[National competitive bidding analysis of osteosynthesis materials in pediatric patients with femur fractures]. / Análisis de licitación pública nacional de materiales de osteosíntesis en los pacientes pediátricos con fracturas de fémur.

INTRODUCTION: health promotion policy requires the identification of barriers to the adoption of public policies. Paraguay's national healthcare system is inequitable, expensive, and inefficient. The Ministry of Public Health and Social Welfare (MSPyBS) is the entity responsible for covering the needs of a significant portion of the population. In January 2022, the MSPyBS financed the purchase of titanium elastic nails through a National Public Tender for Osteosynthesis Materials (LPN 02/22) to provide them for free in the pediatric service. Using research as a tool, we seek to analyze the impact of the implementation of LPN 02/22 at the Trauma Hospital, believing that this action would help streamline administrative and bureaucratic processes, making them more efficient with the assistance of the hospital's human resources. MATERIAL AND METHODS: a retrospective, analytical, and comparative study conducted at a high-complexity trauma center in Asunción, Paraguay. Patients aged 4 to 14 years with an indication for stabilization with elastic nails were included. Demographic data, the mechanism of injury, time elapsed from hospital arrival to surgical treatment, length of hospital stay, and the average hospital cost were analyzed based on the daily expense of pediatric patient hospitalization. RESULTS: 52 patients, divided into 25 cases in 2021 before implementation and 27 cases after implementation. The time elapsed from hospital arrival to definitive treatment was six days in the pre-implementation period, with an average stay from admission to discharge of 7.4 days. After implementation, the time from hospital arrival to definitive treatment was 4.3 days, and the average discharge time for the Post group was six days. The potential savings per patient amount to 332 dollars, offset by the institution's implant supply cost of 197 dollars, resulting in an approximate savings of 135 dollars per patient for the ministry. CONCLUSIONS: we view the implementation of free titanium elastic nails for pediatric femur fracture patients positively. We encourage the institution to continue with similar policies and strive to achieve even greater benefits for users.

INTRODUCCIÓN: la política de promoción de la salud requiere la identificación de los obstáculos para la adopción de políticas públicas. El sistema nacional de salud de Paraguay es inequitativo, caro e ineficiente. El Ministerio de Salud Pública y Bienestar Social (MSPyBS) es el ente que cubre las necesidades de gran parte de la población. El MSPyBS en Enero del 2022 financió, mediante la Licitación Pública Nacional de Materiales de Osteosíntesis (LPN 02/22), la compra de clavos elásticos de titanio para disponer de su uso gratuito en el Servicio de Pediatría; usando a la investigación como herramienta, buscamos analizar el impacto de la implementación de la LPN 02/22 en el Hospital de Trauma, creyendo que esta acción ayudaría a dinamizar los procesos administrativos y burocráticos, haciéndolos más eficientes con la ayuda de los recursos humanos del hospital. MATERIAL Y MÉTODOS: estudio retrospectivo, analítico y comparativo, realizado en un centro de trauma de alta complejidad de Asunción, Paraguay. Fueron incluidos los pacientes con edad comprendidas entre cuatro y 14 años, con indicación de estabilización con clavos elásticos. Se analizaron los datos demográficos, el mecanismo de trauma, el tiempo transcurrido desde la llegada al hospital hasta el tratamiento quirúrgico, así como el tiempo de estadía hospitalaria. Se evaluó el costo hospitalario promedio, basados en el gasto diario de la internación de un paciente pediátrico. RESULTADOS: cincuenta y dos pacientes, separados en 25 casos en el 2021 previo a la implementación y 27 casos posterior a la implementación. El tiempo transcurrido desde la llegada al hospital hasta el tratamiento definitivo fue de seis días para la etapa previa a la implementación; el promedio desde el ingreso hasta el alta fue de 7.4 días. Desde la implementación se tuvo un transcurso de 4.3 días desde la llegada al hospital hasta el tratamiento definitivo. El egreso del grupo Post tuvo un promedio de seis días. El ahorro probable en relación con cada paciente es de 332 dólares; a esto debemos contrarrestar el monto que paga la institución para la provisión del implante (197 dólares), por lo que el ahorro del ministerio sería de aproximadamente 135 dólares por cada paciente. CONCLUSIONES: vemos como positiva la implementación de la gratuidad de los clavos elásticos de titanio en los pacientes en edad pediátrica con fractura de fémur. Alentamos a la institución a seguir con políticas similares y tratar de lograr mayores beneficios para los usuarios.

Craniofacial and occlusal features of individuals with Turner Syndrome: A cephalometric study.

Craniofacial features of 18 individuals with Turner Syndrome (TS) were compared with age and gender matched healthy individuals. Dental history, panoramic radiograph, dental casts and cephalometric measurements were assessed. The dental casts analysis showed a significantly higher PH/PW ratio in individuals with TS under GH therapy compared to healthy individuals (p=0.004; paired t-test). This data objectively supported the definition of a high-narrow palate. The ANB angle and the Wits index were similar in the two group, showing a skeletal class I malocclusion. The vertical characteristics did not differ between the two groups, showing a mesofacial growth pattern. Our results showed similar cephalometric characteristics in individuals with TS treated with GH and healthy controls.

Multi-institutional Outcomes and Associations After Excision and Primary Anastomosis for Radiotherapy-associated Bulbomembranous Urethral Stenoses Following Prostate Cancer Treatment.

OBJECTIVE: To evaluate the outcomes of excision and primary anastomosis (EPA) for radiation-associated bulbomembranous stenoses using a multi-institutional analysis. The treatment of radiation-associated urethral stenosis is typically complex owing to the adverse impact of radiation on adjacent tissue. METHODS: An IRB-approved multi-institutional retrospective review was performed on patients who underwent EPA for bulbomembranous urethral stenosis following prostate radiotherapy. Preoperative patient demographics, operative technique, and postoperative outcomes were abstracted from 1/2007-6/2018. Success was defined as voiding per urethra without the need for endoscopic treatment and a minimum follow-up of 12 months. RESULTS: One hundred and thirty-seven patients from 10 centers met study criteria with a mean age of 69.3 years (50-86), stenosis length of 2.3 cm (1-5) and an 86.9% (119/137) success rate at a mean follow-up 32.3 months (12-118). Univariate Cox regression analysis identified increasing patient age (P = .02), stricture length (P <.0001) and combined modality radiotherapy (P = .004) as factors associated with stricture recurrence while body mass index (P = .79), diabetes (P = .93), smoking (P = .62), failed endoscopic treatment (P = .08) and gracilis muscle use (P = .25) were not. On multivariate analysis, increasing patient age (H.R.1.09, 95%CI 1.01-1.16; P = .02) and stenosis length (H.R.2.62, 95%CI 1.49-4.60; P = .001) remained associated with recurrence. Subsequent artificial urinary sphincter was performed in 30 men (21.9%), of which 25 required a transcorporal cuff and 5 developed cuff erosion. CONCLUSIONS: EPA for radiation-associated urethral stenosis effectively provides unobstructed instrumentation-free voiding. However, increasing stenosis length and age are independently associated with surgical failure. Patients should be counseled that further surgery for incontinence may be necessary.

Comparison of the accuracy of intraoral scanning and conventional impression techniques on implants: a review.

The aim of this review was to collect available evidence and evaluate accuracy outcomes of dental implant impression techniques, and to compare the accuracy of conventional implant impression versus digital implant impression. Inclusion and exclusion criteria were defined by the authors before the start of the study. The inclusion criteria were: all studies published in English language; studies no older than five years; analyzing the accuracy of digital vs conventional technique impression on implants. The exclusion criteria were: publications that reported the same data as later publications by the same authors and systematic reviews; commentaries and letters to the editor; case report and case series. The search resulted in 106 titles. Following the first stage of screening, after the records identification through database manual searching, 112 potentially relevant studies were identified. After the second stage screening, 33 full text publications were obtained and analyzed and 17 were excluded. Afterwards, 18 articles resulted eligible after full text reading and a cross search of the articles' references was accomplished; 3 articles were consequently added. At the end only 7 articles were included in the quantitative analysis. Within the limitations of this systematic review, digital impression on dental implants offers a comparable accuracy compared with conventional impressions technique. More clinical trials are recommended to investigate the accuracy of these scanners and their validity in clinical use.

Skin lesion-associated pathogens from Octopus vulgaris: first detection of Photobacterium swingsii, Lactococcus garvieae and betanodavirus.

The common octopus Octopus vulgaris Cuvier, 1798 is extremely important in fisheries and is a useful protein source in most Mediterranean countries. Here we investigated pathogens associated with skin lesions in 9 naturally deceased specimens that included both cultured and wild common octopus. Within 30 min after death, each octopus was stored at 4°C and microbiologically examined within 24 h. Bacterial colonies, cultured from swabs taken from the lesions, were examined using taxonomical and biochemical analyses. Vibrio alginolyticus and V. parahaemolyticus were only isolated from cultured animals. A conventional PCR targeting the 16S ribosomal RNA (rRNA) gene and sequencing were performed on 2 bacterial isolates that remained unidentified after taxonomical and biochemical analysis. The sequence results indicated that the bacteria had a 99% identity with Lactococcus garvieae and Photobacterium swingsii. L. garvieae was confirmed using a specific PCR based on the 16S-23S rRNA internal transcribed spacer region, while P. swingsii was confirmed by phylogenetic analyses. Although all animals examined were found to be infected by the protozoan species Aggregata octopiana localised in the intestines, it was also present in skin lesions of 2 of the animals. Betanodavirus was detected in both cultured and wild individuals by cell culture, PCR and electron microscopy. These findings are the first report of L. garvieae and betanodavirus from skin lesions of common octopus and the first identification of P. swingsii both in octopus skin lesions and in marine invertebrates in Italy.

Evaluation of cephalometric, hormonal and enzymatic parameters in young obese subjects.

AIM: The aim of the present investigation was to analyse cephalometric skeletal structures and hormonal and enzymatic parameters in young obese subjects in comparison with those of normal weight subjects. MATERIALS AND METHODS: The whole sample consisted of 50 Caucasian patients (28 males and 22 females) whose lateral radiographs, laboratory hormonal and enzymatic analyses were already available. The test group included 25 obese patients (11 females and 14 males, average age: 9.8 +/- 2.11 years old), while the control group included 25 normal weight subjects matched for age and sex (11 females and 14 males, 9.9 +/- 2.5 years old). Data were statistically analysed: Student's t-test for independent samples was adopted and the level of significance was set at: p < 0.05. RESULTS: As regards cephalometric records, the anterior cranial base length was significantly greater in the test group (S-N: 69.9 +/- 4 mm) compared to the controls (S-N: 68.1 +/-2.7 mm). Moreover, the maxillary lenght was higher in the test group (Pm-A: 48.5 +/- 2.5 mm) in comparison to the control group (Pm-A: 46.1 +/- 1.9 mm). As regards skeletal class and vertical dimension, no significant differences were found between the two groups, with the exception of the intermaxillary plane angle, which was significantly lower in the obese subjects in comparison to the controls. Laboratory analysis showed significant (p < 0.05) higher levels of leptin and insulin in the test group in comparison with control subjects. Furthermore, LH, FSH, IGF-1 values were significantly (p < 0.05) lower in the test group in comparison with the control group. CONCLUSION: Obese subjects exhibited an increase of some craniofacial parameters and alteration of some laboratory parameters that may be involved in the process of skeletal maturation, in comparison to normal weight subjects. These findings may be of interest in orthodontics, as young obese subjects may need a different orthodontic treatment plan in comparison to normal weight subjects of the same age.

Effects of a randomized maintenance intervention on adiposity and metabolic risk factors in overweight minority adolescents.

OBJECTIVE: The objective of this study was to assess the effects of a maintenance programme (monthly newsletters vs. monthly group classes and telephone behavioural sessions) on obesity and metabolic disease risk at 1 year in overweight minority adolescents. METHODS: After a 4-month nutrition and strength training intervention, 53 overweight Latino and African-American adolescents (15.4 ± 1.1 years) were randomized into one of two maintenance groups for 8 months: monthly newsletters (n = 23) or group classes (n = 30; monthly classes + individualized behavioural telephone sessions). The following outcomes were measured at months 4 (immediately following the intense intervention) and 12: height, weight, blood pressure, body composition via BodPod™ (Life Measurement Instruments, Concord, CA, USA), lipids and glucose/insulin indices via frequently sampled intravenous glucose tolerance test. RESULTS: There were no significant group by time interactions for any of the health outcomes. There were significant time effects in several outcomes for both groups from months 4 to 12: bench press and leg press decreased by 5% and 14%, respectively (P = 0.004 & P = 0.01), fasting insulin and acute insulin response decreased by 26% and 16%, respectively (P < 0.001 & P = 0.046); while high-density lipoprotein cholesterol and insulin sensitivity improved by 5% and 14% (P = 0.042 & P = 0.039). CONCLUSIONS: Newsletters as opposed to group classes may suffice as follow-up maintenance programmes to decrease type 2 diabetes and cardiovascular risk in overweight minority adolescents.

Development of type I gastric carcinoid in patients with chronic atrophic gastritis.

BACKGROUND: Long-term observational studies assessing the incidence of type I gastric carcinoid (typeIGC) in patients with chronic atrophic gastritis are few. AIM: To evaluate the occurrence of typeIGC at diagnosis and during follow-up and to identify patient features associated with the presence of typeIGC in a cohort of chronic atrophic gastritis patients. METHODS: Three hundred and sixty-seven chronic atrophic gastritis patients [245 women, age 54 (18-79) years] underwent regular follow-up by gastroscopy. The incidence of typeIGC was determined in chronic atrophic gastritis patients with at least 2 years of follow-up (n = 214). Baseline clinical and histological features were analysed as factors associated with the presence of typeIGC by univariate analysis. RESULTS: Type I gastric carcinoid was diagnosed in nine (2.4%) patients at the moment when chronic atrophic gastritis was diagnosed. After 1463 person-years, six patients developed typeIGC with an annual incidence rate (person-year) of 0.4%. Patients with typeIGC had significantly higher levels of gastrin, chromogranin A and more frequently the presence of body polyps and ECL-dysplasia compared with chronic atrophic gastritis patients without typeIGC. CONCLUSIONS: This cohort study shows that typeIGC is a rare complication in patients with chronic atrophic gastritis, and the presence of body polyps and ECL-dysplasia at gastroscopic/histologic evaluation is strongly associated with the presence of typeIGC.

Comparison of the effects of two resistance training regimens on muscular and bone responses in premenopausal women.

SUMMARY: A 28-week resistance training with linear periodization was compared with an undulating model in 27 premenopausal women. In both groups, bone mineral density (BMD) was not changed but muscle strength increased, and there were changes in anthropometrical and muscle damage parameters, indicating that in this population, these models are similar concerning these variables. INTRODUCTION: This study seeks to compare the effects of resistance training with undulating versus linear periodization on BMD, muscle strength, anthropometrical variables, and muscle damage parameters in premenopausal women. METHODS: Twenty-seven females (39.6 +/- 0.41 years, mean +/- standard error), without osteopenia or osteoporosis and without calcium supplementation, were randomly assigned either to a linear periodization group (LPG, n = 14) or to an undulating periodization group (UPG, n = 13). The subjects were trained three times a week for 28 weeks. Lumbar spine and femoral neck BMDs were measured through dual-energy X-ray absorptiometry. Maximal and submaximal dynamic muscle strengths were measured through the 1-RM and 20-RM tests, respectively. Anthropometrical (body mass, skinfolds, and perimeters) and muscle damage parameters were assessed through serum creatine kinase (CK) and delayed-onset muscle soreness (DOMS). RESULTS: BMD remained unchanged in both groups, despite significant increases in maximal (LPG, 37-73%; UPG, 40-70%) and submaximal (LPG, 82-114%; UPG, 70-102%) muscle strength. The perimeter of the distal thigh was increased (about 1.7 cm) in both groups. CK and DOMS were greater in the first mesocycle than in the subsequent ones. After the 1st training session in each mesocycle, 24 and 48 h CK was increased as compared to pretraining values. CONCLUSIONS: The resistance training of 28 weeks increased muscle strength in both training groups with no difference in BMD or in the occurrence of muscle damage.

Longitudinal study on a rehabilitative model for correction of atypical swallowing.

AIM: The aim of the study is to analyse the prevalence of anomalous function of the orofacial muscles and their aetiological factors in a small sample of paediatric patients, to evaluate the correlation between anomalous functions of the orofacial muscles and malocclusions, and finally to verify the effects of a myofunctional protocol, composed of a series of exercises aimed at correcting the anomalous function and position of the tongue. METHODS: The protocol that has been used in this research is a re-elaboration of the diagnostic and therapeutic methods set by two authors, Daniel Garliner and Aurelio Levrini. A group of 57 children (aged 5 to 13, mean age 8.2) with atypical swallowing diagnosis, has been treated for almost 3 years. RESULTS: Physiologic swallowing was achieved in 47% of the children treated. CONCLUSION: The results show the benefits of the myofunctional therapy in the treatment of children with abnormal swallowing.

Infection with human papillomaviruses of sexual partners of women having cervical intraepithelial neoplasia.

Epidemiological studies show that human papillomaviruses (HPV) are strongly related to cervical cancer and cervical intraepithelial neoplasias (CIN). Unlike the case for women, there are no consistent data on the natural history of HPV in the male population even though these viruses are prevalent in males. We carried out a prospective study to assess the prevalence of HPV in males as well as the factors that determine such infections in 99 male sexual partners of women with CIN. The genitalia of the males were physically examined and subjected to peniscopy for the collection of scrapings which were subjected to the polymerase chain reaction and restriction fragment length polymorphism to detect HPV. Of the 99 males sampled, 54 (54.5%) were positive for HPV DNA, 24% of whom presented normal peniscopy, 28% presented evident clinical lesions and 48% isolated lesions consistent with subclinical infection. In the HPV-negative group, 53% showed normal peniscopy, 4% presented evident clinical lesions and 42% isolated lesions consistent with subclinical infection. The study detected a statistically significant association (P < 0.02, Pearson chi-square test) between HPV infection and both the mean number of sexual partners which a male had during his life and the mean number of sexual partners in the year prior to testing. Viral types 6 and 11 were most frequently encountered. The study shows that infection with HPV was frequent in male sexual partners of women with CIN.

Infection with human papillomaviruses of sexual partners of women having cervical intraepithelial neoplasia

Epidemiological studies show that human papillomaviruses (HPV) are strongly related to cervical cancer and cervical intraepithelial neoplasias (CIN). Unlike the case for women, there are no consistent data on the natural history of HPV in the male population even though these viruses are prevalent in males. We carried out a prospective study to assess the prevalence of HPV in males as well as the factors that determine such infections in 99 male sexual partners of women with CIN. The genitalia of the males were physically examined and subjected to peniscopy for the collection of scrapings which were subjected to the polymerase chain reaction and restriction fragment length polymorphism to detect HPV. Of the 99 males sampled, 54 (54.5 percent) were positive for HPV DNA, 24 percent of whom presented normal peniscopy, 28 percent presented evident clinical lesions and 48 percent isolated lesions consistent with subclinical infection. In the HPV-negative group, 53 percent showed normal peniscopy, 4 percent presented evident clinical lesions and 42 percent isolated lesions consistent with subclinical infection. The study detected a statistically significant association (P < 0.02, Pearson chi-square test) between HPV infection and both the mean number of sexual partners which a male had during his life and the mean number of sexual partners in the year prior to testing. Viral types 6 and 11 were most frequently encountered. The study shows that infection with HPV was frequent in male sexual partners of women with CIN.

Degradation of pyrimethanil in soil: influence of light, oxygen, and microbial activity.

The research was carried out in order to verify the influence that light, oxygen, and microbial activity have on the degradability of pyrimethanil (PYR) in soil. The products of degradation were also identified and their evolution in time evaluated. The results indicate that the molecule is more persistent in the absence of light, oxygen, and microbial activity. The order of importance of these three factors is as follows: light < microbial activity < oxygen. The following products of degradation were identified: (1) benzoic acid, (2) cis,cis-muconic acid, (3) hydroxyl-4,6-dimethyl-2-pirimidinamine, (4) N'-ethyl-N-hydroxyformamidine, and (5) 4,6-dimethyl-2-piridinamine, which appeared different from those reported in literature for the degradation of PYR in abiotic conditions. This result suggests that the degradation in soil is mainly biotic.

Photodegradation of Pyrimethanil induced by iron(III) in aqueous solutions.

In this study an abiotic process was suggested to evaluate the behaviour of Pyrimethanil (antibotrytic fungicide) in real matrices. This process consists of a photodegradation of the fungicide carried out in the presence of iron(III) in three types of buffer; acetate, phosphate and citrate. The experimental results show that the nature of buffered solutions influences both the rate of disappearance of Pyrimethanil and, in the case of citrate, also the kind of by-products formed during the photodegradation process. For each case examined, the breakdown products were identified by using liquid chromatography (LC) or gas chromatography (GC), coupled with mass spectrometry (MS). The degradation pathways of the fungicide were proposed and the relative kinetic constants were evaluated. The abiotic photodegradation process shows the possibility of different pathways for Pyrimethanil degradation in environmental matrices such as the soil, plants and foodstuffs, where iron (free and/or bonded) is a natural component.

Catalytic and spectroscopic characterisation of a copper-substituted alcohol dehydrogenase from yeast.

Yeast alcohol dehydrogenase (Y-ADH) is widely studied for its biotechnological importance and various attempts to improve its catalytic properties have been made. In this paper, a catalytically active metal-substituted Y-ADH was prepared in vitro by substituting one zinc atom with copper. EPR and Raman spectroscopy suggest that copper maintains the same co-ordination geometry as zinc in native Y-ADH. The active Cu-ADH shows lower substrate affinity and lower specific activity (SA) than native ADH, but greater than a previously obtained Co-ADH. Furthermore, Cu-ADH maintains its catalytic efficiency in a wider pH range than native enzyme.

Characteristics of violent behaviour in acute psychiatric in-patients: a 5-year Italian study.

OBJECTIVE: In order to examine prospectively the characteristics of violence among psychiatric patients, a 5-year study was carried out in an acute psychiatric unit. METHOD: All assaultive behaviour occurred in the ward during the study period were assessed routinely using the Staff Observation Aggression scale (SOAS). RESULTS: Of 1534 patients admitted to the unit during the study period, 116 were responsible for 329 aggressive episodes (prevalence of violence=7.5%, 2.8 incidents/patient). Most violent patients had an ICD-9 diagnosis of schizophrenia and/or delusional syndromes (55.1%), a history of violence (80.7%) and previous psychiatric admissions (92%). Approximately half of the incidents had no specific cause, occurred during daytime and the first week of admission and, in most cases, were directed towards individuals (77.8%). CONCLUSION: Although confirming the low rate of violence among Italian psychiatric in-patients, the study indicates the need for more attention to the problem of aggression in general hospital psychiatric units.

Day-night variation in aggressive behavior among psychiatric inpatients.

Self-directed aggressive behaviors of human beings show a 24h pattern. The aim of this study was to evaluate if violence of psychiatric inpatients against one another and hospital staff varies over the 24h. The clock time occurrence of 334 episodes of assault behaviors by 119 psychiatric inpatients (78 males and 41 females, mean age 34.8+/-11.3 years) committed during a 5-year span in the psychiatric unit of the university-based hospital of Ferrara, Italy, was evaluated. The clock time of each event was categorized by hour during the 24h and into one of four 6h intervals for analysis of temporal variation by cosinor and chi2 tests, respectively. A significant 24h variation, characterized by an early afternoon peak, was detected irrespective of gender and number (single vs. repeated) of episodes committed. Changes during the 24h in ward activity, patient contact, and endogenous circadian rhythms are likely to contribute to the observed 24h pattern, although further study is needed to confirm our findings and to define causal factors.

Functionalized biopolymers as soluble macromolecular chelating agents.

Two different conjugates of bovine serum albumin (BSA) with lysine and a derivative of imidazole have been synthesized to obtain watersoluble macromolecules with binding properties against bivalent transition metal ions. Syntheses have been carried out using the 60 aminogroups or the 99 carboxylic groups on BSA for the coupling reactions, with such molar ratios able to produce highly substituted BSA. The skill of each conjugate to bind metal ions in aqueous medium was studied through the use of titration curves with some metal ions, characterized by a good affinity for the free ligand. Both the conjugates allow us to recover a high number of metal ions per protein molecule, close to the number of ligand molecules on the BSA surface in the case of the lysine conjugate, whereas in the case of the imidazole conjugate M3L complexes are performed.

Improved resistance to transition metals of a cobalt-substituted alcohol dehydrogenase 1 from Saccharomyces cerevisiae.

Cobalt-substituted alcohol dehydrogenase 1 was purified from a yeast culture of Saccharomyces cerevisiae. Its reactivity towards different transition metals was tested and compared with the native zinc enzyme. The cobalt enzyme displayed a catalytic efficiency 100-fold higher than that of the zinc enzyme. Copper, nickel and cadmium exerted a mixed-type inhibition, with a scale of inhibition efficiency: Cu(2+)>Ni(2+)>Cd(2+). In general, a higher resistance of the modified protein to the inhibitory action of transition metals was observed, with two orders of magnitude for copper I(50). The presence of nickel in the complexes enzyme-coenzyme-inhibitor-substrate resulted in a decrease of the ampholytic nature of the catalytic site. On the contrary, cadmium and copper exerted an enhancement of this parameter. Electrostatic or other types of interactions may be involved in conferring a good resistance in the basic pH range, making cobalt enzyme very suitable for biotechnological processes.