[Newborn Hearing Screening - Results of a Parental Survey in Saxony-Anhalt]. / Neugeborenen-Hörscreening ­ Ergebnisse einer Elternbefragung in Sachsen-Anhalt.

Background: In recent years quality assurance has become an essential part of today's health-care system in the wake of the modern patient-oriented quality management. With the statutory introduction of newborn hearing screening (NHS) in 2009, a quality assurance of these early detection methods has become necessary. The aim of the study was to determine patient satisfaction in relation to the NHS in Saxony-Anhalt. Patients/Methods: During the period from November 2013 to April 2014, 394 parents were retrospectively interviewed about their experiences and expectations in relation to the NHS, using a standardised questionnaire. In total, 21 child care centres and 6 paediatric primary care centres from all over Saxony-Anhalt were involved. Results: It turns out that the majority of parents are satisfied with the NHS and 97.7% are in favour of the offer of an NHS. Of the surveyed parents, 69.3% felt the information as sufficient. However, only 66.2% of parents took a closer look at the leaflet issued by the G-BA. In addition, 17.7% of respondents are dissatisfied with the professional competence of the examining staff. Conclusion: The study shows that the general attitude among parents towards newborn hearing screening was very positive. They felt reassured by it although there are some aspects still open to criticism.

Schistosome calcium channel beta subunits. Unusual modulatory effects and potential role in the action of the antischistosomal drug praziquantel.

Schistosomes are parasitic flatworms that cause schistosomiasis, a major tropical disease. The current drug of choice against schistosomiasis is praziquantel (PZQ), which has minimal side effects and is potent against all schistosome species. The mode of action of PZQ is unknown, though the drug clearly affects Ca(2+) homeostasis in worms, and there is indirect evidence for interaction of PZQ with schistosome voltage-gated Ca(2+) channels. We have cloned and expressed two Ca(2+) channel beta subunits, one from Schistosoma mansoni and one from Schistosoma japonicum. These two subunits (SmCa(v)beta A and SjCa(v)beta) have structural motifs that differ from those found in other known beta subunits. Surprisingly, coexpression of either SmCa(v)beta A or SjCa(v)beta with a cnidarian (CyCa(v)1) or mammalian (Ca(v)2.3) Ca(2+) channel alpha(1) subunit results in a striking reduction in current amplitude. In the case of Ca(v)2.3, this current reduction can be partially reversed by addition of 100 nm PZQ, which results in a significant increase in current amplitude. Thus, these unusual schistosome beta subunits can confer PZQ sensitivity to an otherwise PZQ-insensitive mammalian Ca(2+) channel, indicating that a possible target for PZQ action is the interaction between beta subunits and pore-forming alpha(1) subunits in schistosomes.

Proximal receptors and the mechanical stimulation of the fingers: a somatosensory evoked potential study.

OBJECTIVE: To characterize scalp responses to mechanical stimulation of the fingers and evaluate the contribution of different receptors. DESIGN AND METHODS: Somatosensory evoked responses to mechanical stimulation of the right third finger were recorded from a P3-P4 montage (n = 15) and from a F3-P4 montage (n = 9) as well as after electrical stimulation (n = 9). Responses after mechanical stimulation of the distal region of the finger, with the hand at different positions, were also recorded (n = 8). Complementary experiments in a small number of individuals included EMG and accelerometer recordings as well as anaesthesia of the finger. RESULTS: Scalp responses characterized by an initial sequence of waves, here called NI-PI-NII, were recorded from the P3-P4 montage. Mean peak latencies were 20, 23 and 26 ms, respectively; electrical stimulation of the same region evoked an initial negativity (mean peak latency 23 ms). EMG recordings suggested the involvement of different receptors in response to electrical and mechanical stimulation. Accelerometer recordings showed the spread of a sizable mechanical wave at the forearm. Anaesthesia did not change the responses to mechanical stimulation. CONCLUSIONS: Relatively small mechanical stimuli applied at distal phalanxes may activate proximal receptors which generate scalp recorded responses that may completely occlude the contribution of the distal receptors.

Prospective evaluation of transabdominal bowel sonography in the diagnosis of intestinal obstruction in Crohn's disease: comparison with plain abdominal film and small bowel enteroclysis.

Transabdominal ultrasonography is a noninvasive, radiation-free method that is well tolerated by patients with acute abdominal symptoms. The aim of this study was to investigate the validity of transabdominal ultrasonography, compared with plain abdominal film and small bowel enteroclysis in the diagnosis of small bowel obstruction in patients with Crohn's disease (CD). Forty-four patients with CD ileitis or ileocolitis and acute obstructive symptoms who received ultrasonography and plain abdominal film at hospital admission were evaluated by small bowel enema before dismissal or surgery and were considered for statistical analysis. Small bowel obstruction was diagnosed by ultrasonography in 23 of 44 patients (52%), by plain abdominal film in 26 of 44 patients (59%), and by small bowel enema in 28 of 44 patients (64%); the diagnostic accuracy of plain abdominal film and ultrasonography compared with small bowel enema was 73% and 89%, respectively. Ultrasonography proved to be highly specific (100%) with no false positive results. Surgery performed in 25 of 44 patients for symptoms refractory to medical treatment confirmed the high diagnostic value of ultrasonography. The result of this study indicates that transabdominal ultrasonography is accurate and highly specific in the diagnosis of small bowel obstruction and can be considered a valuable first choice examination in CD patients with obstructive symptoms.

[Therapeutic evaluation of artesunate in experimental Schistosoma mansoni infection]. / Avaliação terapêutica do artesunato na infecção experimental pelo Schistosoma mansoni.

Mice experimentally infected with Schistosoma mansoni were treated orally with artesunate (Lactab) in a single dose of 300 or 500 mg/kg or over a period of five consecutive days. The animals were sacrificed 7, 30, 60 or 90 days after treatment. Statistically significant differences were found in the distribution and mortality of the worms and in the alterations of the oogram in the treated group when compared to control in all of the tested schemes when the animals were sacrificed 30 days after treatment. Morphological analysis of female worms showed a reduction of ovarian volume and rarefaction of the vitelline follicles. These modifications were more marked after treatment with the higher dose, explaining the alteration of the oogram which reached 100%. However, when the animals were sacrificed 60 or 90 days after treatment, the differences and alterations were smaller, showing that the surviving worms recovered and restarted oviposition.

An antibiotic regimen for the treatment of active Crohn's disease: a randomized, controlled clinical trial of metronidazole plus ciprofloxacin.

OBJECTIVES: Bacteria in the gut lumen may play a role in the etiology and/or the symptoms of Crohn's disease (CD). Although various antibacterial drugs have been employed in clinical practice, few controlled trials have been conducted, and those had conflicting results. The aim of this study was to investigate the efficacy and the safety of a combination of metronidazole and ciprofloxacin, compared with methylprednisolone, in treating 41 consecutive patients with active CD. METHODS: Eligible patients, 13 men and 28 women, mean age 38 yr, were randomly allocated to receive, for 12 wk, ciprofloxacin 500 mg twice daily plus metronidazole 250 mg four times daily or methylprednisolone 0.7-l mg/kg/day, with variable tapering to 40 mg, followed by tapering of 4 mg weekly. RESULTS: Ten of the 22 antibiotic patients (45.5%) and 12 of the 19 steroid patients (63%) obtained clinical remission (Crohn's Disease Activity Index < or = 150) at the end of the 12-wk study (p = NS). Five patients on antibiotics (22.7%) and five patients on steroids (26.3%) were considered treatment failures because of deterioration or persistent symptoms. Six patients receiving antibiotics (27.3%) and two on steroids (10.6%) were withdrawn from the trial because of side effects. One patient on antibiotics was not compliant. CONCLUSIONS: metronidazole and ciprofloxacin could be an alternative to steroids in treating the acute phase of CD.

Activity of the artemether in experimental schistosomiasis mansoni.

The action of the ether of artemisinin (artemether) on Schistosoma mansoni in mice and hamsters experimentally infected with the LE strain was studied. In mice, the drug showed high schistosomicidal activity using a single intramuscular dose of 100 mg/kg/day. By the oral route, this dose showed a low activity. Mice treated with a single intramuscular dose of 200 mg/kg/day, and examined 15 days after treatment, presented 100% alteration of the oogram; when examined 45 days after treatment, the oogram was normal. With doses of 100 mg/kg/day, i.m., during 3 or 5 consecutive days, the death rate of mice was very high. Morphologic analysis of the worms collected by perfusion of mice treated with a single dose of 100 mg/kg/day, i.m., detected a marked decrease in the length of male and female worms, degenerative alterations in the parenchyma and in the reproductive system of the females, with the reduction of vitellinic material and in ovary volume; the intestinal contents presented a marked despigmentation. In the male worms significant alteration was not apparent by optical microscopy.

Dipalmitoylphosphatidylcholine-palmitic acid phase diagram studied by 13C nuclear magnetic resonance.

The phase diagram of dipalmitoylphosphatidylcholine (DPPC) and palmitic acid mixtures in excess D2O was studied by 13C-NMR. Phase boundaries were determined from plots of apparent spin-spin relaxation time T2 (for both choline methyl and fatty acid chain carbons) versus temperature. A peritectic transition in the 1-10 mol% region, whose existence has been theoretically inferred from the Gibbs phase rule but which was undetectable by differential thermal analysis (DTA) (S.E. Schullery et al. Biochemistry, 20 (1981) 6818-6824), was located by NMR at 41.6 degrees C. A second, nearby peritectic line at 44 degrees C, which had been shown by DTA to extend from about 3-25 mol% palmitic acid, was seen by NMR only above 10 mol%. The palmitic acid/DPPC complex (2:1), with a sharp melting point at 64 degrees C, reported in earlier studies, was also seen by NMR. A phase diagram including both NMR and DTA results is presented. Important general conclusions from this study are: (i) NMR and scanning thermal analysis are complementary techniques for phase studies; each can see transitions that are invisible to the other. (ii) The case for the applicability of the Gibbs phase rule to lipid bilayer systems has been strengthened by the observance of two predicted, close-spaced boundaries. (iii) Low concentrations of fatty acids and related molecules can not be assumed to disperse as simple ideal solutes in the bilayer matrix.