Impact of individual molecular components in determining primary sensitization to latex

Allergy to natural rubber latex emerged as one of the main allergies at the beginning among some professional groups and the general population. Sensitization and development of latex allergy have been attributed to exposure to products containing residual latex proteins. The prevailing cross-reactivity of latex proteins with other food allergens is of great concern. Numerous purified allergens are currently available, which greatly help in patient management, thus determining their specific profile. We conducted a multicenter study to investigate changes, from the ROC analysis, in the characteristics of patients with latex allergy by measuring its major protein components. Sensitization to latex proteins is crucial because it highlights the cross reactivity to inhalants (pollen) and food (fruit). It is very essential in an accurate and specific clinical setting.

Intensive monitoring of adverse drug events associated with the use of new glucose-lowering drugs: results from an inception cohort study in Portugal

AIMS

To determine the frequency and the time-course profile of adverse drug events associated with new glucose-lowering drugs in daily practice and to explore factors potentially associated to these events.

METHODS

An inception cohort study was implemented. Adults with type 2 diabetes mellitus initiating a dipeptidyl peptidase-4 inhibitor, a glucagon-like peptide-1 receptor agonist or a sodium-glucose co-transporter-2 inhibitor were eligible for inclusion. Data were collected through baseline and follow-up telephone questionnaires, administered at 2 weeks, 3 months and 6 months. Kaplan-Meier curves and log-rank were computed to compare the time to adverse drug event onset. Cox models were used to explore potential factors associated with adverse drug events.

RESULTS

A total of 1328 participants were recruited to the study. In all, 1118 adverse drug events were reported (of which 36% were not listed in the summary of product characteristics) by 41% of participants. The median latency time of adverse drug events reported in ≥1% of participants ranged from 0 to 2 days. Glucagon-like peptide-1 receptor agonist and sodium-glucose co-transporter-2 inhibitor subgroups were associated with an increased likelihood of adverse drug event reporting when compared with the dipeptidyl peptidase-4 inhibitor subgroup. A total of 328 glucose-lowering drugs were withdrawn, more than half as a result of an adverse drug event.

CONCLUSIONS

More than two-fifths of participants reported an adverse drug event; dipeptidyl peptidase-4 inhibitors led to the highest proportion of unlabelled adverse drug events. Adverse drug event latency time data show that counselling and adverse drug event management should be proactively addressed from treatment initiation. There should be greater focus on prevalent new users of glucose-lowering drugs, who were more complex participants in this study in terms of type 2 diabetes disease, as they were more likely to report an adverse drug event than the incident new users.

Effect of sterilization and of dietary fat and carbohydrate content on food intake, activity level, and blood satiety-related hormones in female dogs

Animal sterilization is suggested to promote food overconsumption, although it is unknown whether this effect is mediated by variations in satiety-related hormones, which are released in response to food intake. The aim of this study was to evaluate the effect of sterilization and of the main energy-delivery nutrients, fat and nonstructural carbohydrates, on food intake, blood concentration of satiety-related hormones, and activity level in dogs. In a 2-phase experiment (phase I [Ph.I], 74 d, and Ph.II, 84 d), 12 female Beagle dogs were assigned to a control group (intact in both phases) and a sterilization group (spayed 20 d before Ph.II). In each phase, dogs received a high-carbohydrate (HC) diet (313 and 105 g/kg DM starch and fat, respectively) and a high-fat (HF) diet (191 and 213 g/kg DM starch and fat, respectively), both high in total dietary fiber (>200 g/kg DM) and providing 27% ME as protein, in 2 consecutive periods following a crossover arrangement. During each period, dogs' voluntary DMI and activity level were recorded during 5 d. Then, energy allowance was restricted to 0.7 maintenance and the level of intake of a common challenge food offered 4 h after feeding the experimental diets (challenge food intake [ChFI]) was used as an index of the satiety state of dogs. Blood concentration of active ghrelin, cholecystokinin (CCK), total peptide YY (PYY), and insulin were determined before and 15, 60, 120, 240, and 360 min after feeding. Voluntary DMI was greater ( < 0.05) in HF-fed dogs, but ChFI did not differ between diets ( > 0.10). Dogs fed the HF diet showed a lower increase of CCK at 120 ( < 0.01) and 240 min ( < 0.05), resulting in a lower ( < 0.001) total area under the curve from 0 to 240 min (tAUC). A lower PYY elevation ( < 0.05) was also found in HF-fed dogs at 120 min. Only active ghrelin concentration at 240 min and insulin tAUC correlated ( < 0.05) with ChFI (r = 0.357 and r = -0.364, respectively), suggesting a role of these hormones in appetite. Dog sterilization did not affect voluntary DMI, ChFI, or blood hormones ( > 0.10) but led to a reduced activity level compared with control dogs ( < 0.05). In summary, dog sterilization was not associated with an impaired appetite control. Feeding dogs the HF diet led to energy overconsumption and to a lower blood elevation of CCK and PYY but was not associated with a weaker satiating effect 4 h later compared with the HC diet.

Impact of continuous positive airway pressure in patients with obstructive sleep apnea during drug-induced sleep endoscopy

OBJECTIVES

The primary objective of the study was to understand the differential impact of continuous positive airway pressure (CPAP) on the location, degree and pattern of airway collapse in obstructive sleep apnea (OSA) patients utilizing drug-induced sleep endoscopy (DISE).

STUDY DESIGN

Non-randomized trial.

SETTING

University Medical Center.

PARTICIPANTS

Fifteen consecutive OSA patients undergoing DISE.

MAIN OUTCOMES AND MEASURES

The patterns of airway collapse were videorecorded at baseline and under differential application of nasal CPAP (nCPAP) at 5, 10 and 15 cm H₂ O. For each modality, the pattern and degree of airway collapse were analyzed by three independent observers using the velum, oropharynx, tongue base, epiglottis (VOTE) classification system.

RESULTS

The modest nCPAP pressures (10 cm H₂ O) had the greatest impact on the lateral walls of the pharynx, followed by the palatal region. The collapsibility of the tongue base and epiglottis demonstrated significant resistance to nCPAP application, which was overcome by increasing nCPAP to 15 cm H₂ O. Compared to 5 cm H₂ O, nCPAP pressures of 10 and 15 cm H₂ O improved complete collapse at least at one level of the upper airway (P=.016 and .001, respectively). Increased nCPAP pressures also led to changes in the configuration of airway collapse at the level of the velum.

CONCLUSIONS

The differential nCPAP effects observed in this study may help to understand some of the mechanisms responsible for inadequate patient response and poor nCPAP compliance. The use of DISE in combination with CPAP may serve as a first step in optimizing patients that failed to adapt to treatment with CPAP. This approach can help the physician identify patterns of airway collapse that may require varying pressures different from the one the patient is using, as well as anatomical factors that may be corrected to help with compliance.

Simultaneous detection of circulating immunological parameters and tumor biomarkers in early stage breast cancer patients during adjuvant chemotherapy

BACKGROUND

Chemotherapy-induced immune suppression has mainly been studied in patients with advanced cancer, but the influence of chemotherapy on the immune system in early stage cancer patients has so far not been studied systematically. The aim of the present study was to monitor the immune system during anthracycline- and taxane-based adjuvant chemotherapy in early stage breast cancer patients, to assess the impact of circulating tumor cells on selected immune parameters and to reveal putative angiogenic effects of circulating endothelial cells.

METHODS

Peripheral blood samples from 20 early stage breast cancer patients were analyzed using a flow cytometric multi-color of antibodies to enumerate lymphocyte and dendritic cell subsets, as well as endothelial and tumor cells. An enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of various serological factors.

RESULTS

During chemotherapy, all immunological parameters and angiogenesis surrogate biomarkers showed significant decreases. The numbers of circulating tumor cells showed significant inverse correlations with the numbers of T helper cells, a lymphocyte subset directly related to effective anti-tumor responses. Reduced T helper cell numbers may contribute to systemic immunosuppression and, as such, the activation of dormant tumor cells.

CONCLUSIONS

From our results we conclude that adjuvant chemotherapy suppresses immune function in early stage breast cancer patients. In addition, we conclude that the presence of circulating tumor cells, defined as pan-cytokeratin(+), CD326(+), CD45(-) cells, may serve as an important indicator of a patient's immune status. Further investigations are needed to firmly define circulating tumor cells as a predictor for the success of breast cancer adjuvant chemotherapy.

SERUM IMMUNOGLOBULIN IgE IN A PEDIATRIC POPULATION: A RETROSPECTIVE ANALYSIS

Allergic sensitization is mediated by immunoglobulin E (IgE) and an increase of their total value is frequently used to complete a correct diagnosis of atopy. Serum IgE may be considered a typical biomarker for the allergic phenotype. The aim of this study was to evaluate total serum IgE, according to sensitizations and to find a cut off to discriminate between atopic and non-atopic subjects. Seven hundred and ninety-five patients were enrolled in this study. Serum levels of total IgE were measured by a fluorescence immunoassay (ImmunoCAP; ThermoFisher, Uppsala, Sweden) while specific IgE levels were measured by immunofluorometric assay (ImmunoCAP; ThermoFisher, Uppsala, Sweden). Both tests were expressed in kU/L, according to manufacturer’s instructions.

RESULTS

A difference for total IgE, according to the gender, has been found (p = 0,0012 ) with higher values for males than for females. A correlation has been found between total IgE and specific IgE, even distinguishing the population in sensitized and non-sensitized. A statistically significant difference has been found according to the presence or the absence of sensitization (p less than 0.0001) and also considering mono-sensitized and polysensitized patients (p less than 0.0001). ROC analysis has been performed to define a cut off for total serum IgE, according to sensitization and to the type of sensitization (mono-sensitization or poly-sensitization). Finally multiple regression models have been performed to describe total IgE response (positive or negative) and to predict total IgE values. Since clinical limitations are well known, total IgE provide a useful aid to define atopy, allowing the clinician to carry out further investigations in patients with total IgE values beyond normal limits.

Isolation and identification of Porphyromonas spp. and other putative pathogens from cats with periodontal disease

The purpose of this study was to evaluate the subgingival microbiota and determine the most prevalent periodontal pathogens implicated in feline periodontal disease and to correlate these findings with the clinical periodontal status. Subgingival microbiological samples were taken under sedation from 50 cats with clinical signs of periodontal disease. Pooled paper point samples from 4 selected subgingival sites were cultured on blood agar and on Dentaid-1 medium. Suspected pathogens were identified, subcultured, and preserved. The association between the microbiological findings and the clinical status was studied using correlation coefficients (CC). In addition, cats were stratified in subgroups according to presence of putative pathogens, and comparisons were carried out using unpaired t-test. Three bacterial species were frequently detected including Porphyromonas gulae (86%), Porphyromonas circumdentaria (70%) and Fusobacterium nucleatum (90%). The mean proportion of total flora was high for P. gulae (32.54%), moderate for P. circundentaria (8.82%), and low for F. nucleatum (3.96%). Among the clinical variables, tooth mobility was correlated (CC > 0.50, p < 0.001) with recession, pocket depth, attachment level, gingival index, and calculus index (CC = 0.29, p = 0.04) as well as with total bacterial counts (CC = 0.38, p = 0.006). Cats with more than 10% of P. gulae showed significantly more mobility (p = 0.014) and recession (p = 0.038), and a tendency for deeper probing pocket depths (p = 0.084) and attachment loss (p = 0.087). The results from this cross-sectional study confirmed that P. gulae is the most relevant pathogen in periodontal disease in cats.

Parenchymal and vascular lesions in ageing equine brains: histological and immunohistochemical studies

Many age-related changes are described in the nervous system of different species, but detailed studies of brain lesions in ageing horses are lacking. The aim of the present study was to systematically characterize lesions in the brains of 60 horses aged from 7 to 23 years. No gross changes were present in any brain. Microscopically, spongiform changes, lipofuscin storage, corpora amylacea, gliosis and satellitosis were common, together with axonal and neuronal swellings. The most important findings were the presence of pseudocalcium-calcium (pCa-Ca) deposits and arterial wall degeneration. Scanning electron microscopical examination of two cases with vascular mineralization revealed marked deposition of an amorphous substance in the vessel walls that was probably formed by a polyanionic protein matrix and a mineral component. Immunohistochemically, numerous axonal spheroids were positively labelled for ubiquitin. No PrPsc was detected in sections with neuronal vacuolation. Neuronal swelling, corpora amylacea, hippocampal Tau-positive neurons and methenamine-positive diffuse (preamyloid) plaques were also detected. Congo red staining failed to detect amyloid deposition. The characterization of age-related lesions in the brains of these horses will allow these changes to be discriminated from pathological processes in future studies. Some lesions described here, including some vascular changes, the presence of diffuse plaques and tau accumulation in hippocampal neurons, have not been described previously in the horse.

Reference values for IgG and IgG4 serum levels specific for inhalant allergens in non-atopic subjects

The IgG response to allergens is well-known, however few studies have investigated IgG and IgG4 production in normal subjects. Therefore, total IgG and IgG4 serum levels specific for 6 common inhalant allergens were measured in 282 non-allergic subjects to establish reference values at different ages and sex. Thus, 282 subjects were studied (141 female and 141 male) ranging from pre-school to adult age, all living in Northern Italy at the time of the study. Family history of first degree relatives and personal history were negative for allergic diseases. The findings obtained in this study indicate that: i) reference values for specific IgG4 and IgG levels against the allergen studied should take into account both the sex and age of the subject evaluated; ii) there is a difference in trend for age between seasonal and perennial allergens and iii) the relationships between age and specific IgG4 and IgG levels have different slopes. In conclusion, relevant differences exist in the distribution of IgG and IgG4 levels in normal subjects.

Prediction of digestible energy value of extruded dog food: comparison of methods

The proposal of National Research Council (NRC), based on the use of modified Atwater factors, is nowadays the widely used method to estimate digestible energy (DE) content of pet foods. Recently, alternative methods have been suggested for predicting energy content of commercial canine dry food. Factorial equations including food fibre content as estimator, in vitro digestions methods or near-infrared spectroscopy (NIRS) techniques have been considered as good approaches to predict the energy content of dog foods. The aim of this study was to compare the accuracy of some of those estimation methods. Seventeen samples of commercial extruded dog food were used to validate and compare some estimation methods of energy digestibility (Ed, %) and DE value [MJ/kg dry matter (DM)]. The apparent Ed and DE of each food were previously determined by in vivo trials. In vivo Ed and DE of foods ranged from 79.30% to 91.05% and from 16.25 to 21.82 MJ/kg DM, respectively, and their crude fibre (CF) content ranged from 0.72% to 3.28% (in DM base). The % Ed of each sample was estimated by the factorial equation (% Ed = 91.2 - 1.43 x CF %) and by the in vitro digestion method [% Ed(in vitro) = -2.45 + 0.98 organic matter (OM) disappearance(in vitro)%]. The set of samples also was analysed by NIRS, using a calibration equation developed from a set of 69 samples of commercial extruded dog food (0.76 and 0.89 cross-validation r(2) and 2.33 and 0.61 cross-validation SE for Ed and DE respectively). The in vitro method gave better estimations of Ed in vivo than NIRS and factorial methods, although all the methods assessed showed a very good and similar accuracy in the prediction of DE value. These three methods showed a slight better accuracy than that previously proposed by the NRC. To consider constant digestibility values of nutrient content of food can result in bias and error in the estimated energy values. The alternative prediction methods used in this study take into account differences of ingredient composition and availability of nutrients of different extruded dog foods thus could be better systems of valuating energy content in a wider range of different kind of foods than in use method.

Analysis of Y-chromosomal SNP haplogroups and STR haplotypes in an Algerian population sample

The distribution of Y-chromosomal single nucleotide polymorphism (SNP) haplogroups and short tandem repeat (STR) haplotypes was determined in a sample of 102 unrelated men of Arab origin from northwestern Algeria (Oran area). A total of nine different haplogroups were identified by a panel of 22 binary markers. The most common haplogroups observed in the Algerian population were E3b2 (45.1%) and J1 (22.5%). Y-STR typing by a 17-loci multiplex system allowed 93 haplotypes to be defined (88 were unique). Striking differences in the allele distribution and gene diversity of Y-STR markers between haplogroups could be found. In particular, intermediate alleles at locus DYS458 specifically characterized the haplotypes of individuals carrying haplogroup J1. All the intermediate alleles shared a common repeat sequence structure, supporting the hypothesis that the variant originated from a single mutational event.

Development of two multiplex PCR systems for the analysis of 12 X-chromosomal STR loci in a northwestern Italian population sample

Two multiplex polymerase chain reaction systems for the automated profiling of 12 X-chromosomal short tandem repeat (STR) markers were developed. Multiplex A consisted of DXS6789, DXS6809, GATA172D05, DXS101, DXS8378, and DXS8377. Multiplex B consisted of DXS7132, DXS6800, DXS6801, DXS7424, HPRTB, and DXS10011. The set of amplified X-STRs was designed to include groups of closely linked markers (DXS101-DXS7424 and DXS6789-DXS6801-DXS6809) to generate highly informative haplotypes for kinship testing. A population genetics study of the 12 X-STRs was conducted in a northwestern Italian population sample (n=160, 80 women and 80 men). A diallelic pattern at locus DXS6789 was observed in one man.

A randomized phase I trial of melphalan + bortezomib as conditioning for autologous transplant for myeloma

17550

High dose chemotherapy and autologous transplant (HDT) clearly benefits most patients with myeloma, but the addition of chemotherapy or TBI to melphalan (M) does not improve outcomes. Bortezomib (B) is a proteasome inhibitor which synergizes with chemotherapy due to its effects on DNA repair enzymes. Recent data has shown that B upregulates the anti-apoptotic protein MCL-1, which would suggest that B followed by M is inferior to M followed by B. We designed a randomized phase I trial combining B and Melphalan 200 mg/m2 (Mel200) in order to determine the toxicity, optimal dose and sequence of administration. Patients were randomized to receive either B 24 hours before Mel 200 or B 24 hours after Mel 200. Standard transplant criteria were used with the addition of requiring measurable numbers of plasma cells at the time of transplant. Enrolled patients underwent BM aspirate on day -4 (before B) and day 0 (before PBSC infusion). Bone marrows were tested for apoptosis, and myeloma cells were sorted for protein analysis. Age range was 48–74 years. Prior therapy has included Velcade (n = 2, both responsive) thalidomide (n = 2) and prior melphalan in 2 (1 HDT). Time to WBC and Plt engraftment were not different from historical cohorts receiving MEL 200 alone. Four patients have been randomized to date with 3 in the B “before“ arm, and 1 in the B “after” arm. Of the 3 patients who received B before M, day 0 bone marrow revealed minimal changes in marrow myeloma cell apoptosis in two patients, and in one patient a >20 fold increase in myeloma cell apoptosis on the day 0 marrow sample when compared to the day - 4 marrow. In the patient enrolled in the B after M arm, there was a 10 fold increase in the day 0 marrow myeloma cell apoptosis. Western blot analysis for DNA repair enzymes and MCL-1 on sorted tumor cells are planned, as is ELISA for secreted cytokines before and after therapy. Toxicity and response data with an update of the molecular correlates will be presented. The combination of B and M as conditioning for HDT is feasible. The optimal dose and sequence of administration remains unknown. Accrual continues.

[Table: see text]

Y-chromosomal STR haplotypes in Sicily

Eight Y-chromosomal short tandem repeats (STRs)-DYS19, DYS389-I, DYS389-II, DYS390, DYS391, DYS392, DYS393 and DYS385-were typed in a population sample (n=255) of unrelated Sicilian males from nine different towns on the main island and from the island of Pantelleria.

Y-chromosomal STR haplotypes in a population sample from continental Greece, and the islands of Crete and Chios

Eight Y-chromosomal short tandem repeats (STRs)--DYS19, DYS389-I, DYS389-II, DYS390, DYS391, DYS392, DYS393, and DYS385--were typed in a population sample (n = 113) of unrelated males from seven different regions of Greece (Macedonia, Thessaly, Epirus, Central Greece, Peloponnese, Crete Island, and Chios Island).

Y-chromosomal STR haplotypes in an Albanian population sample

Eight Y-chromosomal short tandem repeats (STRs), DYS19, DYS389-I, DYS389-II, DYS390, DYS391, DYS392, DYS393 and DYS385, were typed in a population sample (n=101) of first-generation Albanian immigrants living in Italy.

Bringing decision support to nurse managers

Modern hospital nursing management requires timely and accurate information to allow nurse managers to adjust resources to patient requirements. We report an experience using production theory to provide the framework for the development of Decision Support Objects: graphic displays of nursing hours budgeted, scheduled, and worked within institution-specific control limits. Every month, nurse managers follow an analytic algorithm to understand nursing resources and trends on their units. Exception reporting closes the accountability loop. The essentials of education for nurse managers include skill training in the use of the decision-support tools and supportive lecture/seminars for understanding the managerial implications of using them.

Effects of calcium soaps and rumen undegradable protein on the milk production and composition of dairy ewes

Forty-eight Manchega dairy ewes were used during a complete lactation in a 2 x 2 factorial design to determine the effects of supplementing diets with fat (calcium soaps of palm oil fatty acids, CSFA) and rumen undegradable protein (RUP) on milk production and composition. Factors tested were amounts of CSFA (0 or 200 g/kg) and RUP (300 or 450 g/kg crude protein) in the concentrate. RUP was altered by adding a mixture of maize gluten meal and blood meal. Lactation was divided into one nursing period (period 1, weeks 1-4), and three milking periods (periods 2-4, weeks 5-8, 9-14 and 15-21). Concentrates were given at 0.8 kg/d during periods 1 and 2, and at 0.6 kg/d in periods 3 and 4. Ewes grazed rotationally in an Italian rye-grass pasture and received a daily supplement of 0.8 kg vetch-oat hay during period 1, and 0.3 kg lucerne hay during periods 2-4. For the whole lactation, supplemental fat markedly increased milk fat content (+23%) and yield (+16%), and decreased milk protein content (-9%). The positive effect of feeding CSFA on milk fat content was more evident at the beginning of lactation; however, its negative effect on milk protein was more pronounced in late lactation. Supplementary RUP had little effect, increasing milk protein content only in period 3, when the crude protein content of pasture was lower. Milk yield and lamb growth were not affected by dietary treatments. The results indicated that CSFA can be useful for increasing the milk fat content of dairy ewes at pasture, which may help farmers to produce milk reaching the minimum requirements of fat content for the cheese industry.

LDLR, GYPA, HBGG, D7S8 and GC allele and genotype frequencies in the northwest Italian population

Allele and genotype frequencies for five PCR-based DNA markers (LDLR, GYPA, HBGG, D7S8 and GC) were determined in 100 unrelated individuals from Piedmont (Northwest Italy). All five Ioci met Hardy-Weinberg expectations in the sampled population. The combined PD and CE were, respectively, 0.995 and 0.697. Frequencies obtained were compared with other previously published data on Caucasian populations with no significant differences. The genetic data from this study, in addition to those already collected by other groups, contribute to the expansion of the Italian DNA database suitable for forensic casework and paternity testing.

Influence of kid rearing systems on milk composition and yield of Murciano-Granadina dairy goats

One-hundred eight lactations of Murciano-Granadina goats from different years were used to compare two kid rearing systems. Goats were separated into two groups: suckling and milking. Dams in the suckling group were milked once daily until kids were weaned (wk 0 to 7) and then were milked twice daily. Dams in the milking group were separated from their kids at 48 h after birth; then, kids were raised artificially, and goats were milked twice daily. Total milk yield was estimated according to the oxytocin method during suckling. Stage of lactation, parity, prolificacy, and year effects on milk yield and composition were also studied. As expected, during the first 7 wk of lactation, marketable milk was higher for dams that were milked than for dams that were suckled. Neither milk yield nor milk composition throughout the entire lactation was affected by group or prolificacy with the exception of the percentage of milk CP. The lactation curve peaked at wk 4 or 5 and declined slowly afterward. First parity goats had the lowest milk yield but the highest fat and protein percentages. Third parity goats had the highest milk yield. The separation of kids from their dams after birth did not affect total lactation performance because of the minimal importance of the neuroendocrine milk ejection reflex in goats compared with that of other ruminants.

Neonatal cranial ultrasound abnormalities in low birth weight infants: relation to cognitive outcomes at six years of age

OBJECTIVE

To assess the independent relation of neonatal cranial ultrasound (US) abnormalities in low birth weight (LBW) infants to cognitive outcomes at 6 years of age.

DESIGN

Prospective cohort study.

SAMPLE AND METHODS

Six-year follow-up data were obtained on a regional birth cohort of LBW infants (< 2 kg) systematically screened as neonates with serial US. US abnormalities were dichotomized into isolated germinal matrix/intraventricular hemorrhage (GM/IVH) and parenchymal lesions/ventricular enlargement (PL/VE). Global cognitive outcomes (mental retardation, borderline intelligence, and normal intelligence) and selected specific cognitive abilities were assessed at 6 years of age with standardized instruments. Multivariate techniques were used to assess the effects of US independent of maternal social disadvantage at birth and other perinatal and neonatal risk factors.

RESULTS

The sample as a whole had a significantly elevated rate of mental retardation (MR; 5%), almost all moderate to profound in severity. PL/VE was independently related to MR (odds ratio [OR], 65.8; confidence interval [CI], 19.1 to 22.4) and borderline intelligence (OR, 3.7; CI, 1.3 to 10.8); isolated GM/IVH was more modestly related to MR (OR, 4.6; CI, 1.2 to 18.6) but not related to borderline intelligence. Approximately half of the cases of MR were attributable to PL/VE independent of other factors. Of non-US factors, the number of days receiving mechanical ventilation increased the risk for MR. Maternal social disadvantage increased the risk for borderline intelligence but not MR. Among children of normal intelligence, those with PL/VE, but not isolated GM/IVH, performed more poorly than those without US abnormalities on tests of visual perceptual organization but not on tests of language, memory, or quantitative skills.

CONCLUSION

Prevention of white matter injury would substantially improve cognitive outcomes for LBW infants.

Epidermal cells on stubs used for detection of GSR with SEM-EDX: analysis of DNA polymorphisms

DNA from epidermal cells attached to the adhesive tape of stubs employed to collect and identify gunshot residue (GSR) with scanning electron microscope (SEM) was extracted, amplified with PCR and typed. The method allowed identification of specimens when attribution to a definite person was uncertain. These results also suggest that adhesive tape could be used as a non invasive method for obtaining biological material suitable for DNA analysis from the skin surface.

Injection-corrosion cast study of the microcirculation of the brain in haemorrhagic and ischaemic disorders. Preliminary investigation

The results of studies with the injection-corrosion cast technique in cases of haemorrhagic and ischaemic complications of saccular cerebral aneurysm in man are presented. This technique in conjunction with SEM makes possible a detailed qualitative analysis of the microvascular network. The morphological features of the pathologic areas are analysed. The pathophysiological significance of the observed abnormalities of the cerebral microcirculation are discussed.

Predicting effective contraceptive behavior in college females

This article reports the results of a preliminary research project that explored the relationship between assertiveness, cognitive development and contraceptive behavior among single young women in their freshman and senior years at college. A total of 60 college women at a university health center volunteered to participate in this pilot study. They filled out three instruments: the Galassi College Self-Expression Scale (SES), the Measure of Intellectual Development (MID) tool and an author-developed sexuality questionnaire. Although there was a significant relationship between cognitive development and assertiveness, no significant relationships were found between cognitive development, assertiveness and use of effective contraception. Interesting descriptive characteristics were identified. Clinical implications are discussed.

An exceptional case of necrophilia

The authors describe a case of necrophilia in which the corpse of a young girl was disinterred. No lesions were observed on the genitals and breasts, but the aspect of the anus suggested that some object had been introduced in it. The possible modalities of the event are discussed.