Subolesin/Akirin vaccines for the control of arthropod vectors and vectorborne pathogens.

Diseases transmitted by arthropod vectors such as mosquitoes, ticks and sand flies greatly impact human and animal health, and therefore, their control is important for the eradication of vectorborne diseases (VBD). Vaccination is an environmentally friendly alternative for vector control that allows control of several VBD by targeting their common vector. Recent results have suggested that subolesin (SUB) and its orthologue in insects, akirin (AKR) are good candidate antigens for the control of arthropod vector infestations and pathogen infection. SUB was discovered as a tick-protective antigen in Ixodes scapularis. Vaccination trials with recombinant SUB/AKR demonstrated effective control of arthropod vector infestations in various hard and soft tick species, mosquitoes, sand flies, poultry red mites and sea lice by reducing their numbers, weight, oviposition, fertility and/or moulting. SUB/AKR vaccination also reduced tick infection with tickborne pathogens, Anaplasma phagocytophilum, A. marginale, Babesia bigemina and Borrelia burgdorferi. The effect of vaccination on different hosts, vector species, developmental stages and vectorborne pathogen infections demonstrated the feasibility of SUB/AKR universal vaccines for the control of multiple vector infestations and for reduction in VBD.

[What is the opinion of Spanish internists on osteoporosis?]. / 'Qué opinan los internistas españoles de la osteoporosis?

OBJECTIVE: To conduct an opinion survey on osteoporosis in Spanish internists. METHOD: Survey sent by mail and by personal visit to members of the Spanish Internists Society. Collection of data on opinion on the disease, diagnostic and therapeutic attitude and means available (general laboratory analyses, conventional radiology, biochemical markers of bone remodeling, densitometry and ultrasounds) and preference when choosing a certain treatment. RESULTS: A total of 538 internists answered. More than 90% of those surveyed consider that osteoporosis is a disease that should be treated by internists. A total of 93% consider that osteoporosis is a prevalent disease. More than 80% have access to densitometry. CONCLUSIONS: The majority of Spanish internists consider that osteoporosis is a disease that should be treated by internists and that it is a disease that enters into their action scope. In general, they have the means necessary for its study and treatment. Bisphosphonates constitute the drug of choice and calcium and vitamin D supplements are indicated in almost all the cases.

¿Qué opinan los internistas españoles de la osteoporosis? / What is the opinion of Spanish internists on osteoporosis?

Objetivo. Realizar una encuesta de opinión sobre osteoporosis en internistas españoles. Método. Encuesta remitida por correo y por visita personal a miembros de la Sociedad Española de Medicina Interna. Recogida de datos sobre opinión acerca de la enfermedad, actitud diagnóstica y terapéutica y medios disponibles (analítica general, radiología convencional, marcadores bioquímicos de remodelamiento óseo, densitometría y ultrasonidos) y preferencias a la hora de elegir un determinado tratamiento. Resultados. Contestaron un total de 538 internistas. Más del 90% de los encuestados opina que la osteoporosis es una enfermedad que deben tratar los internistas. El 93% considera que la osteoporosis es una patología prevalente. Más del 80% tiene acceso a una densitometría. Conclusiones. Los internistas españoles opinan mayoritariamente que la osteoporosis es una enfermedad que deben tratar los internistas y que entra en su ámbito de actuación. Por lo general disponen de los medios que necesitan para su estudio y tratamiento. Los bifosfonatos constituyen el fármaco de elección y en la práctica totalidad de los casos indican un suplemento de calcio y vitamina D

Objective. To conduct an opinion survey on osteoporosis in Spanish internists. Method. Survey sent by mail and by personal visit to member of the Spanish Internists Society. Collection of data on opinion on the disease, diagnostic and therapeutic attitude and means available (general laboratory analyses, conventional radiology, biochemical markers of bone remodeling, densitometry and ultrasounds) and preference when choosing a certain treatment. Results. A total of 538 internists answered. More than 90% of those surveyed consider that osteoporosis is a disease that should be treated by internists. A total of 93% consider that osteoporosis is a prevalent disease. More than 80% have access to a densitometry. Conclusions. The majority of Spanish internists consider that osteoporosis is a disease that should be treated by internists and that it is a disease that enters into their action scope. In general, they have the means necessary for its study and treatment. Bisphosphonates constitute the drug of choice and calcium and vitamin D supplements are indicated in almost all the cases

Woman feels breast lump--surgeon cannot: the role of ultrasound in arbitration.

The role of ultrasound scanning (USS) in patients complaining of a breast lump where the clinical examination (CE) is normal is not clearly defined. To determine this in greater detail, all patients complaining of a breast lump underwent CE. Where no lump could be found, but was still reported by the patient, an USS was performed. All lesions underwent biopsy and/or aspiration, as well as mammography in suspicious cases or those over 40 years of age. This cohort represented 5% of all referrals in the study period. Four hundred and twenty women were prospectively studied in this way. Median follow up is 3.4 years (range 2.5-4.2 years). Twenty two had solid lumps (of which 3 were cancers) and 48 had cysts. Nineteen patients re-presented with symptoms in the same breast (median time = 12 months (range 4.5-20 months), all of which were imaged on USS: 15 cysts and 4 further cancers (3 in the same quadrant as the original lump, one contralateral) were identified. Women with symptomatic breast lumps and a normal CE can be considered a reliable indication that cancer is very unlikely to be present (negative predictive value = 0.98). Ultrasound may be a suitable complimentary investigation, which will relieve symptoms in those with cysts and can detect small clinically--and sometimes mammographically--occult breast cancers.

Laparoscopic surgery in the elderly patient.

BACKGROUND: Elderly patients represent a unique surgical challenge because of the associated complex comorbidity and diminished cardiopulmonary reserve. Therefore, minimally invasive surgery in the elderly may have a larger impact compared to the younger population. The aim of this study was to prospectively evaluate the experience of laparoscopic surgery in patients >or=70 years of age in our unit. METHODS: Two hundred and thirty-two patients (34 females and 98 males) older than 70 years who underwent various elective and emergency laparoscopic procedures between 1992 and 1997 were assessed prospectively. Preoperative comorbidity, operative results, and postoperative outcomes were analyzed. RESULTS: The median age of the patients was 76 years. The majority of patients were ASA class II. The mean hospital stay was 3.4 days. The overall morbidity and mortality rates were 10.8% and 3.4% respectively, and the conversion rate was 4.3%. CONCLUSIONS: Our experience suggests that laparoscopic surgery in the elderly is safe, is associated with short hospital stay, and produces less morbidity and mortality. Therefore, it should be adopted widely if the expertise in the area of laparoscopic surgery is available for this group of patients.

[Osteoporosis in patients admitted to an internal medicine service of a university general hospital]. / Osteoporosis en pacientes ingresados en un servicio de medicina interna de un hospital de tercer nivel.

OBJECTIVE: To ascertain the incidence of osteoporosis and epidemiological factors in patients admitted to an Internal Medicine Service of a University General Hospital in Madrid, Spain. We also took into account the reasons for admission, associated diseases, and the preventive and therapeutic diagnostic implications. PATIENTS AND METHODS: The analytical, descriptive, retrospective and transversal study of one hundred patients over fifty years of age admitted to an internal medicine service during 1997, obtaining in addition to the clinical discharge report, epidemiological data with regard to the radiological diagnosis of osteoporosis, the reason for admission, past history, the prevention and treatment of the initial complaint as well as the osteoporosis previous diagnosis. RESULTS: 26% of those patients included in the survey had radiologic criteria of osteoporosis although only in 1 per cent of them had osteoporosis been diagnosed previously. The main risk factors, apart from the age and sex, are the associated illnesses which cause malnutrition and immobilization, and the use of drugs, especially heparin. CONCLUSIONS: Osteoporosis is a condition common in patients above 50 especially women, who are admitted to an Internal Medicine Service. A quarter of those patients admitted have osteoporosis. Very few are diagnosed and treated. In this group of patients apart from the habitual risk factors, are added those for the associated disease generally chronic, and the treatment they receive. During their stay in the hospital osteoporotic patients are three times more likely to receive heparin and other drugs which aggravate osteoporotic, than non osteoporotic patients. For that reason the risk of fractures is greater and the need for prospective diagnostic studies is even more necessary in this group of patients.

Anemia hemolítica autoinmune e hipernefroma / Autoimmune hemolytic anemia and hypernephroma

No disponible

[Chemical-nutritional evaluation of Sorghum saccharatum var. sugar drip. A supplementation study with lactoserum proteins]. / Evaluación químico-nutricional de Sorghum saccharatum var. sugar drip. Estudio de complementación con proteína de lactosuero.

The chemical-nutritional composition and some indexes of biological quality of sorghum (Sorghum saccharum, var. sugar drip) unwashed whole flour were studied. The culture and selection of sorghum were assayed in the "San Roque" Experimental Station of the Agriculture Department, Undersecretary of Agricultural Affairs, San Luis, Argentina. The obtained protein content was 7.5% (Nx6.25). The values for net protein utilization (NPU); true digestibility (tD); net protein ratio (NPR) and and relative net protein ratio (RNPR) were 12.4 +/- 0.6, 22.0 +/- 0.2, 0.8 +/- 0.1 and 24%, respectively. Deficient nitrogen utilization constitutes a limitation for the use of sorghum. However, considering its abundance and low cost, sorghum could become a profitable feeding resource if conveniently supplemented without increasing costs. Sorghum flour was supplemented with protein recovered from ricotta serum (50:50), discarded as industrial waste, in order to compensate for lysine and threonine deficiency in this cereal. Studies performed on this mixture gave RNPR values of 85.7%. This might permit us to infer that despite its low biological value, sorghum can be used as food resource, potentially for poultry, with adequate supplementation.

[Biological value of protein from leaves of Atriplex suberecta]. / Valor biológico de la proteína foliar de Atriplex suberecta.

The study of Atriplex suberecta leaf protein concentrate has been included within our work line entitled "Biological value of the leaf protein of Atriplex" amino acid profile and chemical score. In order to evaluate nitrogen retention, net protein utilization (NPU), true digestibility (TD) and biological value (BV) data were obtained. Weight gain was studied after determining net protein ratio (NPR) and relative net protein ratio (RNPR) with the following results: CS = 96, calculated for sulphur amino acids; NPU = 60 +/- 4.00; TD = 76 +/- 5.20; BV = 87; NPR = 3.34 +/- 2.50 and RNPR = 88%, which enable us to infer that its protein is of good quality. These data, therefore, should indicate that the product studied could be a good complement for cereals, considering its high lysine content (CS superior to 100).

[Chemical composition and nutritive value of the protein of Amaranthus quintensis]. / Composición química y valor nutritivo de la proteína de Amaranthus quintensis.

An account is given of some considerations concerning the chemical recognition and evaluation by biological methods of the quality of the flour obtained from Amaranthus quitensis seeds, submitted to grinding and sifting. The protein content of the flour (21.70g/100g) can be considered as very important, as well as that of the available lysine (5.20g/16gN). The calcium content was also remarkable (500mg/100g), and the starch ratio reached 45.00g/100g. The amount of nitrates found was 20.00mg/100g, which is an acceptable limit. The research for organic nitro compounds was negative. As for the biologic quality of the protein, the experiments revealed that it has quite an acceptable availability, as demonstrated by the following values: NPU = 42.50 +/- 6.10, D = 68.50 +/- 5.30, VB = 62, NPR = 2.10 +/- 1.80 and RNPR = 42.

[Biologic value of the protein concentrate of Atripex lampa and its value as a complement to wheat flour]. / Valor biológico y complementario a la harina de trigo, del concentrado proteínico de Atriplex lampa.

The Atriplex lampa, chenopodiáceae, is a very abundant bush in the arid and semiarid regions of our Province. This work was undertaken to characterize from the chemical point of view, both the fresh leaves and the protein concentrate (PC) obtained from them. A second purpose was to determine the biological value of the protein, and to evaluate its capacity as a complement to wheat flour (WF). Through this study, the leaf was shown to have a high content of ashes, sodium, potassium and silica, what accounts for its low palatability. The PC obtained has a protein concentration of 59.37 g/100 g and its biological value is limited by the sulfur amino acids, with a chemical score of 85.70. Since the protein is poorly utilized, this results in a relatively low value of its net protein utilization (NPU), a fact which may be attributed to its low true digestibility. The studies on the complementary effects of PC on WF were made at three levels, i.e., 30, 50 and 60%, respectively. The results revealed that the best complementation, measured by the nitrogen utilization, happened to be when 50% of the protein contribution was provided by the A. lampa protein concentrate.

[Biological quality of the protein isolated from the leaves of Atriplex numularia]. / Calidad biológica del aislado proteínico de hojas de Atriplex numularia.

Plant leaf proteins have acquired great relevance during the last two decades because of their well-balanced amino acid composition. A study was therefore undertaken to evaluate the biological quality of the leaf protein of Atriplex numularia. The protein content of the fresh leaves from this plant was found to be 4.70 g/100, with a dry matter content of 18.70 g/100 g. A protein concentrate (PC) from the same material was then obtained by macerating the leaf in a 2% sodium sulfite solution at a pH of 10 and subjecting it to filtration and pressing. The product thus obtained had a dark greenish color and contained 55.42 g/100 g of protein. The amino acid analysis revealed that its protein has a balance similar to that of animal origin proteins, with a lysine and methionine content of 8.5 g/16 g N and 3.0 g/16 g N, respectively. Biological assays were then carried out to evaluate nitrogen utilization, with the following resulting values: net protein utilization (NPU) = 48.3 +/- 2.7; digestibility (D) = 58.0 +/- 1.4, and biological value (BV) = 83. As inferred from the NPU value, nitrogen utilization was low. Therefore, to improve digestibility values, the action of papain on the PC was assayed. The material thus treated was again submitted to biological trials, obtaining, this time a D of 75.4 +/- 1.05, and thus, an improved new NPU value of 54.8 +/- 1.1 (p less than 0.01).

[Obtaining flour and protein concentrate from seeds of Melilotus albus. Study of the protein quality]. / Obtención de harina y concentrado proteínico de semillas de Melilotus albus. Estudio de la calidad de la proteína.

The present research was carried out to determine the nutritive quality of the flour and protein concentrate from Melilotus albus (white clover) seeds. The flour was studied first. The protein analysis showed methionine to be the first limiting amino acid with a chemical score of 25, with threonine as the second. The biological value obtained was 27. Supplementation studies were performed with different levels of methionine and it was found that the 0.3% level resulted in the best net performance. The biological value obtained under these conditions was 60. The protein efficiency ratio (PER) was also determined, with a value of 1.40 after being corrected with respect to casein. The protein was isolated after studying the pH optimum solubility and precipitation conditions until the flour coumarin compounds were eliminated. Further biological experiments were carried out with the supplemented isolated protein. Under these conditions, a PER value of 2.4 and a biological value of 69 were obtained. No toxicity was observed in rats of both sexes by administration of the protein concentrate during 60 days, at least in the parameters studied during this period.