Occupational injuries in workers of a Spanish bank.

BACKGROUND: In 2017, 69 108 work-related traffic injuries with medical leave were documented, constituting 12% of all occupational injuries (OI) in Spain. AIMS: The aim of this study was to describe OI within a Spanish bank company during 2017. METHODS: A cross-sectional analysis was conducted using the company's mandatory OI records, presenting data in both absolute (n) and relative (%) frequencies. The chi-square test was employed for comparisons. RESULTS: Among the company's 10 399 employees, 176 OI cases were recorded. Most were minor musculoskeletal incidents, with one severe myocardial infarction and one mild anxiety episode. Lower limb injuries were the most prevalent. Injuries of the trunk (P < 0.001), neck (P < 0.05), and upper limbs (P < 0.001) were linked to workplace factors. Approximately 62% of OI occurred outside the workplace and resulted in more extended medical leave (P < 0.01). Traffic-related injuries accounted for 39% of OI cases and caused 49% of days lost due to OI (P < 0.001).Female gender (P < 0.001) and age over 40 years (P < 0.05) were significantly associated with OI. CONCLUSIONS: In our study, musculoskeletal injuries were the most common, with a single cardiovascular event being the most severe. OI occurring outside the workplace was more frequent and led to longer medical leaves. Notably, traffic-related injuries were especially significant, exceeding official statistics 4-fold.

Efficacy and safety of administering oral misoprostol by titration compared to vaginal misoprostol and dinoprostone for cervical ripening and induction of labour: study protocol for a randomised clinical trial.

BACKGROUND: Among the various methods available, the administration of prostaglandins is the most effective for inducing labour in women with an unfavourable cervix. Recent studies have compared treatment with various titrated doses of oral misoprostol with vaginal misoprostol or dinoprostone, indicating that the use of an escalating dose of an oral misoprostol solution is associated with a lower rate of caesarean sections and a better safety profile. The objective of this study is to assess which of these three therapeutic options (oral or vaginal misoprostol or vaginal dinoprostone) achieves the highest rate of vaginal delivery within the first 24 h of drug administration. METHODS: An open-label randomised controlled trial will be conducted in Araba University Hospital (Spain). Women at ≥41 weeks of pregnancy requiring elective induction of labour who meet the selection criteria will be randomly allocated to one of three groups: 1) vaginal dinoprostone (delivered via a controlled-release vaginal insert containing 10 mg of dinoprostone, for up to 24 h); 2) vaginal misoprostol (25 µg of vaginal misoprostol every 4 h up to a maximum of 24 h); and 3) oral misoprostol (titrated doses of 20 to 60 µg of misoprostol following a 3 h on + 1 h off regimen up to a maximum of 24 h). Both intention-to-treat analysis and per-protocol analysis will be performed. DISCUSSION: The proposed study seeks to gather evidence on which of these three therapeutic options achieves the highest rate of vaginal delivery with the best safety profile, to enable obstetricians to use the most effective and safe option for their patients. TRIAL REGISTRATION: NCT02902653 Available at: https://clinicaltrials.gov/show/NCT02902653 (7th September 2016).

UAV-borne LiDAR revolutionizing groundwater level mapping.

In hydrogeological research, the systematic and periodic measurement of the piezometric level is fundamental to assess aquifer storage, identify recharge and discharge areas, define flow directions and to infer the balance between inputs and withdrawals. Furthermore, knowledge of this variable and its fluctuations is essential for the efficient management and protection of groundwater resources. In this work, a novel methodology is proposed for the remote acquisition of piezometric information from traditional large-diameter wells, using drone-borne LiDAR observations. The workflow developed consists of different stages, from flight planning and parameter setting, to point cloud generation, data processing and validation and its statistical treatment to extract piezometric information. This methodology has been applied in a small coastal aquifer with numerous wells that have served as monitoring points. The UAV-LiDAR has enabled the straightforward obtention of measurements of the piezometric level with very high vertical accuracies (RMSE of 5 cm) with minimum and maximum residuals of -8.7 and 7.9 cm respectively. Likewise, the method has shown vertical accuracies 3 times better than those inferred from the official DTM of best resolution available in Spain, which is usually used in hydrogeological works. Since the technique provides absolute values of the piezometric level, it eliminates the need for laborious levelling work prior to hydrogeological campaigns. This method has proved to be an effective alternative/complementary technique to traditional measurements of the piezometric level, allowing to monitor extensive or inaccessible areas over short periods of time and to potentially reduce gaps in hydrogeological databases.

Tissue distribution of sprifermin (recombinant human fibroblast growth factor 18) in the rat following intravenous and intra-articular injection.

Objective: Fibroblast growth factor 18 (FGF18) is involved in chondrogenesis and articular cartilage repair. We investigated tissue distribution and pharmacokinetics of radioactive [3H]sprifermin, a recombinant human FGF18, in rats after a single intravenous (i.v.) or intra-articular (i.a.) injection. Design: In two studies (48-96-h [n = 23] and 28-day [n = 12]), 35 male albino (Sprague Dawley) rats received single i.v. or i.a. dose [3H]sprifermin (0.24 mg/kg). Radioactivity was measured in blood, serum, and (in animals receiving i.a. administration) in the knee joint by liquid scintillation counting. Radioactivity in organs, tissues, and distribution in the whole body were measured with whole-body autoradiography. Results: After i.v. injection, radioactivity peaked in serum and whole blood after 4 and 24 h, respectively, with greater total radioactivity in serum. After i.a. injection, radioactivity peaked in serum and whole blood after 24 and 48 h, respectively; intact [3H]sprifermin was not detected in vena caval serum and systemic exposure was low, approximately 20% of that with i.v. injection. Following i.v. injection, radioactivity was mainly found in the liver, adrenal glands, kidney, and spleen; following i.a. injection, radioactivity was preferentially concentrated in articular cartilage after initial distribution in the joint capsule, and still evident in the joint after 28 days. Conclusions: After i.a. injection of [3H]sprifermin in rats, radioactivity was concentrated in the knee joint, particularly articular cartilage, with low levels in other investigated tissues. Systemic exposure to sprifermin was greater with i.v. than i.a. injection. Subsequent clinical investigation in patients with osteoarthritis has reported consistent results.

[Migraine medical control and related variables. Results of the European Work and Migraine survey]. / Control médico en migraña y variables relacionadas. Resultados de la encuesta europea Trabajo y Migraña.

OBJECTIVE: This purpose of this work is to determine the care preferences and the required use of medical care by migraine patients in the different countries of Europe, and the observed differences depending on their social and demographic conditions. MATERIAL AND METHODS: Cross-sectional observational study by anonymous web survey of 3,342 patients from Spain, Italy, France, Portugal, Ireland, United Kingdom, Germany, and a mixed group of countries not included in the initial design. VARIABLES: age, gender, country, type of location, level of studies and rural or urban area. The demand for care is collected by neurologist, primary care doctors/family/general practitioners, by occupational health doctors, nurses, by other doctors/other specialists, non-medical control/self-control. RESULTS: The patients more seen by a neurologist were about 21-60years old and with a high cultural level. Primary care/family doctor care is higher in urban areas. Occupational medicine, nursing, and other specialties predominate in large cities. Self-control is greater in patients aged 21-40years and in women. Spain and Germany are the countries with the greatest demand for care in Neurology and Primary Care. CONCLUSIONS: The medical demand for migraine care in Europe shows irregular results according to countries, with it being a priority in neurology and with less participation of Primary Care physicians, work doctors, nurses, or other specialties. Differences are observed by age, gender, and cultural level both in the demand for care and in the choice of specialist. It is important to take into account the percentage of patients who have no medical control.

Fractionation of U and heavy metals into the colloidal fraction in acid mine drainage conditions in the Río Tinto area (SW Spain).

The Río Tinto mining area provides ideal conditions for studying the role of colloidal particles in concentrating. All the elements are present in higher concentrations respect to their content in common natural waters. 234U/238U activity ratio ranges between 2.286 ±â€¯0.149 and 2.531 ±â€¯0.151. Concentration of Fe and Al are in the order of 104-103 mg/L; Co, Zn and Cu values are three times lower than Fe and Al, but still much greater than in natural waters; U reaches values up to 40.73 µg/L. To evaluate the partitioning of these elements into the colloidal fraction, ultrafiltration (UF) experiments were made. A permeation model describing the relationship between concentration of the elements or isotopes in the permeate solution and the concentration factor (CF) was calculated. Experiments were carried out using CF from 1.5 to 25.0. The behaviour of investigated heavy metals and U can be predicted by a permeation model that provides similar permeation coefficient (Pc) for all of them (Pc = 0.95-0.97 for 50 kDa, Pc = 0.86-0.88 for 10 kDa, and Pc = 0.80-0.86 for 3 kDa). Retention for all the investigated elements occurs, resulting in up to 23% of the element associated to the 3 kDa colloidal fraction. The increase in U and heavy metals concentrations in the retentate fraction with the increasing CF is due to the retention of the colloidal fraction. The colloidal abundance of related metals increased with decreasing membrane MWCO even though the difference is small between 3 and 10 kDa fraction for some metals Characterization of colloidal material is needed to better understand the state of play in this context.

Control médico en migraña y variables relacionadas. Resultados de la encuesta europea Trabajo y Migraña / Migraine medical control and related variables. Results of the European Work and Migraine survey

OBJETIVO: Es objetivo de este trabajo conocer las preferencias asistenciales y el uso requerido de atención médica por pacientes con migraña en distintos países de Europa y las diferencias en función de las condiciones sociales y demográficas. MATERIAL Y MÉTODOS: Estudio observacional transversal mediante encuesta anónima vía web a 3.342 pacientes de España, Italia, Francia, Portugal, Irlanda, Reino Unido, Alemania y un grupo mixto de países no incluidos en el diseño inicial. VARIABLES: edad, género, país, tipo de localidad, nivel de estudios y ámbito rural o urbano. Se recoge demanda asistencial por neurólogo, médico de atención primaria/de familia/médico general, médico del trabajo, enfermería, otro médico/otra especialidad, o no control médico/autocontrol. RESULTADOS: Acuden más a Neurología los pacientes de 21-60 años y alto nivel cultural. La asistencia por atención primaria/familia es mayor en áreas urbanas. Medicina del trabajo, enfermería y otras especialidades predominan en grandes ciudades. Mayor autocontrol en pacientes de 21-40 años y en mujeres. España y Alemania son los países con mayor demanda asistencial en Neurología y Atención Primaria. CONCLUSIONES: La demanda médica asistencial por migraña en Europa muestra resultados irregulares por países, siendo principalmente en Neurología y con menor participación de médicos de atención primaria, médicos del trabajo, enfermería u otras especialidades. Se observan diferencias por edad, género y nivel cultural tanto en la demanda asistencial como en la elección de especialista. Un importante porcentaje de pacientes se automedican o no llevan ningún control médico

OBJECTIVE: This purpose of this work is to determine the care preferences and the required use of medical care by migraine patients in the different countries of Europe, and the observed differences depending on their social and demographic conditions. MATERIAL AND METHODS: Cross-sectional observational study by anonymous web survey of 3,342 patients from Spain, Italy, France, Portugal, Ireland, United Kingdom, Germany, and a mixed group of countries not included in the initial design. VARIABLES: age, gender, country, type of location, level of studies and rural or urban area. The demand for care is collected by neurologist, primary care doctors/family/general practitioners, by occupational health doctors, nurses, by other doctors/other specialists, non-medical control/self-control. RESULT: The patients more seen by a neurologist were about 21-60 years old and with a high cultural level. Primary care/family doctor care is higher in urban areas. Occupational medicine, nursing, and other specialties predominate in large cities. Self-control is greater in patients aged 21-40 years and in women. Spain and Germany are the countries with the greatest demand for care in Neurology and Primary Care. CONCLUSIONS: The medical demand for migraine care in Europe shows irregular results according to countries, with it being a priority in neurology and with less participation of Primary Care physicians, work doctors, nurses, or other specialties. Differences are observed by age, gender, and cultural level both in the demand for care and in the choice of specialist. It is important to take into account the percentage of patients who have no medical control

PEGylation of growth hormone-releasing hormone (GRF) analogues.

Synthetically produced GRF1-29 (Sermorelin) has an amino acid composition identical to the N-terminal 29 amino acids sequence of the natural hypothalamic GHRH1-44 (Figure 1). It maintains bioactivity in vitro and is almost equally effective in eliciting secretion of endogenous growth hormone in vivo. The main drawbacks associated with the pharmaceutical use of hGRF1-29 relate to its short half-life in plasma, about 10-20 min in humans, which is caused mostly by renal ultrafiltration and enzymatic degradation at the N terminus. PEGylation has been considered as one valid approach to obtain more stable forms of the peptide, with a longer in vivo half-life and ultimately with increased pharmacodynamic response along the somatotropic axis (endogenous GH, IGF-1 levels). Different PEGylated GRF conjugates were obtained and their bioactivity was tested in vitro and in vivo by monitoring endogenous growth hormone (GH) serum levels after intravenous (i.v.) injection in rats, and intravenous and subcutaneous (s.c.) injection in pigs. It was found that GRF-PEG conjugates are able to bind and activate the human GRF receptor, although with different potency. The effect of PEG molecular weight, number of PEG chains bound and position of PEGylation site on GRF activity were investigated. Mono-PEGylated isomers with a PEG5000 polymer chain linked to Lys 12 or Lys 21 residues, showed high biological activity in vitro, which is similar to that of hGRF1-29, and a higher pharmacodynamic response as compared to unmodified GRF molecule.

Early tumor effect on splenic Th lymphocytes in mice.

Tumors are characterized by their ability to avoid the host immune system. Ehrlich ascites tumor cells were used to investigate the early alterations of the host immune system after tumor inoculation. The results show that frequencies of splenic Th lymphocytes were drastically reduced during tumor growth, reaching a minimum only two days after tumor inoculation. The frequency of splenic CD4+ lymphocytes expressing IFN-gamma was significantly increased, although the total number was unchanged, suggesting that there was no net induction of Th1-type response. Splenic macrophages were increased, in both frequency and cell number, after four days of tumor growth. The same pattern was observed when mice were inoculated with cell free ascitic fluid. TGF-beta precursors were detected in tumor cells as well as in ascitic fluid. The data suggest that tumor actively interacts with host immune system by means of tumor cell secreted factors.

Upregulation of glyceraldehyde-3-phosphate dehydrogenase mRNA in the spleen of tumor-bearing mice.

The influence of tumor implantation on glyceraldehyde-3-phosphate dehydrogenase (GAPDH) mRNA levels and stability was determined in the spleen of tumor-bearing mice. While GAPDH mRNA levels were not altered in skeletal muscle, kidney and liver from tumor-bearing mice, tumor implantation led to a 5.6-fold increase in the levels of splenic GAPDH mRNA. An enhanced message stability was observed in splenocytes from tumor-bearing animals, suggesting the involvement of post-transcriptional mechanisms in the selective GAPDH mRNA accumulation after tumor implantation. The GAPDH activity/glycolytic flux ratio was 18.5 in the spleen of healthy mice. Therefore, the three-fold increase in the glycolytic flux observed after tumor implantation could hardly justify the necessity for the upregulation of GAPDH.

Complex glycosphingolipids of the pheochromocytoma cell line PC12: enhanced fucosylglycolipid synthesis following nerve growth factor treatment.

The effect of nerve growth factor treatment on the expression of neutral glycosphingolipids and gangliosides was examined in PC12 pheochromocytoma cells grown in spinner culture. These studies show that PC12 cells contain an unusual group of fucose containing neutral glycolipids and gangliosides. The fucose containing neutral glycolipids, which appear to be derivatives of globoside, are very minor components. However, nearly all of the gangliosides in PC12 cells contain fucose. Two minor neutral glycolipids were isolated from these cells, and were identified as fucosylgloboside and galactosylgloboside. Two major gangliosides were also isolated and identified as fucosyl GM2 and fucosyl GD2. Studies using [3H]fucose to examine the synthesis of fucosylglycolipids indicate that nerve growth factor enhances the incorporation of fucose into glycolipids and gangliosides by as much as 80%. These studies show that all of the gangliosides in PC12 cells appear to increase in concentration when the cells are treated with nerve growth factor in spinner culture. However, only the complex fucose containing neutral glycolipids increase in concentration during this same treatment, while the non-fucosylated precursors do not.

Ehrlich ascites tumour unbalances splenic cell populations and reduces responsiveness of T cells to Staphylococcus aureus enterotoxin B stimulation.

Tumours must avoid host immune response to survive and proliferate; to achieve this purpose, tumours interact with cells of the immune system by means of tumour secreted factors. The alterations of splenic cell populations in mice bearing the Ehrlich ascites tumour have been studied. A rapid and acute response was observed, characterized by a decrease in both CD4 and CD8 T cells, and a transient increase in the number of B cells, which peaked 2 days after tumour inoculation. An increase in macrophage population and in the homing antigen CD18 was also detected. In vitro incubations of splenic cells with the Staphylococcus aureus enterotoxin B (SEB) showed that tumour induces a state of reduced responsiveness to stimulation of T cells, mainly affecting CD8 T cells, and a diminished IFN-gamma expression.

Early differential expression of two glutaminase mRNAs in mouse spleen after tumor implantation.

The influence of progressive tumor growth on phosphate-activated glutaminase (PAG) expression in splenocytes from mice bearing Ehrlich ascites carcinoma cells was investigated. Implantation of Ehrlich ascites tumor cells in the peritoneal cavity of mice led to a 2.3-fold stimulation of spleen PAG activity 48 h later. Four days after tumor implantation the glutaminase activity had returned to nearly basal value and remained at this level throughout the tumor development. Northern blot analysis indicated that two species of glutaminase mRNA were expressed in the spleen, which showed a differential expression pattern during the first 2 days after tumor implantation. The abundance of the transcript of higher electrophoretic mobility (approximately 3 kb) constantly increased over the first 2 days of tumor growth. The mRNA of lower electrophoretic mobility (approximately 6 kb) peaked at 12 h after tumor implantation and returned to control values at 48 h. These results demonstrate that tumor has the capability of altering glutaminase expression in the host spleen.

Removal of nitrate from industrial wastewaters in a pilot plant by nitrate-tolerant klebsiella oxytoca CECT 4460 and arthrobacter globiformis CECT 4500

Two strains, a gram-negative bacterium Klebsiella oxytoca CECT 4460 and a gram-positive, mycelium-forming bacterium Arthrobacter globiformis CECT 4500, tolerant to up to 1 M nitrate, were isolated from the grounds of a munitions factory. Under strict aerobic conditions and with appropriate C-sources, growth of these bacteria took place when the nitrate concentration in the medium was below 150 mM. Optimal growth conditions regarding the culture medium composition for the biological removal of nitrate were established in batch cultures. Then, the system was scaled up to a 40-L pilot plant and operated under continuous conditions in a factory with direct waste streams from dinitroethylene glycol production after appropriate dilution with nontreated groundwaters. The level of nitrate in the effluent was below 0.5% of the initial N-load. Nitrite and ammonium were undetectable and the level of the C-source in the effluent was below 50 mg per L. On the basis of these results, we conclude that the system worked on site satisfactorily. Copyright 1998 John Wiley & Sons, Inc.

A monoclonal antibody, WCC4, recognizes a developmentally regulated ganglioside containing alpha-galactose and alpha-fucose present in the rat nervous system.

A monoclonal antibody, WCC4, raised against PC12 cells, recognizes a ganglioside which is present in low concentrations in the postnatal rat nervous system. The antigen is also present in the adrenal and kidney, as determined immunohistochemically, but is not detectable in liver or spleen. A neutral glycosphingolipid is also immunoreactive. In the present report, the chemical characterization of this ganglioside, isolated from PC12 cells, and the anatomical distribution of the antigens recognized by the WCC4 antibody are described. By enzymatic cleavage of terminal saccharide moieties, the ganglioside is identified as alpha-galactosyl, (alpha-fucosyl) GM1. The ganglioside increases in concentration postnatally to day 35 (P35) and is present in a slightly diminished concentration in the adult. Immunohistochemical studies revealed that this glycolipid is also present on neuronal cell soma throughout the cerebrum, cerebellum and spinal cord. It is expressed in highest concentration in the molecular layer of the dentate gyrus and is also present in the olfactory bulb, the molecular layer of the hippocampus, the piriform cortex, the olfactory tubercle and the entorhinal cortex. The dentate molecular layer receives most of its innervation from neurons in the entorhinal cortex, and gangliosides are known to have an effect on plasticity following entorhinal cortical lesions. Therefore, the WCC4 antibody should prove to be a useful tool for the study of the role of endogenous gangliosides in this region of the nervous system.

The image of self and of the environment in drug abusers: a comparative study using the TAT.

This study attempted to add to our understanding of the heroin abusers' identity problems, using images of the self and the environment. Murray's Thematic Apperception Test (TAT) was applied to a group of male drug users undergoing withdrawal treatment with methadone and also to a group of male, non-drug using controls. The needs of the subjects and the demands of the environment, plus interaction between the two, were compared between the two groups to obtain information about the self and lifestyle. Among the data which emerged, is an increased need for destructive aggression and an environment experienced as coercive and emarginating. Among the interactions we observed coerced imagination, difficulties in identification, personal relationships based on abandonment with persecutory projection of the female figure and a tendency toward immature defences such as avoidance, denial and acting out. This information is discussed in relation to possible means of treatment.

Set-up of large laboratory-scale chromatographic separations of poly(ethylene glycol) derivatives of the growth hormone-releasing factor 1-29 analogue.

In this paper we report the scale-up of the purification of poly(ethylene glycol) (PEG) derivatives of the growth hormone-releasing factor 1-29, from laboratory scale (100 mg of bulk starting material) to larger scale (3 g of bulk), through the use of a cation-exchange TSK-SP-5PW chromatographic column. A one-step purification process capable of purifying large amounts of mono-PEGylated GRF species from the crude reaction mixture was developed. A simple, straightforward stepwise gradient elution separation was developed at laboratory scale and then scaled up with a larger column packed with a chromatographic resin with the same chemistry which maintained the laboratory-scale separation profile. Active material recovery and material purity remained constant through the scale-up from the 13-microm stationary phase to the 25-microm larger column. Overall, the gram GRF equivalent/batch process scale showed to be quite reproducible, and could be considered as a good platform for scale up to production scale.

Magnetic resonance imaging of the gastrointestinal tract: investigation of baby milk as a low cost contrast medium.

After the incidental observation of the high signal intensity of the upper GI tract in a nourished baby, we tested eight baby milks; five different fresh commercial milks, one sweetened and condensed and two lyophilized milks in order to compare their ability to contrast MR images. The images were obtained with a 1.5 T magnet whereas the "in vitro" water proton relaxation time (T1 and T2) measurements were carried out at 0.5 T. After having selected the most effective lyophilized product, that was prepared according to the manufacturer's instructions, a group of 23 adult patients, 17 males and 6 females, with a mean age of 55.8 years (range 37 to 71 years) were examined. Thirteen patients had gastric cancer and ten patients had rectal or rectosigmoid junction tumors. The most effective imaging sequence was a spin-echo T1.w. After oral intake of milk a good contrast of the stomach, with sufficient distribution in the duodenum and the very proximal bowel, was achieved in all 13 patients with gastric cancer, as was a good depiction of the rectum and the recto-sigmoid junction after enema achieved in the 10 patients with rectal cancers. Disadvantages of lyophilized milk as a contrast agent are due to partial intestinal absorption, inhomogeneous distribution and irregular intestinal passage, whereas a clear advantage of lyophilized milk as a contrast agent is its good acceptance and palatable, inexpensive and non invasive properties. Because of these limitations lyophilized milk cannot be considered a real oral contrast medium but it can enhance MR imaging of the upper abdomen, and mainly of the lower GI tract in infants and adults.

[Evaluation of diabetes control by new numerical indices of daily blood glucose values]. / Valutazione del controllo del diabete con nuovi indici numerici del profilo glicemico giornaliero.

Attempts to assess the degree of diabetic control by numerical expressions of blood glucose behaviour have been performed by Schlichtkrull et Al. (M-Ms value) and by Molnar, Service et Al. (MAGE, MODD, MBG and FBG values). However these methods, partly derived from the results of continuous blood monitoring, fail to give qualitative information about the glycemic daily profile. In order to obtain a more complete estimation of the diurnal blood sugar curve, a simple set of three indices is introduced by our group: 1) the Mbs value (modified); 2) the mean difference (delta value) of the various Mbs/bs calculated with a HP 25 Hewlett-Packard, and 3) the mean of the differences, exceeding delta, which are between contiguous Mbs/bs (M delta value). This investigation was carried out in 103 diabetic observations, on the basis of eight blood-sugar daily determinations (Destrostix Reflectance Meter) on two successive twenty-four-hour periods, under standard conditions of diet, exercise and therapeutic regimen. As the results show, modified Mbs describes the mean level of the glycemic profile; delta indicates the amplitude of the glycemic variability field; M delta reports both maximal and minimal extremes of the curve. A correlation of these parameters is expressed by a formula, which might distinguish stable from unstabel ("brittle") diabetes and allow clinical comparison in different treatment conditions.

[Treatment with monocomponent semi-lente insulin in diabetes of difficult compensation]. / Trattamento con insulina semilenta monocomponente del diabete a compenso particoloarmente difficile.

According to personal experience, good clinical effects may be obtained by monocomponent insulin treatment, independently from strict immunological indications (i.e. high plasma-anti-insulin antibody titers). The present paper reports on a two daily injection treatment with monocomponent Semilente insulin (SeLe MC) in comparison with an earlier management with conventional retard insulins, in a group of 16 insulin dependent diabetics, selected among the most poorly controlled patients with unstable diabetes and/or high insulin requirement. In 6 subjects, after transfer to SeLe MC, it was observed a reduction in M bs, delta, and M delta indices of the glycemic regulation, indicating lower mean glycemic profiles with fewer irregularities. In 11 cases a marked improvement in the subjective symptomatology was noticed. Some minor hypoglycemic reactions induced to a reduction in the high insulin requirement in 8 cases. All but two patients had significant values of insulin IgG antibodies. The period of observation was too short to take in consideration an immunological modification, as an explanation of the present clinical results. However, these could be hypothetically referred to an amelioration in the releasing of endogenous insulin and/or in the hormone-receptor interaction as a consequence of treatment with monocomponent insulin preparations, in comparison to non purified conventional preparations. Treatment with SeLe MC seems to be suitable in particularly difficult control of the diabetes and in emergency situations.