Plasmodium yoelii: the effect of second blood meal and anti-sporozoite antibodies on development and gene expression in the mosquito vector, Anopheles stephensi.

The sporogonic development of the malaria parasite takes place in the mosquito and a wide range of factors modulates it. Among those, the contents of the blood meal can influence the parasite development directly or indirectly through the mosquito response to the infection. We have studied the effect of a second blood meal in previously infected mosquitoes and the effect of anti-sporozoite immune serum on parasite development and mosquito response to the infection. The prevalence and intensity of infection and gene expression of both Plasmodium yoelii and Anopheles stephensi was analyzed. We verified that a second blood meal and its immune status interfere with parasite development and with Plasmodium and mosquito gene expression.

Effect of chloroquine on the expression of genes involved in the mosquito immune response to Plasmodium infection.

Chloroquine has been described to increase Plasmodium infectivity to the mosquito vector and is known to affect the vertebrate host immune response including during malarial infection. Although knowledge of the mosquito immune response has recently improved, nothing is known about the impact of chloroquine on mosquito immunity. In order to characterize the influence of chloroquine on the mosquito immune system, we have analyzed the effect of chloroquine on Anopheles gambiae (i) serine proteases and (ii) antimicrobial peptide gene expression, in uninfected and Plasmodium berghei infected mosquitoes, using real-time PCR. We have demonstrated for the first time that mosquitoes fed on chloroquine-treated mice showed a significant down regulation of some immune-related genes. This effect was independent of midgut bacterial burden. These results suggest that chloroquine might act on the Anopheles serine proteases cascade, interfering with signal transduction pathways and at a transcriptional activation level.

[Birdshot retinochoroidopathy. Five clinical cases analysis]. / Retinocoroidopatía en perdigonada (tipo Birdshot). Revisión de cinco casos clínicos.

PURPOSE: The Birdshot retinochoroidopathy is a rare chronical intraocular inflammatory disease. The authors made a comparative study of the disease's clinical manifestations and its response to therapy. METHODS: We selected five patients who had ocular inflammation which presented on the ocular fundus examination typical multifocal yellow-white patches of depigmentation of choroid and pigment epithelium and vitreous inflammation. RESULTS: All the patients showed early spots of hypofluorescence that became hyperfluorescent in the venous phase of angiography, a depression of b-wave amplitude of electroretinogram, a blue-yellow defect of colour vision and carried HLA-A 29 antigen. We recorded an improvement of the visual acuity and of the clinical picture after treatment with corticosteroid and cyclosporine A. CONCLUSION: Even though Birdshot retinochoroidopathy is a rare pathology in Southern Europe, the cases presented allowed us to conclude that early diagnosis and appropriate therapy greatly improve the well being of these patients (Arch Soc Esp Oftalmol 2002; 77: 247-256).

Retinocoroidopatía en perdigonada (tipo birdshot). Revisión de cinco casos clínicos / Birdshot retinochoroidopathy. Five clinical cases analysis

Objetivo: La retinocoroidopatía en perdigonada es una enfermedad inflamatoria intraocular crónica de incidencia infrecuente. Se realizó un estudio comparativo de las manifestaciones clínicas de la enfermedad y de su respuesta a la terapéutica. Métodos: Los autores seleccionaron 5 enfermos que eran seguidos en la consulta de inflamación ocular, presentando en el fondo ocular las típicas lesiones multifocales, blanquecinas o amarillentas, despigmentadas, localizadas en la coroides y epitelio pigmentado e inflamación vítrea. Resultados: En todos los casos fue evidente en la angiografía fluoresceínica una hipofluorescencia precoz e hiperfluorescencia tardía de estas lesiones, en el ERG una disminuición de la amplitud de la onda 'b', en el estudio de la visión cromática una alteración del eje azul-amarillo y una positividad para el Ag HLA-A29. Se observó una mejoría de la agudeza visual y de la sintomatología después de hacer la terapéutica con corticoides y ciclosporina A. Conclusiones: Aunque la retinocoroidopatía en perdigonada sea una patología rara en los países de Europa del Sur, los casos presentados permiten llegar a la conclusión que el diagnóstico precoz y el tratamiento adecuado mejora mucho la calidad de vida de estos enfermos (AU)

Clinical evaluation of twice-daily emedastine 0.05% eye drops (Emadine eye drops) versus levocabastine 0.05% eye drops in patients with allergic conjunctivitis.

PURPOSE: The efficacy and safety of emedastine 0.05% eye drops (Emadine; Alcon Laboratories, Inc, Fort Worth, Texas), a new H(1) antagonist, were studied in comparison to levocabastine 0.05% eye drops (Livostin; Janssen-Cilag N V, Berchem, Belgium) during a twice-daily treatment schedule for 6 weeks in adult and pediatric patients with seasonal allergic conjunctivitis. METHODS: In a prospective, multicenter, randomized, double-masked, parallel group study, 222 patients with allergic conjunctivitis were randomized (221 received treatment) to either emedastine or levocabastine, instilled twice daily for 6 weeks. Patient diaries were completed four times daily (before the morning and evening instillations, at noon, and in the afternoon), and clinical examinations were conducted at regular intervals. Primary efficacy variables of ocular redness and itching and secondary efficacy variables of chemosis, eyelid swelling, patient diary data, and physician's global assessment were analyzed. RESULTS: Both emedastine and levocabastine produced a statistically significant (P =.0001) reduction in itching and redness within 5 minutes of the first instillation. All signs and symptoms improved progressively over the 6-week treatment period. After 7 days of use, and throughout the remainder of the study, emedastine was statistically superior to levocabastine (P <.006) in preventing and alleviating the signs and symptoms (itching, redness, chemosis, and eyelid swelling) of allergic conjunctivitis. CONCLUSIONS: Emedastine 0.05% eye drops administered twice daily are more efficacious than levocabastine 0.05% eye drops in the prevention and treatment of the signs and symptoms of allergic conjunctivitis in adults and children of 4 years and above. Both emedastine 0.05% eye drops and levocabastine 0.05% eye drops were well tolerated.

Merkel cell carcinoma of the eyelid: a case report.

A 22-year-old woman who presented with a tumour of the upper eyelid with clinical, histological, immunohistochemical and ultrastructural features of a Merkel cell carcinoma is reported. This is a unique case of Merkel cell carcinoma in such a young patient. This neuroendocrine tumour is typically found in the elderly. It can grow rapidly, has the potential for local recurrence and early metastatic spread. The authors recommend wide resection of the primary site, which proved effective in this case.

[Physician-patient communication in oncology]. / Comunicação médico doente em oncologia.

The authors analyse the problems of doctor/patient communication in Oncology with a particular incidence on the matter of diagnosis information. In a short theoretical review on the subject are debated the reasons that lead to an unbalanced power in doctor/patient relation, ships. It is pointed a general view of medical attitude along the last 25 years in several countries concerning diagnosis information and cultural differences, among other aspects. The AA seek to foresee reasons that may lead to a change on this matter. The medical class has been questioned about it's attitude on the diagnosis information of cancer. For that purpose a questionnaire was made and 80 doctors of HUC and CHC were interviewed. From the results the AA consider it is to be noted the following: 59% of the colleagues interviewed usually don't reveal the whole truth about the diagnosis; -Fear of patient's emotional reactions, is the most frequent reason to not to inform; There's the feeling among doctors that the knowledge of the truth has commonly a positive effect on doctor/patient relations.