Sampling study for larval density quantification of Aedes aegypti and Aedes albopictus in the state of S?o Paulo, Brazil]

The Yellow Fever and Dengue Vector Control Program developed by the Superintendency for the Control of Endemic Diseases in the State of S. Paulo recommends Aedes aegypti and Aedes albopictus larval density monitoring in cities with domiciliar infestation. The sampling plan which has been applied in the countries of the Presidente Prudente region (SP- Brazil) since 1987 is described. The infestation is measured by using the Breteau Index. A sample of buildings is drawn, monthly and independently, in the infested cities, in which measurements are to be made. The sample is stratified and the elementary unit selection is made by using two-stage cluster sampling: of blocks and buildings. The sample sizes were defined using the coefficient of variation and the intraclass correlation as estimated for towns covered by the Regional Health Service of S. José do Rio Preto. These sizes must be corrected periodically in accordance with the values of the Breteau Index and its variance obtained in previous months.     

Evaluation of larval development of Anopheles darlingi (Diptera-Culicidae) raised in the laboratory on different diets

Three diets for A. darlingi larvae were tested in order to arrive at the following parameters indicative of development in this phase: length of time, both for overall as for each stage of evolution and daily and total stage-survival. A methodology which combined two vital statistical methods of analysis, adjusted to the study of populations under laboratory conditions, was used for determining these parameters. The length of time for overall and for each stage of, evolution were graphically assessed on the basis of trend curves of colony median stages, in sequential surveys. Values for the total and the daily stage-survival were stimulated from survival tables. Results permitted the selection of the most adequate diet for the larval development as that composed of one part of fish flour to two parts of bread flour and two parts of a heat germ, giving an average length of 12.9 days between the first larval stage and the emergent adult. Total survival rate was of 95%.     

Attenuation of visceral nociception by alpha- and beta-amyrin, a triterpenoid mixture isolated from the resin of Protium heptaphyllum, in mice

In the search for novel natural compounds effective against visceral nociception, the triterpenoid mixture alpha- and beta-amyrin, isolated from Protium heptaphyllum resin, was assessed in two established mouse models of visceral nociception. Mice were pretreated orally with alpha- and beta-amyrin (3, 10, 30, and 100 mg/kg) or vehicle, and the pain-related behavioral responses to intraperitoneal cyclophosphamide or to intracolonic mustard oil were analyzed. The triterpenoid mixture showed a dose-related significant antinociception against the cyclophosphamide-induced bladder pain, and at 100 mg/kg, the nociceptive behavioral expression was almost completely suppressed. Intracolonic mustard oil-induced nociceptive behaviors were maximally inhibited by 10 mg/kg alpha- and beta-amyrin mixture in a naloxone-reversible manner. While pretreatment with ruthenium red (3 mg/kg, s. c.), a non-specific transient receptor potential cation channel V1 (TRPV1) antagonist, also caused significant inhibition, the alpha (2)-adrenoceptor antagonist, yohimbine (2 mg/kg, s. c.), showed no significant effect. The triterpene mixture (10 mg/kg, p. o.) neither altered significantly the pentobarbital sleeping time, nor impaired the ambulation or motor coordination in open-field and rotarod tests, respectively, indicating the absence of sedative or motor abnormalities that could account for its antinociception. These results indicate that the antinociceptive potential of alpha- and beta-amyrin possibly involves the opioid and vanilloid (TRPV1) receptor mechanisms and further suggests that it could be useful to treat visceral pain of intestinal and pelvic origins.     

Eyelid ptosis associated with pachydermoperiostosis: case report

We describe a clinical case of a patient with pachydermoperiostosis and bilateral palpebral ptosis. It is a hereditary, dominant autosomic disease, which affects skin, bones and soft tissues. In the eyelid, it causes an important tarsal hypertrophy. We discuss the physiopathology and treatment of the ptosis.     

Hyperinsulinemic hypoglycemia evolving to gestational diabetes and diabetes mellitus in a family carrying the inactivating ABCC8 E1506K mutation

Vieira TC, Bergamin CS, Gurgel LC, Moisés RS. Hyperinsulinemic hypoglycemia evolving to gestational diabetes and diabetes mellitus in a family carrying the inactivating ABCC8 E1506K mutation. Congenital hyperinsulinism of infancy (CHI) is the most common cause of hypoglycemia in newborns and infants. Several molecular mechanisms are involved in the development of CHI, but the most common genetic defects are inactivating mutations of the ABCC8 or KCNJ11 genes. The classical treatment for CHI has been pancreatectomy that eventually leads to diabetes. More recently, conservative treatment has been attempted in some cases, with encouraging results. Whether or not the patients with heterozygous ABCC8 mutations submitted to conservative treatment may spontaneously develop type 2 diabetes in the long run, is a controversial issue. Here, we report a family carrying the dominant heterozygous germ line E1506K mutation in ABCC8 associated with persistent hypoglycemia in the newborn period and diabetes in adulthood. The mutation occurred as a de novo germ line mutation in the mother of the index patient. Her hypoglycemic symptoms as a child occurred after the fourth year of life and were very mild, but she developed glucose metabolism impairment in adulthood. On the other hand, in her daughter, the clinical manifestations of the disease occurred in the neonatal period and were more severe, leading to episodes of tonic–clonic seizures that were well controlled with octreotide or diazoxide. Our data corroborate the hypothesis that the dominant E1506K ABCC8 mutation, responsible for CHI, predisposes to the development of glucose intolerance and diabetes later in life.     

Respiratory viral infection in lower airways of asymptomatic children

Aim: The aim of this study was to determine if asthmatic children have viruses more commonly detected in lower airways during asymptomatic periods than normal children. Methods: Fifty‐five asymptomatic children attending elective surgical procedures (14 with stable asthma, 41 normal controls) underwent non‐bronchoscopic bronchoalveolar lavage. Differential cell count and PCR for 13 common viruses were performed. Results: Nineteen (35%) children were positive for at least one virus, with adenovirus being most common. No differences in the proportion of viruses detected were seen between asthmatic and normal ‘control’ children. Viruses other than adenovirus were associated with higher neutrophil counts, suggesting that they caused an inflammatory response in both asthmatics and controls (median BAL neutrophil count, 6.9% for virus detected vs. 1.5% for virus not detected, p = 0.03). Conclusions: Over one‐third of asymptomatic children have a detectable virus (most commonly adenovirus) in the lower airway; however, this was not more common in asthmatics. Viruses other than adenovirus were associated with elevated neutrophils suggesting that viral infection can be present during relatively asymptomatic periods in asthmatic children.