[In vitro susceptibility of isolates of Scytalidium spp. from superficial lesions against posaconazole]. / Etude in vitro de la sensibilité au posaconazole de souches de Scytalidium spp. isolées de lésions superficielles.

Scytalidium spp. is a dematiaceous fungi that has been frequently reported from tropical to semi subtropical regions. We distinguish two pathogenic species: S. dimidiatum and S. hyalinum which is an homologous non-pigmented mutant of S. dimidiatum. This keratinophilic mold may produce superficial disease (skin, nails) indistinguishable from dermatophytes. In Martinique, this pseudodermatophyte could represent more than 50 % of onychomycosis. Contrary to dermatophytes, the clinical response of Scytalidium spp. are typically very poor and topical treatment or systemic agents ineffective. To evaluate the potential efficacy of the new antifungal agent posaconazole, we tested in vitro 12 clinical isolates of Scytalidium spp. (seven S. dimidiatum and five S. hyalinum) against posaconazole by Etest method. For the totality of the isolates, the minimum inhibitory concentrations (MICs) were low: MICs less or equal to 0.25 microg/ml (maximum MICs of 0.25 microg/ml for S. dimidiatum and 0.032 microg/ml for S. hyalinum). These in vitro efficacy suggest that the new agent posaconazole may be a future alternative treatment.

Onchocerciasis and epilepsy: a matched case-control study in the Central African Republic.

The occurrence of epileptic seizures during onchocercal infestation has been suspected. Epidemiologic studies are necessary to confirm the relation between onchocerciasis and epilepsy. A matched case-control study was conducted in dispensaries of three northwestern towns of the Central African Republic. Each epileptic case was matched against two nonepileptic controls on the six criteria of sex, age (+/-5 years), residence, treatment with ivermectin, date of last ivermectin dose, and the number of ivermectin doses. Onchocerciasis was defined as at least one microfilaria observed in iliac crest skin snip biopsy. A total of 561 subjects (187 cases and 374 controls) were included in the study. Of the epileptics, 39.6% had onchocerciasis, as did 35.8% of the controls. The mean dermal microfilarial load was 26 microfilariae per mg of skin (standard deviation, 42) in the epileptics and 24 microfilariae per mg of skin (standard deviation, 48) in the controls. This matched case-control study found some relation (odds ratio = 1.21, 95% confidence interval 0.81-1.80), although it was nonstatistically significant.

PIP: Epileptic seizures are frequent in neurocysticercosis and may occur during cerebral malaria. Findings are reported from a matched case-control study conducted in March 1996 in the savannah woodland region of northwest Central African Republic to determine whether any relation exists between Onchocerca volvulus infestation and epilepsy. About 70% of the study region's inhabitants are infested with O. volvulus. Each epileptic case was matched against 2 nonepileptic controls on the criteria of sex, age, residence, treatment with ivermectin, date of last ivermectin dose, and the number of ivermectin doses. Onchocerciasis was defined as at least 1 microfilaria observed in iliac crest skin snip biopsy. 187 cases and 374 controls were included in the study. 39.6% of the epileptics and 35.8% of the controls had onchocerciasis. The mean dermal microfilarial load was 26 microfilariae per mg of skin in the epileptics and 24 microfilariae per mg of skin in the controls. The relation between O. volvulus infestation and epilepsy was statistically nonsignificant.

Sequence-dependent modulation of nucleotide excision repair: the efficiency of the incision reaction is inversely correlated with the stability of the pre-incision UvrB-DNA complex.

The UvrABC excinuclease is involved in the nucleotide excision repair (NER) pathway. Sequence-dependent differences in repair efficiency have been reported for many different lesions, and it is often suggested that sites with poor repair contribute to the occurrence of mutation hot spots. However, guanine bases modified by N-2-acetylaminofluorence (AAF) within the NarI site (5'-G1G2CG3CC-3') are incised by the UvrABC excinuclease with different efficiencies in a pattern not correlated with the potency of mutation induction. To gain insight into the mechanism of sequence-dependent modulation of NER, we analyzed the formation, the structure and the stability of UvrB-DNA pre-incision complexes formed at all three positions of the AAF-modified NarI site. We show that the efficiency of release of UvrA2 from specific UvrA2B-DNA complexes is sequence-dependent and that the efficiency of incision is inversely related to the stability of the pre-incision complex. We propose that the pre-incision complex, [UvrB-DNA], when formed upon dissociation of UvrA2, undergoes a conformational change (isomerization step) giving rise to an unstable but incision-competent complex that we call [UvrB-DNA]'. The [UvrB-DNA] complex is stable and unable to form an incision-competent complex with UvrC. As the release of UvrA2, this isomerization step is sequence-dependent. Both steps contribute to modulate NER efficiency.

The influence of patient and physician gender on prescription of psychotropic drugs.

There is a wealth of evidence that more psychotropic drugs are prescribed to female than to male patients. We studied the psychotropic drug prescription of 15 male and 9 female physicians to 2493 patients in the Ambulatory Care Clinic of a University hospital. The relative odds (RO) of benzodiazepine prescription to a female compared to a male patient was the same when the physician was a male or a female (adjusted RO: 1.8; 95% CL: 1.5-2.1). But female patients were significantly more likely to be prescribed psychotropic drugs of all types from a female than from a male physician (adjusted RO: 1.3; 95% CL: 1.0-1.7). Information on patient diagnosis or on severity of symptoms would be needed to determine whether the present results reflect gender differences in medical care needs, overprescription of psychotropic drugs to females or underprescription of psychotropic drugs to males.

Kinetic studies of the modulation of ada promoter activity by upstream elements.

We have determined the kinetics of initiation of transcription of the wild-type ada promoter by abortive initiation assays. In the absence of activation, it is a weak promoter, with an association constant KB and an isomerization rate constant k2 comparable to those obtained under the same conditions for other positively regulated promoters (0.36 x 10(7) M-1 and 1.7 x 10(-2) s-1, respectively, at 37 degrees C and 50 mM NaCl, on a supercoiled template). As already observed for other promoters, these constants are modulated by varying the supercoiling of the plasmid. However, the strength of the promoter (given by the KB.k2 product) remains almost constant, because the maximum value of KB and k2 are obtained for different values of the superhelical density. The ada promoter has a stretch of seven adenosine residues (A7) in its upstream region. We have analysed the effect of this upstream sequence on the efficiency of initiation of the ada promoter by comparing the wild-type sequence with an up-mutant promoter characterized by the inversion of the central base pair in the sequence (A7) leading to the sequence (A3TA3). Although the mutation, which is located outside the promoter consensus regions, has no effect on the isomerization step, it affects the equilibrium constant KB that characterizes the association step. In the mutant promoters, the supercoiling of the plasmid modulates the isomerization and association constants in such a way that both KB and k2 are maximum for the same superhelical density (-0.05), leading to a 12-fold increase of the strength of the promoter, on a supercoiled template.(ABSTRACT TRUNCATED AT 250 WORDS)

[Evaluation of the main intestinal parasitosis in 860 Ivory Coast children from thirteen different villages (author's transl)]. / Evaluation des principales parasitoses intestinales chez 860 enfants ivoiriens provenant de treize villages différents. 1. - Nématodes et Entamoeba histolytica.

A survey has been carried out in 2 forest villages, 9 savanna villages and 2 Abidjan suburb districts. A total sample of 860 children aged between 6 and 15, has been examined. Data tabulation indicated a prevalence of the main intestinal nematodes, of S. mansoni and of E. histolytica, with variable respective percentage. Ascaris lumbricoides affected 26 p. 100 of children but is less frequent in the savanna areas than in the forest areas. Trichiuris trichiura affected 1 child out of 4 but infestation rate reached 76 p. 100 in the Abidjan suburb district. Necator americanus is the most frequently detected parasite (67 p. 100) and is more frequent in the forest areas than in the 2 savanna villages. E. histolytica has an uniform and low (5 p. 100) geographical distribution. S. mansoni has such an irregular distribution that no extrapolation is possible from the results obtained to the geographical area considered. Its infestation rates is from 1 p. 100 to 60 p. 100 with important differences inside small geographical zones.

[A survey of schistosomiasis in Ivory Coast (author's transl)]. / Panorama de la bilharziose en Côte d'Ivoire.

S. intercalatum has not yet been observed in Ivory Coast whereas S. mansoni and S. haematobium are frequent. S. mansoni schistosomiasis is distributed in limited foci as a consequence of the vital requirements of Biomphalaria. Its clinical detection is uneasy and stool control is necessary. Kato's technique is recommended. Prevalence has great topographic variations with an average value of 0,7 p. 100. Complications are not frequent, and can be detected only with rather sophisticated techniques available only in hospital. S. haematobium schistosomiasis is much more widespread according to the strong resistence of the mollusc host. Its clinical syndrome is significant and the diagnosis is easily controlled by a microscopic examination of the urine centrifugation deposit. The average prevalence is about 20-25 p. 100. Detection of complication requires hospital equipments.

[Distributions of Ascaris lumbricoides, Necator americanus and Trichuris trichiura in 6 villages of Ivory Coast (author's transl)]. / Répartitions d'Ascaris lumbricoides de Necator americanus et de Trichuris trichiura dans 6 villages de Côte D'ivoire.

Results of stool controls (Kato's technic) in 425 children from 7 to 14 years old in 6 villages of the south districts of Ivory Coast. Necator and Trichuris have a high prevalence (75 p. 100) versus 40 p. 100 for Ascaris-Trichuris is specially frequent in urban and suburban areas.

[Coprologic survey in Bilharzia infected children of the Adzope region (Ivory Coast)]. / Enquete coprologique chez des enfants bilharziens de la région d'Adzopé (Cote-D'Ivoire)

During a stool examination survey on 174 bilharzia attained children living in a rural area of Ivory Coast, 93% were found to have intestinal parasites mainly Entamoeba coli, Necator americanus and Ascaris lumbricoides. The prevalence of the cysts of Entamoeba histolytica (4,7%) is lower than the one found in France (7%). Concerning the other intestinal parasites, their respective occurrence have been compared with those noted in other regions of Ivory Coast and of Africa.