Iron status of inner-city African-American infants

The iron status of African-American infants continues to be subject to debate. We characterized the iron status of 198 9-month-old inner-city infants (94% fed iron-fortified formula) using a comprehensive panel of measures and assessing lead and inflammation markers. The proportion with iron deficiency was calculated based on three approaches (> or = 2 abnormal iron measures with or without anemia for MCV model--NHANES II, ferritin model--NHANES III, or Sweden/Honduras study) and a promising new measure-body iron, calculated from ferritin and transferrin receptor (TfR). There were no sex differences for any iron measure. Hb < 110 g/l was observed in 25%; Hb < or = 105 g/l in 10.1%. Free erythrocyte protoporphyrin (FEP) values were elevated without elevated lead concentrations or an inflammatory response: mean FEP = 86.6 microg/dl red blood cells [75.5 micromol/mol heme]; 52.3% were > 80 microg/dl (1.42 micromol/l), almost half of which were accompanied by a second abnormal iron measure. The estimated prevalence of iron deficiency was 14.4, 5.3, and 2.5% for the MCV model, ferritin model, and Sweden/Honduras cutoffs, respectively, and 4.1% for body iron < 0 mg/kg. Regulation of iron storage is immature at < 1 year of age, making estimates of iron deficiency that depend on ferritin, including body iron, suspect in this age period. Thus, the "true" prevalence of iron deficiency could not be established with confidence due to major differences in the results, depending on the guidelines used. Functional indicators of poor iron status in young infants are urgently needed.     

Early complications from the use of porcine dermal collagen implants (Permacol) as bridging constructs in the repair of massive rotator cuff tears. A report of 4 cases

The repair of massive rotator cuff tears can be very challenging. Different surgical techniques are described in the literature, including debridement of the cuff with subacromial decompression, attempts at direct partial repair, various tendon transfers, shoulder hemiarthroplasty, reversed shoulder arthroplasty and allograft augmentation. Following favourable published evidence of the use of porcine dermal collagen implants, Permacol (Tissue Science Laboratories, Hampshire, UK, now known as Collagen Repair Patch, Zimmer, Warsaw, Ind) as a bridging device to repair massive defects, we used it in four of our patients. However, we have seen with great concern that in all four cases, the grafts failed between 3-6 months after a promising early postoperative period. We report on these 4 cases giving clinical, radiographic and histological findings. We conclude that although Permacol has man obvious advantages, it should not be used to bridge irreparable massive rotator cuff tears.     

Different Lineages of Chikungunya Virus in Equatorial Guinea in 2002 and 2006

Chikungunya virus is a mosquito-borne virus that causes an acute febrile infection and severe arthralgia and is considered a re-emergent pathogen. During a study investigating arboviruses causing febrile infection in infants in Bata, Equatorial Guinea, the genome of this virus was amplified from blood samples during near two rainy seasons (2002–2003). In 2006, this virus was isolated from a traveler returning to Spain from Equatorial Guinea. These results show that chikungunya virus is present in this country and two lineages are circulating. Thus, this virus should be considered in the differential diagnosis of febrile syndromes in inhabitants and in travelers returning from this country.Tropical Africa is the likely site of origin of many of the arboviruses of modern medical importance. However, there is little data about the prevalence of arboviral infections in this region.Equatorial Guinea is located in the equatorial part of Africa between Cameroon and Gabon and is divided into a continental part (area = 26,017 km²) and some islands (area = 2,034 km²). It has a population of approximately 500,000 persons, with a high percentage (45%) less than 15 years of age. This country has an equatorial climate with an annual average temperature of 25°C. The average annual precipitation (> 2,000 mm) is divided into two rainy seasons: from April to May and from October to December.In west and central Africa, data on the circulation of chikungunya virus (CHIKV) are rare. In Cameroon, serologic prevalence assays have shown that the alphaviruses CHIKV and O''nyong nyong virus are the most common arboviral infections.¹ In Gabon, an outbreak of a dengue-like syndrome caused by CHIKV was described in 2006–2007.² The virus was phylogenetically related to strains isolated in 2006 in Cameroon and seen years earlier in the Democratic Republic of Congo, where 50,000 persons were infected.³Chikungunya virus belongs to the family Togaviridae and the genus Alphavirus. It causes an acute infection with an abrupt onset of fever, headache and severe joint pains and is transmitted mainly by Aedes mosquitoes.⁴ In recent years, it has been considered a re-emergent virus and has become a public health problem in countries such as the Democratic Republic of Congo.³ More recently, CHIKV has caused large outbreaks that affected different Indian Ocean territories and continental India.^5,6 This epidemic was the source of an outbreak in Italy caused by an infected traveler from India.⁷In 2002–2003, a project to study the presence of some viruses in Equatorial Guinea was conducted. Samples from febrile children attending the Reference Center for the Control of Endemic Diseases located in Bata (continental region of Equatorial Guinea) were obtained. From June 2002 to January 2003, 720 blood samples were obtained. RNA was preserved in a guanidinium isothiocyanate buffer. Samples were sent to the National Center for Microbiology in Madrid, Spain, for testing. Samples used were not given personal identifiers to comply with bioethics guides.After RNA extraction,⁸ samples were assayed. We used generic primers to potentially detect arboviruses in different polymerase chain reaction (PCR) assays. We searched for arenaviruses,⁹ hantaviruses, and orthobunyaviruses (using in-house methods); no positive results were obtained. Arboviruses belonging to the genera Flavivirus, Phlebovirus, and/or Alphavirus were tested by using a generic multiplex real-time nested PCR in which consensus primers for each of the three genera were mixed.¹⁰ Positive amplification with the generic multiplex method was achieved in eight samples obtained in the rainy seasons when vector activity is high. Sequences of amplified fragments corresponding to 195 basepairs of the non-structural protein 4 gene of alphaviruses identified a homogeneous cluster of CHIKV belonging to the Central–East/South Africa genotype. Chikungunya virus was found in 2002 (three samples in June, one sample in July, and two samples in December) and 2003 (two samples in January). Four of these eight virus-positive samples were also positive for Plasmodium falciparum.To obtain a sequence with more phylogenetic information, primers designed by Powers and others (sense ₁₀₂₄₆ 5′-TTACCCNTTYATGTGGGG-3′₁₀₂₆₂ and antisense ₁₀₇₉₃ 5′-CTTACSGGGTTTGTYGC-3′₁₀₇₇₇),¹¹ were used in combination with primer₁₀₇₁₄ 5′-TRAAGCCAGATGGTGCC-3′₀₆₉₈ to amplify a fragment of a region of the envelope 1 (E1) gene often used for CHIKV phylogenetic analysis. Three of the eight positive samples (probably those with the highest concentration of virus) showed a 469-basepair product whose sequences formed a unique cluster within the Central/East African genotype clade (Figure 1).Open in a separate windowFigure 1.Phylogenetic tree showing the relationships of chikungunya virus (CHIK) strains. A 434-basepair fragment from the envelope 1 gene was analyzed by using the neighbor-joining method, the number of differences model, and bootstrap percentage corresponding to 1,000 replicates with the MEGA 4 software. O''nyong nyong virus (ONNV) was used as an outgroup. Accession number, name of the strain, and place and year of isolation are indicated. Strains sequenced in this paper are shown in bold. Bootstrap values > 80 are shown.In Spain, CHIKV was considered in the differential diagnosis of a febrile syndrome in travelers returning from Equatorial Guinea. In 2006, one of three such travelers returning from this area was diagnosed in Spain as being infected with CHIKV on the basis of a positive PCR result, which showed amplification of part of the E1 gene.¹² This sequence is similar to others described at the same time from Cameroon and Gabon,^1,2 but is different from sequences obtained in Equatorial Guinea in 2002. There is evidence of endemic circulation of a genetically stable monophyletic CHIKV population during 2000–2007 in west central Africa.²Our results suggest that a paraphyletic population of CHIKV was circulating in Equatorial Guinea in 2002. Our results indicate that CHIKV is likely endemic in Equatorial Guinea, and suggest that either two (or more) CHIKV populations were co-circulating in Equatorial Guinea or the western Central African lineage has replaced the lineage detected during 2002–2003. Our data clearly identified three genotypes but cannot be used to unequivocally demonstrate the endemicity of CHIKV in Equatorial Guinea. To conduct a robust phylogenetic analysis, complete sequences of viruses belonging to each group are needed. Therefore, studies of CHIKV in patients infected in Equatorial Guinea are ongoing.     

Right impairment of temporal order judgements in dyslexic children

This study investigates the spatial bias of visual attention measured by a temporal order judgement (TOJ) task and the influence of a high attentional load condition in a group of dyslexic children compared to a control group with normal reading skills (each group N=10). The TOJ task (T2) was placed after a shape discrimination task (T1). In a low attentional load block participants worked only on T2, whereas in the high attentional load block they were required to process both T1 and T2. Several t-tests were executed to compare performance between conditions and groups. In the low attentional load conditions, results in dyslexic children were significantly impaired for the right visual field compared to a control group. The high attentional load conditions did not enhance these effects and seems to provoke the same leftward bias in the control group.     

Calbindin-D28k and calretinin expression in the forebrain of anuran and urodele amphibians: further support for newly identified subdivisions

A general pattern of organization of the forebrain shared by amphibians, mainly anurans, and amniotes has been proposed considering the relative topography of the territories, their connectivity, and their neurochemistry. These criteria were needed because the amphibians possess limited cell migration from the ventricle that precludes a parcellation into circumscribed nuclei. In the present study we have tested the identity of most newly described forebrain territories in anurans and urodeles with regard to their content in calbindin-D28k (CB) and calretinin (CR). By means of immunohistochemistry, these proteins were demonstrated to be particularly abundant and specifically distributed in the amphibian forebrain and were extremely useful markers for delineating nuclear boundaries otherwise indistinguishable. In the telencephalon, labeled cells in the pallium allowed the identification of particular regions with marked differences between anurans and urodeles, whereas the subpallium showed more conservative patterns of distribution. In particular, the components of the amygdaloid complex and the basal ganglia were distinctly labeled. The distribution in the nonevaginated secondary prosencephalon and diencephalon showed abundant common features between anurans and urodeles, highlighted using the prosomeric model for the comparison. In the pretectum, thalamus, and prethalamus of urodeles, the CB and CR staining was particularly suitable for the identification of diverse structures within the simple periventricular gray layer. However, the analysis across species also revealed a considerable degree of heterogeneity, even within comparatively well-defined neuronal populations. Therefore, the content of a particular calcium binding protein in a neuronal group is not a fully reliable criterion for considering homologies.     

Progressive behavioral deficits in DJ-1-deficient mice are associated with normal nigrostriatal function

Loss-of-function mutations in the DJ-1 gene account for an autosomal recessive form of Parkinson's disease (PD). To investigate the physiological functions of DJ-1 in vivo, we generated DJ-1 knockout (DJ-1^−/−) mice. Younger (< 1 year) DJ-1^−/− mice were hypoactive and had mild gait abnormalities. Older DJ-1^−/−, however, showed decreased body weight and grip strength and more severe gait irregularities compared to wild-type littermates. The basal level of extracellular dopamine, evoked dopamine release and dopamine receptor D2 sensitivity appeared normal in the striatum of DJ-1^−/− mice, which was consistent with similar results between DJ-1^−/− and controls in behavioral paradigms specific for the dopaminergic system. An examination of spinal cord, nerve and muscle tissues failed to identify any pathological changes that were consistent with the noted motor deficits. Taken together, our findings suggest that loss of DJ-1 leads to progressive behavioral changes without significant alterations in nigrostriatal dopaminergic and spinal motor systems.     

Bevacizumab in the management of solid tumors

Angiogenesis is defined as the formation of new blood vessels from a pre-existing vascular bed. By supplying nutrients and oxygen and removing waste products in malignant tumors, it is an essential process that regulates cancer growth and dissemination. This process is regulated by both pro- and antiangiogenic compounds. Vascular endothelial growth factor is one of the most important and best-studied proangiogenic factors. Bevacizumab, a monoclonal antibody against vascular endothelial growth factor, has been shown to inhibit angiogenesis and is proving to be of clinical benefit in a variety of tumor types. The strongest evidence comes from studies in advanced colorectal and non-small-cell lung cancer, with growing evidence in breast and epithelial ovarian tumors. The duration and timing of bevacizumab's use is currently the focus of several ongoing clinical trials.