Validation of the verbal autopsy method to ascertain acute respiratory infection as cause of death

The validity of the Verbal Autopsy (VA) in death due to acute respiratory infection (ARI), Was tested in 36 children who died by any acute infectious disease as stated by the necropsy diagnosis, at two public hospitals in Mexico City; the illness started at home. Clinical data obtained through VA were compared with diagnoses of necropsies, which were considered as “gold standard”. The presence of dyspnoea for more than one day showed sensitivity of 0.69 and Specificity of 0.74, while history of coughing showed a sensitivity of 0.61 and a specificity of 0.73. Combination of both clinical data improved specificity (0.83), but decreased sensitivity (0.54). Additional sources of diagnosis (a panel of assessors, the clinical record and the death certificate), also showed good sensitivity (0.69–0.77) and specificity (0.74–7.8). Focus on history of dyspnea and/or cough in children with an infectious syndrome should be emphasized, as a useful epidemiologic tool to determine children’s mortality due to ARI in areas where diagnosis resources are constrained.     

Oxidative stress response involving induction of protective enzymes in Candida dubliniensis.

Candida dubliniensis is a yeast species closely related to Candida albicans, but in contrast to C. albicans, limited information is available on the virulence factors of this important fungal pathogen. The objective of the present study was to determine if this species was able to evoke an adaptive response to oxidants. C. dubliniensis, treated with a low concentration of either H(2)O(2) or methyl viologen (a superoxide generating agent), mounts an adaptive response that results in increased survival against lethal doses of both oxidants. This response was characterized by the induction of enzymes with known antioxidant function. C. dubliniensis strains were less resistant to oxidants than C. albicans, displaying higher susceptibility to their toxic effects. The adaptive response described here might be responsible, among other factors, for the ability of this pathogen to cause infections in individuals with impaired immunity.     

Maternal dietary omega fatty acid intake and auditory brainstem-evoked potentials in Mexican infants born at term: cluster analysis

OBJECTIVE: To identify biological and socioeconomic factors associated with the neurological development of Mexican infants born at term, as measured by brainstem auditory-evoked potentials (BAEPs). SUBJECTS AND METHODS: We conducted a cohort study among 76 women with low risk pregnancies recruited in their third trimester of pregnancy and followed their infants until 12 months of age. BAEP tests were conducted on the infants before 3 months of age during physiologic sleep, using 100 msec bipolar clicks. Maternal dietary intake was evaluated by food frequency questionnaire. Two BAEP groups (short latency, long latency) were identified by cluster analysis. The association between BAEP group and maternal PUFAs was estimated using logistic regression models adjusted for socioeconomic and biological factors. RESULTS: Short latency BAEPs were associated with a maternal diet rich in arachidonic acid (OR=3.63, 95% CI 1.23-10.67) after adjusting for age (in days) sex, head circumference and gestational age but was not significantly associated to a maternal diet rich in docosahexaenoic acid (DHA). CONCLUSIONS: Our results suggest the importance of arachidonic acid intake during pregnancy for short latency BAEPs and adequate fetal myelination.     

Bioactivity-guided isolation of beta-sitosterol and some fatty acids as active compounds in the anxiolytic and sedative effects of Tilia americana var. mexicana

Tilia species have been used as anxiolytics for many years. In a previous study anxiolytic-like effects of a hexane extract of Tilia americana var. mexicana inflorescences were observed in experimental models in mice. To get additional insights into the neuroactive actions of this particular Tilia species, in this study we report a bioactivity guided-fractionation of the extract and separation by column chromatographic methods to isolate three fatty acids and a triterpene identified as beta-sitosterol as major constituents. Our results revealed that the crude extract at 10 and 30 mg/kg I. P. and some pooled fractions at the same dosages potentiated sodium pentobarbital-induced sleeping time and caused a significant increase in the time spent at the open-arm sides in the plus-maze test. A reduction in the exploratory behavioral pattern manifested as ambulatory activity, as well as head dipping and rearing tests was also observed. Further fractionation and purification yielded four major fractions containing fatty acids and beta-sitosterol as the active compounds. A dose-response curve of beta-sitosterol in the range 1 to 30 mg/kg doses indicated that this compound produced an anxiolytic-like action from 1 to 10 mg/kg and a sedative response when the dose was increased to 30 mg/kg, these effects resemble those produced by diazepam (0.1 mg/kg). Our results suggest that hexane extract of Tilia americana var. mexicana produces depressant actions on the central nervous system, at least in part, because of the presence of beta-sitosterol and some fatty acids that remain to be identified.     

Gamma-aminobutyric acid GABRA4, GABRE, and GABRQ receptor polymorphisms and risk for essential tremor

Some clinical and experimental data suggest a possible role of γ-aminobutyrate (GABA)-ergic mechanisms in the pathophysiology of essential tremor (ET). We studied the allelic and genotype frequencies of the single nucleotide polymorphisms, such as GABRA4-L26M (Leu26Met, rs2229940), GABRE-S102A (Ser26Ala, rs1139916), and GABRQ-I478F (Ile26Phe, rs3810651), in 200 patients with familial ET and 250 healthy controls using TaqMan genotyping. GABRA4-L26M, GABRE-S102A, and GABRQ-I478F genotype and allelic frequencies did not differ significantly between patients with ET and controls, and were unrelated to the age at onset of tremor or sex. The GABRQ-478F allele seemed to be related to improvement of tremor with ethanol use among men (odds ratio=2.32, 95% confidence interval=0.26-4.3, P=0.007, Pc=0.021). The results of this study suggest that the single nucleotide polymorphisms studied in the GABRA4, GABRE, and GABRQ genes are not related to the risk for familial ET.     

Paraoxonase 1 Polymorphisms Are Not Related with the Risk for Multiple Sclerosis

It has been suggested a possible role of oxidative stress and lipid peroxidation in the inflammatory processes and in the pathogenesis of multiple sclerosis. Human serum paraoxonase 1 is a polymorphic enzyme encoded by the gene PON1, located in chromosome 7q21.3, that plays a major role in the metabolism of organophosporus compounds, and in the protection against oxidative stress. Paraoxonase-1 activity has been found decreased in the plasma of multiple sclerosis patients. An association between PON1 polymorphism and the risk of multiple sclerosis has been described in Italians. To investigate the possible association between the PON1 genotype and allelic variants of the polymorphisms L55M and Q192R and the risk for multiple sclerosis in the Spanish Caucasian population; we studied the frequency of the PON1 genotypes and allelic variants in 228 patients with multiple sclerosis and 220 healthy controls using a PCR-RLFP method. The frequencies of the PON1 genotypes and allelic variants did not differ significantly between patients and controls, and were unrelated with gender, age of onset, and course of the disease. The OR (95% confidence intervals) for the variant alleles PON1-55L and PON1-192R were 0.96 (0.73–1.26) and 1.01 (0.76–1.35), respectively. The results of the present study suggest that PON1 polymorphism is not related with the risk for multiple sclerosis in our population.     

Tardive blepharospasm associated with cinnarizine use

OBJECTIVE: To report a patient with chronic blepharospasm possibly induced by the calcium-channel blocker cinnarizine. CASE REPORT: A 53-year-old woman developed chronic blepharospasm during a prolonged therapy with calcium-channel blocker cinnarizine for the treatment of vertigo. CONCLUSIONS: "Tardive blepharospasm" should be considered as a possible adverse effect of cinnarizine.