Biogas production from slaughterhouse waste: Effect of blood content and fat saponification.

The effect of fat saponification and the inclusion or exclusion of blood in slaughterhouse mixtures were assessed in terms of anaerobic digestion performance. Mixtures of animal by-products (ABP) were collected for 1 year, whereby following the daily activity and waste generation at a slaughterhouse facility, seasonal fluctuations were found. The blood content of ABP mixtures was variable, affecting both the methane yield and the production rate (287.8-320.5 NLCH4 kgCOD-1 and 80.3-94.7 and NLCH4 kgCOD-1 d-1, respectively). The saponification of fatty ABP materials was studied to assess the methane production rate, singularly or combined, with and without the addition of blood. Data showed that saponification significantly reduced the lag phase, from 2.2 to 1.5 days in winter mixtures and from 1.5 to 0.9 days in summer mixtures (all with blood), and from 0.3 to 0.1 days in summer mixtures without blood. Finally, the percentage of energy demand at the slaughterhouse potentially covered by net biogas energy was estimated, finding that the facility could be 100% energy self-sufficient in winter, whereas this would be reduced to 85% in the summer due to different methane yields of ABP mixtures based on season.

The immune status against tetanus and diphtheria in healthcare workers in Catalonia.

The objective was to investigate the immune status against tetanus and diphtheria of healthcare workers in Catalonia. A cross-sectional multicentre study was conducted in seven health centres. Blood samples were obtained, and demographic and clinical variables collected. 509 health workers were included. The prevalence of protective antibodies against tetanus was 94.7% (95% CI: 92.3-96.4) overall and 85.1% (95% CI: 74.5-92.0) in workers aged ≥55 years. The prevalence of protective antibodies against diphtheria was 68.6% (95% CI: 64.3-72.5%) overall and 29.7% (95% CI: 19.9-41.6) in workers aged ≥55 years. Protection against tetanus in healthcare workers is high, but should be improved in workers aged ≥55 years. Protection against diphtheria has improved in healthcare workers over the past decade (68.6% vs 46.5%) but should be improved in all ages, especially in workers aged ≥55 years.

Prognostic impact of CD133 expression in Endometrial Cancer Patients.

To assess the impact of CD133 expression on the prognosis of endometrioid endometrial carcinoma (EEC). We retrospectively assessed CD133 expression in tissue microarray of 116 surgically treated FIGO I-III EEC. Tumors with ≥10% of CD133-expressing cells were considered CD133-positive (CD133+). On the basis of CD133 expression, clinical and pathological parameters, progression-free survival (PFS) and overall survival (OS) were evaluated. Of the EEC studied 85.2% showed CD133-expressing cells. Only 61% (n = 66) of EEC presented ≥10% of CD133 expressing cells and were considered CD133+. The mean OS for CD133+ tumour patients was 161 months (95% CI, 154-168) as compared with 146 months (95% CI, 123-160) for those with CD133- tumors (p = 0.012). The mean PFS for CD133+ tumour was 159 months (95% CI, 149-168) as compared with 147 months (95% CI, 132-161) in those with a CD133-tumour (p = 0.014). CD133+ tumours were less likely to have vascular invasion (p = 0.010) and more likely to be well differentiated (p = 0.034). C133+ tumours predicted favorable OS and PFS of EEC patients, with a Hazard Ratio 4.731 (95% CI, 1.251-17.89; p = 0.022). CD133+ tumor status correlates with favorable prognosis of EEC. Our findings are in agreement with studies addressing brain and colorectal tumours.

Pig cognitive bias affects the conversion of muscle into meat by antioxidant and autophagy mechanisms.

Slaughter is a crucial step in the meat production chain that could induce psychological stress on each animal, resulting in a physiological response that can differ among individuals. The aim of this study was to investigate the relationship between an animal's emotional state, the subsequent psychological stress at slaughter and the cellular damage as an effect. In all, 36 entire male pigs were reared at an experimental farm and a cognitive bias test was used to classify them into positive bias (PB) or negative bias (NB) groups depending on their decision-making capabilities. Half of the animals, slaughtered in the same batch, were used for a complete study of biomarkers of stress, including brain neurotransmitters and some muscle biomarkers of oxidative stress. After slaughter, specific brain areas were excised and the levels of catecholamines (noradrenaline (NA) and dopamine (DA)) and indoleamines (5-hydroxyindoleacetic acid and serotonin (5HT)) were analyzed. In addition, muscle proteasome activity (20S), antioxidant defence (total antioxidant activity (TAA)), oxidative damage (lipid peroxidation (LPO)) and autophagy biomarkers (Beclin-1, microtubule-associated protein I light chain 3 (LC3-I) and LC3-II) were monitored during early postmortem maturation (0 to 24 h). Compared with PB animals, NB pigs were more susceptible to stress, showing higher 5HT levels (P<0.01) in the hippocampus and lower DA (P<0.001) in the pre-frontal cortex. Furthermore, NB pigs had more intense proteolytic processes and triggered primary muscle cell survival mechanisms immediately after slaughter (0 h postmortem), thus showing higher TAA (P<0.001) and earlier proteasome activity (P<0.001) and autophagy (Beclin-1, P<0.05; LC3-II/LC3-I, P<0.001) than PB pigs, in order to counteract the induced increase in oxidative stress, that was significantly higher in the muscle of NB pigs at 0 h postmortem (LPO, P<0.001). Our study is the first to demonstrate that pig's cognitive bias influences the animal's susceptibility to stress and has important effects on the postmortem muscle metabolism, particularly on the cell antioxidant defences and the autophagy onset. These results expand the current knowledge regarding biomarkers of animal welfare and highlight the potential use of biomarkers of the proteasome, the autophagy (Beclin-1, LC3-II/LC3-I ratio) and the muscle antioxidant defence (TAA, LPO) for detection of peri-slaughter stress.

Prevalence of anti-rubella, anti-measles and anti-mumps IgG antibodies in neonates and pregnant women in Catalonia (Spain) in 2013: susceptibility to measles increased from 2003 to 2013.

Non-immune neonates and non-immune pregnant women are at risk of developing rubella, measles and mumps infections, including congenital rubella syndrome. We describe the seroepidemiology of measles, mumps and rubella (MMR) in neonates and pregnant women in Catalonia (Spain). Anti-rubella, anti-measles and anti-mumps serum IgG titres were assessed using enzyme-linked immunosorbent assay (ELISA) tests in 353 cord blood samples from neonates of a representative sample of pregnant women obtained in 2013. The prevalence of protective antibody titres in neonates was 96 % for rubella IgG (≥8 IU/ml), 90 % for measles IgG (>300 IU/ml) and 84 % for mumps IgG (>460 EU/ml). Slightly lower prevalences of protective IgG titres, as estimated from the cord blood titres, were found in pregnant women: 95 % for rubella IgG, 89 % for measles IgG and 81 % for mumps IgG. The anti-measles and anti-mumps IgG titres and the prevalences of protective IgG titres against measles and mumps increased significantly (p < 0.001) with maternal age. The prevalence of protective anti-measles IgG titres decreased by 7 % [odds ratio (OR) = 0.15, p < 0.001), the prevalence of protective anti-rubella IgG titres increased by 3 % (OR = 1.80, p < 0.05) and the MMR vaccination coverage (during childhood) in pregnant women increased by 54 % (OR = 2.09, p < 0.001) from 2003 to 2013. We recommend to develop an MMR prevention programme in women of childbearing age based on mass MMR vaccination or MMR screening and vaccination of susceptible women to increase immunity levels against MMR.

Electrical stunning effectiveness with current levels lower than 1 A in lambs and kid goats.

An experiment with 360 lambs grouped into three Spanish commercial categories, (Pascual, 13-16 kg; Recental, 9-13 kg and Lechal <7 kg carcass weight) and kid goats (7 kg) was performed to assess stunning effectiveness after head-only (HO) and head-to-body (HB) electrical stunning with intensity currents of 0.3, 0.5 and 0.7 Amperes (A) compared to 1.0 A. After stunning, all animals showed tonic-clonic muscular activity and epileptiform EEG, absence of rhythmic breathing, corneal reflex, spontaneous blinking and pain sensibility. The quiescent EEG occurred earlier (P < 0.05) in HB compared to HO in all categories. More animals recovered corneal reflex and rhythmic breathing before onset of the quiescent activity after HO (from 15 to 50%) compared to HB (from 0 to 15%) (P < 0.05). Concluding, HO and HB electrical stunning with 0.3, 0.5 and 0.7 A induce effective stunning similar to 1.0 A in lambs and kid goats. After stunning and sticking, brain failure occurs earlier in HB than HO system.

Urine human papillomavirus prevalence in women with high-grade cervical lesions.

OBJECTIVE: To determine the prevalence of human papillomavirus (HPV) in urine samples from women with high-grade cervical lesions. Secondary objectives are to identify the influence of socio-demographic factors and the different genotypes with urinary HPV positivity. STUDY DESIGN: 75 women with a positive biopsy for CIN2+ were included in the study from October 2010 to July 2011. A sample of urine was collected immediately before conization at the outpatient clinic. We analyzed the presence of HPV using a PCR technique. RESULTS: The mean age of the patients was 34.8 years (range 24 to 61). All patients had histological CIN2+, of whom 54.67% had CIN3. The prevalence of HPV in urine test was 58.82% in CIN2 population versus 78.05% in CIN3 patients (p 0.072). 31 different genotypes were found. The most frequent HPV genotype was 16-HPV, which was identified in 58% of women with positive HPV-DNA in urine samples. No demographic characteristics were significantly associated to urinary HPV prevalence. CONCLUSION: Most of the patients with CIN2+ showed positive results for urine HPV test. The prevalence of positive urinary HPV test was higher for patients with CIN3. HPV urine detection could be considered as an acceptable option for high-risk population who skip regular screening programs.

Polymorphisms and haplotypes across the osteoprotegerin gene associated with bone mineral density and osteoporotic fractures.

UNLABELLED: Osteoprotegerin plays a key role in bone remodelling. We studied the association between 24 polymorphisms and haplotypes on the OPG gene and bone mineral density and fractures. After multiple-testing correction, one SNP and two block-haplotypes were significantly associated with FN BMD. Two other block-haplotypes were associated with fracture. INTRODUCTION AND HYPOTHESIS: Osteoprotegerin (OPG) plays a key role in bone remodelling. Here we studied the association between polymorphisms and haplotypes on the OPG gene and bone mineral density (BMD) and fractures. METHODS: Twenty-four single nucleotide polymorphisms (SNPs) were selected to cover six haplotypic blocks and were genotyped in 964 postmenopausal Spanish women. Haplotypes were established with HaploStats. Association was analysed by GLM (for BMD) and logistic regression (for fractures) both at single SNP and haplotype levels. RESULTS: Upon adjustment for multiple testing (p < 0.0073), one of the SNPs (SNP #17, rs1032129) remained significantly associated with FN BMD (p = 0.001). Four block-haplotypes stood multiple-testing correction. Two remained associated with FN BMD and two with fracture. The association of block-4 haplotype "AC" (of SNPs #18 and #17) with FN BMD (p = 0.0002) was stronger than that of SNP#17 alone and was the best result overall. A global assessment of the results indicated that all the alleles and haplotypes with a protective effect, at p < 0.05, belonged to a frequent long-range haplotype. CONCLUSIONS: In conclusion, these results provide a detailed picture of the involvement of common variants and haplotypes of the OPG gene in bone phenotypes.

Polymorphisms in the interleukin-6 receptor gene are associated with bone mineral density and body mass index in Spanish postmenopausal women.

OBJECTIVE: Osteoporosis and obesity are complex diseases with a strong genetic component. Bone mineral density (BMD) and body mass index (BMI) linkage studies identified a locus at 1q21-23, where the interleukin-6 receptor (IL6R) gene is located. The IL6R and the gp130 receptors are the mediators of IL6 action. Serum levels of IL6 and sIL6R (the soluble form of IL6R) are higher in several diseases such as osteoporosis or obesity. Variants at IL6R have been associated with BMI and obesity. However, IL6R is an as-yet-unexplored osteoporosis candidate gene. DESIGN: In the present study we analysed two polymorphisms in the IL6R promoter, -1435 C/T (rs3887104) and -208 G/A (rs4845617), and the Asp358Ala polymorphism (rs8192284), in relation to both BMD and BMI in a cohort of 559 postmenopausal Spanish women. RESULTS: The promoter polymorphisms, -1435 C/T and -208 G/A were associated with femoral neck (FN) BMD (P=0.011 and P=0.025 respectively). The C-A and T-G promoter haplotypes were also associated with FN BMD. Additionally, the Asp358Ala variant was associated with lumbar spine BMD (P=0.038). Finally, the -208 G/A polymorphism and the C-G and C-A haplotypes were associated with BMI and obesity, where GG was the risk genotype (P=0.033 for BMI; P=0.010 for obesity). CONCLUSION: These data suggest that variants in the IL6R gene are not only involved in the determination of BMI but also relevant for the determination of BMD. The IL6R gene may belong to the growing list of genes known to be involved in both phenotypes.

A study of Ki-67, c-erbB2 and cyclin D-1 expression in CIN-I, CIN-III and squamous cell carcinoma of the cervix.

The histological criteria for cervical intraepithelial neoplastic lesions and their follow-ups have been established, but their reproducibility, specificity and sensibility are not certain. Immunohistochemical markers provide more information on each specific case, in order to facilitate its classification and, eventually, its prognosis. Using immunohistochemical techniques, this study analyzes the prognostic value of three markers (Ki-67, c-erbB2 and Cyclin D1) in cases of low grade squamous intraepithelial neoplasia (CIN-I), high grade squamous intraepithelial neoplasia (CIN-III), and infiltrating squamous cell carcinoma (SCC) taken from a group of cervical samples. In situ hybridization was performed in order to detect high-risk HPV. High risk HPV was demonstrated in 82%, 89% and 100% of the LGSIL, HGSIL and SCC cases, respectively. C-erbB2 expression was detected in 9%, 33% and 50% of the LSIL, HGSIL and SCC cases, respectively. The Ki-67 LI was 25%, 68% and 65.5% in the LGSIL, HGSIL and SCC cases, respectively. Nuclear Cyclin D1 expression was seen in 82%, 11% and 30% of the CIN-I,CIN-III and SCC cases, respectively. We observed that the cytoplasmic cyclin D1 expression increased with the severity of the lesion instead of the nuclear expression decreasing with the progression of the pathology. Nuclear and cytoplasmic Cyclin D1 expression seemed to be related to HPV high risk infection. We concluded that Cyclin D1, cerbB2 and The Ki-67 LI expression changed in relation to the severity of the lesion and that they could be helpful in making a differential diagnosis.

COL1A1, ESR1, VDR and TGFB1 polymorphisms and haplotypes in relation to BMD in Spanish postmenopausal women.

INTRODUCTION AND HYPOTHESIS: Genetic studies of osteoporosis have focused on analysing single polymorphisms in individual genes - with inconclusive results. An alternative approach may involve haplotypes and gene-gene interactions. The aim of the study was to test the association between the COL1A1, ESR1, VDR and TGFB1 polymorphisms or haplotypes and bone mineral density (BMD) in Spanish postmenopausal women. METHODS: Sixteen polymorphisms were analysed in 719 postmenopausal women. ANOVA, ANCOVA and Xi2 tests were used to perform the statistical analysis. RESULTS: COL1A1 -1997G > T (p=0.04) and TGFB1 Leu10Pro (p=0.02) were found to be associated with adjusted lumbar spine (LS) BMD. Interactions were observed between: the COL1A1 -1997 G/T and Sp1 polymorphisms (p < 0.01 for LS BMD) and the COL1A1 -1663 indelT and VDR ApaI polymorphisms (p < 0.01 for femoral neck (FN) BMD). The COL1A1 GDs and ESR1 LPX haplotypes were associated with FN BMD (p=0.03 and p=0.03). CONCLUSIONS: Polymorphisms at COL1A1 and TGFB1 and haplotypes at COL1A1 and ESR1 were found to be associated with BMD in a cohort of postmenopausal Spanish women. Moreover, COL1A1 polymorphisms showed significant interactions among them and with the VDR 3' polymorphisms.

A comparison of raloxifene and calcium plus vitamin D on vaginal atrophy after discontinuation of long-standing postmenopausal hormone therapy in osteoporotic women. A randomized, masked-evaluator, one-year, prospective study.

OBJECTIVES: We assessed the effects of the discontinuation of long-standing transdermal estrogen replacement therapy (>4 years) and substitution of this treatment by calcium or raloxifene on the vaginal epithelium and climateric symptoms in a study population of osteoporotic women. METHODS: A total of 136 women (mean age 55.5 years) were randomized to calcium (500 mg elemental calcium, 400 IU Vitamin D3) (n=40), raloxifene (60 mg/day) (n=48), or estrogen patches (3.9 mg estradiol) and progesterone (100 mg/day) (n=48). Treatment was given for 1 year. The vaginal maturation value (VMV), serum estradiol levels, and climateric symptoms using a 12-item modification of the SF-36 quality of life questionnaire were evaluated at baseline and at 6 and 12 months. RESULTS: At 6 months, mean VMV decreased significantly (P<0.001) in the calcium (-51.8%) and raloxifene (-18.6%) groups compared with baseline and the estrogen/progesterone group. At 12 months, significant decreases of mean VMV in the calcium (-38.7%) and raloxifene groups (-32%) (P<0.001) were also observed. Serum estradiol levels and changes of VMV correlated significantly at 6 months (rho=0.361, P<0.01) and at 12 months (rho=0.269, P<0.035). A significantly higher number of patients complained of hot flushes and palpitations in the calcium and raloxifene groups than in the estrogen/progesterone group. Raloxifene-treated women reported a significantly higher number of adverse events at 6 months compared to the other treatment groups. CONCLUSIONS: Withdrawal and change of long-standing transdermal hormone replacement therapy by treatment with calcium or raloxifene resulted in worsening of vaginal atrophy assessed by the VMV, although it was not clinically perceived by the patients. However, increases in dyspareunia and urinary leaks were reported. Menopausal complaints related to vasomotor symptoms worsened in the calcium- and raloxifene-treated groups and persisted throughout the study period.

Timing of follow-up densitometry in hormone replacement therapy users for optimal osteoporosis prevention.

The objectives of the study were (1) to determine the time interval for repeat dual-energy X-ray absorptiometry (DXA) to detect significant bone loss, i.e., greater than the coefficient of variation (CV) of the center (2.8 x CV%) and (2) to assess how long hormone replacement therapy can be maintained to avoid undetected development of low bone mass and to not unduly delay appropriate treatment. A total of 3,826 healthy women, aged 40-65 years, participated in a prospective cohort study, 807 of whom were treated with transdermal estrogen replacement therapy and 626 with transdermal estrogen/progesterone regimens. The untreated group included the remaining 2,393 women. Between 1996 and 2002 they underwent a baseline DXA scan, and DXA scans were then repeated annually. There were no differences among the study groups at entry into the study. Treatment with estrogen was a protective factor for loss of bone mass at the lumbar spine (odds ratio [OR] =0.431, 95% confidence interval [CI] 0.344 to 0.522) and at the femoral neck (OR =0.433, 95% CI 0.352 to 0.521). Treatment with estrogen/progesterone also showed a protective effect against significant changes in follow-up BMD (>2.8 x 1.05% CV of densitometry at L1-L4, >2.8 x 2.3% CV at the femoral neck). In the treated group, significant differences in BMD at the lumbar spine (OR =1.593, 95% CI 1.423 to 2.355) did not appear within the first 3 years, and differences in BMD at the femoral neck (OR =3.555, 95% CI 2.782 to 4.905) did not appear within the first 4 years. It is concluded that in women aged 45-65 years, receiving transdermal hormone replacement therapy without risk factor for loss of bone mass, such as age < 55 years and body mass index <25 kg/m(2), periodical follow-up densitometries would not be necessary, provided that the duration of estrogen or estrogen/progesterone therapy is shorter than 3 years.

Trends in the use of emergency contraception: an epidemiological study in Barcelona, Spain (1994-2002).

We conducted a retrospective review of the medical records of women requesting emergency contraception (EC) at our emergency department over a 9-year period (1994-2002). EC accounted for 5.9% of all visits (n = 95,288) and increased from 1.26% in 1994 to 9.82% in 2002 (p < 0.001). Reasons for EC were condom problems in 79.5% of cases. EC was used only once by 93% of women. The mean daily number of visits was significantly higher in August (2.46), July (2.01) and September (2.02) than in other months (p < 0.05), and was more frequent on Sunday (3.26), Saturday (2.92) and Monday (2.05) compared to other week days (p < 0.001). New Year's Day and the St. John's Night registered the highest number of visits (mean of 17.2 and 11.7, respectively), with significant differences compared to the remaining days of the year (p < 0.001).

The Ki-67 labeling index is not a useful predictor for the follow-up of cervical intraepithelial neoplasia 1.

OBJECTIVE: Our aim was to determine whether the Ki-67 immunostaining pattern, present on diagnosis of cervical intraepithelial neoplasia (CIN), predicts the change from low-grade to high-grade CIN over a 2-year period after diagnosis. MATERIALS AND METHODS: Of 59 cervical biopsy samples from 59 patients diagnosed as having cervical CIN, 35 were diagnosed as CIN 1 and 24 were diagnosed as CIN 2 or CIN 3. The Ki-67 immunostain showed immunopositive cells in the upper two thirds of the epithelium in all specimens. Two hundred nuclei were counted in 25 high-power fields in each specimen, including all of the epithelial layers, to determine the mean number of Ki-67-positive cells. In situ hybridization was used to demonstrate and type human papillomavirus. The chi test, Fisher exact test, Student t test, one-way analysis of variance, and Tukey test were used for statistical analysis, with significance set at p < .05. RESULTS: The mean Ki-67 labeling index for CIN 1, CIN 2, CIN 3, and CIN 2,3 were, respectively, 32.5%, 43.2%, 53.2%, and 47.8%. The statistical study showed significant differences between CIN 1 versus CIN 2, CIN 1 versus CIN 3, and CIN 1 versus CIN 2,3. For CIN 1, the mean Ki-67 labeling index was 32.8% when the lesion disappeared and was 34.6% for persisting lesions. There was no statistically significant difference. CONCLUSIONS: Ki-67 labeling index did not predict persisting CIN 1.

Atipia citológica de significado incierto en células escamosas. Importancia del seguimiento de las pacientes. Relación con la edad y las células metaplásicas / Atypical squamous cells of undetermined significance. Importance of patient follow-up and relation with age and metaplastic cells

Objetivos: Evaluar la importancia de la edad y de las células sobre las que asientan las lesiones de atipia citológica de significado incierto en células escamosas (ASCUS) en relación con la evolución de la lesión. Material y método: Revisión de las citologías correspondientes a 296 pacientes diagnosticadas de ASCUS (ASC-US y ASC-H), desde 1995 a 1999 en el Servicio de Patología del Hospital del Mar de Barcelona. Evaluación de la aparición de displasia de cualquier grado en uno de los controles posteriores, en relación con los antecedentes, con el tipo de células sobre las que asientan los cambios, y con la edad de las pacientes. Resultados: Antecedentes: La tasa de aparición de lesión escamosa intraepitelial de bajo grado (LSIL) es variable y no tiene relación con los antecedentes de la paciente. La tasa de aparición de lesión escamosa intraepitelial de alto grado (HSIL) muestra un aumento lineal en relación con la gravedad de los antecedentes. Edad: Se observa mayor tasa de aparición de LSIL en mujeres menores de 45 años y mayor tasa de aparición de HSIL en mujeres mayores de 45 años, pero las diferencias no son estadísticamente significativas. Células escamosas inmaduras: Se observa mayor tasa de aparición de lesión escamosa intraepitelial (SIL) de cualquier grado cuando los cambios asientan sobre células escamosas inmaduras, pero las diferencias no son estadísticamente significativas. Conclusiones: Sí parecen tener importancia los antecedentes en relación con la recidiva de la lesión. Pese a que la tasa de aparición de HSIL es baja, aumenta en relación con la gravedad de los antecedentes. La identificación de una citología ASCUS en una paciente con antecedentes de displasia puede marcar la progresión-evolución del proceso displásico. Parece, además, que HSIL es más frecuente cuando ASCUS asienta sobre células escamosas inmaduras. Nuestros datos favorecen esta hipótesis, a pesar de que las diferencias no son estadísticamente significativas. Respecto a la edad, nuestro estudio confirma los datos establecidos previamente en la bibliografía. Por fin, parece importante el hecho de realizar controles citológicos al menos durante los primeros 2 años, dado que la tasa de aparición de HSIL es mayor en este período (AU)

A new report of mesomelic camptomelia, polydactyly and Dandy-Walker complex in siblings.

Two male siblings with several malformations are reported. The anomalies detected in both fetuses were mesomelic camptomelia, postaxial hexadactyly and Dandy-Walker complex. There was only one similar previous report in the literature. This combination could represent a specific pattern of malformation or a new syndrome, with different variants. The parents' consanguinity and the recurrence in a subsequent pregnancy suggest an autosomal recessive inheritance pattern.

Linfomas primariosdel aparato genital femenino / Primary lymphomas of the female genital tract

Presentamos dos casos de linfomas primarios del aparato genital femenino que afectan a ovario y útero. Los linfomas del aparato genital femenino son una enfermedad poco frecuente; es más habitual la afección secundaria por un linfoma sistémico que la afección primaria. Acostumbran presentarse con la sintomatología típica de otros cánceres ginecológicos, por lo que es difícil establecer el diagnóstico de sospecha previamente a la cirugía. Para realizar el diagnóstico diferencial preciso a menudo se requieren técnicas inmunohistoquímicas. El tipo histológico más habitual es el linfoma no hodgkiniano del tipo B. Se les aplica el sistema de estadificación de Ann-Arbor, y la extensión de la enfermedad es el principal factor pronóstico. Aprovechamos para efectuar una revisión de los datos existentes en la bibliografía (AU)

[Impact of medical counselling on giving up smoking during pregnancy]. / Impacto del consejo médico para dejar de fumar durante la gestación.

OBJECTIVE: Women s tobacco consumption has increased in Spain in recent years, especially among women of reproductive age. This study aims to evaluate the impact of medical counselling integrated into pre-natal care on tobacco consumption during pregnancy and the period after delivery. DESIGN: Quasi-experimental intervention study.Setting. Hospital del Mar, Barcelona. PATIENTS: 219 patients who attended the Hospital del Mar for delivery during 1996 (control group) and 169 patients seen during their pregnancies at the same hospital in 1997 (intervention group). INTERVENTIONS: The control group patients had received normal care. The pregnant women in the intervention group received systematic structured counselling on giving up smoking, backed up by a special brochure composed for this purpose. MEASUREMENTS AND RESULTS: The intervention and control groups showed no statistically significant differences either in their social or demographic variables or in their tobacco consumption. In both groups the evolution of their smoking during pregnancy was determined during their pre-natal visits and six months after delivery through a telephone interview. 44 of the women in the control group (20.1%) gave up smoking before their first pre-natal visit, and 11 (5%) gave up during pregnancy. In the intervention group 26 (17.7%) had given up spontaneously and 16 (10.9%) gave up during pregnancy. Of those who gave up completely during pregnancy, 36.4% of women in the control group and 64.3% in the intervention group remained abstinent at six months (P=.002). CONCLUSIONS: Counselling at pre-natal check-ups to give up smoking lightly increases the number of women who give up and reduces significantly the number of post-delivery backsliders.