Development of a quantitative risk assessment of bovine viral diarrhea virus and bovine herpesvirus-1 introduction in dairy cattle herds to improve biosecurity.

A quantitative risk assessment model was developed to estimate the annual probability of introducing bovine viral diarrhea virus (BVDV) and bovine herpesvirus 1 (BoHV-1) at the farm level through animal movements. Data from 2017 official animal movements, biosecurity questionnaires, scientific literature, and expert opinion from field veterinarians were taken into consideration for model input parameters. Purchasing or introducing cattle, rearing replacement heifers offsite, showing cattle at competitions, sharing transport vehicles with other herds, and transporting cattle in vehicles that have not been cleaned and disinfected were considered in the model. The annual probability of introducing BVDV or BoHV-1 through infected animals was very heterogeneous between farms. The median likelihoods of BVDV and BoHV-1introduction were 12 and 9%, respectively. Farms that purchased cattle from within their region (i.e., local movements) and shared transport with other farms had a higher probability for BVDV and BoHV-1 introduction. This model can be a useful tool to support decision-making on biosecurity measures that should be prioritized to reduce the probability of introduction of these 2 diseases in dairy herds.

Results of a multicenter survey showing interindividual variability among neurosurgeons when deciding on the radicality of surgical resection in glioblastoma highlight the need for more objective guidelines

Purpose. We assessed agreement among neurosurgeons on surgical approaches to individual glioblastoma patients and between their approach and those recommended by the topographical staging system described by Shinoda. Methods. Five neurosurgeons were provided with pre-surgical MRIs of 76 patients. They selected the surgical approach [biopsy, partial resection, or gross total resection (GTR)] that they would recommend for each patient. They were blinded to each other’s response and they were told that patients were younger than 50 years old and without symptoms. Three neuroradiologists classified each case according to the Shinoda staging system. Results. Biopsy was recommended in 35.5-82.9%, partial resection in 6.6-32.9%, and GTR in 3.9-31.6% of cases. Agreement among their responses was fair (global kappa = 0.28). Nineteen patients were classified as stage I, 14 as stage II, and 43 as stage III. Agreement between the neurosurgeons and the recommendations of the staging system was poor for stage I (kappa = 0.14) and stage II (kappa = 0.02) and fair for stage III patients (kappa = 0.29). An individual analysis revealed that in contrast to the Shinoda system, neurosurgeons took into account T2/FLAIR sequences and gave greater weight to the involvement of eloquent areas. Conclusions. The surgical approach to glioblastoma is highly variable. A staging system could be used to examine the impact of extent of resection, monitor post-operative complications, and stratify patients in clinical trials. Our findings suggest that the Shinoda staging system could be improved by including T2/FLAIR sequences and a more adequate weighting of eloquent areas (AU)

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Results of a multicenter survey showing interindividual variability among neurosurgeons when deciding on the radicality of surgical resection in glioblastoma highlight the need for more objective guidelines.

PURPOSE: We assessed agreement among neurosurgeons on surgical approaches to individual glioblastoma patients and between their approach and those recommended by the topographical staging system described by Shinoda. METHODS: Five neurosurgeons were provided with pre-surgical MRIs of 76 patients. They selected the surgical approach [biopsy, partial resection, or gross total resection (GTR)] that they would recommend for each patient. They were blinded to each other's response and they were told that patients were younger than 50 years old and without symptoms. Three neuroradiologists classified each case according to the Shinoda staging system. RESULTS: Biopsy was recommended in 35.5-82.9%, partial resection in 6.6-32.9%, and GTR in 3.9-31.6% of cases. Agreement among their responses was fair (global kappa = 0.28). Nineteen patients were classified as stage I, 14 as stage II, and 43 as stage III. Agreement between the neurosurgeons and the recommendations of the staging system was poor for stage I (kappa = 0.14) and stage II (kappa = 0.02) and fair for stage III patients (kappa = 0.29). An individual analysis revealed that in contrast to the Shinoda system, neurosurgeons took into account T2/FLAIR sequences and gave greater weight to the involvement of eloquent areas. CONCLUSIONS: The surgical approach to glioblastoma is highly variable. A staging system could be used to examine the impact of extent of resection, monitor post-operative complications, and stratify patients in clinical trials. Our findings suggest that the Shinoda staging system could be improved by including T2/FLAIR sequences and a more adequate weighting of eloquent areas.

Traumatic epidural retroclival hematoma with odontoid fracture and cardiorespiratory arrest.

STUDY DESIGN: Case report. OBJECTIVES: To describe a case or traumatic retroclival hematoma with features not previously reported. SETTING: Single center. METHODS: Description of a case, in the context of relevant literature on the subject. RESULTS: Traumatic retroclival hematomas are a rare, typically pediatric, entity. Only four cases of epidural hematoma in adult patients have been reported. We describe an additional case, the first with a fatal course in the acute setting. It is also the first retroclival hematoma associated to an odontoid base fracture. CONCLUSION: Retroclival hematomas are a rare diagnosis, to be considered in pediatric patients with flexion-extension, high-energy injuries. Morphology is typically epidural. Brain stem and cranial nerve symptoms are typical. Treatment is usually conservative. Outcome is regarded as favorable, with partial recovery and neurologic sequelae. Adult cases are extremely rare. The case we describe adds new characteristics to the scarcity of cases.

[Meduloblastoma: infrequent onset in local recurrence]. / Meduloblastoma: una presentación infrecuente en la recurrencia local.

INTRODUCTION. Meduloblastoma is high potential to recur and spread tumour. CASE REPORT. One case posterior fosse meduloblas toma in six years old boy who received 3 surgeries, chemotherapy and radiotherapy, with local recurrence and extracranial extension into neck laterocervical musculature. CONCLUSION. Although meduloblastoma extraneural metastases are not isolated phenomenon, meduloblastoma extracraneal extension is uncommon phenomenon in local recurrence.

Epidemiology of tuberculosis in the Americas: the Stop TB strategy and the millennium development goals.

BACKGROUND: Tuberculosis (TB), a preventable and curable disease, remains a major public health threat in the poorest regions of the Americas. The DOTS strategy was implemented to control TB in the region in 1993, and the new Stop TB strategy, emphasizing high-quality DOTS expansion, in 2006. OBJECTIVES: To describe TB epidemiology in the region of the Americas from 1994 to 2005 and to analyze the progress made towards and prospects for achieving Goal 6 of the Millennium Development Goals (MDGs) by 2015. METHODS: TB incidence, mortality and prevalence rates as well as DOTS coverage and DOTS treatment success rates were collated from the World Health Organization (WHO) databases from 1994 to 2005. RESULTS: DOTS coverage and DOTS treatment success rates rose steadily from 1994 to 2005, with 88% of the population covered under DOTS by 2005, and an 80% success rate by the end of 2004. The TB incidence, prevalence and mortality rates have also decreased steadily from 1994 to date, but differ with respect to the various scenarios. CONCLUSIONS: With the exception of some countries, further reduction in TB incidence, prevalence and deaths by 2015 is possible. Widespread implementation of DOTS should continue in order to meet WHO targets and attain the MDGs.

[Intracranial tuberculoma: a case report and review of the literature]. / Tuberculoma intracraneal: caso clínico y revisión de la bibliografía.

INTRODUCTION: Cerebral tuberculoma constitutes an important neurotuberculosis clinical form with high morbimortality and important diagnoses difficulty. CASE REPORT: Only giant cerebral tuberculoma case in 3 years-old man who present dizziness and surgically treated by diagnostic suspicion of cerebral tumor. CONCLUSION: Cerebral tuberculomas can often be confused with cerebral tumors when they are not included in differential diagnosis.

Tuberculoma intracraneal: caso clínico y revisión de la bibliografía / Intracranial tuberculoma: A case report and review of the literature

Introducción. El tuberculoma cerebral constituye una forma clínica importante de neurotuberculosis con una elevada morbimortalidad y una notable dificultad diagnóstica. Caso clínico. Único caso de tuberculoma cerebral gigante en un niño de 3 años, que comenzó con crisis epiléptica y se trató quirúrgicamente por sospecha diagnóstica de tumor cerebral. Conclusión. Los tuberculomas cerebrales pueden confundirse muchas veces con tumores cerebrales cuando no se incluyen enel diagnóstico diferencial

Introduction. Cerebral tuberculoma constitutes an important neurotuberculosis clinical form with high morbimortality and important diagnoses difficulty. Case report. Only giant cerebral tuberculoma case in 3 years-old man who present dizziness and surgically treated by diagnostic suspicion of cerebral tumor. Conclusion. Cerebral tuberculomas can often be confused with cerebral tumors when they are not included in differential diagnosis

[Comparison [corrected] of Chiari I malformation treatment using suboccipital craniectomy and posterior arch of C1 resection with or without dural graft]. / Comparación del tratamiento de la malformación de Chiari tipo I mediante craniectomía suboccipital y resección del arco posterior de C1 con o sin duroplastia.

UNLABELLED: There are various surgical approaches to treat Chiari I malformation. In spite of the good clinical results that are reported with most of them, there is still controversy about the optimal treatment of this pathology. OBJECTIVE: To compare the clinical and radiological results of surgical treatment of the Chiari I malformation with suboccipital craniectomy, posterior arch of C1 resection with or without dural graft, analyzing clinical and radiological findings and describing the complications. MATERIAL AND METHODS: Retrospectively clinical cases series of patients who underwent Chiari I malformation surgery between 1998 and 2006 in the Hospital Germans Trias i Pujol in Badalona. The inclusion criteria consisted in: patients older than 18 years, who have had surgery in our hospital, detailed neurological examination before and after surgery (calculating the EDSS scale punctuation), craniospinal magnetic resonance imaging before and after surgery and minimal follow up period of 6 months. The election of the surgical approach was left to the discretion of the main surgeon. Patients were divided in two groups depending of the surgical technique: Group A (with dural graft) and Group B (without dural graft). To evaluate the morphological results in both groups, measurements of the position of the fastigium above a basal line in the midsagittal T1 weighted magnetic resonance images were obtained. In patients with syringomyelia, siringo-to-cord ratio was measured before and after surgery. To evaluate the clinical results, neurological examination was recorded in both groups before and after surgery. RESULTS: The mean age of Group A patients was 47 (-/+12.89) years, and of Group B was 38.3 (-/+7.77) years. Mean follow up period was 2.48 (-/+2.44) years in Group A and 4.2 (-/+4.46) in Group B. Creation of an artificial cisterna magna was observed en 35.7% of Group A patients and only in 3.5% of Group B patients (p=0.022). In 8 patients front Group A, 8 patients (28.6%) an upward migration of the cerebellum was seen, whereas any of the Group B patients presented it (p=0.022) Siringo-to-cord ratios were decreased in both groups without significant differences. All of the Group A patients improved their clinical exploration. In Group B, 60% of the patients improved and the 40% left maintained clinical stability. Any patient worsened. All patients that maintained clinical stability belonged to Group B, the differences between the two groups were statistically significant (p=0.04). Five patients presented immediate surgical complications (2 pseudomeningoceles, 2 meningitis and 1 hydrocephalus). All this patients where operated with dural graft (p=0.049). CONCLUSIONS: According to our study, suboccipital craniectomy with resection of the posterior arch of C1 and dural graft shows better clinical and radiological results than without dural graft. Nevertheless this technique can increase the incidence of surgical complications.

Comparación del tratamiento de la malformación de Chiari tipo I mediante craniectomía suboccipital y resección del arco posterior de C1 con o sin duroplastia / Comparation of Chiari I malformation treatment using suboccipital craniectomy and posterior arch of C1 resection with or without dural graft

Existen múltiples tratamientos descritos para la malformación de Chiari tipo I. Se reportan buenos resultados clínicos con la mayoría de las variantes. Aún así, sigue habiendo controversia acerca del tratamiento óptimo de esta entidad. Objetivo. Comparar los resultados clínico-radiológicos del tratamiento quirúrgico de la malformación de Chiari tipo I mediante craniectomía suboccipital, resección del arco posterior de C1 con o sin duroplastia, analizando las variables clínicas, radiológicas y describiendo las complicaciones. Material y métodos. Se realizó un estudio retrospectivo de los pacientes intervenidos en nuestro centro entre los años 1998 y 2006. La muestra cumplía los siguientes criterios de inclusión: pacientes mayores de 18 años, que hubieran sido intervenidos en nuestro centro en todas las ocasiones, examen neurológico preoperatorio y de control postoperatorio (calculando su puntuación en la escala EDSS), estudio de imagencraneo espinal preoperatorio y postoperatorio y tiempomínimo de seguimiento clínico de 6 meses. Los pacientes se intervinieron con una u otra técnicaen función del criterio del cirujano principal. Dividimosa los pacientes en dos grupos según la técnica utilizada: Grupo A (intervenidos mediante duroplastia) y grupo B (intervenidos sin duroplastia). Para evaluar los resultados radiológicos en los dos grupos se midieron en la resonancia magnética, antes y después de la cirugía: la migración cerebelos a siguiendo el método de Duddy y Williams y la ratio siringo espinal en los pacientes con siringomielia. Para evaluar el resultado clínico, se recogió en los dos grupos la exploración neurológica antes y después de la cirugía. Resultados. La edad media de los pacientes del grupo A fue de 47 (±12,89) años, mientras que la del grupo B fue de 38,30 (±7,77) años. El tiempo medio de seguimiento de los pacientes del grupo A fue de 2,48 (...)

There are various surgical approaches to treat ChiariI malformation. In spite of the good clinical results that are reported with most of them, there is still controversy about the optimal treatment of this patology.Objective. To compare the clinical and radiologicalresults of surgical treatment of the Chiari I malformation with suboccipital craniectomy, posterior arch of C1 resection with or without dural graft, analyzing clinical and radiological findings and describing the complications.Material and methods. Retrospectively clinical casesseries of patients who underwent Chiari I malformationsurgery between 1998 and 2006 in the Hospital GermansTrias i Pujol in Badalona. The inclusion criteriaconsisted in: patients older than 18 years, who have hadsurgery in our hospital, detailed neurological examination before and after surgery (calculating the EDSS scale punctuation), craniospinal magnetic resonanceimaging before and after surgery and minimal followup period of 6 months.The election of the surgical approach was left to thediscretion of the main surgeon.Patients were divided in two groups depending ofthe surgical technique: Group A (with dural graft)and Group B (without dural graft). To evaluate themorphological results in both groups, measurementsof the position of the fastigium above a basal line in the midsagittal T1 weighted magnetic resonance imageswere obtained. In patients with syringomyelia, siringoto-cord ratio was measured before and after surgery. Toevaluate the clinical results, neurological examinationwas recorded in both groups before and after surgery.Results. The mean age of Group A patients was 47(±12,89) years, and of Group B was 38,3 (±7,77) years.Mean follow up period was 2,48 (...)

Scaling up collaborative TB-HIV activities in Latin America.

TB-HIV collaborative activities are one of the cornerstones of TB control in the Stop TB strategy. Since 2003, most countries in Latin America and the Caribbean have been gradually implementing TB-HIV collaborative activities; however, limited information is currently available on the degree of implementation. This study is therefore aimed at describing to what degree TB-HIV collaborative activities are being implemented in 17 countries selected for the study. These countries were asked to complete a semi-structured questionnaire. An analysis of this questionnaire revealed that the challenges for TB-HIV collaboration lie in the fields of human resources, surveillance and HIV testing of TB patients.

[Anterior approach complications in cervical spine pathology]. / Complicaciones del abordaje anterior en la patología de la columna cervical.

OBJECTIVE: To analyze cervical discectomy complications with anterior approach. MATERIAL AND METHODS: Retrospectively clinical cases series of 193 patients, between December 1989 to December 2004, in the Hospital Germans Trias i Pujol in Badalona. We analyzed complications arisen with cervical anterior approach and its relation with differents procedures. Demographic variables (age, sex), clinical variables (onset symptoms, cervical pathology cause, complication type, and duration time) and surgical variables (operated levels number, procedure, graft used) were analyzed. We made a statistical analysis with multivariant analysis, T-Student test and Chi-square test to analyze the relation between the complications and different studied variables. RESULTS: We found complications in 50 patients (25.91%). Most frequent has been dysphagia, present in 15 patients. Most of them appear with transitory form (13 patients) and in very few occasions permanent form (2 patients). T-Student test in statistical analysis showed no statistically significant differences (p=0.431) between the ages and complications, and were not statistically significant differences, used Chi-square test, in sex (p=0.515), in onset symptoms (p=0.923), in pathology origin (p=0.364), in a procedure(p=0.295), and graft used (p=0.382). We found statistically significant differences in operated levels number (p=0.018) with a ratio for the advantages (single /multiple) of 2.221. Multivariant analysis with linear regression model considering age, sex and operated levels number, showed that persistist the risk of complications in operated number levels, independently of the age or sex, being the multiple spaces a 117.3% more frequent than the single space (OR 2.173; IC95% 1.104-4.279). CONCLUSIONS: 1. Cervical anterior approach, is a simple technique, and safe surgically procedure with under number of complications. 2. Dysphagia is most frequent complication, but it is inherent to the procedure and it is solved without treatment in most ocasions. 3. Have been many the procedures used for the cervical spine fixation, with more than 40 years of experience, and still it is to define as he is the best one. It would be necessary more studies of prospective multicentric character to be able to compare clinical, radiological results, and the presence of complications.

Complicaciones del abordaje anterior en la patología de la columna cervical / Anterior approach complications in cervical spine pathology

Objetivo. Analizar las complicaciones de pacientes intervenidos mediante abordaje cervical anterior en la patología de la columna. Material y métodos. Estudio retrospectivo de una serie de 193 casos clínicos, entre Diciembre de 1989 y Diciembre de 2004, en el Hospital Germans Trias i Pujol de Badalona, donde se analizaron las complicaciones surgidas con el abordaje cervical anterior y su relación con las distintas técnicas aplicadas. Se analizaron variables sociodemográficas (edad, sexo), variables clínicas (sintomatología inicial, origen de la patología cervical, tipo de complicación, y tiempo de duración de la complicación)y quirúrgicas (número de niveles intervenidos, nivel intervenido, tipo de intervención realizada, tipo de injerto utilizado). A partir de los datos obtenidos se realizó un análisis estadístico con modelos de análisis multivariante, con la prueba de T-Student y con el test de Chi-cuadrado para analizar la relación entre las complicaciones y las distintas variables estudiadas. Resultados. De todos los individuos estudiados (193), hallamos complicaciones en 50 pacientes (25,91%). De ellas, la más frecuente fue la disfagia, presente en 15 pacientes. La mayoría de ellas se presentaron de forma transitoria (13 pacientes) y en muy pocas ocasiones de forma permanente (2 pacientes). El análisis estadístico mediante la prueba de la T de Student mostró que no existían diferencias estadísticamente significativas(p=0,431) entre las edades de los pacientes que habían presentado complicaciones frente a los que no, y tampoco se encontraron diferencias estadísticamente significativas, utilizado el test de la Chi-cuadrado, respecto el sexo (p=0,515), síntomas iniciales p=0,923), origen de la patología (p=0,364), tipo de intervención realizada (p=0,295), y tipo de injerto utilizado (p=0,382,). Donde sí encontramos diferencias estadísticamente significativas fue en el número de niveles intervenidos (p=0,018) con una razón de las ventajas para el número de niveles (único/múltiple) de 2,221. Con el análisis multivariante siguiendo en modelo de regresión lineal considerando edad, sexo y número de niveles intervenidos, observamos que persistía el riesgo de complicaciones del número de espacios intervenidos, independientemente de la edad o el sexo, siendo los múltiples espacios un 117,3% más frecuente que la intervención de un único (OR 2,173; IC95% 1,104-4,279). Conclusiones. 1. La cirugía de la columna cervical por vía anterior, es una técnica simple, y un procedimiento quirúrgicamente seguro con un número bajo de complicaciones. 2. La disfagia es la complicación más frecuente, pero que se encuentra casi inherente al procedimiento y en la mayoría de ocasiones se resuelve sin tratamiento. 3. Han sido muchos los procedimientos utilizados para la fijación de la columna cervical, con más de 40 años de experiencia, y aún queda por definir cual es el mejor. Harían falta más estudios de carácter rmulticéntrico y de cohorte prospectiva para poder comparar resultados clínicos, radiológicos, y la presencia de complicaciones

Objective. To analyze cervical discectomy complications with anterior approach. Material and methods. Retrospectively clinical cases series of 193 patients, between December 1989 to December 2004, in the Hospital Germans Trias i Pujol in Badalona. We analyzed complications arisen with cervical anterior approach and its relation with differents procedures. Demographic variables (age, sex), clinical variables (onset symptoms, cervical pathology cause, complication type, and duration time) and surgical variables (operated levels number, procedure, graft used) were analyzed. We made a statistical analysis with multivariant analysis, T-Student test and Chi-square test to analyze the relation between the complications and different studied variables. Results. We found complications in 50 patients(25,91%). Most frequent has been dysphagia, present in 15 patients. Most of them appear with transitory form (13 patients) and in very few occasions permanent form (2 patients). T-Student test in statistical analysis showed no statistically significant differences (p=0,431) between the ages and complications, and were not statistically significant differences, used Chi-square test, in sex (p=0,515), in onset symptoms (p=0,923), in pathology origin (p=0,364), in a procedure(p=0,295), and graft used (p=0,382). We found statistically significant differences in operated levels number (p=0,018) with a ratio for the advantages (single /multiple) of 2,221. Multivariant analysis with linear regression model considering age, sex and operated levels number, showed that persistist the risk of complications in operated number levels, independently of the age or sex, being the multiple spaces a 117.3% more frequent than the single space (OR 2,173; IC95% 1,104-4,279). Conclusions. 1. Cervical anterior approach, is a simple technique, and safe surgically procedure with under number of complications. 2. Dysphagia is most frequent complication, but it is inherent to the procedure and it is solved without treatment in most ocasions.3. Have been many the procedures used for the cervical spine fixation, with more than 40 years of experience, and still it is to define as he is the best one. It would be necessary more studies of prospective multicentric character to be able to compare clinical, radiological results, and the presence of complications

Epidemic soybean asthma and public health: new control systems and initial evaluation in Barcelona, 1996-98.

OBJECTIVE: To evaluate the new measures adopted to control the risks from soybean unloading operations in the Port of Barcelona, after an episode of epidemic asthma in June 1996. METHODS: After an initial cautionary suspension of all soybean unloading operations, they were subsequently resumed under restrictive criteria for time, flux, simultaneity, and meteorological conditions. Emission filtration systems based on either micro pore size filters or polytetrafluoroethylene membranes on tetratex filters showed promising results. RESULTS: Allergen emission underwent a very important decrease to levels 95% to 98% lower. Emissions from the two plants with unloading operations are in the same order of magnitude as the processing plant that does not unload soybean. Allergen concentration levels presented fluctuations initially, but the new filters decreased mean values; despite increased unloading, allergen levels did not increase-mean allergen levels on unloading days (67 U/m(3)) and on days without unloading operations (63 U/m(3)) are similar. A panel of patients detected a cluster of increased symptoms during unloading operations on a day with suboptimal meteorological conditions and comparatively low allergen levels (225-415 U/m(3)). Since the June 1996 episode, no further asthma outbreak has been detected. CONCLUSIONS: The evaluation shows the effectiveness of the new filters in the control of soybean dust emission. With a systematic control programme, industrial soybean operations may function near urban centres without public health risks. These data may be useful in the development of future standards for allergenic agents.

Enfermedad tromboembólica y anticonceptivos de tercera generación / Thromboembolic disease and third-generation oral contraceptives

La tromboembolia pulmonar es un proceso infrecuente. Presentamos un caso de tromboembolia pulmonar en una paciente joven, que se asocia al tratamiento con contraceptivos orales de tercera generación. Aunque la tromboembolia pulmonar es un trastorno infrecuente, en vista de la gravedad del proceso sería importante tenerla en cuenta antes de iniciar este tipo de tratamiento en pacientes jóvenes. Se lleva a cabo, asimismo, una revisión de los diferentes artículos publicados sobre riesgo tromboembólico y el uso de anticonceptivos de tercera generación (AU)

Effect of germinated seeds extract on the respiratory activity of human skin fibroblasts and sheep liver mitochondria. Influence on cell viability and proliferation and their uselfulness as active cosmetic ingredient.

The present work studies the ability of a germinated seeds extract (alfalfa, radish, wheat, soy) to influence cell respiration of skin fibroblasts and the respiratory activity of sheep liver isolated mitochondria, and the cytotoxicity of the product on cultured skin fibroblasts. The content of free and total amino acids present in this extract was determined. Aspartic acid represented 37.52% of free amino acids in the extract, but 48.07% glutamic acid was found when total amino acids obtained by acid hydrolysis were quantified. The extract contains more than 6.5% free serine, glutamic acid and alanine. Arginine, serine, aspartic acid and threonine are the other amino acids that represent more than 4.5% total amino acids. Respiration of sheep liver mitochondria and human skin fibroblasts (Foreskin ATCC CRL-1635) was checked polarographically. The results obtained show the ability of this extract to stimulate cellular respiration of both in vitro models, but the effect is more marked on cell cultured fibroblasts, and its dose dependency. The role of acidic amino acids, aspartic and glutamic acids, on the increase of oxygen consumption by mitochonria is suggested. Cytotoxicity of the germinated seeds extract was tested by the assessment of the viability, the morphological changes and the proliferation of cell cultured human skin fibroblasts. It has been shown that germinated seeds extract are non-toxic to cell cultures at doses of up to 10 mg mL(-1); neither morphological changes nor membrane integrity alterations or changes in cell proliferation were observed.

The molecular epidemiology of tuberculosis in Caracas, Venezuela, with IS6110 DNA fingerprinting.

In this retrospective study we asses the molecular epidemiological situation of Tuberculosis of the city of Caracas, Venezuela in the year 1994, applying IS6110 DNA Fingerprinting of clinical isolates. Fingerprinting of Mycobacterium tuberculosis strains of sixty-four patients TB patients from all the 5 districts of the city revealed fifty-one distinct IS6110 patterns. Isolates from 20 patients (30%) had fingerprints that were shared with at least one other patient. Based on this sampling we conclude that at least a third of the tuberculosis cases in Caracas in the year 1994 were the result of recent and ongoing transmission, indicating micro-epidemics in the town.

[Vertigo, imbalance and mourning]. / Vértigo, inestabilidad y duelo.

It is a well-known fact, and there are several publications on this matter, the links between panic attacks, simulation, anxiety, depression and lightheadedness or imbalance, but in our perusal of the related literature no connection between pathological mourning, dizziness and imbalance was found. In this paper are reported the outcomes of a prospective study of 58 patients suffering vertigo and imbalance as well and psychiatrically assessed. Pathologic mourning shows its predominance among otic vertiginous. This feature, we think, should be investigated when collecting the anamnesis of patients complaining of dizziness and/or imbalance in order to planning the appropriate treatment.

[Coping with the toll of heroin: 10 years of the Barcelona Action Plan on Drugs, Spain]. / Afrontar los estragos de la heroína: evaluación de diez años de un programa integral en Barcelona.

INTRODUCTION: The epidemic of heroin use began in Barcelona, as in the rest of Spain, in the late 70's, to reach its peak by the end of the 80's. In a first period, responsible officers experimented difficulties to define the specific objectives of opiate control policies. This paper reviews the effects of the adoption of an explicit policy on drug dependence grounded on a wide consensus in the City of Barcelona (Catalonia, Spain). SUBJECTS AND METHODS: Over a period of twelve years, from 1986 to 1997, both demand and offer of care and harm reduction services were analyzed, as well as the evolution of the adverse effects of drug use, such as mortality from acute adverse drug reaction, human immunodeficiency virus (HIV) infection, aids incidence, and incidence of tuberculosis. Data for city residents was compared through four different stages in this period. RESULTS: Despite the lack of data in initial years, relevant changes are apparent. Treatment offer changes clearly, with significant increases in initial treatment, coverage of methadone maintenance programmes, and sterile syringes distribution. Therapeutic compliance of tuberculous intravenous drug users IVDU and risk of HIV infection improve. Emergency service use linked to heroin, overdose, or withdrawal syndrome decreases. Mortality rates decline, although this decline does not reach statistical significance. DISCUSSION: Service offer shows a clear increase, reflected in treatment initiation, while harm reduction services expand. With the development of this process, outcome indicators change, both reflecting changes in the toll of the heroin epidemic (cases of tuberculosis and aids among IVDUs, HIV infection). and changes in a more comprehensive care (better treatment compliance of IVDUs with tuberculosis). There is a lower distortion of emergency services. These changes occur although the predominance of white heroin in Barcelona favors parenteral use.