[Parosteal osteosarcoma of the femur and salvage surgery with intercalary prosthesis. Experience in a third level unit and surgical technique]. / Osteosarcoma parostal de fémur y cirugía de salvamento con prótesis intercalar. Experiencia en una unidad de tercer nivel y técnica quirúrgica.

INTRODUCTION: parosteal osteosarcoma is an extramedullary malignant bone tumor in which cells produce osteoid, represents less than 5% of all osteosarcomas, it occurs predominantly in women between the second and fourth decade of life. It is often located in the distal region of the femur and proximal tibia. Clinically it presents with increased volume and thigh or knee pain. Due to its low incidence and clinical features, a clinical case of femoral parosteal osteosarcoma is presented, with description of the surgical technique performed. CASE REPORT: a 14-year-old female presented with a 6-month history of increased volume and right thigh pain. Radiological studies revealed a bone lesion with malignant characteristics, for which she was sent to third-level hospital where oncology study protocol was set up; consisting in two percutaneous biopsies of the lesion with Jamshidi needle, which were histopathology reported as negative for malignant cells. The pulmonary high-resolution computed tomography showed metastasis and a Tc-99m MDP bone scintigraphy showed increased osteoblastic activity in the right femoral shaft. Given the results, is confirmed the need of en-bloc resection and intercalary prosthesis implantation with adjuvant chemotherapy. CONCLUSION: the intercalary prosthesis is a suitable therapeutic option in limb-salvage surgery for patients with femoral parosteal osteosarcoma.

INTRODUCCIÓN: el osteosarcoma parostal es un tumor óseo maligno extramedular en el cual las células tumorales producen osteoide. Representa menos de 5% de los osteosarcomas. Se presenta predominantemente en la mujer, entre la segunda y cuarta década de la vida. Su localización más frecuente es la región distal del fémur y proximal de la tibia. Clínicamente, se manifiesta con aumento de volumen y dolor en muslo o rodilla. Debido a su baja incidencia y características clínicas, se presenta un caso clínico de osteosarcoma parostal femoral con descripción de la técnica quirúrgica realizada. CASO CLÍNICO: femenino de 14 años edad con cuadro clínico caracterizado por aumento de volumen y dolor en muslo derecho de seis meses de evolución. Se realizaron radiografías de fémur derecho, encontrando lesión ósea con características compatibles de malignidad, por lo que es enviada a unidad de tercer nivel para iniciar protocolo oncológico; se realizan dos biopsias percutáneas con aguja de Jamshidi, ambas con reporte histológico negativo para células malignas. En tomografía pulmonar de alta resolución se observó presencia de metástasis y la gammagrafía ósea con Tc99 reportó actividad osteoblástica en fémur derecho. Se decide tratamiento con resección en bloque y colocación de prótesis intercalar más quimioterapia adyuvante. CONCLUSIÓN: la prótesis intercalar resulta una opción terapéutica adecuada en la cirugía de salvamento de extremidad para pacientes con diagnóstico de osteosarcoma parostal femoral.

Association of the rs1801133 variant in the MTHFR gene and sporadic Parkinson's disease.

The MTHFR gene has been reported as a susceptibility locus for sporadic Parkinson's disease (sPD). The functional variant rs1801133 has been linked to hyperhomocysteinemia and dopaminergic cell death. Among different populations, Mexican-Mestizos (most present-day Mexicans) have the highest frequency of this variant. Therefore, we sought to determine a possible association of rs1801133 with SPD. In total, 356 individuals were included: 140 patients with PD, diagnosed according to the Queen Square Brain Bank criteria, and 216 neurologically healthy controls. Genotyping was performed using TaqMan probes for rs1801133 and real-time PCR. Logistic regression analysis with adjustment for smoking and gender was used to test for an association between genotype and SPD. The CC genotype was associated with SPD; exp() = 2.06; 95% CI: 1.101-3.873, p = 0.024. No association with age at onset, cognitive impairment or gender was found in our study group. Our data suggest an important role of MTHFR gene variants in SPD.

Effect of losartan compared with captopril on mortality in patients with symptomatic heart failure: randomised trial--the Losartan Heart Failure Survival Study ELITE II.

BACKGROUND: The ELITE study showed an association between the angiotensin II antagonist losartan and an unexpected survival benefit in elderly heart-failure patients, compared with captopril, an angiotensin-converting-enzyme (ACE) inhibitor. We did the ELITE II Losartan Heart Failure Survival Study to confirm whether losartan is superior to captopril in improving survival and is better tolerated. METHODS: We undertook a double-blind, randomised, controlled trial of 3,152 patients aged 60 years or older with New York Heart Association class II-IV heart failure and ejection fraction of 40% or less. Patients, stratified for beta-blocker use, were randomly assigned losartan (n=1,578) titrated to 50 mg once daily or captopril (n=1,574) titrated to 50 mg three times daily. The primary and secondary endpoints were all-cause mortality, and sudden death or resuscitated arrest. We assessed safety and tolerability. Analysis was by intention to treat. FINDINGS: Median follow-up was 555 days. There were no significant differences in all-cause mortality (11.7 vs 10.4% average annual mortality rate) or sudden death or resuscitated arrests (9.0 vs 7.3%) between the two treatment groups (hazard ratios 1.13 [95.7% CI 0.95-1.35], p=0.16 and 1.25 [95% CI 0.98-1.60], p=0.08). Significantly fewer patients in the losartan group (excluding those who died) discontinued study treatment because of adverse effects (9.7 vs 14.7%, p<0.001), including cough (0.3 vs 2.7%).

[Frequency of Diphyllobothrium sp. infection in Argentine wild carnivores]. / Frecuencia de infección por Diphyllobothrium sp. (Cestoda: Diphyllobothriidae) en carnívoros silvestres de Argentina.

With the aims to determine the infection frequency by tapeworms of Diphyllobothrium genus 30 samples from captive wild carnivores were analyzed. A 30% of the animal analyzed was positive to the infection. Whereas the family Procionidae has a high percentage of positivity (60%), Canidae have lower infection ratio (20-25%). The accuracy for the diagnosis of Diphylobothrium was made by the morphology of scolex, proglottids and eggs. This is the first report of the parasite presence in Argentine wild carnivores.

Effects of losartan versus captopril on mortality in patients with symptomatic heart failure: rationale, design, and baseline characteristics of patients in the Losartan Heart Failure Survival Study--ELITE II.

BACKGROUND: In the Evaluation of Losartan in the Elderly (ELITE) heart failure study, a survival benefit (primarily because of a reduction in sudden deaths) was observed in symptomatic patients treated with losartan compared with captopril. METHODS AND RESULTS: The Losartan Heart Failure Survival Study--ELITE II (currently ongoing) is a double-blind, randomized clinical trial being conducted in 45 countries at 288 sites. ELITE II formally tests the hypotheses that losartan, compared with captopril, will reduce all-cause mortality (primary end point) and sudden cardiac death and/or resuscitated cardiac arrest (secondary end point). In addition, all-cause mortality and/or hospitalizations and cardiovascular mortality and/or hospitalizations will be evaluated. The trial has 90% power to detect a 25% treatment difference in all-cause mortality (event driven, 510 deaths). Substudies are examining quality of life, health care resource utilization, and mechanisms related to the reduction in sudden death. During recruitment (June 1997 to May 1998), 3,152 patients aged 60 years or older (mean age, 71.6 years), with New York Heart Association classes II (51%), III (44%), and IV (5%), and left ventricular ejection fraction of 40% or less (mean, 31%) were randomized to receive either 12.5 mg of losartan, titrated as tolerated to 50 mg once daily, or 12.5 mg of captopril, titrated as tolerated to 50 mg thrice daily. Randomization was stratified by clinical site and for baseline beta-blocker use. CONCLUSION: The ELITE II study will further define the role of losartan in the treatment of patients with symptomatic heart failure relative to the angiotensin-converting enzyme inhibitor captopril, an agent from a class currently considered standard treatment for this disease.

Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study, ELITE)

BACKGROUND: To determine whether specific angiotensin II receptor blockade with losartan offers safety and efficacy advantages in the treatment of heart failure over angiotensin-converting-enzyme (ACE) inhibition with captopril, the ELITE study compared losartan with captopril in older heart-failure patients. METHODS: We randomly assigned 722 ACE inhibitor naive patients (aged 65 years or more) with New York Heart Association (NYHA) class II-IV heart failure and ejection fractions of 40% or less to double-blind losartan (n = 352) titrated to 50 mg once daily or captopril (n = 370) titrated to 50 mg three times daily, for 48 weeks. The primary endpoint was the tolerability measure of a persisting increase in serum creatinine of 26.5 mumol/L or more (> or = 0.3 mg/dL) on therapy; the secondary endpoint was the composite of death and/or hospital admission for heart failure; and other efficacy measures were total mortality, admission for heart failure, NYHA class, and admission for myocardial infarction or unstable angina. FINDINGS: The frequency of persisting increases in serum creatinine was the same in both groups (10.5%). Fewer losartan patients discontinued therapy for adverse experiences (12.2% vs 20.8% for captopril, p = 0.002). No losartan-treated patients discontinued due to cough compared with 14 in the captopril group. Death and/or hospital admission for heart failure was recorded in 9.4% of the losartan and 13.2% of the captopril patients (risk reduction 32% [95% CI -4% to + 55%], p = 0.075). This risk reduction was primarily due to a decrease in all-cause mortality (4.8% vs 8.7%; risk reduction 46% [95% CI 5-69%], p = 0.035). Admissions with heart failure were the same in both groups (5.7%), as was improvement in NYHA functional class from baseline. Admission to hospital for any reason was less frequent with losartan than with captopril treatment (22.2% vs 29.7%). INTERPRETATION: In this study of elderly heart-failure patients, treatment with losartan was associated with an unexpected lower mortality than that found with captopril. Although there was no difference in renal dysfunction, losartan was generally better tolerated than captopril and fewer patients discontinued losartan therapy. A further trial, evaluating the effects of losartan and captopril on mortality and morbidity in a larger number of patients with heart failure, is in progress.

First Report of White Rust of Gerbera Caused by Albugo tragopogonis in North America.

In October, 1995, in Villa Guerrero, Mexico, white erumpent sori were detected on the undersurfaces of leaves of a bed of African daisy (Gerbera jamesonii H. Bolus ex J. D. Hook.). The white sori on the undersurfaces of leaves corresponded to chlorotic spots on the upper leaf surfaces. All gerbera plants examined were severely diseased. The gerbera planting was adjacent to a planting of chrysanthemums with symptoms of white rust caused by Puccinia horiana Henn. Symptoms on the leaves of the two crops looked similar, and therefore P. horiana was suspected of causing both diseases. However, when subepidermal sori (pustules) on Gerbera plants were examined microscopically, erumpent chains of round to cylindrical, hyaline to pale yellow sporangiospores borne on short club-shaped sporangiophores were found. The sporangiospores are typical of Albugo tragopogonis (Pers.) S. F. Gray, and it was concluded that the white rust found on gerbera in Villa Guerrero, Mexico, was caused by A. tragopogonis. This disease was reported on gerbera from Australia and New Zealand in 1965 (1) and from Spain in 1977 (2). Other hosts of A. tragopogonis include members in the genera Pericallis (cineraria), Centaurea (dusty miller, basket flower, cornflower, bachelor's-buttons), Ambrosia (common ragweed), Tragopogon (salsify), Antennaria (everlasting, pussytoes), Artemisia (wormwort, mugwort), Cirsium (thistle), Matricaria (false chamomile, pineapple weed), Iva (marshelder), Parthenium (guayule, American feverfew), and Xanthium (common cocklebur, spiny cocklebur). This is the first report of white rust of gerbera caused by A. tragopogonis in North America, and may represent a new disease problem for species of important floral crops in the future. References: (1) R. F. Doepel. J. Agric. West. Aust. Ser. 4 6:439, 1965. [Rev. Appl. Mycol. 45:80, 1966] (2) H. P. Plate and H. Kruber. Nachrichtenbl. Dtsch. Pflanzen-schutzdienst (Berlin) 29(11):169, 1977. [Rev. Plant Pathol. 57:204, 1978].

Overview of the LiMB database.

The rapidly increasing number of databases relevant to molecular biology has given rise to a need for a coordinated effort to identify, characterize, and link them. The LiMB database, which contains information about molecular biology and related databases, is a step in that direction. It serves molecular biologists seeking data sets containing information relevant to their research, and is also intended to anticipate the needs of database designers and managers building software links for related data sets. We present an abbreviated version of the database here; the full database is available free of charge as described below.