Seasonal mosquito (Diptera: Culicidae) dynamics and the influence of environmental variables in a land use gradient from Yucatan, Mexico.

Mosquito-borne diseases constitute a significant global impact on public and animal health. Climatic variables are recognized as major drivers in the mosquitoes' life history, principally rainfall and temperature, which directly influence mosquito abundance. Likewise, urbanization changes environmental conditions, and understanding how environmental variables and urbanization influence mosquito dynamics is crucial for the integrated management of mosquito-borne diseases, especially in the context of climate change. In this study, our aim was to observe the effect of temperature, rainfall, and the percentage of impervious surface on the abundance of mosquito species over a temporal scale of one complete year of fortnightly samplings, spanning from June 2021 to June 2022 in Yucatan, Mexico. We selected nine localities along an urbanization gradient (three natural, three rural, and three urban) from Mérida City to Reserva de la Biosfera Ría Celestún. Using BG-traps, mosquitoes were collected biweekly at each locality. Additionally, we estimated the percentage of impervious surface. Daily data of the maximum, mean and minimum temperatures, diurnal temperature range and rainfall were accumulated weekly. We calculated the accumulated quantities of temperatures and rainfall and lagged from one to four weeks before sampling for each locality. Generalized linear mixed models were then performed to study the influence of environmental variables and percentage of impervious surfaces on each of the 15 most abundant species. A total of 131,525 mosquitoes belonging to 11 genera and 49 species were sampled with BG-Sentinel traps baited with BG-lure and dry ice. The most frequently significative variable is the accumulated precipitation four weeks before the sampling. We observed a positive relationship between Cx. quinquefasciatus and Cx. thriambus with the diurnal temperature range. For Ae. aegypti, we observed a positive relationship with minimum temperature. Conversely, the percentage of impervious surface serves as a proxy of anthropogenic influence and helped us to distinguishing species exhibiting habitat preference for urban and rural environments, versus those preferring natural habitats. Our results characterize the species-specific effects of environmental variables (temperature, rainfall and impervious surface) on mosquito abundance.

Experiencia de aplicación de modelos de seguimiento de cumplimiento del perfil de egreso en el plan de estudios en las carreras de la Facultad de Medicina de la Universidad Finis Terrae / Experience of applying models for monitoring compliance with the graduation profile in the study plan in the careers of the Faculty of Medicine of the Finis Terrae University

El Perfil de egreso constituye un modelo teórico y la imagen del profesional que la institución de educación superior aspira formar. Es un conjunto de atributos que son certificados y le permiten a una persona ser reconocida y aceptada por la sociedad como profesional. La emergencia de estándares de calidad, utilizados por las agencias de acreditación de carreras universitarias, hoy exigen la necesidad de evaluar y rendir cuentas acerca del logro de las competencias establecidas y declaradas en el perfil de egreso, sin embargo, hay escasa evidencia concreta que demuestre modelos operativos de cómo abordar ese proceso de evaluación en distintos programas. Dada la relevancia del Perfil de Egreso de una carrera de pregrado y considerando que constituye el eje fundamental para el desarrollo curricular de los programas educativos, para realizar el proceso de autoevaluación y la posterior acreditación de las carreras, diseñamos e implementamos un modelo de seguimiento del cumplimiento del perfil de egreso en el plan de estudios de las carreras de la Facultad de Medicina de la Universidad Finis Terrae.

The Graduate Profile constitutes the theoretical model and the professional image that higher education aspires to form. It is a set of certified attributes and allows a person to be recognized and accepted by society as a professional. The emergence of quality standards, used by university careers' accreditation agencies, demands the need to evaluate and be accountable for achieving the competencies established and declared in the Graduate Profile. However, the is limited concrete evidence to demonstrate operational models of how to approach this evaluation process in different programs. Given the relevance of the Graduate Profile of an undergraduate career and considering that it constitutes the fundamental axis for the curricular development of educational programs, to carry out the self-evaluation process and the subsequent accreditation of the degrees, we design and implement a model for monitoring the compliance with the graduation profile in the study plan of the Faculty of Medicine of Universidad Finis Terrae.

Evaluation of the Combined Effect of Heterodera glycines and Macrophomina phaseolina on Soybean Yield in Naturally Infested Fields with Spatial Regression Analysis and in Greenhouse Studies.

Heterodera glycines, the soybean cyst nematode, and Macrophomina phaseolina, causal agent of charcoal rot, are economically important soybean pathogens. The impact and effect of these pathogens on soybean yield in coinfested fields in the Midwest production region is not known. Both pathogens are soilborne, with spatially aggregated distribution and effects. Spatial regression analysis, therefore, is an appropriate method to account for the spatial dependency in either the dependent variable or regression error term from data produced in fields naturally infested with H. glycines and M. phaseolina. The objectives of this study were twofold: to evaluate the combined effect of H. glycines and M. phaseolina on soybean yield in naturally infested commercial fields with ordinary least squares and spatial regression models; and to evaluate, under environmentally controlled conditions, the combined effect of H. glycines and M. phaseolina through nematode reproduction and plant tissue fungal colonization. Six trials were conducted in fields naturally infested with H. glycines and M. phaseolina in Ohio. Systematic-grid sampling was used to determine the population densities of H. glycines and M. phaseolina, and soybean yield estimates. Though not used in any statistical analysis, M. phaseolina colony forming units from plant tissue, charcoal rot severity, and H. glycines type were also recorded and summarized. In two greenhouse experiments, treatments consisted of H. glycines alone, M. phaseolina alone, and coinfestation of soybean with both pathogens. Moran's I test indicated that the yield from five fields was spatially correlated (P < 0.05) and aggregated. In these fields, to account for spatial dependence, spatial regression models were fitted to the data. Spatial regression analyses revealed a significant interaction effect between H. glycines and M. phaseolina on soybean yield for fields with high initial population densities of both pathogens. In the greenhouse experiments, H. glycines reproduction was significantly (P < 0.05) reduced in the presence of M. phaseolina; however, soybean tissue fungal colonization was not affected by the presence of H. glycines. The direct mechanisms by which H. glycines and M. phaseolina interact were not demonstrated in this study. Future studies must be conducted in the field and greenhouse to better understand this interaction effect.

Patterns of helminth infections in Rattus rattus and Mus musculus from two Mayan communities in Mexico.

The black rat Rattus rattus and the house mouse Mus musculus are two commensal rodent species that harbour and shed zoonotic pathogens, including helminths. The aim of this survey was to study the helminth community and the patterns of infections in R. rattus and M. musculus from two Mayan communities in Mexico. Gastrointestinal helminths were isolated from 322 M. musculus and 124 R. rattus, including Gongylonema neoplasticum, Hassalstrongylus aduncus, Hassalstrongylus musculi, Hydatigera taeniaeformis metacestode, Hymenolepis diminuta, Nippostrongylus brasiliensis, Oligacanthorhynchidae gen. sp., Syphacia muris, Syphacia obvelata, Rodentolepis microstoma and Trichuris muris. The overall richness of helminths was seven in R. rattus and six in M. musculus. The results of generalized linear models showed that juvenile rodents had lower probabilities of being infected with G. neoplasticum, H. taeniaeformis and H. musculi than adult rodents. A positive association between the prevalence of S. muris and rat abundance was found. The intensity of infection with S. muris was higher in the rainy season than in the dry season; the opposite result was found for H. musculi infection. Male R. rattus harboured more S. muris specimens. The intensity of infection with T. muris was inversely associated with mouse abundance. The presence of the zoonotic H. diminuta, as well as H. taeniaeformis and R. microstoma in rodent populations indicates that there is risk of transmission, and that their entire life cycle occurs in the study area.

Evolution of morphology and locomotor performance in anurans: relationships with microhabitat diversification.

The relationships between morphology, performance, behavior and ecology provide evidence for multiple and complex phenotypic adaptations. The anuran body plan, for example, is evolutionarily conserved and shows clear specializations to jumping performance back at least to the early Jurassic. However, there are instances of more recent adaptation to habit diversity in the post-cranial skeleton, including relative limb length. The present study tested adaptive models of morphological evolution in anurans associated with the diversity of microhabitat use (semi-aquatic arboreal, fossorial, torrent, and terrestrial) in species of anuran amphibians from Brazil and Australia. We use phylogenetic comparative methods to determine which evolutionary models, including Brownian motion (BM) and Ornstein-Uhlenbeck (OU) are consistent with morphological variation observed across anuran species. Furthermore, this study investigated the relationship of maximum distance jumped as a function of components of morphological variables and microhabitat use. We found there are multiple optima of limb lengths associated to different microhabitats with a trend of increasing hindlimbs in torrent, arboreal, semi-aquatic whereas fossorial and terrestrial species evolve toward optima with shorter hindlimbs. Moreover, arboreal, semi-aquatic and torrent anurans have higher jumping performance and longer hindlimbs, when compared to terrestrial and fossorial species. We corroborate the hypothesis that evolutionary modifications of overall limb morphology have been important in the diversification of locomotor performance along the anuran phylogeny. Such evolutionary changes converged in different phylogenetic groups adapted to similar microhabitat use in two different zoogeographical regions.

The Factors Associated With Older Adults Receiving Care in Jamaica / Factores Asociados con los Adultos Mayores que Reciben Cuidados en Jamaica

ABSTRACT Objective: To ascertain the level of care and the predisposing, enabling and need factors associated with care received by older adults using Andersen's framework. Methods: The 2012 Jamaica Survey of Living Conditions was used to conduct descriptive, bivariate and binary logistic analyses for the receipt of care among older adults defined by activities of daily living (ADL) and the instrumental activities of daily living (IADL) measures. The ADL sample comprised 3152 older adults and the IADL sample comprised 3141 older adults. Results: Approximately 16% of older adults received ADL care and significant binary logistic associations with age, area of residence, living arrangements, source of financial support, disability, and perceived health status were found. Approximately 69% received IADL care and significant binary logistic associations with gender, age, employed, living arrangements, wealth status, source of financial support, satisfaction with life accomplishments, disability and perceived health status were found for those receiving IADL care. Conclusion: Predisposing, enabling and need factors of the Andersen framework predict ADL and IADL care. Therefore, plans for care of older adults must address those 70 years or older who live alone, have a disability, a chronic illness and rate their health poorly.

RESUMEN Objetivo: Determinar el nivel de cuidados y los factores predisponentes, capacitantes y de necesidad asociados con el cuidado recibido por los adultos mayores, usando el modelo de Andersen. Métodos: La Encuesta de Condiciones de Vida en Jamaica 2012 fue utilizada para realizar análisis descriptivos, bivariantes y logísticos binarios en relación con el recibimiento de cuidados entre los adultos mayores, definidos por las medidas de las actividades de la vida diaria (AVD) y las actividades instrumentales de la vida diaria (AIVD). La muestra de AVD abarcó 3152 adultos mayores y la muestra de AIVD abarcó 3141 adultos mayores. Resultados: Aproximadamente el 16% de los adultos mayores recibieron cuidados de AVD, y en su análisis se hallaron asociaciones logísticas binarias significativas con la edad, el área de residencia, la situación de vivienda, la fuente de apoyo financiero, la discapacidad y el estado de salud percibido. Aproximadamente el 69% recibió cuidados de AIVD, y en su análisis se hallaron asociaciones logísticas binarias con el género, la edad, los empleados, la situación de vivienda, la situación económica, la fuente de apoyo financiero, la satisfacción con los logros de vida, la discapacidad, y el estado de salud percibido. Conclusión: Los factores predisponentes, capacitantes y de necesidad del modelo de Andersen predicen los cuidados de AVD y AIVD. Por lo tanto, los planes para el cuidado de adultos mayores tienen que abarcar a aquellas personas de 70 años o más que viven solas, tienen una discapacidad, una enfermedad crónica, y valoran su salud como pobre.

A survey of zoonotic pathogens carried by house mouse and black rat populations in Yucatan, Mexico.

The house mouse (Mus musculus) and the black rat (Rattus rattus) are reservoir hosts for zoonotic pathogens, several of which cause neglected tropical diseases (NTDs). Studies of the prevalence of these NTD-causing zoonotic pathogens, in house mice and black rats from tropical residential areas are scarce. Three hundred and two house mice and 161 black rats were trapped in 2013 from two urban neighbourhoods and a rural village in Yucatan, Mexico, and subsequently tested for Trypanosoma cruzi, Hymenolepis diminuta and Leptospira interrogans. Using the polymerase chain reaction we detected T. cruzi DNA in the hearts of 4·9% (8/165) and 6·2% (7/113) of house mice and black rats, respectively. We applied the sedimentation technique to detect eggs of H. diminuta in 0·5% (1/182) and 14·2% (15/106) of house mice and black rats, respectively. Through the immunofluorescent imprint method, L. interrogans was identified in 0·9% (1/106) of rat kidney impressions. Our results suggest that the black rat could be an important reservoir for T. cruzi and H. diminuta in the studied sites. Further studies examining seasonal and geographical patterns could increase our knowledge on the epidemiology of these pathogens in Mexico and the risk to public health posed by rodents.

Blood Feeding Status, Gonotrophic Cycle and Survivorship of Aedes (Stegomyia) aegypti (L.) (Diptera: Culicidae) Caught in Churches from Merida, Yucatan, Mexico.

Blood-feeding status, gonotrophic cycle, and survival rates of Aedes (Stegmyia) aegypti (L.) was investigated in catholic churches from Merida, Yucatan. Female Ae. aegypti were caught using backpack aspirator during 25 consecutive days in rainy (2015) and dry season (2016). Blood-feeding status was determined by external examination of the abdomen and classified as unfed, fed, and gravid. Daily changes in the parous-nulliparous ratio were recorded, and the gonotrophic cycle length was estimated by a time series analysis. Also, was observed the vitellogenesis to monitoring egg maturity. In total, 408 females Ae. aegypti were caught, and there was a significant difference in the number of females collected per season (Z = -6.729, P ≤ 0.05). A great number was caught in the rainy season (n = 329). In the dry season, 79 females were caught, which the fed females were twice greatest than the unfed. The length of gonotrophic cycle was estimated on the base of a high correlation coefficient value appearing every 4 days in rainy at 26.7 ± 1.22°C, and 3 days in dry season at 29.8 ± 1.47°C. The daily survival rate of the Ae. aegypti population was higher in both seasons, 0.94 and 0.93 for the rainy and dry season, respectively. The minimum time estimated for developing mature eggs after blood feeding was similar in both seasons (3.5 days in rainy versus 3.25 days in dry). The measurement of the vectorial capacity of Ae. aegypti in catholic churches could help to understand the dynamics of transmission of arboviruses in sites with high human aggregation.

Generation of LIF-independent induced pluripotent stem cells from canine fetal fibroblasts.

Takahashi and Yamanaka established the first technique in which transcription factors related to pluripotency are incorporated into the genome of somatic cells to enable reprogramming of these cells. The expression of these transcription factors enables a differentiated somatic cell to reverse its phenotype to an embryonic state, generating induced pluripotent stem cells (iPSCs). iPSCs from canine fetal fibroblasts were produced through lentiviral polycistronic human and mouse vectors (hOSKM/mOSKM), aiming to obtain pluripotent stem cells with similar features to embryonic stem cells (ESC) in this animal model. The cell lines obtained in this study were independent of LIF or any other supplemental inhibitors, resistant to enzymatic procedure (TrypLE Express Enzyme), and dependent on bFGF. Clonal lines were obtained from slightly different protocols with maximum reprogramming efficiency of 0.001%. All colonies were positive for alkaline phosphatase, embryoid body formation, and spontaneous differentiation and expressed high levels of endogenous OCT4 and SOX2. Canine iPSCs developed tumors at 120 days post-injection in vivo. Preliminary chromosomal evaluations were performed by FISH hybridization, revealing no chromosomal abnormality. To the best of our knowledge, this report is the first to describe the ability to reprogram canine somatic cells via lentiviral vectors without supplementation and with resistance to enzymatic action, thereby demonstrating the pluripotency of these cell lines.

Acquisition of response thresholds for timed performance is regulated by a calcium-responsive transcription factor, CaRF.

Interval timing within the seconds-to-minutes range involves the interaction of the prefrontal cortex and basal ganglia via dopaminergic-glutamatergic pathways. Because the secreted protein brain-derived neurotrophic factor (BDNF) is able to modulate dopamine release as well as glutamatergic activity, we hypothesized that BDNF may be important for these timing mechanisms. Recently, the calcium-responsive transcription factor (CaRF) was identified as an important modulator of BDNF expression in the cerebral cortex. In this study, a strain of Carf knockout mice was evaluated for their ability to acquire the 'Start' and 'Stop' response thresholds under sequential and simultaneous training conditions, using multiple (15-second and 45-second) or single (30-second) target durations in the peak-interval procedure. Both Carf(+/-) and Carf(-/-) mice were impaired in their ability to acquire timed response thresholds relative to Carf(+/+) mice. Additionally, control mice given microinjections of BDNF antisense oligodeoxynucleotide to inhibit protein expression in the prefrontal cortex showed timing impairments during acquisition similar to Carf mice. Together, these results suggest that the inhibitory processes required to update response thresholds and exert temporal control of behavior during acquisition may be dependent on CaRF regulation of genes including Bdnf in cortico-striatal circuits.

A high resolution analysis of the structure and chemical composition of the calcareous corpuscles from Mesocestoides corti.

Mesocestoides corti (syn. vogae), similar to many other cestode platyhelminthes, contains abundant calcium carbonate structures called calcareous corpuscles. These concretions that may constitute as much as 40% of the dry weight of the body, and were proposed to form intracellularly in certain parenchymal cells. As an approach to elucidate the biological role of calcareous corpuscles in cestodes, our aim was to characterize more precisely the structure and topological composition of the corpuscles from M. corti. Employing a variety of high resolution technical approaches, we found that the calcareous corpuscles are spheroid or ovoid layered concretions. They are formed by topographically homogeneous but compositionally heterogeneous layers, suggesting a cyclic process of biomineralization. The layers are composite structures, with granules of tens of nanometers, each surrounded by a cortex of about eight nanometers.

Use of statins for the treatment of spontaneous intracerebral hemorrhage: results of a pilot study.

BACKGROUND AND STUDY AIMS: Spontaneous intracerebral hemorrhage (ICH) represents the most fatal kind of stroke, and there is still no treatment available that improves the outcome. Statins are cholesterol reducers, and during the last few years many additional effects have been demonstrated that might be neuroprotective. We designed a pilot clinical study in order to evaluate whether the administration of statins is associated with a better outcome. PATIENTS AND METHODS: From August to December 2006 we carried out a prospective/retrospective non-randomized clinical study. The prospective group was treated with rosuvastatin (20 mg) and the retrospective control group was taken from our clinical records with a relation of 1:3. We included patients of both sexes, aged > or =15 years with proven ICH in CT-scan. Exclusion criteria were a history of neoplasm, head injury four weeks before admission, non-hypertensive reasons, brainstem hemorrhage, steroid administration, cranial surgery, initial hydrocephalus, and NIHSS > or =30. RESULTS: We analyzed 18 patients treated with rosuvastatin and 57 controls with similar basic characteristics. The mortality rate during hospitalization was 1 (5.6%) patient in the statin group and 9 (15.8%) in the control group; the hazard ratio adjusted by the initial Glasgow Coma Scale (GCS), intubation, admission in intensive care unit, disruption into the subarachnoid space was 0.20 (95% CI 0.02-1.67). The odds ratio for NIHSS > or =15 at release was 0.04 (95% CI 0.003-0.93). CONCLUSIONS: The use of statins during the acute phase of ICH could be associated with a better outcome. Further clinical trials are necessary to confirm a possible therapeutic effect and evaluate the toxicity of statins.

Removal of heavy metals from acid mine drainage (AMD) using coal fly ash, natural clinker and synthetic zeolites.

Acid mine drainage (AMD) is a widespread environmental problem associated with both working and abandoned mining operations, resulting from the microbial oxidation of pyrite in presence of water and air, affording an acidic solution that contains toxic metal ions. The generation of AMD and release of dissolved heavy metals is an important concern facing the mining industry. The present study aimed at evaluating the use of low-cost sorbents like coal fly ash, natural clinker and synthetic zeolites to clean-up AMD generated at the Parys Mountain copper-lead-zinc deposit, Anglesey (North Wales), and to remove heavy metals and ammonium from AMD. pH played a very important role in the sorption/removal of the contaminants and a higher adsorbent ratio in the treatment of AMD promoted the increase of the pH, particularly using natural clinker-based faujasite (7.70-9.43) and the reduction of metal concentration. Na-phillipsite showed a lower efficiency as compared to that of faujasite. Selectivity of faujasite for metal removal was, in decreasing order, Fe>As>Pb>Zn>Cu>Ni>Cr. Based on these results, the use of these materials has the potential to provide improved methods for the treatment of AMD.

Microsatellites and 16S sequences corroborate phenotypic evidence of trans-Andean variation in the parasitoid Microctonus hyperodae (Hymenoptera: Braconidae).

Eight South American geographical populations of the parasitoid Microctonus hyperodae Loan were collected in South America (Argentina, Brazil, Chile and Uruguay) and released in New Zealand for biological control of the weevil Listronotus bonariensis (Kuschel), a pest of pasture grasses and cereals. DNA sequencing (16S, COI, 28S, ITS1, beta-tubulin), RAPD, AFLP, microsatellite, SSCP and RFLP analyses were used to seek markers for discriminating between the South American populations. All of the South American populations were more homogeneous than expected. However, variation in microsatellites and 16S gene sequences corroborated morphological, allozyme and other phenotypic evidence of trans-Andes variation between the populations. The Chilean populations were the most genetically variable, while the variation present on the eastern side of the Andes mountains was a subset of that observed in Chile.

Obtaining family consent for participation in Alzheimer's research in a Cuban-American population: strategies to overcome the barriers.

Cultural values and beliefs affect family attitudes toward participation in research. Significant resistance to allowing their elders with dementia to participate in clinical research was encountered in Cuban-American families. These families expressed concern about disturbing the elder's comfort (tranquilidad) and solitude (soledad). Furthermore, most believed that intervention would be futile. Feelings of guilt associated with nursing home placement may have been exacerbated by the suggestion that active intervention could be effective. Strategies to overcome these barriers included reduced emphasis on the potential superiority of the intervention to be tested, reassurance that contact with research staff was usually appreciated by participants, arrangements to talk with the family as a group about the study, and increased use of Spanish-language consent forms.

Familial osteoarthritis and Milwaukee shoulder associated with calcium pyrophosphate and apatite crystal deposition.

OBJECTIVE: To characterize and define the phenotypes observed in a large Italo-Argentinean kindred with osteoarthritis, chondrocalcinosis, and Milwaukee shoulder (MS). METHODS: Seventy-five members were evaluated with a history, examination, and radiographs of shoulders, spine, hands, and knees. Superior subluxation of the glenohumeral joint was graded using shoulder radiographs and tomography and nuclear magnetic resonance imaging and 3 dimensional computed tomography was performed on selected members. In 31 family members peripheral blood DNA was utilized for genetic linkage analysis of several candidate gene loci previously linked to chondrocalcinosis phenotypes, as well as those implicated in the proper patterning of skeletal elements and cartilage differentiation. In addition, direct sequence analysis of type II collagen gene (COL2A1), the gene that codes for the major structural protein of cartilage, was undertaken in 3 affected and 3 unaffected members of the family. RESULTS: MS was seen in one member of the first generation and 6 members of the 2nd generation, while 8 members of the 3rd generation showed an incomplete form of MS. Isolated superior subluxation of the shoulder was seen in 16 other family members of the 3rd and 4th generations. Osteoarthritis of the spine and peripheral joints was seen in 31 affected members, while chondrocalcinosis was observed in 6 members of the first generation. Shoulder synovial fluid from 2 patients showed the presence of both apatite and calcium pyrophosphate dihydrate crystals. Direct analysis of the COL2A1 gene indicated no known disease determining mutations in affected members, thus excluding this gene as a candidate gene in this family. Genetic linkage to several candidate loci, including the chondrocalcinosis loci on chromosomes 5p and 8q, as well as loci for HOX A and C were also excluded. Linkage analyses of other loci for the HOX B and D genes and the PAX 1 and 9 genes were uninformative in this kindred. CONCLUSION: This kindred illustrates an unusual type of osteoarthritis with secondary intraarticular and periarticular calcification and MS in the most severely affected elderly members. A search for linkage to some potential candidate genes was either excluded or uninformative. Further linkage analysis to identify potential candidate genes is in progress.

Abnormal theta response to nociceptive stimuli during sleep EEG in children with febrile convulsions and control children.

Nociceptive stimuli were tested in 373 sleep EEG from 349 children with febrile convulsions and 50 control children (mean age: 2.54 and 2.05 years, respectively). Stimuli consisted of light pecks on each limb with a beveled cut plastic straw or a toothpick. Responses were deemed abnormal if frontal theta episodes would repeat three times without awakening. These abnormal responses appeared in 232 (62%) out of the 373 children of the febrile convulsive group, and in only 4 (8%) out of the 50 children in the normal control group: confidence interval significant at 95%. During sleep recording without stimulation, this sign is directly related to spontaneous theta bursts and inversely related to focal activity, but bears no relationship with sleep induction agents, generalized spike and waves, or delta discharges. In 24 repeat recordings, it begins to disappear at 3.7 years of age. Such responses to nociceptive stimuli should be considered characteristic of febrile convulsions.

Pharmacoeconomics of intravenous antibiotic use in serious infection.

A pharmacoeconomic study of 15 antibiotics available in Barbados was performed. The antibiotics studied were amoxycillin/clavulanate, ampicillin, ampicillin/sulbactam, cefazolin, cefotaxime, ceftazidime, ceftriaxone, clindamycin, cloxacillin, cotrimoxazole, gentamicin, imipenem, metronidazole, piperacillin, piperacillin/tazobactam, and vancomycin. The costs of use of these compounds were calculated for a five-day course using a formula comprising eight categories: antibiotic purchase cost, maintenance of intravenous access, drug delivery cost, drug monitoring cost, dose readjustment, general monitoring cost, 'sharps' disposal cost and adverse effects. The costs of adverse effects were not included in this study due to lack of accurate data. The total cost of antibiotic use (in U.S. dollars) ranged from $42.52 to $463.73 per five-day course. Generic compounds were less expensive ($45.52 - $98.23) than brand-name compounds ($106.18 - $106.18 - $463.73). Antibiotic purchase costs accounted for proportions of total costs ranging from 7 to 93%. Non-drug costs represented a much greater proportion of total costs of generic compounds. For most compounds the non-drug costs were related to the frequency of dosing, but for gentamicin the non-drug costs were relatively higher because of the need for monitoring of serum gentamicin levels. Efficacy and freedom from side-effects will remain the most important determinants in the choice of antibiotic therapy. However, pharmacoeconomic analyses can provide prescribers with the information required to make cost-effective choices for treatment of their patients.