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OBJECTIVE: I review the status of dichlorodiphenyltrichloroethane (DDT), used for disease vector control, along with current evidence on its benefits and risks in relation to the available alternatives. DATA SOURCES [...]

The purpose of this study was to examine whether intestinal [Beta]-carotene cleavage activity, measured with the dioxygenase assay, is affected by vitamin A intake and whether this in vitro activity is a determinant of [Beta]-carotene cleavage in vivo, measured in lymph-cannulated rats. Six groups of 10-20 rats were fed a diet with a low, normal or high retinyl palmitate concentration (120 RE, 1200 RE and 12,000 RE per kg, respectively) for 14 to 18 wk, either supplemented or not with 50 mg [Beta]-carotene/kg in the last 6 wk. intestinal dioxygenase activity was 90% higher (P < 0.05) in the animals fed the unsupplemented low vitamin A diet than in the animals fed the unsupplemented high vitamin A diet, whereas in [Beta]-carotene-supplemented rats intestinal dioxygenase activity was significantly lower than in unsupplemented rats. The molar ratio between retinyl esters and [Beta]-carotene in lymph collected over 8 h after a single intestinal dose of [Beta]-carotene (250 [[micro]grams]) to [Beta]-carotene-unsupplemented rats fed the three levels of vitamin A was correlated with intestinal dioxygenase activity (r = 0.66, P = 0.003). Dioxygenase activity in the liver was not affected by the vitamin A concentration of the diet but was 70% higher in the [Beta]-carotene-supplemented rats. Based on the difference in liver vitamin A contents between [Beta]-carotene-supplemented and unsupplemented rats we estimated [Beta]-carotene conversion factors of 9:1 for the rats fed the high vitamin A diet and 4:1 for the rats fed the normal and low vitamin A diets. Intestinal [Beta]-carotene cleavage activity is higher in vitamin A-deficient rats than in rats with a high intake of either vitamin A or [Beta]-carotene. The intestinal dioxygenase activity as measured in vitro is an adequate indicator of in vivo [Beta]-carotene cleavage activity. INDEXING KEY WORDS: rats, [Beta]-carotene metabolism, vitamin A, dioxygenase assay, lymph cannulation

The article discusses the sustainable management of malaria vectors. It explores the malaria vector control, as well as the emerging insecticide resistance crisis. It describes several sustainable integrated vector management (IVM) strategies that use optimal suites of control tactics to prevent the insecticide resistance crisis. According to agricultural industry, such integrated approaches can provide more effective and durable pest management.

Background: Data on insecticide use for vector control are essential for guiding pesticide management systems on judicious and appropriate use, resistance management, and reduction of risks to human health and the environment. Objective: We studied the global use and trends of insecticide use for control of vector-borne diseases for the period 2000 through 2009. Methods: A survey was distributed to countries with vector control programs to request national data on vector control insecticide use, excluding the use of long-lasting insecticidal nets (LNs). Data were received from 125 countries, representing 97% of the human populations of 143 targeted countries. Results: The main disease targeted with insecticides was malaria, followed by dengue, leishmaniasis, and Chagas disease. The use of vector control insecticides was dominated by organochlorines [i.e., DDT (dichlorodiphenyltrichloroethane)] in terms of quantity applied (71% of total) and by pyrethroids in terms of the surface or area covered (81% of total). Global use of DDT for vector control, most of which was in India alone, was fairly constant during 2000 through 2009. In Africa, pyrethroid use increased in countries that also achieved high coverage for LNs, and DDT increased sharply until 2008 but dropped in 2009. Conclusions: The global use of DDT has not changed substantially since the Stockholm Convention went into effect. The dominance of pyrethroid use has major implications because of the spread of insecticide resistance with the potential to reduce the efficacy of LNs. Managing insecticide resistance should be coordinated between disease-specific programs and sectors of public health and agriculture within the context of an integrated vector management approach. [ABSTRACT FROM AUTHOR]

Background: Legislation and regulation of pesticides used in public health are essential for reducing risks to human health and the environment. Objective: We assessed the global situation on legislation and regulatory control of public health pesticides. Methods: A peer-reviewed and field-tested questionnaire was distributed to 142 member states of the World Health Organization (WHO); 113 states completed the questionnaire. Results: Legislation on public health pesticides was absent in 25% of the countries. Where present, legislation often lacked comprehensiveness, for example, on basic aspects such as labeling, storage, transport, and disposal of public health pesticides. Guidelines or essential requirements for the process of pesticide registration were lacking in many countries. The capacity to enforce regulations was considered to be weak across WHO regions. Half of all countries lacked pesticide quality control laboratories, and two-thirds reported high concern over quality of products on the market. National statistics on production and trade of pesticides and poisoning incidents were lacking in many countries. Despite the shortcomings, WHO recommendations were considered to constitute a supportive or sole basis in national registration. Also, some regions showed high participation of countries in regional schemes to harmonize pesticide registration requirements. Conclusions: Critical deficiencies are evident in the legislative and regulatory framework for public health pesticides across regions, posing risks to human health and the environment. Recent experience in some countries with situational analysis, needs assessment, action planning, and regional collaboration has signaled a promising way forward. [ABSTRACT FROM AUTHOR]

The article presents response of the authors on comments made by researcher Richard Tren and Donald Roberts on their study "DDT and Malaria Prevention: Addressing the Pradox." The authors tell that Robert Tren and colleagues failed to add the qualification included in the same paragraph in which the World Health Organization (WHO has assessed DDT.

Intracranial Ewing sarcoma (EwS) is rare and publications on primary or metastatic intracranial EwS are minimal. The aim of this study was to describe incidence, clinical behavior, treatment, and factors associated with outcome in patients with primary intracranial EwS or patients with a primary extracranial EwS and cerebral metastases at diagnosis. We reviewed all patients with primary or with metastatic intracranial EwS at diagnosis registered in the International Clinical Trial Euro-E.W.I.N.G.99 (EE99). In total, 17 of 1435 patients (1.2%) presented with primary intracranial EwS; 3 of them had metastatic disease. Four patients (0.3%) with primary extracranial EwS presented with intracranial metastatic lesions. The 3-year event-free survival (EFS) was 64% and overall survival (OS) was 70% in patients with a primary intracranial EwS. Local control in patients with primary intracranial EwS consisted of surgery (6%), radiotherapy (RT) (18%), or both modalities (76%). Univariate analysis showed that patients < 15 years of age had significantly better outcome (EFS: 72%; OS: 76%) compared to those aged above 15 years (EFS: 13%; OS: 25%). In conclusion, primary intracranial EwS and extracranial EwS with cerebral metastases at diagnosis is rare, yet survival is comparable with local and metastatic EwS elsewhere in the body. Age and stage of disease are important prognostic factors. Besides chemotherapeutic treatment, local control with surgical resection combined with RT is recommended whenever feasible.