Infection by Rhodotorula sp. in children receiving treatment for malignant diseases

Rhodotorula sp. are commensal yeasts that may cause opportunistic infections. There have been only a few case reports of Rhodotorula fungemia in children with cancer, and in all of them the patients had a central venous catheter inserted. The authors report three nonfatal cases of fungemia by Rhodotorula in patients with post-chemotherapy neutropenia. Two of three patients required catheter removal, and a response was achieved with systemic antifungal therapy. Aggressive therapy may be required for selected high-risk patients.     

Anxiety disorders in outpatients with schizophrenia: prevalence and impact on the subjective quality of life

OBJECTIVE: To describe the prevalence of comorbid lifetime anxiety disorders in outpatients with schizophrenia and to compare the subjective quality of life of patients with and without comorbid anxiety disorders. METHODS: Fifty-three outpatients were recruited. They were interviewed with the Anxiety Disorders section of the SCID for DSM-IV. Quality of life was assessed with the Sheehan disability scale (SDS). RESULTS: Specific prevalences of anxiety comorbidity were: social phobia (17%), OCD (15.1%), GAD (9.4%), anxiety disorder NOS (7.5%), panic disorder (5.7%), specific phobia (5.7%), PTSD (3.8%), and agoraphobia (1.9%). Schizophrenic patients with comorbid anxiety disorder (41.5%) showed significantly higher scores in global scale (p=0.005), work subscale (p=0.007), and social life subscale (p=0.003) of the SDS than their counterparts without comorbid conditions. CONCLUSIONS: Anxiety disorders may impose an additional burden to patients with schizophrenia, resulting in further decline in their subjective quality of life.     

Mother-to-Infant transmission of hepatitis C virus (HCV) in Brazil

Sixty-one women with anti-HCV antibodies, detected by a third-generation enzyme immunoassay (EIA3), were prospectively recruited for investigation of vertical HCV transmission during child-birth, at the University Hospital of the Catholic University of Campinas, Brazil, between January 1994 and July 1998. Six of the women presented coinfection with the human immunodeficiency virus type 1 (HIV-1). All of the 72 children born in this period were followed at least until they were 18 months of age. Analyses of anti-HCV, HCV RNA, and alanine aminotransferase were performed in a minimum of two blood samples during follow-up. One (2.4 per cent; 95 per cent CI, 2.2-7) of the 42 children born to HCV viremic mothers was both anti-HCV and HCV RNA-positive, with altered ALT levels. Passively transferred maternal anti-HCV antibodies became undetectable within 9-12 months. None of the nine infants born to HIV-1 infected mothers were infected either by HIV or HCV. Thus, the mother-infant HCV transmission rate is low and seems to be associated with maternal HCV RNA positivity.     

Effect of the hypothyroidism-castration association on bone and parathyroids from adult female rats

The effect of hypothyroidism on bone metabolism and the parathyroids in states of deficiency or sufficiency of sex steroids was studied in 32 two-months-old female Wistar rats distributed in 4 groups of 8 animals each: intact euthyroid (IE), castrated euthyroid (CE), intact hypothyroid (IH) and castrated hypothyroid (CH). After 120 days of treatment, animals were sacrificed and plasma taken to assess free T4. Hyperplasia or hypertrophy of all parathyroids were evident only in IH and CE groups. Of all groups, IH rats presented the most extensive osteopenia, reaching lumbar vertebrae, dental alveolae (jaw and mandible) and long bones. In this group osteopenia resulted from the reduced bone growth, inhibition of bone apposition and return of bone resorption. Although osteopenia in the CH group was almost always more intense in relation to osteopenia presented by CE rats, its intensity was variable when compared to IH rats and dependent on the region studied. Even though it also caused necrosis of higher metabolism bones, the association hypothyroidism-castration did not potentialize the resultant osteopenia of the isolated action of hypothyroidism or castration until 120 days of treatment.     

Plasmodium falciparum histidine-rich protein II binds to actin,phosphatidylinositol 4,5-bisphosphate and erythrocyte ghosts in a pH-dependent manner and undergoes coil-to-helix transitions in anionic micelles

The recombinant histidine-rich protein II (HRPII) from Plasmodium falciparum was shown to bind actin and phosphatidylinositol 4,5-bisphosphate (PIP(2)) in vitro in a pH-dependent manner, very similar to hisactophilin, an actin-binding protein from ameba. Binding of HRPII to actin and PIP(2) occurred at pH 6.0 and 6.5, but not above pH 7.0. Circular dichroism (CD) spectroscopy confirmed that HRPII interacts with actin at pH below 7.0, as judged by the changes induced in the secondary structure of the HRPII/actin mixture. Further CD analysis demonstrated that HRPII adopts a predominantly alpha-helical conformation with anionic micelles of PIP(2) and SDS, but not with neutral micelles of phosphatidylcholine (PC), a feature that is common to many actin-binding proteins involved in cytoskeleton remodeling. Similarly to hisactophilin, a GFP-HRPII fusion protein shuttled from the cytoplasm to the nucleus of HeLa cells as the cellular pH was lowered from 8.0 to 6.0. HeLa cells transfected with the HRPII gene showed increased levels of histidine-rich proteins (HRPs) in the soluble cell fraction at pH 8.0. At pH 6.0, however, HRPs were detected mainly in the insoluble cell fraction. Interestingly, we found that HRPII binds to human erythrocyte membranes at pH 6.0 and 6.5 but not at pH above 7.0. Our results point to remarkable similarities between HRPII, hisactophilin, and actin-binding proteins. Possible roles of the HRPII during Plasmodium infection are discussed in the light of these findings.     

Fiberoptic endoscopic swallowing disorders in chronic encephalopathy

OBJECTIVE: To evaluate the results of fiberoptic endoscopic examination of swallowing safety in children with cerebral encephalopathy in order to identify patients with oropharyngeal dysphagia. METHODS: 68 children from the Association for the Care of Disabled Children (Associa??o de Assistência à Crian?a Deficiente -AACD), S?o Paulo, were submitted to fiberoptic endoscopic examination of swallowing safety from March 1999 to March 2000. RESULTS: We observed premature spillage (53%), penetration in a pureed consistency (5.9%), penetration in a liquid consistency (4.4%), tracheal aspiration in a pureed consistency (14.7%), tracheal aspiration in a liquid consistency (32.3%), residue (7.4%), cough effectiveness (44.1%). CONCLUSIONS: Children showed a high incidence of pharyngeal swallowing disorders. Tracheal aspiration was the most important disorder because it is related with high morbidity in children with cerebral encephalopathy. The texture and consistency of the patientacute;s diet may be modified to decrease the risk of aspiration and improve swallowing examination.     

A different technique to create a 'myelomeningocele-like' defect in the fetal rabbit

OBJECTIVE: To evaluate the fetal survival rate using a modified technique to surgically create a 'myelomeningocele-like' defect in a rabbit model. METHODS: Six white New Zealand rabbits had a spinal defect created in their fetuses at 23 days of gestation. At 30 days of gestation, the fetuses were harvested for anatomo-pathologic evaluation. RESULTS: The defect was created in 19 fetuses and an attempt to correct it was made in 15 cases (group I), and 4 fetuses where left without correction (group II). At 30 days, a 'myelomeningocele-like' defect was present in all surviving fetuses. The total survival rate was 73.68% (14/19); 11 fetus survived in group I and 3 in group II. CONCLUSION: The technical modifications, including fetal positioning and exposure of its back prior to the incision of the lamina, associated with a different technique for myometrium closure, offer an alternative and probably safer method to surgically create a spinal defect in the fetal rabbit.