A European multicentre survey of impulse control behaviours in Parkinson's disease patients treated with short- and long-acting dopamine agonists.

BACKGROUND AND PURPOSE: Impulse control disorders (ICDs) in Parkinson's disease (PD) are associated primarily with dopamine agonist (DA) use. Comparative surveys of clinical occurrence of impulse control behaviours on longer acting/transdermal DA therapy across age ranges are lacking. The aim of this study was to assess the occurrence of ICDs in PD patients across several European centres treated with short- or long-acting [ropinirole (ROP); pramipexole (PPX)] and transdermal [rotigotine skin patch (RTG)] DAs, based on clinical survey as part of routine clinical care. METHODS: A survey based on medical records and clinical interviews of patients initiating or initiated on DA treatment (both short- and long-acting, and transdermal) across a broad range of disease stages and age groups was performed. RESULTS: Four hundred and twenty-five cases were included [mean age 68.3 years (range 37-90), mean duration of disease 7.5 years (range 0-37)]. ICD frequencies (as assessed by clinical interview) were significantly lower with RTG (4.9%; P < 0.05) compared with any other assessed DAs except for prolonged release PPX (PPX-PR). The rate of ICDs for PPX-PR (6.6%) was significantly lower than for immediate release PPX (PPX-IR) (19.0%; P < 0.05). Discontinuation rates of DA therapy due to ICDs were low. CONCLUSION: Our data suggest a relatively low rate of ICDs with long-acting or transdermal DAs, however these preliminary observational data need to be confirmed with prospective studies controlling for possible confounding factors.

Malaria in penguins - current perceptions.

Avian malaria is a mosquito-borne disease caused by protozoans of the genus Plasmodium, and it is considered one of the most important causes of morbidity and mortality in captive penguins, both in zoological gardens and rehabilitation centres. Penguins are known to be highly susceptible to this disease, and outbreaks have been associated with mortality as high as 50-80% of affected captive populations within a few weeks. The disease has also been reported in wild penguin populations, however, its impacts on the health and fitness of penguins in the wild is not clear. This review provides an overview of the aetiology, life cycle and epidemiology of avian malaria, and provides details on the strategies that can be employed for the diagnostic, treatment and prevention of this disease in captive penguins, discussing possible directions for future research.

Chromosomal localisation of five genes in Perkinsus olseni (Phylum Perkinsozoa).

The molecular karyotype of Perkinsus olseni, a pathogenic protist that infects the clam Ruditapes decussatus, comprises nine chromosomes, ranging in size from 0.15 Mb to 6.5 Mb, representing a haploid genome of about 28 Mb. In order to establish chromosome specific markers, PCR-amplified DNA sequences belonging to five conserved genes (18S rRNA, actin type I, hsp90, ß-tubulin and calmodulin) were hybridised to chromosomal bands separated by pulsed-field gel electrophoresis. Three of those probes (actin type I, hsp90 and calmodulin) hybridised to only one chromosome and the remaining two (18S rRNA and ß-tubulin) hybridised to two chromosomes. In the first place, the hybridisation pattern obtained serves to dispel any doubt about the nuclear location of the smallest chromosome observed in the molecular karyotype of Perkinsus olseni. Additionally, it will be a reference for further analysis of karyotype polymorphisms in the genus Perkinsus.

Meconium aspiration syndrome - the experience of a tertiary center.

BACKGROUND: Approximately 5 % of infants born with a meconium-stained amniotic fluid (MSAF) develop meconium aspiration syndrome (MAS). AIM: The aims of this study were to analyse demographic data, morbidity and mortality associated with MAS and to identify possible risk factors. METHODS: Retrospective chart review of newborns with MAS delivered at a tertiary centre from January 1st, 1997 to December 31st, 2008. RESULTS: MAS was responsible for 1.4 % of all Neonatal Intensive Care Unit (NICU) admissions, with a trend towards a decreasing incidence during the study duration, especially in the cases of thin meconium. Seventy two newborns were analysed during the study period: 55.6 % (n = 40) were of the female gender, 62.5 % were delivered by caesarean section, 93 % had > 36 weeks of gestational age and 91.2 % had a birth weight over 2500g. Sixty-nine percent had an Apgar score < 7 at 1 minute and 23.6 % an Apgar score < 7 at 5 minutes; foetal bradicardia was present in 26.4 % of the newborns and tachycardia in 1.4 %. The presence of meconium was associated with severe asphyxia and carried a bad prognosis with an increased risk of developing hypoxia (58.3 %), need of mechanical ventilatory support (43.1 %), respiratory and/or metabolic acidosis (30.6 %), pulmonary hypertension (11.1 %) and hypoxic ischemic encephalopathy (29.2 %). The mortality rate was 2.8 %. Thick meconium was associated with higher morbidity and mortality rates. CONCLUSION: The number of admissions for MAS has been decreasing mostly because of a lower admission rate due to thin meconium; the number of cases with thick meconium has remained constant throughout the years. An Apgar score < 7 at 1 minute and signs of foetal distress during labour were associated with MAS. The MAS related morbidity remains significant.

Morphological and genetical description of Loma psittaca sp. n. isolated from the Amazonian fish species Colomesus psittacus.

A previously unrecognised fish-infecting microsporidia (Loma psittaca n. sp.), found adherent to the intestinal mucosa of the freshwater puffer fish Colomesus psittacus (Teleostei, Tetraodontidae) from lower Amazon River, was described based on light and transmission electron microscope and phylogenetic analysis. The whitish xenoma was completely filled by numerous spores, including several developmental stages of the parasite. In all of these stages, the nuclei were monokaryotic. The merogonial plasmodium divided by binary fission and the sporont gave rise to disporoblastic ovoid spores measuring 4.2 +/- 0.4 x 2.8 +/- 0.4 microm. In mature spores, the polar filament was arranged in 10-11 (rarely 12) coils in one row in turn of posterior vacuole. The polaroplast had two distinct regions around the manubrium. The polyribosomes were organised in coiled tapes. The small subunit rRNA gene was sequenced and maximum parsimony analysis placed the microsporidian described here in the clade that includes the genera Ichthyosporidium, Loma and Pseudoloma. Based on differences from previously described microsporidians, such as ultrastructural characteristics of the xenoma, developmental stages including the spore and phylogenetic analysis supported the recognition of a new species, herein named L. psittaca n. sp.

A new microsporidian parasite, Potaspora morhaphis n. gen., n. sp. (Microsporidia) infecting the Teleostean fish, Potamorhaphis guianensis from the River Amazon. Morphological, ultrastructural and molecular characterization.

A fish-infecting Microsporidia Potaspora morhaphis n. gen., n. sp. found adherent to the wall of the coelomic cavity of the freshwater fish, Potamorhaphis guianensis, from lower Amazon River is described, based on light microscope and ultrastructural characteristics. This microsporidian forms whitish xenomas distinguished by the numerous filiform and anastomosed microvilli. The xenoma was completely filled by several developmental stages. In all of these stages, the nuclei are monokaryotic and develop in direct contact with host cell cytoplasm. The merogonial plasmodium divides by binary fission and the disporoblastic pyriform spores of sporont origin measure 2.8+/-0.3 x 1.5+/-0.2 microm. In mature spores the polar filament was arranged into 9-10 coils in 2 layers. The polaroplast had 2 distinct regions around the manubrium and an electron-dense globule was observed. The small subunit, intergenic space and partial large subunit rRNA gene were sequenced and maximum parsimony analysis placed the microsporidian described here in the clade that includes the genera Kabatana, Microgemma, Spraguea and Tetramicra. The ultrastructural morphology of the xenoma, and the developmental stages including the spores of this microsporidian parasite, as well as the phylogenetic analysis, suggest the erection of a new genus and species.

Molecular karyotype analysis of Perkinsus atlanticus (Phylum Perkinsozoa) by pulsed field gel electrophoresis.

Perkinsus atlanticus is a pathogenic protist that infects the clam Ruditapes decussatus. Although it was recently proposed that the genus Perkinsus belongs to a new phylum, Perkinsozoa, in the infra-kingdom Alveolata, there remain different opinions about whether this genus should form a phylum on its own and consequently divergent views about its taxonomic characterization. In this work, we have identified nine chromosomes by pulsed field gel electrophoresis (PFGE) combined with densitometry analysis. The obtained karyotype of Perkinsus atlanticus, like that of other early branches of the dinoflagellate lineage, displays a more conventional chromosome organization, different from that of most dinoflagellates.

Is there a plastid in Perkinsus atlanticus (Phylum Perkinsozoa)?

Perkinsus atlanticus is a pathogenic protist that infects the clam Ruditapes decussatus. The recent proposal for the inclusion of the genus Perkinsus in a new phylum, Perkinsozoa, in the infra-kingdom Alveolata, gave rise to controversies whether this genus should form a phylum on its own. Molecular analysis of some conserved nuclear genes shows a closer proximity of the genus Perkinsus to the dinoflagellates than to the apicomplexans. Studies on extranuclear genomes, however, could also be very helpful for a more precise definition of those phyla. In Perkinsozoa, there have been until now no reports about the isolation of mitochondria as well as no conclusive results about the presence of any plastids, therefore a comparison with the data already obtained in Apicomplexa and Dinoflagellata has not yet been possible. In this work, we identify a plastid in Perkinsus atlanticus, using ultrastructural techniques and inhibition growth tests. It will be important to analyze the plastid genome at a molecular level, in order to confirm if the plastid in Perkinsus is more similar to those of Dinoflagellata or Apicomplexa. Such information will doubtless contribute to a more precise determination of the phylogenetic position of the genus Perkinsus.

Differential expression of collagens type I and type IV in lymphangiogenesis during the angiogenic process associated with bleomycin-induced pulmonary fibrosis in rat.

In order to assess the role of collagens I and IV during the angiogenic process associated with bleomycin-induced pulmonary fibrosis in rat, in situ hybridization and immunocytochemical studies were carried out. An increased expression of collagen IV was observed before an enhanced expression of collagen I after intratracheal instillation of bleomycin. Deposits of both collagen types were detected on the 21st day after treatment with bleomycin, surrounding the new blood vessels formed during the fibrotic process. At this time, the presence of new lymphatic vessels was associated uniquely with deposition of collagen I. These observations lead us to conclude that, at least during pulmonary fibrosis, lymphangiogenesis takes place after blood angiogenesis.

[Value of "cardiac event recorders" in the assessment of sporadic cardiac symptoms]. / Valor do "registador de eventos" no esclarecimento de sintomas cardíacos esporádicos.

OBJECTIVES: To determine the value of the Cardiac Event Recorder (CER) in the diagnosis and treatment orientation of bradydysrhythmias, tachydysrhythmias and ischaemic events, based on our experience at the Santa Cruz Hospital. METHODS: We retrospectively analysed 100 consecutive patients tested with a CER between January 1990 and December 1996 (mean follow-up, 272 +/- 202 days); the mean age of the patients (66 women and 34 men) was 45 +/- 18 years (range: 7 to 83); structural cardiac disease was present in 34% of the patients. CER was indicated for the investigation of symptoms suggestive of bradydysrhythmias (pre-syncope and/or syncope)--Group B--in 24 patients, tachydysrhythmias (palpitations and/or tachycardia sensation)--Group T--in 72 patients and ischaemic events--Group I--in the remaining four patients. We compared these groups with respect to demographic characteristics, prevalence of structural cardiac disease and efficacy of the test in the investigation of symptoms; periodicity of symptoms and duration of CER testing were analysed. In patients that experienced typical symptoms during the test, we analysed the electrocardiogram recorded at the time of the event and we investigated whether abnormal ECG findings influenced the therapeutic approach and whether this led to better symptomatic outcome. RESULTS: Patients in groups B and T were mainly women (54 percent vs 74 percent, NS). Group B patients were older than group T patients (mean age, 56.4 +/- 17.8 vs 40.0 +/- 16.0 yrs, P < 0.001). In group B, structural cardiac disease was less prevalent (37.5% vs 78.0%, P < 0.001) and symptom periodicity was greater (weekly: 12.5% vs 78.0%, monthly: 87.5% vs 15.2%, P < 0.001) than in group T. Duration of CER testing and number of events recorded were similar in the two groups. In both, CER testing was an important aid for therapeutic approach. Twenty two patients (eight B, 13 T and one I) had no typical symptomatic episodes during the CER test; in the remaining 78 patients (16 B, 59 T and three I), an electrocardiogram recording during such episodes was available for analysis. The ECG was abnormal in 44 of these patients, 12 (75%) being of group B and 32 (54%) of group T. Symptom periodicity was a few weeks in 65% of all patients (6 B, 57 T and two I). Duration of CER testing was < or = two weeks in 91 percent of the patients (22 B, 65 T and four I). CER testing guided the therapeutic approach in 78% of all patients. Changes of treatment strategy were more frequent in patients with CER documented typical symptomatic episodes than in those without (46% vs 9%, P < 0.02). When changes of treatment occurred, symptomatic outcome was better (97% vs 55%, P < 0.001). CONCLUSIONS: The CER is an important guide for the diagnostic and therapeutic approach for patients with intermittent arrhythmia suggesting, symptoms (78% of patients). A recording of normal ECG during typical symptoms reassures the patient and excludes potentially toxic treatments. Our selection of patients for CER testing seemed adequate since most typical symptomatic events occurred during the first two weeks of the test; longer duration of CER testing seems unnecessary.

Measurement of body composition changes during hemodialysis by bioimpedance analysis.

Monitoring of fluid exchanges during hemodialysis is essential for the safety and efficacy of the procedure. Bioimpedance analysis has been used for the measurement of body compartments in many settings, but experience during hemodialysis is relatively scare. In a prospective study of 28 cases of chronic renal failure treated by long-term hemodialysis on an outpatient basis, body composition studies were done immediately before and after the dialysis session. Methods included body weight, serum albumin, hematocrit, hemoglobin, sodium and osmolality. These variables were compared with impedance (BIA) findings, namely lean body mass, body fat, total water, extra and intra-cellular water, third space, and exchangeable sodium/potassium ratio. Patients lost weight and improved hematocrit, hemoglobin, osmolality and serum sodium during the therapy, and BIA measurements were consistent with these changes. Lean body mass and body fat markedly changed along the dialysis session (respectively -24.5% and + 7.5%), and these results were out of proportion regarding known gains and losses in that period. It is concluded that BIA was useful for monitoring water fluxes during hemodialysis, but provided unreliable information about body fat and lean body mass.

Influence of edeine on intergenic and interallelic recombination in Neurospora crassa.

The effect of edeine and the mutation edr-2 to edeine resistance on genetic recombination in Neurospora crassa was investigated. For this purpose crosses between pairs of edeine sensitive and edeine resistant strains respectively were set up without or in the presence of the drug (0-750 microg/ml). The genetic markers ylo-1, ad-1, pan-2 (B3 and B5) and tryp-2, all on linkage group VI, were used for scoring recombinants. These were ad+, tryp+ (intergenic recombination) and pan+ (interallelic recombination). Frequencies of about 6-7% for intergenic and of about 0.4% for interallelic recombination were found in crosses between eds strains and ed(r) strains respectively, if edeine was absent. However, crosses in the presence of edeine gave higher frequencies of both intergenic and interallelic recombination (about 12% intergenic and 1% interallelic with 180 to 200 microg ed/ml). The pan+ prototrophs (interallelic recombinants) obtained in the different crosses were tested for distribution of outside markers. The data thus obtained revealed that under the effect of both the mutation to edeine resistance and edeine itself the relative number of noncrossover (gene conversion) recombinants decreases in favour of crossover recombinants, and the relative number of double crossover recombinants (events outside the pan locus) decreases in favour of single crossover recombinants. It is concluded that a) edeine and the mutation ed(r)-2 to edeine resistance affect recombination via related pathways, and b) noncrossover and crossover recombinants are caused by different molecular mechanisms, in agreement with the work of other authors.