Effects of Birth Weight on Animal Performance, Fattening Traits and Meat Quality of Lambs.

Intrauterine growth restriction (IUGR) is a key developmental programming factor which might impair both the feed efficiency of lambs and meat quality, since it deeply impacts skeletal muscle and adipose tissue development. To determine the effect of birth weight on the growth performance, ruminal parameters, digestibility, non-carcass components, carcass traits, physicochemical characteristics and fatty acid profile of meat, two experimental groups (six animals in each group) of male Merino lambs with different body weights (BW) at birth (low BW (LW; 3.88 ± 0.281 kg) and high BW (HW; 5.80 ± 0.647 kg)) were used. The lambs were penned with their corresponding ewe during the natural suckling period, being weaned at 15 kg. Then, the lambs were penned individually and offered a complete pelleted diet during the fattening period. All the animals were slaughtered when they reached 27 kg of BW. After weaning, both daily dry matter intake (578 vs. 615 g/day; p = 0.021) and average daily gain (141 vs. 190 g/day; p = 0.004) were significantly lower in LW lambs, and a higher feed:gain ratio was recorded for this group (3.98 vs. 3.45; p = 0.008). Carcass traits did not show differences (p > 0.05) between both groups of lambs, except for higher chilling losses for the LW group (3.29 vs. 2.69%; p = 0.012). Additionally, higher amounts of kidney knob and channel fat were observed for LW lambs (85.4 vs. 152 g; p = 0.028). Apart from a higher hardness of meat in LW lambs (152 vs. 189 Newtons, p = 0.040), no other differences (p > 0.05) were observed in the physicochemical traits of this product; however, the meat of LW lambs tended (p = 0.057) to contain more total fatty acid content with a higher (p = 0.041) proportion of saturated fatty acids than the meat of HW lambs. In conclusion, under the conditions of the present study, a low body weight at birth increased the deposition of fat in carcass and non-carcass components during the fattening period of lambs, thus reducing animal performance and worsening the nutritional indexes of the meat. Accordingly, it seems reasonable to try to identify these animals during early life, to be sold as suckling lambs in the meat market instead of being fattened.

Effect of Dietary Crude Protein on Animal Performance, Blood Biochemistry Profile, Ruminal Fermentation Parameters and Carcass and Meat Quality of Heavy Fattening Assaf Lambs.

Thirty Assaf male lambs (30 ± 1.9 kg of body weight) were allocated to three groups fed diets differing in their crude protein (CP) contents (low protein (LP), 134 g CP/kg dry matter (DM); medium protein (MP), 157 g CP/kg DM; and high protein (HP), 173 g CP/kg DM) to test the effect of dietary protein content on animal performance, rumen function, animal health, and carcass and meat quality. Feed intake was recorded daily, and animals were weighed every second week. Lambs were blood-sampled to determine their acid-base status and biochemical profile. After 70 days of trial, lambs were slaughtered, and the ruminal content was collected to assess ruminal fermentation. Finally, carcass and meat quality were evaluated. Dry matter intake and average daily gain increased (p < 0.05) when increasing the level of dietary CP. There were not significant differences (p > 0.05) in the evaluated parameters in the rumen fluid of lambs. There were not significant differences in carcass or meat quality (p > 0.05) and in those parameters related to blood acid-base status. Several biochemical parameters showed differences depending on diet CP level (urea, protein, albumin, glucose, and calcium; p < 0.05). Feeding costs calculated in relation to cold carcass weight decreased when dietary CP decreased. The results suggested that a dietary protein content greater than 157 g/kg DM would be required to maximize growth performance in Assaf male fattening lambs under 50 kg of body weight. However, a protein content beyond that level was not found to improve either carcass or meat quality and could worsen profitability.

Whole-exome sequencing in three children with sporadic Blau syndrome, one of them co-presenting with recurrent polyserositis.

Blau syndrome (BS) is a rare, chronic autoinflammatory disease with onset before age 4 and mainly characterised by granulomatous arthritis, recurrent uveitis, and skin rash. Sporadic (also known as early-onset sarcoidosis) or familial BS is caused by gain-of-function mutations in the NOD2 gene, which encodes for a multi-task protein that plays a crucial role in the innate immune defense. We report on three Mexican patients clinically diagnosed with BS who exhibited a likely pathogenic variant in NOD2 as revealed by whole-exome sequencing (WES) and Sanger sequencing: two variants (c.1000 C > T/p.Arg334Trp and c.1538 T > C/p.Met513Thr) lie in the ATP/Mg2+ binding site, whereas the other (c.3019dupC/p.Leu1007ProfsTer2) introduces a premature stop codon disrupting the last LRR domain (LRR9) formation; all three variants are consistent with gain-of-function changes. Interestingly, all these patients presented concomitant likely pathogenic variants in other inflammatory disease-related genes, i.e. TLR10, PRR12, MEFV and/or SLC22A5. Although the clinical presentation in these patients included the BS diagnostic triad, overall it was rather heterogeneous. It is plausible that this clinical variability depends partly on the patients' genetic background as suggested by our WES results. After this molecular diagnosis and given the absence of NOD2 mutations (demonstrated in two trios) and related symptoms in the respective parents (confirmed in all trios), patients 1 and 2 were considered to have sporadic BS, while patient 3, a sporadic BS-recurrent polyserositis compound phenotype. Altogether, our observations and findings underscore the overlapping among inflammatory diseases and the importance of determining the underlying genetic cause by high-throughput methods. Likewise, this study further reinforces a pathogenic link between the here found NOD2 variants and BS and envisages potential additive effects from other loci in these, and probably other patients.

Cultura de la salud en los familiares de niños sobre la vacunación. Policlínico "5 de Septiembre", enero-junio 2015 / Culture of health in family members of children about vaccination. Polyclinic "5 de Septiembre", January-June 2015

Objetivo: conocer desde la perspectiva social, los conocimientos y creencias de la población a partir del significado que las personas le atribuyen a las vacunas preventivas y al proceso de vacunación. Métodos: Se realizó un estudio exploratorio con familiares de niños de 0 a 24 meses pertenecientes al Policlínico 5 de Septiembre, municipio Playa, La Habana, que abarcó de enero a junio de 2015. Se utilizó un diseño mixto convergente o por triangulación de datos. Para la recolección de datos se utilizó la entrevista-cuestionario, entrevista a expertos y entrevista a informantes claves. Se elaboró una base de datos en Excel, la que se exportó al programa SPSS versión 19.0. En un primer momento, se realizó un análisis descriptivo, en el que se calcularon frecuencias absolutas y relativas para las variables de estudio. Para establecer las relaciones entre el nivel de conocimiento y algunas variables sociodemográficas, para el análisis de los datos cualitativos, se realizaron lecturas reiteradas de las transcripciones de las entrevistas a expertos e informantes claves y de las respuestas a las preguntas abiertas del cuestionario para la familiarización con el contenido de estos. Resultados: Se puso de manifiesto la vía institucional en la cultura de la salud que poseen los familiares con relación a las vacunas y el proceso de vacunación. Los familiares presentaban en su mayoría conocimientos insuficientes acerca de las vacunas y las enfermedades que protegen estas. No presentaban conocimientos sobre los eventos adversos graves o severos. El proceso de vacunación mostró gran significado para los familiares, asociados a experiencias positivas con este. Conclusiones: Se inicia un acercamiento a la cultura de la salud, poseída por un grupo de familiares, relativos a las vacunas preventivas y el proceso de vacunación en Cuba. Las madres refuerzan la responsabilidad de vacunar al niño/a como parte del cuidado de la salud de este. La cultura de la salud en los familiares de niños/as no incluye información distorsionada sobre las vacunas preventivas y su efectividad. Se nutre exclusivamente de la cultura científica, aunque no la reproduce en su totalidad. El proceso de vacunación es altamente valorado por los familiares, dada la importancia que le atribuyen, la confianza que tienen en el Programa Nacional de Inmunización, la satisfacción que muestran con la organización del servicio y la atención del personal de salud(AU)

Objective: to know, from the social perspective, the population´s knowledge and beliefs based on the meaning that people attribute to preventive vaccines and the vaccination process. Methods: An exploratory study was carried out with relatives of children from 0 to 24 months from "5 de Septiembre" community clinic in Playa municipality, Havana, from January to June 2015. A mixed convergent or triangulation design was used. Data collection was completed by questionnaire interview, expert interview and interview to key informants. A database was created in Excel, which was exported to the SPSS program version 19.0. Initially, a descriptive analysis was performed, in which absolute and relative frequencies were calculated for the study variables. Repeated readings were made of the transcripts of the interviews with experts and key informants and for the answers to the open questions of the questionnaire, to establish the analysis of the qualitative data, and for familiarization with their content. Results: It was shown the institutional pathway in health culture that family members have in relation to vaccines and the vaccination process. Most family members had poor knowledge about vaccines and the diseases they prevent. They did not show knowledge about serious or severe adverse events. The vaccination process showed great significance for family members, associated with positive experiences with it. Conclusions: This study initiates an approach to the health culture a group of family members had related to preventive vaccines and the vaccination process in Cuba. Mothers reinforce the responsibility of vaccinating the child as part of their child's health care. The health culture in family members of children does not include distorted information about preventive vaccines and their effectiveness. Their knowledge is fed exclusively by scientific culture, although it is entirety not reproduce. The vaccination process is highly valued by family members, given the importance they attach to it, the confidence they have in the National Immunization Program, the satisfaction they show with the organization of the service and the care of health personnel(AU)

Características clínico-epidemiológicas de pacientes ancianos con Hipoacusia atendidos en el Hospital Calixto García / Clinical and epidemiological characteristics of elderly patients with hearing loss treated in Calixto García University Hospital

Introducción: El envejecimiento en Cuba constituye el principal problema demográfico y la Hipoacusia es una de las condiciones crónicas más frecuentes en los adultos mayores. Objetivo: Describir las características clínico-epidemiológicas de los pacientes de la tercera edad con Hipoacusia atendidos en el Hospital Universitario General Calixto García en el período de septiembre de 2015 hasta septiembre de 2016. Material y Método: Se realizó un estudio descriptivo, transversal en el Hospital Universitario General Calixto García durante el período de septiembre de 2015 hasta septiembre de 2016. La población (N) estuvo constituida por 387 pacientes de la tercera edad, quienes asistieron a consulta en el período estudiado. Resultados: Predominó la Hipoacusia en los pacientes con edades entre 65 y 79 años (67,2 por ciento) y el sexo masculino fue el más afectado con esta discapacidad (69,5 por ciento). La Hipoacusia en el anciano se asoció con frecuencia a otras afecciones crónicas como las enfermedades cardiovasculares. La Presbiacusia o Hipoacusia asociada a la edad fue la causa más frecuente de sordera. Conclusiones: La Hipoacusia resultó ser una discapacidad frecuente en los pacientes masculinos de la tercera edad. La misma estuvo asociada a enfermedades crónicas no trasmisibles. Las perdidas auditivas neurosensoriales y mixtas, de moderada y severa intensidad, fueron las más frecuentemente encontradas en la audiometría tonal(AU)

Introduction: Aging constitutes the main demographic problem in Cuba, and hearing loss is one of the most frequent chronic conditions in older adults. Objective: To describe the clinical and epidemiological characteristics of elderly patients with hearing loss, treated in Calixto Gracía University Hospital during the period from September 2015 to September 2016. Material and Method: A descriptive cross-sectional study was conducted in Calixto Garcia University Hospital during the period from September 2015 to September 2016. The population (N) was composed of 387 elderly patients, who went to the doctor´s office during the period under study. Results: Hearing loss predominated in patients aged from 65 to 79 years (67,2 percent), and the male sex was the most affected by this disability (69,5 percent). Hearing loss in the elderly was frequently associated with other chronic conditions such as cardiovascular diseases. Age-related hearing loss (Presbycusis) or hearing loss associated with age was the most frequent cause of deafness. Conclusions: Hearing loss was a frequent disability in male elderly patients. It was associated with non-communicable chronic diseases. Sensorineural and mixed hearing losses of moderate and severe intensity were the most frequent ones found in the tonal audiometry(AU)

Cross-cultural validation of the paediatric Gait, Arms, Legs, Spine (pGALS) tool for the screening of musculoskeletal disorders in Mexican children.

The aim of this study was to validate the paediatric Gait, Arms, Legs, Spine (pGALS) tool for Mexican Spanish to screen Mexican paediatric population for musculoskeletal (MSK) disorders. A cross-sectional study was performed in the Paediatric Hospital of the Mexican Social Security Institute in Guadalajara, Jalisco. The validation included children and adolescents aged 6-16 years, 87 patients with musculoskeletal disorders and 88 controls without musculoskeletal disorders. The cross-cultural validation followed the current published guidelines. The average pGALS administration time was 2.9 min (SD 0.54). The internal consistency score (Cronbach's α) was 0.90 (0.89 for inflammatory and 0.77 for non-inflammatory disorders) for MSK disorders, with a sensitivity of 97 % (95 % CI 92-99 %), a specificity of 93 % (95 % CI 86-97 %), a LR+ of 14.3, and a ROC curve of 0.95 (95 % CI 0.92-0.98 %). The inflammatory disorders group had a sensitivity of 97 % (95 % CI 86-99 %), a specificity of 93 % (95 % CI 86-97 %), a LR+ of 14.2, and a ROC curve of 0.95 % (95 % CI 0.91-0.99 %). The non-inflammatory disorders group had a sensitivity of 98 % (95 % CI 89-99 %), a specificity of 93 % (95 % CI 86-97 %), and a LR+ of 14.37, with a ROC curve of 0.95 % (95 % CI 0.92-0.98 %). pGALS is a valid screening tool, fast, easy to administer, and useful for detecting musculoskeletal disorders in Mexican children and adolescents.

Improved prediction of knee osteoarthritis progression by genetic polymorphisms: the Arthrotest Study.

OBJECTIVE: The aim of this study was to develop a genetic prognostic tool to predict radiographic progression towards severe disease in primary knee OA (KOA) patients. METHODS: This investigation was a cross-sectional, retrospective, multicentric association study in 595 Spanish KOA patients. Caucasian patients aged ≥40 years at the time of diagnosis of primary KOA of Kellgren-Lawrence grade 2 or 3 were included. Patients who progressed to Kellgren-Lawrence score 4 or who were referred for total knee replacement within 8 years after diagnosis were classified as progressors to severe disease. Clinical variables of the initial stages of the disease (gender, BMI, age at diagnosis, OA in the contralateral knee, and OA in other joints) were registered as potential predictors. Single nucleotide polymorphisms and clinical variables with an association of P < 0.05 were included in the multivariate analysis using forward logistic regression. RESULTS: A total of 23 single nucleotide polymorphisms and the time of primary KOA diagnosis were significantly associated with KOA severe progression in the exploratory cohort (n = 220; P < 0.05). The predictive accuracy of the clinical variables was limited: area under the curve (AUC) = 0.66. When genetic variables were added to the clinical model (full model), the prediction of KOA progression was significantly improved (AUC = 0.82). Combining only genetic variables (rs2073508, rs10845493, rs2206593, rs10519263, rs874692, rs7342880, rs780094 and rs12009), a predictive model with good accuracy was also obtained (AUC = 0.78). The predictive ability for KOA progression of the full model was confirmed on the replication cohort (two-sample Z-test; n = 62; P = 0.190). CONCLUSION: An accurate prognostic tool to predict primary KOA progression has been developed based on genetic and clinical information from OA patients.

Incidencia y tratamiento de la roncopatía en el Hospital Universitario General Calixto García Íñiguez, diciembre 2008-2009 / Incidence and treatment of snore disease in the General Calixto García Iñíguez University Hospital, December 2008-2009

Introducción: La roncopatía es un problema de salud actual, frecuente en la población adulta por su incidencia y repercusión negativa sobre la calidad de vida de los pacientes afectados. Objetivos: Conocer la incidencia, los síntomas, los factores predisponentes, las enfermedades asociadas más frecuentes y evaluar los resultados del tratamiento quirúrgico de esta afección en la población sometida a estudio. Métodos: Se realizó un estudio descriptivo prospectivo transversal. Se estudiaron 21 pacientes, 14 (66,6 por ciento) del sexo masculino y 7 (33,4 por ciento) del femenino, atendidos en el servicio de Otorrinolaringología del Hospital Universitario General Calixto García Íñiguez durante el período comprendido de diciembre de 2008 a diciembre de 2009. Resultados. El 33 por ciento de los pacientes presentaron síndrome de apnea del sueño, más trastornos diurnos como hipersomnolencia diurna y cefalea matinal y en algunos casos popliglobulia e hipertensión arterial. Los factores predisponentes más frecuentes fueron la obesidad y la obstrucción orofaríngea. A 19 (90,47 por ciento) de los pacientes con roncopatía se les realizó tratamiento quirúrgico y evolucionaron satisfactoriamente a la semana y al mes de operados. Conclusiones: Los síntomas más frecuentes en los pacientes roncadores fueron la hipersonmolencia diurna, los ahogos nocturnos y la cefalea matinal. Los factores de riesgo más frecuentes fueron la obesidad y la obstrucción orofaríngea

Introduction: The snore disease is a current health problem frequent in adult population due to its incidence and negative repercussion on the quality of life of involved patients. Objectives: To know the incidence, symptoms, predisposing factors, the more frequent associated diseases and also to assess the results of surgical treatment of this affection in the study population. Methods: A cross-sectional and descriptive study was conducted. Twenty one patients were studied, 14 (66,6 percent) of male sex and 7 (33,4 percent) of female sex, seen in the Otorhinolaryngology Service of the "General Calixto GarcÝa I±iguez " University Hospital from December, 2008 to December, 2009. Results: The 33 percent of patients had sleep apneic syndrome plus diurnal disorders like the diurnal hypersomnia and morning headache and in some cases popligulia and arterial high blood pressure. The more frequent risk factors were obesity and oropharyngeal obstruction. A total of 19 patients (90,47 percent) were surgically treated with a satisfactory evolution at one week and at one month after surgery. Conclusions: The more frequent symptoms in snoring patients were the diurnal hypersomnia, nocturnal breathlessness and morning headache. The more frequent risk factors were obesity and oropharyngeal obstruction

Incidencia y tratamiento de la roncopatía en el Hospital Universitario General Calixto García Íñiguez, diciembre 2008-2009 / Incidence and treatment of snore disease in the General Calixto García Iñíguez University Hospital, December 2008-2009

Introducción: La roncopatía es un problema de salud actual, frecuente en la población adulta por su incidencia y repercusión negativa sobre la calidad de vida de los pacientes afectados. Objetivos: Conocer la incidencia, los síntomas, los factores predisponentes, las enfermedades asociadas más frecuentes y evaluar los resultados del tratamiento quirúrgico de esta afección en la población sometida a estudio. Métodos: Se realizó un estudio descriptivo prospectivo transversal. Se estudiaron 21 pacientes, 14 (66,6 por ciento) del sexo masculino y 7 (33,4 por ciento) del femenino, atendidos en el servicio de Otorrinolaringología del Hospital Universitario General Calixto García Íñiguez durante el período comprendido de diciembre de 2008 a diciembre de 2009. Resultados. El 33 por ciento de los pacientes presentaron síndrome de apnea del sueño, más trastornos diurnos como hipersomnolencia diurna y cefalea matinal y en algunos casos popliglobulia e hipertensión arterial. Los factores predisponentes más frecuentes fueron la obesidad y la obstrucción orofaríngea. A 19 (90,47 por ciento) de los pacientes con roncopatía se les realizó tratamiento quirúrgico y evolucionaron satisfactoriamente a la semana y al mes de operados. Conclusiones: Los síntomas más frecuentes en los pacientes roncadores fueron la hipersonmolencia diurna, los ahogos nocturnos y la cefalea matinal. Los factores de riesgo más frecuentes fueron la obesidad y la obstrucción orofaríngea(AU)

Introduction: The snore disease is a current health problem frequent in adult population due to its incidence and negative repercussion on the quality of life of involved patients. Objectives: To know the incidence, symptoms, predisposing factors, the more frequent associated diseases and also to assess the results of surgical treatment of this affection in the study population. Methods: A cross-sectional and descriptive study was conducted. Twenty one patients were studied, 14 (66,6 percent) of male sex and 7 (33,4 percent) of female sex, seen in the Otorhinolaryngology Service of the "General Calixto GarcÝa I±iguez " University Hospital from December, 2008 to December, 2009. Results: The 33 percent of patients had sleep apneic syndrome plus diurnal disorders like the diurnal hypersomnia and morning headache and in some cases popligulia and arterial high blood pressure. The more frequent risk factors were obesity and oropharyngeal obstruction. A total of 19 patients (90,47 percent) were surgically treated with a satisfactory evolution at one week and at one month after surgery. Conclusions: The more frequent symptoms in snoring patients were the diurnal hypersomnia, nocturnal breathlessness and morning headache. The more frequent risk factors were obesity and oropharyngeal obstruction(AU)

Micronuclei in diabetes: folate supplementation diminishes micronuclei in diabetic patients but not in an animal model.

Diabetes mellitus (DM) is associated with a high risk of health complications, mainly due to excessive free radical (FRs) production that could result in an increased frequency of micronuclei. The consumption of antioxidants, like folic acid (FA), may mitigate the effects of the FRs. In the present study, micronucleated polychromatic erythrocyte (MNPCE) frequencies were determined in blood sampled weekly from the tails of pregnant female Wistar rats and pregnant Wistar rats with experimental diabetes that were given unsupplemented diets and diets supplemented with FA. At birth, the pups were sampled to analyze micronucleated erythrocyte (MNE) and MNPCE frequencies. Moreover micronucleated cells (MNCs) were evaluated in buccal mucosa samples taken from 81 healthy adult subjects, 48 patients with DM, and 30 DM patients who were sampled before and after FA treatment. Increases in MNPCE frequencies were significant only at the first sampling (P<0.01 and P<0.03) in pregnant rats with experimental diabetes. In addition, the pups from the diabetic group and from diabetic group treated with FA had higher frequencies of MNEs (P<0.03 and P<0.001, respectively) and MNPCEs (P<0.009 and P<0.05, respectively) than the controls. No differences were found in diabetic rats and newborn rats born to diabetic mothers treated with FA compared with untreated animals. Patients with DM had a higher frequency of MNCs compared with healthy subjects (P<0.001). Also FA reduced the frequency of MNCs in DM patients (P<0.001). The results of this study indicate that diabetes results in elevated frequencies of micronuclei, and that, at least in humans, FA can protect against the elevation.

Repercusiones psicológicas y sociales de la prejubilación / Psychological and sociological repercussions of early retirement

En la actualidad, un gran número de investigadores han puesto su atención sobre el impacto psicosocial de la jubilación. El presente trabajo persigue principalmente dos objetivos: (1) elaborar un perfil de la prejubilación en el Principado de Asturias, atendiendo variables psicológicas, familiares y sociales; (2) tratar de determinar la posible existencia de un constructo específico en los prejubilados, denominado aquí vida laboral interrumpida y que a su vez englobaría la autopercepción negativa” de otras investigaciones. Los resultados parecen mostrar la existencia de un posible constructo integrado por varios factores conductuales además de la tradicional autopercepción negativa (AU)

In our days, a great number of researchers have pointed out the psychosocial outcome of early retirement. Present work has two objetives: (1) to make a profile of early retired in Asturias Principality, paying attention to psychological, family, and social variables; (2 find out about a possible theoretical construct in early retired people, which is called «laboral life broken» and «negative self-perception» as a part of it. Results are shown in the sense of a true construct with several behavioral factors apart from the classical «negative self-perception» factor (AU)

Tratamiento de la leucemia promielocítica con ácido retinoico / m

Se estudiaron 25 pacientes con diagnóstico de leucemia promilocítica (LPM). El estudio citogenético se realizó mediante técnica de bandas G. El ácido transretinoico (ATRA) se administró por vía oral a la dosis de 50 mg/m²/día en dosis única dividida en 2 tomas al día. Después de la remisión completa (RC) se mantuvo el ATRA durante 1-3 meses asociado con microdosis de arabinósido de citosina o interferón alfa. Posteriormente se hizo un tratamiento rotatorio ccon 3 combinaciones poliquimioterapéuticas diferentes (TRAP, POMP, DOAP). Catorce pacientes eran mujeres y 11 hombres; 18 adultos y 7 niños, con una mediana de edad de 25 años (rango 6-60 años). Sólo 3 pacientes tenían leucocitosis, el resto presentaba leucopenia. El 60 por ciento de los casos tenía una cifra de plaquetas menor que 30 x 10 a la 9/L, el 80 por ciento algún tipo de manifestación hemorrágica y el 56 por ciento evidencias biológicas de coagulación intravascular diseminada (CID). En el 58 por ciento de los estudios citogenéticos analizables se encontró la (15;17). En 21 pacientes (84 por ciento) se obtuvo la RC en un período medio de 42 días. La reacción secundaria más frecuente fue la cefalea. Durante el tratamiento 11 pacientes desarrollaron leucocitosis, 9 con cifras de leucocitos mayores de 20x 10 a la 9/L. Seis tuvieron fiebre sin evidencias de infección, en 3 la temperatura se normalizó después de recibir corticosteroides y 3 casos presentaron el síndrome del ácido retinoico y posteriormente hicieron RC. ocho pacientes sufrieron recaída y 13 (62 por ciento) se mantenían en RC después de 5,9 -33 meses de obtenida esa respuesta. La sobrevida total a los 3 años era de 41 por ciento y la sobrevida libre de enfermedad 37 por ciento. se observó un espectro de reacciones secundarias similares a las coomunicadas por otros investigadores. Estos efectos en su mayoría fueron transitorios y bien tolerados (AU)