Design and application of model for training ultrasound-guided vascular cannulation in pediatric patients.

UNLABELLED: Central vascular cannulation is not a risk-free procedure, especially in pediatric patients. Newborn and infants are small and low-weighted, their vascular structures have high mobility because of tissue laxity and their vessels are superficial and with small diameter. These characteristics, together with the natural anatomical variability and poor collaboration of small children, make this technique more difficult to apply. Therefore, ultrasound imaging is increasingly being used to locate vessels and guide vascular access in this population. OBJECTIVE: (a) To present a model that simulates the vascular system for training ultrasound-guided vascular access in pediatrics patients; (b) to ultrasound-guided vascular cannulation in the model. RESULTS: The model consisted of two components: (a) muscular component: avian muscle, (b) vascular component: elastic tube-like structure filled with fluid. 864 ecoguided punctures was realized in the model at different vessel depth and gauge measures were simulated, for two medical operators with different degree of experience. The average depth and diameter of vessel cannulated were 1.16 (0.42)cm and 0.43 (0.1)cm, respectively. The average number of attempts was of 1.22 (0.62). The percentage of visualization of the needle was 74%. The most frequent maneuver used for the correct location, was the modification of the angle of the needle and the relocation of the guidewire in 24% of the cases. The average time for the correct cannulations was 41 (35.8)s. The more frequent complications were the vascular perforation (11.9%) and the correct vascular puncture without possibility of introducing the guidewire (1.2%). The rate of success was 96%. CONCLUSIONS: The model simulates the anatomy (vascular and muscular structures) of a pediatric patient. It is cheap models, easily reproducible and a useful tool for training in ultrasound-guided puncture and cannulation.

Study of association of CTLA4 gene variants to non-anterior uveitis.

This study was undertaken to investigate the possible genetic association of functional CTLA4 polymorphisms with susceptibility to non-anterior uveitis. Four hundred and seventeen patients with endogenous non-anterior uveitis and 1517 healthy controls of Spanish Caucasian origin were genotyped for the CTLA4 polymorphisms rs733618, rs5742909 and rs231775, using predesigned TaqMan(©) allele discrimination assays. PLINK software was used for the statistical analyses. No significant associations between the CTLA4 polymorphisms and susceptibility to global non-anterior uveitis were found. It was also the case when the potential association of these genetic variants with the anatomical localization of the disease, such as intermediate, posterior or panuveitis, was assessed. Our results do not support a relevant role of these CTLA4 polymorphisms in the non-anterior uveitis genetic predisposition.

Injection of CO2-saturated water through a siliceous sandstone plug from the Hontomin test site (Spain): experiment and modeling.

Massive chemical reactions are not expected when injecting CO(2) in siliceous sandstone reservoirs, but their performance can be challenged by small-scale reactions and other processes affecting their transport properties. We have conducted a core flooding test with a quartzarenite plug of Lower Cretaceous age representative of the secondary reservoir of the Hontomín test site. The sample, confined at high pressure, was successively injected with DIW and CO(2)-saturated DIW for 49 days while monitoring geophysical, chemical, and hydrodynamic parameters. The plug experienced little change, without evidence of secondary carbonation. However, permeability increased by a factor of 4 (0.022-0.085 mD), and the V(P)/V(S) ratio, whose change is related with microcracking, rose from ~1.68 to ~1.8. Porosity also increased (7.33-8.1%) from the beginning to the end of the experiment. Fluid/rock reactions were modeled with PHREEQC-2, and they are dominated by the dissolution of Mg-calcite. Mass balances show that ~4% of the initial carbonate was consumed. The results suggest that mineral dissolution and microcracking may have acted in a synergistic way at the beginning of the acidic flooding. However, dissolution processes concentrated in pore throats can better explain the permeability enhancement observed over longer periods of time.

[Severe pediatric head injuries (II): factors associated to morbidity-mortality]. / Traumatismo craneoencefálico pediátrico grave (II): factores relacionados con la morbilidad y mortalidad.

OBJECTIVE: To describe the factors associated to morbidity-mortality in pediatric patients with severe head injury (SHI). MATERIAL AND METHOD: A review was made of the patients admitted to the Pediatric Intensive Care Unit (PICU) with SHI between July 1983 and December 2009. RESULTS: Of the 389 patients with head injuries, 174 (45%) presented SHI. The mean age of these subjects was 67 (9) months, with a Glasgow Coma Score (GCS) of 5.5 (1.8) and a PRISM score of 10.6 (6.7). Thirty-nine percent of the patients showed diffuse encephalic injury (DEI) in the computed tomography (CT) study. Seventy-nine percent of the patients subjected to intracranial pressure monitoring (ICP) presented intracranial hypertension. These patients had a greater incidence of serious sequelae (66.7 vs. 23.1%; p=0.01). Sequelae of clinical relevance were recorded in 59 patients (34%), and proved serious in 64% of the cases. The mortality rate among the patients with SHI was 24.7%, and mortality was significantly associated with a lower GCS score, hyperglycemia, intracranial hypertension and the presence of mydriasis or shock. The mortality rate associated to severe DEI was significantly higher than in the case of mild-moderate DEI (87.5 vs. 7.2%; p<0.001). The independent mortality risk factors in the pediatric patients with SHI were found to be the presence of mydriasis (OR: 31.27), intracranial hypertension (OR: 13.23) and hyperglycemia (OR: 3.10). CONCLUSIONS: a) SHI in pediatric patients was associated with high morbidity-mortality; b) intracranial hypertension was associated to the development of serious sequelae; c) independent mortality risk factors were the existence of mydriasis, intracranial hypertension and hyperglycemia.

[Severe pediatric head injuries (I). Epidemiology, clinical manifestations and course]. / Traumatismo craneoencefálico pediátrico grave (I). Epidemiología, clínica y evolución.

OBJECTIVE: To describe the epidemiology, clinical manifestations and evolutive characteristics of pediatric patients with severe head injury (SHI). MATERIAL AND METHOD: A review was made of the patients admitted to the pediatric intensive care unit (PICU) with SHI between July 1983 and December 2009. RESULTS: Of the 389 patients with head injuries admitted to the PICU during the study period, 174 (45%) presented SHI. The mean age in this group was of 67±9 months, with a Glasgow Coma Score (GCS) of 5.5±1.8 and a PRISM score of 10.7±6.7. The most frequent etiology of SHI was traffic accidents (56%), though these have decreased significantly in the last decade (58.5% vs 45.3%; P<.001). Twenty-one percent of the patients required evacuation of the lesions detected by computed tomography (CT), and 39% presented severe diffuse encephalic injury (DEI). Seventy-nine percent of the patients in whom intracranial pressure (ICP) was monitored presented intracranial hypertension. Sequelae of clinical relevance were recorded in 59 patients (39%), and proved serious in 64% of the cases. The mortality rate in this patient series was 24.7%. Intracranial hypertension decreased significantly in the last decade (88% vs 54%; P<.05), and clinical recovery has improved (23.3% vs 63.1%; P<.001). CONCLUSIONS: a) The incidence of traffic accidents has decreased in the last decade in the studied population; b) patients with SHI in which ICP was monitored showed a high incidence of intracranial hypertension; c) morbidity-mortality among pediatric patients with SHI has decreased over the course of the study period.

[Early biochemical failure after radical prostatectomy for prostate cancer. Impact factors?]. / Recidiva bioquímica precoz tras prostatectomía radical retropúbica por cáncer de próstata. Factores implicados. Influye el tiempo de espera entre biopsia y cirugía?

UNLABELLED: Does delay from biopsy to surgery have any influence? OBJECTIVES: To determine wether WT may impact on the EBF (before one year) alter RRP in our series, and to study other factors that may impact on this issue. MATERIAL AND METHODS: We study 310 RRP. Inclusion criteria are: one year follow up, no hormonal manipulation neither previous radiotherapy. Patients are divide in two groups attending WT. Group A < 90 days (n: 148), Group B > 90 days (n: 162). We study EBF (2 or more PSA determinations >= 0.2 ng/ml), and the impact of previous PSA, biopsy Gleason, Gleason of the specimen (G), pT stage (pT), and WT. T of Student or W of Wilcoxon are used to determine the homogeneity of the two groups. Chi Square of Pearson to compare the two group's EBF and pT attending to WT and EBF attending to pT. U of Mann Whitney is used to study EBF attending to G. Multivariate logistic regresion (LR) is used to study the impact of the variables on EBF. RESULTS: There are no differences between the two groups in age (p<0.129), PSA (p<0.479), biopsy's Gleason (p<0.913). There are no differences in EBF nor in pT attending to WT. Significant statystical differences are founded in EBF attending to pT and G. T3 tumors have more chance of recurrence than T2. EBF is more frecuent as G increases. In logistic regresion of the global serie, independent variables for progression are: Previous PSA and pT. Nor biopsy's Gleason nor specimen's Gleason, nor WT, impact on the EBF. CONCLUSIONS: Biopsy Gleason and WT do not impact on EBF. WT do not impact on pT. In our serie differences on EBF are lead by previous PSA and pT. Also Gleason of the especimen seems to impact on EBF, but in lower proportion, with no significance in multivariate analysis.

Vascular ultrasound in pediatrics: utility and application of location and measurement of jugular and femoral vessels.

OBJECTIVE: To measure the depth (D p) and diameter (D m) of the internal jugular vein (IJV), femoral vein (FV), and femoral artery (FA) in pediatric patients to evaluate the clinical implications. METHODS: This study included 125 pediatric patients. All of them underwent bilateral ultrasound study of vessels and were classified into three groups based on anthropometric and demographic parameters. RESULTS: Measured mean D p values were: 0.72 (0.34) cm for the FA, 0.79 (0.35) cm for the FV, and 0.77 (0.24) cm for the IJV. Mean antero-posterior D m values were: 0.37 (0.17) cm for the FA, 0.42 (0.22) cm for the FV, and 0.59 (0.23) cm for the IJV. D p and D m increased with age (A), weight (W), height (H), and body surface area (BSA). In the lower ranges of these variables, D p was similar for all three studied vessels (0.6-0.7 cm). In the higher ranges, femoral vessel D p values (1.1-1.2 cm) were larger than jugular ones (0.9 cm). Additionally, in these low ranges, IJV D m values were larger than femoral ones (0.45-0.50 vs. 0.25 cm). In the higher ranges, diameter values were similar (0.6-0.7 cm). CONCLUSIONS: In pediatric patients, major vessels can be located and their depth and diameter measured by vascular ultrasound. In younger patients, jugular and femoral vessels had similar depth values; in older ones, they had similar diameters. Ultrasound measurements in pediatric patients could facilitate the choice of the vessel to be cannulated, the catheter diameter, and the length of the needle to be used. Vascular canalization of IJV may be recommended as the first choice because of its low depth and large diameter.

[Bladder neoplasm after nephroureterectomy for upper urinary tract tumor. Does distal ureter surgery influx on the evolution?]. / Neoplasia vesical tras nefroureterectomía por tumores de urotelio superior. La cirugía del uréter distal influye en la evolución?

OBJECTIVE: To compare evolution in patients with urothelial upper tract tumor (UUTT) in whom we performed the classic open approach to the distal ureter with those in whom whe performed the endoscopic approach. We study the bladder recurrences in each group and the factors which may influx on the evolution. MATERIAL AND METHODS: Retrospective review of nephroureterectomies in our department in the last 20 years. Group A (n:24): double incision (lumbar and pelvic incision), Group B (n:29): endoscopical approach of the distal ureter and classic lumbar incision. A descriptive study is first performed in which we review: sex, and patients age, background transuretral resection of bladder tumor (TURBT), UUTT side, and UUTT location (calices, pelvis or urether). Pathological stage and tumor grade are also exposed. Secondly, a review of the bladder recurrences in each group is performed. In order to find differences between de groups we used the Fisher's Exact test. RESULTS: We observed that in terms of bladder recurrence there is a statistically significant difference between the two groups favoring Group B (p < 0.036), which means that there are less bladder recidives when perform endoscopic approach of distal ureter. Noneless due to the groups inhomogeneity in tumor stage, grade, and location, this differences seem to be associated to these sigues, more than to the approach to the ureter as an independant variable. In that concerning to the eventual relationship between bladder recidive and background of previous TURBT, we have not found any differences between the two groups but there are statystically significant difference in the global series. The small number of recurrences (13) does not allow us to establish a well based conclusion on this issue, but it seems that the background of previous TURBT is an important factor that may influx in posterior bladder recurrences. CONCLUSIONS: In our results, endoscopic approach of distal ureter in nephroureterectomy for UUTT does seems to positively influx in the posterior chance of bladder recurrences. But the studied sample is small and the two groups have not been aleatorized because of ethical reasons. May the low number of cases affect the test's statistical potency. It seems that previous TURBT may conditionate these recurrences, as we show in global serie. It should be necessary a prospective and statistically analised multicenter trial to understand if distal ureter approach influx on the evolution of these tumors.

[Prognostic factors in community acquired pneumonia. Prospective multicenter study in internal medical departments]. / Factores pronósticos de la neumonía comunitaria. Estudio prospectivo multicéntrico en Servicios de Medicina Interna.

AIMS: the aims of the present study were to evaluate the clinical and microbiological characteristics of patients suffering from community-acquired pneumonia attended in the Internal Medical Departments of several Spanish institutions and to analyze those prognostic factors predicting thirty-day mortality in such patients. MATERIAL AND METHODS: Past medical history, symptoms and signs, radiological pattern and blood parameters including albumin and C Reactive Protein, were recorded for each patient. Time from admission to starting antibiotics (in hours) and follow-up (in days) were also recorded. Patients were stratified by the Pneumonia Severity Index in five risk classes. RESULTS: 389 patients were included in the study, most of them in Fine categories III to V. Mortality rate for all patients was 12.1% (48 patients), increasing up to 40% in Fine Class V. Neither age, sex nor time from admission to the start of antibiotic treatment predicted survival rates. Plasmatic levels of PCR or microbiologic diagnosis were not related to clinical outcome. In the Cox regression analysis, oriented patients (OR 0.138, IC95% 0.055-0.324), and those with normal albuminemia (OR 0.207, IC95% 0.103-0.417) showed better survival rates. On the contrary, those with active carcinoma (OR 3.2, IC95% 1.181-8.947) significantly showed a reduced life expectancy. CONCLUSION: Besides the fully accepted Fine scale criteria, albumin measurements should be included in routine evaluation in order to improve patient s prognostic classification.

A novel approach in the treatment of acute whiplash syndrome: Ultrasound-guided needle percutaneous electrolysis. A randomized controlled trial.

INTRODUCTION: Whiplash associated disorders are currently a common musculoskeletal problem. Besides the high incidence in western countries, the costs derived from prolonged treatment and medicolegal compensation, make this entity a challenging problem for clinicians and insurance companies. To date, no conservative treatment has shown clear superiority in the management of acute cases. HYPOTHESIS: Percutaneous needle electrolysis (PNE) is an effective approach for the treatment of Quebec type II acute whiplash syndrome (AWS). PNE consists in the application of brief galvanic currents into a damaged structure, producing a local controlled inflammatory response, with subsequent tissular healing enhancement. MATERIALS AND METHODS: One hundred AWS patients were randomized into: (a) standard physiotherapy intervention for AWS; (b) a standardized PNE protocol for AWS. Both groups were assessed for treatment outcome at the 5th week mark. RESULTS: Both groups showed a statistically significant improvement according to the Northwick Park Neck Questionnaire, visual analogic scale and pressure pain threshold. The improvement was similar in both groups, except for the pain pressure threshold, with a 56.6% reduction vs. 44.4% reduction in favour of the PNE group (P=0.035). In addition, the physio group consumed a mean treatment time of 20hours, while the PNE intervention averaged less than 1 hour in total. DISCUSSION: PNE can be considered as an effective treatment option for AWS. Importantly, the technique is highly cost-effective, with limited equipment required and a notable treatment time reduction, compared to more comprehensive physiotherapy protocols. TYPE OF STUDY: Randomized controlled trial. LEVEL OF PROOF: 1b.

Vascular ultrasound in pediatrics: estimation of depth and diameter of jugular and femoral vessels.

OBJECTIVES: To estimate, on the basis of anthropometric and demographic variables, the depth (Dp) and diameter (Dm) of femoral and jugular vessels, which have been located and measured by ultrasound, in pediatric patients. METHOD: 750 measurements of Dp and Dm of the femoral vein (FV), femoral artery (FA) and internal jugular vein (IJV) were made in 125 pediatric patients. The values were correlated with patients' sex, weight, age, size and body surface area (BSA). RESULTS: Mean Dp values were 0.72 (0.34) cm for FA, 0.79 (0.35) cm for FV and 0.77 (0.24) cm for IJV. Mean antero-posterior Dm values were 0.37 (0.17) cm for FA, 0.42 (0.22) cm for FV and 0.59 (0.23) cm for IJV. In the studied pediatric patients, femoral and jugular vessels depth correlated with age, size, weight and BSA (R = 0.46-0.60); vascular depth could be estimated from patients' weight and size (FA-Dp: R = 0.71; FV-Dp: R = 0.72; IJV-Dp: R = 0.53). Correlation with diameter was better for FA and FV (R = 0.81-0.89) than for IJV (R = 0.42-0.51); vascular diameter could be estimated from patient's size (FA-Dm: R = 0.89; FV-Dm: R = 0.86; IJV-Dm: R = 0.52). CONCLUSIONS: FV, FA and IJV depth and diameter correlated with weight, size, age and body surface area in the studied pediatric patients. Correlation was better for femoral than for jugular vessels. Depth could be estimated from patients' weight and size, while diameter could be estimated from the size. Such estimations may facilitate the choice of vessels to be cannulated, length and diameter of cannulation needles and the diameter of catheters to be used in pediatric patients.

Does chlorhexidine improve outcomes in non-surgical management of peri-implant mucositis or peri-implantitis?: a systematic review and meta-analysis

BACKGROUND: With greater number of implants being placed in clinical practice, incidence of peri-implant diseases are on the rise. It is not known whether chlorhexidine (CHX) improves outcomes in the management of peri-implant diseases. The aim of this systematic review and meta-analysis was to evaluate the role of CHX in improving outcomes with non-surgical management of peri-implant mucositis and periimplantitis. MATERIAL AND METHODS: An electronic search of PubMed, Scopus, Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) databases up to 1st August 2019 was carried out to search for studies evaluating the efficacy of CHX for non-surgical management of peri-implant diseases. RESULTS: Seven studies were included. Four studies evaluated the role of CHX in peri-implant mucositis and three in peri-implantitis. Oral prophylaxis with mechanical cleansing of implant surface prior to CHX use was carried out in all seven studies. Meta-analysis indicated that use of CHX did not improve probing depths in peri-implant mucositis (SMD = 0.11; 95% CI: -0.16 to 0.38; p = 0.42, I2= 0%). Similarly, CHX did not significantly reduce probing depths in patients with peri-implantitis (MD= 1.57; 95% CI: -0.88 to 4.0; p = 0.21, I2 = 98%). Results on the efficacy of CHX in reducing BOP in peri-implantitis are conflicting. CONCLUSIONS: Results of our study indicate that adjunctive therapy with CHX may not improve outcomes with non-surgical management of periimplant mucositis. Conclusions with regards to its role in non-surgical management of periimplantitis cannot be drawn. There is a need for more homogenous RCTs with large sample size to define the role of CHX in non-surgical management of peri-implant mucositis and peri-implantitis

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Antibiotic-loaded polypropylene surgical meshes with suitable biological behaviour by plasma functionalization and polymerization.

Hernia repair is one of the most common operations in general surgery, and its associated complications typically relate to infections, among others. The loading of antibiotics to surgical meshes to deliver them locally in the abdominal hernia repair site can be one way to manage infections associated with surgical implants. However, the amount of drug loaded is restricted by the low wettability of polypropylene (PP). In this work, plasma has been used to tailor the surface properties of PP meshes to obtain high loading of ampicillin while conserving the desired biological properties of the unmodified samples and conferring them with antibacterial activity. It was demonstrated that the new surface chemistry and improved wettability led to 3-fold higher antibiotic loading. Subsequently, a PEG-like dry coating was deposited from tetraglyme with low-pressure plasma which allowed maintaining the high drug loading and kept cell properties such as chemotaxis, adhesion and morphology to the same levels as the untreated ones which have shown long-standing clinical success.

[Influence of phosphatidylcholine/cholesterol molar ratios in liposomes on cholesterol reactivity with cholesterol:oxygen oxidoreductase]. / Influence du rapport molaire phosphatidylcholines/cholestérol des liposomes sur la réactivité du cholestérol à la cholestérol : oxygène oxydorèductase.

The reactivity of sonicated phosphatidylcholine-cholesterol liposomes with cholesterol : oxygene oxydoreductase, an enzyme which catalyses the oxidation of the 3 beta hydroxyl group of cholesterol to a ketone group, is compared with that of ternary system phosphatidylcholine-cholesterol-Thesit. Regardless to the phosphatidylcholines nature and the phosphatidylcholine/cholesterol molar ratio (R), the enzymatic oxidation rate of liposomal cholesterol is slower than when the reaction is developed in the present of Thesit, a surfactif agent which destroyes the lamellar particles. This is true whether Thesit is added during preparation of dispersions or during incubation with cholesterol oxydase. The enzymatic oxydation rate of cholesterol of ternary systems phosphatidylcholine-cholesterol-Thesit is independent of the (R) value and the phosphatidylcholine fatty acid unsaturation, whereas that of phosphatidylcholine-cholesterol dispersions depends on these two parameters. The reaction rate increases in the order: dipalmitoylphosphatidylcholine to yolk egg phosphatidylcholines, and dioleylphosphatidylcholine. The optimal conditions for cholesterol oxidation were found to be R = 0.5. This result is not affected by the phosphatidylcholines nature. In order to explain these data, various hypotheses are considered. In particular, the weak liposomal cholesterol reactivity with cholesterol oxidase could result from an inhibitory effect on the enzyme-substrate combination due to the polar phosphorylcholine groups.

Total automated method for determination of cholesterol concentration in high density lipoprotein by heparin-magnesium-albumin precipitation.

We describe an automated procedure for determination of high-density-lipoprotein cholesterol in serum by use of heparin-MgCl2-albumin reagent. 'AutoAnalyzer' II equipment was used in which high-density lipoprotein was separated from precipitate containing very-low and low-density lipoproteins by filtering on-line across a cellulose acetate membrane. Cholesterol concentration was measured by the enzymic method of Allain. Good correlation was obtained using the automated method compared to the heparin-MgCl2-albumin (r=0.99) or sodium phosphotungstate-MgCl2 procedure (r=0.97). Contamination was minimal with a contamination coefficient lower than 2.5%. The method presented was linear (0 to 2.50 mmol/1) and could be applied to lipemic samples with a coefficient of variation better than 3%. This study showed thus that this new procedure was suitable for routine work with a good rate (60 samples/h) in almost any laboratory.

Experimental diabetes treated with ficus carica extract: effect on oxidative stress parameters.

Parameters related to oxidative stress were studied in rats divided into 4 groups: streptozotocin-induced diabetic rats (n=10), diabetic rats who received a single dose of a basic fraction of Ficus carica extract (n=14), diabetic rats who received a single dose of a chloroform fraction of the extract (n=10), and normal rats (n=10). Compared to normal animals, the diabetic animals presented significantly higher values for erythrocyte catalase normalized to haemoglobin levels (1.5+/-0.15 vs. 0.96+/-0.18 microg/mg) and for plasma vitamin E (73.4+/-43.9 vs. 12.0+/-1.6 mg/l), monounsaturated fatty acids (0.219+/-0.118 vs. 0.067+/-0.014 mg/ml), polyunsaturated fatty acids (PUFA, 0.567+/-0.293 vs. 0.175+/-0.040 mg/ml), saturated fatty acids (0.779+/-0.262 vs. 0.401+/-0.055 mg/ml), and linoleic acid (0.202+/-0.086 vs. 0.106 +/-0.014 mg/ml). Both Ficus carica fractions tended to normalize the values of the diabetic animals' fatty acids and plasma vitamin E values. On studying the ratios of vitamins E and A to PUFA (129.4+/-77.5 diabetic and 68.8+/-9.1 microg/mg normal; 37.5+/-20.8 vs. 108.0+/-43.6 microg/mg) and to C18:2 (259.9+/-65.8 vs. 161.0+/-21.3 microg/mg; 68.3+/-37.9 vs. 252.7+/-102.1 microg/mg), we found statistically significant differences as a function of diabetes, with the vitamin E/C18:2 ratio being normalized by the administration of the chloroform fraction (to 152.1+/-80.3 microg/mg) and the vitamin A/C18:2 ratio being raised relative to the untreated diabetic rats by the administration of the basic fraction (91.9+/-14.5 microg/mg). Our work confirms that antioxidant status is affected in the diabetes syndrome, and that Ficus carica extracts tend to normalize it.

Skin cross-reactivity between Dermatophagoides pteronyssinus and storage mites in atopic children.

In our environment, some children with allergic respiratory pathology do not have as favorable an evolution as expected after three years of immunotherapy with D. pteronyssinus extracts. We believe this is due to the existence of other mites whose antigenic determinants are not present in D. pteronyssinus. The purpose of the present study was to evaluate skin cross-reactivity between Dermatophagoides and storage mites in children with bronchial asthma. Fifty patients were chosen, with a mean age of 7.78 +/- 2.98 years and a range of 3-14 years. There were 38 boys (76%) and 12 girls (24%) with rhinitis and bronchial asthma. All patients had skin tests and prick tests with the following extracts performed on them: house dust (HD), Dermatophagoides farinae (DFA), Dermatophagoides pteronyssinus (DPT), Acarus siro (AS), Glycyphagus domesticus (GD), Lepidoglyphus destructor (LD), Tyrophagus putrescentiae (TP), with negative and positive controls. The areas of the papulae were evaluated in crosses, according to the size of the histamine and using computerized papulometry, using the Kurta series one graphic tablet with one resolution of 200 points per inch. The data were processed with the "Image-pro" analysis image program. The following conclusions were obtained from our study: 1) No case of skin sensitization to storage mites was found in any of our 50 patients, without house dust and/or Dermatophagoides mites also being present. 2) The greatest skin response with regard to histamine was found for DFA (52%), DPT (44%), HD (22%), GD (10%), AS (4%) and GF (2%).(ABSTRACT TRUNCATED AT 250 WORDS)

Oxidative stress in normal and diabetic rats.

Parameters related to oxidative stress were studied in a group of 10 Wistar diabetic rats and 10 control rats. The levels of total erythrocyte catalase activity in the diabetic animals were significantly (p<0.001) greater than the control levels. The diabetic animals presented an amount of vitamin E far greater (p<0.0001) than the controls, as was also the case for the vitaminE/polyunsaturated fatty acid (PUFA) and vitaminE/linoleic acid (C18:2) ratios. Greater vitaminE/triglyceride (TG) ratio, however, appeared in the control group. The corresponding vitamin A ratios (vitaminA/TG, vitaminA/PUFA, vitaminA/C 18:2) were higher in the control group. Our work corroborates the findings that fatty acid metabolism presents alterations in the diabetes syndrome and that the antioxidant status is affected.

Individual housing influences certain biochemical parameters in the rat.

Individual housing has been reported to modify animal behaviour. The present study compares the plasma levels of glucose, triglycerides and total cholesterol, weight, and food and water intake in two groups of female rats. Group A: 10 rats who remained grouped in two cages for 21 days; and Group B: 10 rats housed in two cages for 7 days, then isolated in individual cages from day 8 to day 15, and finally grouped together again for the last 7 days of the study. The results showed that the plasma values of glucose declined (P < 0.05) in the Group B rats when they had been returned to group condition (4.79 +/- 0.72 mM) than when they had been isolated (5.45 +/- 0.94 mM). Plasma triglyceride levels were lower (P < 0.05) in isolated rats (0.70 +/- 0.26 mM) than in any determination of the grouped rats. Group B: 1st week 1.21 +/- 0.21 mM, 3rd week 0.88 +/- 0.20 mM; and Group A: 1.22 +/- 0.20, 0.96 +/- 0.16, and 0.96 +/- 0.36 mM, in the first, second, and third week, respectively. There were no statistically significant differences in total cholesterol values as a function of the individual housing of animals. While there was no weight difference between the two groups of rats that could be ascribed to individual housing, there was a statistically significant increase (P < 0.05) in the food intake of isolated rats (17.5 +/- 3.2 g) with respect to values in the same Group B animals when they were housed together (1st week, 16.6 +/- 2.8 g; 3rd week, 16.8 +/- 3.1 g). These results therefore confirm that individual housing of female rats provoke variations in certain biochemical parameters, and that if this is not taken into account in performing different scientific studies, it could give rise to unreliable or even dubious results.

[Morbidity and mortality of osteoporotic proximal femoral fracture after one year follow-up]. / Morbilidad y mortalidad de la fractura osteoporótica de la extremidad proximal del fémur tras un año de seguimiento.

BACKGROUND: The aim of the present study was to follow for a year all the osteoporotic proximal femoral fractures that happened in the island of Gran Canaria during 1990 and to analyze: a) mortality; b) the degree of functional capacity; c) their destination after being attended from the fracture. METHODS: Personal interviews were performed in almost every patient (68%), either directly to them or the relatives who were at their care (23.5%), after excluding those patients who died during the acute phase (7.6%) a year after the fracture. Two patients were missed (0.9%). We had the collaboration of every public and private center in the island. 209 patients (154 women and 55 men) were interviewed. Age mean of the patients was 77.1 +/- 10.9 years. The degree of functional capacity was determined by Karnofsky scale. RESULTS: Mortality within the acute phase was 7.6%, rising to 20.8% 6 months later and to 30.7% after a year. There was an important disability in 30.7% of the remainder living patients. In the postsurgical period, 18% of the patients were transferred to a center for chronic care and 25% to a rehabilitation center. Although 48.9% of the patients are discharged to their homes from the hospital, surprisingly, when they die, only 15% do so in their homes, while 59% of the patients die in a center for chronic care. CONCLUSIONS: Osteoporotic proximal femoral fracture produces an important mortality within the first year after fracture, and also an important deterioration of functional capacity. Most of the patients are admitted later on and die in a center for chronic care.