COPD patient profiles in primary care. Referral criteria.

COPD is a disease with a high prevalence that diminishes the quality of life of many patients. Despite this, there are still high rates of under-diagnosis in Spain, partly due to a lack of recognition of the pathology by patients. In this context, the role played by primary care teams becomes fundamental, as they are one of the first lines of entry into the health system. In this paper we explain the different COPD profiles that may be present, and update the tools for diagnosis and treatment, which, together with an attitude of active suspicion of the disease, can help in the correct management of patients, whether they are undiagnosed or have subsequent complications.

Scope and limitations of a multiplex conventional PCR for the diagnosis of S. stercoralis and hookworms.

OBJECTIVES: Describe the diagnostic characteristics of a conventional multiplex PCR for the diagnosis of S. stercoralis, N. americanus and Ancylostomas spp. METHODS: Fecal samples were collected from a cross-sectional study in Orán department, Salta province, Argentina. The stool samples were analyzed using concentration-sedimentation, Harada Mori, McMaster, and Baermann techniques. DNA was extracted from 50 mg fecal sample using the FastPrep® Spin Kit for Soil. Three pairs of primers were used for the amplification of three products of 101, 330, and 577 base pairs (bp) for S. stercoralis, N. americanus and Ancylostoma spp, respectively. The sensitivity and analytical specificity of multiplex PCR were evaluated, as well as the sensitivity and diagnostic specificity, using a composite standard and Bayesian approach. RESULTS AND CONCLUSIONS: Multiplex PCR did not present cross-reaction with other intestinal parasites, and the detection limit for multiplex PCR was between 2 and 20 pg of genomic DNA. In addition it presented a diagnostic sensitivity of 97.4% for S. stercoralis and 90.3% for hookworms with a specificity of 100% and 87.6%, respectively. PCR identified a higher proportion (p <0.01) of coinfections (15.3%) than microscopic techniques (3.5%). Also, multiplex PCR showed that there was a positive association between S. stercoralis and hookworms (odds ratio = 2.12). However, this association was due to N. americanus (odds ratio= 3.22), since no association was observed between S. stercoralis and Ancylostoma spp. Neither was an association observed between the two species of hookworms.

Efficacy of Bifidobacterium breve CECT7263 for infantile colic treatment: an open-label, parallel, randomised, controlled trial.

Infantile colic is a prevalent condition characterised by excessive crying with no effective treatment available. We aimed to evaluate the efficacy of Bifidobacterium breve CECT7263 and a combination of this and Lactobacillus fermentum CECT5716 versus simethicone in reducing the daily time spent crying in colicky infants. A multicentre randomised, open-label, parallel, controlled trial of 28 days was performed in 150 infants who were diagnosed with colic according to the Rome III criteria and who randomly received simethicone (80 mg/day; Simethicone group), B. breve CECT7263 (2×108 cfu/day, Bb group), or a combination of L. fermentum CECT5716 and B. breve CECT7263 (1×108 cfu/day per strain, Bb+Lf group). The main outcomes were minutes of crying per day and the percentage of reduction in daily crying from baseline. Data were analysed per intention to treat. All treatments significantly decreased the daily crying time at the end of the intervention (P-time <0.001). However, the infants in the Bb group had significantly decreased crying time from the first week of the study (P<0.05), whereas the Bb+Lf group and the simethicone group had significantly decreased crying time from the second week (P<0.05). The percentage of reduction in the minutes of crying from baseline in the Bb group was significantly higher than that in the Simethicone group every week of the intervention (-40.3 vs -27.6% at 1-week; -59.2 vs -43.2% at 2-weeks; -64.5 vs -53.5% at 3-week and -68.5 vs -59.5% at 4-weeks, P<0.05). Additionally, in the Bb group, infants had better night sleep, and parents reported a more positive mood at the end of the intervention. All the products used in the study were safe and well tolerated. In conclusion, the breastmilk-isolated probiotic strain B. breve CECT7263 is a safe and effective treatment for infantile colic, presenting an earlier and more robust effect than the reference prescribed drug, simethicone.

La tecnología 2.0 al servicio de la salud materno-infantil / Technology 2.0 at the service of maternal and child health

No disponible

Porfirias agudas en la unidad de cuidados intensivos / Acute porphyria in an intensive care unit

Las porfirias son enfermedades metabólicas hereditarias muy raras, causadas por la hipoactividad de determinadas enzimas implicadas en la síntesis del grupo hemo. Presentamos tres casos de pacientes jóvenes que debutaron con crisis de porfiria aguda, y en los que, como es frecuente, se retrasó el diagnóstico y llegaron a precisar ingreso en la unidad de cuidados intensivos (UCI) por encefalopatía grave. Tras realizar el tratamiento con hemina, la clínica mejoró rápidamente, pero en un paciente persistió una polineuropatía periférica grave como secuela durante meses. Además, comunicamos el primer caso de desencadenamiento de crisis porfírica por el uso de la "píldora del día después" (levonorgestrel) (AU)

Porphyrias are rare hereditary metabolic disorders caused by the inactivity of certain enzymes that participate in hemesynthesis. We report 3 cases in which porphyria debuted with acute episodes in young patients. As is often the case, diagnosis was delayed, and intensive care was required for severe encephalopathy. Symptoms improved rapidly after hemintherapy was started, but peripheral polyneuropathy persisted for several months in 1 patient. We report the first case of aporphyria-related seizure triggered by use of the morning-after pill (levonorgestrel) (AU)

Evaluation of the dispersive component of the surface energy of active carbons as determined by inverse gas chromatography at zero surface coverage.

The methods to obtain the dispersive component of the surface energy (gamma(s)(d)) of active carbons (AC) from inverse gas chromatography (IGC) measurements usually render values much higher than those obtained by other techniques. In this paper this is ascribed to two factors: (i) the high temperatures at that IGC measurements are carried out and (ii) the microporosity of the AC. It is shown that the temperature dependence of the area of the methylene group is an important factor in the high gamma(s)(d) values. Thus, corrections for this dependence should be considered in the calculations. In relation to microporosity, the cooperative effect of the pore walls is also an important factor to be considered in the evaluation of gamma(s)(d). The values gamma(s)(d) obtained after these corrections have their own physical meaning related to ideal flat carbon surfaces. Critical comments are made about some reported relationships between gamma(s)(d), obtained from IGC, and the BET surface area or pore volume of AC as determined from nitrogen adsorption at 77K. These are based on the very different experimental conditions at which nitrogen and IGC measurements are carried out.

Use of specific surface areas in inverse gas chromatography studies at zero surface coverage.

Inverse gas chromatography (IGC) is frequently used to study adsorption processes at zero surface coverage on microporous activated carbons. This allows to determine the thermodynamic adsorption parameters as equilibrium constants, V(S), standard enthalpies of adsorption, Delta HA degrees, standard free energy of adsorption, Delta GA degrees, and so on. Nevertheless, the surface areas of the adsorbents (microporous carbons in this case) are needed for this purpose. The experimental determination of the surface areas of microporous solids is not univocal and the results depend on the adsorbate employed in the measurements, usually N2 or CO2. This means that the thermodynamic parameters obtained by IGC are subjected to a degree of uncertainty depending on whether N2 or CO2 is used to determine the surface area values. The aim of this paper is to discuss which of the two surface area values is more appropriate to be used in IGC measurements at zero surface coverage. Experimental and theoretical considerations are supplied in a thorough discussion which supports that CO2 surface area value is more appropriate. Thus, it is proposed that this should be used instead of the more generally extended nitrogen specific surface area obtained by the BET equation.

Surface characteristics of activated carbons obtained by pyrolysis of plasma pretreated PET.

Activated carbon materials have been prepared by pyrolysis of plasma pretreated recycled PET. The obtained carbon materials have been texturally characterized by N2 (77 K) and CO2 (273 K) adsorption. Atomic force microscopy (AFM) and diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS) have been used to analyze the surface of the treated precursors. Carbon materials obtained by He, N2, and CO2 plasma pretreatments (4 min) of the precursor and subsequent pyrolysis have shown a higher adsorption capacity than the corresponding chars (untreated pyrolised PET). This effect seems to be related to the elimination by the plasma treatments of low-molecular-weight products in the precursor, which are responsible for the formation of amorphous carbon deposits during the carbonization that blocks the porosity. Longer periods of treatment (15 min) do not favor the opening of the microporosity because cross-linking reactions in the precursor producing high molecular weight deposits prevail. The development of porosity is less relevant if oxygen plasma is used, as a considerable amount of oxygen functionalities are also formed. These groups can decompose during pyrolysation producing the above-mentioned amorphous carbon deposits. The textural characteristics of the carbon materials obtained after 4 min of plasma treatment on the precursor are very similar to those obtained after 4 h of CO2 (1073 K) activation of the same char. Therefore, this method can be an alternative to avoid the burnoff and high energy cost of the activation step.

Surface characterisation of plasma-modified poly(ethylene terephthalate).

This paper reports the modifications produced by nitrogen and helium cold plasmas on the surface of PET. The changes have been studied by diffuse reflectance Fourier transform spectroscopy (DRIFTS), atomic force microscopy (AFM) and inverse gas-solid chromatography (IGSC). Nitrogen and oxygen atoms seem to appear on the surface of PET as a consequence of the exposure to the atmosphere after the treatments with plasmas. AFM shows that both plasmas altered in different extent the surface of PET as they break the polymer chains producing low molecular products which appear as bumps on the surface. The surface area and the porosity of PET does not change by plasma treatments even after 15 min. The dispersive component of the surface free energy, gamma(s)(d), decreases after long treatments with nitrogen plasma whereas it remains almost unchanged after long treatment with helium plasma.

Effects of oxygen and carbon dioxide plasmas on the surface of poly(ethylene terephthalate).

Poly(ethylene terephthalate) was exposed to oxygen and carbon dioxide plasmas for different periods of time. The surface-modified samples were characterized by infrared spectroscopy, atomic force microscopy, and inverse gas-solid chromatography. The main difference between both types of plasma was connected to the time scale of degradation, which was much faster when using oxygen plasma. Aggregate globular features were produced by different treatments due to chain scission and further recombination of evolved products. Oxygenated functionalities were introduced in significant amounts after long exposure times to the oxygen plasma. As a consequence, the specific component of the surface free energy was clearly observed to increase after these long treatments.

Effect of rice bug Leptocorisa oratorius (Hemiptera: Alydidae) on rice yield, grain quality, and seed viability.

The effect of Leptocorisa oratorius (F.) on the yield, grain quality, and seed viability of four rice, Oryza sativa L., lines was studied. Three of the lines, C2, IR64, and PSBRc20, are grown in the Philippines. The fourth, IR72164-201-1 is an unreleased experimental line of an O. sativa japonica x O. sativa indica cross. Each line was exposed to four infestation densities for 21 d. L. oratorius feeding produced unfilled and partially filled grains, resulting in a negative correlation of yield to rice bug density. When filled grains were sown, germination rates were negatively correlated with rice bug densities. The percentage of discolored grains was positively correlated with L. oratorius density on all rice lines. At the same infestation rates, PSBRc20 and IR64 had higher yields, less damaged grain, and higher germination rates than IR72164-201-1 and C2, suggesting host plant tolerance to rice bug feeding. The economic injury levels (EILs) currently used for rice bug management are based solely on yield loss estimates. The results of this study suggest that EIL for rice bugs should be revised to take into account reductions in grain quality and seed germination rates in addition to yield loss.

Syntax and morphology in Williams syndrome.

Williams syndrome (WS) is a neuro-developmental disorder which is characterized by an unusual fractionation of language abilities and other cognitive functions. We have investigated four cases of English-speaking subjects with WS, and we show that despite their low IQs the WS children's performance on syntactic tasks and on regular inflection is not impaired. Irregular inflection, however, is affected causing many errors. We also report results from studies investigating the same linguistic phenomena in children with specific language impairment. These children exhibit a different pattern of impairment, with relatively poor performance on syntactic tasks and regular inflection. We suggest a linguistic characterization of the morphosyntax in WS according to which WS subjects are impaired in accessing (particular kinds of) information from lexical entries, with their computational system for language appearing to be intact. We interpret the selective impairments found in WS and SLI as supporting the theoretical distinction between a computational system and an associative memory system for language.

The PerFect lipid optimizer kit for maximizing lipid-mediated transfection of eukaryotic cells.

The transfection efficiencies of a panel of eight uniquely different lipid reagents has been evaluated with two other commercially available lipids for use in transfecting a diversity of eukaryotic cell lines. The PerFect lipids are available individually or together in an optimization panel format that can be tested in any given cell line, enabling one to evaluate the optimal lipid for transfecting each individual cell line. Our results demonstrate that no single lipid is optimal for plasmid transfection over a broad range of cell types, thus emphasizing the need for multiple unique lipid reagents and a simple format for testing their transfection efficiency on a given cell type.

Triple-strand-forming methylphosphonate oligodeoxynucleotides targeted to mRNA efficiently block protein synthesis.

Antisense oligonucleotides are ordinarily targeted to mRNA by double-stranded (Watson-Crick) base recognition but are seldom targeted by triple-stranded recognition. We report that certain all-purine methylphosphonate oligodeoxyribonucleotides (MPOs) form stable triple-stranded complexes with complementary (all-pyrimidine) RNA targets. Modified chloramphenicol acetyltransferase mRNA targets were prepared with complementary all-pyrimidine inserts (18-20 bp) located immediately 3' of the initiation codon. These modified chloramphenicol acetyltransferase mRNAs were used together with internal control (nontarget) mRNAs in a cell-free translation-arrest assay. Our data show that triple-strand-forming MPOs specifically inhibit protein synthesis in a concentration-dependent manner (> 90% at 1 microM). In addition, these MPOs specifically block reverse transcription in the region of their complementary polypyrimidine target sites.

[Comparability of the data presented in the medical death certificate and the death rate statistics index]. / Análisis de la concordancia de los datos recogidos en el certificado médico de defunción y el boletín estadístico de defunción.

It having been impossible to use the Death Rate Statistics Index for analyzing the death rate in the city of Seville for 1985 and this Index having been substituted by the Medical Death Certificate has lead us to carry out this study to compare the data reflected in these two documents and determine the extent to which the Medical Death Certificate conforms to the Death Rate Statistics Index, used officially, and its validity. The results show that both documents tally to a great degree, the DRSI providing somewhat more information with regard to the process leading up to the deaths, this having led us to decide to make the death rate analysis for 1985 in Seville by using the Medical Death Certificate as the document on which the information will be based.

Primase p49 mRNA expression is serum stimulated but does not vary with the cell cycle.

Expression of the small-subunit p49 mRNA of primase, the enzyme that synthesizes oligoribonucleotides for initiation of DNA replication, was examined in mouse cells stimulated to proliferate by serum and in growing cells. The level of p49 mRNA increased approximately 10-fold after serum stimulation and preceded synthesis of DNA and histone H3 mRNA by several hours. Expression of p49 mRNA was not sensitive to inhibition by low concentrations of cycloheximide, which suggested that the increase in mRNA occurred before the restriction point control for cell cycle progression described for mammalian cells and was not under its control. p49 mRNA levels were not coupled to DNA synthesis, as observed for the replication-dependent histone genes, since hydroxyurea or aphidicolin had no effect on p49 mRNA levels when added before or during S phase. These inhibitors did have an effect, however, on the stability of p49 mRNA and increased the half-life from 3.5 h to about 20 h, which suggested an interdependence of p49 mRNA degradation and DNA synthesis. When growing cells were examined after separation by centrifugal elutriation, little difference was detected for p49 mRNA levels in different phases of the cell cycle. This was also observed when elutriated G1 cells were allowed to continue growth and then were blocked in M phase with colcemid. Only a small decrease in p49 mRNA occurred, whereas H3 mRNA rapidly decreased, when cells entered G2/M. These results indicate that the level of primase p49 mRNA is not cell cycle regulated but is present constitutively in proliferating cells.

Peptide production from proteins separated by sodium dodecyl-sulfate polyacrylamide gel electrophoresis.

The development of amino acid sequencers with subnanomolar sensitivities has increased the need for both selective and highly efficient methods for both protein and peptide isolation. In this paper, we describe a simple procedure that utilizes the high resolving capacity of polyacrylamide gel electrophoresis to isolate a single target polypeptide, which can subsequently be subjected to proteolytic digestion and sequencing. Polypeptides are visualized in polyacrylamide gels as dodecyl sulfate/protein complexes, which are passively diffused from gel slices. Free dodecyl sulfate eluted with the protein solution is removed by KCl precipitation, allowing protein digestion with small amounts of trypsin or other proteolytic enzymes. Following enzymatic digestion, the peptide solution is made 6 M guanidine-HCl to remove interfering contaminants and thereby improve resolution of the digest by reverse-phase high-performance liquid chromatography. The peptides generated by this method are suitable for amino acid sequencing with good overall yields, averaging 15-30% on a gas-phase sequenator. The method described is useful for obtaining multiple peptide sequences from a single polypeptide isolated from a complex protein mixture.

Mouse primase p49 subunit molecular cloning indicates conserved and divergent regions.

Primase is a specialized RNA polymerase that synthesizes RNA primers for initiation of DNA synthesis. A full cDNA clone of the p49 subunit of mouse primase, a heterodimeric enzyme, has been isolated using a primase p49-specific polyclonal antibody to screen a lambda gt11 mouse cDNA expression library. The cDNA indicated the subunit is a 417-amino acid polypeptide with a calculated molecular mass of 49,295 daltons. The p49 mRNA is approximately 1500 nucleotides long with a 5'-untranslated region of 74 nucleotides and a 3'-untranslated region of 200 nucleotides. Comparison with a similar sized primase subunit from yeast showed highly conserved amino acid sequences in the N-terminal halves of the polypeptides and included a potential metal-binding domain suggesting the functional importance of this region for DNA binding. In contrast, the 3' portion of the cDNA has rapidly diverged in nucleotide sequence, as primase mRNA can be detected in mouse and rat cells with a 3' probe (including coding and noncoding) but not in RNA from hamster or human cells. A full-length cDNA probe detected mRNA from hamster and human cell lines, indicating a conserved 5' portion and divergent 3' region of the expressed gene. The rapid divergence may be related to the species-specific protein interactions found for the DNA polymerase alpha-primase complex. The mRNA is detected in proliferating but not in quiescent cells consistent with its function in DNA replication.