Evidence for an immune-dependent action of praziquantel on Schistosoma mansoni in mice

Effective schistosomicidal action of praziquantel against Schistosoma mansoni infections in mice appears to be dependent to some extent on appropriate immunological stimulation. Indirect evidence consistent with this hypothesis was obtained by demonstrating a positive relationship between drug efficacy and both the intensity and the age of the parasitic infection. More directly, it has previously been shown that praziquantel kills fewer S. mansoni worms in immunosuppressed T cell-deprived mice than in immunologically intact controls; and we show here that infections 5 weeks old, against which the drug alone is sub-optimally active, are more effectively killed by a combination of drug and a rabbit antiserum raised against adult worm antigens.     

The initial flare-up induced by gonadotropin releasing hormone agonist May serve as a predictor of ovarian response in the current IVF-ET treatment cycle in normogonadotropic women aged 40–48 years

Objective: Our purpose was to assess the potential role of the baseline hormone profile in combination with the initial pattern of response to gonadotropin releasing hormone (GnRH) analogue in predicting ovarian function and hence reproductive outcome in normogonadotropic patients aged 40 years or older undergoing IVF treatment. Patients and Methods: A retrospective analysis of 394 controlled ovarian hyperstimulation (COH) cycles that reached the stage of oocyte retrieval was conducted. The study included 163 normogonadotropic (serum FSH 15 IU/L) patients aged between 40 and 48 years who had regular menstrual cycles. Superovulation was achieved using menotropins in combination with GnRH analog (short protocol, beginning on menstrual day 2). The ovarian response was monitored on the third cycle day, the day following the first GnRH analogue administration. Results: Cycle distribution by patient age was 175 (44.4%), 122 (30.9%), and 97 (24.7%), while the patient distribution was 85 (52.2%), 48 (29.5%), and 30 (18.3%) for age groups 40–41, 42–43, and 44–48 years, respectively. The mean total dose of menotropins needed for optimal COH was 1787 IU (range, 600–6000 IU). This dose increased with age, while the yield of oocytes and embryos declined (P<0.05; ANOVA). A positive correlation was demonstrated between the E₂ level on day 3 (GnRH analogue flare effect) and the outcome of the treatment cycle (number of oocytes and embryos). Using multiple stepwise regression analysis, it was demonstrated that the initial (day 3) serum E₂ levels, combined with baseline FSH levels, patient's age and body mass index enabled early prediction of the ovarian response in the current IVF-ET treatment cycle (oocytes=8.2–0.18×Age+0.17×BMI–0.12×FSH+0.0042×E₂). Conclusions: Multiple-parameter analysis demonstrated that the use of the initial E₂ response to GnRH analogue stimulation combined with basic clinical data may assist in the prediction of ovarian function and hence the reproductive outcome in normogonadotropic IVF patients aged 40 years or older. This may serve as a clinical tool for improving patient selection and treatment outcome in IVF-ET.Presented at the IXth World Congress on In Vitro Fertilization and Alternate Assisted Reproduction, April 3–7, 1995, Vienna, Austria.     

Human noroviruses in swine and cattle

Human noroviruses are the predominant cause of foodborne gastroenteritis worldwide. Strains of norovirus also exist that are uniquely associated with animals; their contribution to the incidence of human illness remains unclear. We tested animal fecal samples and identified GIII (bovine), GII.18 (swine), and GII.4 (human) norovirus sequences, demonstrating for the first time, to our knowledge, that GII.4-like strains can be present in livestock. In addition, we detected GII.4-like noroviral RNA from a retail meat sample. This finding highlights a possible route for indirect zoonotic transmission of noroviruses through the food chain.     

Brucella endocarditis complicated with a mycotic aneurysm of the superior mesenteric artery: a case report

Brucella endocarditis, although a rare complication of brucellosis, is the main cause of death attributable to this disease. Mycotic aneurysm is an important extracardiac complication of infective endocarditis. Mycotic aneurysm of the superior mesenteric artery is extremely rare. In the present case, we report a patient with Brucella melitensis endocarditis complicated with a superior mesenteric artery aneurysm. To our knowledge, this is the first such reported case.     

C1-esterase inhibitor autoantibodies in a patient with acute tongue swelling.

Angioedema occurs when there is fluid leakage into the deep dermis of the skin and underlying subcutaneous tissues. Affected individuals usually present with swelling of the face or extremities. Acquired angioedema is an uncommon but potentially life-threatening disease in the older adult population. After the individual is cleared of the initial danger period, a thorough workup for an underlying etiology must be done. We report a 62-year-old male presenting with significant tongue swelling who was diagnosed with acquired angioedema. He had autoantibodies to C1 esterase inhibitor and was subsequently diagnosed with a lymphoma. Angioedema should be recognized by clinicians as a potential presentation of a more ominous malignancy.     

Efficacy of chloroquine, sulphadoxine-pyrimethamine and amodiaquine for treatment of uncomplicated Plasmodium falciparum malaria in Kajo Keji county, Sudan

To provide advice on the rational use of antimalarial drugs, Médecins Sans Frontières conducted a randomized, an open label efficacy study in Kajo Keji, an area of high transmission of malaria in southern Sudan. The efficacy of chloroquine (CQ), sulphadoxine-pyrimethamine (SP) and amodiaquine (AQ) were measured in a 28-day in vivo study, with results corrected by PCR genotyping. Of 2010 children screened, 115 children aged 6-59 months with uncomplicated Plasmodium falciparum malaria were randomized into each group to receive a supervised course of treatment. Of these, 114, 103 and 111 were analysed in the CQ, SP and AQ groups, respectively. The overall parasitological failure rates at day 28 were 93.9% [95% confidence interval (CI) 87.3-97.3] for CQ, 69.9% (95% CI 60.0-78.3) for SP, and 25.2% (95% CI 17.7-34.5) for AQ. These results provide important missing data on antimalarial drug efficacy in southern Sudan. They indicate that none of the drugs could be used in monotherapy and suggest that even in combination with artemisinin, cure rates might not be efficacious enough. We recommend a combination of artemether and lumefantrine as first-line treatment for uncomplicated P. falciparum malaria cases in Kajo Keji county.