Serum levels of albumin, triglycerides, total protein and glucose in rats are altered after oral treatment with low doses of 13-cis-retinoic acid or all-trans-retinoic acid.

Currently used to treat severe acne, 13-cis-retinoic acid (13-cis-RA) is under investigation for its anticancer effects as is the isomer, all-trans-retinoic acid (all-trans-RA). Here, the effects of oral 13-cis-RA or all-trans-RA treatment on serum chemistry, leptin and adiponectin levels were evaluated. Adult Sprague-Dawley rats were gavaged once daily for 7 consecutive days with 13-cis-RA (7.5 or 15 mg kg(-1)), all-trans-RA (10 or 15 mg kg(-1)) (n=24/sex/dose), or soy oil (n=16/sex) and blood was sampled 30-480 min after the last gavage. The body weight was unaffected; however, the liver/body weight ratios were increased by both doses of all-trans-RA. Sex differences were noted for levels of cholesterol, creatine, triglycerides, albumin, alanine aminotransferase and total protein. Both doses of all-trans-RA reduced albumin levels to approximately 90% of the control and total protein levels to approximately 93% of the control while substantially elevating triglyceride levels to approximately 66%-99% above the control. Additionally, triglyceride levels of the 15 mg kg(-1) 13-cis RA group were approximately 62% higher than the controls and total protein levels were approximately 5% less. Glucose levels were affected by sex and RA treatment in that males treated with 15 mg kg(-1) of 13-cis-RA or 10 mg kg(-1) all-trans-RA had lower (13%-19%) levels than the same-sex controls; however, females were not similarly affected. Neither 13-cis-RA nor all-trans-RA treatment had significant effects on the levels of blood urea nitrogen, aspartate amino transferase, leptin or adiponectin. On a mg kg(-1) basis, all-trans-RA was more potent than 13-cis-RA. These results replicate previous findings of RA-induced increased triglyceride levels. Additionally, several new findings indicate there may be sex-specific effects of RA treatment. Finally, neither treatment appeared to alter the typical diurnal cycles of these endpoints.

Primary thrombophilia in Mexico. II. Factor V G1691A (Leiden), prothrombin G20210A, and methylenetetrahydrofolate reductase C677T polymorphism in thrombophilic Mexican mestizos.

We have shown that in Mexican mestizo patients with clinical features of primary thrombophilia, 39% have activated protein C resistance phenotype, 5% protein C deficiency, and 2% protein S deficiency. In the present study, in a group of 37 thrombophilic Mexicans and 50 normal controls, we assessed the factor V G1691A (Leiden), the prothrombin G20210A, and the methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphisms. Four patients were found to be heterozygous for factor V Leiden, 5 heterozygous for the prothrombin 20210, 16 heterozygous, and 6 homozygous for the MTHFR 677. There were four individuals with co-segregation of alleles: two heterozygotes for the factor V Leiden/prothrombin 20210, one heterozygote for prothrombin 20210/MTHFR 677, and one heterozygote for prothrombin 20210/homozygote for MTHFR 677. For factor V Leiden, prothrombin 20210, and MTHFR 677 mutations, the allele frequencies were respectively 1% (+/-0.2%, alpha = 0.05), <1% and 51% (+/-5%, alpha = 0.05), with calculated relative risks for thrombosis of 5.94 (P = 0.08), >7.66 (P < 0.05), and 0.44 (P NS), respectively. In Mexican mestizo thrombophilic patients, the low prevalence of the factor V Leiden mutation (10.8%) and the high prevalence of the prothrombin 20210 mutation (13.5%) contrast with those identified in Caucasian thrombophilic patients (21% and 6%, respectively; P < 0.01). On the other hand, the high prevalence of the MTHFR 677 mutation gene both in normal controls (78%) and thrombophilic patients (61%) does not support a role of this mutation in the thrombogenesis of Mexican mestizo patients.

Diminished morbidity and mortality in portal hypertension surgery: relocation in the therapeutic armamentarium.

Although several effective therapeutic options are available for bleeding from portal hypertension, surgery has a well-defined role in the management of patients with good liver function who are electively operated. The aim of this investigation was to evaluate the operative mortality and morbidity of portal blood flow-preserving procedures in a highly select patient population. The records of 148 patients operated on between 1996 and 2000 using one of two techniques (selective shunts or a Sugiura-Futagawa operation [complete portoazygos disconnection]) were analyzed with particular attention to operative mortality, postoperative rebleeding, and encephalopathy. Survival was calculated according to the Kaplan-Meier method. Sixty-one patients had distal splenorenal shunts placed, and 87 patients had a devascularization procedure. Operative mortality for the group as a whole was 1.2%. In the group with selective shunts, the rebleeding rate was 4.9%, the encephalopathy rate was 9.8%, and the shunt obstruction rate was 1.6%. Survival at 24 months was 94% and at 48 months was 92%. In those undergoing devascularization, the encephalopathy rate was 5% and the rebleeding rate was 14%. Survival at 24 months was 90% and at 48 months was 86%. Portal blood flow-preserving procedures have very low morbidity and mortality rates at specialized centers. In addition, a low rebleeding rate is associated with a good quality of life. Low-risk patients with bleeding portal hypertension should be considered for surgical treatment.

Analysis of HFE-codon 63/282 (H63D/C282Y) gene variants in mexican mestizos. Blood donors and patients with hereditary hemochromatosis.

BACKGROUND: The prevalence of hereditary hemochromatosis (HH) (H63D/C282Y) gene variants in Mexico is unknown. METHODS: Using amplification refractory mutation system polymerase chain reaction, an analysis of HFE-codon 63/282 (H63D/C282Y) gene variants was performed in a group of 153 Mexican mestizo blood donors and six individuals with familial iron overload. RESULTS: In normal blood donors, three heterozygotes for the C282Y mutation (2.0%) were found, whereas 18 heterozygotes and one homozygote for the H63D mutation (11.8% and 0.6%, respectively) were identified; there was one compound heterozygote for the C282Y/H63D mutation. These data resulted in allele frequencies of 0.013 (+/-0. 2%, alpha = 0.05) and 0.062 (+/-0.9%, alpha = 0.05), respectively, for these two mutations, results similar to those found in whites. In the six patients with the HH phenotype, two were found to be heterozygous for C282Y and one heterozygous for H63D; three individuals with HH had no gene mutations. Two heterozygous HH individuals were found to have iron overload associated with other conditions: one heterozygous for C282Y infected with HIV, and another heterozygous for H63D with heterozygous beta-thalassemia. CONCLUSIONS: The prevalence of C282Y and H63D HFE gene mutations in Mexican mestizos is similar to that found in other populations. In addition, other gene mutations responsible for HH in the Mexican mestizo population should be investigated, because, in three of six individuals with the HH phenotype, neither of the two mutations was recorded.

Assessment of residual disease in acute leukemia by means of polymerase chain reaction.

Along a 5-year period in a single institution, specific molecular markers were prospectively looked for in consecutive patients with acute leukemia, by means of polymerase chain reaction (PCR): In patients with acute lymphoblastic leukemia (ALL), the BCR/ABL and TEL-AML1 fusion transcripts as well as clonotypic immunoglobulin gene rearrangements were investigated, whereas in patients with acute myelogenous leukemia (AML) the PML-RAR alpha, AML1-ETO and CBF beta-MYH11 fusion proteins were assessed. Specific molecular markers were identified in 15/75 patients: Four with ALL (three with clonotypic IgG rearrangements and one with BCR/ABL) and 11 with AML (nine with the PML/RAR alpha fusion protein--M3 AML-, and two with the AML1/ETO fusion protein--M2 AML-). During follow-up periods ranging from 1 to 60 months, seven patients cleared the residual disease assessed by PCR (RD-PCR), whereas eight patients had either persistence of RD-PCR or a molecular relapse. For patients without or with RD-PCR, the 30-month survival (SV) was 86% and 14%, respectively, whereas median SV was > 60 and two months, also respectively (p < 0.01). Six of eight patients with detectable RD-PCR died, all of them within three months after the detection of the RD-PCR, whereas two of the patients that relapsed were rescued with treatment and entered a second molecular remission. Two of the three molecular relapses were detected without an overt morphological relapse. It is concluded that PCR is a valuable method for assessing residual disease and that early diagnosis of relapses may lead into effective salvage treatment in some instances.

Waldenström's macroglobulinemia is infrequent in Mexican Mestizos: experience of a hematological diseases referral center.

Along a 17-year period 7,373 patients were prospectively studied in a private practice Health facility; of these 11 were patients with Waldenström's macroglobulinemia; calculations from these data and previous publications show that this lymphoid malignancy represents in Mexico 0.18% of all hematologic malignancies, a figure 11 times lower than that described from caucasians. The median age was 65 years (range 31 to 84); there were 6 males and 5 females. Ten individuals were mexican mestizos, whereas one had a caucasian phenotype. The clinical features of the patients afflicted by the disease in Mexico were similar to those reported from caucasian populations. The median survival (SV) of the group of patients was 40 months, whereas the 42-month survival was 49%; the prognosis of the disease was relatively good despite the fact that complete remissions were unfrequent as a result of the treatment.

[Glycosilphosphatidylinositol-anchored cell surface protein deficiency in Mexican mestizo patients with aplastic anemia]. / Deficiencia de proteínas de superficie ancladas por glucosilfosfatidilinositol en células de pacientes mestizos mexicanos con hipoplasia medular.

The peripheral blood cells of ten patients with biopsy-proven aplastic anemia were studied by means of flow-cytometry in order to assess the expression of two phosphatidylinositol-anchored surface proteins: CD55/DAF (decay accelerating factor) and CD59/MIRL (membrane inhibitor of reactive lysis). An abnormal expression was found in five of these ten patients, whereas the "traditional" tests for paroxysmal nocturnal hemoglobinuria (PNH) were positive only on two of these five individuals. Five of the aplastic patients were treated with anti-thymocyte globulin and cyclosporin-A and three entered a complete remission; of the latter, one had CD55/CD59 deficiencies whereas two did not. Along the study period one patient with a hemolytic pattern of PNH was identified. It is concluded that CD55 and/or CD59 abnormalities are frequent in Mexican mestizo patients with aplastic anemia, that the aplastic presentation of PNH is more frequent in Mexico than the hemolytic presentation, that the flow-cytometric identification of CPI-anchored proteins is more sensitive than the "traditional" PNH tests, and that some patients with PNH-aplasia may respond to intensive immunosuppressive treatment. The flow-cytometric identification of GPI-anchored cell surface proteins should replace the "traditional" tests in the identification of patients with PNH.

[Vaccination schedules on Spanish territory. Necessity of unification and execution]. / Calendarios vacunales en el territorio español. Necesidad de unificación y actualización.

In this article, it's studied the actual condition of the different vaccination programmes followed across the Spanish nation. They have been proposed by the different Regland Communities, Health Ministry an Spanish Pediatrics Association. It's shown a critical review of the different programmes asking for a single vaccination programme for al the country. The changes in these programmes are due to bring them up to day, to unify them and to make them easier to keep.

[Maximum oxygen consumption and serum lipids in diabetics, controls, and athletes]. / Consumo máximo de oxígeno y los lípidos séricos en diabéticos, controles y atletas.

Although it has been pointed out that the main cardiovascular risk factors in diabetic are dyslipidemias, hypertension, and cigarette smoking, very few studies have analyzed other risk factors, such as sedentarism and maximal aerobic capacity (VO2 max). The purpose of this study was to evaluate VO2 max and blood lipids (total cholesterol = TC, high density lipoproteins cholesterol = HDL; low density lipoproteins cholesterol = LDL; triglycerides = TG), in 19 diabetics subjects, 19 sedentary and 19 long distance runners. The diabetics of 5-10 years of evolution were non obese (body fat < 28%), and in regular metabolic control (Hb A1 < 12%). The athletes had more than five years of uninterrupted training. The diabetics had significantly lower VO2 max, than the other groups. The mean +/- SEM (mL/kg/min) in diabetics was 30.5 +/- 1.6 versus 41.3 +/- 2.3 in the controls and 54.2 +/- 2.5 in the athletes. There were significant group differences in TG (218 +/- 44 in diabetics vs 106 +/- 16 in controls and 94 +/- 10 mg/dL in athletes) and in HDL (27.3 +/- 4.3 in diabetes versus 34.1 +/- 4.3 and 43.9 +/- 6.3 mg/dL). These data suggest that sedentarism and low VO2 max may be important risk factors in diabetics. An aerobic program for them could perhaps change their blood lipids favorably as their VO2 max was significantly correlated with TG (r = -0.45), HDL (r = 0.52) and the TC/HDL ratio (r = -0.57).

[Symptoms in adolescents in two Mexican cities and association with the menstrual cycle]. / Síntomas en adolescentes de dos ciudades de México y su asociación con el ciclo menstrual.

Frequency an severity of physical and emotional symptoms in young female students from two cities of México (a medium and a large sized city), were studied. An interview was carried out in 447 female adolescents, non seeking treatment, in a cross sectional design (146 from Guadalajara, and 301 from León). The mean age was 16.7 years (16.5 + SD 1.7 and 17.1 +/- 1.9 respectively). Most frequent symptoms for both groups were abdominal bloating, acne, increased appetite, low back pain, polydipsia, and emotional symptoms related to depression such as fatigue, desire to stay at home, desire to be alone and anxiety. Adolescents from Guadalajara reported increased intensity of diverse symptoms in comparison with adolescents from León: Breast tenderness, polydipsia and symptoms of depression. Difference was maintained after adjustment for covariates. In regards to the phase of the menstrual cycle, significantly different symptoms were: Abdominal bloating, breast tenderness, constipation, pruritus, lack of concentration, lack of coordination and symptoms of depression. It is concluded that female adolescents report increased scores on several physical and emotional symptoms during the menstrual phase of the cycle. Women from large urban populations report symptoms with increased intensity.

[Influence of the autonomic nervous system on the initial response of heart rate to active and passive orthostatism]. / Influencia del sistema nervioso autónomo en la respuesta inicial de la frecuencia cardíaca al ortostatismo activo y pasivo.

Influence of the autonomic nervous system on the heart rate response to active and passive orthostatism. The purposes of this study were twofold. First, to compare heart rate responses as measured by R-R interval under two conditions of orthostatic stress, i.e. a change from supine to an active free standing-up position (active orthostatism, AO), and from supine to a passive 70 head-up tilt posture (passive orthostatism, PO) second, to utilize a standard pharmacological model to study the participation of the autonomic nervous system upon heart rate responses evoked by AO. In the first part of the research, eight healthy subjects (seven men, one woman) were evaluated for AO and PO. In both occasions, subjects were supine for 5 minutes and then adopted an upright or a tilted position in 3-5 seconds and remained motionless during 5 minutes. In the second part, eight men participated twice in the pharmacological studies. In day one, they stood up for control (AOC), after IV administration of atropine sulfate (0.04 mg/kg) (AO+atro) and after IV administration of propranolol hydrochloride (0.16 mg/kg) (AO+ATRO+PROPRA). In day two, subjects repeated the control AO (AOCII) and after the administration for propranolol hydrochloride alone. In the first study, AO was characterized by a fast shortening of R-R interval, which was maximal at beat 15th (relative tachycardia), followed by a rebound lengthening of R-R interval, reaching a plateau at beat 30 (relative bradycardia), demonstrating a biphasic response. PO was characterized by a small and gradual shortening of R-R interval without the biphasic responses of AO.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effect of body posture on serum concentration of lipids]. / "Efecto de la postura corporal sobre la concentración de los lipidos séricos".

The purpose of this study was to evaluate the effects of body postural changes (supine-upright), upon the serum concentration of cholesterol (CT), triglycerides (TG), high density lipoproteins (HDL), low density (LDL) and very low density lipoproteins (VLDL) and hemoglobin, hematocrit, and plasma proteins (to calculate delta% change in plasma y volume). Nine healthy men participated as subjects. Their age ranged from 32 +/- 3 years old, and 16 +/- 4% body fat (X +/- SD). After 10-12 hours post absorptive and appropriate rest, they performed a standard orthostatic maneuver: subjects remained supine for 30 minutes, then assumed the standing position (unsupported and with minimal movement) for additional 30 minutes. Blood samples were obtained after 30 minutes supine and at 10, 20 and 30 minutes of standing. At 10 minutes of orthostatism, CT, TG, HDL and VLDL had a significant increase as compared to supine values; these changes were associated with a reduction of 8.9% on plasma volume (PV) (p less than 0.05). After 30 minutes of orthostatism CT, TG, HDL and VLDL showed increments of 8.5%, 33.3%, 20.1% and 32% respectively, in relation to the supine values (p less than 0.05). Changes on serum lipids were associated with PV reductions until 20 minutes of orthostatism. However, there was not a significant association between these variables at 30 minutes of standing. These data indicated that the body position and the time in which blood samples are obtained significantly influence lipid and lipoprotein serum level. Therefore, in any study related to lipids, such variables should be considered and properly controlled.

[Effects of an aerobic exercise program and diet on body composition and cardiovascular function in obese persons]. / Efectos de un programa de ejercicio aeróbico y dieta sobre la composición corporal y función cardiovascular en obesos.

The purpose of this study was to determine the effect of a combination of aerobic exercise and hypocaloric diet on body composition, cardiovascular function and some cardiovascular risk factors in obese patients. Ten subjects, (8 women 2 men X age 30 years and 138% of ideal body weight) volunteered as participants. The program lasted 12 weeks and consisted of a hypocaloric diet (1257 kcal/day) and 3-5 days/week supervised sessions of aerobic exercise (65-90% maximal heart rate and/or 50-80% of maximal oxygen uptake). The program resulted in a significant mean decrease in body weight of 7.7 kg. for the group (P less than or equal to 0.05). Mean (+/- EE) relative body fat significantly decreased from 35.9 +/- 2 to 31.6 +/- 2%. Interestingly, the decrease in relative body fat was solely accounted for by a significant decrease in fat weight, as body free of fat remained constant. Cardiovascular function as evidenced by oxygen uptake, increased 11.3%. Resting systolic and diastolic blood pressure fell significantly from 131/90 +/- 8/9 to 115/76 +/- 2/1 mmHg. Total cholesterol significantly dropped from a mean value of 247 +/- 24 to 183 +/- 20 mg/100 ml (P less than 0.05). Triglycerides significantly decreased from 212 +/- 32 to 45 +/- 10 mg/100 ml (P less than 0.05). It was concluded that a combination of aerobic exercise and hypocaloric diet can favorably improve body composition, cardiovascular function and cardiovascular risk factors.

[Effects of orthostatism on heart rate and arterial pressure in sedentary subjects and in those in good physical condition]. / Efectos del ortostatismo sobre la frecuencia cardíaca y presión arterial en sujetos sedentarios y en los fisicamente acondicionados.

Heart rate (HR), Systolic (SBP), Diastolic (DBP), and Mean Blood Pressures (MBP), were evaluated during a resting sitting and during upright moveless positions, in fifty seven highly trained runners with a maximal oxygen consumption equal or superior to 55 ml/kg. min. (VO2 max greater than or equal to 55 ml/kg . min., group I), and in fifty seven sedentary untrained men (group II). During sitting position the members of group I, had a significantly lower DBP and MBP than the members of group II. In the members of group II the assumption of upright posture did not produce significant changes in blood pressure, whereas subjects of group I showed a significantly drop in SBP, DBP and MBP. The results of this investigation indicated that in human, vigorous physical activity produce lower values of arterial blood pressure, and might be of value in the prevention of high blood pressure. On the other hand, the observed responses in group I during orthostatism, reveal a different regulation of the cardiovascular system. Changes in sympathetic and parasympathetic nervous system, venous compliance and plasma volume are designated as responsible of observed differences. This finding might also support the tendency to faintness reported by some authors in athletes.