High duty cycle moth sounds jam bat echolocation: bats counter with compensatory changes in buzz duration

Tiger moth species vary greatly in the number of clicks they produce and the resultant duty cycle. Signals with higher duty cycles are expected to more effectively interfere with bat sonar. However, little is known about the minimum duty cycle of tiger moth signals for sonar jamming. Is there a threshold that allows us to classify moths as acoustically aposematic versus sonar jammers based on their duty cycles? We performed playback experiments with three wild-caught adult male bats, Eptesicus fuscus. Bat attacks on tethered moths were challenged using acoustic signals of Bertholdia trigona with modified duty cycles ranging from 0 to 46%. We did not find evidence for a duty cycle threshold; rather, the ability to jam the bat's sonar was a continuous function of duty cycle consistent with a steady increase in the number of clicks arriving during a critical signal processing time window just prior to the arrival of an echo. The proportion of successful captures significantly decreased as the moth duty cycle increased. Our findings suggest that moths cannot be unambiguously classified as acoustically aposematic or sonar jammers based solely on duty cycle. Bats appear to compensate for sonar jamming by lengthening the duration of their terminal buzz and they are more successful in capturing moths when they do so. In contrast to previous findings for bats performing difficult spatial tasks, the number of sonar sound groups decreased in response to high duty cycles and did not affect capture success.

Extreme Duty Cycles in the Acoustic Signals of Tiger Moths: Sexual and Natural Selection Operating in Parallel

Sound production in tiger moths (Erebidae: Arctiinae) plays a role in natural selection. Some species use tymbal sounds as jamming signals avoiding bat predation. High duty cycle signals have the greatest efficacy in this regard. Tiger moth sounds can also be used for intraspecific communication. Little is known about the role of sound in the mating behavior of jamming species or the signal preferences underlying mate choice. We recorded sound production during the courtship of two high duty cycle arctiines, Bertholdia trigona and Carales arizonensis. We characterized variation in their acoustic signals, measured female preference for male signals that vary in duty cycle, and performed female choice experiments to determine the effect of male duty cycle on the acceptance of male mates. Although both species produced sound during courtship, the role of acoustic communication appears different between the species. Bertholdia trigona was acoustically active in all intraspecific interactions. Females preferred and ultimately mated with males that produced higher duty cycles. Muted males were never chosen. In C. arizonensis however, sound emissions were limited during courtship and in some successful matings no sound was detected. Muted and clicking males were equally successful in female mate-choice experiments, indicating that acoustic communication is not essential for mating in C. arizonensis. Our results suggest that in B. trigona natural and sexual selection may work in parallel, to favor higher duty cycle clicking.

Bacterial cellulose hydrogel loaded with lipid nanoparticles for localized cancer treatment

The use of hybrid materials, where a matrix sustains nanoparticles controlling the release of the chemotherapeutic drug, could be beneficial for the treatment of primary tumors prior or after surgery. This localized chemotherapy would guarantee high drug concentrations at the tumor site while precluding systemic drug exposure minimizing undesirable side effects. We combined bacterial cellulose hydrogel (BC) and nanostructured lipid carriers (NLCs) including doxorubicin (Dox) as a drug model. NLCs loaded with cationic Dox (NLCs-H) or neutral Dox (NLCs-N) were fully characterized and their cell internalization and cytotoxic efficacy were evaluated in vitro against MDA-MB-231 cells. Thereafter, a fixed combination of NLCs-H and NLCs-N loaded into BC (BC-NLCs-NH) was assayed in vivo into an orthotopic breast cancer mouse model. NLCs-H showed low encapsulation efficiency (48%) and fast release of the drug while NLCs-N showed higher encapsulation (97%) and sustained drug release. Both NLCs internalized via endocytic pathway, while allowing a sustained release of the Dox, which in turn rendered IC50 values below of those of free Dox. Taking advantage of the differential drug release, a mixture of NLCs-N and NLCs-H was encapsulated into BC matrix (BC-NLCs-NH) and assayed in vivo, showing a significant reduction of tumor growth, metastasis incidence and local drug toxicities.

Comparative study of the B-SAQ, OAB-V8 and OAB-V3 questionnaires as screening tools for overactive bladders in clinical practice

OBJECTIVE

To compare the capacity shown by 3 self-assessment questionnaires validated in Spanish (B-SAQ, OAB-V8 and OAB-V3) for the screening of patients with overactive bladder (OAB) in clinical practice.

MATERIAL AND METHOD

A noninterventional observational study was conducted of men and women older than 30 years evaluated in primary care consultations. The clinical diagnosis of OAB was conducted through a case history review, physical examination, urine analysis, ultrasonography and voiding diary. The presence of coping strategies and discomfort was investigated. The differential diagnosis was established in patients with symptoms not due to OAB. We assessed the correlation between the clinical tests and diagnosis (kappa <.4 poor; .4-.6 moderate; >.6 good; >.8 excellent) and ROC curves to define the capacity to screen the assessed questionnaires.

RESULTS

A total of 411 patients were investigated. OAB was detected in 207 (50.4%) patients, other causes for the lower urinary tract symptoms were detected in 63 (15.3%), and 141 (34.3%) patients had no diagnosis. The voiding diary suggested OAB in 197 (47.9%) patients. The correlation between the clinical diagnosis and the diagnosis based on the voiding diary was .702. The correlation between the clinical diagnosis and B-SAQ, OAB-V8 and OAB-V3 was .59, .673 and .732, respectively. The area under the curve (AUC) was .799 for B-SAQ; .837 for OAB-V8 and .867 for OAB-V3 (OAB-V3 vs. OAB-V8, P=.02; OAB-V3 vs. B-SAQ, P<.0001). The AUC for the voiding diary was .852 (OAB-V3 vs. diary, P=.47).

CONCLUSIONS

OAB-V3 is a simple questionnaire with excellent performance for screening OAB in a specific population and that is superior to the OAB-V8 and B-SAQ. The accuracy of the voiding diary for the same indication is equivalent to that of the OAB-V3 in our setting.

Preventive Analgesia with Pregabalin in Neuropathic Pain from “Failed Back Surgery Syndrome”: Assessment of Sleep Quality and Disability

OBJECTIVE

Pregabalin group (PGB) is an antiepileptic used to treat neuropathic pain. We evaluated analgesic efficacy and safety for postoperative/chronic pain, disability, and sleep quality in patients who underwent spine surgery administered with PGB, or not, during the presurgical and postsurgical periods.

DESIGN

Retrospective cohort study of 60 patients (two groups with 30 patients) with full information on 50 (29 with PGB and 21 without PGB). Ten patients were dismissed as information was lacking. The PGB group (P) (29 patients) received 75 mg/12 hours before surgery, 150 mg 10 hours after surgery, and 150 mg/12 hours 3 days after surgery. The control group (C; 21 patients) took no PGB.

METHODS

Neuropathic pain was assessed before surgery, and 2 and 6 months later using visual analog scales (VAS), DN4, disability (Oswestry), and sleep quality. No serious adverse events occurred with PGB.

RESULTS

The median VAS pain score at rest was lower in the PGB group at 2 months postsurgery (1 vs 2, P = 0.032), as was the median DN4 score (0 vs 3, P = 0.032) and the median Oswestry disability index (ODI: 12 vs 18, P = 0.001). At 6 months postsurgery, pain scores were also lower in the PGB group for VAS (0 vs 4, P = 0.001), DN4 score (0 vs 4, P = 0.001) and the ODI (10 vs 24, P = 0.001). Improvement in the functionality and sleep quality of the PGB group was noteworthy (P = 0.018).

CONCLUSIONS

PGB has analgesic/antihyperalgesic effects on postoperative neuropathic pain after surgery for lumbar disc hernia. Our findings show that this benefit increases with time.

Tone-deaf ears in moths may limit the acoustic detection of two-tone bats

Frequency alternation in the echolocation of insectivorous bats has been interpreted in relation to ranging and duty cycle, i.e. advantages for echolocation. The shifts in frequency of the calls of these so-called two-tone bats, however, may also play its role in the success of their hunting behavior for a preferred prey, the tympanate moth. How the auditory receptors (e.g. the A1 and A2 cells) in the moth's ear detect such frequency shifts is currently unknown. Here, we measured the auditory responses of the A1 cell in the noctuid Spodoptera frugiperda to the echolocation hunting sequence of Molossus molossus, a two-tone bat. We also manipulated the bat calls to control for the frequency shifts by lowering the frequency band of the search and approach calls. The firing response of the A1 receptor cell significantly decreases with the shift to higher frequencies during the search and approach phases of the hunting sequence of M. molossus; this could be explained by the receptor's threshold curve. The frequency dependence of the decrease in the receptor's response is supported by the results attained with the manipulated sequence: search and approach calls with the same minimum frequency are detected by the moth at the same threshold intensity. The two-tone bat M. molossus shows a call frequency alternation behavior that may enable it to overcome moth audition even in the mid-frequency range (i.e. 20-50 kHz) where moths hear best.

Breast cancer management in the elderly

The increase in life expectancy in the western world means that we are faced with patients diagnosed with breast cancer in old age with increasing frequency. The management of these cases is a challenge for the oncologist, who must take into account the conditions associated with advanced age and the lack of trials in this population. In this review, we addressed the incorporation of geriatric assessment methods that may be useful in making decisions, the particular biological characteristics of breast cancer in elderly patients and their treatment in both localized and advanced disease. Finally, we collected recommendations based on scientific evidence regarding the monitoring and life-style after finishing treatment.

Sound-evoked oscillation and paradoxical latency shift in the inferior colliculus neurons of the big fruit-eating bat, Artibeus jamaicensis

Frequency tuning, temporal response pattern and latency properties of inferior colliculus neurons were investigated in the big fruit-eating bat, Artibeus jamaicensis. Neurons having best frequencies between 48-72 kHz and between 24-32 kHz are overrepresented. The inferior colliculus neurons had either phasic (consisting in only one response cycle at all stimulus intensities) or long-lasting oscillatory responses (consisting of multiple response cycles). Seventeen percent of neurons displayed paradoxical latency shift, i.e. their response latency increased with increasing sound level. Three types of paradoxical latency shift were found: (1) stable, that does not depend on sound duration, (2) duration-dependent, that grows with increasing sound duration, and (3) progressive, whose magnitude increases with increasing sound level. The temporal properties of paradoxical latency shift neurons compare well with those of neurons having long-lasting oscillatory responses, i.e. median inter-spike intervals and paradoxical latency shift below 6 ms are overrepresented. In addition, oscillatory and paradoxical latency shift neurons behave similarly when tested with tones of different durations. Temporal properties of oscillation and PLS found in the IC of fruit-eating bats are similar to those found in the IC of insectivorous bats using downward frequency-modulated echolocation calls.

[Safety and effectiveness of nitrous oxide for sedation-analgesia in emergency departments]

OBJECTIVES

PRIMARY OBJECTIVES

to assess the safety and the effectiveness (analysing the behaviour of the patient) with the use of nitrous oxide during the performance of painful procedures in the Paediatric Emergency Departments (PED); secondary objectives: to evaluate the manageability of the method and its acceptance by both the medical team and the patient.

PATIENTS AND METHODS

Post-marketing observational, prospective, multicentre, non-randomised and open (November 2007-December 2008) study, which involved seven national PED. We included patients between 2 and 18 years-old on whom a painful procedure was performed in the PED and nitrous oxide was used.

RESULTS

A total 213 patients were included (27,2% < 5 years). Patient behaviour was considered «good/very good» in 79,7%, with no statistically significant difference in relation to the procedure performed. Patient behaviour was more often classified as «bad/accept with difficulty» among those < 5 years (33.3% vs 15.1%, P=.006). Adverse events occurred in 17 cases (7.9%), with no significant difference in the rate in relation to the age, fasting or not or in association with other drugs; the most frequent were dizziness and/or headache (10), followed by vomiting (3). The administration was considered easy by the medical team in the 96.6% of the cases. Parents would accept the use of nitrous oxide in their child in a similar situation in 92.7% of the cases.

CONCLUSIONS

Administration of nitrous oxide achieves proper sedation and analgesia during painful procedures, especially in children older than 5 years. Adverse events reported were few, mild and expected. Most parents would accept its use again in a similar situation.

Leaching zinc from spent catalyst: process optimization using response surface methodology

The spent catalyst from vinyl acetate synthesis contains large quantity of zinc. The present study attempts to leach zinc using a mixture of ammonia, ammonium carbonate and water solution, after microwave treatment. The effect of important parameters such as leaching time, liquid/solid ratio and the ammonia concentration was investigated and the process conditions were optimized using surface response methodology (RSM) based on central composite design (CCD). The optimum condition for leaching of zinc from spent catalyst was identified to be a leaching time of 2.50 h, a liquid/solid ratio of 6 and ammonia concentration 5.37 mol/L. A maximum of 97% of zinc was recovered under the optimum experimental conditions. The proposed model equation using RSM has shown good agreement with the experimental data, with a correlation coefficient (R(2)) of 0.95. The samples were characterized before and after leaching using X-ray diffraction (XRD), nitrogen adsorption and scanning electron microscope (SEM).

Repetition of the rapid antigen test in initially negative supposed streptococcal pharyngitis is not necessary in adults

AIMS

To determine whether the repetition of the rapid antigen detection test (RADT) in patients, with a high suspicion of presenting pharyngitis by group A beta-haemolytic streptococci (GABHS), with a previously negative test improves the validity of the test.

METHODS

Two hundred and twenty-two patients aged 14 years or more with acute pharyngitis and two or more Centor criteria--tonsillar exudates, fever, tenderness in the lymph glands and/or absence of cough--were consecutively recruited. In all patients, a pharyngotonsillar sample was obtained with two swabs, one for the RADT (OSOM Strep A Genzyme test, Genzyme Diagnostics, Cambridge, MA, USA) and the other was sent to the Department of Microbiology for culture. In patients with a negative RADT, the determination was repeated. The sensitivity, specificity and predictive values were determined.

RESULTS

Cultures were positive for GABHS in 55 patients (24.8%). Three false-negatives and 14 false-positives were observed by comparing the rapid test with throat culture, achieving a sensitivity of 94.5% and a specificity of 91.6%. Positive and negative predictive values were 78.8% and 98.1% respectively. Taking the second determination in the negative cases into account, the results were 96.4%, 91.6%, 79.1% and 98.7% respectively.

CONCLUSIONS

The negative predictive value achieved with the RADT determination was very high. Repetition of the test only slightly improved this percentage, making repetition of this test unnecessary.

[Quality of neurological care in the emergency services: a study from the community-hospital]

INTRODUCTION

The medical conditions shared by hospital emergency services and community-hospital neurology clinics (CHNC) have not been described, and the quality of the medical care received in these conditions has not been evaluated in our environment.

METHODS

Over a 2 month period, those patients presenting at any of the seven CHNC in a Health Care Area 1 of Madrid due to previously attended medical conditions in the emergency services were systematically registered. The area neurologists of the CHNC collected administrative and clinical variables and made a judgment on the medical care (primary outcome measure) and diagnoses (secondary outcome measure) received.

RESULTS

A total of 181 patients were included (mean age: 58 years; 60% women). The inclusion rate was one patient per working day, and 31% of patients were visited out of the established quota number of patients for the clinic. The most frequent reasons for visiting the emergency room were: headache (20%), focal neurological syndrome (16%) and loss of consciousness (14%). The most frequent diagnoses at the CHNC were: primary headache (19 %), stroke (11%) and epilepsy (9 %). Emergency care was deemed correct in 56 % of patients. When the patients with intervention were compared to those with no intervention, participation of the neurology service in the emergency room was associated to a greater percentage of correct diagnoses (59% vs. 41%; p=0.019) and care (69% vs. 47%; p=0.003).

CONCLUSIONS

The medical conditions shared with the emergency services represent a small but relevant proportion of the patients assisted in the CHNC. Some of these conditions (primary headaches, syncopes) should be canalized into primary health care. Others (epilepsy) require a circuit between emergency room and CNNC, but the appointment system should be adapted. The intervention of a neurologist in the emergency room raises the quality of the care.

Kaposiform hemangioendothelioma

Kaposiform hemangioendothelioma (KHE) is a rare, locally aggressive vascular neoplasm that mainly occurs during childhood. It generally originates on the skin, usually affecting deeper tissue by infiltrative growth. It appears as one or multiple masses, and in most cases is associated to consumptive coagulopathy (Kasabach-Merritt syndrome), and lymphangiomatosis. Although visceral involvement is very uncommon, several cases with bone, retroperitoneal, or mediastinal involvement have been described. These tumors tend to be locally invasive, but are not known to produce distant metastases. The development of KHE in adolescents or in adults is very rare, but cases have also been described. Several factors are associated with the outcome of patients with KHE: accessibility to surgical excision, location (cutaneous versus visceral), size of tumoral mass, clinical response to interferon and glucocorticoids, and the absence of lymphangiomatosis and Kasabach-Merritt syndrome, may result in partial remissions. On the other hand, bulk visceral masses lead to a 40-50% mortality rate, mainly due to progressive failure of the infiltrated organ(s), in spite of interferon, glucocorticoids, and combined chemotherapy. In conclusion, the onset of a consumptive coagulopathy following the presence of a vascular tumor, in children as well as in older patients, should spark suspicion of KHE, among other entities.

Treatment of coke wastewater in a sequential batch reactor (SBR) at pilot plant scale

Coke wastewater is a highly toxic industrial effluent which is usually treated by a combination of physico-chemical and biological treatments. With the aim of completing prior studies carried out in CSTR, in this work we studied the treatment of coke wastewater in a pilot plant equipped with a 400 L stripping tank, a 350 L neutralization/homogenization tank and a 6 m high 1500 L sequential batch reactor (SBR), controlled by a PLC. Ammonia stripping efficiencies of 96% were obtained for HRT of 66 h. The biological treatment in the SBR led to removal efficiencies of 85% COD, 98% thiocyanate and 99% phenols for HRT of 115 h. Final concentrations in the effluent of 1.8 mg phenols/L, 5.4 mg SCN/L, 206 mg COD/L and 78 mg N-NH(4)(+)/L were obtained.

Bio-syngas production with low concentrations of CO2 and CH4 from microwave-induced pyrolysis of wet and dried sewage sludge

This paper assesses the feasibility of producing syngas from sewage sludge via two pyrolysis processes: microwave-induced pyrolysis (MWP) and conventional pyrolysis (CP). The changes in the composition of the produced gas as a function of the pyrolysis treatment and the initial moisture content of the sludge were evaluated. It was found that MWP produced a gas with a higher concentration of syngas than CP, reaching values of up to 94vol%. Moreover, this gas showed a CO2 and CH4 concentration around 50% and 70%, respectively, lower than that obtained in the gas from CP. With respect to the effect of moisture on gas composition, this was more pronounced in CP than in MWP. Thus, the presence of moisture increases the concentration of H2 and CO2 and decreases that of CO, especially when CP was used. In order to elucidate the behaviour of CO2 during the pyrolysis, the CO2 gasification kinetics of the char obtained from the pyrolysis were investigated. It was established that in microwave heating the gasification reaction is much more favoured than in conventional heating. Therefore, the low concentration of CO2 and the high concentration of CO in the microwave pyrolysis gas could be due to the self-gasification of the residue by the CO2 produced during the devolatilization of the sewage sludge in the pyrolysis process.

Therapeutic window for melanoma treatment provided by selective effects of the proteasome on Bcl-2 proteins

Melanoma cells depend on sustained proteasomal function for survival. However, bortezomib, the first proteasome inhibitor in clinical use, is not sufficient to improve the poor prognosis of metastatic melanoma patients. Since the proteasome is also expressed in all normal cell compartments, it is unclear how to enhance the efficacy of bortezomib without exacerbating secondary toxicities. Here, we present pharmacological and genetic analyses of mechanisms of resistance to proteasome inhibition. We focused on Bcl-2, Bcl-x(L) and Mcl-1 as main antiapoptotic factors associated with melanoma progression. Despite an efficient blockage of the proteasome, bortezomib could not counteract the intrinsically high levels of Bcl-2 and Bcl-x(L) in melanoma cells. Moreover, Mcl-1 was only downregulated at late time points after treatment. Based on these results, a combination treatment including (-)-gossypol, an inhibitor of Mcl-1/Bcl-2/Bcl-x(L), was designed and proven effective in vivo. Using a specific RNA interference approach, the survival of bortezomib-treated melanoma cells was found to rely primarily on Mcl-1, and to a lesser extent on Bcl-x(L) (but not on Bcl-2). Importantly, neither Mcl-1 nor Bcl-x(L) inactivation affected the viability of normal melanocytes. This hierarchical requirement of Bcl-2 family members for the maintenance of normal and malignant cells offers a therapeutic window to overcome melanoma chemoresistance in a tumor cell-selective manner.

Study of the aerobic biodegradation of coke wastewater in a two and three-step activated sludge process

A laboratory-scale biological plant composed of two aerobic reactors operating at 35 degrees C was used to study the biodegradation of coke wastewater. The main pollutants to be removed are organic matter, especially phenols, thiocyanate and ammonium nitrogen. The concentrations of the main pollutants in the wastewater during the study ranged between 922 and 1,980 mg COD/L, 133 and 293 mg phenol/L, 176 and 362 mg SCN/L and 123 and 296 mg NH(4)(+)-N/L. The biodegradation of these pollutants was studied employing different hydraulic residence times (HRT) and final effluent recycling ratios in order to minimize inhibition phenomena attributable to the high concentrations of pollutants. During the optimisation of the operating conditions, the removal of COD, phenols and thiocyanate was carried out in the first reactor and the nitrification of ammonium took place in the second. The best results were obtained when operating at an HRT of 98 h in the first reactor and 86 h in the second reactor, employing a recycling ratio of 2. The maximum removal efficiencies obtained were 90.7, 98.9, 98.6 and 99.9% for COD, phenols, thiocyanate and NH(4)(+)-N, respectively. In order to remove nitrate, an additional reactor was also implemented to carry out the denitrification process, adding methanol as an external carbon source. Very high removal efficiencies (up to 99.2%) were achieved.

Simultaneous removal of phenol, ammonium and thiocyanate from coke wastewater by aerobic biodegradation

A laboratory-scale activated sludge plant composed of a 20 L volume aerobic reactor followed by a 12 L volume settling tank and operating at 35 degrees C was used to study the biodegradation of coke wastewater. The concentrations of ammonium nitrogen (NH(4)(+) -N), phenols, chemical oxygen demand (COD) and thiocyanate (SCN(-)) in the wastewater ranged between 504 and 2,340, 110 and 350, 807 and 3,275 and 185 and 370 mg/L, respectively. The study was undertaken with and without the addition of bicarbonate. The addition of this inorganic carbon source was necessary to favour nitrification, as the alkalinity of the wastewater was very low. Maximum removal efficiencies of 75%, 98% and 90% were obtained for COD, phenols and thyocianates, respectively, without the addition of bicarbonate. The concentration of ammonia increased in the effluent due to both the formation of NH(4)(+) as a result of SCN(-) biodegradation and to organic nitrogen oxidation. A maximum nitrification efficiency of 71% was achieved when bicarbonate was added, the removals of COD and phenols being almost similar to those obtained in the absence of nitrification. Batch experiments were performed to study the influence of pH and alkalinity on the biodegradation of phenols and thiocyanate.

Removal of ammonium from aqueous solutions with volcanic tuff

This paper presents kinetic and equilibrium data concerning ammonium ion uptake from aqueous solutions using Romanian volcanic tuff. The influence of contact time, pH, ammonium concentration, presence of other cations and anion species is discussed. Equilibrium isotherms adequately fit the Langmuir and Freundlich models. The results showed a contact time of 3h to be sufficient to reach equilibrium and pH of 7 to be the optimum value. Adsorption capacities of 19 mg NH(4)(+)/g were obtained in multicomponent solutions (containing NH(4)(+), Zn(2+), Cd(2+), Ca(2+), Na(2+)). The presence of Zn and Cd at low concentrations did not decrease the ammonium adsorption capacity. Comparison of Romanian volcanic tuff with synthetic zeolites used for ammonium removal (5A, 13X and ZSM-5) was carried out. The removal efficiciency of ammonium by volcanic tuff were similar to those of zeolites 5A and 13X at low initial ammonium concentration, and much higher than those of zeolite ZSM-5.

Cisplatin plus gemcitabine with or without vinorelbine as neo-adjuvant therapy for radically treatable stage III non-small cell lung cancer. Results of a randomised study of the Grupo Oncológico del Norte de España

7121

The combinations of cisplatin (C) with gemcitabine (G) and/or vinorelbine (V) have shown to be effective and safe regimens in the first line treatment of NSCLC. This study has been designed to detect a 25% increase in objective response measured by CT scan with the triplet combination (CGV) with respect to cisplatin/gemcitabine combination (CG) administered as neo-adjuvant therapy in patients with radically-treatable stage III NSCLC. With 80% of power and one-sided 5% significant level, the simple size required to confirm this hypothesis is 75 evaluable patients in each arm of treatment. Patients (pts) ≤ 75 years old, Karnofsky index ≥ 70% and adequate haematological, renal and hepatic function are stratified by stage (IIIA versus IIIB) and randomly assigned to: C 50 mg/m2 i.v. and G 1250 mg/m2 i.v. d1 and d8 alone (CG) or in combination with V 25 mg/m 2 i.v. d1 and d8 (CGV) both regimens every 3 weeks for 3 consecutive cycles followed by definitive local treatment (LT). From December 1999 to December 2005, a hundred and forty-nine pts have been randomised (CG/CGV); median age 58/58; median Karnofsky index 80/80; stage IIIA 24/26; stage IIIB 51/48; squamous 37/39; adenocarcinoma 31/32; anaplastic 7/3. Major haematological toxicities grade 3–4 were (CG/CGV; %); Anaemia (5/5) neutropenia (31/34); thrombocytopenia (4/5). Two pts in CG (2.7%) and 4 in CGV arm (5.5%) developed neutropenic fever. Major non-haematological toxicities grade 2–3 were: N/Vomiting (31/32) and fatigue (12/20). Global recurrences have been registered in 57% and 54% of pts treated with CG and CGV arm respectively. Exclusive local/ distant failure (%) has been 16/23 in CG and 23/18 in CGV arm. Preliminary results show similar high efficacy associated with moderate toxicity in both groups of treatment. The study is continuing.

[Table: see text]

No significant financial relationships to disclose.

Prospective randomised phase II study of gemcitabine and vinorelbine versus gemcitabine and docetaxel combination in patients with previously untreated advanced non-small cell lung cancer

17052

Background: Previous comparative studies have shown similar efficacy and less toxicity with either the Gemcitabine(G)/Vinorelbine(V) or Gemcitabine/Docetaxel(D) combination with respect to platinum-based chemotherapies in patients with advanced NSCLC. This trial was designed to test the efficacy and safety of both GV and GD combination in non-selected patients with advanced NSCLC. Methods: Patients (n = 39) with ≤75 years of age, KPS ≥ 60% and adequate haematological, renal and hepatic function were randomly assigned to: G 1250 mg/m2 i.v. d1 and d8 plus either V 25 mg/m2 i.v. d1 and d8 or D 35 mg/m2 i.v. d1 and d8 every 3 weeks. Prophylactic i.v. ranitidine (50 mg), diphenhydramine (25 mg) and dexamethasone (8 mg) were prescribed just prior to the administration of taxane that was given over 30 minutes immediately before gemcitabine. Results: Baseline characteristics were comparable in GV (n = 20) and GD (n = 19) arms: median age (67 years) and KPS (70%), most patients were male (79%), had metastatic disease (85%) and adenocarcinoma histology (55%). Treatment indicated objective response of 7 (35%) versus 6 (31%) patients, median time-to-treatment failure of 120 versus 90 days, and overall survival of 209 versus 177 days in GV and GD arms respectively. The most common non-haematological toxicities were (GV versus GD; No. of patients): grade 2–4 pulmonary toxicity in 1 versus 7 (37%); grade 2–3 diarrhoea in 0 versus 4 (21%) and oedemas 1 versus 3. Grade 2–4 haematological toxicities in 5 versus 2 patients. All side effects were reversible phenomena since resolution was achieved by suspending the treatment and in the case of the pulmonary toxicity, by the prescription of additional corticoids. Conclusion: The combination of Gemcitabine/Docetaxel does not have a favourable safety profile with this schedule of administration, particularly in terms of pulmonary toxicity. Further patients’ enrolment was stopped and the study has been terminated. This kind of toxicity and alternative schedules of GD combination warrant further investigation.

No significant financial relationships to disclose.

[Modified EMJH medium for cultivation of Leptospira interrogans serogroup ballum]

Strains within the Ballum serogroup of spirochete Leptospira show fastidious growth with more exigent nutritional requirements than those of other Leptospira pathogenic strains. The influence of 37 nutritional compounds on the growth of Leptospira interrogans serogroup Ballum was investigated employing the synthetic EMJH medium as the base for the study. Microbial growth was estimated spectrophotometrically and direct counts were performed with a Petroff-Hausser counting chamber. Virulence stability was evaluated by calculating the mean lethal dose in hamsters. Antigenicity stability was evaluated by Western blotting using a specific antiserum. Cell yields commonly obtained in EMJH were triplicated without virulence or antigenicity depletions after culturing in a modified EMJH medium with an increased concentration of Tween 80, and the incorporation of sodium acetate and beef extract. Neither the increased concentration of at least 6 components of EMJH nor the incorporation of a variety of new nutrients stimulated cell yields or the growth rate of the microorganism. The results allow us to make use of an enriched culture medium that promotes high cell yields of this fastidious serogroup most prevalent in humans in Cuba.

Anaerobic treatment of sludge from a nitrification-denitrification landfill leachate plant

The viability of anaerobic digestion of sludge from a MSW landfill leachate treatment plant, with COD values ranging between 15,000 and 19,400mg O(2)dm(-3), in an upflow anaerobic sludge blanket reactor was studied. The reactor employed had a useful capacity of 9l, operating at mesophilic temperature. Start-up of the reactor was carried out in different steps, beginning with diluted sludge and progressively increasing the amount of sludge fed into the reactor. The study was carried out over a period of 7 months. Different amounts of methanol were added to the feed, ranging between 6.75 and 1cm(3)dm(-3) of feed in order to favour the growth of methanogenic flora. The achieved biodegradation of the sludge using an upflow anaerobic sludge blanket Reactor was very high for an HRT of 9 days, obtaining decreases in COD of 84-87% by the end of the process. Purging of the digested sludge represented approximately 16% of the volume of the treated sludge.

Removal of Cd and Zn from inorganic industrial waste leachate by ion exchange

This paper presents a study of the removal of Cd and Zn present in the leachate from an inorganic industrial waste landfill using cationic exchange resins (Amberlite 200, 252-C, IR-120, Duolite C-464), a chelating resin, Amberlite IRC 718, and an adsorbent resin, XAD-2. The chelating resin Amberlite IRC 718 presented the higher removal in batch experiments for both metals (93% for Zn and 50% for Cd). Five hundred ten bed volumes of leachate were treated in column experiments using this material, reducing the concentrations of Cd and Zn from 18 mg/dm3 to 0.1 and 1.0mg/dm3, respectively. Regeneration of the saturated bed was achieved with 11 BV of 2M HCl.

Outbreak of Pitch Canker Caused by Fusarium circinatum on Pinus spp. in Northern Spain

During the winter of 2003-2004, dieback symptoms were observed on Pinus radiata and P. pinaster in pine nurseries in Asturias (northern Spain). Small groups of affected seedlings appeared randomly distributed throughout the nurseries. The seedlings died rapidly, showing basal needle dieback, stem lesions, resin exudations, and wilting. Isolations from infected material onto potato dextrose agar (PDA) supplemented with 0.5 mg/ml of streptomycin sulfate and Komada's medium consistently yielded Fusarium sp. cultures. The isolates were transferred to PDA and Spezieller Nährstoffarmer agar and incubated at 25°C for 10 days with a 12-h photoperiod. The cultures were identified as Fusarium circinatum Nirenberg & O'Donnell (= Fusarium subglutinans Wollenweb. & Reinking), causal agent of pitch canker disease, on basis of the presence of polyphialides and characteristic sterile, coiled, hyphae (2). To further confirm their identity, a polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) based on histone H3 gene sequences (4) and a test based on the F. circinatum-specific primers, CIRC1A-CIRC4A, which amplifies a 360-bp DNA fragment of the intergenic spacer region of the nuclear ribosomal operon (3), were used. Results obtained with both techniques confirmed the morphological identification of the cultures. A representative culture has been placed in the Centraalbureau voor Schimmelcultures (CBS 117843). The pathogen was isolated only from seedlings of P. radiata and P. pinaster. Other species such as P. nigra, P. sylvestris, and Pseudotsuga menziesii, which were also grown in these nurseries, did not show symptoms. Pathogenicity was confirmed by inoculating 6- to 9-month-old P. radiata and P. pinaster seedlings. Small strips of bark (10 × 1 mm) were cut from the stems and similar sized pieces of PDA colonized by F. circinatum were placed in contact with the open wounds and covered with parafilm. Basal needle dieback was observed 10 days after inoculation that resulted in wilting of the seedlings. F. circinatum was reisolated from the affected stems fulfilling Koch's postulates. Later in the year, symptoms of pitch canker were also observed on 20-year-old P. radiata in one forest plantation in Cantabria (northern Spain). Infected branches and shoots of the trees exudated abundant resin, resulting in resinous cankers. The needles, distal to branch tip infections, wilt, fade to yellow then red, and fall from the tree. Affected trees showed noticeable crown dieback. The isolations from the cankers also yielded F. circinatum cultures that were identified as described above. Although a nonrefereed report appeared in 1998 (1), to our knowledge, this is the first report of F. circinatum on P. radiata and P. pinaster in Spain and in Europe. References: (1) L. D. Dwinell et al. Int. Congr. Plant Pathol. 7th. 3:9, 1998. (2) H. I. Nirenberg and K. O'Donnell. Mycologia 90:434, 1998. (3) W. Schweigkofler et al. Appl. Environ. Microbiol. 70:3512, 2004. (4) E. T. Steenkamp et al. Appl. Environ. Microbiol. 65:3401, 1999.

Biweekly paclitaxel plus gemcitabine in advanced breast cancer: phase II trial and predictive value of HER2 extracellular domain

BACKGROUND

We wanted to assess the toxicity and efficacy of paclitaxel plus gemcitabine in advanced breast cancer and to confirm whether circulating HER2 extracellular domain (ECD) correlates with treatment response.

PATIENTS AND METHODS

Forty-three patients received paclitaxel 150 mg/m2 followed by gemcitabine 2500 mg/m2, both on day 1 of 14-day cycles, with a maximum of eight cycles. Serum levels of HER2 ECD were assessed by ELISA.

RESULTS

All patients were evaluable for toxicity and 42 for efficacy. Overall toxicity was low. Grade 3 neutropenia occurred in 12% of patients and grade 4 in 17%, and other grade 3 toxicities in <5%. One patient had an allergic infusion reaction. Overall response rate was 71% [95% confidence interval (CI) 62% to 81%], with 11 patients achieving a complete response (26%). With a median follow-up of 26 months, the median time to progression was 16.6 months. Response rate correlated significantly with HER2 ECD, with 42% of HER2 ECD-positive patients responding versus 83% of HER2 ECD-negative patients (P = 0.02). Furthermore, response duration was shorter in patients with positive HER2 ECD levels (7.9 versus 14.4 months; P = 0.04).

CONCLUSIONS

Paclitaxel plus gemcitabine given as an every 2-weeks schedule is a well tolerated and active regimen in advanced breast carcinoma. This is an attractive combination to use when anthracyclines are not indicated, such as in HER2 positive cases that receive trastuzumab. In addition, elevated levels of HER2 ECD adversely affect the efficacy of treatment.

Prospective randomised phase II study of docetaxel versus paclitaxel administered weekly in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy

BACKGROUND

Docetaxel and paclitaxel have activity in the second-line treatment of non-small-cell lung cancer (NSCLC), and can be administered as weekly schedules. This phase II randomised study was designed to test the efficacy and toxicity of both taxanes in patients with NSCLC previously treated with platinum-based chemotherapy.

PATIENTS AND METHODS

Patients (n = 71) with documented NSCLC were randomised to receive docetaxel (n = 35 patients; 36 mg/m(2)) or paclitaxel (n = 36 patients; 80 mg/m(2)) as a 1 h weekly infusion for 6 weeks followed by a 2-week rest. The cycles were repeated until disease progression or non-acceptable toxicities occurred.

RESULTS

Treatment achieved partial response of one versus five patients, median time-to-progression of 74 versus 68 days, and overall survival of 184 versus 105 days, with docetaxel and paclitaxel, respectively. The most common non-haematological toxicities were (docetaxel versus paclitaxel): grade 3/4 pulmonary toxicity in seven versus one patient; grade 2/3 diarrhoea in nine versus five; and grade 3/4 haematological toxicities occurred in two versus four patients. There were no treatment-related deaths.

CONCLUSIONS

Docetaxel and paclitaxel administered weekly have discrete efficacy in patients with NSCLC previously treated with platinum-based chemotherapy. The higher non-haematological toxicity of docetaxel, particularly pulmonary toxicity and diarrhoea, is of concern and warrants further investigation.

Metastatic behavior of human breast carcinomas overexpressing the Bcl-x(L) gene: a role in dormancy and organospecificity

The ability of metastatic cells to survive antiapoptotic signals may contribute to the organospecific-spread patterns of clinical metastasis and dormancy. MDA-MB-435 breast cancer cells (435/Bcl-x(L)), which overexpress the Bcl-x(L) gene, were labeled with the luciferase gene and injected orthotopically into homozygous athymic Balb/c (nude) mice to study the metastatic behavior of the breast cancer cells. The overexpression of Bcl-x(L) in tumors increased the overall metastatic burden in mice (bones, liver, kidneys, brain, lungs, and lymph nodes) in comparison with control tumors (435/NEO:luc) during the same time interval (ANOVA, p = 0.005). The principal differences after 110 days were found in bones, which had 1.5 x 10(5) +/- 1.2 x 10(5) tumor cell equivalents (p = 0.03), and lymph nodes, which had 7.0 x 10(6) +/- 6.0 x 10(6) tumor cell equivalents (p = 0.08). The analyses of light production by tissues at different times showed that cells from 435/NEO:luc and 435/Bcl-x(L).luc tumors were detectable in several organs by the second day after intramammary fat pad implantation. Although initially arriving at the target organs in similar numbers, 435/Bcl-x(L) cells developed more metastases than 435/Neo cells, indicating that the Bcl-x(L) gene might have a role in breast cancer dormancy, promoting survival of cells in metastatic foci. Thus, we suggest that overexpression of Bcl-x(L) could counteract the proapoptotic signals in the microenvironment and favor the successful development of metastasis in specific organs.

[The headache in general neruological practice]

INTRODUCTION

Headache is one of the most frequent causes of consultation in a neurology clinic. We present a descriptive, epidemiological study about such a pathology in a general neurology clinic. We evaluated as the most relevant points the frequency of different types of headaches, the reasons for remission and diagnosis concordance with the remitting doctor, normally the General Practitioner.

PATIENTS AND METHODS

The collection of data was carried out by means of structured interviews over a three month period. Apart from the epidemiological data of the subjects, the characteristics of the headache, the medication and its possible overuse, were also collected. A systematic neurological examination of all patients was carried out.

RESULTS

286 patients were included. The frequency of different diagnosis (the most frequent chronic daily headache, 39.2%), the number of patients who abused of analgesics (31.8%) and the diagnosis concordance with the referring doctor (20%) was analyzed among other variables.

CONCLUSIONS

The study highlights the high number of patients suffering from daily chronic headache and the fundamental role that the abuse of analgesics plays in this diagnostic entity. The diagnosis concordance is too low. A correct initial diagnosis as a result of a better neurological training in primary care would prevent in greater numbers the abuse of analgesics and would offer a better quality of care.

Bcl-xL promotes metastasis of breast cancer cells by induction of cytokines resistance

Metastasis is a highly complex process involving the survival of tumor cells, both in the blood stream and within specific organs. Cell-death and survival are determined by a number of gene products from an expanding family of the Bcl-2 gene, either promoting or preventing apoptosis. Furthermore, the survival of tumor cells may favor the accumulation of additional genetic alterations causing further growth and invasive opportunities which may lead to metastasis. To examine whether the prevention of cell-death influences the metastatic behavior, we transfected a human breast cancer cell line MDA-MB-435 with the Bcl-xL cDNA and then studied metastatic ability of the selected clones in vivo. Our results show that Bcl-xL-clones had a decreased tumor growth latency and an increased metastatic ability. Apoptosis-resistance to cytokines was induced in 435 cells by Bcl-xL-expression with minor modifications in their proliferation rates. These cells also showed diminished adhesion to extracellular matrix proteins and a survival advantage in suspension over 435/Neo cells. Moreover, to determine survival in blood stream and in cells lodged in the lungs, we injected 435/Bcl-xL and 435/Neo cells at 1:3 proportion i.v., and animals were killed at intervals of 15' to 16 h after injection. Tumor cells were recovered from the lungs and Southern-blot analysis revealed the presence of exogenous Bcl-xL cDNA. These results showed that 435/Bcl-xL cells had a survival advantage in circulation over 435/Neo cells. This advantage in vivo was attributable to Bcl-xL expression. We conclude that Bcl-xL expression in breast cancer cells can increase metastatic activity. This advantage could be created by inducing resistance to apoptosis against cytokines, increasing cell survival in circulation, and enhancing anchorage-independent growth.

Paclitaxel/gemcitabine administered every two weeks in advanced breast cancer: preliminary results of a phase II trial

The purpose of this study was to evaluate the toxicity and efficacy of paclitaxel/gemcitabine administered every 2 weeks in the first-line treatment of advanced breast cancer. Forty-three chemonaive patients with histologically confirmed metastatic breast carcinoma were enrolled. Patients received paclitaxel 150 mg/m2 followed by gemcitabine 2,500 mg/m2, both on day I of a 14-day cycle, for a maximum of eight cycles. Thirty-four patients were evaluable for toxicity; 38 were evaluable for efficacy. The median age at the time of diagnosis was 54 years, the median performance status was 90, and the median number of lesions was three. Most patients (71%) had received prior adjuvant therapy. Grade 3 and 4 toxicity was limited to leukocytes (14% and 18%, respectively). Grade 3 toxicities (5% each) were thrombocytopenia, nausea and vomiting, elevation of aspartate transaminase, neurosensory, and constipation. One patient had neutropenia and fever. The objective response rate was 68% (21% complete response and 47% partial response); 18% had stable disease and 13% had partial disease. The preliminary evaluation of paclitaxel/gemcitabine given as a 2-week schedule to patients with untreated advanced breast carcinoma shows encouraging activity and a favorable toxicity profile.

Uracil and tegafur modulated with leucovorin: an effective regimen with low toxicity for the treatment of colorectal carcinoma in the elderly. Oncopaz Cooperative Group

BACKGROUND

In spite of the high prevalence of cancer in the elderly, little information is available about the efficacy and toxicity of chemotherapy in elderly patients. In a previous study, the authors demonstrated that the combination of uracil and tegafur (UFT) with leucovorin (LV) was active and well tolerated in patients with advanced colorectal carcinoma (ACC). The objective of the current study was to determine the efficacy and toxicity of this regimen in elderly patients with ACC.

METHODS

Thirty-eight unselected patients older than 70 years (median age, 74 years) with measurable ACC were included. All patients were evaluable for toxicity and response. The regimen consisted of intravenous LV 500 mg/m2 on Day 1, oral LV 15 mg every 12 hours on Days 2-14, and oral UFT 390 mg/m2 on Days 1-14. Treatment was repeated every 28 days for a minimum of 4 courses per patient.

RESULTS

Two hundred eighty-eight cycles of chemotherapy were delivered (median, 7 per patient). Two patients (5%) achieved a complete response and 9 (24%) a partial response, for an overall response rate of 29%. Toxicity was mild, without dose-limiting myelosuppression. Four patients (10%) experienced Grade 3-4 diarrhea, 1 patient had Grade 3-4 nausea/vomiting, and 1 had Grade 3-4 mucositis. Grade 3-4 toxicity was more frequent among women than men (38% vs. 4%, P < 0.05).

CONCLUSIONS

Treatment with oral UFT modulated with LV is effective, well tolerated, and feasible on an outpatient basis for elderly patients with ACC. However, elderly women should be followed closely for the early detection of toxicity.

[Evaluation of biological fish silage in broiler chicken]

Biological fish silage was produced from the mixture of three low price fish species. After mixing it with molasse, papaya and pineapple wastes, and Lactobacillus plantarum incoculation, the product was stored for seven days, dehydrated and added to several diets of formulated poultry feed as a substitute of fish meal. Physical-chemical and microbiological analyses were done to the raw materials and final products. Biological tests of acceptability indicated that chicken preferred diets up to 50% of fish silage. Chicken's weigh increased and food consumption tests, in addition to the sensory evaluation tests in the chickens white meat, showed the advantages of inclusion of 5-20% fish silage in the diets of experimental animals.

Transcranial oblique lateral radiography to verify the position of the mandibular condyles with the use of functional appliances

By means of standardized transcranial oblique lateral (TOL) radiographs, the position of the mandibular condyles in the glenoid fossae of 14 patients with Class II division 1 malocclusion was studied at the beginning of treatment with or without functional appliances placed in position, and also at the end of treatment. A significant increase in the distance between the upper point of the condyle and the glenoid fossa was found when the appliance was worn for the first time. This displacement was found to disappear at the end of the treatment even when the appliance was placed in position.