RESUMEN

Brain cancer is one of the most malignant types of cancer in both children and adults. Brain cancer patients tend to have a poor prognosis and a high rate of mortality. Additionally, 20-40% of all other types of cancer can develop brain metastasis. Numerous pieces of evidence suggest that omega-3-polyunsaturated fatty acids (ω-PUFAs) could potentially be used in the prevention and therapy of several types of cancer. PUFAs and oxylipins are fundamental in preserving physiological events in the nervous system; it is, therefore, necessary to maintain a certain ratio of ω-3 to ω-6 for normal nervous system function. Alterations in PUFAs signaling are involved in the development of various pathologies of the nervous system, including cancer. It is well established that an omega-6-polyunsaturated fatty acid (ω-6 PUFA)-rich diet has a pro-tumoral effect, whereas the consumption of an ω-3 rich diet has an anti-tumoral effect. This review aims to offer a better understanding of brain cancer and PUFAs and to discuss the role and impact of PUFAs on the development of different types of brain cancer. Considering the difficulty of antitumor drugs in crossing the blood-brain barrier, the therapeutic role of ω-3/ω-6 PUFAs against brain cancer would be a good alternative to consider. We highlight our current understanding of the role of PUFAs and its metabolites (oxylipins) in different brain tumors, proliferation, apoptosis, invasion, angiogenesis, and immunosuppression by focusing on recent research in vitro and in vivo.

RESUMEN

Sexual selection theory provides a framework for investigating the evolution of traits involved in attracting and competing for mates. Given the sexual function of such traits, studies generally focus on individual interactions (i.e., displays and contests) in explaining trait origin and persistence. We show that ecological factors can strongly influence the adaptive value of these traits, and changes to these factors can lead to rapid evolutionary change. We compared sexually selected traits in the small Indian mongoose (Urva auropunctata) between their sparsely populated native range and four tropical islands to which they were introduced within the last 150 years and where, due to a lack of interspecific competition and predation, they have become invasive and densely populated. Because of a likely increase in encounter rate, we predicted that selection on long-distance chemical advertisement by males would relax in the introduced range. Accordingly, male, but not female, anal pads (used in scent marking) decreased in size in relation to both time since introduction and population density, and their relationship to body size and condition weakened. Concurrently, as predicted by intensified sperm competition, testis size increased following introduction. The small Indian mongoose thus experienced an inversion in the relative contributions to fitness of two sexual traits, followed by their rapid evolution in line with ecological changes.

Asunto(s)

Comunicación Animal , Evolución Biológica , Herpestidae/fisiología , Selección Sexual , Animales , Hawaii , Herpestidae/anatomía & histología , Herpestidae/genética , India , Especies Introducidas , Jamaica , Mauricio , Islas Virgenes de los Estados Unidos

RESUMEN

Alkaloid contents of leaf and seed samples of eight species of Sophora native to New Zealand, plus Sophora cassioides from Chile are reported. Fifty-six leaf and forty-two seed samples were analysed for alkaloid content by proton nuclear magnetic resonance spectroscopy, which showed major alkaloids as cytisine, N-methyl cytisine and matrine. GC analyses quantified these and identified further alkaloid components. The alkaloids identified were cytisine, sparteine, and matrine-types common to Sophora from other regions of the world. Cytisine, N-methyl cytisine, and matrine were generally the most abundant alkaloids across all species with seeds containing the highest concentrations of alkaloids. However, there was no clear taxonomic grouping based on alkaloid composition. A quantitative analysis of various parts of two Sophora microphylla trees showed that the seeds were the richest source of alkaloids (total 0.4-0.5% DM), followed by leaf and twig (0.1-0.3%) and then bark (0.04-0.06%), with only low amounts (<0.02%) found in the roots. This study represents the most comprehensive phytochemical investigation of New Zealand Sophora species to date and presents data for three species of Sophora for which no prior chemistry has been reported.

Asunto(s)

Alcaloides/análisis , Sophora/química , Alcaloides/química , Alcaloides/metabolismo , Azocinas/análisis , Chile , Medicamentos Herbarios Chinos/química , Estructura Molecular , Nueva Zelanda , Hojas de la Planta/química , Raíces de Plantas/química , Quinolizinas/análisis , Semillas/química , Sophora/genética , Matrinas

Asunto(s)

Enfermedad de Alzheimer/genética , Factor Neurotrófico Derivado del Encéfalo/genética , Polimorfismo de Nucleótido Simple , Edad de Inicio , Sustitución de Aminoácidos , Brasil , Estudios de Casos y Controles , China , Humanos , Italia , Metionina , Valores de Referencia , España , Valina , Población Blanca

RESUMEN

OBJECTIVES: To report a high frequency of idiopathic intracranial hypertension (IIH) in patients with cystinosis and to speculate on the relationship between these two disorders. STUDY DESIGN: Retrospective case series and review of the literature regarding risk factors for the development of IIH in cystinosis. RESULTS: Eight patients with cystinosis had documented papilledema, normal neuroimaging of the brain, cerebrospinal fluid (CSF) opening pressure greater than 200 mm of H2O, and normal CSF composition. No common medication, condition, or disease except cystinosis was found in these persons. Six of the patients had received prednisone, growth hormone, cyclosporine, oral contraceptives, vitamin D, or levothyroxine at the time of onset of IIH. Five patients had previous renal transplants. CONCLUSION: No single risk factor for the development of IIH linked IIH to cystinosis in our patients. However, thrombosis susceptibility as a result of renal disease or impaired CSF reabsorption in the arachnoid villi as a result of cystine deposition might lead to the development of IIH in cystinosis.

Asunto(s)

Cistinosis/complicaciones , Seudotumor Cerebral/etiología , Adolescente , Preescolar , Humanos , Masculino , Persona de Mediana Edad , Insuficiencia Renal/complicaciones , Factores de Riesgo

RESUMEN

Since 1969, several classical linkage studies suggested an X-chromosome locus for bipolar affective disorder. However, methods using highly polymorphic DNA markers have provided conflicting evidence for linkage, and an X-chromosomal locus for bipolar disorder remains controversial. More recently, Pekkarinen et al. (1995) found a maximum LOD score of 3.54 at the marker DXS994 in a large bipolar Finnish kindred. In the present study, we attempted to replicate this finding using 43 families multiply affected by bipolar affective disorder. These families were selected for the absence of male-to-male transmission of the disease, and were genotyped for two microsatellte markers, DXS1227 and DXS1062 (which is about 2 cM telomeric to DXS994). Linkage to this region was excluded either using a two-point lod score method with two plausible genetic models, or by a model-free lod score analysis which does not require specification of a particular mode of transmission. We conclude that there is no evidence of a common major gene for bipolar affective disorder at Xq25-q27 in our set of families.

Asunto(s)

Trastorno Bipolar/genética , Cromosoma X/genética , Trastorno Bipolar/epidemiología , Brasil/epidemiología , Inglaterra/epidemiología , Femenino , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Escala de Lod , Masculino , Gales/epidemiología

RESUMEN

Straub et al. (1994: Nature Genet. 8. 291-296) have suggested that a susceptibility gene for bipolar affective disorder is located at chromosome 21q22.3, on the basis of linkage analysis in one large family. This result has been supported by Gurling et al. (1995: Nature Genet. 10, 8-9) who also found some evidence for linkage to this region under locus heterogeneity. In order to investigate the validity of these results and to estimate how broadly applicable they are, we performed a linkage study between bipolar affective disorder and two DNA markers (D21S171 and PFKL) from 21q22.3 using 60 bipolar pedigrees from three European centres and Brazil. The most positive result obtained was a maximised admixture lod score of 1.2 for the marker PFKI, under the assumption of locus heterogeneity, dominant transmission and a diagnostic classification which included recurrent unipolar depression. However, since lod scores obtained for both markers were substantially negative overall, we conclude that there is no common major gene for bipolar affective disorder at 21q22.3. It remains possible that a gene of major effect in this region operates in a minority of families.

Asunto(s)

Trastorno Bipolar/genética , Cromosomas Humanos Par 21 , Ligamiento Genético/genética , Marcadores Genéticos/genética , Brasil , Trastorno Depresivo/genética , Europa (Continente) , Frecuencia de los Genes/genética , Humanos , Modelos Genéticos , Fenotipo , Trastornos Psicóticos/genética

RESUMEN

In spite of significant advances in perinatal/neonatal care, preterm infants remain at high risk for unexplained death in infancy. Using continous documented monitoring as a predischarge screen for persistance of apneas and bradycardias in preterm infants (mean GA 30.5 weeks) prior to hospital discharge, 21 of 332 infants (6.3 per cent) had asystolic events defined as cardiac pauses > 3 seconds. All affected infants had a history of O2 desaturation < 85 per cent and/or colour change in the weeks prior to event monitor screening. Concurrent 72-hour Holter monitoring confirmed sinus pauses of 3 - 10 seconds. Echocardiogram revealed pulmonary artery branch stenosis in 9 of the 21 infants, but no other structural abnormalities. Gastroesophageal reflux was diagnosed by pH probe and/or Milk-Scan in all 21 infants; clinical symptoms improved after specific therapy but asystoles and bradycardias persisted. All infants were followed with home monitoring until asystole-free for 2 months. Asystoles decreased with age: with a mean of 33.7 events/wk at 36 wks post-conceptional age, 24.7 at 47 wks and only 1 infant had asystolic events beyond 58 weeks. Pacemakers were recommended in 3 infants, but only placed in one. None of the infants died. Conclusion: asystolic events occur in preterm infants without significant anatomical cardiac abnormalities and can be diagnosed by continuous documented monitoring. Resolution occurs spontaneously, but long-term cardiology follow-up is necessary to determine later outcome and complications. The significance of these events and their relationship to sudden death in infancy need to be explored (AU)

Asunto(s)

Humanos , Recién Nacido , Lactante , Muerte Súbita del Lactante/etiología , Paro Cardíaco/complicaciones , Recien Nacido Prematuro , Electrocardiografía Ambulatoria

RESUMEN

OBJECTIVE: To evaluate the rate of bacteriologic failure of amoxicillin-clavulanate in the treatment of acute otitis media (AOM) and to identify the risk factors associated with failure. METHODS: Ninety-nine subjects (mean age, 21.4 months) with AOM were treated with amoxicillin-clavulanate in two prospective study trials that compared efficacy of two experimental antibiotics with amoxicillin-clavulanate. Tympanocentesis for microbiologic studies was performed in all subjects at enrollment; at 3 to 6 days, during amoxicillin-clavulanate therapy; and at other times when clinically indicated. The subjects were followed up for 1 month. Clinical, bacteriologic, and virologic characteristics of the subjects were analyzed. RESULTS: Bacteriologic failure of treatment occurred in none of 39 subjects (0%) with Streptococcus pneumoniae, two of 25 (8%) with Moraxella catarrhalis, and 11 of 29 (38%) with nontypeable Haemophilus influenzae (NTHi) infection. The failure rate for NTHi was higher than that for other pathogens (p = 0.0007) and was increased when compared with the preceding study period (p = 0.017). Bacteriologic failure was also associated with clinical failure (p = 0.041). In subjects with AOM caused by NTHi the rates of adequate drug compliance were comparable in both success and failure groups. Antimicrobial susceptibility testing by minimum inhibitory concentration and minimum bactericidal concentration (MIC/MBC) assays showed that amoxicillin-clavulanate resistance was not significantly associated with bacteriologic failure of treatment. However, in two subjects, MIC/MBC of the NTHi isolates during therapy were higher than MIC/MBC of the isolates before therapy; these strains of isolates pretherapy and during therapy were discordant as determined by outer membrane protein analysis. The bacteriologic failure rate was higher in nonwhite boys (p = 0.026) and in subjects with a history of three or more previous episodes of AOM (p = 0.008). Other factors such as age, bilaterality of disease, polymicrobial infection, and biotype pattern of NTHi were not associated with treatment failure. When children with adequate drug compliance were analyzed separately, only those with concomitant viral infection of the nasopharynx or middle ear were found to be at an increased risk of bacteriologic failure of treatment (p = 0.04). CONCLUSIONS: The bacteriologic failure rate of amoxicillin-clavulanate therapy for AOM caused by NTHi was higher in the current study period than in the preceding period. Factors contributing to treatment failure were race, gender, proneness to otitis, and concomitant viral infection.

Asunto(s)

Amoxicilina/uso terapéutico , Antibacterianos/uso terapéutico , Ácidos Clavulánicos/uso terapéutico , Infecciones por Haemophilus/tratamiento farmacológico , Haemophilus influenzae , Otitis Media/tratamiento farmacológico , Enfermedad Aguda , Técnicas de Tipificación Bacteriana , Niño , Preescolar , Ácido Clavulánico , Farmacorresistencia Microbiana , Quimioterapia Combinada/uso terapéutico , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Pruebas de Sensibilidad Microbiana , Moraxella catarrhalis , Infecciones por Neisseriaceae/tratamiento farmacológico , Otitis Media/microbiología , Infecciones Neumocócicas/tratamiento farmacológico , Estudios Prospectivos , Insuficiencia del Tratamiento

RESUMEN

The relation of infant feeding practices, cigarette smoke exposure, and group child care to the onset and duration of otitis media with effusion (OME) was evaluated in a cohort of 698 healthy infants prospectively monitored by tympanometry in the home every 2 to 4 weeks until 2 years of age. Except for an experimental group of children who were offered early tube placement, the study children received conventional care from their personal physician or clinic. We used LISREL, a structural equation modeling procedure (computer software), to explore associations between environmental variables and OME onset and duration while controlling for interrelations among the variables. Supine feeding position and early initiation of group child care were associated with earlier onset of OME. Shorter duration of breast-feeding, increased packs of cigarettes smoked per day in the home, and increased hours per week in group child care were associated with an increase in the amount of time with OME during one or more of the age blocks studied (birth to 6, 6 to 12, 12 to 18, and 12 to 24 months). For a decrease in the amount of time with OME during the first 2 years of life, prolonged breast-feeding and upright feeding position should be encouraged, and cigarette smoke exposure should be minimized. Limiting early child care in large groups might also be advisable.

Asunto(s)

Lactancia Materna , Cuidado del Niño , Otitis Media con Derrame/etiología , Contaminación por Humo de Tabaco/efectos adversos , Lactancia Materna/estadística & datos numéricos , Cuidado del Niño/estadística & datos numéricos , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Otitis Media con Derrame/epidemiología , Estudios Prospectivos , Factores de Riesgo , Factores Socioeconómicos , Factores de Tiempo , Contaminación por Humo de Tabaco/estadística & datos numéricos

RESUMEN

We prospectively studied 271 infants and children (2 months to 7 years of age) with acute otitis media (AOM) for viral and bacterial causes, outcome at the end of therapy, and frequency of recurrence within 1 month. Comprehensive virologic methods, including viral antigen detection, cell culture, and serologic studies, were used to diagnose viral infection of the respiratory tract, middle ear, or both. Evidence of viral infection was found in 46% (124/271) of patients with AOM. Sixty-six patients (24%) had virus or viral antigen in the middle ear fluid; 50 of these patients (76%) also had bacteria in middle ear fluid, and 16 (24%) had virus alone. More patients with AOM and combined bacterial and viral infection (51%) had persistent otitis (3 to 12 days after institution of antibiotic treatment), compared with those with only bacterial otitis (35%; p = 0.05) or patients with only viral infection (19%; p less than 0.01). Of patients with only viral infection, 4 of 10 with virus in middle ear fluid had persistent otitis, compared with none of 11 patients who had virus only in nasal wash specimens or whose viral infection was diagnosed only by serologic studies. Our data suggest that viruses interact with bacteria and that concurrent viral infection can significantly worsen the clinical course of bacterial AOM. The presence of virus in middle ear fluid may contribute to the pathogenesis and outcome of bacterial AOM. The mechanism of these interactions deserve further investigation.

Asunto(s)

Infecciones Bacterianas/tratamiento farmacológico , Otitis Media/microbiología , Infecciones del Sistema Respiratorio/epidemiología , Virosis/epidemiología , Amoxicilina/uso terapéutico , Combinación Amoxicilina-Clavulanato de Potasio , Infecciones Bacterianas/epidemiología , Ceftizoxima/análogos & derivados , Ceftizoxima/uso terapéutico , Claritromicina , Ácidos Clavulánicos/uso terapéutico , Quimioterapia Combinada/uso terapéutico , Eritromicina/análogos & derivados , Eritromicina/uso terapéutico , Femenino , Humanos , Lactante , Masculino , Otitis Media/tratamiento farmacológico , Otitis Media/epidemiología , Resultado del Tratamiento , Cefpodoxima

Asunto(s)

Peso Corporal , Cuidado del Niño , Inmunización/educación , Padres/educación , Adulto , Niño , Fenómenos Fisiológicos Nutricionales Infantiles , Humanos , Indias Occidentales

RESUMEN

An evaluation of the knowledge of adults accompanying children to child health clinics in St. Lucia was undertaken, to determine adult knowledge of weight-for-age graphs (as present on the St. Lucia Child Health Passport) and to determine the knowledge of immunization status of the child. Respondents' knowledge of weight-for-age curves was unsatisfactory and appears to be determined by the clinic nurse and her workload. Knowledge of immunization was satisfactory. Emphasis should be placed by health workers on the understanding of weight-for-age graphs, so that they may act as a basis for nutrition education and intervention (AU)

Asunto(s)

Adulto , Niño , Humanos , Peso Corporal , Cuidado del Niño , Inmunización/educación , Padres/educación , Nutrición del Niño , Santa Lucia

Asunto(s)

Niño , Adulto , Humanos , Educación en Salud , Inmunización , Indias Occidentales , Encuestas y Cuestionarios

RESUMEN

PIP: The usefulness of a home based pediatric record is examined in the home, child health clinics and hospital as a means of communicating health information. Such a record, the Child Health Passport (CHP) was successfully introduced into St. Lucia in 1976-77 and issued to all children under 5 years of age in order to facilitate communication between health workers and also between health workers and their patients. Data to be recorded on the CHP included weight (with a weight for age chart imprinted on the CHP), name and address, immunizations, and significant hospital problems and treatment. The card also had a pocket for messages and appointment schedules. Surveys on the use and condition of the card were taken at health centers, Casualty Department (Emergency Room) of the main hospital on the island, and the pediatric ward of the hospital; in addition, individual health workers were interviewed on the card's effectiveness and their feelings about its use. Results show the CHP highly accepted by the public with 86.1% to 93.6% of children being in possession of it. However, there was a progressive decrease in the presence of the card in the district doctor's clinic (69%), Casualty Department (57.2%), and hospital ward (39%). The main problem appears to be the need for the involvement of the doctor in using this record in hospital and in the district clinic. Parents and primary health care workers are shown to be conscientious in using the home based records and recommentation is made to extend use of the CHP to at least the antenatal and chronic disease areas, and possibly to the area of all clinical information at primary and secondary levels in the Caribbean. Charts detail the content of the CHP, and reasons it is preferable to the clinic record from different health worker's points of view.^ieng

Asunto(s)

Servicios de Salud del Niño , Comunicación , Registros Médicos , Niño , Humanos , Relaciones Interprofesionales , Relaciones Profesional-Paciente , Indias Occidentales

RESUMEN

The use of a home-based paediatric record is examined in the home, child health clinics and hospital, as a means of communicating health information. The usefulness of the record is examined in the various situations in which the child is met. Problems identified in the various settings are described, and suggestions are made as to how they may be reduced. After three years in use, the home-based paediatric record in St. Lucia has been judged a success over the clinic-based record system (AU)

Asunto(s)

Niño , Humanos , Servicios de Salud del Niño , Comunicación , Registros Médicos , Relaciones Interprofesionales , Relaciones Profesional-Paciente , Santa Lucia

Asunto(s)

Indicadores de Salud , Registros Médicos

RESUMEN

Much of the Work of the District Medical Officer in St. Lucia is of a nature which may be performed by other Health workers. This study was conducted to quantify how much of this work could be performed by the present District Nurses with no further training. Patients were seen by a single physician and 30 different nurses, each patient was seen separately by the physician and nurse. The physician recorded diagnosis and treatment and the nurse recorded diagnosis and recommended treatment. The nurse was also requested to evaluate the urgency of referral to a doctor if none was available. Nine hundred and ninety patients were seen jointly, with an average of 30 patients per nurse in areas of heavy usage a sample 1:2 or 1:3 was taken. The errors made by the district nurses in diagnosis were small - only 3.3 percent were considered incorrect and harmful, 1.7 percent of diagnoses were not stated. Approximately a quarter of the diagnoses was incorrect, but owing to the nature of the illness these were considered by the physician as harmless misdiagnoses. The balance were correct diagnosis, or partially correct/incomplete/symptomatic in nature. In terms of treatment the majority fell into the categories; correct, partially correct but harmless, or incorrect harmless (84.7 percent), 2.4 percent of patients had no treatment stated. Patients who were not suggested as referrable but who should have been were 12.9 percent. The urgency of referral recommended by District Nurses indicated that the nurses felt in the majority of cases that most patients either could wait until the next clinic in one week usually, or did not need to see the doctor at all. Less than 5 percent of patient visits were considered urgent (see doctor the same day) and just under 15 percent fairly urgent (see doctor within 24 hours). The referral decision was felt correct/excessively urgent in 87.1 percent of cases. In only 0.8 percent was inappropriate delay felt to be present. The referral urgency was not stated in 12.1 percent of patients. The study shows that there is good evidence for using District Nurses without further training, a careful delineation of responsibilities would be necessary however (AU)

Asunto(s)

Enfermeras y Enfermeros , Evaluación de Procesos y Resultados en Atención de Salud , Santa Lucia