A new and simple scoring system to predict overall survival after irradiation for metastatic spinal cord compression.

PURPOSE: To develop a model that predicts survival in patients irradiated for metastatic spinal cord compression (MSCC), hence assisting in the decision between a short and a long-course radiotherapy (RT) regimen. METHODS: 138 patients diagnosed with MSCC and treated with RT alone were included. Based on a multivariate analysis, a scoring system was developed. It included four prognostic variables: age, number of vertebrae, ECOG and histology. Total scores ranged between 14 and 24 points and patients were divided into two groups. RESULTS: The 6-month survival rate was 22% for patients with a score of 14-18 points; and 69% for patients with a score of 19-24 points (P < 0.001). The system exhibits a high specificity and positive predictive value and an appropriate discriminative ability. CONCLUSIONS: Patients with scores between 19 and 24 points were found to survive longer, thus a long-course RT appears to be more appropriate.

Carcinoma de recto de alto riesgo: factores pronóstico y resultados del tratamiento combinado postquirúrgico en el Hospital Universitario Doce de Octubre / High-risk rectal carcinoma: prognostic factors and postoperative adjuvant combined treatment results at Doce de Octubre University Hospital

Propósito: Análisis retrospectivo de los resultados del tratamiento adyuvante combinado postquirúrgico en el carcinoma de recto de alto riesgo en el H.U. Doce de Octubre (Madrid). Material y métodos: Entre 1992 y 1997, 186 pacientes diagnosticados de carcinoma de recto estadios II y III recibieron tratamiento postquirúrgico con radioterapia (50.4Gy) y quimioterapia (146 con 5 FU bolus o infusión continua y 40 con Tegafur oral). Resultados: La supervivencia global a 5 años es del 70 por ciento, la supervivencia libre de enfermedad del 65 por ciento, y el control loco-regional del 80 por ciento. Resultaron factores pronóstico significativos la afectación ganglionar, el estadio patológico, el grado histológico, el T y la prolongación del tratamiento radioterápico. Ni la localización del tumor en recto ni el esquema de quimioterapia empleado han influido significativamente en los resultados. Conclusiones: Los resultados obtenidos con el tratamiento adyuvante combinado postquirórgico en el carcinoma de recto son muy satisfactorios. El factor con mayor valor pronóstico es la afectación ganglionar. No existen diferencias significativas en función del régimen de quimioterapia administrado (AU)

Effect of subinhibitory concentrations of ampicillin on the R plasmid transfer in Escherichia coli.

The effects of subinhibitory concentrations (sub-MICs) of ampicillin on R plasmid transfer in Escherichia coli were studied. Each donor strain culture was separated into two parts; one was mixed with a recipient strain culture for mating, the other was treated with the sub-MIC of ampicillin and then mixed with the recipient strain culture. In both cases the R plasmid transfer frequency was determined at 30, 60, 90 and 120 min of mating. Results showed that there exists a general decrease in the transfer frequencies under sub-MIC treatment (two plasmids did not transfer at all). The proportion of aggregates and the number of cells that compose them were not affected by the sub-MIC of ampicillin. Our study supports the idea that the changes induced in E. coli by sub-MICs of ampicillin did not affect the function of the surface structures responsible for aggregation but did affect the proteins implicated in DNA transfer, situated on the cell surface.

[Neonatal lupus erythematosus: complete atrioventricular block and SSA/Ro antibodies]. / Lupus eritematoso neonatal: bloqueo A-V completo y anticuerpos SSA/Ro.

A newborn boy with complete A-V block and positive anti-SSA/Ro antibodies is reported. Authors comment on pathological findings of neonatal lupus erythematosus. They also review prognosis and clinical course and point out management of these patients before and after birth.

Single doses of ofloxacin in uncomplicated gonorrhoea.

The clinical efficacies of 2 different single-dose oral treatments of ofloxacin were evaluated in a double-blind, randomised study of 60 males with gonococcal urethritis. 30 patients received a single dose of ofloxacin 100mg and 30 received a single dose of ofloxacin 200mg. The minimal inhibitory concentrations of ofloxacin against all isolates were less than or equal to 0.25 mg/L. Neisseria gonorrhoeae was eradicated from all 50 patients evaluated and clinical cure was achieved in 84%. In total, 8 patients developed post-gonococcal urethritis, although there was a significantly (p less than 0.05) lower rate of post-gonococcal urethritis in the group treated with ofloxacin 200mg. In conclusion, a single oral dose of ofloxacin 100mg could be an alternative treatment for uncomplicated gonorrhoea.

Comparative clinical efficacy of two different single-dose ciprofloxacin treatments for uncomplicated gonorrhea.

The clinical efficacies of two different single-dose, oral treatments with ciprofloxacin were evaluated in a double-blind randomized study of 50 men with gonococcal urethritis. Two groups of patients were studied. The 25 patients in group A (age, 18-32 years; mean = 26.2) received a single dose of 250 mg of ciprofloxacin; the 25 in group B (age, 16-42 years; mean = 26.3) received a single dose of 100 mg of ciprofloxacin. The minimal inhibitory concentrations of ciprofloxacin for all the isolates were less than or equal to 0.0015 microgram/ml. Neisseria gonorrhoeae was eradicated from all 50 patients; 80% of them were clinically cured, and 20% developed postgonococcal urethritis. There was no significant difference between the two treatments evaluated. We conclude that a single oral dose of 100 mg of ciprofloxacin could be an alternative treatment for uncomplicated gonorrhea in men. Neither treatment prevented the development of postgonococcal urethritis.

Fe(III) and Cu(II) conalbumin visible circular dichroism spectra.

The single polypeptide chain of conalbumin strongly binds two Fe(III) or two Cu(II) ions to yield intense absorption in the visible region similar to that shown by the related protein transferrin. Comparison of the metal-ion-binding sites in the two proteins is made by exploiting the sensitivity to ligand geometry of circular dichroism (CD). For the Fe(III) proteins strong similarities of the CD spectra outweigh marginal differences. For Cu(II) conalbumin an additional negative extremum near 506 nm appears between two positive ones at 634 and 410 nm suggesting greater subtraction of oppositely signed CD components leading to lesser magnitudes for the two positive peaks than are found in Cu(II)-transferrin. The two Fe(III)-binding sites within conalbumin are compared by noting the strong similarities of the CD and MCD of proteins with Fe(III) in one site and Ga(III) in the other site, and vice versa, with the protein containing Fe(III) in both sites. Due to features of the amino acid sequences of the single protein chains, the four strong metal ion binding sites in conalbumin and transferrin cannot be identical in all particulars, yet CD spectra of their metal ion complexes are closely similar. From a study of model phenolate complexes and the wavelength maxima of visible absorption in the Fe(III), Cu(II), and Co(III) proteins near 465, 440, and 405 nm, respectively, these strong absorption bands are identified as ligand to metal ion electron-transfer transitions. It is suggested that tyrosyl residues are the donors in the electron transfer transitions and that they lock in the metal ions after being keyed into position by binding of bicarbonate or other anions.