Performance, Effectiveness, and Efficiency of Honeybees as Pollinators of Coffea arabica (Gentianales, Rubiaceae).

Studies in crop plants analyzing floral biology in conjunction with effectiveness and efficiency of pollinators on pollen transfer and fruit formation are not common, although they are essential to provide better management actions. On this base, we selected a farm in Bahia, Brazil, to study pollination on coffee plants (Coffea arabica L.). Specifically, we want to analyze if nectar traits influence visitor's performance throughout flower lifetime and if honeybees (Apis mellifera scutellata Lepeletier, 1836) are effective and efficient for coffee pollination comparing fertilization and fructification among four experimental treatments: open (OP), wind (WP), cross (HCP), and single-visit bee pollination (SVBP). We found that honeybees collect both nectar and pollen from coffee flowers and transfer pollen on stigmas even after one visit. No differences were found among treatments regarding the number of pollen grains transferred on the stigmas (effectiveness). OP flowers showed a comparative lower efficiency (pollen tubes and fruit set) probably due to pollination failure as those flowers have a higher variability on the number of deposited pollen grains. Two of the treatments (HCP and SVBP) showed higher fertilization (measuring tubes until the end of the style). Pollen loads seem to be limited by a peak of pollen transference by pollinators, followed by the stabilization in the number of pollen grains deposited per stigma. Thus, reproduction of the coffee can be limited by the quality of pollen grains moved by pollinators instead of quantity. Management strategies should focus on monitoring bee density on plants for increasing pollen quality transfer on flowers trough maintaining the adequate proportions of seminatural habitats and/or the number of hives on agricultural fields according to the flowering of the crop.

[A urachus cyst revealing a torpid Crohn's disease in a young adult with chronic fever]. / Kyste de l'ouraque révélateur d'une maladie de Crohn torpide chez un adulte jeune atteint d'une fievre nue chronique.

INTRODUCTION: This case report describes a rare situation in which a superinfected cyst of the urachus complicated initially unknown and inactive Crohn's disease. CASE: A 21-year-old man presented a chronic fever finally attributed to a superinfected urachal cyst. Six months after ablation of the cyst, progressive Crohn's disease was diagnosed. DISCUSSION: The association of Crohn's disease and a superinfected urachal cyst is extremely rare. The case reported here is original in two aspects: the slowly progressive Crohn's disease was diagnosed after its complication; the superinfection developed through local bacterial translocation (ileal loop adjacent to the urachal cyst).

Clinical value of CEA and CA125 regarding relapse and metastasis in resectable non-small cell lung cancer.

BACKGROUND: The aim of the present study was to evaluate the value of serum Carcinoembryonic Antigen (CEA) and CA125 antigen assay for monitoring the activity of non-small cell lung cancer (NSCLC) after curative surgical resection. PATIENTS AND METHODS: Serum CEA and CA 125 were determined preoperatively and at every postoperative visit, in 113 patients with NSCLC (TNM stages I, II, IIIA). Both markers were assayed by magnetic particle enzyme immunoassay. RESULTS: Tumor recurrence was more frequent in patients with preoperative CA 125 levels above the cut-off (15 U/ml) (28 out of 47) (59.5%) than in those with low values (18 out of 66) (27.2%) (p < 0.001). The 36-month disease-free survival was lower for patients with elevated CA 125 (37%) than among those with low levels (72%) (p = 0.006). High CA 125 was an independent predictor of the risk of postoperative recurrence (Hazard Ratio: 3.02)(95% CI: 1.41-6.49). No relationship was detected between preoperative serum CEA and risk of recurrence. High preoperative CA125 indicated elevated risk for disseminated recurrence (Hazard Ratio: 7) (95% CI: 2.39-20.51), but not for locoregional failure. No significance was detected for CEA, either in locoregional or disseminated recurrence. Forty-six subjects (40.7%) developed tumor recurrence. At the diagnosis of relapse, serum CEA was elevated in 16 patients (34.7%) and CA125 in 26 (56.5%). Sensitivity was higher in the case of disseminated recurrence (63% for CA125 and 43.3% for CEA) and decreased in locoregional relapse (43.7% for CA125 and 18.7% for CEA). The specificity was 97% for CEA and 59% for CA125. CONCLUSION: Serum CA125 is a useful prognostic marker in NSCLC. The predictive information is especially useful to estimate the risk of disseminated recurrence. Serial determinations of CEA and CA125 during the postoperative follow-up do not show enough sensitivity/specificity to recommend their use for diagnosis of tumor relapse.

[Usefulness of the percentage of free prostatic specific antigen in the differential diagnosis between benign prostatic hyperplasia and prostate cancer]. / Utilidad de la fracción libre del antígeno prostático específico en el diagnóstico diferencial entre hiperplasia prostática benigna y cáncer de próstata.

BACKGROUND: PSA (prostatic specific antigen) is the most used tumor marker to monitor prostate cancer (PC). It is an acceptably sensitive test. Molecular forms of PSA give a chance to improve its specificity. We have evaluated the usefulness of the ratio free PSA/total PSA (f-PSA/t-PSA%) to diagnose prostate cancer, in the range between 4 and 20 ng/ml; i.e. the interval in which values overlap for patients with PC and benign prostatic hyperplasia (BPH) in our environment. PATIENTS AND METHODS: Prospective study on 269 patients, 73 with PC and 196 with BPH. Both t-PSA and f-PSA were determined using microparticles enzyme immune assay (MEIA) with AXSYM (Abbott) analyzer. RESULTS: Statistically significant differences were evidenced in f-PSA/t-PSA% for patients with PC vs. BPH; but that did not happen for t-PSA values. Sensitivity and specificity values were established for different cut-off points. ROC curve analysis proved diagnostic efficacy was better for f-PSA/t-PSA% than for t-PSA. CONCLUSIONS: f-PSA/t-PSA percentage is a useful tool for the differential diagnosis between PC and BPH. A ratio lower than 12% selects a population with high risk of cancer. A percentage over 18% is useful to avoid or delay the indication of biopsy.

Diagnostic efficacy and prognostic value of serum procalcitonin concentration in patients with suspected sepsis.

BACKGROUND: Procalcitonin is released in response to bacterial infection and it is not released in Inflammatory and viral diseases. OBJECTIVE: To show the diagnostic efficacy and prognostic value of procalcitonin for sepsis. METHODS: A consecutive series of 103 patients with suspected sepsis were admitted to the intensive care unit over a 2-year period. During the first 24 hours of the admission procalcitonin, C-reactive protein, and complement proteins were determined. The diagnostic efficacy was tested with predictive values, likelihood ratios, receiver operating characteristic curves, and multiple logistic regression. The association of procalcitonin with mortality was assessed by the Multivariate Cox proportional hazards model. RESULTS: Procalcitonin had a better positive likelihood ratio than C-reactive protein -2.2 (95% confidence interval: 1.3-3.7) versus 1.1 (95% confidence interval: 0.9-1.2). Sequential Organ Failure Assessment yielded the highest discriminative value, with an area under the curve of 0.82 (95% confidence interval: 0.73-0.92), followed by procalcitonin (0.81; 95% confidence interval: 0.72-0.89). Multivariate regression analysis showed procalcitonin (adjusted odds ratio: 3.8; 95% confidence interval: 1.2-11.8) and Sequential Organ Failure Assessment score (adjusted odds ratio: 5.3; 95% confidence interval: 1.4-19.9) as the only variables independently associated with infection. Multivariate Cox regression analysis revealed that procalcitonin was not independently associated with mortality. CONCLUSIONS: The diagnostic accuracy of procalcitonin was higher than C-reactive protein and complement proteins. Procalcitonin in combination with Sequential Organ Failure Assessment was useful to diagnose infection. C-reactive protein, Sequential Organ Failure Assessment score, age, and gender showed to be helpful to improve the prediction of mortality risk, but not procalcitonin.

[Comparative study of clinical effectiveness of antibiotic prophylaxis in aseptic mouth-jaw- and facial surgery]. / Vergleichende Studie zur klinischen Effizienz der Antibiotikaprophylaxe in der aseptischen Mund-, Kiefer- und Gesichtschirurgie.

METHODS: This study evaluates the clinical efficiency of four regimens of antibiotic prophylaxis against wound infection in aseptic oral and maxillofacial surgery that does not involve implantation of foreign material and included 140 adult patients randomly distributed into four groups. Patients from two groups received prophylactic amoxicillin/clavulanate in a single-dose regimen or a 5-day regimen, respectively. Subjects from the other two groups received cefazolin in a single-dose regimen or a 5-day regimen, respectively. RESULTS: Clinical prophylactic efficiency proved to be equal for the four types of antibiotic regimens. DISCUSSION: Single-dose regimens are more economical, easier to administer, and carry a lower risk of inducing bacterial resistance. Amoxicillin/clavulanate is more expensive than cefazolin. For aseptic maxillofacial surgery that does not involve implantation of foreign material, we recommend preoperative single-dose antibiotic prophylaxis with cefazolin 2 g i.v. (in adult patients).

Normal reference-intervals for 20 biochemical variables in healthy infants, children, and adolescents.

We determined normal reference values from data on sera of 2099 outpatient children (ages one week to 14 years) at our institution. Using a continuous-flow instrument (SMAC, Technicon), we determined the following analytes in each serum sample: glucose, creatinine, uric acid, inorganic phosphorus, sodium, potassium, chloride, total CO2, iron, cholesterol, triglycerides, total protein, albumin, total bilirubin, creatine kinase, lactate dehydrogenase, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, and calcium. The resulting data were coded and subsequently processed in an IBM 370 computer, and the reference values (3rd and 97th percentiles) were defined for each analyte. A two-way analysis of variance was also done to determine the influence of age and sex on results of these 20 biochemical tests.

Antidiuretic hormone and renal function after water loading in patients with cirrhosis of the liver.

Renal function and plasma antidiuretic hormone (ADH) levels were studied basally and after oral water load in four groups of subjects: 15 healthy controls (group I), 15 cirrhotics without ascites (group II), 15 cirrhotics with ascites (group III), and 10 decompensated cirrhotics with hyponatremia (group IV). Renal function and ADH levels were normal in group II. In groups III and IV water diuresis and fractional proximal sodium excretion were significantly decreased, whereas fractional distal sodium resorption and fractional excretion of potassium did not differ from those of controls. Basal ADH was significantly increased only in patients of group IV. In these patients ADH remained abnormally high after water loading. ADH did not correlate with water diuresis, plasma osmolality, mean arterial pressure, and plasma renin activity. We conclude that impaired water excretion in decompensated cirrhotics without hyponatremia cannot be ascribed to high serum levels of ADH. On the contrary, it seems to be related mainly to a reduced delivery of filtrate to the diluting segment of the nephron. In cirrhotic patients with hyponatremia high levels of ADH may play an additional role.

Necesidades y recursos de enfermos hemato-oncológicos ingresados en un Hospital General / Needs and resoucces of hemato-oncologic patients admitted to a General Hospital

Propósito: Describir el estado de bienestar de los enfermos hemato-oncológicos durante su hospitalización e identificar las posibles influencias que, sobre el mismo, pudieran estar ejerciendo la información de que dispone, el apoyo social y la satisfacción con el equipo sanitario. Material y métodos: Se evaluó a 158 pacientes hemato-oncológicos consecutivos ingresados en el Servicio de Hematología del Hospital Universitario La Paz, mediante un cuestionario elaborado ad hoc. Resultados: Existen diferencias estadísticamente significativas en el estado de ánimo y el grado de intranquilidad entre los distintos grupos diagnósticos. El grado de comprensión de la información recibida, la satisfacción con el equipo sanitario y el apoyo social se muestran predictores de la percepción subjetiva de bienestar. Conclusiones: Determinadas variables de interacción del contexto hospitalario pueden predecir el nivel de bienestar del enfermo hemato-oncológico. Una intervención preventiva en éste ámbito, que considere el manejo de las variables descritas, optimizará el estado de los pacientes (AU)