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Purpose: To evaluate the prevalence, risk factors and evolution of diabetes mellitus (DM) after targeted treatment in patients with primary aldosteronism (PA). Methods: A retrospective multicenter study of PA patients in follow-up at 27 Spanish tertiary hospitals (SPAIN-ALDO Register). Results: Overall, 646 patients with PA were included. At diagnosis, 21.2% (n = 137) had DM and 67% of them had HbA1c levels < 7%. In multivariate analysis, family history of DM (OR 4.00 [1.68–9.53]), the coexistence of dyslipidemia (OR 3.57 [1.51–8.43]) and advanced age (OR 1.04 per year of increase [1.00–1.09]) were identified as independent predictive factors of DM. Diabetic patients were on beta blockers (46.7% (n = 64) vs. 27.5% (n = 140), P < 0.001) and diuretics (51.1% (n = 70) vs. 33.2% (n = 169), p < 0.001) more frequently than non-diabetics. After a median follow-up of 22 months [IQR 7.5–63.0], 6.9% of patients developed DM, with no difference between those undergoing adrenalectomy and those treated medically (HR 1.07 [0.49–2.36], p = 0.866). There was also no significant difference in the evolution of glycemic control between DM patients who underwent surgery and those medically treated (p > 0.05). Conclusion: DM affects about one quarter of patients with PA and the risk factors for its development are common to those of the general population. Medical and surgical treatment provides similar benefit in glycemic control in patients with PA and DM.

To assess attitudes and perceptions from nursing staff, surgeons and anesthetists about compliance, utility, and impact on patient's safety of the surgical checklist in a teaching hospital. We also aimed to identify improvement opportunities for strengthening the usefulness of the checklist in the operating theater.

Aims: To assess the association between prenatal exposure to organochlorine compounds and thyroid status in newborns from an area with high levels of hexachlorobenzene (HCB) Methods: A total of 98 [...]

Identificar la percepción de los profesionales sobre los factores que pueden influir en el cumplimiento de la higiene de manos según categoría profesional y servicio.

Given a binary nonlinear code, we provide a deterministic algorithm to compute its weight and distance distribution, and in particular, its minimum weight and its minimum distance, which takes advantage of fast Fourier techniques. This algorithm's performance is similar to that of best-known algorithms for the average case, while it is especially efficient for codes with low information rate. We provide complexity estimates for several cases of interest.

Abstract Background--Polychlorinated biphenyls (PCBs) are complex mixtures of persistent contaminants that are widespread in the environment. Newborns are exposed across the placenta and through breast feeding. Experimental animal studies have [...]

Abstract Objectives--Hexachlorobenzene (HCB) is a highly lipophulic organochiorine compound of widespread environmental occurrence, that accumulates in the biological system. It affects the porphyrine metabolism, thyroid hormones, and the liver function [...]

SHANK3(also called PROSAP2) genetic haploinsufficiency is thought to be the major cause of neuropsychiatric symptoms in Phelan-McDermid syndrome (PMS). PMS is a rare genetic disorder that causes a severe form of intellectual disability (ID), expressive language delays and other autistic features. Furthermore, a significant number of SHANK3mutations have been identified in patients with autism spectrum disorders (ASD), and SHANK3truncating mutations are associated with moderate to profound ID. The Shank3 protein is a scaffold protein that is located in the postsynaptic density (PSD) of excitatory synapses and is crucial for synapse development and plasticity. In this study, we investigated the molecular mechanisms associated with the ASD-like behaviors observed in Shank3Δ11−/−mice, in which exon 11 has been deleted. Our results indicate that Shank3 is essential to mediating metabotropic glutamate receptor 5 (mGlu5)-receptor signaling by recruiting Homer1b/c to the PSD, specifically in the striatum and cortex. Moreover, augmenting mGlu5-receptor activity by administering 3-Cyano-N-(1,3-diphenyl-1H-pyrazol-5-yl)benzamide ameliorated the functional and behavioral defects that were observed in Shank3Δ11−/−mice, suggesting that pharmaceutical treatments that increase mGlu5 activity may represent a new approach for treating patients that are affected by PMS and SHANK3mutations.

Depending on their relationship with the pelagic particulate matter, planktonic prokaryotes have traditionally been classified into two types of communities: free-living (FL) or attached (ATT) to particles, and are generally separated using only one pore-size filter in a differential filtration. Nonetheless, particulate matter in the oceans appears in a continuum of sizes. Here we separated this continuum into six discrete size-fractions, from 0.2 to 200?µm, and described the prokaryotes associated to each of them. Each size-fraction presented different bacterial communities, with a range of 23–42% of unique (OTUs) in each size-fraction, supporting the idea that they contained distinct types of particles. An increase in richness was observed from the smallest to the largest size-fractions, suggesting that increasingly larger particles contributed new niches. Our results show that a multiple size-fractionation provides a more exhaustive description of the bacterial diversity and community structure than the use of only one filter. In addition, and based on our results, we propose an alternative to the dichotomy of FL or ATT lifestyles, in which we differentiate the taxonomic groups with preference for the smaller fractions, those that do not show preferences for small or large fractions, and those that preferentially appear in larger fractions.

Resonant inelastic x-ray scattering in the soft x-ray regime has been profiting much from technical advances that have lowered considerably the instrumental linewidth. At the ADRESS beam line of the Swiss Light Source the SAXES spectrometer can be used to measure RIXS spectra at the L edges of the 3d transition metals with unprecedented energy resolution, of the order of 100 meV for Mn, Ni and Cu. We present here some preliminary spectra on CuO, malachite, NiO, NiCl2, MnO and LaMnO3. The dd excitations are very well resolved allowing accurate experimental evaluation of 3d state energy splitting. The low energy scale becomes accessible opening the way to the study of collective excitations in strongly correlated electron systems, like magnons and orbitons.

Bovine tuberculosis (TB) is a disease of zoonotic importance for which control and eradication programmes have been carried out in many countries for decades. While the impact of these programmes on public health is still uncertain, the impact on trade is significant because of movement restrictions for animals, costs of testing and culling. The objective of this systematic review was to provide a contribution to the general debate over costs against benefits for the control and eradication of bovine TB in cattle. The search strategy was performed on four electronic databases following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) guidelines. The selection process, data abstraction and quality appraisal were carried out according to the Cochrane Collaboration guidelines. The search identified 66 articles out of which eight fulfilled the inclusion criteria. The evidence gathered in this review by combining the conclusions of the most methodologically sound articles supports the idea that, when multiple cost and benefit components are taken into account, efforts to control or eradicate bovine TB may be effective in reducing disease prevalence, economically viable and worth doing.

El objetivo de este estudio es medir la accesibilidad al sistema sanitario de los pacientes diabéticos y analizar si las posibles diferencias en la accesibilidad explican la mayor mortalidad conocida en aquellos.

A hepatitis A+B vaccine vaccination program of 12-year-olds was introduced in Catalonia in 1998. The aim of this study was to investigate the evolution of hepatitis A outbreaks in Catalonia and estimate the preventable fraction of cases associated with outbreaks as a measure of the impact of the vaccination program. Hepatitis A outbreaks reported to the Health Department between 1991 and 2012 were analyzed. The incidence rates of outbreaks, outbreak-associated cases and hospitalizations were calculated. The preventable fraction (PF) and 95% confidence intervals (CI) were estimated for the whole study period (pre-vaccination and post-vaccination) and the post-vaccination period. One-hundred-eight (108) outbreaks (rate of 2.21 per 106persons-year) were reported in the pre-vaccination period and 258 outbreaks (rate of 2.82 per 106persons-year) in the post-vaccination period. The rate of cases associated with outbreaks was 1.52 per 105persons-year in the pre-vaccination period and 1.28 per 105persons-year in the post-vaccination period. Hospitalization rates were 0.08 and 0.75 per 106persons-year, respectively. The number of person-to-person outbreaks whose index case was a school contact decreased in the post-vaccination period (aOR 2.72; 95%CI 1.35–5.48), but outbreaks whose index case was a man who has sex with men (MSM) or an immigrant increased. The PF of all outbreak-associated cases was 6.46% (95%CI 3.11–9.82) and the highest PF was in the 15–24 years age group (42.53%; 95%CI 29.30–55.75). In the 0–4 years age group, the PF was 18.35% (95%CI 9.59–27.11), suggesting a protective herd effect in unvaccinated subjects. Vaccination of immigrants traveling to endemic countries and MSM should be reinforced.

We present relative astrometric measurements of visual binaries, made in 2009 with the speckle camera PISCO at the 102 cm Zeiss telescope of Brera Astronomical Observatory, in Merate. Our observing list contains orbital couples as well as binaries whose motion is still uncertain. We obtained 345 new measurements of 259 objects, with angular separations in the range 0.″18–4.″6, and an average accuracy of 0.″011. The mean error on the position angles is 0.°6. Most of the position angles were determined without the usual 180° ambiguity with the application of triple‐correlation techniques and/or by inspection of the long integration files. We have found a possible new close component for ADS 2377, which would be a new quadruple star system. We also present new revised orbits for ADS 8035, 9982, 11484, and MLR 198, partly derived from those observations, and infer estimated values for the masses of those systems that are compatible with the spectral types (© 2011 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)

We present relative astrometric measurements of visual binaries made during the second semester of 2007, with the speckle camera PISCO at the 102 cm Zeiss telescope of Brera Astronomical Observatory, in Merate. Our sample contains orbital couples as well as binaries whose motion is still uncertain. We obtained 283 new measurements of 279 objects, with angular separations in the range 0″.17–4″.4, and an average accuracy of 0″.014. The mean error on the position angles is 0°.6. Most of the position angles were determined without the usual 180° ambiguity with the application of triplecorrelation techniques andor by inspection of the long integration files. We also present the new orbit we have computed for Zeta Aqr AB ADS 15971, for which our measurements lead to large residuals with the previously computed orbit. We were also able to compute the elements of the perturbation orbit BbP caused by an invisible companion, whose mass is estimated at 0.7 M© 2010 WILEYVCH Verlag GmbH & Co. KGaA, Weinheim

Abstract: Resonant inelastic x-ray scattering in the soft x-ray regime has been profiting much from technical advances that have lowered considerably the instru- mental linewidth. At the ADRESS beam line of the Swiss Light Source the SAXES spectrometer can be used to measure RIXS spectra at the L edges of the 3d transition metals with unprecedented energy resolution, of the order of 100 meV for Mn, Ni and Cu. We present here some preliminary spectra on CuO, malachite, NiO, NiCl2, MnO and LaMnO3. The dd excitations are very well resolved allowing accurate experimental evaluation of 3d state energy splitting. The low energy scale becomes accessible opening the way to the study of collective excitations in strongly correlated electron systems, like magnons and orbitons.

We present relative astrometric measurements of visual binaries made during the second semester of 2006, with the speckle camera PISCO at the 102 cm Zeiss telescope of Brera Astronomical Observatory, in Merate. Our sample contains orbital couples as well as binaries whose motion is still uncertain. We obtained 175 new measurements of 169 objects, with angular separations in the range 0″.1–4″.2, and an average accuracy of 0″.01. The mean error on the position angles is 0°.6. Most of the position angles could be determined without the usual 180° ambiguity with the application of triplecorrelation techniques andor by inspection of the long integration files.We also present the new orbits we have computed for ADS 11479, 11584 and 16538, for which our measurements lead to large residuals andor for which the revision was justified by the significant number of observations made since the last orbit computation © 2009 WILEYVCH Verlag GmbH & Co. KGaA, Weinheim

We present relative astrometric measurements of visual binaries made during the second semester of 2005, with the speckle camera PISCO at the 102 cm Zeiss telescope of Brera Astronomical Observatory, in Merate. Our sample contains orbital couples as well as binaries whose motion is still uncertain. The purpose of this long term program is to improve the accuracy of the orbits and determine the masses of the components.We performed 130 new observations of 120 objects, with most of the angular separations in the range 0″.1–4″, and with an average accuracy of 0″.01. Most of the position angles could be determined without the usual 180. ambiguity with the application of triple-correlation techniques, and their mean error is 0°8. We have found a possible new triple system: ADS 11077.The measurements of the closest binaries were made with a new data reduction procedure, based on model fitting of the background of the auto-correlations. As this procedure proved to be very efficient, we have re-processed the old observations of close binaries made with PISCO in Merate since 2004. We thus improved 20 measurements already published and obtained 7 new measurements for observations that were previously reported as “unresolved”.We finally present revised orbits for ADS 684, MCA 55Aac (in the Beta 1 Cyg–Albireo multiple system) and ADS 14783 for which the previously published orbits led to large residuals with our measurements and for which the new observations made since their computation allowed a significant improvement of those old orbits. The sum of the masses that we derived for those systems are consistent with the spectral type of the stars and the dynamic parallaxes are in good agreement with the parallaxes measured by Hipparcos. (© 2008 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

In August 2002 an outbreak of Shigella sonnei infection occurred in a Spanish town of 6343 inhabitants. In total, 756 people developed acute gastroenteritis and 181 cases were shigella-confirmed. The peak incidence was during 5–6 August 2002. The estimated primary attack rate was 9·97%; the attack rate for secondary cases was 38%. The <15 years ago group was most affected (16·49%). The town and its surroundings were served by two water systems, A and B. The cases had consumed water provided by system A (attack rate 164 cases/1000 population). Microbiological analysis of water from system A did not show the presence of coliform bacteria or shigella. This shigellosis outbreak was the largest reported in Spain. The impact of the epidemic was probably greater than the incidence detected.

Tin dioxide and ruthenium(platinum)-doped tin dioxide were synthesized in the form of inverted opals, aiming to investigate the interaction of these materials with CO reducing gas. The results of electron paramagnetic resonance (EPR) investigation allowed us to conclude that CO interaction causes the formation of singly ionized oxygen vacancies located in the subsurface region. These ones transfer their electrons to transition metal centers, Ru or Pt, enhancing the SnO2 surface reactivity toward CO. The reduction of Ru⁴⁺ and Pt⁴⁺ was assessed both by EPR and Mössbauer spectroscopy. Resistance measurements showed that the materials are well-suitable for use in CO sensor devices because of their reproducible and fast electrical response; this was related to the homogeneous and high dispersion of Ru and Pt centers in the oxide matrix and to the subsurface location of the species active in the electron-transfer processes.

The channel of the lower Tordera River (Catalan Coastal Ranges) was intensively mined between 1956 and 1987, at an extraction rate 14 times higher than the replenishment rates. Mining caused incision of up to 2 m over the whole reach, leading to damage of infrastructures and affecting the groundwater system. In this paper we analyse the response of the river sediment budget by means of sediment transport measurements (both in suspension and as bedload) and topographic surveys. Historical data on mining activities was used to verify current values of sediment transport and to locate the main extraction areas in the long profile of the river. This has led to an integrated methodology that can be useful for assessing and managing current and future sediment deficits in heavily mined rivers. In the lower Tordera, a minimum of 3 million cubic metres of sand and gravel were extracted, especially from two gravel pits still visible as concavities in the river's longitudinal profile. Nowadays, 15 yr after mining ceased, the river shows during dry periods a general tendency towards aggradation (3.6 mm yr−1on average and up to 12 mm yr−1in central sections where mining took place), but a slight long‐term tendency to erode the riverbed. Sediment yield at the entrance of the study reach attains 552 000 t yr−1, while net sediment deposition reaches 16 400 t yr−1(78% as bedload), mostly during small floods in dry periods. Estimated time for the river to recover pre‐extraction bed‐level is of the order of 420 yr. Copyright © 2005 John Wiley & Sons, Ltd.

Norovirus infection is associated with approximately 90% of epidemic non-bacterial acute gastroenteritis. The objective of this study is to describe an outbreak of norovirus genogroup I gastroenteritis which affected workers in a hospital and was attributed to food prepared by an infected food handler. Forty cases were detected, of whom 80% were interviewed. The index case was the cook employed in the hospital cafeteria. The following symptoms were observed: abdominal pain in 90·6%, vomiting in 71·9%, diarrhoea in 71·9%, general indisposition in 62·5%, headaches in 53·1% and fever in 32·4% of cases. The initial symptoms were abdominal pain in 37% and vomiting in 28%. Of the 14 samples analysed by RT–PCR, 12 (86%) were positive for a genogroup I norovirus. After sequencing the strain was identified as genotype Desert Shield. Many of the foodstuffs consumed were made by hand, favouring transmission from the index case to the cafeteria users.

Curative therapies for hepatocellular carcinoma (HCC), such as resection, liver transplantation, and percutaneous ablation, can be applied in selected patients with early tumors; this includes approximately 30%-40% of all cases. More advanced stages require local or systemic therapies. Data on the efficacy of these treatments are derived from small randomized controlled trials (RCT) and meta-analysis. Chemoembolization, a technique combining intra-arterial chemotherapy and selected ischemia, has produced modest survival advantages in 2 RCTs and a meta-analysis, and is currently the mainstay of treatment for these stages. The ideal candidates for this option are patients with well-preserved liver function (Child-Pugh class A) and multinodular asymptomatic tumors without vascular invasion, who constitute less than 15% of the HCC population. In these cases, the benefits derived by achieving objective responses (30%-50% of cases) are not offset by the deterioration of the liver function. Treatment-related mortality is less than 4%. No survival advantages have yet been shown with embolization or intra-arterial chemotherapy alone. Further RCTs are needed to assess the best chemotherapeutic agent and the ideal retreatment schedule. The analysis of efficacy in these trials should be adjusted for prognostic factors, such as the presence of symptoms, Child-Pugh class, and segmental vascular invasion.

A new macrocyclic tetrafunctional nitroxyl radical, I, developed by Ciba Specialty Chemicals, is a particularly effective catalyst in combination with Mn(II) and Co(II) or Cu(II) nitrates for the selective oxidation of primary and secondary alcohols to the corresponding aldehydes and ketones by air or O2 under mild conditions (ambient temperature and pressure) or H2O2. A distinctive feature of I is the possibility of easy recovery and recycles, due to its low solubility, particularly as ammonium salt, in most organic solvents, which makes it especially useful for practical applications.

This study was designed to assess whether a rice-hydrolysate formula allows normal growth and adequate metabolic balance in infants with cows' milk protein allergy. Infants (seven females, nine males; aged 6–14 months) were randomly assigned to receive a rice-hydrolysate formula (n= 8) or a soy formula (control group, n= 8). Standardized growth indices (Zscores) and biochemical parameters were evaluated during a 6-month treatment period. Infants in both groups showed normal growth patterns during the study, and no adverse reactions were seen. Mean plasma biochemical parameters were within the normal ranges, and did not differ between groups. In conclusion, rice-hydrolysate formula may be a nutritionally suitable alternative for infants with cows' milk protein allergy. Larger studies, with satisfactory power, should be undertaken to confirm these findings.

Background & Aims: A randomized, double-blind, placebo-controlled, multicenter study was conducted to assess the efficacy of 2 g sucralfate suspension in treating gastric mucosal lesions caused by long-term treatment with nonsteroidal anti-inflammatory drugs (NSAIDs). Methods: Only patients given NSAIDs continuously for at least 2 months with positive fecal occult blood (FOB) and endoscopically confirmed mild to moderate mucosal lesions (Lanza scale, grades 2-4) were included. After 1-week run-in phase, patients were stratified into 2 groups according to gastropathy-related symptoms during the preceding 7 days (symptomatic vs. asymptomatic) and randomized to 2 g (10 mL) of sucralfate suspension or placebo twice a day over a 6-week period. NSAIDs were given according to each patient's dosage schedule and always after meals. Results: Twenty-five patients received sucralfate and 25 received placebo. At the end of the study, 68% (17/25) of patients given sucralfate had no lesions (Lanza grade 0) on endoscopy compared with 35% (8/23) in controls (P = 0.042). The Lanza grades in patients given sucralfate were significantly improved compared with the placebo patients (P = 0.022). Conclusions: In this target population selected according to positive FOB test and endoscopic evidence of mucosal injury, chronic administration of sucralfate significantly decreased NSAID-induced gastric erosions. CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2003;1:51-56

Background.Vinorelbine (Navelbin®; N) has proven to be active in patients with advanced breast cancer (ABC) and cyclophosphamide (C) and epirubicin (Epiadriamycin®: E) are still among the main cytostatic agents against this tumor. On this basis was carried out a study to determine the activity and toxicity of the combination of these three agents (CEN). Patients and method.From April 1996 to March 1998, 59 patients with ABC were recruited of whom 56 were found eligible and evaluable for toxicixty and 55 for activity. The treatment regimen was C: 400 mg/m2, E: 30 mg/m2and N: 25 mg/m2administered intravenously on days 1 and 8 of a 28-day cycle. Results.The median number of cycles administered was 6 (range: 1–16). The most common hematological toxicity was grade (G) 3 and 4 neutropenia occurring in 36% of patients, associated with fever in 7% of them. Grade 3–4 thrombocytopenia and anemia occurred in 5% and 7%, respectively. Other G2–G3 non hematologic toxicities were: N/vomiting in 34%, alopecia in 73% and mucositis in 11% of patients. An objective response was achieved in 28 of 56 patients (50%) (95% confidence interval (CI): 37–63%): complete response (CR) in 9%, partial response (PR) in 41%. The median duration of response, time to progression and overall survival time was 54, 47 and 90 weeks, respectively. Conclusion.The CEN combination at these doses and treatment schedule appears to have acceptable tolerability but there is no apparent improvement in therapeutic efficacy when compared to other regimens used as first line treatment in ABC.

The molecular array of the outermost surface of bacteria and their physico-chemical characteristics modulate various functions which, when expressed in terms of the human environment, are generally known as factors of bacterial virulence. The present study investigated the ability of sub-MIC concentrations of cefodizime to interfere with the virulence factors of Escherichia coli. Bacterial adhesiveness to human epithelial cells was inhibited down to 1/32 x MIC of cefodizime, an antibiotic that is also capable of inducing the widespread production of filamentous forms at levels ranging from 1/2 to 1/8 x MIC. Given that this interfered with the correct evaluation of other virulence parameters, the study was extended to consider the effects of 1/16 to 1/128 x MIC. Sub-MIC concentrations of cefodizime inhibit haemagglutination, hydrophobicity and electrophoretic mobility, which are correlated with each other and provide clues relating to the physico-chemical characteristics of the outer surface. Cefodizime also reduces swarming. Phagocytosis was not affected but killing increased significantly. Oxidative bursts investigated by a chemiluminescence procedure were not modified. The interpolation of these pharmacodynamic findings with pharmacokinetic curves indicates that the effect of sub-MIC concentrations of cefodizime can prolong antimicrobial effects on virulence determinants up to 12 h after the antibiotic concentration has fallen below the MIC value.

The relationship between human immunodeficiency virus (HIV) type 1 reverse transcriptase tG:T mispair formation and base pair stability was investigated using DNA and RNA templates with 15 bp matched or mismatched DNA primers. tG:T mispair formation during primer elongation was undetectable on tDNA‐DNA duplexes but occurred with a frequency of 10(‐4) on matched tRNA‐DNA duplexes. The frequency increased to 7.0 × 10(‐4) and 1.3 × 10(‐3) on tRNA‐DNA duplexes with tG:T mismatches located 6 and 9 bp beyond the polymerization site. From Km values at 37 degrees C, the free energy change upon dissociation (delta G degrees 37) of the tG:T mispair increased from matched to mismatched tRNA‐DNA duplexes by 0.36–1.21 kcal/mol. delta G degrees 37 for a correct tG:C pair decreased by 0.06–1.00 kcal/mol. In comparison with DNA‐DNA duplexes, thermal melting measurements on RNA‐DNA duplexes demonstrated smaller enthalpy (delta delta H degrees = −17.7 to −28.1 kcal/mol) and entropy (delta delta S degrees = −59.3 to −83.4 cal/mol/K) components. A strong entropy‐enthalpy compensation resulted in small free energy differences (delta delta G degrees 37 = 0.8 to −2.2 kcal/mol). Thus, although DNA‐DNA and RNA‐DNA duplexes are of comparable stability in solution, the RNA‐DNA duplex presents more facile base pair opening and higher conformational flexibility. The release of helical strain at constant helix stability in RNA‐DNA duplexes may facilitate base mispairing during reverse transcription, particularly in the context of lentiviral G–>A hypermutation.

The efficacy and safety of γ-linolenic acid in the treatment of atopic dermatitis was evaluated. The children (mean age, 11.4 months) with atopic dermatitis (mean duration, 8.56 months) were openly treated with 3 g/day γ-linolenic acid, for 28 days. Clinical evaluations were carried out every 7 days, and parents were asked to keep a diary, recording details of symptoms of eczema every day. Blood chemistry and immunological tests were done before and after treatment. None of the children showed complete recovery of symptoms. A gradual improvement in erythema, excoriations and lichenification was seen; significant differences were shown for itching (P< 0.01), and the use of antihistamines (P< 0.01). A significant rise in the percentage of circulating CD8 was found. No side-effects were recorded. Dietetic and pharmacological approaches are the basis of the treatment of atopic dermatitis and γ-linolenic acid appears to be a safe and efficient additional therapy for infants and young children.

A nonhomogeneous spatial distribution of human immunodeficiency virus type 1 quasispecies was observed for epidermal Langerhans cells purified from skin patches taken from a patient with AIDS soon after death. Each patch presented a unique collection of sequences, distinct from those of juxtaposed patches or those derived from the other leg. Infection of Langerhans cells by virus from underlying T cells in the dermis might explain this partition. The analysis revealed the presence of two distinct cocirculating viral strains, indicating double infection.

Histamine (HA) injected i.c.v. to rats inhibited intestinal propulsion in linear relation to the log of the administered doses (in the range from 20-100 micrograms/rat). In the same dose range HA also induced a dose-related analgesic effect (tail-flick test). The dose of HA maximally active by the i.c.v. route (100 micrograms/rat) showed neither of these effects when injected i.v. or i.p. HA-induced intestinal inhibition and analgesia were antagonized competitively by i.c.v. mepyramine (10 micrograms/rat), an H1 receptor antagonist, whereas cimetidine (10 micrograms/rat), an H2 receptor antagonist, had no effect. Repeated i.c.v. injections of HA resulted in tachyphylaxis of both intestinal inhibition and analgesia. Pretreatment with i.c.v. naloxone (20 micrograms/rat) antagonized the antipropulsive effect of HA in a noncompetitive fashion, but did not affect its antinociceptive action. The relevance of the central histaminergic system in the modulation of gastrointestinal motility and its relationship with the opioid system are discussed.

The aim of our investigation was to evaluate thyroid function by a follow-up study in 45 polytransfused thalassemic patients, since endocrine abnormalities are frequent consequences of iron overload in thalassemia major. Significant changes of thyroid function have been revealed in the time elapsing the observation, despite unchanged haematological parameters; at the end of the present study five patients were affected by overt hypothyroidism and 15 patients by subclinical hypothyroidism. Ultrasound thyroid volume in 13 randomly selected patients was greatly reduced, while thyroid Magnetic Resonance Imaging (MRI) was not able to detect tissue alterations. Inversely, liver MRI was markedly reduced in 14 patients and negatively related to ferritine levels (P< 0.01). We conclude that polytransfused thalassemics are frequently affected by thyroid disfunction; haepatic haemosiderosis due to iron overload seems influence hormonal peripheral metabolism, although the patients display a moderate compliance with iron chelation therapy. Therefore, periodic thyroid investigation should be carried out in thalassemic subjects in order to detect patients who need hormone replacement therapy.

We present our experience with three different lithotriptors: Dornier HM3, EDAP LT02 and Piezolith 2300. Materials and methods:1876 patients with ureteral stones were treated between 1 January 1988 and 1 January 1996. The above 3 lithotriptors were used. In 925 patients the stones were located in the upper ureter, in 182 in the middle ureter and in 769 in the pelvic ureter. Auxiliary procedures were performed in 37% of patients. A DJ stent was used to catheterise 299 (16%) patients and a nephrostomy was performed in 19 (1%). Catheterisation was carried out in 247 (13.1%) ureters to localise the stones, plus 83 (4.4%) push ups and 52 (2.7%) Dormia baskets. Results:one treatment was sufficient in 1395 (74.3%) patients, 2 treatments in 335 (29.1%), 3 in 114 (6%), 4 in 21 (1.1%), 5 in 10 (0.5%) and 6 in 1 (0.05%). Patients were considered stone-free when they had negative X-ray and sonography two months after treatment; stones smaller than 3 mm, capable of being spontaneously eliminated without retrograde dilatation, were considered as fragments. The results were 1475 (78.6%) stone-free patients, 246 (13.1%) with fragments and 117 (6.2%) failures. 38 patients failed to appear at follow-up. Complications:complications were considered as hyperpyrexia and colics. There was very little hematuria, which regressed spontaneously in any case within the first 24 hours. Conclusion:side effects were few and required no treatment, so in our experience lithotripsy is the first choice treatment for ureteral stones. Particular attention, however, must be paid to the size of the stone in predicting the number of treatments.