Multiple primary cancer: an increasing health problem. Strategies for prevention in cancer survivors

This study was set to look for associations between the sites of the first and subsequent tumours in patients with multiple primary cancer (MPC) diagnosed from 1975 to 2002 in the reference hospital of a Spanish northern region, and propose prevention strategies. Patient and tumour variables were measured. Crude and standardized incidence rates per 100 000 inhabitants were obtained, and the association between MPC incidence and time was analysed by means of lineal regression. Relative risks were calculated to analyse associations between tumour sites. A total of 2737 MPC cases were registered (male/female ratio = 2). The percentage of MPC with respect to the total cancer increased from 1.78% in the 1975–1979 period to 7.08% in the 2000–2002 period ( R ² = 0.92; P  = 0.003). Great increase of incidence by time was found ( R ² = 0.90; P  = 0.004). Breast, prostate and bladder cancers increase risk of second tumour in female genital organs [RR 4.78 (3.84–5.93)], urinary system [RR 3.69 (2.89–4.69)] and male genital organs [RR 3.76 (2.84–4.69)] respectively. The MPC incidence is increasing. Interventions for MPC prevention, according to the European Code against Cancer, should be implemented early after the first cancer principally if patients suffer breast, bladder, prostate, larynx and colon cancers.     

Fibrinogen biosynthesis in isolated guinea pig megakaryocytes

Fibrinogen synthesis was investigated in guinea pig megakaryocytes. Purified megakaryocytes were incubated with 35S-methionine in methionine-free incubation medium for 18 hours. Newly synthesized fibrinogen in megakaryocyte lysates enriched with purified carrier guinea pig fibrinogen was immunoprecipitated with a specific anti- guinea pig fibrinogen antiserum produced in rabbits. Proteins in the immunoprecipitates were analyzed with a 3.5% to 10.0% gradient polyacrylamide slab gel electrophoresis and auto-radiography. Radioactivity was detected in a protein band of 340,000 daltons. In order to verify fibrinogen synthesis, immunoprecipitate was analyzed by two-dimensional slab gel electrophoresis: (1) the first dimension separated unreduced fibrinogen using a 3.5% to 10.0% gradient gel; (2) following reduction by 2-beta-mercaptoethanol, fibrinogen chains were separated in the second dimension using a 10% gel. Alpha, beta, and gamma fibrinogen chains, which represented carrier guinea pig plasma fibrinogen, were visualized by Coomassie brilliant blue. Autoradiography identified the incorporation of radioactivity into the three fibrinogen chains. In control experiments, immunoprecipitates, produced by exposing megakaryocyte lysates to preimmune rabbit serum and goat anti-rabbit IgG, were also analyzed by the two-dimensional gel system. Radioactivity was not detected in sites corresponding to the migration of fibrinogen subunits. The study demonstrates that isolated guinea pig megakaryocytes can synthesize fibrinogen. The electrophoretic mobility of newly synthesized fibrinogen and subunits is similar to that of guinea pig plasma fibrinogen.     

Pet exposure and the symptoms of asthma, allergic rhinitis and eczema in 6-7 years old children

Allergic diseases are frequent in children and their prevalence and severity differ in the different regions of the world. The association between pet ownership in childhood and subsequent asthma and sensitization is very controversial.In our survey conducted with standardized method (International Study of Asthma and Allergies in Childhood), 3200 children 6-7 years old were questioned regarding asthma, allergic rhinitis and eczema. The prevalence of Attacks and shortness of breath with wheezing during last 12 months in the children who had exposure to pets in the first year of life was 34.3% 'that was less than children who had not exposure (OR=3.06, 95% confidence interval [CI] 1.14-8.21, P=0.021). Also during the past 12 months the prevalence of night dry coughs, allergic rhinitis symptoms and eczema symptoms in those who had pet exposure in the first year of their life was lower than the children did not have it. However there was no significant difference in some other symptoms of asthma in two groups.Our findings suggest that pet exposure in the first year of life can have a protective effect on asthma, allergic rhinitis and eczema.     

Clinical presentation and natural history of infantile-onset ascending spastic paralysis from three families with an <Emphasis Type="Italic">ALS2</Emphasis> founder variant

Biallelic mutations of the alsin Rho guanine nucleotide exchange factor (ALS2) gene cause a group of overlapping autosomal recessive neurodegenerative disorders including infantile-onset ascending hereditary spastic paralysis (IAHSP), juvenile primary lateral sclerosis (JPLS), and juvenile amyotrophic lateral sclerosis (JALS/ALS2), caused by retrograde degeneration of the upper motor neurons of the pyramidal tracts. Here, we describe 11 individuals with IAHSP, aged 2–48 years, with IAHSP from three unrelated consanguineous Iranian families carrying the homozygous c.1640+1G>A founder mutation in ALS2. Three affected siblings from one family exhibit generalized dystonia which has not been previously described in families with IAHSP and has only been reported in three unrelated consanguineous families with JALS/ALS2. We report the oldest individuals with IAHSP to date and provide evidence that these patients survive well into their late 40s with preserved cognition and normal eye movements. Our study delineates the phenotypic spectrum of IAHSP and ALS2-related disorders and provides valuable insights into the natural disease course.     

Neuroimaging findings of <Emphasis Type="Italic">postnatally acquired</Emphasis> Zika virus infection: a pictorial essay

Zika virus (ZIKV) is a mosquito-borne arbovirus from the Flaviviridae family, first discovered in 1947. There has been no report of severe complications caused by this virus in humans until recently. However, it is confirmed now that prenatally acquired ZIKV infection may cause severe congenital brain abnormalities in the infected fetuses. In addition, there has been an increasing number of reports during recent years about the causal relationship between postnatally acquired ZIKV infection and severe neurologic complications (mostly immune-mediated ones). Hence, ZIKV should not be considered as benign as it was initially thought, but it might be seen as a serious global threat to human health that may severely affect not only fetuses. In this pictorial essay, we aim to describe and illustrate the currently recognized spectrum of neuroimaging findings in postnatally acquired ZIKV infection. Although neurologic complications do not frequently occur in postnatal ZIKV infection, it is important to be aware of them because they may cause high morbidity and mortality in the affected patients. In addition to clinical and laboratory findings, neuroimaging may help in the diagnostic work-up to make the correct diagnosis, determine the extent of the disease, and follow the clinical course.     

纳洛酮催瘾试验2例

0　引言　阿片类依赖一般根据 DSM- 3- R标准诊断并不困难 .但有时患者不愿意承认暗中使用阿片类药物 ,而医生需迅速作出有否依赖的判断 ,则需使用纳洛酮催瘾试验 .我们应用此方法催瘾 2例的情况及有关注意事项介绍如下 :1　病例报告　患者 2例 ,男性 ,年龄 2 5和 31岁 ,因卖毒品被公安部门当场抓捕 ,为尽快初步验证其是否吸食毒品 ,随来求证 .催瘾诊断时 ,分别给两人 im 0 .4mg盐酸纳洛酮 ,1例 15min内出现心慌、烦躁不安、打哈欠、流泪、流涕等轻度戒断反应 .另 1例 30 min内无反应 ,随追加 im 0 .4mg. 5 min后即出现明显的戒断症状 .收…