Search

A biosimilar (BS) is a biological drug that contains a version of the active substance of an already authorized original biological product. The BSs are marketed after patent period of the original drug has ended and once it has been demonstrated that the differences regarding the innovative medicine have no relevant effect on its safety or clinical efficacy. The Spanish Society of Rheumatology, in line with the European Medicines Agency, considers that because of its nature and complexity of production, a BS cannot be considered to be the same as a generic drug. The Spanish Society of Rheumatology expresses an unequivocal commitment to the sustainability of the health system in our country and our steadfast alignment with all measures designed to ensure continuity, without reducing the quality of care. Therefore, we believe that the advent of BSs will likely facilitate access of patients with rheumatic diseases to the biological drugs. This article reviews the European Medicines Agency requirements for authorization, the Spanish legal framework and controversies on BS and presents the position paper of the Spanish Society of Rheumatology on these drugs. [ABSTRACT FROM AUTHOR]

Resumen Objetivo Describir cuantitativa y cualitativamente las publicaciones sobre Medicina Nuclear (MN) en revistas ajenas a la especialidad, entre los años 2000-2009. Material y métodos Estudio descriptivo retrospectivo durante 2000-2009 en 3 revistas de Medicina Interna (MI) y en 3 de especialidades afines (EA). Los criterios utilizados son que algunos de los autores esté ubicado profesionalmente en un servicio, unidad o centro de MN y/o que el título del artículo o al menos su contenido haga alusión a algún aspecto específico de la MN. Se ha recogido la fecha de publicación, sección de la revista, temática, datos de autores, provincia y hospital de referencia. Resultados Se han encontrado un total de 186 artículos, 81 en revistas de MI y 105 en EA. Los artículos de las revistas de MI se originaron en 43 hospitales/centros españoles. El de mayor producción fue Vall d’Hebron. Se han identificado 24 provincias, destacando Barcelona con 20 artículos y Madrid con 17. En las revistas de EA se hallaron 59 hospitales/centros, destacando el Vall d’Hebron con 21 artículos. Hay 9 artículos extranjeros. Se distribuyen en 19 provincias, destacando Barcelona con 32 trabajos y Madrid con 20. Conclusiones Los trabajos en las revistas de EA duplican, al menos, los de las revistas de MI. Los «originales» son los más frecuentes. Destacan la revista Clinical and Translational Oncology en EA y Medicina Clínica en MI. No hay una temática que destaque. Barcelona y Madrid son las provincias más productivas. Por hospitales el Vall d’Hebron es el más productor. Objective This article aims to provide a quantitative and qualitative description of the publications on Nuclear Medicine (NM) in journals from other disciplines, between 2000 and 2009. Material and methods A retrospective descriptive study was carried out including the years 2000-2009 in three internal medicine journals (IM) and in three related specialty journals (RS). The criteria used are that some of the authors were located professionally in a Service, Unit or Central MN and/or that the title of the article or at least its content made a reference to some specific aspect of NM. Date of publication, the magazine section, thematic, data of the authors, province and referral hospital were collected. Results A total of 186 articles were found, 81 in IM journals and 105 in RS. The IM journal articles came from 43 different hospitals. Vall d’Hebron (Barcelona, Spain) was the hospital with the largest volume. Twenty-four provinces were identified, Barcelona and Madrid standing out among them with 20 and 17 articles, respectively. In the RS journals, 59 hospitals/centers had participated, Vall d’Hebron standing out with 51 articles. There were 9 foreign articles. The articles were distributed into 19 provinces, Barcelona and Madrid standing out with 32 papers and 20 papers, respectively. Conclusions There are at least twice as many articles in the RS Journals than in the IM ones. «Original» articles are the most frequent. The Clinical and Translational Oncology journal in RS and Medicina Clínica in IM stand out with the highest number of articles. No specific topic prevailed. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the systematic review was to evaluate the safety and efficacy of rituximab for the treatment of rheumatoid arthritis patients, as part of the Consensus on the use of rituximab in rheumatoid arthritis. A document with evidence based recommendations5. Methods: All papers published from January 2003 to September 2009 were reviewed in a systematic way in Medline, EMBASE and Cochrane Library database. The Mesh terms used were: «Rituximab», «Rheumatoid arthritis», «and Anti-CD20», «Biologics». The abstracts of the EULAR and ACR congress of 2003 to 2009 were also reviewed, as well data of Roche Pharma. Two rheumatologists (BHC y MGH) made the bibliographic review by title and summary of each work. Two authors (BHC y RAA) selected them by quality according the GRADE SCALE after they review. The data were collected in paper. The outcomes evaluated were of efficacy in agreement with OMERACT13 (Outcome Measurements in Rheumatoid Arthritis Clinical Trials) and The Musculoskeletal Cochrane Study Group. The outcomes of safety evaluated were: mortality, severe infections, severe adverse events, withdraw for any cause, for severe adverse events, and for infusion related reactions. The review was conducted with Cochrane methodology. The odds ratio and relative risk for dichotomist variables; and mean difference between baseline and final measurements for continuous variables, and risk differences were calculated with RevMan 519. The number of patients needed to treat was calculated with Cares' calculator20. Results: RTX is an effective drug in three groups of patients with RA: patients who fail to MTX, those who fail anti-TNF and in patients with no prior exposure to MTX. It is necessary to treat 7 (5-10) patients with RTX vs. placebo to obtain an ACR70 response; 9 (6-15) to achieve a DAS28 < 2.6: and 5 (4-8) to achieve a HAQ improvement >0.2. Safety of the drug was similar to that of placebo except for infusion reactions where 12 (8-26) patients need to be treated with RTX vs. placebo to see a reaction to the first infusion with steroid premeditation. Severe adverse events to the infusion had an incidence of 0.7% in patients of the RTX treated group. It was impossible to identify a larger increase in the number of severe infections, probably due to methodological problems, however, the risk of developing infections in patients treated with RTX seems to be comparable to that of other anti-TNF and biologics. [ABSTRACT FROM AUTHOR]

The aim of this descriptive study is to analyze the scientific productivity of doctorate programs in Clinical and/or Health Psychology in Spain. That productivity is assessed from teachers of doctorate programs. A second aim is to find out whether doctorate programs with quality mention have a higher scientific productivity than those programs without quality mention. Scientific productivity of 375 teachers that participated in 17 doctorate programs was examined. Specifically, papers published in journals included in Web of Science and IN-RECS data bases were analyzed as well as the number of dissertations registered in TESEO data base. A total of 2,772 papers of Web of Science, 2,479 papers of IN-RECS and 604 dissertations included in TESEO were obtained. According to these results, a ranking of doctorate programs was made for each criterion. Subsequently, a global ranking was made through adjusting each criterion according to the weight that was assigned by scientific community to each indicator. Finally, a comparison of global results of programs with and without quality mention was carried out. Results showed that programs with Quality Mention doubled scientific productivity in all criteria compared to programs without Quality Mention. [ABSTRACT FROM AUTHOR]

Abstract: The most recent results in the dynamics of infinite systems of particles have shown there is no necessary connection between the performance of a deterministic supertask and the non-conservation of energy. Much more difficult to prove is the non-existence of any necessary connection between the performance of an indeterministic supertask and the non-conservation of energy; however, this paper does just that. So the requirement that energy be conserved does not mean we can exclude as “non-physical” either of the two major types of supertask considered to date. The paper also proposes, in this context, a “hidden variables method” to prove general results of compatibility in dynamics. [Copyright &y& Elsevier]

Resumen Las técnicas de valoración cualitativa han sido el estándar tradicional de valoración diagnóstica en los estudios PET con 18 F-FDG. Desde los inicios de la técnica se han buscado parámetros cuantitativos, más exactos y con mejor precisión diagnóstica, que puedan ofrecer información relevante en cuanto al comportamiento, agresividad o pronóstico de los tumores. Cada vez hay más estudios con evidencia de alta calidad sobre la utilidad de diferentes parámetros metabólicos distintos al SUV máximo, cuyo uso es controvertido, a pesar de ser ampliamente utilizado en la práctica clínica, y del que muchos médicos desconocen todavía su significado real. El objetivo de este trabajo ha sido revisar los conceptos clave de estos parámetros metabólicos que pueden ser relevantes en la práctica habitual durante los próximos años. Se ha visto que existe mayor evidencia en la valoración del metabolismo de una lesión de forma completa a través de parámetros volumétricos que reflejan de forma más adecuada la carga tumoral que presenta un paciente. Básicamente, estos parámetros calculan el volumen de tumor que cumple unas características determinadas. Para ello se ha utilizado un software , disponible en la mayor parte de las estaciones de trabajo y procesado de estudios PET, que ha permitido calcular estos volúmenes utilizando criterios más o menos complejos. Los métodos de segmentación más simples, basados en umbrales, están disponibles en la mayor parte de los equipos, son fáciles de calcular y han demostrado en muchos trabajos tener un importante significado pronóstico. Qualitative techniques have traditionally been the standard for the diagnostic assessment with 18 F-FDG PET studies. Since the introduction of the technique, quantitative parameters have been sought, more accurate and with better diagnostic precision, that may offer relevant information of the behavior, aggressiveness or prognosis of tumors. Nowadays, more and more studies with high quality evidence show the utility of other metabolic parameters different from the SUV maximum, which despite being widely used in clinical practice is controversial and many physicians still do not know its real meaning. The objective of this paper has been to review the key concepts of these metabolic parameters that could be relevant in normal practice in the future. It has been seen that there is more evidence in the complete evaluation of the metabolism of a lesion, through volumetric parameters that more adequately reflect the patient's tumor burden. Basically, these parameters calculate the volume of tumor that fulfills certain characteristics. A software available in the majority of the workstations has been used for this purpose and it has allowed to calculate these volumes using more or less complex criteria. The simplest threshold-based segmentation methods are available in most equipments, they are easy to calculate and they have been shown in many studies to have an important prognostic significance. [ABSTRACT FROM AUTHOR]

Resumen El cáncer de próstata (CaP) representa el tumor maligno más frecuente en los varones, pero según las directrices de la European Association of Urology (EAU) no deben realizarse cribados masivos para el diagnóstico de CaP debido a problemas relacionados con el sobrediagnóstico y sobretratamiento. El diagnóstico clínico precoz es posible, principalmente basado en el tacto rectal y la determinación del antígeno prostático específico (PSA). Sin embargo, el único test que puede determinar la presencia de un CaP es la biopsia guiada por ecografía, obteniendo múltiples muestras, la cual tiene un elevado valor pronóstico. En este contexto, la imagen diagnóstica juega un importante papel tal como lo confirmó la EAU, que en una actualización de 2016 de su guía clínica sobre CaP estableció la importancia de la tomografía por emisión de positrones (PET) con 11 C- o 18 F-colina combinada con la tomografía computarizada (TC) para individualizar la recidiva local, la afectación de ganglios linfáticos y la diseminación metastásica en todos los estadios. En consecuencia, en 2017, la European Association of Nuclear Medicine (EANM) junto con la Society of Nuclear Medicine and Molecular Imaging (SNMMI) compartieron nuevas directrices para la PET/TC con 68 Ga-antígeno de membrana prostático específico (PSMA) para ayudar a los médicos en la recomendación, realización e interpretación de los estudios PET/TC en pacientes con CaP. De esta manera, el objetivo de este «artículo de evidencia» es definir el algoritmo diagnóstico actual en el CaP para incrementar el nivel de confianza global en el enfoque de un tema tan crucial. Prostate Cancer (PCa) represents the most common malignant tumor in men but according to the European Association of Urology (EAU) guidelines, a mass screening for PCa diagnosis should not be performed due to over-diagnosis and over-treatment related problems. An early clinical diagnosis is possible, mainly based on digital rectal examination and Prostatic Specific Agent (PSA) testing. However, the only mandatory test to define the presence of PCa is ultrasound guided-biopsy, obtained on multiple samples, which has also a high prognostic value. In this context, diagnostic imaging plays an important role as confirmed by EAU that in a 2016 update of their guidelines on PCa stated the importance of Positron Emission Tomography (PET) with 11 C- or 18 F-choline combined with computed tomography (CT) to identify local relapse, lymph node involvement and metastatic spread at all stages. Consequently, in 2017, the European Association of Nuclear Medicine (EANM) together with the Society of Nuclear Medicine and Molecular Imaging (SNMMI) published new guidelines for 68 Ga-Prostate Specific Membrane Antigen (PSMA) PET/CT to help physicians in the recommendation, execution and interpretation of PET/CT scans in patients with PCa. Thus, the aim of this ‘evidence paper’ is to define the current diagnostic algorithm in PCa in order to increase the general level of confidence in approaching such a crucial topic. [ABSTRACT FROM AUTHOR]

Resumen Objetivo El estreñimiento crónico es una enfermedad común en el niño. Nuestro objetivo fue poner de manifiesto la utilidad de la gammagrafía de tránsito gastrointestinal en el estudio de pacientes pediátricos con estreñimiento crónico y las ventajas que tiene respecto a otros estudios de imagen, a pesar de nuestra limitada experiencia. Material y métodos Se valoraron 5 pacientes remitidos a nuestro servicio con diagnóstico de estreñimiento crónico refractario al tratamiento. Se realizó un protocolo de estudio completo, incluyendo gammagrafía de vaciamiento gástrico para líquidos y tránsito de intestino delgado y grueso, utilizándose una única dosis de 111 In-DTPA. Siguiendo guías internacionales se definieron áreas de interés en estómago, íleon terminal y en 6 regiones del intestino grueso. Resultados Todos los enfermos presentaron estudios gammagráficos alterados, mostrando 4 de ellos exploraciones radiológicas normales. El estudio radioisotópico cambió el diagnóstico del paciente en 2 casos y en otros 2 contribuyó a aclararlo, ante la discordancia entre pruebas radiológicas normales y biopsia rectal patológica. Uno de los pacientes mostró concordancia entre los 2 estudios de imagen. Tras la gammagrafía se produjo cambio en el manejo terapéutico en 2 casos. Conclusiones Nuestra limitada experiencia coincide con los datos publicados en los que el estudio gammagráfico resulta ser un método reproducible y preciso. Proporciona una información fisiológica, cuantitativa y útil en el estudio del estreñimiento, siendo la única exploración que permite la determinación tanto global como regional del tiempo de tránsito gastrointestinal. Aim Chronic constipation is a common pathology in children. The aim of this paper was to show the usefulness of gastrointestinal transit scintigraphy in pediatric patients with chronic constipation, and the advantages with respect to other imaging techniques, despite our limited experience. Material and methods We evaluated 5 patients sent to our service with a diagnosis of chronic constipation refractory to treatment. We performed a complete study protocol, including liquid gastric emptying scintigraphy and small and large bowel transit times, using a single dose of 111 In-DTPA. Following international guidelines regions of interest were defined in stomach, terminal ileum and in 6 regions of the large intestine. Results All patients showed altered scintigraphy study, showing 4 of them normal radiological tests. Radioisotopic study changed diagnosis in 2 patients and in other 2 patients contributed to clarify it, since discordance between normal radiological tests and abnormal rectal biopsy. One of the patients showed concordance between each imaging modality. The results of the test changed the therapeutic management in 2 cases. Conclusions Our limited experience coincides with published data in which scintigraphy study turns out to be a reproducible and accurate method. It provides physiological, quantitative and useful information in the study of constipation, being the unique exploration that allows both global and regional gastrointestinal transit time determination. [ABSTRACT FROM AUTHOR]

Introduction: Complex regional pain syndrome (CRPS) type 1 is characterized by the presence of pain, edema, functional impotence, impaired mobility, trophic changes, vasomotor instability and bone demineralization. Material and methods: We carried out a retrospective and prospective, descriptive, observational study of 108 patients over 18 years of age with suspected CRPS who met Doury’s criteria. We recorded demographic data, clinical characteristics, comorbidities, previous predisposing conditions and triggering factors, such as injury or fracture. We evaluated laboratory data, serial plain X-rays, 3-phase bone scintigraphy with technetium 99 and bone density scan, as well as drug treatment, rehabilitation and disease course. Results: In all, 89% of the 108 patients were women with an average age of 54.8 ± 12.4 years. The time between the onset of the symptoms and the first visit to a physician was 3.1 months. The most common triggering factor was injury (91.7%). The most frequent psychological factor was anxiety (42.6%). All the patients reported pain and 99.07% had impaired mobility. The most frequently affected part of the body was the hand (75%; 81/108 patients) followed by the shoulder, in the shoulder-hand syndrome. All the patients had serial X-rays and changes were observed in 93.5%. Three-phase bone scintigraphy revealed evidence of disease in all 32 of the patients who underwent this study. Bone density scanning was performed in 54 patients (50%). All the patients were treated with nonsteroidal anti-inflammatory drugs, mainly diclofenac (60%). Calcium therapy was initiated in 106 patients (98.2%) and vitamin D3 therapy in 97.2%. All the patients received bisphosphonates, primarily alendronate and ibandronate (67.6% and 27.8%, respectively). Thirty-six patients (33.3%) received corticosteroids. All of the evaluated patients underwent rehabilitation involving occupational therapy. The average time to recovery was 6.31 months (range, 4-24). The outcome was favorable in 88.9% of the patients. Conclusion: This paper describes the clinical characteristics, therapeutic features and outcome of CRPS type 1 in 108 patients. This syndrome is known to be heterogeneous, and does not always present with the wellknown symptoms. We recommend establishing a differential diagnosis including other infectious and inflammatory conditions, and point out the importance of early referral, which enables early treatment. [ABSTRACT FROM AUTHOR]

Resumen La cirugía radioguiada puede ser útil en la localización de tumores neuroendocrinos, detectando más lesiones y de menor tamaño que las pruebas de imagen prequirúrgicas y la palpación por el cirujano, detectando lesiones residuales e indicando una ruta más corta para acceder a la lesión. No obstante, su uso no se ha generalizado, ya que plantea dificultades técnicas, las series publicadas son limitadas, y no existe una uniformidad de criterios, debido a la gran variabilidad en cuanto al tipo de radiofármaco, dosis a emplear e intervalo entre la inyección del trazador y la cirugía. De estos aspectos nos ocupamos en esta revisión, describiendo la experiencia de distintos grupos, en los diversos tumores. Radioguided surgery can be a useful technique in the localization of neuroendocrine tumors. It detects more and smaller lesions compared to pre-surgical imaging and intraoperative digital palpation by the surgeon. It detects residual lesions and also indicates the shortest access route to the lesion. Nevertheless, its use has not become widespread because of technical difficulties. There is a limited number of published series, a lack of standardized protocol because of the great variability regarding type of radiopharmaceutical, dose of radiotracer, timing between injection and surgery. In this paper, we review these issues, describing the experience of different authors in diverse tumors. [ABSTRACT FROM AUTHOR]

Copyright of Revista Iberoamericana de Micologia is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Iberoamericana de Micologia is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Hemophagocytic syndrome (HS) occurs in autoimmune diseases and belongs to the hemophagocytic lymphohistiocytosis group of diseases. This paper describes the features of 2 patients with systemic lupus erythematosus (SLE) who presented HS as the initial clinical manifestation. Clinical observations: Both patients had prolonged fever not associated to an infectious process and did not respond to broad-spectrum antibiotics. Discussion: The diagnosis of HS secondary to SLE is complicated, because it has some features in common, but HS is characterized by hyperferritinemia, hipofibrinogemia, hypertriglyceridemia and a decrease in the erythrocyte sedimentation rate, unlike SLE. HS treatment when associated to SLE is not well established, but steroids and/or immunoglobulins are effective as the initial treatment, and in refractory cases, cyclosporine or cyclophosphamide may be associated. Conclusions: HS can be the initial manifestation of SLE and should be suspected in patients with organ enlargement, cytopenias, clotting disorders, liver disorders and prolonged fever unresponsive to antibiotics. Anakinra may be a treatment option in adult HS associated to SLE. [ABSTRACT FROM AUTHOR]

Transforming growth factor-beta (TGF-β) is a cytokine with pleiotropic functions in hematopoiesis, angiogenesis, cell proliferation, differentiation, migration and apoptosis. Although its role in rheumatoid arthritis is not well defined, TGF-β activation leads to functional immunomodulatory effects according to environmental conditions. The function of TGF-β in the development of arthritis in murine models has been extensively studied with controversial results. Recent findings point to a non-relevant role for TGF-p in a mice model of collagen-induced arthritis. The study of TGF-β on T-cell responses has shown controversial results as an inhibitor or promoter of the inflammatory response. This paper presents a review of the role of TGF-β in animal models of arthritis. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Patología is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Enthesitis is one of the characteristic etiopathogenic manifestations of spondyloarthritis. However, in clinical practice, its presence often goes unnoticed because of the lack of precision and sensitivity of physical examination to detect it. Viable, valid and reliable imaging tests are needed for early diagnosis, as well as a good sensitivity to change to monitor therapeutic response. In this paper we review the most relevant aspects of current knowledge of the enthesis and discusses the validity of ultrasound for assessing enthesitis in spondyloarthritis and its sensitivity to change to monitor therapeutic response. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Patología is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The introduction of magnetic resonance imaging in spondyloarthritis constitutes the main improvement in imaging over the past two decades. X-rays remains the cornerstone of diagnosis, although magnetic resonance imaging is more sensitive in early stages of the disease. The primary advantage of magnetic resonance imagingI is its ability to visualize soft tissue inflammation and inflammatory lesions within bone in three dimensions. Studies continue to appear describing its diagnostic utility, its sensitivity in early disease, its reliability, its predictive value for the detection of damage progression and its value in the assessment of certain complications. In this paper we review the characteristics of this imaging technique and the advantages and limitations of magnetic resonance imaging in spondyloarthritis. [ABSTRACT FROM AUTHOR]

Resistance to insulin action is a feature that accompanies certain diseases among which chronic inflammatory states like rheumatoid arthritis are included. What is, what its pathogenesis is, how it is measured, and what clinical and therapeutic implications have in rheumatoid arthritis patients is a topic not familiar to rheumatologists that is reviewed in this paper. [ABSTRACT FROM AUTHOR]

The advent of biological therapies has revolutionized the management of rheumatoid arthritis, demonstrating effectiveness in controlling clinical and radiological damage. However, 20 to 40% of the patients will not respond to these therapies, which are associated to a very high cost. In addition, non-responder patients are exposed to possible adverse effects. For these reasons, we need to identify predictors of response to these treatments. These predictors are reviewed in this evidence-based paper and classified into genetic and non-genetic. Despite extensive search, nowadays there are no predictors powerful enough to be used in regular clinical practice. Serum factors, the presence of rheumatoid factor and anti-cyclic citrullinated peptide antibodies, are the only factors currently being used to predict the response to specific biological therapy. In the future, probably thanks to new technologies based on genomics, transcriptomics and proteomics, it will be possible to identify genetic predictors of response to biological drugs that will allow us to select suitable patients for a specific biological therapy. [ABSTRACT FROM AUTHOR]

The antiphospolipid syndrome (APS) is an autoimmune disease characterized by recurrent fetal loss, thrombotic events (arterial or venous) and hemocytopenic disorders associated to high titers of circulating aPL Two variants of the APS have been described. Primary APS is a clinical entity without evidence of any other autoimmune disease and secondary APS is a clinical disorder mainly associated with Systemic Lupus Erithematosus (SLE). aPL are a widely group of immunoglobulins directed against different components or proteins factors. In 1990 three groups of researchers identified that β2GP-I is the mainly antigenic target of aPL in APS patients. There are evidences that show that more than one pathogenic mechanism is involved in the development of the APS. The best documented clinical manifestations associated with the APS are recurrent fetal loss and thrombotic disorders. The latter is based on observations in vivo in animal models and in vitro on the effects caused by β2GP-I antibodies from patients with APS or from animals which cause experimental APS. The objective of the present paper is to show the pathogenic mechanisms that participate in the development of the APS. We also presented evidence that shows that β2GP-I induces pro-inflammatory, pro-adhesive and pro-coagulant disorder. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Patología is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

During the past few years technological advance have been allowed the developing of techniques that help to the diagnosis of multiple diseases. In the case of the autoimmune diseases, immunological techniques are helpful since they allow the detection of multiple autoantibodies at the same time with small volumes of sample. Together with the development of the new techniques, sensitivity and specificity in the detection of the antibodies specificities' also have been increased, in such a way that the clinicians can count with tests that allow them to make early diagnoses with greater certainty and also to follow the course of the disease based on the variation of the antibodies presents in the patient's samples. It is important to emphasize that the new techniques of laboratory that are used for the support of the diagnosis of autoimmune diseases, no longer are exclusive for research laboratories but by their facility of standardization, quality control and reproducibility they can be used in clinical laboratory of medium and small sizes. In the present paper we describe those techniques with greater application in the clinical laboratory of autoimmune diseases. [ABSTRACT FROM AUTHOR]

This theoretical study deals with a review of empirical research and theoretical papers in which typologies of the men who are violent against their intimate partners are analyzed. First, the most relevant typologies and the aspects that have in common are described. Specifically, most studies about batterer men have distinguished three categories: a) Family only batterer; b) Borderline/Disforic; and c) Generally Violent/Antisocial. Recently, other studies have identified new subtypes of aggressors (for example, Low-level Antisocial Batterers) or they have focused on other variables of classification (personality and psychopathological characteristics or stages and processes of change). Second, some of the current questions on typologies (temporal stability of the typologies and categorical versus continuous antisocial type) are examined. Third, it is also considered the possibility of tailoring specific therapeutic interventions to specific typology. Implications of this study for clinical practice and future research in this field are commented upon. [ABSTRACT FROM AUTHOR]

The aim of this paper was to evaluate an individual 20 sessions cognitive- behavioral programme in the treatment of male batterers after implementing it for ten years in a community setting. The sample consisted of 196 subjects who voluntarily participated in the study. An experimental design with repeated measures (pre-treatment, posttreatment and 1-, 3-, 6- and 12-month follow-up) was used. The success rate was of 88% in the treatment completers. In spite of the lost patients in the follow-ups (46% at the end of twelve months), the results were maintained in the contacted patients at follow-up (53% in the 12-month-follow-up), with a high impact on reducing recidivism. However, the rate of refusals and drop-outs of the treatment was rather high. Therefore it is necessary to develop strategies to improve motivation for treatment. Implications of this study for clinical practice, policy decisions and future research in this field are commented upon. [ABSTRACT FROM AUTHOR]

Copyright of Revista Iberoamericana de Micologia is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Patología is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Patología is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Patología is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: In this paper, a model of carnivore taphonomic action in the Argentinean Puna is applied to archaeological site Inca Cueva-cueva 4, on the Eastern Fringe of the Puna East of the Andes cordillera, which contains hunter–gatherer occupations dating to the early and middle Holocene. Different indicators, such as the low levels of bone modifications (ca. 2 to 8% NISP), consisting mainly in subtle marks, suggest a low intensity of the intervention of carnivores during the formation of these deposits. Variables such as the frequency of carnivore scats attest to repeated carnivore visits to the cave, but the “dilution effect” upon the small faunal assemblages these carnivores tend to accumulate in a context of larger zooarchaeological assemblages would have faded their traces away. [Copyright &y& Elsevier]

Copyright of Revista Española de Patología is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Iberoamericana de Micologia is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: This paper employs artificial neural network and decision tree to derive knowledge about the job attitudes of Generation Xers. The sample frame consisted of 1000 large Manufacturing Industries and 500 large Service Industries, randomly selected from the Common Wealth Magazine 1000 index of Taiwan Manufacturing Industries and Service Firms. Then, we exploited the ART2 neural model to take the collected data as inputs and form performance classes according to their similarities. Finally, the decision tree was employed to determine definitions for each class, resulting in 52 rules associated with certainty factors. The results could be used to develop an intelligent decision support system for the recruitment and management of Generation Xers. [Copyright &y& Elsevier]

Abstract: Taxonomy of 57 bivalves, internal and external molds is described in this paper, corresponding to three paleotaxodontids genera Praectenodonta, Praenucula and Notonucula. Samples were collected from nine sites, where stratigraphic columns were measured in Silurian to Devonian series from Altiplano, Cordillera Oriental and Interandean of Bolivia. For the first time in Bolivia, Praectenodonta and Notonucula have been identified. Four species have been described, three of them are new: Praectenodonta boliviensis n. sp., Praenucula quichua n. sp. and Notonucula altiplanica n. sp. Paleogeography of new species and genera is proposed. [Copyright &y& Elsevier]

Most of the material review in this paper was included in the work of Sudre et al. (1983), some other provides from new sites. Two new species of primitive artiodactyls are described here: Diacodexis corsaensis n. sp. and Eygalayodon isavenaensis n. sp., which is considered the most plesiomorphic form of the subfamily Eurodexeinae and probable derived from Diacodexis corsaensis n. sp. It is for the first time that a representative of the Eurodexeinae is found in the Iberian Peninsula, where they might originate. [Copyright &y& Elsevier]