Bolivian kindred with combined spinocerebellar ataxia types 2 and 10

BACKGROUND

Spinocerebellar ataxias (SCA) are a group of rare hereditary neurodegenerative disorders. Rare cases of two SCA mutations in the same individual have been reported in the literature, however, family descriptions are lacking.

AIMS

To characterize a family with combined SCA2 and SCA10 mutations.

MATERIALS & METHODS

Analysis of the clinical features and genetic findings of a Bolivian family expressing both SCA2 and SCA10 mutations.

RESULTS

The index case and his mother had both SCA2 and SCA10 mutations with a combined clinical phenotype of both disorders, including slow saccades (SCA2) and seizures (SCA10). The uncle of the index case had only an SCA10 mutation.

DISCUSSION

Although the presence of two SCA mutations in the same individuals may be coincidental, the low probability of having both mutations suggests that these mutations might be particularly prevalent in Bolivian population.

CONCLUSION

This is the first description of a family with two SCA mutations with affected subjects having a combined SCA2 and SCA10 phenotype.

Study of a measles outbreak in Granada with preventive measures applied by the courts, Spain, 2010 to 2011

Binary file ES_Abstracts_Final_ECDC.txt matches

Remediation trials for hydrocarbon-contaminated sludge from a soil washing process: evaluation of bioremediation technologies

The usual fate of highly contaminated fine products (silt-clay fractions) from soil washing plants is disposal in a dump or thermal destruction (organic contaminants), with consequent environmental impacts. Alternative treatments for these fractions with the aim of on-site reuse are needed. Therefore, the feasibility of two technologies, slurry bioremediation and landfarming, has been studied for the treatment of sludge samples with a total petroleum hydrocarbon (TPH) content of 2243 mg/kg collected from a soil washing plant. The treatability studies were performed at the laboratory and pilot-real scales. The bioslurry assays yielded a TPH reduction efficiency of 57% and 65% in 28 days at the laboratory and pilot scale, respectively. In the landfarming assays, a TPH reduction of 85% in six months was obtained at laboratory scale and 42% in three months for the bioremediation performed in the full-scale. The efficiency of these processes was evaluated by ecotoxicity assessments. The toxic effects in the initial sludge sample were very low for most measured parameters. After the remediation treatments, a decrease in toxic effects was observed in earthworm survival and in carbon mineralisation. The results showed the applicability of two well known bioremediation technologies on these residues, this being a novelty.

Restoration of Norepinephrine-Modulated Contextual Memory in a Mouse Model of Down Syndrome

Cognitive deficits in mice with a Down syndrome–like genetic defect can be reversed with precursors to the neurotransmitter norepinephrine.

Anti-tumor necrosis factor α F(ab')2 antibody fragments protect in murine polymicrobial sepsis: Concentration and early intervention are fundamental to the outcome

BACKGROUND

Negative results are frequent using anti-TNFalpha antibodies in sepsis models and clinical trials.

METHODS AND RESULTS

Different prophylactic doses of anti-TNFalpha F(ab')2 antibody fragments were compared for the prevention of death by sepsis induced by cecal ligation and puncture (CLP) in mice. High (10 mg/kg) and very low (0.01 and 0.1 mg/kg) concentrations of anti-TNFalpha antibody fragments were not the most adequate for treating polymicrobial sepsis, since they did not significantly improve survival. To the contrary, intermediate doses (1 mg/kg) significantly protected the challenged animals. Protective activity was also observed when administration of the antibody fragments was initiated early (up to 30 min) after CLP.

CONCLUSIONS

These results suggest that in processes where excessive production of cytokines is involved, the aim should be to return them to their physiologically acting range but not to inhibit their production. The timing of initiating therapy should also be considered in order to maximize the possible benefits.

Environmental and lifestyle factors for organochlorine exposure among women living in Southern Spain

Southern Spain has the largest area of intensive greenhouse agriculture in Europe, and may constitute a special case of occupational and female exposure, because this type of farming requires considerable pesticide use and employs many women. We measured adipose tissue levels of 14 organochlorine pesticides in 458 women living in this area and analyzed the relationship between pesticide level/presence and sociodemographic characteristics, reproductive history or life-style factors that may influence this exposure. Pesticide presence was determined by gas chromatography with electron-capture detector. All fat samples were positive for 1 residue. DDT or metabolites were found in 98.25%, with mean value of 660 ngg(-1) of lipid. p,p'-DDE level was higher in women who were older, with lower educational level or obese. Almost 70% had measurable levels of endosulfan and/or metabolites, with a mean total value of 38.8 ngg(-1) of lipid. Endosulfan-I exposure was higher in women with shorter residence in rural settings and more frequent in women with 3 children. 52.62% were exposed to 1 of aldrin-dieldrin-endrin group. Endrin was more frequent in women who were younger, with higher educational level or no agricultural working experience; dieldrin was more frequent in women who were older, with lower educational level or more children. Finally, lindane residues were found in 39.30%. Lindane levels were higher in women who breastfed longer or had more children. Research is required on women occupationally exposed to a selected group of organochlorine pesticides, especially those of reproductive age, as a basis for preventive action.

[Usefulness of thoracic radiography after insertion of transitory catheters for hemodialysis]

A chest X-ray has been routinely used to evaluate possible complications of a catheter installed for hemodialysis. The objective of the present study was to evaluate the utility of routine chest X-ray to detect complications derived from the installation of temporary catheters through a jugular vein access. We studied prospectively 95 successive jugular catheters for hemodialysis. After installation the operator answered a questionnaire that asked for details of the procedure and his opinion of the utility of a chest X-ray to detect a complication in each particular case. A chest X-ray was done in every patient and analyzed blindly. There were 17 minor complications: 7 arterial punctures, 5 neck hamatomas and 5 malpositions of catheters. No major complications were found. Sixty per cent of the catheters that required three or more punctures had a complication vs only 10% of the ones that required two or less puncture (p < 0.05). In five occasions the catheters were malpositioned, in four of these cases a complication was suspected. The wire guide was twisted in all of these cases. The procedure was considered of medium or high difficulty in four of the five malpositioned catheters, in contrast a medium or highly difficult case was considered only in 13 of the 90 well positioned catheters (p < 0.05). The time employed for the catheters installation was significantly higher for the malpositioned catheters. In 29.5% of the cases the operator considered a chest X-ray necessary, 2/3 of the cases did not have a well founded clinical suspicion of complication. We conclude that routine chest X-ray after installation of a jugular catheter for hemodialysis has a low diagnostic value for the detection of complications derived from the procedure and should be ordered only when clinical features suggest a complication.

Subthalamotomy in parkinsonian monkeys. Behavioural and biochemical analysis

Nineteen Macaca fascicularis monkeys were divided into four different groups: Group A (n = 3), control; Group B (n = 3), monkeys treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP); Group C (n = 8), animals treated with MPTP in which the subthalamic nucleus (STN) was unilaterally lesioned by kainic acid injection; in Group D (n = 5), the STN was lesioned prior to MPTP administration. Subthalamotomy resulted in a bilateral improvement of tremor, spontaneous activity, bradykinesia (evaluated by a manual motor test) and freezing in Group C. All these monkeys developed hemichorea contralateral to the lesion. The improvement was maintained and the hemichorea continued until death. The monkeys in group D showed severe hemiballism which persisted throughout MPTP administration and developed parkinsonian signs mainly on the side ipsilateral to the lesion. Analysis of the in situ hybridization of the mRNA coding for glutamic acid decarboxylase (GAD) of MPTP monkeys showed a significant increase in the mean density of silver grains over every labelled neuron in the globus pallidum lateralis (56.8% over control) as well as the globus pallidus medialis (GPM) (45.7% over control) and the substantia nigra reticulata (SNR) (35.8% over control). No significant change was observed in the thalamic nucleus reticularis. Subthalamotomy (Groups C and D) produced a significant reduction in mRNA GAD expression on the side of the lesion in the GPM and the SNR (34% and 42.3%, respectively) with respect to the ipsilateral (non-lesioned) side and also when compared with parkinsonian monkeys. These results confirm and expand, at the cellular level, the paramount role of STN hyperactivity in the pathophysiology of parkinsonism. The therapeutic consequences of these findings for surgical treatment of Parkinson's disease are discussed.

Functional interaction between dopamine D1 and D2 receptors in 'MPTP' monkeys

We have studied the motor response induced by independent administration of 4 different doses of a dopamine D2 [(+)-PHNO] and a dopamine D1 (CY 208-243) receptor agonist in 5 MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) monkeys. Both drugs had similar antiparkinsonian effects and both elicited choreic dyskinesias. Simultaneous administration of (+)-PHNO [(+)-4-propyl-9-hydroxynaphthoxazine] and CY 208-243 [(-)4,6,6a,7,8,12b-hexahydro-7-methylindolo[4,3a-b]phenan thyxidine] did not result in modification of the dose-response curve induced by each dopamine receptor agonist given alone. Pretreatment with the dopamine D1 receptor antagonist SCH 23390 (0.8 mg/kg) and the dopamine D2 receptor antagonist sulpiride (60 mg/kg) reduced the magnitude and the duration of the motor response induced by (+)-PHNO and CY 208-243, respectively, but did not modify the intensity and characteristics of choreic dyskinesias. These results demonstrate that the motor effects and the dyskinesias cannot be dissociated by selective dopamine D1 and D2 receptor stimulation. It appears that stimulation of dopamine D1 and D2 receptors by endogenous dopamine is required to obtain the full motor response induced by selective dopamine receptor agonists as demonstrated by the reduction of the motor improvement found after pretreatment with SCH 23390 and sulpiride.

Does neuromelanin contribute to the vulnerability of catecholaminergic neurons in monkeys intoxicated with MPTP?

The question has been raised as to whether neuromelanin, a by-product of catecholamine metabolism which accumulates during aging in primate midbrain neurons, contributes to the selective vulnerability of subgroups of dopaminergic neurons in Parkinson's disease. 1-Methyl-4-phenylpyridinium (MPP+) a metabolite of 1-methyl, 4-phenyl, 1,2,3,6-tetrahydropyridine (MPTP) is toxic to dopaminergic neurons, particularly in primates, producing a motor syndrome similar to that observed in Parkinson's disease. To test whether this neurotoxin preferentially affects melanized neurons, the survival of melanized and non-melanized catecholaminergic neurons was analysed after MPTP intoxication in the midbrain of the cynomolgus monkey (Macaca fascicularis). Experiments were performed on six animals chronically treated with MPTP (two were severely disabled, four moderately affected) and two age-matched control monkeys. Two populations of neurons were examined on regularly spaced sections throughout the midbrain: catecholaminergic neurons, identified by tyrosine hydroxylase immunohistochemistry and neuromelanin-containing neurons, visualized by Masson's method. The total number of neurons of each type was estimated in the different midbrain catecholaminergic cell groups using computer assisted image analysis. In the midbrains of control animals not all catecholaminergic neurons contained neuromelanin. The percentage of melanized neurons compared to the total population of tyrosine hydroxylase-positive neurons was high in the substantia nigra pars compacta (81.5%) and in the locus coeruleus (98%), intermediate in the substantia nigra pars lateralis (70%), in the catecholaminergic cell group A8 (50%), and in the ventral tegmental area (41.5%) and almost nil in the central gray substance. In MPTP-treated monkeys, the severity of the loss of catecholaminergic neurons was variable within the different midbrain cell groups, though of similar intensity in severely and mildly disabled monkeys. A relationship was found between the loss of dopaminergic neurons in the different mesencephalic cell groups of MPTP-intoxicated animals and the percentage of melanized neurons they normally contain (r = 0.98; P = 0.04). The percentage loss of catecholaminergic neurons in the locus coeruleus, the only noradrenergic cell group studied, was lower than expected from the correlation curve obtained for dopaminergic cell groups. Altogether, these findings indicate: (i) that dopaminergic neurons are more vulnerable to MPTP-toxicity than noradrenergic neurons; and (ii) that among dopaminergic neurons, those containing neuromelanin are more susceptible, indicating a possible role of neuromelanin in MPTP-toxicity.(ABSTRACT TRUNCATED AT 400 WORDS)

The AMPA receptor antagonist NBQX does not alter the motor response induced by selective dopamine agonists in MPTP-treated monkeys

We studied the motor response induced by the administration of the AMPA receptor antagonist, NBQX (2,3-dihydroxy-6-nitro-7-sulfamoylbenzo[f]quinoxaline(1H,4H)dione sodium salt), in two parkinsonian monkeys and its interaction with the selective D-2 dopamine receptor agonist, (+)-PHNO [(+)-4-propyl-9-hydroxynaphthoxazine], and the partial dopamine D-1 receptor agonist, CY 208-243 [(-)-4,6,6a,7,8,12b-hexahydro-7-methyl-indolo[4,3a-b]phen anthyxidine]. NBQX treatment did not reverse the parkinsonism or change the responses previously induced by dopamine agonists. These results do not support an antiparkinsonian effect of the AMPA receptor antagonist, NBQX. In addition they indicate that there is no functional interaction between AMPA and dopamine receptors in monkeys with a substantia nigra lesion.

Behavioral tolerance to repeated apomorphine administration in parkinsonian monkeys

Four consecutive injections (s.c.) of apomorphine (Apo) were given to 5 parkinsonian monkeys after i.v. MPTP administration. The minimal effective dose (MED) of Apo was defined as that capable of reducing motor disability by 50% or more for a minimum period of 30 min. Repeated apomorphine injections were given with an interval of 30 min after the motor effect of the previous injection had worn off or with a separation of 3 h between injections. The doses used in different experiments were the MED (2.4 micrograms/kg), 4 MED and 8 MED. In every experiment the duration of motor benefit was longest with the first Apo injection. There was a decay in the duration of the response elicited by consecutive Apo injections when given 30 min after the previous effect had waned. This was significant for the MED and 4 MED (ANOVA, P < 0.01). When Apo boluses were given with an interval of 3 h there was a significant reduction in the duration of the response elicited by the MED, 4 MED and 8 MED of apomorphine. For the MED the reduction in the duration of the motor response was significantly greater for injections given with a 30-min interval than 3-h interval. These findings indicate that behavioral hyposensitivity to repeated Apo administration in parkinsonian monkeys occurs preferentially when near threshold doses are given with short intervals.

Selective D2 receptor stimulation induces dyskinesia in parkinsonian monkeys

Stimulation of D1 striatal receptors has been proposed as the main mechanism mediating levodopa-induced dyskinesia in Parkinson's disease. We used (+)-PHNO, a selective D2 agonist, as the only treatment in 6 cynomolgus monkeys made parkinsonian by repeated 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine administration. All animals developed choreic dyskinesia after a mean treatment period of 12.8 days (range, 1-29). Administration of the D1 antagonist SCH-23390 1 hour before administration of (+)-PHNO did not change the dyskinesia. These results indicate that drug-induced dyskinesia in a primate model of Parkinson's disease is not solely induced by D1 receptor activation.

[Risk factors for the heterosexual transmission of HIV from man to woman: a Spanish multicenter study]

BACKGROUND

The aims of this study were to estimate the rate of heterosexual transmission of HIV in a population of intravenous drug users (IVDU), as to well as to identify the possible risk factors associated.

METHODS

One hundred thirty heterosexual couples were analyzed in which the male was seropositive for the human immunodeficiency virus (HIV) with the only possible risk factor for the companion being the sexual intercourse with the case index.

RESULTS

The rate of global transmission estimated was 16% (confidence interval of 95% = 10-22.4%). The risk factors significantly associated to HIV transmission were: case index of over 30 years of age (OR = 3.1), clinical status IV (OR = 4.1), less than 0.8 x 10(8) lymphocytes/I (OR = 7), antecedents of sexually transmitted disease (STD) in the woman (OR = 4), and the practice of anal intercourse (OR = 3.1). In the multivariate analysis only the clinical status of the case index and the STC antecedents of the woman were statistically significant (p less than 0.05).

CONCLUSIONS

In this study some of the classical risk factors for the heterosexual transmission of HIV have been confirmed, and the importance of decreasing the prevalence of STD in the IVDU collective in Spain has been corroborated to lower heterosexual transmission and, indirectly the vertical transmission of AIDS.

Motor Response to Repeated Dopaminergic Stimulation in Parkinsonʼs Disease

Recent studies giving subcutaneous apomorphine or intravenous levodopa boluses have not found clear evidence of behavioral hyposensitivity to repeated dopaminergic stimulation in Parkinson's disease (PD). Here we analyze that data, and review experimental findings in animal models and our previous experience with parkinsonian patients. We conclude that acute tolerance to pulsatile stimulation is likely to play a role in the pathophysiology of motor fluctuations in PD.

Controlled clinical trial of cannabidiol in Huntington's disease

Based on encouraging preliminary findings, cannabidiol (CBD), a major nonpsychotropic constituent of Cannabis, was evaluated for symptomatic efficacy and safety in 15 neuroleptic-free patients with Huntington's Disease (HD). The effects of oral CBD (10 mg/kg/day for 6 weeks) and placebo (sesame oil for 6 weeks) were ascertained weekly under a double-blind, randomized cross-over design. A comparison of the effects of CBD and placebo on chorea severity and other therapeutic outcome variables, and on a Cannabis side effect inventory, clinical lab tests and other safety outcome variables, indicated no significant (p greater than 0.05) or clinically important differences. Correspondingly, plasma levels of CBD were assayed by GC/MS, and the weekly levels (mean range of 5.9 to 11.2 ng/ml) did not differ significantly over the 6 weeks of CBD administration. In summary, CBD, at an average daily dose of about 700 mg/day for 6 weeks, was neither symptomatically effective nor toxic, relative to placebo, in neuroleptic-free patients with HD.

[Parkinsonism induced by MPTP as an experimental model of Parkinson disease: similarities and differences]

MPTP administration, preferably to mice and primates, induces a selective damage of substantia nigra dopaminergic cells. Intrinsic mechanisms mediating MPTP induced toxicity, remain still under evaluation. There are very few semiological differences between Parkinson's disease (PD) and MPTP parkinsonism, but significant biochemical and neuropathological differences have been reported between these two entities. However, at the moment it represents the best model of Parkinson's disease available for the study of the basal ganglia function. In addition it could be a useful tool for a better understanding of mechanisms involved in neuronal death and regeneration. The present paper, summarize the real knowledge about the mechanism by which MPTP induces neuronal toxicity, the differences reported between PD and MPTP parkinsonism and finally its application for research.

[Strategies for applied research]

The need of increasing the amount and quality of applied research in the health field es emphasized. The social and economical determinants of health and health care services require a multidisciplinary approach. The most important issue is the utilization of research results in the definition of policies and in the decision making process. Some of the barriers and obstacles to implement research results are discussed as well as the strategies that can be put forward to overcome the former. It is suggested tah participatory research could be an innovative methodology to improve the application of research results. Participative research is a collaborative effort that involves different actors of the health arena including administrators, health personnel, community members, and the researchers themselves. This type of research carries out diagnostic and intervention activities from the very beginning of the studies; its main strength is that decision made and the community members are active participants, impinging a scientific approach to their daily work and so the application of results is facilitated through out the process.

Generalized reflex myoclonus in a patient with alcohol-sensitive spontaneous myoclonus and an abnormal gait

A patient with alcohol-sensitive spontaneous, action- and stimulus-sensitive generalized reflex myoclonus is reported. Gait was abnormal but could not be clearly classified as dystonic. No other neurological abnormality was present. The possible relationship between alcohol-sensitive myoclonic dystonia and this case is discussed. Reflex myoclonus may serve as an additional clinical marker in the study of families with alcohol-sensitive myoclonus, dystonia, or both.

Priming effects in a letter-by-letter reader depend upon access to the word form system

Several types of cognitive and neuropsychological evidence suggest that priming effects on such implicit memory tests as word identification are mediated by a pre-semantic visual word form system that can operate independently of episodic memory. We investigate priming in a letter-by-letter reader, P.T., whose pattern of performance on neuropsychological tests indicates preservation of the word form system. Experiment 1 revealed robust priming on a word identification test following letter-by-letter study of target words, despite P.T.'s great difficulty in identifying non-studied words. Experiment 2 showed that the priming effect was modality specific whereas Experiment 3 indicated that recall of previously studied words was not modality specific, thus indicating that the observed priming could not be attributed to explicit memory strategies. Experiment 4 revealed no priming of illegal nonwords on a letter identification test. The results support the notion that priming on the word identification test depends on access to the word form system.

Diagnosis of carotid artery stenosis: comparison of oculoplethysmography and Doppler supraorbital examination

Both Doppler supraorbital examination (OSM) and oculoplethysmography (OPG) were administered to 101 patients (202 arteries) to document the presence or absence of hemodynamically significant lesions of the internal carotid artery prior to angiography. There was no significant difference between the OSM and OPG with respect to diagnostic sensitivity or specificity, incidence of false-negative or false-positive results, and overall diagnostic accuracy. The diagnostic accuracy for the OSM and the OPG were 94.2% and 91.6%, respectively. In 171/202 (84.6%) arteries, the OSM and OPG were in diagnostic agreement, and the overall diagnostic accuracy of the combined tests was 97%. However, when the OSM and OPG did not agree (31/202 arteries, 15.4%), the diagnostic accuracy of neither the OSM nor the OPG was acceptable. Although the best diagnostic accuracy was obtained using two means of noninvasive cerebrovascular testing, in those instances where only one test may be available, the OPG would appear to be the test of choice. In those laboratories in which high diagnostic accuracy is obtained with the OSM, the addition of OPG testing will increase the overall diagnostic accuracy to a very high level. The presence of a midcervical bruit was found to have a very poor correlation with the incidence of hemodynamically significant stenoses of the internal carotid artery. Although both the OSM and OPG have minimal value in patients with symptomatic cerebrovascular disease, these tests play a very important role in screening patients for asymptomatic carotid stenosis or atypical cerebrovascular symptoms.

Anesthesia in multiple sclerosis

The effect of general anesthesia on 42 multiple sclerosis (MS) patients who underwent 88 episodes of general anesthesia was analyzed. One patient experienced a relapse after a procedure under general anesthesia, which is compatible with the natural history of the disease. A literature review revealed little information on this subject or on the use of particular anesthetic agents in MS. Our experience with spinal and local anesthesia is reported. In the evaluation of the former our limited data suggested that spinal anesthesia is less preferable than other alternatives in MS. Local anesthetics had a benign effect on the course of MS.

Cardiobacterium hominis endocarditis with cerebral mycotic aneurysm

Cardiobacterium hominis, a recently recognized Gram-negative pathogen, was recovered in blood cultures from a 65-year-old man with indolent endocarditis of previously normal heart valves. Despite the low virulence of the organism, major cardiac damage required valvular replacement, and there were multiple cerebral emboli with development of a mycotic aneurysm. After bacteriological cure, he died of a ruptured aneurysm.

Unilateral arhinencephaly in goldenhar-gorlin syndrome

The post-mortem examination of the brain of a 2 1/2-year-old girl with clinical featutes of oculo-auriculo-vertebral dysplasia and hemifacial microsomia (Goldenhar-Gorlin syndrom) revealed a unilateral absence of the olfactory foramina of the lamina cribrosa of the ethmoid bone and ipsilateral absence of olfactory bulb and tract. Other cerebral abnormalities were also present. In this report, unilateral arhinencephaly in this disorder has been documented for the first time and an attempt has been made to correlate various nosological, clinical and pathological aspects of the case with previously reported instances of arhinencephaly. It is concluded that unilateral arhinencephaly occurs in a variety of cranial and facial abnormalities and is not specific for any particular syndrome.