Artesunate suppositories: an effective treatment for severe falciparum malaria in rural areas

Artesunate is a potent antimalarial agent available in oral, parenteral and rectal formulations. Artesunate suppositories rapidly reduce and quickly clear parasitaemias. The rapidity of effect, availability and convenient dosage regimen make artesunate in suppository form a promising treatment for severe falciparum malaria, particularly in rural areas where parenteral formulations are unavailable.     

Extended field trial of deltamethrin WDP for control of malaria at Jagdalpur, Madhya Pradesh, India

The synthetic pyrethroid, deltamethrin 2.5% wdp, was evaluated at a dosage of 25 mg/sq m in a group of villages of tribal area around Jagdalpur, District Bastar (Madhya Pradesh). Study was carried out in three consecutive years from 1986 to 1988 with a total of five rounds of deltamethrin spray covering a population of approximately 10,000. The suspension of deltamethrin wdp was white in colour, odourless, non-irritant and the deposits were faintly visible on the surface of wall. A total of 3848 kg of 2.5% deltamethrin wdp was consumed during the trial. Insecticide was found effective in keeping the adult vector density An. culicifacies to a very low level for a period of 14-16 wks. Both anopheline and culicine mosquitoes were affected by the spray. The trial confirmed its long residual effectiveness from 15 to 16 wks on both mud and cement plastered surfaces. Deltamethrin spray shortened the average life span of vector mosquitoes. Observations indicated that insecticide although has an excito-repellent effect on mosquitoes, thus forcing exodus from treated area but with poor survival. Partial impact of deltamethrin spray was observed on the larval population confirm this. Deltamethrin spray did not exhibit any fumigant effect on mosquitoes. Significant decline in SPR from 17.93 to 4.26% was observed in areas sprayed with deltamethrin as compared to the comparison area. Similarly, SfR showed 81% reduction in experimental area while the control area showed increase by 42 per cent. No ill-effect of spray was noticed on the inhabitants, spray personnels, animal population and other non-target organisms of the area. The acceptability of the deltamethrin spray was found to be very high.     

Distortion in person perception as a consequence of the need for effective control.

Conducted 2 experiments to assess the impact of the need for effective control on attributions made in a conflict situation. In the 1st experiment with 32 undergraduates, it was hypothesized that the prospect of future interaction with a target person would lead observers to exaggerate the degree of dispositional information they believed could be inferred from the target person's behavior. Results confirm the hypothesis. In the 2nd experiment with 90 undergraduates, it was hypothesized that Ss scoring high on Rotter's Internal–External Locus of Control Scale would draw more dispositional inferences from a target person's behavior than would Ss scoring low on this scale. This prediction was also supported. The overall pattern of results is construed as supporting the position that the attributional differences found between the various types of observers were due, at least in part, to motivational as opposed to information-processing factors. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical trial of an oral vestibular shield for the control of snoring

1. Comparative aspects of iodine conservation in mammals were studied on the basis of published data on kidney and thyroid weights and function. 2. Very small mammals possessed an efficient reabsorption of iodide to compensate for the high glomerular filtration rate (GFR). 3. Humans and mammals of a similar and larger size had "lost" the ability to reabsorb iodide efficiently. 4. Very large mammals are protected against renal loss of iodide due to the relatively low GFR. 5. Thyroid weights in relation to body weight were highest in humans suggesting that humans and other mammals of a similar size are especially susceptible to iodine deficiency.     

Beauveria bassiana (Hyphomycetes) as a possible agent for biological control of Chagas disease vectors

Beauveria bassiana (Balsamo) Vuillemin (isolate CG306) was tested on 3rd instars of 9 Triatoma spp., 4 Rhodnius spp., 2 Panstrongylus spp. and Dipetalogaster maxima (Uhler) at 25 degrees C and 50% RH. Quantitative sporulation of the fungus on cadavers was studied at 25 degrees C and 97% RH. Mortality, estimates of survival time, and conidial production on cadavers differed significantly among the genera and species tested. Panstrongylus herreri Wygodzinsky, Dipetalogaster maxima, Triatoma picturata Usinger, Rhodnius robustus Larrousse, Rhodnius prolixus St?l, Triatoma infestans (Klug), and Triatoma brasiliensis Neiva were most susceptible to fungal infection. Most conidia per cadaver were produced on Triatoma williami Galv?o, Souza & Lima and Triatoma lecticularia (St?l). Results indicate that B. bassiana (CG306) might be a candidate for control of important or potential vectors of Trypanosoma cruzi using the fungus as a bioinsecticide.     

Second derivative spectrophotometry as an effective tool for examining phenylalanine residues in proteins

The second derivative absorption spectra of N-acetyl ethyl esters of phenylalanine, tyrosine and tryptophan, as models of the aromatic amino acid residues in proteins, were measured. The second derivative spectra of tyrosine and tryptophan were found to have no influence on the spectrum of phenylalanine over the range of 245 to 270 nm, where characteristic absorbance bands of phenylalanine were observed. Thus the second derivative spectrum is a good tool for examining the optical properties of phenylalanine residues in proteins.     

Psychotherapy—is it safe, effective, and appropriate? The beginning of an evolutionary dialogue.

Discusses efforts made by the US Congress in the late 1970's and early 1980's to explore the extent to which those seeking psychotherapeutic services could be assured that the care they would receive would be beneficial. It is contended that psychology, psychiatry, and the mental health field have presented few summary statements to guide the educated consumer or enlightened 3rd-party payers in decision making about mental health care. The mental health field is still young, and there has been insufficient time to evaluate the efficacy of all forms of therapy for all the problems for which patients/clients seek help. But the knowledge gained from clinical experience can be used in a tentative fashion to direct more rigorous empirical investigation. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Biochemical characterization of glycyrrhizin as an effective inhibitor for hyaluronidases from bovine testis

The inhibitory effects of several anti-inflammatory agents, including glycyrrhizin (GL), on the activities of hyaluronidases (HAses) purified from bovine testes and Streptomyces were investigated in vitro. It was found that (i) GL inhibits the activity of HAse (p55) from bovine testes in a dose-dependent manner, but does not affect HAse from Streptomyces; (ii) GL was the most effective of the compounds tested on bovine testis HAse activity (50% inhibition with approx. 3 microM GL); and (iii) glycyrrhetinic acid (GA), a derivative (oGA) of GA and diglucuronic acid had no detectable effects on HAse activity at 9.0 microM. The GL-induced inhibition of HAse activity is uncompetitive for its substrates. Data are provided to support the contentions that (i) bovine testis HAse (p55) is a GL-binding protein; and (ii) GL acts as a potent inhibitor of HAse in vitro.     

Cortical areas and the control of self-determined finger movements: an fMRI study

We investigated cortical areas involved in the control of self-determined finger movements. In a tapping task, subjects tapped with different movement frequencies in two different movement conditions (predetermined vs self-determined). fMRI provided evidence for the involvement of the horizontal and ascending parts of the intraparietal sulcus (IPS), the left superior frontal gyrus and the posterior cingulate gyrus in the control of self-determined finger movements. Higher movement frequency increased the extent of activated area only in the horizontal part of IPS. The results suggest a major role of the IPS in controlling sequences of finger movements. This area probably serves as a region for integration of motor, sensory and sensorimotor feedback information used for movement control.     

Dexpanthenol nasal spray as an effective therapeutic principle for treatment of rhinitis sicca anterior

BACKGROUND: Controlled clinical studies on medical treatment of rhinitis sicca anterior have not yet been published. Therapy recommendations are based on experiences but not on results of controlled clinical studies. The aim of this study was to examine the efficacy and tolerance of a new form of application of Dexpanthenol in physiologic saline solution (Nasicur). PATIENTS AND METHODS: A randomized comparison of parallel groups was performed. One group was treated with the nasal spray while the control group received a placebo. The assessment of nasal breathing resistance and the extent of crust formation according to scores were defined as target parameters. Statistical analysis was carried out according to Wilcoxon at alpha < or = 0.05. RESULTS: Forty-eight outpatients diagnosed with rhinitis sicca anterior were included in this study. Twenty-four received the medication, and 29 were treated with a placebo. The superiority of the dexpanthenol nasal spray in comparison to the placebo medication was demonstrated for both target parameters as clinically relevant and statistically significant. The placebo spray showed clinical improvement of the other treatment outcome parameters. Dexpanthenol nasal spray showed no statistically significant difference in comparison to placebo. The clinically proven efficacy is emphasized by good tolerance of both treatments which was validated by the objective rhinoscopy findings. Good compliance was confirmed. CONCLUSION: The result of the controlled clinical study confirms that the dexpanthenol nasal spray is an effective medicinal treatment of rhinitis sicca anterior and is more effective than common medications.     

Inhaled nitric oxide in primary pulmonary hypertension: a safe and effective agent for predicting response to nifedipine

OBJECTIVES: The purpose of this study was to assess the utility of inhaled nitric oxide (NO), a selective pulmonary vasodilator, for predicting the safety and acute hemodynamic response to high-dose oral nifedipine in primary pulmonary hypertension (PPH). BACKGROUND: A significant decrease in pulmonary vascular resistance with an oral nifedipine challenge is predictive of an improved prognosis, and potential clinical efficacy in PPH. However, the required nifedipine trial carries significant first-dose risk of hypotension. While inhaled NO has been recommended for assessing pulmonary vasodilator reserve in PPH, it is not known whether it predicts the response to nifedipine. METHODS: Seventeen patients with PPH undergoing a nifedipine trial were assessed for hemodynamic response to inhaled NO at 80 parts per million for 5 minutes. The nifedipine trial consisted of 20 mg of nifedipine hourly for 8 hours unless limited by hypotension or intolerable side effects. Patients were classified as responders and nonresponders with positive response defined as > or =20% reduction in mean pulmonary artery pressure (mPA) or pulmonary vascular resistance (PVR) with the vasodilator administration. RESULTS: NO was safely administered to all participants. Seven of 17 (41.2%) responded to NO, and 8 of the 17 to nifedipine (47.1%). Nifedipine was safely administered in 14 of the 17. Three suffered either mild or severe hypotension, including one death. All NO responders also responded to nifedipine, and 9 of the 10 NO nonresponders were nifedipine nonresponders, representing a sensitivity of 87.5%, specificity of 100%, and overall predictive accuracy of 94%. All NO responders tolerated a full nifedipine trial without hypotension. There was a highly significant correlation between the effects of NO and nifedipine on PVR (r=0.67, p=0.003). CONCLUSIONS: The pulmonary vascular response to inhaled NO accurately predicts the acute hemodynamic response to nifedipine in PPH, and a positive response to NO is associated with a safe nifedipine trial. In patients comparable with those evaluated, a trial of nifedipine in NO nonresponders appears unwarranted and potentially dangerous.     

Effectiveness of polyclonal and monoclonal antibodies prepared for an immunoassay of the etofenprox insecticide

The aim of this study was to compare hemodynamic responses to intubation and pin head-holder application in two groups of neurosurgical patients given oral clonidine (3 microg/kg) or oral temazepam (10-20 mg) 90 min before the induction of anesthesia. Fifty patients undergoing elective craniotomy were randomized to either group. Anesthesia was induced with i.v. propofol 1500 mg/h, fentanyl 4 microg/kg, vecuronium 0.15 mg/kg, and lidocaine 1.5 mg/kg and was maintained with propofol 6 mg x kg(-1) x h(-1). Mean arterial blood pressure (MAP) and heart rate were recorded before the induction of anesthesia and before and after intubation and application of the pin head holder. Interventions required to maintain hemodynamic stability were compared between groups. Preinduction sedation scores and MAP values were similar between groups. MAP was significantly lower (P = 0.031) in the clonidine group after pin head-holder application. Interventions to stabilize MAP were not significantly different between groups (P = 0.11). We conclude that clonidine is effective in reducing the MAP increase with pin head-holder application in patients undergoing craniotomy. Implications: In this study, we investigated an approach to the prevention of increased blood pressure often seen during the early part of anesthesia for brain surgery. Oral clonidine was effective in reducing the mean arterial blood pressure increase resulting from pin head-holder application. Clonidine, a blood pressure-reducing drug, was given to 25 patients before anesthesia. Their blood pressure measurements were then compared with those of 25 patients not given clonidine.     

Pantoprazole-based dual and triple therapy for the eradication of Helicobacter pylori infection: a randomized controlled trial

BACKGROUND/AIMS: The eradication of Helicobacter pylori (Hp) infection in duodenal ulcer and dyspepsia has been achieved using various therapy regimens. The efficacy of protein pump inhibitor pantoprazole as part of these regimens has not been widely studied. METHODOLOGY: During a prospective randomized trial, 250 Hp positive patients with either duodenal ulcer, erosive bulbitis, or gastritis and dyspepsia were treated using 14 days of therapy 1) pantoprazole 40 mg daily and clarithromycin 500 mg b.i.d. (PC), 2) pantoprazole 40 mg daily and clarithromycin 500 mg b.i.d. plus amoxicillin 1 g b.i.d. (PCA), or 3) bismuth subcitrate 120 mg t.i.d., roxithromycin 150 mg b.i.d., metronidazole 250 mg b.i.d. plus ranitidin 300 mg (BRMR). Hp status was assessed on 3 tests at the inclusion (2-specimen rapid urease test, 2-specimen histology, serology) and 2 tests (2-specimen rapid urease test, 2-specimen histology) 4 weeks after the end of the treatment. RESULTS: The entry criteria was fulfilled in 250 patients, of whom 13 missed the control endoscopy. The treatment had to be discontinued for adverse effects in 8 (10%) BRMR patients, and 1 (1%) PCA patients. Compliance was 100% in the PC group. All ulcers were healed at the end of the study with one exception in the BRMR group. The best eradication rate of Hp was shown by the PCA group with 94.8% (n = 73/77) followed by the PC group with 82.5% (n = 66/80) and finally the BRMR with 67.6% (n = 48/71)-PCA:BRMR - p < 0.001; PC:BRMR-p < 0.001; PCA:PC-p < 0.05. CONCLUSION: This study showed that triple therapy using PPI pantoprazole combined with antibiotics clarithromycin and amoxicillin was very effective in the eradication of Hp and treatment of duodenal ulcer with rare side effects. The dual pantoprazole and clarithromycin therapy had the highest rate of patient compliance, but is less effective than triple therapy. The combination of ranitidin with bismuth based triple therapy had the highest number of adverse events and the lowest rate of Hp eradication and therefore, should not be recommended.     

Potassium permanganate and tetraethylammonium chloride are a safe and effective substitute for osmium tetroxide in solid-phase fluorescent chemical cleavage of mismatch

Whilst chemical cleavage of mismatch (CCM) detects all point mutations in DNA, its widespread use has been hampered by the complex multistage methodology and the need for toxic chemicals, in particular osmium tetroxide. Here we show that osmium tetroxide can be replaced by potassium permanganate, giving the same spectrum of mutation detection, but with greater sensitivity. The use of potassium permanganate is compatible with solid phase capture and fluorescent detection, giving a safer method of mutation detection. We present here a comparison of CCM with osmium tetroxide and with potassium permanganate, tested on a complete set of single base pair mismatches and a number of small insertion/deletions.     

The use of vaccines and genetically resistant animals in tick control

The control of ticks and diseases transmitted by ticks is extremely difficult. Application of acaricides is the most common prophylactic and therapeutic control measure against these ectoparasites. The selection of tick strains which are resistant to these products, the appearance of chemical residues in milk and meat, and environmental pollution resulting from the use of acaricides pose real problems. This article deals with aspects of current work on the alternative control of ticks and places special emphasis on the development of vaccines and the utilisation of genetically resistant animals.     

A prospective randomized trial comparing the use of omeprazole-based dual and triple therapy for eradication of Helicobacter pylori

BACKGROUND: Controversy surrounds the optimal composition, dosage, and duration of therapies for eradication of Helicobacter pylori. We prospectively compared omeprazole-based dual and triple therapies in the eradication of H. pylori in a randomized manner. METHODS: Between June 1995 and March 1997, 1000 consecutive patients with acid-peptic disease associated with H. pylori infection (duodenal ulcer, 388 patients, gastric ulcer, 179 patients; duodenitis, 173 patients; gastritis, 260 patients) were prospectively recruited. They were randomized to either a 2-wk (OA) course of omeprazole 20 mg and amoxicillin 1 g, both given twice daily, or treatment for 1 wk (OCM) with omeprazole 20 mg once daily, clarithromycin 500 mg twice daily, and metronidazole 400 mg twice daily. RESULTS: The age of these 1000 patients ranged from 16 to 90 yr, with a mean of 54.9 yr. Side effects occurred in 29.6% (95% confidence interval [CI] 25.6-33.8%) and 10.6% (95% CI 8.0-13.6%) of patients taking OCM and OA, respectively (p < 0.0001). Apart from taste disturbance, however, there were no significant differences in the incidences of side effects between the two groups. One patient in the OA group and four patients of the OCM group could not tolerate the medications, and therefore did not complete treatment (p = 0.37). Seven and 13 patients in the OA and OCM groups, respectively, refused a second endoscopy (p = 0.25). The remaining 975 patients underwent a second endoscopy. Positive endoscopic findings were significantly more common in the OA group (51/492; 10.4%; 95% CI 7.8-13.4%) than in the OCM group (25/483; 5.2%; 95% CI 3.4-7.5%) in the per-protocol (PP) analysis (p = 0.004). On intent-to-treat (ITT) analysis, the overall eradication rates in the OA and OCM groups were 73.6% (95% CI 69.5-77.4%) and 92% (95% CI 89.3-94.2%), respectively (p < 0.0001). On PP analysis, the corresponding rates were 74.8% (95% CI 70.7-78.6%) and 95.2% (95% CI 92.9-97.0%), respectively (p < 0.0001). CONCLUSIONS: A course of omeprazole, clarithromycin, and metronidazole for 1 wk is a safe, well-tolerated, efficacious, and cost-effective treatment for H. pylori infection.     

Insecticide barrier spraying for the control of sand fly vectors of cutaneous leishmaniasis in rural Guatemala

An initial evaluation of insecticide barrier spraying directed against sand fly vectors of cutaneous leishmaniasis was done in a nonclimax forested area with heavy undergrowth in Peten, Guatemala. A 100 m-wide swath of vegetation was sprayed once with a 1:3 mixture of cyfluthrin insecticide and a palm oil carrier using back-pack sprayers to simulate a central cantonment area in one site while another site remained as an untreated control. Prior to spraying and throughout 87 days post-treatment, sand fly populations were monitored at both sites with light traps set at ground and canopy levels at 50-m intervals radiating out from the centers of the cantonments, 150-m in the four cardinal directions. A total of 2,876 female sand flies were captured, representing 16 species. Three species, Brumptomyia galindoi, Lutzomyia panamensis, and Lu, ovallesi, comprised 70% of the total collection. The single insecticide barrier significantly reduced sand flies from reaching the cantonment area for more than 80 days, while sand fly populations outside the treated cantonment and in the untreated (control) cantonment remained high (52 sand flies in the treated cantonment versus 235 sand flies in the untreated cantonment).