School failure and epilepsy: a case-control study

School difficulties and educational inadequacy usually correlate with the child's epilepsy. The target of our study is to discover the most precocious possible the epilepsy and to prevent educational failure in the population of children from 6 to 15 years old. We have carried out a retrospective study on 162 children of an educational age. This population was made up of 100 epileptic children followed over a period of 3 years (1995-1997) and a witness group made up of 62 children selected from brothers and sisters of the study group, with the same sex in default of the opposed sex who are educated. We have noted that at the same age between children from the group of study and children from the witness group. The class of study was significantly inferior in the group of study: the educational average class is 4th against 5th in the witness group P = 0.11. The difference was about one year. The difference of educational results was significant. For the last educational year, the educational mark was 8.99/20 in the group of study against 12/20 in the witness one. P < 10-5. For the last educational semester, the educational mark was 9.5/20 in the group of study against 11.9/20 in the witness group. (P = 3 x 10(-4)).     

New compounds,chemical composition,antifungal activity and cytotoxicity of the essential oil from Myrtus nivellei Batt. & Trab., an endemic species of Central Sahara

Ethnopharmacologic relevance

Myrtus nivellei Batt. & Trab. (Myrtaceae) known as Sahara myrtle is appreciated by the Touaregs as medicinal plant. Infusion of leaves is employed against diarrhea and blennorrhea. Crushed leaves added to oil or to butter ointment have been traditionally used for the treatment of dermatosis. Aim of the study is to consider the traditional medicinal uses and the lack of scientific studies on their biological activities, the present study was designed to elucidate the chemical composition, the antifungal activity of its essential oils against fungi responsible for human infections, as well as, its cytotoxicity in the mammalian keratinocytes.

Materials and methods

Chemical analysis of Myrtus nivellei essential oil isolated by hydrodistillation of aerial parts (leaves and flowers), was carried out using a combination of chromatographic (CC, GC with retention indices) and spectroscopic techniques (MS, ¹³C NMR, 2D NMR). The antifungal activity was evaluated by using broth macrodilution methods for yeasts and filamentous fungi. Cytotoxicity was tested in HaCaT keratinocytes through the MTT assay.

Results

Ten samples coming from two localities of harvest were investigated. The chemical composition was largely dominated by 1,8-cineole (33.6–50.4%) and limonene (17.5–25.0%). The structure of two new compounds bearing the isoamylcyclopentane skeleton has been elucidated. The oil was more active against Cryptococcus neoformans with MIC of 0.16 μL/mL followed by dermatophytes, with MICs of 0.64 and 1.25 μL/mL. Furthermore, evaluation of cell viability showed no cytotoxicity in HaCaT keratinocytes at concentrations up to 1.25 µL/mL.

Conclusions

The composition of Myrtus nivellei oil differed from that of Myrtus communis. The structure of two di-nor-sesquiterpenoids has been elucidated. It was possible to find appropriate doses of Myrtus nivellei oil with both antifungal activity and very low detrimental effect on keratinocytes. These findings add significant information to the pharmacological activity of Myrtus nivellei essential oils, specifically to its antifungal properties, thus justifying and reinforcing the use of this plant in traditional medicine.     

Plasmodium falciparum infection transmitted by transfusion: A cause of hemophagocytic syndrome after bone marrow tranplantation in a non‐endemic country

A 27‐year‐old man with severe aplastic anemia underwent bone marrow transplantation from his HLA identical brother in July 2016. Conditioning included ATGAM 30 mg/kg for 3 days and Cyclophosphamide 50 mg/kg for 4 days. The patient received several platelet and red blood cell transfusions before and after the conditioning. The patient received broad spectrum antibiotics and caspofungin because persistant febrile neutropenia without bacteriological or mycological documentation. Hemophagocytic syndrome was diagnosed on day +12. Steroids at 1 mg/kg were started on day +12. Fever resolved the same day but resumed 3 days later associated to intravascular hemolysis with no schizocytes on blood smears and negative DAT. Thick blood film smears performed on day +26 revealed Plasmodium falciparum parasites (parasitemia = 20%). Except the level of parasitemia, there were no signs of gravity. Quinine was started on day 26 at a loading dose of 15 mg/kg followed by 8 mg/kg three times a day for 20 doses. Fever vanished after 2 days. Parasitemia cleared in 3 days and remained negative thereafter. Investigations revealed that the patient was transfused by a red cell unit harvested in a voluntary donor native of a malaria endemic country. PCR for P. falciparum performed in this donor in the frame of investigations was positive. The patient is alive with a normal blood count 1 year after BMT.     

Islands inside an island: reproductive isolates on Jerba island.

Jerba Island, located in South Eastern Tunisia, is inhabited by four ethnic groups: Berbers, Arabs, sub-Saharans, and Jews. All live in distinct areas, although the Arabs are also distributed all over the island. The first Arab settlement was founded in the 7th century A.D., so co-existence with Berbers has lasted for more than a millennium. Religious and cultural differences have represented an obstacle to the intermixing of these groups, and among both Arabs and Berbers marriages usually occur between members from the same extended family. Using new mtDNA data and previously described Y-chromosome STR-defined haplotypes, we tested whether this reported inbreeding would be reflected in the differentiation between Berber and Arab communities. Concerning mtDNA, the Berber group presented a greater Eurasian contribution (87%), and, surprisingly, no U6 haplotypes were found; in contrast, the Arabs showed a larger contribution of sub-Saharan lineages (24%) and the U6 haplogroup amounted to 10%. Another source of evidence for the reproductive isolation of the two groups was revealed through the analysis of haplotype matching (both mtDNA and Y-chromosome), showing that matching probabilities between them is of the same order of magnitude of that observed when contrasting samples from different European countries.     

Molecular characterization of amoxicillin-clavulanate resistance in a clinical isolate of Escherichia coli

The resistance phenotype of the clinical isolate of Escherichia coli 1941 was characterized by high-level resistance to penicillins and to combinations amoxicillin-ticarcillin/clavulanate and ampicillin/sulbactam. This resistance was carried by the conjugative plasmid pEC1941 that encoded a beta-lactamase activity. The purified enzyme focused at pI 5.4 and was strongly inhibited in vitro by clavulanic acid (IC50 = 0.09 microM). Nucleotide sequence analysis revealed identity between the plasmid borne blaTEM gene of E. coli 1941 and the blaTEM-1B gene, except for a single C-to-T substitution at position 32 in the promoter region leading to the overlapping promoters Pa and Pb. No alterations in the expression of outer membrane porins OmpC and OmpF have been detected. These findings show that the resistance of E. coli 1941 to the combinations of beta-lactams with beta-lactamase inhibitors is related to high-level production of TEM-1 enzyme expressed from the strong promoters Pa and Pb.     

The primary hereditary form of distal renal tubular acidosis: clinical and genetic studies in 60-member kindred

A distal (type 1) renal tubular acidosis (RTA-1) has been studied in 60 of 69 living members of a large family "HK" and two unrelated small families. The "HK" family, including 28 RTA-1 subjects, presents the first large family with only primary RTA-1 reported to date. The genetic situation in this family confirms the autosomal dominant transmission of the hereditary primary RTA-1 suggested previously on the basis of a few small families. Our data show that, in contrast to the secondary hereditary form, RTA-1 in its primary hereditary form is always complete and often tolerated (asymptomatic). It occurs in non-hypercalciuric families with no clinical variants observed in family members without RTA-1. In our series some clinical abnormalities commonly associated with RTA-1, such as nephrocalcinosis and growth retardation, appeared only in three cases among offspring when both parents were affected. The appearance of such abnormalities, taken as consequences of chronic acidosis in RTA-1, could be favored by the genetic background and/or the homozygosity for the RTA-1 gene. Linkage studies between RTA-1 and 10 genetic markers have been carried out. Results show that only ABO, MNS, GM and RH loci are informative for linkage analysis and none of these loci can be suggested as linked to RTA-1 locus.     

Normal production of inflammatory cytokines in chronic fatigue and fibromyalgia syndromes determined by intracellular cytokine staining in short-term cultured blood mononuclear cells

It has been proposed that cytokines play a role in the pathogenesis of chronic fatigue syndrome (CFS) and fibromyalgia syndrome (FMS). However, different studies have reported conflicting results using enzyme-linked immunosorbent assay or polymerase chain reaction to detect cytokines in these conditions. In the present study, for the first time, the production of inflammatory [interleukin (IL)-1alpha, IL-6, and TNF-alpha] and anti-inflammatory (IL-10) cytokines by CD14+ and CD14- peripheral blood mononuclear cells (PBMC) from chronic fatigue syndrome (CFS) and fibromyalgia syndrome (FMS) patients and sex- and age-matched normal subjects was investigated at the level of individual cells using the technique of intracellular cytokine staining and flow cytometry. Cultures were carried out in the presence of polymyxin B to inhibit the effect of endotoxins on cytokine production by monocytes. The mean intensity of fluorescence (MIF) and percentage of CD14+ (monocytes) and CD14- (lymphocytes) cytokine-producing mononuclear cells were comparable in patients and controls in either unstimulated or IFN-gamma-stimulated conditions. Our study indicates that dysregulation of cytokine production by circulating monocytes or non-monocytic cells (lymphocytes) is not a dominant factor in the pathogenesis of CFS/FMS.     

Operative treatment and avascular necrosis of the hip development disorder

Purpose

The purpose of this research was (1) to evaluate the consequences of an operative treatment of hip developmental disorder in children, (2) to evaluate the significance of hip vascular supply in children through indirect radiological signs, such as morphological changes on femoral head, and to classify them with standard classification methods, and (3) to analyse the research results and make a recommendation for the following treatment dilemma: when is the optimal time for an operative treatment of a hip development disorder?

Methods

The research is a retrospective and observational analysis based on the classification of indirect radiological signs of local vascular disorder by the Bucholz-Ogden’s scale. Materials used for this research are medical records of treated patients at the Clinic for Orthopaedics and Traumatology of the Sarajevo University Clinical Centre. Using a random selection, two groups of 30 patients with hip development disorder were formed. The first group was comprised of patients aged six to 18 months and the second group of patients aged 18–60 months. The medical records used for this research included all necessary anamnestic details and postoperative state treatments with clinical findings and regular radiological check-up findings that include the presence or absence of the ossification nucleus as well as its position. All patients underwent surgery with the same operative technique. Data analysis points include the state at the beginning of the treatment, the postoperative state, the state at discharge as well as control findings that followed the development of the proximal femoral part up to 72 months on average. The analysis covered data such as age, sex, family anamnestic data, clinical findings and radiological findings regarding the femoral head morphology (appearance, size, shape, position and indirect signs showing lack of vascular supply). In addition, data analysis included the types of any previous conservative or operative treatments, the duration of previous conservative treatments and repeated hospitalization.

Results

In group 1, 86.6 % were female patients and 80 % in group 2. Family history was positive in 15.6 % in group 1 and 13.3 % in group 2. A total of 51.6 % of all patients started walking on time, while the rest had problems with verticalization. Of all patients, 47 % did not undergo any kind of prior treatment. Only 62.2 % of group 1 patients had ossification nucleus present, while the entire group 2 had it present. Results showed that 24.32 % of group 1 patients had none or minimal signs of avascular necrosis (AVN) while 39.47 % of group 2 had none or minimal signs of AVN; 60.52 % of group 2 patients had signs of AVN.

Conclusion

The results of this study show that the performance of a surgical treatment during the age between 12 and 20 months is burdened by the highest percentage of avascular necrosis. Even though AVN can be noticed in other age groups, according to the results of our research, it seems that vascular supply of the hip is the most vulnerable in the period between 12 and 20 months.