Prenatal screening for congenital toxoplasmosis in Campania: preliminary report on activities and results

By 1997, an open cohort of 1,652 live newborn of 1,637 mothers with gestational toxoplasmosis had been recruited in the Campania region to monitor the burden of congenital toxoplasmosis (CT). Of the 1,556 mother-child pairs that completed the follow up, 92 definite cases were detected, yielding a 5.9 percent (4.8-7.1 95 percent CI) transmission rate. The onset was patent for 43 percent of patients and sensorineural complications were shown for a further 15 percent of subclinical onset patients later than two years of age. The overall prevalence of toxoplasmosis during gestation was 2.46 of 1,000 deliveries, while the prevalence of definite CT was 1.38 of 10,000 live newborns. However, there is still room for intervention, as only 23 percent of the maternal diagnoses were proven through seroconversion, 63 of the late-gestation seroconverters remained untreated, and six probable CT diagnoses were made following referrals due to patent sequelae and born during the study period. There was a positive secular trend on the rates of infant referral and definite CT diagnosis, according to the live birth rate (Ç2 for trend < 0.001). Extension of this surveillance system across the country could help to define a future strategy for prevention.

Las pruebas cutáneas con bencilpenicilina siguen siendo importantes en el diagnóstico de las reacciones inmediatas de hipersensibilidad a las penicilinas / Benzylpenicillin skin testing is still important in diagnosing immediate hypersensitivity reactions to penicillins

Antecedentes. El hecho de que tanto Hollister-Stier como Allergopharma haya cesado la producción de penicilil-polilisina (PPL) y la mezcla de determinantes menores (MDM) en 2004, es un obstáculo importante en el diagnóstico de la hipersensibilidad a los ß-lactámicos y puede producir consecuencias negativas. Objetivo. Evaluar la contribución de las pruebas cutáneas con bencilpenicilina para el diagnóstico de la hipersensibilidad a penicilina mediada por IgE, con el fin de determinar cuánto podría compensar esta prueba cutánea la falta de disponibilidad de PPL y MDM. Métodos. Se seleccionaron pacientes con antecedentes de reacciones inmediatas a penicilina y test cutáneo para uno o más reactivos de penicilina (PPL, MDM o bencilpenicilina), una o más penicilinas semisintéticas (ampicilina, amoxicilina o piperacilina) o ambos. Resultados. Se seleccionaron en total 300 pacientes, 105 en el centro de Francia y 195 en los centros italianos. Las principales drogas responsables fueron la amoxicilina y ampicilina. La manifestación clínica más común fue la anafilaxia. Las pruebas cutáneas más frecuentemente positivas fueron con amoxicilina (188; 62,7%), ampicilina (151; 50,3%) y bencilpenicilina (111; 37,0%). Entre los 300 sujetos, 113 (37,7%) fueron positivos sólo para las penicilinas semisintéticas, 109 (36,3%) a ambas penicilinas semi-sintéticas y el clásico reactivo penicilina y 78 (26,0%) sólo a este último. En el último grupo, 64 (21,3% de los 300 sujetos) fueron positivos sólo a PPL y/o MDM y 14 (4,7%) a bencilpenicilina, de los cuales 8 (2,7%) fueron positivos sólo a este último Conclusiones. Las pruebas cutáneas con bencilpenicilina pueden compensar en parte la falta de PPL y de MDM. Por otra parte, puede aumentar ligeramente la sensibilidad del estudio diagnóstico alergológico y, por lo tanto, reducir el número de desafíos potencialmente peligrosos(AU)

Novas espécies de Sundarion Kirkaldy (Hemiptera, Membracidae) / New species of Sundarion Kirkaldy (Hemiptera, Membracidae)

Quatro novas espécies de Sundarion Kirkaldy, 1904 são descritas e ilustradas: S. compactum Souza & Rothéa sp. nov., S. costaricense Souza & Rothéa sp. nov., S. notabile Souza & Rothéa sp. nov. e S. rubricatum Souza & Rot´héa sp. nov. As duas primeiras são da Costa Rica e as outras do Brasil, Mato Grosso.

Characterisation of group A streptococcal (GAS) isolates from children with tic disorders.

BACKGROUND & OBJECTIVES: An association between the onset or recrudescence of some neuropsychiatric disorders in children such as tic disorders and group A streptococcal (GAS) infections has been suggested. No information is available on the characterization of GAS strains associated with such disorders. The present study was undertaken to characterize the GAS strains isolated from children with tic disorders and to determine and correlate the antistreptolysin O (ASO) titre with the presence of GAS. METHODS: During 1996-2001, 368 children with tic disorders were investigated for possible exposition to streptococcal antigens. All children, at the time of the first visit and during the follow up visits were apparently healthy and showed no clinical evidence of streptococcal infections or post streptococcal sequelae. Blood and throat swab samples were collected and serological and bacteriological tests done. The isolates obtained were investigated for T pattern, M protein and emm type, as well as for the production of protease. RESULTS: Of the 800 throat swabs studied 100, corresponding to 67 patients, were positive for GAS; 49 children were found positive for GAS only once during the study, 18 had more than one sample positive for different serotypes, 8 were positive twice or more for the same type. ASO titres of these children were, in general, elevated. Five types, namely type M12, 3, 13, 11, 1, accounted for 39 per cent of the isolates, M12 being the most common, but a large number of different types were also found. A large number of isolates (62%) showed an elevated prodution of protease in the casein plate assay. INTERPRETATION & CONCLUSION: Despite the high level of ASO titres found, the results were not in favour of a particular virulence or invasivity of the isolates. Only a few colonies per sample were found indicating that factors different from the microbial virulence play a role in this type of disease.

Colour Doppler echocardiography in children with group A streptococcal infection related tic disorders.

BACKGROUND & OBJECTIVES: A possible relationship has been suggested between tic disorders and streptococcal infections. To understand the complex relationship between streptococcal infections and neuropsychiatric disorders in children the present study was done on colour Doppler echocardiography of patients with possible post-streptococcal tic disorders. METHODS: The patients were 23 children (22 males, 1 female) affected by tic disorders, who at the time of the observation presented (or had presented in the past) signs of streptococcal infections temporally related to the onset or recrudescence of tic disorders. Echocardiographic examination and laboratory tests were performed on these children. RESULTS: In 4 cases a mild mitral insufficiency and in 8 cases a minimal mitral insufficiency was seen, all haemodynamically not significant. Follow up studies (up to 1 yr) showed the consistency and persistence of these findings. Of the 12 patients with echocardiographic abnormalities, 10 displayed very high anti streptolysin O (ASO) titres, 5 showed positive cultures for GAS and 9 had abnormal ESR, even if no significant differences were found in respect to patients with tics and normal echocardiography. INTERPRETATION & CONCLUSION: With the caution due to the design of study and to low number of patients, our data seem to indicate that the pathophysiology of GAS-infection related tic disorders is similar to that SC, at least in some cases.

Long-term habituation (LTH) in the crab Chasmagnathus: a model for behavioral and mechanistic studies of memory

A decade of studies on long-term habituation (LTH) in the crab Chasmagnathus is reviewed. Upon sudden presentation of a passing object overhead, the crab reacts with an escape response that habituates promptly and for at least five days. LTH proved to be an instance of associative memory and showed context, stimulus frequency and circadian phase specificity. A strong training protocol (STP) (( 15 trials, intertrial interval (ITI) of 171 s) invariably yielded LTH, while a weak training protocol (WTP) (( 10 trials, ITI = 171 s) invariably failed. STP was used with a presumably amnestic agent and WTP with a presumably hypermnestic agent. Remarkably, systemic admministration of low doses was effective, which is likley to be due to the lack of an endothelial blood-brain barrier. LTH was blocked by inhibitors of protein and RNA synthesis, enhanced by protein kinase A (PKA) activators and reduced by PKA inhibitors, facilitated by angiotensin II and IV and disrupted by saralasin. The presence of angiotensins and related compounds in the crab brain was demonstrated. Diverse results suggest that LTH includes two components: an inital memory produced by spaced training and mainly expressed at an inital phase of testing, and a retraining memory produced by massed training and expressed at a later phase of testing (retraining). The inital memory would be associative, context specific and sensitive to cycloheximide, while the retraining memory would be nonassociative, context independent and insensitive to cycloheximide.

Craniectomía mínima como tratamiento definitivo de los hematomas subdurales crónicos / Minimum craniotomy as definitive treatment of chronic subdural haematome

El tratamiento de los hematomas subdurales crónicos ha variado a través de los años desde el médico hasta diferentes métodos quirúrgicos. La craneotomía con extirpación extensa de las membranas a veces produce los resultados deseados. En la actualidad métodos más sencillos como la craniectomía con drenaje del hematoma son aceptados por muchos autores. Se presentan 43 casos de hematomas subdurales crónicos tratados con craniectomía mínima, observándose curación en 93% de los casos