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Fruits are foods that contain plenty of vitamins, minerals and some bioactive phytochemicals like polyphenols. Thus, fruits may exert different functional properties on human health, some of which are directly related to their antioxidant capacity like cancer or atherosclerosis. Owing to globalization, consumers have a wide repertory of fruits throughout the year. Among them, tropical and subtropical fruits are steadily expanding, as well as the studies about them. In this sense, this timely review focused on the nutritional value and chemical composition of persimmon and kiwifruit, two tropical fruits with a protective role on different chronic diseases. Thus, this review focused mainly on the presence of bioactive compounds such as polyphenols, tannins, carotenoids, vitamin C and the different functional properties (i.e. antioxidant capacity, antithrombotic activity, decrease of plasmatic lipids, etc.) arising from the presence of such biologically active molecules. Finally, the effects of genotype and ripening stage on antioxidant capacity and the content of bioactive compounds in persimmon and kiwifruit are also discussed.

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INTRODUCTION: The specific diagnosis of toxic encephalopathy (TE) by chronic exposure to neurotoxics presents difficulties, mainly due to lack of consensus of clinical diagnostic criteria. The EUROQUEST (EQ) is a multicultural tool proposed for using in epidemiological studies on neurotoxicity. The aim of this study was to validate the Spanish version of this questionnaire for using as a diagnostic and prevention tool in the workplace. METHODS: After translation and cultural adaptation, leading to a final questionnaire in Spanish, validation was performed by asking a total of 759 people to complete the questionnaire, of whom 292 were workers exposed to neurotoxic solvents, 391 non-exposed workers, and 22 patients diagnosed with chronic alcoholism. RESULTS: In the analysis of the reliability, the Cronbach α value for the questionnaire was 0.94, indicating very high internal consistency. The test-retest reproducibility analysis was highly significant (r=0.91, P<.001). In the analysis of the validity, comparing the three study groups, the mean scores of the questions included in each of the dimensions of the test (ANOVA) detected major differences in the dimensions that assess cognitive symptoms, depressive disorders, sleep and psychopathological symptoms. After factor analysis obtained a total of nine axes, allowing a clear distinction between the three study groups.

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BACKGROUND: The detection and diagnosis of present or past hypomanic episodes is of key importance for the differential diagnosis between depressive disorders and type II bipolar disorder. However, there are few instruments available to satisfactorily screen for the latter condition. The Hypomania Symptom Checklist-32 (HCL-32) is a self-applied questionnaire with 32 hypomania items and 8 severity and functional impact items which is being developed in several European countries for this purpose. Our aim was to develop and validate the psychometric properties of the HCL-32 scale in Spain in patients with bipolar disorder and to compare its properties with other instruments available for the detection of bipolar II disorder. METHODS: Patients were selected from 15 psychiatric outpatient departments, diagnosed with type I or type II bipolar disorder (BDI and BDII) and unipolar major depression (MD) according to DSM-IV-TR criteria. A control group of healthy subjects (HS) was likewise assessed. The patient selection criteria included a well-established diagnosis and a stable disorder and pharmacological treatment. The HCL-32 was administered to 237 subjects distributed among the above groups, on two occasions four weeks apart. We analysed the internal consistency, test-retest reliability and discriminative capacity of the HCL-32. RESULTS: The internal consistency of the Spanish version of the HCL-32, evaluated by Cronbach's alpha, was 0.94. Mean of affirmative questions by group were 21.2 (SD 5.8) for BDI, 19.3 (SD 6.2) for BDII, 8.6 (SD 6.6) for MD and 6.6 (SD 6.1) for HS, with statistically significant differences between them (Kruskal-Wallis test, p<0.001). Concurrent validity using the diagnosis variable was 0.72. Test-retest reliability was 0.90. We analysed the best cut-off point by means of a ROC curve analysis; for 14 affirmative responses, a sensitivity of 0.85 95%CI (0.78, 0.91) and specificity of 0.79, 95%CI (0.72, 0.87) were obtained. The positive and negative probability ratios were 4.1 and 5.3 (1/0.19 respectively). HCL-32 shows a dual factor structure of items, one as an energy-activity factor and another one as a factor involving items related to disinhibition and problems with self-control and attention. LIMITATIONS: The sample size of bipolar patients (particularly type BDII) should be increased in further studies. CONCLUSIONS: The Spanish version of the HCL-32 has good psychometric properties and sufficient sensitivity and specificity, detecting 8 out of every 10 patients with BD. The HCL-32 is a useful screening tool of patients with bipolar disorder in clinical settings. In its present form it adequately discriminates between bipolar and unipolar or healthy subjects, but not between BD I and BII.

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Febrile neutropenia is a common complication in pediatric oncohematological patients. It is defined by fever > or = 38.3 degrees C or > or = 38 for more than one hour together with a neutrophil count of < or = 500/microl(3). These children are usually admitted to hospital and receive empirical broad-spectrum antibiotic therapy. Recent studies support the possibility of early discharge or outpatient management in selected cases of febrile neutropenia. This translates into a lower risk of nosocomial infections and a reduction in the discriminate use of broad-spectrum antibiotics, with a consequent reduction in resistance, toxicity and costs. All of these factors would improve the patient's quality of life. The estimated incidence of bacteremia in children with febrile neutropenia is 10-36%. However, the experience of multiple centers suggests that not all children have the same risk of complications or death due to infection and that the risk is much lower than that in adults.

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OBJECTIVE: To determine the influence of type of infant feeding on the incidence of lower (LRTI) and upper respiratory tract infections during the first 12 months of life. DESIGN: Historical cohort study. SETTING: Primary care centers. PARTICIPANTS: A total of 250 babies born at term between October 1, 1994 and February 1, 1998. INCLUSION CRITERIA: current medical record available at a participating primary care center, participation in a Healthy Baby Program, residence in the basic health area involved in the study, birth weight #>2500 g. Interventions. Breastfeeding alone or in combination with formula feeding; artificial feeding alone. MAIN OUTCOME MEASURES AND RESULTS: Attending day care, antecedents of atopy, fathers and mothers smoking habit, parents level of education, number of persons in the household, mothers age. There was no association between type of feeding and the incidence of respiratory infections. All 95% confidence intervals (95% CI) of the odds ratios (OR) included the value of 1. At age 3 months, LRTI was associated with the number of persons in the household (OR, 1,87; 95% CI, 1.18-2.95) and with antecedents of atopy (OR, 2.96; 95% CI, 1.19-7.4). At age 6 months, LRTI was associated with the number of persons in the household (OR, 1.62; 95% CI, 1.07-2.44) and with attending day care (OR, 4.52; 95% CI, 1.20-17.1). CONCLUSIONS: In the present study breastfeeding was not effective in lowering the incidence of respiratory infections.

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Objetivo. Determinar la influencia del tipo de lactancia sobre la incidencia de infecciones del tracto respiratorio inferior (ITRI) y superior (ITRS) durante los primeros 12 meses. Diseño. Cohortes históricas. Emplazamiento. Atención primaria. Emplazamiento. Un total de 250 niños nacidos a término entre el 1 de octubre 1994 y el 1 de febrero de 1998. Criterios de inclusión: historia clínica abierta en el centro de salud; haber seguido el programa del niño sano; residencia dentro de la zona básica de salud, y peso al nacer 2.500 gramos. Intervenciones. LM: lactancia materna, exclusiva o combinada con fórmula, y LART: lactancia artificial. Mediciones y resultados principales. Asistencia a guardería; antecedentes de atopia; tabaquismo paterno y materno; nivel de estudios paternos; personas que conviven en el hogar; edad materna. No existió asociación entre tipo de lactancia e incidencia de infecciones respiratorias -todos los intervalos de confianza del 95 por ciento (IC del 95 por ciento) de odds ratio (OR) incluyeron el valor 1-; a los 3 meses de edad, la ITRI se asoció con el número de personas que convivían en el domicilio (OR, 1,87; IC del 95 por ciento, 1,18-2,95) y con antecedentes de atopia (OR, 2,96; IC del 95 por ciento, 1,19-7,4); a los 6 meses, la ITRI se asoció con el número de personas que convivían en el domicilio (OR, 1,62; IC del 95 por ciento, 1,072,44) y con la asistencia a guardería (OR, 4.52; IC del 95 por ciento, 1,20-17,1).Conclusiones. En el presente estudio la LM no se mostró efectiva para originar una disminución de la incidencia de infecciones respiratorias (AU)

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OBJECTIVE: To evaluate the efficacy of eutectic mixture of local anesthetics 5% (Emla) in reducing pain associated with lumbar punctures in children. DESIGN: Prospective, double-blind, randomized, placebo-controlled trial. SETTING: University pediatric hospital. PATIENTS: Eleven pediatric oncology patients (mean age 6.6 y, range 4-16) who underwent 31 lumbar punctures. MAIN OUTCOME MEASURES: The analgesic effect was measured by using two methods. The first was a 10-point visual analog scale reported by the patient and the second was an 8-point behavioral pain scale assessed by the nurse who applied the cream. RESULTS: Emla cream was associated with significantly lower pain scores than those with placebo as measured by the patient when the puncture was successful on the first attempt (2.0 +/- 1.6 Emla group, 3.8 +/- 1.9 placebo group; p < 0.05). CONCLUSIONS: The use of Emla cream may reduce pain substantially only in patients who undergo a successful lumbar puncture on the first attempt.

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We analyzed the errors occurring in the preparation circuit of cytotoxic mixtures of the Centralized Cytotoxic Preparation Unit during one year. Analysis of their evolution meant the investigation of twenty parameters susceptible to error. Each parameter was considered one error opportunity. Error has been defined either by the lack of data or mistake in the controlled parameter. In 4,734 preparations (94,680 parameters) there were 314 errors. The percentage of error per parameter in the first month of study was 0.74; at sixth was 0.34 and the last month was 0.26. Only in four months the day of maximum number of preparations coincided with the day of maximum number of errors. We conclude that the percentage of errors in the preparation process is low with a tendency to decrease and that the number of daily preparations is not the single factor that influences the production of errors.

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The properties of hexose transport across the apical and basolateral membranes of chicken enterocytes have been studied in the small and large intestine. Results show that (a) isolated epithelial cells from all segments except the coprodeum can accumulate 3-O-methylglucose (Glc3Me) against a concentration gradient, by a Na(+)-dependent and phloridizin-sensitive mechanism. (b) The cell cumulative capacity for Glc3Me (control/phloridizin-incubated cells) is lower in the small intestine than in the large intestine (rectum = proximal caecum = ileum > jejunum > duodenum). (c) Theophylline enhances the cell Glc3Me cumulative capacity 2.9-fold in the duodenum and 2.4-fold in the jejunum but has no effect in the other segments studied. (d) Analysis of sugar uptake indicates that net hexose influx rates decrease from proximal to distal regions: jejunum > duodenum > ileum = proximal caecum = rectum for the apical transport system (alpha-methyl glucoside as substrate and phloridizin as inhibitor) and duodenum > jejunum > ileum = proximal caecum = rectum for the basolateral system (2-deoxyglucose; theophylline). (e) The duodenum and the jejunum show high apical and basolateral hexose transport rates, which confer a significant capacity for sugar absorption on the proximal intestine. More distal regions, including the ileum, the proximal caecum and the rectum, have transport systems analogous to those of the proximal intestine that keep a considerable potential capability to recover hexoses from the lumen.

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The authors refer their experience in cervical cancer screening in a subdeveloped population of Sierra Leone. On this basis they define some etiopatogenetic aspect of nature history of cervical cancer. In particular they emphasize the role of vaginal infections diseases as a very important epidemiological datum.

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