GPx and albumin were significantly low in patients versus controls (p < 0.05). After treatment, TAS, GST and GPx were significantly increased in patients versus patients before treatment (p < 0.001). SOD, alpha1, alpha2, beta1, beta2, gamma globulins, CRP, albumin, leukocytes and basophils were significantly decreased after treatment versus before treatment (p < 0.05). A significant correlation between CRP and UAS (r = 0.3; p = 0.011) was noted. UAS assessment revealed the efficacy of 30 d-antihistaminic treatment.

CONCLUSIONS

Desloratadine exerted anti-inflammatory and antioxidant effects on CSU patients revealed by CRP. Patients' remission was synergistic to CRP attenuation emphasizing CRP relevance for CSU clinical assessment.

Characteristics of non-cerebral coenurosis in tropical goats

The epidemiological, clinical, and biochemical profile of non-cerebral coenurosis in goats and the morphological characteristics of the responsible metacestodes (cysts) were examined in a cross-sectional survey of slaughtered goats in abattoirs of the United Arab Emirates (U.A.E.) originating from Abu Dhabi and various tropical countries. The age, country of origin, and location of each cyst in the body of goats were recorded. Blood samples collected from infected and matching healthy goats were subjected to biochemical analysis. Data on the morphological characteristics of the cysts as well as the clusters, scoleces, and rostellar hooks in one cyst from each affected carcass were collected. The data collected were subjected to statistical analysis. A total of 2,284 slaughtered goats were examined and 40 goats were diagnosed as infected with non-cerebral coenurus cysts. The prevalence of non-cerebral coenurosis was 1.75% and the degree of parasite aggregation (k) was 0.003, which is indicative of overdispersion (k<1). The only abnormalities observed in the infected goats were palpation of large single cysts in thigh muscles and higher serum aspartate aminotransferase (AST) value. A total of 76 non-cerebral coenurus cysts from 14 different body locations were collected. No cysts were found in the brain or spinal cord. Cysts located in psoas muscles had on average significantly bigger volumes and higher numbers of scoleces and clusters compared to cysts located in other body parts (P-value=0.000). Significant differences in the morphometric measurements of the rostellar hooks were observed between cysts found in goats from different countries of origin (P-value<0.05) perhaps due to initial steps of allopatric speciation by geographic isolation. A significant positive correlation was found between number of scoleces and volume of cysts (b=6.37>5; R-Sq=89.4%; P-value=0.000) and between number of clusters and number of scoleces (b=25.13>1; R-Sq=79.8%; P-value=0.000) indicative of following a positive allometric growth as well as between number of clusters and volume of cysts (b=0.25<0.5; R-Sq=69.4%; P-value=0.000) indicative of following a negative allometric growth. The biological significance of the observed allometries is not known, but perhaps for evolutionary reasons the parasite is investing its resources more on the growth of scoleces, less on the growth of cyst volume, and even less on the number of clusters.

Modified technique for the exposure of the inferior alveolar nerve in rats

The inferior alveolar nerve (IAN), a branch of the mandibular division of the trigeminal nerve, is a major component of the neurovascular bundle along with the inferior alveolar artery and vein. In rats, when exposed using an external oral approach while remaining intact, it can serve as an important tool to study the different effects of neuromediators and assess the role of different groups of nerve fibers. This paper describes a new technique to expose this nerve giving some experimental results to support its usefulness.

Computed tomography and cross-sectional anatomy of the metatarsus and digits of the one-humped camel (Camelus dromedarius) and buffalo ( Bos bubalis)

The purpose of the present study was to provide a detailed computed tomography (CT) and cross-sectional anatomic reference of the normal metatarsus and digits for the camel and buffalo, as well as to compare between metatarsus and digits in these animals to outstand a basis for diagnosis of their diseases. Advantages, including depiction of detailed cross-sectional anatomy, improved contrast resolution and computer reformatting, make it a potentially valuable diagnostic technique. The hind limbs of 12 healthy adult camel and buffalo were used. Clinically relevant anatomic structures were identified and labelled at each level in the corresponding images (CT and anatomic slices). CT images were used to identify the bony and soft tissue structures of the metatarsus and digits. The knowledge of normal anatomy of the camel and buffalo metatarsus and digits would serve as initial reference to the evaluation of CT images in these species.

Comparison of two policies for induction of labour postdates

The objective of this study was to compare maternal and midwifery manpower effects of policies for induction of labour (IOL) postdates, using a retrospective cohort design, in a level two maternity unit in a district hospital in South-West England. Primary outcome measures included mode of delivery, admission-delivery interval, midwifery manpower use. Group I consisted of 124 women who underwent IOL at 40+10. Group II were 104 women who underwent IOL at 42 weeks' gestation and 123 women who laboured spontaneously between 40+10 and 42 weeks' gestation. The nulliparous women had a shorter admission-delivery interval when induction was planned for 42 weeks, compared with 40+10 (p = 0.003), and required less frequent use of syntocinon (p = 0.04) and of continuous fetal monitoring (p = 0.02). The caesarean rate was higher in Group I than in Group II (p = 0.04) for nulliparous women only. The earlier induction policy was associated with a higher midwifery manpower requirement for nulliparae (p = 0.002). For parous women, the only difference was the greater use of oxytocin in labour. There was no difference between the groups in duration of labour, analgesia, Apgar scores, admission to neonatal care and meconium aspiration. In conclusion, delaying planned induction by three days was associated with lower medicalisation of labour and manpower needs for nulliparous women.

The normal anatomical, radiographical and ultrasonographic appearance of the carpal region of one-humped camel (Camelus dromedarius)

The macroscopic, radiographic and ultrasonographic anatomy of the carpal region of eight clinically normal camels (Camelus dromedarius) was determined with the help of a 7.5-MHz linear transducer. At the dorsal aspect of the carpus and distal radius, the extensor carpi radialis, extensor digitorum communis and extensor digitorum lateralis tendons were easily identified. The ulnaris lateralis tendon was observed laterally. The extensor carpi obliqus tendon was identified with difficulty. At the palmar aspect, the flexor carpi radialis, the flexor digitorum superficialis and the flexor digitorum profundus tendons were observed. Other soft structures examined include the lateral collateral ligament and the medial collateral ligament. Ultrasonographic findings correlated with gross anatomy in the dissected limbs. The results of the present study serve as reference data for ultrasonographic investigation of disorders of camel carpus.

[Clinical, biologic and molecular characteristics of two Tunisian MPS IV A patients]

Mucopolysaccharidosis type IV A (MPS IV A) is an autosomal recessive disorder resulting from the deficient activity of the lysosomal enzyme, N-acetylgalactosamine-6-sulfate sulfatase (GALNS) and the progressive lysosomal accumulation of keratane sulfate. Clinically, the MPS IV A differs from the other MPS by the localisation of the keratane sulfate in skelet and in eyes associated to the conservation of a normal intelligence. To date, the characterization and purification of the GALNS gene made a research for pathogenic mutations in patients with MPS IV A easier. These mutations are responsible of severe, intermediate or mild phenotype. The aim for this work was the research of clinical, biologic and molecular characteristics of two Tunisian MPS IV A patients who were offsprings of consanguineous mating. Enzymatic and urinary diagnostics suggested a MPS IV A phenotype. A novel homozygous mutation IVS1+1G-A was identified by direct sequencing in the GALNS gene of the two patients. Identification of GALNS mutations provide genotype/phenotype correlations and permit the precision of anomalies responsible of Morquio A phenotype in concerned families.

Unusual presentation of 22-kilogram retroperitoneal müllerian serous cystadenoma

BACKGROUND

Müllerian cyst of the retroperitoneum is an extremely rare disease that is thought to be a subtype of urogenital cyst. It is a benign condition that can only be diagnosed and cured by surgical resection.

CASE

An 80-year-old female with a huge cystic swelling, thought to be ovarian in origin, underwent laparotomy. Surgical exploration and subsequent histopathological analysis of the cyst revealed a müllerian serous cystadenoma of the retroperitoneum, 22 kg in weight. Preoperative ultrasound scan and computed tomography failed to elucidate a correct preoperative etiology.

CONCLUSION

Huge retroperitoneal cysts may coexist with other pelvic pathology creating diagnostic and therapeutic dilemmas. The use of computed tomography for diagnosis may be not helpful with huge cysts. Good preoperative preparation and surgical technique are essential for managing these cases.

[Detection of EBV by PCR in fresh and paraffin embedded samples of cavum tumour]

The nasopharyngeal carcinoma (NPC) is frequent in Tunisia. It's the second ORL cancer of men after the larynx one. To analyse the NPC characteristics in our population, we determined the frequency of EBV infection in 47 paraffin-embedded and 6 fresh NPC biopsies. We first extracted the DNA from tumoral tissus and then amplified viral sequences by PCR to detect and to type the infecting virus (EBV-A or ABV-B). Our results showed that amplifiable DNA has been obtained from 34/47 paraffin-embedded NPC biopsies while 13/47 of the others biopsies contained degraded and not amplifiable DNA. All the fresh biopsies allowed to obtain DNA with good quality. The EBV infection frequency in paraffin-embedded NPC biopsies is 35% while EBV is detected in all fresh biopsies (6/6). Our analyse also showed that the EBV-A is predominant in our population compared to EBV-B as it was shown in most countries of the world. This study clearly shows that PCR results obtained with paraffin-embedded NPC biopsies are divergeant from those obtained with fresh biopsies. Because of DNA degradation in paraffin-embedded NPC biopsies, the biology molecular results from that kind of samples is criticable. Moreover the results obtained from fresh NPC biopsies confirmed the quasi-constant association of EBV with undifferenciated carcinoma nasopharyngeal type.

Tramadol encapsulated into polyhydroxybutyrate microspheres: in vitro release and epidural analgesic effect in rats

BACKGROUND

Controlled release techniques are used to increase the duration of action and decrease the toxicity of drugs. Any controlled release form of tramadol in spinal or epidural blocks has not been studied previously. Tramadol was encapsulated into polyhydroxybutyrate (PHB) microspheres and release kinetics was studied. The epidural analgesic effect of this solution in rats was also compared with free tramadol.

METHODS

Controlled release of tramadol from PHB microspheres into 10 ml of phosphate buffer solution at pH 7.4 and 37 degrees C was studied in vitro. In vivo studies were performed in 40 rats. Epidural catheters were placed during general anaesthesia. Rats were randomly allocated into one of the four study groups to receive normal saline, 4 mg of tramadol, PHB microspheres without tramadol, or 4 mg of tramadol encapsulated into PHB microspheres. Analgesia was evaluated with tail flick tests performed at 52.5 +/- 0.5 degrees C before injection and at intervals up to 30 h after injection. Catalepsy and loss of corneal reflexes were considered as signs of supraspinal toxicity.

RESULTS

In vitro drug release was observed for more than 6 days. Epidural analgesic effects of tramadol released from PHB microspheres were observed for 21 h, whereas an equal dose of free tramadol was effective for less than 5 h. No signs of toxicity were observed.

CONCLUSION

Controlled release of tramadol from PHB microspheres is possible, and pain relief during epidural analgesia is prolonged by this drug formulation compared with free tramadol.

Poor response to ovulation induction is a stronger predictor of early menopause than elevated basal FSH: a life table analysis

BACKGROUND

During the course of assisted reproduction treatment, a number of women exhibit a "poor response" to ovulation induction, or demonstrate an elevated basal FSH level (> or =10 IU/l) at a young age. We sought to determine whether these women are at increased risk of early menopause and poor reproductive performance.

METHODS

A retrospective cohort study included 118 "poor responders" with normal basal FSH level (<10 IU/l), 164 women with raised basal FSH (> or =10 IU/l), and 265 controls, who underwent assisted reproduction treatment between 1987 and 1998. All women were < 40 years of age at the time of treatment and had normal menstrual cycles. Participants were sent a postal questionnaire in 2000-2001, seeking information on ovarian function and reproductive performance following cessation of treatment.

RESULTS

After adjusting for age and smoking habits, women with poor response and raised basal FSH levels were more likely to experience symptoms of the peri-menopause [hazard ratios 2.4, 95% confidence interval (CI) 1.52-3.78, and 2.76, 95% CI 1.78-4.29 respectively, P = 0.0001]. Poor responders were six times and 23 times more likely to experience the menopause within 10 years of treatment than those with raised basal FSH levels and controls respectively (hazard ratio 5.97 and 23.9, P = 0.015 and 0.002 respectively). Poor responders and those with raised basal FSH levels have half the chance of spontaneous conception after discontinuation of treatment compared with controls (P < 0.007).

CONCLUSIONS

Both poor response to ovarian stimulation and raised basal FSH are markers of reduced ovarian reserve and predict an increased risk of early menopause.

The morphology of the iridocorneal angle in the eye of buffaloes (Bos bubalis): a light and scanning electron microscopic study

The morphology of the iridocorneal angle in the eye of the buffalo (Bos bubalis) was studied in eighteen eyes using light and scanning electron microscope (SEM). The buffalo iridocorneal angle included the pectinate ligament, the ciliary cleft, the trabecular meshwork (uveal and corneoscleral) and the angular aqueous plexus. The pectinate ligament was prominent anteriorly and appeared as strong, thick compact structure. The strands of the pectinate ligament were short and had narrow spaces between them as observed by SEM. The ciliary cleft appeared quadrilateral and contained large amount of trabecular tissue that could be divided into two parts, the uveal part and the corneoscleral part. The uveal meshwork was the internal part of the trabecular meshwork. It occupied wide area in the anterior region and narrow area in the posterior one. It composed of thick-pigmented trabeculae in the anterior part, which became thin and loose in the posterior part. Their intertrabecular spaces were large and wide anteriorly. The corneoscleral meshwork was the external part of the trabecular meshwork. It was narrow anteriorly and widened posteriorly. Their trabeculae were non-pigmented and closely arranged and the intertrabecular spaces were small. The angular aqueous plexus consisted of four to five veins. They were located between the outer border of the corneoscleral meshwork and the inner border of the sclera. These results of the iridocorneal angle suggest important implications for understanding the glaucoma disease in buffaloes.

[How I treat...persistent atrial fibrillation, by internal cardioversion, in a patient with exreme obesity]

An ethylic hypertensive patient with a BMI of 51.4 developed persistent atrial fibrillation with high ventricular rates. External electrical cardioversion was attempted, but failed in spite of high energy shocks (350 joules). Sinus rhythm was restored by internal cardioversion (12 joules). The value and indications of the techniques are briefly discussed.

Human serum albumin chromatography by Cibacron Blue F3GA-derived microporous polyamide hollow-fiber affinity membranes

An affinity dye ligand, Cibacron Blue F3GA was covalently attached onto commercially available microporous polyamide hollow-fibre membranes for human serum albumin (HSA) adsorption from both aqueous solutions and human plasma. Different amounts of Cibacron Blue F3GA were incorporated on the polyamide hollow-fibres by changing the dye attachment conditions, i.e. initial dye concentration, addition of sodium carbonate and sodium chloride. The maximum amount of Cibacron Blue F3GA attachment was obtained at 42.5 micromol g(-1) when the hollow-fibres were treated with 3 M HCI for 30 min before performing the dye attachment. HSA adsorption onto unmodified and Cibacron Blue F3GA-derived polyamide hollow-fibre membranes was investigated batchwise. The non-specific adsorption of HSA was very low (6.0 mg g(-1) hollow-fibre). Cibacron Blue F3GA attachment onto the hollow-fibres significantly increased the HSA adsorption (147 mg g(-1) hollow-fibre). The maximum HSA adsorption was observed at pH 5.0. Higher HSA adsorption was observed from human plasma (230 mg HSA g(-1) hollow-fibre). Desorption of HSA from Cibacron Blue F3GA derived hollow-fibres was obtained using 0. 1 M Tris-HCl buffer containing 0.5 M NaSCN or 1.0 M NaCl. High desorption ratios (up to 98% of the adsorbed HSA) were observed. It was possible to reuse Cibacron Blue F3GA derived polyamide hollow-fibre without significant decreases in the adsorption capacities.

Heterophil/lymphocyte ratio as a selection criterion for heat resistance in domestic fowls

1. Two experiments were conducted to examine the Heterophil/Lymphocyte ratio (H/L) as criterion for selection for resistance to heat stress and some aspects of general resistance in domestic fowls. 2. The first experiment on a small sample (n = 64) of light breed Iraqi local fowls showed that this ratio could be used as an indicator of heat stress resistance. 3. The second experiment on a large sample (n = 1160) of heavy parent stock confirmed the results. It showed that there was a different H/L ratio for the two strains and that there was much individual variability in the H/L ratio within-strain that could be utilised for individual selection for heat resistance. 4. The H/L ratio was highly heritable; Resistant and Sensitive groups, defining all individuals with an H/L ratio over the upper 95% confidence limit as 'Sensitive' and those below as 'Resistant' produced progeny with significantly different H/L ratios. 5. There were indications of differences in mortality between the progeny of the Resistant and the Sensitive groups. 6. The H/L indicator could be used as a criterion to select for heat stress resistance.

Evaluation of the effects of molsidomine by cardiac equilibrium blood pool scintigraphy

We have used equilibrium gated blood pool scintigraphy to evaluate the hemodynamic effects and duration of action of molsidomine, a new peripheral vasodilator antianginal drug, after sublingual administration (4 mg) in five patients with heart failure. The following parameters were studied at rest and 10, 60, and 240 minutes after drug administration: left and right ventricular ejection fractions, end-diastolic and end-systolic volumes, stroke volume, heart rate, and cardiac index. Systolic and diastolic blood pressures were determined by cuff measurement. Statistically significant (p less than 0.05) changes were observed after 10 minutes for left ventricular ejection fraction (+26.2%), left and right end-diastolic volume (-12.4% and -15.2%), left ventricular end-systolic volume (-15%), and cardiac index (+7.9%); after 60 minutes for left ventricular ejection fraction (+49%), left ventricular systolic volume (+30.5%), cardiac index (+29.7%), systolic blood pressure (-7.9%), and right ventricular end-diastolic volume (-14.3%); and after 240 minutes for cardiac index (+23.9%), systolic blood pressure (-6.3%), and right ventricular ejection fraction (+23.1%). No changes in heart rate were observed. No patient experienced any side effect. We conclude that the hemodynamic improvement observed with molsidomine can be prolonged and results both from preload and afterload reduction.