Pretibial myxoedema associated with Hashimoto''s thyroiditis

Pretibial myxoedema is a cutaneous mucinosis typically associated with Graves' disease, although it may also develop in subjects with non-thyrotoxic thyroid pathologies. This report presents a rare case of pretibial myxoedema occurring in a 58-year-old woman with biopsy-proven Hashimoto's thyroiditis. The hypothetical pathogenetic link between the two disorders is discussed with particular attention to the role of thyroid stimulating hormone receptor antibodies.     

Structural particularities of parainfluenza type 1 (Sendai) virus progens obtained by cultivation in the presence of ceruloplasmin

Sendai virus multiplication in the presence of ceruloplasmin resulted in the appearance of qualitatively modified progens. There was an increase in the proportion of incomplete virus particles and a decrease in hemagglutinin and neuraminidase activities, in virus infectivity and antigenicity (with the exception of subviral fractions with predominant hemagglutinating activity). Virus progens obtained in the presence of ceruloplasmin had a higher sensitivity to detergent treatment; virus ghosts formed by re-aggregation of envelope fragments could be observed in the electron microscope.     

PROGRESSIVE MYOCLONIC EPILEPSY WITH LAFORA''S BODIES

Two cases of Lafora's disease of rapid evolution with a typical clinical picture, and increased glutamic acid urine excretion are described. Partial critical control was obtained using clonazepam. The relation-ship between PME and heredodegenerative ataxia is discussed; the existence of subacute and precocious forms with long evolution in Lafora's disease is also considered. Cerebral biopsies showed multiple Lafora's bodies. Ultrastructurally, the smaller Lafora's bodies revealed a membrane that separated them from the neuronal cytoplasm; differences were found between the periphery and the central zone of Lafora's bodies, as well as between the different sizes of these inclusions. Their origin and the present concept of a possible biochemical composition are also discussed.     

Clinical status and parasitic infection in a Wichi Aboriginal community in Salta,Argentina

In a study, carried out in 2000, of the clinical and parasitological status of a Wichi Aboriginal community living in the suburbs of Tartagal, northern Salta, Argentina, 154 individuals were screened for parasitic infections. Ninety-five faecal samples were also obtained from the same population. Ninety-three percent of the subjects were positive for 1 or more of the parasites investigated by direct test and 70.5% of them had parasitic superinfection. The most frequent helminths were Strongyloides stercoralis (50.5%) and hookworm (47.4%). We found low reinfection rates and a long reinfection period after treatment and provision of safe water and sanitation. Serum reactivity of these patients was analysed by enzyme-linked immunosorbent assay and indirect immunofluorescent assay and 22.1% of them had anti-Toxocara antibodies, 16.2% were positive for a complex antigen of Leishmania braziliensis, 29.9% were positive for a complex Trypanosoma cruzi antigen, and 17.5% were positive for a specific Trypanosoma cruzi antigen, Ag1 63136/cruzipain.     

Assessment of the epidemiological parameters of the most widespread viral diseases in the Socialist Republic of Romania and in Sibiu County for period 1967-1986

Essential peculiarities of the kinetics of the morbidity evolution of most frequent virus diseases were explained using a determinant mathematical model. The main epidemiological parameters for the whole territory of the S.R. of Romania and of Sibiu County were evaluated for the 1967-1986 period.     

Giant meningioma in a 5-month-old infant

A case of intracranial meningioma is reported in a 5-month-old infant. To date, 25 cases have been reported in the world literature in children less than 1 year of age. Macrocephaly was the most prominent clinical finding. Skull radiological studies, head CT scans, and cerebral angiography were definitive tools in making the diagnosis. Pathological analysis was conclusive. Complete surgical extirpation was the treatment of choice; the tumor weighed 600 g. The child remains stable 24 months later.     

Inhibition of tissue factor/factor VIIa activity in plasma requires factor X and an additional plasma component

A study was carried out to explore requirements for the inhibition of tissue factor-factor VIIa enzymatic activity in plasma. Reaction mixtures contained plasma, 3H-factor IX or 3H-factor X, tissue factor (vol/vol 2.4% to 24%), and calcium. Tissue factor-factor VIIa activity was evaluated from progress curves of activation of factor IX or factor X, plotted from tritiated activation peptide release data. With normal plasma, progress curves exhibited initial limited activation followed by a plateau indicative of loss of tissue factor-factor VIIa activity. With hereditary factor X-deficient plasma treated with factor X antibodies, progress curves revealed full factor IX activation. Adding only 0.4 micrograms/mL factor X (final concentration) could restore inhibition. Inhibition was not observed in purified systems containing 6% to 24% tissue factor, factor VII, 0.5 micrograms/mL, factor IX, 13 micrograms/mL, and factor X up to 0.8 micrograms/mL, but could be induced by adding barium-absorbed plasma to the reaction mixture. Thus, both factor X and an additional material in plasma were required for inhibition. The amount of factor X needed appeared related to the concentration of tissue factor; adding more tissue factor at the plateau of a progress curve induced further activation. These results also indicate that inhibited reaction mixtures contained active free factor VII(a). Preliminary data suggest that inhibition may stem from loss of activity of the tissue factor component of the tissue factor- factor VII(a) complex.     

Considerations on the clinical application of the human papillomavirus vaccine in Spain

The circumstances that in the opinion of the authors influence the lower than expected uptake of the vaccine against human papillomavirus in Spain are analyzed. Among others, aspects related to doubts about efficacy and safety, the attitude of the Spanish health authorities or the role of media and the antivaccine groups, as well as the vaccination "culture" of the gynecologist, are discussed. The authors conclude that only with the coordinated effort of all involved bodies in the vaccination process (health authorities, scientific societies, social agents, media...) wide coverage of HPV vaccine will be achieved.     

One year open-label safety and efficacy trial with rotigotine transdermal patch in moderate to severe idiopathic restless legs syndrome

BackgroundLong-term efficacy and tolerability data are not yet available for patch formulations of dopamine agonists in restless legs syndrome.MethodsEfficacy and safety of rotigotine (0.5–4 mg/24 h), formulated as a once-daily transdermal system (patch), were investigated in an open extension (SP710) of a preceding 6-week placebo-controlled trial (SP709, 341 randomized patients) in patients with idiopathic restless legs syndrome. For efficacy assessment the international RLS severity scale (IRLS), the RLS-6 scales, the clinical global impressions (CGI) and the QoL-RLS questionnaire were administered. In addition, long-term tolerability and safety were assessed.ResultsOf 310 patients who finished the controlled trial, 295 (mean age 58 ± 10 years, 66% females) with a mean IRLS score of 27.8 ± 5.9 at baseline of SP709 were included. We report results after one year of this ongoing long-term trial. Two hundred twenty patients (retention rate = 74.6%) completed the 12-month follow-up period. The mean daily dose was 2.8 ± 1.2 mg/24 h with 4 mg/24 h (40.6%) being the most frequently applied dose; 14.8% were sufficiently treated with 0.5 or 1.0 mg/24 h. The IRLS total score improved by −17.4 ± 9.9 points between baseline and end of Year 1 (p < 0.001). The other measures of severity, sleep satisfaction and quality of life supported the efficacy of rotigotine (p < 0.001 for pre-post-comparisons of all efficacy variables). The tolerability was described as “good” or “very good” by 80.3% of all patients. The most common adverse events were application site reactions (40.0%), which led to withdrawal in 13.2%. Further relatively frequent adverse events were nausea (9.5%) and fatigue (6.4%). Two drug-related serious adverse events, nausea and syncope, required hospitalization. Symptoms of augmentation were not reported by the patients.ConclusionRotigotine provided a stable, clinically relevant improvement in all efficacy measures throughout one year of maintenance therapy. The transdermal patch was safe and generally well tolerated by the majority of patients. Comparable to any transdermal therapy, application site reactions were the main treatment complication.