Antipsychotics as environmental pollutants: An underrated threat?

The heterogeneous class of what we nowadays call antipsychotics was born almost 70 years ago with the serendipitous discovery of chlorpromazine. Their utilization is constantly growing because they are used to treat a diverse group of diseases and patients across all age groups: schizophrenia, bipolar disease, depression, autism, attention deficit hyperactivity disorder, behavioural and psychological symptoms in dementia, among others. They possess a complex pharmacological profile, acting on multiple receptors: dopaminergic, serotoninergic, histaminergic, adrenergic, and cholinergic, leading scientists to call them "agents with rich pharmacology" or "dirty drugs". Serotonin, dopamine, acetylcholine, noradrenaline, histamine and their respective receptors are evolutionary ancient compounds, and as such, are found in many different living beings in the environment. Antipsychotics do not disappear once excreted by patient's urine or faeces and are transported to wastewater treatment plants. But as these plant's technology is not designed to eliminate drugs and their metabolites, a variable proportion of the administered dose ends up in the environment, where they have been found in almost every matrix: municipal wastewater, hospital sewage, rivers, lakes, sea and even drinking water. We believe that reported concentrations found in the environment might be high enough to exert significant effect to aquatic wildlife. Besides, recent studies suggest antipsychotics, among others, are very likely bioaccumulating through the web food. Crucially, psychotropics may provoke behavioural changes affecting populations' dynamics at lower concentrations. We believe that so far, antipsychotics have not received the attention they deserve with regards to drug pollution, and that their role as environmental pollutants has been underrated.

Goal-directed fluid therapy on laparoscopic colorectal surgery within enhanced recovery after surgery program

INTRODUCTION

Enhanced recovery after surgery protocols (ERAS) are used in peri-operative care to reduce the stress response to surgical aggression. As fluid overload has been associated with increased morbidity and delayed hospital discharge, a major aspect of this is fluid management. Intra-operative goal-directed fluid protocols have been shown to reduce post-operative complications, particularly in high risk patients.?.

OBJECTIVE

To compare 2fluid therapy models (zero-balance versus goal-directed fluid therapy) in patients who were scheduled for laparoscopic colorectal surgery within an ERAS program, recording the rate of complications such as surgical site infection, ileus, post-operative náusea and vomiting, and variability of the estimated glomerular filtration rate (eGFR).

MATERIALS AND METHODS

An observational, retrospective study was conducted including adults who were scheduled for elective laparoscopic colorectal surgery within an ERAS program, and to investigate the postoperative complication rate.

RESULTS

A total of 128 patients were included in this study; 43 (33.6%) in the zero-balance group and 85 (66.4%) in the goal-directed fluid therapy group. The total fluids administered was lower in the goal-directed fluid therapy group, as well as the incidence of post-operative complications (surgical site infection, anastomotic leak, ileus, and postoperative náusea and vomiting). No significant differences were found for length of stay, intra-operative urine output, and variability of the eGFR.?.

CONCLUSION

The results of this study show that by using a goal-directed fluid therapy algorithm, the total amount of fluids administered can be reduced, as well as obtaining a lower incidence of post-operative complications.

[Prevalence of human papillomavirus in Spanish women from a population screening program]

OBJECTIVE

The human papillomavirus (HPV), is necessary to cause a woman developing cervical cancer. The aim of the study was to estimate the prevalence of women with HPV infection, covered by the program of prevention and early detection of cervical cancer of Castile and León (Spain).

METHODS

Samples of women included in the screening program were analyzed. Including a total of 120,326 cervical swab samples, collected in the period from January 2012 to December 2014.

RESULTS

12,183 HPV positive samples were detected, representing a prevalence of 9.6 ‰, (IC 95% 9.5%-9.8%) in the female population. High-risk HPV were found in higher proportion that HPV low-risk genotypes. HPV prevalence correlates inversely with women age. Coinfections of multiple genotypes were found in one third of screened women population.

CONCLUSIONS

Data showed in this study are the first and wider Spanish results from a cervical cancer screening program population non opportunistic based on HPV detection. These results would serve as a reference for future prevalence studies and to evaluate the future impact of HPV vaccination campaigns.

Ontogenetic stage-dependent effect of temperature on developmental and metabolic rates in a holometabolous insect

Different hypotheses attempt to explain how different stages of organisms with complex life cycles respond to environmental changes. Most studies have focused at the among-species level showing similar responses to temperature throughout ontogeny. However, there is no agreement about the pattern expected at the intraspecific scale where a strong selective effect is expected. In this paper, we studied the effects of thermal treatments on a life history trait (developmental rate) and a physiological trait (metabolic rate) during development in the fruitfly Drosophila buzzatii. First, we estimated the rate of development during larval life (LDR) and the pupal stage (PDR) in flies derived from two natural populations exposed to several thermal treatments. Our results showed that the developmental rate ratio, LDR/PDR, did not vary between populations, and that the effects of thermal treatments were stage specific. Second, we studied the relationship between developmental rate (DR) and metabolic rate (MR) in each life cycle stage. We found that allometric relationships between DR and MR varied throughout ontogeny, a pattern that shed light on the mechanisms responsible for thermal plasticity. We conclude that, although different populations may show developmental rate isomorphy; larvae and pupae may choose alternative "decisions" in terms of life-history evolution and physiological traits when confronted to different thermal environments.

[In vitro activity of fosfomycin against ESBL-producing enterobacteria of urinary origin]

In vitro activity of fosfomycin, compared with other antibiotics used for urinary tract infections (UTI), against extended spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae clinical isolates obtained from UTIs, was determined. The activity of fosfomycin, co-trimoxazole, ciprofloxacin, nitrofurantoin, amoxicillin/clavulanic acid and gentamicin against 71 ESBL-producing E. coli clinical isolates and 13 ESBL-producing K. pneumoniae clinical isolates obtained from UTI was studied by the agar-dilution method or E-test. E. coli isolates produced mainly CTX-M type ESBL (76.1%), especially CTX-M 14 (56.3%). K. pneumoniae isolates produced most predominantly SHV-type ESBL (92.3%), mainly SHV-2 (76.9%). Gentamicin (4.4%), fosfomycin (5.6%) and nitrofurantoin (5.6%) showed the lowest resistance proportions against E. coli. Co-trimoxazole and ciprofloxacin (7.7%) showed the lowest resistance proportions against K. pneumoniae.

Effect of tetrahydropteridines on the monophenolase and diphenolase activities of tyrosinase

This study explains the action of compounds such as 6-tetrahydrobiopterin, (6BH4) and 6,7-dimethyltetrahydrobiopterin (6,7-di-CH3BH4) on the monophenolase and diphenolase activities of tyrosinase. These reductants basically act by reducing the o-quinones, the reaction products, to o-diphenol. In the case of the diphenolase activity a lag period is observed until the reductant is depleted; then the system reaches the steady-state. In the action of the enzyme on monophenol substrates, when the reductant concentration is less than that of the o-diphenol necessary for the steady-state to be reached, the system undergoes an apparent activation since, in this way, the necessary concentration of o-diphenol will be reached more rapidly. However, when the reductant concentration is greater than that of the o-diphenol necessary for the steady-state to be reached, the lag period lengthens and is followed by a burst, by means of which the excess o-diphenol is consumed, the steady-state thus taking longer to be reached. Moreover, in the present kinetic study, we show that tyrosinase is not inhibited by an excess of monophenol, although, to confirm this, the system must be allowed to pass from the transition state and enter the steady-state, which is attained when a given amount of o-diphenol has accumulated in the medium.

A review on spectrophotometric methods for measuring the monophenolase and diphenolase activities of tyrosinase

Tyrosinase is a copper enzyme with broad substrate specifity toward a lot of phenols with different biotechnological applications. The availability of quick and reliable measurement methods of the enzymatic activity of tyrosinase is of outstanding interest. A series of spectrophotometric methods for determining the monophenolase and diphenolase activities of tyrosinase are discussed. The product of both reactions is the o-quinone of the corresponding monophenol/diphenol. According to the stability and properties of the o-quinone, the substrate is classified as four substrate types. For each of these substrate types, we indicate the best method for measuring diphenolase activity (among eight methods) and, when applicable, for measuring monophenolase activity (among four methods). The analytical and numerical solutions to the system of differential equations corresponding to the reaction mechanism of each case confirm the underlying validity of the different spectrophotometric methods proposed for the kinetic characterization of tyrosinase in its action on different substrates.

[Delayed perforation of the cecum and sigmoid colon after blunt abdominal trauma in a patient with multiple injuries]

Blunt abdominal trauma can damage the intestinal vasculature and may occasionally lead to delayed intestinal perforation, associated with a combined rate of morbidity and mortality of 25%. The diagnosis of such complications is hindered by sedation in critical patients, however, and morbimortality in this population is therefore higher. We report the case of a man with multiple injuries admitted to the intensive care unit, where delayed perforations of the sigmoid colon and cecum were diagnosed. The management of blunt abdominal trauma is reviewed and the possible causes, diagnostic approaches, and treatment options for colon injuries are discussed.

An approximate analytical solution to the lag period of monophenolase activity of tyrosinase

Tyrosinase shows a lag period in its action on monophenols (l-tyrosine). We propose an approximate analytical solution for the lag period, which fulfils the dependences with regard to initial enzyme concentration, and initial monophenol concentration. Furthermore, from a study of the dependences of the lag period on these variables, we can determine experimentally the o-diphenol concentration in the steady state. The Michaelis constant of the o-diphenol in the presence of the monophenol can be determined from the relationship between the o-diphenol concentration in the steady state and the initial monophenol concentration, taking into consideration the experimentally calculated Michaelis constant for the monophenol substrate. Although this Michaelis constant is much lower than the Michaelis constant for diphenol in the absence of monophenol, the binding site is the same. A kinetic analysis of the action mechanism of tyrosinase explains this difference in the values of the Michaelis constants.

Calculating molar absorptivities for quinones: Application to the measurement of tyrosinase activity

The molar absorptivities of the quinones produced from different o-diphenols, triphenols, and flavonoids were calculated by generating the respective quinones through oxidation with an excess of periodate. Oxidation of these substrates by this reagent was analogous to oxidation by tyrosinase with molecular oxygen, although the procedure showed several advantages over the enzymatic method in that oxidation took place almost immediately and quinone stability was favored because no substrate remained. The o-diphenols studied were pyrocatechol, 4-methylcatechol, 4-tert-butylcatechol, 3,4-dihydroxyphenylalanine, 3,4-dihydroxyphenylethylamine, 3,4-dihydroxyphenylacetic acid, 3,4-dihydroxyphenylpropionic acid, and caffeic acid; the triphenols studied were pyrogallol, 1,2,4-benzenetriol, 6-hydroxydopa, and 6-hydroxydopamine; and the flavonoids studied were (+)catechin, (-)epicatechin, and quercetin. In addition, the stability of the quinones generated by oxidation of the compounds by [periodate]0/[substrate]0 << 1 was studied. Taking the findings into account, tyrosinase could be measured by following o-quinone formation in rapid kinetic studies using the stopped-flow method. However, measuring o-quinone formation could not be useful for steady-state studies. Therefore, several methods for following tyrosinase activity are proposed, and a kinetic characterization of the enzyme's action on these substrates is made.

Inactivation of HSV-2 by ascorbate–Cu(II) and its protecting evaluation in CF-1 mice against encephalitis

Ascorbate is an important antioxidant. However, in the presence of transition metals such as Cu(II) or Fe(III), it also has pro-oxidant capabilities. The effect of ascorbate-Cu(II) in the in vitro infection of herpes simplex virus type 2 (HSV-2) and its protecting effect in a murine model was investigated. HSV-2 was treated with different concentrations of ascorbate in the presence of Cu(II). A group of CF-1 mice were treated with the inactivated virus and other treated with maintenance medium containing only ascorbate-Cu(II). Weeks later, mice were challenged intranasally with infectious viruses. HSV-2 was completely inactivated by 2mM ascorbate plus 1mM Cu(II). Ascorbate or Cu(II) alone did not inactivate the virus. Compared with the control group, 60% of the immunized animals did not show any sign of encephalitis and survived the herpes virus infection, while a 7% survival rate was observed in the control group (P = 0.056). We concluded that the in vitro treatment of HSV-2 with ascorbate-Cu(II) is not only able to inactivate the virus, but also suggested that the viral particles induced a protective response against herpes encephalitis. This inactivation may provide an alternative method to develop new agents therapeutics.

Hysteroscopic myomectomy: our experience and review

OBJECTIVE

To analyze the results of hysteroscopic myomectomy in our center and to compare the results to those published in the literature.

METHODS

We performed a retrospective study of the clinical histories of patients who had undergone hysteroscopic myomectomy with a resectoscope between January 1992 and December 1999. Procedures were performed at a hysteroscopic clinic in the Department of Obstetrics and Gynecology at the University Public Hospital in Madrid's south zone. One hundred twenty pre-, peri-, and postmenopausal women with submucous myomas were included in the study. All patients underwent hysteroscopic resection with a monopolar loop.

RESULTS

We performed 120 hysteroscopic myomectomies. The patients' median age was 44.8 years (23 to 74). Abnormal uterine bleeding (AUB) was the most frequent indication (84.1%). Inability to reproduce was the indication in 14 (11.6%) cases. GnRH analogue preparation was used in 60% of cases. We operated on 52 (43.3%) type 0, 51 (42.5%) type I, and 17 (14.1%) type II myomas, according to Wamsteker and Blok classification. A median of 32.5 (10 to 105) minutes was required for the interventions. The myomectomy was combined with another operation (12 polypectomies, 24 endometrial resections, and 1 laparoscopic ovarian cystectomy) in 32 patients. The median retention of glycemia was 281 cc (0 to 1300). We could not complete the resection in 22 patients. Twelve underwent reoperation (3 hysterectomies and 9 second myomectomies). No serious complications occurred, and the median hospital stay was 25.4 hours. The histological study confirmed leiomyoma in all the cases. The intervention results were satisfactory after a follow-up period of 12 months to 7 years, AUB being controlled in 88.5% of the patients.

CONCLUSION

Hysteroscopic myomectomy is a reliable procedure that is effective in controlling abnormal uterine bleeding. It is a good alternative to hysterectomy and has an acceptable surgical time and minimum hospital stay. To reduce the need of reintervention, appropriate patient selection and improved technique are necessary. The technique also offers significant economic savings compared with the conventional surgical methods.

Oxidative stress biomarkers in bivalves transplanted to the Guadalquivir estuary after Aznalcóllar spill

Biological effects of metals were studied in clams (Scrobicularia plana) transplanted to Guadalquivir estuary (Spain) at several times after the spill of toxic metals from Aznalcóllar pyrite mine (southwest Spain) (April 1998) using biochemical biomarkers responsive to reactive oxygen species. Significant As, Cd, Fe, Mn, Ni, and Pb uptake was found in clams living for seven months at the estuary (from July 1999). Increased activity of antioxidant (catalase, glucose-6-phosphate, and 6-phosphogluconate dehydrogenase) and glutathione-related (glutathione reductase and glyoxalase I and II) enzymes was also found after short exposures; the levels of malondialdehyde and metallothionein increased also, particularly with long exposures. Clams living four weeks at the estuary (from March 2000) but not at a reference site also accumulated metals. The higher malondialdehyde and lower reduced-glutathione levels and the more oxidized glutathione status confirmed the oxidative stress of clams living at the estuary, while no marked increase of antioxidant activities was found this time. Lower metal availability along the second transplant could explain the limited responses in this shorter experiment. Although the status of Guadalquivir estuary has recovered since Aznalcóllar spill, continuous monitoring is needed to confirm its progress and to be alert to possible deterioration after heavy rains.

The stress response of the gilthead sea bream (Sparus aurata L.) to air exposure and confinement

We investigated short-term effects (up to 24 h) of air exposure and confinement, and long-term effects (up to 11 days) of confinement, to elucidate signalling pathways in the stress response of gilthead sea bream Sparus aurata L. Plasma glucose and lactate were taken as indicators of sympathetic activation, and alpha-melanocyte stimulating hormone (alpha-MSH), adrenocorticotrophic hormone (ACTH) and cortisol as indicators of activation of the brain-pituitary-interrenal (BPI) axis. Air exposure for 3 min resulted, within 30 min, in an increase in plasma concentrations of cortisol, alpha-MSH, glucose, lactate, osmolality and plasma Na, Cl and Mg. Plasma ACTH and beta-endorphin and plasma K, Ca and P did not change. We conclude that air exposure mainly activates the brain-sympathetic-chromaffin cell (BSC) axis. In fish confined at a density of 70 kg/m(3) (compared with 4 kg/m(3) in controls), cortisol, ACTH and alpha-MSH increased within 1 h, indicating activation of the BPI axis. Plasma glucose, Na, Cl and Mg increased with an 8 h delay compared with the response to air exposure. No changes in plasma lactate, osmolality, K, Ca and P were observed. Long-term confinement induced a biphasic cortisol response with peaks at 1 h and at 2 and 3 days. A gradual increase in plasma beta-endorphin concentrations peaked at 7 days; the concentration of alpha-MSH increased rapidly within 1 h and then declined to control values 4 days after the onset of confinement. No changes in ACTH were detected. Our data provide evidence that a stressor-specific activation of the BSC and BPI axes may occur in Sparus aurata.

[Identification of Escherichia coli and coliforms in childhood urinary sepsis using CROMOCEN CC chromogenic-fluorogenic medium]

In the last few years, the use of chromogenic and fluorogenic reactions for the identification of the most important pathogens in human urinary tract infections has became a powerful tool in clinic diagnostic. The study was carry out in two hospitals in Havana City, comparing the performance of experimental medium with the traditional one: C.L.E.D. Medium produced by Centro Nacional de Biopreparados (BIOCEN). Additional biochemical test were applied (indole, motility, citrate, H2S glucose and lactose) for the more accurate identification of different strains. During the test 119 positive samples were evaluated with 82 identified as E. coli (68.9%). As coliforms 18 samples (15.1%) were identify without any biochemical test. The diagnostic sensitivity was 100% and diagnostic specificity of new medium was of 97.4% for all assayed samples.

In vitro evaluation of the amebicidal activity of Buddleia cordata (Loganiaceae, H.B.K.) on several strains of Acanthamoeba

Infectious diseases produced by free-living amoebae from the genus Acanthamoeba have been recently recognized. The need for antiamebic compounds is urgent as the occurrence of these diseases is being registered more frequently since the late sixties. We screened the aqueous and methanolic extract of a plant used by folk medicine (Buddleia cordata) against eye and skin inflammation for antiamebic activity. We tested the extracts on 29 strains of free-living amoebae, with the result that they were amebostatic for 14 and 15 strains, respectively. We obtained linarin and vanillic acid from the extracts, but only linarin was amebostatic to all the strains and vanillic acid had no activity. However, acetyl vanillic acid had similar effects on amoebae to linarin. Threshold values of these two active compounds ranged from 31.25 microg/ml to 4 mg/ml and from 31.25 microg/ml to 8 mg/ml for linarin and acetyl vanillic acid, respectively. These differences in threshold values were observed even on several strains belonging to the same species (as in the case of A. castellanii and A. polyphaga) indicating the need of susceptibility testing for each clinical isolate of free-living amoebae.

Mode of action of Buddleja cordata verbascoside against Staphylococcus aureus

We evaluate the mode of action of verbascoside obtained from Buddleja cordata against Staphylococcus aureus by killing kinetics and incorporation of precursors methods. Verbascoside induced lethal effect on S. aureus, by affecting protein synthesis and inhibiting leucine incorporation.

[Seroprevalence versus Parvovirus B19 in blood donors]

BACKGROUND

The aim of the study was to describe the seroprevalence against Parvovirus B19 in a random sample of blood donors in the Hospital Universitario de Salamanca.

METHODS

We studied the presence of IgG and IgM antibodies against Parvovirus B19 in 136 sera from asymptomatic blood donors by enzyme immunoassay methods.

RESULTS

From 136 samples tested, 88 (64.7%) had positive absorbance values for IgG. Forty eight samples (35.5%) were negative. IgM was negative in all cases. We did not find indeterminate results.

DISCUSSION

Parvovirus primoinfection usually happens in the childhood. Thus, we can expect a high percentage of general population to have antibodies against Parvovirus B19. Anti-Parvovirus B19 antibodies prevalence in blood donors was 64.7%. This failure is similar to data reported before (65%). Clinical importance of these viruses in currently related with hemathopoyesis diseases and with the possible role in theratogenesis. The presence of IgG seems to give protection except in some chronic infections recently described.

Human T-lymphocyte transformation with human T-cell lymphotropic virus type 2

Human T-cell lymphotrophic virus type 2 (HTLV-2), a common infection of intravenous drug users and subpopulations of Native Americans, is uncommon in the general population. In contrast with the closely related HTLV-1, which is associated with both leukemia and neurologic disorders, HTLV-2 lacks a strong etiologic association with disease. HTLV-2 does shares many properties with HTLV-1, including in vitro lymphocyte transformation capability. To better assess the ability of HTLV-2 to transform lymphocytes, a limiting dilution assay was used to generate clonal, transformed lymphocyte lines. As with HTLV-1, the transformation efficiency of HTLV-2 producer cells was proportionately related to the number of lethally irradiated input cells and was comparable to HTLV-1-mediated transformation efficiency. HTLV-2-infected cells were reproducibly isolated and had markedly increased growth potential compared to uninfected cells; HTLV-2 transformants required the continued presence of exogenous interleukin 2 for growth for several months and were maintained for over 2 years in culture. All HTLV-2-transformed populations were CD2 and/or CD3 positive and B1 negative and were either CD4+ or CD8+ populations or a mixture of CD4+ and CD8+ lymphocytes. Clonality of the HTLV-2 transformants was confirmed by Southern blot analysis of T-cell receptor beta chain rearrangement. Southern blot analysis revealed a range of integrated full-length genomes from one to multiple. In situ hybridization analysis of HTLV-2 integration revealed no obvious chromosomal integration pattern.

Activity of trimethoprim/sulfamethoxazole plus polymyxin B against multiresistant Stenotrophomonas maltophilia

The inhibitory activity of eight antibiotics and the inhibitory and bactericidal activities of combinations of trimethoprim/sulfamethoxazole (TMP/SMX) plus three fixed concentrations of polymyxin B (0.01 microgram/ml, 0.1 microgram/ml and 0.5 microgram/ml) against 30 multi-resistant strains of Stenotrophomonas maltophilia were tested. Polymyxin B at 0.01 microgram/ml modified the inhibitory activity of TMP/SMX against only 40% of strains. At 0.1 microgram/ml and 0.5 microgram/ml, polymyxin B enhanced the inhibitory activity of TMP/SMX activity against all strains. Polymyxin B enhanced the bactericidal activity of TMP/SMX only at concentrations near the minimum inhibitory concentration of polymyxin B alone.

Time course and cytokine dependence of human T-cell lymphotropic virus type 1 T-lymphocyte transformation as revealed by a microtiter infectivity assay

Human T-cell lymphotropic virus type 1 (HTLV-1) enhances the growth of T lymphocytes, allowing the generation of T-lymphocyte cell lines. This report describes a limiting-dilution assay system which uses low input numbers of HTLV-1-producing cells for generation of T-lymphocyte cultures. The HTLV-1 transformants generated with this assay system produced high levels of HTLV-1 p24 antigen and required exogenous cytokines for maintenance. Clonal populations of CD4- or CD8-positive HTLV-1 transformants were generated with transformation efficiency rates as high as 78%. An exogenous cytokine is necessary for HTLV-1 T-lymphocyte transformation, and cytokine dependence is the most likely outcome of infection and transformation. HTLV-1 T-lymphocyte transformation can occur in the presence of cytokines other than interleukin-2 (IL-2), such as IL-4 or IL-7. IL-4- or IL-7-dependent HTLV-1 transformants underwent T-lymphocyte mitogenesis in response to their homologous cytokines but proliferated best in the presence of IL-2. Since the receptors for IL-2, IL-4, and IL-7 share the IL-2 gamma chain, this component may be the common element in the signaling pathway for HTLV-1-associated transformation.

[Importance of anaerobic bacteria in recurrent childhood non-streptococcal tonsillitis]

BACKGROUND

The presence of anaerobes in the oropharyngeal flora was already known, but they were infrequently involved in infections, except for specific diseases (abscesses, Vincent's angina). The involvement of anaerobes in more frequent by observed oropharyngeal diseases has been recently proposed.

METHODS

We analyzed the tonsillar flora of 22 healthy children (control group) and 54 children diagnosed of recurrent tonsillitis. We compare the clinical response of children with recurrent tonsillitis to two treatments: penicillin, and penicillin plus metronidazole.

RESULTS

We isolated Streptococcus pyogenes from 22.2% of children with tonsillitis, and did not isolate it from any healthy children. The rest of tonsillar flora was qualitatively similar in both groups. Both populations showed a high proportion of beta-lactamase-producer bacteria. In children from whom S. pyogenes was isolated, the response to the treatment was similar for both treatments. In those cases where S. pyogenes was not isolated, penicillin + metronidazole cured the 77.2% of children treated, but penicillin cured only 30% of cases.

CONCLUSIONS

These results suggest that anaerobes might be involved, at least, in recurrent tonsillitis when S. pyogenes is not found, and justify further studies about the etiology and treatment of this disease.

[Development of a selective differential medium for the isolation of Corynebacterium urealyticum (group D-2)]

BACKGROUND

We have developed a new selective culture medium for the isolation of C. urealyticum, with the aim of improving and making easier the isolation and identification of this microorganism.

MATERIAL AND METHODS

The medium is based on components similar to other media, usually used for diagnosis of urinary tract infections, also containing glucose, urea, phenol red, polysorbate 80 (Tween 80), polymixin B, amphotericin B, nalidixic acid and lyncomycin. The medium was tested in 65 clinical isolates and three type strains, and in 533 clinical samples of urine.

RESULTS

All 65 clinical strains and 3 reference strains of C. urealyticum tested grew faster on this medium than on blood agar. E. coli, Klebsiella spp., Enterobacter spp., Citrobacter spp., M. morganii, Proteus spp., S. aureus, Enterococcus spp. and Corynebacterium spp. did not grow in the selective agar. S. epidermidis and Streptococcus spp. grew in less than 10% of cases, P. aeruginosa in 29.2% and Serratia spp. in 41.7%. The colonies were always easily differentiated from C. urealyticum. In the studies performed on 553 clinical samples from patients with urinary tract infections, six infections by C. urealyticum were detected. The growth of all strains being faster on this medium than on blood-agar.

CONCLUSIONS

This new selective medium may be a valuable tool for diagnosis of UTIs caused by C. urealyticum in patients with retard risk factors.

[Effect of cyclosporin A, azathioprine, and methylprednisolone on plasma levels and heart atrial content of atrial natriuretic peptide in the rat]

In Wistar normotense male rats of six months old the effect of Cyclosporine A (Cys A), azathioprine (AZA) and methyl prednisolone (M-Pred), alone or associated, on the plasmatic levels and atrial content of the atrial natriuretic peptide (PNA) have been studied. The values of creatinine, urea, sodium a potassium were also measured in serum. This treatment was maintained for 30 consecutive days at these doses: Cys A (5.00 mg/kg b.w./day), AZA (2.50 mg/kg b.w/day) and M-Pred (20.00 mg/kg b.w./day), being the peritoneal the way of administration. Eight groups were organized: control, vehicle, Cys A, AZA, M-Pred, Cys A + M-Pred, AZA + M-Pred, Cys A + AZA + M-Pred. All the above parameters were estimated at 24 hours after respective injections. No changes are found after Cys A or AZA in the plasmatic and atria contents of PNA. Nevertheless, m-Pred alone or in association determines high increases of PNA in plasma and tissue. The other parameters are unchanged. The data reveal the beneficial use of M-Pred, glucocorticoid of the low mineral activity, in the therapy of rejection in cardiac transplantation. On the other hand, Cys A and AZA appear not to be important in the secretion and atrial synthesis of PNA.

Neurocysticercosis in an Orthodox Jewish community in New York City

BACKGROUND AND METHODS

From June 1990 through July 1991, intracerebral infection with the larval stage of the pork tapeworm Taenia solium was diagnosed in four unrelated persons in an Orthodox Jewish community in New York City. None of the patients had eaten pork, and only one had traveled to a country in which T. solium infection was endemic. We investigated this outbreak, screened serum samples from family members and household contacts for antibodies to cysticercosis, and examined stool specimens from household employees for eggs of taenia species.

RESULTS

The four patients had recurrent seizures and brain lesions that were radiologically consistent with the presence of cysticerci. The diagnosis was confirmed in two patients by a brain biopsy, and in two by immunoblot assays for cysticercus antibodies. Of 17 immediate family members screened serologically, 7 from two families had cysticercus antibodies. Magnetic resonance imaging of the brain showed cystic lesions in two of the seropositive family members, one of whom had had a seizure. Examinations of six domestic employees from all four households revealed an active infection with taenia species in one and a positive serologic test in another. Since these women had recently emigrated from Latin American countries where T. solium infection is endemic, they were the most likely sources of infection in the members of these households.

CONCLUSIONS

A diagnosis of neurocysticercosis should be considered in patients with seizures and radiologic evidence of cystic brain lesions, even in those who do not eat pork and who have not traveled to a country in which T. solium infection is endemic. Recent emigrants from countries in which T. solium infection is endemic should be screened for tapeworm infection in their stools before they are employed as housekeepers or food handlers.

[Treatment of spasticity with intrathecal baclofen]

INTRODUCTION

Severe spasticity, according to Lance's definition, is a manifestation of superior motoneurone injury syndrome which is characterized by increased stretching tonic reflexes, osteotendinous hyperreflexia, and release of propioceptive reflexes. Baclofen (a beta-4 chlorophenyl derived from gamma-amino-butyric acid) was firstly administered by intradural route in humans by Penn and Kroin in 1985 for the treatment of severe spasticity of muscular and central origin.

MATERIAL AND METHODS

We report the results obtained in eleven patients with severe spastic picture, six of medullar origin and five of central origin who were treated with intradural administration of baclofen using an implanted programmable continuous perfusion system (Synchromed 8611H). The age of patients ranged from 12 up to 58 years. Six were males and five females. The duration of the treatment ranged from a maximal period of 36 months to a minimal period of 12 months. The initial dose of baclofen varied from 50 micrograms/day to 144 micrograms/day.

RESULTS

The better results were obtained in patients with spasticity of medullar origin. The most marked beneficial effects were the reduction of spasms elicited, or not, by external stimuli. In all cases the doses of baclofen had to be progressively increased, leading to a mean final dose of 235.6 micrograms/day, with a maximal dose of 480 micrograms/day and a minimal dose of 144 micrograms/day.

CONCLUSIONS

Baclofen administered by intradural route is more effective than administered by orally and the required doses were lower. Intradural administration was effective even though the oral route was unsuccessful.

Selective transmission of human immunodeficiency virus type-1 variants from mothers to infants

Multiple human immunodeficiency virus type-1 sequences from the V3 and V4-V5 regions of the envelope gene were analyzed from three mother-infant pairs. The infants' viral sequences were less diverse than those of their mothers. In two pairs, a proviral form infrequently found in the mother predominated in her infant. A conserved N-linked glycosylation site within the V3 region, present in each mother's sequence set, was absent in all of the infants' sequence sets. These findings demonstrate that a minor subset of maternal virus is transmitted to the infant.

Respiratory syncytial virus infection in C57BL/6 mice: clearance of virus from the lungs with virus-specific cytotoxic T cells

We describe respiratory syncytial virus (RSV)-specific cytotoxic T-cell (CTL) lines and clones developed from the spleens of C57BL/6 and BALB/c mice. Line 7 and clones derived from it were H-2Kb restricted, whereas line 12 had both Kb and Db components. Both lines, and all the clones except one, could lyse targets infected with either strain A or strain B RSV. Line 7 or 7-11E1 cells (8 x 10(6) to 10 x 10(6) given intravenously cleared RSV from the lungs of infected mice. There was no morbidity or mortality in any of the infected mice whether or not they received T cells. The C57BL/6 mouse is a useful model system in which to study the role of the CTL response in protective immunity to RSV. CTL lines and clones can mediate clearance of RSV from the lungs of normal mice without producing any associated morbidity.

Influence of Endogenous Cytokinins on Reverse Mobilization in Cotyledons of Cicer arietinum L: Reproduction of Endogenous Levels of Total Cytokinins, Zeatin, Zeatin Riboside, and Their Corresponding Glucosides

The embryonic axis plays an essential role in the mobilization of the main reserves of the cotyledons of seeds of Cicer arietinum L. cv Castellana. This control by the axis of the metabolism of the storage products of the cotyledons largely takes place through the cytokinins, which are transported from the embryonic axis to the cotyledons where the mobilization of reserves begins. The principal regulatory role of the endogenous cytokinins concerns the metabolism of carbohydrates and proteins; there is less influence on lipid metabolism. However, each cytokinin seems to have a different role in the mobilization processes. The glucosides, glucosyl zeatin riboside, and glucosyl zeatin act only as storage forms of the hormones. Zeatin riboside affects mainly the mobilization of carbohydrates and has less effect on protein mobilization. Zeatin regulates both the mobilization of carbohydrates and that of proteins and is more marked in the latter case.

[Effect of oxytocin and naloxone on the plasma levels of corticosterone in the rat]

The effect of two doses of oxytocin (2 or 4 UI/kg i.p.) has been studied in the male Wistar rats, either preceded or not by a naloxone administration (10 mg/kg i.p.), on the response of the hypothalamus-pituitary-adrenal system, the latter being valued by changes produced in the plasmatic corticosterone levels. Oxytocin produced significant increases of the plasmatic corticosterone levels, this effect being stronger and longer lasting after the superior dose. Naloxone alone produced the same effect, but not as intense and stable as that of oxytocin. Pretreatment with naloxone modified the response of the hypothalamus-pituitary-adrenal system to oxytocin, producing partial blockade. The results suggest that the oxytocin action on the hypothalamus-pituitary-adrenal axis might be mediated by the endogenous opiates.

Osteoid osteoma of the hamate bone. Case report and review of the literature

Osteoid osteoma is rarely located in the hamate. Only five similar cases have appeared in the international literature, and none have appeared in the Spanish literature. In a 15-year-old girl, the lesion was excised en bloc, and the defect was filled with a bone graft. Two and one-half years after the operation the patient was asymptomatic with normal mobility of the affected wrist.

A study of the hypoglycemic effect of some Mexican plants

Diabetes mellitus is a disease that annually causes many deaths, and to date no really efficient remedy has been found. We studied a number of plants traditionally used in Mexico against diabetes, some of them since prehispanic times. Specimens of each species were collected and extracts from them were tested on CD1 strain mice with alloxan-induced diabetes. Hypoglycemic activity was determined by the O-toluidine and the Dextrostix tape methods. Several of the plants showed a marked hypoglycemic effect.