Osmotic gradient ektacytometry: A valuable screening test for hereditary spherocytosis and other red blood cell membrane disorders.

INTRODUCTION: New generation osmotic gradient ektacytometry has become a powerful procedure for measuring red blood cell deformability and therefore for the diagnosis of red blood cell membrane disorders. In this study, we aim to provide further support to the usefulness of osmotic gradient ektacytometry for the differential diagnosis of hereditary spherocytosis by measuring the optimal cutoff values of the parameters provided by this technique. METHODS: A total of 65 cases of hereditary spherocytosis, 7 hereditary elliptocytosis, 3 hereditary xerocytosis, and 171 normal controls were analyzed with osmotic gradient ektacytometry in addition to the routine red blood cell laboratory techniques. The most robust osmoscan parameters for hereditary spherocytosis diagnosis were determined using receiver operating characteristic curve analysis. RESULTS: The best diagnostic criteria for hereditary spherocytosis were the combination of decreased minimal elongation index up to 3% and increased minimal osmolality point up to 5.2% when compared to the mean of controls. Using this established criterion, osmotic gradient ektacytometry reported a sensitivity of 93.85% and a specificity of 98.38% for the diagnosis of hereditary spherocytosis. CONCLUSION: Osmotic gradient ektacytometry is an effective diagnostic test for hereditary spherocytosis and enables its differential diagnosis with other red blood cell membrane diseases based on specific pathology profiles.

Consejo breve para la prevención del tabaquismo en escolares de 2º a 4º de Educación Secundaria Obligatoria de Zaragoza / No disponible

Se realizó una intervención en el ámbito escolar para administrar consejo breve antitabacoa escolares de la Educación Secundaria Obligatoria (ESO) en Zaragoza durante los cursos2006-2007 y 2007-2008. Los objetivos del estudio fueron medir la efectividad del consejobreve apoyado por material escrito y estudiar la progresión del tabaquismo. El estudióincluyó una encuesta autoadministrada y una coximetría, así como una reevaluación un añodespués.Se estudiaron 15 centros escolares, 8 del grupo intervención y 7 de control. Se administróconsejo apoyado con un folleto frente al control en el que no se utilizaba el folleto. Laasignación a los grupos no fue aleatoria.Se evaluaron 1.720 estudiantes entre los dos cursos 2006-07 y 2007-08 de los cuales51,95% fueron hombres y 48,5% mujeres. La edad media fue 14,6 años (desviación estándar[DE] = 1,36) y fueron fumadores el 19,7%. Entre las mujeres fueron fumadoras el24,7% frente al 18,3% de los hombres (p < 0,0001). No hubo diferencias significativas parael tabaquismo según grupo de intervención o control. La progresión del tabaquismo crecióun 8,8% en el grupo intervención frente a un 12% en el de control entre 2.º y 3.º. Las diferenciasfueron 3% para el grupo intervención frente al 1,1% en el de control entre 3.º y 4.º,no siendo estas diferencias estadísticamente significativas. Conclusiones: el porcentaje de fumadores en escolares de ESO es del 19,7%. La escaladade consumo se produce entre 2.º y 3.º. No se demostró una mayor efectividad del consejobreve mediante el uso de un folleto(AU)

Authors report a community school study about smoking adolescent behaviour, 8º, 9º,and 10 º year in Zaragoza (Spain). The study was implemented in the 2006-2007 and 2007-2008 courses respectively. The study’s objectives were to asses the effectiveness of smokingcounselling with the aid of a specifically designed leaflet. The study also included an evaluationof expired CO. The authors surveyed on smoking behaviour as well as on personaldetails of the students.The study includes 8 intervention schools and 7 control schools. Allocation wasn’t randomizeddue to logistic reasons. The interventional group received advice against smokingby means of spoken counsel from a professional supported by a leaflet. The control grouponly received the spoken counsel. The expired CO was assessed in each group. The counselwas repeated in each group one year later to the same students.In all 1,720 students were assessed: 51.95% men and 48.5% women. The median ageof the students was 14.6 years SD: 1.36. The authors found that 19.7% of the students weresmokers. The distribution of smokers by sex was 24.7% of women versus 15.3% of men X2= 24.1 p < 0.0001. Smoking behaviour between interventional or control group wasn’t statisticallydifferent.Conclusions: There wasn’t any evidence of effectiveness in using a leaflet added to thespoken counsel. Prevalence of smoking was very high: 19.7% among adolescents of Zaragoza.The study shows a increase of smoking between 8º and 10º(AU)

Results of the MITRA project: monitoring and intervention for the transportation of dangerous goods.

The objective of the MITRA (monitoring and intervention for the transportation of dangerous goods) project was to prototype a new operational system for monitoring the transportation of dangerous goods in Europe based on regional responsibilities. This concept, based on systems used in air traffic control, aims to provide civil security centres with real-time knowledge of the position and contents of dangerous vehicles circulating in their area of responsibility, and, in the event of a dangerous situation, to issue warnings, alerts and crisis management information, thereby allowing intervention teams to react immediately with maximum safety. The project was funded by the European Commission under the 6th Framework Programme (STREP--specific targeted research project--under the Information Society Technologies priority). It started on 1 September 2004 and ended on 31 October 2006. This paper presents the results of this project and the conclusions derived from the field tests carried out in Germany and in the French/Spanish border region in order to test the proposed operational system.

A risk severity index for industrial plants and sites.

A risk index (Risk Severity Index, S) has been devised to allow the assessment of the risk level originated by a given installation or site over the affected zone. A set of threshold levels for thermal radiation, toxic concentration and overpressure, together with the probabilities and frequencies associated to critical events and their effects have been the basis for calculating the values of S. A computer tool has been designed to perform a quick calculation of the diverse Risk Severity Indexes (for a critical event, for a dangerous phenomenon, for a type of effect and for the whole installation) and to plot a map of the risk severity levels around the site. The methodology has been applied to diverse test cases and it has proved to be useful for risk assessment, for comparative studies and for land use planning.

A survey of accidents occurring during the transport of hazardous substances by road and rail.

A study of 1932 accidents that occurred during the transport of hazardous substances by road and rail from the beginning of the 20th century to July 2004 was carried out. The results obtained show an increase in the frequency of accidents over time. More than half of the accidents happened on roads (63%). The most frequent accidents were releases (78%), followed by fires (28%), explosions (14%) and gas clouds (6%). The various causes of the accidents, the type of substance involved and the consequences for the population (number of people killed, injured or evacuated) were also analysed. Among the diverse measures taken to improve this situation, the training of professional people involved in transportation seems to be of major importance.

Alteraciones gasométricas en pacientes cirróticos hospitalizados / Gasometric alterations in hospitalized cirrhotic patients

Introducción y objetivos: Aunque se ha descrito la existencia de diversas alteraciones del intercambio gaseoso en la cirrosis, existen pocos estudios que las hayan estudiado de forma prospectiva. El objetivo de este trabajo fue conocer la frecuencia y gravedad de dichas alteraciones en los pacientes cirróticos hospitalizados, correlacionándolas con el grado de disfunción hepática. Pacientes y métodos: Se estudiaron 50 pacientes cirróticos consecutivos (41 varones) que requirieron ingreso hospitalario por descompensación de su hepatopatia (ascitis, encefalopatía hepática, hepatitis alcohólica y hemorragia digestiva alta), y que no presentaban procesos pulmonares ni cardiacos agudos o crónicos que pudiesen producir hipoxemia. Los pacientes fueron agrupados según su estadio de Child-Pugh (A, n = 13; B, n = 21; C, n = 16). En siete pacientes se constató la presencia de una hepatitis alcohólica sobre añadida grave (HAAG). En todos ellos se realizó una gasometría arterial basal antes de ser dados de alta, y se efectuó un ecocardiograma transtorácico con contraste en caso de sospecha de síndrome hepatopulmonar (SHP). Resultados: Se observó una discreta hipoxemia global (80,9 mmHg) sin diferencias según el grado de Child-Pugh. La hipocapnia fue significativamente más marcada en los pacientes con estadio Child C que en aquellos con estadios A y B (31,2 ± 3,1 frente a 38,1 ± 4,3 y 36,3 ± 5mmHg; p < 0,05), respectivamente. En cambio, los pacientes cirróticoscon HAAG presentaron un hipocapnia significativamente menor que aquellos otros sin HAAG (31,2 ± 3,1 frente a 36,3 ± 5 mmHg; p < 0,05). En el análisis multivariante, las variables con valor pronóstico independiente para la presencia de hipocapnia fueron la protrombina, la albúmina y el sodio plasmáticos. Se constató la presencia de SHP en 8 pacientes (16%). Conclusiones: La alteración gasométrica más frecuentes de la cirrosis es la alteración del gradiente alvéolo-arterial de oxígeno, que se acentúa conforme empeora la función hepática. La hipocapnia, aunque supatogenia no es bien conocida, podría constituir una mecanismo compensador de la hipoxemia o bien ser el resultado de la activación de los centros respiratorios centrales por sustancias no aclaradas en el hígado

Background and objectives: Gas exchange alterations have been described in cirrhotic patients; but by the moment, a few prospective studies have focused in them. The aim of this study was to describe the frequency and severity of gasometric alterations in hospitalized cirrhotic patients, a their correlation with hepatocellular disfunction. Patients and methods: 50 consecutive cirrhotic patients (41 males) admited for liver decompensation (ascites, liver encephalopathy, alcoholichepatitis and upper gastrointestinal bleeding) without acute or chronic cardiopulmonary disfunction were included in the study. Patients were classificated according with Child-Pugh score (A, n = 13; B, n =21; C, n = 16). Severe alcoholic hepatitis (SAH) was confirmed in 7 patients. Arterial gasometry was performed in all patients before discharge. Contrast echocardiography was performed in any case of suspicion of hepatopulmonary syndrome (HPS). Results: Light hypoxemia was observed (80.9 mmHg), without differences with Child-Pugh. Hypocapnia was significantly more evident in Child C than in A and B (31.2 ± 3.1 vs. 38.1 ± 4.3 y 36.3 ± 5 mmHg; p <0,05), respectively. Cirrhotic patients with SAH showed a significantly higher hypocapnia by comparison with others (31.2 ± 3.1 vs. a 36.3 ± 5mmHg; p < 0.05). In multivariate analysis, independent prognostic variables for hypocapnica were plasmatic levels of protrombin time, albumin and sodium. HPS was confirmed in 8 patients (16%). Conclusions: The most prevalent gas exchange abnormality in cirrhosis was the alteration of alveolar-arterial oxygen tension gradient, directly correlated with hepatocellur disfunction. Hypocapnia could be a compensatory mechanism or the result of the activation of central respiratory centres by non-depurated substances by the liver

Antinociceptive/anti-edema effects of liposomal morphine during acute inflammation of the rat paw.

We evaluated the anti-edema/antinociceptive effects of subcutaneous free and liposomal morphine in rats with carrageenan-induced inflammation of the paw. We assessed antinociception by the paw pressure test and edema by plethysmography. Unilamellar liposomes (150-200 nm) with 0.3% morphine hydrochloride were used; encapsulation significantly reduced the rate for release of morphine in vitro. During inflammation, the antinociceptive potency of free, but not liposomal morphine increased 2.5 times; moreover, duration of the effects was prolonged by encapsulation (p < 0.001). The anti-edema effects of liposomal morphine were more pronounced (p < 0. 001) and of longer duration (p < 0.05). All the effects were reversed by naloxone. The results show that morphine encapsulation enhances the anti-edema effects and prolongs antinociception.

Effects of morphine and liposomal morphine in a model of intestinal inflammation in mice.

We have investigated the antitransit effects of free and liposomal morphine in a model of intestinal inflammation. Mice received saline or croton oil orally, 3 h prior to evaluation, and gastrointestinal transit was measured 20 min afterwards. Peak/duration of effects, potency (ED50) and antagonism by naloxone and naloxone methiodide were evaluated. Peak effects occurred 30 and 40 min after administration of morphine and liposomal morphine, respectively. Encapsulated morphine had a more pronounced and prolonged effect than morphine. Comparison of the ED50S demonstrated that the potency of liposomal morphine was 3.5 times higher than that of morphine during inflammation; in addition, inflammation increased the potency of morphine and liposomal morphine, 3 and 9.2 times, respectively. The effects of morphine and liposomal morphine in croton oil-treated mice were reversed by naloxone and naloxone methiodide. The results show that during inflammation, the potency and duration of the antitransit effects of morphine are significantly enhanced by encapsulation.

Peripheral effects of naloxone in mice with acute diarrhea associated with intestinal inflammation.

The aim of the study was to evaluate the effects of centrally and peripherally acting opioid antagonists such as naloxone (NX), naloxone methiodide, (+)-naloxone [(+)NX], (-)-a-5,9-diethyl-2'-hydroxy-2 (3-furylmethyl)-6,7-benzomorphan and naltrindole on gastrointestinal (GI) transit in mice with diarrhea associated with intestinal inflammation. Our hypothesis was that diarrhea/inflammation could induce a release of endogenous opioid peptides that would play an inhibitory role in the physiological response to intestinal inflammation; the administration of opioid antagonists would uncover the effects of the endogenous opioid peptides on the gut. Diarrhea associated with inflammation was induced in mice by administration of croton oil (CO) although control animals received saline (SS); GI transit was evaluated with a charcoal meal. The i.p. administration of 0.1 mg/kg NX or NXME, induced a significant increase in GI transit in CO but not in SS-treated animals (P < .005). At the same dose, (+)NX had no effect either in CO or SS groups. The kappa antagonist MR-2266 (1 and 3 mg/kg) had no effect on GI transit in SS or CO animals. However, the delta antagonist naltrindole (3 mg/kg), caused a small but significant (P < .01) increase in GI transit in the CO group. These results suggest that endogenous opioid peptides are released in CO-treated animals and exert an inhibitory control of intestinal motility, which is unmasked by opioid antagonists.(ABSTRACT TRUNCATED AT 250 WORDS)

Ecopathology in aquaculture: risk factors in infectious disease outbreak.

This paper describes a study of the risk factors associated with disease outbreaks in fish species of fish farms and rivers of north-east Spain. We focused our work on the isolation of fish pathogens (bacteria, virus), the water quality (physicochemical and microbiological quality) and management characteristics. We have observed 2 important viral diseases, infectious pancreatic necrosis and spring viraemia of carp, and 2 important bacterial ones, furunculosis (Aeromonas salmonicida) and bacterial kidney disease (BKD) (Renibacterium salmoninarum). Our preliminary results show that there are some potential risk factors associated with the main diseases of fish, such as fish age, fish species, production system, season and water temperature, but their role depends on the disease.

Iron-related damage in acute ischemic stroke.

BACKGROUND AND PURPOSE: Although iron-mediated mechanisms are important in experimental brain injury after carotid occlusion, their clinical role in acute ischemic stroke has not been determined. We evaluated the influence of iron stores, measured as serum ferritin, on the outcome of acute cerebral infarct. METHODS: Admission and fasting glycemia, glycosylated hemoglobin, serum cortisol, serum ferritin, and 24-hour urinary free cortisol levels were measured on the first day of hospitalization in 67 patients admitted with an acute ischemic stroke of less than 24 hours' duration. Patients were classified into two groups according to their Canadian Stroke Scale (CSS) score on day 30: good outcome group (alive and CSS score > 7 points) and poor outcome group (dead or CSS score < or = 7 points). RESULTS: Thirty-three patients (49%) had good outcome and 34 (51%) poor outcome. Fasting glycemia (P = .001), serum cortisol (P < .001), and urinary free cortisol (P = .001) but not admission glycemia and glycosylated hemoglobin had higher levels in patients with poor outcome. Serum ferritin values were greater in the poor outcome group (218 +/- 156 micrograms/L versus 133 +/- 125 micrograms/L; P = .004), and a correlation between ferritin values and degree of worsening or improvement of the CSS score on day 30 was found (P = .002). Serum cortisol (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.7 to 26), fasting glycemia (OR, 5.4; 95% CI, 1.2 to 24), and serum ferritin (OR, 4.6; 95% CI, 1.1 to 19) were independently related to poor outcome in a logistic regression analysis. CONCLUSIONS: High serum ferritin levels within the first 24 hours of hospitalization for an acute ischemic stroke are related to a poor prognosis, independent of the stress response. More research is needed to determine the origin of increased serum ferritin levels and the therapeutic implications.

[HDL cholesterol as a risk factor for arteriosclerosis (author's transl)]. / Determinación del colesterol de la fracción HDL como factor de riesgo de arteriosclerosis.

Recent studies have demonstrated a negative correlation between the cholesterol content of the HDL fraction of serum lipoproteins and the incidence of arteriosclerosis. In this study the limits of normality of HDL-cholesterol have been determined in a male and female population, followed by an analysis of the HDL-cholesterol in patients with myocardial infarction. Normal values for total cholesterol in males and females were, respectively, 194.7 +/- 61.8 mg/dl and 188 +/- 62.8 mg/dl, and those of HDL-cholesterol, 63.1 +/- 14.6 mg/dl and 70.3 +/- 24.4 mg/dl. Total cholesterol in the patients with myocardial infarction was not significantly different from that of the control group, but HDL-cholesterol was significantly lower (p < 0.05).