Users' awareness of factors associated with complications during pill use

This study compared the frequency of factors and diseases that contribute to the risks of oral contraceptive use among current users and non-users of oral contraception in order to evaluate the users' awareness of factors associated with complications during oral contraceptive use. Data from 5317 current users and 8863 non-users in the state of São Paulo, Brazil, were collected using questionnaires requesting information on the following variables: use of oral contraceptives, age, weight, smoking status, and the presence or history of hypertension, diabetes, cardiopathies, painful varicose veins, and epilepsy. Half of the users had some risk factors, and 17.4% were at high risk of complications from oral contraceptive use. Risk factors and diseases which appeared to be poorly known by the population as increasing the risk of oral contraceptive use were smoking, hypertension and painful varicose veins. Only a small percentage of the population appeared to know that these diseases and factors could increase the risk of health problems during oral contraceptive use. The results suggest a lack of information among users and providers on factors which are associated with an increased risk of health problems during use of oral contraceptives.

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Resumen Este estudio comparó la frecuencia de factores y enfermedades que contribuyen al riesgo de los anticonceptivos orales (AO) entre usuarias y no usuarias corrientes de anticonceptivos orales a fin de evaluar el grado de conocimiento entre las usuarias de los factores asociados con complicaciones durante el uso de AO. Se recopilaron datos de 5317 usuarias y 8863 no usuarias corrientes del Estado de S@o Paulo, Brasil, utilizando cuestionarios en los que se solicitabe información acerca de las siguientes variables: uso de AO, edad, peso, fumadora/no fumadora y la presencia o historia de hipertensión, diabetes, cardiopatías, várices dolorosas y epilepsia. La mitad de las usuarias tenían algunos factores de riesgo y el 17,4% de ellas corrían un alto riesgo de complicaciones por el uso de anticonceptivos orales. Los factores de riesgo y enfermedades que parecían ser poco conocidos por la población como tendientes a aumentar el riesgo del uso de anticonceptivos orales eran el fumar, la hipertensión y las várices dolorosas. Sólo un pequeño porcentaje de la población parecía saber que estas enfermedades y factores podían aumentar el riesgo de problemas de salud durante el uso de anticonceptivos orales. Los resultados sugieren una falta de información de las usuarias y proveedores con respecto a factores que están asociados con un riesgo mayor de problemas de salud durante el uso de anticonceptivos orales.

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Resumé Pour évaluer dans quelle mesure les utilisatrices et non utilisatrices de contraceptifs oraux sont sensibilisées aux facteurs associés à des complications, cette étude a comparé la fréquence des facteurs et des maladies qui contribuent au risque que présente l'utilisation de ces contraceptifs. Dans l'Etat de Sao Paulo (Brésil), des données ont été recueillies auprès de 5317 utilisatrices et 8863 non utilisatrices, au moyen de questionnaires demandant des renseignements concernant les variables suivantes: utilisation de contraceptifs oraux, âge, poids, tabagisme, présence ou antécédents d'hypertension, diabète, cardiopathies, varices douloureuses et épilepsie. La moitié des utilisatrices présentaient certains facteurs de risque et 17,4% des facteurs de risque élevé de complications résultant de l'utilisation de contraceptifs oraux. Les facteurs de risque et les maladies dont la population semblait mal connaître l'effet d'augmentation des risques qu'entrîne l'ingestion de contraceptifs oraux étaient le tabagisme, l'hypertension et les varices douloureuses. Un faible pourcentage seulement de la population paraissait savoir que ces maladies et facteurs pouvaient accroître les risques de problèmes de santé durant l'utilisation des contraceptifs oraux. Les résultats suggèrent que les utilisatrices et les pourvoyeurs des services de contraception ne sont pas suffisamment informés des facteurs associés à un risque accru de problèmes de santé durant l'utilisation des contraceptifs oraux.

     

Catheter ablation by low energy DC shocks for successful management of atrial flutter.

OBJECTIVE--To assess the effects of low energy ablation of the substrate for atrial flutter. DESIGN--Initial retrospective analysis of patients undergoing low energy ablation of the atrioventricular node for refractory atrial flutter (group 1) was followed by a prospective assessment of low energy ablation in the posterio-inferior right atrium for the same condition (group 2). SETTING--Tertiary referral centre for management of cardiac arrhythmias. PATIENTS--Seven men (aged 50-67 years) with refractory atrial flutter. INTERVENTIONS--Multiple (3-10) low energy DC shocks with a cumulative energy of 100-245 J in the region of the atrioventricular node in group 1 and 12-15 low energy DC shocks (cumulative energy 110-235 J) guided by the anatomical landmarks of the triangle of Koch and applied directly to the atrial wall. MAIN OUTCOME MEASURE--Freedom from recurrence of atrial flutter. RESULTS--In group 1 despite initial complete atrioventricular block in three patients, atrioventricular conduction had resumed in all by one month. All four, however, were in sinus rhythm at follow up six to 13 months later. Two of the three patients in group 2 were free of atrial flutter at follow up three to four months after ablation. CONCLUSION--Ablation of the atrial flutter substrate with low energy DC shocks is feasible. Precise electrophysiological mapping is not necessary.     

Anti-Trypanosoma-cruzi-proteinase antibodies and immunoprotection in experimental Chagas' disease.

To verify whether anti-Trypanosoma-cruzi-proteinase antibodies are able to play a role in the development of Chagas' disease, CBA/J and C57BL/6 mice were immunized with purified proteinase fractions: antibody production was studied and passive immunization experiments were carried out. No significant differences were observed in the titre, isotype composition and specificity of the antibodies produced by the mouse strains. Immune sera produced in one strain was able to protect mice of both strains, provided that the challenge did not exceed the number of parasites corresponding to 30-fold the LD50. The data presented suggest that anti-proteinase antibodies may play a role in immunoprotection.     

P64Shoe contact dermatitis

Because of its numerous etiologies, foot dermatitis can be difficult to diagnose despite of thorough history and physical examination. The differential diagnoses are challenging and include allergic contact dermatitis, dyshidrosis, juvenile plantar dermatosis, atopic dermatitis, lichen planus.
Methods:  In the Cutaneous Allergology Unit of the Department of Dermatovenereology of Pedro Hispano Hospital, between 1999 and 2003, 804 patients were observed with suspicion of contact dermatitis. In 9,3% there was a history of recurrent foot dermatitis. All these patients were patch tested with GPEDC standard and shoe series and shoe fragments.
Results:  Twenty‐five patients revealed shoe contact dermatitis with positive reactions to the series tested, with an average age of 40 years. The dermatitis involved the dorsal aspect of the foot in 20 patients and the volar aspect in 8, the lateral aspects in 4, typically sparing the instep and flexural creases of the toes. The most common allergen were para‐tertiary‐butylphenol formaldehyde resin – PTBFR (12 patients‐48%), mercapto mix (7 patients‐28%), potassium dichromate (24%), mercaptobenzothiazole (24%).
Conclusions:  The most common causes of shoe contact dermatitis were glues, followed by rubber components and chromated leather. As in other studies the most common allergen in shoe dermatitis in Portugal is PTBFR in neoprene adhesives. Rubber components (accelerators) were the second more frequent allergen in this study, probably a direct result of improved fixation of chrome and a change in footwear style and chrome sensitivity explains leather allergy. Other causes of foot contact dermatitis are iatrogenic complication, clothing (socks), cosmetics, adhesive tape and professional etiology.     

Prevalence of Parkinson's disease in Cantalejo, Spain: a door-to-door survey.

We assessed the prevalence of Parkinson's disease in Cantalejo, Spain. In 1994, we screened 1,579 persons (age > or = 40 years) using a high-sensitivity method. Cases fulfilling established clinical criteria were followed for a minimum of 3 years. Prevalences were compared with those from other door-to-door surveys. We detected 27 individuals with parkinsonism, 20 of whom had Parkinson's disease. The prevalence of Parkinson's disease increased with age and, when age-adjusted to European standards, was 9.01 per 1,000 (age 40 years and over; 10.78 in men and 5.23 in women). Of the 11 men, three were in Hoehn & Yahr grades III-IV, but six of the nine women were more severely affected. Overall, we found 18 newly diagnosed cases of parkinsonism, 13 of which were Parkinson's disease, and the majority of which were in men aged 80 years or older with a mean duration of illness of 5 years. Our prevalence figures are the highest reported, apparently because of the inclusion of several very elderly men. Parkinson's disease in Cantalejo is less severe in men than in women, particularly in those newly diagnosed. Despite the low numbers, the high prevalence and sex-related pattern are unexplained but they probably relate to the high sensitivity of the screening method.     

Right internal thoracic artery through the transverse sinus in myocardial revascularization

Background. A major concern in evaluating dynamic cardiomyoplasty has been whether the synchronous stimulation of latissimus dorsi muscle is essential for benefit or not. We studied 10 patients to determine the efficacy of the systolic augmentation generated by the synchronous electrical stimulation of the latissimus dorsi muscle.

Methods. Left ventricular ejection fraction, end-systolic and end-diastolic volume indexes, and stroke volume index obtained during resting, peak exercise, and recovery periods (“on” values) were compared with those obtained 1 week after cessation of electrical stimulus (“off” values). Double product and estimated total body oxygen consumption at peak exercise were also calculated and compared.

Results. Higher ejection fractions (0.36 ± 0.07 versus 0.33 ± 0.06 at rest, 0.40 ± 0.07 versus 0.33 ± 0.07 peak exercise, and 0.37 ± 0.06 versus 0.31 ± 0.06 at recovery) and lower end-systolic volume indexes with relatively constant end-diastolic volume indexes were observed with the cardiomyostimulator on. Further, exercise response was better with the cardiomyostimulator on. Double product indirectly reflected better myocardial oxygen supply/demand ratio when on at peak exercise (17 ± 2.2 mm Hg × beats/min × 10⁻³ for on versus 19 ± 2.6 mm Hg × beats/min × 10⁻³ for off). Estimated total body oxygen consumption was improved at peak exercise when the cardiomyostimulator was functional (12 ± 2.7 mL · kg⁻¹ · min⁻¹ versus 11 ± 2.6 mL · kg⁻¹ · min⁻¹).

Conclusions. Current data suggest a true systolic assist during synchronous contractions of the latissimus dorsi muscle. It is thought, therefore, that synchronous electrical stimulation is essential for maximum benefit and all the beneficial effect of cardiomyoplasty certainly cannot be attributed to simple wrapping itself.     

Oral leukoplakia. Current concepts and analysis of the term in the Spanish language

The purpose of this paper is to carry out an analysis of the term leukoplakia since its introduction in 1877 and to expose the most accepted concepts and present classification within specialists. For this purpose attention will be paid to definitions established in the international seminary developed in Malm? City, Sweden, in June 1983. A group of observations on present status of research and diagnostic methods and its limitations to pre-establish when a lesion of this type is going to evolve toward malignancy, is included. An important part of this paper is devoted to the linguistic analysis of leukoplakia and leukoplasia expressions. An extensive argumentation demonstrating the systematic impropriety in the Spanish Language of translating the English term "leukoplakia as leukoplasia, is presented. There is in Spanish the accurate translation, given by the expression leukoplakia, which is not only the adequate one for the exactness of its translation but also the one more conceptually adjusted to contemporary definition universally accepted, that is to say, a white plaque. Finally, a comment on importance of incorporates to our language the exact translation of scientific words, not only to fit it to present science, but also to a better fulfillment of its function in allowing the communication within Latin American researches themselves and with the world scientific community, is exposed.     

The Drosophila Mutant tetanic Interacts with a Gene Complex Including the Structural Locus of K+ Channels and Shows Altered Dephosphorylation and Learning

The tetanic (tta; X.-52.6) mutation has been isolated on the basis of its sensitivity to extradoses of the normal Shaker gene complex (ShC) where the K+ channel la is encoded. The mutant shows up to threefold elevation of the membrane bound protein phosphatase type 1 (PP1) activity in body extracts, probably due to reduced levels of the PP1 specific inhibitor 2 (I-2). By contrast, PP1 activity in the head is only half of the normal value. In addition, tta fails to perform normally in a negative reinforcement olfactory paradigm. The functional relationships between phosphorylation, K+ currents, phosphatase activity and modulation of synaptic activity during learning and memory are discussed in the light of their possible genetic links.