Prevalence of white matter hyperintensities is not elevated in a large sample of adolescents and young adults with bipolar disorder

Objective: The increased prevalence rate of white matter hyperintensities is one of the most consistently reported brain abnormalities in adults with bipolar disorder. However, findings in children and adolescents with bipolar disorder are less consistent. Prior studies have been constrained by small sample sizes and/or poor age- and sex-matching of healthy controls. We examined this topic in the largest sample of adolescents with bipolar disorder to date. Methods: T2-weighted 3-Tesla magnetic resonance imaging data were acquired for 83 adolescents with bipolar disorder diagnosed via the Kiddie Schedule for Affective Disorders and the Schizophrenia, Present and Lifetime version semi-structured interview and 64 age- and sex-matched healthy controls. All acquired scans were examined by neuroradiologists and the presence or absence of white matter hyperintensities was determined for each participant. Results: The prevalence of white matter hyperintensities did not differ between adolescents with bipolar disorder (13.3%) and controls (21.9%; χ2 = 1.90; p = 0.168). Conclusion: In contrast to the study hypothesis, the prevalence of white matter hyperintensities was not higher in adolescents with bipolar disorder than controls. The large sample size and good matching for age and sex bolster the reliability of this negative finding. Future studies are warranted to evaluate the prevalence, incidence, and predictors of white matter hyperintensities in early-onset bipolar disorder prospectively.

Modulating the Voltage-sensitivity of a Genetically Encoded Voltage Indicator

Saturation mutagenesis was performed on a single position in the voltage-sensing domain (VSD) of a genetically encoded voltage indicator (GEVI). The VSD consists of four transmembrane helixes designated S1-S4. The V220 position located near the plasma membrane/extracellular interface had previously been shown to affect the voltage range of the optical signal. Introduction of polar amino acids at this position reduced the voltage-dependent optical signal of the GEVI. Negatively charged amino acids slightly reduced the optical signal by 33 percent while positively charge amino acids at this position reduced the optical signal by 80%. Surprisingly, the range of V220D was similar to that of V220K with shifted optical responses towards negative potentials. In contrast, the V220E mutant mirrored the responses of the V220R mutation suggesting that the length of the side chain plays in role in determining the voltage range of the GEVI. Charged mutations at the 219 position all behaved similarly slightly shifting the optical response to more negative potentials. Charged mutations to the 221 position behaved erratically suggesting interactions with the plasma membrane and/or other amino acids in the VSD. Introduction of bulky amino acids at the V220 position increased the range of the optical response to include hyperpolarizing signals. Combining The V220W mutant with the R217Q mutation resulted in a probe that reduced the depolarizing signal and enhanced the hyperpolarizing signal which may lead to GEVIs that only report neuronal inhibition.

Enhancement of chloroquine activity against resistant parasites by co-administration of cimetidine

In vivo studies on reversal of chloroquine [CQ] resistance by cimetidine [CIM] were carried out in thirty five patients infected with Plasmodium falciparum in Omdurman Hospital for Tropical Diseases and Elhaj Yousif area, Khartoum Sudan. Parasites were considered resistant if still present in peripheral blood circulation, three days after the start of standard dose of CQ treatment. Patients with CQ resistant parasites were admitted to the hospital and given CIM [800 mg in two divided doses], 48 hours after the start of standard dose of chloroquine treatment. They were followed clinically and microscopically, daily for one week and then discharged. Treatment in the dose used was found to reverse CQ resistance in [70%] of the patients studied within three days of CIM treatment. No side effects were reported by any of the patients. Glutamicoxaloacetic transaminase [GOT] content in the treated group was found to be 31.57 I.U/L [ +/- 0.85], protein content 6.5 g/dl [ +/- 0.85] and the uric acid 6.5 mg /dl [ +/- 0.71]. The values of GOT, protein and uric acid in the resistant group were found to be slightly higher than those in by the sensitive one

Intravitreal triamcinolone acetonide for the treatment of diffuse diabetic macular oedema--a case report

<p><b>INTRODUCTION</b>Although laser photocoagulation is the primary treatment for diabetic macular oedema, treatment of eyes with diffuse macular oedema has been disappointing. Intravitreal injection of steroids is being investigated for the treatment of diabetic macular oedema. Preliminary results indicate that steroid injections do improve macular oedema, but it is not clear if they improve visual acuity.</p><p><b>CLINICAL PICTURE, TREATMENT, AND OUTCOME</b>In this report, we describe a patient with a form of diffuse diabetic macular oedema that responded favourably to intravitreal steroid injections, with improvements in both foveal thickness and visual acuity.</p><p><b>CONCLUSION</b>Intravitreal steroids can be useful for the treatment of diffuse diabetic macular oedema.</p>

Ablación percutánea mediante radiofrecuencia de osteomas osteoides estratégicamente ubicados: aproximación por vía alternativa / Percutaneous radio frequency ablation of strategically located osteoid osteomas: a \"backdoor\" approach

La ablación percutánea mediante radiofrecuencia (APRF) es una alternativa mínimamente invasiva al tratamiento habitual de resección en block de los osteomas osteoides. La APRF es una alternativa particularmente útil en lugar de la cirugía para el típico osteoma osteoide cuando este se encuentra en localizaciones estratégicas, donde puede existir un aumento del riesgo de injuria a importantes estructuras suprayecentes. En el presente artículo presentamos el tratamiento de dos clásicos osteomas osteoides mediante APRF (90º C durante 5-6 minutos), ubicados en el fémur proximal, inmediatamente distales al trocánter menor. En dichos casos empleamos una vía de abordaje alternativa a través de la cortical opuesta para evitar al nervio ciático así como la musculatura asociada y la vasculatura del comportamiento posterior del muslo. Se observó remisión sintomática completa en el lapso de 24 hs. posteriores al procedimiento, no observándose recidiva clínica en un período de seguimiento de 12 a 18 meses subsiguientes

Quality assurance of immunodiagnostic tests in Australia: II. Five year review.

A Royal College of Pathologists of Australasia (RCPA) sponsored quality assurance program in clinical immunopathology has, over a 5 year period, demonstrated: enrollment by the majority of immunodiagnostic laboratories in Australia and New Zealand; improved compliance with the program over time eg. increasing numbers returning their replies by the due date; different commercial techniques give different mean values for the same analyte. This appears to be due to the use of different reference materials in each technique; greater utilization of nephelometric techniques in quantitating immunoglobulins, C3, C4, CRP and rheumatoid factor resulting in better accuracy and precision; improvement in the frequency of detecting anticentromere antibody as most laboratories use proliferating cell lines as substrate for anti-nuclear antibody (ANA) detection; improved interlaboratory concordance of ANA titers by the provision of reference standards; improved detection of antibodies to extractable nuclear antigens (counter-immunoelectrophoresis being more sensitive than immunodiffusion); the Farr and radioimmunoassay technique for the demonstration of antibodies to native DNA have greater sensitivity than the Crithidia assay; improvement in accuracy and precision of cell phenotype analysis with the use of whole blood and cell flow cytometric techniques; development of techniques to rank each laboratories performance on a rating scale based on the average number of tests outliers (from the consensus mean) per mailing. However deficiencies in performance are still being observed. These relate to both technical factors causing systematic errors and in the provision of interpretive comments on the laboratory result. Continuing education and participation in quality assurance programs are emphasized to monitor and improve performance over time.

Recent advances in the application of molecular biology in filariasis.

Monitoring of filarial parasites in the host and vector has traditionally depended on morphological identification. Recently, species-specific DNA probes have been developed for Brugia malayi, Brugia pahangi and Wuchereria bancrofti. Repeated DNA sequences are useful in developing DNA probes because they evolve more rapidly then coding sequences and their high copy number increases the sensitivity of detection. The Hhal repeated DNA family represents 12% of the total B. malayi DNA. This DNA family is present in species of Brugia (B. malayi, B. timori and B. pahangi) but not W. bancrofti. Sequence analysis of the repeated DNA in B. malayi and B. pahangi has allowed construction of two species-specific DNA probes. These probes were used in a double blind field study in Indonesia. Microfilariae (mf) from infected cats and humans were identified by classical morphological methods and DNA probes. Agreement was found in 98.6% of the 642 samples tested by the two different techniques. Besides mf identification DNA probes can be used to determine the species of infective larvae (L3s) in infected mosquitos. This is useful because the L3s have similar morphology. DNA probes for the identification of W. bancrofti have recently been developed and are in the initial stages of testing in China (Piessens, personal communication) and Egypt (Williams, personal communication). An alternative approach for identification of infected individuals is to detect specific parasite antigens in circulation. A WHO initiative to use either an antigen or antibody assay to replace night blood is presently underway. This approach, if successful would not require the presence of microfilariae, but could detect occult infections.

Measurement of immune complexes with the liquid phase C1q binding assay: ten years experience in a routine diagnostic laboratory.

We describe our 10 years experience in assaying over 15,000 clinical specimens for immune complexes (IC) using the C1q binding assay. Normal ranges were initially established using a large panel of blood donor sera and precision of the assay was optimized by inclusion of heat aggregated IgG (HAGG) as standards. Nevertheless some variability was observed due to variation in C1q binding from batch to batch and with aging of this reagent. In an empirically selected 2 year period involving over 3,000 clinical specimens, 25% had elevated concentrations of IC. Of these the majority were from patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), other connective tissue disorders, infective endocarditis (IE), diffuse interstitial lung disease (DILD) and vasculitis (VASC). In RA, IE and VASC, significant correlations were observed between concentrations of IC and rheumatoid factor (RF) and the addition of a purified monoclonal RF to normal serum caused increased C1q binding. Longitudinal studies in RA and IE demonstrated a striking decline in IC in response to effective treatment. We conclude that the measurement of IC provides little additional useful diagnostic information in those diseases associated with high levels of RF but appears more useful in disorders such as SLE, IE and DILD in which RF is absent or present in low concentration. Sequential monitoring of IC in RA and IE reflects response to treatment.

Two new species of moths (Lepidoptera, Pyralidae, Chrysauginae) associated with the three-toed sloth (Bradypus spp.) in South America

Abstract Two species of chrysaugine moths, discovered as a result of an ecological study in Brazil of tree sloths and their ectoparasites, are described as new and named Cryptoses waagei sp. n. and C. rufipictus sp. n. They are differentiated from their single congener C. choloepi Dyar and near relatives Bradypophila garbei Ihering and Bradypodicola hahneli Spuler which are also found on tree sloths.

RESUMO Duas espécies de mariposas da família Chrysauginae, descobertas pelos estudos ecológicos da preguiça e seus ectoparasitas no Brasil, são descritas como novas e são denominadas, Cryptoses waagei sp. n. e C. rufipictus sp. n. Estas são diferenciadas da única outra espécie deste gênero, C. choloepi Dyar e das espécies afins, Bradypophila garbei Ilhering e Bradypodicola hahneli Spuler que também são encontrados nas preguiças.