Reply from M. Soler and J.J. Soler.
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Journal Article↗
Biomedical subjects
M Soler
Publications and source records attributed to M Soler.
Medical conditions in patients with pancreatic and biliary diseases: validity and agreement between data from questionnaires and medical records. PANKRAS II Study Group.
The aims of the study were to assess the agreement between data from personal interviews and medical records on selected medical conditions, to evaluate the validity of each source of information, and to estimate the prevalence of these conditions in pancreatobiliary pathology. Between 1992 and 1995, 602 patients with pancreatobiliary diseases were included in the PANKRAS II Study. Information from interview and medical records was available in 88% of cases. The agreement between both data sources was poor only for cholecystitis and mental disorders. The validity of both sources of information was high or acceptable for all conditions except for cholecystitis. Prevalence of past medical conditions was similar to that reported previously and varied according to diagnosis, gender, age, educational level, and hospital of admission. Research aimed at assessing the prevalence of less common diseases should consider subject- and health-related factors in collecting information.
Adolescent↗
Body weight and risk of soft-tissue sarcoma.
The relation between body mass (BMI) and soft-tissue sarcoma (STS) risk was evaluated in a case-control study from Northern Italy based on 217 incident STS and 1297 hospital controls. The risk of STS rose with BMI, with multivariate odds ratios of 3.49 (95% confidence interval (CI) 1.06-11.55) among men and 3.26 (95% CI 1.27-8.35) among women with a BMI > 30 kg m(-2) compared to those with BMI < or = 20 kg m(-2).
Adolescent↗
Cytokine profile of human bronchoalveolar macrophages and bronchial epithelial cells in response to inhalation particles of the cyclosporine derivative IMM 125.
Administration of antiasthmatic drugs in the form of inhalation particles may alter the cytokine network in the airways, independently of their pharmacological actions. Changes induced by drugs not well tolerated may potentially contribute to the immunopathology of the disease, a strongly undesirable effect. In this study, cell viability assays and characterization of the cellular profile of cytokines and chemokines were performed in order to investigate the response of human bronchoalveolar macrophages and bronchial epithelial cells in culture to inhalation particles of the cyclosporine derivative IMM 125. Interleukin 1beta (IL-1beta), tumor necrosis factor alpha (TNFalpha), and IL-8 were assayed by enzyme-linked immunosorbent assay (ELISA) in the supernatants of bronchoalveolar macrophages, and RANTES, granulocyte--macrophage colony-stimulating factor (GM-CSF), and IL-8 in those of bronchial epithelial cells. Cells were studied both under basal and stimulated conditions (lipopolysaccharide and TNFalpha were used for activating macrophages and epithelial cells, respectively). The immunosuppressant FK 506 and the glucocorticoid Budesonide served as comparison. IMM 125 did not affect cell viability (except at high concentrations and long time periods). Moreover, IMM 125 did not induce an increase in the secretion of any of the cytokines and chemokines measured with respect to nontreated cells, except for a slight increase in IL-8, an effect that was also observed for FK 506, Budesonide, and inert latex particles, and was therefore regarded as nonspecific. Furthermore, IMM 125 significantly decreased the secretion of TNFalpha, IL-1beta by macrophages, and GM-CSF by epithelial cells, suggesting an antiinflammatory potential. In conclusion, the present in vitro results point to a good tolerance of human airways to IMM 125 inhalation particles.
Administration, Inhalation↗
Refined-cereal intake and risk of selected cancers in italy.
BACKGROUND: Although consumption of whole-grain foods seems to reduce the risk of several types of neoplasms, the potential influence of a diet rich in starches and refined grains is less clear. OBJECTIVE: We studied the relation between the frequency of consumption of refined cereals (bread, pasta, or rice) and the risk of selected neoplasms. DESIGN: This was an integrated series of case-control studies conducted in northern Italy between 1983 and 1993. The subjects were patients admitted to the major teaching and general hospitals in Milan and Pordenone with incident, histologically confirmed cancers: 343 with cancer of the oral cavity and pharynx, 94 with cancer of the esophagus, 146 with cancer of the larynx, 745 with cancer of the stomach, 955 with cancer of the colon, 625 with cancer of the rectum, and 428 with cancer of the thyroid. The control subjects were 3526 patients admitted to the same network of hospitals for acute nonneoplastic conditions unrelated to long-term modification of diet. Odds ratios (ORs) for consecutive tertiles of refined-cereal consumption were computed after allowance for sociodemographic variables, education, smoking status, alcohol consumption, body mass index, and consumption of fruit, vegetables, and whole-grain foods. RESULTS: The ORs for the highest tertile of refined-cereal intake were 1.6 for cancer of the oral cavity, pharynx, esophagus, or larynx; 1.5 for stomach cancer; 1.5 for colon cancer; 1.3 for cancer of the rectum; and 2.0 for thyroid cancer. The trends in risk were significant for all neoplasms considered. CONCLUSION: Consumption of refined cereals was associated with an increased risk of cancers of the large bowel, the stomach, and other selected digestive and nondigestive sites.
Adult↗
Hypertension and hormone-related neoplasms in women.
The relation between hypertension and the risk of selected hormone-related neoplasms in women was investigated in a network of case-control studies conducted in Italy during 1983-1996. Cases were women younger than 75 years with histologically confirmed cancer of the breast (n=3406), endometrium (n=745), ovary (n=970), and thyroid (n=145). Controls were 3054 women admitted in the same geographic area for acute, nonneoplastic, non-hormone-related diseases. Odds ratios (ORs) of treated hypertension were computed after allowance for sociodemographic factors, smoking habits, alcohol consumption, parity, menopausal status, and body mass index (BMI) by means of unconditional logistic regression. The ORs were 1.2 (95% CI, 1.1 to 1.4) for breast cancer and 1.6 (95% CI, 1.3 to 1.9) for endometrial cancer, and the elevated ORs persisted after >/=5 years since diagnosis of hypertension. No significant association was observed for ovarian and thyroid cancer. For breast cancer, the association was apparently stronger at age 55 years or over and consequently after menopause. No appreciable effect modification was evident for endometrial cancer. Allowance for BMI did not explain the association of postmenopausal breast cancer and endometrial cancer with hypertension. The OR of postmenopausal breast cancer was 1.5 (95% CI, 1.1 to 2.0) in hypertensive women with BMI >/=30 kg/m(2) compared with normotensive women with BMI <25 kg/m(2). The corresponding figure for all endometrial cancers was 4.9 (95% CI, 3. 4 to 6.9). Even in the absence of a clear understanding of biological mechanisms, the definition of a role of hypertension on female hormone-related cancers can have relevant implications on individual risk assessment.
Adult↗
[Significance of segmentary reversal defects in the myocardial SPECT with 99mTC-tetrofosmin myocardial SPECT].
OBJECTIVES: To evaluate segmentary reverse defects (RD) (uptake higher in exercise than in rest) in 99mTc-tetrofosmin SPECT. METHODS AND RESULTS: 1,124 consecutive SPECT studies were reviewed and 80 (7%) segmentary RD were identified. Thirty-eight patients with RD attributed to artifact (extra cardiac uptake) were excluded. Thus, 42 patients (3.6%), 21 with and 21 without previous infarct, were studied. Thirteen out of 21 RD in patients without previous infarct corresponded to inferior region and 8 to the anterior region. In three out of 8 patients in whom the coronary angiography was performed, the coronary arteries were angiographically normal and 5 had stenosis of between 50% to 70% of coronary arteries corresponding to RD. Of the 21 RD in patients with previous infarct, the RD site corresponded to the same region of the necrosis (15 inferior and 6 anterior). All had viability criteria (uptake higher than 40% in more than 50% of the region) in rest uptake SPECT quantification. In nine out of 11 patients in whom a coronary angiography was carried out, patency of the artery responsible for the infarct was verified. CONCLUSIONS: 3.6% of segmentary RD, which were not attributed to the artifact, were observed in myocardial perfusion 99mTc-tetrofosmin SPECT studies. Half of these cases corresponded to regions without previous infarct and with normal coronary arteries or non-severe coronary stenosis. The remaining corresponded to regions with previous infarct and with viability criteria.
Convalescence↗
Adhesion-related glycocalyx study: quantitative approach with imaging-spectrum in the energy filtering transmission electron microscope (EFTEM).
Large polysaccharide molecules composing the glycocalyx have been shown to prevent cell adhesion. However, this process was not observed microscopically. Terbium labeling, combined with a new quantitative imaging method based on electron energy loss spectroscopy, allowed specific glycocalyx staining with excellent contrast. Image analysis enabled us to compare glycocalyx structure in free membrane areas and contacts between monocytic cells and bound erythrocytes. Apparent glycocalyx thickness, in contact areas, was half of the sum of glycocalyx thicknesses in free areas without label density increase. Ultrastructural immunogold localization of CD43 molecules, a major component of glycocalyx, was also demonstrated to be excluded from contact areas during adhesion. Thus, both approaches strongly suggest that some glycocalyx elements must exit from contact to allow binding of adhesion molecules.
Antigens, CD↗
Mafia behaviour and the evolution of facultative virulence.
Some organisms enforce "maladaptive" behaviours on others of the same or different species by imposing costs in the absence of compliance. Such enforcement is used by the enforcer to obtain benefits in the possession of the enforced individual. This mechanism is known as mafia behaviour in humans, but may be widespread in parasite-host relationships in nature, from the cellular level to societies. In this paper we describe the evolution of such mafia mechanisms, and we propose a fuzzy logic model where the mafia mechanism is based on enforcement of hosts by exponentially increasing the cost of resistance to the parasite. The benefits of host resistance can be counteracted by parasite virulence, or even a decrease in response to an increment in its resistance. This parasite response to the host defence increment can be used for the parasite to teach the host that it is better to pay part of its benefits than increase its extremely costly defence. This model differs from others because it takes into account the evolution of host defence related to the evolution of parasite virulence (host-parasite coevolution) and points out an optimum in host defence related to the facultative virulence of the parasite. We provide several potential examples of facultative virulence depending on the antiparasite responses of hosts, and we suggest that this kind of mafia behaviour may be a widespread mechanism in biological processes at a number of different levels.
Animals↗
Females are responsible for ejection of cuckoo eggs in the rufous bush robin.
Rufous bush robin, Cercotrichas galactotes, nests were experimentally parasitized in order to test which sex is responsible for egg ejection. We tested nests belonging to the same individuals (male, female or pair) in 2 consecutive years. Whether the eggs were rejected did not depend on environmental variables such as laying date and clutch size, and did not change between tests, when the two consecutive nests tested belonged to the same pair members, supporting the idea that some individuals reject odd eggs, while others accept them. The expected frequencies for rejection and acceptance, if females were the sex responsible for ejection behaviour, did not differ from the observed frequencies when the same female owned both the nests tested. However, the expected frequencies calculated for males as if they were the sex responsible differed from those observed, when the same male owned both the nests tested. A lower percentage of females than males changed ejection behaviour. These results show that female rufous bush robins are responsible for egg ejection. Copyright 1998 The Association for the Study of Animal Behaviour.
Journal Article↗
Learning from case reports: diagnostic issues in an epidemiologic study of pancreatic cancer.
Epidemiologic studies on exocrine pancreatic cancer show a large heterogeneity in diagnostic criteria applied to define "caseness." Reanalyses conducted after review of diagnostic information have yielded substantially different results than those based on more crude classifications of disease. During a multicenter prospective study on mutations in the K-ras gene in pancreatic and biliary diseases, hospital diagnoses from 602 patients were reviewed by a panel of experts. There were two main motivations to do so: a generic interest for the quality of the diagnostic data, and the anticipation that a firm diagnosis could be needed to assess whether patients whose tumors did not harbor the mutation were true negatives or false negatives. In addition, the review of diagnoses was helpful to minimize tissue misclassification, and it had a high educational value for clinicians and epidemiologists. This article illustrates why and how this was so through a brief presentation of the 10 most significant cases. With respect to selection and classification of subjects, the main issues that studies on pancreatic cancer need to address are the differential diagnosis of exocrine pancreatic cancer and pancreatitis, the differential diagnosis of exocrine pancreatic cancer and other abdominal tumors, and the use of survival as a hallmark of pancreatic cancer. In epidemiologic studies of pancreatic cancer, it is warranted that a panel of experts centrally reviews all the existing diagnostic evidence (cytohistological and other) of all patients, regardless of whether they have cytohistological confirmation and of their hospital discharge diagnosis.
Adenocarcinoma↗
Delayed haemolytic transfusion reaction due to anti-M antibody.
A female patient with delayed haemolytic transfusion reaction due to anti-M antibody is described. Diagnosis was based on laboratory evidence of haemolysis and on characteristic serological findings. Anti-M was detected in the recipient's serum 7 d after the last transfusion episode. This alloantibody had not been present in the pretransfusion serum. In addition, the direct antiglobulin test was positive on post-transfusion testing and the implicated antibody was eluted from post-transfused red cells. Delayed haemolytic transfusion reactions have long been recognized as a potential hazard of transfusion therapy, but such cases due to anti-M are extremely rare.
Adenocarcinoma↗
Diet, alcohol, coffee and pancreatic cancer: final results from an Italian study.
The relation between selected indicator foods, alcohol and coffee intake, and the risk of pancreatic cancer was evaluated in a case-control study conducted between 1983 and 1992 in northern Italy on 362 patients with histologically confirmed, incident cancers of the pancreas, and 1,552 controls in hospital for acute, non-neoplastic diseases. Odds ratios (ORs) for subsequent tertiles of intake were computed after allowance for sociodemographic factors and tobacco smoking. Pancreatic cancer risk was directly associated with consumption of meat (OR for the highest frequency tertile = 1.43), liver (OR = 1.43) and ham and sausages (OR = 1.64), and inversely with consumption of fresh fruit (OR = 0.59), fish (OR = 0.65) and olive oil (OR = 0.58). No appreciable association was found with coffee (OR = 1.21) and alcohol consumption (OR = 1.20). A summary score was derived by summing the six related food items; compared to the lowest level, the OR was 2.7 for the highest quintile, and the population attributable risk was 36% (95% confidence interval, 15-57%), indicating the scope of diet for the prevention of this common neoplasm in the Italian population.
Adult↗
[Laboratory diagnosis to dengue virus infections].
Currently, laboratory diagnosis of Dengue virus infection has a special importance because of its emerging character, showing a great geographic propagation of viral activity through out the American Continent. In general, the laboratory diagnosis of Dengue infections is similar to other human infecting viruses, the difference and difficulty of the process lies in the cross reaction activity with other flavivirus that can co-exist in the same region. The effectiveness of the diagnosis depends on the quality of the samples obtained, so it is absolutely necessary to monitor carefully the timing, conditions as well as the accompanying information during the gathering of the samples. The present article describes some of the serologic technics used in the diagnosis of dengue infection: hemaglutination inhibition, plaque reduction neutralization and IgM and IgG ELISA assays, in the same way it outlines the principles and importance of viral isolation and identification as well as the advantages of a new diagnosis technic like PCR.
Clinical Laboratory Techniques↗
Out of hours primary care. Study should have considered other published work, deprivation, seasonal variation, and need.
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England↗
Leukosialin (CD43) behavior during adhesion of human monocytic THP-1 cells to red blood cells.
To understand the modulation and the behavior of glycocalyx elements during adhesion, we explored one of its components, the CD43 molecule, on human monocytic THP-1 cells exposed to cytokine stimulation and its redistribution during heterotypic adhesion to opsonized erythrocytes. First we demonstrated by immunofluorescence and immunoprecipitation that CD43 is dys-sialylated in monocytic THP-1 cells stimulated by interferon-gamma (IFN-gamma) and tumor necrosis factor alpha (TNF-alpha) and stimulation increased correlated to heterotypic adhesion. CD43 anti-adhesive effect seemed to be related to sialic acid moeties because an increase in adhesion was also induced by sialidase treatment and by monoclonal antibodies recognizing sialic acid-dependent epitopes on CD43. Second, a redistribution of CD43 molecules was observed after adhesion, resulting in the exclusion of CD43 molecules from contact areas as demonstrated by immunofluorescence and by ultrastructural immunogold localization. We therefore demonstrated in monocytic THP-1 cells that some glycocalyx molecules can be modulated by cytokines and redistributed during adhesion. These results support the concept that CD43 can regulate cell interactions.
Antibodies, Monoclonal↗
Great spotted cuckoos improve their reproductive success by damaging magpie host eggs
Adult great spotted cuckoos, Clamator glandariusdamage the eggs of their magpie, Pica picahost without removing or eating them. The number of damaged magpie eggs was recorded in 360 parasitized nests of which 62.2% contained between one and eight damaged magpie eggs. Egg-destroying behaviour may be adaptive if it reduces nestling competition and/or enhances the hatching success of the cuckoo. To clarify the role of egg destruction for the reproductive success of great spotted cuckoos, unparasitized magpie nests were experimentally parasitized (without egg damage) by introducing cuckoo eggs or chicks. Egg damage was common in parasitized nests but the eggs were not damaged by the hosts. Egg damage increased the breeding success of the cuckoos, by both reducing the number of competing host chicks in the nest and increasing the likelihood that late-laid cuckoo eggs would hatch.Copyright 1997 The Association for the Study of Animal Behaviour1997The Association for the Study of Animal Behaviour
Journal Article↗
Fewer interventions in the immediate post-extubation management of pediatric intensive care unit patients: safety and cost containment.
PURPOSE: The purpose of this article was to compare the safety and patient charges of two postextubation treatment regimens. MATERIALS AND METHODS: Twenty-two pediatric patients, between the ages of 7 months and 13 years, who were mechanically ventilated for less than 5 days were studied in a prospective randomized nonblinded study at a multidisciplinary pediatric intensive care unit. Immediately after extubation all patients received supplemental oxygen, administered via mask or nasal cannulae, at a flow rate or concentration sufficient to maintain the pulse oximetric arterial oxygen saturations > 95%; arterial blood gas analyses were performed at 30 minutes after extubation. The subjects were randomly assigned to one of two protocols. Protocol A (our standard management) consisted of (1) three nebulized albuterol treatments administered 1 hour apart, and (2) a chest radiograph obtained within 60 minutes of extubation. Protocol B included one nebulized albuterol treatment administered immediately after extubation. We measured the heart rate, respiratory rate, and arterial blood pressure immediately after and at 60, 120, and 180 minutes following extubation. The following data were also recorded: arterial blood gas analysis results and continuous pulse oximetric arterial oxygen saturation levels. Any significant complications, such as stridor, respiratory distress, or requirement for reintubation, were noted if they occurred within 24 hours of extubation. Patient charge costs were calculated after obtaining the prevailing hospital and physician charges at the time of the study. RESULTS: Eleven patients completed each arm of the study (total = 22). There were no statistically significant differences between the two groups with respect to arterial pH, serum bicarbonate, pulse oximetric arterial oxygen saturation, arterial blood pressure, respiratory rate, or heart rate (P > .05). Patients treated with Protocol A had a statistically, but not clinically, significant higher mean PaO2 and PaCO2 (P = .02 and P = .05, respectively) than those in Protocol B. Associated charges per patient for Protocol A were $863.50 versus $476.00 for Protocol B. This is a savings of $387.50 per patient. Our pediatric intensive care unit provides care to over 600 intubated patients per year, which would equate to a charge savings of $232,500.00 per year. CONCLUSION: A modified postextubation management protocol, consisting of fewer interventions, resulted in significant patient charge savings with no increased risk to the patient.
Administration, Inhalation↗