Sclérose en plaques: au-delà des traitements de première ligne [Multiple sclerosis: beyong first line therapies].

We are currently experiencing a key period in the management of patients with relapsing remitting multiple sclerosis. The application of new criteria allows early diagnosis, thus at a stage when the available immune treatments are the most likely to show a good efficacy. The therapeutic offer is expanding but its complexity too. It is thus important, for a given patient, to assess as precisely as possible the degree of severity of his/her disease, in order to give the drug with the optimal risk/benefit ratio.

High prevalence of major cardiovascular risk factors in first-degree relatives of individuals with familial premature coronary artery disease--the GENECARD project.

BACKGROUND: Hypertension, hypercholesterolemia, obesity and smoking are highly prevalent among patients with familial premature coronary artery disease (FP-CAD). Whether these risk factors equally affect other family members remains unknown. METHODS: We examined 222 FP-CAD patients, 158 unaffected sibs, 197 offspring and 94 spouses in 108 FP-CAD families (> or = 2 sibs having survived CAD diagnosed before age 51 (M)/56 (F)), and compared them to population controls. RESULTS: Unaffected sibs had a higher prevalence of hypertension (49% versus 24%, p<0.001), hypercholesterolemia (47% versus 34%, p=0.002), abdominal obesity (35% versus 24%, p=0.006) and smoking (39% versus 24%, p=0.001) than population controls. Offspring had a higher prevalence of hypertension (females), hypercholesterolemia and abdominal obesity than population controls. No difference was observed between spouses and controls. Compared to unaffected sibs, FP-CAD affected sibs had a similar risk factor profile, except for smoking, which was more prevalent (76% versus 39%, p=0.008). CONCLUSIONS: Hypertension, obesity and hypercholesterolemia are highly prevalent among first-degree relatives, but not spouses, of patients with FP-CAD. These persons deserve special medical attention due to their familial/genetic susceptibility to atherogenic metabolic abnormalities. In these families, smoking may be the trigger for FP-CAD.

Improving social measurements: The experience of the ESS first rounds in Spain

With the two aims of monitoring social change and improving social measurement, the European Social Survey is now closing its third round. This paper shows how the accumulated experience of the two first rounds has been used to validate the questionnaire, better adapt the sampling design to the country characteristics and efficiently commit fieldwork in Spain. For example, the dynamic character of the population nowadays makes necessary to estimated design effects at each round from the data of the previous round. The paper also demonstrates how, starting with a response rate of 52% at first round, a 66% response rate is achieved at the third round thanks to an extensive quality control conducted by the polling agency and the ESS national team and based on a detailed analysis of the non-response cases and the incidences reported by the interviewed in the contact form.

Sitobion graminis Takahashi, 1950 (Hemiptera, Aphididae): first record in Brazil, biological and morphometric parameters

The species Sitobion graminis Takahashi, 1950 (Hemiptera, Aphididae) was first detected in Brazil in 1998, in Curitiba, Paraná state, associated with the grass species Erianthus sp., Calamagrotis sp. and Paspalum urvilei. Both the field-collected and laboratory-reared specimens presented a noticeable intrapopulational variation in body and appendix length and in dorso-abdominal sclerotization. This species has been recorded in Malaysia, New Guinea, India, Philippines and Africa, where it colonizes several species of Poaceae. S. graminis differs from other Sitobion species from Brazil associated with grasses, as it presents black cauda and siphunculi and exhibits a constriction in the base of the last rostral segment. Biological data were obtained in the laboratory by rearing newborn nymphs on the inflorescence of the host plants. They passed through four nymphal instars. The mean duration of the nymphal stage was of 11.4 days, with a mortality ratio of 36.5%. The mean pre-larviposition period was of 1.8 days; mean longevity of the females was 25.2 days; and mean fecundity was 18.7 nymphs/female, ranging from 2 to 41 nymphs/female.

Cordiluroides Albuquerque from Costa Rica: first records, descriptions and taxonomic changes (Diptera, Muscidae, Coenosiinae)

Cordiluroides Albuquerque is a genus of Neotropical Coenosiinae (Muscidae), known from six species. The genus is here recorded for the first time from Costa Rica, on the basis of three species: C. listrata Albuquerque, 1954, C. insularis (Willliston, 1896) and C. bistriata (Wulp, 1896) sp. rev.. We provide a key for the identification of these Costa Rican species, redescribe and illustrate their external morphological characters and terminalia. C. bistriata and C. vittifera (Stein, 1904) are both considered to be good species and are re-instated from the synonymy of C. insularis. The type material of C. listrata (Museu Nacional, Rio de Janeiro), of C. insularis and C. bistriata (The Natural History Museum, London) and of C. vittifera (Museum für Naturkunde, Humboldt-Universität zu Berlin) has been examined.

First record of Anastrepha parishi Stone (Diptera, Tephritidae) and its host in Brazil

Anastrepha parishi Stone, 1942 was reared in fruits of Oenocarpus bacaba Martius, 1823 (Arecaceae) collected in Pracuúba, State of Amapá. This is the first record of an Anastrepha species in a native species of Arecaceae.

The Spanish motor industry in the first third of the 20th Century: A lost opportunity

The Spanish automobile industry had a late start. Although the country proved capable of short production runs of high-quality vehicles during the first third of the century it never managed to build up its own industry, unlike Great Britain, France, or Italy. What then, were the critical shortcomings that prevented the establishment of large Spanish motor manufacturers? Put another way, why did all of the companies set up during the first half-century fail to survive? This paper attempts to shed some light on these questions, employing a wide-ranging analysis of both internal and external factors affecting the industry. A feeble internal market, lack of resources and production factors are usually adduced as reasons, as are Spain's general economic backwardness and the role played by the public authorities. However, this paper mainly focuses on the internal factors concerning company strategy and organisation. A comparison with the Italian case helps put the traditional arguments in proper perspective and highlights those covering business strategies. Finally, we argue that a broad range of factors needs to be analysed to fully understand why Spain failed to establish a motor industry.

First record of the genus Myllaena Erichson from Brazil, description of a new species and annotated catalog of Myllaena species from the Neotropical region (Coleoptera, Staphylinidae, Aleocharinae)

The genus Myllaena Erichson, 1837, of the tribe Myllaenini Ganglbauer, 1895, is recorded from Brazil for the first time. A new species, Myllaena brasiliensis sp. nov., is described and illustrated; it is closely related to the insomnis species group, described from the Nearctic region. A short diagnosis of the genus and an annotated catalog of Myllaena species from the Neotropical region are also provided.

Intravenous Lacosamide for Treatment of Status Epilepticus after Failing First-Line Therapy

Rationale: Treatment of status epilepticus (SE) usually requires intravenous anticonvulsant therapy. Although there are established drugs of first choice for its treatment, potentially hazardous side effects of these agents are not uncommon. Lacosamide (LCM) is a novel anticonvulsant drug that is available as infusion solution. LCM could be an alternative for treatment of SE when the standard drugs fail or should be avoided. Methods: We retrospectively identified patients from the hospital databases of two German and one Swiss neurological departments (University Hospital Marburg, Klinikum Osnabrueck, University Hospital Lausanne) between September 1st 2008 and May 22nd 2009 who were admitted because of SE and received at least one dose of intravenous LCM for treatment of SE. Results: Seventeen patients (11 female, 6 male) were identified. Median age was 71 years. 3 patients suffered from generalized convulsive SE, 8 patients had significant reduction of awareness with or without subtle motor symptoms, 6 patients had a simple focal status without relevant reduction of awareness. Etiology was acute symptomatic in 5 patients, remote symptomatic without pre-existing epilepsy in 6 patients, remote symptomatic and pre-existing epilepsy in 5 patients, and unknown in 1 patient. LCM was administered after failure of first line therapy in all cases. The first LCM bolus was 400mg in 13 patients and 200mg in 4 patients. LCM administration stopped SE in 7 patients. In 2 of them, LCM was administered immediately after benzodiazepine administration, in the others after failure of benzodiazepines and other first-line and/or second-line drugs. In 3 patients, SE was terminated by other anticonvulsants like Phenytoin, Phenobarbital or Oxcarbazepine. In 5 patients, SE could only be terminated by intubation and application of high-dose Midazolam, Propofol and/or Thiopental. In 2 patients, SE could not be terminated in spite of high doses of barbiturates. There was no serious adverse event documented that could possibly be attributed to LCM Conclusions: Intravenous LCM may be an alternative treatment for SE after failure of benzodiazepins and other established drugs, or when such agents are considered unsuitable.

Introducing a first AIDS vaccine in Switzerland: a Policy Delphi analysis.

This preliminary exploration was limited by a number of factors. The format of the study has necessarily induced some form of selection bias of the panelists, because of the complexity of some questions, and the time required to complete the questionnaires. Several issues have not been addressed. One example could be the response to HIV infection occurring in a vaccinee. The study also did not address the difficulties related to the licensing of the vaccine. Indeed, the proposed scenario assumed that the vaccine had been registered as a starting point for the analysis. Finally, it has not been possible to conduct a sensitivity analysis, in order to evaluate how the responses would have been modified if some important characteristics of the vaccine had been modified.Very diverse evaluations were given in response to questions related with attitudes and perception of AIDS and AIDS vaccine. The possibility that vaccine availability or usage can be associated with an increased frequency in risky behaviors was spontaneously mentioned by half of the panelists. The estimation of the proportion of persons at highest risk who would choose to use this vaccine also indicated a high degree of uncertainty. This study offers important lessons. According to a broad and diverse panel of individuals, an incompletely effective AIDS vaccine would result in an additional level of complexity for the AIDS prevention strategy, rather than a simplification. The use of such a vaccine would have to be coupled with counselling. This implies a sustained emphasis on the recommendations which have been central to the STOP AIDS campaigns until now. In addition, consensual issues, as well as other issues more likely to be controversial have been identified. This should greatly help focusing the work of any committee designated to develop and implement a vaccination policy if an AIDS vaccine became available. Finally, our experience with the Policy Delphi indicates that this mode of structured communication could be usefully applied to other public health issues presenting a high visibility as well as a complex relationship with public perception.

Body size, activity, employment and wages in Europe: A first approach

This paper examines the associations between obesity, employment status and wages for several European countries. Our results provide weak evidence that obese workers are more likely to be unemployed or tend to be more segregated in self-employment jobs than their non-obese counterparts. We also find difficult to detect statistically significant relationships between obesity and wages. As previously reported in the literature, the association between obesity, unemployment and wages seems to be different for men and women. Moreover, heterogeneity is also found across countries. Such heterogeneity can be somewhat explained by some labor market institutions, such as the collective bargaining coverage and the employer-provided health insurance.

First record of Coenosia attenuata Stein (Diptera, Muscidae) from Chile, with biological notes

First record of Coenosia attenuata Stein (Diptera, Muscidae) from Chile, with biological notes. Coenosia Meigen (Muscidae, Coenosiinae) species are known as predators of other insects and play an important role as potential biocontrol agents. Six species of Coenosia have been recorded in Europe preying on insects pests, one of them is Coenosia attenuata Stein. This species was recently recorded from the Neotropical Region and is herein recorded for the first time to Chile. Biological notes were included.

A new species of Dichanthidium (Hymenoptera, Megachilinae) and first records of the genus in Brazil

The second species of Dichanthidium, D. veredicola sp. nov., is herein described and illustrated from specimens collected in Berizal, Minas Gerais, in southeastern Brazil. Dichanthidium exile Moure is reported for the first time in Brazil, from Corumbá, Mato Grosso do Sul. A diagnosis and a key for the species of the genus are provided.

First description of reproductive behavior of the Amazonian damselfly Chalcopteryx rutilans (Rambur) (Odonata, Polythoridae)

Polythoridae comprise a widespread group of species in the New World tropics, but little is known about their behavior or life history. Here, we described the reproductive behavior of Amazonian Chalchopteryx rutilans, using mark-recapture techniques. Males were resident and territorial, though we found disputes (complex flight manoeuvres) to be rare. Trunks (rotting wood) were important to male persistence in sites, as these are the locations preferred by females for oviposition. The mating system of C. rutilans may be comparable to the resource limitation category, described by Conrad & Pritchard (1992), where males cannot control female access to oviposition sites. So, female choice becomes important and apparently, the observed displays (in which males flash the coppery coloration of their hind wings) may be related to attraction of females to territories, as in a lek system.