Observation of nonanoic acid and aldehydes in exhaled breath of patients with lung cancer.

Lung cancer (LC) is the leading cause of cancer death in men and the second leading cause in women worldwide. The use of low-dose computed tomography in early diagnosis was shown to reduce mortality by 20% with a median follow-up time of 6.5 years. In order to increase profitability and reduce radiation risks and costs, exhaled biomarkers could serve to help establish narrower inclusion criteria. The aim of this study was to identify new, well-founded volatile organic compounds in exhaled breath which distinguish LC patients from chronic obstructive pulmonary disease (COPD) patients and healthy subjects. There were 210 subjects enrolled and divided into three groups: control group (n = 89), COPD group (n = 40 stable COPD patients) and LC group (n = 81 with histological confirmation). Exhaled breath samples were collected using BioVOC® breath sampler devices. The analytical technique used was thermal desorption-gas chromatography-mass spectrometry. The compounds studied were hexanal, heptanal, octanal, nonanal, propanoic and nonanoic acids. Nonanoic acid showed statistically significant differences between the LC group and the other groups. It is 2.5 times and almost 9 times more likely to be found in the LC group than in the control group or COPD group, respectively. It is independent of histology but depends on tumour stage.

Síntomas respiratorios persistentes en los limpiadores cinco años después del vertido de petróleo del Prestige / Persistent respiratory symptoms in clean-up workers 5 years after the Prestige oil spill

Objetivos. Los pescadores que participaron en las actividades de limpieza del vertido del Prestige mostraban un aumento del riesgo de padecer síntomas respiratorios pasados entre uno y dos años después de la catástrofe; sin embargo, la persistencia a largo plazo de estos efectos sobre la salud permanecía incierta. El objetivo del presente estudio ha sido evaluar la persistencia de estos síntomas respiratorios cinco años después de los trabajos de limpieza. Métodos. Subgrupos de 501 pescadores que habían estado expuestos a los trabajos de limpieza y 177 pescadores no expuestos fueron re-entrevistados por teléfono en el 2008, incluyendo las mismas preguntas utilizadas en la encuesta inicial. Las asociaciones entre la participación en los trabajos de limpieza y la presencia de síntomas respiratorios se evaluaron mediante análisis de regresión log-binomial y multinomial, ajustado por sexo, edad y tabaquismo. Resultados. Se obtuvo información de 466 (93%) pescadores expuestos y de 156 (88%) no expuestos. La prevalencia de síntomas del tracto respiratorio bajo (incluyendo sibilancias, falta de aire, tos y flema) disminuyó ligeramente en ambos grupos, pero permaneció más alta entre los expuestos (RR 1,4, IC 95%: 1,1-1,9) El riesgo de tener síntomas respiratorios persistentes(referidos tanto al inicio como durante el seguimiento) aumentó con el nivel de exposición: RR 1,7(IC 95%: 0,9-3,1) y 3,3 (IC 95%: 1,8-6,2) para los moderada y altamente expuestos, respectivamente. El riesgo en relación con la presencia de síntomas nasales y para el uso de medicación respiratoria fue de un orden similar. Conclusiones. La participación en las actividades de limpieza de los derrames de petróleo puede dar lugar a síntomas respiratorios que persisten hasta cinco años después de la exposición. Sería necesario disponer de protocolos para llevar a cabo las medidas preventivas oportunas, así como una continua vigilancia de la salud de los trabajadores que participen en actividades de limpieza en este tipo de accidentes ( AU)

Objectives. Fishermen who had participated in clean-up activities of the Prestige oil spill showed an excess risk of respiratory symptoms 1-2 years later, but the long-term persistence of these health effects is unclear. The aim of this study was to evaluate the persistence of these respiratory symptoms 5 years after clean-up work. Methods. Subgroups of 501 fishermen who had been exposed to clean-up work and 177 non-exposed individuals were re-interviewed by telephone in 2008, including the same symptom questions as in the initial survey. Associations between participation in clean-up work and respiratory symptoms were assessed using log-binomial and multinomial regression analyses adjusting for sex, age and smoking. Results. Information from 466 exposed (93%) and 156 non-exposed (88%) fishermen was obtained. The prevalence of lower respiratory tract symptoms (including wheeze, shortness of breath, cough and phlegm) had slightly decreased in both groups, but remained higher among the exposed (RR 1.4, 95% CI 1.1 to 1.9). The risk of having persistent respiratory symptoms(reported both at baseline and at follow-up) increased with the degree of exposure: RR ratio 1.7 (95% CI 0.9 to 3.1)and 3.3 (95% CI 1.8 to 6.2) for moderately and highly exposed, respectively, when compared with those without any symptoms. Findings for nasal symptoms and for respiratory medication usage were similar. Conclusions. Participation in clean-up activities of oil spills may result in respiratory symptoms that persist up to 5years after exposure. Guidelines for preventive measures and a continued surveillance of clean-up workers of oil spills are necessary(AU)

Resolución de múltiples nódulos pulmonares cavitados con el abandono del hábito tabáquico como único tratamiento / Resolution of multiple cavitated lung nodules with smoking cessation as the only treatment

El término histiocitosis hace referencia a un grupo heterogéneo de enfermedades caracterizadas por la infiltración de células de Langerhans (CL) en diferentes órganos. La histiocitosis pulmonar (HP) es una enfermedad poco frecuente que afecta típicamente a adultos jóvenes. Su patogenia no es bien conocida, aunque se ha observado una relación con el tabaquismo, por lo que la primera medida de tratamiento que se debe realizar es el abandono de éste. Presentamos un caso de histiocitosis pulmonar que evolucionó en seis meses de forma favorable, clínica, funcional y radiológicamente como consecuencia del abandono del tabaco como único tratamiento (AU)

The term histiocytosis refers to a heterogeneous group of diseases characterized by the infiltration of Langerhans cells (LC) in different organs. Pulmonary Histiocytosis (PH) is anuncommon disease that typically affects young adults. Its pathogeny is not well known, although a relationship with smoking has been observed. Thus, the first treatment measure should be smoking cessation. We present a case of pulmonary histiocytosis that showed a favorable clinical, functional and radiological course in six months as a consequence of using smoking cessation as the only treatment (AU)

A tripartite complex composed of ETV6-NTRK3, IRS1 and IGF1R is required for ETV6-NTRK3-mediated membrane localization and transformation.

ETV6-NTRK3 (EN), a chimeric tyrosine kinase generated by t(12;15) translocations, is a dominantly acting oncoprotein in diverse tumor types. We previously showed that insulin-like growth factor 1 receptor (IGF1R) is essential for EN-mediated oncogenesis and that insulin receptor substrate 1 (IRS1) is constitutively tyrosine phosphorylated and bound by EN in transformed cells. Given that IRS1 is also an adapter for IGF1R, we hypothesized that IRS1 might localize EN to IGF1R at the membrane to activate phosphatidylinositol 3-kinase (PI3K)-Akt, which is critical for EN oncogenesis. In this study, we examined EN/IRS1/IGF1R complexes in detail. We find that both IRS1 and kinase active IGF1R are required for EN transformation, that tyrosine phosphorylated IRS1 is present in high molecular weight complexes with EN and IGF1R, and that EN colocalizes with IGF1R at the plasma membrane. Both IGF1R kinase activity and an intact cytoplasmic Y950 residue, the IRS1-docking site of IGF1R, are required, confirming the importance of the IGF1R/IRS1 interaction for EN oncogenesis. The dual specificity IGF1R and insulin receptor (INSR) inhibitor, BMS-536924, blocks EN transformation activity, cell survival and its interaction with IRS proteins, and induces a striking shift of EN proteins to smaller sized molecular complexes. We conclude that a tripartite complex of EN, IRS1 and IGF1R localizes EN to the membrane and that this is essential for EN-mediated transformation. These findings provide an explanation for the observed IGF1R dependency of EN transformation. Blocking IGF1R kinase activity may, therefore, provide a tractable therapeutic strategy for the many tumor types driven by the EN oncoprotein.

rEnolase maternal immunization confers caries protection on offspring.

Therapeutic vaccination with Streptococcus sobrinus recombinant enolase (rEnolase) protects rats from dental caries. Here, we investigated the effect that maternal rEnolase vaccination before pregnancy had on the offspring's immune response to S. sobrinus oral infection and dental caries progression. Female Wistar rats were immunized by intranasal and subcutaneous routes with rEnolase adsorbed onto aluminum hydroxide as adjuvant or similarly treated with the adjuvant alone (sham-immunized). Ten days after the last administration, the immunized females were paired with a male rat. The oral immune responses to S. sobrinus infection and dental caries in the offspring were evaluated. The results showed that pups born from rEnolase-immunized mothers had higher levels of rEnolase-specific salivary IgA and IgG antibodies (indicating a placental antibody transfer) and lower sulcal and proximal enamel caries scores than rats born from sham-immunized mothers. In conclusion, rEnolase maternal immunization before pregnancy provides offspring with protection against S. sobrinus-induced dental caries.

[Primary care physicians' and patients' degree of satisfaction with a new respiratory medicine health care program]. / Grado de satisfacción de médicos y pacientes en atención primaria con un nuevo esquema asistencial neumológico.

BACKGROUND: No ideal model for coordinating primary care and specialized respiratory medicine has been established. OBJECTIVE: To evaluate primary care physicians' and patients' degree of satisfaction with a new program for coordinating respiratory medicine and primary care. METHOD: A questionnaire survey of the level of satisfaction with a program combining consultation and direct patient care. The study was carried out at a primary care facility whose staff comprised 31 general practitioners. The respiratory medicine staff consisted of one physician and two nurses from the reference hospital. A questionnaire to determine the physicians' and patients' satisfaction with the program asked for a) overall evaluation on a scale of 0 to 10; b) evaluation on a scale naming five levels from "very bad" to "very good", and c) comparison of the new program with previous ones. RESULTS: One thousand one hundred seventy patients were seen in 12 months; 663 (57%) received a first visit, 400 (34%) received a second visit, and 107 (9%) received emergency care. The level of satisfaction was 7.8 (1.2) among physicians and 8.7 (1.5) among patients (p = 0.030); 97% of the physicians and 94% of the patients described the program as "very good" or "good". According to 100% of the physicians and 64% of the patients, the new program was better than the old one (p = 0.110). CONCLUSIONS: The coordinated care plan proposed is accepted by most physicians and patients and uses primary respiratory medicine resources more efficiently.

Grado de satisfacción de médicos y pacientes en atención primaria con un nuevo esquema asistencial neumológico / Primary care physicians' and patients' degree of satisfaction with a new respiratory medicine health care program

Fundamento y objetivos: Aún no existe un esquema de relación asistencial óptimo entre la medicina de atención primaria y la neumología. El objetivo de este estudio es presentar y evaluar el grado de satisfacción con un nuevo esquema de relación entre neumología y la medicina de atención primaria. Método: Valorar por encuesta el grado de satisfacción de un esquema mixto, de consultoría y atención directa del paciente. El estudio se efectuó en un centro de atención primaria cuya plantilla estaba formada por 31 médicos generales. La de neumología constaba de un médico y dos enfermeras que provenían del hospital de referencia. Se determinó el grado de satisfacción de los médicos y de 60 pacientes respecto del esquema mediante una encuesta que incluyó: a) valoración global por puntuación de 0 a 10; b) valoración por escala discriminante de 5 niveles (de muy mala a muy buena), y c) comparación del nuevo esquema evaluado respecto a los previos. Resultados: Se atendió a 1.170 pacientes en 12 meses; 663 (57 per cent) en primera visita, 400 (34 per cent) en segunda visita y 107 (9 per cent) urgentes. El grado de satisfacción con el esquema asistencial se puntuó con una media de 7,8 (1,2) por los médicos y de 8,7 (1,5) por los pacientes (p = 0,030); el 97 per cent de los médicos y el 94 per cent de los pacientes lo calificaron de "muy bueno" o "bueno", y lo consideraron mejor que el esquema tradicional el 100 per cent de los médicos y el 64 per cent de los pacientes (p = 0,110). Conclusiones: El esquema asistencial neumológico planteado es mayoritariamente aceptado por médicos y pacientes. La acción asistencial conjunta que propugna agiliza la utilización de los recursos en la actividad neumológica extrahospitalaria (AU)

Sindrome de Eagle - Variante estilo - Carotideo: presentación de un caso clínico / Eagle syndrome - Style variant - Carotid: report of a clinical case

The objective of this publication is the description of a clinical case of long evolution that presented the following symptoms: dizziness and transient syncope, and in occasions, it anguishes and sensation of imminent death. The same one was diagnosed as Syndrome of Eagle. It is important to clarify that this pathology presents different clinical variants, belonging one to them those related with the artery carotid what would explain the sensation of eminent death.

Sindrome de Eagle - Variante estilo - Carotideo: presentación de un caso clínico / Eagle syndrome - Style variant - Carotid: report of a clinical case

The objective of this publication is the description of a clinical case of long evolution that presented the following symptoms: dizziness and transient syncope, and in occasions, it anguishes and sensation of imminent death. The same one was diagnosed as Syndrome of Eagle. It is important to clarify that this pathology presents different clinical variants, belonging one to them those related with the artery carotid what would explain the sensation of eminent death. (AU)

[Undergraduate medical education in Cantabria and its relevance to the new health system]. / Estudio de la formación médica pregraduada en Cantabria y su pertinencia en el nuevo modelo sanitario.

Considering that medical schools should serve the community to which they provide professionals and that, therefore, they should have a knowledge of the community health needs, we evaluated the adequacy of the teaching program of the Medical School of Cantabria and the attitudes and expectations of the medical students. The results showed a majority of students younger than age 20 (90.2%), with a female predominance (68.5%), from upper and middle classes and with professional expectations of becoming a hospital specialist (86.9%) and working in urban media (95.4%). In the analysis of the teaching program a predominance of clinical over social topics was discovered, there was a lack of contact with primary care, the teaching was given as professorial lectures and the education of students was oriented towards hospital specialties. It was concluded that a change in the educational systems is needed for adequacy with the new health care system.

Anti-influenza A activity of some N-substituted bicyclo[3.2.1]octane-3-spiro-3'-pyrrolidine hydrochlorides: synthesis and structure.

Some N-substituted bicyclo[3.2.1]octane-3-spiro-3'-pyrrolidine hydrochlorides (IX-XII) prepared from bicyclo[3.2.1]octan-3-one (I), were assayed in vitro against influenza A viruses. All materials showed activity similar to 1-adamantanamine hydrochloride. A 1H-NMR study revealed only one isomer at the spiro carbon atom.

Synthesis and transport applications of 3-aminobicyclo[3.2.1] octane-3-carboxylic acids.

The isomeric 3-aminobicyclo[3.2.1]octane-3-carboxylic acids were synthesized and compared with the widely used (1R,2S,4S)-2-aminobicyclo[2.2.1]heptane-2-carboxylic acid as to specificity to the Na+-independent membrane transport system L of the Ehrlich ascites tumor cell and of the rat hepatoma cell line HTC. The presence of an additional methylene group in the ring system leads to an optically symmetrical amino acid, with the advantages that the product is devoid of isomeric contamination. Hence, optical resolution is not necessary to secure a homogeneous test substrate for discrimination of amino acid transport systems. Through its inhibitory action on the cellular uptake of known system-specific amino acids, the bicyclo[3.2.1]octane amino acid proved more reactive than the bicycloheptane analogue with the Na+-independent amino acid transport system of the test cells and not perceptibly reactive with the accompanying Na+-dependent systems. Recent evidence of the presence of a second component of Na+-independent amino acid transport, beyond system L, increases the importance of securing a variety of possibly discriminatory model substrates.

Synthesis and structural study of N-substituted nortropane spirohydantoins.

A series of N8-alkyloxycarbonylalkyl-nortropane-3-spiro-5'-hydantoins has been synthesized and studied by spectral and crystallographic methods. The crystal and molecular structure of one [8(gamma-ethoxycarbonyl)nortropane-3-spiro-5'-hydantoin, VI] was determined by X-ray diffraction. The preferred conformations of these compounds and subsequent changes on protonation were determined from 1H-NMR and 13C-NMR data.

[Echodactyly syndrome, ectodermic dysplasia, facial cleft, and EEC syndrome : report on 12 cases (author's transl)]. / Douze observations du syndrome ectrodactylie. Dysplasie ectodermique. Fente faciale, syndrome E.E.C.

Twelve cases of a rare syndrome are reported. Findings included a facial cleft, adactyly of the 2nd and 3rd fingers and 2nd and 3rd toes, and ectodermic dysplasia involving anodontia, hypotrichosis, and albinoid type pigmentation of the skin and the exoskeleton, with clear eyes and chronic conjunctivitis. An interesting finding was that the anodontia affected the permanent teeth only, initially involving the incisors and the second premolars (nine cases out of twelve). Inversely, the deciduous teeth were unaffected, except for the upper first molars in two cases. The canines, usually constantly present, were absent in two out of three cases.

PMR and 13C-NMR spectroscopy of tropane and N-substituted nortropane spirohydantoins.

The preferred conformations of a pharmacologically interesting series of N-substituted nortropane spirohydantoins were determined from PMR and 13C-NMR data to permit a structure-activity relationship study.