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Ventricular late potential detection can be used as a non-invasive diagnostic tool, but traditional detection techniques need around 300 heartbeats and fail to obtain the beat-to-beat information. This paper combines a modified signal averaging and an adaptive enhancer to deal with non-stationary environments and get beat-to-beat information from as little as 60 beats. In the ventricular late potential region of the recovered signal, discernible patterns indicate the presence or not of such waveforms. A maximum absolute value “averaging” can emphasize the boundaries of the QRS complex even further to successfully detect ventricular late potentials.

A case of an adult dog with multifocal, progressive neurological signs caused by Neospora caninum is reported. Pathological studies showed cerebellar lesions due to the parasite, which was also present in other parts of the nervous system and muscle. Cerebellar atrophy related to Neospora infection has been rarely reported in veterinary medicine, and has been shown to affect ruminants and dogs. The cerebellar involvement and the age of the present dog make this case uncommon.

Antecedentes: La anemia ferropénica es frecuente en el anciano, y su causa más frecuente es el sangrado gastrointestinal crónico. En los ancianos es muy común el uso de anti-inflamatorios no esteroideos (AINEs). Las complicaciones gastrointestinales del uso de AINES son más frecuentes en los sujetos de edad avanzada. Objetivos: El estudio fue dirigido a analizar si el uso habitual de AINEs en pacientes ancianos con anemia ferropénica se asocia a mayor prevalencia de determinadas lesiones en la endoscopia digestiva alta. Materiales y métodos: Se incluyeron 91 pacientes (40% varones y 60% mujeres) mayores de 65 años (edad media 77 años, rango 65-90 años). Todos habían sido ingresados en el hospital por anemia ferropénica. Un total de 38 pacientes eran usuarios habituales de AINES. Se realizó endoscopia digestiva alta en todos los casos. Resultados: Las prevalencias de úlcera péptica, gastritis o duodenitis erosiva y esofagitis fueron similares en usuarios y no usuarios de AINEs (13 vs 11%, 18 vs 15%, y 26 vs 26%, respectivamente). La proporción de pacientes con adenocarcinoma gástrico fue mayor en el grupo de no usuarios de AINEs (8% vs 23%, p=0.05). La endoscopia digestiva alta fue enteramente normal en 39% de los usuarios de AINEs y en el 34% de los no usuarios. Conclusiones: Las lesiones en el tramo alto del aparato digestivo en pacientes de edad avanzada con anemia ferropénica son similares en usuarios y no usuarios de AINEa, con la excepción del adenocarcinoma gástrico, que puede ser más común en los no usuarios de AINEs.

El objetivo de la presente revisión es actualizar y estandarizar las indicaciones y sistemas de aplicación de las pruebas de sensibilidad a la tuberculosis (mantoux) y de hipersensibilidad retardada en pacientes con infección por VIH.

Objetivo: El objeto de este trabajo fue determinar la inmunidad celular utilizando el Multitest CMI y correlacionar su resultado con el recuento de linfocitos CD4, y el riesgo de desarrollar tuberculosis activa en el caso de que la pápula correspondiente a la tuberculosis del multitest fuera positiva. Material y Métodos: Se realizó un seguimiento longitudinal prospectivo de 342 pacientes UDVP, 210 infectados con el VIH-1 y 132 de ellos seronegativos. La cohorte objeto del estudio estaba formada por 165 UDVP seropositivos para el VIH-1 (128 varones y 37 mujeres). Las edades estaban comprendidas entre 18 y 45 años. El tiempo del trabajo fue de 25 meses (8-25). La prueba de la tuberculina y el multitest les fueron practicados al inicio y cada tres meses así como un despistaje de tuberculosis activa a lo largo de todo el periodo del estudio cuando se consideró necesario. Resultados: Se desarrolló tuberculosis activa en 9,25 casos por cien personas y año de seguimiento en los estados con mejor nivel inmunológico (score de la PHR >10 mm). Había una correlación significativa entre el diámetro de la pápula de la prueba de la tuberculina y la pápula de la fracción tuberculínica de la prueba de hipersensibilidad retardada. Conclusiones: La prueba de la hipersensibilidad retardada realizada con el Multitest IMC es de utilidad para evaluar la función de la inmunidad celular y en los pacientes seropositivos para el VIH-1 anérgicos o con la fracción tuberculínica de la PHR positiva debe considerarse la posibilidad de quimioprofilaxis con isoniazida (9 meses).

To know the frequency of resistances of Mycobacterium tuberculosis and the associated factors.Prospective study of the sensitivity of Mycobacterium tuberculosis by means of the method of the proportions of Canetti in the Hospital Arquitecto Marcide-Profesor Novoa Santos (Ferrol, Spain) among 1991 and 1998. A descriptive and multiple regression analyses were performed.Were studied 355 strains. Primary resistance: Isoniazid 1.1%, Streptomycin 1.1%. Secondary resistance: Isoniazid 11.6%, in the 5.2% existed multidrug-resistance. The risk factors for drug-resistant tuberculosis were previous treatment (odds ratio [OR] = 10.9; 95% CI, 2.9-39.4) and age higher than 40 years (OR = 3.9; 95% CI, 1.1-14.5).A low frequency of resistance was observed. The factors associated with the resistances were previous treatment and age.

In the presence of 3-amino-L-tyrosine (3-AT), abundant brown pigment forms in human HL-60 cells, but not in a variety of other cell lines, which are reported to be lower in mean myeloperoxidase (MPO) content than HL-60. Cells were assessed for peroxidase activity with an ABTS-based colorimetric assay and compared to values obtained with known amounts of human myeloperoxidase. HL-60 cells were estimated to contain the equivalent of 37.1 ng myeloperoxidase/10(6) cells versus 26.1 and 5.0 ng/10(6) cells for human K562 and murine RAW 264.7 cell lines, respectively. HL-60 cells exhibited a nearly 60% inhibition of proliferation and70% reduction in cell viability after 4 d of culture in the presence of 100 microg 3-AT per ml. Higher concentrations of 3-AT (up to 400 microg/ml) for 4 d reduced HL-60 proliferation by 80% and decreased viability to 1-3%. Comparable levels of cytotoxicity were achieved in KG-1 cells after 7 d with 200 or 400 microg 3-AT per ml. K562 cells exhibited a 40% reduction in cell number after 7 d with 400 microg 3-AT per ml, but concentrations less than 400 microg/ml did not significantly affect K562 proliferation. K562 viability remained unchanged with doses of 3-AT up to 400 microg/ml. RAW 264.7 cells exhibited unchanged viability and proliferation in the presence of 3-AT at concentrations up to 400 microg 3-AT per ml. K562, KG-1, and RAW 264.7 cells exhibited no evidence of brown pigment formation in the presence of 3-AT and medium containing 10% fetal bovine serum. However, RAW 264.7 cells that were converted to protein-free medium and exposed to 3-AT exhibited intense brown pigment in some cell nuclei. A high percentage of HL-60 cells treated with 3-AT exhibited membrane blebbing, pyknosis, and nuclear fragmentation, which was not observed among other 3-AT-treated cell lines. A mechanism involving toxic intermediates of peroxidase-mediated "aminomelanin" formation is hypothesized.

To ascertain the condition of the oral hygiene of school children 6 and 12 years of age in Galicia and to assess the degree to which said condition meets the World Health Organization (WHO) oral hygiene objectives for the year 2000.Observational cross-sectional study conducted in 1995 on a group of school children 6 and 12 years of age in Galicia selected by means of a multi-stage sampling by conglomerates, stratified by provinces and type of habitat.This study was conducted on 1,288 school age children, 643 in the 6-year-old group and 645 in the 12-year-old group. 46.7% of the 6 year-old children and 64.2% of the 12 year-olds were found to have cavities, which means an oc index of 1.84 and a AOC index of 1.60, respectively.A trend toward improvement in the oral hygiene of school-age children in Galicia has been found. The oral hygiene-related objectives recommended by the WHO for the year 2000 in the region of Europe have been accomplished, as a result of which further objectives are recommended.

We show that Vickers micro-indentation is an experimental method that can reveal information about some structural features and the degree of intermixing in these systems

A case of a dog with a long-standing history of seizures is reported. Neurological examination suggested an intracranial focal lesion, while magnetic resonance imaging disclosed a right cerebral mass with ventricular involvement. Pathological analysis of the resected specimen revealed characteristics of meningioangiomatosis.

We determined the extent to which opportunities for prevention were missed among patients with tuberculosis and the costs derived from the lack of prevention.Descriptive study of patients with active tuberculosis were studied in the hospital ward of tuberculosis at the A. Marcide-Novoa Santos Centre (Ferrol, Spain), from September of 1991 to August of 1995. Risk factors to develop tuberculosis, vaccination with BCG, previous tuberculin skin test and previous history of drug prophylaxis or tuberculosis therapy were determined. Then, we determined whether they had undergone prevention procedures in accordance with current recommendations of the American Thoracic Society. An evaluation of the direct and indirect derived costs was carried out in patients with any missed opportunity for tuberculosis prevention.Out of 433 studied patients, 167 (38.6%) got missed any opportunity for prevention. Out of 167, 29 patients (6.7%) did not complete a previous treatment; 9 (2.1%) did not complete drug prophylaxis; 12 (2.8%) with known previous positive tuberculin skin test and an indication for drug prophylaxis never received it, and 117 (27%) with known indications for screening never received a skin test. 62 patients (53%) with known exposure to active pulmonary tuberculosis, and 65 (55.6%) with predisposing medical conditions. From the missed opportunities for prevention we calculated some direct costs of 116,909,911 pesetas and some indirect costs derived from the absence to work (141.9 +/- 114.3 days) and from the death of 6 patients for tuberculosis.A large percentage of missed opportunities to prevent the disease was found among patients with tuberculosis. This means a considerable expense that could have been avoided.

Although subclavian vein stenosis is a well-known complication of haemodialysis subclavian catheters, little is known about its causes. Catheter-related infection is the most common complication of this technique, but its role in the genesis of late subclavian stenosis has not been established. We retrospectively analysed 80 subclavian catheterizations in a total of 54 chronic haemodialysis patients from a single center. Sixteen catheters had to be removed because of a well documented catheter-related infection: three catheter-related sepsis (2 with ipsilateral phlebitis), seven isolated fever with catheter tip colonization which disappeared after catheter removal, and six exit-site discharge with positive culture. For comparison we matched 14 contemporaneous catheters which were electively removed without evidence of infection and with a negative culture of the catheter tip. A venogram of the ipsilateral arm was performed in all the cases after more than 6 months of catheter removal. Both groups were remarkably similar with respect to age, sex, side of insertion, number of inserted catheters, time of indwelling, and time elapsed from removal to venography. Definite subclavian stenosis was three times more common among patients with previous catheter-related infection (75% versus 28%; P0.01). Interestingly, both patients with ipsilateral phlebitis showed total occlusion of the subclavian vein. Although all diabetic patients of the study (n = 6) suffered a catheter-related infection, the incidence of late subclavian stenosis was not more common than in non-diabetic infected patients. In summary, subclavian haemodialysis catheter-related infection is a major risk factor for the development of late subclavian vein stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

CAPD is considered a risk factor for low turnover bone disease. This was previously attributed to aluminum accumulation. We evaluated by biochemical and histomorphometric parameters (including double tetracycline labelling), 26 patients maintained on CAPD for 12-14 months. Three (11.5%) showed mild hyperparathyroidism, 5 (19.2%) osteitis fibrosa, 3 (11.5%) mixed forms, 4 (15%) osteomalacia and 11 (42.3%) adynamic bone disease. Only one patient with diabetes mellitus showed an aluminum stained bone surface10%. Intact PTH serum levels were lower in LTBD (133.2 +/- 128 vs 468.2 +/- 451 pg/ml; p0.05). We also evaluated prospectively 11 patients who underwent a bone biopsy at start of dialysis and after 12 months of CAPD treatment. Bone biopsies pre CAPD demonstrated normal-high bone turnover disease in 8/11 (72.7%) and low turnover bone disease in 3/11 (27%). In the follow-up biopsies, 2 patients showed osteitis fibrosa and other two mild forms. Low turnover bone disease was found in 7 patients (3 osteomalacia and 4 adynamic bone disease). We conclude that the predominant bone lesion in our CAPD patients is low turnover bone disease, predominantly adynamic forms, and aluminum does not seem to play a role on its genesis. Low intact PTH serum levels may be a predictor of low turnover bone disease.

Renal osteodystrophy (ROD) is a common complication of chronic renal failure. Fibrous osteitis and, to a lesser extent, osteomalacia are the predominant lesions. The aim of the present study was to evaluate the prevalence of the different forms of ROD.Nondecalcified bone biopsies were evaluated in 100 patients with end-stage renal disease (57 in pre-dialysis and 43 on hemodialysis) in whom biochemical (calcium, phosphorus, alkaline phosphatase, parathyroid hormone) and histomorphometric studies were carried out. Bone biopsies were classified in four histological groups: mild, fibrous osteitis (FO), osteomalacia (OM) and mixed type (FO + OM).96% of patients had histological findings of ROD with the following distribution: 41% mild; 30% FO; 14% OM; and 11% mixed. The most advanced types of ROD were seen in interstitial renal diseases. Pre-dialysis OM was associated with metabolic acidosis, a low phosphocalcic product and relative hypophosphoremia. Chronic aluminium poisoning was uncommon (7%) and was basically associated with OM. No instance of aluminium poisoning with osteodystrophy and bone fractures was seen.The most severe histological forms of OM were found in hemodialysis patients with persistent hypophosphoremia and associated with osteosclerosis.

It is suggested that asphyxia on newborns increases the susceptibility to epileptic syndromes. The effect of perinatal and postnatal anoxia on subsequent seizure susceptibility was assessed by amygdaloid kindling in adult rabbits. Rabbits from 1 day pre-term to 53 days were exposed to 100% N 2 for an average of 7 min or until the heart rate was reduced by 70%. Non-anoxic littermates served as controls. At 2 months of age, animals were implanted with bilateral amygdalae electrodes. after a postsurgical recovery period, afterdischarge (AD) thresholds were determined for the electrodes sites and a kindling paradigm was performed. There were no significant differences in the rate of kindling in all groups studied (control, anoxic at 1 day pre-term or at term, anoxic at 44 and 53 days). These results demonstrate that perinatal anoxia did not alter the seizure susceptibility in the adult rabbit kindling model.

Assessment of perinatal brain oedema is complicated by normal changes in brain water that accompany the marked physiological, biochemical and morphological alterations occurring during this phase of development. Multiexponential analysis of transverse decay curves (TDCs), derived from 128 echo CPMG images, of white matter (WM) made oedematous by either exposure of animals to triethyltin (TET) or cryogenic cortical lesions revealed a second, slower decay component not apparent in controls. More significantly, an obvious difference was noted between the TET and cryogenic lesion fast decay components which might serve as a basis to differentiate non-invasively cytotoxic and vasogenic oedemas.

Assessment of perinatal brain oedema is complicated by normal changes in brain water that accompany the marked physiological, biochemical and morphological alterations occurring during this phase of development. Multiexponential analysis of transverse decay curves (TDCs), derived from 128 echo CPMG images, of white matter (WM) made oedematous by either exposure of animals to triethyltin (TET) or cryogenic cortical lesions revealed a second, slower decay component not apparent in controls. More significantly, an obvious difference was noted between the TET and cryogenic lesion fast decay components which might serve as a basis to differentiate non-invasively cytotoxic and vasogenic oedemas.

The problem of phase image denoising through nonlinear (NL) filtering is addressed. There are various imaging systems in which the phase information is utilised to generate useful imaging data. However, the presence of noise makes difficult to obtain the appropriate phase image. The authors apply NL vector filtering techniques to denoise the complex data from which the phase image is extracted. A study was realised in which several NL filters were applied to a simulated complex image. The effects of filtering were determined through a Monte Carlo simulation in which the image was successively contaminated with six different noise models. The effectiveness of the filters was measured in terms of normalised mean square error, signal-to-noise ratio and the number of eliminated phase residues. Results indicate a significant noise reduction, especially when NL filters based on angular distances are applied to the noisy input.

Adaptive line enhancing followed by a modified signal average is proposed, for ventricular late potential detection. The acquisition time is reduced five-fold to /spl sim/1 min, while maintaining standards in noise reduction for ventricular late potential analysis.

Approximately 20% of preterm rabbit pups develop spontaneous germinal matrix hemorrhages (GMH). To understand better the pathogenesis of GMH we studied the ultrastructure of germinal matrix (GM) blood vessels in rabbits delivered at gestational day 28. Regardless of luminal size, the walls of most GM vessels had the structural characteristics associated with a blood-brain barrier (BBB) and consisted of endothelial cells and pericytes, surrounded by GM cell processes. Endothelial cells ranged from voluminous to attenuated, with some cells containing intracytoplasmic, membrane-bound vacuoles, and luminal as well as abluminal cytoplasmic projections. Some short interendothelial junctions had no puncta adherentia, whereas long ones often possessed intermittent pores. In two animals with GMH, intact endothelial cells were separated by narrow and wide gaps filled with luminal contents that occasionally extended beyond the interendothelial opening. The basal lamina (BL) was ill-defined, thin, often discontinuous and of low electron density. Smooth muscle cells and collagen were not present, which precluded any classification into arteries, capillaries and veins. Germinal matrix cell processes lacking both micro- and intermediate filaments were haphazardly disposed around the blood vessel walls in place of astrocytic endplates. Recent reports indicate that an astrocytic environment may be necessary for the development of the interendothelial tight junctions and BL. The presence of "glial foot" processes that lack ultrastructural characteristics of mature astrocytes suggests that interendothelial junctions and basal laminae in the vessels of the ganglionic eminence may not have the necessary structural and functional potential to withstand the transmural pressures or the pathophysiological influence of hypertension, hyperosmolarity, sepsis, and other factors known to open the BBB and to contribute to GMH.

Retained gastric antrum was evaluated in six dogs, and diagnostic methods correlated with histopathology. Secretin and calcium infusion did not significantly alter circulating gastrin levels. 99m Tc scanning was uniformly positive and did not depend on the presence of parietal cells. The failure to consistently develop hypergastrinemia and the absence of gastrin cell hyperplasia suggest that factors other than gastrin may be implicated in the recurrent ulceration seen with retained antrum.

Cerebral blood flow was studied in rabbits immediately following complete circulatory stasis of varying duration. Systemic arterial pressure was measured continuously. The postischemic circulation was examined both by an infusion of carbon black and, in separate experiments, by injection of 14C-antipyrine into the blood. We examined the relationship between the duration of stasis, the postischemic arterial pressure, and the amount of cerebral reperfusion. As stasis increased from 5 to 30 min the pressure required to achieve reperfusion of the entire brain rose from 20 to 100 torr. Following even temporary exposure to arterial pressures above 110 torr all areas of the brain were generally reperfused. Blood flow in reperfused brain varied directly with arterial pressure, indicating failure of autoregulation. At normal (preischemic) arterial pressure, postischemic cortical flow was twice the normal rate. The data indicate that the pressure required to initiate flow in ischemic brain increases as the duration of stasis is lengthened and that once flow occurs there will be a significant hyperperfusion unless systemic arterial pressure is lowered to the low normal or hypotensive range.

The process of designing, developing and implementing a computer‐based employee skills inventory system within the Ford Motor Company is described. Important factors influencing the success of such a system are focused on from the perspective of an industrial/organisational psychologist. It is argued that the key to successful consultation is the adoption of a collaborative style that encourages and supports the active involvement of management and employees.

Proton magnetic resonance relaxation time measurements were used to study developmental changes in rabbit cardiac and skeletal muscles during the last days of gestation and at several postnatal times. Tissue water content decreased steadily during late fetal and early postnatal stages of development. During this period T1 and T2 for cardiac and skeletal muscles also decreased. The relaxation times stabilized after the 20th postnatal day, and at this juncture the T1 and T2 values for myocardium remained consistently higher than for skeletal muscle. The developmental changes in proton relaxation time probably represent changes in water distribution and mobility as well as macromolecular structure during muscle maturation.