[Allergy to cow's milk protein, or lactose intolerance: a cross-sectional study in university students]. / Alergia a la proteína de la leche de vaca o intolerancia a lactosa: un estudio transversal en estudiantes universitarios.

BACKGROUND: Factors like ethnic origin and geographical area affect the frequency of cow's milk protein allergy (CMPA) and lactose intolerance (LI). Epidemiological information about the non-pediatric population is still missing. OBJECTIVE: To determine the prevalence of CMPA and LI in university students. METHODS: A cross-sectional study of 1200 students of 18 to 25-year-old. A structured questionnaire was applied in order to identify the clinical manifestations triggered by the intake of cow's milk (CM), and these were categorized as linked to CMPA or linked to LI. RESULTS: Thirty students met the criteria for CMPA (prevalence of 2.5 %; CI 95 % = 1.7-3.6 %) and 128 for LI (prevalence of 10.7 %, CI 95 % = : 9.0 % - 12.5 %). The frequency of personal history of food allergy and dust mite allergy was higher in students with CMPA than in students with LI. Oral pruritus, skin and respiratory discomforts were predominant in CMPA. Abdominal cramps and flatulence were predominant in LI. CONCLUSIONS: IL is more frequent than CMPA; which frequency was one in every 10 students; and the frequency of CMPA was one in 400.

Antecedentes: El origen étnico y la zona geográfica influyen en la frecuencia de la alergia a la proteína de leche de vaca (APLV) y de intolerancia a la lactosa. Faltan datos epidemiológicos en población no pediátrica.Objetivo: Determinar la prevalencia de APLV e intolerancia a la lactosa en estudiantes universitarios.Métodos: Estudio transversal de 1200 estudiantes de 18 a 25 años. Se aplicó cuestionario estructurado para identificar manifestaciones clínicas desencadenadas por la ingesta de leche de vaca y fueron categorizadas como relacionadas con APLV o intolerancia a la lactosa.Resultados: 30 estudiantes cubrieron criterios para APLV (prevalencia de 2.5 %; IC 95 % = 1.7-3.6) y 128 para intolerancia a la lactosa (prevalencia de 10.7 %, IC 95 % = 9.0-12.5). Los estudiantes con APLV tuvieron mayor frecuencia de historia personal de alergia a alimentos y alergia a ácaros del polvo casero, comparados con los estudiantes con intolerancia a la lactosa. El prurito oral y las molestias cutáneas y respiratorias predominaron en la APLV. El cólico abdominal y las flatulencias predominaron en la intolerancia a la lactosa.Conclusiones: La intolerancia a la lactosa fue más frecuente que la APLV; se observó en uno de cada 10 estudiantes y la APLV en uno de cada 400.

Hyperleptinemia as a prognostic factor for preeclampsia: a cohort study.

INTRODUCTION: Leptin is an adipokine which has a direct relationship to obesity. Our aim was to measure this hormone in pregnant women at three months intervals throughout their pregnancies to determine the serum value of those who developed preeclampsia. MATERIAL AND METHODS: We followed 19 women (median age 24.8 +/- 5.7 years) with pre-gestational Body Mass Index (BMI) less than 25 kg/m2, 21 (median age 26.1 +/- 4.6 years) with BMI higher than 25 kg/m2 and 16 (median age 30.9 +/- 5.8 years) with Gestational Diabetes Mellitus (GDM) (median age 30.9 +/- 5.8 years), recruited in the 1st trimester of pregnancy. Serum levels of leptin were measured with radioimmunoassay (RIA) technique. RESULTS: In the first trimester of pregnancy leptin levels showed statistically significant differences between normal weight and overweight-obese women (p < 0.001), diabetic women (p < 0.05) and the subgroup of preeclamptic women (p < 0.001). For those women with PGBMI > or = 40 kg/m2 and leptin > or = 40 ng/ml in the second trimester, the Odds Ratio (OR) to develop preeclampsia was of 47.95% CI (4.1-527.2). Analyzing leptin values with ROC curves, the greatest area under the curve (AUC) was for leptin in the second trimester (0.773, CI: 0.634-0.911). CONCLUSION: Women with morbid obesity (BMI > or = 40 kg/m2) had significantly higher levels of serum leptin (p < 0.01) and a value of 40 ng/ml of this hormone seems to be predictive of developing preeclampsia in this group of patients.

Treatment of patients with hemophilia A and inhibitors to factor FVIII with cimetidine

In this study, cimetidine was used to treat patients with hemophilia A and inhibitors to factor VIII who presented with acute hemorrhages (Group A) and those without hemorrahges (Group B). The dose of cimetidine was 15 mg/kg/day. Group A consisted of five patients with inhibitors between 156 and > 10,000 Bethesda Units (BU), all with serious hemorrhagic problems. The control of hemorrhaging was effective in 100 per cent of these patients, although inhibitor levels remained high (25-380 BU). Group B consisted of seven patients who did not have hemorrhages, whose inhibitor levels were 41-358 BU. Five of these patients no longer had anamnestic responses to Factor VIII after several months of treatment with cimetidine. No difference in the response to cimetidine was seen between HIV positive and HIV negative patients. The results suggest that cimetidine is useful to suppress inhibitores to Factor VIII in patients with hemophilia A

Informe de dos casos con enfermedad de von Willebrand adquirida y uno con hemofilia A adquirida / Report of two cases of acquired von wiellebrand disease and one of acquired hemophilia a

Se informan tres mujeres con inhibidores adquiridos de la coagulación contra el complejo F VIII:C/F vW:Ag que se diagnosticaron como enfermedad de von Willebrand adquidida (vWA) en los casos 1 y 2, y como hemofilia A adquirida en el caso 3. Las edades son de 19, 40, y 38 años para los casos 1, 2 y 3, respectivamente. No tenían historia familiar de padecimientos hemorrágicos, pero sí de enfermedad autoinmune asociada (enfermedad de Graves, lupus eritematosos sistémico y artritis reumatoide + postparto, respectivamente); las tres pacientes presentaban manifestaciones hemorrágicas. En las pruebas de hemostais, el nivel del FVII:C fue menor de 8 U/dL en los tres casos y el F vW:Ag, F vW:RiCof y la agregración plaquetaria con ristocetina estuvieron disminuidos en los dos casos de vWA; la búsqueda del anticoagulante lúpico (Exner) fue positiva en un caso, pero no se confirmó ya que la prueba de neutralización con fosfolípidos plaquetarios fue negativa. La dosificación de los inhibidores contra el F VIII:C, con el método de unidades Bethesda, fue de 50, 38 y 20 para los casos 1 a 3 respectivamente. Al administrar crioprecipitados y DDAVP (desmopresina), las pacientes tuvieron respusta clínica con respuesta parcial en sus parámetros de laboratorio. Con el tratamiento de córticosteroides se obtuvo respuesta; en la paciente con hemofilia adquirida fue necesario un tratamiento inmunosupresor