Retrospective study of incidents of sudden death (SIDS) in 80 infants

The parents of 80 victims of SIDS (Sudden Infant Death Syndrome) participated in this retrospective study. The semistructured interview included questions concerning events preceding infants' death and the situation at the discovery of the death. Fifty-eight of the 80 SIDS victims were male, twenty-two were female. Fourty-four of the babies underwent a postmortem examination. There was a high incidence of death during the winter months and concerning the hour of the day in the morning hours. Most families (91%) had no socioeconomic difficulties--in contrast to reports of other authors. In 34% of the SIDS cases the parents reported about stress or irregularities of the daily family life cycle (journey, mayor family events, quarrels) immediately before the death of the baby. About 20% of the victims were not in the usual surrounding at the time of death. In about 30% of the SIDS victims an infection was observed. Since between the 2nd and 4th month of life a major neuronal reorganization in the central nervous system is assumed (Prechtl, 1984), stress during this period may be particularly effective and dangerous for the baby. This would explain the high incidence of SIDS during this vulnerable phase (60%) in which the baby, apparently, is unable to react properly.     

Effect of aminophylline therapy in mature infants with sleep apnea syndrome

Pneumograms of 33 fullterm infants (age 1-16 weeks) with idiopathic sleep apnea syndrome (SAS), treated with aminophyllin administered orally, were compared with pneumograms of 12 age-matched infants without aminophyllin treatment. In a one hour oxycardiorespirography (OCRG) all infants had pneumogram abnormalities defined as apneas greater than or equal to 15 s, greater than or equal to 3 apneas lasting 10 s, MA-value (mean duration of all apneas during sleep time) greater than or equal to 7 s/min, and greater than or equal to 3 episodes of periodic breathing. The diagnosis of an SAS, discussed as a possible risk factor of SIDS, was made in general in the presence of clinical symptoms such as apneas, cyanosis during sleep, poorly coordinated sucking, swallowing and respiration, and gastro-esophageal reflux (GER) in combination with an abnormal pneumogram. Of the 33 infants 12 with a history of an SIDS sibling were clinically asymptomatic. We found that after one week of aminophyllin treatment in 88% the pneumograms were normal. The mean plasma concentration of aminophyllin at this time was 8.3 micrograms/ml (range 4-19 micrograms/ml). All abnormalities showed a statistically significant reduction. In the infants without aminophyllin the pneumogram was still abnormal and no abnormality was significantly reduced. After at least 6 weeks we discontinued aminophyllin and one week later we monitored the OCRG. In 83% of the infants we found a normal pneumogram and compared to the initial pneumogram there was again a statistically significant difference.(ABSTRACT TRUNCATED AT 250 WORDS)     

Evaluation of the Xe-133 clearance method for indirect placental blood flow determination

The Xe-133 clearance method, chosen by several groups for indirect placental blood flow (PBF) determination, is evaluated using a placenta-fetus compartment model first introduced by Moll (1973). The placenta is modelled as a strong concurrent, counter-current or cross-current exchange system. The fetal circulatory system is simplified by dividing it into two major branches: the umbilical circulation and the fetal tissue or systemic circulation. Following an arbitrary labelling of maternal arterial blood, Xe-133 concentrations in myometrium, placenta and fetus are derived from the model and are used to calculate placental clearance rates. The dependence of clearance rates on maternal and fetal PBF, on the distribution of fetal cardiac output, and on the effect of recirculation times, is considered in the three different arrangements of maternal and fetal placental vessels.     

Modulation of glycine receptor function: a novel approach for therapeutic intervention at inhibitory synapses?

Transmitter-gated ion channels mediate rapid synaptic transmission in the CNS and constitute important targets for many neuroactive drugs. Inhibitory glycine receptors (GlyRs) are members of the nicotinic acetylcholine receptor superfamily and inhibit neuronal firing by opening Cl(-) channels following agonist binding. In this article, we discuss recent developments in GlyR pharmacology, delineate the receptor domains that are involved in binding of agonists and allosteric modulators, and present a molecular model of the extracellular architecture of the receptor. The recent discovery of compounds that act preferentially on specific GlyR isoforms and the differential expression of these isoforms in distinct regions of the developing and adult CNS show considerable promise towards the development of drugs that act in defined glycine-mediated pathways. In particular, compounds that can potentiate GlyR function should provide leads for novel muscle relaxants in addition to sedative and analgesic agents.     

Globulixanthones A and B,two new cytotoxic xanthones with isoprenoid groups from the root bark of Symphonia globulifera

Bioassay-guided fractionation of a root bark extract of Symphonia globulifera has yielded, in addition to stigmasterol, two new xanthones with isoprenoid units, named globulixanthones A (1) and B (2). The structures of these compounds have been elucidated by spectroscopic means. They possess significant cytotoxicity in vitro against the KB cell line.     

Frontotemporal dementia. Results from "Frontotemporal Demential and Pick's Disease Conference"

At the Frontotemporal Dementia and Pick's Disease Conference, recent data concerning the epidemiology, diagnosis, and therapy of frontotemporal dementia were presented. Topics included clinical manifestations, differential diagnosis, pathologic and genetic bases of the disease, therapy, and specific problems facing patients and care givers. A consensus in the terminology of this condition was sought.     

Condoms are not a risk factor for sensitization to latex

The study was conducted to assess the prevalence of sensitization to latex in a group of women with a high risk for atopy and to determine whether the use of condoms is a relevant risk factor. In a prospective study, 100 atopic women (defined as having specific IgE to common aero- or nutritional allergens) were screened for specific IgE antibodies to latex after delivery: Ten of the 100 women (10%) showed specific IgE to latex. Total IgE concentrations were higher with a history of occupational exposure or of symptoms after contact with latex (p < 0.05, and p < 0.005, respectively), but condom users were not significantly more frequent in the latex-positive group. Our results indicate that prior use of condoms does not appear to be a specific risk factor for sensitization to latex in post-partum women at high-risk for atopy. Latex-free condoms should only be recommended to women already known to be sensitized to latex.     

What is the source of mycelial fungi in expressed human milk?

The authors characterized the genera of mycelial fungi found in samples of expressed human milk received through home collection by the Human Milk Bank of the Instituto Fernandes Figueira in Rio de Janeiro. A total of 821 samples of expressed human milk were taken randomly from bottles collected at home by the milk donors themselves and were investigated for molds, yeasts, and mesophilic microorganisms. The analyses showed the occurrence of molds and yeasts in 43 (5.2%) of the samples, with counts reaching 103CFU/ml. Some 48 strains of mycelial fungi were identified by standard laboratory techniques, including: Aspergillus Niger group (6.3%), Aspergillus sp. (4.2%), Paecilomyces sp. (12.6%), Penicillium sp. (60.4%), Rhizopus sp. (2.0%), and Syncephalastrum sp. (14.5%). The authors discuss the importance of donor hands' asepsis prior to collecting human milk.     

Paracoccidioidomycosis mortality in Brazil (1980-1995)

This study analyzes 3,181 deaths from paracoccidioidomycosis in Brazil, based on 16 years of sequential data (from 1980 to 1995). During this period paracoccidioidomycosis showed considerable magnitude and low visibility, representing the eighth most common cause of death from predominantly chronic or recurrent types of infectious and parasitic diseases. It also had the highest mortality rate among the systemic mycoses. The mean annual mortality rate was 1.45 per million inhabitants, indicating a downward long-term trend (reduction of 31.28%), while spatial distribution among the different regions and States of Brazil was non-homogenous. The South (with the highest regional rate) and the Southeast showed a downward trend, while the Central West had the second highest rate in the country. At least one-fifth of Brazilian municipalities (or 22.71% of the country's total area) reported deaths from paracoccidioidomycosis. Overall nationwide mortality per area was 3.73/10,000km2. The disease was endemic in non-metropolitan areas. The majority of deaths occurred in males (84.75%), and there was a sex ratio of 562 men/100 women. The 30-59-year and over-60-year age groups were the most affected. The study showed that the mortality rate justifies classifying this disease as a major health problem in Brazil.