Influence of hepatitis B virus reactivation on the recurrence of HBV-related hepatocellular carcinoma after curative resection in patients with low viral load.

It is unclear whether the reactivation of hepatitis B virus (HBV) influences the prognosis of hepatocellular carcinoma (HCC) after resection in patients with chronic hepatitis B. The aim of this study was to identify the influence of HBV reactivation on the recurrence of hepatitis B-related HCC after curative resection in patients with low viral load (HBV DNA <2000 IU/mL). We retrospectively analysed a total of 130 patients who underwent curative resection for HBV-related early stage HCC (single nodule; <5 cm/two or three nodules; <3 cm) with pre-operative HBV DNA levels <2000 IU/mL with serial HBV DNA tests. The predictive factors including HBV reactivation for the recurrence of HBV-related HCC after curative resection were investigated. Fifty-three patients (41%) had HBV reactivation after resection among 130 patients. HBV reactivation was observed in 22 of 53 patients with undetectable baseline HBV DNA and in 31 of 77 patients with detectable baseline HBV DNA. Cumulative recurrence rates after resection at 1, 2 and 3 years were 17.0%, 23.3% and 31.4%, respectively. The multivariable analysis demonstrated that the risk factors for the recurrence were the presence of microvascular invasion (hazard ratio (HR) 2.62, P = 0.003), multinodularity (HR 4.61, P = 0.005), HBV reactivation after resection (HR 2.03, P = 0.032) and HBeAg positivity (HR 2.06, P = 0.044). HBV reactivation after curative resection is associated with the recurrence of HBV-related HCC in patients with low viral load.

Association of torque teno virus (TTV) and torque teno mini virus (TTMV) with liver disease among patients coinfected with human immunodeficiency virus and hepatitis C virus.

Torque teno virus (TTV) and torque teno mini virus (TTMV) have been potentially related to liver diseases. The aim of the study was to quantify TTV and TTMV in human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients to study the relationship between the TTV and TTMV viral loads and the severity of liver disease. We carried out a cross-sectional study in 245 patients coinfected with HIV and HCV (HIV/HCV-group), 114 patients monoinfected with HIV (HIV-group), and 100 healthy blood donors (Control-group). Plasma samples were tested for TTV and TTMV by quantitative real-time polymerase chain reaction (PCR). The prevalences of TTV and TTMV infections in the HIV/HCV-group and the HIV-group were significantly higher than the Control-group (p < 0.05). Furthermore, TTV and TTMV coinfections were found in 92.2 % (226/245) in the HIV/HCV-group, 84.2 % (96/114) in the HIV-group, and 63 % (63/100 %) in the Control-group (p ≤ 0.05). HIV/HCV-coinfected patients with HIV viral load ≥50 copies/mL and patients with severe activity grade had the highest viral loads of TTV and TTMV (p ≤ 0.05). HIV/HCV-coinfected patients with high TTV load (>2.78 log copies/µL) had increased odds of having advanced fibrosis or severe necroinflammatory activity grade in the liver biopsy. Moreover, HIV/HCV-coinfected patients with high TTMV load (>1.88 log copies/µL) had decreased odds of having no/minimal fibrosis and no/mild activity grade, and increased odds of having a high fibrosis progression rate. In conclusion, TTV and TTMV might play a role in the development of liver disease in immunodeficiency patients, such as the patients coinfected with HIV and HCV.

Association of miR-21 and miR-335 to microsatellite instability and prognosis in stage III colorectal cancer.

BACKGROUND: MicroRNAs (miRs) are frequently altered in colorectal cancer (CRC) and can be used as prognostic factors. OBJECTIVE: To confirm in stage III CRC patients a reported miR signature that was associated to the presence of metastatic disease. To correlate miR expression with microsatellite instability (MSI) and mutations in RAS and BRAF. METHODS: miR-21, miR-135a, miR-206, miR-335 and miR-Let-7a expression was analyzed by RT-qPCR in 150 patients out of the 329 patients used to analyze MSI and RAS and BRAF mutations. Association with disease free survival (DFS) and overall survival (OS) was analyzed. Data was confirmed by a multivariate analysis. RESULTS: MiR-21 high expression (p= 0.034) and miR-335 low expression (p= 0.0061) were significantly associated with MSI-H. A positive trend (p= 0.0624) between miR-135a high expression and RAS mutations was found. Lower miR-21 expression levels are associated with DFS (HR = 2.654, 95% CI: 1.066-6.605, p= 0.036) and a trend with OS (HR = 2.419, 95% CI: 0.749-7.815, p= 0.140). MiR-21 high expression significantly improves DFS of the poor prognosis group (T4 or N2) (p= 0.03). CONCLUSIONS: Association of increased expression of miR-21 and better prognosis in the poor prognostic group may be of interest and could be explored in future prospective clinical trials.

Clinical Study on Minimally Invasive Liquefaction and Drainage of Hypertensive Putaminal Hemorrhage through Frontal Approach.

Background Hypertensive intracerebral hemorrhage is one of the most common cerebrovascular diseases with high mortality and high disability rate. The aim of this study was to observe the curative effect of minimally invasive liquefaction and drainage of hypertensive putaminal hemorrhage (HPH) through frontal approach. Methods This study retrospectively reviewed the clinical data of 66 HPH patients who underwent surgery from January 2012 to January 2017 including 35 males and 31 females, aged 51 to 82 years, with an average age of 61.6 ± 7.32 years. All patients were treated in the first people's hospital of Kunshan. They were divided into two groups: puncture thrombolysis and drainage therapy (PTDT) group and conventional craniotomy (CC) group. Result The pulmonary infection rate in PTDT group was 13.8%, significantly lower than that of 27.7% in CC group ( p < 0.05). One year after onset, the modified Rankin scale (mRS) score of surviving patients was evaluated. The mRS score of the PTDT group with 30 to 60 mL of preoperative bleeding was 1.91 ± 0.82, which was significantly better than that of the CC group (2.21 ± 0.83) ( p < 0.05). There was no significant difference in mRS score between PTDT group (2.59 ± 0.62) and CC group (2.88 ± 0.87) with preoperative bleeding > 60 mL ( p > 0.05). In patients with Glasgow coma scale (GCS) 5 to 8 scores, the mRS of PTDT and CC groups were 2.73 ± 0.72 and 2.94 ± 0.96, respectively ( p > 0.05). In patients with GCS 9 to 13 scores, the mRS score of PTDT group was 1.83 ± 0.69, which was significantly better than that of CC group (2.06 ± 0.74) ( p < 0.05). Conclusion HPH can be treated effectively through PTDT. PTDT group has lower lung infection rate than CC group. And it can significantly improve the prognosis of patients with preoperative bleeding volume of 30 to 60 mL and preoperative GCS score of 9 to 13.

Inhibitory effects of non-ionic surfactants on the microbial activity of activated sludge system.

The purpose of the present work was to study the influence of a non-ionic surfactant, a nonylphenol with four ethoxylated units (NP4EO), on the activity of the microbial population present in a laboratory-scale activated sludge unit. Traditional control methods for this type of unit were used (measurement of suspended solids and chemical oxygen demand) as well as specific techniques for the measurement of bacterial activity (dehydrogenase activity and specific oxygen uptake rate) and the results were compared. It was shown that the Specific Oxygen Uptake Rate (SOUR) is the simplest and quickest way to carry out routine control of activated sludge activity, while measuring dehydrogenase activity provides more complete control. The results obtained indicated that there was no inhibition of microbial activity at a concentration of 5 ppm of NP4EO, which was not the case with a concentration of 10 ppm.

Epidemiology of pathogenic tick-borne viruses in China: a review / 中国血吸虫病防治杂志

Ticks are obligate, haematophagous arthropods that are distributed across the world, which may transmit more than 200 pathogens, including viruses, bacteria and parasites. A large number of tick species are widespread in China, and their transmitting tick-borne viral diseases pose a great threat to human health in endemic foci. This review describes the epidemiology of common, emerging and potentially pathogenic tick-borne viruses in China, and recommends the assessment of public health significance and pathogenicity of emerging tick-borne viruses using reverse microbial etiology, so as to provide insights into the management of emerging tick-borne diseases in China.

[Long-term consequences of pediatric trauma requiring intensive care]. / Consecuencias a largo plazo de los traumatismos pediátricos que precisaron cuidados intensivos.

INTRODUCTION: Trauma is a major cause of pediatric morbidity. The aim of the present study was to determine the long-term effects of severe trauma in children and their families. PATIENTS AND METHODS: We performed an observational, cross sectional study of 209 children admitted to our pediatric intensive care unit due to trauma between 1999 and 2003. Family members and/or children were interviewed at least 2 years after the event. Functional situation was assessed by means of the Pediatric Overall Performance Category (POPC) scale and neurological status by means of the Pediatric Cerebral Performance Category (PCPC) scale. Subjective perception of quality of life was also evaluated. RESULTS: At assessment, patient age was 13+/-4 years. The causes of trauma were traffic accidents (42.6%), falls (30.1%), bicycle accidents (15.3%) and other causes (12%). The trauma affected the brain and cranium in 78.9%, skeleton in 20.2%, abdomen in 16.3% and other body regions in 15.3% of the patients. At assessment, 1.5 % of the patients were in a persistent vegetative state, 0.5% had severe disability, and 1% had moderate disability. A total of 9.5% had some type of persistent psychological disorder and 3.8 % needed some kind of help to perform daily activities. The median (range) score for self-estimated quality of life by the family was 3 (0-6) for the group of children with moderate or severe disability, while 12.9% of parents reported serious alterations of family dynamics related to the trauma event. CONCLUSIONS: Most children who survive after severe trauma achieve a good functional situation in the long term. Although the number of children with severe sequelae is small, these children have serious difficulties in achieving normal social adaptation and their quality of life is clearly impaired.

[Laparoscopic radical cystectomy: initial experience]. / Cistectomía radical laparoscópica: experiencia inicial.

OBJECTIVE: To review our initial experience with laparoscopic radical cystectomy. PATIENTS AND METHODS: Between September 2004 and June 2006 we performed 16 laparoscopic radical cystectomies (14 males and 2 females) with a median age of 63.8 y.o. (51-85). 12 ileal neobladder (with laparoscopic ileal-urethra anastomosis), 3 cutaneous ureteroileostomies and 1 cutaneous ureterostomy were performed as derivation techniques. Median follow up was 12.4 months RESULTS: Mean operation time was 340 minutes. Estimated blood loss was 350 ml. and 3 cases required intra-op blood transfusion. Mean hospitalization discharged was at 7.6 days. Median linph node dissection was 22.9 finding node metastasis in 6 cases. Most frequent complication was ileo in two cases. No local recurrentes in trocar placement was achieved. CONCLUSIONS: Laparoscopic Radical cystectomy is a challenged long-lasting procedure but with the advantage of a less transfusion rate and short hospital stay. Oncologycal outcomes are similar as tose from open surgery.

Tailoring secretion of proteoglycan 4 (PRG4) in tissue-engineered cartilage.

Articular cartilage provides a low-friction surface for joint articulation, with boundary lubrication facilitated by proteoglycan 4 (PRG4), which is secreted by chondrocytes of the superficial zone. Chondrocytes from different zones are phenotypically distinct, and their phenotypes in vitro are influenced by the system in which they are cultured. We hypothesized that culturing cells from the superficial (S) zone in two-dimensional monolayer or three-dimensional alginate would affect their synthesis of PRG4, and that subsequently seeding them atop alginate-recovered cells from the middle/ deep (M) zone in various proportions would result in tissue-engineered constructs with varying levels of PRG4 secretion and matrix accumulation. During monolayer culture, S cells retained their PRG4-secreting phenotype, whereas in alginate culture the percentage of cells secreting PRG4 decreased with time. Constructs formed with increasing percentages of S cells decreased in thickness and matrix accumulation, depending on both the culture conditions before construct formation and the S-cell density. PRG4-secreting cells were localized to the S-cell seeded construct surface, with secretion rates of 0.1-4 pg/cell/day or 0.1-1 pg/cell/day for constructs formed with monolayer-recovered or alginate-recovered S cells, respectively. Tailoring secretion of PRG4 in cartilage constructs may be useful for enhancing low-friction properties at the articular surface, while maintaining other surfaces free of PRG4 for enhancing integration with surrounding tissues.

[In vitro three-dimensional reconstruction of human bladder mucosa]. / Reconstrucción tridimensional in vitro de mucosa vesical humana.

OBJECTIVE: The purpose of this study is to apply the in vitro keratinocyte culture techniques and the tissue engineering principles to human urothelium, to reconstruct an in vitro three-dimensional human bladder mucosa, suitable for grafting. MATERIAL AND METHODS: Biopsy specimens of human bladder mucosa were obtained from patients undergoing suprapubic prostatectomy, in vitro cultured and finally, an immunohistochemical study was made. RESULTS: A three-dimensional in vitro tissue was obtained, composed of a bio-artificial submucosa (fibrin gel and fibroblast) where the uroepithelial cells were seeding. We used a biodegradable polyglycolic acid mesh to facilitate the tissue manipulation and implantation. An immature epithelium was obtained with a weak immunostaining to cytokeratins. The immunohistochemical study could not demonstrate the development of basement membrane. CONCLUSIONS: In vitro keratinocyte culture techniques could be applied to other epithelial tissues like the urothelium. We obtained a three-dimensional in vitro tissue suitable for grafting in a relatively short time, which needs the matrix interactions in order to mature.

[Nutritional status assessment in a group of university students by means of dietary parameters and body composition]. / Evaluación del estado nutricional de un grupo de estudiantes universitarios mediante parámetros dietéticos y de composición corporal.

OBJECTIVE: To assess the nutritional status in a young adults by means of dietary parameters and body composition. METHODOLOGY: The sample comprises 49 young men (35 women and 14 men) with a mean age of 21.9 +/- 2.9 ages, at Alfonso X el Sabio University of Madrid. Body composition was analyzed through anthropometrical parameters. By means of validated questionnaires, physical activity performed within a week was assessed, as well as energy and nutrients intake. The later was estimated through a registry of all foods and beverages consumed for the last 14 days performed by each one of the participants (previously instructed) and estimating the amounts by weight or home or standard servings. The resting energy waste was determined by indirect calorimetry and through the Harris-Benedict predictive formula. RESULTS: Body mass index was similar in both men and women (p = 0.10) (23.5 +/- 1.9 and 22.0 +/- 2.8 kg/m2). The percentage of fat obtained through anthropometrics was 16.4 +/- 3.5% and 27.1 +/- 3.8% (p < 0.05) in men and women, respectively. The physical activity was light-moderate. Daily energy intake was appropriate for the total needs when the later were determined by indirect calorimetry. The caloric intake for macronutrients was unbalanced: high in lipids, and very low in carbohydrates. With regards to micronutrients, the assessed diets were in general appropriate but for folic acid, calcium, magnesium for both genders and vitamin A in men, with levels below the recommended ones. CONCLUSIONS AND RECOMMENDATIONS: In some aspects, the diet from this group deviates from current dietary standards. It would be advisable to increase the physical activity that would allow a higher food intake in order to cover for the insufficient intake of some nutrients without energetically unbalancing the diet. The assessment of resting energetic waste by indirect calorimetry seems to better predict the energetic needs.

[Evolution of the clinical, echographic and pathological characteristics of patients with indication of transrectal ultrasound and prostate biopsy between 1994 and 2003]. / Evolución de las características clínicas, ecográficas y patológicas de los pacientes con indicación de ecografía transrectal y biopsia de próstata entre 1994 y 2003.

OBJECTIVE: The aim of this paper is to evaluate the evolution in the clinical, echographic and pathological characteristics of patients undergoing transrectal ultrasound and prostate biopsy over a 10 year period (1994-2003). MATERIAL AND METHODS: Patients undergoing a first biopsy of the prostate between 1994-2003 were studied retrospectively. Since the biopsy criteria have changed several times over this period, results were analysed for four different periods: 1994-1997, 1998, 1999-2003 (the latter was further divided into two periods--1999-2001 and 2002-2003--to observe the temporal evolution with the same biopsy criteria). Patients were assigned to risk groups according to D'Amico. RESULTS: We observed that individuals referred for biopsy and those diagnosed with prostate cancer (PC) had a lower mean age (p=0.0001 and p=0.01), there were more patients with a PSA from 4.1-10 ng/ml (p=0.0001 and p=0.0001), more patients had no significant DRE findings (p=0.0001 and p=0.0001) or ultrasound findings (p=0.0001 and p=0.0001). The incidence of cancer diagnosis has decreased from 39.4% to 34.3% (p=0.03). There was an increased incidence of score 7, at the expense of a decline in scores 5-6 and 8-10 and disappearance of score 2-4 (p=0.0001). Patients assigned to the low risk group increased from 9% to 18.1%, those assigned to the intermediate risk group from 20.2% to 43.1% and there was a reduction in those assigned to the high risk group from 70.7% to 38.7% (p=0.0001). Analysis of the final two time periods revealed that the evolution of the series remained the same except for a decrease in age at biopsy and diagnosis of cancer. CONCLUSIONS: Nowadays, the risk factors of patients with an indication of biopsy have less weight than ten years ago. We currently diagnose patients with PC with more favourable prognostic factors. However, the price we pay for this earlier diagnosis is reflected in a less effective biopsy, a larger proportion of the population without PC having to experience the physical complications and psychological stress of a biopsy, a greater number of patients having to undergo a second biopsy and, therefore, a greater and more costly use of resources to diagnose PC.

[Localized prostate cancer treatment in renal transplant patient with high intensity focalized ultrasound (HIFU)]. / Tratamiento de adenocarcinoma prostático localizado en paciente con trasplante renal mediante Ultrasonido de Alta Intensidad.

We report a 62 years old kidney transplant (KT) patient who was diagnosed of localized prostatic cancer (PC) after 6 years of the implant. Transrectal prostatic High Intensity Focused Ultrasound (HIFU) was applied. Results have been satisfactory, achieving pathologic and biochemical success. The discharge was completed at 24 hs, the morbidity was minimal. We have not found any reference in the literature on the appliance of HIFU in PC KT patients. We think that HIFU may represent a good alternative for these patients.

[Considerations about angiolymphoid hyperplasia with eosinophilia (ALHE) with regard to a case localized in the penis]. / Consideraciones en torno a la Hiperplasia Angiolinfoide con Eosinofilia (ALHE). A propósito de un caso localizado en el pene.

We report the case of a 27 year old man who presented a nodule in the ventral face of the penis, which increased in volume and turned painful during erection so a vascular lesion was suspected, later confirmed with a Doppler study. A complete excision of the lesion was carried out with local anaesthesia. The pathological specimen was informed as "angiolimphoid hyperplasia with eosinophilia" in its intravascular form. This is the third communication of this kind of lesion in the penis but no other adopted the intravascular variant like the present case. We discuss about this exceptional entity and make review of the most relevant literature.

[Incomplete urethral duplication]. / Duplicidad uretral incompleta.

Urethral duplicity is a rare congenital malformation. We report a case of one 25 years old male suffering recurrent urinary infections. The diagnostic of uncompleted urethral duplicity was performed by retrograde urethrography and micturating cystourethrogram. The accessory channel was excised by a perineal approach. Clinical results were satisfactory, remaining an asintomatic patient two years after surgery, with normal mictional behavior.

[Evaluation and prognostic of cystic renal tumors]. / Valoración y pronóstico de los tumores renales quísticos.

OBJECTIVE: To evaluate the clinical and pathological characteristics of cystic renal tumors in our center. MATERIAL AND METHODS: A retrospective review of 239 nephrectomies is performed comparing the clinical and pathological variables of cystic tumors with those of solid renal tumors. Survival outcomes are analyzed in both groups. RESULTS: Our experience shows that cystic renal tumors behave like solid renal tumors, with no differences in survival shown. The variables studied show statistically significant differences in histological grade and number of tumors, with cystic tumors having a lower histological grade and being more often multiple in number. CONCLUSIONS: The behavior of cystic renal tumors is no different than that of solid renal tumors.

HIV/antiretroviral therapy-related lipodystrophy syndrome (HALS) is associated with higher RBP4 and lower omentin in plasma.

Very little information is available on the involvement of newly characterized adipokines in human immunodeficiency virus (HIV)/antiretroviral therapy (ART)-associated lipodystrophy syndrome (HALS). Our aim was to determine whether apelin, apelin receptor, omentin, RBP4, vaspin and visfatin genetic variants and plasma levels are associated with HALS. We performed a cross-sectional multicentre study that involved 558 HIV type 1-infected patients treated with a stable highly active ART regimen, 240 of which had overt HALS and 318 who did not have HALS. Epidemiologic and clinical variables were determined. Polymorphisms in the apelin, omentin, RBP4, vaspin and visfatin genes were assessed by genotyping. Plasma apelin, apelin receptor, omentin, RBP4, vaspin and visfatin levels were determined by enzyme-linked immunosorbent assay in 163 patients (81 with HALS and 82 without HALS) from whom stored plasma samples were available. Student's t test, one-way ANOVA, chi-square test, Pearson and Spearman correlations and linear regression analysis were used for statistical analyses. There were no associations between the different polymorphisms assessed and the HALS phenotype. Circulating RBP4 was significantly higher (p < 0.001) and plasma omentin was significantly lower (p 0.001) in patients with HALS compared to those without HALS; differences in plasma levels of the remaining adipokines were nonsignificant between groups. Circulating RBP4 concentration was predicted independently by the presence of HALS. Apelin and apelin receptor levels were independently predicted by body mass index. Visfatin concentration was predicted independently by the presence of acquired immunodeficiency syndrome. HALS is associated with higher RBP4 and lower omentin in plasma. These two adipokines, particularly RBP4, may be a link between HIV/ART and fat redistribution syndromes.

An outbreak of Legionnaires' disease in an inner city district: importance of the first 24 hours in the investigation.

OBJECTIVE: To present the main results of the investigation of an outbreak of Legionnaire's disease that occurred in an inner city district of Barcelona between 15 October and 15 November 2000. METHODS: Epidemiological surveys of patients and environmental investigations were initiated on the day the first five cases were notified. Water samples and smears from cooling tower trays were taken for microbiological analysis. Maps of the distribution of cases and possible contamination foci were elaborated. Incidences were calculated for each census tract. RESULTS: A total of 54 patients related to the outbreak were identified, with a case fatality rate of 5.5%. Incidence rate in the area closest to the cooling tower (6.40/1000) was significantly higher than that of the rest of the neighbourhood (2.23/1.000, RR 2.87, 95%CI 1.37-6.12, P = 0.0035). Cultures positive for Legionella pneumophila serogroup 1, subtypes Pontiac, Philadelphia or Allentown, were obtained from eight patients. On the 39th day of the investigation it was found that the strain isolated in one of the cooling towers coincided with the serogroup, subtype and molecular profiles identified in clinical samples. CONCLUSIONS: Rapid coordination of clinicians, microbiologists, epidemiologists and environmentalists permitted the source of infection and the affected cases to be correlated within a few days.

[Treatment perspectives: immunotherapy with latex]. / Perspectivas de tratamiento: inmunoterapia con látex.

Latex allergy currently constitutes a serious problem because of the severity of its symptoms and the at-risk groups it affects. Since complete avoidance of this substance is practically impossible, in the last few years intense efforts have been made to standardize a latex extract with the aim not only of improving clinical diagnosis but also of being able to offer other therapeutic alternatives, such as specific immunotherapy.Since 1998, reports of immunotherapy with oral (three patients) subcutaneous (one patient) and sublingual latex desensitization (one patient) have been published. In all cases, clinical improvement was evident. In 2000, Laynadier published the first pilot study, a phase IIB multicenter, randomized, double-blind, placebo-controlled trial that evaluated the efficacy and safety of specific immunotherapy with latex in patients with occupational allergy. Twenty health care workers without obvious latex exposure and with latex allergy-induced symptoms of rhinitis and/or asthma were included. Treatment started with a 2-day course of rush immunotherapy in hospital and maintenance therapy was continued for 1 year. Efficacy was assessed by symptom and medication scores and by variation in the conjunctival reactivity threshold. The safety of the extract was also evaluated. In the overall analysis of symptom score, the treated group showed a marked improvement and the medication score was significantly lower in patients in the active treatment group than in the placebo group. Concerning safety, almost half the patients receiving active treatment showed local reactions starting with the first injection and four of the nine patients in this group suffered moderate-to-severe systemic reactions. In view of this first clinical trial, it can be concluded that this treatment is effective but that its tolerance is low.A second clinical trial with the same characteristics and extract is currently underway. Its aim is to validate the previous protocol, confirm the efficacy of specific immunotherapy with latex, improve its safety and, if possible, determine the optimal dose.J. Sastre et al. have recently (Formigal 2002) presented the results of the first double-blind study with latex immunotherapy using an extract standardized by the ALK-Abelló-España group. The authors included 24 patients with latex sensitization and symptoms of occupational allergy. To diagnose respiratory allergy, an inhalation challenge was performed in a closed 7-m2 chamber and, in case of contact urticaria, glove-wearing and rubbing tests were performed, using a vinyl glove as negative control. Treatment consisted of a first phase of incremental doses for 14 weeks, with 18 injections, followed by maintenance doses for 6 months. Sixteen patients received active treatment and 8 received placebo. Of the 578 doses administered, adverse effects were observed in 41 (7.1 %). There were 21 immediate systemic reactions (5.7 % of the doses) and 10 delayed systemic reactions (2.6 % of the doses). Adverse effects were more frequent in patients with underlying respiratory disease (p < 0.05). After 6 months' treatment, a clear improvement in the cutaneous response index was found in the active treatment group and in the rubbing and glove-wearing tests. The authors conclude that the immunotherapy tested was a high-risk treatment and that the greatest clinical improvement was found in cutaneous symptoms.In conclusion, although effective, latex immunotherapy is currently a high-risk treatment.

Utilization of blueberry by the lappet moth, Streblote panda Hübner (Lepidoptera: Lasiocampidae): survival, development, and larval performance.

The lappet moth, Streblote panda Hübner [1820] (Lasiocampidae), is a common species found in blueberry, Vaccinium spp. (Ericaceae) fields of Western Andalusia. The biology of this species as well as the extent to which its larvae can use and survive on blueberry is unknown. In this study, the suitability to larvae of several blueberry cultivars was studied. Larvae were grown under controlled laboratory conditions on excised foliage of six blueberry cultivars. Survival, development, and food use were determined for first and fifth instars. According to our results, blueberry has become an alternative host plant for S. panda in southwestern Andalusia. Low growth rates and efficiencies of use of food were observed. Lower gross efficiency of growth was found for larvae fed blueberry 'Sharpblue', despite a higher apparent digestibility of this cultivar. Larvae reared on this cultivar had the highest mortality, increased developmental time, and used a greater part of metabolism for maintenance. Herbivore pressure may be increased with the widespread planting of the most suitable cultivars 'Misty' and 'O'Neal', whereas 'Sharpblue' and'Climax' seem to be the least suitable host plants. These data provide useful information for planning and managing blueberry orchards in the presence of S. panda populations.