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It is hereby presented a quality control study of a systematic vaccination program developed in an urban primary care center. Target population were children between 0 and 8 years attended in the center. They were considered as having a correct vaccination coverage those cases in which it was possible to verify documented accomplishment of the local vaccination schedule. Out of the 538 children included in our study, 168 (31%) were founded not to have appropriate vaccination coverage evidenced in their clinical records, and their families were requested for an interview: 126 (75%) attended de appointment. In 93 of them it was founded a recording mistake, and 33 cases were verified as no correctly covered. Vaccination coverage rate was 86%, being inverse relationship between age and coverage rate. They are discussed corrective actions derived from the quality control.

We report on a 19-year-old Turkish girl who was admitted with suspected oesophageal tumour. A diagnosis of tuberculous oesophagitis was made on the basis of the granulomatous oesophagitis, the country of origin of the girl and the positive response to antituberculosis therapy. It is concluded that tuberculous oesophagitis should be considered when common causes of oesophagitis fail to be established and granulomas are found histologically.

Endoscopic papillotomy as therapeutic procedure of first choice for common bile duct stones is related with a relatively low complications rate and exhibits a very low method-related mortality. Major complications are cholangitis, pancreatitis, retroduodenal perforation and hemorrhage. In rare cases minor bleedings after papillotomy may lead to coagulation with consecutive obstruction of the papilla. Jaundice without major clinical symptoms will occur. Diagnosis is established by repeated retrograde cholangiography; conservative management is satisfactory and efficient.

The effects of a high molecular weight toxin from Physalia physalis (P3) were investigated on glutamate evoked potentials in snail (Zachrysia guanesis) neurons and in crayfish (Cambarus clarkii) neuromuscular junction. The glutamate evoked potentials of snail neurons were reversibly blocked by P3 in a dose-dependent manner (2-200 microM). A reversible blocking action was also found for P3 on excitatory junctional potentials and on glutamate potentials of crayfish at a concentration range of 6 nM-60 microM. Experiments carried out with independent stimulation of the excitatory and inhibitory nerves showed that the effect of P3 (60 nM-10 microM) was exerted predominantly on excitatory junctional potentials. However, at higher doses (greater than 10 microM) a slight reduction of the inhibitory potentials was also observed. These results suggest that P3 reversibly blocks glutamate receptors. Thus, it could be a promising tool for further studies on glutamatergic transmission.

Interaction between anemone toxin BgTX8 and sodium channels in isolated single neurons of rat sensory ganglia was studied by voltage-clamp and intracellular perfusion techniques. It was shown that BgTX8 in external and internal solutions induced a dose-dependent slowdown of inactivation kinetics. Dissociation constant for receptor-toxin complex was found to be 4.10(-6) mol/l.

During a 20 months period (1. 10. 1985-31. 5. 1987) 20 patients with advanced rectal carcinoma received palliative treatment by laser (Neodymium-YAG), 18 for subtotal rectal stenosis, two for profuse bleeding from an exophytic tumour. Re-establishment of intestinal passage or stoppage of bleeding was achieved in all patients, after a mean of 3.4 (1-5) applications. The treatment was well tolerated, cured the anaemia, removed the obstruction and ended painful stool evacuation. To-date 11 patients have died, seven of the malignant tumour. Nine patients are still alive. The mean survival time for all 20 patients is 5.3 months so far, similar to that after a palliative colostomy. There were no complications.

We describe the rare case of a hemosuccus pancreaticus as the cause of an upper gastrointestinal bleeding. A perforated common hepatic artery aneurysm caused a bleeding into the pancreas and the pancreatic duct. Besides the hepatic artery-aneurysm aneurysms of the coeliac trunc and the splenic artery were found. After the bleeding had been localised by pancreoscopy and angiography, the coeliac trunc, the tail of the pancreas and the spleen were resected without any complication.

This study analyzed the effects of 1 week administration of alprazolam (AL; 0.25 mg), lorazepam (LO; 1 mg) and placebo (PL) on sleep as well as their residual effects on attention upon awakening. Under a crossed, double-blind design, six healthy male volunteer subjects between 19 and 30 years of age were studied. After two habituation sessions and a control session, each substance was given orally, twice a day for 7 days, with a 1-week washout period between administrations. At the end of each administration period, sleep studies were conducted from 2300 to 0700 hours. Evaluation of attention was carried out by means of a simple visuomotor reaction time (RT) task, and a time estimation (TE) task, that started at 0700 hours, lasting 1 h. Neither drug significantly affected any sleep variable. Both benzodiazepines tended to increase RT, but only LO did so significantly at the beginning of the attention test. No significant changes in predictive and failure responses during the RT task were produced by either drug. Also, no significant changes were observed in the TE. Even though only LO produced a significant increase of RT at the selected doses and with 1 week administration, it is suggested that both benzodiazepines could have residual effects on attention.