Mitochondrial DNA haplogroups and susceptibility to prostate cancer in a colombian population.

Prostate cancer (PC) is one of the most common cancers and the second leading cause of mortality from cancer in Colombian men. Mitochondrial DNA (mtDNA) haplogroups have been associated with the risk of PC. Several studies have demonstrated dramatic differences regarding the risk of PC among men from different ethnic backgrounds. The present study was aimed at assessing the relationship between mtDNA haplogroups and PC. The mitochondrial DNA hypervariable segment I (HSV-1) was sequenced in a population-based study covering 168 cases (CA) and 140 unrelated healthy individuals as a control group (CG). A total of 92 different mtDNA sequences were found in CA and 59 were found in the CG. According to the geographical origin attributed to each mtDNA haplogroup, 82% of the mtDNA sequences found in both groups were Native Americans (A, B, C, and D). The most frequent was A (41.1%CA-42.1%CG), followed by B (22.0%CA-21.4%CG), C (12.0%CA-11.4%CG), and D (6%CA-10.0%CG). A lower percentage of European haplogroups (U, H, K, J, M, T, and HV) were also found (13.1%CA-12.9%CG), likewise African haplogroups (L0, L1, L2, and L3) (6.5%CA-2.1%CG). There were no statistically significant differences between the distribution of mtDNA haplogroups in CA and the CG in this study.

Ibuprofen metabolism in the liver and gill of rainbow trout, Oncorhynchus mykiss.

The presence of pharmaceuticals in the environment has become an important topic of discussion with respect to pharmaceutical absorption, metabolism and elimination in fish. This study investigates the metabolism of ibuprofen by rainbow trout (Oncorhynchus mykiss). In vitro metabolic loss of parent compound was measured in gill and liver S9 and microsomal fractions. Metabolite analysis found 2-hydroxy-ibuprofen as the major metabolite in uninduced S9 fractions. Supplementing S9 fractions with UDPGA did not significantly enhance metabolism. Additionally, assays involving the induction and inhibition of specific CYP isozymes support CYP1A2 as a possible metabolic pathway in fish.

The influence of gill and liver metabolism on the predicted bioconcentration of three pharmaceuticals in fish.

The potential for xenobiotic compounds to bioconcentrate is typically expressed through the bioconcentration factor (BCF), which has gained increased regulatory significance over the past decade. Due to the expense of in vivo bioconcentration studies and the growing regulatory need to assess bioconcentration potential, BCF is often calculated via single-compartment models, using K(OW) as the primary input. Recent efforts to refine BCF models have focused on physiological factors, including the ability of the organism to eliminate the compound through metabolic transformation. This study looks at the ability of in vitro biotransformation assays using S9 fractions to provide an indication of metabolic potential. Given the importance of the fish gill and liver in metabolic transformation, the metabolic loss of ibuprofen, norethindrone and propranolol was measured using rainbow trout (Oncorhynchus mykiss) and channel catfish (Ictalurus punctatus) gill and liver S9 fractions. Metabolic transformation rates (k(M)) were calculated and integrated into a refined BCF model. A significant difference was noted between BCF solely based on K(OW) and BCF including k(M). These studies indicate that the inclusion of k(M) in BCF models can bring predicted bioconcentration estimates closer to in vivo values.

A serological and bacteriological survey of dogs to detect Brucella infection in Lomas de Zamora, Buenos Aires province.

Canine brucellosis caused by Brucella canis is a disease of the reproductive tract that may cause miscarriage in females, infection of the sexual organs in males and infertility in both sexes. The prevalence of brucellosis in dogs is unknown and little has been done to control the disease, except in certain breeds and some commercial dog kennels. In the course of a free neuter program in Lomas de Zamora, Buenos Aires province, prevalence of antibodies to Brucella sp., bacteriological isolation and clinical observations were performed. Of 224 dogs studied, 33 (14.7%) were found positive for the rapid slide agglutination test (RSAT), 24 (10.7%) of which were confirmed by IELISA. Of the 33 RSAT positive, 17 (51.5%) blood cultures were done, and B. canis were isolated from 2 cases. Since infected dogs have been shown to remain bacteremic for prolonged periods, our results also suggest a risk of human infections in this area.

Lercanidipine in patients with chronic renal failure: the ZAFRA study.

OBJECTIVE: The objective was primary to evaluate the safe use of a new calcium channel blocker, lercanidipine, in patients with chronic renal failure (CRF). The secondary objective was to study the protective effect of calcium channel blocker on renal function in CRF patients previously treated with ACE inhibitors or angiotensin receptor blockers. DESIGN AND METHODS: The study recruited 203 CRF patients (creatinine >1.4 mg/dL for males, creatinine > 1.2 mg/dL for females, or creatinine clearance <70 mL/min). All patients were receiving ACE inhibitors (63.4%) or angiotensin II antagonist (36.6%) therapy, but they had higher blood pressure than recommended for CRF (130/85 mmHg). No patients were under diuretic treatment. Patients were clinically evaluated 1, 3, and 6 months after starting treatment with lercanidipine. Samples for urine and blood examination were taken during the examination. When needed, a third drug was added to the treatment, excluding diuretics. Creatinine clearance was measured using 24 h urine collection. RESULTS: 175 patients rendered valuable for the study (age 63.9+/-11.9 years, 52.9% males and 47.1% females). Blood pressure (BP) significantly decreased from 162+/-17/93+/-8.3 mmHg to 132+/-12/78+/-6 mmHg. 89.2% of patients showed a significant BP reduction, and 58.1% achieved optimal BP control (<130/85 mmHg). Seven patients (3.4%) showed untoward effects. Not one case of edema was detected, and the prevalence of adverse effects related to vasodilatation was extremely low (three patients, 1.48%). Plasmatic creatinine did not change (1.9+/-0.5 baseline versus 1.9+/-0.6 mg/dL), but creatinine clearance increased at the end visit (41.8+/-16.0 baseline versus 45.8+/-18.0 mL/min, p=0.019). Plasmatic cholesterol also decreased from 221+/-46 to 211+/-35 mg/dL (p=0.001). CONCLUSIONS: Lercanidipine showed a high antihypertensive effect in CRF patients. It has a good tolerability profile and showed an interesting effect on plasmatic lipids. An improvement in renal function, measured through creatine clearance, was detected.

The level of preventive health care in an internal medicine residency clinic: still only an ounce of prevention?

BACKGROUND: Clinical prevention is a critical component of primary care residency training. How well residents do preventive services is one measure of the adequacy of their training. METHODS: To assess the level of preventive health care in a university internal medicine residency clinic, we conducted a randomized retrospective review of 225 patient records. RESULTS: We documented preventive services in only 39% of potentially appropriate instances. Cholesterol screening occurred in 53% of eligible cases, breast examination in 41%, mammogram in 69%, Papanicolaou's smear in 53%, estrogen replacement therapy (ERT) in 41%, fecal occult blood testing in 30%, flexible sigmoidoscopy in 18%, influenza vaccination in 65%, pneumococcal vaccination in 44%, and tetanus immunization in only 9%. Male residents were significantly less likely than females to order mammograms or offer ERT. CONCLUSIONS: Compared to earlier studies of similar design, we found that the level of preventive health care has improved during residency training, but remains unacceptably low.

Nursing home policies addressing the use or withdrawal of life-sustaining medical treatments.

There has been increasing interest in the use of nursing home policies and guidelines to improve decisions about the elective use of life-sustaining treatments. Such policies should be based on a sound and complete understanding of the legal and ethical governance responsibilities of health care facilities. Policies should address both the process of decision making and treatment plan implementation. Nursing home administrators should commission policies and monitor their implementation.

Proper care for the dying: a critical public issue.

The ability of the medical profession to sustain life, or more appropriately, to prolong dying, in patients with terminal illness, creates a most complex and controversial situation for all involved: the patient, if mentally alert; the patient's family; and the medical care team including physicians, nurses and attendants. This situation is especially complex in large acute care hospitals where medical and nursing students, residents and house officers receive advanced medical training. A major problem, prolonging the dying of the terminally ill, with its medical, legal, ethical and economic complexities now confronts American society. The problem is particularly acute in teaching hospitals, in which one finds a disproportionate number of terminally ill patients. The ability to work at these questions as a community rather than as adversaries will determine much about the ability of the health care system to respect the dignity and autonomy of those who seek aid and comfort when faced with serious illness and impending death. Better communication between the physicians, health care providers, the lawyers and ethicists must be developed in order to solve these problems. Over the next ten years society and our elected representatives will be making very demanding decisions about the use of the health dollar. One possible way to prevent increasing costs is to reach significant agreement on the proper care of the dying. Proper care for the dying is being considered, discussed, and evaluated by very thoughtful people. It is not governments which should decide who is to live or who is to die. There is the serious problem of the 'slippery slope' to euthanasia by omission if cost containment becomes the major force in formulating policy on the proper care of the dying.