Prevalence of the metabolic syndrome in Spain using regional cutoff points for waist circumference: the di@bet.es study

The aim of the study is to assess the prevalence of metabolic syndrome (MetS) in Spain using specific cutoff points for waist circumference (WC) (>94.5 cm for men and >89.5 cm for women) and evaluating the influence of several socio-demographic and economic factors. Data on MetS were obtained from a national study of 4,727 subjects from 18 to 90 years of age, conducted in Spain between 2009 and 2010 (The di@bet.es study). MetS was defined applying the new Harmonized definition (evaluating the use of abdominal obesity (AO) as a obligatory criterion for MetS or not) as well as with other widely used criteria. Results were then compared with data from previous studies. Multiple logistic regression models were used to evaluate the influence of different social factors. The age-standardized MetS prevalence was 38.37 % (CI 35.74–40.99) in men and 29.62 % (CI 27.56–31.69) in women, when AO was required as a diagnostic criterion; 42.13 % (CI 39.37–44.89) and 32.31 % (CI 30.15–34.47) in men and women, respectively, if AO was not considered mandatory. Prevalence of MetS increased with age (p < 0.001 for trend). Women with a lower educational level were more likely to have MetS (OR 4.4; 95 % CI: 2.84-6.7) as compared with those with a higher educational level. Subjects with MetS had a worse physical quality of life. The combination of AO, hypertension and carbohydrate alterations was the most common MetS’ pattern. A high prevalence of MetS was detected in the Spanish population especially in men, the elderly and women with a low educational level.     

Antibody persistence after primary vaccination with a hexavalent DTPa-HBV-IPV/HiB vaccine coadministered with a meningococcal C-CRM197 vaccine and response to a DTPa-IPV/HiB booster at 18 months of age

Children 17-20 months of age (N = 344) received a diphtheria-tetanus toxoids-acellular pertussis (DTPa)-inactivated poliovirus vaccine (IPV)/Haemophilus influenzae (Hib) booster after a 3-dose primary vaccination course with DTPa-hepatitis B vaccine-IPV/Hib plus conjugate meningococcal C vaccine-CRM. Seroprotection rates were >80% (diphtheria, tetanus, hepatitis B, polio and polyribosylribitol phosphate) before and > or =96.6% (diphtheria, tetanus, polio and polyribosylribitol phosphate) after booster vaccination. The booster was well-tolerated (fever >39.5 degrees C after <2% of doses; large swelling reactions after 6.3% of doses).     

Acute, subacute and subchronic toxicity of besulpamide

The acute oral and intraperitoneal toxicity of besulpamide has been studied in the rat and mouse, together with the subacute and subchronic oral toxicity in the rat at doses of 0, 125, 500 and 2000 mg/kg/day. The LD50 is in excess of 12,800 mg/kg by the oral route and in excess of 5,000 mg/kg intraperitoneally. Toxic signs were very slight and autopsy did not reveal lesions which could be attributed to the test substance. In the subacute and subchronic toxicities the characteristic effects of the diuretic activity were observed. In the subchronic toxicity study significant, although not dose-related, increases were observed in calcium, alkaline phosphatase, GPT and GOT levels. A decrease in liver-weight of the female animals with respect to controls was also noted. Histopathological studies did not reveal any changes which could be attributed to administration of the test substance. Besulpamide has demonstrated the typical effects of diuretics which are derivatives of 3-sulfamoyl-4-chlorobenzoic acid and in acute, subacute and subchronic tests by the oral route in the rat it has shown itself to be a substance of very low toxicity.     

Pharmacokinetics of besulpamide in rats and dogs

The pharmacokinetics of besulpamide were studied in rats and its urinary excretion in rats and dogs. Kinetic characteristics were the same for both male and female rats according to a two-compartment open model. Biological half-life was 1-4 hr, absorption half-life was approximately 10 min and absolute bioavailability was nearly complete (F = 86.4%). In rats, urinary excretion of unchanged besulpamide was 30% after i.v. administration and 7% after oral administration, whereas in dogs after oral administration it was 54%. Values of the area under the plasma concentration-time curve in rats and percent of urinary excretion in dogs show that the kinetics of besulpamide are not dose-related when the drug is administered at doses of 10-50 mg/kg.     

Failure to detect the 22q11.2 duplication syndrome rearrangement among patients with schizophrenia

Chromosome aberrations have long been studied in an effort to identify susceptibility genes for schizophrenia. Chromosome 22q11.2 microdeletion is associated with DiGeorge and Velocardiofacial syndromes (DG/VCF) and provides the most convincing evidence of an association between molecular cytogenetic abnormality and schizophrenia. In addition, this region is one of the best replicated linkage findings for schizophrenia. Recently, the reciprocal microduplication on 22q11.2 has been reported as a new syndrome. Preliminary data indicates that individuals with these duplications also suffer from neuropsychiatric disorders. In this study we have investigated the appropriateness of testing schizophrenia patients for the 22q11.2 microduplication. We used multiplex ligation-dependent probe amplification (MLPA) to measure copy number changes on the 22q11.2 region in a sample of 190 patients with schizophrenia. Our results corroborate the prevalence of the 22q11.2 microdeletion in patients with schizophrenia and clinical features of DG/VCFS and do not suggest an association between 22q11.2 microduplication and schizophrenia.     

Pharmacokinetics of droxicam in rat and dog

A study was made of the oral absorption of droxicam in the rat. Five minutes after administration of 1 mg/kg droxicam, only piroxicam levels (its active metabolite) were detected at the portal vein and caudal vena cava. The transformation of droxicam into piroxicam takes place in the gastrointestional tract. A pharmacokinetic test to compare the plasma levels of piroxicam obtained in rat and dog was then made after oral administration of droxicam and piroxicam. In both animal species the oral absorption of droxicam was not dose-related. However, droxicam given at therapeutic doses (0.2-0.3 mg/kg) was bioequivalent to piroxicam. The elimination half-life of piroxicam after oral administration of droxicam and piroxicam was 8 +/- 2 h in the male rat, 27 +/- 12 h in the female rat and 38 +/- 18 h in the male dog, whilst the half-life of oral absorption of piroxicam did not vary from one animal species to another. In the case of droxicam, however, this value was higher than that after oral administration of piroxicam, as a consequence of the process of transformation of droxicam into piroxicam. It is concluded that droxicam is a prodrug of piroxicam with a slower rate of absorption, but with the same bioavailability within the range of therapeutic doses.     

Mittelgesichtsdistraktion nach LeFort-III-Osteotomie bei kraniofazialen Dysmorphien

BACKGROUND: The success of LeFort III-osteotomy with concurrent advancement of the midface in cases of severe, midfacial hypoplasia is limited by the soft covering tissue of the facial skeleton. There appear to be significant advantages in using distraction osteogenesis of the midface after surgery. CASE REPORT: We discuss the use of an extraoral distraction device after the osteotomy of a 10-year-old girl with Crouzon's disease. and the use of an internal device for a 6-year-old boy with severe midface hypoplasia following Apert's syndrome. RESULTS: In both patients a significant improvement of function, as well as harmonisation of the facial proportions, could be observed and the preoperatively planned distances of midface advancement of 18 and 15 mm respectively could be achieved. DISCUSSION: Distraction osteogenesis is an established procedure for the treatment of mandibular hypoplasia but few reports dealing with complex midface distraction are available outside of the specialist English language literature. We report on both external and internal distraction techniques with which good functional and aesthetic results were achieved.