Valproic acid radiosensitizes anaplastic thyroid cells through a decrease of the DNA damage repair capacity.

BACKGROUND: Anaplastic thyroid cancer (ATC) represents a rare lethal human malignancy with poor prognosis. Multimodality treatment, including radiotherapy, is recommended to improve local control and survival. Valproic acid (VA) is a clinically available histone deacetylase inhibitor with a well-documented side effect profile. In this study, we aim to investigate the combined effect of VA with photon irradiation in vitro. METHODS: Anaplastic thyroid cancer cells (8505c) were used to investigate the radiosensitizing effect of VA. RESULTS: VA sensitized cells to photon irradiation. VA increased radiation-induced apoptosis and radiation-induced DNA damage measured by γH2AX foci induction. Furthermore, VA prolonged γH2AX foci disappearance over time in irradiated cells and decreased the radiation-induced levels of mRNA of key DNA damage repair proteins of the homologous recombination (HR) and the nonhomologous end joining (NHEJ) pathways. CONCLUSIONS: VA at a clinically safe dose enhance the radiosensitivity of 8505c cells through an increase in radiation-induced apoptosis and a disruption in the molecular mechanism of HR and NHEJ DNA damage repair pathways.

Management of congenital and acquired airway pathologies in newborns by a cross-disciplinary committee at a third level hospital. / Manejo de la patología congénita y adquirida de la vía aérea en el neonato por parte de un comité multidisciplinar en un centro terciario.

INTRODUCTION: Neonatal airway examination through flexible/rigid bronchoscopy has proved to be useful in the presence of persistent stridor and extubation failure, as well as to assess complications following cardiac surgery. At our institution, these examinations are carried out by a pulmonologist, a neonatologist, an otorhinolaryngologist, and a pediatric surgeon from the pediatric airway committee, established in 2014. OBJECTIVE: To analyze the airway examinations performed in neonates during their stay at the neonatology/neonatal intensive care unit since the airway committee was established. MATERIAL AND METHODS: A retrospective study of the airway examinations conducted in neonates from 2015 to 2019 was carried out. Clinical and demographic data, number of examinations, indications, findings, and complications were collected. Results are presented as mean and standard deviation. Statistical significance was established at p < 0.05. RESULTS: 92 airway examinations were analyzed in 51 patients (54.9% of whom were female). 51% of the patients were premature. Extubation failure and persistent respiratory symptoms following successful extubation were the most frequent indications for airway examination (35.3%). Stratification by gestational age or weight at birth was not associated with an increased risk of pathological findings at examination (p > 0.05). The most frequent finding was vocal cord paralysis (n = 14; 27.5%). In 10 patients (19.6%), no pathological findings were observed. CONCLUSION: Airway examination is useful in patients with stridor to identify vocal cord paralysis following extubation failure. It also allows congenital airway pathologies to be diagnosed and treated. The number of examinations with no pathological findings was similar to that reported in international series.

INTRODUCCION: La exploración de vía aérea mediante broncoscopia flexible/rígida en el neonato ha demostrado utilidad en el estridor persistente, extubaciones fallidas o para valorar complicaciones tras cirugía cardiaca. En nuestro hospital estas exploraciones son practicadas por un neumólogo, neonatólogo, otorrinolaringólogo y cirujano pediátrico del Comité de Vía Aérea Pediátrica, formado en 2014. OBJETIVO: Analizar las exploraciones de vía aérea practicadas a neonatos durante su estancia en Neonatología/Unidad de Cuidados Intensivos Neonatales desde la constitución del Comité de Vía Aérea. MATERIAL Y METODOS: Estudio retrospectivo de exploraciones de vía aérea practicadas a neonatos de 2015-2019. Se recogen datos clínicos y demográficos, número de exploraciones, indicación, hallazgos y complicaciones. Se presentan las medias con su desviación estándar. Se consideró un resultado estadísticamente significativo cuando p < 0,05. RESULTADOS: Se analizaron 92 exploraciones de vía aérea en 51 pacientes (género femenino: 54,9%). El 51% de los pacientes fueron prematuros. La extubación fallida y la persistencia de sintomatología respiratoria tras una extubación satisfactoria fueron las indicaciones más frecuentes (35,3%). La estratificación por edad gestacional o por peso al nacimiento no se asociaba a un mayor riesgo de presentar hallazgos patológicos en la exploración. El hallazgo más frecuente fue la parálisis de cuerda vocal (n = 14; 27,5%). En 10 pacientes (19,6%) no se encontraron hallazgos patológicos. CONCLUSION: La exploración de la vía aérea es útil en pacientes con estridor postextubación y para identificar parálisis de cuerda vocal tras extubación fallida. Además, permite el diagnóstico y tratamiento de patologías congénitas de la vía aérea.

Study, measurement and mitigation of radon activity concentration in the School of Computer Science ofA Coruñain the North West of Spain.

A study of the radon activity concentration was carried out at the School of Computer Science of 'Universidade da Coruña' (UDC, Spain). For this purpose, building location, the type of soil and the construction materials were analysed. Subsequently, the radon activity concentration was determined using two different techniques: measurement in situ with an on-site ionization chamber detector (short term) and measurement with trace detectors (long term). Based on the results obtained, and according with the Spanish Law (Spanish Official Bulletin-Boletín Oficial del Estado, of 21 December 2011, IS-33 Instruction), corrective works were performed, consisting on the installation of a forced ventilation system underneath the extent of the suspended floor in order to mitigate the high radon specific activity in the building. Four months and 3 years after the works, new measurements were carried out in order to verify the effectiveness of the new ventilation system, obtaining a decrease of the radon gas values ranging between 87% and 90%, which confirmed long term effectivity.

[Sacral nerve stimulation for the treatment of severe fecal incontinence: long-term quality of life and functional outcomes].

BACKGROUND: The aim is to determine whether good functional and quality of life results of sacral nerve stimulation (SNS) in patients with severe fecal incontinence are maintained in the long-term. MATERIAL AND METHODS: Consecutive cohort of patients with severe fecal incontinence not responding to conservative (drugs and/or biofeedback) or surgical (sphincteroplasty) treatment, undergoing SNS between 2002 and 2013. Patients with a definitive implant were individually assessed in consultation throughout the follow-up, until January 2016. Defeca-tory function was assessed by Wexner score and stool diary, and perceived quality of life by FIQL and EQ-5D question-naires. RESULTS: Acute percutaneous nerve evaluation (PNE) was performed on 93 patients; a temporary electrode was implanted in 91 (79.1% women, mean age 62.5 years), obtaining a good functional response in 64. A permanent implant was per-formed in 61 patients, with a mean follow-up of 78.1 months (SD: 35.4; range 1-161); at the end of the study 42 patients remained in follow-up. A significant decrease was observed in the number of days per week with an incontinent episode, from 4.98 (SD 2.1) to 1.25 (SD 1.7), and in Wexner score from 16.88 (SD 2.74) to 6.95 (SD 3.54). Specific FIQL and generic EQ-5D questionnaires showed a significant improvement in quality of life. CONCLUSION: Long-term functional and quality of life outcomes of SNS for the treatment of severe faecal incontinence is maintained, with individual follow-ups that reach 10 years.

[Multidisciplinary approach on subglottic pathology: a 5-year review]. / Manejo multidisciplinar de la patología subglótica: revisión a 5 años.

INTRODUCTION: Pediatric subglottic pathology still represents a challenge when it comes to choosing the right treatment. We present the management of patients followed in our center for this reason during the last 5 years. MATERIAL AND METHODS: Retrospective study of patients followed by glotosubglottic pathology (stenosis, cysts or granulomas) between 2011 and 2016 in a third level hospital. RESULTS: Twenty-seven patients were included in the review. Treatment options varied according to the nature, location and severity of the subglottic stenosis. Two patients with congenital subglottic stenosis were treated by laryngotracheoplasty. Seventeen patients with acquired subglottic stenosis were included: in one (5.9%) laryngotracheoplasty was performed, one (5.9%) received cricotracheal split, two of them (11.8%) underwent partial cricotracheal resection (PCTR) , seven patients (41.2%) underwent microsurgery, three (17.6%) received tracheal dilatation, and the last three (17.6%) were submitted to observation without needing further treatment. Five patients with post-intubation subglottic cysts received microsurgery. Of three patients diagnosed with post-intubation subglottic granuloma, two (66%) resolved spontaneously and one (33%) required microsurgery. CONCLUSIONS: Management of pediatric subglottic pathology remains a major challenge. Since the creation of the Airway Committee in our center, the improvement in the management of these patients has led to a multidisciplinary management, with the consequent impact on the clinical results.

OBJETIVOS: La patología del espacio subglótico en pacientes pediátricos sigue representando un reto a la hora de elegir el tratamiento idóneo. Presentamos el manejo de los pacientes seguidos en nuestro centro por este motivo durante los últimos 5 años. MATERIAL Y METODOS: Estudio retrospectivo de los pacientes seguidos por patología glotosubglótica (estenosis, quistes o granulomas) entre 2011 y 2016 en un centro de tercer nivel. RESULTADOS: Veintisiete pacientes fueron incluidos en la revisión. Las opciones de tratamiento variaron en función de la naturaleza, la localización y la gravedad de la afectación subglótica. Dos pacientes con estenosis subglótica congénita fueron tratados mediante laringotraqueoplastia. Se incluyeron 17 pacientes con estenosis subglótica adquirida: en uno (5,9%) se realizó laringotraqueoplastia, en uno (5,9%) split cricotiroideo, dos de ellos (11,8%) se intervinieron mediante resección cricotraqueal parcial (PCTR), siete pacientes (41,2%) se sometieron a microcirugía, tres (17,6%) recibieron dilatación traqueal y los tres últimos (17,6%) se sometieron a observación sin necesitar finalmente tratamiento. Cinco pacientes con quistes subglóticos postintubación recibieron microcirugía. De tres pacientes diagnosticados de granuloma subglótico postintubación, dos (66%) se resolvieron espontáneamente y uno (33%) requirió microcirugía. CONCLUSIONES: El manejo de la patología subglótica pediátrica sigue representando un gran desafío. Desde la creación del Comité de Vía Aérea en nuestro centro, la mejoría en la gestión de estos pacientes ha conducido a un manejo multidisciplinar de los mismos, con el consiguiente impacto en los resultados clínicos.

Quality of life in caregivers of children with asthma: Validity and reliability of the IFABI-R questionnaire.

BACKGROUND: Parents'/caregivers' quality of life is an important aspect to consider when handling paediatric asthma, but there is a paucity of valid and reliable instruments to measure it. The Family Impact of Childhood Bronchial Asthma (IFABI-R) is a recently developed questionnaire to facilitate the assessment of asthma-related parents'/caregivers' quality of life. This study researches the psychometric properties of IFABI-R. METHODS: Parents/main caregivers of 462 children between 4 and 14 years of age with active asthma were included in the sample. IFABI-R was administered on two different occasions and a number of other variables related to the parents'/caregivers' quality of life were measured: child's asthma control, family functioning, and parents'/caregivers' perception of asthma symptoms in the child. IFABI-R evaluative and discriminative properties were analysed, and the minimal important change in the IFABI-R score was identified. RESULTS: IFABI-R showed high internal consistency (Cronbach's alpha=0.941), cross-sectional construct validity (correlation with the degree of child's asthma control, family functioning and parent/caregiver perception of the child's asthma symptoms), longitudinal construct validity (correlation of changes in the IFABI-R with changes in asthma control and changes in the perception of symptoms), sensitivity to change and test-retest reliability. An absolute change of 0.3 units in IFABI-R related to a minimal significant change in the parents'/caregivers' quality of life. CONCLUSIONS: IFABI-R is a reliable and valid instrument to study the quality of life of parents/caregivers of children with asthma.

A Preliminary Study of the Ability of the 4Kscore test, the Prostate Cancer Prevention Trial-Risk Calculator and the European Research Screening Prostate-Risk Calculator for Predicting High-Grade Prostate Cancer.

INTRODUCTION: To prevent the overdiagnosis and overtreatment of prostate cancer (PC), therapeutic strategies have been established such as active surveillance and focal therapy, as well as methods for clarifying the diagnosis of high-grade prostate cancer (HGPC) (defined as a Gleason score ≥7), such as multiparametric magnetic resonance imaging and new markers such as the 4Kscore test (4KsT). By means of a pilot study, we aim to test the ability of the 4KsT to identify HGPC in prostate biopsies (Bx) and compare the test with other multivariate prognostic models such as the Prostate Cancer Prevention Trial Risk Calculator 2.0 (PCPTRC 2.0) and the European Research Screening Prostate Cancer Risk Calculator 4 (ERSPC-RC 4). MATERIAL AND METHODS: Fifty-one patients underwent a prostate Bx according to standard clinical practice, with a minimum of 10 cores. The diagnosis of HGPC was agreed upon by 4 uropathologists. We compared the predictions from the various models by using the Mann-Whitney U test, area under the ROC curve (AUC) (DeLong test), probability density function (PDF), box plots and clinical utility curves. RESULTS: Forty-three percent of the patients had PC, and 23.5% had HGPC. The medians of probability for the 4KsT, PCPTRC 2.0 and ERSPC-RC 4 were significantly different between the patients with HGPC and those without HGPC (p≤.022) and were more differentiated in the case of 4KsT (51.5% for HGPC [25-75 percentile: 25-80.5%] vs. 16% [P 25-75: 8-26.5%] for non-HGPC; p=.002). All models presented AUCs above 0.7, with no significant differences between any of them and 4KsT (p≥.20). The PDF and box plots showed good discriminative ability, especially in the ERSPC-RC 4 and 4KsT models. The utility curves showed how a cutoff of 9% for 4KsT identified all cases of HGPC and provided a 22% savings in biopsies, which is similar to what occurs with the ERSPC-RC 4 models and a cutoff of 3%. CONCLUSIONS: The assessed predictive models offer good discriminative ability for HGPCs in Bx. The 4KsT is a good classification model as a whole, followed by ERSPC-RC 4 and PCPTRC 2.0. The clinical utility curves help suggest cutoff points for clinical decisions: 9% for 4KsT and 3% for ERSPC-RC 4. This preliminary study should be interpreted with caution due to its limited sample size.

Assessment of microbial risk factors and impact of meteorological conditions during production of baby spinach in the Southeast of Spain.

There is a timely need to evaluate the effect agricultural factors and meteorological conditions on fresh produce contamination. This study evaluated those risk factors and described, for the first time, the distribution of indicator microorganisms (Escherichia coli, Enterococcus, coliforms, and Enterobacteriaceae) and the prevalence of foodborne pathogens (Enterohaemorrhagic E. coli, Listeria monocytogenes and Salmonella spp.) in baby spinach grown in the Southeast of Spain. A longitudinal study was conducted on three farms (2011-2013). Results obtained for E. coli highlighted soil and irrigation water as important factors affecting the microbial safety of baby spinach. Significant differences in the proportion of E. coli positive samples were found between treated (46.1%) and untreated (100%) irrigation water. However, the microbial quality of irrigation water didn't affect E. coli prevalence in produce. All E. coli positive spinach samples were detected at the highest observed temperature range suggesting that ambient temperature affects the probability and extent of spinach contamination. Salmonella spp. was detected by RT-PCR in manure, soil, irrigation water and baby spinach but only two of them (manure and irrigation water) were confirmed by isolation in culture media. Salmonella RT-PCR positive samples showed higher levels of E. coli than Salmonella negative samples. This preliminary finding supports recent identification of E. coli as a suitable parameter for the hygiene criterion at the primary production of leafy greens.

Belgian and Spanish consumption data and consumer handling practices for fresh fruits and vegetables useful for further microbiological and chemical exposure assessment.

A consumer survey was organized in Spain and Belgium to obtain consumption data and to gain insight into consumer handling practices for fresh vegetables consumed raw or minimally processed (i.e., heads of leafy greens, bell peppers, tomatoes, fresh herbs, and precut and packed leafy greens) and fruits to be consumed without peeling (i.e., apples, grapes, strawberries, raspberries, other berries, fresh juices, and precut mixed fruit). This information can be used for microbiological and/or chemical food safety research. After extensive cleanup of rough databases for missing and extreme values and age correction, information from 583 respondents from Spain and 1,605 respondents from Belgium (18 to 65 years of age) was retained. Daily intake (grams per day) was calculated taking into account frequency and seasonality of consumption, and distributions were obtained that can be used in quantitative risk assessment for chemical hazards with chronic effects on human health. Data also were recalculated to obtain discrete distributions of consumption per portion and the corresponding frequency of consumption, which can be used in acute microbiological risk assessment or outbreak investigations. The ranked median daily consumption of fruits and vegetables was similar in Spain and Belgium: apple > strawberry > grapes > strawberries and raspberries; and tomatoes > leafy greens > bell peppers > fresh herbs. However, vegetable consumption was higher (in terms of both portion and frequency of consumption) in Spain than in Belgium, whereas the opposite was found for fruit consumption. Regarding consumer handling practices related to storage time and method, Belgian consumers less frequently stored their fresh produce in a refrigerator and did so for shorter times compared with Spanish consumers. Washing practices for lettuce heads and packed leafy greens also were different. The survey revealed differences between these two countries in consumption and consumer handling practices, which can have an impact on outcomes of future microbiological or chemical risk assessment studies.

Evaluation of the reproducibility of a protocol for the pharmacokinetic study of breast tumors by dynamic magnetic resonance imaging.

OBJECTIVE: To evaluate the reproducibility of a protocol for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the pharmacokinetic study of breast tumors. MATERIAL AND METHODS: We carried out this prospective study from October 2009 through December 2009. We studied 12 patients with stage ii-iii invasive breast cancer without prior treatment. Our center's research ethics committee approved the study. The 12 patients underwent on two consecutive days DCE-MRI with a high temporal resolution protocol (21 acquisitions/minute). The data obtained in an ROI traced around the largest diameter of the tumor (ROI 1) and in another ROI traced around the area of the lesion's highest K(trans) intensity (ROI 2) were analyzed separately. We used parametric and nonparametric statistical tests to study the reproducibility and concordance of the principal pharmacokinetic variables (K(trans), Kep, Ve and AUC90). RESULTS: The correlations were very high (r>.80; P<.01) for all the variables for ROI 1 and high (r=.70-.80; P<.01) for all the variables for ROI 2, with the exception of Ve both in ROI 1 (r=.44; P=.07) and in ROI 2 (r=.13; P=.235). There were no statistically significant differences between the two studies in the values obtained for K(trans), Kep and AUC90 (P>.05 for each), but there was a statistically significant difference between the two studies in the values obtained for Ve in ROI 2 (P=.008). CONCLUSIONS: The high temporal resolution protocol for DCE-MRI used at out center is very reproducible for the principal pharmacokinetic constants of breast.

[Cell saver]. / Recuperador cellular.

The blood retrievers are instruments increasingly used in operating rooms. They are especially useful in operations where there is a high risk of bleeding and transfusion requirements are high. In paediatrics is of great importance in complex interventions in order to avoid allogeneic transfusion (blood collected from donors). The implementation of the recovery of blood in the surgical field is very simple and easy to use. This is a suction tube that collects the blood that is free, transferring it to a centrifuge where it is filtered and washed, stored in a blood collection bag for subsequent infusion. The blood is of high quality and contains a high hematocrit blood from the bank.

[Assessment of the intervention in a therapeutic feeding center for children in Nicaragua]. / Evaluación de la intervención terapéutica realizada en un centro de recuperación nutricional infantil de Nicaragua.

INTRODUCTION: Child malnutrition carries a high morbimortality worldwide. Therapeutic feeding centers are essential in the treatment of malnourished children. OBJECTIVE: To evaluate the effectiveness of the therapeutic intervention in under-5 undernourished children in a Therapeutic Feeding Center. METHODS: A retrospective descriptive research was made through the revision of the clinical histories of children under 5 years that entered the Nutritional Recovery Center for Children in Matagalpa, Nicaragua, from January 2006 to July 2010. RESULTS: Median age at admission was 17.2 months (p25:10.7-p75:27.2) and median stay in the center was 92 days (p25:61.5-p75:134.5). Prevalence of patients with severe acute malnutrition was 45%, moderate acute malnutrition 24% and risk for malnutrition 31%. At discharge 86% of patients were properly nourished. Median weight gain percentage after the first month in the center was 15% (p25:12.6-p75:17.4). Median weight gain was 3.7 g/kg/day (p25:2.6-p75:5.4), being higher in children under 6 months (4.6 g/kg/day; p25:4.3-p75:7.5). Cured rate in the center was 87.5%, being the death rate 0% and the abandonment rate 9%. DISCUSSION: The center evaluated works adequately, and fulfills the internationally recommended quality indicators. However, recommended average stay of 1-2 months and average weight gain of 8 g/kg/day are far of being fulfilled. Therefore, the Nutritional Recovery Center performs an effective intervention, but it's not efficient enough.

Brain magnetic resonance imaging findings in relapsing neuromyelitis optica.

BACKGROUND: Some studies showed abnormalities in brain magnetic resonance imaging (MRI) of relapsing neuromyelitis optica (R-NMO) from 12 to 46%. These abnormalities are described as compatible/non-compatible with multiple sclerosis (MS). OBJECTIVE: To describe the abnormal brain MRI lesions in R-NMO with imaging studies conducted with more sensitive white matter change techniques. METHODS: Thirty patients with R-NMO were selected. All MRI brain studies were performed with a 1.5-T Siemens MRI system according to the Standardized MR Imaging Protocol for Multiple Sclerosis from the Consortium of MS Centers Consensus Guidelines. RESULTS: Brain MRI images were evaluated in 29 R-NMO cases because in one case the MRI images were not appropriate for the study. Of these 29 brain MRI studies, 19 cases (65.5%) had at least one or more lesions (1-57) and 10 were negative (34.4%). Brain MRI findings in 19 cases were characterized in T2/fluid-attenuated inversion-recovery (FLAIR) by the presence of subcortical/deep white matter lesions in 16 (84.2%) cases (1-50), most of them <3 mm and without juxtacortical localization. Periventricular lesions were observed in 13 (68.4%) cases, but morphologically they were not oval, ovoid or perpendicularly orientated. Infratentorial lesions, all >3 mm, were observed in 4 (21.05%) cases without cerebellar involvement. T1 studies demonstrated absence of hypointense regions. Optic nerve enhancement was observed in 6/19 patients (31.5%). None of the brain MRI abnormalities observed were compatible with Barkhof et al. criteria of MS. CONCLUSIONS: This study, based on a Cuban patient population, with long duration of disease, good sample size and detailed characterization by MRI, demonstrated the brain MRI pattern of R-NMO patients, which is different from MS.

[Perinatal outcomes in immigrant women]. / Resultados perinatales de las gestantes inmigrantes.

OBJECTIVES: To describe the characteristics of immigrant women's newborns in our environment, and to compare them with those of native women's newborns. PATIENTS AND METHODS: All newborns attended in the Neonatology Section of Hospital del Mar in Barcelona, Spain, in 2003 and 2004 were included (n 5 2,735). Data were prospectively collected in a database. Pregnant immigrant women were classified in 6 regions (Eastern Europe, the rest of Europe, Africa, Asia, Latin America and other countries). Twelve diagnoses were defined and compared between native newborns and those of immigrant parents, and their relative risks were calculated. RESULTS: There were 1,296 native newborns (47.8 %) and 1,416 of immigrant origin (52.2 %). Immigrant women showed a higher rate of HBsAg carrier status (2.0 % versus 1.0 %) and a lower rate of hepatitis C virus infection (0.8 % vs 2.0 %; p < 0.01). There was only one HIV-positive pregnant immigrant woman compared with 14 Spanish women (p < 0.01), and drug use was lower in the immigrant group (0.4 % vs 4.0 %; p < 0.01). Immigrant newborns had a lower rate of prematurity (6.0 % vs 7.6 %) and of low birthweight (2.3 % vs 4.6 %; p < 0.01). There were no significant differences in the rate of respiratory distress or fetal acidosis. The incidence of neonatal infection risk was higher in immigrant newborns (49.9 % vs 40.6 %; p < 0.01). CONCLUSIONS: In our environment, immigrant mothers' newborns have better perinatal outcomes than native newborns. The most frequent complications are secondary to an inadequate.

Mitochondrial calcium sequestration and protein kinase C cooperate in the regulation of cortical F-actin disassembly and secretion in bovine chromaffin cells.

Mitochondria play an important role in the homeostasis of intracellular Ca(2+) and regulate its availability for exocytosis. Inhibitors of mitochondria Ca(2+) uptake such as protonophore CCCP potentiate the secretory response to a depolarizing pulse of K(+). Exposure of cells to agents that directly (cytochalasin D, latrunculin B) or indirectly (PMA) disrupt cortical F-actin networks also potentiate the secretory response to high K(+). The effects of cytochalasin D and CCCP on secretion were additive whereas those of PMA and CCCP were not; this suggests different mechanisms for cytochalasin D and CCCP and a similar mechanism for PMA and CCCP. Mitochondria were the site of action of CCCP, because the potentiation of secretion by CCCP was observed even after depletion of Ca(2+) from the endoplasmic reticulum. CCCP induced a small increase in the cytosolic Ca(2+) concentration ([Ca(2+)](c)) that was not modified by the protein kinase C (PKC) inhibitor chelerythrine. Both CCCP and PMA induced cortical F-actin disassembly, an effect abolished by chelerythrine. In addition, rotenone and oligomycin A, two other mitochondrial inhibitors, also evoked cortical F-actin disassembly and potentiated secretion; again, these effects were blocked by chelerythrine. CCCP also enhanced the phosphorylation of PKC and myristoylated alanine-rich C kinase substance (MARCKS), and these were also inhibited by chelerythrine. The results suggest that the rapid sequestration of Ca(2+) by mitochondria would protect the cell from an enhanced PKC activation and cortical F-actin disassembly, thereby limiting the magnitude of the secretory response.

Humoral immunity in pediatric patients with acute lymphoblastic leukaemia.

BACKGROUND: Cancer and its treatment are a major cause of secondary immunodeficiency in childhood. Leukaemias are the most frequent pediatric neoplastic diseases and 80 % are lymphoblastic (ALL). The objectives of this study are to describe the epidemiology of children with ALL in our hospital and to analyse the evolution of immunoglobulins' concentration at leukaemia's onset, during its treatment and after finishing it. METHODS AND RESULTS: Retrospective study of patients with ALL treated with the SHOP-LAL-94 protocol. 50 patients were studied. Patients were classified in three groups: ALL- cell line B, ALL-cell line B with relapse, and ALL-cell line T. We analysed clinical data and laboratory results (IgG, IgA and IgM concentration) at leukaemia's onset, during its treatment and until 12 months after it.1. ALL-B: 44 patients. At the onset all patients, but a newborn with congenital leukaemia, had normal immunoglobulins. During treatment there was a significant decrease in immunoglobulins'concentration, being IgM the most affected (65 % of patients), followed by IgG (53 % of patients). The mean normalization time of immunoglobulins was 12 months.2. ALL-B with relapse: 7 patients. At relapse 2 patients had an IgM deficit and 1 overall immunoglobulin deficiency. During treatment there was a decrease in all immunoglobulins, which was significant for IgG. IgG and IgM decreased in all patients during relapse's treatment. There were 5 deaths, all with IgM < 186 mg/L.3. ALL-T: 6 patients, one died 3 days after diagnosis. At the onset all patients had normal immunoglobulins. Two patients had a favourable evolution, having a decrease in immunoglobulins'concentration during treatment, significant for IgM, with normalization 6 months after treatment. The rest 3 patients relapsed and died, having a global immunoglobulins'deficit during treatment and previous to death. CONCLUSIONS: At ALL's onset immunoglobulins' concentration is normal. During treatment the majority of patients have immunoglobulins' deficiency, being IgG and IgM the most affected immunoglobulins. A persistent IgM deficit is associated in our series with a higher risk of relapse and death. In patients with a good outcome immunoglobulins normalize before one year after treatment.

[Clinical predictors of sleep apnea-hypopnea syndrome susceptible to treatment with continuous positive airway pressure]. / Valor predictivo de la clínica para la identificación de los pacientes don síndrome de apneas-hipopneas durante el sueño susceptibles de tratamiento con presión positiva continua de la vía aérea (CPAP).

OBJECTIVE: To analyze the predictive value of clinical data for identifying patients suspected of sleep apnea-hypopnea syndrome with an apnea-hypopnea index (AHI)> or = 30. MATERIAL AND METHODS: Patient characteristics, cardiorespiratory medical history, and clinical signs and symptoms were recorded for all patients. Exclusion criteria were daytime respiratory insufficiency or heart failure. All patients underwent polysomnographic testing (AutoSet Portable Plus II, ResMed Corp, Sydney, Australia) for automatic AHI calculation and manual determination of central and obstructive apneas. A logistic regression model was constructed to calculate the likelihood of an individual's presenting an AHI> or = 30 as well as the predictive value of each variable and of the final model. RESULTS: Three hundred twenty-nine patients with a mean +/- SD age of 58 +/- 13.45 years were studied; 76.4% were men. Data for 207 patients were used to construct the logistic regression model: logit (P) = 2.5 blood pressure + 1.5 Epworth test + body mass index + 0.6 repeated observed episodes of apnea 2.1. Logit(P) was loge (1-P)/P and variables were dichotomized with cut points of 11 for the Epworth test and of 30 kg/m2 for body mass index. The diagnostic sensitivity of the model was 80.2% (75%-86%), specificity was 93.4% (89%-95%), positive predictive value was 89.6% (84%-93%) and negative predictive value was 86.9% (81%-90%), such that 89.6% of the patients were correctly classified. The variable with the greatest predictive value was high blood pressure. The model was validated prospectively in the remaining 102 patients. CONCLUSIONS: Prior to diagnostic tests for SAHS, clinical data can be useful for identifying patients suspected to have a AHI> or = 30.

Online chat rooms: virtual spaces of interaction for socially oriented people.

The internet has opened a new social space for communication. The present work studies interpersonal relationships in cyberspace using the chat channel as an interaction medium. Data obtained have outlined the sociodemographic and personality profile of internet users who engage in online chats as well as group self-perception, chatters' use habits, motivations to interact online, and the chatters' network of virtual and face-to-face relationships. Results suggests that relationships developed online are healthy and a complement to face-to-face relationships. These data are confirmed by personality studies. The theoretical and methodological implications of data are discussed.