Experimental study of the mechanical stabilization of electric arc furnace dust using fluid cement mortars.

This article shows the results of an experimental study carried out in order to determine the maximum amount of electric arc furnace dust (EAFD) that can be incorporated into fluid cement-based mortars to produce mechanically stable monolithic blocks. The leaching performance of all mixes was studied in order to classify them according to the EU Council Decision 2003/33/EC. Two mortars were used as reference and three levels of EAFD incorporation were tested in each of the reference mortars. As the incorporation ratio of EAFD/cement increases, the mechanical strength decreases. This is due to the greater EAFD/cement and water/cement ratios, besides the presence of a double-hydrated hydroxide of Ca and Zn (CaZn2(OH)6·2H2O) instead of the portlandite phase (Ca(OH)2) in the mixes made with EAFD, as well as non-hydrated tricalcium silicate. A mass ratio of 2:1 (EAFD: cement-based mortar) can be added maintaining a stable mechanical strength. The mechanical stabilization process also reduced the leaching of metals, although it was not able to reduce the Pb concentration below the limit for hazardous waste. The high amount of EAFD mechanically stabilized in this experimental study can be useful to reduce the storage volume required in hazardous waste landfills.

Benzo(a)pyrene penetration on a smoked meat product during smoking time.

The Codex Alimentarius gives recommendations to prevent carcinogenic polycyclic aromatic hydrocarbons (PAH) (represented by benzo(a)pyrene (BaP)) contamination during processing of meat products, including the control of smoking time. The influence of direct smoking time (0, 1, 3, 5 and 7 days) on the relationship between the BaP and moisture content of a typical Spanish smoked meat product called chorizo and the mechanism of BaP penetration and water release from four different depths in the product was studied. Chorizo was studied from the Principality of Asturias, a location never before tested. An analytical method was developed for this purpose consisting of PAH extraction assisted by sonication followed by solid-phase extraction (SPE) sample clean-up and analytical determination using GC-MS. Results show that an increase in smoking time produced contradictory and independent effects on the moisture and BaP content (µg kg⁻¹) of chorizos. The moisture content decreased from 49.9% to 31.3%. On the other hand, the BaP content increased from less than 0.24 µg kg⁻¹ to 0.75 µg kg⁻¹, finally stabilising after 5 days of smoking. After this time, the natural pores of the casing could be blocked by the large size tar particles from smoke, preventing the continued penetration of PAHs. The BaP content decreased and the moisture content increased progressively from the casing to the centre of the meat product. BaP mainly accumulated in the smoked casing, being four times in excess of the legal limit. This paper analyses the mechanism for preventing PAHs contamination during the process of smoking meat products.

Detection of human papilloma virus in normal skin and in superficial and nodular basal cell carcinomas in immunocompetent subjects.

BACKGROUND: Human papilloma virus (HPV) is increasingly recognized as an important human carcinogen but its role in the aetiopathogenesis of basal cell carcinoma (BCC) in immunocompetent individuals is unclear. OBJECTIVE: A prospective case-control study was designed to compare the prevalence of HPV in BCC and normal skin samples from immunocompetent subjects and to assess the influence of different clinical features on the risk of cutaneous HPV. METHODS: A total of 142 samples from 70 BCC cases (superficial BCC 38 and nodular BCC 32) and 72 controls were analysed by a degenerated nested PCR technique. Clinical data were recorded and risk factors for HPV infection were assessed by multivariate analysis. RESULTS: There were 31 HPV DNA-positive samples. HPV was detected more frequently in cases (25.7%) than in controls (18.1%) and in nodular (31.3%) than in superficial (21.1%) BCC lesions but differences were not statistically significant. Older age (OR 1.5; 95% CI: 1.02-1.09) and actinic keratosis (OR 2.62; 95% CI 1.15-5.96) were the only significant factors associated to the presence of HPV. Risk of HPV positivity was also higher in blond-haired subjects, fair/pale skin colour, history of sunburn, solar lentigines and seborrheic keratosis but the differences were not significant. Both in cases and controls, ß -types were the most frequent. CONCLUSIONS: HPV does not seem to play a fundamental role in the aetiopathogenesis of either nodular or superficial BCC. The presence of HPV appears to be more related to actinic damage and possibly to an alteration of the barrier function associated with ageing.

[Vancomycin-resistant enterococci: prevalence and factors associated with intestinal colonization in oncology patients from Hospital de Niños de Córdoba]. / Enterococos resistentes a vancomicina: prevalencia y factores asociados a la colonización intestinal en pacientes oncológicos del Hospital de Niños de Córdoba.

Vancomycin-resistant enterococci (VRE) have an important impact on pediatric oncology population. The objectives of this study were: to know the prevalence of VRE intestinal colonization in oncology patients, to identify the risk factors that predispose hospitalized patients to VRE intestinal colonization, and to determine the VRE resistance profile to different antimicrobial agents. We studied all children with oncological disease aged 1 month to 16 years that had joined the protocol and had been hospitalized from October 2006 to April 2007. VRE intestinal colonization was analyzed when the patient was admitted to hospital, 72 hours later, and weekly during hospitalization. A total of 333 samples were taken from 67 patients. From these, VRE were isolated in 12 patients, with a prevalence of 17.9%. Of the 28 isolates studied, taking one per patient, 10 were Enterococcus faecium and 2 Enterococcus faecalis, both with resistance phenotype VanA (CIM90 512 microg/ml to vancomycin and CIM90 256 microg/ml to teicoplanin). The use of vancomycin (p = 0.02), duration of neutropenia greater than 7 days (p = 0.03) and prolonged hospitalization (42.8 days on average) (p = 0.0001) were risk factors significantly related to VRE colonization. We considered it necessary to carry out an epidemiological surveillance and to implement prevention and control measures.

[Prevalence and antimicrobial susceptibility patterns of microorganisms causing bacteremia and fungemia in pediatric oncology patients]. / Prevalencia de microorganismos causantes de bacteriemias y fungemias en pacientes oncológicos pediátricos. Patrones de sensibilidad a los antimicrobianos.

The purpose of our research was to know the frequency of microorganisms causing bacteremia and/or fungemia in oncology patients from Hospital de Niños de Córdoba, as well as to describe the antimicrobial susceptibility patterns of bacteria isolated from January 2006 to April 2007. A total of 59 bacteremia and fungemia cases in 44 patients were studied. From the total number of isolations, 45.8% were gram-negative bacilli, 35.6% were gram-positive cocci, and 18.6% were yeasts. The global distribution of the most prevalent microorganisms was the following: Klebsiella spp. 15.3%; Staphylococcus aureus and Candida parapsilosis 11.9%; coagulase-negative staphylococci 10.2%; Escherichia coli 8.5%, and Pseudomonas aeruginosa 6.8%. More than 40% (41.2%) of enterobacteria showed an extended-spectrum beta-lactamase phenotype, and 20.0% of non-fermenting gram-negative bacilli were multi-resistant to tested antibiotics, while 38.5% of Staphylococcus spp. were methicillin-resistant. In conclusion, the most prevalent microorganisms were gram-negative bacilli, and within this group, enterobacteria evidenced a higher percentage of resistance to tested antibiotics.

Prevalencia de microorganismos causantes de bacteriemias y fungemias en pacientes oncológicos pediátricos: Patrones de sensibilidad a los antimicrobianos / Prevalence and antimicrobial susceptibility patterns of microorganisms causing bacteremia and fungemia in pediatric oncology patients

El objetivo del presente trabajo fue conocer la distribución y frecuencia de los microorganismos causantes de bacteriemias y fungemias en los pacientes oncológicos internados en el Hospital de Niños de Córdoba, así como describir sus patrones de sensibilidad a los antimicrobianos. Se estudiaron 59 episodios de bacteriemias y fungemias ocurridos entre enero de 2006 y abril de 2007 en 44 pacientes. Del total de los aislamientos recuperados, el 45,8% fueron bacilos gram-negativos, el 35,6% cocos gram-positivos y el 18,6% levaduras. La distribución global de los microorganismos más prevalentes fue: Klebsiella spp. 15,3%; Staphylococcus aureus 11,9%; Candida parapsilosis 11,9%; estafilococos coagulasa negativos 10,2%; Escherichia coli 8,5% y Pseudomonas aeruginosa 6,8%. El 41,2% de las enterobacterias aisladas presentó un fenotipo compatible con la presencia de alguna b-lactamasa de espectro extendido, y el 20,0% de los bacilos gram-negativos no fermentadores presentó multirresistencia a los antibióticos ensayados. En cuanto a los cocos gram-positivos, el 38,5% de los Staphylococcus spp. fue resistente a meticilina. Se puede concluir que los microorganismos más prevalentes en la población estudiada fueron los bacilos gram-negativos; dentro de este grupo las enterobacterias fueron las que presentaron mayor porcentaje de resistencia a los antibióticos ensayados.

The purpose of our research was to know the frequency of microorganisms causing bacteremia and/or fungemia in oncology patients from Hospital de Niños de Córdoba, as well as to describe the antimicrobial susceptibility patterns of bacteria isolated from January 2006 to April 2007. A total of 59 bacteremia and fungemia cases in 44 patients were studied. From the total number of isolations, 45.8% were gram-negative bacilli, 35.6% were gram-positive cocci, and 18.6% were yeasts. The global distribution of the most prevalent microorganisms was the following: Klebsiella spp. 15.3%; Staphylococcus aureus and Candida parapsilosis 11.9%; coagulase-negative staphylococci 10.2%; Escherichia coli 8.5%, and Pseudomonas aeruginosa 6.8%. More than 40% (41.2%) of enterobacteria showed an extended-spectrum b-lactamase phenotype, and 20.0% of non-fermenting gram-negative bacilli were multi-resistant to tested antibiotics, while 38.5% of Staphylococcus spp. were methicillin-resistant. In conclusion, the most prevalent microorganisms were gram-negative bacilli, and within this group, enterobacteria evidenced a higher percentage of resistance to tested antibiotics.

Ajoene, el principal compuesto activo derivado del ajo (Allium sativum), un nuevo agente antifúngico / Ajoene the main active compound of garlic (Allium sativum): a new antifungal agent

Desde tiempos inmemoriables el ajo ha transitado junto al hombre por los caminos de la tierra, múltiples son los beneficios que la humanidad ha obtenido de sus propiedades medicinales y mágico-religiosas, pero fue en las últimas décadas cuando el estudio de sus propiedades permitió establecer una base racional para sus potencialidades clínicas. Se conoció la existencia de la alicina, el ajoene los tiosulfinatos y una gama de compuestos organosulfurados como componentes esenciales de este bulbo y se comprobó, para muchos de ellos, una diversidad de efectos que abarcan desde propiedades antitrombóticas, antitumorales, antiparasitarias y antifúngicas. Sin embargo, el ajoene, un producto de gran estabilidad, que se origina de la ruptura y la reparación no enzimática de la alicina, y qe puede también ser obtenido sintéticamente, demostró poseer la mayor actividad biológica en todos los sistemas estudiados. En este artículo nos referiremos a las propiedades antifúngicas del ajoene y a las potencialidades que posee esta novel molécula para ser utilizada en la terapéutica de las infecciones micóticas(AU)

The curative properties of garlic in medicine have been known for a long time. But, it was only in the last three decades when garlic properties were seriously investigated confirming its potential as therapeutic agent. Allicin, ajoene, thiosulfinates and a wide range of other organosulphurate compounds, are known to be the constituents linked to the garlic properties. Regarding the biochemical properties of these compounds, ajoene [(E,Z)-4,5,9 Trithiadodeca 1,6,11 Triene 9-oxide] is stable in water, and it can be obtained by chemical synthesis. There is evidence that some of the garlic constituents exert a wide variety of effects on different biological systems. However, ajoene is the garlic compound related to more biological activities, as showed in in vitro and in vivo systems. Those studies found that ajoene has antithrombotic, anti-tumoral,antifungal, and antiparasitic effects. This study deals with a recently described antifungal property of ajoene, and its potential use in clinical trails to treat several fungal infections(AU)

A case and review of bowel perforation secondary to metastatic lung cancer.

Gastrointestinal tract perforation (GITP) secondary to metastatic lung cancer is extremely rare. We present a case of small bowel perforation secondary to metastatic lung cancer. The objective of this study was to review the current literature and further characterize the incidence, histology, and risk of GITP secondary to lung cancer metastasis. A Medline search was done to identify all the cases of GITP attributed to metastatic lung cancer reported in the literature. Data was collected and analyzed from a collection of cases in the medical literature since 1960. We identified 98 cases of perforated lung cancer metastasis to the small intestine. Four gastric perforations, three colonic perforations, and one appendiceal perforation were also identified but not analyzed. The mean age was 64.5 years. There was a male predominance of 89 per cent versus 11 per cent female. Perforations occurred most often in the jejunum (53%) followed by ileum (28%). Combined jejunum-ileum lesions accounted for 4 per cent of perforations. No duodenal perforations were reported, though a specific site was not determined in 13 per cent of cases. Small bowel perforations were most often caused by adenocarcinoma (23.7%), squamous cell carcinoma (22.7%), large cell carcinoma (20.6%), and small cell carcinoma (19.6%). The prevalence of small bowel perforation secondary to a given primary lung cancer histology varied by region. The mean survival was 66 days with 50 per cent of patients not surviving past 30 days. Despite a high incidence of lung cancer, small bowel perforation secondary to lung cancer metastasis remains relatively rare. Perforated metastases occur more often in men and are found more commonly in the jejunum. Small bowel perforations are caused most often by adenocarcinoma; however, squamous cell and large cell carcinoma metastases are more likely to result in perforation. Small bowel perforation in this setting has a significant impact on mortality, decreasing 1-year survival to less than 3 per cent.

Consensus conference on chronic viral hepatitis and HIV infection: updated Spanish recommendations.

Chronic hepatitis B and C represent a leading cause of morbidity and mortality among human immunodeficiency virus (HIV)-infected patients worldwide. New treatment options against both hepatitis B (HBV) and C (HCV) viruses have prompted us to update previous recommendations for the management of coinfected individuals. Fifteen topics (nine related to HCV, five to HBV and one to both viruses) were selected for this purpose. A panel of Spanish experts in the field was invited to review these areas and propose specific recommendations, which were scored according to the Infectious Disease Society of America (IDSA) grading system. These guidelines represent a comprehensive and updated overview on the management of hepatitis B and C in HIV-infected patients.

Molecular genetic analysis of HLA-DR and -DQ alleles in Spanish patients with melanoma.

Controversial data have been reported about HLA alleles and susceptibility to melanoma. The relationship between distribution of HLA alleles in patients with melanoma and susceptibility to tumour was analysed, to study the possible correlation between HLA class II DQA1, DQB1 and DRBI genes and melanoma in a Spanish population. Genomic DNA from 82 patients with melanoma and 367 random healthy donors, from the same geographic area, were typed by PCR-SSP (sequence specific primers). The patients were also divided into different groups according to the age and presence of cancer relatives, and compared with the controls. None of these HLA class II alleles showed significant positive or negative associations with either the overall population of patients with melanoma or the considered subgroups. Moreover, values for relative risk of DQB1*0301, DQB1*0302, DQB1*0303, DQB*05, DQA1*0401, DQA1*0101/0104 and DRB*08, which have been reported to be increased or decreased in patients with melanoma, were very low and of no statistical significance. Our results indicate that HLA class II alleles may not contribute to a strong susceptibility to melanoma in the Spanish population, although further studies on larger series are needed to corroborate this. Key words:

Polycyclic aromatic hydrocarbons identified in soot extracts from domestic coal-burning stoves of Henan Province, China.

Using high-pressure liquid chromatography with ultraviolet-visible diode-array detection, we have analyzed polycyclic aromatic hydrocarbons (PAH) in the dichloromethane extracts of soot deposits from coal-burning stoves in several homes of Henan Province, China--including Linxian County, where esophageal cancer rates are some of the highest in the world. Thirty-two individual polycyclic aromatic compounds, ranging in size from three to eight fused aromatic rings, have been unequivocally identified among the soot extract components--including 20 benzenoid PAH, 6 fluoranthene benzologues, 1 cyclopentafused PAH, 1 indene benzologue, 3 oxygenated PAH, and 1 ring-sulfur-containing aromatic. Most of the identified compounds have been observed before among the products of laboratory coal pyrolysis experiments, but two of the components, the six-ring C24H14 napthol[1,2-b]fluoranthene and the eight-ring C30H16 tribenzo[e,ghi,k]perylene, have never before been documented as products of coal in any system. All of the Henan coal soot extracts are remarkably similar qualitatively in that they contain the same set of identified PAH, but absolute levels of individual species vary by up to 5 orders of magnitude, from sample to sample. The bulk of the identified component mass in all of these soot extracts lies in the five- and six-ring PAH--the largest single class being the family of five-ring C20H12 isomers, to which the samples' most abundant components, benzo[b]fluoranthene and benzo[e]pyrene, belong. The five- and six-ring PAH also account for the majority of the samples' known mutagens. The three strong mutagens identified in these soot samples are the C20H12 benzo[a]-pyrene and two C24H14 PAH, dibenzo[a,e]pyrene and naphtho-[2,1-a]pyrene. Seven moderate mutagens are found among the C20H12, C22H12, C22H14, and C24H14 PAH. A major class of mutagens, the cyclopenta-fused PAH, appears to be absent from these samples, but our detection of an oxidation product of the major mutagen cyclopenta[cd]- pyrene--itself mutagenic--suggests that these soot deposits may contain additional mutagenic cyclopentafused PAH oxidation products as well.

QSRR prediction of chromatographic retention of ethynyl-substituted PAH from semiempirically computed solute descriptors.

Retention prediction of 12 ethynyl-substituted polycyclic aromatic hydrocarbons (PAH) and their six unsubstituted parent compounds has been elucidated by the application of quantitative structure-retention relationship (QSRR) analysis. Retention data of the PAH were obtained from reversed-phase high-pressure liquid chromatography (HPLC) utilizing an octadecylsilica stationary phase operated under linear-gradient elution (60:40 water/acetonitrile to pure acetonitrile in 40 min). Six solute descriptors (moment of inertia, total energy, polarizability, ionization potential, dipole moment, subpolarity), computed from the optimized semiempirical AM1, MNDO, and PM3 solute geometries, were examined. Results from one-parameter QSRR analysis showed that retention of solutes was best predicted with solute polarizability as the parameter, computed from the AM1-(r = 0.969), MNDO-(r = 0.970), or PM3 (r = 0.967)-optimized solute geometries. From two-parameter QSRR analysis involving a size-specific parameter accompanied by a polarity parameter, it was found that solute retention was best reproduced by using solute polarizability and subpolarity as the parameters calculated from the AM1-(r = 0.983), MNDO-(r = 0.983), or PM3 (r = 0.984)-optimized solute geometries. On the basis of the results from both one-parameter and two-parameter regression analysis, the two-parameter QSRR equation with polarizability and subpolarity as parameters was found to be the best relation in relating solute molecular structure to retention under the HPLC conditions investigated. The results obtained in this study are of significance to predicting the identify of unknown product components based solely on parameters derived from solute structure.

Detection of Epstein-Barr virus DNA in a patient with Kimura's disease.

An 80-year-old man, with a past medical history of senile dementia, presented with a 6-month history of a solitary, gradually enlarging tumor, located on his chin. A squamous cell carcinoma had been surgically excised 30 years previously in the same location. Physical examination revealed an erythematous, well-defined plaque of 3 cm in diameter, located on the chin (Fig. 1). The submandibular lymph nodes were enlarged. Squamous cell carcinoma and primary cutaneous lymphoma were considered. Relevant laboratory findings were as follows: white blood cell count, 5.600/microL; eosinophils, 1000/microL; gammaglobulin, 2.4 g/dL; lactate dehydrogenase, 343 IU/L; and immunoglobulin G (IgG) antibodies to Epstein-Barr virus (EBV) positive (at 1 : 128 serum dilution), with negative IgM. Skin and lymph node biopsies were performed. Histopathologic study of the cutaneous specimen revealed a heavy lymphoid infiltrate with numerous lymphoid follicles, with prominent germinal centers involving the subcutaneous fat as well as the deep dermis and muscular fascia. Some germinal centers showed folliculolysis. The lymphoid follicles were surrounded by fibrous tissue. The interfollicular infiltrate was rich in plasma cells and eosinophils that formed scattered eosinophilic microabscesses. Thin-walled vessels were numerous and prominent, but with no epithelioid or vacuolated endothelial cells (Fig. 2). Histopathology of a lymph node biopsy specimen showed reactive lymphoid follicle hyperplasia, with prominent eosinophilic infiltrates in both follicular and interfollicular areas. Eosinophilic deposits and polykaryocytes of Warthin-Finkeldey type were seen in the germinal centers. The paracortical area showed vascular proliferation. Polymerase chain reaction (PCR) for the detection of specific sequences of EBV from routinely processed paraffin-embedded material was carried out under the conditions and with the same set of primers as described previously in detail (Tenorio A, Echevarría JE, Casas E et al. J Virol Methods 1993; 44: 261-269). DNA samples were confirmed to be amplifiable with PCR primers specific for a conserved region of the human beta-globin gene. Every sample was tested at least twice for EBV DNA and beta-globin gene. One sample from one skin lesion of the patient, with confirmed diagnosis of Kimura's disease, and 10 samples from normal skin biopsies retrospectively collected from other patients in archival files of our department were tested. Only the patient's specimen tested positive to EBV. The amplified product of EBV was analyzed using DNA sequencing and confirmed the results obtained. The patient received radiotherapy at doses of 35 Gy. Nevertheless, the tumor enlarged to reach twofold its original size 1 month later. Due to the physical status of the patient, no further treatments were considered, but the disease remained stable over the following 3 years.

Detection of Epstein-Barr virus and human herpesvirus 7 and 8 genomes in primary cutaneous T- and B-cell lymphomas.

BACKGROUND: Several studies have investigated the possible involvement of viral agents, particularly herpesviruses, in primary cutaneous lymphoma (PCL). OBJECTIVES: Our aim was to screen for the presence of human herpesvirus 7 (HHV-7) and 8 (HHV-8) genomes in samples of PCL, and to determine if their presence was independent of Epstein-Barr virus (EBV). METHODS: Screening was performed using polymerase chain reaction assay in 64 skin samples from historical lesional tissues with PCL. RESULTS: Only nine cases showed positivity for HHV-7: four of 29 mycosis fungoides (MF), two of four CD30-positive large-cell cutaneous T-cell lymphoma (CTCL), two of 12 follicle centre cutaneous B-cell lymphoma (CBCL) and one of nine marginal zone CBCL. Fifteen cases tested positive for EBV: seven of 29 MF, two of four pleomorphic small/medium sized CTCL, three of three angiocentric CTCL, one of 12 follicle centre CBCL and two of nine marginal zone CBCL. All cases were uniformly negative for HHV-8. No simultaneous positivity was found for EBV and HHV-7. Controls tested negative for all viruses. CONCLUSIONS: The findings indicate that EBV, HHV-7 and HHV-8 seem not to be involved in the pathogenesis of PCL.

[Job satisfaction in primary health care nursing in the counties of Alt and Baix Empordà]. / Satisfacción de enfermería de atención primaria en las comarcas del Alt y Baix Empordà.

OBJECTIVES: To determine the labour satisfaction of primary care nursing professionals and find the related associated factors. DESIGN: Cross-sectional, descriptive, observation study. SETTING: Primary care in the counties of the Alt and Baix Empordà. PARTICIPANTS: All those with nursing diplomas who work in the primary care centres of this geographical area (131 professionals). MEASUREMENTS AND MAIN RESULTS: A self-administered questionnaire had a 79.3% response rate. The instrument had 9 dimensions on work satisfaction. The statistical analysis employed univariate and bivariate descriptive techniques (p = 0.05). The general lack of satisfaction was medium (2.18 +/- 0.45). The dimension with the highest score was "professional competence" (1.72 +/- 0.44), and with the lowest was "professional promotion" (2.80 +/- 0.89). The greatest number of significant differences occurred between the two classes of primary care, reformed and unreformed. CONCLUSIONS: The conditions in which professional nurses work in non-reformed primary care causes lack of satisfaction in their work post, in its content and in their professional promotion.

Satisfacción de enfermería de atención primaria en las comarcas del Alt y Baix Empordà / Job satisfaction of primary care nurses in the counties of the alt and baix empordà

Objetivo. Determinar el nivel de satisfacción laboral de los profesionales de enfermería de atención primaria y conocer las relaciones con factores asociados. Diseño. Estudio observacional, descriptivo, transversal. Emplazamiento. Atención primaria de las comarcas del Alt y Baix Empordà. Participantes. Todos los diplomados en enfermería que trabajan en los centros de atención primaria de dicho marco geográfico (131 profesionales). Mediciones y resultados principales. Se aplicó un cuestionario autoadministrado, obteniéndose un porcentaje de respuestas del 79,3 por ciento. Este instrumento constaba de 9 dimensiones sobre satisfacción laboral. El análisis estadístico utilizó técnicas descriptivas univariantes y bivariantes (p = 0,05). El grado de insatisfacción general resultó medio (2,18 ñ 0,45). La dimensión mejor valorada fue 'competencia profesional' (1,72 ñ 0,44) y la peor valorada 'promoción profesional' (2,80 ñ 0,89). El mayor número de diferencias significativas se dio entre las categorías de atención primaria (reformada/no reformada). Conclusiones. Las condiciones en las que trabajan los profesionales de enfermería en la categoría no reformada generan insatisfacción respecto a su puesto de trabajo, al contenido del mismo y a la promoción profesional (AU)

Analysis of the CDKN2A and CDK4 genes and HLA-DR and HLA-DQ alleles in two Spanish familial melanoma kindreds.

Some confusion exists in the literature about which criteria should be used to define familial melanoma. This could explain the different reported frequencies of mutations in predisposing genes, mostly CDKN2A, in these patients. This study evaluated the human leucocyte antigen (HLA) class II genotype and the presence of mutations in CDKN2A and CDK4 genes in 2 families with very different clinical features. The family with a germinal mutation in exon 2 of CDKN2A (Gly101Try) presented the following clinical features: 3 first-degree affected members, 1 of whom had 2 melanomas, and all the melanomas appearing before 35 years of age. In contrast, the second family did not present any mutation in the studied genes and included 2 first-degree affected members diagnosed at over 45 years of age. Neither family showed an association with HLA genotype. Other genes are also involved in familial melanoma but, when the CDKN2A gene is affected, some clinical features seem to be uniform.