Adaptive metabolic responses in females of the fighting breed submitted to different sequences of stress stimuli

The objectives of this study were to evaluate the stress reaction and the metabolic adaptive effort in females of the fighting breed when submitted to different manipulation sequences. Nine 4- to 8-year-old bovine fighting breed females slaughtered to establish the basal levels of different blood parameters. A study was, then, conducted to examine the metabolic response in 30 2-year-old females, divided into 3 groups of 10 animals and submitted to different manipulations in each group: restraint- "open-field" -restraint, "open-field" -restraint, and transportation-restraint- "open-field" -restraint. The basal levels of the different blood parameters found were, in general, similar to the levels for cattle given in the literature. All the manipulations resulted in increases that were statistically different (p < 0.001) from basal levels, in terms of both cortisol plasma levels and the Specie Specific Experimental Response to Stress index (SSERTS). The stress of restraint (and the prior manipulations) seemed to mask the stress associated with the open-field and transport situations. In general, animals responded to 13 of the 15 parameters examined in the various experimental manipulations.

Development of methanogenic consortia in fluidized-bed batches using sepiolite of different particle size

The addition of support materials, such as sepiolite, to fluidized-bed anaerobic digesters enhances the methane production by increasing the colonization by syntrophic microbiota. However, the efficiency in the methanogenesis depends on the particle size of the support material, the highest level of methane production being obtained by the smaller particle size sepiolite. Because of the porosity and physico-chemical characteristics of these support materials, the anaerobic microbial consortia formed quickly (after one week of incubation). The predominant methanogenic bacteria present in the active granules, detected both by immunofluorescence using specific antibodies and by scanning electron microscopy, were acetoclastic methanogens, mainly Methanosarcina and Methanosaeta.

[Effects of surfactant administration in premature infants with severe respiratory distress syndrome]

BACKGROUND

From January 1992 to June 1993 a study was performed to show whether the administration of surfactant to low birth weight infants with respiratory distress decreased the need for ventilatory support and improved survival.

METHOD

Twenty three infants born at a single hospital received the surfactant (one dose of a 100 mg/kg divided in four aliquots) and they were eligible for the treatment if they met the following criteria: 1) Weight between 650 g and 2000 g; 2) postnatal age 4 to 24 hours; 3) clinical-radiographic signs of respiratory distress, and 4) need of mechanical ventilation with FiO2 > or = 0.6. The results of the treatment were evaluated comparing the arterial-alveolar oxygenation ratio, maximal inspiratory pressure and the oxygenation index before and after the administration of surfactant. The last consecutive eighteen infants born at our hospital, before our study was started, that met the same criteria were elected as control group.

RESULTS

In the group of infants treated with surfactant the arterial-alveolar oxygenation ratio increased from 0.10 +/- 0.009 before treatment to 0.28 +/- 0.02 six hours after treatment (p < 0.01); the oxygenation index decreased from 37.79 +/- 4.27 to 12.71 +/- 1.17 (p < 0.01) and the maximal inspiratory pressure from 22.13 +/- 0.81 cmH2O to 19.52 +/- 0.76 (p < 0.001) in the same period of time. This improvement was maintained during the following 72 hours. In the group of infants treated with surfactant, mortality decreased (p < 0.01), the frequency of pneumothorax diminished (p < 0.001) and the frequency of pulmonary haemorrhage increased (p < 0.05). The ventilatory time was similar in both groups of infants but the global length of stay of the newborn that received surfactant was longer due to the fact that the non survivors of the control group died before the 72 hours of life.

CONCLUSIONS

Treatment with surfactant improves the initial evolution of the respiratory distress syndrome of the newborn and decreases mortality.

Similar fragmentation and dissolution after extracorporeal shock wave lithotripsy in eutrophic and overweight patients with gallstones

The aim of this study was to assess the relative importance of overweight and adjuvant treatment with bile acids to obtain fragment dissolution and clearance after biliary extracorporeal shock wave lithotripsy (BESWL), in eutrophic and overweight patients with gallbladder stones. During a 3-year period 103 patients were treated with BESWL. Patients were strictly selected in terms of the number and type of stones. Of the total of 103 patients, 53 were women and 50 men. Mean age was 50.8 +/- 14.3 (range 17 to 86) years. Body mass index was calculated for each patient. All patients underwent BESWL with an electromagnetic device. Medical therapy for stone dissolution included the combination of chenodeoxycholic acid plus ursodeoxycholic acid (50% + 50%), at a total dose of 10-15 mg/day. Of the 103 patients, 45 were eutrophic and 58 were considered overweight. Age was similar in both groups. Number of lithotripsy sessions in eutrophic patients was 1.96 +/- 1.07 and 1.88 +/- 0.84 in overweight patients, but no statistical differences were found. Complete clearance of calculi was observed in more than 50% of the cases after 6 months, and reached 98% after 22 months of therapy in both groups. Total clearance of calculi was similar in patients with single and multiple stones. In conclusion, our results suggest that the time required to obtain complete gallstone clearance after BESWL is similar in eutrophic and overweight patients with gallbladder stones, and also that adjuvant therapy with bile acids plays an important role in gallstone fragment dissolution in these patients.

Behaviour of urinary 2,5-hexanedione in occupational co-exposure to n-hexane and acetone

We analysed the relationship between free 2,5-hexanedione (2,5-HD) and total 2,5-HD in the urine of 87 workers exposed to n-hexane and other solvents (hexane isomers, acetone and toluene), in relation to different working conditions. The concentration of free 2,5-HD in urine of workers exposed to n-hexane was about 12% of total urinary 2,5-HD. The most significant correlation (r = 0.936) was that of total 2,5-HD in urine with environmental n-hexane and exhaled air. With equal exposure to n-hexane, the concentrations in urine of free and total 2,5-HD increased when cutaneous absorption was involved (gloves not used), during the working week and with co-exposure to acetone. An analysis of the relationship between combined exposure to acetone and urinary concentrations of the various forms of 2,5-HD suggests that acetone might influence the toxicokinetics of n-hexane, increasing the proportion of free 2,5-HD.

A direct membrane filter method for enumerating somatic coliphages in drinking water

The application of a simple membrane filter method to enumerate specific somatic bacteriophages of Escherichia coli, using E. coli C as host strain, from drinking water samples was studied. The efficiency of the method using cellulosic membrane filters, samples pretreated with magnesium ions and Tween 80 added to agar medium-host cell lawns ranged from 68.9 to over 112%, depending on the phage content of the sample. To avoid the pre-treatment of the sample with magnesium salts, electropositive-charged filters of cellulosic ester (HA-PEI and HA-Nalco) and Virosorb-1MDS filters were tested in conjunction with the simple membrane filter method. The electropositive filters showed wide bacteriophage recovery rate intervals depending on the sample treatment, ranging between 31.4 and 96.2% for ester-type filters, and a mean recovery lower than 2.2% for Virosorb filters. On the other hand, it was proved that the use of Tween 80 as an eluent improved somatic coliphage recovery rates for all the filters tested. In short, this methodology provides a rapid analysis (6-8 h) of the somatic coliphages from drinking water using the membrane filtration technique.

[Laparoscopic gastrostomy]

Feeding gastrostomy is a method for treating patients unable to ingest food orally. After our experience and good results with the Janeway technique, we decided to perform it by the laparoscopic method. Our first excellent results in seven patients suggest that laparoscopic Janeway gastrostomy is an easy, rapid and efficient surgical technique.

Metal content of drinking water supplied to the city of Maracaibo, Venezuela

Total dissolved aluminum, calcium, iron, potassium, magnesium and sodium were evaluated in the drinking water supplied to the city of Maracaibo, Venezuela, to ascertain the water quality for human consumption. Mean concentrations (+/- S.D.) of 533 +/- 313 micrograms/l Al, 32 +/- 4 mg/l Ca, 167 +/- 104 micrograms/l Fe, 2 +/- 1 mg/l K, 5 +/- 2 +/- 1 mg/l K, 5 +/- 1 mg/l Mg and 16 +/- 4 mg/l Na were obtained during a 4-month sampling period that included dry (January-February 1991) and wet (March-April 1991) seasons. Significant seasonal variations (P < 0.002) for aluminium, potassium and magnesium were as follows: 641 +/- 275 and 445 +/- 340 micrograms/l aluminium, 3 +/- 0.5 and 2 +/- 0.5 mg/l potassium and 4 +/- 0.2 and 6 +/- 2 mg/l magnesium for the wet and dry seasons, respectively. The concentration of aluminum was consistently higher than the levels accepted by most international water quality criteria (approximate acceptable value < 300 micrograms/l aluminum), probably because of the inadequate flocculation treatment given to the raw water at the water plant. The rest of the metals under consideration complied with international guidelines of quality criteria for drinking water. The presence of an elevated concentration of humic material (22 +/- 2 mg/l of total organic carbon) in the drinking water should be a matter of public concern.

Dipyrone interference on several common biochemical tests

We studied the effect in vitro and in vivo of dipyrone on the determination of several biochemical tests in two analyzers, a Hitachi 747 and a Kodak Ektachem 700. From studies in vitro, we found significant interference by dipyrone (P < 0.05) in the determination of creatine kinase (CK), lactate dehydrogenase (LD), uric acid, triglycerides, cholesterol, aspartate aminotransferase, alanine aminotransferase, and urea nitrogen with both instruments, and in the determination of creatinine in the Ektachem analyzer. We also studied the effect of intravenously administered dipyrone in 14 patients. Dipyrone interfered significantly (P < 0.05) in the determination of CK, LD, uric acid, triglycerides, and cholesterol with both instruments, and creatinine only with the Ektachem analyzer. Using high-performance liquid chromatography (HPLC), we measured concentrations of dipyrone in the serum of patients who had received the drug and observed a negative correlation between the concentrations of dipyrone in the blood and the percentage of each analyte concentration.

Dipyrone interference on several common biochemical tests

We studied the effect in vitro and in vivo of dipyrone on the determination of several biochemical tests in two analyzers, a Hitachi 747 and a Kodak Ektachem 700. From studies in vitro, we found significant interference by dipyrone (P &lt; 0.05) in the determination of creatine kinase (CK), lactate dehydrogenase (LD), uric acid, triglycerides, cholesterol, aspartate aminotransferase, alanine aminotransferase, and urea nitrogen with both instruments, and in the determination of creatinine in the Ektachem analyzer. We also studied the effect of intravenously administered dipyrone in 14 patients. Dipyrone interfered significantly (P &lt; 0.05) in the determination of CK, LD, uric acid, triglycerides, and cholesterol with both instruments, and creatinine only with the Ektachem analyzer. Using high-performance liquid chromatography (HPLC), we measured concentrations of dipyrone in the serum of patients who had received the drug and observed a negative correlation between the concentrations of dipyrone in the blood and the percentage of each analyte concentration.

Laboratory study of several enrichment broths for the detection of Salmonella spp. particularly in relation to water samples

The selectivity and efficiency of several enrichment broths used for the the detection of salmonellas were comparatively evaluated under laboratory and environmental conditions. Media with selenite were less efficient in their inhibition of the growth of Gram-positive micro-organisms. Salmonellas grew slowly in tetrathionate broth and in media containing brilliant green. These media inhibited the growth of Salmonella typhi, which grew only in media containing selenite. The results obtained in the experiments with stressed salmonellas indicate that the media selenite F, selenite F with novobiocin, selenite cystine and Rappaport-Vassiliadis (RV/43), in conjunction with the double agar layer technique, showed an optimal efficiency for the detection of stressed salmonellas. When natural samples (freshwater and seawater) were used to evaluate the media, however, those containing malachite green, whether or not supplemented with sodium novobiocin, enhanced the recovery of salmonellas.

Two sibs with Wiedemann-Rautenstrauch syndrome: possibilities of prenatal diagnosis by ultrasound

A girl with Wiedemann-Rautenstrauch syndrome was born to a non-consanguineous couple. During the pregnancy, growth retardation particularly in the biparietal and abdominal diameters but not the femoral length was detected through serial ultrasound scans. When the woman became pregnant again, in spite of having been assessed as having a 25% risk of recurrence, the prenatal findings seen in her previous pregnancy led us to suggest sequential echography and a similar pattern of growth retardation was shown. After termination, the male fetus was found to be affected by Wiedemann-Rautenstrauch syndrome. This case shows that ultrasound examination can be a useful tool in the prenatal diagnosis of this rare, autosomal recessive syndrome.

[Postoperative gallbladder and systemic candidiasis]

Gangrenous cholecystitis occurred in an immunodepressed patient with generalized neoplasia. Evolution was rapid and severe. Emergency cholecystectomy and systemic treatment with Anphotherycin were life-saving.

[Erythema nodosum: a study of 160 cases]

We have evaluated 160 patients diagnosed of erythema nodosum (EN) on the basis of clinical and/or histopathological criteria to assess their etiology and their major epidemiological, clinical and laboratory features in our area. Mean age was 37.5 years and 86% of patients were females. The etiology could be determined in 67.5% of cases: sarcoidosis (20.6%), drugs (18%), streptococcal infection (16.3%), tuberculosis (6.3%), pregnancy (1.9%), Crohn's disease (1.3%), Behçet's disease (1.3%), lymphoma (0.6%), adenocarcinoma (0.6%), and toxoplasmosis (0.6%). 32.5% of cases were idiopathic. We found significant differences between the different etiological factors regarding mean age, fever, joint disease, ESR, leukocytosis and serum proteins. We compare our results with those from other series and we emphasize the need for a systematic workup in all patients with EN to facilitate their etiological diagnosis.

[Extracorporeal shockwave biliary lithotripsy. Physical basis and clinical application]

Extracorporeal shock waves lithotripsy is a new procedure discovered and applied in the present decade to treat urinary and biliary stones. Shock waves are acoustic waves similar to sonic waves which follow the acoustic laws and therefore the shock waves can be refracted or reflected depending on the medium interface. Due to the high water content, the human body can be crossed by shock waves which eventually may be focused on the target stone. There are several commercially available shock waves generators, i.e. the spark gap emisors which were the first ones, and the piezoceramic and electromagnetic emisors. To focus the shock waves on a biliary stone the machines are provided with fluoroscopic or ultrasound devices or with both in the most advanced machines. Using an electromagnetic emisor (Lithostar plus) our group has treated 78 patients with biliary stones without analgesia or anesthesia. Total stone fragmentation was achieved in 85% of the cases. In patients with cholesterol gallstones who undergo lithotripsy, an adjuvant treatment with oral cholesterol solvent is mandatory. Extracorporeal biliary lithotripsy is free of mortality, and the morbidity is less than 5%.

[Electromagnetic shock wave lithotripsy plus bile acids for the treatment of gallblader stones: results and perspectives from the first 57 patients]

Fifty seven patients were selected from 620 cases with gallstones to be treated with an electromagnetic shock wave generator (Lithostar Plus). The machine has an overhead module with an electromagnetic generator able to produce 150-150 bar of pressure in the center of the focal zone (2 x 8 cms.) An in line ultrasound probe permits in vivo view of stone localization and fragmentations. The wide aperture of the device permits to treat patients with little pain in ambulatory basis. The mean age of the patients was 50 +/- 14 years, 57 were female and 20 were male. Stones were single in 35 cases and were multiple (2-4 gallstones) in the rest. The patients received a mean of 2620 +/- 371 shock waves. Intravenous analgesia (Fentanyl 87 +/- 40 ug p/session) was required in 26 cases. In 58.5% of the cases, fragmentation produced gallstone-rests of < 0.5 cm. Larger fragments (> 0.5 cm), were observed after an initial shock wave session in 33%. These patients underwent additional treatments sessions. Hence patients received 1.8 +/- 0.8 sessions. Minor fragmentation or no fragmentation after the first session was observed in the 14.5%. Mild biliary pain appeared in 17 patients and acute biliary colic in 2, one of these underwent emergency cholecystectomy. Overall gallstone disappearance after one year after lithotripsy, plus bile acid therapy (10-12 mg Kg day) was 72%. Patients with single gallstones were free of stones of fragments in 92% of the cases, after the same period of follow up.

[Extracorporeal shock waves lithotripsy during acute obstruction of the cystic duct]

Obstruction of the cystic duct after Biliary Shock Waves Lithotripsy in an uncommon complication. It occurs when a small fragment is hemming in the neck of the gallbladder. Usually, cholecystectomy is the indicated treatment, we challenged this concept and attempted early ESWL to treat this complication. In our clinic, 150 patients were treated with a Lithostar-Plus device between March 1, 1989 to April 30, 1990. Of these, 12 presented acute uncontrolled biliary colic, 28 presented mild abdominal pain and the rest, remained pain free. Of the 12, one presented biliary obstruction and cholecystectomy was performed in other hospital; one refused to be retreated and other presented sonographic gallbladder thickness and hence underwent surgery. Nine patients were re-treated and in all, fragments nested in the gallbladder neck were successfully pulverised and obstruction cleared. To date all patients are free of stones. In summary, we propose early re-treatment with ESWL as a non-surgical alternative approach for treating this complication.

[Focusing and targeting gallstones during extracorporeal shock waves lithotripsy]

The gallbladder lies at the junction of the medial segment of the left and right hepatic lobes. Besides the anatomic location, other factors may interfere with an ideal targeting of gallstones during extracorporeal shock waves treatment. Obesity, malnourishment, the respiratory cycle, the presence of intestinal gas, and colonic content may interfere with an adequate focalization. The use of a multipurpose device able to couple with the anterior abdominal wall like the Lithostar Plus permits to perform the procedure with the patient in supine, oblique or intercostal position. Varying the position permits to avoid interferences due to intestinal gas or intestinal content. The movements of the patients which produce a missing image can be easily refocussed. Technical ability, experience and a good machine permits a successful rate of gallstone fragmentation.

[Analysis of the attitude of the hospital staff regarding the hepatitis B vaccine]

The attitude of the staff of the University Hospital Virgen de la Macarena in Sevilla was evaluated to assess their degree of information about hepatitis B vaccine, their attitude towards vaccination and the possible causes of the latter. To this end, a survey was carried out among 200 individuals from the hospital staff, distributed in four professional level categories (doctors, nurses, clinical assistants and attendants). The level of knowledge of the disease, the participation in the vaccination and the future attitude were evaluated. Group differences were also analysed. The results showed a low information level about the vaccine (81.5% were not adequately informed), a low vaccination index (13.5%) and a low intention to be vaccinated in the future (34.6%), mostly due to poor information.