Probability of intense precipitation from polarimetric GNSS radio occultation observations

There is currently a gap in satellite observations of the moisture structure during heavy precipitation conditions, since infrared and microwave sounders cannot sense water-vapour structure near the surface in the presence of intense precipitation. Conversely, Global Navigation Satellite System (GNSS) radio occultations (RO) can profile the moisture structure with high precision and vertical resolution, but cannot indicate the presence of precipitation directly. Polarimetric RO (PRO) measurements have been proposed as a method to characterize heavy rain in GNSS RO, by measuring the polarimetric differential phase delay induced by large size hydrometeors. Previous studies have shown that the PRO polarimetric phase shift is sensitive to the path-integrated rain rate under intense precipitation scenarios, but there is no current method to invert PRO measurements into quantitative estimates of the path-averaged rain rate. In this manuscript, a probabilistic inversion approach to the GNSS PRO observables is proposed, where the GPM precipitation products are used for the construction of an a priori look-up table (LUT) database. The performance of the LUTs is assessed for use in the inversion of satellite-based GNSS PRO observations, based on synthetically generated PRO data of actual events, which correspond to co-locations between GNSS RO profiles and the TRMM observations. The synthetic data include end-to-end propagation effects of the polarimetric observables and a simple separation algorithm to isolate the hydrometeor component of the observation. The assessment results in agreement better than ±1 mm/hr between the reference LUT and the actual rain statistics of the synthetic data, proving the suitability of the GPM-based probabilistic inversion tool. These findings indicate that the GNSS PRO products are capable of extending the current GNSS RO ones by associating indications of rain-rate probabilities at different altitudes, at ∼250 m vertical resolution and under intense precipitation scenarios with the standard vertical thermodynamic profiles.

Kinetics of Ethanol and Acetaldehyde Production in Fermenting Wheat Dough by Laser-Based Trace Gas Detection

The fermentation process of wheat dough was studied by laser-based trace gas detection. A CO-laser-driven photoacoustic spectrometer was used to monitor simultaneously, in real time, the ethanol and acetaldehyde production rates of two commercial types of active dry yeast ( Saccharomyces cerevisiae) in wheat dough substrates. Both types of yeast, Oand B, produced ethanol for 5 hours. Acetaldehyde was yielded only during 100 minutes by the yeast O, whereas the yeast Bgenerated this compound for 3.5 hours. The total ethanol and acetaldehyde productions amounted to 1.50 mL/g dough and 4.5 µ L/g dough in the Ocase, and 0.84 mL/g dough and 14.75 µ L/g dough, in the Bcase, respectively. The yeasts were also tested for their ability tometabolize mixes consisting of the control wheat dough substrate and extra amounts of glucose or maltose. Both types of yeasts showed a similar ability to consume the added glucose, however, only the yeast Bwas found to possess an adapted enzymatic system to metabolize maltose. This work showed the efficiency of applying photoacoustic trace gas detection to food technology research for on-line monitoring of fermenting wheat dough.

[Morbidity after cesarean section]

OBJECTIVE

To determine the frequency, spectrum of indications and complications and maternal morbidity rate connected with Caesarean sections as the most frequent mode of operative delivery.

DESIGN

Retrospective, epidemiologic and comparative clinical study.

SETTING

Department of Obstetrics and Gynecology, Jessenius Medical Faculty, Comenius University, Martin, Slovak Republic.

METHODS

The authors retrospectively analyzed clinical data during a ten-years period. The number of deliveries, premature deliveries, frequency of Caesarean section, indications and maternal morbidity rate were determined. Further, a special attention was paid to premature deliveries and the related frequency of Caesarean sections and maternal morbidity rate in this group. In addition, the effectiveness of a complex pre-operative management was evaluated.

RESULTS

The evidence shows that the natality rate is decreasing and the incidence of premature deliveries is increasing. The frequency of Caesarean sections is relatively stable with lower morbidity rate in the group of premature Caesarean deliveries. The positive effect of antibiotics, heparin and anti-aspiration medication within a complex pre-operative management was proved to decrease the frequency and severity of complications.

CONCLUSIONS

The maternal morbidity rate following Caesarean delivery is relatively low, owing to the use of prophylaxis. However, it is vital to keep to the indications for Caesarean termination of the pregnancy, because there is still substantial mortality rate connected with it.

[Epidural obstetrical analgesia and cardiotocography]

OBJECTIVE

The increase of cardiotocographic abnormalities, such as late decelerations, bradycardia and reduced variability have been reported with epidural analgesia (EDA) in some studies. The aim of our study was to assess the influence of epidural analgesia on the incidence of the pathological cardiotocographic patterns.

DESIGN

A clinical study.

SETTING

Department of Obstetrics and Gynaecology, Jessenius Medical Faculty of Comenius University, Martin, Slovak Republic.

METHODS

Clinical group consists of 200 parturients, who borne in our department from 1997 to 2000. The epidural group of parturients (n = 100) borne under epidural analgesia, the control group of (n = 100) borne under other resp. no analgesic method. We compared BFHR, variability and the incidence of accelerations and decelerations in CTG between both groups. All cardiotocographic patterns were evaluated by Fischer score. For statistic evaluation was used Student t-test.

RESULTS

We did not find any statistically significant differences in Fischer score between epidural and control group.

CONCLUSION

The epidural labour analgesia is safe method of ease pain during labour. In our study we confirmed, that EDA is not responsible for the increase of pathological cardiotocographic patterns.

[Myocardial necrosis is not observed during acute cocaine abuse detectable by the serum levels of troponin T]

BACKGROUND

Recently we can use a new family of serological markers to objective myocardial damage with hig sensibility and specificity. One of these markers is T troponin (c-TNT). Some cocaine abusers have chest pain during drug consumption due to myocardial ischemia produced by the drug.

OBJECTIVE

To study if in the chest pain appeared after cocaine consumption a c-TNT increased is objective, showing myocardial cellular damage.

PATIENTS AND METHODS

We studied 65 patients; 35 cocaine abusers that were admitted into the emergency room for chest pain after cocaine consumption and 30 patients with no coronary chest pain. To all of them were determined c-TNT and CK.

RESULTS

An increase in c-TNT or CK was not observed in both groups.

CONCLUSION

We don't observe an increase in c-TNT in the group of cocaine abusers that evidence myocardial cellular damage.

[Usefulness of troponin T and troponin I in the diagnosis and prognostic stratification of patients with ischemic cardiopathy attending an emergency service]

BACKGROUND

Diagnostic of chest pain in the emergency services supposes a serious problem. This study wants objective if the new non enzymatic markers of myocardial necrosis (T troponin and I troponin) may be an aid for the diagnostic and prognostic stratification of patients with myocardial ischemia.

PATIENTS AND METHODS

82 successive patients who went to the emergency room for chest pain were studied. Electrocardiogram and blood samples were obtained at 0,4, and 12 house of admission. A clinic-evolutive study was performed at discharge, and they were classified in 3 categories: a) myocardial infarction, b) unstable angina (Braunwald classification) and no coronary pains.

RESULTS

In the 27 patients with myocardial infarction the markers of troponin group were more sensitive than creatinine kinase to determine myocardial necrosis at 4 hours of admission. Of 41 patients with unstable angina, 34% were of Braunwald III-B class. Troponin group markers discriminate a group of high risk patients, 70% of the patients that need an emergency coronarography for bad clinical evolution were troponin group marker positive.

CONCLUSIONS

The use in the emergency room of troponin necrosis markers (T and I troponin) allows to optimize the sanitary resources, detecting quickly the patients with acute myocardial infarction and discriminate a group of high risk of patients with angina.

[Immunohistochemical study of inflammatory infiltrates in minor salivary glands in Sjögren's syndrome and other autoimmune diseases]

BACKGROUND

A study of the phenotype, activation and adhesive cells factors and cytokines in minor salivary glands in patients with primary Sjögren's syndrome (pSS), secondary Sjögren's syndrome (sSS) and autoimmune diseases (AD) without Sjögren's syndrome.

PATIENTS AND METHODS

We have studied the minor salivary glands in 30 patients with pSS, 30 patients with sSS, 19 patients with AD without SS and 18 controls, using immunohistochemical techniques to analyze the molecular expression of CD3, CD4, CD8, CD20, CD25, CD14, CD56, CD11a, CDw50 (ICAM-3), HLA-DR, IL-1, TNF-alpha and IFN-gamma in lymphocytic infiltration and epithelial cells.

RESULTS

Phenotype features were similar in patients with pSS and sSS, except that CD20+ lymphocyte expression was significantly higher in the sSS group (p = 0.023). The patients affected by AD without SS had activated lymphocytes in minor salivary glands in a similar manner to patients affected by pSS and sSS. No significant differences were found in HLA-DR expression in epithelial cells. We found unusual CD25 expression in epithelial cells in patients with SS but not in patients with AD without SS. The differences between pSS and sSS are related to SS theoretical time development and to immunosuppressive treatments.

CONCLUSIONS

The immunohistochemical pattern of minor salivary glands is similar in patients with pSS and sSS. Patients with AD are likely to develop immunological changes in minor salivary glands attributable to activated lymphocytes.

[Clock drawing test: qualitative and quantitative evaluation methods]

INTRODUCTION

The interest about the Clock Drawing Test (CDT) is justified because the importance of praxic disorders and especially the constructive apraxias in demented patients. Generally, this kind of deficits or intellectual losses has been less studied than aphasisas and agnosias. Nevertheless, praxias are usually affected in demential processes, even in initial stages.

OBJECTIVE

We try to determine if the CDT can be useful as an assessment tool for dementia. We have used two assessment systems of the clock drawing in order to select an useful and reliable method of correction.

PATIENTS AND METHODS

The sample is made up of 35 subjects older than 60 years, they were administered the Mini Cognitive Examination (MCE) and the CDT. Patients with previous diagnosis of dementia, others with physical pathology without neurological affectation and, finally, subjects without any kind of pathology were included in order to get a wide rank of punctuations. We carried out a reliability analysis between two raters and the discriminant validity of the CDT compared to the Spanish adaptation of the Mini Mental Examination.

RESULTS

We achieve a high reliability inter examiner rates. Quantitative criteria of both scales are more objective than qualitative ones, therefore, these last should be more operativized.

CONCLUSIONS

The results obtained in this work suggest that the clock drawing allow a rapid evaluation of cognitive function as the presence of cognitive impairment.

Immunohistochemistry of minor salivary gland biopsy specimens from patients with Sjögren's syndrome with and without hepatitis C virus infection

OBJECTIVES

To characterise phenotypically the minor salivary glands of patients with clinical and histological features of Sjögren's syndrome (SS) infected with hepatitis C virus (HCV).

PATIENTS AND METHODS

75 consecutive patients with SS (31 primary SS, 44 secondary SS) diagnosed by preliminary European classification criteria. The presence of anti-HCV antibodies was detected by commercial third generation ELISA and by a second generation immunoblot assay. Presence of HCV genome in serum was determined by polymerase chain reaction analysis. Expression of CD3, CD4, CD8, CD20, HLA-DR, and CD25 molecules in lymphocytic and epithelial cells on minor salivary glands was detected by immunohistochemical assays. Expression of interferon gamma and interleukin 4 cytokines was determined by in situ hybridisation.

RESULTS

Six of 31 primary SS (19%) and one of 44 secondary SS (2%) serum samples were positive for anti-HCV by ELISA. Three samples were positive, three indeterminate, and one sample corresponding to a secondary SS patient was negative by immunoblot. The three immunoblot positive serum samples were also HCV-RNA positive by PCR assay. The study of lymphocytic cells in the diffuse infiltrate of minor salivary glands showed a predominance of the CD3 lymphocytic population. A predominance of CD4 over CD8 T cells (ratio 2:1) was observed in HCV and non-HCV infected patients. The analysis of the lymphocytic focus showed that the HCV infected patients had a predominance of CD20 positive cells. Activation molecules (CD-25 and HLA-DR) were expressed in HCV and non-HCV infected patients in lymphocytic and epithelial cells, however epithelial cell expression of CD25 was low in HCV infected patients. As expected, a pronounced Th1 response was observed in the lymphocytic foci of HCV patients.

CONCLUSIONS

HCV infected patients may develop an autoimmune sialadenitis, similar to that described in primary SS.

Soluble interleukin-2 receptor in primary and secondary Sjögren's syndrome

Serum levels of soluble interleukin-2 receptor (sIL2-R) were studied in patients with or without Sjögren's syndrome (SS). The mean sIL2-R level was significantly higher (P < 0.0001) in those with autoimmune diseases, whether with or without SS, than in healthy people. The serum level of sIL2-R did not help to distinguish primary from secondary SS, or the absence of this syndrome in patients with autoimmune diseases. We found a correlation between the sIL2-R level and the presence of SS-A and SS-B antibodies or antinuclear antibody levels, and no correlation with other serological and clinical markers. Salivary gland anomalies were always accompanied by high sIL2-R levels, but there was no correlation between sIL2-R levels and degree of glandular lesion. Routine determination of sIL2-R in patients with dry syndrome is likely to prove useful for ruling out SS without resorting to invasive testing.

Interleukin-2 receptor expression in salivary glands of patients with Sjögren's syndrome

OBJECTIVE

To study interleukin-2 receptor (IL-2R) expression in lymphocytic and epithelial cells in salivary glands of patients with Sjögren's syndrome (SS).

METHODS

Minor salivary glands of 29 patients with primary SS, 28 with secondary SS, 19 with autoimmune diseases without SS, and 17 controls were studied using immunohistochemical techniques. Sections were analyzed with 3 different antibodies reacting with CD25 molecule.

RESULTS

The presence of IL-2R (CD25) was observed in minor salivary gland lymphocytic infiltrate in 26 (89.6%) primary SS, 24 (85.7%) secondary SS, and 16 (84%) autoimmune diseases without SS. CD25 antibody was expressed in epithelial cells in 12 (41%) patients with primary SS and 11 (39%) with secondary SS, but was absent in the group of autoimmune diseases without SS and the control group.

CONCLUSION

The lymphocytic infiltrate of minor salivary gland expressed IL-2R in patients with primary SS, secondary SS and autoimmune diseases without SS. IL-2R expression in epithelial cells was only present in patients with primary or secondary SS.

Primary Sjögren's syndrome associated with chronic atrophic gastritis and pernicious anemia

Sjögren's syndrome (SS) is a systemic, autoimmune exocrinopathy in which destructive, inflammatory-cell infiltration can affect any gland. Although chronic atrophic gastritis is the most common form of gastrointestinal involvement in SS, pernicious anemia develops in rare cases. We therefore report a patient with these three associated diseases.

Sjögren's syndrome: a stepwise approach to the use of diagnostic tests

One hundred and forty two patients (62 with definite Sjögren's syndrome, 24 with probable Sjögren's syndrome, and 56 in whom Sjögren's syndrome was finally ruled out) were studied. Schirmer's test and rose bengal staining for the diagnosis of keratoconjunctivitis sicca and salivary scintigraphy and a labial biopsy sample for the diagnosis of xerostomaia were studied in all patients. Rose bengal staining showed high specificity (98%) but low sensitivity (55%). All patients with positive rose bengal staining results had associated xerostomia. In the rose bengal staining positive patients, scintigraphy had 100% specificity. A labial biopsy sample showed high sensitivity in the rose bengal staining, salivary scintigraphy positive group, and high specificity in the rose bengal staining positive, salivary scintigraphy negative group. In patients with negative rose bengal staining, salivary scintigraphy showed 96% specificity and 36% sensitivity. A labial biopsy sample had a sensitivity and specificity greater than 90% in rose bengal staining negative patients. Only 29 biopsy samples were needed to achieve a diagnosis of Sjögren's syndrome in 142 patients (20%). Hence the suggested approach may make it unnecessary to take biopsy samples in approximately 80% of patients with suspected Sjögren's syndrome. Using the stepwise approach of first rose bengal staining, then salivary scintigraphy, and eventually a labial biopsy sample in patients with suspected Sjögren's syndrome, the diagnosis is relatively simple.

Bacterial infection as a presenting manifestation of visceral leishmaniasis

Two patients admitted to the hospital because of severe bacterial infection were diagnosed as having visceral leishmaniasis. The types of bacterial infection were perianal abscess and pneumonia; Escherichia coli and Streptococcus pneumoniae were isolated from exudates and blood cultures, respectively. A third patient admitted because of acute necrotizing infection of the pharynx and visceral leishmaniasis is also discussed. Cultures from this patient failed to yield pathogens. Anemia, leukopenia, or thrombocytopenia was present in all patients, and bone marrow aspirate revealed the presence of Leishmania in macrophages. We conclude that in areas where leishmaniasis is endemic, early bone marrow aspirate should, in most instances, be performed in patients with bacterial infection associated with anemia, leukopenia, or thrombocytopenia if hepatomegaly and/or splenomegaly is present.

[Imported malaria: a clinical and epidemiological description of 49 cases]

Malaria is the most common protozoan infection in the world. In 1964, it was considered eradicated in our country, all the new cases being declared as imported, the present migratory and tourism factors obviously having increased the incidence. We analyzed 49 cases of imported malaria diagnosed at "Hospital de Mar" in Barcelona between 1976 and 1987. 14 patients were emigrants from endemic areas. Africa as the continent (73.4%), and equatorial Guinea as the country (44.8%) being the geographical areas most frequently found as sources of the cases. Only 40% of tourists took chemoprophylaxis measures and only half of them did it correctly. The most usual plasmodium found was the P. Falciparum (21 cases). The conclusion is evident, it is necessary to create a greater awareness in our area, improving the information for travellers to tropical countries applying sanitary controls to immigrants who come from endemic areas.

[Epidemiologic and therapeutic aspects of bacteremic infections of the urinary tract]

A survey was carried out of all urinary tract infections which developed bacteremia during an 18 month period. The number of episodes of bacteremia of urinary origin (BUO) detected in our institution during that period was 108. The urinary tract was the most common origin of the cases of community acquired (CA) bacteremia and the third in the hospital acquired (HA) cases. In both types, the most frequent organism was E. coli (69.6% and 40%, respectively). The most common underlying diseases were diabetes mellitus (25.7%) and neoplasia (20%); nephrourologic disorders of some type were present in 29.6% of cases. In 81% of HA episodes there were urinary catheters as risk factors. In the CA bacteremias, the gram-negative bacilli except Pseudomonas aeruginosa had a 100% sensitivity to aminoglycosides. Sensitivity to first generation cephalosporins was detected in 81% of the E. coli and in 100% of the Klebsiella spp strains. In HA cases, amikacin (100% of E. coli, Pseudomonas, Klebsiella and Proteus) and cefotaxime (except Pseudomonas) were the antibiotics to which the highest rates of sensitivity were found. Overall mortality rate of BUO was 16.6% (13.6% for CA and 21.5% for HA); in 6% and 5% of cases, respectively, death was directly associated with bacteremia.