Temporary work disability following trapezial resection and suspension arthroplasty for thumb carpometacarpal osteoarthritis. / Incapacidad laboral temporal tras cirugía de rizartrosis mediante trapecectomía y artroplastia de suspensión con sutura de alta resistencia.

PURPOSE: The aim of this study is to assess the time to return to work (TRW) in patients undergoing trapezial resection using the Mini TightRope® system at our center and to investigate factors that might delay return to work following this surgery. MATERIAL AND METHODS: A retrospective study was conducted on patients who underwent Trapezial resection and suspensionplasty using the Mini TightRope® system between 2015 and 2016, with a minimum one-year follow-up. Telephone interviews were conducted along with a review of medical records and radiology reports, as well as temporary work disability documents, collecting epidemiological and occupational data. Groups were compared based on age, gender, dominant hand, biomechanical occupational requirements of the patients, and whether they had experienced prior temporary work disability. RESULTS: A total of 36 patients (29 women and 7 men) with an average age of 55.7 years were included. The median time to return to work was 126 days. Self-employed workers re-entered the workforce 72 days earlier on average; workers who had experienced prior temporary work disability had a greater total temporary work disability duration and took 91 days longer to return to work compared to those who had not. CONCLUSIONS: Patients employed by others and those who had experienced prior temporary work disability before the surgery had longer temporary work disability periods. In our study, no differences were observed based on gender, dominant hand, or biomechanical work demands of the intervened patients.

Behavioural and physiological responses to salinization and air exposure during the ontogeny of a freshwater South American snail.

Salinization is of global concern, threatening freshwater biodiversity. Salinity tolerance is highly variable and therefore needs to be evaluated on a species-specific basis. An estuarine population of Chilina dombeiana, a freshwater gastropod endemic to Chile and classified as vulnerable, has been recently found in the Biobío River's mouth, suggesting some degree of tolerance to brackish waters. This study evaluated the survival, behaviour (medium preference) and physiology of C. dombeiana when exposed to salinities higher than freshwater, thus elucidating the potential mechanisms used to survive salinization. Chilina dombeiana belongs to the Pulmonate group;, so we evaluated oxygen uptake in air and water, aiming to evaluate emersion as a potential avoidance response to a progressive salinity increase. Complete embryo development was observed for salinities ≤ 16 PSU (practical salinity units) but hatching rates above 50% were only achieved in freshwater (0 PSU). It was also found that salinity had stage-specific effects during embryonic development. In adults, acute exposure to brackish water (12 PSU) caused a decrease in oxygen consumption (compared to freshwater), in the ammonium excretion rates and in the percentage of muscular water content. Although C. dombeiana was able to take up oxygen in both mediums, survival in air decreased over time (days), which correlates with the behavioural preference to remain submerged, even at elevated salinities. Considering the survival of adults and embryos decreased as salinity increased and the lack of an avoidance behaviour or a physiological ability to maintain homeostasis at salinities higher than freshwater, our results suggest this snail could be adversely affected by salinization in the long term. Furthermore, given the ability of C. dombeiana to uptake oxygen in both mediums, it should be considered as a facultative air breather snail, rather than a strictly aquatic species.

Oxidative damages and antioxidant defences after feeding a single meal in rainbow trout.

Feeding and digestion are metabolically demanding causing a rise on metabolic rate called Specific Dynamic Action (SDA). Although SDA has been vastly reported in fish, its potential consequences on the oxidative-antioxidant balance has not been evaluated to date in fish, a model with a long alkaline tide associated with feeding as well. Using rainbow trout (Oncorhynchus mykiss) as a model species, the aims of the present study were to: (1) assess potential oxidative damages and changes in oxidative defences after feeding on a single meal, and (2) identify the timescale of such changes over a 96 h post-feeding period. Oxidative damage in proteins and lipids and the activities of four enzymatic antioxidant defences: superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione-S-transferase (GST) were measured in gill, stomach, intestine and liver. DNA damage was measured in red blood cells. Fish were sampled before and after 1.5, 6, 24, 48, 72 and 96 h of ingestion of a 3% body mass ration. Trends of post-prandial damage were present in all tissues, but only protein oxidation varied significatively during digestion in the stomach. The intestine and stomach presented the highest enzymatic activities, likely due to the high metabolic action that these tissues have during digestion, with peaks during post-feeding: at 24 h of SOD in stomach and at 48 h of CAT in intestine. Observed GPx peaks during post-feeding in gills are likely due to the exacerbated demands for ion fluxes and/or oxygen during feeding. The differential response of the antioxidant system observed in tissues of rainbow trout during digestion indicates a coordinated and tissue-specific antioxidant defence.

Visceral infection by Porocephalus spp. (Pentastomida) in Neotropical wild mammals.

Larval stages of pentastomids were collected from different organs of small mammals from the Peruvian Amazon. These parasitized mammals included: a western Amazonian oryzomys (Hylaeamys perenensis), an elegant oryzomys (Euryoryzomys nitidus), a lowland paca (Cuniculus paca), two kinkajous (Potos flavus), two silvery woolly monkeys (Lagothrix poeppigii) and a brown-mantled tamarin (Leontocebus fuscicollis). Pentastomids were found in the mesentery and parenchyma of the liver and lungs of these animals. All pentastomids were morphologically identified as nymphs of Porocephalus spp. Only the nymphs collected from select animals (the western Amazonian oryzomys, the elegant oryzomys and the brown-mantled tamarin) were analysed molecularly. Molecular analysis was performed amplifying the mitochondrial cytochrome c oxidase subunit I gene from select nymphs collected from the western Amazonian oryzomys, the elegant oryzomys and the brown-mantled tamarin. The nucleotide sequences exhibited 95.8-97.7% similarity between them. Also, these sequences showed an identity of 95.8-97.9% to Porocephalus crotali (GenBank accession numbers MG559647-MG559655). Molecular analysis indicated the presence of at least two Porocephalus species. These findings represent the first record of Porocephalus in these mammals, thus adding new intermediate hosts for this pentastomid genus. This work represents the first molecular data of Porocephalus in a Neotropical climate.

Microplastic ingestion cause intestinal lesions in the intertidal fish Girella laevifrons.

We exposed juvenile intertidal fish to different amounts of Poly(styrene-co-divinylbenzene) microplastics in their diet. We fed ten individuals with pellets containing 0.01 g, another ten fish with pellets containing 0.1 g of PS, and ten fish without plastic as control. After 45 days of treatment, the whole intestine was removed, and the histological evaluation started immediately. We evaluated inflammation due to leukocyte infiltration (Lk), circulatory disorders like Hypermeia (Hyp), and regressive changes in the intestinal tissue, assessing Crypt cell loss (Ccl) and Villi cell loss (Vcl). The severity of the lesions increased according to the microplastic concentration. In the fish group feeding on microplastics, we found that leukocyte infiltration and hyperemia were more severe in the higher exposure group compared to the lower exposure; and crypt cell loss and villi cell loss increased significantly due to Poly(styrene-co-divinylbenzene) microplastic physical abrasion.

Reduction in myocardial strain is evident in adolescents and young adults with obesity and type 2 diabetes.

AIMS/HYPOTHESIS: Heart failure is a complication of type 2 diabetes (T2DM). Echocardiography can identify subclinical systolic dysfunction in adults with T2DM. We hypothesized that reduced systolic strain was present in youth with T2DM. METHODS: Global longitudinal strain (GLS) was measured in 151 subjects with T2DM matched to lean (L = 146), and obese (O = 162) subjects (23.0 ± 4.0 years, 35% male, 63% African American). Anthropometrics, BP, HR, labs, and echocardiograms were obtained. ANOVA was performed to compare differences among groups, and ANCOVA to determine if T2DM remained an independent predictor after corrections. RESULTS: BP, lipid levels, and metabolic control worsened and GLS was reduced from L to O to T2DM. BMI was lower in L than O or T2DM. Global longitudinal strain rate (GLSR) was lower and LVM/ht2.7 was higher in O and T2DM as compared to L (all P ≤ .05). Presence of T2DM was an independent determinant of GLS and GLSR adjusted for most CV risk factors, but lost significance when BMI was added to the model. GLS = -21.6-age*0.088 - male*1.8 + 0.12*BMI + 0.045*DBP + 0.058*HR - 0.023*HDL (R2 = 0.38, P ≤ .0001); GLSR = -1.20-male*0.093 + WHR*0.48 + DBP*0.0029 (R2 = 0.23, P ≤ .0001). CONCLUSION: Both adiposity and T2DM have a deleterious effect on systolic cardiac function. Treatment of obesity in youth is necessary for prevention of future heart failure.

Retraction: Randomized controlled trial of vitamin D supplementation in children with autism spectrum disorder.

The above article, published in print in the Jan 2018 issue of the Journal of Child Psychology & Psychiatry and online in Wiley Online Library (wileyonlinelibrary.com), has been retracted by the JCPP Editor-in-Chief, Edmund Sonuga-Barke, and John Wiley & Sons. Following a series of communications from readers highlighting concerns about the paper (now published on the journal website), the journal editors requested that the authors send them the raw data from the trial. In response the authors informed the editors that; (i) the electronic data base had been lost following a computer outage and (ii) that they could send only 95 out of 120 hard-copy participant data sheets as one site had closed and was no longer contactable. The substantial data loss in and of itself posed a serious difficulty in verifying the correctness of the data presented in the paper. The JCPP then analysed the data from the 95 cases itself. A number of significant discrepancies emerged between the re-analysis and the findings reported in the paper both in terms of means and standard deviations of key outcome variables across the trial. These involved very substantial differences that we judged to be extremely unlikely to have arisen due to variations in composition of the original and re-analysed samples. We also discovered previously unidentified/reported problems with missing data and recording irregularities regarding changes in treatment regimen and subject identifiers. As a result of these issues the Editors no longer have confidence in the findings reported in the original paper. Based on all these matters combined and following published guidance from the Committee on Publishing Ethics (COPE) and Wiley's Best Practice Guidelines on Publishing Ethics, we have decided that the only course of action available to us is to retract the paper.

Effects of pharmaceuticals used to treat salmon lice on non-target species: Evidence from a systematic review.

Aquaculture is currently one of the best prospects to help meet the growing need for protein in the human diet. However, aquaculture development and production result in consequences for the environment and also impact other productive activities. Salmon and trout cage culture has required the use of large quantities of pharmaceuticals in order to control outbreaks and the persistence of different pathogens, including sea lice (parasitic copepods), which cause economic losses of around 0.39 €â€¯Kg-1 of salmon produced. The pharmaceuticals currently used for the control of sea lice (cypermethrin, deltamethrin, azamethiphos, hydrogen peroxide) are applied by in situ immersion treatments, enclosing net pens using tarpaulin and then bathing fish with the pharmaceutical. After treatment the pharmaceuticals are released into the surrounding environment, exposing non-target species. Although the effects of such pharmaceutical exposure has been studied in some species, to date a systematic and exhaustive review of these potential effects has not yet been performed. In this study, an exhaustive review of the literature evaluating lethal and sub-lethal effects of anti-sea lice pharmaceuticals on non-target crustaceans and bivalves was performed, in order to assess the extent of the effects, toxicity, variables affecting such toxicity and identify potential synergistic effects previously unexplored. Our results show clear negative effects at concentrations lower than those used in treatments against sea lice in all of the species studied. Likewise, this study demonstrates knowledge gaps that need to be addressed in order to improve our understanding of the effects of these pharmaceuticals on non-target species, ecosystems in general and other productive activities.

First detection of plastic microfibers in a wild population of South American fur seals (Arctocephalus australis) in the Chilean Northern Patagonia.

The dramatic increase of microplastics (plastic fragments <5 mm) in marine environments is a problem that has attracted public attention globally. Within the different types of microplastics, microfibres are the least studied (size <1 mm). We examined 51 female scats from a population in Northern Patagonia. Our results showed no presence of microplastic particles, however 67% of them showed a remarkable abundance of microfibers, which until now had only been reported in animals fed in captivity. As a result of this work we propose that the examination of scats from South American Fur Seal and also other pinnipeds could be an efficient tool to monitor environmental levels of microfibres and maybe microplastics in the environment due to the easy recognition of the animals and their scats.

Defining new aims for BME programs in Latin America: the case of UAM-Iztapalapa.

The need for upkeep and management of medical technology has fostered the creation of a large number of under graduate programs in the field of biomedical Engineering. In Latin America alone, there are over 85 programs dedicated to this. This contrasts with programs in other regions where most of the undergraduates continue on to pursue graduate degrees or work as research and development engineers in the biomedical industry. In this work we analyze the situation regarding curricular design in the 48 BME programs in Mexico and compare this to suggestions and classifications of programs according to needs and possibilities. We then focus on a particular institution, Universidad Autónoma Metropolitana and due to its characteristics and performance we propose that it should redefine its aims from the undergraduate program on, in order to not only generate research but also to provide a nurturing environment for a budding biomedical industry in Mexico.

Evolución de las derivaciones de atención primaria a urología. Impacto de un protocolo en enfermedad prostática y de formación continuada / Evolution of primary care referrals to urology. Impact of a protocol on prostate disease and continuing education

Objetivo: Analizar la evolución de las derivaciones desde atención primaria (AP) a urología tras implantar un protocolo conjunto en enfermedad prostática y un programa de formación continuada en nuestra área sanitaria. Material y métodos: En enero de 2011 iniciamos un protocolo de actuación en enfermedad prostática, que se complementó con sesiones formativas y con un sistema de consultas vía correo electrónico. Analizamos las derivaciones desde AP a urología entre 2011 y 2013, determinando el motivo de consulta y la adecuación a los criterios establecidos en enfermedad prostática. Obtuvimos los datos del programa «Solicitud de cita en atención especializada» de la Comunidad de Madrid. Calculamos el tamaño muestral con un nivel de confianza del 95% y heterogeneidad del 50%. Resultados: Se produjeron 19.048 derivaciones. El motivo de consulta más frecuente fue STUI asociado a HBP, con una reducción del 27% y una adecuación que pasó del 46 al 67%. Las consultas por PSA, aunque aumentaron un 40%, también mejoraron su adecuación (del 55 al 72%), siendo la principal consulta por sospecha de malignidad (30%). Destacan además la incontinencia femenina, que ha duplicado su número, y el descenso del 41% en disfunción eréctil, que pueden justificarse por la formación impartida a AP. Conclusiones: La colaboración entre urología y AP consigue mejorar la adecuación de las derivaciones en enfermedad prostática y modificar la tendencia de derivación del resto de enfermedades incluidas en el proyecto

Objective: To analyze the evolution of primary care referrals to the Urology Department after the implementation of a joint protocol on prostate disease and a continuing education program in our healthcare area. Material and methods: In January 2011, we launched an action protocol on prostate disease, which was complemented by training sessions and an e-mail-based consultation system. We analyzed primary care referrals to the Urology Department between 2011 and 2013 and determined the reasons for the consultations and the compliance with the established criteria on prostate disease. We obtained data from the "Request for Appointment in Specialized Care" program of the Community of Madrid. We calculated the sample size with a 95% confidence level and a 50% heterogeneity. Results: A total of 19,048 referrals were conducted. The most common reason for the referrals was lower urinary tract symptoms associated with benign prostate hyperplasia, with a 27% reduction and a compliance that went from 46% at 67%. Although prostate-specific antigen consultations increased by 40%, they improved their appropriateness (from 55% to 72%). This was the main type of consultation for suspicion of malignancy (30%). Also worth mentioning were female incontinence, which doubled in number, and a 41% reduction in erectile dysfunction, which could be due to the primary care training. Conclusions: The collaboration between the Department of Urology and primary care succeeded in improving the appropriateness of prostate disease referrals and modified the tendency to refer the rest of the diseases included in the project

Evolution of primary care referrals to urology. Impact of a protocol on prostate disease and continuing education.

OBJECTIVE: To analyze the evolution of primary care referrals to the Urology Department after the implementation of a joint protocol on prostate disease and a continuing education program in our healthcare area. MATERIAL AND METHODS: In January 2011, we launched an action protocol on prostate disease, which was complemented by training sessions and an e-mail-based consultation system. We analyzed primary care referrals to the Urology Department between 2011 and 2013 and determined the reasons for the consultations and the compliance with the established criteria on prostate disease. We obtained data from the "Request for Appointment in Specialized Care" program of the Community of Madrid. We calculated the sample size with a 95% confidence level and a 50% heterogeneity. RESULTS: A total of 19,048 referrals were conducted. The most common reason for the referrals was lower urinary tract symptoms associated with benign prostate hyperplasia, with a 27% reduction and a compliance that went from 46% at 67%. Although prostate-specific antigen consultations increased by 40%, they improved their appropriateness (from 55% to 72%). This was the main type of consultation for suspicion of malignancy (30%). Also worth mentioning were female incontinence, which doubled in number, and a 41% reduction in erectile dysfunction, which could be due to the primary care training. CONCLUSIONS: The collaboration between the Department of Urology and primary care succeeded in improving the appropriateness of prostate disease referrals and modified the tendency to refer the rest of the diseases included in the project.

Brain and central nervous system cancer incidence in navarre (Spain), 1973-2008 and projections for 2014.

Different studies have pointed out Navarre as one of the regions of Spain with the highest incidence rates of brain and other central nervous system (CNS) cancer. Trend analysis for cancer incidence rates for long periods of time, might help determining risk factors as well as, assessing prevention actions involved in this disease. The objective of this study was to describe the incidence of brain and CNS cancer using data from the population-based cancer registry of Navarre, (Spain) during the period 1973-2008 and provide forecast figures up to-2014. Crude and age-standardized (world population) incidence rates of brain cancer per 100,000 person-years were calculated by the direct method separately by gender, area (Pamplona and others), and age-groups. Penalized splines for smoothing rates in the temporal dimensions were applied in order to estimate and forecast cancer incidence rates. Age-adjusted incidence rates showed an increase over the study and forecast periods in both sexes more marked in women than in men. Higher incidence rates were observed in men compared with women but the differences became smaller with time. The increase was due to the rise of rates in the oldest age groups since the rates for younger age groups remained stable or decreased over time. As the entire aetiology of brain and other CNS cancer is not still clear, keep promoting healthful lifestyles for cancer primary prevention among the whole population is necessary.

The importance of cutaneous gas exchange during aerial and aquatic respiration in galaxiids.

The Canterbury mudfish Neochanna burrowsius was found to be a pseudo-aestivating galaxiid with a low metabolic rate and significant cutaneous oxygen uptake (c. 43%) in both air and water. Another galaxiid, inanga Galaxias maculatus, had a higher metabolic rate in both media but the proportion of oxygen uptake met by cutaneous respiration rose significantly from 38 to 63% when the fish were exposed to air. Besides its important role in oxygen uptake, the skin of both species also contributed significantly to excretion of carbon dioxide in air, indicating the critical role of the integument as a respiratory tissue. In air, G. maculatus may increase cutaneous gas exchange to meet metabolic demands owing to the reduced utility of the gills, but as emersed G. maculatus were only able to maintain metabolic rates at c. 67% of that measured in water, this strategy probably only permits short-term survival. By contrast, the low and unchanging metabolic rate in water and air in N. burrowsius is a feature that may facilitate tolerance of long periods of emersion in the desiccating environments they inhabit.

A high oxfendazole dose to control porcine cysticercosis: pharmacokinetics and tissue residue profiles.

Oxfendazole (OFZ) is efficacious for porcine cysticercosis at 30 mg/kg. OFZ is not registered to be used at this dose. The assessment of the OFZ and metabolites [(fenbendazole sulphone (FBZSO2), fenbendazole (FBZ)] plasma pharmacokinetic and tissue residue profiles after its oral administration to pigs and the withdrawal period for human consumption were reported. Forty-eight pigs allocated into two groups received OFZ (30 mg/kg) orally as a commercial (CF) or as experimental formulation (SMF). Samples (blood, muscle, liver, kidney and fat) were collected over 30 days post-treatment and analyzed by HPLC. OFZ was the main compound recovered in plasma, followed by FBZSO2 and low FBZ concentrations. OFZ AUC0-LOQ (209.9±33.9 µg·h/ml) and Cmax (5.40±0.65 µg/ml) parameters for the CF tended to be higher than those for the SMF (AUC0-LOQ: 159.4±18.3 µg h/ml, Cmax: 3.80±0.35 µg/ml). The highest total residue (OFZ+FBZSO2+FBZ) concentrations were quantified in liver, followed by kidney, muscle and fat tissue. FBZSO2 residue levels were the highest found in muscle (0.68±0.39 µg/g) and fat (0.69±0.39 µg/g). In liver and kidney the highest residues corresponded to FBZ (5.29±4.36 µg/g) and OFZ (2.86±0.75 µg/g), respectively. A withdrawal time of 17 days post-treatment was established before tissues are delivered for human consumption.

Chronic dialysis-associated anaemia in end-stage renal disease: analysis of management in two French centres.

BACKGROUND: Treatment of anaemia in renal-insufficient patients relies on the use of an erythropoiesis-stimulating agent (ESA). This study aimed to compare the impact of two different strategies of ESA prescribing on variation in haemoglobin (Hb) concentration in end-stage renal disease (ESRD) patients. METHODS: Patients with ESRD, on haemodialysis, and who had received ESA for >3 months were recruited. Different parameters were analysed: demographics, Hb level the last day of the year before dialysis, the most recent weekly ESA dose, risk factors for resistance and cost. Each institution continued its local practice for achieving the desired Hb level: increasing the ESA dose to overcome resistance in one centre and defining an upper ESA-dose limit in the other. RESULTS: A total of 185 patients were recruited. No significant differences in the biological parameters were found between the two populations. In both centres, Hb levels were comparable and mean levels exceeded 11 g/dL, despite the higher ESA doses given in one centre to achieve this target. This finding also held true for the subgroups with greater than or equal to two resistance factors. These two strategies led to large between-centre differences in treatment costs. CONCLUSION: The ESA-use strategy difference probably indicates that erythropoietin-resistance was not overcome with increased dosing. The Hb concentrations remained stable even when ESA doses were increased. On current evidence, the cheaper ESA-dose limitation strategy is preferable but randomized controlled studies, including comparisons of alternative ESA formulations are necessary.

Effects of zinc ex vivo and intracellular zinc chelator in vivo on taurine uptake in goldfish retina.

Taurine and zinc exert neurotrophic effects. Zinc modulates Na(+)/Cl(-)-dependent transporters. This study examined the effect of zinc (ZnSO(4)) ex vivo and zinc chelator N,N,N',N'-tetrakis-(2-pyridylmethyl) ethylenediamine (TPEN) in vivo on [(3)H]taurine transport in goldfish retina. The effect of TPEN in vivo on taurine and zinc levels was determined. Isolated cells were incubated in Ringer with zinc (0.1-100 microM). Taurine transport was done with taurine (0.001-1 mM) and 50 nM [(3)H]taurine. Zinc (100 microM) noncompetitively inhibited taurine transport. TPEN was administered intraocularly and retinas extracted 3, 5 and 10 days later. Taurine was determined by HPLC (nmol/mg protein) and zinc by spectrophotometry ICP (mg/mg protein). Taurine and zinc levels decreased at 3 days and increased at 10 days after TPEN administration. At 10 days after intraocular TPEN, taurine transport affinity increased (K (s) = 0.018 +/- 0.006 vs. 0.028 +/- 0.008 mM). Apparently, zinc deficiency affects the taurine-zinc complex and taurine availability. The increased taurine uptake affinity by TPEN was possibly associated with a response to maximize retinal taurine content at low zinc concentration.

An empirical test of partner choice mechanisms in a wild legume-rhizobium interaction.

Mutualisms can be viewed as biological markets in which partners of different species exchange goods and services to their mutual benefit. Trade between partners with conflicting interests requires mechanisms to prevent exploitation. Partner choice theory proposes that individuals might foil exploiters by preferentially directing benefits to cooperative partners. Here, we test this theory in a wild legumerhizobium symbiosis. Rhizobial bacteria inhabit legume root nodules and convert atmospheric dinitrogen (N2) to a plant available form in exchange for photosynthates. Biological market theory suits this interaction because individual plants exchange resources with multiple rhizobia. Several authors have argued that microbial cooperation could be maintained if plants preferentially allocated resources to nodules harbouring cooperative rhizobial strains. It is well known that crop legumes nodulate non-fixing rhizobia, but allocate few resources to those nodules. However, this hypothesis has not been tested in wild legumes which encounter partners exhibiting natural, continuous variation in symbiotic benefit. Our greenhouse experiment with a wild legume, Lupinus arboreus, showed that although plants frequently hosted less cooperative strains, the nodules occupied by these strains were smaller. Our survey of wild-grown plants showed that larger nodules house more Bradyrhizobia, indicating that plants may prevent the spread of exploitation by favouring better cooperators.

Noradrenaline transporter and its turnover rate are decreased in blood lymphocytes of patients with major depression.

Lymphocytes possess transporters of serotonin and dopamine, and also contain monoamines. The objective of this work was to determine the presence of noradrenaline transporters, the turnover rate of noradrenaline and serotonin in lymphocytes of major depression patients, and to correlate the biochemical parameters with the severity of the disorder. Lymphocytes from peripheral blood were isolated by Ficoll/Hypaque, and noradrenaline transporter was studied by binding of [3H]nisoxetine: control group (29, age 31.52+/-1.08, 7 men) and major depression patients (35, age 36.68+/-1.69, 6 men), Hospital Vargas de Caracas. Diagnostic was done by criteria of the American Psychiatric Association and severity by Hamilton Scale for Depression. Levels of noradrenaline, serotonin, 3-methoxy-4-hydroxyphenylglycol and 5-hydroxyindoleacetic acid were determined by HPLC. Turnover rate was evaluated by the ratios of monoamines and metabolites. Correlations were done between the biochemical parameters and the severity of depression. The score of Hamilton for Depression was 22.77+/-0.51. There was a reduction in the number of transporters in lymphocytes of patients, 0.95+/-0.27 versus 4.06+/-1.67 fmol/10(6) cells. Levels of monoamines and metabolites did not significantly differ between patients and controls. However, there was a higher monoamine/metabolite ratio in lymphocytes of patients, indicating a reduction of metabolic turnover rate. Also there was a relative greater concentration of noradrenaline than serotonin in the lymphocytes of the patients, as indicated by the ratio noradrenaline/serotonin. Noradrenergic and serotonergic turnover is decreased in blood peripheral lymphocytes of major depression patients; the reduction in noradrenaline transporter could be related to changes in intracellular levels, and these modifications could result in functional changes of the immune system.