Relation between lipoprotein subfractions and TSH levels in the cardiovascular risk among women with subclinical hypothyroidism.

OBJECTIVE: Subclinical hypothyroidism (SCH) is a common condition associated with increased cardiovascular risk. A standard treatment is yet to be established, as there is no consensus on the TSH cut-off values which should be used as indicators. Thus, the aim of this study was to assess cardiovascular risk in patients with SCH and to differentiate it according to TSH levels. DESIGN: This was an observational study conducted in an academic medical centre. PATIENTS: The study population consisted of 95 middle-aged women recently diagnosed with SCH and 65 euthyroid controls. MEASUREMENTS: We measured anthropometric parameters, lipid cardiovascular risk markers and lipoprotein subclasses of HDL and LDL. RESULTS: Patients with SCH exhibited a significant increase in triglycerides and atherogenic index of plasma and a significant reduction in HDL-cholesterol with respect to the control group after adjusted by age and BMI. A similar lipid profile was observed in both SCH groups. However, patients with TSH levels higher than 10 mIU/l showed a significant reduction in LDL particle size, which was associated with a higher prevalence of atherogenic pattern B. CONCLUSIONS: Our findings indicate that cardiovascular risk is affected in patients with TSH levels over 10 mIU/l, who have a lipid profile characteristic of atherogenic dyslipidemia.

Serum lipid responses to phytosterol-enriched milk in a moderate hypercholesterolemic population is not affected by apolipoprotein E polymorphism or diameter of low-density lipoprotein particles.

BACKGROUND/OBJECTIVES: The importance of both low-density lipoprotein cholesterol (LDLc) size and the apolipoprotein E (Apo E) in the atherogenic process is known, but there is little information with regard to the effect of phytosterols (PS) on these parameters. The aim of this study was to evaluate the influence of PS on lipid profile and LDLc size according to Apo E genotype. SUBJECTS/METHODS: This was a randomized parallel trial employing 75 mild-hypercholesterolemic subjects and consisting of two 3-month intervention phases. After 3 months of receiving a standard healthy diet, subjects were divided into two intervention groups: a diet group (n=34) and a diet+PS group (n=41) that received 2 g/day of PS. Total cholesterol (TC), triacylglycerols, LDLc, high-density lipoprotein cholesterol (HDLc), non-HDLc, Apo A-I and B-100, LDLc size and Apo E genotype were determined. RESULTS: Patients receiving PS exhibited a significant decrease in TC (5.1%), LDLc (8.1%), non-HDLc (7.4%) and Apo B-100/Apo A-I ratio (7.7%), but these effects did not depend on Apo E genotype. No significant changes were found in lipid profile according to Apo E genotype when patients following dietary recommendations were considered as a whole population or separately. No variations in LDLc size were observed in any of the intervention groups. CONCLUSION: The results of this study show that Apo E genotype does not have an impact on the lipid response to PS as a cholesterol-lowering agent in mild-hypercholesterolemic patients. Furthermore, the evidence obtained confirms that LDLc particle size is not modified when PS are added to a standard healthy diet.

Utilidad de diversas proteínas en el diagnóstico diferencial de las meningitis bacterianas / The utility of several proteins within the differential diagnosis of bacterian meningitis

Con el fin de realizar una evaluación de su utilidad en el diagnóstico rápido de las meningitis bacterianas se han determinado, en líquido cefalorraquídeo y en plasma, los siguientes parámetros relacionados con procesos inflamatorios: proteína C reactiva, proteína A amiloide sérica, procalcitonina y lisozima. De los 48 pacientes seleccionados, 10 presentaron meningitis bacteriana, 18 meningitis vírica y 20 se tomaron como grupo control. En los dos tipos de muestras utilizadas, se obtuvieron diferencias significativas en los valores medios de todas las proteínas determinadas, entre el grupo de meningitis bacteriana y los grupos vírico y control. Todas las sensibilidades diagnósticas resultaron iguales o mayores del 80 por ciento, destacando las de SAA n líquido cefalorraquídeo procalcitonina plasmática que fueron del 100 por ciento. Esta excelente sensibilidad, junto con la amplia diferencia de valores obtenidos entre el grupo bacteriano y el resto de grupos (las concentraciones medidas de procalcitonina y SAA en el grupo de meningitis bacterianas fueron respectivamente, 24 y 10 veces superiores a la correspondiente a los grupos meníngeo vírico y control), podrían permitir a estos parámetros ser utilizados como marcadores para el despistaje rápido de las meningitis bacterianas. Teniendo en cuenta el reducido tamaño del grupo de meningitis bacterianas. Teniendo en cuenta el reducido tamaño del grupo de meningitis bacterianas estudiado, se considera necesaria una reevaluación de estos parámetros en un grupo de pacientes más amplio. Sería interesante el desarrollo de un método inmunonefelométrico para la determinación de procalcitonina sérica que fuera totalmente automatizado y rápido, lo que permitiría su fácil implantación en los laboratorios de rutina y de urgencias. También se considera conveniente el establecimiento de un valor definido de punto de corte de procalcitonina, con el fin de disminuir las diferencias entre los diversos valores de sensibilidad y especificidad diagnóstica encontrados en la bibliografía (AU)

Development of an automated immunoturbidimetric ferritin assay.

We have developed a new procedure for turbidimetric measurement of ferritin concentration in human serum, based on latex microparticle agglutination technology. The procedure has been automated using the Falcor 300 analyzer. Carboxilated latex particles (336 nm in diameter) were covalently coupled with immunopurified F(ab')2 fragments of anti-ferritin IgG antibodies. Coated microparticles were automatically mixed with undiluted sample and the resulting absorbance due to agglutination was measured at 550 nm. The procedure generated a calibration curve with a measuring range of 0 to 558 microg/l, showing a day-to-day imprecision lower than 5.7%. The detection limit was 4 microg/l. There were no interferences from bilirubin, hemoglobin or rheumatoid factors. Turbid and lipemic samples caused an important interference which could be avoided by pretreating those samples prior to measurement. A prozone effect was provisionally obtained with ferritin concentrations over 1800 microg/l. The results suggested a hook-like effect due to a rapid microparticle precipitation in the reaction media, that could be avoided by increasing the reaction medium density by adding sucrose to the buffer, up to 150 g/l concentration. This sucrose addition resulted in a displacement of the Heidelberger curve with a prozone phenomenon occuring at concentration higher than 3000 microg/l of ferritin. Results obtained with the present procedure correlated well with those obtained by a nephelometric procedure and with those obtained by an RIA. We conclude that this latex turbidimetric immunochemical procedure is simple, rapid, has a good analytical and operational performance on the Falcor 300 analyzer and is well suited for the measurement of ferritin concentration in human serum.

Chronic myeloid leukemia with expression of ALL-type BCR/ABL transcript: a case-report and review of the literature.

CML with exclusive expression of ALL-type bcr/abl has only been rarely described. In some cases, the presence of this fusion gene has been associated to a differentiated subtype of CML that share some features with CMML, while in another case this molecular hallmark has been associated to a bad prognosis of the disease with a blast phase as clinical presentation or an early transformation to blast phase. We report a case of a 30-year-old woman who was diagnosed of CML in chronic phase in May 1989. She received treatment first with busulfan, achieving hematological remission and afterwards with interferon and Hydroxiurea. In February 1998, she was admitted at our hospital for an ABSCT. Then, molecular studies were performed. Multiplex PCR revealed the presence of a 481 bp product identified as the ela2 bcr/abl transcript and confirmed by sequencing. After 9 years from diagnosis, the patient remains in hematological remission and in good clinical condition.