Brachiola vesicularum, n. g., n. sp., is a new microsporidum associated with AIDS and myositis. Biopsied muscle tissue, examined by light and electron microscopy, revealed the presence of organisms developing in direct contact with muscle cell cytoplasm and fibers. No other tissue types were infected. All parasite stages contain diplokaryotic nuclei and all cell division is by binary fission. Sporogony is disporoblastic, producing 2.9 x 2 microns diplokaryotic spores containing 8-10 coils of the polar filament arranged in one to three rows, usually two. Additionally, this microsporidium produces electron-dense extracellular secretions and vesiculotubular appendages similar to Nosema algerae. However, the production of protoplasmic extensions which may branch and terminate in extensive vesiculotubular structures is unique to this parasite. Additionally, unlike Nosema algerae, its development occurred at warm blooded host temperature (37-38 degrees C) and unlike Nosema connori, which disseminates to all tissue types, B. vesicularum infected only muscle cells. Thus, a new genus and species is proposed. Because of the similarities with the genus Nosema, this new genus is placed in the family Nosematidae. Successful clearing of this infection (both clinically and histologically) resulted from treatment with albendazole and itraconozole.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Exploring decision-making for environmental health services: perspectives from four cities.

Increasing resources are being allocated to environmental health monitoring, especially for developing methods and collecting data to construct environmental health indicators (EHIs). Yet, little research has focused on understanding how communities and service providers make decisions with regard to environmental health priorities and the role of indicators in this process. This paper presents insights regarding local decision-making that arose from a project to test the feasibility of using community-based EHIs to facilitate communication between the providers and the recipients of environmental services in four developing-country cities. The results of the study indicate that decision-making for environmental health services is complex and iterative rather than rational and linear. Contextual and process factors play an important role. These factors include the morale of service providers, the extent of collaboration between service agencies, the priorities of different community groups and relations between service providers and communities. Scientific information, in the form of EHIs, did not appear to be a key element of decision-making in the settings studied. As tools, EHIs are unlikely to become part of the decision-making process unless they are integrated with local agendas and backed by strong local representation.

Cities↗

PubMedDate not supplied

[Vertebral and femoral bone mineral density of 724 caucasian Brazilian women: influence of age and body weight].

OBJECTIVE: To study the vertebral (L2-L4) and femoral (neck) bone mineral density (BMD) of normal white women. MATERIAL AND METHOD: We measured the BMD of 724 women (40-79 kg; 20-69 years-age) by dual-energy X-ray absorptiometry. Data were analysed as a function of age and body weight (BW). RESULTS: Thinner women (40-49 kg) attained maximal vertebral and femoral BMD (mBMD) at ages between 30-39 years, while heavier women (60-79 kg) already had the mBMD by the age of 20. At the femur, there was a significant mBMD-BW correlation (r = 0.97; p < 0.001; slope = 0.72%/kg). At the spine, only the 40-49 Kg women exhibited lower mBMD when compared to the others (p < 0.001). The decrease of the vertebral BMD was more intense (-8.3 vs. -5.7%/decade) and started earlier (fourth vs. fifth decade) in women weighting 40-59 kg, as compared to those weighting 60-79 kg. The decrease of the femoral BMD was initiated just after mBMD was achieved and, at the age of 69, heavier women showed a decrease that was 5.3% lower than those weighting 40-49 kg. The vertebral BMD of the Brazilian women was practically the same as reported for a North-American population. CONCLUSIONS: (i) Vertebral and femoral BMD of this Brazilian population varied with age similarly to other white female populations; (ii) provided that appropriate corrections are made for BW, the BMD of Brazilian women is comparable to the BMD of North-Americans; and (iii) the BW is important both in acquisition and decline of bone mass, as it influences the relation BMD-age.

Adult↗

PubMedDate not supplied

Influence of body composition on the bone mass of postmenopausal women.

AIMS: To investigate the influence of body weight (BW), fat mass (FM) and lean mass (LM) on the bone mineral density (BMD) of several areas of the skeleton. PARTICIPANTS: Sixty one white postmenopausal women (50.1 +/- 4.8 years). MEASUREMENTS: Measurement of BMD by dual energy x-ray absorptiometry. The results were analyzed by linear regression and the slopes of each curve were compared. RESULTS: The results showed that the correlations between BW, FM and LM to BMD were positive, whilst the correlations between age and years since menopause to BMD were negative. LM was the main factor that influence BMD in almost all areas. CONCLUSIONS: FM and LM present a positive effect on BMD, although LM is the main determinant of bone mass. Moreover, higher values of LM and FM present a protective effect against the reduction of BMD combined with menopause. Therefore postmenopausal women with low BW, especially low LM, present serious risk for developing osteoporosis.

Absorptiometry, Photon↗

PubMedDate not supplied

[Bone mineral density: correlation with body weight, height, bone age and insulin-like growth factor].

OBJECTIVE: To evaluate bone mineral density and bone mineral content of skeleton and lumbar spine of pre-pubertal children and to correlate results thus found with sex, bone age, body weight, height and insulin-like growth factor 1 serum level. METHODS: 26 boys and 12 girls aged between 7 and 8 years old, students from a São Paulo public school, were studied. They all presented weight and height between 2.5 and 97.5 percentiles of the Brazilian childreńs curve, lack of secondary sex characteristics, no reports on chronic diseases and normal physical examination. Bone age was determined from radiograms of the left hand and wrist. Serum levels of insulin-like growth factor 1 were measured by radioimmunoassay. Bone mineral density and bone mineral content were measured in skeleton and lumbar spine using a dual X-ray absorptiometry equipment. RESULTS: The mean values of skeleton bone mineral density found were 0.812 -/+ 0.057 g/cm(2) in the girls and 0.839 -/+0.053 g/cm(2) in the boys, while the respective mean lumbar values were 0.649 -/+ 0.092 g/cm(2) and 0.657 -/+ 0.062 g/cm(2). The mean values of skeleton bone mineral content found were 840 -/+ 181g in the girls and 919 -/+ 133 g in the boys, while the respective lumbar values were 13.3 -/+ 3,0g and 14.5 -/+ 2,4. It was found that the bone mass of children at this age corresponds to about 50% of the bone mass pick found in the young adult. No significant bone mass differences between sexes were found. No correlation was found between bone mass and insulin-like growth factor 1 serum levels. Positive correlations between bone mass and body weight and bone age were found. CONCLUSIONS: In pre-pubertal children (1) the analysis of bone mass should be interpreted mainly as a function of body weight and (2) bone mineral density of the lumbar spine and skeleton correlate with bone age and may represent an additional parameter of skeleton maturation.

English Abstract↗

PubMedDate not supplied

Teaching medical ethics: a model.

Explore the source record for details and available documents.

Curriculum↗

PubMedDate not supplied

[Diagnosis of osteoporosis using dual photon densitometry].

Osteoporosis is often diagnosed after fracture occurrence, when therapy is less effective. The dual photon densitometry has been the proposed method for osteoporosis early diagnosis. In the present study is presented our experience on the lumbar vertebral and femoral neck bone mass measurement by utilizing a Lunar DP-3 densitometer in normal young 82 volunteers and 103 women with radiologically and clinically diagnosed osteoporosis. The values found in osteoporotical patients were significantly lower when compared to those normals either in lumbar vertebrae (L2-L4) or in the femoral neck. The method's coefficient of variation was less than 0.5%, when determinated with a synthetic phantom aid and less than 1.5% repeating the exam in 10 normal volunteers. These results show that dual photon densitometry is a simple, sensitive and non-invasible method for early diagnosis and therapeutic follow-up of osteoporotical patients.

Absorptiometry, Photon↗

PubMedDate not supplied

Teaching medical ethics in a medical college in India.

To the best of our knowledge, medical ethics is not taught as a separate subject in Indian medical colleges. St John's Medical College has a programme for teaching medical ethics to its undergraduate students. We describe here the structure of our programme, the syllabus and the teaching methodology. We feel that we have an effective way of teaching medical ethics at our medical college and would encourage other medical colleges to introduce the subject in their curriculum.

Curriculum↗