Cuestionarios sobre factores de riesgo de la exposición y la accidentalidad por tráfico en conductores. Una revisión / A review of questionnaires exploring driver’s exposure and risk factors in road crashes

Dada la diversidad de cuestionarios empleados en el estudio de la epidemiología analítica de las lesiones por tráfico, realizamos una revisión de los estudios publicados al respecto entre 1989 a 2011, con objeto de identificar sus fortalezas y debilidades. Dicha revisión puso de relieve que la mayor parte de los cuestionarios se centran en el factor humano sobre el riesgo de accidente, pero son muy pocos los que incluyen la intensidad de exposición y la asociación de ésta con otros factores de riesgo de la accidentalidad. Muchos cuestionarios poseen un elevado número de ítems y complejas escalas de valoración. Además, en España son escasos los cuestionarios validados sobre la exposición y la accidentalidad por tráfico. Por todo ello, es necesario trabajar en el diseño y la validación de cuestionarios que recojan de forma sencilla información integral sobre la epidemiología de las lesiones por tráfico de cara a su mayor conocimiento y prevención (AU)

Given the diversity of questionnaires currently being used in the study of the analytic epidemiology of traffic injuries, we made a review of studies on this question published between 1989 and 2011 in order toidentify their advantages and disadvantages. We wereable to observe that most of the questionnaires were focused on the human factor regarding the risk of road crashes, but very few of them included intensity of exposure and its association with other risk factors in road crashes. Many questionnaires have a high number of items and complex rating scales. Further more, in Spain there are few validated questionnaires which contain complete information about exposure and road crashes. In Spain we should work on the design and validation of questionnaires containing questions aimedat obtaining complete and easy information about the epidemiology of traffic injuries. In this way we would be able to increase our awareness of traffic injuries and how to prevent them (AU)

Phosphorus bioavailability, true metabolizable energy, and amino acid digestibilities of high protein corn distillers dried grains and dehydrated corn germ.

There is currently much ongoing research and interest for developing new processing technologies to produce corn distillers dried grains with solubles (DDGS). The current study evaluated a high protein (HP) distillers dried grains (DDG) and a dehydrated corn germ, which are products that can be produced by a modified dry milling process. Two chick experiments were conducted to determine the P bioavailability based on tibia ash. In addition, precision-fed rooster assays were conducted to determine TME(n) and amino acid digestibility. In the first chick assay, a P-deficient cornstarch-dextrose-soybean meal basal diet containing 0.10 to 0.13% nonphytate P was supplemented with 0.0, 0.05, and 0.10% P from KH(2)PO(4) or 7 and 14% conventional DDGS, HP DDG, and corn germ. In the second experiment, the P-deficient basal was supplemented with 7 and 14% conventional DDGS and 12.5 and 25% HP DDG. New Hampshire x Columbian female chicks were fed the experimental diets from 9 to 22 d posthatch, and bioavailability of P was estimated using the slope-ratio method where tibia ash was regressed on P intake. The total P content (90% DM basis) of the conventional DDGS, HP DDG, and corn germ were 0.76, 0.33, and 1.29%, respectively. Bioavailabilities of the P in conventional DDGS, HP DDG, and corn germ relative to KH(2)PO(4) were found to be 60, 56, and 25%, respectively. The TME(n) in conventional roosters was found to be significantly reduced for HP DDG and increased for the corn germ when compared with the conventional DDGS. The protein content (90% DM basis) of the HP DDG and corn germ was 33 and 14%, respectively, and the total lysine as a % of CP was approximately 2 times greater for the corn germ than for the HP DDG. Amino acid digestibilities in cecectomized roosters were consistently higher for the corn germ than for the HP DDG, which was similar to conventional DDGS.

Nutritional characteristics of corn distillers dried grains with solubles as affected by the amounts of grains versus solubles and different processing techniques.

Experiments were conducted to evaluate the nutritional value of corn distillers dried grains with solubles (DDGS) and its components of grains and solubles, the effect on amino acid digestibility of autoclaving DDGS with different proportions of wet grains:solubles, and the effect of several new processing technologies on the nutritional value of DDGS for poultry. In the latter experiments, corn was processed under laboratory conditions to produce ethanol and DDGS by using the conventional dry-grind process and compared with 2 modified dry-grind corn processes. Modified dry-grind corn processes consisted of wet quick germ, quick fiber (QGQF process) and dry degerm defiber (3D process) fractionation of corn to recover the germ and pericarp fiber prior to fermentation. In another process, a commercial DDGS sample was subjected to an Elusieve method to remove fiber and increase the protein content. Freeze-dried solubles were higher in total P but lower in CP than in the grains and DDGS. Digestibilities of several amino acids in the freeze-dried grains and solubles were higher than those for DDGS, particularly for Lys. Autoclaving reduced the digestibility of amino acids in DDGS, and this effect was not influenced by the proportion of grains:solubles. The QGQF and 3D processes increased the protein and reduced the fat and total dietary fiber content in DDGS. Total P was increased by the QGQF process, but was reduced by the 3D process. The Elusieve process increased the protein, amino acids, and fat, and decreased the total dietary fiber content of DDGS from 34.5 to 19.7% on a DM basis. None of the processing technologies had a significant effect on DDGS amino acid digestibility. The results of this study indicated that the nutritional value of DDGS can be influenced greatly by the proportion of grains vs. solubles and by processing technologies.

Effect of increased heat processing and particle size on phosphorus bioavailability in corn distillers dried grains with solubles.

Previous studies have reported that increased heat processing and feeding larger particle size ingredients may increase the bioavailability of phytate P in some feedstuffs. Therefore, one chick experiment was conducted to determine the effect of various increased heat processing treatments on bioavailability of P in corn distillers dried grains with solubles (DDGS), and 2 chick experiments were conducted to determine the effect of particle size on bioavailability of P in DDGS. In addition, one precision-fed cecectomized rooster assay was conducted to evaluate the effects of increased heating on amino acid digestibility. For the chick experiments, a P-deficient cornstarch-dextrose-soybean meal basal diet containing 0.10% nonphytate P was supplemented with 0.0, 0.05, or 0.10% P from KH(2)PO(4) or 1 of 2 levels of DDGS. Diets were fed from 8 to 22 d of age, and P bioavailability relative to the P in KH(2)PO(4) was estimated using the standard curve or slope-ratio methods with tibia ash as the response variable. Increased heating of DDGS by autoclaving at 124 kPa and 121 degrees C for 60 to 80 min or by heating in a drying oven at 121 degrees C for 60 min significantly increased relative P bioavailability in DDGS (from 70 to as high as 91%) in several treatments. Amino acid digestibility, however, was greatly reduced by increased heating in most cases, particularly for Lys. Relative bioavailability of P was not significantly affected by DDGS particle sizes ranging from 542 to 837 microm. Our results indicated that increased heating of DDGS increased bioavailability of P but decreased digestibility of amino acids, particularly Lys, and that bioavailability of P was not affected by particle size.

Effect of reciprocating dietary lysine fluctuations on chick growth and carcass yield.

Three experiments (Exp) were conducted to study the effect of reciprocating (i.e., back-and-forth) fluctuations in dietary Lys concentration on growth performance of male broiler chicks. The Lys, CP, and ME concentrations were fluctuated in Exp 1 by varying corn and soybean meal concentrations. Corn-peanut meal diets in Exp 2 and 3 contained a constant calorie-protein ratio, but Lys concentrations were fluctuated by varying supplemental L-Lys x HCl. During 7-d feeding periods from d 8 to 43 posthatch, chicks fed the fluctuating regimen were provided diets with nutrient concentrations arranged in the following order (relative to control diets at any given point): excess-deficient-excess-deficient-adequate. In each Exp, differences in feed intake and gain:feed were observed during the first 7 d. Weight gain was never affected by dietary regimen. Overall, chicks fed the fluctuating regimen showed similar weight gain and feed intakes relative to chicks fed the control regimen. Additionally, efficiency of feed, Lys, CP, and ME utilization over the 35-d growth period of Exp 2 and 3 were not affected by dietary regimen. An increase in carcass yield (dressed, carcass weight as a percentage of live weight) of birds fed the fluctuating regimen was observed, but there were no differences in abdominal fat yield (as a percentage of dressed, carcass weight). These data support the conclusion that reciprocating 7-d periods of nutrient excess and deficiency do not affect overall growth performance of growing chicks.

Endometrial cancer patients have a significant risk of harboring isolated tumor cells in histologically negative lymph nodes.

In this study, we examine the prevalence of finding isolated tumor cells (ITCs) in negative lymph nodes of endometrial cancer patients using immunohistochemistry. Seventy-six endometrial cancer patients with lymph nodes histologically negative for metastatic disease were examined. Nodal tissue sections were stained with anticytokeratin antibodies AE-1 and CAM 5.2. Nodes with single or groups of cells (two to four cells) < or =0.2 mm and showing cytokeratin reactivity were positive for ITCs. Findings were compared to features of the primary tumor and patient outcome. ITCs were present in 31 of 1712 lymph nodes. Fifteen (19.7%) patients had ITC-positive nodes. ITCs involved only pelvic nodes in nine cases, only para-aortic nodes in five cases, and pelvic and para-aortic in one case. Tumor in adnexa was the only pathologic feature associated with nodal ITCs (P= 0.0485). All 15 patients with nodal ITCs were alive at follow-up. One (6.7%) patient suffered recurrent disease but was alive at last encounter. Disease recurred in 5 (8.8%) of 57 patients without nodal ITCs. Two are alive without disease, two alive with disease, and one died from her cancer. In summary, a significant proportion of endometrial cancer patients have ITCs detected by immunohistochemistry in histologically negative regional lymph nodes.

Effect of microbial phytase and citric acid on phosphorus bioavailability, apparent metabolizable energy, and amino acid digestibility in distillers dried grains with solubles in chicks.

Three experiments were conducted to evaluate the effectiveness of OptiPhos phytase and citric acid for releasing the P that is not bioavailable in distillers dried grains with solubles (DDGS). The effect of OptiPhos phytate on AME(n) and amino acid digestibility was also determined. New Hampshire x Columbian chicks were fed experimental diets from 8 to 21 d of age. For Experiment 1, a basal P-deficient diet contained 40% DDGS plus supplemental amino acids, and DDGS was the only source of P. The basal diet was then supplemented with 1,000 or 10,000 phytase units (FTU)/kg of OptiPhos phytase or with 0.2% of P from KH2PO4. In Experiment 2, a slope-ratio chick growth and tibia ash assay used a P-deficient soybean meal basal diet, and it was found that the bioavailability of P in DDGS was 67%. For Experiment 3, a P-deficient basal diet with 30% DDGS plus supplemental amino acids was supplemented with 0.05 or 0.1% P from KH2PO4, with 3% citric acid, or with 1,000 or 10,000 FTU/kg of OptiPhos phytase. In Experiment 1, both 1,000 and 10,000 FTU/kg of phytase increased tibia ash but had no effect on AME(n). Both 10,000 phytase units (FTU)/kg of phytase and supplemental P increased digestibility of amino acids. In Experiment 3, supplemental phytase and citric acid increased tibia ash (mg/tibia), and it was estimated that phytase and citric acid could release from 0.04 to 0.07% P from DDGS. In terms of bioavailability coefficients, the bioavailability of the P in DDGS was increased from 62 to 72%. These results indicate that phytase and citric acid increase the bioavailability of P in DDGS, but phytase at 1,000 FTU/kg had no consistent effect on AME(n) and amino acid digestibility.

Relative bioavailability of phosphorus and true amino acid digestibility by poultry as affected by soybean extraction time and use of low-phytate soybeans.

The objectives of this study were to determine if lengthening the time that soybeans (SB) spend in the extractor during preparation of soybean meal (SBM) results in increased relative bioavailability of phosphorus without negatively impacting true amino acid digestibilities, and to compare those modified SBM with that produced from a low-phytate SB. Three SBM were prepared under uniform conditions with the exception of the length of time SB spent in the extractor [45 min (300 rpm), 60 min (225 rpm), or 90 min (150 rpm)]. A SBM prepared from low-phytate SB was obtained for comparison. Relative phosphorus bioavailability in chicks and true amino acid digestibilities by cecectomized roosters were determined. Increasing the length of time that SB spent in the extractor from 45 to 90 min resulted in lower phytate phosphorus and increased phosphorus bioavailability from 34 to 56%. However, this increase came at the expense of available lysine status, with the SBM extracted for 90 min containing less total lysine and less digestible lysine than the SBM extracted for 45 min (traditional extraction time). Phosphorus bioavailability from SBM prepared from low-phytate SB was 1.5 times higher than for SBM extracted for 45 min. Increasing the length of time that SB spend in the extractor led to an increase in bioavailable phosphorus but a decrease in bioavailable lysine, potentially negating the positive effect on phosphorus.

Citric acid improves phytate phosphorus utilization in crossbred and commercial broiler chicks.

Previous research in our laboratory has shown that citric acid (CA) improves phytate P utilization in New Hampshire x Columbian (NHC) crossbred chicks fed a P-deficient corn-soybean meal diet. The current study was conducted to determine if CA is also effective in commercial broiler chicks (Ross x Ross). In 3 experiments, 4 replicate groups of 5 male NHC chicks and male commercial chicks were fed corn-soybean meal diets varying in CA and nonphytate P (NPP) from 8 to 22 d of age. In experiment 1, a 2 x 2 x 2 factorial treatment arrangement was used to evaluate the effect of 2 levels of CA (0 and 3%) and NPP (0.13 and 0.28%) in NHC chicks and commercial chicks. The commercial chicks, but not the NHC chicks, fed the 0.13% NPP diet had to be removed from the experiment after 3 to 5 d due to very poor growth and severe leg problems. Chick weight gain and tibia ash were significantly increased (P < 0.05) by CA in both types of chicks. In experiment 2, the same 2 x 2 x 2 factorial treatment arrangement was again used except that the NPP levels were 0.18 and 0.28%. Tibia ash was increased significantly (P < 0.05) with the addition of CA in both breeds of chicks; response was greater at 0.18% NPP than at 0.28% NPP. In experiment 3, graded levels of CA (0, 1, 2, 3, and 4%) were evaluated in commercial chicks fed diets containing 0.18% NPP. Tibia ash increased linearly (P < 0.05) as CA increased from 0 to 4%. The average increase in bone ash resulting from 3% CA supplementation in experiments 2 and 3 was 41%. These results indicate that CA markedly improved phytate P utilization in NHC and Ross x Ross commercial broiler chicks.

Aggressive angiomyxoma of the female genital tract: a clinicopathologic and immunohistochemical study of 12 cases.

Aggressive angiomyxoma (AAM) is a distinctive neoplasm seen in the female genital tract. We present the clinicopathological findings of 12 female patients with AAM. Immunohistochemical analysis for vimentin, desmin, smooth-muscle actin (SMA), muscle-specific actin (MSA), S-100, CD44, estrogen receptor (ER), and progesterone receptor (PR) was performed. Mean patient age was 39 years (range 20-77 years). Eight tumors arose in the vulva, two in the suburethral area, and two in the perirectal area. Three were pedunculated (two vulvar and one suburethral). Perineal tumors were locally excised, with limited removal of adjacent tissue or tissue surrounding the pedicle base of pedunculated tumors. Perirectal tumors were removed by wide excision. Tumors ranged 2.8-40.0 cm in size. Eleven patients were followed-up (mean 19 months). Recurrence occurred in one patient 48 months after tumor resection from perirectum and abdomen. Immunohistochemistry showed tumor positivity for vimentin (11/11), desmin (8/11), CD44 (8/11), ER (10/12), PR (11/12), and SMA (3/11). MSA and S-100 were negative. In summary, AAM in the perineum especially pedunculated tumors may possibly require only local excision for definitive treatment. Furthermore, the majority of AAM have CD44 expression.

Content and relative bioavailability of phosphorus in distillers dried grains with solubles in chicks.

Total phosphorus analysis was performed on 20 samples of corn distillers dried grains with solubles (DDGS), and three experiments were conducted to determine the bioavailability of P in different samples of DDGS varying in Lys digestibility and heat processing (autoclaving). Relative bioavailability of P was estimated from tibia ash using the slope ratio method after chicks were fed a P-deficient corn-soybean meal diet supplemented with 0.05 or 0.10% P from KH2PO4 or supplemented with 2 levels of the test DDGS (7 to 25%). The mean total P value for the 20 DDGS samples was 0.73 +/- 0.04% (SD), with an average dry matter value of 88 +/- 0.8% (SD). In experiment 1, the bioavailability coefficient for P in a random sample of DDGS relative to KH2PO4 was 69%. In experiment 2, the relative bioavailabilities of P in low digestible Lys DDGS 1, low digestible Lys DDGS 2, and high digestible Lys DDGS 3 were 102, 82 and 75%, respectively (P < 0.05). For experiment 3, the P bioavailability coefficients for a light-colored nonautoclaved DDGS and the same DDGS autoclaved at 121 degrees C and 124 pKa were 75 and 87%, respectively (P < 0.05). Our results showed that the total P content of DDGS was similar to the 0.72% value reported by the NRC (1994), but the relative P bioavailability is higher than the value estimated from NRC (1994) based on table values for total and nonphytate P content. Our results also indicated that there is substantial variability in P bioavailability among different DDGS samples and suggest that increased heat processing may increase the bioavailability of P in DDGS.

Alteraciones en la atención y en el reconocimiento de emociones faciales en esquizofrénicos refractarios y no refractarios al tratamiento, evaluadas a través de un paradigma odd-ball / Impairments in attention and facial emotion recognition in treatment refractory and non refractory schizophrenics evaluated through an odd-ball paradigm

Introducción. Algunos de los procesos afectados en la esquizofrenia son la atención y el reconocimiento emocional. El objetivo de este estudio fue probar varias cuestiones: 1. Si en los esquizofrénicos refractarios (RE) existen mayores alteraciones de la atención que en los no refractarios (NR), evaluados a través de la amplitud del P300 y la ejecución en un paradigma odd-ball con letras como estímulo; 2. Si las alteraciones en el reconocimiento emocional notificadas en los esquizofrénicos se pueden reflejar a través de un paradigma semejante al de letras, especialmente en los refractarios, y 3. Si existe una correlación entre la amplitud del P300 y el grado de psicopatología en ambos subgrupos de pacientes esquizofrénicos. Pacientes y métodos. Se evaluó la ejecución y la amplitud del P300 ante una tarea de letras (TL) y otra semejante de reconocimiento de emociones faciales (EF) bajo un paradigma oddball, en 10 controles normales (CO), 10 NR y 10 RE. Resultados. El tiempo de reacción fue mayor en ambas tareas y en TL, la amplitud del P300 fue menor en NR y RE que en los CO. En EF los RE mostraron menor número de aciertos y mayor de omisiones que los NR y los CO, correlacionada con la dosis de neurolépticos. Únicamente en el grupo NR para EF, existió una correlación negativa entre la amplitud del P300 y las puntuaciones del BPRS y de la escala de síntomas positivos del PANSS. Conclusiones. Los resultados indican que los RE muestran alteraciones semejantes a los NR en la atención y mayores déficit en el reconocimiento emocional relacionados con la dosis de neurolépticos. En los NR, una menor amplitud del P300 estuvo relacionada con un mayor grado de psicopatología sólo en EF (AU)

Abnormal EEG patterns in treatment-resistant schizophrenic patients.

This study was conducted in order to compare the EEG patterns of schizophrenics who do not respond to typical neuroleptics with those who do respond under typical neuroleptic medication and a group of controls. Absolute (AP) and relative power (RP), and inter- and intrahemispheric correlations were calculated. Nonresistant schizophrenics showed lower delta RP, higher alpha 1 AP and RP and higher correlation between prefrontal areas than the resistant ones and controls. Resistant schizophrenics showed lower alpha 2 RP, lower beta 1 and beta 2 in temporal but higher beta 2 AP and RP in occipital derivations, and higher intrahemispheric correlation between Fp2 and F4 and lower between F8 and T4 than the nonresistant and controls. The resistants also showed a higher antero-posterior beta 1 and beta 2 index than the controls. We concluded that the EEG pattern showed by the nonresistants may be associated with their good neuroleptic response that was not present in the resistant schizophrenics.

Immunohistochemical expression of cell cycle proteins E2F-1, Cdk-2, Cyclin E, p27(kip1), and Ki-67 in normal placenta and gestational trophoblastic disease.

The role of cell cycle protein expression in gestational trophoblastic disease is poorly understood. In this study we investigated the immunostaining patterns of G(1) restriction point and G(1)-S regulatory proteins E2F-1, Cdk2, cyclin E, p27(kip1), and the proliferation marker Ki-67 on routinely processed sections of 29 hydatidiform moles (10 partial moles and 19 complete moles, including 9 persistent moles), 7 choriocarcinomas, and 7 normal placentas. Ki-67 trophoblast staining decreased with increasing gestational age of the placenta, and showed maximal expression in gestational trophoblastic disease. Cyclin-dependent kinase activity, as reflected by Cdk2 expression patterns, also decreased with placental maturation. E2F-1 was uniquely expressed by trophoblasts of moles and choriocarcinoma. Cyclin E was maximally expressed by complete moles and choriocarcinomas, and showed an inverse relationship with the cyclin-dependent kinase inhibitor p27(kip1). Abnormal trophoblastic proliferations may be mediated through interactions of Cdk-2, E2F-1, cyclin E, and p27(kip1). Overexpression of cyclin E was associated with more aggressive forms of gestational trophoblastic disease. However, we did not find distinguishing features between complete moles that spontaneously resolved after evacuation and persistent moles that required chemotherapy. The different expression patterns of cyclin E and E2F-1 in partial and complete moles may be useful in distinguishing these two entities. Furthermore, loss of p27(kip1) in malignant trophoblast may represent a necessary step in the development of choriocarcinoma.

Expression of human telomerase reverse transcriptase, the catalytic subunit of telomerase, is associated with the development of persistent disease in complete hydatidiform moles.

OBJECTIVE: This study was undertaken to determine the putative role of telomerase activity and human telomerase reverse transcriptase (hTERT) expression in the development of persistent disease in patients with a diagnosis of complete hydatidiform mole. The ribonucleoprotein telomerase has been shown to have a major role in the process of cellular immortality and carcinogenesis. The reactivation of this enzyme that occurs in the development of malignancies appears to be limited by the regulation of its catalytic subunit hTERT. Compared with their somatic counterparts, most human malignancies demonstrate telomerase activity, and this activity is dependent on the cellular presence of hTERT. The role of telomerase in the pathogenesis of complete hydatidiform moles is not clearly understood. Moreover, the role of hTERT in trophoblastic disease, as well as in the development of persistent trophoblastic disease, has yet to be elucidated. STUDY DESIGN: Telomerase activity and hTERT expression were analyzed in the initial uterine evacuation specimen of 54 complete hydatidiform moles by use of the telomeric repeat amplification protocol assay and reverse transcription-polymerase chain reaction methods. The results were compared and then correlated with the development of persistent trophoblastic disease. RESULTS: Among the 54 patients who were examined with a diagnosis of complete hydatidiform mole, persistent trophoblastic disease requiring postevacuation chemotherapy developed in 6. In the remaining 48 patients, spontaneous remission of the disease occurred after uterine evacuation. Both telomerase activity and hTERT expression were detected in all 6 cases of persistent disease on the initial molar tissue sampled. Among the 48 nonpersistent moles, telomerase activity was detected in 29 (60%) and hTERT expression was demonstrated in 26 (54%). The detection of hTERT expression was significantly associated with the presence of persistent disease (P =.035). Moreover, the absence of hTERT expression in molar tissue obtained from uterine evacuation demonstrated a 100% negative predictability in determining cases of complete mole that were nonpersistent. CONCLUSIONS: Compared with telomerase activity, the expression of hTERT is significantly associated with the development of persistent disease in complete hydatidiform moles. The absence of hTERT expression in the initial tissue sample from complete moles may have potential clinical value in determining patients who will eventually undergo spontaneous remission after uterine evacuation.

[Impairments in attention and facial emotion recognition in treatment of refractory and non refractory schizophrenics evaluated through an odd-ball paradigm]. / Alteraciones en la atención y en el reconocimiento de emociones faciales en esquizofrénicos refractarios y no refractarios al tratamiento, evaluadas a través de un paradigma odd ball.

INTRODUCTION: Some of the processes impaired in schizophrenia are attention and emotional recognition. The aim of this study was to test: 1) if refractory schizophrenics (RS) present higher attentional deficits than non refractory (NR) evaluated through performance and the P300 amplitude in an odd ball paradigm using letters as stimuli; 2) if emotional recognition deficits in schizophrenics can be reflected by means of a similar paradigm than that used for letters, especially in RS, and; 3) if there exist a correlation between P300 amplitude and the level of psychopathology in these patients. PATIENTS AND METHODS: Performance and P300 amplitude were measured during a letter (LE) task and a similar one of facial emotion recognition (ER) applicating an odd ball paradigm, on 10 normal controls (CO), 10 NR and 10 RS. RESULTS: Reaction time was longer in both tasks and in LE, P300 amplitude was lower in NR and RS than in CO. In ER the RS showed a lower number of correct responses and higher of omissions than NR and CO, correlated with neuroleptics doses. A negative correlation between P300 amplitude and the scores of BPRS and PANSS positive symptoms scale was only found for the NR in ER. CONCLUSIONS: Present results point out that RS show similar deficits in relation to attention as NR do, but they show major deficits in emotional recognition related with neuroleptics doses. Furthermore, a lower P300 amplitude for NR was related to a higher level of psychopathology only in EF.

Apoptosis may be an early event of progestin therapy for endometrial hyperplasia.

OBJECTIVE: The aim of this study was to investigate the role of apoptosis during progestin therapy for the treatment of endometrial hyperplasia. METHODS: Pre- and posttreatment paraffin-embedded endometrial tissue samples from 19 women with endometrial hyperplasia were examined for changes in glandular cellularity and apoptotic activity related to the administration of progestins. Twelve patients were successfully treated with progestin therapy and 7 patients failed treatment. Glandular cellularity was assessed based on calculating the average number of cells per gland obtained on histologic examination of hematoxylin and eosin stained tissue sections. Apoptotic activity was assessed on the same tissue sections by counting the average number of apoptotic cells per 10 high power fields (hpf) using the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) assay. The effects of progesterone on apoptotic activity in a low-grade endometrial adenocarcinoma cell line (Ishikawa cells) was also examined using an ELISA cell death detection kit. RESULTS: Glandular cellularity significantly decreased with progestin therapy in both treatment outcome groups. The reduction in cells per gland was significantly greater in the group of successfully treated cases compared to the treatment failures (P = 0.005). However, within the successfully treated group, in situ detection of apoptotic cells using the TUNEL assay showed no statistical difference between pre- and posttreatment endometrial samples. Interestingly, a significant decrease in apoptosis was found in posttreatment samples of the group with persistent hyperplasia. The average number of apoptotic cells detected in 10 hpf was reduced from 7.9 prior to treatment to 3.1 after progestin therapy (P = 0.03). In the progesterone-treated Ishikawa cell line, an increase in apoptotic activity started at 24 h, reached a peak at 48 h, and continued up to 72 h of hormone treatment. At 48 h, apoptotic activity was 42.6% greater than in the untreated control (P = 0.04). By 72 h of progesterone treatment, apoptosis was 37.2% greater in the treated cells compared to the noninoculated cells (P = 0.04). CONCLUSIONS: Progestin-induced apoptosis may occur during the early period of treatment for endometrial hyperplasia. Compared to the fully responsive group, persistent endometrial hyperplasia may have intrinsically different molecular mechanisms in response to progestin therapy.

Down-regulation of bcl-2 is a potential marker of the efficacy of progestin therapy in the treatment of endometrial hyperplasia.

OBJECTIVE: The objective of this study was to evaluate the expression of bcl-2, a regulatory protein in programmed cell death, in endometrial hyperplasia before and after progestational therapy. METHODS: Pre- and posttreatment paraffin-embedded endometrial tissue samples from 20 women with an initial diagnosis of endometrial hyperplasia were obtained from archived files. Cases were evaluated and classified as either complete resolution of hyperplasia or persistent hyperplasia in response to progestin treatment. Sections were examined for bcl-2, estrogen receptor, and progesterone receptor expression using immunohistochemistry and compared within the treatment response groups. RESULTS: Among the 20 women studied, 13 had complete regression of their hyperplasia with progestin treatment and 7 had evidence of persistent disease after therapy. Bcl-2 expression was significantly decreased after treatment from a mean reactivity score of 2.08 to 0.31 (P = 0.0005) in the group of patients whose hyperplasia completely regressed with progestin administration. Among the women who had persistent hyperplasia after therapy, no significant change was observed between pre- and posttreatment bcl-2 expression, with a mean reactivity of 1.86 to 1. 29, respectively (P = 0.075). Progestational therapy significantly decreased the status of estrogen receptors from a mean score of 2.08 to 0.46 (P = 0.0005) in completely resolved cases of hyperplasia and from 2.00 to 0.43 (P = 0.0025) in persistent hyperplasias. Treatment also significantly decreased the status of progesterone receptors from a mean reactivity score of 1.92 to 0.31 (P = 0.0005) in cases of regressed hyperplasia and from a mean reactivity of 1.86 to 0.29 (P = 0.005) in persistent cases of hyperplasia. CONCLUSIONS: Bcl-2 expression decreases following successful progestin treatment of endometrial hyperplasias, whereas it remains expressed in hyperplasias which persist despite progestational therapy. This suggests that bcl-2 expression may represent a component of the therapeutic effects exerted in the endometium during progestational therapy in the treatment of hyperplasia. The activity of the oncoprotein may be a potential measure of the progress of treatment.

Transrectal ultrasonography: relationship with anorectal manometry, electromyography and sensitivity tests in irritable bowel syndrome.

Irritable bowel syndrome is the most frequently diagnosed disorder in gastroenterology. It has been demonstrated with specialized motility studies that these patients compared to healthy subjects show changes in rectoanal electrical and mechanical activity and in rectoanal sensitivity. However, until now no report has been published on morphological alterations in the rectum or the internal anal sphincter. Twenty-five consecutive patients with irritable bowel syndrome (mean age 32, range 17-47 years; 24 females) were evaluated prospectively by transrectal ultrasonography, rectal sensitivity studies, and recordings of both electrical and mechanical activity of the distal rectum and internal anal sphincter during a 2-h inter-digestive period. Ten healthy volunteers (mean age 34.5, range 19-50 years) served as a control group. Paired and non-paired Student's two-tailed t test and linear regression analysis were used. It was shown that muscle thickness of the rectum during rest (4.7 +/- 0.1 mm) was correlated neither with its rectal spike amplitude (0.73 +/- 0.1 mV) nor with rectal spike frequency (17.06 +/- 3.6 spike/2 h). In addition, the diameter of the internal anal sphincter (1.2 +/- 0.1 mm) was correlated neither with its resting pressure, nor with frequency (17.1 +/- 3.2/2 h), duration (14.9 +/- 1.5 s), or amplitude (14.1 +/- 1.9 mmHg), of inhibition of the spontaneous rectoanal inhibitory reflex. No correlation was found between ultrasonographic parameters and rectal distension variables (r = 0.03). This study demonstrates for the first time morphological anorectal changes in patients with irritable bowel syndrome compared to healthy subjects, in addition to showing that morphological changes are independent of physiological ones. Therefore both transrectal ultrasonography to determine anorectal morphology and electromanometry to assess anorectal function are important measures in the evaluation of patients with irritable bowel syndrome.

Smoking cessation in Texas-Mexico border communities: a quasi-experimental panel study.

UNLABELLED: BACKGROUDd. Smoking-related disease and injury is prominent among the numerous health problems on the U.S.-Mexico border, but little is known about the methods that might help promote smoking cessation among the low-income populations in this region. METHOD: Media campaigns were combined with different forms of intensive and community-wide interpersonal communication to encourage smoking cessation in a border U.S. city and in a Mexican city. Panels of moderate to heavy smokers were followed in four groups to allow quasi-experimental comparison of smoking cessation rates. RESULTS: Over a five-year study period smoking cessation rates of 17% (self-reported) and 8% (verified) were observed in panels in the program community (N = 160). In the comparison community (N = 135) corresponding rates of smoking cessation were 7% (self-reported) and 1.5% (verified). Within the program community, no differences were observed in smoking cessation among smokers exposed to a community-wide program and those assigned to receive personal counseling. DISCUSSION: Although the observed changes in smoking were unexpectedly small in the treatment and comparison groups, the approximately 8% effect size for the community-wide program was close to what was predicted. Results indicate that such programs may yield effects similar to those of more intensive approaches, but further research with greater statistical power will be necessary to confirm that point.