Recommendations for the management of urinary disorders in multiple sclerosis: a consensus of the Italian Multiple Sclerosis Study Group.

Urinary disorders are uncommon in the initial phases of multiple sclerosis, but increase in frequency as the disease progresses, with a negative impact on quality of life. The goal of this study was to propose a protocol for the diagnosis and treatment of urinary disorders in multiple sclerosis, based on data from the scientific literature and the experience of Italian clinical centres. In particular, the following clinical aspects were considered: what to do with patients with asymptomatic multiple sclerosis; what to do with symptomatic patients; how and when to perform a second-level diagnostic evaluation; and how to treat urinary disorders. A diagnostic-therapeutic algorithm is proposed, that can be applied in Italian clinical centres.

Calibration of (109)Cd KXRF systems for in vivo bone lead measurements: the guiding role of the assumptions for least-squares regression in practical problem solving.

The use of least-squares regression to probe the level of lead contamination of plaster of Paris standards in the calibration of (109)Cd KXRF systems for bone lead measurement, as well as the use of iteratively reweighted least-squares (IRLS) in the case of violation of the assumptions for ordinary least-squares (OLS), is discussed here. One common violation is non-uniform residual variance, which makes the use of OLS inappropriate due to strong influence of points with large variance on the calibration line and variance of the slope and intercept. Comparison between OLS and IRLS in that case showed that IRLS estimates of the intercept are significantly smaller and more precise than OLS estimates, while a less marked increase in the calibration slope is observed when IRLS is used. Moreover, OLS underestimates bone lead concentrations at low levels of lead exposure and overestimates those concentrations at higher levels. These discrepancies are smaller in magnitude than the measurement uncertainty of conventional systems, except for high concentrations. For the newly developed cloverleaf systems, the suggested differences at bone lead concentrations below 17 ppm are comparable to the minimum detection limit, but are larger than the measurement uncertainty for bone lead concentrations above 60 ppm.

Neisseria meningitidis PorA variable regions: rapid detection of P1.7 and P1.19 variants by PCR.

AIM: Rapid characterization of variable region (VR)1 variants of the porA gene among invasive strains is crucial for outbreak management and epidemiology studies. Recent sequence analysis studies in Brazil showed that the VR1 P1.7 and P1.19 variants are highly prevalent, accounting for 68%, of the total number of VR1 variants characterized. The aim of this work is to develop a rapid polymerase chain reaction (PCR)-based method for genosubtyping Neisseria meningitidis by detection of porA variable regions P1.7 and P1.19. METHODS AND RESULTS: PCR primers for the detection of porA VR1 P1.7 and P1.19 were designed and tested using 198 clinical N. meningitidis isolates that had been previously evaluated by porA sequencing. All 50 strains with VR1 P1.7 and all 65 strains with VR1 P1.19 were positively identified by the respective VR-specific PCR and no false-positive reactions occurred. CONCLUSIONS: VR-specific PCR amplification accurately identified VR P1.7 and P1.19 strains. SIGNIFICANCE AND IMPACT OF THE STUDY: To overcome the disadvantages of serosubtyping and sequencing for typing the porA VR1 segment of N. meningitidis, we developed a PCR-based method to rapidly and accurately detect VR1 P1.7 and P1.19 variants. This approach is highly specific and sensitive; moreover it may allow for genotype determination of culture-negative samples.

Lesion characteristics and depressed mood in the stroke data bank study.

This study examined the relationship between post-stroke lesion size and location and depressed mood by using data from the multicenter National Stroke Data Bank. For in patients with first-ever cerebral infarction, lesions were characterized by location and size from CT scans. Forty-seven (24%) of the 193 patients studied were depressed. In the complete sample, neither lesion size nor location was associated with depression. However, among patients with comparable small-sized lesions (n = 124), depression was more frequent among those with left hemisphere stroke than those with right hemisphere stroke (31% vs. 16%; P = 0.04). Among patients with larger lesions, brain edema was common and may have obscured lateralized findings. Different biogenic amine neurotransmitter responses to right and left hemisphere brain injury may underlie this mood asymmetry.

[Risk factors for death caused by pneumonia in children younger than 1 year old in a metropolitan region of southeastern Brazil. A case- control study]. / Fatores de risco para morte por pneumonia em menores de um ano em uma região metropolitana do sudeste do Brasil. Um estudo tipo caso-controle.

In a case-control study, a sample of post-neonatal deaths from pneumonia occurring in the Metropolitan Area of Rio de Janeiro, Brazil (1986-1987) were compared with healthy controls who lived in the same neighborhood. Risk factors investigated were variables related to the mother's pregnancy history and the child's birth, to the family's social condition and to the use of health services. Using the univariate logistic regression model, the coefficients of each independent variable, the relative risk and its confidence limits were first estimated. Birth weight and age of weaning were strongly associated with the dependent variable. After adjustment by means of the multiple logistic regression model, only 4 variables remained statistically associated with mortality: age of weaning, birth weight, over crowding, and BCG vaccination. Based on the available data, it was concluded that mortality from pneumonia in children under 1 year of age is significantly related to the social condition of the family, particularly to that of the mother.

[Agreement in the the determination of the basic cause of death among children under one year of age in the metropolitan region of Rio de Janeiro, Brazil]. / Concordância na determinação da causa básica de óbito em menores de um ano na região metropolitana do Rio de Janeiro, 1986.

An evaluation was undertaken, during the assessment of the quality of the filling up of death certificates, with the purpose of evaluating the agreement, in the determination of the basic cause of death, between the physician who certified the death and a medical team which examined the information provided by hospital records. This survey included the analysis of a sample of deaths among children under one year of age which occurred in the Metropolitan Region of Rio de Janeiro (Brazil) in the period from May 1986 to April 1987. As regards neonatal deaths, the greatest concentration of causes of death is perinatal and, despite the changes that have been observed, the composition of the main groups of causes presented no significant alteration. However, within the perinatal group, those generically classified or poorly defined causes were reduced by about 50% and new certificates were made out. Among post-neonatal deaths, we found significant changes, particularly for deaths caused by pneumonia and malnutrition. Given the great interrelation observed among the major causes of death within this group (pneumonia, diarrhoea, malnutrition), it is believed that the investigation of multiple causes of death would provide a more accurate, overall notion of the process that led to death, thus allowing the formulation of a more comprehensive view.

[Cerebellar glioblastoma multiforme: report of a case in a child]. / Glioblastoma multiforme cerebelar: relato de um caso em criança.

The authors relate a case of glioblastoma multiforme of the cerebellum in a nine-years old girl. They correlate this case with reports published and they think that this pathology is not so rare as believed. This is the second case report, in Brazil, in children.