Search

With the objectives of dengue prevention, health promotion, and action-based research, two experiments were conducted in pilot areas of Buenos Aires and Vicente López, Argentina. In each area, community, government, and non-governmental references were identified. The study included an entomological survey (with ovitraps), environmental survey (with field observations, interviews, and workshops), and social survey (using questionnaires, interviews, and meetings). Spaces for dialogue and collaboration were developed with the community, thereby spawning participatory activities and empowerment. Environmental reordering and reduction of mosquito breeding sites were promoted by: incorporation of environmental issues and vector-borne disease prevention into the school curricula; neighborhood workshops; training of environmental agents to transmit information and train peers; and planning community environmental projects. The households were visited, seeking to integrate the residents into their own community environmental diagnosis. There were significant differences between the pilot areas in knowledge and social practices, but not according to socioeconomic status. The schools and health promotion settings proved to be the main community reference for promoting healthy environmental practices.

The occurrence of multiple neoplasms in the central nervous system is well documented. In von Recklinghausen's disease, patients frequently present with multiple neurofibromas and/or meningiomas at different sites within the spinal axis. However, the presence of multiple, histologically different spinal tumors in the absence of von Recklinghausen's disease is extremely rare. The authors describe a patient with progressive paraparesis in whom an extradural, malignant lesion and a separate benign, intradural tumor of the thoracic spine were found. The histological diagnosis of the intradural tumor was a pigmented schwannoma. On review of the literature, the authors found nine additional cases of coexisting, histologically different tumors of the spine. The majority of these tumors occurred in the thoracic spine and, not unexpectedly, intradural meningiomas and schwannomas prevailed. Except for the presumed same mesenchymal cell origin of neurinomas and meningiomas, no explanation for the coexisting, different spinal tumors could be determined.

Amplification and rearrangement of the epidermal growth factor receptor (EGFR) gene occur frequently in malignant gliomas. Rearrangement may also lead to the expression of potentially oncogenic EGFR deletion mutants. Data presented here indicate the existence of a 190 kDa mutant form of the EGFR in A-172 glioma cells that is substantially different from the deletion mutants characterized previously. The EGFR-like protein is expressed along with the 170 kDa wild type EGFR. It is detectable with antibodies to both extracellular and intracellular regions of the EGFR, but is not crossreactive with other HER-family members. The wild type and mutant receptors undergo phosphorylation in response to treatment with TGFalpha and are associated with expression of both 10.5 kb and 11.5 kb EGFR-related transcripts. Combined reverse transcription-polymerase chain reaction (RT-PCR) identifies a unique transcript in A-172 cells that encodes an in-frame, tandem duplication of both tyrosine kinase and calcium internalization (TK/CAIN) domains (exons 18 through 26). The duplication of these domains is associated with a specific genomic rearrangement between potential v-myb and c-myb consensus binding sites within introns 26 and 17 of the EGFR gene resulting in the formation of a chimeric intron.

The authors present the selective catheterization of the veins of the neck and mediastinum via the subclavian vein. Benefits and complications of the technique are discussed. The subclavian approach is very helpfull and technique of choice when the femoral route is not available.

The authors examined 186 professional and 300 occasional divers finding 12 cases of sudden deafness and 3 cases of real hearing fluctuations. Supporting and producing factors are described, pathogenical hypotesis are formulated and medical therapy is suggested.

Between November 1983 and January 1986, 70 patients with recurrent squamous cell carcinoma of the head and neck were treated with simultaneous cisplatin (20 mg/m2 for 5 consecutive days) and 5-fluorouracil (400-200 mg/m2 by iv push for 5 consecutive days) every 3 weeks. Sixty-seven patients were fully evaluable. The major toxic effect was myelosuppression, and two patients died from septic or hemorrhagic complications. Other toxic effects were moderate and quite rare, including nausea and vomiting. All of the patients were treated in the outpatient clinic. The overall response rate was 52.2% (14 complete responses +21 partial responses). The worst prognostic factor in the present series was the persistence of disease after front-line therapy. This treatment has shown an acceptable toxicity and its antitumoral activity seems to be in the range of the higher activity reported by literature in these kind of patients.

The authors describe the technique employed for selective catheterization of the main mediastinal trunks and the veins of the brachiocephalic and cervicocephalic regions by means of the subclavian approach. The importance and advantages of this procedure as an alternative to the femoral approach, especially if this is contra-indicated, are emphasized.