Composite material with enhanced recyclability as encapsulant for photovoltaic modules

Encapsulation of photovoltaic cells was carried out using a transparent glass fiber reinforced composite with enhanced chemical recyclability based on a matrix of an epoxy resin containing cleavable functional groups. The current-voltage curves showed a decrease of 6.3% on the short-circuit current (Isc) after encapsulation of the cell, lower than the one observed for the reference non-recyclable standard epoxy composite. Its performance stability under thermal cycling, ultraviolet (UV), and damp-heat exposure was evaluated and compared with the one of the reference standard epoxy. Both resins showed good stability performance under UV exposure and thermal cycling accelerated aging. Moreover, a power loss below the 5% allowed by the photovoltaic standard was observed for the recyclable resin after 1000 h of damp-heat exposure, even the pronounced loss of 4.7% in power remains a concern. Regarding the recyclability, the composite was dissolved in acetic acid dissolution and glass fiber fabrics were successfully recovered. A new module was manufactured with these fabrics, showing this time a loss of 12% in Isc comparing with the non-encapsulated cell. Further work will consider improving the moisture barrier properties of the composite, and adjusting the recycling conditions to allow component recovery valid for new modules.

Cooperation dynamics under pandemic risks and heterogeneous economic interdependence

The spread of COVID-19 and ensuing containment measures have accentuated the profound interdependence among nations or regions. This has been particularly evident in tourism, one of the sectors most affected by uncoordinated mobility restrictions. The impact of this interdependence on the tendency to adopt less or more restrictive measures is hard to evaluate, more so if diversity in economic exposures to citizens' mobility are considered. Here, we address this problem by developing an analytical and computational game-theoretical model encompassing the conflicts arising from the need to control the economic effects of global risks, such as in the COVID-19 pandemic. The model includes the individual costs derived from severe restrictions imposed by governments, including the resulting economic interdependence among all the parties involved in the game. By using tourism-based data, the model is enriched with actual heterogeneous income losses, such that every player has a different economic cost when applying restrictions. We show that economic interdependence enhances cooperation because of the decline in the expected payoffs by free-riding parties (i.e., those neglecting the application of mobility restrictions). Furthermore, we show (analytically and through numerical simulations) that these cross-exposures can transform the nature of the cooperation dilemma each region or country faces, modifying the position of the fixed points and the size of the basins of attraction that characterize this class of games. Finally, our results suggest that heterogeneity among regions may be used to leverage the impact of intervention policies by ensuring an agreement among the most relevant initial set of cooperators.

A collective risk dilemma for tourism restrictions under the COVID-19 context

The current COVID-19 pandemic has impacted millions of people and the global economy. Tourism has been one the most affected economic sectors because of the mobility restrictions established by governments and uncoordinated actions from origin and destination regions. The coordination of restrictions and reopening policies could help control the spread of virus and enhance economies, but this is not an easy endeavor since touristic companies, citizens, and local governments have conflicting interests. We propose an evolutionary game model that reflects a collective risk dilemma behind these decisions. To this aim, we represent regions as players, organized in groups; and consider the perceived risk as a strict lock-down and null economic activity. The costs for regions when restricting their mobility are heterogeneous, given that the dependence on tourism of each region is diverse. Our analysis shows that, for both large populations and the EU NUTS2 case study, the existence of heterogeneous costs enhances global agreements. Furthermore, the decision on how to group regions to maximize the regions' agreement of the population is a relevant issue for decision makers to consider. We find out that a layout of groups based on similar costs of cooperation boosts the regions' agreements and avoid the risk of having a total lock-down and a negligible tourism activity. These findings can guide policy makers to facilitate agreements among regions to maximize the tourism recovery.

Effects of long-term exposure to an extremely low frequency magnetic field (15 µT) on selected blood coagulation variables in OF1 mice

The long-term exposure of OF1 mice to an extremely low frequency magnetic field (ELF-MF; 50 Hz, 15 µT [rms]) has been associated with the appearance of leukaemia. Neoplasms are usually accompanied by changes in haemostatic processes but reports on changes in blood coagulation following exposure to an ELF-MF are scarce and rather fragmentary. The aim of the present work was to determine whether any global or partial coagulation variables are modified after such long-term exposure. A parental generation of six week-old OF1 mice was exposed to an artificial ELF-MF for 14 weeks. Mating was then allowed, and the resulting filial generation raised until the age of 31-35 weeks within the same ELF-MF. Control animals were subjected only to the magnetic field of the Earth. Whole blood samples were extracted from the anesthetised filial generation of mice by cardiac puncture. White blood cells (WBC) were counted, the activated partial thromboplastin time (APTT) and prothrombin time (PT) determined, and plasma fibrinogen, reptilase time (RT), and factor VIII activity examined. The similarity between the results for the present control animals and those recorded in the literature for human blood render OF1 mice a suitable study model. The differences in the studied coagulation variables were largely owed simply to sex. However, the females showed a very significant shortening of the PT time associated with ELF-MF exposure. Exposure also caused significant increases in the female APTT and RT values, and in general reduced the differences between the sexes.

Estimating the influence of the network topology on the agility of food supply chains

Several studies have shown that the performance of a supply chain is heavily influenced by the pattern of relationships among firms. This paper analyzes the structure of relationships (network topology) that leads to the highest agility of a food supply chain when sudden demand changes occur. To do this, a simulation model that represents a supply chain and specific rules to allocate orders is built. The supply chain in the model follows the specific characteristics of trade in the primary sector. The model is fitted to the conditions of a real seafood supply chain in Mexico. Agility is measured through the effect on the order fulfillment of a sudden demand shock and the recovery time of this rate to previous values. The simulation results show that the most suitable structure depends on how product is distributed among suppliers. If product is evenly shared, supply chains with homogeneous topologies are more agile than supply chains with heterogeneous topologies, but the result is the opposite if product is unevenly shared among suppliers. Other previous recommendations, such as having multiple suppliers and horizontal links, are confirmed by the simulations. These findings contribute to the general debate on which is the optimal topology for an agile supply chain.

Using radio astronomical receivers for molecular spectroscopic characterization in astrochemical laboratory simulations: A proof of concept

We present a proof of concept on the coupling of radio astronomical receivers and spectrometers with chemical reactors and the performances of the resulting setup for spectroscopy and chemical simulations in laboratory astrophysics. Several experiments including cold plasma generation and UV photochemistry were performed in a 40 cm long gas cell placed in the beam path of the Aries 40 m radio telescope receivers operating in the 41-49 GHz frequency range interfaced with fast Fourier transform spectrometers providing 2 GHz bandwidth and 38 kHz resolution. The impedance matching of the cell windows has been studied using different materials. The choice of the material and its thickness was critical to obtain a sensitivity identical to that of standard radio astronomical observations. Spectroscopic signals arising from very low partial pressures of CH₃OH, CH₃CH₂OH, HCOOH, OCS, CS, SO₂ (<10^-3 mbar) were detected in a few seconds. Fast data acquisition was achieved allowing for kinetic measurements in fragmentation experiments using electron impact or UV irradiation. Time evolution of chemical reactions involving OCS, O₂ and CS₂ was also observed demonstrating that reactive species, such as CS, can be maintained with high abundance in the gas phase during these experiments.

Social networks, market transactions, and reputation as a central resource. The Mercado del Mar, a fish market in central Mexico

Fish consumption in Mexico is considered low (around 12 kg per person per year) and non-homogeneously distributed across the country. One of the reasons for this situation is the scarcity of wholesale selling sites. In this context, the Mercado del Mar (MM), located in Guadalajara city, Jalisco, is the second biggest wholesale fish market in Mexico, with a distribution of about 500 tons per day and a variety of about 350 different species of fish. In this paper, we argue that MM has accumulated social capital, which is formed from two main resources: buyer and seller relationships, and reputation. Specifically, the MM manages a broad and intensive interaction among business actors and the already achieved reputation allows the MM to adapt to market changes. To validate our hypotheses, an empirical study was conducted in 2015 by means of interviews to fish wholesalers in the MM and a sample of their suppliers and buyers. For simplicity we have only considered fresh water fish. We have followed snow-ball sampling as the survey strategy. Results show that the MM has responded to fish market dynamics organizing a complex network of buyers and suppliers whose relationships can be explained in the form of strong and weak ties. At the same time, reputation has been the central resource to build this social capital and also gives place to market transactions. Additionally, the strategic position of Guadalajara city and the well-connected routes have facilitated fish bulking and distribution in the region.

Bence Jones proteinuria in smoldering multiple myeloma as a predictor marker of progression to symptomatic multiple myeloma

The diagnosis of smoldering multiple myeloma (SMM) includes patients with a heterogeneous risk of progression to active multiple myeloma (MM): some patients will never progress, whereas others will have a high risk of progression within the first 2 years. Therefore, it is important to improve risk assessment at diagnosis. We conducted a retrospective study in a large cohort of SMM patients, in order to investigate the role of Bence Jones (BJ) proteinuria at diagnosis in the progression to active MM. We found that SMM patients presenting with BJ proteinuria had a significantly shorter median time to progression (TTP) to MM compared with patients without BJ proteinuria (22 vs 88 months, respectively; hazard ratio=2.3, 95% confidence interval=1.4-3.9, P=0.002). We also identified risk subgroups based on the amount of BJ proteinuria: ⩾500 mg/24 h, <500 mg/24 h and without it, with a significantly different median TTP (13, 37 and 88 months, P<0.001). Thus, BJ proteinuria at diagnosis is an independent variable of progression to MM that identifies a subgroup of high-risk SMM patients (51% risk of progression at 2 years) and ⩾500 mg of BJ proteinuria may allow, if validated in another series, to reclassify these patients to MM requiring therapy before the end-organ damage development.

Bioeconomic analysis of the environmental impact of a marine fish farm

The evaluation of the environmental impact of aquaculture installations is nowadays a common social demand in many countries. The usual scientific approach to this question has been to assess the outcome from an ecological perspective, focussing on the effects produced on benthos or the water column and interactions with marine flora and fauna. In this paper, a bioeconomic model is developed to extend this traditional approach, to determine both the amount of total settled matter, its dispersion on the ocean floor and impacts on the marine ecosystem, while also taking into account other social considerations such as discounted net profits and investment returns. The model was applied to the case of off-shore gilthead seabream production in a coastal area of the Canary Isles archipelago, where the tidal current is predominant. Cage emissions and the degree of degradation of seagrass meadows on the seabed were taken as ecological impact indicators, while the net present value (NPV) for a specific time period was used as an economic indicator. By analysing the simulation results obtained by the bioeconomic model, we were able to determine the combination of production volume and harvest quantity which yields the greatest economic efficiency for different levels of degraded area.

Psychological modulation in patients surgically intervened for gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) has been related with certain psychological dimensions. The influence of mood, emotional intelligence, and perceived quality of life on clinical symptoms and outcome of antireflux surgery was evaluated in GERD patients with and without hiatal hernia. The study included 61 patients who were diagnosed with GERD between 2003 and 2008: 16 of them without hiatal hernia (group A) and 45 of them with hiatal hernia (group B). All of these patients had undergone laparoscopic antireflux surgery. Patients were clinically examined and evaluated with the following instruments: Short Form (SF)-36 Health Survey, Gastrointestinal Quality of Life Index, Hospital Anxiety and Depression (HAD) Scale, and Trait Meta-Mood Scale (TMMS)-24. Proportions were compared by using the chi-squared test; averages were compared by using the Student's t-test (with Bonferroni's correction). In general, our patients intervened for GERD showed results lower than normal or close to the lower limit of normal in the administered tests. Patients in the group without hernia were younger (P < 0.001) and with lower American Society of Anaesthesiologists risk. They showed higher scores in the SF-36 dimensions: Physical Functioning, Physical Role and Emotional Role, and lower scores in the Social Role (P < 0.001). They showed lower scores in the Emotional dimension of Gastrointestinal Quality of Life Index (P = 0.0068) and worse results in the Hospital Anxiety and Depression subscales of Anxiety (P < 0.001) and Depression (not significant). Men in the group without hernia showed higher scores than men in the group with hernia in the TMMS subscales corresponding to Emotional Clarity and Emotional Repair (P < 0.001). Women in the group with hernia showed higher scores than women in the group without hernia regarding Emotional Clarity (P = 0.0012). GERD patients showed poor results in all the tests, and patients without hiatal hernia compared with patients with hernia showed higher levels of anxiety, which interfered with their social life. Moreover, they showed lower tolerance to stress and higher frustration, fear, and worry. On the basis of such unfavorable phychoemotional results observed with GERD patients (especially those without hernia) in the different tests, we propose that improving our knowledge of the psychological profile of GERD patients - particularly those without hiatal hernia - could help in designing individualized medical and psychological therapies and increase success rates.

Vertical flow constructed wetlands: kinetics of nutrient and organic matter removal

The kinetics of organic matter and nutrient removal in a pilot vertical subsurface wetland with red ferralitic soil as substrate were evaluated. The wetland (20 m(2)) was planted with Cyperus alternifolius. The domestic wastewater that was treated in the wetland had undergone a primary treatment consisting of a septic moat and a buffer tank. From the sixth week of operation, the performance of the wetland stabilized, and a significant reduction in pollutant concentration of the effluent wastewater was obtained. Also a significant increase of dissolved oxygen (5 mg/l) was obtained. The organic matter removal efficiency was greater than 85% and the nutrient removal efficiency was greater than 75% in the vertical subsurface wetland. Nitrogen and biochemical oxygen demand (BOD) removal could be described by a first-order model. The kinetic constants were 3.64 and 3.27 d(-1) for BOD and for total nitrogen, respectively. Data on the removal of phosphorus were adapted to a second-order model. The kinetic constant was 0.96 (mg/l)(-1) d(-1). The results demonstrated the potential of vertical flow constructed wetlands to clean treated domestic wastewater before discharge into the environment.

[Carpal tunnel release with minimal incisions. Evaluation of the technique in fresh cadaver models]

OBJECTIVE

To assess the carpal tunnel release technique with minimal incisions, blindly, based on the portals of Chow's endoscopic technique in fresh cadaver models.

MATERIAL AND METHODS

From January 2007 to June 2009, 23 carpal tunnel releases were performed in fresh cadavers, using Chow's endoscopic portals. A malleable retractor and a fluted probe were introduced and the transverse carpal ligament was released with a retrograde scalpel from distal to proximal. We then meticulously dissected the palmar region and the anterior aspect of the forearm under magnification. We recorded the possible injuries to neurovascular and tendinous structures and whether the ligament release had been complete or incomplete, as well as the anatomical variants found. All the procedures were performed by the first author.

RESULTS

21 complete transverse carpal ligament releases were performed (91.3%). In two specimens the release of the thenar-hypothenar fascia was incomplete. We found the type I Lanz anatomical variant in one specimen and the type III in two. No associated neurovascular or tendinous injuries were reported.

FINAL REMARKS

Transverse carpal ligament blind release with minimal incisions should be taken with reservations. With proper training it may be a practical and low cost procedure for the treatment of carpal tunnel syn- drome in our hospital setting. It may be performed quickly, with minimal scars and may decrease the recovery time and the loss of grip strength.

Identification of a novel recurrent gain on 20q13 in chronic lymphocytic leukemia by array CGH and gene expression profiling

BACKGROUND

The presence of genetic changes is a hallmark of chronic lymphocytic leukemia (CLL). The most common cytogenetic abnormalities with independent prognostic significance in CLL are 13q14, ATM and TP53 deletions and trisomy 12. However, CLL displays a great genetic and biological heterogeneity. The aim of this study was to analyze the genomic imbalances in CLL cytogenetic subsets from both genomic and gene expression perspectives to identify new recurrent alterations.

PATIENTS AND METHODS

The genomic imbalances and expression levels of 67 patients were analyzed. The novel recurrent abnormalities detected with bacterial artificial chromosome array were confirmed by FISH and oligonucleotide microarrays. In all cases, gene expression profiling was assessed.

RESULTS

Copy number alterations were identified in 75% of cases. Overall, the results confirmed FISH studies for the regions frequently involved in CLL and also defined a new recurrent gain on chromosome 20q13.12, in 19% (13/67) of the CLL patients. Oligonucleotide expression correlated with the regions of loss or gain of genomic material, suggesting that the changes in gene expression are related to alterations in copy number.

CONCLUSION

Our study demonstrates the presence of a recurrent gain in 20q13.12 associated with overexpression of the genes located in this region, in CLL cytogenetic subgroups.

Three-dimensional magnetic resonance image of structures enclosed in the spinal canal relevant to anesthetists and estimation of the lumbosacral CSF volume

Three-dimensional (3D) image-reconstruction of structures inside the spinal canal certainly produces relevant data of interest in regional anesthesia. Nowadays, all hospital MRI equipment is designed mainly for clinical diagnostic purposes. In order to overcome the limitations we have produced more accurate images of structures contained inside the spinal canal using different software, validating our quantitative results with those obtained with standard hospital MRI equipment. Neuroanatomical 3D reconstruction using Amira software, including detailed manual edition was compared with semi-automatic 3D segmentation for CSF volume calculations by commonly available software linked to the MR equipment (MR hospital). Axial sections from seven patients were grouped in two aligned blocks (T1 Fast Field Eco 3D and T2 Balance Fast Field Eco 3D-resolution 0,65 x 0,65 x 0,65 mm, 130 mm length, 400 sections per case). T2 weighted was used for CSF volume estimations. The selected program allowed us to reconstruct 3D images of human vertebrae, dural sac, epidural fat, CSF and nerve roots. The CSF volume, including the amount contained inside nerve roots, was calculated. Different segmentation thresholds were used, but the CSF volume estimations showed high correlation between both teams (Pearson coefficient = 0.98, p = 0.003 for lower blocks; Pearson 0.89, p = 0.042 for upper blocks). The mean estimated value of CSF volume in lower blocks (L3-S1) was 15.8 + 2.9 ml (Amira software) and 13.1 +/- 1.9 ml (software linked to the MR equipment) and in upper blocks (T11-L2) was 21 +/- 4.47 ml and 18.9 +/- 3.5 ml, respectively. A high variability was detected among cases, without correlation with either weight, height or body mass index. Aspects concerning the partial volume effect are also discussed. Quick semi-automatic hospital 3D reconstructions give results close to detailed neuroanatomical 3D reconstruction and could be used in the future for individual quantification of lumbosacral CSF volumes and other structures for anesthetic purposes.

Effect of tumor resection on the characteristics of functional brain networks

Brain functioning such as cognitive performance depends on the functional interactions between brain areas, namely, the functional brain networks. The functional brain networks of a group of patients with brain tumors are measured before and after tumor resection. In this work, we perform a weighted network analysis to understand the effect of neurosurgery on the characteristics of functional brain networks. Statistically significant changes in network features have been discovered in the beta (13-30 Hz) band after neurosurgery: the link weight correlation around nodes and within triangles increases which implies improvement in local efficiency of information transfer and robustness; the clustering of high link weights in a subgraph becomes stronger, which enhances the global transport capability; and the decrease in the synchronization or virus spreading threshold, revealed by the increase in the largest eigenvalue of the adjacency matrix, which suggests again the improvement of information dissemination.

Deregulation of microRNA expression in the different genetic subtypes of multiple myeloma and correlation with gene expression profiling

Specific microRNA (miRNA) signatures have been associated with different cytogenetic subtypes in acute leukemias. This finding prompted us to investigate potential associations between genetic abnormalities in multiple myeloma (MM) and singular miRNA expression profiles. Moreover, global gene expression profiling was also analyzed to find correlated miRNA gene expression and select miRNA target genes that show such correlation. For this purpose, we analyzed the expression level of 365 miRNAs and the gene expression profiling in 60 newly diagnosed MM patients, selected to represent the most relevant recurrent genetic abnormalities. Supervised analysis showed significantly deregulated miRNAs in the different cytogenetic subtypes as compared with normal PC. It is interesting to note that miR-1 and miR-133a clustered on the same chromosomal loci, were specifically overexpressed in the cases with t(14;16). The analysis of the relationship between miRNA expression and their respective target genes showed a conserved inverse correlation between several miRNAs deregulated in MM cells and CCND2 expression level. These results illustrate, for the first time, that miRNA expression pattern in MM is associated with genetic abnormalities, and that the correlation of the expression profile of miRNA and their putative mRNA targets is useful to find statistically significant protein-coding genes in MM pathogenesis associated with changes in specific miRNAs.

Propagation of magnetic avalanches in Mn12Ac at high field sweep rates

Time-resolved measurements of the magnetization reversal in single crystals of Mn12Ac in pulsed magnetic fields, at magnetic field sweep rates from 1.5 kT/s up to 7 kT/s, suggest a new process that cannot be scaled onto a deflagrationlike propagation driven by heat diffusion. The sweep rate dependence of the propagation velocity, increasing from a few 100 m/s up to the speed of sound in Mn12Ac, indicates the existence of two new regimes at the highest sweep rates, with a transition around 4 kT/s that can be understood as a magnetic deflagration-to-detonation transition.

Low expression of ZHX2, but not RCBTB2 or RAN, is associated with poor outcome in multiple myeloma

RAN, ZHX2 and RCBTB2 (CHC1L) expression was evaluated by quantitative real time reverse transcription polymerase chain reaction in plasma cells from 85 monoclonal gammopathies: 58 symptomatic multiple myeloma (MM) (52 untreated, six relapsed), eight smouldering MM, five monoclonal gammopathy of undetermined significance, four plasma cell leukaemias and 10 myeloid cell lines. ZHX2 was weakly expressed in high-risk/proliferative disease compared to low-risk or indolent disease. High ZHX2 expression was associated with better response and longer survival after high-dose therapy. RCBTB2 expression was weaker in hyperdiploid versus non-hyperdiploid cases while RAN was more expressed in symptomatic MM and cell lines.

Gene expression profiling of B lymphocytes and plasma cells from Waldenström's macroglobulinemia: comparison with expression patterns of the same cell counterparts from chronic lymphocytic leukemia, multiple myeloma and normal individuals

The tumoral clone of Waldenström's macroglobulinemia (WM) shows a wide morphological heterogeneity, which ranges from B lymphocytes (BL) to plasma cells (PC). By means of genome-wide expression profiling we have been able to identify genes exclusively deregulated in BL and PC from WM, but with a similar expression pattern in their corresponding cell counterparts from chronic lymphocytic leukemia (CLL) and multiple myeloma (MM), as well as normal individuals. The differentially expressed genes have important functions in B-cell differentiation and oncogenesis. Thus, two of the genes downregulated in WM-BL were IL4R, which plays a relevant role in CLL B-cell survival, and BACH2, which participates in the development of class-switched PC. Interestingly, one of the upregulated genes in WM-BL was IL6. A set of four genes was able to discriminate clonal BL from WM and CLL: LEF1 (WNT/beta-catenin pathway), MARCKS, ATXN1 and FMOD. We also found deregulation of genes involved in plasma cell differentiation such as PAX5, which was overexpressed in WM-PC, and IRF4 and BLIMP1, which were underexpressed. In addition, three of the target genes activated by PAX5 - CD79, BLNK and SYK - were upregulated in WM-PC. In summary, these results indicate that both PC and BL from WM are genetically different from the MM and CLL cell counterpart.

Design and operation of SBR processes for small plants based on simulations

The paper firstly presents an experimental study in a SBR pilot plant operated at 20 degrees C for nitrogen removal from a very small village wastewater. The plant consisted of only one reactor fed continuously throughout the day and aerated intermittently. Two tests with seven and three intermittences of mixing/aerated phases were conducted and verification of the results by simulations of the activated sludge model (ASM) was also carried out. The experimental results and simulation showed that a wide range of effluent N03-N can be obtained using different numbers of intermittences and values of the oxygen transfer coefficient (K(L)a). At the same time, the paper presents a design procedure for SBR processes based on an iterative process of simulations of the ASM model. After the selection of the cycle time, the mixing/aeration pattern, the initial volume, the solid retention time, and the duration of the phases, the simulation is undertaken, resulting in values for the effluent NH4-N and NO3-N, and the suspended solids before settling. Then, the latter parameters are verified to match the effluent and settling requirements. As an application of the design procedure, the effect on design and operation of different SBR configurations and of several operating conditions are analysed in three case studies.

Prognostic and biological implications of genetic abnormalities in multiple myeloma undergoing autologous stem cell transplantation: t(4;14) is the most relevant adverse prognostic factor, whereas RB deletion as a unique abnormality is not associated with adverse prognosis

Fluorescence in situ hybridization (FISH) has become a powerful technique for prognostic assessment in multiple myeloma (MM). However, the existence of associations between cytogenetic abnormalities compels us to re-assess the value of each abnormality. A total of 260 patients with MM at the time of diagnosis, enrolled in the GEM-2000 Spanish transplant protocol, have been analyzed by FISH in order to ascertain the independent influence on myeloma prognosis of IGH translocations, as well as RB and P53 deletions. Survival analyses showed that patients with t(4;14), RB or P53 deletions had a significantly shorter survival than patients without these abnormalities. However, patients with RB deletions without other abnormalities in FISH analysis, displayed a similar outcome to those patients without genetic changes by FISH (46 vs 54 months, P=0.3). In the multivariate analysis the presence of t(4;14), RB deletion associated with other abnormalities, age >60 years, high proportion of S-phase cells and advanced stage of the disease according to the International Staging System retained their independent prognostic influence. In summary, RB deletion as a sole abnormality does not lead to a shortening in the survival of MM patients, whereas t(4;14) confers the worst prognosis in MM patients treated with high-dose chemotherapy.

[Good practice guidelines for the treatment of autistic spectrum disorders]

INTRODUCTION

Due to the inexistence of an aetiology-based intervention for autistic spectrum disorders (ASD) families and professionals are exposed to diverse and sometimes conflictive recommendations when they have to decide the most adequate alternative for treatment.

AIM

To elaborate treatment guidelines agreed by consensus at the ASD Study Group of the (National) Institute of Health Carlos III.

DEVELOPMENT

Information about treatment of ASD was searched and gathered through available evidence based medical (EBM) databases. The data generated was complemented with practice parameters published elsewhere, reports from prestigious international institutions, focus oriented searches in PubMed and, finally, the opinion and experience of a multidisciplinary Study Group with extensive experience in treating ASD in Spain. Most popular treatment methods were reviewed as well as the common elements to be considered in successful support programs.

CONCLUSION

No simple treatment algorithm can be produced at this time, and the level of available evidence based recommendations are in the weaker degrees of EBM classifications. Nevertheless, there is widespread agreement to stress that education, with special incidence in the development of communication and social competence, with the addition of community support are the main means of treatment. They can be complemented, depending on individual needs, with medication, behavioural approaches and cognitive-behavioural therapy for associated psychological problems in persons with higher cognitive level. Support to families and community empowerment are essential elements for the quality of life of persons with ASD.

Pegylated liposomal doxorubicin, melphalan and prednisone therapy for elderly patients with multiple myeloma

Melphalan & Prednisone (MP) is considered as the standard therapy for Multiple Myeloma (MM) patients not eligible for high-dose therapy. Here, we report the results of a phase I-II study to evaluate the feasibility and efficacy of the association of PLD to the conventional MP regimen during the first six cycles of the front-line therapy for untreated MM patients older than 70. Thirty patients were included in the study with a median age of 77 years (71-84) and a M/F ratio of 17/13. The phase I of the study demonstrated that the maximum tolerable dose of PLD in this setting was 30 mg/m(2), so it was the final dose evaluated in the study. Twenty-nine patients were valuable for response, which was: complete in 4 (14%) partial in 15 (52%) minor/no changes in 7 (24%) and progressive in 3 (10%). The median progression free survival (PFS) was 24 months. The median overall survival (OS) has not been reached yet, with a 3-year probability for OS and PFS of 52 and 37%, respectively. Haematological toxicity was frequent but usually weak/moderate (grades 1 & 2 of the WHO scale) and it was resolved only with dose delays. Infection was a relatively frequent event (30% of patients), but only in 4 cases it was of grade 3. No cases of palmar-plantar erythrodysesthesia were observed. In conclusion, pegylated liposomal doxorubicin can be safely added to the other chemotherapeutic drugs in the treatment of elderly MM patients, which can be very useful for patients in whom novel agents are not tolerated or inefficient.

Optical absorption and thermoluminescence in single NaCl:Cu crystals exposed to 60Co and UV light

Optical absorption (OA) and thermally stimulated luminescence measurements were performed on NaCl:Cu+(0.04 and 0.08%) crystals blocks grown by the Czochralski technique. The NaCl:Cu+ crystals were exposed to gamma rays from a 60Co source (0.954-30 kGy) as well as UV radiation. The radiation-induced defects were mainly F, Cu- and Cu+ centres, with absorption bands located at 464, 256.7 and 236 nm, respectively. The absorption bands were found to be independent of the Cu impurity concentration. As the gamma-dose irradiation increased, the absorption band at 256.7 nm decreased while the band at 236.3 nm increased highly along with the 256.7 nm band. The F-centres produced at high gamma-radiation dose while thermally bleached showed an increase of the Cu+ OA bands with a simultaneous decrease of Cu- absorption band. The bleaching with F-light showed the participation of the F centre generated by gamma radiation on the ion valence changes of the doping impurity as well as on the TL phenomenon. The TL measurements in NaCl:Cu crystals with both impurity concentrations demonstrated that the Cu+ concentration has a strong influence on the intensity and shape of the glow peaks.

Evaluation of diagnostic markers for measles virus infection in the context of an outbreak in Spain

A measles outbreak occurred from January to July 2003 in Spain, despite the fact that the Plan of Eradication of Measles and its surveillance program had been set up in 2001. Different diagnostic markers for measles virus infection were compared for 246 patients in tests of serum, urine, and pharyngeal exudate specimens. Measles virus immunoglobulin M (IgM) and IgG and rubella virus and parvovirus IgM levels in serum were assayed. Multiplex PCR was done on urine, serum, and pharyngeal exudates, and isolation of measles virus in the B 95 a cell line from urine was attempted. At least one positive marker for measles virus was obtained from 165 patients (67.1%; total number of patients, 246). A total of 136 cases (82.4% of the patients showing positive markers) were diagnosed by PCR and/or isolation and IgM detection methods. The results for 27 patients (16.4%) were positive only by direct methods. The results for two patients (1.2%) were positive only by IgM detection. In the case of the first group (136 cases), the time elapsed from appearance of the rash was significantly longer than in the case of the group which was only positive by PCR. Besides, 8 out of 27 PCR-positive IgM-negative cases showed specific IgG results, suggesting either secondary vaccine failure or reinfection. Numbers resulting from PCR performed with pharyngeal exudates proved to be significantly higher than those obtained with other specimens. Phylogenetic analysis showed the presence of genotype B3. The results strongly back the World Health Organization recommendation that detection of IgM should be supplemented by PCR and isolation for the diagnosis of measles virus infection.

Evaluation of the antitumor activity of interleukin-12 in an experimental murine model of colorectal cancer induced by 1,2 dimethyl-hydrazine (DMH)

OBJECTIVE

Interleukin 12 (IL-12) is a cytokine that may enhance the proliferation and cytotoxic activity of T lymphocytes and natural killer (NK) cells. A relationship between extensive intratumoral infiltration of NK cells and longer survival rates in colorectal cancer (CRC) patients was previously noted. Preliminary evidence suggests that the combined administration of IL-12 and IL-2 may produce additive immunomodulatory activity. The purpose of this study was to determine whether the systemic administration of IL-12 (+/- IL-2) may induce an immune response against CRC as induced by 1,2-dimethylhydrazine (DMH).

METHODS

Sixty-five 6-week-old Wistar rats were treated with weekly subcutaneous injections of DMH for 26 weeks at a dose of 20 mg/kg of body weight. Once tumoral induction was over, the animals were randomly allocated to one of three groups: I, control; II, intraperitoneal injections of IL-12; III, intraperitoneal injections of IL-12 combined with IL-2. At 30 weeks, all surviving animals were sacrificed. We studied the following parameters in each rat--number of tumors, size of tumors, and total tumoral volume. Tumor samples were studied using the monoclonal antibody CD 57 for the detection of NK cells. The extent of NK infiltration was classified as small, less than 50 NK cells/50 high-power field (HPF); moderate, 50 to 150 NK cells/50 HPF, and extensive, more than 150 NK cells/50 HPF.

RESULTS

Thirty-five rats died before completion of the carcinogen exposure, and 30 rats were randomized (10 each group). In group II, 2 animals died during treatment. All rats in groups I and III developed tumors, while in group II two rats (25%) were tumor-free. Moreover, only one rat in group II developed multiple neoplasms, in contrast with group I and group III, where six rats (60%) and seven rats (70%), respectively, had more than one tumor. We found statistically significant differences in the mean number of tumors found in group II when compared to group I (p = 0.028) and group III (p = 0.019). Other parameters measured, such as biggest tumor size and total tumoral volume were found to be lower in group II, although no statistical differences were found between groups. Only 10% of rats in group I showed moderated/extensive NK cell infiltration, vs. 60% of rats in group II (p = 0.077) and 70% in group III (p = 0.02).

CONCLUSION

The administration of DMH to rodents provides a reliable and consistent means of inducing CRC that may be suitable for the evaluation of anti-cancer therapies. Our findings suggest that IL-12 is effective against the development of experimental CRC. Its antineoplastic effect could be attributed to the stimulus of this cytokine on the intratumoral infiltration of NK cells.

F2-Isoprostanes in Kidney Transplant Patients: Relationship With Inflammatory Markers

This prospective study evaluated the relationship between inflammation and oxidative stress in a group of dialysis patients just before and 3 months after kidney transplantation and compared the results with a control group of healthy subjects. The oxidative stress markers determined were different F2-isoprostane isomers. The inflammatory markers included C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and pregnancy-associated plasma protein A. Forty-three patients were the study group and 50 healthy subjects from a hospital blood bank as controls. The results showed levels of inflammatory and oxidative stress markers to be higher in the dialysis patients than in the control group, although they improved following kidney transplantation. Finally, significant correlations were observed between F2-isoprostane isomers and inflammatory markers.

[Best practice guidelines for research in autistic spectrum disorders]

INTRODUCTION

Achieving a better knowledge of autism and other pervasive developmental disorders known as autistic spectrum disorders (ASD), poses a major scientific challenge. These disorders are some of the earliest and most severe psychopathological disorders in infancy; they include an heterogeneous group of conditions; its prevalence rate seems to be continually increasing and they generate a significant social impact.

AIMS AND DEVELOPMENT

Nowadays, there is a current international agreement on the general requirements to be fulfilled by research projects and the priority areas to be considered when developing ASD high quality research. In Spain, although there are some established research groups with broad experience and expertise in these disorders, public funding opportunities and research development are still scarce. For this reason, the Study Group of the Instituto de Salud Carlos III has generated by consensus some Good Practice Guidelines for Research in ASD.

CONCLUSIONS

After comparing priorities and recommendations from international reference documents with the results obtained after having carried out an exhaustive bibliographic revision of articles published in autism in the last 30 years by Spanish authors, methodological and ethical recommendations are established. Finally, structural deficiencies to be corrected and emerging research initiatives to be supported are identified.

[Best practice guidelines for the diagnosis of autistic spectrum disorders]

INTRODUCTION

The autism spectrum disorder (ASD) diagnostic process requires expertise both in the knowledge of autism as in teamwork strategies with different professionals, often working in different clinic services, and with parents.

AIM

To recommend a consensus diagnostic procedure for ASD, that has been designed by the Study Group of the Instituto de Salud Carlos III.

DEVELOPMENT

The reports emphasize the need to obtain a complete clinical history, covering personal, family and psychosocial antecedents; detailing the basic areas affected in ASD--social interaction, communication and restricted patterns of behaviour, activities and interests. Diagnostic tests to be used as a routine in all cases are described and analysed--including both psychoeducational and biomedical tests. Also, tests indicated in cases with suspected identifiable physical disorders are covered, as well as those medical tests to be used for research purposes only.

CONCLUSION

The diagnostic procedure requires the implementation of a coordinated interdisciplinary assessment strategy, that needs to ensure the participation of professionals from very different fields in active collaboration with the family. Their role culminates in the preparation and delivery of a personalized report. Every diagnostic procedure needs to be accompanied by an action plan that includes immediate support to the person with ASD, as well as information to the family on resources and community initiatives in their living area.

[Best practice guidelines for the early detection of Autistic Spectrum Disorders (I)]

INTRODUCTION

The interest in early detection of Autism Spectrum Disorders (ASD) lies in the accumulated evidence of the fact that an early customized intervention for children with an ASD and their families leads to an improvement of the child's prognosis in most cases.

OBJECTIVE

To establish criteria and procedures for early identification of children at risk of ASD and to facilitate full diagnostic assessment and prompt referral leading to adequate support. Early detection of ASD is extremely important, since early specific individualized treatment for the child and his or her family leads to long-term improvement in many children' prognosis.

DEVELOPMENT

Firstly, a critical appraisal of the situation of early detection of ASD in Spain is made after reviewing the scarce bibliography available on current screening and diagnostic practices in the country. Data generated by questionnaires received from 646 Spanish families is also taken into account. Secondly, the Study Group of the Instituto de Salud Carlos III recommends the screening and early diagnosis process to be followed, describing the necessary steps, the public services involved and the available screening and diagnostic tools.

CONCLUSIONS

The Study Group draws the main conclusions regarding the situation of ASD early detection in Spain, and makes a consensus proposal for the detection procedures, including routine developmental surveillance and identification of children at risk for ASD by using sensitive and specific assessment tools.

Gene expression profile reveals deregulation of genes with relevant functions in the different subclasses of acute myeloid leukemia

Bone marrow samples from 43 adult patients with de novo diagnosed acute myeloid leukemia (AML)--10 acute promyelocytic leukemias (APL) with t(15;17), four AML with inv(16), seven monocytic leukemias and 22 nonmonocytic leukemias--were analyzed using high-density oligonucleotide microarrays. Hierarchical clustering analysis segregated APL, AML with inv(16), monocytic leukemias and the remaining AML into separate groups. A set of only 21 genes was able to assign AML to one of these three classes: APL, inv(16) and other AML subtype without a specific translocation. Quantitative RT-PCR performed for 18 out of these predictor genes confirmed microarray results. APL expressed high levels of FGF13 and FGFR1 as well as two potent angiogenic factors, HGF and VEGF. AML with inv(16) showed an upregulation of MYH11 and a downregulation of a gene encoding a core-binding factor protein, RUNX3. Genes involved in cell adhesion represented the most altered functional category in monocytic leukemias. Two major groups emerged from the remaining 22 AML: cluster A with 10 samples and cluster B with 12. All the eight leukemias that were either refractory to treatment or that relapsed afterwards were assigned to cluster B. In the latter cluster, CD34 upregulation and serine proteases downregulation is consistent with a maturation arrest and lack of granulocytic differentiation.

An analysis of postnatal growth in OF1 mice within an interval of 1-220 days of age

The body weight growth of OF1 mice, both females and males, from day of birth to 220 days old is studied herein. After comparison of different theoretical models, an extension of Koops's multiphasic functions, the tetraphasic, is proposed as the best choice in so wide a time interval in mouse development. This function has allowed us to take into account different aspects of growth. Coefficients and phases of this function are characterized. The end of the first phase was established at 17 days of age. The second phase finished at 35 days of age in females and at 39 days in males. This difference increased during the third phase: the end of it was at 173 days of age in males, and at 160 days in females. The end of the fourth phase in OF1 mice would be produced after 220 days of age. Inflexion points in every four phases, in females and males, are situated. The biggest weight increase occurred in the second phase in both sexes, specially in males (1.26 g per day). Biological meanings of every phase are also discussed. The short lifetime of rodents have allowed us to study a great number of growth phases in a short period of time. Thus the present analysis could be a good starting point for the study of growth curves in other species of mammals.

Limits for the central production of Theta+ and Xi(--)pentaquarks in 920-GeV pA collisions

We have searched for Theta+(1540) and Xi(--)(1862) pentaquark candidates in proton-induced reactions on C, Ti, and W targets at midrapidity and square root of s = 41.6 GeV. In 2 x 10(8) inelastic events we find no evidence for narrow (sigma approximately 5 MeV) signals in the Theta+ --> pK0(S) and Xi(--) --> Xi- pi- channels; our 95% C.L. upper limits (UL) for the inclusive production cross section times branching fraction B dsigma/dy/(y approximately 0) are (4-16) mub/N for a Theta+ mass between 1521 and 1555 MeV, and 2.5 mub/N for the Xi(--). The UL of the yield ratio of Theta+/Lambda(1520) < (3-12)% is significantly lower than model predictions. Our UL of B Xi(--)/Xi(1530)0 < 4% is at variance with the results that have provided the first evidence for the Xi(--).

Randomized comparison of dexamethasone combined with melphalan versus melphalan with prednisone in the treatment of elderly patients with multiple myeloma

Melphalan-prednisone (MP) has been the gold standard treatment for more than 30 years in elderly multiple myeloma (MM) patients. In order to assess whether the combination of dexamethasone with melphalan (MD) could improve on the efficacy of MP, we have carried out a randomized trial comparing both treatment approaches. A total of 201 patients >/=70 years old were included in the study. The overall response rate was similar after six cycles (MP: 67.9%versus MD: 64.5%) and after 12 cycles (MP: 49.4%versus MD: 46.1%). However, the proportion of complete responses (CR) was higher in the MD arm, particularly after 12 cycles (MD: 22.4%versus MP: 9.1%; P < 0.05). There was no significant difference in event-free survival (MP: 15.9 months versus MD: 23.3 months). The median overall survival in both arms was almost identical (MP: 29.4 months versus MD: 27.2 months; P = 0.63). No significant differences in haematological toxicity were observed, but non-haematological toxicity was significantly higher in the MD arm. According to these results MP remains as the gold standard for treatment of MM and should be the reference for comparison of new therapeutic approaches involving novel agents.

Proliferative activity of plasma cells is the most relevant prognostic factor in elderly multiple myeloma patients

Although multiple myeloma (MM) is predominantly a disease of the elderly, few studies have focused on the identification of prognostic factors in this group of patients. Four hundred twenty five MM patients >65 years were uniformly treated with chemotherapy (MP or VCMP/VBAD). Multivariate analysis identified 4 factors with independent unfavorable prognostic influence: high percentage of S-phase bone marrow plasma cells (>2.5%); elevated beta(2) microglobulin (B2M) (>4 mg/L); age >80 years old; and LDH serum levels (above normal limit). The S-phase value was the most powerful independent prognostic factor to discriminate subgroups of patients with different prognosis. Thus, 3 main risk categories could be identified according to S-phase values: </=1%, 1-3% and >3%, with median survivals of 34, 22 and 12 months, respectively (p < 0.0001). Our study also proved the value for elderly patients of the recently developed International Score System (ISS) based on B2M and albumin. Furthermore, the number of S-phase cells helped to subdivide the ISS III Group identifying a subset of patients with very poor prognosis defined by an additional high S-phase, who displayed a median survival of only 8 months. These results demonstrate that elderly patients can be accurately classified according to prognosis, which may be particularly valuable when comparing the efficacy of new treatment strategies. Moreover, our results underline the high prognostic value of proliferative activity of PC, a parameter that should be considered in routine laboratory investigations of MM.

The oral combination of thalidomide, cyclophosphamide and dexamethasone (ThaCyDex) is effective in relapsed/refractory multiple myeloma

We evaluate the efficacy of the oral combination of thalidomide, cyclophosphamide and dexamethasone (ThaCyDex) in 71 refractory/relapsed multiple myeloma patients, including a prognostic analysis to predict both response and survival. Patients received thalidomide at escalating doses (200-800 mg/day), daily cyclophosphamide (50 mg/day) and pulsed dexamethasone (40 mg/day, 4 days every 3 weeks). On an intention-to-treat basis and using the EBMT response criteria, 2% patients reached complete response (CR), 55% partial response (PR) and 26% minor response (MR) yielding a total response (CR+PR+MR) rate of 83% after 3 months of therapy. After 6 months of therapy, responses were maintained including a 10% CR. The 2-year progression free and overall survival were 57 and 66%, respectively. A favorable response was associated with beta2 microglobulin < or =4 mg/dl, platelets >80 x 10(9)/l and nonrefractory disease. Regarding survival, low beta2 microglobulin (< or =4 mg/dl), age (< or =65 years) and absence of extramedullary myelomatous lesion were associated with a longer survival. Major adverse effects included constipation (24%), somnolence (18%), fatigue (17%) and infection (13%). Only 7% of patients developed a thrombo-embolic event. ThaCyDex is an oral regimen that induces a high response rate and long remissions, particularly in relapsing patients with beta2 microglobulin < or =4 mg/dl and < or =65 years.

Hysteroscopic myomectomy: our experience and review

OBJECTIVE

To analyze the results of hysteroscopic myomectomy in our center and to compare the results to those published in the literature.

METHODS

We performed a retrospective study of the clinical histories of patients who had undergone hysteroscopic myomectomy with a resectoscope between January 1992 and December 1999. Procedures were performed at a hysteroscopic clinic in the Department of Obstetrics and Gynecology at the University Public Hospital in Madrid's south zone. One hundred twenty pre-, peri-, and postmenopausal women with submucous myomas were included in the study. All patients underwent hysteroscopic resection with a monopolar loop.

RESULTS

We performed 120 hysteroscopic myomectomies. The patients' median age was 44.8 years (23 to 74). Abnormal uterine bleeding (AUB) was the most frequent indication (84.1%). Inability to reproduce was the indication in 14 (11.6%) cases. GnRH analogue preparation was used in 60% of cases. We operated on 52 (43.3%) type 0, 51 (42.5%) type I, and 17 (14.1%) type II myomas, according to Wamsteker and Blok classification. A median of 32.5 (10 to 105) minutes was required for the interventions. The myomectomy was combined with another operation (12 polypectomies, 24 endometrial resections, and 1 laparoscopic ovarian cystectomy) in 32 patients. The median retention of glycemia was 281 cc (0 to 1300). We could not complete the resection in 22 patients. Twelve underwent reoperation (3 hysterectomies and 9 second myomectomies). No serious complications occurred, and the median hospital stay was 25.4 hours. The histological study confirmed leiomyoma in all the cases. The intervention results were satisfactory after a follow-up period of 12 months to 7 years, AUB being controlled in 88.5% of the patients.

CONCLUSION

Hysteroscopic myomectomy is a reliable procedure that is effective in controlling abnormal uterine bleeding. It is a good alternative to hysterectomy and has an acceptable surgical time and minimum hospital stay. To reduce the need of reintervention, appropriate patient selection and improved technique are necessary. The technique also offers significant economic savings compared with the conventional surgical methods.

Estimated risk of transfusion-transmitted viral infections in Spain

BACKGROUND

Estimates of the risk of transfusion-transmitted viral infections are essential for monitoring the safety of the blood supply. The aim of the present study was to estimate the residual risk of blood-borne viral infections in Spain.

STUDY DESIGN AND METHODS

Incidence rates of seroconversion for HIV, HBV, and HCV were calculated among 673,018 persons who donated blood more than once (repeat donors), from 1997 through 1999 at 22 blood donation centers (for a total of 2,464,964 allogeneic blood donations and 1,052,752 person-years).

RESULTS

Incidence rates per 100,000 person-years and their 95-percent CIs were as follows: for HBV, 8.36 (5.24-12.62); for HIV, 3.23 (2.24-4.52); and for HCV, 3.70 (2.63-5.07). After adjusting incidence rates for the estimated duration of the infectious window period for each virus, the residual risk per unit transfused was estimated at 1 in 513,000 for HIV, 1 in 74,000 for HBV, and 1 in 149,000 for HCV. The introduction of new screening test based on NAT would have reduced these risks by 27 to 50 percent for HIV, by 42 percent for HBV, and by 62 to 65 percent for HCV.

CONCLUSION

The residual risks of transmission of HIV, HBV, and HCV in Spain are similar to those reported in other countries and should be further reduced in the future.

Tight junctions are sensitive to peptides eliminated in the urine

We prepare an extract of dog urine (DLU) that, when applied to monolayers of MDCK cells (epithelial, derived from a normal dog), enhances the transepithelial electrical resistance (TER) in a dose-dependent manner. This increase is not reflected in variations of the linear amount of TJ nor in changes of the pattern of junctional strands as observed in freeze fracture replicas, nor in the distribution of claudin 1 (a membrane protein of the TJ) nor ZO-1 (a TJ-associated protein). A preliminary characterization of the active component of DLU indicates that it weighs 30-50 kDa, bears a net negative electric charge, and is destroyed by type I protease but not by 10-min boiling. DLUs prepared from human, dog, rabbit and cat are effective on MDCK cells. However, dog DLU increases TER in MDCK (dog) as well as LLCPK1 (pig) monolayers, but not in other epithelial cell lines such as LLCRK1 (rabbit), PTK2 (kangaroo) and MA-104 (monkey), nor in the endothelial cell line CPA47 (cow). Given that in its transit from the glomerulus to the urinary bladder the filtrate increases its concentration by more than two orders of magnitude, the substance(s) we report may act at increasingly higher concentrations in each segment, and afford a potential clue to the progressive increase of TER across the walls of the nephron from the proximal to the collecting duct.

Recognition of carbohydrate epitopes specific for electron-dense granule antigens from Entamoeba histolytica by monoclonal antibodies in the cecal content of infected hamsters

The pathogenic trophozoites of Entamoeba histolytica produce and secrete electron-dense granules (EDG) containing collagenase, considered a virulence factor. Two monoclonal antibodies (MAbs) (L7.1 and L1.1) anti-EDG antigens were raised. MAb L7.1 has been reported to recognize proteic EDG antigens and MAb L1.1 reacted with a carbohydrate epitope. These epitopes were present in axenic and xenic amoebas. To detect EDG antigens by a enzyme-linked immunosorbent assay (ELISA) in a experimental model of early intestinal amoebiasis, both MAbs were employed. E. histolytica HM1 axenic and monoxenic trophozoites were inoculated into the cecum according to the washed-closed cecal loop technique. The cecal content was recovered at 8, 24, and 48 h post-inoculation. Antigens from EDG in whole trophozoites and cell-free supernatants were detected. Our results indicate that it is possible to detect EDG antigens in the cecal content of hamsters in the early phase of the invasive amoebiasis.

[Registry of the Activity of the Section of Hemodynamics and Interventional Cardiology of the Spanish Society of Cardiology for the year 2000]

The results of the Registry of the Working Group on Hemodynamics and Interventional Cardiology of the Spanish Society of Cardiology for 2000 are presented. Date came from 100 centers representing all the cardiac catheterization laboratories in Spain; 93 centers performed mainly adult catheterization and 7 carried out only pediatric procedures. In 2000, 88,339 diagnostic catheterization procedures were performed (73,382 coronary angiograms), representing a total increase of 12.5% over 1999. The population-adjusted rate was 1,825 coronary angiograms per 106 inhabitants. With a total of 26,993 procedures and a rate of coronary interventions per 106 inhabitants of 671, coronary intervention increased by 17% over figures for 1999. Coronary stents were the devices used most often, with 29,504 implanted in 2000; stenting accounted for 77.2% of procedures, a 30.5% increase over 1999. The increase in direct stenting without predilatation was noteworthy. Direct stenting was done in 8,778 procedures (38.9% of the total), an increase of 131% compared to 1999. IIb-IIIa glycoprotein were used in 4,700 coronary interventions (17%). Angioplasty, performed in 3,128 cases of acute myocardial infarction, accounted for 11.6% of coronary interventions 33.5% more than in 1999. A decrease of 6.5% in valvuloplastics occurred, attributable to the performance of fewer mitral valve repairs (493 vs 525 in 2000 and 1999, respectively). Pediatric procedures increased by 20.5%, from 678 to 817 cases. In conclusion, we would like to underline the high rate of reporting by laboratories, through which the Registry has been able to compile data that are highly representative of the hemodynamic activity in Spain.

Progression to large B-cell lymphoma in splenic marginal zone lymphoma: a description of a series of 12 cases

Splenic marginal zone lymphoma (SMZL) is considered to be an indolent extranodal B-cell lymphoma. Despite its low aggressivity, histologic progression has been described in sporadic reports, although the frequency, characteristics, and underlying molecular abnormalities of this phenomenon are largely unknown. We review here the clinical, morphologic, immunohistochemical, and molecular features of a series of 12 SMZL cases that showed progression to large B-cell lymphoma (LBCL). The most frequent location of secondary LBCL was in peripheral lymph node. This occurred between 12 and 85 months after diagnosis of SMZL. However, in two cases LBCL was diagnosed at the initial stage of the disease (one spleen tumoral nodule and one hilar lymph node). The histologic and immunophenotypic features of these cases were similar to those of transformed LBCL at other sites. In four cases the immunoglobulin heavy chain gene polymerase chain study revealed the same rearrangement pattern in both primary and secondary tumors, thereby confirming their identity and excluding the possibility of a second malignancy. As is the case with other low-grade lymphoproliferative disorders, SMZL may undergo high-grade transformation. These 12 cases represent 13% of our series of SMZL with adequate follow-up. The incidence of large cell transformation in SMZL seems to be lower than in follicular lymphoma (25-60%) and mantle cell lymphoma (11-39%), although it is similar to the frequency of transformation in B-chronic lymphocytic lymphoma/small lymphocytic lymphoma (1-10%). The mean proliferative index (MIB1 staining) in initial SMZL specimens of cases with LBCL transformation was 28.6%, higher than that of MIB1 staining in the overall SMZL series (21.8%), although not statistically significantly so. p53 or p16INK4a inactivation in this series was observed in only one case, in contrast with the situation observed in chronic lymphocytic leukemia, follicular lymphoma, and mantle cell lymphoma. It seems that progression in SMZL is mainly independent of p53 or p16INK4a inactivation. The frequency of the 7q deletion in this series was 3 of 7 (42%). 7q loss may play an alternative role in the inactivation of the p53 and p16INK4a pathway, thereby favoring tumoral progression.

Onset of tuberculosis disease: new converters in long-term care settings

Elders living in communal settings, such as nursing homes or other types of long-term care facilities have a tuberculosis (TB) incidence rate of 39.2 per 1,000, nearly four times the rate of TB in the general population. This fact mandates routine screening, reporting, and strict follow-up of TB in long-term care facilities as well as recognizing and addressing barriers to worker and resident protection. As healthcare in this country evolves from acute care facilities to alternative ambulatory care settings, the focus for infection control personnel is to develop effective TB control plans appropriate to the care setting using current clinical guidelines set forth by the Centers for Disease Control and Prevention (CDC) or other agencies, the main goal of which is to reduce the number of infections and exposures to this disease. As the incidence of TB continues in long-term care settings, away from acute care facilities, public health officials, administrators, and infection control personnel need to develop TB control plans, risk assessment procedures, and appropriate follow-up on positive converters among the workers and the residents. The case study presented herein is a good example of an individual being offered a screening test for an infectious airborne disease and positive test results being disregarded.