Risk factors for 30-day hospital readmission in patients with diabetic foot.

INTRODUCTION: Diabetic foot (DF) is part of the natural history of diabetes mellitus, ulceration being a severe complication with a prevalence of approximately 6.3 %, which confers a significant economic burden. Hospital readmission in the first thirty (30) days is considered a measure of quality of healthcare and it's been identified that the most preventable causes are the ones that occur in this period. This study seeks to identify the risk factors associated with readmission of patients with DF. METHODS: A case-control study was done by performing a secondary analysis of a database. Descriptive statistics were used for all variables of interest, bivariate analysis to identify statistically significant variables, and a logistic regression model for multivariate analysis. RESULTS: 575 cases were analyzed (113 cases, 462 controls). A 20 % incidence rate of 30-day readmission was identified. Statistically significant differences were found in relation to the institution of attention (Hospital Universitario de la Samaritana: OR 1.9, p value < 0.01, 95 % CI 1.2-3.0; Hospital Universitario San Ignacio: OR 0.5, p value < 0.01, 95 % CI 0.3-0.8) and the reasons for readmission before 30 days, especially due to surgical site infection (SSI) (OR 7.1, p value < 0.01, 95 % CI 4.1-12.4), sepsis (OR 8.4, p value 0.02, 95 % CI 1.2-94.0), dehiscence in amputation stump (OR 16.4, p value < 0.01, 95 % CI 4.2-93.1) and decompensation of other pathologies (OR 3.5, p value < 0.01, 95 % CI 2.1-5.7). CONCLUSION: The hospital readmission rate before 30 days for our population compares to current literature. Our results were consistent with exacerbation of chronic pathologies, but other relevant variables not mentioned in other studies were the hospital in which patients were taken care of, the presence of SSI, sepsis, and dehiscence of the amputation stump. We consider thoughtful and close screening of patients at risk in an outpatient setting might identify possible readmissions.

Pérdida de espacio en la arcada dentaria según el tiempo trancurrido entre la exodoncia prematura de un diente temporario y la colocación de un mantenedor de espacio / Loss of space in the dental arch according to the time elapsed between the premature extraction of a deciduous tooth and placing a space maintainer

Una de las funciones vitales de la dentición temporaria es conservar el espacio necesario para la erupción natural correcta de los dientes permanentes. Los dientes temporarios son mantenedores de espacio naturales; el cuidado del espacio de la arcada dental es fundamental desde el nacimiento hasta completar el recambio dentario para lograr la estética y la funcionalidad del sistema estomatognático. Se realizó un estudio experimental con el objetivo de determinar la pérdida del espacio en la arcada dentaria luego de la exodoncia prematura de molares temporarios y la colocación de mantenedores de espacio en tiempo diferente de tres grupos en 10 niños cada uno. La muestra estuvo constituida por 30 niños de ambos sexos de 4 a 10 años con indicación de extracción prematura de molares temporarios, que acudieron a la Facultad de Odontología de la Universidad Nacional de Asunción, durante el año 2009; se manipuló el tiempo transcurrido entre la exodoncia y la colocación de mantenedores de espacio, el primer grupo recibió inmediatamente el mantenedor, el segundo una semana después y el tercero al cabo de dos semanas. Se utilizó la prueba de Kruskal-Wallis para comparar la pérdida del espacio entre los grupos. Se concluyó que al realizar la exodoncia existe pérdida de espacio, aún en los casos de colocación inmediata y que los milímetros perdidos son proporcionales al tiempo transcurrido entre la exodoncia y la colocación del mantenedor

[Evaluation of the information given to parents during the planned preanaesthetic consultation in a paediatric hospital]. / Evaluation de l'information donnée aux parents en consultation préanesthésique programmée dans un hôpital pédiatrique.

INTRODUCTION: Information given to the parents of paediatric patients during the preanaesthetic consultation (CS) must be understandable. OBJECTIVE: We have studied the impact of this information given during CS. METHODS: Prospective study over four months with a questionnaire completed by parents after CS and before the hospitalization. The Sfar information booklet was given to the parents before CS. The study evaluated whether the information had been given ("have you received the information on...?"), understood ("Did you understand...?"), and if CS had influenced anxiety of parents/child; on four items of information, anesthetic risk, transfusion, postoperative pain, and anesthetic technique. The questionnaire noted also the parents sociocultural level (NSC), and if they had read the Sfar booklet. Statistical analysis (descriptive, uni-, multivariate), p<0.05. RESULTS: Four hundred questionnaires were distributed, 334 were analyzed. The information on the four items was considered to have been given in 75%, understood 72%, and to have diminished anxiety 68%. These results were not influenced by whether or not (88%) parents had read the Sfar booklet. How much information was given was a function of the physician giving the information. Elevated NSC and amount if information given improved comprehension optimized. Diminution of anxiety was when all four items were understood, CS was performed by a senior physician and the parent's NSC was high. DISCUSSION: Information better adapted to NSC may improve the quality of CS. The Sfar booklet does not contribute to parents understanding in this context.

Documentation of subtype C HIV Type 1 strains in Argentina, Paraguay, and Uruguay.

HIV subtypes B, F, and BF recombinants have been previously reported in South America. This report describes the presence of HIV-1 subtype C infection in the countries of Argentina, Uruguay, and Paraguay dating back to at least 1999. Surveillance for uncommon non-B/non-F subtype viruses circulating in South America has been conducted in samples obtained from nine countries. Peripheral blood mononuclear cells (PBMC), dried filter paper (FP), and fresh blood (FB) samples were collected from HIV-positive patients from Ecuador, Colombia, Venezuela, Peru, Chile, Bolivia, Argentina, Uruguay, and Paraguay. From a total of 2962 HIV seropositive samples examined during a 9-year period (1995-2003), only 11 (0.4%) were found to be infected with non-B/non-F HIV variants. Eight of these 11 strains were determined to be subtype C by heteroduplex mobility assay (HMA). Five of these 8 strains were further characterized by sequencing and phylogenetic analysis of the protease (Pro) and reverse transcriptase (RT) region of the genome and two were sequenced full length. One of the strains was found to be a unique BC recombinant. The spread of a third subtype of HIV, subtype C, should raise the question of its potential future role in the HIV epidemic in this region.

Indolent systemic mast cell disease: immunophenotypic characterization of bone marrow mast cells by flow cytometry.

BACKGROUND: Mast cell disease has a low prevalence and is difficult to diagnose in the absence of the characteristic skin lesions that usually accompany the condition. Extracutaneous involvement is not easy to assess. There are reports in the recent literature on the use of tryptase as a reliable immunohistochemical marker as well as on the study of the immunophenotype of bone marrow mast cells. The latter is of great help for the diagnosis of systemic involvement as, after the skin, the bone marrow is the organ most commonly affected by the disease. OBJECTIVE: We describe two cases of indolent systemic mast cell disease (SMCD) where flow cytometry was used to identify immunophenotypical characteristics of bone marrow mast cells. Recent advances in the application of this technique prove it can be a good diagnostic tool for assessing systemic involvement of the disease. PATIENTS AND METHODS: Two adult subjects with indolent SMCD had multiple clinical symptoms. Cutaneous lesions were the clue to the diagnosis but, subsequently, in the presence of disturbing symptoms, involvement of other organ systems was confirmed. In both cases, the authors used flow cytometry techniques, as described by Escribano et al. (1998) to define the immunophenotype of bone marrow mast cells. RESULTS: Both patients were diagnosed with indolent SMCD with cutaneous and bone marrow involvement. Also, they presented visible clues to the presumptive bone, cardiovascular and nervous system involvement. Gastrointestinal manifestations were documented in one case. CONCLUSIONS: The use of flow cytometry on bone marrow samples from patients with mastocytosis reveals immunophenotypic differences that can serve to allow classification of these subjects in the category of indolent SMCD even though involvement of another organ system may not be thoroughly confirmed.

Early effects of insulin-like growth factor-1 in activated human T lymphocytes.

This study evaluates the effects of insulin-like growth factor (IGF)-1 receptor (IGF-1R) down-regulation in stimulated T lymphocytes by investigating the expression of early activation proteins CD69, CD25, and interleukin (IL)-2. We found that IGF-1 does not modify CD69 expression but increases transcription and protein synthesis of CD25 and IL-2. The lowest level of IGF-1R detected after 15 min of activation suggested that the effects of IGF-1 occur at the initiation of cell activation. The activation of IGF-1R was confirmed by IGF-1R phosphorylation and increased phosphorylation of microtubule-associated protein kinase. We also detected the alternative IGF-1 transcripts Ea, with paracrine/autocrine regulation, and Eb, with endocrine regulation, in Jurkat cells and in quiescent T lymphocytes, and we detected IGF-1 protein in the culture medium after stimulation. These data suggest that the proliferative effects of IGF-1 on T lymphocytes include both autocrine/paracrine and endocrine processes.

Emerging genetic diversity of HIV-1 in South America.

OBJECTIVE: Genotype determination and risk group analysis of HIV-1 infected individuals in selected regions of South America. DESIGN: Cross-sectional convenience sampling of HIV-1-positive individuals in Peru, Ecuador, Uruguay and Paraguay from March, 1994 through September, 1998. METHODS: HIV-1-positive subjects were identified through the national AIDS surveillance program in each country. A standardized questionnaire was used to obtain demographic, clinical and risk factor data on each study subject. Viral DNA was extracted from participants' peripheral blood mononuclear cells either directly or after co-cultivation. A nested PCR was used to obtain selected fragments of the envelope genes for genotyping by the heteroduplex mobility assay (HMA). A 600 bp sequence encompassing the V3 loop was sequenced from a selection of 23 of these samples for phylogenetic analysis and confirmation of HMA genotype. RESULTS: Among the 257 successfully genotyped HIV-1-positive samples, genotype B was found in 98.3% (228/232) of those obtained from subjects in Peru, Ecuador, and Paraguay. In contrast, 56% (14/25) of the samples from Uruguay were genotype F, and the remainder were genotype B. Genotype F was detected for the first time in Peru (2/224) and Paraguay (1/4), and genotype A for the first time in Peru (1/224). Phylogenetic analysis confirmed the genotype identified by HMA in the 23 samples sequenced. There was no detectable genetic clustering of HIV-1 within the different high-risk groups or geographic locations. CONCLUSIONS: These findings verify and extend the presence of several different HIV-1 genotypes in South America.

Flow cytometric analysis of intestinal intraepithelial lymphocytes in a model of immunodeficiency in Wistar rats.

BACKGROUND: We have shown, in a rat model of immunodeficiency, permanent alterations in the thymus and in the gut-associated lymphoid tissues. We observed by immunohistochemistry an increase in the number of gamma/delta+ T cells in the gut lamina propria and in the number of CD8alpha/alpha+, CD25+, gamma/delta+ subpopulations of intestinal intraepithelial lymphocytes (iIEL). The aim of the present study was to analyze the isolated rat iIEL by flow cytometry. Materials and Methods Cells from mesenteric lymph nodes were examined in parallel with isolated iIEL. After staining with different antibodies, samples were run on a FACScan flow cytometer. Background staining was evaluated using isotype controls. Data analysis was performed using Lysys II software (Becton Dickinson) and WinMDI 2.3 software. RESULTS: 1) CD8alpha/beta populations do not express TCRgamma/delta, 2) CD8alpha/alpha+ populations express TCRgamma/delta, and its percentage is significantly increased in R21, 3) CD8alpha/beta and CD8alpha/alpha iIEL express TCRalpha/beta, being the percentage of CD8alpha/alpha+ TCRalpha/beta+ iIEL increased and the percentage of CD8alpha/beta+ TCRalpha/beta+ iIEL decreased in R21, and 4) CD8alpha/alpha as well as CD8alpha/beta iIEL do express CD25 only in R21. CONCLUSIONS: Considering the above results, we conclude that there exists an "in situ" origin and extrathymic maturation of the CD8alpha/alpha+ iIEL in the intestinal epithelium. The increase of TCRgamma/delta+ T cells may be triggered by the carbohydrate dextrin, to provide immune protection and control of inflammation at the intestinal level.

Manejo del tétanos neonatal en una unidad de cuidados intensivos pediátricos / Management of neonatal tetanus in a pediatric intensiv care unit

Introcucción. El tétanos neonatal sigue constituyendo un problema de salud pública en Latinoaméerica y los países en vías de desarrollo. El objetivo del presente estudio ha sido analizar la experiencia de una serie de casos de tétanos neonatal que fueron atendidos en la Unidad de Cuidados Intensivos Pediátricos (UCIP) del Hospital de Clínicas de Asunción, Paraguay. Material e Método. Estudio de diseño retrospectivo basado en la revisión de historias clínicas de neonatos ingresados en la UCIP del Hospital de Clínicas con el diagnóstico de tétanos neonatal grave según criterios clínicos y antecedentes epidemiológicos. Resultados. Entre enero de 1990 y enero de 1997 fueron hospitalizados en la UCIP del Hospital de Clínicas 6 pacientes con diagnóstico de tétanos neonatal. Todos fueron recién nacidos de término e la relación M/F fue 2/1. La edad media a la admisión fue de 8,6 días. El período de Cole's varió entre 24 y 144 hs. Todos fueron asistidos con ventilación mecánica (VM), sedación y relajación con drogas. El promedio de VM fue de 21,6 días y el promedio de internación en UCIP fue de 25,5 días. El diazepán fue usado para sedación en infusión intravenosa continua hasta una dosis de 4mgkg/h. Las complicaciones más frecuentes observadas fueron la neumonía nosocomial (100 por ciento), sepsis (66,6 por ciento), atelectasias (66,6 por ciento). La mortalidade de la serie fue del 16,6 por ciento (1 de 6 casos). Discusión. El tétanos neonatal sigue siendo una importante causa de morbimortalidad en el Paraguay. Aunque la mortalidad es elefada en las series manejadas sin suporte de cuidados intensivos, nuestra experiencia demuestra que la asistencia en unidades de cuidados intensivos disminuye considerablemente la mortalidad neonatal por tétanos. Representa, sin embargo, una terapéutica costosa y compleja en una enfermedad absolutamente prevenible por vacunas

Downregulation of insulin-like growth factor-1 receptor (IGF-1R) expression in human T lymphocyte activation.

Although it is known that IGF-1 increases T lymphocyte proliferation, the regulation of its receptor expression during the process has not been defined. Consequently the regulation of IGF-1R expression by IGF-1 and the activation events in human blood T lymphocytes and the Jurkat T cell line were now investigated. IGF-1R expression in nonstimulated Jurkat cells was confirmed and downregulation by IGF-1 was demonstrated. In addition, both cell types showed a time-dependent reduction in the number of IGF-1R-positive cells following activation, which was increased by IGF-1. In Jurkat cells the negative regulation of IGF-1R levels was correlated with the appearance and continuous increase in IL-2R. In T lymphocytes the decrease in IGF-1R expression was faster, reaching its plateau after 3 h of activation. Our findings suggest that loss of the IGF-1R is one of the initial events of the activation process not regulated by IL-2.

manejo del tétano neonatal en una unidad de cuidados intensivos pediátricos / Neonatal tetanos managment in a pediatric intensive care unit

Introducción. El término neonatal sigue constituyendo un problema de salud pública en Latinoamérica y los países en vías de desarrollo. El objetivo del presente estudio ha sido analizar la experiencia de una seri de caso de tétanos neonatal que fueron atendidos en la Unidad de Cuidados Intensivos Pediátricos (UCIP) del Hospital de Clínicas de Asuncion, Paraguay. Material y Métodos. Estudio de diseño retrospectivo basado en la revision de historias clínicas de neonatos ingresados en la UCIP dle Hospital de Clínicas con el diagnostico de tétanos neonatal grave según criterios clínicos y antecedentes epidemiológicos. Resultados. Entre enero de 1990 y enero de 1997 fueron hospitalizados en la UCIP del Hospital de Clínicas 6 pacientes con diagnóstico de tétanos neonatal. Todos fueron recién nacidos de término y la relación M/F fue 2/1. la edad media a la admisión fue de 8,6 días. El periódo de incubación fue de 5,6 días. El periódo de Cole's varió entre 24 y 144 hs. Todos fueron asistidos con ventilación mecánica (VM), sedación y relajación con drogas. El promedio de VM fue 21,6 días y el promedio de internación en UCIP fue de 25,5 días. el diazepan fue usado para sedación en infusión intravenosa continua hasta una dosis de 4 mgkg/h. Las complicaciones más frecuentes observadas fueron la neumonia nosocomial (100 porciento), sepsis (66,6 porciento), atelectasis (66,6 porciento). La mortalidad de la serie fue del 16,6 porciento (1 de 6 casos). Discusión. El tétano neonatal sigue siendo una importante causa de morbilidad en el Paraguay. aunque la morrtalidad es elevada en las series manejadas sin soporte de cuidados intensivos, nuestra experiencia demuestra que la asistencia en unidades de cuidados intensivos disminuye considerablemente la mortalidad neonatal por tétanos. Tepresenta, sin embargo, una terapeutica costosa y compleja en una enfermedad absolutamente prevenible por vacunas.

Longitudinal study of periodontal condition in students of the Dental School the University of Buenos Aires Argentina.

The aim of the present study was to describe, clinically and radiographically, the gingivoperiodontal condition of students (young adults) entering the Dental School and reassess it 2 years later. Four hundred and seventy-five students, 147 male and 328 female (mean: 19.66 years) were studied (Initial examination: IE); two years later, 240 students 76 male and 164 female were reevaluated (Final examination: FE). The clinical examination include Plaque Index (P1I), Gingival Index (GI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD), and Attachment Level (AL). Alveolar bone level was measured on bite wing radiographs. At the IE, 46.5% of the sites had no visual signs of inflammation and 65.3% did not bleed on probing, however 91% of the students had at least one site with BOP. (Prevalence). Of the total sites probed 99.47% had crevices between 1 to 4 mm. 92% had AL between 0 to 1 mm. And only 7.9% had AL > 1 mm. 49.6% of the students had at least one site with AL > 1 mm. Prevalence of alveolar bones loss > 2 mm. was 2.95% and in no case measurements exceeded 3 mm. Distal of teeth 16 and 36 showed the highest P1I, GI, PPD and AL, therefore these teeth showed the highest risk of pathology in the population studied. In the final examination 70.5% of the sites had GI 0 and 73% did not bleed on probing. 90.4% of the students had at least one site with BOP. No statistically significant difference in PPD nor in AL was found between IE and FE. In this population of young adults prevalence of gingivitis was high but severity was low. Prevalence of loss of attachment was near 50% but only 7.9% of the sites had AL > 1 mm. After studying dentistry for two years the prevalence of gingivitis was similar but the severity was lower. Periodontal condition was not substantially modified.

Control de calidad en laboratorios de análisis clínicos a través de un programa de intervención educativa / Quality assessment in clinical laboratories throught on educative program

Estudios previos dirigidos a conocer el estado de calidad en química clínica de los laboratorios en Paraguay, revelaron inexactitud en los resultados y falta de conocimientos en control de calidad. Esto llevó a realizar este estudio de diseño experimental, con el objeto de investigar si cambia la calidad de los resultados emitidos por los laboratorios del Area Metropolitana de Asunción, con un programa educativo en control de calidad, con y sin seguimiento sistemático a los laboratorios participantes. De los 71 laboratorios participantes el 25 por ciento (18/17) fueron públicos y el 75 por ciento (53/71) fueron privados, de un total de 150 laboratorios registrados. Por selección al azar, 37 laboratorios conformaron el grupo de intervención con seguimiento y los 34 restantes del conjunto el grupo de intervención sin seguimiento. Las mediciones realizadas al inicio del estudio, a los 6 y 12 meses post-intervención fueron, el nivel de conocimiento del bioquímico responsable designado por el laboratorio y el nivel de exactitud de los resultados emitidos. Teniendo como instrumentos, un cuestionario de autorreporte y una encuesta serológica de exactitud. Las medidas de intervención proporcionadas a ambos grupos fueron, un manual y un curso básico de control de calidad interna en química clínica. El grupo de intervención con seguimiento recibió, además, jornadas teórico prácticas y material de control para implementar un control interno de precisión. En las mediciones realizadas al inicio del estudio no hubo diferencia en los grupos de intervención, detectándose 65 por ciento resultados insatisfactorios en exactitud y 53 por ciento de profesionales con resultados insatisfactorios en conocimientos de control de calidad. En las mediciones realizadas a los 6 y 12 meses en los 71 laboratorios, sin distinción de grupo, mejoró el nivel de conocimiento (p < 0,05). Lo que constata que el programa educativo empleado fue bueno. En las mediciones del nivel de exactitud no cambiaron los resultados en los grupos de estudio (p > 0,05). Sin embargo, el grupo con seguimiento sistemático, tuvo un incremento de los resultados satisfactorios de 32 por ciento a 41 por ciento y 38 por ciento respectivamente, sin ser estadísticamente significativo (p > 0,05). Los que mejoraron su exactitud fueron aquellos que ya trabajaban con precisión e implementaron medidas preventivas y correctivas en el trabajo diario. Mientras que en los laboratorios que no mejoraron, detectamos problemas de mala organización administrativa y falta de interés en adoptar medidas de control. Los resultados de este estudio sugieren que la duración del seguimiento sistemático educativo fue probablemente insuficiente para que el profesional de nuestro país adopte sistemas de control de calidad en el laboratorio y así poder mejorar la exactitud de los resultados emitidos. Siendo probablemente necesaria una educación continua que se inicie a nivel pregrado

Control de calidad en laboratorios de análisis clínicos a través de un programa de intervención educativa / Quality assessment in clinical laboratories throught on educative program

Estudios previos dirigidos a conocer el estado de calidad en química clínica de los laboratorios en Paraguay, revelaron inexactitud en los resultados y falta de conocimientos en control de calidad. Esto llevó a realizar este estudio de diseño experimental, con el objeto de investigar si cambia la calidad de los resultados emitidos por los laboratorios del Area Metropolitana de Asunción, con un programa educativo en control de calidad, con y sin seguimiento sistemático a los laboratorios participantes. De los 71 laboratorios participantes el 25 por ciento (18/17) fueron públicos y el 75 por ciento (53/71) fueron privados, de un total de 150 laboratorios registrados. Por selección al azar, 37 laboratorios conformaron el grupo de intervención con seguimiento y los 34 restantes del conjunto el grupo de intervención sin seguimiento. Las mediciones realizadas al inicio del estudio, a los 6 y 12 meses post-intervención fueron, el nivel de conocimiento del bioquímico responsable designado por el laboratorio y el nivel de exactitud de los resultados emitidos. Teniendo como instrumentos, un cuestionario de autorreporte y una encuesta serológica de exactitud. Las medidas de intervención proporcionadas a ambos grupos fueron, un manual y un curso básico de control de calidad interna en química clínica. El grupo de intervención con seguimiento recibió, además, jornadas teórico prácticas y material de control para implementar un control interno de precisión. En las mediciones realizadas al inicio del estudio no hubo diferencia en los grupos de intervención, detectándose 65 por ciento resultados insatisfactorios en exactitud y 53 por ciento de profesionales con resultados insatisfactorios en conocimientos de control de calidad. En las mediciones realizadas a los 6 y 12 meses en los 71 laboratorios, sin distinción de grupo, mejoró el nivel de conocimiento (p < 0,05). Lo que constata que el programa educativo empleado fue bueno. En las mediciones del nivel de exactitud no cambiaron los resultados en los grupos de estudio (p > 0,05). Sin embargo, el grupo con seguimiento sistemático, tuvo un incremento de los resultados satisfactorios de 32 por ciento a 41 por ciento y 38 por ciento respectivamente, sin ser estadísticamente significativo (p > 0,05). Los que mejoraron su exactitud fueron aquellos que ya trabajaban con precisión e implementaron medidas preventivas y correctivas en el trabajo diario. Mientras que en los laboratorios que no mejoraron, detectamos problemas de mala organización administrativa y falta de interés en adoptar medidas de control. Los resultados de este estudio sugieren que la duración del seguimiento sistemático educativo fue probablemente insuficiente para que el profesional de nuestro país adopte sistemas de control de calidad en el laboratorio y así poder mejorar la exactitud de los resultados emitidos. Siendo probablemente necesaria una educación continua que se inicie a nivel pregrado (AU)

Fine needle aspiration for flow cytometry immunophenotyping of non Hodgkin lymphoma.

The aim was to evaluate the usefulness of lymph node biopsies obtained by fine needle aspiration (FNA) for immunophenotyping of non Hodgkin lymphoma (NHL). Seventeen superficial and deep lymph node samples were fractioned for conventional cytological examination and immunophenotyping studies. Out of ten NHL, nine were readily detected by flow cytometry (FC), while failure on the remaining case was due to selective loss of large cell population, which is liable to occur with this procedure. A single case, which proved negative for all markers employed, was finally diagnosed by immunohistochemistry as germ cell tumor. The other six cases, presenting lymphoid population without phenotypic abnormalities, were diagnosed by cytology and/or histology as Hodgkin disease or hyperplasic disorders. To conclude, FC immunophenotyping seems to improve the efficacy of FNA in NHL diagnosis, whereas for Hodgkin disease and hyperplasic disorders, classic morphological criteria are more useful for differential diagnosis. Although FNA for FC immunophenotyping cannot replace histopathological examination for NHL diagnosis, it proves to be a useful tool for staging and follow up, making surgical procedures for sample collection unnecessary.

Fine needle aspiration for flow cytometry immunophenotyping of non Hodgkin lymphoma.

The aim was to evaluate the usefulness of lymph node biopsies obtained by fine needle aspiration (FNA) for immunophenotyping of non Hodgkin lymphoma (NHL). Seventeen superficial and deep lymph node samples were fractioned for conventional cytological examination and immunophenotyping studies. Out of ten NHL, nine were readily detected by flow cytometry (FC), while failure on the remaining case was due to selective loss of large cell population, which is liable to occur with this procedure. A single case, which proved negative for all markers employed, was finally diagnosed by immunohistochemistry as germ cell tumor. The other six cases, presenting lymphoid population without phenotypic abnormalities, were diagnosed by cytology and/or histology as Hodgkin disease or hyperplasic disorders. To conclude, FC immunophenotyping seems to improve the efficacy of FNA in NHL diagnosis, whereas for Hodgkin disease and hyperplasic disorders, classic morphological criteria are more useful for differential diagnosis. Although FNA for FC immunophenotyping cannot replace histopathological examination for NHL diagnosis, it proves to be a useful tool for staging and follow up, making surgical procedures for sample collection unnecessary.

Antitumor activity of some ruthenium derivatives in human colon cancer cell lines in vitro.

Six ruthenium derivatives were evaluated in vitro in two human colon cancer cell lines (SW707 and SW948) utilizing the microculture tetrazolium test (MTT) and cell counting with a Coulter Counter. The ruthenium compound sodium-(tetrachloroimidazoledimethylsulfoxideruthenate)- bisdimethylsulfoxide (Na(RuDMSOimCl4)) showed the best efficacy in inhibiting cell proliferation of both colon cancer cell lines followed by the other DMSO ruthenium compound sodium-(tetrachloroindazoledimethylsulfoxideruthenate) - bisdimethylsulfoxide (Na(RuDMSOIndCl4)), as demonstrated by IC50 values (80 and 90 micrograms/ml in SW707 and SW948 cell lines for Na(RuDMSOImCl4); 155 and 165 micrograms/ml in SW707 and SW948 cell lines for Na(RuDMSOIndCl4), respectively). Out of the ruthenium derivatives without DMSO, transindazolium - [tetrachlorobis(1H - indazole)ruthenate (III,N2)] (HInd[RuInd2Cl4(N2)]), was as active as its DMSO-containing congener whereas trans-imidazolium- [tetrachlorobisimidazoleruthenate)(III)], (HIm(RuIm2Cl4)) was less active, as shown by the IC50 values: (HIm (RuIm2Cl4) = 250 and 260 micrograms/ml in cell lines SW707 and SW948; HInd[RuInd2Cl4(N2)] = 110 and greater than 200 micrograms/ml in cell lines SW707 and SW948, respectively). The other ruthenium derivatives containing pyrazole and triazole as ligands (trans - pyrazolium (tetrachlorobispyrazoleruthenate) (III), PzH(RuPz2Cl4) and triazolium(tetrachlorobistriazoleruthenate) (III), TrH(RuTr2Cl4)) were active only at high concentrations that cannot be regarded as realistic in vivo, as shown by the respective IC50 values: (PzH(RuPz2Cl4) = 1056 and 750 micrograms/ml in cell lines SW707 and SW948; TrH(RuTr2Cl4) = 350 and 300 micrograms/ml in cell lines SW707 and SW948). The promising activity of ruthenium compounds with DMSO, indazole and imidazole as ligands should be evaluated in vivo for elucidating their possible role in the treatment of colorectal cancer.

Activity of two platinum-linked phosphonic acids against autochthonous rat colorectal cancer as well as in two human colon-cancer cell lines.

Two new platinum-containing phosphonate compounds, cis-diammine[nitrilotris(methylphosphonato)(2-)- O1,N1]platinum(II) (AMDP) and cis-cyclohexane-1,2-diamine[nitrilotris(methylphosphonato) (2-)-O1,N1]platinum(II) (DADP) were investigated in acetoxy-methyl-methylnitrosamine-induced autochthonous colorectal rat adenocarcinoma in vivo as well as in two human colon-cancer cell lines (SW707 and SW948) in vitro. In the in vivo model, the two compounds were given i.v. at doses of 8 and 13 mg/kg as well as p.o. at 16 and 26 mg/kg twice a week for 10 weeks, respectively. AMDP produced more intensive toxicity at both doses but showed higher antitumour activity only following i.v. administration. On the other hand, DADP caused significant tumour-growth inhibition after both modes of application, but as it produced only low toxicity, its use should be favoured. The in vitro assays were performed using two cell lines derived from human colorectal adenocarcinomas. According to the microculture tetrazolium test (MTT) AMDP (IC50, 34 and 59 microM in SW707 and SW948, respectively) was more effective than DADP (IC50, 412 and 660 microM in SW707 and SW948, respectively) in inhibiting cell growth. Based on cell counts AMDP (IC50, 8 and 11 microM in SW707 and SW948, respectively) and DADP (IC50, 266 and 285 microM in SW707 and SW948, respectively) showed more intensive antiproliferative efficacy as determined by the Coulter Counter method vs the MTT assay. The promising activities of these new platinum-linked phosphonic acids in autochthonous rat colorectal carcinoma and in human colorectal cancer cell lines warrant further investigations of compounds of this class to elucidate their role in the treatment of colorectal cancer.

[Excision of epididymal neoformations with microsurgical techniques. Notes on operating technique]. / Escissione delle neoformazioni epididimarie con tecnica microchirurgica. Nota di tecnica operatoria.

Following a broad review of the literature on the topic, the paper illustrates the technique of removing epididymal neoformations using a microscope which proves to be extremely useful not only during the delicate phase of isolating pathological formations, the majority of which are not more than 1.5 cm in diameter, but above all during the careful process of reconstructing damaged structures. The use of microsurgery is particularly important since it is extremely accurate and non-invasive, both of which attributes are fundamental to maintain and preserving fertility in subjects affected by this pathology.

Appearance of immunoreactive endocrine cells during the development of the rat pancreas, with special reference to polypeptide-secreting cells.

The chronological appearance of PP cells in fetal pancreatic islets was studied using specific anti-PP serum and the direct peroxidase method. The presence of A and B cells was also studied, using the same immunocytochemical technique, as a reference pattern related to data previously reported. Our data confirm that the A cell is the earliest endocrine cell type, appearing on the 12th day of gestation, followed by B cells (14th day) and later on by PP cells (19th day). Primitive islets were identified in the pancreas after the 15th day. However, the spatial cell disposition observed in the adult islet was only recognized at the 20th day of gestation. The data reported provide the necessary information to establish the complete chronology in the rat fetus. Consequently, the development of pancreatic islets in the rat fetus could be employed as a useful model to study the existence of factors that control the sequential appearance of endocrine cells and the possible changes occurring in the islets of animals with genetic diabetes during the fetal period.