Epidemiology of neurosensorial deafness in the Foral Community of Navarra

Congenital deafness is a relatively frequent disorder that shows a heterogeneous aetiology. Knowledge and the control of some risk factors have decreased the incidence of acquired deafness and increased the relative importance of genetic cause. In an attempt to investigate the clinical relevance of congenital deafness and the mechanisms of prevention in our population, a clinical and genetic study of cases with neurosensorial deafness born in Navarra between 1975 and 1990 was carried out. A total of eighty-one cases were identified, giving an incidence of 0.8 per thousand. Thirty per cent of the cases showed deafness associated with defects. Cause of deafness was identified in seventy per cent of the cases with whom a detailed clinical and genetic study could be performed (n=50). Genetic factors were responsible for the disorder in more than half of these cases. The most frequent hereditary factor was of the autosomic recessive type. This was associated with a more severe form of hearing loss.     

Abdominal tuberculosis. A report of 3 cases

Three patients admitted to the surgical wards of Johannesburg Hospital in whom abdominal tuberculosis was suspected are presented. In every case difficulties were encountered in diagnosis and treatment. Each case presentation is followed by a short commentary on relevant aspects of abdominal tuberculosis.     

Ceftriaxione associated biliary lithiasis in newborns-report of two cases

The occurrence of biliary calculosis as a complication of the use of ceftriaxone was first described in an 18-year-old patient with chronic granulomatosis. Since then many reports have been published on this type of complication both in children and in adults, but until the present moment, this complication had never been reported in pre-term neonates.The authors describe two cases of biliary calculosis associated with the use of ceftriaxone in preterm-newborns, emphasizing that due to the frequent use of this type of antibiotic in neonatal I.C.U., routine ultrasonographic control exams should be performed to diagnose this possible complication in all neonates receiving ceftriaxone.     

Role of the amygdaloid nuclei in the modulation of tonic immobility in guinea pigs

Tonic immobility (TI) is thought to represent the terminal reaction in the chain of antipredatory responses involved in maintaining survival. TI is an inhibitory behavioral response in which the animal presents a significant decrease in body activity and responsiveness to the environment induced by some form of physical restraint. This response is induced in the laboratory by inversion of the animal and brief postural contention of its movements. In nature, the TI response may be triggered by some threatening or predatory stimulus, indicating the physical contact between response occurs when there is physical contact between prey and predator. In this case, the physical inactivity of the prey may prevent the continuation of the attack. The neural substrate of this response is not well known, and the objective of the present study was to investigate the effect of cholinergic stimulation of amygdala regions on TI modulation in guinea pigs. Microinjection of carbachol (0.5 microg/0.2 microL) into the central (CEA), basolateral (BLA), and lateral posterior (LPA) nuclei of the amygdala promoted a reduction in the duration of TI episodes. Pretreatment with atropine (0.5 microg/0.2 microL) showed that the action of carbachol is mediated by muscarinic receptors.     

Molecular cloning and sequencing of the aroA gene from Actinobacillus pleuropneumoniae and its use in a PCR assay for rapid identification

The gene (aroA) of Actinobacillus pleuropneumoniae, serotype 2, encoding 5-enolpyruvylshikimate-3-phosphate synthase was cloned by complementation of the aroA mutation in Escherichia coli K-12 strain AB2829, and the nucleotide sequence was determined. A pair of primers from the 5' and 3' termini were selected to be the basis for development of a specific PCR assay. A DNA fragment of 1,025 bp was amplified from lysed A. pleuropneumoniae serotypes 1 to 12 of biovar 1 or from isolated DNA. No PCR products were detected when chromosomal DNAs from other genera were used as target DNAs; however, a 1,025-bp DNA fragment was amplified when Actinobacillus equuli chromosomal DNA was used as a target, which could be easily differentiated by its NAD independence. The PCR assay developed was very sensitive, with lower detection limits of 12 CFU with A. pleuropneumoniae cells and 0.8 pg with extracted DNA. Specificity and sensitivity make this PCR assay a useful method for the rapid identification and diagnosis of A. pleuropneumoniae infections.     

Management of arterial hypertension in patients with acute ischemic stroke

PURPOSE: We aimed with study to assess the current clinical practice about the management of high blood pressure in patients in the acute phase of ischemic stroke. We also comment some topics of ischemic stroke treatment. METHODS: A case report of a patient admitted 8 hours after onset of ischemic stroke and with blood pressure of 186 x 110 mmHg was presented to 120 surgeons and clinician. They were asked to decide the best therapeutic option: to increase, decrease or maintenance blood pressure. RESULTS: Thirty-eight physicians (31.7%) considered decreasing blood pressure the best therapeutics, 82 (68.3%) considered maintenance and none decided to increase it (p < 0.05). There was no difference between the two specialties conduct. The physicians, with more than 10 years of graduation, had a tendency to decrease the blood pressure (p < 0.05). CONCLUSION: The maintenance of blood pressure may present a sufficient blood support to compensate brain flow. A high percentage of the physicians (31.7%) do not know about the current concepts of therapeutics considering hypertension in acute ischemic stroke. The development on special units to treat these patients ("stroke units") may eventually decrease the morbimortality rates of ischemic stroke.     

Syncope-related trauma: rationale and yield of diagnostic studies

BACKGROUND: Syncope occasionally occurs in trauma patients. The most appropriate and cost-effective evaluation for such patients is unknown. METHODS: Trauma patients admitted to a Level I trauma center with a diagnosis of syncope or possible syncope between 1988 and 1994 were reviewed. History, physical examination, and past medical history were noted, as were the results of tests done as part of the syncope evaluation. RESULTS: Eighty-eight patients were reviewed; 45% had been injured in falls. Thirteen patients who remembered their entire injury and denied syncope as a cause had negative evaluations. History, physical examination, and admission laboratory values were helpful in diagnosis 59% of the time. Subsequent evaluation provided useful diagnostic information 30% of the time. No patients with normal admission electrocardiograms (EKGs) had cardiac causes for their syncope. CONCLUSIONS: (1) Patients with possible syncope without loss of consciousness require no further evaluation. (2) A cerebrovascular evaluation should be the initial diagnostic approach in patients with signs and symptoms suggestive of stroke or transient ischemic attack. (3) Possible syncope patients with normal admission EKGs should undergo computed tomography of the head and electroencephalography. Those with abnormal EKGs should undergo echocardiography.