First Report of Blue Mold Caused by Penicillium oxalicum in Tomato (Solanum lycopersicum) in Mexico.

Tomato is the primary vegetable exported from Mexico to the United States. In June 2007, stem rots were observed in tomato cv. Imperial plants growing in a greenhouse in the Culiacan Valley. Disease symptoms included stem rot with a mycelial growth with a grayish blue sporulation. The disease was observed to be affecting 1% of the tomato plants growing in the greenhouse, and has been observed sporadically in greenhouses during subsequent agricultural cycles in other tomato-growing areas in Mexico. Affected stems showed initial symptoms of a dark brown necrotic area surrounding only the cut regions of pruned leaves and stems. As the infection continued on the tissues, the spot grew and then became covered with a grayish blue sporulation. Severe stem rot led to death of the plants. Rotted stems of tomato plants were collected and samples of the infected tissues were plated onto potato dextrose agar (PDA) to isolate the fungus. The preliminary identification of the pathogen was Penicillium oxalicum Currie & Thom on the basis of morphological criteria with ellipsoidal conidia approximately 4 × 3 µm borne in columns, conidiophores mostly biverticillate, and ampulliform phialides (2). The identification was confirmed by sequencing internal transcribed spacer 1 (ITS1), 5.8S, and ITS2 regions of the ribosomal DNA (GenBank Accession No. HM452308). The isolate was deposited in the Coleccion Nacional Microbiana y de Cultivos Celulares CINVESTAV-IPN, Mexico. Koch's postulates were fulfilled by reproducing stem rots on healthy inoculated tomato stems. Pathogenicity testing involved fungal growth on PDA for 5 days, after which a 4-mm disk of actively growing mycelia was transferred to wounds (4 × 4 mm) made with a scalpel in stems of 6-week-old tomato cv. Imperial plants. Inoculated plants were covered with plastic bags to maintain a high relative humidity for 24 h and were maintained in a greenhouse at 25 ± 2°C. Seven days after inoculation, all of the inoculated stems showed rot symptoms similar to those observed in the greenhouse. Stems that were inoculated only with an agar disk did not show any symptoms of the disease. The pathogen was reisolated from inoculated plants but not from noninoculated plants. Artificial inoculation was performed twice. Although P. oxalicum has been previously reported as a causal agent of cucumber (1) and tomato stem rots in Japan (3), to our knowledge, this is the first report of P. oxalicum causing stem rot in tomato plants in Mexico. References: (1) T. M. O'Neill et al. Plant Pathol. 40:78, 1991. (2) J. I. Pitt. The Genus Penicillium and Its Teleomorphic States Eupenicillium and Talaromyces. Academic Press, London, UK, 1979. (3) S. Umemoto et al. J. Gen. Plant Pathol. 75:399, 2009.

Adenosine 5'-monophosphate in asthma: gas exchange and sputum cellular responses.

Adenosine 5'-monophosphate (AMP) bronchoprovocation reproduces the lung function abnormalities that occur spontaneously during acute asthma and detects peripheral airway inflammation better than direct bronchoconstrictive agents. Pulmonary gas exchange disturbances may reflect changes in small airways related to airway inflammation rather than bronchoconstriction alone. The present authors investigated whether AMP induced a greater imbalance in the ventilation/perfusion ratio than methacholine (MCh), at an equivalent degree of bronchoconstriction, with and without salbutamol pre-medication. In total, 36 asthmatics were studied in three randomised, double-blind, crossover studies: 1) before and after AMP or MCh; 2) before and 30 min after salbutamol or placebo, followed by AMP; or 3) MCh challenge. Sputum was collected before and 4 h post-challenge. Compared with MCh, AMP provoked similar pulmonary gas exchange abnormalities at an equivalent degree of intense bronchoconstriction (forced expiratory volume in one second decrease of 28-44%). While salbutamol blocked AMP- or MCh-induced bronchoconstriction, arterial oxygen tension (P(a,O(2))) and alveolar-arterial oxygen tension difference (P(A-a,O(2))) disturbances induced by AMP and MCh were only partially blocked (P(a,O(2)) by 46 and 42%, respectively; P(A-a,O(2)) by 58 and 57%, respectively). Compared with MCh, AMP increased the percentage of neutrophils (mean+/-se increased from 28+/-4% to 38+/-4%), but this increase did not occur after salbutamol pre-treatment. Both adenosine 5'-monophosphate and methacholine induced similar peripheral airway dysfunction. The fully inhibited adenosine 5'-monophosphate-induced neutrophilia with residual hypoxaemia observed after salbutamol treatment is probably related to beta(2)-agonists acting on both bronchial and pulmonary circulation.

Effect of obesity on breathlessness and airway responsiveness to methacholine in non-asthmatic subjects.

BACKGROUND: Obesity is associated with increased prevalence and incidence of asthma, but the mechanism is unknown. Obesity reduces lung volumes, which can increase airway responsiveness, and increases resistive and elastic work of breathing, which can increase dyspnea. OBJECTIVE: To determine if the intensity of dyspnea due to airway narrowing or if airway responsiveness is increased in obese, non-asthmatic subjects. SUBJECTS: Twenty-three obese (BMI (body mass index) > or =30 kg m(-2)) and 26 non-obese (BMI <30 kg m(-2)) non-asthmatic subjects, aged between 18 and 70 years. METHODS: High-dose methacholine challenge was used to determine the sensitivity and the maximal response to methacholine. Respiratory system resistance (Rrs) and reactance were measured, using the forced oscillation technique, as indicators of resistive and elastic loads during challenge. Perception of dyspnea was measured by the Borg score during challenge. Static lung volumes were measured by body plethysmography. RESULTS: Static lung volumes were reduced in the obese subjects. There were no significant differences in the sensitivity or maximal response to methacholine between obese and non-obese subjects. The magnitude of change in Rrs was similar in both groups, but obese subjects had more negative reactance after challenge (P=0.002) indicating a greater elastic load. The intensity of dyspnea was greater in obese subjects (P=0.03). CONCLUSIONS: Obesity reduces lung volumes, but does not alter the sensitivity or maximal response to methacholine. However, obese subjects have enhanced perception of dyspnea, associated with greater apparent stiffness of the respiratory system, and may therefore be at greater risk of symptoms.

[Minor surgery in primary care: is continuing education within the team a valid strategy for improving quality?]. / Cirugía menor en atención primaria: es válida la formación continuada intraequipo como estrategia de mejora de calidad?

OBJECTIVE: To evaluate the impact of continuing education within the team (FCI, in Spanish) on the quality of minor surgery. DESIGN: Study of level of quality. SETTING. Primary care. PARTICIPANTS: First evaluation: all the lesions referred for biopsy during 1998 (62 samples). Second evaluation: those referred in 1999-2000 (150). MAIN MEASUREMENTS: Four explicit criteria regulating procedure and result were designed: C1, sufficient information; C2, correct referral; C3, correct extirpation of lesion; C4, clinical-pathological concordance. Request forms and anatomical-pathological reports were assessed. Evaluation was before and after corrective measures (FCI and organisational changes designed to support FCI). The Kappa index of inter-observer concordance, the Compliance Index and Fisher's Z index were analysed. RESULTS: 62 lesions were included in the first evaluation, with high reliability for C1 and C4, good for C2 and moderate for C3. 150 lesions were included in the second evaluation. The compliance indices showed statistically significant increases from the first to the second evaluation for C1 (38.09% and 50.66%, relative improvement of 19%) and C4 (68.85% and 85.2%, relative improvement of 53%). C2 showed an improvement, but without statistical significance (87.30% and 92.66%). The compliance index for C3 dropped (94.73% and 87.50%). 5.33% of cases in the second evaluation (8 biopsies) were malignant or pre-malignant lesions, compared with 20.96% in the first (P<.05). 100% of these latter showed free resection limits. 77.99% of lesions studied through a biopsy in the second evaluation were nevus, seborrhoeic keratosis or dermatofibroma. CONCLUSIONS: FCI is a valid strategy for improving the quality of programmes of minor surgery in primary care. There was significant improvement in the identification of malignant and pre-malignant pathology, in correct referral and in the clinical-pathological concordance of the lesions.

Cirugía menor en atención primaria: ¿es válida la formación continuada intraequipo como estrategia de mejora de calidad? / Minor surgery in primary care: is continuing education within the team a valid strategy for improving quality?

Objetivo. Evaluar el impacto de la formación continuada intraequipo (FCI) en la calidad de la cirugía menor (CM).Diseño. Estudio de nivel de calidad. Emplazamiento. Atención primaria. Participantes. Primera evaluación: todas las lesiones remitidas para biopsia durante 1998 (62 muestras). Segunda evaluación: las remitidas durante 1999-2000 (150).Mediciones principales. Se diseñaron 4 criterios explícitos y normativos de proceso y resultado: C1: información suficiente; C2: remisión adecuada; C3: extirpación lesional correcta, y C4: concordancia clinicopatológica. Se evaluaron hojas de solicitud e informes anatomopatológicos. Evaluación antes y después de medidas correctoras (FCI y cambios organizativos diseñados para potenciarla). Se analizó el índice Kappa de concordancia interobservador, el índice de cumplimiento (IC) y la Z de Fisher. Resultados. En la primera evaluación se incluyeron 62 lesiones, con una fiabilidad alta para C1 y C4, buena para C2 y moderada para C3. En la segunda evaluación se incluyeron 150 lesiones. Entre la primera y la segunda evaluación, los índices de cumplimiento presentaron incrementos estadísticamente significativos para C1 (38,09 per cent y 50,66 per cent; mejora relativa del 19 per cent) y C4 (68,85 per cent y 85,2 per cent; mejora relativa del 53 per cent). C2 presentó mejoría estadísticamente no significativa (87,30 per cent y 92,66 per cent). El índice de cumplimiento de C3 presentó una disminución (94,73 per cent y 87,50 per cent). Un 5,33 per cent de casos en la segunda evaluación (8 biopsias) fueron lesiones malignas y premalignas respecto al 20,96 per cent de la primera (p < 0,05). El 100 per cent de estas últimas presentó límites de resección libres. Un 77,99 per cent de las lesiones biopsiadas en la segunda evaluación fueron nevus, queratosis seborreicas y dermatofibromas. Conclusiones. La FCI es una estrategia válida para mejorar la calidad de programas de CM en atención primaria, observándose mejora significativa en la discriminación de patología maligna y premaligna, en la correcta derivación y en la concordancia clinicopatológica de las lesiones (AU)

[Can we improve the therapeutic management of allergic rhinitis in primary care?]. / ¿Podemos mejorar el manejo terapéutico de la rinitis alérgica en atención primaria?

OBJECTIVE: To evaluate improvement in therapeutic management of allergic rhinitis. DESIGN: Study of level of quality (longitudinal, prospective, intervention). SETTING: Primary care. PATIENTS AND OTHERS PARTICIPANTS: First evaluation (second quarter of 1995): 73 out of 305 patients were sampled (confidence 5%, accuracy 10%). Second evaluation (second quarter of 1996). Sample of 51 patients from a total of 210. INTERVENTIONS: Explicit criteria and standard procedure, based on consensus, for rhinitis treatment and an overall indicator of the general quality of rhinitis management were analysed. Criterion 1 (C1): correctly scaled treatment; criterion 2 (C2): initial treatment of choice with inhaled corticoids; criterion 3 (C3): correct use of oral corticoids or immunotherapy; criterion 4 (C4): coadjutant therapy according to predominant symptoms. Corrective measures: ongoing training and routine use of guide to practice. STATISTICS: index of compliance with criteria, Chi squared and Fisher's Z tests of a tail to compare both evaluations. MEASUREMENTS AND MAIN RESULTS: First evaluation: index of compliance with C1 = 59% (CI +/- 11), C2 = 41% (CI +/- 11), C3 = 90% (CI +/- 6) and C4 = 83% (CI +/- 8). Criteria and summary indicator obtained better results in patients attended by allergists. Second evaluation with overall improvement: C1 = 68.6% (CI +/- 13), C2 = 57% (CI +/- 13), C3 = 94% (CI +/- 6), C4 = 98% (CI +/- 3). Significant differences for C4 and C2 (p < 0.05). Overall quality and quality of criteria improved for patients attended in our environment. The summary indicator went up from 35.6% to 57% (p = 0.019), with the quality levels (C1-C4) becoming the same as those of the patients with allergy attended and with significant differences in the first evaluation disappearing. CONCLUSIONS: Ongoing training and routine use of guides to practice enables the therapeutic management of allergic rhinitis in primary care to be improved.

¿podemos mejorar el manejo terapéutico de la rinitis alérgica en atención primaria? / Can we improve therapeutic management of allergic rhinitis in primary care?

Objetivo. Evaluar mejora del manejo terapéutico de la rinitis alérgica. Diseño. Estudio de nivel de calidad (longitudinal, prospectivo, de intervención).Emplazamiento. Atención primaria. Pacientes u otros participantes. Primera evaluación (segundo trimestre de 1995): entre 305 pacientes se muestrearon 73 (confianza, 5 por ciento; precisión, 10 por ciento). Segunda evaluación (segundo trimestre de 1996). Tamaño muestral de 51 pacientes de un total de 210.Intervenciones. Se analizaron criterios explícitos y normativos de proceso basados en consenso de tratamiento de rinitis y un indicador resumen de calidad de manejo global. Criterio 1 (C1): tratamiento correctamente escalonado. Criterio 2 (C2): tratamiento inicial electivo con corticoides inhalados. Criterio 3 (C3): correcta utilización de corticoides orales o inmunoterapia. Criterio 4 (C4): terapia coadyuvante según síntomas predominantes. Medidas correctoras: formación continuada y uso rutinario de guía para la práctica. Estadística: índice cumplimiento criterios, 2 y Z de Fisher con test de una cola para comparar ambas evaluaciones. Mediciones y resultados principales. Primera evaluación: índice cumplimiento C1 = 59 por ciento (IC ñ 11); C2 = 41 por ciento (IC ñ 11); C3 = 90 por ciento (IC ñ 6), y C4 = 83 por ciento (IC ñ 8). Los criterios y el indicador resumen obtuvieron mejores resultados en los pacientes atendidos por alergólogos. Segunda evaluación con mejora global: C1 = 68,6 por ciento (IC ñ 13); C2 = 57 por ciento (IC ñ 13); C3 = 94 por ciento (IC ñ 6), y C4 = 98 por ciento (IC ñ 3). Diferencias significativas para C4 y C2 (p < 0,05). La calidad global y de criterios mejoró entre los pacientes atendidos en nuestro ámbito. El indicador resumen pasó del 35,6 por ciento al 57 por ciento (p = 0,019), igualándose los niveles de calidad (C1-C4) a los de pacientes atendidos en alergia y desapareciendo las diferencias significativas de la primera evaluación. Conclusiones. La formación continuada y la utilización rutinaria de guías para la práctica permite mejorar el manejo terapéutico de la rinitis alérgica en atención primaria. (AU)

Isquemia aguda de la mano como complicación de la canalización de la arteria radial. A propósito de dos casos tras cirugía de sarcoma abdominal / Acute ischemia of the hand as a complication of radial artery catheterization: a report of two cases after surgery for abdominal sarcoma

La canalización arterial es una técnica sencilla que aporta grandes beneficios, como son la monitorización continua de la presión arterial y la posibilidad de extraer analíticas seriadas, pero no está exenta de complicaciones. Dentro de estas últimas, las principales son la isquemia de la extremidad y la embolia gaseosa. A fin de disminuir el riesgo de aparición de complicaciones, existen unas normas para la canalización y mantenimiento de los catéteres arteriales.Presentamos 2 casos clínicos de isquemia aguda de la mano secundaria a cateterización arterial. Ambos pacientes fueron intervenidos de cáncer abdominal tipo sarcoma y presentaron, en el intervalo de unas horas, isquemia aguda de la mano. Fueron tratados con prostaglandinas, y a uno de ellos se le realizaron bloqueos del ganglio estrellado. La mejoría en los días siguientes fue leve y quedó establecida una necrosis seca de parte de la mano. En los 2 casos se encontró, como antecedente predisponente para la presentación de la isquemia, la existencia de un tumor muy avanzado abdominal tipo sarcoma, probablemente asociado a un estado de hipercoagulabilidad (AU)

Propuesta para la estimación del consumo diario de drogas de abuso y sus connotaciones jurídicas / Proposal for the estimate of daily consumption of drugs of abuse and its legal connotations

Se exponen, a criterio de los autores, las dosis comunes de sustancias de abuso tanto ilegales como de fármacos empleados con el mismo fin, los niveles habituales de adulteración o dilución de las mismas, el cálculo estimado de consumo diario -para usuarios con consumo elevado-, así como la aproximación a las cantidades de droga que puedan ser consideradas como destinadas al consumo particular, y aquellas que constituirían el límite inferior a partir del cual serían catalogadas como cantidades de notoria importancia, en las que es de aplicación el artículo 369 del Código Penal (AU)

[Dietary habits and consumption patterns in a health district]. / Hábitos alimentarios y patrones de consumo en una zona de salud.

OBJECTIVE: To describe nutritional habits in a Health District by defining the patterns of food consumption. DESIGN: A descriptive, crossover study. SETTING: Health District of Molina de Segura, Murcia. METHOD: A community survey by interview of 1,071 people (95% confidence; accuracy to 3%), selected from the Municipal Roll by simple randomised sampling, was performed. The statistical methods were: Chi-squared and Student's tests, ANOVA, Pearson's linear correlation, factorial and discriminatory analysis. MEASUREMENTS AND MAIN RESULTS: 17.3%, especially men, never took milk products (p < 0.0005). 12.5%, mainly young people, consumed more than 3 eggs a week (p < 0.02). 85% ate fruit daily; 70%, green and root vegetables; and 78%, olive oil. 12.6% had pulses more than 3 days a week. Only 6.5% had potatoes or pasta daily. Among men and young people there was a "bar culture", along with a "fast food" pattern. CONCLUSIONS: The abandoned Mediterranean diet must be promoted. Measures should be taken to moderate young people's and men's alcohol consumption. "Fast food" and "bar culture" patterns are the most deeply rooted. The nutritional education of the chronically ill should also be emphasised.

[Diagnosis of mild arterial hypertension: 3 or 5 measurements?]. / Diagnóstico de hipertensión arterial ligera: tres o cinco tomas?

OBJECTIVE: To determine the differences in the diagnosis of light arterial hypertension between using three tension measurements (over 2 or 3 weeks) or five (6 or 7 weeks). DESIGN: A descriptive, longitudinal study. SETTING: Santomera Health Centre, Murcia. PARTICIPANTS: In 245 patients initially diagnosed as suffering from light Hypertension (with three takes of blood pressure), two more tension measurements were taken, over four weeks, to make a definitive diagnosis of light arterial Hypertension. 156 patients completed the series, for whom the differences in diagnosis between three and five takes, and variations in their blood pressure figures on repetition of the measurements, were studied. There were no differences in patients' basic characteristics between those who completed the tests and those who didn't. But there were differences between different professionals regarding their compliance with the procedure. RESULTS: 19.9% of the patients diagnosed initially after three blood pressure measurements did not have the diagnosis confirmed after five. Repetition of the measurements signified decrease in diastolic (p < 0.00005) and systolic (p < 0.00005) pressures. Average age of patients definitely diagnosed as having light hypertension was higher than the age of those not confirmed (p < 0.005). The older the patient, the higher the systolic pressure (p < 0.0001). CONCLUSIONS: The diagnosis of light arterial hypertension differed in 19.9% between three measurements and five.

[Carpal tunnel syndrome in primary care. Impact of workplace risks]. / Síndrome del túnel carpiano en atención primaria. Impacto de los riesgos laborales.

OBJECTIVE: To describe a series of cases of carpal tunnel syndrome (CTS) diagnosed at our health centre, with an analysis of the influence of work activity. DESIGN: A retrospective and descriptive study of a series of cases. SETTING: Patients on two medical lists who sought health care. PARTICIPANTS: 27 people diagnosed as having CTS. MEASUREMENTS AND MAIN RESULTS: We selected all the cases of CTS diagnosed according to the NIOSH criteria. We analysed symptoms, signs, additional tests and work risks. 24 out of the 27 cases were women. 100% had suggestive symptoms and 48.15% were affected bilaterally. The Tinell sign was positive in 5 cases, the Phalen in 7 and both in 11. 17.4% tested normal. We could see a diagnostic EMG in 19 cases. 59.2% were aged between 40 and 60. In all the cases we detected workplace risk factors: 18.5% housewives, 14.8% working in canning factories and dressmaking, 11.1% working in canning factories and dressmaking and shops/bars, 7.4% were cleaners, canning and fur operatives and mechanics. 3.7% worked at sewing shoes and in agriculture. As an accompanying pathology we detected 14.8% with obesity, 7.4% tenosynovitis and wrist fractures. For 3.7% CTS was a side-effect of diabetes, cervical arthrosis, ACV and dermatomyositis. 55.5% had non associated pathology. CONCLUSIONS: 1) The population of Molina de Segura can be considered at high risk of developing CTS. 2) In our environment women seek care for CTS much more often. 3) Most of our patients develop the condition in the workplace.

[Tobacco: risk factor in a health district]. / El tabaco: factor de riesgo en una zona de salud.

OBJECTIVE: To find the prevalence of tobacco dependency in our community and to identify tobacco consumption in our chronic patients. DESIGN: A crossover study. A descriptive analysis of the data. SETTING: A Health District. Mixed population, both urban and rural. PARTICIPANTS: A Health Survey which included 1,071 individuals (95% Confidence and 3% precision), selected by means of simple random sampling from the Municipal Census. MEASUREMENTS AND MAIN RESULTS: A 32.3% prevalence of tobacco dependency, greater among men (50.7%) than women (15.7%). Among the young, there is a marked tendency for the number of smokers to level out between the sexes. 15.6% of smokers consume more than 24 cigarettes per day. Between 15 and 20% of patients suffering hypertension, diabetes, hypercholesterolaemia and the effects of ischaemic cardiopathy, along with 25% of those who had suffered a CVA and almost 40% of chronic bronchitics, continue to smoke. CONCLUSIONS: Advice against smoking must be directed towards younger and younger age groups, including both men and women. The high prevalence of people still smoking among the chronically ill should cause us to reflect on our advice against tobacco to such patients.

Optimization of the power targeted to the frequency region of maximum tactile sensitivity.

Tactile stimulation is a means of transferring information to visually handicapped individuals. A study of the power delivered by the driving waveform to a transducer used for tactile stimulation as a function of the parameters of the waveform is presented. The power delivered within the region of maximum tactile skin sensitivity, Qfw, is compared to the total power delivered by the waveform in one cycle, PT, as a function of the waveform parameters with the objective of finding the parameters that would maximize the ratio Qfw/PT. In this study, the driving waveform is composed of an excitatory period followed by a recovery time. The excitatory period is formed by a burst of rectangular pulses modulated in amplitude by different waveforms. After a Fourier decomposition of the excitatory waveform, the contribution of each harmonic was added to compute the power delivered within the frequency region of interest. Additionally, to take in account the contribution of each harmonic in the overall tactile sensation, the power delivered within the region of maximum tactile skin sensitivity was weighed by the skin tactile sensitivity function and then linearly summed. The results show that the ratio Qfw/PT has a maximum for pulse widths between 0.8 and 1.2 ms for all pulse frequencies in the range 50-700 Hz when the tactile sensitivity function was not considered. The optimum pulse width, when the tactile sensitivity weighing function is considered in the computations, was in the range between 0.7 and 1.7 ms for pulse frequencies between 50-700 Hz. The ratio Qfw/PT is invariant to changes in the number of pulses per burst and the length of the recovery time. Once the tactile system frequency response is identified, all the waveform parameters can be specified for maximum power targeted to the region of maximum tactile sensitivity.

[Is stated income a valid indicator of the socioeconomic status?]. / Son válidos los ingresos declarados como indicador del nivel socioeconómico de la población?

OBJECTIVE: 1) To analyse the validity of the reply to the question on socio-economic income included in health questionnaires. 2) To identify other valid indicators of socio-economic status. DESIGN: Crossover and retrospective observation study. SETTING: Community (Molina de Segura Health District). PARTICIPANTS: 1,071 people over 18, selected by means of simple random sampling. INTERVENTIONS: Analysis of 16 questions relating to home furnishing, consumer goods and stated income. We used Factorial Analysis and the ji2 test. RESULTS: We identified three levels by means of the factorial analysis: a) basic--consisting of hot water, washing-machine, absence of damp patches in the house, individual heating and television. b) Intermediate--consisting of car, video and telephone. c) High--with dishwasher, domestic help and air-conditioning. On analysing the relationship between stated income and socio-economic status we detected association to p < 0.001. The basic level answered more often than expected that their income was less than 50,000 pesetas; the intermediate, between 50 and 100,000; and the high, over 101,000. CONCLUSIONS: 1) It is possible to identify the socio-economic profile of the general population by the belonging of selected of determined consumer items. 2) Stated income is a reliable indicator of socio-economic status. Despite a tendency to a low reply to the question on income, income is not generally under-declared.

[Social assessment of anxiety in primary health care]. / Valoración social de la ansiedad en atención primaria de salud.

OBJECTIVE: Identification of the social profile of our anxious patients, and analysis of the usefulness of Bell's questionnaire for our area of work. DESIGN: A retrospective observation study of a crossover type. SETTING: Primary Care. PARTICIPANTS: 55 patients who consulted their Family Doctor and were diagnosed as suffering from Anxiety. MEASUREMENTS AND MAIN RESULTS: We confirmed the diagnosis with the DSM-III-R and then analysed the level of Anxiety with the Hamilton Scale. The social evaluation was done by means of Bell's profile. As test statistics we used the lineal correlation Coefficient, the Student's t and Xi2 tests and Variance Analysis. 65% of diagnoses were Generalised Anxiety. The Hamilton mean was 20.9 points (S = 9.2). Overall social adaptation was unsatisfactory, with the worst results being for the emotional aspects. We observed a higher level of Anxiety as age increased (p = 0.021), related to a worse adaptation to Health (p = 0.014). Dissatisfaction with work and the working environment took the form of professional adaptation being poorer as their work situation deteriorated (p = 0.006). Anxiety levels were higher among the unemployed. Social adaptation was less among people with higher Anxiety levels (p = 0.04), above all as a consequence of worse adaptation to Health (p = 0.002) and worse emotional (p = 0.00001) adaptation. CONCLUSIONS: 1) We must introduce social aspects into analysis of patients with Anxiety. 2) Bell's profile enables us to identify those social aspects which can be tackled when caring for our patients. Its fundamental use is in individual application.

Characterization of two anti-DNA antibodies bearing distinct idiotypes. Correlation with clinical manifestations.

Spontaneous idiotype shift of anti-DNA antibodies in systemic lupus erythematosus was shown to be associated with changes in the clinical manifestations of the disease. Characterization of two anti-DNA antibody preparations from the same lupus patient showed that lupus nephritis was associated with antibodies showing higher specific antigen-binding activity and avidity to DNA and presenting more cationic quality upon isoelectric focusing and Western blot analysis than the ones found in patients without renal involvement. Lupus cerebritis was associated with anti-DNA antibodies with different idiotypic characteristics not shared by anti-DNA antibodies present in lupus nephritis. Lupus cerebritis anti-DNA antibodies had less specific antigen-binding activity and avidity to DNA and did not show cationic quality. Idiotypic and immunochemical changes of anti-DNA antibodies in lupus may be associated with various clinical manifestations.

Monoclonal antibody detects embryonic epitope specific for nerve-derived transferrin.

Monoclonal antibodies were generated against transferrin purified from chick embryo extract by fusing spleen cells from BALB/c mice immunized against embryonic transferrin, with myeloma cells. Antibodies produced by the selected hybridoma clones were all type IgG. Twelve clones were selected for secretion of antibodies to the embryo extract-derived transferrin, and three clones were studied extensively. Immunoblotting was used to demonstrate antibody binding to several avian transferrin proteins derived from adult chicken serum, adult chicken peripheral nerves, and ovotransferrin. Screening and detailed epitope analysis were accomplished by solid-phase immunoassay. The results indicated that two clones, 2G9.1 and 2B11.1, recognized the embryonic and egg antigens in preference to the adult proteins. However, a third clone, 6H2.1, recognized the nerve-derived transferrin preferentially to both the embryonic and adult serum antigens. None of the clones recognized the serum-derived transferrin in preference to the other antigens. These results indicate that embryonic epitope(s) are conserved in the nerve- but not the serum-derived transferrin. They also show that the neural antigen has site(s) distinct from the embryonic proteins. No changes in displacement curves were observed after these proteins were digested with neuraminidase, indicating that the epitope differences discovered are not intimately related to sialic acid residues on the various transferrins.