Objective: To determine the reliability of a delay in the microscopic examination of synovial fluid (SF) to detect and identify crystals. Methods: Ninety one SF samples were examined, 31 with monosodium urate (MSU) crystals, 30 with crystals of calcium pyrophosphate dihydrate (CPPD), and 30 containing no crystals. The specimens were stored with EDTA, sodium heparin, and without anticoagulant at 4ºC before examination at 24 and 72 hours with ordinary and polarised light microscopy. Another aliquot of the same samples was stored in a plastic container without anticoagulant at −80°C and examined after two months. Results: When the samples stored at 4ºC were re-examined after 24 hours, intracellular crystals of MSU were seen in 90/93 (97%) cases where they had been identified previously and 89/93 (96%) cases after 72 hours. Similarly, CPPD crystals were identified in 90/90 (100%) and 87/90 (97%) cases after 24 and 72 hours. Examination of the samples stored at −80°C showed intracellular MSU crystals in 25/31 (81%) of cases and CPPD crystals in 25/30 (83%). No crystals were seen in any sample which had previously been diagnosed as crystal-free. Conclusions: Deferred microscopic examination of refrigerated or deep frozen SF provides a strong probability of detecting MSU or CPPD crystals if these are present initially.

The purpose of this study was to determine the effect of muscle mass and the level of force on the contraction-induced rise in heart rate. We conducted an experimental study in a sample of 28 healthy men between 20 and 30 yr of age (power: 95%, alpha: 5%). Smokers, obese subjects, and those who performed regular physical activity over a certain amount of energetic expenditure were excluded from the study. The participants exerted two types of isometric contractions: handgrip and turning a 40-cm-diameter wheel. Both were sustained to exhaustion at 20 and 50% of maximal force. Twenty-five subjects finished the experiment. Heart rate increased a mean of 15.1 beats/min [95% confidence interval (CI): 5.5-24.6] from 20 to 50% handgrip contractions, and 20.7 beats/min (95% CI: 11.9-29.5) from 20 to 50% wheel-turn contractions. Heart rate also increased a mean of 13.3 beats/min (95% CI: 10.4-16.1) from handgrip to wheel-turn contractions at 20% maximal force, and 18.9 beats/min (95% CI: 9. 8-28.0) from handgrip to wheel-turn contractions at 50% maximal force. We conclude that the magnitude of the heart rate increase during isometric exercise is related to the intensity of the contraction and the mass of the contracted muscle.

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2531 Background: A direct correlation between anti–epidermal growth factor (EGF)antibody titers and survival was demonstrated in vaccinated patients with novel NSCLC advanced in Phase II studies. We show the results of treatment with anti-EGF vaccine in a cohort of patients with metastatic NSCLC after progressing to first line therapy. We evaluated immunogenicity, safety, treatment response and effect on survival. Methods: 12 patients with metastatic NSCLC after progressing to first-line therapy received anti EGF-vaccine alone or in combination with chemotherapy. Results: From October 2009 until August 2011, 12 patients started treatment with anti EGF vaccine; mean age 56.5 (42-79 y); 66.7% male; ECOG 0 and 1: 41.7% and 58,3% respectively. Adenocarcinoma (50%), bronchioloalveolar (33.3%), adenosquamous (16.7%). Metastatic sites: lung (41.7%), pleura (25%), CNS (16.7%), Kidney (8.3%). In addition to chemotherapy previous used: radiotherapy (50%), surgery (41.7%), erlotinib (41.7%), bevacizumab (25%). The 50% patients received vaccine alone. The 83.3% of patients had titers 1/4000 sera dilutions or more (good responders). According to RECIST 1.1: CR: 8.3%, PR: 16.7%, SD: 41.7%, PD 25%. Median overall survival was 18.8 months (95% CI: 13.3- 24.4 m). Median progression-free survival was 7.3 months (95% CI: 6.4 -8.2 m). We found no statistically significant differences in OS and PFS when comparing vaccine alone or combined (p = 0.181 and p = 0.801). 75% of patients had adverse effect: more frequently were: 42.4% application site pain, 15.1% fever and 10.38% chills, none of them serious. Conclusions: Vaccination anti EGF in patients with metastatic NSCLC after progressing to first line, alone or in combination, was safe and provoked an increase in anti-EGF antibody titers, produced clinical benefit, improved overall survival and progression free survival.

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