Association Between Gambling Motives, Violence and Early Maladaptive Schemas in Women with Gambling Disorder

Analyzing why being a victim of violence has led women to have problems with gambling is a field yet to be explored. Thus, the objectives of the present study were (I) analyze the relationship between gambling motives, received psychological violence, and early maladaptive schemas in women; (II) study differences in the study variables in women with and without gambling disorder (GD); (III) analyze the predictive role of violence and schemas in gambling motives; and (IV) analyze the mediating role of schemas in the relationship between violence and gambling motives. The sample comprised 61 women with GD (M = 48.43, SD = 12.78) and 342 women without GD (M = 26.91, SD = 11.47). The results of the present study revealed positive correlations between gambling motives, psychological violence received and early maladaptive schemas. In addition, women with GD scored higher on the study variables. It was also found that early maladaptive schemas based on subjugation and defectiveness may be a vulnerability factor for engaging in gambling to cope with the negative emotions produced by gender violence. From a clinical perspective, knowing the risk factors related to gambling motives in women is crucial to developing effective prevention and intervention programs.

Mediating Role of Rumination Between Anger and Anxious-Depressive Symptomatology in Family Members of People with Gambling Disorder

Gambling disorder is characterized by a behavioural pattern of dysfunctional gambling that persists despite its negative implications in different areas of people's daily life. One of the most negatively affected areas is the one related to family members. This study aimed, firstly, to study the differences between family members of people with gambling disorder and a general population sample in anger (state, trait, expression-out, expression-in. control-out and control-in), rumination (brooding, reflection and total), and anxiety and depression. The second aim was to analyse the correlation between these variables in the family members of people with gambling disorder, and thirdly, to analyse the mediating role of rumination between anger, anxiety and depression. This study consisted of 170 people, of whom 87 were family members of people with a gambling disorder, and 83 were from the general population. Instruments measuring anger, anxiety, depression, and ruminative responses were administered. Results showed that family members had significantly higher scores in anger (state), depression, anxiety, rumination (total and brooding). Also, results showed that anger correlated positively and significantly with rumination, depression and anxiety, which also correlated positively and significantly with each other. Third, rumination mediated the relationship between the following variables: anger (state) and depression; anger (trait) and anxiety and depression; anger (external expression) and anxiety and depression. A complete mediating effect was found in the latter case and a partial mediating effect in the first two cases. In conclusion, it is found that having a family member with a gambling disorder may increase levels of anger, anxiety, depression and rumination. Furthermore, it is shown that working on rumination may reduce depression and anxiety in family members of gamblers.

Gambling: Exploring the Role of Gambling Motives, Attachment and Addictive Behaviours Among Adolescents and Young Women

There is a growing body of research that seeks to understand the aetiology, consequences and risk factors associated with addictive behaviours in youths. However, research examining the specific profile of adolescent females is very limited. Therefore, the objectives of the present study were, firstly, to explore the differences between attachment, gambling motives (social enhancement and coping), positive and negative affect, and addictive behaviours (gambling, drugs, spending, alcohol and video games) in female adolescents with and without risk of gambling problems. Secondly, the relationships between attachment, gambling motives, positive and negative affect and addictive behaviours were analysed in the subsample of female adolescents with problem gambling Thirdly, we examine the predictive role of positive and negative affect, gambling motives, and attachment in the aforementioned addictive behaviours. The sample was composed of 351 adolescents and young women, of which 312 had no risk of gambling and 39 had gambling problems. The results obtained revealed higher scores in drugs, spending, maternal attachment, and all gambling motives in the group of gambling problems. Likewise, analyses showed that the relevance of the predictor variables (attachment, gambling motives, and affect) varied according to the addiction that was taken as a reference point (i.e., gambling, drugs, spending, alcohol and video games).Consequently, the identification of the possible vulnerability factors for each addiction could be useful in the design of prevention and treatment approaches. In addition, the need for integrated and holistic health- and social- care programmes are suggested in terms of sex and age.

Genetic parameters and genotype-environment interactions for skeleton deformities and growth traits at different ages on gilthead seabream (Sparus aurata L.) in four Spanish regions

One of the most important problems of fish aquaculture is the high incidence of fish deformities, which are mainly skeletal. In this study, genetic parameters on gilthead seabream (Sparus aurata L.) for skeleton deformities at different ages (179, 269, 389, 539 and 689 days) and their correlations with growth traits were estimated, as were as their genotype × environment interactions (G × E) at harvesting age. A total of 4093 offspring from the mass spawning of three industrial broodstocks belonging to the PROGENSA(®) breeding programme were mixed and on-grown by different production systems in four Spanish regions: Canary Islands (tanks and cage), Andalusia (estuary), Catalonia (cage) and Murcia (cage). Parental assignment was inferred using the standardized SMsa1 microsatellite multiplex PCR. From three broodstocks, 139 breeders contributed to the spawn and a total of 297 full-sibling families (52 paternal and 53 maternal half-sibling families) were represented. Heritabilities at different ages were medium for growth traits (0.16-0.48) and vertebral deformities (0.16-0.41), and low for any type of deformity (0.07-0.26), head deformities (0.00-0.05) and lack of operculum (0.06-0.11). The genetic correlations between growth and deformity traits were medium and positive, suggesting that to avoid increasing deformities they should be taken into account in breeding programmes when growth is selected. The G × E interactions among the different facilities were weak for length and deformity and strong for growth rate during this period. These results highlight the potential for the gilthead seabream industry to reduce the prevalence of deformities by genetic improvement tools.

High dietary arachidonic acid levels affect the process of eye migration and head shape in pseudoalbino Senegalese sole Solea senegalensis early juveniles

The effect of high dietary levels of arachidonic acid (ARA) on the eye migration and cranial bone remodelling processes in Senegalese sole Solea senegalensis early juveniles (age: 50 days post hatch) was evaluated by means of geometric morphometric analysis and alizarin red staining of cranial skeletal elements. The incidence of normally pigmented fish fed the control diet was 99·1 ± 0·3% (mean ± s.e.), whereas it was only 18·7 ± 7·5% for those fed high levels of ARA (ARA-H). The frequency of cranial deformities was significantly higher in fish fed ARA-H (95·1 ± 1·5%) than in those fed the control diet (1·9 ± 1·9%). Cranial deformities were significantly and negatively correlated with the incidence of normally pigmented animals (r² = -0·88, P < 0·001, n = 16). Thus, fish displaying pigmentary disorders differed in the position of their eyes with regard to the vertebral column and mouth axes, and by the interocular distance and head height, which were shorter than in fish not displaying pigmentary disorders. In addition to changes in the positioning of both eyes, pseudoalbino fish showed some ARA-induced osteological differences for some of the skeletal elements from the splanchnocranium (e.g. right premaxillary, dentary, angular, lacrimal, ceratohyal and branchiostegal rays) and neurocranium (e.g. sphenotic, left lateral ethmoid and left frontal) by comparison to normally pigmented specimens. Pseudoalbino fish also had teeth in both lower and upper jaws. This is the first study in Pleuronectiformes that describes impaired metamorphic relocation of the ocular side eye, the right eye in the case of S. senegalensis, whereas the left eye migrated into the ocular side almost normally.

Beauveria bassiana (Ascomycota: Hypocreales) wound dressing for the control of Euzophera pinguis (Lepidoptera: Pyralidae)

Injury to olive tree trunks and branches because of biotic and abiotic factors, such as pruning and mechanical harvesting, attracts the olive pyralid moth Euzophera pinguis Haworth (Lepidoptera: Pyralidae). This moth has become increasingly important in the Mediterranean region during recent years. The use of an entomopathogenic fungus for wound dressing for pest control is reported for the first time in this study. Beauveria bassiana (Ascomycota: Hypocreales) strain EABb 08/04-Ep was originally obtained from a diseased E. pinguis larva and has shown effective E. pinguis control in an olive crop in Jaén, Andalusia, Spain, under field conditions during the spring and fall of 2008 and 2009 and the spring of 2011. Experimental artificial 30 by 30-mm square wound cages were large enough to allow the E. pinguis females to oviposit. Approximately 80 and 40-60% of the control wounds contained live larvae in the experiments that occurred during the spring and fall, respectively. The B. hassiana wound dressing gave similar results as the chlorpyrifos wound dressing throughout the experiment, with efficacies reaching 80-85% in the spring and 90-95% in the autumn. The B. bassiana fungus was recovered from 60-90% of the wounds at the completion of the experiments and after 60 d of treatment. These data indicate that strain EABb 08/04-Ep applied to the pruning wounds can be an effective tool for the microbial control of E. pinguis in olive crops. Moreover, B. bassiana may be used within integrated pest management strategies to minimize chemicals, depending on the population density of the pyralid moth.

Development of the first standardised panel of two new microsatellite multiplex PCRs for gilthead seabream (Sparus aurata L.)

The high number of multiplex PCRs developed for gilthead seabream (Sparus aurata L.) from many different microsatellite markers does not allow comparison among populations. This highlights the need for developing a reproducible panel of markers, which can be used with safety and reliability by all users. In this study, the first standardised panel of two new microsatellite multiplex PCRs was developed for this species. Primers of 138 specific microsatellites from the genetic linkage map were redesigned and evaluated according to their genetic variability, allele size range and genotyping reliability. A protocol to identify and classify genotyping errors or potential errors was proposed to assess the reliability of each marker. Two new multiplex PCRs from the best assessed markers were designed with 11 markers in each, named SMsa1 and SMsa2 (SuperMultiplex Sparus aurata). Three broodstocks (59, 47 and 98 breeders) from different Spanish companies, and a sample of 80 offspring from each one, were analysed to validate the usefulness of these multiplexes in the parental assignation. It was possible to assign each offspring to a single parent pair (100% success) using the exclusion method with SMsa1 and/or SMsa2. In each genotyped a reference sample (Ref-sa) was used, and its DNA is available on request similar to the kits of bin set to genotype by genemapper (v.3.7) software (kit-SMsa1 and kit-SMsa2). This will be a robust and effective tool for pedigree analysis or characterisation of populations and will be proposed as an international panel for this species.

Morphological and histological study of larval development of the Senegal sole Solea senegalensis: an integrative study

This study provides a comprehensive description of the main morphological and histological events that take place during larval and post-larval development of Senegal sole Solea senegalensis in order to establish a reference for its normal developmental organogenesis. Five stages have been described. Before gill development at the onset of metamorphosis (eye migration process, stage 4c), the skin was the main site of gas and ion exchange, whereas during stages 3 and 4, the skin begins differentiating into the definitive juvenile structure. The timing of development of the endocrine system depends on each organ, the endocrine pancreas and thyroid gland being the first to differentiate (stages 2 and 3, respectively), followed by the interrenal tissue and stannius corpuscles that develop at metamorphosis (stages 4 and 4c, respectively). The differentiation and maturation of the lymphohaematopoietic organs was coupled with the increase in complexity of the cardiovascular system and the presence of mature erythrocytes (stage 4b), which might be attributed to the change in respiration and the development of fully functional gills. In the differentiation of sensory structures, the development of eyes, inner ear, neuromasts and olfactory organs was rapid, with most of these organs becoming fully developed soon after hatching (stage 1). Vision, chemo- and mechano-reception developed very early in ontogeny, in parallel with the development of the central nervous system and changes in feeding habits. Although the general pattern of development in S. senegalensis appeared similar to most marine fish larvae already described, there were species-specific ontogenetic characteristics probably derived from the species' particular environment (subtropical waters) and behaviour (nocturnal, benthic, omnivorous feeding habits). These results on the organogenesis of larvae are a useful tool for establishing the functional systemic capabilities and physiological requirements of larvae to ensure optimal welfare and growth under aquaculture conditions.

Evidence for the fragmentation of VtgAb LvH in common dentex (Dentex dentex), a marine pelagophil teleost

Since the timing of the lipovitellin heavy chain (LvH) of vitellogenin Ab (VtgAb) degradation during marine teleosts ontogeny is poorly understood, the current study was planned to address some aspects of this shortcoming. Fertilized eggs (before epiboly) of Dentex dentex were analysed. Vtg-derived proteins, that appeared as 6 protein bands after SDS-PAGE, were purified using specific ion exchange chromatography. Five bands (i.e., ∼78, ∼57, ∼22, ∼19, and ∼17 kDa) were merely stained with Coomassie Blue and one band (i.e., ∼16 kDa) only with Periodic Acid Schiff (PAS). The ∼16 kDa protein band was subjected to a mass spectrometry-based sequencing. These results showed that the ∼16 kDa protein band contains a mixture of "LvH-Ab" derivatives with the same molecular weight. The specific staining system (i.e., PAS) also revealed the glycosylation of some of the LvH-Ab fragments inside the ∼16 kDa protein band. The study provides new data about fragmentation of the LvH-Ab in marine pelagophil teleosts.

Embryo and larva development in common dentex (Dentex dentex), a pelagophil teleost: the quantitative composition of egg-free amino acids and their interrelations

Free amino acids (FAAs) play a key role in the physiology of marine teleosts (eggs, embryos, and larvae). However, the relationship between the egg FAAs content and the production of viable embryos and larvae (at different developmental stages) in batch spawner pelagophils has not yet comprehensively been investigated. Viable eggs of common dentex, Dentex dentex, were obtained from captive broodstocks. Egg wet weight (WW), dry weight (DW), and water content (%W) and viability parameters, or VPs (egg floating rate [FR], hatching rate [HR], and larval survival rate [SR] at days 0 to 5 posthatch) were determined for 45 egg batches. The egg batches were classified according to their HR magnitude. Twelve egg batches with the same WW, DW, and %W were taken from the same broodstock and at the same developmental stage to determine the qualitative and quantitative composition of FAAs. The total FAA (TFAA) content, glutamic acid (Glu), asparagine (Asn), glutamine (Gln), and arginine (Arg) were correlated with VPs. The Glu was significantly correlated with HR and SR at 0 day posthatch (dph), the Asn with SR at 1 dph, and the Gln and Arg with FR and HR. Of the 361 ratios made based on the absolute concentrations of FAAs, 24 ratios were correlated with VPs (P<0.005) through 42 simple regression models (R(2)=0.641 to 0.846). Of the 42 significant relationships found approximately 10%, approximately 28%, approximately 12%, approximately 30%, approximately 8%, approximately 4%, approximately 2%, approximately 2%, and approximately 2% of the models show the relations of the egg FAAs ratios with FR, HR, SR at days 1 to 5 posthatch, and %W, respectively. A path coefficient in combination with a Pearson's correlation coefficient provided a series of statistical evidences to show the effects of the egg FAAs interrelations on the relationships found between quantitative composition of a FAA and a VP.

A comparative study of two histological techniques for the identification of cytomegalovirus infection in colorectal biopsies from patients with chronic inflammatory bowel disease

BACKGROUND

the role that cytomegalovirus (CMV) plays in inflammatory bowel disease (IBD) is controversial. The diagnosis of CMV infection in IBD depends on viral identification with hematoxylin-eosin (HE) or immunohistochemistry (IHC). Our aim was to compare the sensitivity of HE and IHC for this diagnosis in IBD patients.

PATIENTS AND METHODS

a case-control study. Our database was searched for IBD patients with HE- or IHC-based CMV-positivity from 1997 to 2007. Controls were selected among IBD inpatients matched for age and year of diagnosis with CMV. Their clinical characteristics were analyzed. HE and IHC were performed on biopsies from cases and controls at 6 months before and after inclusion in the study. In the statistical analysis, p values below 0.05 were considered significant.

RESULTS

ten IBD patients with CMV infection were identified. IBD-CMV patients were more steroid-resistant or steroid-dependent (p = 0.03), and underwent a higher number of colonic biopsies (p = 0.03). From 97 biopsies analyzed, 12 were HE-negative and IHC-positive, and 3 showed reversed results. The sensitivity of HE was 58.6%, 95% CI (38.9-78.3), and that of IHC was 89.7%, 95% CI (76.8-100). We did not find a good level of agreement between both techniques: kappa value 0.55, 95% CI (0.36-0.75). CMV positivity with IHC was associated with the use of more than one immunosuppressant drug, OR 13.5, 95%CI (1.2-152.2). Antiviral treatment was useful for CMV patients with steroid-dependent and steroid-refractory IBD.

CONCLUSIONS

IHC shows a 30% higher sensitivity than HE for the diagnosis of CMV infection in IBD patients. There is no good level of agreement between both histological techniques.

Interleukin-1β up-regulates nitrite production: effects on ovarian function

We have previously reported that Interleukin-1beta (IL-1beta) affects ovarian function in the rat, modulating prostaglandin and progesterone (P) production. As IL-1beta effects were associated to nitric oxide (NO) synthesis, in the present work we have further examined the role of ovarian NOS-system, in IL-1beta antisteroidogenic action. Mid-luteal explants from rats were incubated for 4 h in the presence of IL-1beta (1-35 ng/ml)-alone or in combination with NOS-inhibitors-and then assayed for P and nitrite production. IL-1beta treatment reduced P levels in a dose-dependent manner, returning to basal levels at 35 ng/ml. This reduction in steroid synthesis was paralleled by a dose-dependent increase in nitrite levels, reaching a maximum at 25 ng/ml but without effect at 35 ng/ml. L-Arginine (1 and 2 mM) was able to mimic IL-1beta actions and the NOS blocker L-Nitro-Arginin-Methyl Ester reverted these effects. Moreover, the selective iNOS inhibitor, 1400 W, completely abolished IL-1beta antisteroidogenic effect, therefore confirming the dependence of IL-1beta action upon iNOS activation. Finally, IL-1beta did not affect eNOS expression but up-regulated iNOS mRNA and protein levels. Our results suggest an interaction between IL-1beta and the NOS-system. Thus, we may conclude that in the rat iNOS-derived NO production, induced by IL-1beta, affects ovarian P biosynthesis and hence NO may be a major effector molecule of ovarian IL-1 system.

[Headache caused by cerebral angiopathy during labor with epidural analgesia]

A 29-year-old woman presented projectile vomiting followed by frontal headache, immediately upon receiving epidural analgesia for labor. The clinical picture persisted until expulsion. Although no leaking of spinal fluid into the needle or epidural catheter had been observed, post-dural puncture headache was diagnosed. The postpartum persistence of symptoms and the patient's generally worsening condition indicated the need for more thorough physical examination, which revealed signs of neurological involvement. Those findings and imaging studies (computed tomography of the brain, transcranial Doppler and magnetic resonance angiography) established a final diagnosis of postpartum cerebral angiopathy. Although epidural analgesia is increasingly requested by women entering labor, it is not a risk-free procedure. We describe a relatively unknown clinical entity, postpartum cerebral angiopathy, that developed during epidural analgesia for labor and that was initially believed to be a complication of the analgesic technique.

[Licensure in the practice of the medical profession in Chile: experience of the Re-valuation Committee of the Medical School of the University of Chile period 1984-1999]

We report the experience of the re-valuation committee of the University of Chile Medical School, in the period 1984-1999. This experience is relevant to the licensing processes in Latin America. We report the political, legal and regulatory backup and the academic criteria used to establish different evaluation methodologies. We also communicate the main results obtained. Factors such as the country and University conferring a title, nationality and length of service of the applicant, influence in the percentage of licensure examination approval. Some modifications to the licensure process should be incorporated but, the overall results obtained, fully justify the existence of this licensure committee.

[Role of nitric oxide in the synthesis of prostaglandin F2 alpha and progesterone during luteolysis in the rat]

In the corpus luteum (CL) prostaglandin F2 alpha (PGF2 alpha) is a luteolytic agent. Nitric oxide (NO) is a messenger molecule capable of modulating diverse pathophysiological processes. Many of these functions are related with the female reproductive tract. The aim of the present study was to investigate the role of ovarian NO in PGF2 alpha production arid in progesterone synthesis during CL regression in the rat. By means of the intrabursa (i.b.) ovarian sac treatment of two competitive NO inhibitors, NG-monomethyl-L-arginine (L-NMMA; 1 mg/kg); NW-Nitro-L-arginine methyl ester (L-NAME, 3 mg/kg) and sodium nitroprusside (SNP, 0.05 mg/kg) as a NO generator we found that NO, produced by the ovarian tissue during the last days (days 8 and 9) of CL development, acted by increasing PGF2 alpha production in the ovary and diminishing seric progesterone levels leading to CL involution. We also postulated a positive feedback mechanism between PGF2 alpha and NO, to ensure luteal regression. Thus, we injected intraperitoneally (i.p.) a luteolytic dose (3 micrograms/kg) of a synthetic PGF2 alpha during the mid and late phase of CL development. The ovarian activity was evaluated. The results confirmed our hypothesis; we did not see any effect in mid-stage of CL development, while at a late stage enhancement of ovarian NOs activity was observed in PGF2 alpha-infected animals.

[Accreditation professional degrees and teaching institutions: the case of Chile]

Accreditation has acquired special relevance for the habilitation of professional practice, considering the proliferation of teaching institutions, the variety of training programs and the increasing amount of professionals requiring accreditation or revalidation of their titles. The internationalization of professional activities requires global and uniform accreditation procedures to avoid inequalities in evaluation of different professionals coming from abroad or from Chile. In the scope of medical practice, these concepts acquire special relevance, considering the appearance of new medical schools in the last decade and the increasing number of foreign physicians that need to revalidate their titles. In the period between January 1996 and September 1997, 192 foreign physicians applied to revalidate their titles and only 55 were approved. Therefore, the establishment of and effective evaluation system will correct deficiencies in the accreditation process and will promote the revision of training programs and the progress of teaching institutions. The organisms that will require to be accredited must be confident that this action will improve the quality of Chilean professional training.

[Infectious endocarditis: prognostic factors of mortality in 131 cases]

BACKGROUND

Global hospital mortality for infective endocarditis ranges from 13 to 40%.

AIM

To compare clinical, microbiological, echocardiographic factors and complications between patients that died during an episode of infective endocarditis and those who survived.

PATIENTS AND METHODS

We followed during their hospital stay, 129 patients, aged 14 to 74 years old, who had 131 episodes of infective endocarditis. Clinical assessment, echocardiography and microbiological study was done to all patients. Surgical indications were those derived from complications.

RESULTS

Thirty three patients died during hospital stay (25.2%). There were no differences between survivors and deceased patients in the lapse between onset of symptoms and hospital admission, presence of fever, dyspnea or heart murmurs. Skin and mucosal septic manifestations occurred with higher frequency in deceased patients (57.1 and 24.3% respectively). Blood cultures were positive in 55% in survivors and 48% in those who died. The most frequent infecting organisms were staphilococci and streptococci. Vegetations were found with greater frequency in aortic position in both groups of patients. Deceased patients had a higher frequency of cardiac failure (84 and 65% respectively) and embolic episodes (77 and 46% respectively) than survivors. Antimicrobial treatment was successful in 94% of survivors and 15% of those who died. Forty percent of survivors and 54% of deceased patients were subjected to surgical procedures.

CONCLUSIONS

The most important predictor of hospital mortality in this series of patients with infective endocarditis was antimicrobial treatment failure.

Characterization of mevalonate metabolism in the sea bass (Dicentrarchus labrax L) liver

The activities of mevalonate kinase, mevalonate 5-phosphate kinase and mevalonate 5-pyrophosphate decarboxylase, were examined in sea bass (Dicentrarchus labrax L) liver. The activities of the three enzymes were studiedin vitro in relation to the influence of protein content, time of incubation, pH, temperature, mevalonate, ATP and Mg(++) concentration. Protein content in the assay medium affected the three enzymes differently. Mevalonate kinase, mevalonate 5-phosphate kinase, and mevalonate 5-pyrophosphate decarboxylase activities were linear up to 0.2, 0.4 and 0.8 mg protein, respectively. With respect to the time course studies, the enzymes also behaved differently. Mevalonate kinase activity increased over forty minutes, reaching a plateau thereafter, while mevalonate 5-phosphate kinase and decarboxylase increased over the entire assay period. All the three enzymes showed a maximum in activity at pH 7.5. The effect of reaction temperature showed that phosphorylation increased to maximum around 35°C for mevalonate kinase and 30°C for mevalonate 5-phosphate kinase while decarboxylation rates remained constant well until 30°C temperature decreasing afterwards. The enzymes behaved differently as a function of mevalonate concentration. Mevalonate 5-phosphate formed was maximal when the initial mevalonate concentration was 272 μM, whereas mevalonate 5-pyrophosphate and CO2 were formed maximally at mevalonate concentrations of 136 μM and 68μM, respectively. Optimal ATP concentration in the medium was 3 mM for decarboxylase and 6 mM for kinases, and Mg(++) requirements varied from 4 mM for decarboxylase to 6 mM for kinases.

[Infective endocarditis: clinical aspects and necropsy study in 20 cases]

Aiming to know the principal anatomo-pathological findings in patients that died with a diagnosis of infective endocarditis, the clinical histories and necropsy protocols of such patients that died between 1984 and 1989 were reviewed. Twenty patients (11 male) aged 43.2 +/- 16.1 years were studied. In nine, the endocarditis was subacute, and 80% had a history of valvular or congenital heart disease. The principal clinical complication was sepsis followed by neurological, nephrological and cardiac complications. The necropsy disclosed cardiac, nephrological and abdominal lesions in 100, 80 and 65% of patients respectively. In 65% of necropsies, neurological injuries were found (cerebral edema in 7 patients and hemorrhagic complications in 11). It is concluded that extra cardiac lesions are frequent in patients dying with a diagnosis of infective endocarditis.

[Physician-patient communication and health education]

The aim of the present study was to analyze the content in health education of the patient-physician interview. The study was observational and descriptive. The target population were the patients attending the general practices of the Social Security clinics. With permission of patients and physicians, 53 visits of two general practitioners were recorded on tape. 48 interviews were analyzed with definition of activities (asking, answering, discussing, etc.) and contents (health problems, treatment, health education, etc.). Health education was 10% of the contents, and it was associated with the physician's activity of commenting/instructing and with the patient's activity of commenting/asking.

[Infectious endocarditis: clinical and echocardiographic initial follow-up]

We analyzed the clinical and echocardiographic features of 24 patients with infective endocarditis followed for a mean of 20.2 month (range 3-84) after discharge. Mean age was 38 years, male to female ratio was 2:1 and 87% of cases had a subacute clinical course; 17% of patients had late prosthetic endocarditis. Positive blood cultures were obtained in only 50% of patients. Vegetations were detected by echocardiography in 88%, 66% of them located at the aortic valve. Heart failure (62%) was the main complication, leading to valve replacement in 4 patients. Four patients died during follow up, 3 males due to heart failure and a female from systemic emboli. Twenty patients survive at the end of follow up (84%), 50% of them in FC I or II, 40% in FC III or IV (2 lost to follow up). Eleven patients had a late echocardiogram at a mean of 12 months after discharge: 6 of them showed persistence of vegetations (55%).

Cell surface glycoconjugates control the activity of the NADH-ascorbate free radical reductase of rat liver plasma membrane

Plasma membrane isolated by two-phase partition from rat liver showed rates of ascorbate free radical reduction by NADH of 4-5 nmoles of oxidized NADH/min/mg protein. This activity was inhibited 80% by ConA and up to 97% by WGA and LFA lectins. NADH-ascorbate free radical reductase was also inhibited in rat liver plasma membranes preincubated with neuraminidase or trypsin, but no additional inhibition was observed in the presence of LFA after enzyme digestion. It appears that the integrity of glucan moieities of the cell surface glycoconjugates are necessary for the optimal function of this activity that could be considered as part of the transplasma membrane electron transport system.

Serum immunoglobulin A changes in alcoholic patients

1. Serum concentrations of immunoglobins IgA and IgG were determined in: Alcoholic men without liver damage (normal laboratory tests and only slight abnormalities in liver biopsy). 2. Patients at different stages of alcoholic liver disease. 3. Non alcoholic patients with liver disease. The serum IgA concentration was increased in all groups of alcoholics and this increase was related to the severity of liver damage. It was also raised in non alcoholic patients but both the degree of increase and the IgA/IgG ratio could be used to differentiate them. The increase in the serum IgA concentration in alcoholics without liver damage has not previously been proved and the reasons put forward for it in alcoholics are not valid for this group.