Determinación de antígeno carcinoembrionario en los exámenes rutinarios de salud realizados desde Atención Primaria / Carcinoembryonic antigen as a cancer screening marker by primary care physicians

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Evaluation of the effect of training using auditory stimulation on rhythmic movement in Parkinsonian patients--a combined motor and [18F]-FDG PET study.

INTRODUCTION: A programme of rehabilitation using auditory cues has previously been shown to decrease movement variability in the gait of Parkinsonian patients. OBJECTIVE AND METHODS: We studied the temporal variability of finger-tapping and gait in 9 patients with Parkinson's disease (PD) before and after they undertook a physical rehabilitation programme. Positron Emission Tomography (PET) using 2-deoxy-2[(18)F]fluoro-D-glucose (FDG) was performed in these subjects to look for changes in metabolic brain activity after completion of the rehabilitation program. RESULTS: The reduction of variability was seen not only in gait but also other repetitive movements such as finger tapping. Furthermore, here we show differences in resting regional cerebral glucose utilisation in these patients compared to healthy controls (significant hypometabolism-p < 0.001-for the PD group in the right parietal and temporal lobes, left temporal and frontal lobes and a hypermetabolism in the left cerebellum) and specific changes following the improvements in repetitive movement abilities (significant metabolic increment-p < 0.001-in the PD group in the right cerebellum and in the right parietal and temporal lobes). CONCLUSIONS: Although our study does not allow us to draw firm conclusions, it provides new information on the neural basis of auditory stimulation in PD. Our results extend those from previous studies to show improvement in the temporal variability of two types of rhythmic movements after participation by PD patients in a physical rehabilitation programme, along with changes in glucose uptake in several brain areas involved in sensorimotor processing.

Chemical analysis of used three-way catalysts by total reflection X-ray fluorescence.

The methodology developed for evaluating, by total reflection X-ray fluorescence, the main elements in used three-way catalysts for cars after more than 59 000 km is described. The analytical method does not require chemical manipulation of the samples, is quick (30 min for sample preparation and 10 min for analysis), precise (between 1% and 10% of variation coefficient), and simple. The two catalytic monoliths contained in the cartridge of a car with more than 59,000 km have been analyzed. The mass relationships between the detected elements and Si, a component of the cordierite ceramic substrate, have been used to follow the axial and radial profiles of the elements. Information concerning the loss of active elements and the retention of contaminating elements as a consequence of the working conditions was attained by comparison between the results obtained for the used catalyst (59 000 km) with those of a fresh catalyst (0 km). The interface effect between the first and the second catalytic bricks was also studied.

Reparación perineal transvaginal del rectocele sintomático mediante perineorrafia protésica con malla de marlex. Valoraciones anatomoclínicas, fisiológicas y de tratamiento / Transvaginal perineal repair of symptomatic rectocele using a Marlex mesh prosthesis: anatomoclinical, physiological and treatment considerations/assessment

Introducción. El propósito de este estudio es valorar el tratamiento de los rectoceles sintomáticos, en un grupo seleccionado de pacientes, mediante una técnica diseñada personalmente, en función de su etiología (fallo de la fascia de Denonvilliers), y con la colocación de una malla de Marlex. Pacientes y métodos. Se seleccionaron exclusivamente 12 pacientes en las cuales existía una historia de estreñimiento grave y que, además del uso diario de laxantes, recurrían a la digitación como única solución para la evacuación rectal. Se realizó un abordaje quirúrgico perineal transvaginal, colocándose una malla de Marlex anclada sobre la fascia de Denonvilliers y posteriormente una colpectomía romboidal posterior de la pared redundante. Resultados. Todas las pacientes notaron una mejoría inmediata de los síntomas con una evacuación sin necesidad de digitación, a la vez que desapareció el prolapso vaginal posterior. La rectificación del rectocele fue perfecta y se normalizaron los parámetros anatómicos, fisiológicos y radiológicos. Conclusiones. La perineorrafia protésica transvaginal mejora de forma definitiva los síntomas del rectocele de gran tamaño, tratando a la vez los dos parámetros anatomoclínicos, de distensión rectal anterior y prolapso vaginal posterior (AU)

[Preconceptional control in diabetic women]. / El control preconcepcional en la gestante diabética.

The experience of the Preconceptional Clinic developed in our hospital from 1992 to 1996 is here reported. Twenty-eight insulin-dependent diabetic patients underwent a preconceptional control (PCC). Pregnancy was obtained in 19 patients (2 miscarriages, 12 full pregnancies, and 5 pregnancies in course). A comparative case-control study was performed between the 12 patients undergoing PCC, who have completed their pregnancy, and other 12 prepregnant diabetic patients, controlled from the 7-12 weeks of pregnancy. HbA1c levels in the PCC group were lower, and no differences regarding fetal morbidity were observed. The presence of a severe congenital malformation in the PCC group, with normal periconceptional HbA1c levels, denotes the teratogenic influence of factors yet to be elucidated.

Neurocutaneous melanosis, neurofibromatosis and spinal meningioma: an unusual association.

The case of 38-year-old woman bearer of a congenital giant naevus "en pélerine" with numerous neurofibromas and other satellite naevi was reported: the patient was afflicted by spastic tetraparesis, more pronounced on the right side. MRIscan of the spine revealed the presence of a cervical spinal tumor shown histologically to be a psammomatous meningioma. The skin picture was consistent with neurocutaneous melanosis; the rarity of its association with neurofibromatosis and spinal meningioma is discussed in the light of embryologic arguments.

Motor and inflammatory effect of hyperosmolar solutions on the rat urinary bladder in relation to capsaicin-sensitive sensory nerves.

1. Intravesical administration of hyperosmolar NaCl or urea solutions produced a concentration-dependent stimulatory action on the micturition reflex in urethane-anesthetized rats. This effect was not modified in rats pretreated with capsaicin as adults (50 mg/kg s.c. 4 days before). 2. Hyperosmolar NaCl also produced Evans blue leakage (plasma extravasation) in the rat bladder. This effect was greatly reduced by extrinsic bladder denervation and in rats desensitized to capsaicin as newborns but not as adults. 3. Cumulative addition of NaCl produced a concentration-dependent increase in tone and biphasic effects on neurogenic contractions of the rat isolated bladder. These effects were not modified by in vitro capsaicin desensitization. 4. These findings do not support the idea that true osmoreceptors are present in the rat urinary bladder. The neurogenic component of the inflammatory response to hyperosmolar NaCl could involve activation of a subpopulation of bladder sensory fibers susceptible to the neurotoxic action of capsaicin in the early postnatal period only.

Pharmacological profile of the new anticonvulsant etazepine.

The pharmacological profile of the new anticonvulsant etazepine (5,6-dihydro-5-methyl-11H-11-ethoxy-dibenzo[b,e]azepin-6-one) was investigated. It protected mice and rats from a wide variety of convulsant agents (maximal electroshock, pentetrazol (metrazole), bicuculline, strychnine, 3-mercaptopropionic acid, nicotine, cefazoline and kainic acid) at doses about 16-45 times lower than those exerting neurotoxic effects (depending on the test used). The anticonvulsant effect of etazepine was long-acting (more than 24 h) and did not seem to develop tolerance. Moreover, etazepine did not prolong thiopental-induced sleeping time. Based on pharmacological studies etazepine seems to exert its anticonvulsant effects by activating the GABAergic system.

Further studies on mechanisms regulating the voiding cycle of the rat urinary bladder.

1. The effect of transection of pudendal or hypogastric nerves and of various pharmacological pretreatments on the bladder voiding cycle elicited by saline filling was investigated in urethane-anesthetized rats. 2. Sectioning of pudendal nerves reduced efficiency of the expulsive phase of the voiding cycle while sectioning of hypogastric nerves enhanced voiding efficiency and reduced residual volume. 3. An increased voiding efficiency was also observed in 6-hydroxydopamine-treated rats. 4. Atropine and physostigmine decreased and increased voiding efficiency, respectively. Indomethacin pretreatment produced a marked increase in residual volume. 5. These findings indicate that the autonomic innervation of the bladder and urethra as well as production of local factors such as prostanoids regulates not only the collecting phase of the cystometragram but also influence markedly voiding efficiency.

Experimental procedure to favor an otherwise undetectable potential rat muricidal behavior.

We hypothesized that variation in mouse aggressiveness could, at least in part, affect muricidal attitude of rats, therefore we introduced a sedated (diazepam 50 mg/kg/PO) instead of a normal (nonsedated) mouse into a cage with a rat. Rats were challenged with sedated or nonsedated mice for two-four days. It was found that a) the percentage (40-60%) of rats which killed a sedated mouse was higher than that (about 10%) of those which killed a nonsedated mouse; b) rats trained to kill a sedated mouse did not kill a nonsedated mouse and c) rats which did not kill a nonsedated mouse did not kill a sedated mouse. The present results indicate that the first experience in the presence of a sedated mouse uncovers a muricidal behavior which persists upon exposure to subsequent similar experimental conditions. This behavior undergoes seasonal variations, reaching a maximum in September-October and a minimum in February-March.

The effect of SC-19220, a prostaglandin antagonist, on the micturition reflex in rats.

SC-19220 (5-20 mg/kg i.v.), a competitive receptor antagonist of PGE, increased the bladder capacity and reduced the voiding efficiency of micturition (elicited by slow transvesical filling) of urethane-anesthetized rats. The effect of SC-19220 was prevented by indomethacin pretreatment, whereas indomethacin per se mimicked the effects of SC-19220. SC-19220 produced a competitive rightward shift of the dose-response curve for the contractile effect induced by PGE2 on strips of rat detrusor muscle in vitro, whereas the amplitude of nerve-mediated twitches was unaffected. These findings support the hypothesis that endogenous PGE2 is physiologically involved in the regulation of vesicourethral motility in this species by facilitating attainment of the micturition threshold during the collection phase of the cystometrogram.

Tachykinin-like immunoreactivity in the mammalian urinary bladder: correlation with the functions of the capsaicin-sensitive sensory nerves.

The tachykinin-like immunoreactivity of the urinary bladder has been measured in various species by means of an antiserum (K12) having negligible cross-reactivity with substance P. The rank order for bladder content of tachykinin-like immunoreactivity was guinea-pig greater than mice greater than rat, similar to that found for substance P-like immunoreactivity. In all three species, both substance P- and tachykinin-like immunoreactivities were depleted by systemic capsaicin desensitization. The time course for depletion of substance P- and tachykinin-like immunoreactivities of the rat bladder following extrinsic denervation was almost superimposable. At reverse phase high pressure liquid chromatography, the major constituent of tachykinin-like immunoreactivity of the rat bladder co-eluted with neurokinin A. In vitro, the contractile response of the rat bladder to capsaicin (1 microM) was directly proportional to bladder tachykinin-like immunoreactivity while the response to field stimulation was not. In vivo, the volume threshold for reflex micturition was inversely proportional to bladder tachykinin-like immunoreactivity while amplitude of micturition contraction was not. Similar correlations were found in a previous study for substance P-like immunoreactivity. The contractile response to capsaicin or neurokinin A of the rat isolated bladder were significantly reduced by incubation with phenoxybenzamine at a concentration reported to produce a selective alkylation of neurokinin-2 receptors, while the response to substance P or KCl was unaffected. These findings indicate that multiple neurokinins co-exist in those bladder sensory nerves which are capsaicin-sensitive in adult rats. Both substance P- and tachykinin-like immunoreactivities in the rat bladder appear to be good functional markers of the sensory and "efferent" functions mediated by capsaicin-sensitive nerves, consistent with the hypothesis of a transmitter role for the corresponding peptides.

New method for recording cystometrograms in conscious, freely moving rats.

A new cystometric technique has been developed that is suitable for quantitative studies on physiopharmacology of micturition in conscious, freely moving rats. The method involves the transvesical infusion of warm saline at various filling rates through a catheter chronically implanted into the bladder dome. The various parameters of the collecting and voiding phase of the cystometrogram were recorded. Results obtained indicate that characteristics of the bladder voiding cycle of conscious, freely moving rats are qualitatively similar but quantitatively different from those described previously in anesthetized animals.

Management of Pneumocystis carinii pneumonia in patients with AIDS and other conditions: experience in a Philadelphia University Teaching Hospital.

We reviewed the records of 49 patients who had 55 episodes of Pneumocystis carinii pneumonia (PCP) from January 1984 to January 1987. Thirty-three patients had acquired immunodeficiency syndrome (AIDS), with the risk groups being homosexual/bisexual practices (26), hemophilia (6), and blood transfusion (1). Fourteen patients had a history of malignancy or chemotherapy and two underwent organ transplantation. Overall response to therapy of PCP was 75% (77% of patients with AIDS, 68% of those with other conditions). All six relapses occurred in patients with AIDS. Both trimethoprim-sulfamethoxazole (TMP-SMX) and pentamidine were associated with a higher rate of toxicity in those patients than in patients with other conditions. A 30% rate of failure due to side effects occurred when TMP-SMX was used as initial therapy, but the combination is considered effective and should be given an adequate therapeutic trial. Pentamidine was an effective alternative for patients who failed with TMP-SMX and for those who failed therapy due to side effects, but was associated with serious toxicities. Our experience was similar in some respects to previous published results from New York and California.

Prostanoids modulate reflex micturition by acting through capsaicin-sensitive afferents.

Topical application of exogenous prostanoids (PGE2, TBX B2) on the serosal surface of the urinary bladder of urethane-anaesthetized rats activated reflex micturition. Likewise, intravesical instillation of PGE2 during the cystometrogram lowered the threshold for reflex micturition. Both effects were prevented by systemic capsaicin desensitization (50 mg/kg s.c., 4 days before). Indomethacin pretreatment and systemic capsaicin desensitization each increased the micturition threshold without affecting the amplitude of micturition contraction. However, the effect of the two treatments combined was not greater than the effect of either alone. These findings support the idea that endogenous prostanoids facilitate reflex micturition by stimulating or sensitizing, directly or indirectly, the subset of bladder mechanoreceptors which is capsaicin-sensitive in adult rats.

The effects of baclofen on spinal and supraspinal micturition reflexes in rats.

1. The effect of (+/-)-baclofen on micturition reflexes was investigated in urethane-anaesthetized rats. A 'low' dose of (+/-)-baclofen (0.5 mg/kg i.v.) barely affected the early phase of the transurethral cystometrogram (CMG) which involves activation of a spinal vesico-vesical excitatory reflex. 2. At a higher dose (2.5 mg/kg i.v.) (+/-)-baclofen suppressed both the spinal and supraspinal components of the bladder response to transurethral saline filling. 3. When the bladder was filled by the transvesical route a series of regular voiding cycles was obtained which are due to activation of a supraspinal vesico-vesical excitatory reflex. In this model, voiding efficiency of the rat bladder was markedly reduced even after a low dose of (+/-)-baclofen (0.5 mg/kg) and almost suppressed at 2.5 mg/kg. 4. (+/)-Baclofen reduction of voiding efficiency was mainly ascribable to an inhibitory effect on the expulsive phase of the voiding cycle which, in rats, depends critically upon the activation of a reflex which induces a twitch-like contraction of urethral/periurethral skeletal muscles. 5. (+/-)-Baclofen produced a small inhibition of the pinching-induced somatovesical excitatory reflex. (+/-)-Baclofen (2.5 mg/kg i.v.) produced also a marked but transient inhibition of bladder contractions induced by preganglionic nerve stimulation. However the time course of this effect was markedly shorter as compared to the long lasting suppression of voiding cycle observed with this same dose of the drug.(ABSTRACT TRUNCATED AT 250 WORDS)