Inositol hexaphosphate: a potential chelating agent for uranium

Chelation therapy is an optimal method to reduce the radionuclide-related risks. In the case of uranium incorporation, the treatment of choice is so far i.v infusion of a 1.4% sodium bicarbonate solution, but the efficacy has been proved to be not very high. In this study, we examine the efficacy of some substances: bicarbonate, citrate, diethylenetriamine pentaacetic acid (DTPA), ethidronate (EHBP) and inositol hexaphosphate (phytic acid) to chelate uranium using a test developed by Braun et al. Different concentrations of phytic acid, an abundant component of plant seeds that is widely distributed in animal cells and tissues in substantial levels, were tested and compared to the same concentrations of sodium citrate, bicarbonate, EHBP and DTPA. The results showed a strong affinity of inositol hexaphosphate for uranium, suggesting that it could be an effective chelating agent for uranium in vivo.

Risk factors associated with drug-resistant Mycobacterium tuberculosis in Castilla-la-Mancha (Spain)

The aim of this study was to investigate the incidence of primary and secondary resistance to antituberculosis drugs and the risk factors associated with the resistance in southeast Spain. Our research was based on the clinical histories of 276 patients, diagnosed as having tuberculosis by positive culture, who were tested for drug susceptibility between January 1988 and October 1994. The clinical histories were checked by two independent investigators. Drug-resistant strains were isolated from 24 patients (8.7%). Among the 239 patients without previous tuberculosis therapy, 7 (2.9%) were drug-resistant. Among the 37 patients with previous therapy, 17 (46%) were drug-resistant. Seventeen of the 276 patients (6.2%) had resistance to a single drug. Primary resistance to isoniazid was 1.7%. Previous treatment for tuberculosis (odds ratio (OR) 39.2; 95% confidence interval (95% CI) 10.2-150); hepatic cirrhosis (OR 104; 95% CI 12.8-847); and age 45 yrs and older (OR 4.80; 95% CI 1.15-20.1) were considered risk factors associated with drug-resistant tuberculosis. We conclude that primary and secondary resistance is low in the southeast of Spain and we recommend that susceptibility testing be performed on initial M. tuberculosis isolated from patients with a history of previous tuberculosis therapy, hepatic cirrhosis or more than 44 yrs of age.

[Internal medicine at a health center. Experience evaluation]

GROUND: The current situation of internal medicine is evolving to alternative asistential plans related to traditional hospital attention. We present in this article the resulte obtained in an experience conducted to share the assistential task with a primary care center which is located in our Health Area.

METHODS

During the period of time between 11-15-93 and 06-30-94 it was prospectively analyzed all the outpatients studied by an internist of the Department of Internal Medicine of the Albacete General Hospital in the Primary Care Center of Almansa. After a definitive diagnosis the following parameters were evaluated: age, sex, type of consult, first and second diagnosis and follow-up. Data of the evaluation according to the request new consults and waiting list patients was taken.

RESULTS

The total consults analyzed were 1,651 (578 first visits and 1,073 second visits). Definitive diagnosis were obtained in 752 patients during this time (342 males and 406 females). The average age was 55.56 +/- 0.72 years and the number of diagnosis 1.7 +/- 0.32. The weekly request of new consults decreased from 25.7 to 12.25. Number of patients in waiting list decreased from 94 to 37.

CONCLUSIONS

Approach between Internal Medicine and Primary Care is a feasible plan useful for both and for the assistential quality in the Primary Care Centers.