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.

A new species of Eccopsis Zeller (Lepidoptera, Tortricidae) from the coastal valleys of northern Chile, with the first continental record of E. galapagana Razowski & Landry

A new species of Eccopsis Zeller (Lepidoptera, Tortricidae) from the coastal valleys of northern Chile, with the first continental record of E. galapagana Razowski & Landry. Eccopsis Zeller, 1852 is reported for the first time from Chile. Eccopsis razowskii Vargas, n. sp. is described and illustrated based on specimens reared from larvae collected on native Acacia macracantha Willd. (Fabaceae) in the coastal valleys of the northern Chilean desert. Eccopsis galapagana Razowski & Landry, 2008, previously known only from the Galapagos Islands, Ecuador, is recorded for the first time from continental South America. Larvae of the latter were collected in northern Chile feeding on Prosopis alba Griseb (Fabaceae).

First record of larvae of Allograpta exotica Wiedemann (Diptera, Syrphidae) preying on Aphis gossypii Glover (Hemiptera, Aphididae) in watermelon in Brazil

First record of larvae of Allograpta exotica Wiedemann (Diptera, Syrphidae) preying on Aphis gossypii Glover (Hemiptera, Aphididae) in watermelon in Brazil. Brazil is one of the largest world producers of watermelon (Citrullus lanatus Thumb. Mansf.) and Aphis gossypii Glover, 1877 (Hemiptera, Aphididae) is among the most important pest on this crop. Larvae of Allograpta exotica Wiedemann, 1830 (Diptera, Syrphidae) were found preying on A. gossypii in watermelon crop, in Santa Maria, Rio Grande do Sul State, what represents the first report of this tritrophic association in Brazil.

First report of Oxysternon silenus Castelnau (Scarabaeidae, Scarabaeinae, Phanaeini) in the Brazilian Atlantic Forest

First report of Oxysternon silenus Castelnau (Scarabaeidae, Scarabaeinae, Phanaeini) in the Brazilian Atlantic Forest. This is the first record of Oxysternon silenus in the Brazilian Atlantic Forest. Specimens were collected in the Serra Grande landscape, municipality of Ibateguara, in Alagoas State. The samples were done from August 17 to 19, 2007 with pitfall traps. Before the present study, Oxysternon silenus had been reported predominantly in Amazonian region. The finding of this species corroborates the hypothesis of the biogeographical relationships between the Amazon Rainforest and the Atlantic Forest.

First report of parasitism on pupae of Opsiphanes invirae amplificatus Stichel (Lepidoptera, Nymphalidae) by Conura (Conura) maculata (Fabricius) (Hymenoptera, Chalcididae) in Rio Grande do Sul, Brazil

First report of parasitism on pupae of Opsiphanes invirae amplificatus Stichel (Lepidoptera, Nymphalidae) by Conura (Conura) maculata (Fabricius) (Hymenoptera, Chalcididae) in Rio Grande do Sul, Brazil. This scientific note records the parasitism on pupae of Opsiphanes invirae amplificatus Stichel (1904) by Conura (Conura) maculata (Fabricius). This is a report of this interaction in the subtropical region of South America and the first report of the occurrence of this parasitoid in the state of Rio Grande do Sul, Brazil.

First record of the behavior of latex drainage by Trigona spinipes (Fabricius) (Hymenoptera, Apidae) in laticiferous flowers

This paper describes the behavior of the bee Trigona spinipes, to avoid the latex, when piercing the base of the tubular corolla of the flowers of Mandevilla guanabarica in order to steal the nectar.

On the first tachinid fly (Diptera, Tachinidae) carrying Asclepiadoideae pollinaria in the Neotropical Region

On the first tachinid fly (Diptera, Tachinidae) carrying Asclepiadoideae pollinaria in the Neotropical Region. This paper reports the first Neotropical Tachinidae species possibly associated to pollination of Asclepiadoideae: a female of Euacaulona sumichrasti Townsend, 1908 (Diptera, Tachinidae, Phasiinae, Trichopodini) carrying pollinaria of Gonolobus parviflorus Decne., 1844 (Apocynaceae, Asclepiadoideae, Asclepiadeae: Gonolobinae) attached to its proboscis. The fly specimen was collected in Paraguay, Departamento Canindeyú. The pollinarium is illustrated and described herein. This represents the first anthophilous record to G. parviflorus and to the genus.

First record of Phoebis argante chincha Lamas (Lepidoptera, Pieridae) in Chile

First record of Phoebis argante chincha Lamas (Lepidoptera, Pieridae) in Chile. The presence of Phoebis argante chincha Lamas, 1976 (Lepidoptera, Pieridae) is reported for the first time in Chile, from the Azapa valley, Arica.

First record of Coprophanaeus bellicosus (Olivier) (Coleoptera, Scarabaeidae) in a "Brejo de Altitude" forest in northeastern Brazil: a historical biogeographical approach

First record of Coprophanaeus bellicosus (Olivier) (Coleoptera, Scarabaeidae) in a "Brejo de Altitude" forest in northeastern Brazil: a historical biogeographical approach. This note presents the first record for a species of dung beetle of the genus Coprophanaeus, subgenus Megaphanaeus, in a "Brejo de Altitude" forest. Besides the new record, the paper discusses biogeographic aspects of the species and subgenus, as well as of the natural history of the "Brejos de Altitude", unique ecosystems in the northeast region of Brazil.