Pamidronate for the treatment of osteoporosis secondary to chronic cholestatic liver disease in Wistar rats

Osteoporosis is a major complication of chronic cholestatic liver disease (CCLD). We evaluated the efficacy of using disodium pamidronate (1.0 mg/kg body weight) for the prevention (Pr) or treatment (Tr) of cholestasis-induced osteoporosis in male Wistar rats: sham-operated (Sham = 12); bile duct-ligated (Bi = 15); bile duct-ligated animals previously treated with pamidronate before and 1 month after surgery (Pr = 9); bile duct-ligated animals treated with pamidronate 1 month after surgery (Tr = 9). Rats were sacrificed 8 weeks after surgery. Immunohistochemical expression of IGF-I and GH receptor was determined in the proximal growth plate cartilage of the left tibia. Histomorphometric analysis was performed in the right tibia and the right femur was used for biomechanical analysis. Bone material volume over tissue volume (BV/TV) was significantly affected by CCLD (Sham = 18.1 ± 3.2 vs Bi = 10.6 ± 2.2%) and pamidronate successfully increased bone volume. However, pamidronate administered in a preventive regimen presented no additional benefit on bone volume compared to secondary treatment (BV/TV: Pr = 39.4 ± 12.0; Tr = 41.2 ± 12.7%). Moreover, the force on the momentum of fracture was significantly reduced in Pr rats (Sham = 116.6 ± 23.0; Bi = 94.6 ± 33.8; Pr = 82.9 ± 22.8; Tr = 92.5 ± 29.5 N; P < 0.05, Sham vs Pr). Thus, CCLD had a significant impact on bone histomorphometric parameters and pamidronate was highly effective in increasing bone mass in CCLD; however, preventive therapy with pamidronate has no advantage regarding bone fragility.

Características epidemiológicas del embarazo en la adolescencia: estudio en la maternidad escuela de Fortaleza/Brasil / Characteristic epidemiologists of pregnancy in the adolescence: study in the maternity Fortaleza/Brasil school

Objetivo: analizar características epidemiológicas del embarazo en la adolescencia y comparar las variables entre las gestantes precoces y tardías. Pacientes y Métodos: en un estudio transversal, analítico, se evaluaron 2.058 prontuarios, 322 (15,65 por ciento) del grupo de las precoces y 1.736 (84,35 por ciento) de las tardías, que tuvieron su parto en la Maternidad Escuela Assis Chateaubriand /UFC del 01/01/2000 al 31/12/2000. Resultados: del total de partos, el 25,95 por ciento eran adolescentes. Promedio de edad fue de 17,19 años; 35,50 por ciento de las gestantes se declararon sin pareja (p=0,017). Escolaridad, el 15,83 por ciento eran analfabetas o poseían la escuela primaria incompleta y 29,68 por ciento declaraban 8 o más años de estudio (p=0,0001). El consumo de cigarrillo, alcohol y drogas ilícitas fue bajo y sin diferencia estadística entre los dos grupos de edad. Hubo un gran número de primigestas, 73,06 por ciento. Reincidencia de gestaciones, 6,83 por ciento en las precoces y 30,67 por ciento en las tardías (p<0,0001). Los índices de aborto, 4,04 por ciento entre las de menor edad y 8,43 por ciento en las de mayor edad (p=0,033). Conclusiones: El índice de embarazo en la adolescencia fue elevado y el número de partos creció, en la medida en que aumentó la edad materna. Las adolescentes se caracterizaron por: la mayoría declaró estar con pareja, tener escolaridad media y presentar bajo consumo de cualquier tipo de droga. La incidencia de primigestas fue elevada y la mayoría no declaró aborto anterior.

Infrequent p53 gene alterations in ulcerative colitis

The purpose of this study was to determine whether point mutations and loss of the p53 gene take place in ulcerative colitis which is histologically negative for dysplasia. DNA was extracted from 13 frozen rectal or colon biopsies and blood samples. Ulcerative colitis was classified histologically as active (10 cases) and inactive (3 cases). Exons 5-8 were amplified by PCR, treated with exonuclease and shrimp alkaline phosphatase and sequenced by the dideoxy chain termination method with the Sequenase Version 2.0 DNA sequencing kit. PCR products of intron 6 and exon 4 were digested with MspI and AccII, respectively, for RFLP analysis. No p53 gene mutation was detected in these cases. The number of informative patients for loss of heterozygosity (LOH) at the p53 intron 6 was high, 11 out of 12 (92 percent), whereas no LOH was observed. LOH affecting p53 exon 4 was not detected in lesions from 5 of 12 patients (42 percent). In ulcerative colitis, tumor progression is similar to that in sporadic colon cancer, and other oncogenes and tumor suppressor genes are likely to be mutated before the p53 gene

Anemia falciforme e gravidez. / Sickle cell anemia and pregnancy

Os autores, analisando 5.876 partos ocorridos na Escola Paulista de Medicina, no periodo de 1978 a 1983, observaram 12 gestacoes em seis pacientes com anemia falciforme, sendo tres em homozigotas e tres em heterozigotas (AS). Todas eram oriundas da raca negra, e o diagnostico foi estabelecido antes da gravidez. A maioria das pacientes nao apresentou alteracoes da intensidade do quadro clinico, contudo, os tres casos homozigotos exibiam sintomatologia mais exuberante. Observam maior numero de intercorrencias clinico-cirurgicas e obstetricas. Apuram 25% de perdas conceptuais representadas por uma gravidez ectopica, um aborto espontaneo e um obito fetal. Nao registram mortalidade perinatal ou materna

Aumento da frequencia da cesariana.Analise da percentagem verificada na Escola Paulista de Medicina. / The increase in the frequency of cesarean section. Analysis of verified percentage at the Escola Paulista de Medicina

Analisa-se o aumento da incidencia de cesareas verificado na literatura e na Disciplina de Obstetricia da Escola Paulista de Medicina. Apresentam-se dados desse servico num periodo de sete anos, em que se observa elevacao da percentagem de cesarianas em relacao ao numero total de partos de 25,50% em 1975 para 37,94% em 1981. Outrossim, verificaram no periodo estudado, que as cesareas iterativas representaram 31,83% de todas as cesareas realizadas