Características clínicas, manejo y resultados de los pacientes con endoftalmitis estéril asociados con la inyección intravítrea de factores de crecimiento endotelial antivascular / Clinical features, management and outcomes of patients with sterile endophthalmitis associated with intravitreal injection of antivascular endothelial growth factor

OBJETIVO: Analizar las características clínicas, el manejo y los resultados de los pacientes con endoftalmitis estéril asociada con el factor de crecimiento endotelial antivascular intravítreo. MÉTODOS: Serie de casos de observación retrospectiva de pacientes con endoftalmitis estéril después de inyecciones intravítreas anti-VEGF. Se han revisado los datos clínicos de pacientes tratados con anti-VEGF intravítreos durante un año. Se analizan los que han presentado un episodio de endoftalmitis estéril y se estudia su causalidad y manejo. RESULTADOS: Siete pacientes tuvieron un inicio de endoftalmitis estéril en los 4días posteriores a la inyección intravítrea (aflibercept n = 5 y ranibizumab n = 2). Estos pacientes tienen alguna condición neovascular activa: degeneración macular relacionada con la edad (n = 4), neovascularización coroidea miope (n = 1) o edema macular: edema macular diabético (n = 1), oclusión de la vena retiniana ramificada (n = 1). Los signos y síntomas compartidos incluyeron pérdida de visión indolora, células en cámara anterior o vítrea y falta de hipopión. En todos los pacientes, la agudeza visual volvió a estar dentro de una línea de agudeza basal. CONCLUSIÓN: Diferenciar casos de endoftalmitis estéril de infecciosa puede ser un desafío. Es crucial diferenciar ambas entidades, ya que un buen diagnóstico determina el pronóstico visual. Debemos ser conscientes de una inflamación mínima después de repetidas inyecciones intravítreas para establecer el tratamiento adecuado

PURPOSE: Analyze clinical features, management and outcomes of patients with sterile endophthalmitis associated with intravitreal antivascular endothelial growth factor. METHODS: Observational retrospective case series of patients with sterile endophthalmitis following anti-VEGF intravitreal injections. Clinical data of patients treated with intravitreal anti-VEGFs during one year have been revised. Those who have presented an episode of sterile endophthalmitis are analyzed and their causality and management are studied. RESULTS: Seven patients have had a sterile endophthalmitis onset within 4days after intravitreal injection (aflibercept n = 5 and ranibizumab n = 2). These patients have some active neovascular condition: age related macular degeneration (n = 4), myopic choroidal neovascularization (n = 1) or macular edema: diabetic macular edema (n = 1), branch retinal vein occlusion (n = 1). Shared signs and symptoms included painless vision loss, anterior chamber and vitreous cell and lack of hypopyon. In all patients, visual acuity returned to within one line of baseline acuity. CONCLUSIÓN: Differentiating cases of sterile from infectious endophthalmitis may be challenging. It is crucial to differentiate both entities as a good diagnosis determines the visual prognosis. We should be aware of minimal inflammation after repeated intravitreal injections in order to establish the adequate treatment

Clinical features, management and outcomes of patients with sterile endophthalmitis associated with intravitreal injection of antivascular endothelial growth factor. / Características clínicas, manejo y resultados de los pacientes con endoftalmitis estéril asociados con la inyección intravítrea de factores de crecimiento endotelial antivascular.

PURPOSE: Analyze clinical features, management and outcomes of patients with sterile endophthalmitis associated with intravitreal antivascular endothelial growth factor. METHODS: Observational retrospective case series of patients with sterile endophthalmitis following anti-VEGF intravitreal injections. Clinical data of patients treated with intravitreal anti-VEGFs during one year have been revised. Those who have presented an episode of sterile endophthalmitis are analyzed and their causality and management are studied. RESULTS: Seven patients have had a sterile endophthalmitis onset within 4days after intravitreal injection (aflibercept n=5 and ranibizumab n=2). These patients have some active neovascular condition: age related macular degeneration (n=4), myopic choroidal neovascularization (n=1) or macular edema: diabetic macular edema (n=1), branch retinal vein occlusion (n=1). Shared signs and symptoms included painless vision loss, anterior chamber and vitreous cell and lack of hypopyon. In all patients, visual acuity returned to within one line of baseline acuity. CONCLUSION: Differentiating cases of sterile from infectious endophthalmitis may be challenging. It is crucial to differentiate both entities as a good diagnosis determines the visual prognosis. We should be aware of minimal inflammation after repeated intravitreal injections in order to establish the adequate treatment.

[Strategies to improve the quality of care in the chronic patient on multiple medications]. / Líneas estratégicas para mejorar la calidad de la atención al paciente crónico polimedicado.

OBJECTIVE: To carry out an evaluation of the impact on the number of patients in the risk situation due to safety problems with the medications after compliance with a program to improve the quality of care of the chronic patient on multiple medications in the Health Area of Santiago de Compostela. METHOD: The intervention program consisted of the design of a computer tool that would allow the detection and stratification of the risk of patients with potential safety problems with medications. The program included sessions and pop-ups on the quality of the prescription and the systematic periodic communication of the results on the use of the prescriptions to the doctors and pharmacists of Primary Care. A one-year time horizon was considered. RESULTS: In January 2018, there were 9,874 patients at risk due to potential safety problems related to medicines in the Health Area of Santiago de Compostela. At the end of December 2018, the patients at risk had fallen to 5,797 patients (41.2% reduction; P<.05). CONCLUSIONS: The design of computer tools that allow the use of the information available from the electronic prescription using standardised protocols, along with the team work of hospital pharmacists and primary care pharmacists, the collaboration between physicians, nurses and pharmacists, as well as the design of information adapted to the computer equipment and the stratification of the risk have all been actions with very positive results in the decrease in exposure of chronic patients to risk situations related to medications.

Evaluation of antimicrobial resistance of Campylobacter spp. isolated from broiler carcasses.

1. The aim of the present study was to evaluate the antimicrobial resistance of Campylobacter strains (C. jejuni, C. coli and C. lari) isolated from broiler carcasses processed in the State of Paraná, Brazil. 2. Rates of microbial resistance and susceptibility were assessed by both Disk Diffusion (DD) and Etest (Minimum Inhibitory Concentration) techniques. Antibiotics were tested using DD (12 antibiotics) and/or MIC (7 antibiotics) methods. 3. A total of 95.8% of the strains were resistant to at least two agents. In terms of multidrug resistance, 75% of strains were resistant to three or more groups of antibiotics. The highest rates of resistance were detected for cefalotin, ciprofloxacin, tetracycline and nalidixic acid. A high rate of susceptibility of the strains to erythromycin (95.8%) was found confirming that this is considered the agent of choice for treating campylobacteriosis. Comparison of the microbial resistance and susceptibility, as determined simultaneously by the two methods, found the techniques to be statistically equivalent for 5 out of the 6 antibiotics tested. 4. The results of this study suggest the need for adopting measures to control the use of antibiotics in broiler production to prevent multidrug resistance of Campylobacter strains and reduce the risk of serious human diseases caused by the consumption of contaminated chicken meat.

Enfermedad de La Peyr onie: tratamiento con interferón y láser / Peyronie's disease: treatment with interferon and laser

Evaluar comparativamente los resultados del tratamiento con interferón, láser y su asociación en un grupo de sujetos con la enfermedad de La Peyronie. Método: Se realizó un estudio experimental para evaluar los principales resultados del tratamiento de la enfermedad de La Peyronie con interferón y láser, en el Hospital Provincial Universitario Saturnino Lora Torres y en el Hospital General Universitario Dr. Juan Bruno Zayas Alfonso de la ciudad de Santiago de Cuba, desde enero de 2003 hasta julio de 2005. Quedaron incluidos 96 pacientes, divididos en tres grupos de tratamiento: interferón, láser e interferón más láser. Luego de la evaluación inicial se inició el tratamiento que duró 28 semanas, con reevaluaciones a los 6 y 12 meses de terminado éste. Resultados: Los resultados finales del tratamiento con interferón y láser combinado fueron mejoría de los síntomas (84.7%), disminución del tamaño de la placa fibrosa (90.6%) y de la curvatura del pene (87.5%). Conclusiones: La combinación de ambas terapias resultó ser más eficaz que su empleo por separado, por lo que se recomienda su incorporación como otra terapéutica en la enfermedad de La Peyronie...

[Peyronie's disease: treatment with interferon and laser]. / Enfermedad de la Peyronie: tratamiento con interferon y láser.

OBJECTIVES: To evaluate comparatively the results of treatment with interferon, laser and their association in a group of patients with Peyronie's disease. METHODS: We performed an experimental study to evaluate the main results of the treatment of Peyronie's disease with interferon and laser, at Hospital Provincial Universitario "Saturnino Lora Torres" and Hospital General Universitario "Dr. Juan Bruno Zayas Alfonso" in the city of Santiago de Cuba from January 2003 to July 2005. Ninety-six patients were included, divided into three treatment groups: interferon, laser and interferon plus loser. After initial evaluation, treatment was started and continued for 28 weeks, with reevaluation six and 12 months after the end of treatment. RESULTS: Final results with combined interferon and laser were: symptoms improvement 84.7%, decrease of the size of the fibrous plaque 90.6% and decrease of penile curvature 87.5%. CONCLUSIONS: The combination of both therapies resulted to be more effective than each of them separately, so the recommendation is to incorporate it as another therapeutic alternative in Peyronie's disease.

Enfermedad de la Peyronie. Tratamiento con interferon y láser / Peyronie's disease: treatment with interferon and laser

Objetivo: Evaluar comparativamente los resultados del tratamiento con interferón, láser y su asociación en un grupo de sujetos con la enfermedad de la Peyronie. Método: Se realizó un estudio experimental para evaluar los principales resultados del tratamiento de la enfermedad de La Peyronie con Interferón y Láser, en el Hospital Provincial Universitario «Saturnino Lora Torres» y en el Hospital General Universitario «Dr. Juan Bruno Zayas Alfonso» de la ciudad de Santiago de Cuba desde Enero del 2003 hasta Julio del 2005. Quedaron incluidos 96 pacientes, divididos en 3 grupos de tratamiento: Interferón, Láser e Interferón más Láser. Luego de la evaluación inicial se inició el tratamiento que duró 28 semanas, con reevaluaciones a los 6 y 12 meses de terminado el mismo. Resultados: Los resultados finales del tratamiento con Interferón y láser combinado fueron: mejoría de los síntomas (84,7 %), disminución del tamaño de la placa fibrosa (90,6 %) y, de la curvatura del pene (87,5 %). Conclusiones: La combinación de ambas terapias resultó ser más efectiva que su empleo por separado, por lo que se recomienda, la incorporación de la misma como otra terapéutica en la enfermedad de La Peyronie (AU)

Objectives: To evaluate comparatively the results of treatment with interferon, laser and their association in a group of patients with Peyronie's disease. Methods: We performed an experimental study to evaluate the main results of the treatment of Peyronie's disease with interferon and laser, at Hospital Provincial Universitario «Saturnino Lora Torres» and Hospital General Universitario «Dr. Juan Bruno Zayas Alfonso» in the city of Santiago de Cuba from January 2003 to July 2005. Ninety-six patients were included, divided into three treatment groups: interferon, laser and interferon plus laser. After initial evaluation, treatment was started and continued for 28 weeks, with reevaluation six and 12 months after the end of treatment. RESULTS: Final results with combined interferon and laser were: symptoms improvement 84.7%, decrease of the size of the fibrous plaque 90.6% and decrease of penile curvature 87.5%. Conclusions: The combination of both therapies resulted to be more effective than each of them separately, so the recommendation is to incorporate it as another therapeutic alternative in Peyronie's disease (AU)

Técnica quirúrgica modificada en la Enfermedad de La Peyronie. Nuestra experiencia / Modified surgical technique in Peyronie´s disease. Our experience

Introducción: La enfermedad de La Peyronie consiste en la formación de una o varias placas fibrosas, que además de afectar la túnica albugínea y alrededor del tejido cavernoso restringen no sólo la expansión del pene durante la tumescencia, sino la de ese segmento del conducto peneano, con lo cual generan una erección curva. Se conocen varias modalidades terapéuticas. El objetivo de este trabajo es proponer en esta patología una modificación a la técnica quirúrgica de Essed y precisar la evolución de estos pacientes. Método: Se llevó a efecto un estudio descriptivo y transversal entre el 2003 y el 2005 con el propósito de modificar una técnica quirúrgica en sujetos con enfermedad de La Peyronie. Se incluyeron en esta investigación 210 pacientes con edades entre los 30 y 70 años con diagnóstico clínico y ecográfico de esta patología. Cada sujeto firmó previamente un documento (consentimiento informado de participación). Se midió la curvatura peneana previa cirugía y se valoró la función sexual según el índice internacional de función eréctil (IIFE). Resultados: Predominó el grupo etáreo de 45 a 60 años con el 62 % y aquellos pacientes con síntomas de más de un año de evolución para el 52,4 %. La hipertensión arterial, diabetes Mellitus y el síndrome Kelami se señalan como los antecedentes personales más frecuentes, con el 35,2; 19,7; y 7,2% respectivamente El 98,6 % de los pacientes tuvieron solución quirúrgica definitiva a los 6 meses post cirugía y el resto a los 9 meses. Conclusiones: El examen ecográfico constituyó un medio eficaz para una mejor definición de la localización, cuantificación y tamaño de las placas. La modificación quirúrgica propuesta, evita las complicaciones de la operación original y tiene un extraordinario impacto económico al disminuir costos por ser una cirugía ambulatoria, con anestesia local y sin complicaciones (AU)

The authors conducted a study from 2003 to 2005 with the purpose of modifing a surgical technique in subjects with Peyronie´s disease. Each subject filled out and signed an informed consent form establishedfor use by the Hospital Provincial Universitario 'Saturnino Lora Torres', in Santiago de Cuba, that included a description of the variables of the investigation. The study confirmed that Peyronie´s disease affecting predominatly males between the ages of 30 to 70 years. Dorso lateral in curvation was the most comon. The ecogram is an effective method for locating and measuring plaque. Results: Total correction of the curvature in 98,6%. High grade of satisfaction in 200 patients .Conclusion: Essed operation is an easy and effective surgical technique in the Peyronie´s disease for curvature correction. The proposed surgical technique avoided the complications found in original operations and has an economic impact of reducing costs by providing an ambulatory surgery using local anesthesic (AU)

Técnica quirúrgica modificada en la Enfermedad de La Peyronie: nuestra experiencia / Modified surgical technique in peyronies diseases: our experience

Introducción: La enfermedad de La Peyronie consiste en la formación de una o varias placas fibrosas,que además de afectar la túnica albugínea y alrededor del tejido cavernoso restringen no sólo la expansión del pene durante la tumescencia, sino la de ese segmento del conducto peneano, con lo cual generan unaerección curva. Se conocen varias modalidades terapéuticas. El objetivo de este trabajo es proponer en estapatología una modificación a la técnica quirúrgica de Essed y precisar la evolución de estos pacientes.Método: Se llevó a efecto un estudio descriptivo y transversal entre el 2003 y el 2005 con el propósito demodificar una técnica quirúrgica en sujetos con enfermedad de La Peyronie. Se incluyeron en esta investigación210 pacientes con edades entre los 30 y 70 años con diagnóstico clínico y ecográfico de esta patología.Cada sujeto firmó previamente un documento (consentimiento informado de participación). Se midió lacurvatura peneana previa cirugía y se valoró la función sexual según el índice internacional de función eréctil(IIFE). Resultados: Predominó el grupo etáreo de 45 a 60 años con el 62 por ciento y aquellos pacientes con síntomasde más de un año de evolución para el 52,4 por ciento. La hipertensión arterial, diabetes Mellitus y el síndromeKelami se señalan como los antecedentes personales más frecuentes, con el 35,2; 19,7; y 7,2 por ciento respectivamente El 98,6 por ciento de los pacientes tuvieron solución quirúrgica definitiva a los 6 meses post cirugía y el resto a los 9 meses. Conclusiones: El examen ecográfico constituyó un medio eficaz para una mejor definición de la localización,cuantificación y tamaño de las placas. La modificación quirúrgica propuesta, evita las complicacionesde la operación original y tiene un extraordinario impacto económico al disminuir costos por ser una cirugíaambulatoria, con anestesia local y sin complicaciones(AU)

The authors conducted a study from 2003 to 2005 with the purpose of modifing a surgical technique insubjects with Peyronie´s disease. Each subject filled out and signed an informed consent form establishedfor use by the Hospital Provincial Universitario Saturnino Lora Torres, in Santiago de Cuba, that includeda description of the variables of the investigation. The study confirmed that Peyronie´s disease affecting predominatlymales between the ages of 30 to 70 years. Dorso lateral incurvation was the most comon. Theecogram is an effective method for locating and measuring plaque.Results: Total correction of the curvature in 98,6 percentil. High grade of satisfaction in 200 patients .Conclusion: Essed operation is an easy and effective surgical technique in the Peyronie´s disease for curvaturecorrection. The proposed surgical technique avoided the complications found in original operationsand has an economic impact of reducing costs by providing an ambulatory surgery using local anesthesic(AU)

Enfermedad de la Peyronie: tratamiento con interferon y láser / Peyronie's disease: treatment with interferon and laser

Objetivo: Evaluar comparativamente los resultados del tratamiento con interferón, láser y su asociación en un grupo de sujetos con la enfermedad de la Peyronie. Método: Se realizó un estudio experimental para evaluar los principales resultados del tratamiento de la enfermedad de La Peyronie con Interferón y Láser, en el Hospital Provincial Universitario Saturnino Lora Torres y en el Hospital General Universitario Dr Juan Bruno Zayas Alfonso de la ciudad de Santiago de Cuba desde Enero del 2003 hasta Julio del 2005. Quedaron incluidos 96 pacientes, divididos en 3 grupos de tratamiento: Interferón, Láser e Interferón más Láser. Luego de la evaluación inicial se inició el tratamiento que duró 28 semanas, con reevaluaciones a los 6 y 12 meses de terminado el mismo. Resultados: Los resultados finales del tratamiento con Interferón y láser combinado fueron: mejoría de los síntomas (84,7 por ciento), disminución del tamaño de la placa fibrosa (90,6 por ciento) y, de la curvatura del pene (87,5 por ciento). Conclusiones: La combinación de ambas terapias resultó ser más efectiva que su empleo por separado, por lo que se recomienda, la incorporación de la misma como otra terapéutica en la enfermedad de La Peyronie(AU)

Objectives: To evaluate comparatively the results of treatment with interferon, laser and their association in a group of patients with Peyronies disease. Methods: We performed an experimental study to evaluate the main results of the treatment of Peyronies disease with interferon and laser, at Hospital Provincial Universitario Saturnino Lora Torres and Hospital General Universitario Dr Juan Bruno Zayas Alfonso in the city of Santiago de Cuba from January 2003 to July 2005. Ninety-six patients were included, divided into three treatment groups: interferon, laser and interferon plus laser. After initial evaluation, treatment was started and continued for 28 weeks, with reevaluation six and 12 months after the end of treatment. Results: Final results with combined interferon and laser were: symptoms improvement 84.7 percent, decrease of the size of the fibrous plaque 90.6 percent and decrease of penile curvature 87.5 percent. Conclusions: The combination of both therapies resulted to be more effective than each of them separately, so the recommendation is to incorporate it as another therapeutic alternative in Peyronies disease(AU)

[Use of magnetic resonance imaging to evaluate morphological disorders in the brains of patients with sickle cell anaemia]. / Evaluación de las afecciones morfológicas en el cerebro de pacientes con anemia de células falciformes con el uso de imágenes de resonancia magnética.

INTRODUCTION: Blocked blood flow in the brain of patients with sickle cell anaemia (SCA) gives rise to disorders in this organ and, occasionally, courses with no clinical symptoms. AIMS: Our objective was to determine the most common lesions in the brains of patients with SCA in the eastern region of Cuba. PATIENTS AND METHODS: We conducted a study with children and adults with SCA, who were voluntarily included in the research protocol. The 28 adult patients had no history of vaso-occlusive crises of the central nervous system, and their ages ranged from 17 to 48 years. In addition, 50 paediatric-aged patients between the ages of 2 and 17 years were evaluated. Images were obtained with the Cuban magnetic resonance imaging equipment Giroimag 01 at 0.05 T. RESULTS: Both studies showed that cortical atrophy (CA) is the most frequent brain lesion among those found in the population of patients evaluated. The study revealed 35.7% of patients with silent lesions in adults and 18% in the children. CONCLUSIONS: CA is the lesion that is most commonly seen in the population studied. The brain lesions that were found are possibly triggered by the effect of blockages in the blood flow in the brain. A population study must be conducted in order to determine the first disorders triggered by the blocked blood flow in the brains of these patients. There is also a need to evaluate the possible risk factors that favour the development of these lesions.

Evaluación de las afecciones morfológicas en el cerebro de pacientes con anemia de células falciformes con el uso de imágenes de resonancia magnética / Use of magnetic resonance imaging to evaluate morphological disorders in the brains of patients with sickle cell anaemia

Introducción. La oclusión del flujo de sangre en el cerebro de los pacientes con anemia de células falciformes (ACF) provoca afecciones en este órgano, y en ocasiones transcurren sin síntomas clínicos. Objetivo. Encontrar las lesiones más comunes en el cerebro de pacientes con ACF de la región oriental de Cuba. Pacientes y métodos. Estudio de niños y adultos con ACF, incluidos voluntariamente en el protocolo de investigación. Los 28 pacientes adultos no tenían antecedentes de crisis vasooclusivas del sistema nervioso central, y sus edades estaban comprendidas entre 17 y 48 años. Se evaluaron 50 pacientes en edad pediátrica, entre los 2 y los 17 años. Las imágenes se obtuvieron con el equipo cubano de imágenes de resonancia magnética Giroimag ® 01 a 0,05 T. Resultados. Ambos estudios mostraron que la atrofia cortical es la lesión cerebral más frecuente de las encontradas en la población de pacientes evaluados. El estudio refleja un 35,7 por ciento de pacientes con lesiones silenciosas en los adultos y un 18 por ciento en los niños. Conclusiones. La atrofia cortical es la lesión que más se manifiesta dentro de la población estudiada. Las lesiones cerebrales encontradas pueden ser provocadas por el efecto de la oclusión de la circulación sanguínea en el cerebro. Es necesario desarrollar un estudio de población para determinar las primeras afecciones provocadas por la oclusión del flujo sanguíneo en el cerebro de estos pacientes. También se deben evaluar los posibles factores de riesgo que favorecen el desarrollo de estas lesiones (AU)

Introduction. Blocked blood flow in the brain of patients with sickle cell anaemia (SCA) gives rise to disorders in this organ and, occasionally, courses with no clinical symptoms. Aims. Our objective was to determine the most common lesions in the brains of patients with SCA in the eastern region of Cuba. Patients and methods. We conducted a study with children and adults with SCA, who were voluntarily included in the research protocol. The 28 adult patients had no history of vaso-occlusive crises of the central nervous system, and their ages ranged from 17 to 48 years. In addition, 50 paediatric-aged patients between the ages of 2 and 17 years were evaluated. Images were obtained with the Cuban magnetic resonance imaging equipment Giroimag ® 01 at 0.05 T. Results. Both studies showed that cortical atrophy (CA) is the most frequent brain lesion among those found in the population of patients evaluated. The study revealed 35.7% of patients with silent lesions in adults and 18% in the children. Conclusions. CA is the lesion that is most commonly seen in the population studied. The brain lesions that were found are possibly triggered by the effect of blockages in the blood flow in the brain. A population study must be conducted in order to determine the first disorders triggered by the blocked blood flow in the brains of these patients. There is also a need to evaluate the possible risk factors that favour the development of these lesions (AU)

Immunohematological aspects of bone marrow transplantation.

Allogeneic bone marrow transplantation (BMT) is an effective treatment for some severe hematologic or nonhematologic diseases. The blood group antigen mismatch between donor and recipient may cause immunohematological complications during or after BMT. In this review, we analyze the ABO, Rh and other red cell antigen mismatches between donor and recipient, the main immunohematological complications and the techniques to prevent them. The data reported are derived from the experience of the authors and from the medical literature. The clinical implications of the immunohematological aspects of BMT emphasize the importance of close immunohematological monitoring in patients undergoing allogeneic BMT with ABO, Rh or other red cell antigen mismatches between donor and recipient.

Preoperative autologous blood donation by elderly patients undergoing orthopaedic surgery.

BACKGROUND AND OBJECTIVES: To assess the feasibility of a programme of predeposit in elderly patients undergoing elective orthopaedic surgery. PATIENTS AND METHODS: We retrospectively studied 789 elderly patient candidates (> 65 years of age) for orthopaedic surgery (total hip and knee replacement and spinal surgery), who were undergoing a programme of preoperative autologous blood donation (PABD) in our city hospital between January 1990 and December 1998. RESULTS: Six hundred and eighty-eight patients (87.2%) were transfused with autologous blood; 128 (16.2%) also received allogeneic blood. Hip arthroplasty revision was characterized by the greatest blood consumption. The predeposit programme was discontinued in 96 patients (12.2%) because of the following complications: the onset of anaemia (11.0%); vasovagal reactions (0.5%); lack of venous access (0.4%); or cardiac complications (0.2%). No episodes of reaction to autologous transfusion were recorded. CONCLUSIONS: Our study confirms the feasibility of PABD in elderly patients undergoing elective orthopaedic surgery.

The effect of cetirizine on the integrin-dependent respiratory burst of normodense eosinophils.

It has been proposed that cetirizine inhibits eosinophil migration and adherence. We evaluated the possible effect of cetirizine on integrin-induced eosinophil proinflammatory activation. Normodense eosinophils were triggered with monoclonal antibodies to integrins in the presence of different concentrations of certirizine. Proinflammatory activation was measured by evaluation of O2- production. Only at high concentrations (250 micrograms/ml) and in the first 15 min did certirizine significantly inhibit (p < 0.02) the eosinophil respiratory burst. No effect was shown for lower concentrations (50 and 100 micrograms/ml) or after 15 min. These data suggest that, only at very high concentrations, cetirizine may induce a transient inhibition of the integrin-induced eosinophil respiratory burst.

The effects of early postnatal modification of body shape on the somatosensory-visual organization in mouse superior colliculus.

Different regions of the body of an animal have their own shape and location within visual space. Accordingly, in the superior colliculus there are somatosensory-visual bimodal neurons receiving tactile and visual input from the same region of space. In newborn mice, we changed the position of some body parts within visual space in order to see what happened to the alignment of the somatosensory and visual receptive fields of superior colliculus bimodal neurons. To do this, we modified the shape of the head by displacing the superior vibrissae and the ears, normally in the superior portion of visual space, into the inferior visual space. Analogously, we bent the inferior vibrissae into the superior visual space. At the sixth postnatal week we recorded from somatosensory-visual bimodal neurons of the deep layers of the superior colliculus and found that the tactile and visual receptive fields were aligned. Neurons receiving tactile input from the downward-displaced superior vibrissae and ears showed visual receptive fields in the inferior portion of visual space, whereas neurons receiving input from the upward-displaced inferior vibrissae showed visual receptive fields in the superior visual space. These results show that an experience-dependent interaction between visual and somatosensory inputs occurs during development, and that early exposure to abnormal visual-somatosensory experience modifies the organization of multisensory neurons in the superior colliculus.

Implantation of artificial whiskers on the ears of newborn mice induces visual re-mapping in the superior colliculus.

In newborn mice, we modified the body scheme by implanting artificial whiskers (pig hair) on the ears, which are located in the superior and temporal portions of the visual field. In normal mice, multisensory neurons in the deep layers of the superior colliculus receiving somatosensory input from the ears showed visual receptive fields in the superior and temporal portions of visual space. By contrast, in the implanted mice, there was a modification of the visual receptive fields strictly related to the direction of the artificial whiskers. If these were directed toward the nose, visual receptive fields expanded in the nasal direction. If the whiskers were directed downward, visual receptive fields expanded downward. These results show that an interaction between visual and somatosensory inputs occurs in the superior colliculus during development, and that the collicular visual topography undergoes a re-mapping on the basis of the altered tactile experience.

Dual effects of formylpeptides on the adhesion of endotoxin-primed human neutrophils.

Neutrophils, treated with sequential additions of bacterial products such as endotoxin (E. Coli lipopolysaccharide, LPS) and the chemotactic peptide N-formyl-methionyl-leucyl-phenylalanine (fMLP), undergo to metabolic activation and express membrane-anchoring proteins that promote adhesion to serum-coated culture wells. By investigating the dose-response relationships of these phenomena, we have found that: (a) resting neutrophils do not produce a significant amount of superoxide (O2-) and show only minimal adhesion to serum-coated plastic surfaces; (b) fully activatory doses (> 5 x 10(-8) M) of fMLP induce the release of O2- and a significant increase of the cell adhesion; (c) pretreatment of the cells for 1 h with LPS augments cell adhesion to serum-coated culture wells in the absence of further stimulation and primes the neutrophils to enhanced fMLP-dependent O2- release; (d) addition of low, substimulatory doses of fMLP (from 10(-10) M to 5 x 10(-9) M) inhibits and reverses the adhesion of LPS-treated cells, (e) high fMLP doses ( > 10(-7) M) are additive to LPS in promoting adhesion. Phorbol-myristate acetate (> 10(-9) M) increased adhesion in both normal and LPS-treated neutrophils, but low doses of this stimulant did not inhibit adhesion. Low doses (10(-9) M) of fMLP increased intracellular cyclic AMP in both normal and LPS-treated neutrophils, suggesting that stimulus-induced rises in cAMP may be the negative signal responsible for down-modulation of adhesion.(ABSTRACT TRUNCATED AT 250 WORDS)

IL-8 production by human polymorphonuclear leukocytes. The chemoattractant formyl-methionyl-leucyl-phenylalanine induces the gene expression and release of IL-8 through a pertussis toxin-sensitive pathway.

IL-8 is a novel chemotactic cytokine, produced by a variety of blood and tissue cells, that has marked activating effects on polymorphonuclear leukocytes (PMN). We report that IL-8 is produced and released by human PMN after stimulation with the chemotactic agonist FMLP. Release of IL-8 in response to FMLP was transient and not influenced by PMN adherence or by the absence of serum in the medium. Maximum yields were usually obtained with 10 nM FMLP within 2 h of stimulation (0.5-3.5 ng/ml/7 x 10(6) cells, range of 17 different donors). IL-8 release was dependent on FMLP-induced de novo protein synthesis because it was inhibited by cycloheximide, was paralleled by enhanced expression of IL-8 mRNA and was potentiated from two- to sixfold after preincubation of PMN with cytochalasin B. The FMLP effect was direct and not dependent on LPS or on contaminating monocytes, which showed only low responsiveness to FMLP. Pretreatment of PMN with pertussis toxin prevented FMLP-dependent IL-8 production, the effect being evident both at the level of mRNA expression and protein secretion. In addition, two other chemoattractans, platelet-activating factor and C5a, were found capable to induce release of IL-8 by PMN. The results of this study suggest that chemotactically stimulated PMN may be able to amplify the recruitment process of PMN to the inflammatory site by releasing IL-8. As a long-lived cytokine, IL-8 could markedly prolong the attractant effect.