Varicella zoster virus: review of its management.

Varicella zoster virus (VZV) is one of eight herpes viruses known to infect humans. Primary infection causes varicella (chickenpox), after which virus becomes latent. Years later, VZV reactivates and causes a wide range of neurological diseases. The aim of the present report was to critically examine the published literature to evaluate advantages and limitations of therapy of VZV infection in both immunocompetent and immunocompromised patients. Aciclovir (ACV) has been the drug of choice for many years for the treatment of VZV infections. Recently, other antiviral agents have been developed to overcome the low oral bioavailability of ACV, as well as to provide a more flattering dosage regime. Chickenpox is a benign self-limiting disease in the majority of cases and usually no specific treatment is required. Treatment of shingles is indicated to reduce the acute symptoms of pain and malaise, to limit the spread and duration of the skin lesions and to prevent the development of post-herpetic neuralgia. Different classes of drugs have been used for the treatment of post-herpetic neuralgia. The first choice of any of these medications should be guided by the patient's medical health, the likely adverse effects of the drug and the patient's preference.

Influence of thyroid status on responses of rat isolated pulmonary artery, vas deferens and trachea to smooth muscle relaxant drugs.

1 Responses to relaxant drugs have been examined on isolated KCl-contracted smooth muscle preparations from rats in which thyroid status was changed by prior treatment with either thyroxine (T4) for 1 week (preparations of pulmonary artery, trachea and vas deferens) or methimazole for 10-12 weeks (pulmonary artery preparations). 2 On pulmonary artery preparations, T4 treatment caused a significant increase in the magnitude of the relaxant responses to noradrenaline and isoprenaline but not those to adrenaline. The potency of noradrenaline was increased 5.6 fold but that of isoprenaline and adrenaline was unchanged. This resulted in a change in the relative potencies from adrenaline greater than noradrenaline (controls) to noradrenaline = adrenaline (T4-treated). Methimazole treatment caused a significant reduction in the magnitude of the responses to noradrenaline and in its potency (2.8 fold). Isoprenaline and procaterol were unaffected. 3 On pulmonary artery preparations, T4 treatment did not affect the magnitude of the responses to forskolin, sodium nitrite or isobutylmethylxanthine (IBMX) or their potency. In vitro treatment with the monoamine oxidase (MAO) inhibitors, iproniazid or pargyline, did not potentiate responses to either noradrenaline or isoprenaline. Therefore, it was concluded that the T4-induced changes in the magnitude of the responses to noradrenaline and isoprenaline and in the potency of noradrenaline were unlikely to be due to reduced activity of cyclic nucleotide phosphodiesterase(s) or MAO. 4 On preparations of vas deferens and trachea, T4 treatment had no effect on the magnitude of the responses to noradrenaline, isoprenaline, adrenaline or procaterol. 5 We concluded that, on pulmonary artery T4 treatment of rats increased, while methimazole treatment reduced, the magnitude of the responses to, and/or the potency of, the beta-adrenoceptor agonists, noradrenaline and isoprenaline, by a mechanism which is specifically associated with the beta-adrenoceptors, and which is probably selective for the beta-subtype. T4 treatment caused no change in responses of vas deferens to beta-adrenoceptor agonists. On trachea the only change was a small increase in the potency of noradrenaline. The differences in the effects of T4 treatment on beta-adrenoceptormediated responses of rat pulmonary artery, vas deferens and trachea may be due to the differences in the beta-adrenoceptor populations of these three tissue types and/or differences in the effects of thyroid hormones on vascular compared with non-vascular smooth muscle.

Onchocerciasis in Sudan: the Southern Darfur focus.

The prevalence, intensity and clinical manifestations of onchocerciasis were investigated in three village communities along the Bahr El Arab and its tributaries in Southern Darfur, Western Sudan. Onchocerca volvulus has not been reported from this region before. Over 300 people were examined and the selection of patients was aimed at obtaining a cross-sectional view of the disease at all ages and in both sexes. Prevalence rates were high (67.5%, 28.6% and 32% in Titribi, Radom and Kafia Kingi, respectively). The intensity of infection in young adults was generally about 30 mf/mg, but ranged up to 100 mf/mg. Infections were detected in subjects as young as two years old; about one quarter of those sampled in Titribi had nodules, mostly in the pelvic region. Clinical signs of acute and chronic dermal changes were especially marked in Titribi. This village was located closest to the breeding sites, which appear in the rainy season only. More than a third of those samples had severe pruritus and showed many self-inflicted excoriations. Both anterior and posterior eye segment changes were detected in each community, and cases of onchocercal blindness were attributed to sclerosing keratitis and to optic and chorioretinal atrophy. One case typical of intensely localized disease was seen, where the affliction was unilateral and severe with oedema and pigment changes, but very few microfilariae present. Onchocerciasis appears to be well established in this region and has apparently caused abandonment of some settlements in recent years.(ABSTRACT TRUNCATED AT 250 WORDS)

Influence of beta-adrenoceptor-mediated relaxation on alpha-adrenoceptor-mediated contraction of rat pulmonary artery to adrenaline or noradrenaline.

Concentration-response (contraction) curves to either adrenaline or noradrenaline were obtained on isolated ring preparations of pulmonary artery from rats. In preparations from young rats the curve for adrenaline was bell-shaped, unless beta-adrenoceptors were blocked with propranolol (1 X 10(-6) M). The maximum contraction to adrenaline was less in the absence than in the presence of propranolol. In preparations from aged rats the adrenaline curve was no longer bell-shaped, even in the absence of propranolol. This reflected a decrease in the beta-adrenoceptor-mediated relaxant responses of preparations from aged rats, seen as a separation between the concentration-response (relaxation) curves to adrenaline on preparations (phenoxybenzamine-treated, KCl-contracted) from young and aged rats. In preparations from young rats the noradrenaline curve was not bell-shaped, but if the preparations were from young rats treated with thyroxine (T4), then a bell-shaped curve for noradrenaline was obtained, unless beta-adrenoceptors were blocked by propranolol. These data could be explained by an increase in beta-adrenoceptor-mediated relaxant responses of preparations from T4-treated rats, seen as a separation in the concentration-response (relaxation) curves to noradrenaline on preparations from control and T4-treated rats, respectively. Thus alpha-adrenoceptor-mediated contractile responses of rat pulmonary artery preparations, to adrenaline or noradrenaline, can be attenuated by activation of beta-adrenoceptors, mediating relaxation, and the extent of this attenuation changes under the influence of factors, such as ageing or T4-treatment, which modify beta-adrenoceptor-mediated relaxation in this blood vessel type.

Fate of developing larvae of Onchocerca lienalis and O. volvulus in micropore chambers implanted into laboratory hosts.

Infective larvae of Onchocerca lienalis and O. volvulus implanted subcutaneously within micropore chambers into laboratory hosts moulted to the fourth stage (L4) and underwent limited development and growth. Similar recoveries of O. lienalis L4 larvae in the range of 33-66% were obtained from chambers implanted into CBA and BALB/c strains of mice, jirds, and the natural bovine host. A relatively constant proportion of larvae survived up to 24 days post implantation and thereafter recoveries declined, although some worms were still alive after 96 days. Recoveries of O. volvulus L4 larvae from chambers given to normal or T-cell deprived mice were equivalent to one another and to those obtained with O. lienalis. Moulting of O. lienalis in chambers was observed on days 3 and 5, in close accordance with the timing of the third moult in cattle following systemic infection. Moulting of O. volvulus occurred between days 3-6. Morphological changes in developing larvae included a small but significant increase in length, a transient increase in width, and early development of the spicular primordia and genital tube. L4 larvae of O. lienalis, but not those of O. volvulus, exhibited 3 distinct caudal papillae not present on infective larvae.

A semi-automated system of intrathoracic injection for the large-scale production of Onchocerca lienalis infective larvae.

Intrathoracic injection of Onchocerca lienalis microfilariae (mf) into Simulium ornatum sl. is a highly efficient procedure for routine production of infective stage larvae (L3). This bovine parasite provides a useful analogue of Onchocerca volvulus from man, which presents far greater difficulties for L3 production outside endemic areas of onchocerciasis. Using novel systems for the infection and caging of adult blackflies in the laboratory, mean yields of 10.1-38.6 L3 per fly have been regularly obtained. Cyclical maintenance of either the parasite or vector is not a requirement for the success of this approach. An automated device has been developed to control deliveries of mf inoculations, that permits an experienced operator to perform injections at a rate of approximately 200 flies an hour. Mass recoveries of larvae by Baermann extraction appeared to be highly efficient, contrasting an earlier report on the application of this method to Onchocerca L3. Typical performance of these techniques in routine use over a period of time is illustrated with data on 18,000 inoculated blackflies, which yielded over 100,000 L3. Viability of the L3 obtained by the procedures described was confirmed by successful transmission of patent infections to laboratory-reared calves.