Probiotics enhance alveolar bone microarchitecture, intestinal morphology and estradiol levels in osteoporotic animals.

BACKGROUND AND OBJECTIVE: Osteoporosis is associated with bone microarchitecture alterations, and the depletion of estrogen during menopause is a major contributing factor to its development. The literature highlights the noteworthy role of gut microbiota in bone metabolism, particularly in the progression of osteoporosis. Periodontal disease leads to alveolar bone loss, which may be influenced by estrogen deficiency, and this mechanism is intricately associated with an imbalance in systemic microbiota. The aim of this study was to evaluate the effects of Bifidobacterium animalis subsp. lactis HN019 (B. lactis HN019) and Lacticaseibacillus casei 01 (L. casei 01) administrations on an osteoporosis animal model. MATERIALS AND METHODS: Thirty-three female rats were randomly divided into three groups: control (C-OVX), C-OVX-HN019 and C-OVX-LC01. All animals were ovariectomized. In groups C-OVX-HN019 and C-OVX-LC01, the probiotics were administered for 4 months. All animals were euthanized after 16 weeks from ovariectomy. Microtomographic, histopathological and immunohistochemical examinations were conducted on periodontal tissues, whereas histomorphometry, histopathological and immunohistochemical analyses were carried out on the intestine. The levels of estradiol were assessed in blood using an immunoenzymatic assay. The data were subjected to statistical analyses (p < .05). RESULTS: The C-OVX-LC01 group exhibited a significant reduction in alveolar bone porosity and an increase in connective tissue density compared to C-OVX (p < .05). The C-OVX-HN019 and C-OVX-LC01 groups presented reduced expression of TRAP and RANKL compared to the C-OVX (p < .05). The C-OVX group presented villi defects, mild neutrophil infiltration, decrease in both villous height and intestinal crypts and reduced expression of intestinal junctional epithelium markers e-cadherin and claudin 01 compared to C-OVX-HN019 and C-OVX-LC01 (p < .05). The C-OVX group had lower estradiol levels than C-OVX-HN019 and C-OVX-LC01 (p < .05). CONCLUSION: The probiotic therapy promoted a reduction in alveolar bone destruction and intestinal permeability as well as an increase in estradiol levels in ovariectomized rats. Specifically, the probiotic strain Lacticaseibacillus casei 01 exhibited greater effectiveness compared to Bifidobacterium animalis subsp. lactis HN019, indicating strain-dependent outcomes.

Comparison of Teleconsultations and In-Person Consultations from Outpatients with Rheumatoid Arthritis, During the COVID-19 Pandemic: An Internal Audit of Medical Notes.

Introduction: The objectives of this study were to compare the quality-of-care and compliance with medical record regulations between in-person consultations (QIP and CIP) and telephone consultations (QTP and CTP), from rheumatoid arthritis (RA) outpatients, during the COVID-19 pandemic, and to explore the impact of the consultation modality on the treatment. Methods: Data from 324 medical notes corresponding to rheumatic consultations between July and December 2020 were abstracted. Notes were selected considering a stratified (in-person and telephone consultations) random sampling strategy. QIP, CIP, QTP, and CTP were scored based on prespecified criteria as percentages, where higher numbers translated into better standards. Logistic regression analysis investigated the association between the consultation modality and the treatment recommendation (dependent variable). Results: There were 208 (64.2%) medical notes related to in-person consultations and 114 (35.2%) to telephone consultations. Overall, medical notes corresponded to middle-aged women with long-standing disease. QIP was superior to QTP (median, interquartile range): 60% (60-75%) versus 50% (25-60%), p ≤ 0.001, and differences were related to disease activity and prognosis documentation (81.3% vs. 34.5% and 55.8% vs. 33.6%, respectively, p ≤ 0.001) and the prolonged prescription of glucocorticoids with a documented management plan (58.5% vs. 30.4%, p = 0.045). Meanwhile, CIP and CTP were similar. Telephone consultation was a significant risk factor for no changes in the treatment recommendation (odds ratio: 2.113, 95% confidence interval: 1.284-3.479, p = 0.003), and results were consistent in the 142 medical notes with documented absence of disease activity. Conclusions: In the clinical context of RA, the quality-of-care provided by telephone consultations is below the standard of care and impacts the treatment.

[Characterisation of thromboembolic risk in a mexican population with non-valvular atrial fibrillation and its effect on anticoagulation (MAYA Study)]. / Caracterización del riesgo tromboembólico en una población mexicana con fibrilación auricular (FA) no-valvular y su efecto en la indicación de anticoagulación (estudio MAYA).

OBJECTIVE: To evaluate the risk of stroke and bleeding using the CHA2DS2-VASc and HAS-BLED scores in Mexican patients with atrial fibrillation and to analyze whether the risk score obtained determined treatment decisions regarding antithrombotic therapy. METHODS: This is an observational, retrospective study in Mexican patients recently diagnosed with atrial fibrillation. The risk of stroke was assessed using the CHA2DS2-VASc scores. The bleeding risk was evaluated using the HAS-BLED score. The frequency of use of antithrombotic therapy was calculated according to the results of the score risk assessment. RESULTS: A total of 350 patients with non-valvular atrial fibrillation were analyzed. A 92.9% of patients had a high risk (score ≥ 2) of stroke according to the CHA2DS2-VASc score and only 17.2% were treated with anticoagulants. A high proportion of patients with atrial fibrillation (72.5%) showed both a high risk of stroke and a high risk of bleeding based on HAS-BLED score. CONCLUSIONS: In this group of patients with atrial fibrillation, from Northeast Mexico, there is a remarkably underutilization of anticoagulation despite the high risk of stroke of these patients.

Impact of a hybrid medical care model in the rheumatoid arthritis patient-reported outcomes: A non-inferiority crossover randomized study.

OBJECTIVE: Patients and physicians can naturally adopt hybrid healthcare models that combine face-to-face consultations with telemedicine. The study's objective was to compare the impact of two healthcare interventions, hybrid care modality and face-to-face consultation, on the patient-reported outcomes of rheumatoid arthritis patients, during the COVID-19 pandemic. METHODS: Consecutive outpatients reincorporated to a clinic previously in lockdown were invited to a non-inferiority, randomized study (October 2020--May 2022). Patients were randomized to 6 months of face-to-face consultation or hybrid care modality (intervention period-1) and then the converse modality (intervention period-2). The primary outcome was disease activity/severity behavior (Routine Assessment of Patient Index Data 3). Additional patient-reported outcomes were disability (Health Assessment Questionnaire Disability Index), quality-of-life (World Health Organization quality of life questionnaire-brief version), adherence and satisfaction with medical care, and treatment recommendation. Sample size calculation established 55 patients/healthcare interventions. RESULTS: There were 138 patients invited to participate, 130 agreed and 121 completed their study participation. Sixty-one and 60 patients respectively, received face-to-face consultation and hybrid care modality over intervention period-1. Patients were primarily middle-aged females (90.1%), with (median, IQR) 12 (9-16) years of education, long-standing disease, working (62.8%), receiving disease-modifying anti-rheumatic drugs (96.7%), and corticosteroids (61.2%). Patients had low disease activity (median Routine Assessment of Patient Index Data 3: 2.7) and Health Assessment Questionnaire Disability Index score that translated into the absence of disability, while quality of life was compromised. Baseline characteristics were similar between patients assigned to each healthcare intervention. Differences in Routine Assessment of Patient Index Data 3 behavior were below the non-inferiority margin. Results considered the order in which patients received the intervention and baselines scores, and extended to the patient-reported outcomes left. CONCLUSIONS: Hybrid care modality was non-inferior to in-person consultations in achieving patient-reported outcomes during the COVID-19 pandemic in rheumatoid arthritis patients.

Quality of life of patients with rheumatic diseases during the COVID-19 pandemic: The biopsychosocial path.

BACKGROUND: Previous models that assess quality-of-Life (QoL) in patients with rheumatic diseases have a strong biomedical focus. We evaluated the impact of COVID-19 related-health care interruption (HCI) on the physical, psychological, social relationships and environment QoL-dimensions, and explored factors associated with QoL when patients were reincorporated to the outpatient clinic, and after six-month follow-up. PATIENTS AND METHODS: Study phase-1 consisted of a COVID-19 survey administered from June 24th-October 31st 2020, to outpatients with rheumatic diseases who had face-to-face consultation at outpatient clinic reopening. Study phase-2 consisted of 3 consecutive assessments of patient´s QoL (WHOQOL-BREF), disease activity/severity (RAPID-3), and psychological comorbidity/trauma (DASS-21 and IES-R) to patients from phase-1 randomly selected. Sociodemographic, disease and treatment-related information, and comorbidities were obtained. Multiple linear regression analysis identified factors associated with the score assigned to each WHOQOL-BREF dimension. RESULTS: Patients included (670 for phase-1 and 276 for phase-2), had primarily SLE and RA (44.2% and 34.1%, respectively), and all the dimensions of their WHOQOL-BREF were affected. There were 145 patients (52.5%) who referred HCI, and they had significantly lower dimensions scores (but the environment dimension score). Psycho-emotional factors (primarily feeling confused, depression and anxiety), sociodemographic factors (age, COVID-19 negative economic impact, years of scholarship, HCI and having a job), and biomedical factors (RAPID-3 score and corticosteroid use) were associated with baseline QoL dimensions scores. Psycho-emotional factors showed the strongest magnitude on dimensions scores. Most consistent predictor of six-month follow-up QoL dimensions scores was each corresponding baseline dimension score, while social determinants (years of scholarship and having a job), emotional factors (feeling bored), and biomedical aspects (RAPID 3) had an additional impact. CONCLUSIONS: HCI impacted the majority of patient´s QoL dimensions. Psycho-emotional, sociodemographic and biomedical factors were consistently associated with QoL dimensions scores, and these consistently predicted the QoL trajectory.

Clinical and bioethical implications of health care interruption during the COVID-19 pandemic: A cross-sectional study in outpatients with rheumatic diseases.

BACKGROUND: To determine the impact of health care interruption (HCI), on clinical status of the patients reincorporated to an outpatient clinic for rheumatic diseases (OCDIR), from a tertiary care level center who was temporally switched to a dedicated COVID-19 hospital, and to provide a bioethical analysis. METHODS: From March to June 2020, the OCDIR was closed; since June, it is limited to evaluate 25% of the ongoing outpatients. This cross-sectional study surveyed 670 consecutive rheumatic outpatients between June 24th and October 31th, concomitant to the assessment of the rheumatic disease clinical status by the attendant rheumatologist, according to disease activity level, clinical deterioration and adequate/inadequate control. Multiple logistic regression analysis identified factors associated to HCI and to clinical deterioration. RESULTS: Patients were middle-aged females (86.7%), with median disease duration of 10 years, comorbidity (38.5%) and 138 patients (20.6%) had discontinued treatment. Primary diagnoses were SLE and RA, in 285 (42.5%) and 223 (33.3%) patients, respectively. There were 344 patients (51.3%) with HCI. Non-RA diagnosis (OR: 2.21, 95%CI: 1.5-3.13), comorbidity (OR: 1.7, 95%CI: 1.22-2.37), patient's need for rheumatic care during HCI (OR: 3.2, 95%CI: 2.06-4.97) and adequate control of the rheumatic disease (OR: 0.64, 95%CI: 0.45-0.9) were independently associated to HCI. There were 160 patients (23.8%) with clinical deterioration and associated factors were disease duration, substantial disease activity previous HCI, patients need for rheumatic care and treatment discontinuation. CONCLUSIONS: HCI during COVID-19 pandemic impacted course of rheumatic diseases and need to be considered in the bioethical analysis of virus containment measures.

[Outcome of pregnancy for immigrant women: a retrospective study]. / L'outcome della gravidanza nella donna immigrata: studio retrospettivo.

AIM: Italy is experiencing a continuous increase in female immigration and, as a consequence, the number of births by immigrant mothers. The objective of our study was therefore to compare indices for maternal-foetal wellbeing as regards immigrant as opposed to autochthonous pregnant women. METHODS: An analysis was made of CEDAP data from 2001 to 2008 concerning parturients at Udine Obstetric and Gynaecological Clinic, DRG clinical data for 2008 and clinical records for 2008 of foreign parturients: the focus was on which geographical area they came from, hypertensive and metabolic symptoms during pregnancy, maternal serology, gestational period up to childbirth, weight at birth, Apgar index, duration of hospitalisation for the mother and infant. RESULTS: The study covered 13,352 women of whom 2,139 were foreigners, while 363 of the latter gave birth in 2008. In terms of geographical area the largest group of immigrants came from Eastern Europe, followed by sub-Saharan African and Arab countries. The worst outcome of pregnancy was found in African women, who showed the highest incidence of chronic hypertension, pregnancy-induced hypertension and pre-eclampsia and they also developed gestational diabetes more frequently, although a high incidence was also seen for Eastern European and Arab women. Furthermore, African women were found to be HIV-seropositive more frequently, showed a greater tendency to preterm or severely preterm birth, with a significantly lower weight and Apgar at birth compared to all other immigrant women. As a result, African women and infants remained in hospital for a longer period. CONCLUSION: Monitoring, both pre-conceptional and during pregnancy, needs to be intensified, especially among African mothers, in order to reduce the maternal-foetal disadvantage when compared to other women.

[Retrospective analysis of one year of cesarean sections: indications and risk factors associated with intrapartum cesarean section]. / Analisi retrospettiva su un anno di tagli cesarei: indicazioni e fattori di rischio per taglio cesareo in travaglio di parto.

AIM: Cesarean section (CS) is currently the most commonly performed surgical intervention worldwide. Indications include previous CS, podalic presentation and fetal macrosomia in antepartum CS, fetal distress, and prolonged first or second phase of labor in intrapartum CS. Despite the marked reduction in fetal mortality and morbidity in selected circumstances, maternal complication rates associated with CS are far higher than with vaginal delivery. The aim of this study was to evaluate the indications and maternal and fetal outcomes in a population undergoing antepartum or intrapartum CS and to analyze the risk factors of intrapartum CS. METHODS: An analysis was conducted on data from 1748 deliveries performed at the Gynecology-Obstetrics Clinic of the University of Udine during 2006. A total of 603 medical records of the mothers who had delivered by CS and their infants were analyzed. The Indications and maternal and fetal outcomes were evaluated in mothers who had undergone elective CS, emergency antepartum or intrapartum CS; multivariate analysis was then performed to define the risk factors associated with intrapartum CS. RESULTS: Cesarean sections accounted for 34.5% of all deliveries performed during 2006, of which 42.1% were elective CS, 21.1% emergency antepartum CS, and 36.8% intrapartum CS. The principal reason for CS delivery was previous CS in elective CS, gestational hypertension in emergency antepartum CS, and cardiotocographic alterations in emergency intrapartum CS. Multivariate logistic regression analysis showed that the independent risk factors for intrapartum CS were excessive weight gain during pregnancy and medically induced labor. CONCLUSION: A more accurate evaluation of the mother's and neonate's needs could help to improve the current rates of CS. This could be achieved by selection of cases in which there is a real need for CS and by acting on modifiable risk factors of intrapartum CS such as excessive weight gain during pregnancy.

Effects of Bifidobacterium animalis subsp. lactis HN019 on ligature-induced periodontitis in rats with experimental rheumatoid arthritis.

The purpose of this study was to evaluate the effects of systemic administration of the probiotic Bifidobacterium animalis subsp. lactis HN019 (HN019) on ligature-induced periodontitis in rats with experimental rheumatoid arthritis (RA). 28 rats were divided into four groups (n=7): RA (rheumatoid arthritis), RA/PROB (probiotic), RA/EP (experimental periodontitis) and RA/EP/PROB. From day zero, HN019 was added daily to the water of the PROB groups animals until the end of the experiment. From day seven, RA was induced. On day 28, in EP groups, ligatures were positioned around mandibular first molars and remained in position for 11 days, in order to induce periodontitis. The animals were euthanised on day 39. Microtomographic, histomorphometric, immunoenzymatic and microbiological analyses were performed. Data were statistically analysed (P<0.05). Group RA/EP/PROB presented reduced alveolar bone loss, tumour necrosis factor-α and interleukin (IL)-6 levels and increased IL-17 levels when compared with group RA/EP. There were no significant differences regarding connective tissue attachment level and IL-10 levels between groups RA/EP and RA/EP/PROB. Group RA/PROB showed decreased anti-citrullinated protein antibodies levels when compared with groups RA and RA/EP. Group RA/EP/PROB presented a higher rate of aerobic/anaerobic bacteria than group RA/EP. Systemic administration of HN019 promoted a protective effect against periodontal tissue destruction, decreasing both bone loss and inflammatory mediators and increasing the proportion of bacteria compatible with periodontal health, in rats with experimental RA and EP.

Textural characterization of media composed of compacted pieces of cardboard and polyethylene using a gas tracer method.

The aim of this work is the experimental determination of effective transport properties of porous media consisting of compacted pieces of cardboard and polyethylene (PE). The proposed method itself is more general and can be applied to many different materials and contexts. Three major transport properties were determined: porosity, tortuosity factor and permeability. Three parameters characterizing the media were varied over a wide range: the bulk density, the size of the elements entering the mix, and the proportion of cardboard and PE in the mix. The properties were measured by means of a specially designed experimental device based on miscible gas tracing. The porosity and tortuosity factor were simultaneously determined by parametric identification, based on the experimental sample output response to an inlet gas concentration step change compared to the results of a direct numerical model. Permeability was calculated in the standard way from the measurement of the pressure drop across the sample. The reproducibility of the measurements was very good. It was found that changing the material density of the medium significantly affects all three structural properties. When the bulk density is varied between 300 and 900 kg m(-3), the tortuosity factor varies in a range as large as 18-8 and the permeability decreases by a ratio of 2-3. The tortuosity factor shows unusual variation, characterized by a decrease when density is increased above 500 kg m(-3). The size of the elements does not significantly affect the structural properties of the medium in the range of parameters studied.

[Axillary lymph node recurrence after sentinel lymph node biopsy for breast cancer]. / Récidives ganglionnaires axillaires après lymphadénectomie sentinelle pour cancer du sein.

OBJECTIVE: The aim of this review is to summarize the current knowledge about axillary recurrences after sentinel lymph node (SLN) biopsy for breast cancer. METHODS: A Pubmed search for publications (in English or French) related to breast cancer, SLN and axillary recurrence was carried out from 1995 to 2006. RESULTS: Under controlled conditions (notably after a learning curve concerning the multidisciplinary team), the SLN procedure proved to be a reliable method for evaluation of axillary nodal status in selected patients with early-stage invasive breast cancer. When the SLN is free of cancer cells, the rate of axillary recurrence varies from 0% to 2% with a follow-up ranging from 14 to 57 months. Recurrence after axillary lymph node dissection is similar. When isolated cancer cells or micrometastases invaded the SLN, the rate of axillary recurrence remains low, but a complete axillary lymph node dissection must be performed to reduce this rate significantly. The use of intraoperative miniaturized gamma cameras could contribute to the optimization of the SLN procedure and to reduce axillary recurrences.

Group treatment for race-related stresses among minority Vietnam veterans.

Treatment for symptoms arising from exposure to adverse race-related events is critical to culturally competent healthcare delivery to ethnic minorities, particularly in light of recent findings demonstrating significant relationships between adverse race-related events and post-traumatic stress disorder (PTSD) and general psychiatric distress. This article offers a developmental model consisting of stages by which psychological symptoms develop in response to race-related stressors in the military. This article also describes a model of group treatment for ethnic minority veterans related to psychological symptoms arising from exposure to race-related stressors. Both models were used in a race-related support group for Pacific Islander Vietnam veterans diagnosed with PTSD. A combined approach of group intervention, psychosocial education, identity reframing, cognitive differentiation, and cognitive restructuring, which included 'depersonalizing discrimination' and rejection of faulty beliefs, appear to offer an effective approach to treating psychological sequelae arising from adverse race-related events. This article offers an intervention model that is linked to a developmental model of race-related stressors for Asian American Pacific Islander minority personnel in the military.

Diagnosis and treatment of brain metastases from solid tumors: guidelines from the European Association of Neuro-Oncology (EANO).

The management of patients with brain metastases has become a major issue due to the increasing frequency and complexity of the diagnostic and therapeutic approaches. In 2014, the European Association of Neuro-Oncology (EANO) created a multidisciplinary Task Force to draw evidence-based guidelines for patients with brain metastases from solid tumors. Here, we present these guidelines, which provide a consensus review of evidence and recommendations for diagnosis by neuroimaging and neuropathology, staging, prognostic factors, and different treatment options. Specifically, we addressed options such as surgery, stereotactic radiosurgery/stereotactic fractionated radiotherapy, whole-brain radiotherapy, chemotherapy and targeted therapy (with particular attention to brain metastases from non-small cell lung cancer, melanoma and breast and renal cancer), and supportive care.

Halitosis and periodontal disease in subjects with mental disabilities.

OBJECTIVE: The aim of this study was to investigate the relationship between halitosis, presence of N-benzoyl-DL-arginine-2-naphthylamide (BANA) positive activity (indicative of Treponema denticola, Porphyromonas gingivalis, Tannerella forsythensis) and periodontal conditions in subjects with mental disabilities. MATERIALS AND METHODS: The population consisted of 17 Down syndrome (DS), 17 mentally retarded (MR) and 17 mentally healthy subjects (MH) - control group. A portable sulfide monitor was used to measure the concentration of volatile sulfur compounds (VSC) found in the mouth. Clinical parameters [Plaque Index (PlI), Probing Depth (PD), Bleeding on Probing (BOP)] were obtained from six reference teeth. Subgingival plaque samples for BANA Test were taken from the same six teeth and dorsum of the tongue. RESULTS: PlI and BOP were higher in DS than in MR and MH, respectively (P < 0.05). Mean PD was similar between DS and healthy groups but it was higher than the MR group. No significant differences were found among the three groups regarding the presence of BANA positive species, however the VSC levels were significantly lower in DS (97.23 ppb) than in MR (203.23 ppb) and MH individuals (180.53 ppb). CONCLUSIONS: Even though the presence of BANA positive activity was similar among DS, MR and MH subjects, halitosis seemed to be lower in the DS group.

Heavy metals in the tissues of common dolphins (Delphinus delphis) stranded on the Portuguese coast.

The concentrations of Hg, Sn, Cr, Zn, Ni, Co, Cd, Mn, Fe and Cu were determined in the liver, kidney and muscle of 24 common dolphins stranded on the Portuguese coast between 1995 and 1998. Nitric acid was used to extract the metals from the tissues for analysis by inductively-coupled plasma/atomic emission spectroscopy (ICP/AES). Those metals with relatively higher concentrations included Fe, Zn and Hg, particularly in liver. Other metals including Cr, Ni and Cd tended to show much lower levels, or were even undetected (e.g. Co). Different metals seemed to show different temporal trends, although due to substantial variations of the mean concentrations for each year obtained, such temporal pattern has to be studied further. Total Hg concentration in the kidney, muscle and particularly liver, were higher in females than in males. Total Hg concentrations in all the organs increased with body length of dolphins, whilst those of Zn and Cu in muscle decreased with dolphin length. A strong correlation was found between essential metals Zn and Cu in muscle, possibly resulting from sequestration of these metals by metallothionein. In addition, significant co-associations existed between the same metal (e.g. Hg, Sn and Zn) in different organs.

The axillocoronary bypass. Blood flow and short-term graft histology in a porcine model.

BACKGROUND: Bypass grafts arising from the axillary artery may be indicated for complications during minimally invasive direct coronary artery bypass grafting, for redo operations and for management of a severely atherosclerotic ascending aorta. As basic data research on this technique is scanty, we investigated intraoperative function and postoperative morphology of axillocoronary bypass grafts in a porcine model. METHODS: Thirteen German domestic pigs received an axillocoronary vein graft (Group I, n=7) or an aortocoronary vein graft (Group II, n=6) to the left anterior descending artery. In Group I the proximal anastomosis was performed to the left axillary artery, and after partial rib resection the graft was brought transpleurally to the target vessel. In both groups the coronary anastomosis was carried out on the beating heart without cardiopulmonary bypass. Graft flow was measured using transit time ultrasonic flow probes. RESULTS: Intraoperatively all grafts showed a typical diastolic flow profile. Stable graft flow was lower in axillocoronary bypass grafts: 47 (30-60 mL/min) in Group I and 65 (35-126 mL/min) in Group II (p=0.005). Flow given as percentage of cardiac output, however, did not differ between the two grafts: 0.9 (0.6-1.2%) in Group I and 1.2 (0.8-2.4%) in Group II (p=NS). At day 4 after surgery there was no clear histologic predilection site for microtrauma and early degenerative changes in the axillocoronary graft. CONCLUSIONS: Axillocoronary bypass flow compares well with flow in the aortocoronary graft. Microtrauma after implantation and early degenerative changes in the axillocoronary vein bypass are not particularly impacted by the thoracic entry site.

Air concentrations of 239Pu and 240Pu and potential radiation doses to persons living near Pu-contaminated areas in Palomares, Spain.

On 17 January 1966, an accident during a refueling operation resulted in the destruction of an air force KC-135 tanker and a B-52 bomber carrying four thermonuclear weapons. Two weapons, whose parachutes opened, were found intact. The others experienced non-nuclear explosion with some burning and release of the fissile fuel at impact. Joint efforts by the United States and Spain resulted in remedial action and a long-term program to monitor the effectiveness of the cleanup. Air concentrations of 239Pu and 240Pu have been continuously monitored since the accident. The average annual air concentration for each location was used to estimate committed dose equivalents for individuals living and working around the air sampling stations. The average annual 239Pu and 240Pu air concentrations during the 15-y period corresponding to 1966-1980 and the potential committed dose equivalents for various tissues due to the inhalation of the 239Pu and 240Pu average annual air concentration during this period are shown and discussed in the report.

The relationship between place BANA reactivity and clinical parameters in subjects with mental disabilities.

The purpose of the present investigation was to determine whether subjects institutionalized with mental retardation have a relationship between periodontal clinical parameters and the presence of the BANA-positive periodontal pathogens Porphyromonas gingivalls, Treponema denticola, and Bacteroides forsythus in their subgingival plaques. Fifty institutionalized subjects (25 patients with Down syndrome and 25 subjects with mental retardation) were matched with respect to age and sex. Periodontal clinical parameters (Bleeding on Probing, BOP; Papillary Bleeding Score, PBS; and Probing Depth, PD) were obtained from 6 reference teeth (3, 8, 14, 19, 24, 30). In addition, subgingival plaque samples taken from the same 6 teeth were analyzed for the presence of the BANA-positive species, by means of the chairside BANA test. In both the patients with Down syndrome and the group with mental retardation, the presence of BANA-positive plaques was significantly associated with bleeding on probing (p < 0.05) and increased probing depth (p < 0.01, Chi-square). Analysis of these data indicated that the BANA test could be used in combination with clinical criteria to diagnose a periodontopathy anaerobic infection in institutionalized subjects.

[Pseudoxanthoma elasticum. A X-ray microanalytic study]. / Pseudo-xanthome élastique: étude avec microanalyse de rayons X.

We present a very typical case of pseudo-xanthoma elasticum (PXE) with very remarkable cutaneous lesions, a great number of angioid streaks and, at the moment, with no involvement of the peripheral vascular system. From a genetic standpoint, we believe it must be considered as recessive Type I. An X-ray microanalysis was performed showing intense Ca and P deposits in the affected areas as well as complete absence of Si.

Antimicrobial action of AXOL on periodontopathic bacteria.

The antimicrobial action of AXOL was tested against a panel of periodontopathic bacteria, which included Treponema denticola, Treponema vincentii, Treponema sp., Porphyromonas gingivalis, Prevotella intermedia, Prevotella melaninogenica, and Fusobacterium nucleatum. The AXOL commercial solution (undiluted) was effective in inhibiting some of the bacteria but not all. The rational for the use of antimicrobials is discussed.