Feasibility of School-Based Smoking Cessation Programs

ABSTRACT: This study obtained input from Australian student smokers approximately 15 years old, which may be useful in designing school-based smoking cessation programs. The sample was analyzed by previous quitting experience and intentions to quit. The order of preference for assistance options and incentives for quitting was similar across all groups: however, those who previously attempted to quit (previous quitters) and those who intended to quit (intenders) in the future were significantly more likely than non-quitters and non-intenders to find assistance options for quitting acceptable. The potential for saving money emerged as an important variable in convincing all groups of smokers not to smoke, and using personal willpower and cutting down slowly were identified as important in actual attempts to quit. The need for programs to be free and for friends to be supportive also was evident across all groups.     

Migration of human blood dendritic cells across endothelial cell monolayers: adhesion molecules and chemokines involved in subset-specific transmigration

Distinct subsets of dendritic cells (DCs) are present in blood, probably "en route" to different tissues. We have investigated the chemokines and adhesion molecules involved in the migration of myeloid (CD11c(+)) and plasmacytoid (CD123(+)) human peripheral blood DCs across vascular endothelium. Among blood DCs, the CD11c(+) subset vigorously migrated across endothelium in the absence of any chemotactic stimuli, whereas spontaneous migration of CD123(+) DCs was limited. In bare cell migration assays, myeloid DCs responded with great potency to several inflammatory and homeostatic chemokines, whereas plasmacytoid DCs responded poorly to all chemokines tested. In contrast, the presence of endothelium greatly favored transmigration of plasmacytoid DCs in response to CXCL12 (stromal cell-derived factor-1) and CCL5 (regulated on activation, normal T expressed and secreted). Myeloid DCs exhibited a very potent transendothelial migration in response to CXCL12, CCL5, and CCL2 (monocyte chemoattractant protein-1). Furthermore, we explored whether blood DCs acutely switch their pattern of migration to the lymph node-derived chemokine CCL21 (secondary lymphoid-tissue chemokine) in response to microbial stimuli [viral double-stranded (ds)RNA or bacterial CpG-DNA]. A synthetic dsRNA rapidly enhanced the response of CD11c(+) DCs to CCL21, whereas a longer stimulation with CpG-DNA was needed to trigger CD123(+) DCs responsive to CCL21. Use of blocking monoclonal antibodies to adhesion molecules revealed that both DC subsets used platelet endothelial cell adhesion molecule-1 to move across activated endothelium. CD123(+) DCs required beta(2) and beta(1) integrins to transmigrate, whereas CD11c(+) DCs may use integrin-independent mechanisms to migrate across activated endothelium.     

Sevoflurane does not inhibit human platelet aggregation induced by thrombin

BACKGROUND: Sevoflurane reportedly inhibits adenosine diphosphate-induced platelet aggregation by suppressing thromboxane A2 formation. The increase in intracellular calcium concentration that fosters platelet aggregation, however, is also induced by other cell signaling pathways, such as activation of the production of inositol 1,4,5-triphosphate by thrombin. The current study aimed to clarify the net influence of sevoflurane on thrombin-induced platelet aggregation. METHODS: Washed platelets were stimulated by thrombin after incubation with 0.5, 1.0, or 1.5 mM sevoflurane, halothane, or isoflurane. Aggregation curves were measured by an aggregometer. Intracellular calcium concentration was measured fluorometrically using fura-2. Calcium mobilization via plasma membrane calcium channels and the dense tubular system was assessed differentially. Intracellular inositol 1,4,5-triphosphate was measured by radioimmunoassay. RESULTS: Halothane significantly suppressed aggregation ratios at 5 min compared with those in controls (89 +/- 7%) to 71 +/- 10% (1.0 mM) and 60 +/- 11% (1.5 mM) and the increase in intracellular calcium concentration (controls, 821 +/- 95 nM vs. 440 +/- 124 nM [1.0 mM] or 410 +/- 74 nM [1.5 mM]). Halothane also significantly inhibited release of calcium from the dense tubular system (controls, 220 +/- 48 nM vs. 142 +/- 31 nM [1.0 mM]). Neither sevoflurane nor isoflurane produced a net change in aggregation ratios, intracellular calcium concentration, or calcium mobilization. Halothane (1 mM) significantly suppressed inositol 1,4,5-triphosphate concentrations, whereas neither 1 mM isoflurane nor 1 mM sevoflurane had any effect. CONCLUSIONS: Although sevoflurane has been reported to inhibit human platelet aggregation induced by weak agonists such as adenosine diphosphate, it does not inhibit human platelet aggregation induced by strong agonists such as thrombin.     

Análisis coste-efectividad de samario-153 (Quadramet®) en el tratamiento del dolor en pacientes con cáncer de próstata y metástasis óseas

Objective. To evaluate the cost-effectiveness of samarium [¹⁵³Sm-EDTMP] (Quadramet®) compared to conventional therapy in the treatment of pain in patients with prostate cancer and bone metastases. Method. A decision tree model for the treatment of bone pain due to metastases was adapted to the Spanish context. The model represents the standard treatment patterns in Spain for the study population. The time-course of the model is 4 months and it computes an estimate for the cost of pain control per patient. The effectiveness data for the model derive from a randomised trial. The current treatment patterns have been established according to the consensus opinions of a group of medical experts. Results. The cost of pain control per patient is ? 12,515.39 for conventional therapy and ? 5,595.52 for samarium-153 (Quadramet®) therapy. The incremental cost-effectiveness analysis shows that samarium-153 (Quadramet®) is a dominant therapy. It presents lower costs and higher efficacy than the conventional strategy. The sensitivity analyses showed these results to be robust. Conclusion. Samarium-153 (Quadramet®) is costeffective in treating pain in patients with prostate cancer and bone metastases.     

Key challenges for nanotechnology: Standardization of ecotoxicity testing

Nanotechnology is expected to contribute to the protection of the environment, but many uncertainties exist regarding the environmental and human implications of manufactured nanomaterials (MNMs). Contradictory results have been reported for their ecotoxicity to aquatic organisms, which constitute one of the most important pathways for their entrance and transfer throughout the food web. The present review is focused on the international strategies that are laying the foundations of the ecotoxicological assessment of MNMs. Specific advice is provided on the preparation of MNM dispersions in the culture media of the organisms, which is considered a key factor to overcome the limitations in the standardization of the test methodologies.     

Cronicidad,envejecimiento y multimorbilidadChronicity,ageing and multimorbidity

Thanks to highly active antiretroviral therapy (HAART), HIV-related mortality has been drastically reduced and HIV infection has become a chronic disease. The HIV-infected population is ageing prematurely. Despite good immunovirological control, HIV causes chronic inflammation and accelerated immunosenes-cence. This clinically manifests as an increased prevalence of age-related comorbidity and frailty occurring earlier than in the general population. The heterogeneity of older HIV-infected adults highlights the rele-vance of identifying those who are at risk of poor health, and frailty may be an effective indicator. The rela-tionship between ageing, HIV infection, antiretroviral treatment, comorbidities and frailty still needs to be clarified. Elderly HIV-infected adults are complex patients who require a specific, global and multidisci-plinary approach.     

Should we try to determine the specific cause of cardiac tamponade?

INTRODUCTION: The causes of cardiac tamponade vary and it has been suggested that underlying causes should be sought in all cases. The purpose of this study was to determine the causes of cardiac tamponade in our environment, distinguishing between specific and idiopathic causes, and analyzing the proportion and causes in the subgroup of patients with relapsing tamponade. PATIENTS AND METHOD: We retrospectively studied all patients who underwent therapeutic pericardiocentesis between 1985 and 2001. The clinical and radiographic features and macroscopic characteristics of the pericardial fluid were analyzed. The final diagnosis in each patient was based on the clinical history, follow-up, pericardial fluid cytology, and pericardial biopsy, if available. RESULTS: Ninety-six patients were included (52 men/44 women), mean age 56.1 16.1 years. The cause of pericardial effusion was neoplasm in 50 patients (52.1%), 14 idiopathic pericarditis (14.6%), 12 renal failure (12.5%), 7 iatrogenic cases (7.3%), 4 mechanical tamponades (4.2%), 2 tuberculosis (2.1%), and 7 other causes (7.3%). Thirty-five patients had relapsing tamponade; only 2 of them had idiopathic pericarditis (5.7%). We found no significant differences in age, development time, extracted volume or fluid features between tamponade of specific or idiopathic origin. CONCLUSIONS: Most of the cardiac tamponades in our series had a specific cause. This made it necessary to identify a specific underlying cause in each case, especially in relapsing effusions. However, we did not find any variable suggestive of the cause of the disease.     

Acute necrotizing esophagitis

Acute necrotizing esophagitis is a rare disease. Its pathogenesis is influenced by situations of low systemic perfusion, such as hypertension, heart failure or sepsis, in which other factors, such as the application of a nasal tube, infections or drugs also play a role. We present a case of acute necrotizing esophagitis in a patient with copious vomiting, renal failure, gastric hemorrhage due to Mallory-Weiss syndrome and esophageal infection due to Actinomyces. The patient was undergoing coadjuvant chemotherapy for a surgically-treated colonic neoplasia. Maintenance therapy produced favorable evolution with restoration of esophageal epithelium and no stenotic complications.