A randomised clinical pilot trial to test the effectiveness of parent training with video modelling to improve functioning and symptoms in children with autism spectrum disorders and intellectual disability.

BACKGROUND: Poor eye contact and joint attention are early signs of autism spectrum disorder (ASD) and important prerequisites for developing other socio-communicative skills. Teaching parents evidence-based techniques to improve these skills can impact the overall functioning of children with ASD. We aimed to analyse the impact of conducting a group parent-training intervention with video modelling to improve the intelligent quotient (IQ), social and communication functioning and to minimise symptoms in children with ASD and intellectual disability (ID). METHODS: Study design: A multicentre, single-blinded, randomised clinical pilot trial of parent training using video modelling was conducted. SAMPLE: Sixty-seven parents of children with ASD, aged between 3 and 6 years and with IQs between 50 and 70, were randomised: 34 to the intervention group and 33 to the control group. Intervention program: The intervention group received parent training over 22 sessions, and the control group received the standard community treatment. INSTRUMENTS: Pre-evaluation and post-evaluation (week 28), the following were used: Autism Diagnostic Interview, Vineland Adaptive Behaviour Scale I, Snijders-Oomen Nonverbal Intelligence Test, Autism Behaviour Checklist and Hamilton Depression Rating Scale. DATA ANALYSIS: Intention to treat and complier-average causal effect (CACE) were used to estimate the effects of the intervention. RESULTS: There was a statistically significant improvement in the Vineland standardized communication scores in CACE (Cohen's d = 0.260). There was a non-statistically significant decrease in autism symptomatology (Autism Behaviour Checklist total scores) and a significant increase in the non-verbal IQ in the intervention group. After the false discovery rate correction was applied, IQ remained statistically significant under both paradigms. The effect size for this adjusted outcome under the intention-to-treat paradigm was close to 0.4, and when considering adherence (CACE), the effect sizes were more robust (IQ's Cohen's d = 0.433). CONCLUSIONS: Parent training delivered by video modelling can be a useful technique for improving the care given to children with ASD and ID, particularly in countries that lack specialists.

Kappa free light chains index in the differential diagnosis of Multiple Sclerosis from Neuromyelitis optica spectrum disorders and other immune-mediated central nervous system disorders.

The K free light chains index (K-FLC index) has been proposed as an alternative test for intrathecal immunoglobulin synthesis in MS diagnosis. Aim of the study was to assess the accuracy of the K-FLC index in differentiating MS from other immune-mediated CNS disorders and NMOSD. Data were available from a cohort of 371 patients. K-FLC index was significantly higher in MS: MS mean K-FLC index 90.897 ± 134.198; NMOSD 17.992 ± 15.103; other immune-mediated CNS disorders 12.568 ± 24.440. The overall diagnostic accuracy of the K-FLC index was similar to intrathecal oligoclonal bands detection. However, as a quantitative variable, K-FLC index allowed easier discrimination of MS from other immune-mediated CNS disorders: highest K-FLC index values (> 100) were observed almost only in MS and are therefore strongly predictive of MS, in patients with the appropriate clinical presentation.

Características produtivas e nutricionais do capim-xaraés inoculado com bactérias diazotróficas associativas / Productive and nutritional characteristics of Xaraés grass inoculated with diazotrophic associative bacteria

O objetivo do trabalho foi avaliar as características produtivas e nutricionais do capim- xaraés inoculado com bactérias diazotróficas associativas, em primeiro cultivo em Latossolo Vermelho do Cerrado. O experimento foi realizado em casa de vegetação. O delineamento experimental foi inteiramente ao acaso, constituído por fatorial 6x3: três estirpes de bactérias diazotróficas associativas (MTAz8, MTH2 e Y2), uma combinação das estirpes MTAz8 e MTH2, adubação nitrogenada e testemunha absoluta, e três cortes (30, 60 e 90 dias), em cinco repetições. A inoculação foi feita por meio da inserção de uma alíquota de 5mL de caldo bacteriano contendo 108 células mL-1 no solo próximo ao sistema radicular. As variáveis avaliadas foram: massa seca da parte aérea, porcentagem de proteína bruta, acúmulo e concentração de nitrogênio na parte aérea e determinação do número de bactérias diazotróficas do solo. No tratamento adubado com nitrogênio, a produção de massa seca aumentou ao longo dos cortes. Entre as estirpes de bactérias associativas, a Y2 apresentou maior acúmulo de nitrogênio e maior população de bactérias no meio de cultura LGI. As características nutricionais do capim-xaraés decaíram à medida que foram realizados os cortes.(AU)

The aim of this study was to evaluate yield and nutritional characteristics of Xaraés grass inoculated with diazotrophic associative bacteria in the first cultivation in the Cerrado Oxisol. The experiment was conducted in the greenhouse. The experimental design was completely randomized factorial 6x3 consisting of: three strains of diazotrophic associative bacteria (MTAz8, MTH2 and Y2), a combination of strains MTAz8 and MTH2, nitrogen fertilization and absolute control, and three cuts (30, 60 and 90 days) in five replicates. The inoculation was performed by inserting an aliquot of 5ml of the bacterial broth containing 10 8 cells ml-1 in the soil near the root zone of each plant. The variables evaluated were: dry weight of shoot, crude protein, accumulation and nitrogen concentration in the shoot and determining the number of nitrogen-fixing bacteria in the soil. The fertilized soil dry matter production increased over the cuts. Among the strains Y2 showed higher accumulation of nitrogen and largest population of bacteria in the middle of the LGI culture. The nutritional characteristics of Xaraés grass declined as the cuts were made.(AU)

Safety of bevacizumab in patients with malignant gliomas: a systematic review.

Angiogenesis has recently become a major target for the development of new antineoplastic drugs. The most serious adverse events linked to angiogenesis inhibitors are venous or arterial thromboembolism and haemorrhage. Thus, there is need to define with more certainty the impact of these new drugs in terms of adverse effects in neurological patients. The aim of the study is to assess the risk of venous thromboembolism (VTE) and bleeding in patients with malignant gliomas treated with bevacizumab with or without concomitant anticoagulant therapy. A review of published literature was performed in Medline, from which 476 records were identified. A total of 27 full-text articles, including retrospective analyses, retrospective reviews, and open label trials, were assessed for eligibility. The investigated drugs included bevacizumab alone, bevacizumab plus chemotherapy with/without concomitant radiation therapy; only two articles dealt with bevacizumab in association with anticoagulant treatment. A total of 2,208 patients with malignant gliomas, were identified and included in the analysis. From data it appears that patients receiving bevacizumab had a major risk of developing VTE that increased when bevacizumab is associated with radio-chemotherapy (4.27 vs 7.46 %). Regarding bleeding, data showed that patients treated with anticoagulant had a significantly increased risk of severe central nervous system (CNS) bleeding compared to patients not receiving anticoagulant therapy (0.6 vs 8.2 %). The use of bevacizumab combined with chemo-radiotherapy seems to be associated with a higher risk for VTE compared to patients receiving antiangiogenic therapy alone. The associated use of anticoagulants and bevacizumab far increases the risk of developing CNS and non-CNS bleeding higher than grade 3, compared to patients receiving bevacizumab alone.

Anti-angiogenic approaches to malignant gliomas.

Despite advances in multidisciplinary approaches, the prognosis for most patients with malignant gliomas is poor. Malignant gliomas are highly vascularized tumors with elevated expression of vascular endothelial growth factor (VEGF), an important mediator of angiogenesis. Recent studies of bevacizumab, an anti-VEGF monoclonal antibody, alone or associated with chemotherapy, have demonstrated high response rates and prolongation of median and 6-month progression-free survival. Clinical evaluation of several multitarget small molecule tyrosine kinase inhibitors is ongoing. Other promising antiangiogenic compounds are cilengitide and continuous temozolomide. Toxicity is acceptable. Open issues are represented by patterns of tumor progression, resistance mechanisms and biomarkers.

Disruption of pheromone communication in Tecia solanivora (Lepidoptera: Gelechiidae): flight tunnel and field studies.

The moth Tecia (Scrobipalpopsis) solanivora Povolny (Lepidoptera: Gelechiidae) is the most important pest of potato, Solanum spp., in Central America and adjacent South American countries. Insecticide treatments are not sufficiently effective; therefore, we investigated the feasibility of pheromone-mediated mating disruption for control of T. solanivora. Pheromone dispensers were formulated with 70 mg of the three sex pheromone compounds (E)-3-dodecenyl acetate, (Z)-3-dodecenyl acetate, and dodecyl acetate, in a ratio of 100:56:100, respectively. Male attraction to these compounds is optimal at a ratio of 100:1:20, thus the mating disruption dispensers contained an off-blend, which attracted only a few males. Nonetheless, one mating disruption dispenser suppressed male attraction to calling females in a flight tunnel and reduced male activation in response to female pheromone. Communication disruption is accordingly due to camouflage of the female signal and possibly due to a reduction of male responsiveness by sensory imbalance. Only a few males were observed in a 3-ha potato field treated with 84 g pheromone/ha, compared with an untreated control field. During 2 mo, male attraction to traps baited with calling females or synthetic pheromone was strongly reduced. This reduction confirms the potential of mating disruption for management of T. solanivora. The efficacy of the pheromone treatment can be further improved by earlier dispenser application, by increased dispenser load, and by treatment of larger fields to reduce immigration of mated females.

In search of an ideal single-session penicillin schedule for the treatment of gonorrhoea in Uganda.

PIP: To determine the most effective, economical therapy for gonorrhea in Uganda, 5 single-session penicillin schedules were compared in a group of 460 university students with urethral discharge. A total of 590 episodes of gonococcal urethritis were treated. Patients were randomly allocated to 1 of 5 schedules. Treatment schedules and cure rates were as follows: 1) aqueous procaine penicillin 2.4 m.u. (125 cases), 90.3%; 2) procaine penicillin 2.4 m.u. plus ampicillin 1 gm (143 cases), 97.1%; 3) procaine penicillin 3 m.u. (90 cases), 89.8%; 4) procaine penicillin 3 m.u. plus probenecid 1 gm (103 cases), 97.1%; and 5) probenecid 1 gm orally followed by benzyl penicillin 5 m.u. (129 cases), 96.8%. 30 of the 31 treatment failures were successfully treated with an alternate schedule. The results obtained with procaine penicillin alone are considered unfavorable. Although highly effective, the probenecid and benzyl penicillin regimen is expensive and requires the preparation of penicillin with lignocaine solution and an extra 30-minute wait, making it inappropriate for Uganda's busy multipurpose clinics. The procaine-ampicillin combination was also highly effective, but its high cost limits it use to private practice. The 3rd highly effective schedule, the combination of procaine penicillin and probenecid, appears to most closely approximate the ideal single-session penicillin schedule for treatment of gonorrhea in Uganda. It is both inexpensive and easily administered. Moreover, the prolonged penicillinemia achieved by 3 m.u. procaine penicillin may be more effective in eliminating cases of incubating syphilis than benzyl penicillin. Long-acting procaine penicillin in oil with aluminum monostearate (PAM), which is the most widely used treatment regimen in the rural medical units of Uganda, is no longer indicated and may, in fact, be encouraging the spread of less sensitive strains of gonorrhea. Any change toward a more effective treatment schedule must, however, be accompanied by improvement in the diagnostic and treatment facilities in the country.^ieng