Sistema inmunitario inflamatorio en la cirrosis. Relevancia de la translocación bacteriana / No disponible

No disponible

Supervivencia en España de las paradas cardíacas extrahospitalarias / Survival after extra-hospital cardiac arrest in Spain

Objetivo. Aumentar el conocimiento sobre la parada cardíaca extrahospitalaria (PCR-EH) en España. Método. Analizamos 6.684 episodios de PCR-EH publicados entre junio de 1987 y julio de 1999. Estudiamos los siguientes parámetros: intentos de resucitación, supervivencia inicial (llegada del paciente vivo al hospital), precoz (alta del hospital) y tardía (6 meses), así como la relación incidencia/supervivencia. Comparamos los resultados con 31.078 episodios publicados de PCR-EH incluidos en 31 referencias internacionales. Resultados. Se intentó la resucitación en 3.642 (54,5 por ciento). La edad media fue de 61 ñ 8 años; un 68,5 por ciento eran varones; más del 50 por ciento fueron presenciadas pero el testigo inició reanimación cardipulmonar (RCP) en el 12,5 por ciento. Los intervalos llamada-respuesta fueron menores de 10 min pero el 51,3 por ciento fueron ritmos bradiasistólicos. La incidencia fue de 24 PCR-EH tratadas por 100.000 habitantes/año; la supervivencia inicial fue del 26,2 por ciento (8/100.000 habitantes/año) y la precoz del 10,1 por ciento (2/100.000 habitantes/año), aumentando anualmente (r = 0,079, r = 0,082 y r = 0,211); la supervivencia tardía fue del 5,4 por ciento (1/100.000 habitantes/año), con descenso anual (r = -0,647). El porcentaje de pacientes dados de alta vivos no difieren globalmente de la bibliografía (10,7 por ciento), pero allí se describe un mayor número de PCREH tratadas (59 ñ 25/100.000 habitantes/año; t = 4,548; gl = 14; p < 0,001) y la curva incidencia/ supervivencia se desplaza a la derecha (mayor supervivencia a cualquier nivel de incidencia). Se detecta una considerable mortalidad evitable. Conclusiones. La efectividad de los equipos de emergencias españoles en el tratamiento de la parada cardíaca extrahospitalaria es comparable a la bibliografía internacional, pero con una incidencia menor y un aplanamiento del perfil de incidencia/supervivencia, lo que parece orientar hacia un escaso desarrollo de los primeros eslabones de la "cadena de supervivencia" (AU)

A low blood lymphocyte count is associated with an expansion of activated cytotoxic lymphocytes in patients with B-cell chronic lymphocytic leukaemia.

In order to determine the relationships between CD2+ lymphocyte subpopulations and tumour mass, the immunophenotype of natural killer (NK) cells and T lymphocyte subsets was studied in 56 B-chronic lymphocytic leukaemia (B-CLL) patients and 38 healthy subjects. The patients were classified according to their blood lymphocyte count (BLC). Forty patients had BLC<30x10(9)/l (low BLC, less tumour mass) and 16 patients had BLC>30x10(9)/l (high BLC, larger tumour mass). The percentage of CD3- CD56+ cells, as well as of CD8+, CD8+ CD45RO+ and CD3+ CD57+ T subsets in low BLC patients, were higher than those found in high BLC patients. Conversely, the percentages of CD3+ HLA x DR+, CD4+ and CD4+ CD45RO+ lymphocytes were higher in high BLC patients than in low BLC patients. The CD4/CD8 ratio was decreased in low BLC patients while it was increased in high BLC patients and a significant positive correlation was found between their CD4/CD8 ratio and their BLC. We conclude that in low BLC B-CLL patients there is a decreased percentage of activated helper lymphocytes and an increased percentage of NK cells and activated cytotoxic T lymphocytes. These results suggest a role for NK cells, and helper and cytotoxic T lymphocytes in the control of tumour burden in B-CLL patients.

[Urinary excretion of cytokines in bladder carcinoma]. / Excreción de citocinas urinarias en los carcinomas vesicales.

OBJECTIVE: Analysis of the urinary excretion of cytokines in vesical carcinoma. MATERIAL AND METHOD: The study includes the results obtained in the quantification of several interleukins (IL-1, IL-2, IL-4, IL-6, INF-gamma and TNF-alpha) in urine samples corresponding to 60 patients with transitional cell carcinoma (TCC) with vesical location (40 surface and 20 infiltrant). Concurrently, 40 healthy donors and 20 patients with urinary tract infections were studied. Determination of the various cytokines was done with ELISA enzyme-linked immunoassays. RESULTS: The results obtained in the study show that: a) urinary concentrations of IL-1, IL-2, IL-6, TNF- and INF- in surface TCC, are similar to those found in healthy subjects; b) levels of the mentioned cytokines are significantly higher in patients with urinary infections; c) in patients with infiltrant TCC, IL-6 urinary concentration is significantly higher than in those with S-TCC; d) urinary IL-4 levels show no difference between the various groups under study. CONCLUSION: From all the above it is concluded that there is a large diversity in the excretion of urinary cytokines from the vesical urothelium based on antigenic stimulation (bacterial or tumoral) to which it has been exposed and the tumoral stage, and that baseline determination of IL-6 urine level in patients with vesical TCC could have some prognostic influence.