Multislice CT in Graft Vascular Disease. A Pilot Study

INTRODUCTION

Graft vessel disease (GVD) is one of the main long-term complications in heart transplant (HT) patients. At present, the diagnosis of this complication requires invasive procedures. Multislice CT is an emerging technique that allows visualization of the coronary anatomy, including the vascular lumen and wall thickness. Our objective was to establish the value of 16-detector multislice CT in the detection of GVD, compared with angiography and intravascular ultrasound (IVUS).

PATIENTS AND METHODS

We studied 32 HT patients, who had a mean follow-up of 2016 days. CT was performed 24 hours prior to angiography, associated with IVUS if the latter proved normal. Comparisons were subsequently made using contingency tables to establish the sensitivity, specificity, and predictive values of the CT.

RESULTS

Angiography was not performed on two patients, and eight were excluded from CT assessment due to serum creatinine values >1.5 mg/dL. Comparison of the CT findings with the invasive techniques yielded a sensitivity of 50%, a specificity of 81%, a negative predictive value of 81%, a positive predictive value of 50%, and a precision of 72%.

CONCLUSIONS

Our results suggested good performance of the technique in screening for GVD because a high negative predictive value was recorded. We plan to increase the number of patients and use the 64-detector CT system to ensure greater time and spatial resolution.

Computed tomography perfusion usefulness in early imaging diagnosis of herpes simplex virus encephalitis

An early diagnosis is crucial in herpes simplex virus encephalitis patients in order to institute acyclovir therapy and reduce mortality rates. Magnetic resonance imaging (MRI) is considered the gold standard for evaluation of these patients, but is frequently not available in the emergency setting. We report the first case of a computed tomography (CT) perfusion study that helped to establish a prompt diagnosis revealing abnormal increase of blood flow in the affected temporoparietal cortex at an early stage.

Evidence of association of macrophage migration inhibitory factor gene polymorphisms with systemic lupus erythematosus

The aim of this study was to evaluate the potential association of functional polymorphisms of macrophage migration inhibitory factor with systemic lupus erythematosus. Our study includes 711 systemic lupus erythematosus (SLE) patients and 755 healthy controls. We genotyped the migration inhibitory factor (MIF) -173G/C using a polymerase chain reaction (PCR) system with predeveloped TaqMan allelic discrimination assay and the MIF -794 CATT(n) microsatellite polymorphism using a PCR-fluorescent method. A statistically significant difference in the distribution of the MIF -173(*)C allele between SLE patients and controls (P=0.004, OR=1.34, 95% CI=1.05-1.27) was observed. In addition, the frequency of the MIF -173(*)C/C genotype was higher in SLE patient (P=0.002, OR=2.58, 95% CI=1.32-5.10). No differences in the distribution of CATT(n) were found. However, the haplotypes analyses showed that only the CATT(7)-MIF -173(*)C haplotype was associated with a higher susceptibility to SLE (P=0.001, OR 1.84, 95% CI 1.35-2.79). No association with clinical features was detected in any case. These results suggest that both, MIF -173(*)C allele and CATT(7)-MIF -173(*)C haplotype, confer susceptibility to SLE in our population.

Spontaneous bursting and rhythmic activity in the cuneate nucleus of anaesthetized rats

Spontaneous and rhythmic neuronal activity in dorsal column nuclei has long been identified in anesthetized cats. Here, we have studied the spontaneous behavior of cuneate cells in anesthetized rats through extracellular recording, showing that most cuneate neurones recorded (155 of 185) fired spontaneously. Overall, 74% of these spontaneously firing neurones were single-spiking and 26% were bursting. Cells were considered "bursting" when more than 50% of the spontaneous spikes belonged to bursts. Nevertheless, occasional bursts were seen in 33% of spontaneous cuneate cells which were classified as single-spiking. Rhythmic firing was observed in about 14% of both spontaneously bursting and single-spiking cells, and these cells were located close to the obex (+/-0.5 mm). Although the spike-frequency was mostly in the range 0-15 spikes/s, spontaneous rhythmic activity was circumscribed mainly to the alpha/beta-like range, both in single-spiking (26.1+/-3.6 Hz, n=16) and bursting cells (19.5+/-4.1 Hz, n=6). Lemniscal stimulation often activated several antidromic units with the same latency. About 65% of cuneolemniscal cells were spontaneously active and of these, 83% were single-spiking and 11% rhythmic (all single-spiking). In cells that were not antidromically activated from the medial lemniscus, short latency orthodromic responses consistent with excitation by recurrent lemniscal collaterals were often observed following lemniscal activation. Interestingly, only cells completely unresponsive to lemniscal stimulation showed rhythmic bursting. Most spontaneous cells responded with a burst to natural receptive field stimulation, while rhythmic cells became temporally arrhythmic. These results demonstrate, for the first time, that rat cuneate neurones can fire bursts spontaneously. Besides, this bursting activity can be rhythmic. These two properties, and the fact that groups of cuneolemniscal cells share the same conduction velocity, probably imply the reinforcement of temporal and spatial summation at their targets when they are synchronously recruited by the stimulation of overlapping receptive fields.

Role of turbulence on edge momentum redistribution in the TJ-II stellarator

Radial profiles of the parallel-radial Reynolds stress component, proportional to the cross correlation between parallel and radial fluctuating velocities, have been measured in the plasma boundary region of the TJ-II stellarator. Experimental results show the existence of significant parallel turbulent forces at plasma densities above the threshold value to trigger perpendicular sheared flows. This finding provides the first experimental evidence of the role of parallel turbulence forces on edge momentum redistribution in fusion devices.

Attitudes of Primary Care Professionals in Spain Toward Xenotransplantation

OBJECTIVE

The deficit in transplantable organs is making it necessary to find alternative sources. One possibility is xenotransplantation. However, the use of animal organs may be rejected by society and among health professionals. Primary Care is fundamental for promoting matters of health; in Spain it has access to nearly 100% of the population. Our objective was to analyze the acceptance of this therapy, although it is experimental, among Primary Care professionals, given that they are the ones most involved in spreading information about this therapy if it was confirmed to be useful.

MATERIALS AND METHODS

A random sample was stratified by sex, job category, and geographical location among Primary Care personnel, including 428 professionals in 32 health centers among population of 2851 professionals. Attitudes toward xenotransplantation were evaluated using a questionnaire on psychosocial attitudes validated in our geographical area. Contact was made in each center with the Doctor Coordinator for doctors, the Nursing Coordinator for nurses, and an Administrative Officer for ancillary personnel. The chi-square test and Student t test were applied to evaluate categorical and continuous data, respectively.

RESULTS

Attitudes toward xenotransplantation were similar to those obtained in human organs: favorable in 79% (n = 325), whereas 19% (n = 78) had doubts and 2% (n = 10) were against. The attitude was more favorable in men (89% vs 72%; P < .000), those who had cared for transplant patients (84% vs 71%; P = .009), those with previous experience in organ donation and transplantation (84% vs 75%; P = .033), those with an attitude in favor of cadaveric organ donation (83% vs 66%; P < .0001), and those in favor of living donation of the kidney (P < .000) or the liver (P < .000), as well as those who believed that they may need a transplant at some time in the future (84% vs 74%; P = .045). There was a clear difference in attitude according to job category (P = .018): approval rates were 89% for doctors, 76% for nurses, and 70% for ancillary personnel.

CONCLUSIONS

Attitudes toward future application of xenotransplantation were quite positive among doctors. However, the attitudes of nursing and ancillary personnel were similar to those of the general population. The main factors related to such an attitude depended mainly on the previous relationship and attitude of the respondent toward human organ donation and transplantation.

Primary Care Doctors Faced With Living Organ Donation

OBJECTIVE

The attitudes of health care personnel, specifically doctors, have a significant influence on public attitudes toward organ donation and transplantation. The objective herein was to analyze the attitudes of Primary Care (PC) doctors toward living organ donation and to determine the psychosocial factors that condition these attitudes.

MATERIALS AND METHODS

A random sample was stratified by geographical location (six health areas in our community) among PC doctors, including 155 respondents from 32 health centers. Attitudes toward donation were evaluated using a psychosocial questionnaire validated in our geographical area. Contact was made with the Doctor Coordinator in each center for distribution of the questionnaires, which were completed anonymously. The chi-square test and Student t test were applied to evaluate the data.

RESULTS

When the living donor is not related, only 21% (n = 32) of PC doctors were in favor of living kidney donation, and only 20% (n = 31) for living liver donation (P > .05). In contrast, these percentages were 90% and 89% in favor of kidney and liver related donation, respectively. Upon analysis of the psychosocial variables affecting these attitudes, there was only an association with their partner's opinion (P = .009 for kidney and P = .000 for liver), and the possibility of needing a transplant oneself (P = .000).

CONCLUSIONS

PC doctors have favorable attitudes toward related living donation. If living donation is promoted by transplant coordination units, such PC professionals could act as a source of positive information about the matter for the general public.

Role of intestinal bacterial overgrowth and intestinal motility in bacterial translocation in experimental cirrhosis

BACKGROUND

Intestinal bacterial overgrowth (IBO) is related to small bowel motility and has been involved in the pathogenesis of bacterial translocation (BT) in experimental models, and both overgrowing gut flora and translocating bacteria to mesenteric lymph nodes are common features in cirrhosis.

OBJECTIVES

The aims of this study were to analyze cecal aerobic bacteria and intestinal transit in cirrhotic rats, and their relationship with BT, evaluating the role of intestinal bacterial overgrowth and small bowel dismotility in the development of BT in experimental cirrhosis.

MATERIAL AND METHODS

We included twenty-seven male Sprague-Dawley rats with carbon tetrachloride-induced cirrhosis without ascites and ten controls. Cultures of mesenteric lymph nodes (MLN), peripheral and portal blood, liver, spleen and cecal samples were carried out. Small intestinal transit was determined in ten cirrhotic rats and in ten control rats.

RESULTS

The prevalence of bacterial translocation was 56%. Total cecal aerobic bacteria count was significantly higher in cirrhotic rats than in control rats (p < 0.001). Cirrhotic rats with translocated bacteria had higher total aerobic intestinal counts than culture-negative MLN bacteria (p < 0.05). The prevalence of total intestinal bacterial overgrowth in cirrhotic animals was 67%, and 0% in control animals (p < 0.001). According to BT, total IBO was more frequent in cirrhotic rats with BT versus those without BT (93 vs. 33%) (p < 0.001). Of the translocating bacteria, 95.6% were found to be overgrown in the cecum. The small-intestinal transit was slower in cirrhotic rats (60.5 +/- 12.7 cm vs. 81.2 +/- 5.7 cm) than in control animals (p < 0.001).

CONCLUSIONS

These results suggest that the increase of intestinal aerobic bacteria in experimental cirrhosis is associated with translocation. In addition, IBO is frequent in cirrhotic rats, and is supposed to play an important role in the development of BT. Impaired motility of the small intestine is a common feature in cirrhosis and may be implicated in the pathogenesis of IBO.

No primary association of MICA polymorphism with systemic lupus erythematosus

OBJECTIVE

To replicate the described association between MHC class I chain-related A (MICA) gene polymorphism and susceptibility to systemic lupus erythematosus (SLE).

METHODS

MICA transmembrane microsatellite polymorphism was genotyped using a polymerase chain reaction (PCR)-based method. Genotyping of HLA-B* and DRB1* was performed using PCR and detection with a reverse sequence-specific oligonucleotide (SSO) probe system. Combined data for these three loci (HLA-B*, DRB1* and MICA) were obtained from a total of 333 patients and 361 healthy controls.

RESULTS

Significant association with B*08 [P < 10(-7), odds ratio (OR) 3.17, 95% confidence interval (CI) 2.02-5.00], DRB1*0301 (P < 10(-7), OR 2.07, 95% CI 1.59-2.68) and MICA5.1 (P = 0.01, OR 1.23, 95% CI 1.04-1.46) was observed. The combinations DRB1*0301-MICA5.1-B8 and HLA-DRB1*0301-B*08-positive and MICA5-1-negative were more frequent among SLE patients (11.4 vs 3.3% in healthy controls, P = 3.9 x 10(-5), OR 3.76, 95% CI 1.85-7.73, and 6.9 vs 1.7%, P = 0.0007, OR 4.32, 95% CI 1.68-13.10, respectively). Additionally, individuals who were HLA-DRB1*0301-B*08-negative and MICA5-1-positive were less frequent among patients (22.2 vs 31.3% in healthy controls, P = 0.007, OR 0.63, 95% CI 0.44-0.89) and the magnitude of the OR was similar to that obtained in individuals negative for all the three factors (OR 0.69, 95% CI 050-0.94). Further analysis performed to detect independent association strongly suggested that the association between MICA5.1 and SLE is secondary to the linkage disequilibrium of this allele with B*08.

CONCLUSIONS

Our results do not support an independent association of MICA gene polymorphism with susceptibility to SLE.

Epistatic interaction between FCRL3 and NFkappaB1 genes in Spanish patients with rheumatoid arthritis

BACKGROUND

A Japanese study has described a strong association between rheumatoid arthritis and several polymorphisms located in the Fc receptor-like 3 (FCRL3) gene, a member of a family of genes related to Fc receptors located on chromosome 1q21-23.

OBJECTIVES

To evaluate the association between rheumatoid arthritis and FCLR3 polymorphisms in a large cohort of Caucasian patients with rheumatoid arthritis and healthy controls of Spanish origin. Owing to the described functional link between the FCRL3 polymorphisms and the transcription factor nuclear factor kappaB (NFkappaB), a functional polymorphism located in the NFkappaB1 gene was included.

METHODS

734 patients with rheumatoid arthritis from Madrid and Granada, Spain, were included in the study, along with 736 healthy controls. Polymorphisms in the FCRL3 gene were studied by TaqMan technology. The -94ins/delATTG NFkappaB1 promoter polymorphism was analysed by fragment analysis after polymerase chain reaction with labelled primers. Genotypes were compared using 3x2 contingency tables and chi2 values.

RESULTS

No overall differences were found in any of the FCRL3 polymorphisms and in the NFkappaB1 promoter polymorphism when patients were compared with controls. However, when stratified according to NFkappaB1 genotypes, a susceptibility effect of FCRL3 polymorphisms was observed in patients who were heterozygotes for NFkappaB1 (pc = 0.003).

CONCLUSIONS

The FCRL3 polymorphisms associated with rheumatoid arthritis in a Japanese population are not associated per se with rheumatoid arthritis in a Spanish population. A genetic interaction was found between NFkappaB1 and FCRL3 in Spanish patients with rheumatoid arthritis. These findings may provide a general rationale for divergent genetic association results in different populations.

An evaluation of variables affecting the stability and performance of down-flow anaerobic fixed bed reactors treating piggery wastewater

The influence of the most important variables on the stability and performance of down-flow anaerobic fixed bed reactors treating piggery wastewater after primary sedimentation was evaluated at HRT in the range of 1-6 d and influent substrate concentration in the range of 2 to 12 g TCOD l(-1). The effect of HRT was more pronounced compared to that of influent strength. An increase in the HRT increased the process stability and process performance at different influent strengths. TCOD, SCOD, BOD5 TSS, organic nitrogen (N) and Orthophosphate (P) removals increased with the HRT, independently of the initial substrate concentration (S0). The increase in S0 brought about an increase in the attached biomass concentration (X) at the end of the experiment. Two empirical models based on the individual effect of HRT, X and S0 were evaluated and found to be adequate to describe the influence of these variables on the process performance. The first model took all the above-mentioned variables into consideration while the second model was simplified and based on the use of HRT as the only independent variable. The results obtained by using both models were found to be similar. This demonstrated that independently of the characteristics of the operation, the behaviour and performance of the reactors were comparable. The methane yield coefficient was found to be 0.3371 methane g(-1) TCOD removed.

Production of biomass (algae-bacteria) by using a mixture of settled swine and sewage as substrate

This paper presents the use of a mixture of settled swine and sewage as substrate for biomass production, mainly constituted by microalgae Chlorella vulgaris and aerobic bacteria, growing outdoor at different dilution rates in a continuous mode. The experiments were carried out in 16-litre volume laboratory ponds operating at hydraulic retention times (HRT) in a range of 4-14 days equivalent to dilution rates (D) in a range of 0.250-0.071 d(-1). Total chemical oxygen demand (TCOD), soluble chemical oxygen demand (SCOD), total biochemical oxygen demand (TBOD(5)), total suspended solids (TSS), volatile suspended solids (VSS), total Chlorophyll (S C), total Kjeldahl nitrogen (TKN), ammonia nitrogen, total phosphorous, orthophosphate and pH were monitored. An empirical relationship between the dilution rate (D) and the removal efficiencies of TCOD, SCOD, TBOD(5), TKN and total phosphorous was found. The occurrence of an inhibition process for TCOD, TBOD(5), TKN and total phosphorous removals was observed. The Andrews kinetic model was successfully applied to these experimental data, while the Monod model was more suitable for studying the variation of the SCOD removal rate with the effluent SCOD concentration. The maximum microalgal biomass productivity was found to be in the range of 93-98 mg VSS(A)/L d (37.2-39.2 g/m(2)d) at dilution rates in the range of 0.167-0.250 d(-1), where VSS(A) is the concentration of microalgae expressed in VSS. In the case of the bacteria, the productivity increased linearly with the dilution rate being maximum at a D value of 0.25 d(-1). It was concluded that the mixture of pre-treated swine and sewage used as substrate, contributed to the obtention of a high biomass (microalgae-bacteria) production, providing a simple technology feasible to be applied in developing countries.

The primary care physician faced with organ donation: attitudinal study in South-Eastern Spain

INTRODUCTION

Attitude of health personnel, especially of physicians, has a significant influence on populational attitude towards organ donation and transplantation. The objective here is to analyse the attitude of Primary Care (PC) physicians towards cadaveric organ donation and transplantation and to determine the factors which condition this attitude.

MATERIALS AND METHODS

A random sample was stratified by geographical location (six health areas of our community) among PC physicians. A total of 155 responses from 32 health centres were collected. Attitude towards donation was evaluated using a psychosocial attitudinal questionnaire about donation validated in our geographical area. The co-ordinator of physicians in each centre was contacted in each centre and was made responsible for distribution and collection of the questionnaires which were completed anonymously. The chi2 test and Student's t-test were applied.

RESULTS

88% (n=136) of the PC physicians are in favour of organ donation, 1% (n=2) are against and 11% (n=17) are undecided. Up to 84% of the PC physicians (n=130) have attended to transplant patients, although this fact is not related to a more positive attitude towards donation (p=0.059). In addition, 64% (n=99) have provided favourable information about organ donation and transplantation to their patients and one of the physicians admits having provided unfavourable information about the matter. On analysing the psychosocial variables which influence such an attitude, a relationship has only been found with respect to two variables: attitude towards cadaveric manipulation (p=0.035) and a partner's opinion towards the subject (p=0.006).

CONCLUSIONS

PC physicians have a very favourable attitude towards donation of their own organs and constitute a positive source of information on the subject for the general public.

A study of the natural biodegradation of two-phase olive mill solid waste during its storage in an evaporation pond

A study of the natural biodegradation of two-phase olive mill solid waste (OMSW) during its storage in an evaporation pond was carried out. This system is traditionally used as the final disposal of this waste or constitutes a previous stage before being processed by cogeneration or anaerobic digestion processes. A laboratory-scale pond with a total volume of 520 l was used. The experiment was carried out between December 2002 and August 2003 covering a total period of 269 days. During the experiment, the variations of temperature (outside and inside the pond), the effective volume of the OMSW in the pond, moisture content, total solids (TS), volatile solids (VS), the total chemical oxygen demand (TCOD), total volatile acids (TVA), pH and cumulative methane production as a function of the operation time were evaluated. The experimental results obtained showed that the characteristics of the two-phase OMSW in the pond were dependent on the time of operation and temperature. During the experiment, three periods were clearly observed and differentiated: (a) An initial period with a rapid reduction of moisture content and effective volume, with an increase of TS, VS and TCOD removals, a decrease of pH and an increase of TVA and methane production until day 21. (b) A second period of slow decrease of moisture content and effective volume, due to the decrease of the ambient temperature. This period took place between day 21 and days 120-150 of assay, and it was characterised by a slight change in the OMSW properties. (c) A third period where the characteristics of the waste in the pond changed considerably due to the increase of the temperature outside the pond. The methane gas production also showed an increase due to the increase of methanogenic activity with the increase of temperature. An empirical model to describe the changes of two-phase OMSW characteristics and methane production with the operation time was developed. The proposed model, based on the use of polynomial equations, took into account the influence of the temperature and fit adequately into the experimental results obtained. It was found that the pond could probably be used as preliminary treatment of two-phase OMSW before its anaerobic digestion process, because a maximum conversion of organic matter to TVA was obtained after an operation time of around 200 days.

Two-month ciprofloxacin implants for multibacterial bone infections

A ciprofloxacin implant formulation composed of 12% hydroxyapatite, 36% tricalcium phosphate, 12% poly(DL-lactide) (PLA) and 40% ciprofloxacin was characterized in vivo for use in treatment of multibacterial bone infection. After the implant was inserted in the femur of rabbits, approximately 90% of the total ciprofloxacin was released within 8 weeks, maintaining therapeutic levels in the femur and tibia. Throughout the femoral cortex and marrow these remained higher than the minimum inhibitory concentrations (MIC) against the most common pathogens causing osteomyelitis. Levels in tibia cortex were also above MIC for 6 weeks. The implant was characterized in terms of polymer degradation and morphological and crystallographic changes. X-ray analyses confirmed the osteoconductivity and biocompatibility of these materials. The sequential changes in the femur were those of a normal surgical trauma reaction followed by a repair process. All the results confirmed that ciprofloxacin release is limited by its low solubility, and that implant erosion and bone ingrowth into the implants enhance the antibiotic release.

Attitude of Primary Care Nurses Toward Living Kidney Donation

INTRODUCTION

Nursing is a fundamental service in caring for the health of the public. The opinion of nurses toward a certain type of donation may have a strong population impact. In this respect, living kidney donation is increasing in Spain; it is important to raise awareness at all levels. The objective here was to analyze the attitudes of primary care nursing personnel toward living kidney donation and to their determinants.

MATERIALS AND METHODS

A random sample of primary care nurses stratified by geographical location (six health areas in our community), included 139 nurses from 32 health centres. Attitudes toward living donation were evaluated using a questionnaire with various psychosocial variables. For the distribution of the questionnaires, contact was made with the nursing coordinator in each centre. They were completed anonymously. The chi-squared test and Student's t test were applied.

RESULTS

The attitudes toward living kidney donation were favorable in 93% of those questioned (n = 129), mainly when the donation is related (78%, n = 109). Only one nurse was against the idea of donating a kidney from a living person (1%); nine had doubts about this kind of donation (7%). Seventy-six percent (n = 106) have cared for patients awaiting a transplant; however, no relationship was found with attitude toward this type of donation (P = .209). Of all analyzed variables, there was only a significant relationship with concern about possible body mutilation (P < .0005) and partner's opinion about the matter (P < .0005). We wish to highlight that no relationship was found with attitudes toward cadaveric organ donation (P = .712).

CONCLUSIONS

Attitudes of primary care nursing personnel toward living kidney donation were favorable, especially if it was related donation.

Acceptance Level of Living Liver Donation Among Primary Care Nursing Personnel

INTRODUCTION

Living liver donation is not exempt from risks to the donor, although it is currently ethically accepted. It is important to examine the level of acceptance among the different health levels toward this therapeutic option, in order to design promotion and awareness-raising activities. The objective herein was to analyze the attitudes and the factors that condition them among nursing personnel in Primary Care (PC) toward living liver donation.

MATERIALS AND METHODS

This random survey was stratified by geographical location (6 health areas in our community) among PC nurses, obtaining a total of 139 nurses from 34 health centers. Attitudes toward living liver donation were evaluated using a questionnaire on donation which included different psychosocial variables. For the distribution of the questionnaire, the nursing coordinator of each centers was contacted to distribute questionnaires which were completed anonymously. The chi-square test and Student t test were applied.

RESULTS

Attitudes toward living liver donation were favorable in 89% of those questioned (n = 124) if it is related donation; 3% (n = 4) were against donating a living hemiliver and 8% (n = 11) had doubts. It is important that up to 76% (n = 106) have cared for transplant patients or patients awaiting transplant, however, no relationship was observed with attitude to this type of donation (P = .489). Of all the analyzed variables, there was only a significant relationship between attitudes and concern about possible body mutilation (P < .0005), and partners attitudes toward this matter (P < .0005). It is noteworthy that no relationship was found with attitudes toward cadaveric donation (P = .062).

CONCLUSION

Despite the risk of morbidity and mortality in the donor, the attitude of the PC nursing personnel toward living liver donation was favorable, especially if the donation is related.

Rural Primary Care Centers as a Source of Information About Organ Donation

INTRODUCTION

Primary care is an important way of promoting health in the community, and this includes organ donation. In rural areas, this way of promoting health acquires special importance. Our objective was to analyze attitudes toward organ donation among primary care workers in rural health centers to assess their importance in circulating information about donation.

MATERIALS AND METHODS

A random sample, stratified according to job category among the primary care staff (n = 160), of workers in rural areas in our autonomous community (population < 10,000 inhabitants), evaluated attitudes toward donation using a questionnaire validated in our geographic area. To distribute the questionnaire it was necessary to contact the following in each health center: the coordinating physician, the nursing coordinator, and an administrative worker.

RESULTS

Of those questioned, 78% (n = 124) were in favor of donation, as opposed to 22% (n = 36) who are against it or undecided. As for the job category, physicians and nurses showed a more favorable attitude than nonhealth workers (90% and 80% vs 61%; P = .000). The psychosocial variables that were related to such an attitude were knowledge of the concept of brain death (P = .013) and lack of fear of manipulation of the deceased person (P = .002). Regarding information about organ donation and transplantation, 54% (n = 86) reported having been provided favorable information, with up to a quarter of the physicians considering other programs to be of greater interest for primary care than organ donation and transplantation.

CONCLUSION

Attitudes toward organ donation were favorable among a high percentage of primary care workers in rural centers; more than 50% have circulated favorable information on the subject. However, there is a high percentage with a negative or undecided attitude, especially among nonhealth workers, which should be reversed with promotional activities at the level of the health center.

Study of the role of functional variants of SLC22A4, RUNX1 and SUMO4 in systemic lupus erythematosus

BACKGROUND

Functional polymorphisms of the solute carrier family 22, member 4 (SLC22A4), runt related transcription factor 1 (RUNX1) and small ubiquitin-like modifier 4 (SUMO4) genes have been shown to be associated with several autoimmune diseases.

OBJECTIVE

To test the possible role of these variants in susceptibility to or severity of systemic lupus erythematosus (SLE), on the basis that common genetic bases are shared by autoimmune disorders.

METHODS

597 SLE patients and 987 healthy controls of white Spanish origin were studied. Two additional cohorts of 228 SLE patients from Sweden and 122 SLE patients from Colombia were included. A case-control association study was carried out with six single nucleotide polymorphisms (SNP) spanning the SLC22A4 gene, one SNP in RUNX1 gene, and one additional SNP in SUM04 gene.

RESULTS

No significant differences were observed between SLE patients and healthy controls when comparing the distribution of the genotypes or alleles of any of the SLC22A4, RUNX1, or SUMO4 polymorphisms tested. Significant differences were found in the distribution of the SUMO4 genotypes and alleles among SLE patients with and without nephritis, but after multiple testing correction, the significance of the association was lost. The association of SUMO4 with nephritis could not be verified in two independent SLE cohorts from Sweden and Colombia.

CONCLUSIONS

These results suggest that the SLC22A4, RUNX1, and SUMO4 polymorphisms analysed do not play a role in the susceptibility to or severity of SLE.

A model with 'growth retardation' for the kinetic heterogeneity of tumour cell populations

In the present paper we propose a continuous cell population model based on Shackney's idea of growth retardation. Cells are characterized by two state variables: the cell maturity x, 0 < or = x < or = 1, and a state variable T that identifies the rate of maturation along cell cycle. During their life span, cells can change T at random by jump transitions to T values corresponding to slower maturation rates, while at each jump the maturity x is conserved. Both the time evolution of the population and the exponential stationary solution are numerically computed. The distribution of the cell cycle transit time in asynchronous exponential growth is investigated by Monte Carlo simulation. An approximated formula for the distribution of cell cycle time is also provided.