Social network and social support among poor elderly ill in Guadalajara, Mexico

This paper examines social networks and social support among poor elderly ill in Guadalajara, Mexico. We interviewed 40 hospitalized elderly patients. The mean size of social networks was 7.5, basically involving women, multiple generations, and members of the extended family. Emotional support was more frequent than other types of social support. Elderly women had larger social networks and received more social support than men. Married elderly also had larger social networks and more social support than single patients. There were no differences between age and living arrangements with social networks and social support. Future studies are needed on the social and cultural environment of social support for the elderly.     

Hodgkin's disease presenting as a cholestatic febrile illness: incidence and main characteristics in a series of 421 patients

 In order to determine the frequency and characteristics of patients with liver abnormalities as the presenting manifestation of Hodgkin's disease (HD), 421 consecutive HD patients were studied. Six patients in the series (1.4%) presented with liver abnormalities that led to of a liver biopsy and the subsequent diagnosis of HD. All had fever prior to HD diagnosis, four frank jaundice, and one hepatic failure. No patient had pruritus. Moderate hepatomegaly was present in four patients. Cholestasis was observed in all cases; in most patients a moderate increase in the transaminase activity was also seen. Two patients had a mild rise in the serum LDH, four had leukopenia, and one eosinophilia. At liver histologic study, Reed-Sternberg cells were demonstrated in four patients; in the remaining two, the presence of atypical histiocytes, lymphocytes, and eosinophils was highly suggestive of HD, the latter diagnosis being confirmed by subsequent study of bone marrow and/or retroperitoneal lymphadenopathies. In three of the six patients, HD was not demonstrated in sites other than the liver. Three patients older than 60 years died shortly after HD diagnosis. By contrast, three patients younger than 40 years showed a dramatic response to chemotherapy: two of them had a further relapse, and one is considered cured after 14 years of continuous remission. Liver disease constitutes an infrequent form of HD presentation which must be included in the differential diagnosis of any patient with fever of unknown origin. Received: 26 October 1995 / Accepted: 15 February 1996     

Progesterone facilitation of EEG synchronization in response to milk drinking in female cats

(1) Milk drinking elicits EEG synchronization in the parieto-occipital cortex and inhibits brainstem neuronal activity in cats. (2) These electrical changes are part of an integral response to rewarding stimuli which has been called relaxation behavior. (3) Progesterone (P) either injected in doses of 10 mg twice a day or released from implanted minipumps at the rate of 0.2 mg/hr, significantly lengthened the period of EEG synchronization in the parieto-occipital cortex during milk drinking. (4) Facilitation occurred one or two days after the initiation of P treatment. (5) The characteristics of this effect suggest that P exerts its action by acting like a mild tranquilizer.     

Comparative SEM evaluation of penetration of adhesive systems in human dentin with a non-rinse conditioner and a self-etching primer

The purpose of this study was to compare the effect of a self-etching primer and a non-rinse conditioner with the effect of a conventional adhesive system on the penetration depth in dentin of human teeth, using scanning electronic microscopy (SEM). Fifteen human third molar teeth were sectioned into 2 pieces. All pieces were flattened with grade 600 to 1200 silicon carbide paper and divided into 6 groups: group 1 - Prime & Bond NT (NT), negative control; group 2 - 37% phosphoric acid + Prime & Bond NT (PANT), positive control; group 3 - Non-rinse Conditioner (NRC) + Prime & Bond NT (NRCNT); group 4 - NRC + Prime & Bond 2.1 (NRCPB); group 5 - NRC + Scotchbond MP (NRCSB); group 6 - Prompt L-Pop (PLP). All teeth were covered with Dyract AP. The tooth fragments were decalcified, and its resin replicas were evaluated by SEM by three previously standardized examiners. The penetration was scored from 0 (no penetration) to 3 (maximum penetration). The Kruskal-Wallis and Mann-Whitney U tests (p<0.05) showed three statistically homogeneous groups: (NT, NRCPB, NRCSB and PLP), (NRCNT) and [PANT]. The authors concluded that the self-etching primer and the non-rinse conditioner provide a lower penetration depth in human tooth dentin than the conventional adhesive system.     

Dietary changes in Mexico

Although the Mexican population has traditionally been malnourished, the prevalence of obesity in children and adults has increased by almost 50 % in the last 10 years. Recent studies show substantial changes in the nutritional status of Mexicans, especially in the pediatric population. Among the factors associated with the development of obesity are overeating, sedentariness, and genetics. The apparent economic development in Mexico, as well as the influence of dietary patterns from other countries, have contributed to modifying lifestyle. Despite measures taken by the health system, iron- and zinc-deficiency anemia continue to be prevalent. The present review aims to describe the changes that have taken place in Mexico in the last few decades leading to a generation of short and obese children, as well as to determine the associated factors in order to promote healthier eating patterns among the Mexican population.     

Acute renal failure secondary to imatinib mesylate treatment in chronic myeloid leukemia

A 58-year-old woman with chronic myeloid leukemia (CML), and previous intolerance to interferon was treated with the BCR-ABL tyrosine kinase protein inhibitor imatinib mesylate. Coincidentally, with the start of treatment, the patient developed acute renal failure, with acute tubular necrosis being observed on histopathology. Imatinib was stopped and three hemodialysis sessions were performed, which was followed by a progressive improvement of the renal function and normalization of the urine output. One year later the patient still has mild chronic renal failure and remains in chronic phase of CML on hydroxyurea treatment.     

Choledocholithiasis: new approach to an old problem

The old problem of diagnosis and treatment of choledocholithiasis is analyzed in light of recent developments in the field of radiology and surgery. The traditional indications for common bile duct (CBD) exploration resulted in a large number of unnecessary manipulations of the bile ducts. The same is now true of the widespread use of endoscopic retrograde cholangiopancreatography. With the advent of magnetic resonance imaging cholangiography, which can clearly demonstrate CBD calculi by means of a noninvasive, complication-free technology, we should abandon the old indications for CBD exploration and be more conservative regarding the diagnosis and management of this condition. In an era of minimally invasive surgery we are seeing a significant reduction in the number of patients with choledocholithiasis.