Neuroimaging in non-accidental head injury in children: an important element of assessment

Head injury from physical abuse is unfortunately a common occurrence in our society. It is a major cause of mortality and long-term physical and psychological disability in children. Diagnosis of non-accidental head injury may be difficult, as most infants present with non-specific clinical findings and without external signs of trauma. Neuroimaging plays a fundamental role both for medical management and medicolegal aspects of child abuse. It is therefore imperative for the radiologist to promptly recognise the radiological findings of various forms of non-accidental head injury to render a more accurate opinion. A standardised imaging protocol and good communication between professionals are essential for optimum management.     

In vitro interactions between piperaquine, dihydroartemisinin, and other conventional and novel antimalarial drugs

In an in vitro assessment of antimalarial combinations, dihydroartemisinin (DHA) showed no interaction or was mildly antagonistic when combined with piperaquine, pyronaridine, or naphthoquine. Interactions between 4-aminoquinolines and related drugs were also indifferent/antagonistic. The clinical significance of mildly antagonistic DHA combinations is uncertain but may become important if parasite drug sensitivity declines.     

Investigation of reproductive toxicity of piperaquine in mice

Reproductive toxicity data for the antimalarial drug piperaquine (PQ) were obtained in pregnant mice (F₀) and their offspring (F₁ and F₂). PQ phosphate (0–300 mg/kg/day) was given to pregnant Swiss mice from gestational days 14–18. Two F₁ pups from each litter (one male and one female) proceeded to maturity and were mated within dose groups. Biochemical and haematological indices were determined, and liver and kidney histopathology was assessed in F₁ and F₂ mice at 4 weeks. There were no significant dose-related adverse effects, but leucocytes were mildly elevated (F₁ and F₂ mice) and serum albumin was reduced (F₁ only) in the 300 mg/kg/day group. Low plasma PQ concentrations were detected in F₁ mice at 4 and 8 weeks. Although we found no significant PQ toxicity, clinical data are lacking and monitoring of women and their infants for biochemical and haematological adverse effects is recommended when PQ is used in pregnancy.     

Examining overweight and obesity as risk factors for common mental disorders using fat mass and obesity-associated (FTO) genotype-instrumented analysis: The Whitehall II Study, 1985-2004

The Mendelian randomization approach exploits genetic variants to improve causal inference when using observational data. The authors examined the relation between long-term obesity and common mental disorders (CMD) by utilizing the known relation between fat mass and obesity-associated (FTO) genotype and body mass index (BMI; weight (kg)/height (m)(2)). Data collection in 2,981 men and 1,164 women (mean age at baseline = 44 years) from the Whitehall II Study (London, United Kingdom) included 4 repeated examinations of BMI and CMD over a 19-year follow-up period (1985-2004), plus an assessment of FTO polymorphism rs1421085. In men, there was an association of FTO genotype with all measures of adiposity (mean BMI, number of times obese, and, in nonobese persons, number of times overweight). FTO was also associated with CMD in men. This was independent of adiposity, thus potentially violating the exclusion restriction assumption. According to both conventional and FTO-instrumented regression analysis, measurement of obesity was associated with an increased occurrence of CMD. In the FTO-instrumented analysis only, higher BMI and overweight were also associated with CMD. In women, there was no link between FTO and adiposity. Mendelian randomization analyses supported the status of long-term obesity as a risk factor for CMD in men-a finding that should be interpreted cautiously because the function of the FTO gene is unknown.