Patients with ankylosing spondylitis have been breast fed less often than healthy controls: a case-control retrospective study.

OBJECTIVE: Ankylosing spondylitis (AS) is a chronic inflammatory disease affecting the spine and pelvis of young adults. On the HLA-B27 genetic background, the occurrence of AS is influenced by the intestinal microbiota. The goal of our study was to test whether breast feeding, which influences microbiota, can prevent the development of AS. METHODS: First, 203 patients with HLA-B27-positive AS fulfilling the modified New York criteria were recruited in the Department of Rheumatology, Ste Marguerite hospital in Marseilles. A total of 293 healthy siblings were also recruited to make up a control group within the same families. Second, 280 healthy controls, and 100 patients with rheumatoid arthritis and their siblings were recruited. The data collected were age, gender, number of brothers and sisters, age at disease onset, type and duration of feeding (breast or bottle). RESULTS: Patients with AS had been breast fed less often than healthy controls. In families where children were breast fed, the patients with AS were less often breast fed than their healthy siblings (57% vs 72%), giving an OR for AS onset of 0.53 (95% CI (0.36 to 0.77), p value=0.0009). Breast feeding reduced familial prevalence of AS. The frequency of breast feeding was similar in the AS siblings and in the 280 unrelated controls. However, patients with AS were less often breast fed compared with the 280 unrelated controls (OR 0.6, 95% CI (0.42 to 0.89), p<0.01). CONCLUSIONS: Our study suggests a breastfeeding-induced protective effect on the occurrence of AS. To our knowledge, this is the first study of breastfeeding history in patients with AS.

The relationship between ovarioles number and female size in blackflies of the high Andes of Colombia.

Fitness of a single species is often measured in terms of the number of viable offspring produced. We explore the relationship between the number of ovarioles and the size of females in five species of Simuliidae in two páramo regions of Colombia. Individuals of seven species of female blackflies that landed on animals were collected from mules in the Ucumarí Regional Park (RPNU) and from cattle in the Chingaza Natural National Park (ChNNP). The ovarioles of the five most abundant species were dissected out and counted, and a one-factor ANOVA was performed to explore differences in the mean number of ovarioles produced by different female size categories. Simulium ignescens Roubaud and S. ignescens-like species were collected in RPNU and S. ignescens, Simulium muiscorum Bueno et al, Simulium cormonsi Wygodzinsky and Simulium pautense Coscarón & Takaoka, in ChNNP. In addition, we also analyzed the Pearson product-moment correlation between the mean number of ovarioles per blackfly and female size within species using those which more than 20 individuals were collected. Ovarioles were meroistic-polytrophic type. A multiple range test (least significant difference) indicated that the largest size group had the largest mean number of ovarioles per female. In the other size groups, there were approximately equal numbers of ovarioles per female. Pearson's correlation coefficient was separately measured and indicated a 50% correlation between female size and ovariole number in S. ignescens. Although ovariole number is probably a genetically driven feature, other environmental and physiological conditions, including infections, can influence the number of eggs.

Prevalence of amblyopia and patterns of refractive error in the amblyopic children of a tertiary eye care center of Nepal.

INTRODUCTION: Refractive error is a common cause of amblyopia. OBJECTIVE: To determine prevalence of amblyopia and the pattern and the types of refractive error in children with amblyopia in a tertiary eye hospital of Nepal. MATERIALS AND METHODS: A retrospective chart review of children diagnosed with amblyopia in the Nepal Eye Hospital (NEH) from July 2006 to June 2011 was conducted. Children of age 13+ or who had any ocular pathology were excluded. Cycloplegic refraction and an ophthalmological examination was performed for all children. The pattern of refractive error and the association between types of refractive error and types of amblyopia were determined. RESULTS: Amblyopia was found in 0.7 % (440) of 62,633 children examined in NEH during this period. All the amblyopic eyes of the subjects had refractive error. Fifty-six percent (248) of the patients were male and the mean age was 7.74 ± 2.97 years. Anisometropia was the most common cause of amblyopia (p less than 0.001). One third (29 %) of the subjects had bilateral amblyopia due to high ametropia. Forty percent of eyes had severe amblyopia with visual acuity of 20/120 or worse. About twothirds (59.2 %) of the eyes had astigmatism. CONCLUSION: The prevalence of amblyopia in the Nepal Eye Hospital is 0.7%. Anisometropia is the most common cause of amblyopia. Astigmatism is the most common types of refractive error in amblyopic eyes.

Blood parasites in some birds from eastern plains of Colombia.

A total of 315 birds representing 75 species (23 families) from Villavicencio and San Miguel (Meta, Colombia) were examined for haematozoa. Fifty birds (15.9%) harbored blood parasites. Microfilariae were the most common haematozoans encountered, followed by species of the genera Haemoproteus, Plasmodium and Trypanosoma. This survey included 15 new host-parasite records and 8 species of birds that were examined for haematozoa for the first time. The prevalence registered in this research was similar to others recorded in the Neotropical region, but in sharp contrast with the prevalence of blood parasites in other major land masses.

Muscle ultrasound in the assessment of suspected neuromuscular disease in childhood.

One hundred paediatric, muscle ultrasound examinations performed in the evaluation of suspected neuromuscular disease were reviewed. The results were related to the presence or absence of neuromuscular disease in each child assessed. The group comprised 66 males and 34 females, age range 2 months to 16 years (mean 5.3 years). Scans were graded I-IV, according to muscle echogenicity, using Heckmatt's criteria. Thirty-two children had a final diagnosis of neuromuscular disease. The sensitivity of ultrasound in detecting neuromuscular disease was 78% with 91% specificity. The test was more reliable in the sub-group of > 3 years with a sensitivity of 81% and specificity of 96%. There was a significant difference in disease status, (with and without neuromuscular disease), between children with a normal, grade I, scan and those with an abnormal, grade II, III, IV, image (chi-square, P < 0.001, 95% confidence limits 0.54-0.86). Muscle ultrasound is a specific and sensitive investigation for suspected neuromuscular disease in children.

CAG expansion affects the expression of mutant Huntingtin in the Huntington's disease brain.

A trinucleotide repeat (CAG) expansion in the huntingtin gene causes Huntington's disease (HD). In brain tissue from HD heterozygotes with adult onset and more clinically severe juvenile onset, where the largest expansions occur, a mutant protein of equivalent intensity to wild-type huntingtin was detected in cortical synaptosomes, indicating that a mutant species is synthesized and transported with the normal protein to nerve endings. The increased size of mutant huntingtin relative to the wild type was highly correlated with CAG repeat expansion, thereby linking an altered electrophoretic mobility of the mutant protein to its abnormal function. Mutant huntingtin appeared in gray and white matter with no difference in expression in affected regions. The mutant protein was broader than the wild type and in 6 of 11 juvenile cases resolved as a complex of bands, consistent with evidence at the DNA level for somatic mosaicism. Thus, HD pathogenesis results from a gain of function by an aberrant protein that is widely expressed in brain and is harmful only to some neurons.

Endometriosis extrapelviana de ubicación vagino perineal / Vaginoperineal endometriosis

La endometriosis externa de ubicación vagino perineal, constituye una rareza en cuanto a la localización externa de la endometriosis, aún cuando se ofrecen muchas posibilidades de implantación de tejido endometrial en la atención del parto al practicar episiotomías, perineotomías o bien, desgarros vagino perineales. En revisiones de la literatura extranjera (carecemos de datos nacionales), constituyen el 0,2%. Se estudian 7 pacientes cuyo foco endometrioso asentaba en 6, en la cicatriz de una episiotomía. En cada una de ellas se realiza anamnesis, examen físico, ginecológico, proctológico, extirpación quirúrgica del foco. Estudio histopatológico, tratamiento y control. Seis pacientes mejoraron, pero una continuó con sus molestias por una resección incompleta del foco inicial. Se concluye que el tratamiento médico inicial no mejoraría la endometriosis vagino perineal. El tratamiento debería ser la extirpación completa del foco, con eventual tratamiento hormonal posterior