An interleukin-1 polymorphism additionally intensified by atopy as prognostic factor for aseptic non-mechanical complications in metal knee and hip arthroplasty.

Background: In contrast to infection or mechanical issues joint replacement failure following inflammatory adverse reactions is poorly understood. Objective: To assess the association of IL-1ß polymorphisms and history of allergy with aseptic non-mechanical complications following arthroplasty. Methods: In 102 patients with aseptic non-mechanically caused symptomatic knee or hip arthroplasty (SA) and 93 patients with asymptomatic arthroplasty (AA) questionnaire-based history, patch test with at least standard series, lymphocyte transformation test (LTT) with nickel, cobalt and chromium and interleukin-1 polymorphism analysis were done. Three polymorphisms of the IL1B gene [IL-1b -3954 (rs1143634), IL-1b -511 (rs16944) and IL-1b -31 (rs1143627)] and one polymorphism of the IL1RN gene [IL1RN intron 2, variable number of tandem repeats, VNTR (rs2234663)] were assessed by PCR and gel electrophoresis. Results: We found no significant difference in smoking history and atopy but 25% versus 10% of self-reported metal allergy in SA versus AA; the patch test (respective, LTT) for metal sensitivity was more often positive in SA patients. The allele 498 bp of the IL1RN polymorphism occurred significantly more often in the SA group (37% versus 11%; p < 0.0001). Upon additional presence of atopy, the difference was even greater (60% vs 10%) (p < 0.000001). There was no association of IL-1 polymorphisms with metal allergy. Conclusion: The IL1RN VNTR allele 498 bp was strongly associated with SA. In patients with a history of atopy, presence of the IL1RN VNTR allele 498 bp led to a four-fold higher SA prevalence compared to patients without this allele.

Valoración clínica y angiográfica de la reestenosis del stent coronario convencional / Clinical and angiographic assessment of coronary bare-metal stent restenosis

Introducción: La cardiopatía isquémica es la principal causa de muerte en Cuba. Laangioplastia coronaria con stent es una excelente opción terapéutica, pero la reeste-nosis ensombrece su pronóstico y es mucho más frecuente con el uso de stents con-vencionales. Objetivo: Caracterizar clínica y angiográficamente la reestenosis del stent coronario convencional. Método: Se realizó un estudio descriptivo y transversal en los 59 pacientes con diagnóstico de reestenosis del stent coronario convencional confirmado por angiografía en la Unidad de Cardiología Intervencionista del Cardiocentro Ernesto Che Guevarade Villa Clara, Cuba, durante el período febrero 2010 abril 2012. Las variables analizadas fueron edad, sexo, factores de riesgo coronario, historia previa de angina oinfarto, vaso afectado, tipo de reestenosis y de lesión tratada, diámetro del vaso ylongitud de la lesión. Resultados: Predominaron los pacientes del sexo masculino (76,3 por ciento), con edadescomprendidas entre 60-69 años (40,7 por ciento). Los factores de riesgo más frecuentes fueron la hipertensión arterial (76,3 por ciento), el hábito de fumar (37,3 por ciento) y la diabetes mellitus tipo II (33,9 por ciento). El vaso más afectado fue la descendente anterior (59,3 por ciento), los diámetros arteriales eran predominantemente ≤ 2,5 mm (54,2 por ciento) y la longitud de las lesiones > 20 mm (66,1 por ciento). Las lesiones tipo B (52,5 por ciento) y la reestenosis focal (57,6 por ciento) fueron más frecuentes(AU)

An investigation of environmental levels of cadmium and lead in airborne matter and surface soils within the locality of a municipal waste incinerator.

The results of an investigation into the environmental impact of heavy metals in the airborne emissions from the Baldovie municipal waste incinerator, Scotland, are presented. A sampling network of 1-km grid squares covering a 7 x 9 km area was established over the incinerator plant and its surroundings. Surface soil core samples were collected from within each 1 km2 and analysed for cadmium and lead content. The spatial distribution of lead levels in soils showed a marked variation downwind from the Baldovie incinerator in comparison with the background level for the area but remained well within the typical range of lead in rural, unpolluted, British soils. A comparison of the observed levels of lead in local soils, with the predicted downwind long-term ground level lead distribution in air indicates that atmospheric emissions of lead originating from the Baldovie incinerator directly determine concentrations of lead in soils within a radius of 5 km of the incinerator. An empirical relationship between the levels of lead in soils and the long-term levels in air was established. In the case of cadmium, the spatial distribution of the heavy metal showed neither a marked nor extensive contamination of the sampled area around the incinerator and remained within the typical range of cadmium levels in rural, unpolluted, British soils. The work concludes that atmospheric emissions of lead from the Baldovie incinerator significantly determines the local distribution of lead in soils within the immediate vicinity of the incinerator.

Tc-99m HMPAO brain SPECT scanning in Munchausen syndrome.

Regional cerebral blood flow was studied in a patient with Munchausen syndrome using high resolution Tc-99m HMPAO SPECT. The scan demonstrated marked hyperperfusion of the right hemithalamus. The cranial CT scan was normal. The abnormal right hemithalamic blood flow is discussed in relation to the hypothesized neuropathy of this disorder.

Functional deficits in autistic disorder: characterization by technetium-99m-HMPAO and SPECT.

UNLABELLED: Autistic disorder is an early and severe developmental disorder characterized by deficits in verbal and nonverbal language, social skills, cognitive functioning and an abnormal repertoire of behaviors. Current research, however, has failed to identify the neurobiological mechanisms that underlie autism or those cortical brain regions, if any, that are abnormal. METHODS: We examined regional cerebral blood flow (rCBF) in six young, severely autistic patients. High-resolution brain SPECT with 99mTc-HMPAO was performed while five of the six patients were under general anesthesia. The scans reflected the subjects' rCBF in their usual alert behavioral state, since the tracer was injected at least 15 min prior to anesthesia and is rapidly extracted and fixed in the brain. A computer-automated cortical region of interest (ROI) generator was used to define 12 annular cortical regions (region 1 = left frontal, clockwise to region 12 = right frontal) for count data acquisition. The ratio of average counts in each ROI to whole-slice counts for the autistic patients was compared to age-matched controls using repeated measures (splt-plot) ANOVA statistical analysis for three representative brain levels. RESULTS: In the autistic patients, cortical regions 3, 4, and 10 were abnormally low at the cortical level canthomeatal (CM) + 3.5 cm. At level CM + 5.5 cm, regions 3, 4, 5 and 10 were abnormally low, and at level CM + 7.5 cm, regions 7 and 9 were also abnormally low. These regions correspond to abnormally low rCBF values located predominately in the temporal and parietal lobes, with the left cerebral hemisphere showing greater rCBF abnormalities than the right. CONCLUSION: Our findings suggest that the temporal and parietal lobes have abnormal rCBF in autism. HMPAO brain SPECT in combination with general anesthesia is particularly useful for imaging severely noncompliant patients.

Technetium-99m-HMPAO brain SPECT evaluation of neurotoxicity due to manganese toxicity.

UNLABELLED: We performed initial and follow-up regional cerebral blood flow (rCBF) studies using 99mTc-hexamethylpropyleneamine oxime (HMPAO) SPECT on a patient with manganese-induced central nervous system (CNS) neurotoxicity. METHODS: The patient had a history of long-term exposure to manganese at the time of the first scan, while the follow-up scan was performed 9 mo after removal from the toxic environment. The patient's serum level of manganese was five- to tenfold greater than normal at the time of the initial rCBF brain SPECT scan. RESULTS: The rCBF brain SPECT scan demonstrated significantly decreased rCBF in the right caudate nucleus and both thalami. A MRI scan obtained at the same time was normal. The follow-up rCBF brain SPECT scan was normal. CONCLUSIONS: This report supports the utilization of functional rCBF brain SPECT imaging to provide objective evidence of a function CNS abnormality due to neurotoxicity at an early clinical stage. Our results emphasize that rCBF brain SPECT may provide a confirmational test to support the diagnosis of neurotoxicity in the appropriate clinical setting.