Pre-surgical socket analysis for immediate implant placement.

BACKGROUND: Traditional protocols for implant surgery suggest a healing period of 2-3 months from dental extraction to implant placement. Based on all the volumetric modifications produced by that approach, there are authors who advocate for immediate implantology. The aim of the present study was to determine the prevalence of different sockets, and the dimensions of the bone around the upper anterior incisors and canines, to determine the predictability of immediate implants in our population. MATERIAL AND METHODS: This is an observational, cross-sectional study based on cone-beam computed tomography images of the anterior maxila of patients attending the Odontological Hospital of the University of Barcelona (OHUB) and requesting for implant treatment. Different measurements were performed on every analyzed tooth, and also they were categorized by using the main dental sockets classifications. RESULTS: Bone attachment levels and cortical thickness are lower in women compared to men in all three types of teeth (the difference in the bone attachment levels ranges from 4.68%-8.63% and in the bone thickness goes from 0.02-0.58mm). Bone attachment level gradually reduces with age. The reductions observed in all the measurements are higher in the case of canines, compared with the other teeth. The differences from patients <45 years old and patients between 55-64 years old are 13.58±14.55mm in the case of central incisors, 10.04±5.52 in the case of lateral incisors and 22.39±13.65mm in the case of canines. CONCLUSIONS: According to our results, the canines are the teeth with the greatest complexity when it comes to immediate implantology treatments. Furthermore, that kind of treatment is more complex as age increases, since we observed a gradual percentage of unfavourable sockets in older patients.

Spontaneously Arising Canine Glioma as a Potential Model for Human Glioma.

Human gliomas are malignant brain tumours that carry a poor prognosis and are composed of a heterogeneous population of cells. There is a paucity of animal models available for study of these tumours and most have been created by genetic modification. Spontaneously arising canine gliomas may provide a model for the characterization of the human tumours. The present study shows that canine gliomas form a range of immunohistochemical patterns that are similar to those described for human gliomas. The in-vitro sphere assay was used to analyze the expansion and differentiation potential of glioma cells taken from the periphery and centre of canine tumours. Samples from the subventricular zone (SVZ) and contralateral parenchyma were used as positive and negative controls, respectively. The expansion potential for all of these samples was low and cells from only three cultures were expanded for six passages. These three cultures were derived from high-grade gliomas and the cells had been cryopreserved. Most of the cells obtained from the centre of the tumours formed spheres and were expanded, in contrast to samples taken from the periphery of the tumours. Spheres were also formed and expanded from two areas of apparently unaffected brain parenchyma. The neurogenic SVZ contralateral samples also contained progenitor proliferating cells, since all of them were expanded for three to five passages. Differentiation analysis showed that all cultured spheres were multipotential and able to differentiate towards both neurons and glial cells. Spontaneously arising canine gliomas might therefore constitute an animal model for further characterization of these tumours.

Eficacia y seguridad del control de glucemia guiado por objetivo y dirigido por el personal de enfermería en una unidad de cuidados intensivos: un estudio prospectivo observacional / Effectiveness and safety of goal directed nurse-led blood glucose control in an intensive care unit: a prospective observational study

Objetivo valorar la eficacia y seguridad de un sistema de control de la glucemia guiada por objetivo en una UCI. Metodología estudio descriptivo prospectivo de 13 meses. Se recogieron diariamente los valores de todas las determinaciones de glucemia en los pacientes con perfusión continua de insulina. Resultados se recogieron 12.677 glucemias realizadas a 69 pacientes en tratamiento con insulina intravenosa; el 57,9% se encontraron en el rango objetivo (100-140mg/dl); no hubo ninguna glucemia menor de 40mg/dl y tan solo el 0,2% de ellas se encontraron entre 40-60mg/dl. Conclusiones para un adecuado control de las cifras de glucemia mediante el empleo de terapia con insulina intravenosa es esencial el manejo individualizado de la perfusión de insulina, ajustándose a las características de cada paciente individual. El método guiado por objetivos que planteamos ha permitido obtener mejores resultados que los de otros estudios (AU)

Objective to evaluate the effectiveness and safety of a nurse-led blood glucose control protocol in a medical ICU. Method a descriptive, prospective study was carried out for a period of 13 months. All blood glucose values from patients on insulin therapy for intensive glycemic control were recorded daily. Results A total of 12,677 blood glucose determinations were performed on the 69 patients under glycemic control; 57.9% of the determinations had predetermined study target values for blood glucose (100-140mg/dl) and 68.8% of the determinations had physiological blood glucose values (80-140mg/dl); no values under 40mg/dl were obtained, and only 0.2% were between 40-60mg/dl. Conclusions For an adequate blood glucose control using intensive insulin therapy, individual management of insulin infusion regimen is essential, adjusted to the characteristics of each patient. A nurse-led intervention has allowed better results to be obtained in comparison with other studies in which different protocols for insulin infusion are used (AU)

[Effectiveness and safety of goal directed nurse-led blood glucose control in an intensive care unit: a prospective observational study]. / Eficacia y seguridad del control de glucemia guiado por objetivo y dirigido por el personal de enfermería en una unidad de cuidados intensivos: un estudio prospectivo observacional.

OBJECTIVE: to evaluate the effectiveness and safety of a nurse-led blood glucose control protocol in a medical ICU. METHOD: a descriptive, prospective study was carried out for a period of 13 months. All blood glucose values from patients on insulin therapy for intensive glycemic control were recorded daily. RESULTS: A total of 12,677 blood glucose determinations were performed on the 69 patients under glycemic control; 57.9% of the determinations had predetermined study target values for blood glucose (100-140 mg/dl) and 68.8% of the determinations had physiological blood glucose values (80-140 mg/dl); no values under 40 mg/dl were obtained, and only 0.2% were between 40-60 mg/dl. CONCLUSIONS: For an adequate blood glucose control using intensive insulin therapy, individual management of insulin infusion regimen is essential, adjusted to the characteristics of each patient. A nurse-led intervention has allowed better results to be obtained in comparison with other studies in which different protocols for insulin infusion are used.

Antimicrobial activity and occurrence of bacteriocin structural genes in Enterococcus spp. of human and animal origin isolated in Portugal.

The main objective of this study was to detect the antimicrobial activity and the presence of bacteriocin structural genes in 224 enterococcal isolates from fecal origin obtained from humans, pets, wild animals and birds. Direct antimicrobial activity against Listeria monocytogenes CECT4032 was detected in 102 (45.6%) of the tested isolates. From these, only 22 displayed bacteriocin activity against this indicator. The bacteriocinogenic strains contained one or more of the bacteriocin structural genes tested in this study, with those of enterocins P, A and L50 (L50A and L50B) being the most abundant. Our results show a high occurrence of the combination of different bacteriocin structural genes in the enterococcal isolates analyzed, indicating an elevated genetic potential of these strains to produce various bacteriocins.

[Prevalence of antiretroviral drug genotypic resistance among HIV patients in Cuenca, Spain]. / Prevalencia de la resistencia genotípica a los fármacos antirretrovirales en pacientes VIH positivos en la provincia de Cuenca.

The aims were to assess the prevalence of resistances to antiretroviral drugs in HIV patients in the province of Cuenca and to determine the most frequently detected primary resistances. A total of 79 samples collected from April 2000 to July 2004 were analyzed. Resistance was detected using the genotypic technique VERSANTTM HIV1 (LiPA). Mutations more frequently found were M184V in the reverse transcriptase gene and V82A in the protease gene. The prevalence of primary resistances was 39.4%. Mutations more frequently detected were similar to those reported by other authors. The rate of primary resistance was higher than those found by other authors in Spain.

Antimicrobial and safety aspects, and biotechnological potential of bacteriocinogenic enterococci isolated from mallard ducks (Anas platyrhynchos).

Samples from the intestinal content and carcasses of mallard ducks (Anas platyrhynchos) were evaluated for enterococci with antimicrobial activity, presence of genes coding bacteriocins and their expression, and potential virulence factors. Enterococcus faecalis comprised the largest enterococcal species with antagonistic activity followed by E. faecium, E. hirae, Enterococcus spp., and the non-enterococci. Although all E. faecalis isolates manifested a potent direct antimicrobial activity, no activity was detected in supernatants of most producer cultures. However, all E. faecium isolates showed antimicrobial activity in their supernatants and encoded bacteriocins, although the occurrence in the isolates of several enterocin genes did not always correlate with a higher antagonistic activity in supernatants. The efaAfm determinant was the only virulence gene detected in E. faecium, while E. faecalis showed a larger number of virulence determinants, and E. hirae did not carry any of the virulence genes examined. The rapid identification of genes coding described bacteriocins permits recognition of isolates that are potentially producers of novel bacteriocins. Purification of the antimicrobial activity of E. hirae DCH5 and Lactococcus garvieae DCC43 revealed unique chromatographic fragments after MALDI-TOF mass spectrometry analysis, suggesting the antagonistic peptides were purified to homogeneity. Bacteriocinogenic E. faecium and E. hirae isolates may be considered hygienic for production of bacteriocins, and potentially safe due to their low incidence of potential virulence genes and susceptibility to most clinically relevant antibiotics. However, the presence among the enterococci of E. faecalis strains with a potent antagonistic activity and multiple virulence factors, raises concerns regarding their potential pathogenicity to consumers.

Prevalencia de la resistencia genotípica a los fármacos antirretrovirales en pacientes VIH positivos en la provincia de Cuenca / Prevalence of antiretroviral drug genotypic resistance among HIV patients in Cuenca, Spain

Los objetivos del estudio fueron determinar la prevalencia de la resistencia a los fármacos antirretrovirales en pacientes VIH positivos en la provincia de Cuenca y describir las resistencias primarias observadas con más frecuencia. Se analizaron en total 79 muestras remitidas desde abril de 2000 a julio de 2004. Las resistencias se detectaron utilizando la técnica genotípica VERSANTTM HIV1 (LiPA). Las mutaciones que más se detectaron fueron M184V para la región de la transcriptasa inversa y V82A para la región de la proteasa. La prevalencia de las resistencias primarias fue del 39,4%. Las mutaciones más observadas son similares a las detectadas por otros autores. El porcentaje de pacientes con resistencias primarias es superior a lo hallado por otros autores en España

The aims were to assess the prevalence of resistances to antiretroviral drugs in HIV patients in the province of Cuenca and to determine the most frequently detected primary resistances. A total of 79 samples collected from April 2000 to July 2004 were analyzed. Resistance was detected using the genotypic technique VERSANTTM HIV1 (LiPA). Mutations more frequently found were M184V in the reverse transcriptase gene and V82A in the protease gene. The prevalence of primary resistances was 39.4%. Mutations more frequently detected were similar to those reported by other authors. The rate of primary resistance was higher than those found by other authors in Spain

Telarquia precoz como signo guía de pubertad precoz central / No disponible

La telarquia precoz puede ser una patología benigna sin trascendencia clínica o el inicio de una pubertad precoz verdadera. En este artículo intentamos repasar las diferentes causas de la pubertad precoz, haciendo hincapié en las causas tumorales del sistema nervioso central como etiología de este cuadro, sobre todo, desde la introducción de técnicas de imagen como la resonancia magnética. En el caso clínico que presentamos llama la atención la edad tan temprana a la que se desarrolla la pubertad y cómo en estos casos es obligatorio descartar siempre una etiología tumoral; el hamartoma de hipotálamo es una de las causas más frecuente (AU)

The precocious thelarche can be either a benign condition without clinical significance or the beginning of a real precocious puberty. We try to revise, in this article, the different causes of precocious puberty, emphasizing the tumours of the central nervous system as the aetiology of this condition, especially after the introduction of image techniques as the magnetic resonance. In the clinical case we present, it is remarkable the early age the puberty is developed. In these cases, it is always obligatory to rule out the tumour aetiology being the hypothalamus hamartoma one of the most frequent causes (AU)

Cloning, production and functional expression of enterocin P, a sec-dependent bacteriocin produced by Enterococcus faecium P13, in Escherichia coli.

The cloning and expression of enterocin P (EntP), a sec-dependent bacteriocin produced by Enterococcus faecium P13, was studied in Escherichia coli. PCR-amplified products of the preenterocin P gene (entP) or entP plus the putative EntP immunity gene (entiP), were cloned in plasmid pETBlue-1 under the control of the inducible T7lac promoter. Although target genes in derivative plasmids pJG01 (entP) and pJG02 (entP plus entiP) did not generate products with antimicrobial activity after an in vitro combined transcription/translation reaction, they were expressed as biologically active products following transformation and induction in the E. coli Tuner(DE3)pLacI host. The use of specific antibodies and an ELISA permitted the detection and quantification of EntP in the supernatant (SN), cellular soluble protein fraction (CSF), and inclusion bodies (IB) of E. coli Tuner(DE3)pLacI cells transformed with either pJG01 or pJG02. Functional EntP from the supernatants of E. coli Tuner(DE3)pLacI (pJG01) cultures grown in a complex medium was recovered, at a high efficiency, by immunoaffinity chromatography in a single step. A purification method based on hydrophobic adsorption and reverse-phase chromatographies also permitted the recovery of active EntP from the supernatants of the same cultures grown in a minimally defined medium. The E. coli Tuner(DE3)pLacI (pJG01) cells would merit consideration as an alternative experimental model for the heterologous production and functional expression of EntP, as well as for the fast and efficient recovery of this bacteriocin from the supernatant of this recombinant producer.

Diagnóstico en Urgencias de la trombosis venosa de miembros inferiores: valor de los criterios clínicos unidos al dímero-D / The role of clinical signs in combination to the D-dimer in the diagnosis of deep vein thrombosis of lower limbs in an emergency room

Objetivo. Valorar la utilidad de criterios clínicos unidos a la determinación del dímero-D para el diagnóstico de la trombosis venosa profunda (TVP) de miembros inferiores (MMII) en un Servicio de Urgencias de un hospital de tercer nivel. Pacientes y métodos. Estudio retrospectivo-comparativo. Durante 6 meses (julio a diciembre de 2002) se examinaron 295 pacientes en el Servicio de Urgencias de nuestro centro por sospecha de TVP de MMII. Se les valoró siguiendo los criterios clínicos de Wells, y se estratificaron como pacientes de alta, media o baja probabilidad de TVP. Se les determinó el dímero-D. En todos se realizó eco-Doppler (ED) venoso de MMII como método de referencia diagnóstica. Analizamos los resultados obtenidos en función de sensibilidad, especificidad, valor pronóstico positivo (VPP) y negativo (VPN), y coeficiente kappa para comparar el grado de concordancia entre ambas pruebas diagnósticas, mediante sistema SPSS para Windows. Resultados. Sólo 53 (18%) casos tuvieron diagnóstico positivo de TVP según ED. Probabilidad alta/intermedia con dímero-D positivo: 49 con TVP, seis sin ella. Probabilidad baja o dímero-D negativo: 236 sin TVP, cuatro con TVP (los cuatro con dímero-D positivo). Sensibilidad 92%, especificidad 97%, VPP 89%, VPN 98%, con una exactitud de 96,6%, y el coeficiente kappa fue de 0,88, demostrando un alto grado de concordancia entre ambos procedimientos (p < 0,0001). Conclusiones. Los criterios clínicos de estratificación de Wells unidos a la determinación del dímero-D son muy útiles en un Servicio de Urgencias para el diagnóstico de TVP de MMII, permitiendo un inicio rápido de la terapéutica. En caso de baja probabilidad clínica y dímero-D negativo, se evita la realización de ED en un número elevado de casos, lo que agiliza la asistencia en Urgencias

Aim. To validate the role of clinical sings and D-dimer determination in evaluation of deep venous thrombosis (DVT) of lower limbs suspect in emergency room of high technology hospital. Patients and methods. Retrospective and comparative study since July 2002 to December 2002 about 295 patients looked after in emergency room in our hospital because of DVT of lower limbs suspect. We looked for Wells’ clinical signs, and stratified patients in high, middle and low probability of DVT. We determined D-dimer in all patients evaluated. We achieved venous duplex ultrasound of lower limbs like gold-standard diagnosis. We diagnosed 53 DVT with this method. We evaluated the results in sensibility, specificity, positive predictive value (PPV) and negative predictive value (NPV), and kappa coefficient, with program SPSS for Windows. Results. High and middle probability with D-dimer positive: 49 with DVT, 6 without. Low probability or D-dimer negative: 236 without DVT, 4 with it (these with D-dimer positive). Sensibility 92%, specificity 97%, PPV 89%, NPV 98%, with an exactitude of 96,6%, and kappa coefficient of 0,88. It was demonstrated a high degree of concordance between gold-standard and tests evaluated (p < 0,0001). Conclusions. Wells’ clinical signs and determination of D-dimer give good diagnosis approximation to DVT of lower limbs in emergency room. With low clinical probability of deep venous thrombosis and negative D-dimer determination is not necessary to achieve duplex for suspect deep venous thrombosis

Levofloxacino frente a betalactámicos en el tratamiento de la neumonía adquirida en la comunidad con ingreso hospitalario / Levofloxacin versus betalactamic therapy in commu nity-acquired pneumonia that requires hospitaliza tion

Objetivo: Comparar la eficacia y seguridad de levofloxacino frente al tratamiento estándar con betalactámicos en pacientes con Neumonía Adquirida en la Comunidad que cumplen criterios de ingreso hospitalario (NACH). Pacientes y métodos: Estudio prospectivo de un año de duración de 49 pacientes (ptes.) ingresados en el Servicio de Medicina Interna, diagnosticados de NACH con asignación aleatoria a recibir.- I: cefotaxima o ceftriaxona, II: amoxicilina-clavulánico, (las dos previas asociadas o no a un macrólido) o, III: levofloxacino. Se realizó Rx. tórax a los 7 -10 días, al mes y, posteriormente si era necesario. Resultados: 29 ptes. recibieron pauta estándar (I o II) y 20 ptes. levofloxacino. Eran varones el 84%, con edad media de 70,9 años, 57% con enfermedad de base moderada o grave, y 55% con criterios de gravedad inicial. En el 47% de los casos se llegó a diagnóstico etiológico, siendo en un tercio de los casos bacilos gramnegativos. Se produjo la curación en el 94% de los pacientes y éxitus en 2 pacientes (5%). No se observaron diferencias entre los dos grupos en las características demográficas, enfermedad de base ni gravedad inicial. No se detectaron diferencias en los efectos secundarios, complicaciones, estancia hospitalaria o porcentaje de curaciones. La necesidad de prolongar el tratamiento fue mayor en el grupo estándar que en el tratado con levofloxacino (52 vs 15%, p: 0,02). Conclusiones: En población mayor y con gravedad inicial el tratamiento con levofloxacino puede ser una alternativa válida al tratamiento estándar (AU)

Objective: To compare the effectiveness and security of levofloxacin treatment in front betalactamic therapy in patient with community-acquired pneumonia that require hospitalization (CAPH). Patient and methods: A prospective and randomized study along a year from 49 patients diagnosed of (CAPH) that were admitted in the Internal Medicine Service. The patients were assigned randomly to receive.- I: cefotaxime or ceftriaxone, II: amoxicillin/ clavulanate (both could be associated or not with a macrolide) or III: levofloxacin. It was accomplished Rx. thorax to 7 -10 days, to the month and, other reviews if was necessary. Results: 29 cases were in standard therapy (I or II) and 20 cases received levofloxacin therapy. Male 84 %, half age 70,9 years old, 57 % with moderate or severe underlying disease, and 55 % with approaches of initial severity criteria. In 47 % of the cases we arrived to etiologic diagnosis, in the third of the cases were BGN. The cure took place in 94 % of the patients and 2 patients died (5%). No differences were observed regarding demographic characteristics, underlying disease and severity. No differences were detected in: the secondary effects, complications, hospital stay or, mean stay or percentage of cures. The necessity to prolong the therapy was bigger in the standard group in front of the group tried with levofloxacin (52 % vs. 15 %, p:0.02). Conclusions: In bigger population and with initial severity the treatment with levofloxacin can be a valid alternative to the standard therapy (AU)

[Levofloxacin versus beta-lactamic therapy in community acquired pneumonia that requires hospitalization]. / Levofloxacino frente a betalactámicos en el tratamiento de la neumonía adquirida en la comunidad con ingreso hospitalario.

OBJECTIVE: To compare the effectiveness and security of levofloxacin treatment in front betalactamic therapy in patient with community-acquired pneumonia that require hospitalization (CAPH). PATIENT AND METHODS: A prospective and randomized study along a year from 49 patients diagnosed of (CAPH) that were admitted in the Internal Medicine Service. The patients were assigned randomly to receive.-I: cefotaxime or ceftriaxone, II: amoxicillin/clavulanate (both could be associated or not with a macrolide) or III: levofloxacin. It was accomplished Rx. thorax to 7-10 days, to the month and, other reviews if was necessary. RESULTS: 29 cases were in standard therapy (I or II) and 20 cases received levofloxacin therapy. Male 84%, half age 70.9 years old, 57% with moderate or severe underlying disease, and 55% with approaches of initial severity criteria. In 47% of the cases we arrived to etiologic diagnosis, in the third of the cases were BGN. The cure took place in 94% of the patients and 2 patients died (5%). No differences were observed regarding demographic characteristics, underlying disease and severity. No differences were detected in: the secondary effects, complications, hospital stay or, mean stay or percentage of cures. The necessity to prolong the therapy was bigger in the standard group in front of the group tried with levofloxacin (52% vs. 15%, p:0.02). CONCLUSIONS: In bigger population and with initial severity the treatment with levofloxacin can be a valid alternative to the standard therapy.

[Tularemia outbreak in the province of Cuenca associated with crab handling]. / Brote epidémico de tularemia en la provincia de Cuenca en relación con la manipulación de cangrejos.

OBJECTIVE: To report the clinical and epidemiologic characteristics of 19 patients diagnosed of tularemia at our hospital following an epidemic outbreak occurred in our health area. METHODS: Retrospective analysis of clinical records of patients admitted to our hospital who were examined at the Infectious Diseases Clinic and had clinical findings and epidemiologic data consistent with tularemia during the period from June 1998 to March 1999. CASE DEFINITION: A patient was considered to fulfill the case definition when clinical symptoms, epidemiologic data and the following laboratory criteria were met: antibody titer to Francisella tularensis (tube agglutination test) > or = 1/128 in the convalescence serum specimen, seroconversion or recovery of the microorganism from biological material. RESULTS: Nineteen patients with a median age of 60 years. Males predominated (63.1% male patients); all of them had handled red crayfish from the same source (río Mayor). The incubation period ranged from 0 to 15 days (mean 4.88 days). All patients presented with the ulceroglandular form. Seventy-three percent of patients received doxycycline. Only one patient relapsed. Water samples from the reservoir of the depuration plant of the river were positive to F. tularensis by PCR. This same result was confirmed in stomach and hepatopancreas of crayfish fished in río Mayor in the second half of July. CONCLUSIONS: The most likely hypothesis of this outbreak was the contamination of the river water with animals dead from tularemia which, together with the characteristics of the transmission mechanism (wounds caused by crabs) had contributed to the acquisition of this disease in humans. Interestingly too, red crayfish as the source of infection.

Optimization of enterocin P production by batch fermentation of Enterococcus faecium P13 at constant pH.

The influence of pH on growth, enterocin P production and glucose consumption by Enterococcus faecium P13 was studied during anaerobic batch fermentation in MRS broth at 32 degrees C in a fermentor. Growth and glucose consumption were maximal at pH 7.0. Enterocin P production displayed primary metabolite kinetics and was strongly dependent on pH. A maximum antimicrobial activity of 1,949 bacteriocin units (BU) ml(-1) was obtained at pH 6.0, which represented a four-fold increase compared with the antimicrobial activity obtained without pH regulation. The pH exerted a marked effect on the decrease in bacteriocin activity, with the decrease being maximal at pH 7.0. In this report, we propose models for the growth of E. faecium P13 as well as enterocin P production and inactivation. Enterocin P production decreased when potentially stress-inducing compounds (NaCl or ethanol) were included in the growth medium.

Pulmonary fibrosis induced by cyclophosphamide.

OBJECTIVE: To report a case of pulmonary fibrosis resulting from use of cyclophosphamide as chemotherapy to treat a patient with breast cancer. CASE SUMMARY: We describe the case of a 52-year-old woman with breast cancer who developed pulmonary fibrosis after four cycles of chemotherapy that included cyclophosphamide. Pulmonary function tests revealed the presence of a severe ventilatory restriction. The open lung biopsy revealed pulmonary fibrosis with vascular sclerosis and signs of pulmonary hypertension. DISCUSSION: Cyclophosphamide is an alkylating agent that has been associated with interstitial pneumonia and pulmonary fibrosis. The frequency of these unwanted effects is <1%. The clinical picture consists of the progressive appearance of dyspnea and a non-productive cough that progresses to severe pulmonary insufficiency. The risk factors described for these complications have been the use of chemotherapy regimens that include other drugs with known pulmonary toxicities, the cumulative total dose, the addition of radiotherapy, and the use of high doses of cyclophosphamide. CONCLUSIONS: Even though the frequency of pulmonary fibrosis in patients treated with cyclophosphamide-based chemotherapy regimens is low, the presence of dyspnea and an interstitial pattern in a patient makes it necessary to consider that possible drug toxicity. The open lung biopsy is the most accurate diagnostic technique for these cases. The discontinuation of cyclophosphamide and treatment with corticosteroids is usually followed by clinical recovery in approximately 50% of patients and, in some cases, reversal of the lung injury.

Enterocin P selectively dissipates the membrane potential of Enterococcus faecium T136.

Enterocin P is a pediocin-like, broad-spectrum bacteriocin which displays a strong inhibitory activity against Listeria monocytogenes. The bacteriocin was purified from the culture supernatant of Enterococcus faecium P13, and its molecular mechanism of action against the sensitive strain E. faecium T136 was evaluated. Although enterocin P caused significant reduction of the membrane potential (DeltaPsi) and the intracellular ATP pool of the indicator organism, the pH gradient (DeltapH) component of the proton motive force (Deltap) was not dissipated. By contrast, enterocin P caused carboxyfluorescein efflux from E. faecium T136-derived liposomes.

Short-term follow-up results in 795 nonpalpable probably benign lesions detected at screening mammography.

PURPOSE: To evaluate short-term follow-up of nonpalpable probably benign lesions in a 2-year mammographic screening. MATERIALS AND METHODS: Of 13,790 women aged 45-65 years who underwent first-round screening, 795 (5.8%) underwent short-term mammographic follow-up (every 6 months for 2 years) of nonpalpable probably benign lesions (eg, masses, focal asymmetric densities, and calcifications) previously assessed at an additional imaging evaluation, including ultrasonography. When no changes were found at short-term mammographic follow-up, women were assigned to the 2-year screening interval. Needle localization and surgical biopsy were performed when the lesion progressed (was enlarged or had an increased number or size of calcifications or modification of their initial characteristics). The effectiveness of this approach was evaluated with statistical analysis. RESULTS: Of 795 lesions, 788 (99%) remained stable, and seven (1%) had changes prompting surgical biopsy. Two cancers (0.3%), one microinvasive intraductal carcinoma and one 7-mm invasive ductal carcinoma without positive nodes, were found. Four of the five benign histologic results were probably benign calcifications with progression at short-term follow-up. The sensitivity, specificity, accuracy, and positive and negative predictive values were 100%, 99%, 99%, 29%, and 100%, respectively. CONCLUSION: The benign nature of most nonpalpable probably benign lesions can be typified with short-term mammographic follow-up. This approach permitted identification of a few low-stage carcinomas, but progression in the probably benign calcifications was usually unrelated to malignancy.

Enterocin P causes potassium ion efflux from Enterococcus faecium T136 cells.

Enterocin P is a bacteriocin produced by Enterococcus faecium P13. We studied the mechanism of its bactericidal action using enterocin-P-sensitive E. faecium T136 cells. The bacteriocin is incapable of dissipating the transmembrane pH gradient. On the other hand, depending on the buffer used, enterocin P dissipates the transmembrane potential. Enterocin P efficiently elicits efflux of potassium ions, but not of intracellularly accumulated anions like phosphate and glutamate. Taken together, these data demonstrate that enterocin P forms specific, potassium ion-conducting pores in the cytoplasmic membrane of target cells.