Residential exposure to traffic pollution and mammographic density in premenopausal women

BACKGROUND

Mammographic density (MD) is the most important breast cancer biomarker. Ambient pollution is a carcinogen, and its relationship with MD is unclear. This study aims to explore the association between exposure to traffic pollution and MD in premenopausal women.

METHODOLOGY

This Spanish cross-sectional study involved 769 women attending gynecological examinations in Madrid. Annual Average Daily Traffic (AADT), extracted from 1944 measurement road points provided by the City Council of Madrid, was weighted by distances (d) between road points and women's addresses to develop a Weighted Traffic Exposure Index (WTEI). Three methods were employed: method-1 (1dAADT), method-2 (1dAADT), and method-3 (e1dAADT). Multiple linear regression models, considering both log-transformed percentage of MD and untransformed MD, were used to estimate MD differences by WTEI quartiles, through two strategies: "exposed (exposure buffers between 50 and 200 m) vs. not exposed (>200 m)"; and "degree of traffic exposure".

RESULTS

Results showed no association between MD and traffic pollution according to buffers of exposure to the WTEI (first strategy) for the three methods. The highest reductions in MD, although not statistically significant, were detected in the quartile with the highest traffic exposure. For instance, method-3 revealed a suggestive inverse trend (eβQ1 = 1.23, eβQ2 = 0.96, eβQ3 = 0.85, eβQ4 = 0.85, p-trend = 0.099) in the case of 75 m buffer. Similar non-statistically significant trends were observed with Methods-1 and -2. When we examined the effect of traffic exposure considering all the 1944 measurement road points in every participant (second strategy), results showed no association for any of the three methods. A slightly decreased MD, although not significant, was observed only in the quartile with the highest traffic exposure: eβQ4 = 0.98 (method-1), and eβQ4 = 0.95 (methods-2 and -3).

CONCLUSIONS

Our results showed no association between exposure to traffic pollution and MD in premenopausal women. Further research is needed to validate these findings.

Nigrostriatal blood-brain barrier opening in Parkinson's disease

BACKGROUND

The nigrostriatal system is especially vulnerable to neurodegeneration in Parkinson's disease (PD) and the blood-brain barrier (BBB) is a limiting factor for delivery of therapeutic agents to the brain. This pilot study aimed to demonstrate safety, feasibility and tissue penetration (by 18F-Choline-positron emission tomography (PET)) of MR-guided focused ultrasound (MRgFUS) simultaneous BBB opening (BBB-O) in the substantia nigra (SN) and putamen in PD.

METHODS

Three patients underwent MRgFUS for midbrain and putamen BBB-O. Patients were evaluated clinically and underwent brain MRI with gadolinium (baseline, 24 hours, 14 days and 3 months postprocedure). In two patients, BBB-O was repeated after 2-3 weeks, and 18F-Choline-PET was performed immediately after.

RESULTS

The right SN and putamen were simultaneously opened unilaterally in 3 patients once and the left SN in 1 patient in a different session. No severe clinical or neuroimaging adverse events developed in any patient. 18F-Choline-PET uptake was enhanced in the targeted SN and putamen regions.

CONCLUSION

BBB-O of the nigrostriatal system is a feasible and well-tolerated approach in patients with PD. 18F-Choline-PET uptake indicates penetration into the parenchyma after BBB-O, which suggests that the opening is functionally effective. This minimally invasive technique could facilitate delivery of putative neurorestorative molecules to brain regions vulnerable to neurodegeneration.

Mammographic density in the environs of multiple industrial sources

BACKGROUND

Mammographic density (MD), defined as the percentage of dense fibroglandular tissue in the breast, is a modifiable marker of the risk of developing breast cancer. Our objective was to evaluate the effect of residential proximity to an increasing number of industrial sources in MD.

METHODS

A cross-sectional study was conducted on 1225 premenopausal women participating in the DDM-Madrid study. We calculated distances between women's houses and industries. The association between MD and proximity to an increasing number of industrial facilities and industrial clusters was explored using multiple linear regression models.

RESULTS

We found a positive linear trend between MD and proximity to an increasing number of industrial sources for all industries, at distances of 1.5 km (p-trend = 0.055) and 2 km (p-trend = 0.083). Moreover, 62 specific industrial clusters were analyzed, highlighting the significant associations found between MD and proximity to the following 6 industrial clusters: cluster 10 and women living at ≤1.5 km (β = 10.78, 95 % confidence interval (95%CI) = 1.59; 19.97) and at ≤2 km (β = 7.96, 95%CI = 0.21; 15.70); cluster 18 and women residing at ≤3 km (β = 8.48, 95%CI = 0.01; 16.96); cluster 19 and women living at ≤3 km (β = 15.72, 95%CI = 1.96; 29.49); cluster 20 and women living at ≤3 km (β = 16.95, 95%CI = 2.90; 31.00); cluster 48 and women residing at ≤3 km (β = 15.86, 95%CI = 3.95; 27.77); and cluster 52 and women living at ≤2.5 km (β = 11.09, 95%CI = 0.12; 22.05). These clusters include the following industrial activities: surface treatment of metals/plastic, surface treatment using organic solvents, production/processing of metals, recycling of animal waste, hazardous waste, urban waste-water treatment plants, inorganic chemical industry, cement and lime, galvanization, and food/beverage sector.

CONCLUSIONS

Our results suggest that women living in the proximity to an increasing number of industrial sources and those near certain types of industrial clusters have higher MD.

Developmental Ultrasound Characteristics in Guinea Pigs: Similarities with Human Pregnancy

BACKGROUND

Biometrical and blood flow examinations are fundamental for assessing fetoplacental development during pregnancy. Guinea pigs have been proposed as a good model to study fetal development and related gestational complications; however, longitudinal growth and blood flow changes in utero have not been properly described. This study aimed to describe fetal and placental growth and blood flow of the main intrauterine vascular beds across normal guinea pig pregnancy and to discuss the relevance of this data for human pregnancy.

METHODS

Pregnant guinea pigs were studied from day 25 of pregnancy until term (day ~70) by ultrasound and Doppler assessment. The results were compared to human data from the literature.

RESULTS

Measurements of biparietal diameter (BPD), cranial circumference (CC), abdominal circumference, and placental biometry, as well as pulsatility index determination of umbilical artery, middle cerebral artery (MCA), and cerebroplacental ratio (CPR), were feasible to determine across pregnancy, and they could be adjusted to linear or nonlinear functions. In addition, several of these parameters showed a high correlation coefficient and could be used to assess gestational age in guinea pigs. We further compared these data to ultrasound variables from human pregnancy with high similarities.

CONCLUSIONS

BPD and CC are the most reliable measurements to assess fetal growth in guinea pigs. Furthermore, this is the first report in which the MCA pulsatility index and CPR are described across guinea pig gestation. The guinea pig is a valuable model to assess fetal growth and blood flow distribution, variables that are comparable with human pregnancy.

Residential proximity to industrial pollution and mammographic density

BACKGROUND

Mammographic density (MD), expressed as percentage of fibroglandular breast tissue, is an important risk factor for breast cancer. Our objective is to investigate the relationship between MD and residential proximity to pollutant industries in premenopausal Spanish women.

METHODS

A cross-sectional study was carried out in a sample of 1225 women extracted from the DDM-Madrid study. Multiple linear regression models were used to assess the association of MD percentage (and their 95% confidence intervals (95%CIs)) and proximity (between 1 km and 3 km) to industries included in the European Pollutant Release and Transfer Register.

RESULTS

Although no association was found between MD and distance to all industries as a whole, several industrial sectors showed significant association for some distances: "surface treatment of metals and plastic" (β = 4.98, 95%CI = (0.85; 9.12) at ≤1.5 km, and β = 3.00, 95%CI = (0.26; 5.73) at ≤2.5 km), "organic chemical industry" (β = 6.73, 95%CI = (0.50; 12.97) at ≤1.5 km), "pharmaceutical products" (β = 4.14, 95%CI = (0.58; 7.70) at ≤2 km; β = 3.55, 95%CI = (0.49; 6.60) at ≤2.5 km; and β = 3.11, 95%CI = (0.20; 6.01) at ≤3 km), and "urban waste-water treatment plants" (β = 8.06, 95%CI = (0.82; 15.30) at ≤1 km; β = 5.28; 95%CI = (0.49; 10.06) at ≤1.5 km; β = 4.30, 95%CI = (0.03; 8.57) at ≤2 km; β = 5.26, 95%CI = (1.83; 8.68) at ≤2.5 km; and β = 3.19, 95%CI = (0.46; 5.92) at ≤3 km). Moreover, significant increased MD was observed in women close to industries releasing specific pollutants: ammonia (β = 4.55, 95%CI = (0.26; 8.83) at ≤1.5 km; and β = 3.81, 95%CI = (0.49; 7.14) at ≤2 km), dichloromethane (β = 3.86, 95%CI = (0.00; 7.71) at ≤2 km), ethylbenzene (β = 8.96, 95%CI = (0.57; 17.35) at ≤3 km), and phenols (β = 2.60, 95%CI = (0.21; 5.00) at ≤2.5 km).

CONCLUSIONS

Our results suggest no statistically significant relationship between MD and proximity to industries as a whole, although we detected associations with various industrial sectors and some specific pollutants, which suggests that MD could have a mediating role in breast carcinogenesis.

Occupation, occupational exposures and mammographic density in Spanish women

INTRODUCTION

Mammographic density (MD), the proportion of radiologically dense breast tissue, is a strong risk factor for breast cancer. Our objective is to investigate the influence of occupations and occupational exposure to physical, chemical, and microbiological agents on MD in Spanish premenopausal women.

METHODS

This is a cross-sectional study based on 1362 premenopausal workers, aged 39-50, who attended a gynecological screening in a breast radiodiagnosis unit of Madrid City Council. The work history was compiled through a personal interview. Exposure to occupational agents was evaluated using the Spanish job-exposure matrix MatEmESp. MD percentage was assessed using the validated semi-automated computer tool DM-Scan. The association between occupation, occupational exposures, and MD was quantified using multiple linear regression models, adjusted for age, educational level, body mass index, parity, previous breast biopsies, family history of breast cancer, energy intake, use of oral contraceptives, smoking, and alcohol consumption.

RESULTS

Although no occupation was statistically significantly associated with MD, a borderline significant inverse association was mainly observed in orchard, greenhouse, nursery, and garden workers (β = -6.60; 95% confidence interval (95%CI) = -14.27; 1.07) and information and communication technology technicians (β = -7.27; 95%CI = -15.37; 0.84). On the contrary, a positive association was found among technicians in art galleries, museums, and libraries (β = 8.47; 95%CI = -0.65; 17.60). Women occupationally exposed to fungicides, herbicides, and insecticides tended to have lower MD. The percentage of density decreased by almost 2% for every 5 years spent in occupations exposed to the mentioned agents.

CONCLUSIONS

Although our findings point to a lack of association with the occupations and exposures analyzed, this study supports a deeper exploration of the role of certain occupational agents in MD, such as pesticides.

Mortality in Elderly Waiting-List Patients Versus Age-Matched Kidney Transplant Recipients: Where is the Risk?

The number of elderly patients on the waiting list (WL) for kidney transplantation (KT) has risen significantly in recent years. Because KT offers a better survival than dialysis therapy, even in the elderly, candidates for KT should be selected carefully, particularly in older waitlisted patients. Identification of risk factors for death in WL patients and prediction of both perioperative risk and long-term post-transplant mortality are crucial for the proper allocation of organs and the clinical management of these patients in order to decrease mortality, both while on the WL and after KT. In this review, we examine the clinical results in studies concerning: a) risk factors for mortality in WL patients and KT recipients; 2) the benefits and risks of performing KT in the elderly, comparing survival between patients on the WL and KT recipients; and 3) clinical tools that should be used to assess the perioperative risk of mortality and predict long-term post-transplant survival. The acknowledgment of these concerns could contribute to better management of high-risk patients and prophylactic interventions to prolong survival in this particular population, provided a higher mortality is assumed.

Amylases and Hemicellulases in Breadmaking. Degradation By-Products and Potential Relationship with Functionality

Eleven commercial enzyme preparations, based on pentosanase and/or amylase activities, were added to wheat doughs and were processed to bread. Changes in free sugars, maltodextrins and carbohydrate polymer degradation—starch and pentosans—during fermentation, baking and storage are reported, and their possible relationship to functional properties is evaluated. The main activity of preparations was endo-type, although some arabinosidase action was present, even in•-amylases without other declared activity. Dextrinogenic (low molecular weight) properties of•-amylases depended on the source, and within the same manufacturer, on the enzyme characteristics. The majority of preparations solubilized part of pentosans, changes consistent with reported enzyme composition. Storage of breads induced variations in soluble starch and solids, which were affected by the enzymes. Some low molecular weight dextrins correlated with fresh bread properties, favored crumb and starch solubilization and did not induce changes in texture during storage, whereas water-insoluble pentosans correlated with crumb elasticity and hardness during storage.

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.

Cardiovascular risk in recipients with kidney transplants from expanded criteria donors

INTRODUCTION

Posttransplant cardiovascular disease (CVD) is the leading cause of death in renal transplant (RT) recipients and is more evident in recipients with transplants from expanded criteria donors (ECD).

OBJECTIVES

We analyzed the evolution of cardiovascular risk factors and their association with patient mortality.

MATERIALS AND METHODS

We undertook a single-center, prospective study of RT patients (n = 360) between 1999 and 2006. These were 180 recipients with transplants from ECD and 180 controls. We analyzed the baseline characteristics and the cardiovascular risk factors: hypertension, diabetes, dyslipidemia, CVD, and anemia. Posttransplant analyses included the evolution of cardiovascular risk factors and causes of death.

RESULTS

The mean age of the ECD was 63.5 ± 5.4 versus 32.0 ± 13.2 years in the non-ECD (P < .001) and the recipient ages were 58.4 ± 8.7 versus 40.8 ± 13.3 years, respectively (P < .001). The median interquartile range [IQR] dialysis time was 25 months (15-39) versus 20 months (12-44; P = .017). The pretransplant body mass index was 26.89 ± 3.91 versus 25.43 ± 4.72 kg/m(2) (P = .002); the median (IQR) number of antihypertensive drugs was two (1-2) versus two (1-2.75; P = .015); dyslipidemia was present in 32.5% versus 21.6% (P = .024), diabetes in 10.6% versus 5.6% (P = .087), and CVD in 13.3% versus 7.8% (P = .086). Treatment with erythropoiesis-stimulating agents (ESA) was received by 84.9% versus 83.9% (P = .857). Concerning transplantation, the mean follow-up was 64.3 ± 33.7 months. Hypertension was present at 3 and 5 years in 85.6% versus 69.5% (P = .001) and 87.9% versus 72.8% (P = .009), respiratory. Treatment with angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers at 3 and 5 years was 79.8% versus 64.5% and 85.6% versus 65%. Dyslipidemia was present at 5 years in 63.1% versus 58.0% (P = .482). De novo diabetes occurred in 16.7% versus 11.1% (P = .128), and CVD in 13.5% versus 4.5% (P = .003). Univariate and multivariate Cox regression proportional hazards models were constructed to analyze the factors associated with patient death.

CONCLUSIONS

CVD is the most common cause of death in recipients of ECD, RT, 40% in the ECD group versus 28.6% in the control group. Tight control of cardiovascular risk factors and a good pretransplant patient selection contributed to the good results obtained.

Experimental demonstration of a cognitive quality of transmission estimator for optical communication systems

The impact of physical layer impairments in optical network design and operation has received significant attention in the last years, thereby requiring estimation techniques to predict the quality of transmission (QoT) of optical connections before being established. In this paper, we report on the experimental demonstration of a case-based reasoning (CBR) technique to predict whether optical channels fulfill QoT requirements, thus supporting impairment-aware networking. The validation of the cognitive QoT estimator is performed in a WDM 80 Gb/s PDM-QPSK testbed, and we demonstrate that even with a very small and not optimized underlying knowledge base, it achieves between 79% and 98.7% successful classifications based on the error vector magnitude (EVM) parameter, and approximately 100% when the classification is based on the optical signal to noise ratio (OSNR).

The βI-galactosidase of Cicer arietinum is located in thickened cell walls such as those of collenchyma, sclerenchyma and vascular tissue

We report localisation of the chickpea βI-Gal, a member of the chickpea β-galactosidase family, which contains at least four members. After generation of specific antibodies, the distribution and cellular immunolocalisation of the protein in different organs and developmental stages of the plant was studied. βI-Gal protein is much longer than the other chickpea β-galactosidases because of the presence of a lectin-like domain in the carboxyl terminus of the protein. Western blot experiments indicated that the active βI-Gal retains this lectin-like domain for its function in the plant. The βI-Gal protein was mainly detected in cell walls of elongating organs, such as seedling epicotyls and stem internodes. An immunolocation study indicated a very good correlation between the presence of this βΙ-galactosidase and cells whose walls are thickening, not only in aged epicotyls and mature internodes in the final phase of elongation, but mostly in cells with a support function, such as collenchyma cells, xylem and phloem fibres and a layer of sclerenchyma cells surrounding the vascular cylinder (perivascular fibres). These results could suggest a function for the βI-Gal in modification of cell wall polymers, leading to thicker walls than the primary cell walls.

Transcriptional profiling of cell wall protein genes in chickpea embryonic axes during germination and growth

Cell wall hydrolases have been assumed to be involved in the regulation of seed germination, mostly through their contribution to the cell wall disassembly associated with endosperm cap weakening. In Cicer arietinum (a non-endospermic leguminosae seed), we have focused our research directly on the elongation process of the embryonic axes themselves during germination. The genes encoding cell wall proteins, previously implicated in the elongation of chickpea epicotyls, might also be involved in the expansion of embryonic axis cells, and the modulation of their expression could be part of the control of the germinative process. Thus, chickpea alpha-expansins and xyloglucan endotransglycosylase/hydrolase (XTH) acting on the cellulose/xyloglucan network seem to be involved in the elongation of both chickpea epicotyls and embryonic axes, although the products of different genes perform their actions on each organ. Among the four known cDNAs encoding chickpea alpha-expansins, Ca-EXPA1 was the only isoform highly expressed in embryonic axes during germination. In contrast to epicotyl elongation, the genes encoding cell wall beta-galactosidases, involved in pectin degradation, were not expressed during germination, suggesting no role in embryonic axis elongation, mainly due to the different metabolism of pectins during cell wall loosening in embryonic axis or epicotyl cells. The results concerning CanST-1 and -2, encoding two growth-related cell wall proteins, suggested that these genes were not involved in elongation of embryonic axes during germination. The transcription pattern of Cap28, which encodes a glutamic acid rich cell wall protein of unknown function, indicated a role in the development of the embryonic axes during germination.

In vitro susceptibility of Cryptococcus neoformans serotypes to GM 237354 derivative of the sordarin class

In vitro susceptibility to the sordarin derivative GM 237354 and amphotericin B were tested in a total of 190 Cryptococcus neoformans clinical isolates from different geographical areas of Spain and South American countries. Minimal inhibitory concentrations (MICs) were obtained using the NCCLS reference microbroth dilution method and analysed according the serotypes of Cr. neoformans. The MICs for amphotericin B were lower than 1.0 microg ml(-1) (MIC90% 0.5 microg ml(-1) , MIC50% 0.125 microg ml(-1)) but five isolates showed MICs of 2.0 microg ml(-1) to GM 237354 (MIC90% 1.0 microg ml(-1), MIC50% 0.5 microg ml(-1)). Cryptococcus neoformans var. gattii serotype B, was significantly less susceptible than A and AD serotypes (P = 0.047 and P = 0.022, respectively).

Radiation therapy for symptomatic hepatomegaly in myelofibrosis with myeloid metaplasia

OBJECTIVE

To describe the experience with liver irradiation in advanced cases of myelofibrosis with myeloid metaplasia (MMM).

METHODS

Over a 20-yr period, 14 patients with MMM were treated with a total of 25 courses of liver, abdominal, or abdominal and pelvic irradiation for symptomatic hepatomegaly with (5 patients) or without (9 patients) ascites. All 14 patients had advanced disease and 11 (79%) had previous splenectomy. The median radiation therapy (RT) dose per course was 150 cGy (range 50-1000) administered at a median of six fractions. Four patients received two to six courses.

RESULTS

Twelve of the 14 patients (86%) had a transient (median 3 months) subjective response from RT. However, in only 35% of these was there a transient (median 3 months) decrease in palpable liver size. Four of the five patients with ascites experienced a short-term response from RT. Eight of the 13 patients suitable for evaluation (62%) had treatment-associated cytopenia, often in the form of anemia and/or thrombocytopenia. At last follow-up, 10 patients (71%) had died after a median of 7 months (range 0.1-23) and 4 were alive at 3, 20, 33, and 57 months after RT.

CONCLUSIONS

Low-dose abdominal RT for symptomatic hepatomegaly or ascites associated with advanced-stage MMM is myelosuppressive and provides only temporary and mainly subjective and short-lived relief.

[Minimal inhibitory concentrations of Candida species to five antifungals by using the reference dilution micromethod and the E-test.]

It is accepted that the frequency of candidosis has increased during the last decade, specially in hospitalized patients. The more frequent use of azole antifungals and the recognition of isolates of Candida sp resistant to these and other drugs such as 5-fluorocytosine constitute a great need for a reproducible and useful C. albicans in vitro susceptibility testing method for monitoring antifungal therapy in clinical mycological laboratories. The E-test is a novel agar diffussion technique for testing the susceptibility of yeasts against a defined continous gradient of drug and could be used by most clinical laboratories. In this study the E-test and the NCCLS reference microbroth method (M27-P guidelines) were used to determine the MICs of amphotericin B, 5-flucytosine, itraconazole, fluconazole and ketoconazole for 50 clinical isolates of Candida albicans, Torulopsis glabrata, C. tropicalis and Hansenula anomala and five reference ATCC strains. The main purpose of the study was to compare the results obtained by the two methods. In general good agreement (+/- 1 dilution) was otained between both methods, despite differences observed for some species-antifungal combinations in which the MICs were lower by the E-test than by the microbroth method. MICs for C. albicans and T. glabrata to amphotericin B were < 0.50 microg/mL. Two isolates of C. albicans and two others of H. anomala, showed MIC < 8 microg/mL for 5- flucytosine. All isolates of T. glabrata and 40% of C. albicans showed MICs > 16 microg/mL for fluconazole. The results of this study indicate that E-test is an alternative for susceptibility testing to the NCCLS reference method. Because its simplicity it seems to be an easier test for routine clinical laboratories.

[Incidence and risk factors for nosocomial infections in a neonatology unit]

OBJECTIVE

Neonatal nosocomial infection is a very important cause of morbidity and death in the hospital setting. The aim of our work is to study the incidence and risk factors associated with nosocomial infection in a neonatal unit.

METHOD

We followed 321 patients in a 6-month-long prospective, observational study. As units of measurement we used Incidence Density and Accumulative Incidence. For the statistical analysis we used chi-square and the logistic regression.

RESULTS

Nosocomial infection incidence density for the whole neonatal unit was 39.63% infections per 100 patients per month, while the accumulative incidence was 16.19%. Using a logistic regression method, the umbilical cord artery catheterization and days of stay variables both showed a statistically significant difference with nosocomial infection.

CONCLUSIONS

We conclude that minimizing length of stay, if possible below 10 days could be a key element to achieve a reduction in the neonatal unit's infection rate. However, new studies must be performed to ascertain if a strict enforcement of the rules pertaining to hand-washing and umbilical catheters manipulation would achieve further reductions in the infection rate associated with the umbilical cord catheterization.

[Traffic accidents: a health problem in primary care]

OBJECTIVE

To discover the prevalence and most relevant epidemiological characteristics of the victims of traffic accidents which occur in our health area.

SETTING

Hospital Casualty department (HC), Health area 19, Alcoy.

PATIENTS

This was an observational, crossover study, based on the collection of data from all those patients who had been brought into the HC for attention because of a traffic accident and who were attended between October 1, 1990 and September 31, 1991.

MEASUREMENTS AND MAIN RESULTS

During the study period a total of 1,111 traffic accident victims were attended. Their average age was 26.62 (SD +/- 15.95), with 69.6% being men and 30.2% women. 60.7% of the victims were attended on non-working days or the eve of a non-working day. 44.5% of those involved in accidents were in four-wheeled vehicles; 40% on two-wheeled vehicles and 11.1% of the victims were pedestrians. Injuries were light in 73.3% of cases; moderate in 15.9% and in the other 8.8% serious, grave or critical. 43.7% of the total had the accident in an urban area and 40.9% on the open road.

CONCLUSIONS

The high prevalence of victims of accidents (8.3 per 1000 inhabitants) observed in our health area can be explained by the type of study. It is vital to obtain valid information of the real importance of this health problem. The primary care doctor must take preventive action concerning traffic accidents: a) through full studies of traffic accident levels among primary care centre users; b) primary preventive action, through the spreading of information on norms of safety; and c) secondary and tertiary prevention, by means of effective and efficacious outpatient emergency measures, as well as a thorough rehabilitation of accident victims.

Intraphagocytic bioactivity of lomefloxacin against Pseudomonas aeruginosa

The kinetics of extracellular bactericidal activity and the intraphagocytic bioactivity of lomefloxacin at concentrations 2 mg/L (1/2 x MIC), 4 mg/L (MIC) and 8 mg/L (2 x MIC) against Pseudomonas aeruginosa were measured, the first in 40% human serum and the second in polymorphonuclear leucocytes (PMNLs), by the colony-counting method. The PMNLs were treated with phenylbutazone to prevent them killing the bacteria during the ingestion period. The kinetics of extracellular killing were biphasic with an initial rapid phase lasting 30 min when lomefloxacin was used at concentrations equal to the MIC and 2 x MIC, during which a decrease of 3 log of cfu/mL occurred. Lomefloxacin showed intraphagocytic activity at the three concentrations assayed. With non-treated PMNLs the percentages of intraphagocytic killing after 30 min of incubation were 93.5, 91.3 and 95.5% with 2, 4 and 8 mg/L, respectively, and 79.8, 65.0 and 93.3% for the same lomefloxacin concentrations with phenylbutazone-treated PMNLs, suggesting a synergic interaction between the antibacterial activity of PMNLs and lomefloxacin.

Intramuscular myxoma simulating a cystic mass on computed tomography

A case of an intramuscular myxoma (IMM) of the thigh simulating a cystic mass is reported. A discussion of the computed tomography (CT) characteristics of benign and malignant soft tissue tumors are presented.

Analysis by fluorescence microscopy and flow cytometry of monoclonal antibodies produced against cell surface antigens

The reactivity of seven monoclonal antibodies against the surface antigens of the murine myeloma cell line Sp2/O-Ag 14 was simultaneously analyzed by fluorescence microscopy and flow cytometry. To 1 X 10(6) Sp2/O-Ag 14 cells were added 200 microliters of the monoclonal antibody and the mixture was incubated at 4 degrees C for 30 min. After washing twice with PBS, the Sp2/O-Ag 14 cells were incubated at 4 degrees C for 30 min with a 1:400 dilution of fluoresceinated goat anti-mouse antibodies. Sp2/O-Ag 14 cells were ready for analysis after washing the cells 3 X with PBS. By fluorescence microscopic analysis different patterns of reactivity with monoclonal antibodies were detected. These patterns were identified as: smooth annular, dot-like annular, dot-like patches, diffuse and homogeneous. The observed patterns may represent different cell surface epitopes being recognized by the monoclonal antibodies. Flow cytometry analysis with the EPICS V system showed reactivity of seven monoclonal antibodies with Sp2/O-Ag 14 cell surface epitopes, which ranged from 79 to 90%. Compared to fluorescence microscopy, flow cytometry provides a faster, more sensitive and more accurate quantitative measurement of the reactivity of different monoclonal antibodies against Sp2/O-Ag 14 cell surface antigens.