[Treatment of chronic non-A, non-B-C hepatitis]. / Tratamiento de la hepatitis crónica NANB-C.

Preventive measures, and particularly screening for anti-HCV donors, have diminished the incidence of HCV infections, however, a vaccine against the disease is necessary for an effective prevention. The most active treatment at this time, seems to be alpha-interferon, at the dosage of 3 MU during 6 months. Possibly larger doses during longer periods of time might improve response and recurrence indexes, but not sufficiently as to give indiscriminate treatment to all patients at great cost and with many adverse reactions. While waiting for better predictive factors, the most convenient therapy remains the indicated dosage during 6 months, followed by periodic assessment during 2-3 months of transaminase levels: if they remain normal, the patient should be reassessed later on, if there is a recurrence, another course of treatment should be tried; non-responders should not be treated again with single interferon; other combinations or different treatments should be tried.

[Intrafamilial contagion with the hepatitis B virus]. / Contagio intrafamiliar del virus de la hepatitis B.

BACKGROUND: A study of the intrafamilial transmission of the hepatitis B virus (HBV) and its relationship with the viral replication and epidemiological factors. METHODS: The intrafamilial transmission of 106 chronic carriers of HBV was evaluated: 79 were asymptomatic carriers (AC) and 27 had chronic liver disease (CLD). Overall 347 relatives of the first group individuals and 112 of the second group were investigated. In the index cases, all HBV markers were investigated, and also DNA-HBV in those with CLD. In the relatives, HBsAg, HBsAc and HBcAc were investigated. Also, a survey to evaluate the influence of socioeconomic and cultural factors was also carried out. RESULTS: The prevalence of markers was significantly higher in the relatives of patients with CLD (HBcAg, HBcAc and evidence of contact) followed by AC and controls. The most infective relation in AC was that of other contacts with significant differences from the mother-child relationship (HBsAc p less than 0.003, HBcAc p less than 0.01, and evidence of contact p less than 0.001). By contrast, in CLD the most infective relation was mother-child. The mother-child relation was more infective than the father-child one (HBsAg p less than 0.05, HBcAc p less than 0.03, and evidence of contact p less than 0.02). Regarding viral replication, it was found that the HBeAg and DNA positive patients were more infective. The prevalence of HBcAc and the evidence of contact increased with the time of living together of spouses. Finally, it can be stated in a general sense that, according to the results of the survey, the socioeconomic factors have a small influence on the familial transmission. CONCLUSIONS: The relatives of HBV carriers, particularly in the case of HC with high replication, have a high risk of transmission. Thus, their investigation and subsequent vaccination is mandatory.

[Study of viral replication in HbsAg positive chronic hepatitis]. / Estudio de la replicaciíon vírica en las hepatitis crónicas AgHBs positivo.

Viral replication seric markers (VRSM), (BeHAg, BcHAg, and DNA-VHB) and the hepatic tissue BcHAg of thirty four patients suffering from chronic hepatopathies (6 PCH, 18 ACH, and 10 cirrhosis) were investigated. The greatest incidence of RVSM was observed in PCH. The combined study using all the markers demonstrated a positive correlation: DNA-VHB and BeHAg (p less than 0,001); DNA-VHB and BcHAg (p less than 0,001); BeHAg and BcHAg (p less than 0,001). The same result was obtained when comparing BcHAg (n) with the rest of RVSM: DNA-VHB (p less than 0,001), BeHAg (p less than 0,001) and seric BcHAg (p less than 0,01). Patients with a most intense histologic activity according to the Knodell index, presented a higher ratio of positive nuclei for BcHAg. The conclusion is that there is a good correlation amongst replication markers, specially hepatic BcHAg and DNA-VHB.

[Differential diagnosis of jaundice]. / Diagnóstico diferencial de las ictericias.

Jaundice a frequent diagnostic problem and in many cases difficult to resolve, despite of current advances in exploration techniques, echography specially. In this review the significance of each method is discussed. The significance of clinical data as a first diagnostic stage is analyzed. Afterwards, according to biochemical data, the different jaundice types are distinguished and the diagnostic tests are chosen. Lastly, the main diagnostic invasive and noninvasive methods are evaluated.

[Importance of the function of polymorphonuclear neutrophils in intrinsic and extrinsic asthma. Interaction of whole serum in the control of cellular activity]. / Importancia de la función de los polimorfonucleares neutrófilos en el asma intrínseco y extrínseco. Interacción del suero total en el control de la actividad celular.

A study was made of polynuclear leucocyte function: chemotaxis, NBT reduction and the influence of total plasma on chemotaxis, was investigated in a large group of asthmatic paediatric patients, both during and between asthmatic attacks. It has been proved that polynuclear function is different in the two types of asthma. During the asthmatic's crisis and in the intrinsic patients in intercrisis periods, there is a polynuclear neutrophil hyperreaction when the chemotaxis and the NBT reduction are raised. An inhibited chemotactic activity in the plasma of these patients is noted. This activity doesn't produce irreversible effects on the cells; it acts as a regulating mechanism on the chemotactic factors found in plasmatic fractions.

[Function of neutrophilic polymorphonuclear leukocytes in pediatric patients with intrinsic and extrinsic asthma during the intercrisis period]. / Etude de la fonction des polynucléaires neutrophiles chez des patients pédiatriques atteints d'asthme intrinsèque et extrinsèque pendant l'intercrise.

Polymorphonuclear leukocyte function: chemotaxis, NBT and myeloperoxidases activity, was investigated in a group of asthmatic pediatric patients, 26 with intrinsic and 27 with extrinsic asthma, during intercrisis. There was no difference between the extrinsic asthma group and the control one while the group with intrinsic asthma showed an increase of chemotaxis activity (p less than 0.001) and NBT reduction (p less than 0.01); myeloperoxidases activity was similar to the control group. The comparative study of the two types of asthma shows a significant increase of NBT reduction (p less than 0.02) and chemotaxis activity (p less than 0.001) in the intrinsic group. These findings demonstrate that polymorphonuclear function is different in the two main types of asthma during the asymptomatic period.

[Reduction of the function of polymorphonucleocytes: chemotaxis and myeloperoxidases in viral infections in childhood]. / Depresíon de las funciones de los polimorfonucleares: quimiotaxis y mieloperoxidasas, durante las infecciones virales de la infancia.

Polymorphonuclear leucocytes function--Gey mobility, chemotaxis, NBT and myeloperoxidases--was studied in 29 patients with active viral infection and after clinic recuperation: 19 mumps meningitis, five measles, three varicella, one adenovirosis and one hepatitis A; these patients were compared with 31 age matched controls. Gey mobility and chemotaxis was markedly depressed during the acute period (p [0.05 and p less than 0.001 respectively), returning to normal values with clearing of infection. Also, myeloperoxidase decreases during acute period (p less than 0.05), but they don't return to normal values with clinic recuperation (p less than 0.05). NBT was similar in both groups. Studying mumps meningitis alone authors observed that results were similar to before: chemotaxis deficit (p less than 0.05) and myeloperoxidases (p less than 0,01). According to these results depression of polymorphonuclear function justifies only partially the higher predisposition to bacterial superinfection that some viral infections have.

[The function of polymorphonucleocytes: chemotaxis, the nitroblue tetrazolium test and myeloperoxidases in healthy children and adults]. / Estudio de la función de los polimorfonucleares: quimiotaxis, "test" del nitroazul de tetrazolio y mieloperoxidasas en niños y adultos sanos.

Polymorphonuclear leucocytes function--chemotaxis, NBT and myeloperoxidase--was studied in 31 children and 62 healthy adults. Chemotaxis was superior in adults (p less than 0.001), while the other test had a similar behaviour. Results show that there is a dissociation on the maturity of different functions of the neutrophil, and it is necessary to dispose of age-matched controls to evaluate chemotaxis in children.