Social inequalities, sexual tourism and HIV in Cartagena, Colombia: an ethnographic study.

BACKGROUND: Cartagena, Colombia's main port on the Caribbean Coast, reported an HIV incidence of 7.5 per 100,000 inhabitants in 2007 with 90.0% transmission by heterosexual contact and 70 identified as women with a stable partner. Studies across Colombia illustrate that HIV infection relates to social inequalities; most people with HIV live in poverty and have minimal access to health care, education, and secure jobs. The purpose of this article is to analyse the relationship between social inequalities, sexual tourism and HIV infection in Cartagena, Colombia. METHODS: Data come from a five-year participatory ethnography of HIV in Cartagena in the period 2004-2009, in which 96 citizens (30 of whom were living with HIV) participated in different data collection phases. Techniques included participant observation, in-depth interviews and thematic life histories. Out of this material, we selected three life histories of two women and a man living with HIV that are representative of the ways in which participants expressed how social inequalities make it virtually impossible to engage in safe sex practices. RESULTS: At stake is the exchange of condomless sex for goods within the widespread sexual tourism networks that promote an idealisation of dark-skinned men and women as better sexual performers. Our results illustrate the complex interplay of social inequalities based on class, skin colour, gender and sexual orientation. Furthermore, they suggest a synergistic effect between poverty, racialization, and gender inequalities in the historical maintenance of social dynamics for a fruitful growth of a sexual tourism industry that in turn increases vulnerability to HIV infection. CONCLUSIONS: Although the convergence of social inequalities has been thoroughly reported in the literature on social studies of HIV vulnerability; distinctive dynamics are occurring in Cartagena, including a clear link between the contemporary globalised sexual tourism industries and a racialised social structure - both having historical roots in the colonial past-.

Quality of life improvement with allergen immunotherapy treatment in patients with rhinoconjunctivitis in real life conditions. Results of an observational prospective study (ÍCARA).

Summary: Objectives. Evaluate the changes in quality of life of patients with allergic rhinoconjunctivitis (AR), with or without asthma, after one-year treatment with allergen immunotherapy. Methods. This was an observational prospective multicenter study. RQLQ questionnaire and VAS scale to assess treatment satisfaction were used. Impact on AR and asthma was also analyzed. Any adverse reaction was recorded. Results. 127 patients were recruited. Mean values in RQLQ decreased from 2.61 to 1.34 points, reflecting a statistically and clinically significant improvement (p minor 0.01). The percentage of asthmatic patients decreased significantly (p minor 0.01). Mean value of patients' satisfaction was 7.24 (SD = 1.90). Only 11 patients presented systemic reactions (9.17%), none of them serious. Conclusions. One-year AIT treatment significantly increases QoL in patients with AR. Moreover, high patients' satisfaction values were reported, together with an adequate safety profile.

Adherence to topical treatment of glaucoma, risk and protective factors: A review. / Adherencia al tratamiento tópico del glaucoma, factores protectores y de riesgo; una revisión del tema.

INTRODUCTION: Glaucoma is a chronic asymptomatic disease, progressing to loss of vision. Elevated intraocular pressure is the only modifiable factor. Adherence to glaucoma treatment varies from 2-80%. OBJECTIVE: To evaluate factors associated with adherence to topical glaucoma treatment reported in the literature, and to identify protective factors and risk factors, as well as modifiable and non-modifiable factors, in order to take them into account to perform interventions in adherence. MATERIALS AND METHODS: A bibliographic search of articles published in the last 8 years in databases such as Clinical Key, Cochrane (OVID), EBSCO, Lilacs, PubMed and Science Direct, of different observational studies that performed a measurement of the treatment of glaucoma and to identify associated factors. RESULTS: A total of 7 studies were selected that directly and indirectly measured adherence to glaucoma treatment. Different risk and protective factors for adherence to treatment were found. These showed that African-American race, poor education, low personal income, and high treatment costs, are strongly related to poor adherence to treatment. It was also found that educational interventions and a good patient- physician relationship impacted positively on adherence. CONCLUSION: The results found are a guide for risk and protective factors for adherence to treatment of glaucoma. It is cost effective to educate patients to positively impact adherence. By identifying such factors, attention can be focused on poor adherence patients.

What we need to know about dense breasts: implications for breast cancer screening. / Mama densa, ¿qué debemos saber? Implicaciones en el cribado.

High breast density and its relationship to the risk of breast cancer has become a hot topic in the medical literature and in the lay press, especially in the United States, where it has brought about changes in the legal framework that require radiologists to inform clinicians and patients about breast density. Radiologists, who are mainly responsible for this information, need to know the scientific evidence and controversies regarding this subject. The discussion is centered on the real importance of the risk, the limitation that not having standardized methods of measurement represents, and the possible application of complementary screening techniques (ultrasound, magnetic resonance imaging, or tomosynthesis) for which clear recommendations have yet to be established. We need controlled studies that evaluate the application of these techniques in women with dense breasts, including the possibility that they can lead to overdiagnosis.

Differential effects of bupropion on acquisition and performance of an active avoidance task in male mice.

Bupropion is an antidepressant drug that is known to aid smoking cessation, although little experimental evidence exists about its actions on active avoidance learning tasks. Our aim was to evaluate the effects of this drug on two-way active avoidance conditioning. In this study, NMRI mice received bupropion (10, 20 and 40mg/kg) or saline before a daily training session (learning phase, days 1-4) in the active avoidance task. Performance was evaluated on the fifth day (retention phase): in each bupropion-treated group half of the mice continued with the same dose of bupropion, and the other half received saline. Among the vehicle-treated mice, different sub-groups were challenged with different doses of bupropion. Results indicated that mice treated with 10 and 20mg/kg bupropion exhibited more number of avoidances during acquisition. The response latency confirmed this learning improvement, since this parameter decreased after bupropion administration. No differences between groups were observed in the retention phase. In conclusion, our data show that bupropion influences the learning process during active avoidance conditioning, suggesting that this drug can improve the control of emotional responses.

Platelet-rich plasma in the conservative treatment of painful tendinopathy: a systematic review and meta-analysis of controlled studies.

BACKGROUND: Platelet-rich plasma (PRP) seeks to meet the multifaceted demand of degenerated tendons providing several molecules capable of boosting healing. AREAS TIMELY FOR DEVELOPING RESEARCH: PRP is used for managing tendinopathy, but its efficacy is controversial. SOURCES OF DATA: Electronic databases were searched for clinical studies assessing PRP efficacy. Methodological quality was evaluated using the methods described in the Cochrane Handbook for systematic reviews. AREAS OF AGREEMENT: Thirteen prospective controlled studies, comprising 886 patients and diverse tendons were included; 53.8% of studies used identical PRP protocol. AREAS OF CONTROVERSY: Sources of heterogeneity included different comparators, outcome scores, follow-up periods and diverse injection protocols, but not PRP formulation per se. GROWING POINTS: Pooling pain outcomes over time and across different tendons showed that L-PRP injections ameliorated pain in the intermediate-long term compared with control interventions, weighted mean difference (95% CI): 3 months, -0.61 (-0.97, -0.25); 1 year, -1.56 (-2.27, -0.83). However, these findings cannot be applied to the management of individual patients given low power and precision. RESEARCH: Further studies circumventing heterogeneity are needed to reach firm conclusions. Available evidence can help to overcome hurdles to future clinical research and bring forward PRP therapies.

Avaliação das potenciais atividades tripanocida e antileishmania do extrato de folhas de Piper arboreum (Piperaceae) e de suas frações / Evaluation of the potential trypanocidal and antileishmanial activities in Piper arboreum (Piperaceae) leaf extract and its fractions

A leishmaniose e a tripanossomíase americana fazem parte de um grupo de doenças tropicais endêmicas, especialmente entre as populações pobres. São consideradas doenças negligenciadas por não despertarem interesse da indústria farmacêutica. Atualmente, a quimioterapia é o único tratamento específico disponível para estas doenças, onde os medicamentos utilizados são nifurtimox e benzonidazol. Este trabalho teve como objetivo avaliar a atividade antiparasitária e citotóxica do extrato bruto etanólico e frações de folhas de Piper arboreum, frente a linhagens de Leishmania brasiliensis e de Trypanosoma cruzi. Após a preparação do extrato etanólico bruto e as suas respectivas frações, testes in vitro foram realizados para avaliar atividade antiparasitária frente a T. cruzi, utilizado o clone epimastigota CL-B5 e contra L.brasiliensis foram utilizadas formas promastigotas. O ensaio de citotoxicidade foi realizado com linhagens de fibroblastos NCTC929. Os resultados indicaram que as amostras apresentaram toxidade elevada, com exceção da fração de acetato de etila. Já os resultados da atividade antiparasitária indicaram uma maior atividade da fração hexânica observando a morte de 62% e 51% de células epimastigotas e de 100% e 92% de células promastigotas, respectivamente. Através dos resultados conclui-se que a P. arboreum pode ser considerada uma fonte alternativa de produtos naturais com atividade contra T. cruzi e L. brasiliensis...

Leishmaniasis and South American trypanosomiasis (Chagas disease) are part of a group of related human diseases endemic in tropical regions, especially among the poor. They are referred to as neglected diseases, because of a lack of interest on the part of the pharmaceutical industry. Today, chemotherapy is the only specific treatment against these diseases, the most frequently used drugs being nifurtimox and benznidazole. The aim of this study was to assess the antiparasitic and cytotoxic activity of the crude ethanolic leaf extract of Piper arboreum and its fractions against strains of Leishmania brasiliensis and Trypanosoma cruzi. After preparing the crude ethanolic extract and fractions, in vitro tests were performed to assay antiparasitic activity against T. cruzi, using the epimastigote clone CL-B5, while against L. brasiliensis, promastigote forms were used. The cytotoxicity assay was performed with a fibroblast cell line, NCTC 929. The results indicate that the samples possessed high toxicity, except for the ethyl acetate fraction. The results for antiparasitic activity showed highest activity in the hexane fraction, which was lethal to 62% and 51% of the epimastigotes and 100% and 92% of the promastigotes, at 500 and 100µg/mL, respectively. From these results, it is concluded that P. arboreum can be considered an alternative source of natural products with activity against T. cruzi and L.brasiliensis...

[Proposed profile of omega 3 fatty acids in enteral nutrition]. / Propuesta de perfil de ácidos grasos omega 3 en nutrición enteral.

We review the international recommendations on oral intake of n-3 fatty acids and their content in the enteral nutrition formulas. Their metabolic actions depend on their metabolization to EPA and DHA. The activity of desaturases catalyzing this process increases with exercise, insulin, estrogens in the fertile women, and peroxisomal proliferators, whereas it decreases with fasting, protein and oligoelements deficiencies, age < 30 years, sedentary lifestyle, cigarette smoking, alcohol, cholesterol, trans and saturated fatty acids, insulin deficiency, and stress hormones (adrenalin and glucocorticoids). Most of the guidelines recommend that 20-35% of the total energy comes from fat, being 7-10% saturated fats, 6-10% polyunsaturated, and 20% monounsaturated, in Spain. The recommendation for n-3 FA is 0.5-2 g/day or 0.5-2% of total caloric intake, with an upper limit of 3 g/day. For n-6 FA, 2.5-10% of total caloric intake, the n-6/n-3 ratio not being well established although most of the guidelines recommend 5:1. The EPA and DHA content should be at least 500 mg per day. Finally, the EPA/DHA ratio is 2:1 in most of them. Standard nutrition formulas present an appropriate fat content, although most of the products containing EPA and DHA exceed the limit of 3 g/day. Among the products with hyperprotein and/or concentrated, only of them contains EPA y DHA. Not all the formulas used for the frail elderly contain EPA or DHA, and in those containing them their concentration may be excessive and with a proportion very dissimilar to that of fish oil.

Characterization of mitochondrial and actin patterns in cat oocytes and blastocysts.

Actin microfilaments and mitochondria distribution are considered useful markers of cytoplasmic maturation, but no information is available regarding their distribution in cat oocytes and embryos. Thus, the purpose of this study was to (i) assess cytoplasmic characteristics of the oocyte by mitochondria and actin staining in immature and in vitro/in vivo matured cat oocytes and (ii) characterize mitochondria and actin distribution in in vitro produced blastocysts by confocal laser scanning microscopy. Additionally, in vivo matured oocytes were collected to assess mitochondria and actin. Transzonal cumulus cell projections were more abundant in immature oocytes than in matured oocytes. A relocation of mitochondria throughout meiosis was not clearly observed. However, most in vitro produced blastocysts were of good quality, according to their actin cytoskeleton integrity and mitochondria distribution. The functional significance of mitochondria distribution in cat oocytes in relation to their developmental competence requires further research. This study represents the original description of actin and mitochondrial patterns in cat oocytes and embryos.

Scriptaid and 5-aza-2'deoxycytidine enhanced expression of pluripotent genes and in vitro developmental competence in interspecies black-footed cat cloned embryos.

Somatic cell nuclear transfer offers the possibility of preserving endangered species including the black-footed cat, which is threatened with extinction. The effectiveness and efficiency of somatic cell nuclear transfer (SCNT) depends on a variety of factors, but 'inappropriate epigenetic reprogramming of the transplanted nucleus is the primary cause of the developmental failure of cloned embryos. Abnormal epigenetic events such as DNA methylation and histone modifications during SCNT perturb the expression of imprinted and pluripotent-related genes that, consequently, may result in foetal and neonatal abnormalities. We have demonstrated that pregnancies can be established after transfer of black-footed cat cloned embryos into domestic cat recipients, but none of the implanted embryos developed to term and the foetal failure has been associated to aberrant reprogramming in cloned embryos. There is growing evidence that modifying the epigenetic pattern of the chromatin template of both donor cells and reconstructed embryos with a combination of inhibitors of histone deacetylases and DNA methyltransferases results in enhanced gene reactivation and improved in vitro and in vivo developmental competence. Epigenetic modifications of the chromatin template of black-footed cat donor cells and reconstructed embryos with epigenetic-modifying compounds enhanced in vitro development, and regulated the expression of pluripotent genes, but these epigenetic modifications did not improve in vivo developmental competence.

Applying embryo cryopreservation technologies to the production of domestic and black-footed cats.

Our objectives were (i) compare in vitro development of early cleavage stage domestic cat embryos after cryopreservation by minimal volume vitrification vs a standard slow, controlled-rate method, (ii) determine viability of vitrified domestic cat embryos by oviductal transfer into synchronous recipients and (iii) evaluate in vivo survival of black-footed cat (BFC, Felis nigripes) embryos after intra- and inter-species transfer. In vitro-derived (IVM/IVF) cat embryos were used to evaluate in vitro development after controlled-rate cryopreservation vs vitrification vs controls. Blastocyst development was similar in both groups of cryopreserved embryos (22-26%), but it was lower (p < 0.05) than that of fresh embryos (50%). After embryo transfer, four of eight recipients of vitrified embryos established pregnancies--three of six (50%) and one of two (50%) that received embryos from in vivo- and in vitro-matured oocytes, respectively. Three male and two female kittens weighing from 51 to 124 g (mean = 88 g) were delivered on days 61-65 of gestation. In BFC, four intra-species embryo transfer procedures were carried out--two recipients received fresh day 2 embryos (n = 5, 8) and two recipients received embryos that had been cryopreserved on day 1 (n = 6) or 2 (n = 8). A 2-year-old recipient of cryopreserved embryos established pregnancy and delivered two live male kittens. Subsequently, five cryopreserved BFC embryos were transferred to a domestic cat recipient. On day 29, the recipient was determined to be pregnant and delivered naturally a live, healthy female BFC kitten on day 66. In summary, in vivo survival of vitrified domestic cat embryos was shown by the births of kittens after transfer into recipients. Also, we demonstrated that sperm and embryo cryopreservation could be combined with intra- and inter-species embryo transfer and integrated into the array of assisted reproductive techniques used successfully for propagation of a rare and vulnerable felid species, the black-footed cat.

In vivo survival of domestic cat oocytes after vitrification, intracytoplasmic sperm injection and embryo transfer.

We evaluated: (1) cleavage rate after IVF or intracytoplasmic sperm injection (ICSI) of in vivo- and in vitro-matured oocytes after vitrification (experiment 1); and (2) fetal development after transfer of resultant ICSI-derived embryos into recipients (experiment 2). In vivo-matured cumulus-oocyte complexes (COCs) were recovered from gonadotropin-treated donors at 24 h after LH treatment. In vitro-matured oocytes were obtained by mincing ovaries (from local veterinary clinics) and placing COCs into maturation medium for 24 h. Mature oocytes were denuded and cryopreserved in a vitrification solution of 15% DMSO, 15% ethylene glycol, and 18% sucrose. In experiment 1, for both in vivo- and in vitro-matured oocytes, cleavage frequencies after IVF of control and vitrified oocytes and after ICSI of vitrified oocytes were not different (P > 0.05). After vitrification, blastocyst development occurred only in IVF-derived, in vitro-matured oocytes. In experiment 2, 18 presumptive zygotes and four two-cell embryos derived by ICSI of vitrified in vitro-matured oocytes and 19 presumptive zygotes produced from seven in vivo- and 12 in vitro-matured oocytes were transferred by laparoscopy into the oviducts of two recipients, respectively. On Day 21, there were three fetuses in one recipient and one fetus in the other. On Days 63 and 66 of gestation, four live kittens were born. In vivo viability of zygotes and/or embryos produced via ICSI of vitrified oocytes was established by birth of live kittens after transfer to recipients.

[Phrynoderma secondary to vitamin A deficiency in a patient with biliopancreatic diversion]. / Frinoderma secundario a déficit de vitamina A en un paciente con derivación biliopancreática.

Biliopancreatic diversion (BPD) is a malabsorptivebariatric procedure can lead to the development of several nutritional complications, including fat-soluble vitamins deficiencies. Routine supplementation with vitamins and trace elements and a close follow-up long-term can prevent these nutritional risks. Vitamin A participates in ocular metabolism, epithelial differentiation, growth, and embryogenesis. Have been described several cases of ophthalmological and fetal complications associated with vitamin A deficiency in patients who have undergone BPD. Few information exists in literature about dermatologic manifestations that may occur in these patients. Phrynoderma is a type of follicular hyperkeratosis located on the extensor surfaces of the extremities whose main cause is vitamin A deficiency. We report an exceptional case of severe cutaneous and ocular complications in a patient who had undergone BPD with poor adherence to treatment and postoperative follow-up. Our patient presented simultaneously the characteristic skin lesions of phrynoderma with nytalopia and xerophthalmia in a setting of low serum levels of vitamin A. Treatment with high doses vitamin A obtained the resolution of both processes. We review and discuss the relationship between phrynoderma, malnutrition and vitamin A deficiency.

Derivation of cat embryonic stem-like cells from in vitro-produced blastocysts on homologous and heterologous feeder cells.

The domestic cat is a focal mammalian species that is used as a model for developing assisted reproductive technologies for preserving endangered cats and for studying human diseases. The generation of stable characterized cat embryonic stem cells (ESC) lines to use as donor nuclei may help to improve the efficiency of interspecies somatic cell nuclear transfer for preserving endangered cats and allow the creation of knockout cell lines to generate knockout cats for studying function of specific genes related to human diseases. It will also enable the possibility of producing gametes in vitro from ESC of endangered cats. In the present study, we report the generation of cat embryonic stem-like (cESL) cells from blastocysts derived entirely in vitro. We generated 32 cESL cell lines from 331 in vitro derived blastocysts from which inner cell masses were isolated by immunosurgery or by a mechanical method. Inhibition of cat dermal fibroblast (CDF) proliferation after exposure to mitomycin-C was both dose and time dependent, where doses of 30 to 40 microg/mL for 5 h were most efficient. These dosages were higher than that required to inhibit cell proliferation of mouse fetal fibroblasts (MFF; 10 microg/mL for 2.5 h). Mitomycin-C did not significantly increase necrosis of cells from either species, and had an anti-proliferative effect at concentrations below cytotoxicity. A clear species-specific relationship between feeder layers and derivation of cESL cell lines was observed, where higher numbers of cESL cell lines were generated on homologous cat feeder layers (n = 26) than from those derived on heterologous mouse feeder layers (n = 6). Three cESL cell lines generated from immunosurgery and cultured on CDF maintained self-renewal and were morphologically undifferentiated for nine and twelve passages (69-102 days). These lines showed a tightly packed dome shaped morphology, exhibited alkaline phosphatase activity and immuno-expression of the pluripotent marker OCT-4 and surface marker SSEA-1. Primary colonies at P0 to P3 and cat blastocysts expressed transcription factors OCT-4, NANOG and SOX-2 and the proto-oncogene C-MYC. However, expression was at levels significantly lower than in vitro produced blastocysts. During culture, cESL colonies spontaneously differentiated into fibroblasts, cardiomyocytes, and embryoid bodies. Development of techniques to prevent differentiation of cESL cells will be essential for maintaining defined cell lines.

Birth of domestic cat kittens of predetermined sex after transfer of embryos produced by in vitro fertilization of oocytes with flow-sorted sperm.

Our goals were to: (1) determine if domestic cat sperm could be sorted to high purity by flow cytometry after overnight shipment of cooled samples; (2) evaluate the efficiency with which sorted sperm could be used to generate cat embryos in vitro; and (3) determine if live kittens of predetermined sex could be produced after transfer of embryos derived by IVF using sorted sperm. Semen samples (n=5) from one male were extended in electrolyte-free solution and shipped overnight at 4 degrees C to the sorting facility. Samples were adjusted to 75x10(6)sperm/mL and stained with Hoechst 33342. After 1h at 34.5 degrees C, samples were adjusted to 50x10(6)sperm/mL with 4% egg yolk TALP+0.002% food dye and sorted by high-speed flow cytometry. Later resort analysis confirmed purities of 94% and 83% for X- and Y-chromosome bearing sperm, respectively. Sorted sperm were centrifuged, re-suspended in TEST yolk buffer and shipped overnight to the IVF laboratory. After IVF of in vivo matured oocytes with X-chromosome bearing sperm, cleavage frequency was 62% (54/87). After IVF of IVM oocytes with control, X- or Y-chromosome bearing sperm, the incidence of cleavage was 42% (48/115), 33% (40/120), and 35% (52/150), respectively, and blastocyst development was 53% (21/40), 50% (11/22), and 55% (23/42), respectively (P>0.05). On Day 2, 45 embryos produced by IVF of in vivo matured oocytes with X-chromosome bearing sperm were transferred to the oviduct of four Day 1 recipients, three of which subsequently delivered litters of one, four, and seven female kittens, respectively. In conclusion, we confirmed that sperm sorting technology can be applied to domestic cats and established that kittens of predetermined sex can be produced.

Differential sensitivity to the effects of nicotine and bupropion in adolescent and adult male OF1 mice during social interaction tests.

Few studies have compared the action of both nicotine (NIC) and bupropion (BUP), an antidepressant used to treat NIC dependence, on social and aggressive behavior at different ages. This study aims to determine whether these drugs produce differential effects in adolescent (postnatal day: 36-37) and adult (postnatal day: 65-66) mice that have been housed individually for 2 weeks in order to induce aggressive behavior. Mice received BUP (40, 20, or 10 mg/kg), NIC (1, 0.5, and 0.25 mg/kg as base), or vehicle earlier to a social interaction test. BUP (40 mg/kg) decreased social investigation and increased nonsocial exploration in both adolescent and adult mice. The same effects were also observed in adult mice administered with a lower dose of the same drug (20 mg/kg). In adolescents, NIC (1 mg/kg) decreased social investigation, but this effect did not reach statistical significance in adults. In conclusion, a differential sensitivity to the effects of NIC or BUP emerged in some of the behavioral categories when the two age groups were compared.

[Association among familial atopy, smoking (passive and active), allergic rhinitis, labor environment and adult asthma]. / Asociación entre atopia familiar, tabaquismo (pasivo o activo), rinitis alérgica, ambiente laboral y asma del adulto.

BACKGROUND: Studies of association among parental atopy, tobacco exposure (passive or active) and adult asthma have provided conflicting results. OBJECTIVE: To determine the relationship among parental atopy, smoking, exposure to tobacco smoke, allergic rhinitis, work environment and asthma in adults. MATERIAL AND METHODS: In a population of 329,219 inhabitants of a geographically defined area in Northeastern of Mexico, we identified 791 cases of asthma. The patients were 20 to 54 years old, and were divided in three groups: with asthma in remission (263 patients), with symptoms since childhood (270 patients), and with asthma onset in adult age (258 patients). We included 793 randomly selected control subjects. Information on family atopy, passive and active smoking, allergic rhinitis and workplace conditions were collected by using a questionnaire. RESULTS: Parental atopy history, active smoking, allergic rhinitis and pollution in the workplace induce asthma symptoms. Exposure to smoking is a risk factor of persistence of asthma symptoms in adults (OR = 1.33; IC 95%, 1.07-1.66), but no of their development (OR = 1.10; IC 95%, 0.87-1.39). Working in a polluted environment had not significance in remission of asthma (OR =1.32; IC 95%, 0.95-1.85). CONCLUSIONS: Results support hypothesis that family atopy, active smoke, allergic rhinitis and pollution favor the persistence of asthma symptoms and increase the risk of asthma in adults.

High temporal resolution measurements of ozone precursors in a rural background station. A two-year study.

We present a very complete database of individual non-methane hydrocarbon (NMHC) measurements with high temporal resolution (hourly) in a rural background atmosphere. We show their use to characterize the biogenic NMHC as well as to identify the transport and impact of anthropogenic NMHC on rural areas. In January 2003 an automatic GC-FID analyzer of volatile organic compounds between 2 and 10 carbon atoms (C2-C10 VOCs) was placed in the centre of the Valderejo Natural Park in northern Iberia (42.87 degrees N, 3.22 degrees W), far away from important cities. The system operated continuously until December 2004. Data coverage was higher than 70% for a total of 59 VOC of both anthropogenic and biogenic origin, with detection limits in the range of pptv. Our results allow for the description of the behaviour of these compounds, in order to identify external impacts arriving to the sampling site which has been recognized to be highly representative of a rural background atmosphere. Biogenic VOC concentrations have been compared also with the calculated emissions, using Guenther's algorithm, and the discrepancies interpreted in terms of the different reactivity of such compounds.

[Intrapleural streptokinase in the treatment of complicated parapneumonic empyema]. / Instilación intrapleural de estreptoquinasa en el tratamiento del empiema paraneumónico complicado.

INTRODUCTION: Parapneumonic empyema is a frequent cause of admission in the Pediatric Hospital of the Pereira Rossell Hospital Center. In January 2005, we implemented a treatment protocol that included intrapleural streptokinase (STK) for children with complicated parapneumonic empyema as an alternative to surgery. OBJECTIVES: To describe the results of intrapleural STK in the treatment of hospitalized children with complicated parapneumonic empyema and to compare these results with those of early thoracotomy. PATIENTS AND METHODS: Children with complicated parapneumonic empyema admitted between January 1st 2004 and October 1st 2005 were included. The children were divided into two groups: a historical group, composed of children hospitalized between January 1st and December 31st 2004, treated with conventional thoracotomy before day 8 of chest drain placement and a prospective group, composed of children hospitalized between January 1st and October 1st 2005, treated with intrapleural STK before day 8 of chest drain placement. The variables used to compare outcome and treatment complications were duration of chest tube drainage after the treatment procedure, complications, re-admission, length of hospital stay, and death. RESULTS: The results in both groups were similar. Length of hospital stay showed no significant differences. Duration of chest tube drainage after intrapleural STK was significantly shorter than after thoracotomy (p < 0.001). In the thoracotomy group a significantly higher proportion of patients required partial atypical pneumonectomy (p = 0.051). There were no deaths. CONCLUSIONS: Intrapleural STK is a valid alternative for the treatment of children with complicated parapneumonic empyema.