Efficacy of Lysinibacillus sphaericus against mixed-cultures of field-collected and laboratory larvae of Aedes aegypti and Culex quinquefasciatus.

Lysinibacillus sphaericus (Bacillales: Planococcaceae) is a spore-forming bacillus used for the biological control of mosquitoes (Diptera: Culicidae) due to its larvicidal activity determined by various toxins and S-layer protein produced either during sporulation or by the vegetative cell. Aedes aegypti and Culex quinquefasciatus are the vectors of arboviruses that cause tropical diseases representing a current public health problem. Both species may coexist in the same larval development sites and are susceptible to the larvicidal activity of L. sphaericus. In this study, we compared the larvicidal effects of L. sphaericus 2362 (WHO Reference strain) and native strains III(3)7 and OT4b.25 against Cx. quinquefasciatus and Ae. aegypti in single-species and mixed-culture bioassays. Findings showed that L. sphaericus spores, vegetative cells and a combination thereof possessed high larvicidal activity against Cx. quinquefasciatus larvae, whereas only the formulation of L. sphaericus vegetative cells was effective against Ae. aegypti larvae. Similar results were obtained for field-collected larvae. We propose that a formulation of vegetative cells of L. sphaericus 2362 or III(3)7 could be a good alternative to chemical insecticides for the in situ control of mixed populations of Ae. aegypti and Cx. quinquefasciatus.

Prognostic significance of EEG triphasic waves in patients with altered state of consciousness.

Triphasic waves (TWs) are a distinctive, but nonspecific, EEG pattern found in metabolic encephalopathies and a variety of other neurologic conditions. The prognostic value of TWs was studied in 30 patients with altered state of consciousness. Patients were either comatose (18 patients) or very lethargic (12 patients). Triphasic waves were the dominant EEG pattern, present for at least 35% of the tracing. The etiology of their underlying encephalopathy was multiple metabolic derangements (12 patients), hepatorenal syndrome (5 patients), renal failure (4 patients), hypoxic encephalopathy (4 patients), hepatic failure (3 patients), hyponatremia (1 patient), and hypoglycemia (1 patient). Patients were followed up to 22 months. Fifty percent of the subjects died within 30 days of recording TWs. The overall mortality was 77%. Seven patients (23%) have survived, but only three patients (10%) are neurologically normal. In conclusion, TWs occur most often in patients with metabolic encephalopathies, cannot be used to distinguish different diagnostic entities, and indicate a poor prognosis for survival.

Hereditary paroxysmal cerebellopathy: responsiveness to acetazolamide.

We describe kindred in which affected members had paroxysmal attacks of gait ataxia and other cerebellar symptoms. The mode of inheritance was autosomal dominant. Stress or emotion precipitated attacks. Examination between attacks revealed nystagmus but no other neurologic signs. After adulthood there was no progression of symptoms. Acetazolamide therapy successfully abolished the attacks.

Hyperkinetic shock in viral and pneumococcal pneumonias.

Ten patients, suffering from severe viral or bacterial pneumonia had circulatory shock, characterised haemodynamically by normal or high cardiac output (CI = 4.1 +/- 1.2 1/min/m2) and low systemic resistance (SVR = 14 +/- 3.7 mm Hg/1/min/m2). Existence of such a hyperkinetic state greatly complicates the management of patients. Plasma volume expansion, performed in five cases of initial hypovolaemia, and Dopamine infusion (five patients) increased markedly the intra-pulmonary shunting. High level PEEP ventilation was not tolerated, despite the improvement of blood gases it produced. Extra-corporeal membrane lung oxygenation (three cases), whilst giving an initial decrease of shunting and restoring SVR, produced no long term surviors. All ten patients died from intractable shock and severe hypoxaemia. Spontaneous ventilation with positive expiratory pressure (CPAP) is believed to be an attractive alternative, due to its absence of deleterious haemodynamic effects.