alpha Interferon in the management of essential thrombocythaemia.

Thirteen patients (mean age 60.7 years; female:male ratio 10:3) with essential thrombocythaemia were treated with 3 million units (MU)/day interferon alfa-2b subcutaneously (s.c.) for 12 weeks, with all patients requiring a dose reduction after 4 weeks. The mean pretreatment platelet count was 1,400 x 10(9)/L and megakaryocytes were increased in all cases. Splenomegaly was present in six patients and haemorrhagic phenomena were observed in two. Nine patients (69.2%) had objective responses, including two (15.4%) complete responses (platelets less than 450 x 10(9)/L) which were then maintained with 5 MU interferon twice a week. Acute toxicity consisted of flu-like symptoms in 12 patients. Chronic toxicity (mainly leucopenia) was observed in nine patients. In conclusion, initial therapy and then requiring maintenance therapy at a reduced dose. However, the frequent side effects observed make it advisable to use a low dose of interferon alfa-2b, and to treat only those patients with significant symptoms and signs of thrombocytosis.

Artificial muscle: movement and position control.

The movement of an all polymeric triple-layer artificial muscle based on polypyrrole (PPy) that work in aqueous solution was characterised. The magnitude and direction of the experimental current control both rate and direction of the movement. The described angle is a linear function of the consumed charge.

Life expectancy of patients with chronic nonleukemic myeloproliferative disorders.

This study determines, within the frame of current therapeutic possibilities, the impact of chronic nonleukemic myeloproliferative disorders on expected survival. The survival data for 1067 patients (454 with polycythemia vera, 247 with essential thrombocythemia, and 366 with idiopathic myelofibrosis) were collected from 38 Spanish institutions. The actuarial survival probability of each group of patients was compared with that of the age-matched and sex-matched control population. The survival of the patients with polycythemia vera and essential thrombocythemia did not differ from that of the control population (P = 0.92 and, 0.22, respectively), whereas the survival of the patients with idiopathic myelofibrosis was strikingly reduced with respect to the control population (P = 0.0000000007). Thus, in terms of survival, current therapeutic procedures may be considered as quite satisfactory in patients with polycythemia vera and essential thrombocythemia. On the other hand, due to poor survival of patients with idiopathic myelofibrosis, new therapeutic approaches for this condition are clearly needed.

[Incidence of monoclonal components in lymphoproliferative syndromes. Apropos of 234 cases ]. / Incidencia de componentes monoclonales en síndromes linfoproliferativos. A propósito de 234 casos.

A series of 234 sera from 104 patients with non-Hodgkin's lymphoma (NHL), 77 with Hodgkin's disease (HD) and 53 with chronic lymphocytic leukaemia (CLL) was studied by cellulose acetate gel electrophoresis, agarose gel electrophoresis, immunoelectrophoresis and electroimmunodiffusion, in order to assess the incidence and type of monoclonal components (MC) in these diseases. Monoclonal component was found by cellulose acetate gel electrophoresis in 22 of the 234 cases studied (9.8%); agarose gel electrophoresis disclosed MC in 22 other cases (18.8%), all of them showing rates lower than 5.0 g/L. MC was present in 29 of the 104 NHL cases (27.9%), it being characterised as IgM in 16 patients and IgG in 13 others. The MC was observed in 13 of the 21 cases of lymphoplasmacytoid forms, but it was less conspicuous in the remaining histological forms. With regard to HD, MC was present in 5 cases (6.5%), of IgG, type in all instances, and in 10 of the 53 CLL patients (18.9%), IgG in 8 and IgM in two other cases. The methods used in the present study made it possible to detect and characterise MC in about 20% of the lymphoproliferative syndromes studied. It can be inferred that the use of more sensitive techniques would disclose the presence of MC in the majority of B-cell lymphoproliferative syndromes.

[Levocabastine versus cetirizine for perennial allergic rhinitis in children]. / Levocabastina contra cetirizina en niños con rinitis alérgica perenne.

OBJECTIVE: To compare the efficacy and safety of levocabastine nasal spray asid cetirizine oral for the treatment of perennial allergic rhinitis in children. MATERIAL AND METHODS: In this randomized, prospective experimental, open clinical trial. We studied 30 children with ages between 6 and 16 years with perennial allergic rhinitis. Group 1, 17 subjects (7 female, 10 male) received cetirizine once daily, 5 mg children weientig less dian 30 k asid 10 mg in children weighing more trw' 30 k during 15 days. Group 2, 13 subjects (7 male, 6 female) received levocabastine 2 puffs BID on each nostril during tbe same time. A nasal symptoms score, nasal peal: flow vid eosinophils in a nasal smear were performed before and after treatment. RESULTS: There were no statistical differences in age, weight, height and arid duration of symptoms. Both groups showed improvement of symptoms via nasal peak flow with no differences between them (intergroup); nasal eosinophils remained unchanged. We for third statistical differences pre vid postreatment in each group (intragroup): Group 1, nasal congestion p = 0.002, ocular itch p = 0.01, sneezing p = 0.007, nasal secretion p = 0.01, nasal itch O = 0.009, total points O = 0.0005. Group 2, nasal congestion O = 0.02, ocular itch p = 0.05, sneezing p = 0.01, nasal secretion p = 0.01, nasal itch p = 0.04, total points p = 0.005. Significant differences were found in nasal peal' flow in Group 1 (p = 0.01) but no differences in eosinophils between file two groups. Side effects: 3 subjects in Group 1 (drowsiness, 1 appetite increase said 1 rhinorrea with epistaxis) vide 1 in Group 2 sensation of facial edema. CONCLUSION: Bofil drugs are effective the clinical relief of symptoms of perennial allergic rhinitis in children vied levocabastine has less side effects.

Community-oriented medical education: comparison of tracks in Mexico and New Mexico.

Most major innovations in medical education have occurred in a small number of new schools. Attempts to create change in traditional schools are far more complex. Relevant models for such change are few and there is an urgent need for institutions pioneering such changes to learn from each other's experiences. Two conventional medical schools described in this paper have attempted to create community-oriented institutional change by establishing experimental undergraduate curricular tracks. One is in a developing country, Mexico, the other in a technically developed country, the United States. These new tracks in medical education evolved independently of one another, yet they have many similarities and have experienced common problems. A formal exchange between the two schools has led to new insights in medical education and improvements to both programmes. Exchange agreements like the one reported here would be valuable for other medical schools in both developing and technically developed countries.

La conducta prosocial: una vision de conjunto / Prosocial behavior: a comprehensive view

En el presente trabajo se lleva a cabo una revisión de la evolución histórica que ha experimentado el concepto prosocial, intentando ofrecer una visión actualizada del mismo. Partiendo de la investigación de Gonzalez Portal et al (1989,1992), como marco de referencia, se presentan las perspectivas actuales que gozan de mayor relevancia en esta área. Con objeto de analizar el incremento en la producción cientifica, los autores mas importantes y las áreas de investi-gación que sobre el comportamiento prosocial se han ido desarrollando; se utiliza el material recensionado a lo largo del periodo comprendido entre 1989 y 1997 en la base de datos del Psychological Abstracts.