Alterations in iron metabolism in chronic anti-HCV positive hepatitis. The relationship with response to interferon treatment

A prospective study in which the existence of iron metabolism alterations (increase in the serum levels of iron and ferritin and the presence of iron in liver tissue) in a group of 53 patients diagnosed with chronic anti-HCV positive hepatitis was performed. The aim of the study was to determine whether these parameters influence the response to interferon treatment. Elevations were observed in the serum levels of iron and/or ferritin in 17 (32%) of the patients. Higher than normal values of serum iron or ferritin in pretreatment analyses were associated with worse therapeutic response. The basal serum levels of iron and ferritin were significantly higher in non responding patients. No relationship was found between the presence of iron in the hepatic parenchyma and response to interferon treatment.     

Nasal rhinosporidiosis in children

Rhinosporidiosis is a rare fungal disease resulting from infection by Rhinosporidium seeberi. There seems to be a relationship between the disease and agriculture, suggesting that Rhinosporidium lives in soil, and many authors agree that water is a necessary medium of transmission. The sites of infection are the nose (most common), eye, nasopharynx, penile urethra and external ear. Nasal cases generally present obstruction, epistaxis, watery or mucopurulent discharge, presence of tumoral pedunculated polypoid mass, generally with septal implantation. Histological examination presents characteristic sporangia in large numbers and in the submucosa a granulomatous host response. The treatment is by surgical excision (recurrence occurs in 10% of cases), and medical treatment used diaminodiphenylsulfone or Amphotericin B to avoid recurrent cases. We present a case of Rhinosporidiosis in a 10 years-old child, female, with 3 months history of nasal obstruction, epistaxis and presence of nasal mass in left nasal cavity that was submitted to surgical excision.     

Underreporting of percutaneous exposure accidents in a teaching hospital in Spain

The study's objectives were to determine the frequency of biological-risk accidents involving percutaneous exposure and to identify factors associated with underreporting. Two hundred fifty healthcare professionals from inpatient services at high risk for exposure at the Puerta del Mar University Hospital of Cádiz, Spain, participated in the study. A questionnaire was used to measure personal and work variables, the number of accidents suffered and reported in the last year, and the circumstances motivating the reporting or nonreporting. Two hundred thirty-two persons (92.8%) completed the questionnaire. The accident rate was 12 per 100,000 hours worked. Physicians were the most frequent accident victims (rate 22/100,000 hours). The general surgery and emergency services had higher rates than other services (rates 19.82 and 14.17, respectively). Sixty-six percent of the accidents were not reported to the register. The main predictors of the underreporting were length of professional service greater than 19 years, working in the surgery service, and the perception that the accidents did not involve health risk. The true accident rate was higher than that reflected in the Accident Register. Underreporting was high. The main variables associated with underreporting were length of professional service, work area or department, and perception of risk from the accident.     

Minimum basic set of data of hospital discharges as a source of information for a study of congenital abnormalities

BACKGROUND: The purpose of this study is that of assessing the validity of the computerized diagnoses of hospital discharges of congenital defects by comparing them with the information included in the medical history. METHODS: Based on the discharge records generated over a one-year period at 7 hospitals in the Autonomous Region of Valencia, 100 children were selected at random from each hospital. As a standard, the diagnoses stated in the medical histories were indexed and coded. Solely those discharges having taken place during the first year of life were considered. A study was also made of the type, seriousness and individual or combinations of congenital defects. A calculation was made of the sensitivity, specificity, predictive values and the 95% confidence intervals thereof by the exact binomial method for the case studies (children) and the positive predictive value and sensitivity for the study of diagnoses. RESULTS: 126 children were detected as having congenital defects, and 201 diagnoses in medical records, and 83 children with congenital defects and 108 diagnoses on record. For the detection of cases, the records showed a 64% sensitivity, a 99.1% specificity and some positive and negative predictive values of over 90%. With regard to the detection of diagnoses, the sensitivity was 46% and the positive predictive value 83%. The sensitivity varied a great deal depending upon the diagnoses. CONCLUSIONS: The hospital discharge records revealed a high degree of specificity and high predictive values, but a low degree of sensitivity. These facts must be considered when these records are used as a source of cases for the epidemiological studies of congenital defects.     

The main problems of occupational health in Navarra, 1994-1996

In 1996 the Navarra Occupational Health Institute, an autonomous technical organization that integrates the functions and means related to occupational health matters, drew up the Occupational Health Diagnosis of Navarra, which is a region characterised by its important industrial sector and its high proportion of small and medium size companies. The results emphasise the high accident rate in the construction sector, the constant increase of professional diseases through "fatigue of tendon pods", as well as the importance of osteo-muscular processes as a cause of temporary and permanent disability. Forty sentinel occupational tumors, mainly mesothelioma, and 27 Obligatory Statement Diseases of occupational origin, mainly brucellosis, were identified in a period of seven years and three years, respectively. Verification was made of a lack of systematised information about population exposure to occupational risks, a scarce development of medical surveillance of exposed workers, and a lack of information about the incidence of occupational injuries in self-employed workers.     

Helicobacter pylori is not a determinant factor of persistent diarrhoea or malnutrition in Peruvian children

To investigate the role of Helicobacter pylori in childhood diarrhoea, specific IgG antibodies to H. pylori (determined by an ELISA) were sought in 119 infants aged 3-36 months in Peru. Thirty one of the infants had acute diarrhoea (defined as lasting < 72 h and not present in the previous 3 weeks), 67 had persistent diarrhoea (lasting > or = 14 days with no more than 1 intervening diarrhoea-free day) and the remaining 21 had not had diarrhoea in the previous 3 weeks. The children with diarrhoea had been admitted to hospital in Lima for diarrhoea treatment, and the diarrhoea-free children for investigation of possible tuberculosis. Aspirates of duodenal contents and duplicate stool samples were investigated for the presence of bacterial overgrowth and of pathogenic bacteria, viruses and parasites. Anthropometric measurements were also made. There were no statistically significant differences between the prevalence rates of IgG against H. pylori in the children with acute diarrhoea, persistent diarrhoea and without diarrhoea (32%, 43% and 29%, respectively). In addition, H. pylori infection (as evidenced by specific antibodies) had no apparent influence on the presence of small-bowel overgrowth (in 20% of seropositive children compared with 18% of seronegative children) or of pathogens in the stool (in 53% of seropositive children compared with 49% of seronegative children) or on the occurrence of malnutrition in the groups of children considered as a whole. We conclude that H. pylori infection is not associated with acute or persistent diarrhoeal disease, small-bowel overgrowth, stool pathogens or malnutrition in Peruvian children.     

Lime-treated maize husks lower plasma LDL-cholesterol levels in normal and hypercholesterolaemic adult men from northern Mexico

Lime-treated maize husks (LTCH), a by-product of tortilla manufacturing in Mexico, have been shown to decrease plasma LDL-cholesterol levels in guinea-pigs by specific alterations in hepatic cholesterol metabolism. To determine whether LTCH would also lower plasma cholesterol levels in normal and hyperlipidaemic individuals, the fibre content of a typical diet was increased by supplementing free-living subjects in North-West Mexico with cookies containing 450 g LTCH/kg. Normal subjects (n 11) with plasma cholesterol levels of less than 5.7 mmol/l and hypercholesterolaemic subjects (n 12) with plasma cholesterol levels higher than 5.7 mmol/l participated in the study. Plasma glucose, cholesterol, triacylglycerol, LDL-cholesterol and HDL-cholesterol concentrations, LDL:HDL values and blood pressure were determined at baseline and after 6 weeks of supplementation with LTCH. LTCH supplementation significantly lowered the plasma total cholesterol level by 11-15% and LDL-cholesterol by 25%, and improved the LDL:HDL value by 29-33% (P < 0.01) in both normal and hypercholesterolaemic subjects. HDL-cholesterol, triacylglycerol and glucose concentrations did not change. Both groups consumed equal amounts of LTCH per week; individuals showed excellent compliance and good acceptance of the product. Neither group changed their dietary habits during the time of the experiment as determined by 3 d dietary records at baseline and at week 6. We conclude that LTCH supplements are suitable to increase fibre intake and reduce plasma LDL-cholesterol levels in healthy and hypercholesterolaemic subjects in this population.     

Neutron activation analysis determination of body composition

The nutritional status of patients can be evaluated by monitoring changes in body composition, including the depletion of protein and muscle, adipose tissue distribution and changes in hydration status, bone or cell mass. Neutron activation analysis is a unique reference tool for the in-vivo determination of body composition. In this review we describe the recent changes in the field that followed the advent of new portable generators of fast neutrons, capable of performing elemental analysis in the clinical environment. New models were developed based on the partition of the measurable elements of the body. The recent developments help evaluate new treatments for wasting and obesity, in which change in body composition is the main outcome.     

Different discharge properties of rat facial nucleus motoneurons

In this paper, we describe two types of putative facial motoneuron based on their electrophysiological properties and on their firing frequency adaptation as recorded in rat brainstem slices. Type I motoneurons (n = 33, 61%) were characterized by a sustained spike firing during depolarizing current injections and a marked depolarizing sag (inward rectification) during hyperpolarizing pulses. The time-course and voltage-dependence of the inward rectification together with the finding that it was blocked by Cs+ are consistent with the involvement of a Na+ -and K+ -mediated Q current. Type II motoneurons (n = 21, 39%) were identified by a fast spike firing adaptation. Type II cells showed a less pronounced inward rectification with hyperpolarizing current pulses and a higher discharge rate than type I cells during depolarizing current pulses. These distinct discharge properties imply the activation of a Ca2+ -dependent K+ current, because when carbachol was added to the bath, or the slice was exposed to a Ca2+ -free solution, a decrease was noticed in the firing frequency adaptation. The two types of motoneuron were further differentiated by the initial delay of the first spike, observed only in type I cells, which was blocked by bath application of 4-aminopyridine, indicating the presence of a K+ -mediated A current. The addition of 4-aminopyridine to the bath also increased the firing rate due to a decrease of the post-spike afterhyperpolarization. However, the two types of motoneuron were not morphologically differentiated. Facial motoneurons exhibited rhythmic membrane potential oscillations (8-20 Hz) at depolarized membrane potentials or during the silence following spike frequency adaptation. It is suggested that the intrinsic properties of these two types of facial motoneuron may be relevant in the government of distinct facial muscle activities. The fact that their discharge rate and the level of spike frequency adaptation were modified by altering some K+ currents suggests a potential plasticity in the modulation of motoneuron firing activities depending upon functional motor needs.