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Copyright of American Journal on Mental Retardation is the property of American Association on Intellectual & Developmental Disabilities and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Unlabelled: Heterozygous familial hypercholesterolemia (FH) is the most common inherited type of primary hyperlipidemia. Patients with familial hypercholesterolemia have an increased level of LDL cholesterol since childhood, and present early associated cardiovascular disease. Ezetimibe reduces LDL by blocking sterol absorption in enterocytes., Aim: to show our experience on the use of ezetimibe in children and adolescents with familial hypercholesterolemia, with short and medium term follow-up., Patients and Methods: Retrospective and longitudinal study. Patients who were receiving ezetimibe as monotherapy from 2003 to 2009 were included. The primary efficacy parameter was the effect of ezetimibe on the LDL after three months of treatment. Serum levels of aspartate aminotransferase, alanine aminotransferase and creatine kinase were monitored. Patients were asked if they experienced any side effect with the ezetimibe treatment. If the Patients did not achieve therapeutical goals with ezetimibe as monotherapy a statin was added. Outcome at medium term follow-up is analysed., Results: The study included a total of 32 patients. The mean age at the start of ezetimibe was 9.5 years (range: 2 to 15.5). The mean total time of Ezetimibe was 2.45 years (r: 0.4 - 5.9).The decrease in mean LDL levels was -25.7% ± 12.3 or 59.5 ± 34 mg% (P<.0001; 95% CI: 47.3-71.5, t test). There were no side effects with ezetimibe monotherapy. At the end of the study, 11 patients required added statins due to failing to achieve the treatment goal., Conclusions: Ezetimibe is effective and safe for children and adolescents with FH in short and medium term follow-up., (Copyright © 2011 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.)

Fungal infections have increased in frequency in the last decades because of the growing number of immunocompromised patients who survive longer periods of time than in the past, the widespread use of immunosuppressive drugs, a large aging population with increased numbers of malignancies, and the spread of AIDS. Although fungi are present everywhere, some mycoses predominate in the tropics, not only in view of warm temperature and humid climate, which favor their growth, but also because of inadequate hygienic and working conditions brought about by poverty. Mycotic diseases in the brain are usually secondary to infections elsewhere in the body, usually the lungs, less often from other extracranial sites, and in the vast majority of the cases spread via blood circulation. Only occasionally they result from direct extensions from infections of the sinuses or bone, and less frequently from prosthetic heart valves. Candida may be endogenous in origin, inhabiting the digestive tract. Most fungi cause basal meningitis or intraparenchymal abscesses. Direct extension from the cribriform plate cause necro-hemorrhagic lesions in the base of the frontal lobe. Although fungi are common in our environment, few are pathogenic. In this paper mycotic infections are divided into opportunistic and pathogenic; although most of the latter have also been described in immunosuppressed patients, some of those caused by opportunistic organisms, have also occurred in the absence of predisposing factors.

A survey was carried out with the purpose of evaluating the nutritional status of the population of Jequitinhonha Valley in regard to vitamin A deficiency and iron-deficiency anemia. A Program--"Programa de Combate à Hipovitaminose A e à Anemia Nutricional Ferropriva em Bolsões de Probreza de Minas Gerais"--is being implanted by the Instituto Nacional de Alimentacão e Nutriçao (INAN) aiming to the prevention of such deficiencies. A random sample of 2,357 children from the towns: Turmalina, Minas Novas and Capelinha (Vale do Jequitinhonha), Minas Gerais (1,604 living in the urban and 753 in the rural areas) was submitted to an eye examination. Blood was drawn from a random subsample of these children (157 from the urban area and 107 from the rural area), in oder to detect possible nutritional problems. The following results were observed (preschool and school children, respectively): 1. Hemoglobin: 23.9% and 20% of the population in the urban area, 34.6 and 18.2% in the rural area, had low and deficient values, respectively. 2. Hematocrit: 1.5 and 2.2% of the population in the urban area, 17.3 and 5.5% in the rural area, had low values. 3. Vitamin A: 8.9 and 4.4% of the population in the urban area, 5.8 and 0% in the rural area, had deficient values (less than 10 micrograms/dl); 26.9 and 31.1% in the urban area, 26.9 and 23.6% in the rural area, had low values (10-20 micrograms/dl). These results show the occurrence of nutritional anemia and vitamin A deficiency in the observed children. As to the eye examination this was performed in 2,357 children. A high incidence of conjunctival xerosis (3.16 and 6.04% in the urban area, 7.7 and 12.6% in the rural area, in preschool and school children, respectively), was detected. Five cases of conjunctival xerosis with Bitot spot (0.2%), corneal xerosis (0.08%) and kerotomalacia (0.04%) were observed. The therapeutic effect of 200,000 UI of oral vitamin A was more efficient in preschool children (90.3% of positive reactions) than in school children (25.9% of positive reactions). The causes of the different reactions are now under study.

The occurrence of nest of trypanosoma cruzi in the smooth muscle cells of the central veins of the adrenal glands and the inferior vena cava was studied in 21 chronic Chagas' patients, by serial sections. Nine patients presented parasites in the adrenal veins, with a total of 24 nests, and only one nest was found in the inferior vena cava. The area of muscular tissue examined was of 2944.3 mm2 for the adrenal veins and of 47808.6 mm2 for the vena cava, giving a relation of 0.815 nests/100 mm2 for the adrenal vein and of 0.002 for the vena cava. Thus the smooth muscle of the adrenal vein was 407 times more parasited than the muscular wall of the inferior vena cava. This higher parasitism of the adrenal vein by trypanosoma cruzi in chronic Chagas' disease may be determined by its greater corticosteroid concentration, which can reduce the anti-trypanosomal defenses.

Randon samples of children from both sexes from Belo Horizonte, the capital City, and from Turmalina, Jequitinhonha Valley, Minas Gerais, Brazil, were submitted to nutritional evaluation before and after the intervention "Program to Overcome Vitamin A and Iron Deficiencies in Areas of Poverty in Minas Gerais, Brazil". After the first examination, all the children received, with an interval of 180 days, a single oral dose of vitamin A, oral iron sulfate during 50 days, and 200 mg of Mebendazol/day for three days. Thirty days after ending administration of the third dose of medicine, the children were subjected to a new evaluation. In Belo Horizonte, the first evaluation revealed a high prevalence of deficient and low values of vitamin A in preschool children (21.5%) and school children (21.7%). A small prevalence of low hematocrit values was also observed in both groups. Deficient and low values of hemoglobin were found as well in 21.5% of preschool children and in 17.5% of school children. The second evaluation, practiced 30 days after the third dose of medicine, showed a small incidence of low vitamin A values (4.3% in preschool children and 2.9% in school children) and low hemoglobin values (6.5% in preschool children and 2.9% in school children). No deficient values of hemoglobin and vitamin A were observed. Concerning the hematocrit value, only one school child presented a low value at the second evaluation. On the other hand, in Jequitinhonha Valley, five cases of Bitot spot with conjunctival xerosis, two cases of corneal xerosis, and one case of keratomalacia were detected at the first examination. Thirty days after ending the third dose of medicine, only one corneal scar was observed. Only a small number of children with deficient and low levels of vitamin A and hemoglobin was found in the final evaluation (less than 8%), while this number was high at the first evaluation (above 38 and 12%, respectively). These results show the efficiency of the intervention Program in relation to hypovitaminosis A and iron anemia prevention. The Program is now being implemented by the Brazilian Ministry of Health.