Biochemical and endocrine-disrupting effects in Clarias gariepinus exposed to the synthetic pyrethroids, cypermethrin and deltamethrin.

In the present study, we investigated plasma biochemical and steroid hormone responses, together with gonado-histopathological alterations in Clarias gariepinus exposed to sublethal concentrations of two synthetic pyrethroids (cypermethrin and deltamethrin). Fish were exposed to environmentally-relevant concentrations of cypermethrin at 0 (ethanol solvent control), 0.07, 0.014, 0.028, 0.056) and deltamethrin at 0.22, 0.44, 0.88 and 1.76 µg/L, for 7, 14, 21 and 28 days. Plasma enzyme (aspartate transaminase: AST, alanine transaminase: ALT and alkaline phosphatase: ALP) and steroid hormones (estradiol-17ß: E2, testosterone: T) levels were analyzed. Gonado-histopathological evaluation shows the presence of ovo-testis (intersex), oocytes atresia, cytoplasmic degeneration and clumping of vitellogenic oocytes in females, while male fish displayed enlargement and degeneration of testicular seminiferous tubules after 28 days exposure to cypermethrin and deltamethrin. Plasma biochemical analysis in pesticides exposed fish revealed that AST, ALT and ALP were significantly increased in a concentration-dependent manner. In addition, we observed respective and apparent concentration- and time-dependent increase and decrease of plasma E2 and T levels, compared to control. Interestingly, the significant increase in E2 levels paralleled gonadal ovo-testis (intersex) condition in exposed fish, indicating endocrine disruptive effects of cypermethrin and deltamethrin that favor the estrogenic pathway, in addition to overt negative consequences on reproductive, biochemical and physiological health of the exposed fish.

[Epicardial VT ablation : In whom, when, how and why?] / Epikardiales Mapping und Ablation bei ventrikulären Tachykardien : Bei wem, wann, wie und mit welchen Erfolgsaussichten?

Ventricular tachycardia (VT) is a leading cause of cardiovascular death and remains the main cause of sudden cardiac death. Implanted cardiac defibrillators (ICD) improve survival but the recurrent ICD therapies, mostly ICD shocks, are associated with an increased mortality and deleterious psychological effects. In this regard and based on the results of multicenter studies, the current European guidelines recommend early referral for catheter ablation. The ablation strategy (isolated endocardial approach or combined epi-/endocardial) depends mostly on the underlying myocardial disease. Thus, almost all patients with right ventricular dysplasia and Chagas disease, the majority of those with dilative cardiomyopathy, and some patients with ischemic cardiomyopathy (mostly posterior wall infarction or large transmural anterior wall infarction) have an epicardial scar as the underlying substrate for recurrent VT episodes. Thus, in this group of patients, isolated endocardial VT ablation may be associated with an increased VT recurrence and therefore an epicardial approach is also needed. Cardiac imaging (cardio-CT/MRI with late enhancement[MRI LE]) can reliably identify the distribution and characteristics of the myocardial scar and may be helpful in planning the ablation strategy. When performed in highly specialized centers, epicardial catheter ablation of VT leads to a significant reduction of recurrent VT episodes compared to the endocardial VT ablation alone and with lower complication rates.

[Epicardial ablation of ventricular tachycardias]. / Epikardiale Ablation ventrikulärer Tachykardien.

Ventricular tachycardias (VT) in patients with structural heart diseases have predominantly a scar-associated reentry mechanism so that substrate-based ablation approaches also have to be used in nearly all procedures. In many VT cases-especially in nonischemic cardiomyopathy (NICM) and arrhythmogenic right ventricular cardiomyopathy-a critical epicardial substrate can be identified as an essential component of the reentry circuit so that for the ablation-based modification of the substrate in these cases an epicardial approach is necessary. In cases of redo-VT ablation procedures in ischemic cardiomyopathy (after a previously endocardial ablation), an epicardial approach should also be considered. There are also cases in whom no endocardial substrate can be identified and an isolated epicardial substrate can be identified. Worldwide epicardial VT ablations are usually performed after gaining epicardial access using subxyphoidal puncture. The results of recent studies show a higher efficiency with stabilization of cardiac rhythm and reduction of recurrent VT episodes (about 70% event-free survival at the 2­year follow-up) after endo-plus epicardial substrate modification. In electrical storm cases, an early epicardial VT ablation approach also appears to be relevant, especially in NICM. Epicardial instrumentation and ablation represents a complex procedure which should only be performed in experienced centers with cardiac surgery back-up. In these experienced centers, the complications rate is less than 5%.

Epidemiology of tree-hole breeding mosquitoes in the tropical rainforest of Imo State, south-east Nigeria.

The study of tree-hole breeding mosquitoes was carried out in the tropical rainforest of Imo State Nigeria (two rural areas and two forest reserves in some parts of Orlu Senatorial Zone) between May-October 2002. Using standard entomological procedures, two macrohabitats (natural tree-holes and bamboo traps) and two microhabitats (leaf axils of cocoyams/pineapples and leaf axils of plantain/banana) were sampled for various mosquito species. Mosquitoes were recovered from all the various biotypes sampled. Types of mosquitoes species encountered, their relative abundance, as well as genera varied significantly during the study (p<0.05). Four genera of mosquitoes: Aedes, Culex, Anopheles and Toxorhynchites were recovered while 16 species of mosquitoes encountered include: Aedes aegypti, Ae. africanus, Ae. simpsoni, Ae. albopictus, Ae. stokesi, Ae. taylori, Ae. apicoargenteus, Culex quinquefasciatus, Cx. nebulosus, Cx. trigripes, Cx. decens, Anopheles gambiae, An. funiestus, An. coustani and Toxorhynchites viridibasis. Most of the mosquitoes showed oviposition preferences for one or more habitats. The presence of Ae. africanus, Ae. simpsoni and Ae. aegypti indicate that the study areas were at risk of yellow fever epidemic. The presence of Anopheles and Culex species ensured endemicity of malaria and filariasis, while the recovery of Ae. albopictus in this region suggests a possible outbreak of dengue fever in future if not properly controlled.

Lymphatic filariasis among the Ezza people of Ebonyi State, eastern Nigeria.

A total of 1,243 Ezza people living in 10 communities of Ebonyi State, eastern Nigeria were examined between July 2002-January 2003 for lymphatic filariasis. This is the first time a filariasis survey due to Wuchereria bancrofti has been carried out in this state. Of the 1,243 persons examined, 210 (16.9 %) had W. bancrofti microfilariae. Infection varied significantly among communities and ages (p < 0.05) but not sex-related (p > 0.05). The Ezza people are predominantly farmers and professional hired labourers. There was a close association between microfilaria rate and microfilaria -density in various age groups (r = 0.812; p < 0.01). Microfilaria density is an important measure in the epidemiology, treatment and control of human filarisis in this endemic foci. Clinical signs and symptoms of the disease include elephantiasis, hydrocoele, dermatitis and periodic fever. Clinical symptoms without microfilaraemia and microfilaraemia without clinical symptoms were also observed. Of 1,603 mosquitoes dissected, Anopheles gambiae, An. funestus and Culex quinquefasciatus showed infectivity rates of 6.3 %, 5.1 % and 6.0 % respectively. The affected persons and other key informants are unaware of the cause of the disease and attributed it to witchcraft, violation of taboo, bad water and food. Intervention strategies to be integrated into the on-going Community-Directed Treatment with Ivermectin (CDTI) project are discussed.

Dracunculiasis in the north eastern border of Ebonyi State, south eastern Nigeria.

Between January and August 2000, a house-to-house survey of dracunculiasis was conducted in 15 communities along the north eastern border of Ebonyi State, south eastern Nigeria. Of the 3,777 subjects examined, 192 (5.1%) had active cases of guinea worm comprising 109 males (5.5%) and 83 females (4.6%). Infections were observed in all age groups. Of the 3,777 persons examined, 2,092 (55.4%) had ever been infected in the area. Protruding adult female Dracunculus medinensis worms were found predominantly on the lower limbs (80.2%), but also on the scrotum (9.4%), umbilicus (3.1%) groin (2.6%), buttocks (20.8%) and chest (1.6%). Prevalence of dracunculiasis had no significant sex, age and occupation related differences (P > 0.1). All the 47 stagnant ponds in the area were infested with cyclops while the 6 streams and 13 newly constructed community wells were free of cyclops. Of the five species of cyclopoid copepods found in the stagnant ponds, only Thermocyclops oblongatus nigerianus and Mesocyclops aequatorialis harboured guinea worm larvae. The efforts of the endemic communities, government and international organizations in guinea worm eradication in these areas are discussed.

[Peripheral-type acute cochleovestibular involvement in the Klippel-Feil syndrome. Comments on 2 clinical cases]. / Suferinte cohleovestibulare acute de tip periferic in sindromul Klippel-Feil. Consideratii pe marginea a doua cazuri clinice.

The authors present the clinical observations performed on two medium aged patients with a Klippel-Feil syndrome met with during 1980-1987, in the polyclinic and the hospital. The patients presented themselves to the doctor with acute vestibular suffering of a peripheric type, constantly accompanied by bilateral, symmetric loss of hearing, in various degrees, and, sometimes, associated with neurological signs and some laboratory modifications. The cochleovestibular phenomena made themselves conspicuous together with acute cervical arthritic attacks. If following the treatment with cerebral vasodilator, sympatholytic, analgetic, antiphlogistic, antiemetic and neurotrophic medication the vestibular syndrome was easily compensated and the acute arthritic phenomena improved, the loss of hearing as well as other clinical elements of the syndrome persisted. Concerning these two clinical cases there are presented a series of physiopathologic considerations linked to the importance of the vertebral-basilar periarterial sympathetic system in regulating the dynamics and the biochemistry of the labyrinth liquids. We consider as interesting the presentation of these cases, as being so rare in the ORL practice.

Effect of acupuncture on disorders of musculoskeletal system in Nigerians.

Acupuncture was offered to patients with lesions affecting the locomotor system. These patients had received conventional physiotherapy treatment with limited success. The lesions treated by acupuncture were hemiplegia, low back pain, frozen shoulder, dropped foot, Sciatica, and arthritis of the knee and hip. Response to acupuncture was excellent in the more acute conditions of low back pain and frozen shoulder, where six treatment sessions were required for complete recovery. The more chronic conditions required many more treatment sessions and the improvement recorded was significant, though not complete. It was concluded that acupuncture has a valuable role to play in a physiotherapy department.