Immunophenotypic aspects of cylindroma and nodular hidradenoma

Background Some adnexal tumours have many controversies about their histogenesis. Objectives To evaluate the eccrine and/or apocrine differentiation phenotype in cases of cylindroma and clear cell hidradenoma with CD15 and p63 antibodies. Methodology Slides and blocks of six cases of cylindroma and seven cases of nodular hidradenoma (clear cells) were analyzed by the technique of immunohistochemistry with CD15 and p63 antibodies. Results In all cases of cylindroma we obtained negative results for CD15 antibody and positive for p63 antibody. In five of seven cases of nodular hidradenoma (clear cell), we could easily observe clear cells between 20% and 50% of tumour cells. In the two other cases, cystic lesions were present and occasional clear cells could be seen. The reaction with CD15 antibody was positive in granular and cytoplasmic pattern in six of seven cases, especially in cells with suggestive clear cytoplasm in lower proportion than this clear cells could be seen in haematoxylin and eosin. The positivity for p63 antibody, nuclear pattern, was observed in six of seven cases, in the major part of tumour cells. In only one case, the positivity was in 20% of cells. Limitation Samples are in small number because these are relatively rare tumours. Conclusions The present study suggests eccrine origin for both tumours: cylindroma and clear cell hidradenoma.     

Otoacoustic emissions as a screening test for hearing impairment in children

Transient evoked otoacoustic emissions (TEOAEs) are low amplitude sound waves produced by the healthy cochlea. They can be recorded with a microphone in the external ear. TEOAEs are abolished by hearing losses of 30 dB or more. The feasibility of using TEOAEs as a screening test for hearing loss in children was studied. TEOAE recordings were attempted in 56 children attending an audiology clinic. Recordings were possible from both ears in 52 children; of these 104 ears, 32 had hearing deficits of 30 dB or more. Hearing status was compared with the results of six TEOAE screening criteria. All criteria had a sensitivity of 1.00. Four standard TEOAE criteria yielded specificities of 0.46-0.58. Two new criteria derived from analysis of limited frequencies from the TEOAE waveform gave specificities of 0.76 and 0.82. It can be concluded that, when appropriate pass/fail criteria are employed, TEOAEs are a feasible screening test in children.     

Health impact evaluation of particle air pollution in five Spanish cities. European APHEIS project

BACKGROUND: The health effects of air pollution have been analyzed in numerous studies over recent years, thus having made it possible to quantify the relationship between the two. This study is aimed at analyzing the theoretical benefits which would be achieved by meeting the air quality objectives set forth under EC Directive 1999/30/EC with regard to suspended particles. METHODS: The exposure measurement was taken for Black Smoke (Barcelona, Bilbao, Valencia) and suspended particles under 10 microm (PM10) (Bilbao, Madrid y Sevilla). The health indicators calculated were the mortality due to all causes and respiratory and cardiovascular causes, and emergency hospital admissions and mortality due to respiratory and cardiovascular causes. In the case of PM10 the impact has been calculated because its effects to short-term, within a period of up to 40 days following exposure, and to long-term. For Black Smoke the effects only has been calculated to short-term. RESULTS: The daily levels of PM10 from exceeding 50 microg/m3 in Bilbao, Madrid and Sevilla cause the earlier death of 1.4/100,000 individuals per year because its effects. The effect within a period of up to 40 days following exposure is of 2.8 deaths/100,000. The total number of deaths per year which may be later due to long-term exposure if the yearly average is lowered to 20 microg/m3 is 68/100,000. CONCLUSIONS: The health impact of the current air pollution levels is quantifiable and is not insignificant. APHEIS and the impact evaluations may be of aid in healthcare planning and environmental policies.     

Use of drug-eluting stents for the treatment of in-stent restenosis in routine clinical practice

BACKGROUND: Although target lesion revascularization (TLR) has been dramatically decreased by using drug-eluting stents (DESs) in de-novo lesions, their efficacy for in-stent restenosis (ISR) has not yet been well established. METHODS: We retrospectively analysed patients treated for ISR with DESs from three referral hospitals. RESULTS: Eighty-seven consecutive patients, from June 2002 to April 2004, were included, with a mean age of 64+/-11 years; 83% were men, 32% had diabetes, 47% had had a previous myocardial infarction and 16% had low left ventricular ejection fraction. Angiographic characteristics were as follows: mean vessel diameter, 3.05+/-0.4 mm; lesion length, 17.8+/-7.7 mm; diameter stenosis, 84.0+/-10.7%; and complex lesion, 81%. The restenosis was focal in 45%, diffuse/proliferative in 51.3% and total occlusion in 3.7% of the cases. Sirolimus- and paclitaxel-eluting stents were used in 42 and 58% of the patients, respectively. Stent diameter was 3.1+/-0.3 mm and the length was 26.1+/-5.8 mm. Angiographic success was achieved in all patients, with one patient experiencing a post-procedural non-Q-wave myocardial infarction. At 6-month clinical follow-up, two patients had died from non-cardiac deaths, five had experienced a new TLR (5.7%, four percutaneous and one coronary artery bypass graft) and eight (9.2%) had had major adverse cardiac events. A stress test was performed in 60% of the population; target vessel ischemia was observed in one patient (3.3%). CONCLUSION: In this non-select cohort of patients, the use of DESs is a safe and effective strategy for ISR lesions.