MACACO II test-beam with high energy photons.

The IRIS group at IFIC Valencia is developing a three-layer Compton camera for treatment monitoring in proton therapy. The system is composed of three detector planes, each made of a [Formula: see text] monolithic crystal coupled to a SiPM array. Having obtained successful results with the first prototype (MACACO) that demonstrated the feasibility of the proposed technology, a second prototype (MACACO II) with improved performance has been developed, and is the subject of this work. The new system has an enhanced detector energy resolution which translates into a higher spatial resolution of the telescope. The image reconstruction method has also been improved with an accurate model of the sensitivity matrix. The device has been tested with high energy photons at the National Accelerator Centre (CNA, Seville). The tests involved a proton beam of 18 MeV impinging on a graphite target, to produce 4.4 MeV photons. Data were taken at different system positions of the telescope with the first detector at 65 and 160 mm from the target, and at different beam intensities. The measurements allowed successful reconstruction of the photon emission distribution at two target positions separated by 5 mm in different telescope configurations. This result was obtained both with data recorded in the first and second telescope planes (two interaction events) and, for the first time in beam experiments, with data recorded in the three planes (three interaction events).

Monitoring piroplasms infection in three cattle farms in Minorca (Balearic Islands, Spain) with previous history of clinical piroplamosis.

Bovine piroplasmosis are tick-borne protozoan diseases caused by parasites of the genera Theileria and Babesia. Three Friesian cattle farms (F1-F3) with previous history of clinical piroplamosis were selected in Minorca (Balearic Islands, Spain). Blood samples were collected from 8 to 11 animals every two months throughout a year and, a newly developed multiplex DNA bead-based suspension array based on the Luminex(®) xMAP technology was used to monitor for the presence of piroplasms. The assay incorporated probes for Babesia divergens, Babesia bovis, Babesia bigemina, Babesia major, Babesia occultans, Theileria annulata and Theileria buffeli, and a Catch-all Theileria and Babesia (TB) control probe. An internal amplification control that was detected with a Luminex probe was also included to monitor for inhibition. Infection was detected in 87.5% of the samples, 38.7% as single infections and 48.8% as mixed infections. T. annulata was widespread in Farm F1, with all animals positive over the whole study; albeit less frequently, T. annulata was also detected in Farms F2 and F3. T. buffeli was the overall most prevalent piroplasm, with a wide distribution in Farms F2 and F3 but only occasionally detected in F1. B. bigemina was the most frequent Babesia species, but was absent from Farm F1. B. bovis, previously reported in Minorca, was only sporadically detected in F2 and F3. A further 3 Babesia species not previously found in Minorca were also identified: B. major present in the 3 farms; B. divergens detected once in 2 animals in F2; and B. occultans found in 4 animals in F2 and in 1 Hyalomma marginatum female tick collected from a positive animal. Sequencing confirmed the identity of B. occultans thus extending the distribution of this species to Mediterranean Europe. This study confirmed the endemic situation for piroplasm infection in the region and detected the presence of a large number of chronic asymptomatic carriers. More importantly, 3 Babesia species not previously detected in the region were detected for the first time.

First detection of Babesia occultans in Hyalomma ticks from Tunisia.

Descriptions of Babesia occultans have previously been restricted to sub-Saharan Africa. Here, we report the finding, for the first time, of this low or non-pathogenic bovine Babesia species in Tunisia, northern Africa. B. occultans DNA was detected by molecular methods in Hyalomma marginatum unfed ticks collected in 3 bioclimatic regions of Tunisia. The near-full-length 18S rRNA gene was sequenced and compared with related sequences retrieved from GenBank. Phylogenetic analysis indicated that other sequences deposited as Babesia sp. could also correspond to B. occultans, suggesting that this species may have a wide distribution in Mediterranean and Asiatic regions, and not only in sub-Saharan Africa as previously described. A B. occultans-specific Reverse Line Blot (RLB) oligonucleotide probe was designed for future epidemiological studies that would help to clarify this possibility.

Notificación de reacciones adversas a medicamentos.Conocimientos y actitudes entre médicos de Atención Primaria / Adverse drug reactions reporting: knowledge and attitude among primary health care practitioners

Objetivo: conocer los factores asociados a la infranotificación de sospechas de reacciones adversas a medicamentos (RAM) a los centros de farmacovigilancia mediante tarjeta amarilla y las diferencias entre los médicos notificadores y no notificadores. Diseño: estudio descriptivo transversal, mediante cuestionario autocumplimentado. Emplazamiento: diez equipos de Atención Primaria de la Comunidad Valenciana (España) seleccionados mediante muestreo a conveniencia. Participantes: la población de estudio estuvo constituida por los 143 médicos de familia y pediatras de los equipos seleccionados. Mediciones y resultados principales: se obtuvieron 109 cuestionarios (tasa de respuesta 76 porciento). El 77 porciento de los encuestados habían notificado alguna RAM. El sistema de notificación mediante tarjeta amarilla era conocido por el 94,5 porciento y sería el destino prioritario en caso de declarar una reacción adversa. La pereza, la difícil confirmación y la creencia de que la mayoría de las reacciones son ya conocidas fueron los motivos de no declaración más frecuentes. La mayor confianza en la seguridad de los medicamentos, menor conocimiento del mecanismo de declaración, menor acuerdo en la utilidad de declarar sospechas y en la posibilidad de identificar nuevas reacciones, la carencia de tarjetas amarillas, el desacuerdo con la necesidad de identificarse y con la ausencia de incentivo económico caracterizaron más frecuentemente a los no notificadores. Conclusiones: los médicos de Atención Primaria conocen mayoritariamente el sistema de farmacovigilancia. Los no notificadores no entienden la utilidad de un sistema basado en sospechas, confían excesivamente en la seguridad de los fármacos y no se sienten compensados por notificar reacciones (AU)

[Validity of semiquantitative methods of microalbuminuria screening in diabetes mellitus]. / Validez de los métodos semicuantitativos de cribado de la microalbuminuria en la diabetes mellitus.

OBJECTIVE: To analyse the validity of the Micraltest and Microbumintest semi-quantitative methods for microalbuminuria screening in type 2 diabetes mellitus in primary care clinics. DESIGN: Crossover study to validate diagnostic tests. SETTING: Three general practices at an urban health centre. PATIENTS: Consecutive sample of 64 diabetics not dependent on insulin. MEASUREMENTS AND MAIN RESULTS: Each patient's own doctor performed in the consultation the semi-quantitative determinations in a simple sample of the morning's first urine. As standard, a rate of albumin excretion above 20 micrograms/min, determined by immunonephelometry in a 2-hour controlled time sample, was used. The prevalence of Microalbuminuria was 25% (C.I. 95%, 14.4-35.6). The sensitivity of Micraltest was 69% (CI, 42-88), and its specificity 52% (CI, 37-67), corresponding to the cut-off point of 10 mg/L. The sensitivity of Microbumintest was 63% (CI, 36-84), and its specificity 67% (CI, 52-79). The combination of both tests in one sample had 75% sensitivity (CI, 47-92) and 44% specificity (CI, 30-59). Negative predictive values ranged between 84 and 85%. CONCLUSIONS: The semi-quantitative microalbuminuria detection tests are of limited use in the primary care clinic. Their sensitivity and the negative predictive value obtained in an isolated sample do not seem acceptable for a screening method.

[Primary care research in the Valencia community. Original articles published over a 4-year period (1990-1993)]. / Investigaciíon en atención primaria en la Comunidad Valenciana. Artículos originales publicados durante 4 años (1990-1993).

OBJECTIVE: To evaluate the quality of Primary Care (PC) research in the Community of Valencia through research articles. DESIGN: Descriptive study. SETTING: Primary Care in the community of Valencia. PATIENTS AND OTHER PARTICIPANTS: Research articles on PC published 1990-1993 by professionals from the Community of Valencia in: Atención Primaria, Medicina Clínica, Revista Clínica Española and Gaceta Sanitaria. MEASUREMENTS AND MAIN RESULTS: 43 articles published between 1990 and 1993 (6, 6, 9 and 22, respectively) were obtained from the Medline and Indice Médico Español (Spanish Medical Index) bases. Characteristics of the study, authors and bibliographic references were analysed. The greatest number of studies were published in Atención Primaria (81%), making up consistently about 10% of the annual total of articles in this journal. A descriptive design and inferential statistical analysis (comparison of proportions) were mainly used. Average number of authors was 5.14 (C.I. 95%, 4.7 - 5.6). The participation of residents (39%) was greater than that of family doctors and below that of other specialists, suggesting a certain disenchantment with research. The collaboration of different centres (49%) was high, fundamentally Health Centres among themselves and with universities. CONCLUSIONS: PC research in the Community of Valencia appears to be experiencing similar growth to that in the rest of Spain.