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.

O Erro, uma Análise Necessária: sua Implicação no Ensino da Língua Portuguesa em Cabo Verde

O trabalho de investigação que ora se apresenta entronca nas preocupações do dia a dia enquanto profissional e dirigente da educação que tem experimentado e acompanhado de perto a prática pedagógica e docente. Por esses imperativos, senti-me na obrigação de procurar uma resposta, refletir sobre as dificuldades do ensino da língua portuguesa e perceber melhor esses obstáculos, nomeadamente o erro linguístico nas práticas letivas, as causas subjacentes e, eventualmente, a quota-parte de responsabilidades dos outros intervenientes no processo, nomeadamente, dos professores de língua portuguesa e do próprio sistema. Nesta sequência, o presente estudo aborda o erro como conceito, marcado pela polissemia da sua definição, abordado pelas múltiplas metodologias de ensino, mas também como elemento central no ensino e aprendizagem de uma língua segunda, no ensino básico, em contextos de coabitação de línguas muito próximas como o português e a língua cabo-verdiana; pretendemos também elencar os procedimentos e atitudes dos atores no processo, bem como os meios didático-pedagógicos essenciais com vista a sua deteção, análise e tratamento do mesmo. A aprendizagem de uma língua segunda como o português, num contexto como o de Cabo Verde, constitui uma tarefa complexa e por vezes demorada, que não pode ser resumida a atos corriqueiros e previsíveis de sala de aula, ignorando as necessidades, disposições e interesses dos aprendentes que são colocados perante uma encruzilhada, o de aprender uma língua que não é sua, mas que não pode recusar. A aparente aproximação entre as duas línguas constitui um obstáculo acrescido, por propiciar a interferência, principal causa do erro, apesar do avanço verificado no desenvolvimento de metodologias e materiais de apoio que auxiliam e tornam mais eficiente o processo de aquisição de uma língua segunda. Para operacionalização do assunto foi elaborado um estudo com recurso à análise de erros, em quarenta e um (41) textos produzidos por alunos do 6.º ano de escolaridade de cinco escolas do ensino básico do Tarrafal, Cabo Verde, com o intuito de recolher informações, analisá-las e, após uma reflexão sobre os resultados, concluir sobre as suas implicações no ensino aprendizagem da língua portuguesa.

O Cabo-verdiano através dos olhos de forasteiros: representações nos textos portugueses, 1784-1844

Ao ler os textos portugueses dos finais do século XVIII e a primeira metade do século XIX deparase com uma certa depreciação e africanização do homem cabo-verdiano. As formas de sociabilidade dos cabo-verdianos eram reprovadas por estes serem demasiados próximo dos “negros africanos”. Estas representações continuam a ser menos conhecidas tanto no domínio da História como nos outros campos do saber. Ora, o presente trabalho debruça-se sobre a imagem do homem caboverdiano construída, pensada, e dada a ler nos textos portugueses produzidos pelos forasteiros no período entre 1784 e 1844. O corpo textual que sustenta este estudo foi produzido a partir do contacto com as ilhas e os seus habitantes ou, muitas vezes, a partir de informações de terceiros, por alguém cujos padrões mentais e culturais pertenciam à outra realidade. Da longa relação dos portugueses/europeus com os africanos sob a soberania portuguesa no espaço cabo-verdiano desenvolveu-se uma cultura nova e um homem novo – uma nova sociedade, que por um lado reflecte o fracasso português na assimilação dos cabo-verdianos e por outro mostra a capacidade de, num espaço novo, através do processo de mestiçagem, que foi quase um fenómeno natural nas ilhas de Cabo Verde, surgir algo novo, com contornos próprios, que se pode caracterizar de caboverdiano

Labour market in the Catalan cotton textile sector: Employment and fertility (1850-1913)

This paper deals whit the dynamics of the Catalan textile labour market (theSpanish region that concentrated most of the industrial and factory activity duringthe 19 Century) and offers hypotheses and results on the impact it had on livingstandards and fertility levels. We observe the formation of an uneven labourmarket in which male supply for labour (excluding women and children) grewmuch faster than the demand. We stress the fact that labour supply is verydependant on institutional factors liked to the transmition of household propertybetween generations. Instead the slow path of growth of adult males demand forlabour is witnessing the limits of this industry to expand and to compete ininternational markets. The strategy of working class families to adapt to scarceopportunities of employment we document here is the diminution of legitimatefertility levels. Fertility control is the direct instrument we think workers have tocontrol their number in a situation that was likely to create labour surpluses in theshort and mid run.

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 nationwide study on driving under the influence of drugs in Switzerland.

In Switzerland, a two-tier system based on impairment by any psychoactive substances which affect the capacity to drive safely and zero tolerance for certain illicit drugs came into force on 1 January 2005. According to the new legislation, the offender is sanctioned if Delta(9)-tetrahydrocannabinol THC is >or=1.5ng/ml or amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyethylamphetamine (MDEA), cocaine, free morphine are >or=15ng/ml in whole blood (confidence interval+/-30%). For all other psychoactive substances, impairment must be proven in applying the so-called "three pillars expertise". At the same time the legal blood alcohol concentration (BAC) limit for driving was lowered from 0.80 to 0.50g/kg. The purpose of this study was to analyze the prevalence of drugs in the first year after the introduction of the revision of the Swiss Traffic Law in the population of drivers suspected of driving under the influence of drugs (DUID). A database was developed to collect the data from all DUID cases submitted by the police or the Justice to the eight Swiss authorized laboratories between January and December 2005. Data collected were anonymous and included the age, gender, date and time of the event, the type of vehicle, the circumstances, the sampling time and the results of all the performed toxicological analyses. The focus was explicitly on DUID; cases of drivers who were suspected to be under the influence of ethanol only were not considered. The final study population included 4794 DUID offenders (4243 males, 543 females). The mean age of all drivers was 31+/-12 years (range 14-92 years). One or more psychoactive drugs were detected in 89% of all analyzed blood samples. In 11% (N=530) of the samples, neither alcohol nor drugs were present. The most frequently encountered drugs in whole blood were cannabinoids (48% of total number of cases), ethanol (35%), cocaine (25%), opiates (10%), amphetamines (7%), benzodiazepines (6%) and methadone (5%). Other medicinal drugs such as antidepressants and benzodiazepine-like were detected less frequently. Poly-drug use was prevalent but it may be underestimated because the laboratories do not always analyze all drugs in a blood sample. This first Swiss study points out that DUID is a serious problem on the roads in Switzerland. Further investigations will show if this situation has changed in the following years.