Intratypic differentiation of polioviruses isolated from suspected cases of poliomyelitis in Brazil during the period of 1990 to 1993

This study analyzed 3129 fecal samples derived from 1626 patients with sudden onset acute flaccid paralysis clinically compatible with poliomyelitis. The samples were collected in the period ranging from January 1990 to September 1993 in all regions of Brazil. Among the 1626 cases studied, 196 had isolation of poliovirus. Nevertheless, it was observed that some factors influenced the isolation rate and the intratypic characterization of these polioviruses. No cases of acute flaccid paralysis has been found to be etiologically related with wild polioviruses.

Polítiques del càstig? Anàlisi comparada del discurs de la política penitenciària a Dinamarca, França, Anglaterra i Gal·les, i el Canadà

L'objectiu principal de l'estudi ha estat conèixer els marcs cognitius i institucionals que tenen les polítiques penitenciàries de Dinamarca, França, Regne Unit i Gal·les i Canadà. Es comparen els discursos presents de fonts directes i indirectes que donen fonamentació semàntica a cada una de les accions polítiques reals d'aquests països. En aquest sentit, es parteix del paradigma que la acció és una comunicació, un discurs que produeix el sistema, que s'orienta significativament al voltant dels marcs cognitius de construcció autoreferencial. Aquests marcs s'agrupen per a la seva presentació en 4 nivells de categories conceptuals: a) fonaments político-filosòfics de la organització social del país en qüestió b) fonaments político-semàntics en la seva forma d'Estat; c) fonaments político-filosòfics en la forma del seu dret penal i el seu sistema penitenciari d) fonaments político-filosòfics de la seva execució penitenciària. Es tracta, doncs, d'analitzar el sentit mateix del càstig i de les formes que adopta. Amb tot això, es presenten arguments suficients que estableixen el valor diferencial de cada política penitenciària, malgrat els esforços d'homogeneïtzació que s'han volgut fer en el procés anomenat d'europeïtzació. En segon lloc es presenta una comparació dels quatre casos, en funció de les categories establertes i una reflexió crítica respecte les maneres que s’està duent a terme el debat sobre la europeïtzació de les polítiques penitenciàries. Amb tot això, es mostra com el anomenat vocable "reinserció social", es desdibuixa i es posa en dubte en funció de la singularitat de cada política, i ressaltat per la tendència de la europeïtzació de les polítiques penitenciàries.

Territorial autonomy and self-determination conflicts: opportunity and willingness cases from Bolivia, Niger, and Thailand

The paradox of autonomy is about whether self-rule accommodates or exacerbates armed conflict. This study attempts to unpack the puzzle examining the effectiveness of territorial autonomy as a state response to self-determination conflicts throughout the world. It challenges the conflict-inducing features of autonomy arguing that territorial autonomy can mitigate armed conflict by channeling group grievances into peaceful forms of protest. Thus, this study aims at arriving at a comprehensive theory that identifies which factors are responsible for violent escalation of conflicts grounded in self-determination demands. By using the concepts of opportunity structures and willingness dimension, this study shows that conflict escalation only takes place when minorities with greater bargaining power vis-à-vis the center, in contexts of high levels of economic inequality within dyad, are mobilized around autonomy and separatist demands.

Vincristine and intestinal pseudo-obstruction in children: report of 5 cases, literature review, and suggested management.

Summary: Intestinal pseudo-obstruction is a rare complication resulting from a variety of disorders. Symptoms include abdominal pain, nausea, vomiting, diarrhea, constipation, and malnutrition. Vincristine-related pseudo-obstruction has been reported in the literature, but its description in children and recommendations for management are lacking. A review of the literature revealed 21 reported pediatric cases of vincristine-related pseudo-obstruction. Most have, however, been attributed to a drug interaction with itraconazole, accidental vincristine overdose, or liver failure. Potential genetic causes are rarely addressed. We present here 5 cases of pseudo-obstruction related to vincristine without any identifiable predisposing factors, and a suggested algorithm for management

GABA receptor subunits in human auditory cortex in normal and stroke cases.

GABA receptors are ubiquitous in the cerebral cortex and play a major role in shaping responses of cortical neurons. GABAA and GABAB receptor subunit expression was visualized by immunohistochemistry in human auditory areas from both hemispheres in 9 normal subjects (aged 43-85 years; time between death and fixation 6-24 hours) and in 4 stroke patients (aged 59-87 years; time between death and fixation 7-24 hours) and analyzed qualitatively for GABAA and semiquantitatively for GABAB receptor subunits. In normal brains, the primary auditory area (TC) and the surrounding areas TB and TA displayed distinct GABAA receptor subunit labeling with differences among cortical layers and areas. In postacute and chronic stroke we found a layer-selective downregulation of the alpha-2 subunit in the anatomically intact cerebral cortex of the intact and of the lesioned hemisphere, whereas the alpha-1, alpha-3 and beta-2/3 subunits maintained normal levels of expression. The GABAB receptors had a distinct laminar pattern in auditory areas and minor differences among areas. Unlike in other pathologies, there is no modulation of the GABAB receptor expression in subacute or chronic stroke.

Acute Schistosomiasis: Report on Five Singular Cases

The cases of five patients with unusual manifestations of acute schistosomiasis mansoni are described in this paper. One patient developed skin lesions, three displayed diverse lung involvement, and one presented pyogenic liver abscesses caused by Staphylococcus aureus

Stroke Aphasia: 1,500 Consecutive Cases.

Background: To study the characteristics of vascular aphasia in a cohort of patients with a first-ever stroke. Methods: All patients admitted to the Lausanne neurology department for a first-ever stroke between 1979 and 2004 were included. Neurological examination including language was performed on admission. Stroke risk factors, stroke origin and location, associated symptoms and Rankin scale scores were recorded for each patient. The influence of these factors on aphasia frequency and subtypes was analyzed using logistic regression models. Results: 1,541 (26%) of patients included in this study had aphasia. The more frequent clinical presentations were expressive-receptive aphasia (38%) and mainly expressive aphasia (37%), whereas mainly receptive aphasia was less frequently observed (25%). In ischemic stroke, the frequency of aphasia increased with age (55% of nonaphasic vs. 61% of aphasic patients were more than 65 years old), female sex (40% of women in the nonaphasia group vs. 44% in the aphasia group) and risk factors for cardioembolic origin (coronary heart disease 20 vs. 26% and atrial fibrillation 15 vs. 24%). Stroke aphasia was more likely associated with superficial middle cerebral artery (MCA) stroke and leads to relevant disability. Clinical subtypes depended on stroke location and associated symptoms. Exceptions to the classic clinical-topographic correlations were not rare (26%). Finally, significant differences were found for patients with crossed aphasia in terms of stroke origin and aphasia subtypes. Conclusions: Risk factors for stroke aphasia are age, cardioembolic origin and superficial MCA stroke. Exceptions to classic clinical-topographic correlations are not rare. Stroke aphasia is associated with relevant disability. Stroke location and associated symptoms strongly influence aphasia subtypes.

Two Unusual Cases of Sudden Death in Children

We report two unusual cases of sudden unexpected death in children. Histopathologic examination showed intimal fibroplasias, a variant of fibromuscular dysplasia of the right coronary artery associated in both cases with fatty infiltration of the right ventricular myocardium. The significance of this particular combination of two lesions known to induce a sudden death in young people is discussed.

Resolution of foveal detachment in dome-shaped macula after treatment by spironolactone: report of two cases and mini-review of the literature.

Dome-shaped macula (DSM) was recently described in myopic patients as a convex protrusion of the macula within a posterior pole staphyloma. The pathogenesis of DSM and the development of associated serous foveal detachment (SFD) remain unclear. The obstruction of choroidal outflow and compressive changes of choroidal capillaries have been proposed as causative factors. In this paper, we report two cases of patients with chronic SFD associated with DSM treated with oral spironolactone. After treatment, there was a complete resolution of SFD in both patients. To the best of our knowledge, this is the first report of successful treatment of SFD in DSM by a mineralocorticoid receptor antagonist.

Sylvatic vectors invading houses and the risk of emergence of cases of Chagas disease in Salvador, State of Bahia, Northeast Brazil

During the last twenty years, several adults of Triatoma tibiamaculata infected with Trypanosoma cruzi have been spontaneously caught by inhabitants, inside their houses in the new habitational district of Pituaçu of Salvador, Bahia. In this communication the authors call attention to the necessity of studies about the possibility of occurrence of new human cases of Chagas disease, to clarify the obscure origin of some positive blood donors in Salvador.

Detection of poxvirus in cattle associated with human cases in the State of Rio de Janeiro: preliminary report

This preliminary report describes human and cow cases of poxvirus that recently ocurred in the State of Rio de Janeiro. The electron microscopic findings were consistent with parapoxviral and orthopoxviral infection. Orthopoxvirus strains were isolated from human and cow cases. Detailed viral characterization by means of genetical techniques is under investigation. Based on these informations, poxviral diseases should be also considered an emerging viral zoonosis that can affect human beings.

Human infection by Pseudoterranova decipiens (Nematoda, Anisakidae) in Chile: report of seven cases

From 1997 to 1999, we identified seven human cases of infection by fourth stage larvae of Pseudoterranova decipiens in Chile. All identified larvae were coughed up by the patients. Subjects were 10-55 years old; five were female. Some patients complained of coughing, expectoration, pharyngeal pain, nausea or anal and nasal pruritus. Larvae of three patients were coughed up from 36 h to 7 days after having eaten raw (cebiche or sushi) or lightly fried fish. P. decipiens has a marine life cycle. Infective third stage larva develop to adult stage in pinniped mammals. The nematode eggs are voided with the host faeces and develop and hatch releasing third stage larvae. Some crustaceans and fish act as hosts of third stage larvae. Man is an accidental host for third or fourth stage larvae.

Immunological follow-up of hydatid cyst cases

Hydatid disease is caused by Echinococcus granulosus. In this study, we aimed to investigate the benefit of monitoring cases with hydatid cyst by means of immune components in patients in a long-term follow-up after surgery. Eighty-four preoperative and postoperative serum samples from 14 cases undergoing surgery for hydatid disease were evaluated in terms of immune parameters, such as total and specific IgE, IgG, IgM, IgA and complement. Total and specific IgE were determined by ELISA. Specific IgG levels were measured by indirect hemaglutination.Total IgG, IgM, IgA and complement (C3 and C4) were detected by nephelometry. Imaging studies were also carried out during the follow-up. In none of the patients hydatid cysts were detected during the follow-up. Total IgE levels in the sera of the patients decreased to normal six months after surgery. Although specific IgE against echinococcal antigens decreased one year after operation, levels were still significantly high. There were no changes in the levels of anti-Echinococcus IgG and total IgG in follow-up period. Additionally, other parameters, such as IgA, IgM, C3 and C4, were not affected.