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Old patients with hepatotoxicity have been scarcely studied in idiosyncratic drug-induced liver injury (DILI) cohorts. We sought for the distinctive characteristics of DILI in older patients across age groups. A total of 882 DILI patients included in the Spanish DILI Registry (33% ≥65 years) were categorized according to age: “young” (

Melatonin, a pineal gland synthesized neurohormone is known as a multifunctioning pleiotropic agent which has a wide range of neuroprotective role in manifold age-related neurodegenerative disorders especially Alzheimer's diseases (AD). AD is a devastating neurodegenerative disorder and common form of dementia which is defined by abnormal and excessive accumulation of several toxic peptides including amyloid β (Aβ) plaques and neurofibrillary tangles (NFTs). The Alzheimer's dementia relates to atrophic changes in the brain resulting in loss of memory, cognitive dysfunction, and impairments of the synapses. Aging, circadian disruption, Aβ accumulation, and tau hyperphosphorylation are the utmost risk factor regarding AD pathology. To date, there is no exact treatment against AD progression. In this regard, melatonin plays a crucial role for the inhibition of circadian disruption by controlling clock genes and also attenuates Aβ accumulation and tau hyperphosphorylation by regulating glycogen synthase kinase-3 (GSK3) and cyclin-dependent kinase-5 (CDK5) signaling pathway. In this review, we highlight the possible mechanism of AD etiology and how melatonin influences neurogenesis by attenuating circadian disruption, Aβ formation, as well as tau hyperphosphorylation. Furthermore, we also find out and summarize the neuroprotective roles of melatonin by the blockage of Aβ production, Aβ oligomerization and fibrillation, tau hyperphosphorylation, synaptic dysfunction, oxidative stress, and neuronal death during AD progression.

Highlights • HFPV maybe a tool for immobilizing thoracic targets in radiotherapy. • The procedure itself was well tolerated and well complied. • Chest wall motion was significantly reduced by greater than 60%. • HFPV can be greatly advantageous, particularly for SBRT and PBS proton therapy. • Duty cycle under HFPV was significantly higher than conventional methods. • The appropriate interface can lead to extensive HFPV prolonged times., High frequency percussive ventilation (HFPV) employs high frequency low tidal volumes (100–400 bursts/min) to provide respiration in awake patients while simultaneously reducing respiratory motion. The purpose of this study is to evaluate HFPV as a technique for respiratory motion immobilization in radiotherapy. In this study fifteen healthy volunteers (age 30–75 y) underwent HFPV using three different oral interfaces. We evaluated each HFPV oral interface device for compliance, ease of use, comfort, geometric interference, minimal chest wall motion, duty cycle and prolonged percussive time. Their chest wall motion was monitored using an external respiratory motion laser system. The percussive ventilations were delivered via an air driven pneumatic system. All volunteers were monitored for PO2 and tc-CO2 with a pulse oximeter and CO2 Monitoring System. A total of N = 62 percussive sessions were analyzed from the external respiratory motion laser system. Chest-wall motion was well tolerated and drastically reduced using HFPV in each volunteer evaluated. As a result, we believe HFPV may provide thoracic immobilization during radiotherapy, particularly for SBRT and pencil beam scanning proton therapy.

Goal The aim of this study is to investigate whether weight-bearing and gravity stress radiographs have additional value in predicting concomitant deep deltoid ligamentous (DDL) injury in case of isolated Weber type B fibular fractures. This may help to make the clinically relevant distinction between unstable fractures and fractures that can be treated conservatively. Methods In this prospective cohort study, 90 patients with an isolated type B ankle fracture, without a medial or posterior fracture, and a medial clear space (MCS) < 6 mm on the regular mortise (RM) view were included. In all patients, an additional gravity stress (GS) view and an MRI scan were performed. Furthermore, in 51 patients, an additional weight-bearing (WB) radiograph was performed. The MCS and superior clear space (SCS) measurements of these radiographs were compared with MRI findings to measure sensitivity and specificity in excluding deep deltoid ligament (DDL) rupture. Results The mean MCS on the RM view was 3.32 mm (1.73-5.93) compared to 4.75 mm (2.33-10.40) on the GS view and 3.18 mm (1.93-6.9) on the WB radiograph. MRI showed a high-grade or complete deltoid ligament tear in 25 (28%) patients. Using an MCS cut-off value of >= SCS + 2 mm, the RM view showed 0% sensitivity and 97% specificity in diagnosing a DDL rupture. Both the GS view (with MCS >= SCS + 3 mm as cut-off value) and the WB radiograph (with cut-off value MCS >= SCS + 2 mm) showed 6% sensitivity and 100% specificity. Conclusion The gravity stress and weight-bearing radiograph can accurately exclude DDL injury. They might have extra value in addition to the conventional mortise view in assessing the stability of isolated type B ankle fractures. This helps in deciding whether patients should be selected for operative or safe conservative treatment.

An outbreak of SARS-CoV2 infection in a Barcelona prison was studied. One hundred and forty-eight inmates and 36 prison staff were evaluated by rt-PCR, and 24.1% (40 prisoners, two health workers and four non-health workers) tested positive. In all, 94.8% of cases were asymptomatic. The inmates were isolated in prison module 4, which was converted into an emergency COVID unit. There were no deaths. Generalised screening and the isolation and evaluation of the people infected were key measures. Symptom-based surveillance must be supplemented by rapid contact-based monitoring in order to avoid asymptomatic spread among prisoners and the community at large.

International audience; The sizeable global production of wood-based products requires new sources of raw material, but also creates large quantities of wastes or composites that do not comply with requirements. In this study, the influence of dierent shares of recovered high-density fiberboards (HDF-r), reversed into the production, on industrial HDF properties, has been examined. HDF-r may be a suitablepartial substitute for raw pinewood for industrial HDF production. Although most of the mechanical properties, as well as thickness swelling and water absorption, had a linear decrease with the increase in the share of HDF-r share, the elaborated boards met most of the commercial requirements (EN 622-5). The property that did not meet the requirements was the internal bond strength for panels with 10% of HDF-r. The presented results show that, after some adjustments, it should be possible to produce HDF boards with up to 10% of recycled HDF being able to meet all commercial requirements.

Purpose Lung transplantation is a lifesaving therapy in patients with advanced lung disease. However, frail lung transplant candidates are more likely to be delisted or die on the waitlist. It is not clear if currently used frailty tools can predict outcomes after lung transplantation. We investigated the correlation between frailty measurements and outcomes after lung transplantation. Methods We prospectively assessed frailty in 25 consecutive lung transplant candidates using the Fried Frailty Phenotype (FFP), Short physical performance battery (SPPB) tools, and the Montreal Cognitive Assessment (MoCA). We evaluated the correlation between frailty measurement and lung transplant outcomes such as death, length of stay in the hospital, number of rejection episodes, and pulmonary function tests (PFT) one year after lung transplantation. The data was analyzed using R 4.0.2 (The R Foundation for Statistical Computing http://www.R-project.org) Packages PerformanceAnalytics and ggplot2 were used in addition to core R. Results We evaluated 25 lung transplant patients with an average age of 56. Both “Frail” and “Pre-frail” frailty phenotypes had 11 (44%) patients. The remaining 3/25 (12%) had a “Robust” phenotype. There was no clear relationship between frailty score and mortality (p=0.23), length of stay (p=0.5), number of rejections episode (p=0.83), and PFT after one year (FVC p=0.71 and FEV1 p=0.78). Age has a strong trend for association with frailty however, it did not reach statistical significance (p=0.16). Among used frailty tools, MOCA had the strongest association with mortality after one year (p=0.17). Conclusion Frailty score, as assigned by three phenotypes pre-frail, frail, and robust, had no significant relationship with outcomes after lung transplantation. Interestingly amongst used frailty instruments, MOCA has the strongest correlation with mortality one year after lung transplantation. Larger studies are needed to understand better if frailty measurements can predict outcomes after lung transplantation.

Genomic data analysis is a fundamental system for monitoring pathogen evolution and the outbreak of infectious diseases. Based on bioinformatics and deep learning, this study was designed to identify the genomic variability of SARS-CoV-2 worldwide and predict the impending mutation rate. Analysis of 259044 SARS-CoV-2 isolates identified 3334545 mutations with an average of 14.01 mutations per isolate. Globally, single nucleotide polymorphism (SNP) is the most prevalent mutational event. The prevalence of C > T (52.67%) was noticed as a major alteration across the world followed by the G > T (14.59%) and A > G (11.13%). Strains from India showed the highest number of mutations (48) followed by Scotland, USA, Netherlands, Norway, and France having up to 36 mutations. D416G, F106F, P314L, UTR:C241T, L93L, A222V, A199A, V30L, and A220V mutations were found as the most frequent mutations. D1118H, S194L, R262H, M809L, P314L, A8D, S220G, A890D, G1433C, T1456I, R233C, F263S, L111K, A54T, A74V, L183A, A316T, V212F, L46C, V48G, Q57H, W131R, G172V, Q185H, and Y206S missense mutations were found to largely decrease the structural stability of the corresponding proteins. Conversely, D3L, L5F, and S97I were found to largely increase the structural stability of the corresponding proteins. Multi-nucleotide mutations GGG > AAC, CC > TT, TG > CA, and AT > TA have come up in our analysis which are in the top 20 mutational cohort. Future mutation rate analysis predicts a 17%, 7%, and 3% increment of C > T, A > G, and A > T, respectively in the future. Conversely, 7%, 7%, and 6% decrement is estimated for T > C, G > A, and G > T mutations, respectively. T > G/A, C > G/A, and A > T/C are not anticipated in the future. Since SARS-CoV-2 is mutating continuously, our findings will facilitate the tracking of mutations and help to map the progression of the COVID-19 intensity worldwide.

Background Neurological disorders represent one of the most prominent causes of morbidity and mortality that adversely affect the lifestyle of patients and a major percentage of these diseases exists in developing countries. Purpose The objective of this study was to examine the prevalence and prescription pattern for outpatients with neurological disorders in Bangladesh. Methods The study was conducted on 1,684 patients in 6 hospitals (National Institute of Neurosciences and Hospital, Dhaka Medical College and Hospital, Bangabandhu Sheikh Mujib Medical University, Shaheed Suhrawardy Medical College, Sir Salimullah Medical College, and Apollo Hospitals Dhaka) of the Dhaka City from March 2014 to June 2015. Data were collected through a predesigned questionnaire from the patients that contain information about gender, age, marital status, occupation, residential status, affected disease, self-medicated medicines, and prescribed medicines. Results Out of 1,684 patients, 28.38% patients were aged 51-60 years and male, 57.19% predominance. The study exposed headache and migraine for 29.75% patients, followed by stroke for 23.93% patients and seizure for 7.07% patients. Genetic reason for the neurological disorders was seen only among 12.35% patients. In this study, 16.98% patients had been affected by neurological disorders for more than 2 years and 19% of patients for less than 6 months. Most extensively prescribed medicines were multivitamins and multiminerals used by 17.89% of patients followed by nonsteroidal anti-inflammatory drugs and other analgesic by 14.84%; afterwards antiulcerants were used by 12.62%, subsequently anticoagulants were used by 11.61% followed by antihyperlipidemic medicines by 10.26% and antiepileptic drugs by 8.08% of patients. The crucial reasons for the selection of prescribed medicines were the confidence that patients had with the physician's prescribed medicines, which was shown for 40.97% patients and knowledge of the medicines was reported for 35.04% patients. The period of prescribed medicine usage was 1-3 months for 39.73% patients and 3-6 months for 29.16% patients. The patient's compliance for prescribed medicines was satisfactory for 34.56% patients, good for 28.15% patients, and side effects were reported for 23.22% patients. Conclusion In Bangladesh, it is not surprising to note that neurological diseases are more prevalent than other different diseases among different age groups and genders. Headache and migraine, stroke and seizure are most frequently encountered neurological disorders here. Treatment procedure of these disorders is not quite suitable due to the anomalies of health care management systems. Appropriate management of the health care system, especially the placement of hospital and community pharmacy can overcome the existing inconsistencies as well as increase the knowledge, awareness, and perception of the patients about health and neurological disorders.

We evaluated stereotactic volume modulated arc radiotherapy (VMAT) for canine gliomas, alone (radiotherapy [RT]) and in combination with temozolomide (RT + TMZ), compared with palliation. Overall and disease-specific survival times were estimated. Thirty dogs were palliated, 22 dogs were treated with RT and 20 with RT + TMZ. Complete and partial responses were observed in 63.2% and 90.9% of patients in the RT and RT + TMZ arms, respectively, that were alive at 1 year. Median survival in the palliation arm was 94 days (95% conformity index [CI] 87÷101). Median survivals of the RT arm (383 days, 95% CI 276÷490) and RT+TMZ arm (420 days, 95% CI 280÷560) were not significantly different (P = .61). Positive correlation with survival was found both for the ratio between target and brain (relative) volume of the tumour of

Background:Oxidative stress is intensely linked with several pathological manifestations. Searching for medicinal plant with the superior safety profile for the treatment of oxidative stress related disorders are ongoing due to multiple unwanted effects associated with synthetic antioxidants. Therefore the purpose of this study was to examine the phytochemical content, in vitro antioxidant potentiality of crude methanol extract (CME), carbon tetrachloride fraction (CTF), petroleum ether fraction (PEF), chloroform fraction (CLF) and ethyl acetate fraction (EAF) of aerial parts of Gnaphalium luteoalbum (GL) L. Methods:The aerial parts of the GL were extracted with methanol followed by fractionation using carbon tetrachloride, petroleum ether, chloroform and ethyl acetate.The phytochemical screening of this plant was performed by using standard methods to evaluate the existence of alkaloids, carbohydrates, phenols, flavonoids, saponins, tannins, terpenoids and fixed oils.Antioxidant potentiality was estimated by, 2,2-diphenyl-1-picrylhydrazyl (DPPH), hydroxyl (OH) and nitric oxide (NO) radical scavenging tests. Total antioxidant capacity (TAC), total phenolic content (TPC) and total flavonoid content (TFC) were also measured. Results: Phytochemical analysis of the aerial parts of GL confirmed the presence of carbohydrates, phenols, flavonoids and saponins in crude extract and its all fractions. The CME showed the highest scavenging activity (43.28%) with IC50 of 398.49 μg/mL in the DPPH radical scavenging test. The IC50 values of EAF, CME were statistically significant (P < 0.05, P < 0.01) with respect to ascorbic acid (ACA). For OH and NO radical scavenging tests maximum scavenging (48.39%, 69.64%) was also reported for CME compared to CTF, PEF, CLF and EAF. Compared to ACA, in case of OH and NO radical scavenging activities the IC50 values of CME were markedly significant (P < 0.01, P < 0.05). In the TAC test, CME showed the highest antioxidant activity (absorbance, 2.6 nm) related to other fractions. TPC was found to be the highest in the CME (115.96 mg of gallic acid equivalent/g of dried extract) rather than other fractions. The ranking order of CTF, PEF, CLF, EAF and CME for TFC was 48.67 < 55.75 < 65.29 < 71.35 < 82.29 mg quercetin equivalent/g of dried extract. Conclusion: The existing study suggested that CME of the aerial parts of GL can be used as a natural source of antioxidant which might be effective towards preventing or slowing oxidative stress related disorders.

Determination of different forms of 25-OHD (total, free and bioavailable) in healthy young women does not offer additional advantages over standard 25-OHDDetermination of 25-OH vitamin D serum levels (25-OHD) constitutes the method of choice for evaluating vitamin D deficiency. However, vitamin D-binding protein (DBP) may modulate its bioavailability thereby affecting correct evaluation of 25-OHD status. We analysed the impact of the determination of 25-OHD (total, free and bioavailable) on the evaluation its biologic activity (estimated by serum PTH determination) in healthy young women.173 premenopausal women (aged 35-45 yrs.) were included. We analysed serum values of total 25-OHD (25-OHD62% of subjects had 25-OHD values20 ng/ml and also had significantly lower 25-OHDDetermination of different forms of 25-OHD in healthy young women does not offer additional advantages over standard 25-OHD

Abstract The growing production of wood-based panels and the linked consumption result in a need for substituting standard wooden raw materials. The shortage of wood availability, as well as the increasing prices and a trend towards more environmentally friendly materials and processes, have encouraged the producers of wood-based products to consider extending the life cycle of wood composites. In the present work, the influence of substituting pine with spruce for industrial high-density fiberboards with 5% of recovered fibers was studied. Samples containing 0%, 25%, 50%, and 100% spruce fibers were tested in their mechanical resistance and their interaction with water. Boards from all samples met relevant standard requirements; however, the addition of spruce caused a decrease in mechanical properties, with homogeneity having the most significant influence. The modulus of rupture dropped up to 6% and the internal bond for 47% for samples having 50% of spruce. The most significant drop (50%) was observed for surface soundness for samples made with 100% spruce. Regarding physical properties, swelling increased up to 19% with 50% spruce; on the other hand, its water absorption decreased for up to 12%. The addition of spruce to industrial high-density fiberboards also influenced the formaldehyde content negatively, with an increase of up to 21% with 50% spruce. Graphic Abstract

A cross-sectional survey was carried out to estimate the seroprevalence of Coxiella burnetii in extensively grazed cattle and sheep from central Italy and to identify the related risk factors. Data on notified human Q fever cases in the area were also collected and described. A two-stage cluster sampling was performed. A total of 5083 animals (2210 cattle; 2873 sheep) belonging to 186 farms (92 herds; 94 flocks) were tested for the presence of antibodies against C. burnetii using a commercial enzyme-linked immunosorbent assay kit. The prevalence at the animal-level resulted three times higher in sheep compared to cattle (37.8% vs. 12.0%; χ2 = 270.10, P < 0.001). The prevalence at the herd-level was also higher in sheep than in cattle (87.2% vs. 68.5%; χ2 = 9.52, P < 0.01). The multivariate analysis showed a higher risk of seropositivity for cattle aged 67–107 months (OR 2.79, 95% CI 1.86–4.18), cattle >107 months of age (OR 2.07, 95% CI 1.36–3.14) and mixed breed cattle (OR 1.74, 95% CI 1.11–2.72). A herd size >92 animals was recognized as herd-level risk factor in cattle (OR 6.88, 95% CI 1.67–28.37). The risk of being seropositive was double in sheep belonging to flocks >600 animals (odds ratio (OR) 2.04, 95% CI 1.63–2.56). Sheep were confirmed to be the most exposed species. Nevertheless, the prevalence observed in cattle also suggests the potential involvement of this species in the circulation of the pathogen in the area. Seven confirmed human Q fever cases were reported. In five out of seven cases there was at least one exposed herd within a 5 km buffer. Even though the source of the infection was not identified, the possibility of C. burnetii circulating in the livestock and human population in the study area cannot be overlooked. The integration between veterinary and human surveillance will be crucial to understand the spread of this zoonosis and to support the adoption of appropriate control measures.

Objectives To evaluate the feasibility and efficacy of hypofractionated stereotactic volumetric-modulated arc radiotherapy in treating canine adrenal tumours with vascular invasion. Methods A single-arm clinical study was performed. The dogs underwent total body computed tomography, brain and abdomen magnetic resonance imaging and endocrine assay. Adrenal masses were classified as cortisol-secreting adrenal tumour or non-secreting adrenal tumour. Radiotherapy treatments were delivered by hypofractionated stereotactic volumetric-modulated arc radiotherapy via a linear accelerator. The overall survival was estimated by the Kaplan–Meier method. The overall response and radio-toxicity effects were determined. Results Nine dogs were enrolled. Three dogs were affected by cortisol-secreting adrenal tumours and the remaining dogs had non-secreting adrenal tumours. The prescribed doses ranged from 30 to 45 Gy in three or five consecutive daily fractions. The median overall survival time was 1030 days, and the overall mean reduction of the diameter and volume were ~32 and 30% respectively. The endocrine profile normalised in two dogs with cortisol-secreting adrenal tumours. Radio-toxicities were mild and self-limiting. Seven deaths were recorded during the follow-up period and two dogs were censored. Clinical Significance Hypofractionated stereotactic volumetric-modulated arc radiotherapy should be considered as a feasible and effective therapeutic option for adrenal tumours with vascular invasion.

Psoriasis is a chronic inflammatory disease affecting mainly the skin but which can be complicated by psoriatic arthritis (PsA).This autoimmune skin disorder concerns 2-5% of the world population. To date, the physiopathology of psoriasis is not still completely elucidated but many researches are ongoing which have led for example to the discovery of the Th17/Th22 pathway. The conventional therapeutic approaches (local or systemic route) appeal to various classes of drugs with complex mechanisms of action and non-negligible side effects. Although there is no therapy capable to cure psoriasis, the current goal is to relieve symptoms as longer as possible with a good benefit/risk ratio. That is one of the principal limits of conventional antipsoriatic drugs. New formulations based on nanoencapsulation are a promising opportunity to answer to this limit by offering an optimization of the conventional antipsoriatic drug use (higher activity, lower side effects and frequency of application, etc.). Herein, we tried to put in perspective the mechanistic insights (histological and immunological views) proposed into scientific literature these last years in order to have a better comprehension of psoriasis physiopathology resulting in skin lesions and PsA. The therapeutic armamentarium and the different strategies in the management of psoriasis are discussed in greater details. To finish, the field of encapsulation in nanoparticles is broached in order to put forward recent advances in innovative skin drug delivery systems (ISDDSs) of antipsoriatic active agents for a better efficacy, safety and compliance.

Background:Tight control of rheumatoid arthritis (RA) is essential and we need a validated, objective and reproducible disease measure to achieve it. There is not gold standard in RA. There is a rising interest in evaluating disease activity on the patient’s point of view using patient-reported outcomes like RAPID3. Furthermore, some new biomarkers have appeared, like serum calprotectin, with promising results on its analyzing.Objectives:To evaluate correlation between disease activity measures usually used in patients with RA (DAS28 ESR/CRP, SDAI and CDAI) and other alternative tools (RAPID3 and calprotectin). To analyze correlation between RAPID3 and serum calprotectin levels.Methods:A cross-sectional study was performed. RA-patients (n=114) according to the ACR/EULAR 2010 classification criteria were consecutively enrolled from Rheumatology department at Hospital de Figueres during the period from February to June 2019. Disease activity, biomarkers and the assessment of the patient’s health status with RAPID3 data were collected. Modified RAPID3 (mRAPID3) was calculated by subtracting the questions about the mood included in the questionnaire (k,l,m questions) to the results of the RAPID3 as if it were a response of the HAQ test. Coefficient Spearman’s correlation (r) was used to assess the relationship between the variables, and coefficient of determination (r-squared=r2and adjusted r2) was used to show the strength of correlation.Results:114 patients were included: 71% women, mean (SD) age 60(11) years, median disease duration 13(8) years. 80% had positive RF and 70% positive ACCP antibodies. 52% had erosions. 89% patients had been receiving treatment with csDMARDs, 38% with bDMARDs o dsDMARS and 66% with glucocorticoids. Disease activity measures’ median values were DAS28ESR 3.07, DAS28CRP 2.76, SDAI 9.62 and CDAI 8.99 and showed low activity. The mean values of RAPID3 y mRAPID3 showed moderate activity (8.95 and 8.68 respectively). Median serum calprotectin level was 1.48μg/ml.All correlations between variables were statistically significant and directly proportional although with different values (table).Spearman’s correlation coefficient between mRAPID3, serum calprotectin, disease activity scores and laboratory parametersmRAPID3CalprotectinCRPESRDAS28ESRDAS28PCRSDAICDAImRAPID31Calprotectin0.231CRP0.330.591ESR0.230.390.541DAS28-ESR0.620.320.410.621DAS28-CRP0.690.320.420.280.831SDAI0.740.310.350.270.820.911CDAI0.730.250.240.210.800.890.991DAS28: Disease Activity Score, SDAI: Simplified Disease Activity Index, CDAI: Clinical Disease Activity Index, RAPID3m: Routine Assessment of Patient Index Data 3 modificative with k,l,m questions. CRP: C-reactive protein. ESR: erythrocyte sedimentation rateCoefficient of determination found a weak association between RAPID3 and mRAPID3 with DAS28ESR (r2=0,38) and moderate with DAS28CRP, SDAI and CDAI (r2=0,47, 0,55 y 0,53). Determination serum calprotectin levels together with RAPID3 or mRAPID3 increased strength of correlation between DAS28ESR, DAS28CRP, SDAI and CDAI with RAPID3 (adjusted r2=0,40, 0,49, 0,56, 0,52) and with mRAPID3 (adjusted r2=0,41, 0,50, 0,56, 0,53). Correlation between RAPID3 and serum calprotectin levels was very weak (r2=0,05).Conclusion:Correlation between disease activity measures and mRAPID3 was strong, but it was weak with serum calprotectin levels. Correlation strength between RAPID3 and DAS28ESR was low and it was moderate with other composite indices, it maintained with RAPID3m and improved by adding serum calprotectin levels although modestly. There was a very weak correlation between RAPID3 and serum calprotectin levels suggesting that these two variables give us different information about the disease activity.Acknowledgments:Mrs. Dolors Ragolta. Mr. Carlos Sanchez Piedra and Mr. Fernando Sanchez AlonsoDisclosure of Interests:None declared

Purpose: Introduction Lung transplantation is a lifesaving therapy in patients with advanced lung disease. However, frail lung transplant candidates are more likely to be delisted or die on the wait list. There is a need to objectively identify frailty and assess potentially reversible risk factors in potential lung transplant candidates Methods: Methods We prospectively assessed frailty in 43 consecutive lung transplant candidates using the Fried Frailty Phenotype (FFP), Short physical performance battery (SPPB) tools, and the Montreal Cognitive Assessment (MoCA). We determined prevalence and risk factors associated with frailty utilizing multi-variable logistic regression analysis after adjusting for covariates. Results: Results We evaluated 43 lung transplant candidates. The average age was 60 years, 23 of whom were female. Their primary diagnoses included COPD (20%), ILD (50%), and Other (30%). Of the 43 lung transplant candidates, 34/43 (79%) were frail (9) or pre-frail (25) by the SPPB and 37/43 (86%) were frail (17) or pre-frail (20) by the FFP (p Conclusion: Conclusion Frailty is highly prevalent in lung transplant candidates but varies by the frailty tool. Frailty is associated with decreased DLCO. Patients with COPD have a strong trend for a higher prevalence of frailty. Also, lower BMI is associated with increased frailty, and the validity of the MOCA score is questionable in patients with lower educational levels. Further evaluation of risk factors for frailty and mitigation of these risk factors may enhance patient outcomes post lung transplantation. Further evaluation of frailty in larger populations are needed to validate these findings.

Herein, we detail a promising strategy of nanovesicle preparation based on control of phospholipid self-assembly: the Double Solvent Displacement. A systematic study was conducted and diclofenac as drug model encapsulated. In vitro skin studies were carried out to identify better formulation for dermal/transdermal delivery.This method consists in two solvent displacements. The first one, made in a free water environment, has allowed triggering a phospholipid pre-organization. The second one, based on the diffusion into an aqueous phase has led to liposome formation.Homogeneous liposomes were obtained with a size close to 100 nm and a negative zeta potential around -40 mV. After incorporation of acid diclofenac, we obtained nanoliposomes with a size between 101 ± 45 and 133 ± 66 nm, a zeta potential between 34 ± 2 and 49 ± 3 mV, and the encapsulation efficiency (EE%) was between 58 ± 3 and 87 ± 5%. In vitro permeation studies showed that formulation with higher EE% dispayed the higher transdermal passage (18,4% of the applied dose) especially targeting dermis and beyond.Our results suggest that our diclofenac loaded lipid vesicles have significant potential as transdermal skin drug delivery system. Here, we produced cost effective lipid nanovesicles in a merely manner according to a process easily transposable to industrial scale. Graphical Abstract ᅟ.

Background Sonography is a diagnostic tool with great development in diagnosing entrapment neuropathy. It9s an easy, painless, fast, non-invasive technique and can explore how the nerve9s morphology and pathologies are associated. An electroneurogram is used to assess the intensity of nerve involvement. Objectives To determine the relationship between the intensity of nerve involvement by electroneurogram and the measurement of the cross-sectional area (CSA) of the median nerve by sonography in patients with idiopathic carpal tunnel syndrome (CTS) waiting for surgery. Methods 56 wrists of 39 consecutive patients waiting for surgery were tested, however 5 were excluded because were found to have anatomic variants (4 bifid nerves, 2 median arteries) and 1 fybrolipoma. Therefore, the final sample was 51 wrists of 37 consecutive patients (11 male and 26 females), with a mean age of 59.2 years (26–85), all with electrophysiologically confirmed idiopathic CTS. Patients were classified by their electrophysiologic grade. The median nerve cross-sectional area at proximal and distal carpal tunnel was measured using high frequency ultrasound. Relationships between CSA, the severity of the electrophysiologic grade and the duration of symptoms were analysed. Also, a median nerve morphological characteristics examination (hipoecogenicity, loss of fascicular structure, Power Doppler signal and anatomical variants) was undertaken. A comparison between CSA and the severity of the electrophysiologic grade was made using an independent T test and the connection between CSA and the duration of symptoms was calculated using ANOVA test. Results Patients were classified by their electrophysiologic severity grade (8 mild, 13 moderate, 29 severe and 1 very severe). The mean ultrasound area of distal medial nerve was 8.7 mm 2 in mild-moderate and 9.2 mm 2 in severe-very severe cases (p=0.52). The average of proximal CSA was 11.6 mm 2 in mild-moderate and 14.1 mm 2 in severe-very severe cases with statistical signification differences (p=0.026). Relationship between CSA and symptom9s duration wasn9t identified. In 89.2% of the cases, hipoecogenicity and the loss of fascicular structure were observed but no cases were found to show positive Power Doppler signal. Conclusions The most valid and relevant parameter regarding the electroneurogram in the diagnosis of CTS is CSA at proximal carpal tunnel by sonography. A cross-sectional area measuring more than 9–10 mm 2 has been suggested to be pathologic and our study confirms these results. While the electroneurogram is the gold-standard method in the diagnosis of nerve involvement severity, a sonography could improve the diagnostic sensibility and give information about nerve9s morphology and associated pathologies. Disclosure of Interest None declared

We present herein a case of bacterial gastroenteritis due to Yersinia enterocolitica, occurred in a young woman undergoing haemodialysis with a previous history positive for prolonged (20 years) immunosuppressive therapy for glomerulonephritis before and for kidney transplant later. The patient’s outcome was favourable after a third-generation cephalosporin treatment without complications. The possible pathophysiological association between patient clinical condition and Yersinia bacteraemia is discussed, along with the review of literature.

BACKGROUND: A better understanding of caregiver burden and its determinants is essential to support caregivers. Many instruments have been developed to measure caregiver burden in various illness contexts, but few have been psychometrically tested for caregivers of heart failure patients. AIMS: The aim of this study was to test the validity (factorial and concurrent validity) and reliability (internal consistency) of the caregiver burden inventory (CBI) in a cohort of caregivers of heart failure patients. METHODS: This was a secondary analysis from a cross-sectional study on heart failure patients and their caregivers enrolled from various Italian outpatient centres. The factorial validity of the CBI was tested with confirmatory factor analysis, and concurrent validity was tested correlating CBI scores with the short form-12 health survey scores. The internal consistency reliability was assessed with Cronbach's alpha. RESULTS: In total, 505 caregivers of heart failure patients (52.2% women, mean age 56.59±14.9 years) were enrolled. Confirmatory factor analyses confirmed the original five-factor model: time-dependence, developmental, physical, social and emotional burden. This model fits the data better than the single-factor model, and the dimensions showed high internal consistency reliability (Cronbach's alpha 0.91 for time-dependence burden, 0.92 for developmental burden, 0.88 for physical burden, 0.89 for social burden and 0.93 for emotional burden; 0.96 for the total score of burden). CONCLUSION: The CBI proved to be a good multidimensional instrument for evaluating the burden in caregivers of heart failure patients and can be used in clinical practice and research. This tool can be considered to tailor interventions aimed at improving caregiver outcomes.

Background: False-positives are a major concern in breast cancer screening. However, false-positives have been little evaluated as a prognostic factor for cancer detection. Our aim was to evaluate the association of false-positive results with the cancer detection risk in subsequent screening participations over a 17-year period. Methods: This is a retrospective cohort study of 762,506 women aged 45-69 years, with at least two screening participations, who underwent 2,594,146 screening mammograms from 1990 to 2006. Multilevel discrete-time hazard models were used to estimate the adjusted odds ratios (OR) of breast cancer detection in subsequent screening participations in women with false-positive results. Results: False-positives involving a fine-needle aspiration cytology or a biopsy had a higher cancer detection risk than those involving additional imaging procedures alone (OR = 2.69; 95% CI: 2.28-3.16 and OR = 1.81; 95% CI: 1.70-1.94, respectively). The risk of cancer detection increased substantially if women with cytology or biopsy had a familial history of breast cancer (OR = 4.64; 95% CI: 3.23-6.66). Other factors associated with an increased cancer detection risk were age 65-69 years (OR = 1.84; 95% CI: 1.67-2.03), non-attendance at the previous screening invitation (OR = 1.26; 95% CI: 1.11-1.43), and having undergone a previous benign biopsy outside the screening program (OR = 1.24; 95% CI: 1.13-1.35). Conclusion: Women with a false-positive test have an increased risk of cancer detection in subsequent screening participations, especially those with a false-positive result involving cytology or biopsy. Understanding the factors behind this association could provide valuable information to increase the effectiveness of breast cancer screening. (C) 2012 Elsevier Ltd. All rights reserved.

Acinetobacter baumannii has emerged as a major cause of healthcare-associated infections. It commonly expresses clinical resistance to multiple antimicrobial agents, and hence, it is considered the paradigm of an extensively drug-resistant (XDR) bacterium. XDR A. baumannii is a rapidly emerging pathogen, especially in the intensive care unit (ICU), causing nosocomial infections including sepsis, ventilatorassociated pneumonia, meningitis, peritonitis, urinary tract infection, and central venous catheter-related infection. In the present report, we described an in vivo evolution of A. baumannii strain from a colistinsusceptibility to a colistin-resistance state. A 65-year-old male, who suffered a duodenal ulcer, two days after hospitalization and during the stay in ICU, contracted a pneumonia and peritoneal infection by a carbapenem-resistant A. baumannii strain. After a combination treatment with colistin, vancomycin plus imipenem, and within seven days, the pathogen rapidly evolved in seven days to a pandrug-resistant phenotype. As the antimicrobial treatment was stopped, the A. baumannii isolate changed another time its profile to colistin, becoming newly susceptible, showing a very high level of adaptability to external conditions. We also have reviewed here the current literature on this worryingly public health threat.

Objective Previous trials have shown little benefit for preventing preterm birth in twin pregnancies using 90–200 mg of daily vaginal natural progesterone. Higher doses have not been tested. Our aim was to determine the efficacy and safety of two different daily doses of vaginal natural progesterone (200 and 400 mg), compared with placebo, for preventing preterm birth in unselected twin pregnancies. Design Randomised controlled double-blind multicentre trial (1:1:1). Setting The study was carried out in five university centres from Valencia, Murcia and Alicante (Spain). Population Women with dichorionic diamniotic twin pregnancies. Methods The women self-inserted two vaginal pessaries daily, containing placebo (n = 96), 200 mg of natural progesterone (n = 97) or 400 mg of natural progesterone (n = 97), from 20 to 34 weeks of gestation or delivery. Randomisation was performed by an external centre. Data were analysed on an intention-to-treat basis. Main outcome measure Preterm birth rate. Results The baseline characteristics for placebo and progesterone groups were similar. Comparison of the three groups and analysis of progesterone-treated versus untreated women showed similar pregnancy and neonatal outcomes. The proportion of preterm and very preterm births, low birthweight, perinatal mortality and neonatal morbidity showed no differences between the three groups. Similar results were also obtained when comparing the 200- versus 400-mg progesterone groups. No serious adverse effects were encountered. Conclusions Vaginal progesterone therapy was generally well tolerated, but failed to prevent preterm births in unselected dichorionic diamniotic twin pregnancies. The 400-mg progesterone dose offered no advantages over the 200-mg regimen.

Purpose Histological analysis of the remodelling process of human hamstring tendon (HT) grafts after standardized anterior cruciate ligament reconstruction (ACLR) with an accelerated rehabilitation protocol. Methods Sixty-seven patients underwent retrieval of mid-substance biopsies after clinically successful hamstring autograft ACLR. Samples were allocated to one of three groups depending on the time point of retrieval: group 1 (6–12 months; n = 15), group 2 (13–24 months; n = 16) and group 3 (>24 months; n = 11). Biopsies from native HT (n = 17) and ACL (n = 8) served as controls. Cellular density, vascular density and myofibroblast density and collagen fibril alignment were analysed by haematoxylin–eosin, Masson-Goldner-Trichrom and immunohistochemical staining protocols. Results Compared with native HT (330.4/mm²), total cell number was increased in groups 1-3 (Group 1 = 482.0/mm² (P = 0.036); group 2 = 850.9/mm² (P = 0.005); and group 3 = 595.6/mm² (P = 0.043). There were no significant differences between the groups for vessel density. Myofibroblast density was higher in group 2 (199.6/mm²) compared with native HT (1.9/mm², P = 0.014). Collagen orientation was irregular up to 12 months. Thereafter, collagen orientation became more regular, adapting to, but not fully restoring, the appearance of the intact ACL. For the first 12 months, cells were predominantly ovoid. Ensuing cell morphology changed to spindle shaped in group 2 and predominantly narrow long cells over 24 months. Conclusion Human hamstring grafts showed typical stages of graft remodelling, which was not complete up to 2 years after ACLR. The remodelling process in humans was prolonged compared with the results obtained in several animal studies. Level of evidence Case–control study, Level III.

Aim: To evaluate whether a relationship exists in hospital admissions for respiratory conditions in children with outdoor pollution in the Southwest Milan, Italy. Methods: Daily count of hospital admissions for asthma, upper or lower respiratory diseases (LRD) occurred among children aged ≤14 years at the San Paolo Hospital during 2007–2008 was recorded. Pollutants included the particular matter of

Information on the distribution and related epidemiological characteristics of herpesvirus infections, and in particular referring to Bovine Herpesvirus 1 (BoHV1) and Bubaline Herpesvirus 1 (BuHV1) in buffaloes, have to date not been reported. Different studies based on serological surveys and viral isolation describe the circulation of both infections in this species. The specific etiological attribution of the infections in sero-surveys can be uncertain because of antigenic cross-reactivity of these ruminant α-herpesvirus and therefore depends on the diagnostic techniques employed. For this , we proceeded in verifying the diffusion of the two infections in a buffalo population of Central Italy. The sample size for the number of herds to test was defined considering an expected prevalence > 20% and the number of heads to be tested within each herd was established using an expected prevalence of > 25% (absolute precision of 5%, with 95% confidence level). The 155 herds to test were those with no IBR vaccination history. A maximum of 15 random blood samples were collected within the >3 year age category. The same sampling criteria was adopted when cows were present on buffalo farms to study the possible role of this species. Through the combined use of gB-gE Elisa tests, we assigned a specific infection status, for the BuHV1 infection status (gB-pos/gE-neg), as confirmed by an experimental infection conducted by us inoculating buffaloes with the BuHV1 “strain Metzler”, and for the BoHV1 status (gBpos/ gE-pos) as that observed for the infection in bovines. Prevalence of infection, based on the Elisa status of each animal, were estimated for the whole sample and within each herd. Furthermore, the selected farms were investigated for their numeric consistency, presence of bovines, occurrence of typical clinical herpesvirus disorders occurring during the year prior to sampling. The association of these factors with the infection status was verified using logistic linear regression models. Prevalence for all infection status were observed at population level with no statistical difference between them, while the highest prevalence obtained at herd level was that for the co-existence of the two infections within the same herd. From the linear regression analysis, only the numeric consistency was associated with herds positive for BuHV1 and BoHV1 infection. Concomitance of the two herpesvirus infection in buffaloes as well as in bovine herds should be kept in focus both in their diagnosis as well as in their control.

The present study evaluates the efficacy of two treatment regimens in individuals possibly suffering from chronic exercise induced compartment syndrome (CECS) of the deep posterior compartment of the leg. We hypothesised that the current method of fasciotomy of the deep posterior compartment of the leg is a procedure with a limited success rate. Dynamic intra-compartmental pressure measurements were applied to 46 patients that had symptomatology of a posterior CECS. Only those patients that met predefined pressure criteria, the "high-pressure group" (27 patients), were offered surgical treatment in the form of fasciotomy. The other 19 patients, "low-pressure group", received conservative treatment, consisting of inlays and physiotherapy. In addition, these patients were examined more closely in order to exclude different pathology. Efficacy of both approaches was evaluated by a questionnaire after a mean three-year follow-up. Fifty-two percent of the high-pressure group judged their operation successful, whereas 48 % did not. The majority of the low-pressure group (84 %) was free of symptoms, after conservative treatment as well as following treatment of other pathology. The present study shows that the success rate of patients surgically treated for posterior CECS is relatively low (52 %). The established cut-off points for the compartment pressure to deselect patients for an operation are justified based on the long-term success rate of the low-pressure group.

Resumen Objetivo Evaluar la seguridad mostrada por el paciente ante el proceso quirurgico propuesto y su relacion con la informacion previa recibida. Metodo Se realizo un estudio transversal en el que se valoro la seguridad en la decision de operarse del paciente mediante la “Decisional Conflict Scale” (DCS). Con un cuestionario estandarizado se obtuvo informacion sobre datos demograficos (edad, sexo y nivel de estudios) y sobre la informacion recibida relativa a la intervencion quirurgica. En funcion de la puntuacion obtenida en la DCS, se clasificaron los pacientes en seguros e inseguros en su decision de operarse. Se creo un modelo de regresion logistica para ajustar posibles factores de confusion y analizar la seguridad con las variables relativas a la informacion recibida. Resultados Se incluyeron 358 pacientes. El 31,6% de pacientes mostraron inseguridad en la decision tomada y un 30% manifestaron no haber recibido informacion. Los hombres mas jovenes, con nivel de estudios superior mostraron mas seguridad en la decision. La inseguridad del paciente guardo relacion con la percepcion de no haber recibido suficiente informacion previa (OR = 4,3; 95% IC = 2,4-7,7) ajustando por edad, sexo y nivel de estudios. Conclusion La percepcion de seguridad en la decision del paciente esta en clara relacion con la comprension de la informacion previa recibida. Los resultados obtenidos muestran la necesidad de mejorar la informacion que damos a los pacientes, principalmente en pacientes mayores y con bajo nivel de estudios.

It has been suggested that routine CD4 cell count monitoring in human immunodeficiency virus (HIV)-monoinfected patients with suppressed viral loads and CD4 cell counts300 cell/μL could be reduced to annual. HIV/hepatitis C virus (HCV) coinfection is frequent, but evidence supporting similar reductions in CD4 cell count monitoring is lacking for this population. We determined whether CD4 cell count monitoring could be reduced in monoinfected and coinfected patients by estimating the probability of maintaining CD4 cell counts ≥200 cells/µL during continuous HIV suppression.The PISCIS Cohort study included data from 14 539 patients aged ≥16 years from 10 hospitals in Catalonia and 2 in the Balearic Islands (Spain) since January 1998. All patients who had at least one period of 6 months of continuous HIV suppression were included in this analysis. Cumulative probabilities with 95% confidence intervals were calculated using the Kaplan-Meier estimator stratified by the initial CD4 cell count at the period of continuous suppression initiation.A total of 8695 patients were included. CD4 cell counts fell to200 cells/µL in 7.4% patients, and the proportion was lower in patients with an initial count350 cells/µL (1.8%) and higher in those with an initial count of 200-249 cells/µL (23.1%). CD4 cell counts fell to200 cells/µL in 5.7% of monoinfected and 11.1% of coinfected patients. Of monoinfected patients with an initial CD4 cell count of 300-349 cells/µL, 95.6% maintained counts ≥200 cells/µL. In the coinfected group with the same initial count, this rate was lower, but 97.6% of coinfected patients with initial counts350 cells/µL maintained counts ≥200 cells/µL.From our data, it can be inferred that CD4 cell count monitoring can be safely performed annually in HIV-monoinfected patients with CD4 cell counts300 cells/µL and HIV/HCV-coinfected patients with counts350 cells/µL.

We have recently characterized ‘Pinalate’ ( Citrus sinensis L. Osbeck), a yellow abscisic acid (ABA)-deficient mutant derived from the orange ‘Navelate’. In this study we have compared the postharvest performance of fruit of both cultivars stored at 2 and 12 °C to further understand mechanisms underlying chilling injury (CI) and non-chilling peel pitting disorders and whether deficiency in ABA may affect other quality and physiological processes in citrus fruit. The rate of dehydration in ABA-deficient fruit was higher than in its wild type ‘Navelate’. ABA levels in the flavedo of the mutant were about six-fold lower than in its parental. No changes in ABA were observed in fruit of the mutant stored at both 2 and 12 °C, while ABA increased during holding of ‘Navelate’ fruit at 12 °C and decreased at the temperature causing CI. Water, osmotic and turgor potential in the flavedo of freshly harvested fruit of both cultivars were similar and changed differentially in response to storage at 2 and 12 °C. Turgor potential was higher in ‘Pinalate’ than in ‘Navelate’ fruit held at 2 °C, probably by impaired osmotic adjustment. At 12 °C, both water and osmotic potential were lower in the ABA-deficient mutant and as a result, turgor remained constant and similar to that of ‘Navelate’ fruit. The most relevant differential feature associated with fruit quality was the higher susceptibility of ‘Pinalate’ fruit to decay and its higher loss of peel firmness during storage at 12 °C. Interestingly, fruit of the ABA-deficient mutant were more prone to develop peel pitting at non-chilling temperatures than ‘Navelate’, but more resistant to CI, which was manifested as brown non-depressed areas. A transient increase in ethylene production was observed before the appearance of both chilling and non-chilling peel pitting symptoms, suggesting that ethylene may be an indicator of the initial cell damage occurring in both citrus cultivars under postharvest conditions inducing different peel disorders. Under high rates of water loss, ethylene production was markedly enhanced in the ABA-deficient mutant, but not in ‘Navelate’ fruit, indicating that in citrus fruit, ABA may be a negative regulator of water stress-induced ethylene synthesis.

The objective is of this study is to examine the relationship of dietary glycemic load (GL) and overall glycemic index (OGI) with macronutrients intake, body mass index (BMI) and insulin sensitivity in healthy children. The subjects comprised of 105 healthy non-obese eight -years old children, 60 boys and 45 girls. A Food Frequency Questionnaire (FFQ) evaluating dietary habits, GL and OGI. Insulin sensitivity was evaluated by the homeostatic model assessment (HOMA). GL was positively associated with dietary total (correlation coefficient, r=0.57) and starch (r=0.67) carbohydrates, daily consumption of pasta and white bread, cooked potatoes, bakery products and cookies, and negatively with dietary fats (r=-0.52). OGI was positively associated with daily consumption of white bread and cookies, and negatively associated with soluble carbohydrates (r=-0.35), and consumption of fibres, proteins, fruit, legumes and carrots. No significant association was found of GL or OGI with BMI or insulin sensitivity. In healthy children, GL and OGI may represent a useful indicator of quality of diet. Asia Pac J Public Health 2005; 17(2): 88-92.

Background:Norovirus belongs to the Caliciviridae family and causes outbreaks of infectious enteritis by fecal-oral transmission. In Spain, there have been few outbreaks reported due to this virus. We describe an outbreak on a long-term-care hospital ward.Methods:Cases were classified as probable, confirmed, and secondary. Stool cultures were performed. Polymerase chain reaction detection of norovirus was also performed.Results:The outbreak occurred from December 7 to 28, 2001, involving 60 cases (32 patients, 19 staff members, 8 patients' relatives, and 1 relative of a staff member). Most (82%) of the cases were female. The most frequently involved ages were 20 to 39 years for staff members and 70 to 89 years for patients. The incubation period of secondary cases in patients' families had a median of 48 hours (range, 1 to 7 days). Clinical symptoms included diarrhea (85%), vomiting (75%), fever (37%), nausea (23%), and abdominal pain (12%). Median duration of the disease was 48 hours (range, 1 to 7 days). All cases resolved and the outbreak halted with additional hygienic measures. Stool cultures were all negative for enteropathogenic bacteria and rotaviruses. In 16 of 23 cases, the norovirus genotype 2 antigen was detected.Conclusion:This outbreak of gastroenteritis due to norovirus genotype 2 affected patients, staff members, and their relatives in a long-term-care facility and was controlled in 21 days.

La insuficiencia renal aguda secundaria al consumo de cocaina es bien conocida y normalmente condicionada por rabdomiolisis. La posibilidad de que el fracaso renal este relacionado con hipertension arterial y con hallazgos histologicos renales indistinguibles de cualquier otro cuadro de hipertension arterial maligna es un hecho no tan bien conocido. Ciertos derivados de la cocaina son potentes inductores de vasoespasmo, lo que seria la clave del origen de las lesiones isquemicas que se producen no tan solo a nivel renal, sino sistemico, y especialmente tambien neurologico. Presentamos 4 Pacientes Afectos De Insuficiencia Renal Aguda, Dos De Ellos Por HipertensioN Arterial Maligna, Otro Por Consumo De CocaiNa Con Lesiones NeuroloGicas IsqueMicas Muy Severas, Pero Reversibles Con La Retirada De La Droga, Y El Cuarto Por RabdomioLisis. Los 4 Tuvieron Una EvolucioN Diferente Probablemente Relacionada Con El Distinto HaBito De Consumo, Y Tal Vez A Consecuencia De Distintos Derivados De La Cocaina.

The involvement of active oxygen detoxifying enzymes on postharvest rindstaining occurring in citrus fruit at non-chilling temperature has been investigated. Changes in the activities of superoxide reductase (SOD, EC 1.15.1.1), catalase (CAT, EC 1.11.1.6), ascorbate peroxidase (APX, EC 1.11.1.11) and glutathione reductase (GR, EC 1.6.4.2) in the flavedo of ‘Navelina’ (Citrus sinensis L. Osbeck) oranges stored at 22 °C under high (85–90%) and low (55–60%) relative humidity (RH) have been examined. In addition, the effect of conditioning the fruit for 4 days with 10 μl l−1 ethylene at 22 °C and 85–90% RH before being transferred to air at the same temperature and 65–70% RH was studied. The SOD activity increased during storage of fruit at 22 °C under low (55–60% RH) or high (85–90% RH) humidity, being the rate of increase higher in fruit kept under low humidity. By contrast GR decreased and a slower decline rate was observed in fruit stored at low RH. A significant reduction in the activities of CAT and APX also occurred in ‘Navelina’ oranges maintained at 85–90% RH, but not at 55–60% RH. Thus, fruit kept under high RH, which showed higher rindstaining, presented lower SOD, CAT, GR and APX activities than fruit stored under low RH. The incidence of this physiological disorder was reduced by the ethylene pre-treatment. No significant differences in the activities of these enzymes were found in fruit examined after 4 days of ethylene or air treatment. GR activity of fruit pre-treated with ethylene and then held under air was significantly higher than that of their respective control air-treated fruit. Conversely, CAT was higher in fruit continuously held under air and no significant differences in APX and SOD were found. These results indicate that SOD, CAT, GR and APX may play a role in the lower rindstaining incidence observed in ‘Navelina’ fruit continuously exposed to low RH, as compared with fruit held under high RH, while GR may be involved in the beneficial effect of ethylene reducing this non-chilling physiological disorder.

Scrapie-infected hamsters were tested for spontaneous motor activity and passive avoidance at various times after infection. After testing, some animals were killed and their whole brains assayed for norepinephrine, dopamine, serotonin and their metabolites. The apparent rate of turnover was estimated in terms of metabolite/amine concentrations. After 70 days, there was a decrease in passive avoidance and dopamine and serotonin. Passive avoidance correlated with the apparent rate of turnover of dopamine, whereas motor activity correlated with that of serotonin and dopamine.

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 ( Z scores) 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.