Severity and duration of allergic conjunctivitis: are they associated with severity and duration of allergic rhinitis and asthma?

Summary: Objective. The association of allergic conjunctivitis (AC) with rhinitis and/or asthma is poorly understood. The objective of this study was to apply the Consensus Document for Allergic Conjunctivitis (DECA) criteria for the classification of AC to a population of patients with AC to assess the association between the severity and duration of AC and rhinitis and/or asthma. Methods. Patients with ocular symptoms of AC who participated in the 'Alergológica 2015' study were included. The demographics, classification according to the DECA criteria, etiology, and comorbidities were evaluated by age groups (less or equal than 14 and greater than 14 years). Results. A total of 2,914 patients (age range, 1-90 years) were included in the "Alergológica 2015" study. Of these, 965 patients (33.1%) were diagnosed with AC (77.5% > 14 years). AC was classified as severe, moderate, or mild in 1.8%, 46.4%, and 51.8%, respectively; and as intermittent or persistent in 51.6% and 48.4% of the patients. AC alone occurred in 4% of patients. AC was mainly associated with rhinitis (88.4%), asthma (38.2%), food allergy (8.3%) and atopic dermatitis (3.5%). In allergic respiratory disease rhinitis preceded AC and asthma developed later. The severity and duration of AC was significantly associated with severity and duration of rhinitis (p less than 0.001 for both age groups) and asthma (p less than 0.001 only in adults). Conclusions. The application of the new DECA classification for AC reveals a direct relationship between AC, rhinitis and asthma respect to severity and duration. These relationships suggest that AC should be considered an integral part of the "one airway, one disease" hypothesis.

Low bone mineral density and associated factors in patients with haemophilia in Colombia.

INTRODUCTION: Patients with haemophilia may have lower levels of bone mineral density (BMD) compared with the general population. Moreover, haemophilic patients have increased risk factors for low bone mineral density (LBMD) such as arthropathy and resulting immobility, increasing their risk for osteoporosis and fractures. AIM: To assess the prevalence of LBMD and associated risk factors among a group of Colombian haemophilic patients. METHODS: In this case-control study, 90 patients with haemophilia A and B, over the age of five, were recruited. Controls were healthy participants matched by age, gender, body mass index (BMI), socioeconomic status, and race. All participants underwent dual energy X-ray absorptiometry (DXA) and the Global Physical Activity Questionnaire. Blood tests were collected to evaluate LBMD determinants in cases. RESULTS: BMD was lower in cases than in the control group. BMD of femoral necks was 0.907 g/cm2 in cases vs. 1.020 g/cm2 in controls (P = .019), and BMD of hips 0.930 g/cm2 in cases vs. 1030 g/cm2 in controls (P = .019). The greater the severity of haemophilia, the lower BMD in spine, femoral neck, and hips. Elevated C-protein levels were found in 44.1% of patients with LBMD and 14.8% with normal BMD (P = .003). The study found an adjusted prevalence ratio of 2.11, indicating that haemophilic patients are two times more likely to have LBMD (CI95% = 1.43-3.11 P < .001). CONCLUSION: Results from the present study showed that haemophilia was associated with a higher frequency of LBMD. Severity of haemophilia, haemophilic arthropathy, and elevated C-reactive protein levels was directly associated with LBMD.

Relationship between respiratory and food allergy and evaluation of preventive measures.

Food allergy and respiratory allergy are two frequently associated diseases and with an increasing prevalence. Several reports show the presence of respiratory symptoms in patients with food allergy, while certain foods may be related to the development or exacerbation of allergic rhinitis and asthma. The present update focuses on this relationship, revealing a pathogenic and clinical association between food and respiratory allergy. This association is even more intense when the food hypersensitivity is persistent or starts in the early years of life. Food allergy usually precedes respiratory allergy and may be a risk factor for allergic rhinitis and asthma, becoming a relevant clinical marker for severe atopic asthma. Furthermore, the presence of co-existing asthma may enhance life-threatening symptoms occurring during a food allergic reaction. Recommendations for dietary restrictions during pregnancy and breastfeeding to prevent the development of respiratory allergy are controversial and not supported by consistent scientific data. Current recommendations from medical societies propose exclusive breastfeeding during the first four months of life, with the introduction of solid food in the fourth to the seventh month period of life. A delayed introduction of solid food after this period may increase the risk of developing subsequent allergic conditions. Further studies are encouraged to avoid unjustified recommendations involving useless dietary restrictions.

Nasal Hyperreactivity: Nonspecific Nasal Provocation Tests. Review by the Rhinoconjunctivitis Committee of the Spanish Society of Allergy and Clinical Immunology.

Nasal hyperreactivity is the abnormal reaction of nasal tissue to a stimulus that is innocuous to most people. This response is caused by dysregulation of the autonomic nervous system at various levels of the nasal autonomic reflex arc. Various stimuli (methacholine, histamine, adenosine 5'-monophosphate, cold air, mannitol, rapsaicin, phentolamine, and distilled water) have been used in an attempt to find the test that most reliably differentiates between healthy individuals and patients and also between different types of rhinitis. Despite the small number of publications available, in the present review, we provide an update on current nonspecific nasal provocation techniques. The studies published to date are not comparable: the stimuli applied act through different mechanisms and are used to assess different pathways, and the methodologies differ in terms of selection of participants, concentrations used, and assessment of response (criteria for positivity). Given the limited use of nonspecific nasal provocation tests in routine clinical practice, we believe that more studies are warranted to address the research issues we present at the end of the present review, for example, the need to standardize the methodology for each test or even the clinical benefits of knowing whether or not a patient has nasal hyperreactivity.

Consensus document on allergic conjunctivitis (DECA).

Allergic conjunctivitis (AC) is an inflammatory disease of the conjunctiva caused mainly by an IgE-mediated mechanism. It is the most common type of ocular allergy. Despite being the most benign form of conjunctivitis, AC has a considerable effect on patient quality of life, reduces work productivity, and increases health care costs. No consensus has been reached on its classification, diagnosis, or treatment. Consequently, the literature provides little information on its natural history, epidemiological data are scarce, and it is often difficult to ascertain its true morbidity. The main objective of the Consensus Document on Allergic Conjunctivitis (Documento dE Consenso sobre Conjuntivitis Alérgica [DECA]), which was drafted by an expert panel from the Spanish Society of Allergology and Spanish Society of Ophthalmology, was to reach agreement on basic criteria that could prove useful for both specialists and primary care physicians and facilitate the diagnosis, classification, and treatment of AC. This document is the first of its kind to describe and analyze aspects of AC that could make it possible to control symptoms.

[Impact of COVID-19 lockdown on patients with idiopathic intracranial hypertension in Spain]. / Impacto del confinamiento por COVID-19 en pacientes con hipertensión intracraneal idiopática en España.

INTRODUCTION: The nationwide lockdown implemented in Spain in March 2020 in response to the 2019 coronavirus disease pandemic (COVID-19) could have had an effect on the clinical situation, disease management and access to care in patients with idiopathic intracranial hypertension. PATIENTS AND METHODS: A cross-sectional observational study was conducted by means of an online survey. The frequency and impact of headache, visual symptoms, dizziness, cognitive symptoms, diplopia, anxiety and depression on patients' quality of life were recorded. Disease treatment and delays experienced in accessing care were recorded. Participants were grouped according to the time elapsed since diagnosis. RESULTS: A total of 112 patients participated in the study (103 women). The average time since disease onset was 6.25 years. Headache, anxiety and depression were responsible for considerable impact in the period prior to lockdown. The impact of headache was not aggravated during lockdown, but anxiety and depression did become significantly worse. Recently diagnosed participants reported higher rates of anxiety, depression, dizziness and diplopia; chronically diagnosed participants reported a higher frequency of cognitive symptoms. CONCLUSIONS: The clinical situation of the participants deteriorated during lockdown, although the differences were smaller than previously thought. This was probably because the baseline situation was more severe than expected. Further studies are needed to clarify the medium and long-term impact of the COVID-19 pandemic on patients with idiopathic intracranial hypertension.

TITLE: Impacto del confinamiento por COVID-19 en pacientes con hipertensión intracraneal idiopática en España.Introducción. El confinamiento nacional instaurado en España en marzo de 2020 como respuesta a la pandemia por la enfermedad por coronavirus 2019 (COVID-19) pudo tener un efecto en la situación clínica, el manejo de la enfermedad y el acceso a la atención médica en pacientes con hipertensión intracraneal idiopática. Pacientes y métodos. Se realizó un estudio observacional transversal por medio de una encuesta en línea. Se registraron la frecuencia y el impacto en la calidad de vida de la cefalea, los síntomas visuales, el mareo, los síntomas cognitivos, la diplopía, la ansiedad y la depresión. Se registró el tratamiento de la enfermedad y los retrasos experimentados en el acceso a la atención médica. Se agrupó a los participantes según el tiempo de evolución desde el diagnóstico. Resultados. Participaron 112 pacientes (103 mujeres). El tiempo medio de evolución de la enfermedad fue 6,25 años. La cefalea, la ansiedad y la depresión fueron responsables de un impacto considerable en el período previo al confinamiento. El impacto de la cefalea no empeoró durante el confinamiento, pero la ansiedad y la depresión empeoraron significativamente. Los participantes diagnosticados recientemente comunicaron mayores tasas de ansiedad, depresión, mareo y diplopía; los de evolución crónica, mayor frecuencia de síntomas cognitivos. Conclusiones. La situación clínica de los participantes se deterioró durante el confinamiento, aunque las diferencias fueron menores de lo que se pensaba. Esto se debió, probablemente, a que la situación basal era más grave de lo esperado. Son necesarios más estudios para aclarar el impacto a medio y largo plazo de la pandemia por COVID-19 en pacientes con hipertensión intracraneal idiopática.

Translational and post-translational regulation of polyamine metabolic enzymes in plants.

Polyamines are small organic and basic polycations that perform essential regulatory functions in all living organisms. Fluctuations in polyamine content have been observed to occur during growth, development and under stress conditions, implying that polyamines play pivotal roles in diverse cellular and physiological processes. To achieve polyamine homeostasis, the entire metabolic pathway is subjected to a fine-tuned regulation of its biosynthetic and catabolic genes and enzymes. In this review, we describe and discuss the most important mechanisms implicated in the translational and post-translational regulation of polyamine metabolic enzymes in plants. At the translational level, we emphasize the role of polyamines in the modulation of upstream open reading frame (uORF) activities that control the translation of polyamine biosynthetic and catabolic mRNAs. At the post-translational level, different aspects of the regulation of polyamine metabolic proteins are depicted, such as the proteolytic activation of enzyme precursors, the importance of dimerization in protein stability as well as in protein intracellular localization.

Differential expression of Phaseolus vulgaris genes induced during the interaction with Rhizoctonia solani.

Common bean (Phaseolus vulgaris L.) is the most important grain legume for direct human consumption; however, bean production is affected by several diseases such as Rhizoctonia root rot. Few bean cultivars have been identified that effectively resist the attack of this fungus. Herein, we used the P. vulgaris Pv-2094 landrace, which is less susceptible to Rhizoctonia root rot, for the construction of a suppressive subtractive hybridization cDNA library in order to isolate plant defense-related genes. Total RNAs obtained after 8 and 16 h from inoculated and non-inoculated roots with R. solani Kühn, were used as the source of the "tester" and the "driver" samples, respectively. A total of 136 unigenes were obtained and classified into 12 functional categories. Six unigenes were selected to analyze for differential expression by qRT-PCR, including a receptor-like kinase (PvRK20-1), an acid phosphatase associated to defense (PA), a pathogenesis related protein (PR1), an ethylene responsive factor (ERF), a polygalacturonase inhibitor protein (PGIP), and an alpha-dioxygenase (α-DOX). These genes were found to be differentially expressed in a time-dependent manner in bean roots during the interaction with R. solani. Data generated from this study will contribute to the understanding of the molecular mechanisms associated with plant defense against root rot in common bean.

Cutaneous sarcoidosis: updates in the pathogenesis.

Sarcoidosis is a multiorgan granulomatous disease in which the skin is one of the frequently involved target organs. Cutaneous involvement occurs in a third of patients with sarcoidosis and has protean manifestations. More than a century has passed since the initial description of sarcoidosis, but its cause continues to be an enigma. Recent studies have introduced several new insights into the pathogenesis of this disease. The aim of this literature review was to provide a comprehensive overview on the current updates in the pathogenesis of sarcoidosis. This review has revealed that several genetic polymorphisms are associated with an increased risk of developing sarcoidosis, suggesting that genetic susceptibility to sarcoidosis is probably polygenic. Environmental factors may also modify the susceptibility to sarcoidosis. Evidence favouring an infectious aetiology has been accumulating, but the results of studies are conflicting. The current concept is that the pathogenesis of sarcoidosis involves a T-helper-1-mediated immune response to environmental antigens in a genetically susceptible host. The studies carried out on sarcoidosis have largely focused on the pulmonary aspects and have been mainly conducted by respiratory physicians. In contrast, research conducted on the cutaneous aspects of sarcoidosis is comparatively limited. Although tremendous advances have been made, there is a significant gap between the vast knowledge accumulated on sarcoidosis in recent years and the understanding of this disease.

Development of an animal experimental model to study the effects of levonorgestrel on the human endometrium.

BACKGROUND: This study was designed to develop an animal model to test the response of endometrium to local progestin delivery. METHODS: Proliferative human endometrium was subcutaneously grafted in two groups of SCID mice that received, 2 days before, a subcutaneous estradiol (E(2)) pellet and, for half of them, an additional implant of levonorgestrel (LNG). Mice were sacrificed 1, 2, 3 or 4 weeks after endometrial implantation and grafts were histologically analysed. Proliferation, steroid hormone receptors, blood vessels and stromal decidualization in both groups (E(2) and LNG) were immunohistologically evaluated and compared with proliferative endometrium and endometrium from women with an LNG intrauterine device. RESULTS: Grafts presented normal morphological endometrial characteristics. The expression of progesterone receptors was significantly decreased in glands and stroma of the LNG group as compared with the E(2) group at all times. A significant decrease was also observed in the stromal expression of estrogen receptor-alpha in the LNG group. At 4 weeks, the mean cross-sectional area of vessels was significantly higher after LNG treatment. CONCLUSIONS: These morphological and immunohistochemical characteristics are similar to those observed in women treated with local LNG. This mouse model might facilitate further investigations needed to understand the mechanisms responsible for the breakthrough bleeding frequently observed in progestin users.

Mixed origin of neovascularization of human endometrial grafts in immunodeficient mouse models.

BACKGROUND: In vivo mouse models have been developed to study the physiology of normal and pathologic endometrium. Although angiogenesis is known to play an important role in endometrial physiology and pathology, the origin of neovasculature in xenografts remains controversial. The aim of this study was to assess the origin of the neovasculature of endometrial grafts in different mouse models. METHODS: Human proliferative endometrium (n = 19 women) was grafted s.c. in two immunodeficient mouse strains: nude (n = 8) and severely compromised immunodeficient (SCID; n = 20). Mice were also treated with estradiol, progesterone or levonorgestrel. Fluorescence in-situ hybridization using a centromeric human chromosome X probe, immunohistochemistry (von Willebrand factor and collagen IV) and lectin perfusion were performed to identify the origin of the vessels. RESULTS: More than 90% of vessels within xenografts were of human origin 4 weeks after implantation. Some vessels (9.67 +/- 2.01%) were successively stained by human or mouse specific markers, suggesting the presence of chimeric vessels exhibiting a succession of human and murine portions. No difference in staining was observed between the two strains of mouse or different hormone treatments. Furthermore, erythrocytes were found inside human vessels, confirming their functionality. CONCLUSION: This article shows that human endometrial grafts retain their own vessels, which connect to the murine vasculature coming from the host tissue and become functional.

The practicalities of photodynamic therapy in acne vulgaris.

A staple clinical skill in a dermatologist's repertoire is the ability to treat acne vulgaris effectively. Light-based therapies such as photodynamic therapy (PDT) widen the therapeutic options available for acne. Numerous review articles have agreed on the answer to core questions such as: 'Does PDT work?' and 'Which acne lesions respond best to PDT?' They conclude that PDT is especially useful in inflammatory acne and may be superior to light therapy alone. This literature review seeks to offer guidance regarding treatment-specific queries about the photosensitizer, route of administration, treatment intervals, light sources and patient selection. Ovid Medline, PubMed and EMBASE database searches were executed between January 2007 and March 2008. Due to the scarcity of data, all five randomized trials, four of which were at least investigator blinded and controlled, 12 open clinical studies, two case reports and two abstracts published in English were considered. Four hundred and nineteen patients were recruited. As the quality of the data was suboptimal in a significant number of articles, the conclusions are drawn in very broad strokes: topical short-contact (90 min or less) 5-aminolaevulinic acid or methyl aminolaevulinate using a noncoherent light source at 2-4-week intervals for a total of two to four treatments produces the greatest clinical effect. Papulopustular acne is more responsive and all Fitzpatrick skin types are eligible. However, patients with skin types I-III have a reduced risk of postinflammatory hyperpigmentation seen in darker skin types. These treatment parameters demonstrate a good side-effect profile resulting in acne remission for at least 3 months to a year in a relatively cost-effective manner. Well-designed nonsplit-face randomized controlled trials would offer further guidance, especially for queries surrounding the light source and illumination schemes.

Impacto del confinamiento por COVID-19 en pacientes con hipertensión intracraneal idiopática en España / Impact of COVID-19 lockdown on patients with idiopathic intracranial hypertension in Spain

Introducción: El confinamiento nacional instaurado en España en marzo de 2020 como respuesta a la pandemia por la enfermedad por coronavirus 2019 (COVID-19) pudo tener un efecto en la situación clínica, el manejo de la enfermedad y el acceso a la atención médica en pacientes con hipertensión intracraneal idiopática. Pacientes y métodos: Se realizó un estudio observacional transversal por medio de una encuesta en línea. Se registraron la frecuencia y el impacto en la calidad de vida de la cefalea, los síntomas visuales, el mareo, los síntomas cognitivos, la diplopía, la ansiedad y la depresión. Se registró el tratamiento de la enfermedad y los retrasos experimentados en el acceso a la atención médica. Se agrupó a los participantes según el tiempo de evolución desde el diagnóstico. Resultados: Participaron 112 pacientes (103 mujeres). El tiempo medio de evolución de la enfermedad fue 6,25 años. La cefalea, la ansiedad y la depresión fueron responsables de un impacto considerable en el período previo al confinamiento. El impacto de la cefalea no empeoró durante el confinamiento, pero la ansiedad y la depresión empeoraron significativamente. Los participantes diagnosticados recientemente comunicaron mayores tasas de ansiedad, depresión, mareo y diplopía; los de evolución crónica, mayor frecuencia de síntomas cognitivos. Conclusiones: La situación clínica de los participantes se deterioró durante el confinamiento, aunque las diferencias fueron menores de lo que se pensaba. Esto se debió, probablemente, a que la situación basal era más grave de lo esperado. Son necesarios más estudios para aclarar el impacto a medio y largo plazo de la pandemia por COVID-19 en pacientes con hipertensión intracraneal idiopática.(AU)

Introduction: The nationwide lockdown implemented in Spain in March 2020 in response to the 2019 coronavirus disease pandemic (COVID-19) could have had an effect on the clinical situation, disease management and access to care in patients with idiopathic intracranial hypertension. Patients and methods: A cross-sectional observational study was conducted by means of an online survey. The frequency and impact of headache, visual symptoms, dizziness, cognitive symptoms, diplopia, anxiety and depression on patients’ quality of life were recorded. Disease treatment and delays experienced in accessing care were recorded. Participants were grouped according to the time elapsed since diagnosis. Results: A total of 112 patients participated in the study (103 women). The average time since disease onset was 6.25 years. Headache, anxiety and depression were responsible for considerable impact in the period prior to lockdown. The impact of headache was not aggravated during lockdown, but anxiety and depression did become significantly worse. Recently diagnosed participants reported higher rates of anxiety, depression, dizziness and diplopia; chronically diagnosed participants reported a higher frequency of cognitive symptoms. Conclusions: The clinical situation of the participants deteriorated during lockdown, although the differences were smaller than previously thought. This was probably because the baseline situation was more severe than expected. Further studies are needed to clarify the medium and long-term impact of the COVID-19 pandemic on patients with idiopathic intracranial hypertension.(AU)

Neuroendocrine mechanism of onset of puberty. Sequential reduction in activity of inhibitory and facilitatory N-methyl-D-aspartate receptors.

In humans and in several animal species, puberty results from changes in pulsatile gonadotropin-releasing hormone (GnRH) secretion in the hypothalamus. In particular, the frequency of pulsatile GnRH secretion increases at the onset of puberty, as can be shown by using hypothalamic explants of male rats of 15 and 25 d. Previous observations from us and others suggested that the initiation of puberty could involve a facilitatory effect of excitatory amino acids mediated through N-methyl-D-aspartate (NMDA) receptors. We found that GnRH secretion could be activated through NMDA receptors only around the time of onset of puberty (25 d). The aim of this study was to clarify why this activation did not occur earlier (at 15 d) and could no longer be observed by the end of puberty (at 50 d). We studied GnRH secretion in the presence of MK-801, a noncompetitive antagonist of NMDA receptors or AP-5, a competitive antagonist. We showed that, in the hypothalamus of immature male rats (15 d), a highly potent inhibitory control of pulsatile GnRH secretion in vitro was mediated through NMDA receptors. These data were confirmed in vivo because administration of the antagonist MK-801 (0.001 mg/kg) to immature male rats resulted in early pubertal development. Onset of puberty (25 d) was characterized by the disappearance of that NMDA receptor-mediated inhibition, thus unmasking a facilitatory effect also mediated through NMDA receptors. During puberty, there was a reduction in activity of this facilitatory control which was no longer opposed by its inhibitory counterpart. We conclude that a sequential reduction in activity of inhibitory and facilitatory NMDA receptors provides a developmental basis for the neuroendocrine mechanism of onset of puberty.

[Solitary fibrous tumors of the meninges: report of three cases and literature review]. / Tumor fibroso solitario meníngeo: descripción de tres casos y revisión de la literatura.

We report 3 patients with fibrous solitary tumor of meningeal location where we described the histological study, as well as evolution after the surgical treatment. The described patients presented ages of 37, 52 and 65 years, after the resection has not appeared an objective sign of recurrence in any case after 4, 6 and 7 years of follow-up respectively. Checking the literature the tumor is indistinguishable clinical and radiolocally of the typical meningioma, doing necessary the use of inmunohistochemistry to do the differential diagnosis, where positiveness for CD34 and the negativeness for EMA define the fibrous solitary tumor. It is about a benign tumor, where total removing is the principal factor in prognosis, nevertheless there are cases of local recurrences and long-distance metastasis. We can find all these characteristics in the showed cases of the present article, having the uncertainty of its local or systemic relapse ability in the future.

Validation of a HPLC method for simultaneous determination of five sunscreens in lotion preparation.

The aim of this research was to develop and validate a high-performance liquid chromatographic (HPLC) method for simultaneous determination of five sunscreens, namely benzophenone-3 (B-3), butyl methoxydibenzoylmethane (BM), octyl methoxycinnamate (OM), octyl salicylate (OS) and homosalate (HS). The separation and quantitative determination was made by HPLC at 40 +/-1 degrees C with a gradient elution from 10% to 100% mobile phase B in mobile phase A. The gradient liquid chromatographic system constituted of mobile phase A [acetonitrile : water (10 : 90 v/v)] and mobile phase B [acetonitrile : water (90 : 10 v/v)], at a flow rate of 1.0 mL min(-1) and ultraviolet detection at 310 nm. The separation was obtained with two Waters reversed phase columns: Novapack C-18 and Symmetry((R)) C-18 connected in series. All sunscreens were efficiently separated within 17 min. The coefficient of correlation and average recovery for B-3, BM, OM, OS and HS were 0.9798 and 98.5%, 0.9672 and 98.8%, 0.9922 and 99.1%, 0.9961 and 98.9% and 0.9909 and 99.4% respectively. The relative standard deviations obtained were between 1.07% and 2.44%. The excipients did not interfere in the analysis. The results showed that the proposed method could be used for rapid and simultaneous determination of B-3, BM, OM, OS and HS in sunscreen lotions with precision, accuracy and specificity.

[Compliance with contact isolation precautions of multidrug-resistant microorganisms in a tertiary hospital]. / Cumplimiento de las precauciones de aislamiento de contacto por microorganismos multirresistentes en un hospital de tercer nivel.

INTRODUCTION: Preventive isolation of patients with multidrug-resistant microorganisms is considered an effective measure to prevent outbreaks in hospitals. The objective of this study is to assess compliance by healthcare workers and family of contact isolation precautions in colonised/infected patients with multidrug-resistant microorganisms. METHODS: An observational study was conducted from October 2014 to March 2015. A checklist with a structure was designed (equipment trolley), including knowledge of the situation and compliance by the patients, families, and healthcare workers. Univariate and bivariate analyses were performed. Non-parametric tests Mann-Whitney and Kruskal-Wallis were used. RESULTS: Out of the 467 observations made, the equipment trolley was correctly situated in 97% (453) of cases, the sphygmomanometer in 90% (421), the stethoscope 43.9% (205), and thermometer 16.5% (77). A dustbin and the alcoholic solution were observed in over 98.7% (461) of cases. The antiseptic soap for patient hygiene was observed to be correctly placed in 348 (74%) of occasions. The situation was known by 84.9% (305) of patients and 91.4% (234) of families. As regards compliance by professionals with the placement/removal of disposable gowns and gloves was about 50% for entering the room (49.5%, 56 gown and 53.09%, 60 gloves), and 40% (28) for leaving the room by professionals. Hand hygiene compliance was 26.5% (30) for entering and 35.2% (25) when leaving. CONCLUSIONS: There is significant room for improvement in the compliance with isolation precautions. Non-compliance to isolation procedures is not due to a deficit of materials, but to individual behaviours. It is important to implement and evaluate programs based on psychosocial intervention models that can change attitudes and behaviours related to contact isolation precautions for multidrug-resistant microorganisms.

Trypanosoma cruzi infection in a Spanish liver transplant recipient.

The shortage of suitable organ donors for transplantation has stimulated the use of organs from donors with transmissible infections such as Chagas disease in noninfected recipients. A case is described of liver transplantation from an anti-Trypanosoma cruzi-positive donor to a noninfected recipient who showed favorable evolution despite not having undergone preemptive therapy.

Gonadotropin releasing hormone inhibitory autofeedback by subproducts antagonist at N-methyl-D-aspartate receptors: a model of autocrine regulation of peptide secretion.

The secretion of Gonadotropin-releasing Hormone (GnRH) involves activation of N-methyl-D-aspartate (NMDA) receptors. Here, we show that pulsatile GnRH secretion from hypothalamic explants is suppressed by 1-5GnRH, an endogenous breakdown product of GnRH, while 2-10GnRH has no effect. GnRH secretion evoked by NMDA is selectively inhibited by 1-5GnRH and this effect is similar to that of AP-5, a competitive antagonist at NMDA receptors. In addition, 1-5GnRH accounts for a dose-related inhibition of tritiated glutamate binding to hypothalamic membrane preparations. Using GnRH secretion as a model of NMDA-receptor controlled system, the effect of different peptides has been studied. Growth Hormone Releasing Factor (GRF), Insulin-like Growth Factor-I (IGF-I) and Proinsulin result in inhibition of GnRH secretion. Bioactive subproducts of those peptides (1-29GRF, 4-701GF-I and insulin) do not show any effect, suggesting that their classical receptors are not involved. In contrast, GnRH secretion is inhibited by other subproducts (1-37GRF, 1-31GF-I and C-peptide) all terminating in a glutamate residue. These subproducts selectively suppress the NMDA-evoked secretion of GnRH. Protease inhibitors prevent the inhibitory effects of IGF-I on GnRH secretion. This, breakdown products of different peptide hormones are possible endogenous antagonists at NMDA receptors. This effect could account for an autocrine or paracrine limitation of NMDA-receptor-mediated secretion of peptides.