Hemorheological alterations in patients with chronic renal failure. Effect of hemodialysis.

The rheological profile of 45 patients who had kidney failure and were undergoing periodical hemodialysis was studied to ascertain whether they showed rheological alterations and if these alterations improved after hemodialysis. Our results indicate that the patients studied suffer rheological alterations with respect to the control group, specifically increased plasma fibrinogen (436 +/- 119 vs 271 +/- 43 mg/dl, p < 0.001), increased plasma viscosity (1.30 +/- 0.10 vs 1.22 +/- 0.05 mPa.s, p < 0.001), higher erythrocyte aggregability (8.3 +/- 1.2 vs 7.4 +/- 1.4, p < 0.01) and a lower hematocrit (31.2 +/- 5.9 vs 43.4 +/-3.7, p < 0.001). In contrast, erythrocyte deformability did not seem to be altered with respect to the control group. The analyses carried out immediately after hemodialysis showed that in general the rheological profile worsened during this treatment; there was a significant increase in fibrinogen and in plasma viscosity. The rheological alterations detected may play a role in the development of the atherosclerosis processes often experienced by these patients.

[Predictive value of the study of cerebro-spinal fluid in neurological diseases. Discriminant analysis of 733 cases]. / Valor predictivo del estudio de líquido cefalorraquídeo en enfermedades neurológicas. Análisis discriminante en 733 casos.

INTRODUCTION: The study of cerebrospinal fluid (CSF) gives very valuable data for the diagnosis of certain neurological disorders. Objective. To discover the discriminative value of different tests and their usefulness in the study of neurological disorders. MATERIAL AND METHODS: Discriminative multivariate analysis was used for the group of parameters obtained from study of CSF and serum in a sample of 733 patients. BO was included, CSF cytobiochemical data and five of the equations used for calculation of the synthesis of intrathecal IgG. RESULTS: The best discriminative function was expressed as the intrathecal IgG with normal BHE. The formula of Tourtellotte was noteworthy for overestimation of the synthesis of intrathecal IgG when the albumin index indicated BHE rupture. Prospective reclassification of the 733 cases showed that these tests are well worthwhile to rule out immunologically mediated disorders (93% of the cases were correctly reclassified); they suggest the diagnosis in multiple sclerosis (66% correctly reclassified) and give very poor reliability when trying to distinguish between inflammatory infectious processes. CONCLUSIONS: In spite of their undoubted use in supporting the clinical diagnosis, the tests used for study of the synthesis of IgG, even complemented by cytobiochemical examination of the CSF, are not in themselves sufficient for use as a discriminative test in the differential diagnosis of neurological processes.

Use of genomic fingerprinting in the characterization of Neisseria gonorrhoeae isolated in Valencia, Spain.

Ninety-five Neisseria gonorrhoeae organisms isolated in Valencia, Spain, were characterized by antibiotic sensitivity testing, auxotyping, serotyping, plasmid analysis and restriction endonuclease fingerprinting (HindIII digestion). Cluster analysis of the restriction patterns revealed that 31 isolates (32.6%) formed 12 clearly defined clusters. Penicillinase-producing Neisseria gonorrhoeae strains formed four of these groups. Eight groups of gonococcal strains were identified by auxotyping, although 83% of isolates belonged to two auxotypes (Proto, Pro-). Twenty-three different serovars were identified by serotyping. The serovar pattern IB/rop was found in 38% of isolates. A 60% coincidence was found between gonococcal groupings obtained by combination of auxotyping, serotyping and plasmid analysis and those obtained with the restriction enzyme fingerprinting technique. The specificity of enzyme restriction patterns of Neisseria gonorrhoeae is confirmed to be of practical importance in the epidemiologic study of gonorrhoea.

Genomic fingerprinting of penicillinase-producing strains of Neisseria gonorrhoeae in Valencia, Spain.

OBJECTIVE: To compare the value of different markers and their combinations with the restriction enzyme technique in the differentiations of penicillinase-producing N. gonorrhoeae (PPNG) strains. MATERIALS AND METHODS: 17 PPNG strains isolated from symptomatic, untreated male patients with urethritis were characterised by antibiotic sensitivity testing, auxotyping, serotyping, plasmid profile, and restriction endonuclease fingerprinting (Hind III digestion). Cluster analysis with the method of unweighted pair-group average (UPGMA) linkage was used to calculate similarity or dissimilarity for PPNG strains. MAIN RESULTS: Either auxotyping or plasmid profile alone differentiated three groups of PPNG strains, whereas the combination auxotyping/serotyping identified 10. Although the combination auxotyping/serotyping/plasmid profile and the restriction enzyme technique showed a similar discrimination ability (differentiation of 11 PPNG strains), genomic fingerprinting gave highly specific restriction patterns on individual gonococcal isolates. CONCLUSIONS: The combination of different markers gave more epidemiological information than the use of only one. The sequence of discriminating ability for PPNG strains was: auxotyping/serotyping less than auxotyping/serotyping/plasmid profile less than restriction patterns of genomic DNA.