[Severe intoxication with verapamil]. / Intoxicación grave con verapamilo.

Calcium channel blockers are currently widely used to treat many cardiological alterations; however, overdose and poisoning have been associated with morbidity and mortality mainly in those patients with suicidal attempts. We report a case and review the pathophysiology of overdose, treatment, and prognosis.

[Bacteriological quality of human drinking water in high-margination zones in Chiapas]. / Calidad bacteriológica del agua para consumo humano en zonas de alta marginación de Chiapas.

OBJECTIVE: To analyze the bacteriological quality of drinking water (BQDW) and its association with diarrhoea and intestinal parasites in children 1 to 14 years old, in areas of high levels of poverty in Chiapas, Mexico. MATERIAL AND METHODS: From March to September 1998, drinking water was collected from a random sample of 99 households in the Border Region of Chiapas, Mexico; data on diarrhoeal disease (in the past 15 days) were collected and stool testing for intestinal parasites was performed in children 1 to 14 years old (n = 322). The BQDW was determined by the filtration membrane technique. Intestinal parasitic infections were determined by the Faust Method. The chi 2 statistic was used to analyse factors associated with BQDW. RESULTS: Only 31% of the water samples were adequate for human consumption. The BQDW and the presence of diarrhoea (informed by the mothers of the children) showed no association. Children living in households with inadequate BQDW had a higher prevalence of Entamoeba histolytica and a greater tendency to have intestinal parasites. CONCLUSIONS: It is necessary to develop programs that improve BQDW and to develop education efforts aimed at increasing the use of boiled water and the adequate management and care of community water storage sites.

[Application of gas chromatography in the identification of Enterobacter cloacae, Enterobacter aerogenes, and Enterobacter agglomerans]. / Aplicación de la cromatografía de gases en la identificación de Enterobacter cloacae, Enterobacter aerogenes y Enterobacter agglomerans.

Enterobacter cloacae, Enterobacter aerogenes and Enterobacter agglomerans were identified using gas chromatography as a substitution of the traditional techniques. Their acid methyl esters profiles were determined using a gas chromatograph Hewlett Packard 5890A and a RSL-150 heliflex capillary column. A total of 120 samples were analyzed from reference strains (ATCC 13047, 13048, 27155) and environmental isolations, eleven fatty acids were included in the profiles from which cis-9, 10-methyleneoctadecanoic acid (peak 24), cis-9-hexadecenoic acid (peak 14), octadecanoic acid (peak 23) and dodecanoic acid (peak 3), were the most important for the differentiation of the three species analyzed.

Study of CYP2D6 gene in children with autoimmune hepatitis and P450 IID6 autoantibodies.

Cytochrome P450 IID6 is an autoantigen recognized by the sera of children affected with a subtype of autoimmune hepatitis. It was hypothesized that a mutation in the CYP2D6 gene could explain the autoimmune response in these patients. To examine this question, genomic DNA from peripheral lymphocytes (n = 9) and liver (n = 1) of 10 patients with anti-LKM-1 antibody was analysed by Southern blot for genetic association studies between a particular CYP2D6 haplotype and autoimmune hepatitis. In addition, a region of CYP2D6, from the same genomic DNA, was amplified by polymerase chain reaction (PCR) and digested by BstNI, in a search for the most prevalent 29B mutation, described in subjects who do not express the P450 IID6. Total RNA and proteins, prepared from the liver of an anti-LKM-1+ patient, were analysed by Northern and Western (immunoblot) blots respectively. Our results do not reveal any major structural change in the DNA of this patient at the CYP2D6 locus that could explain their autoimmune response. Corroborating this observation, no changes were noted either in P450 IID6 mRNA size or in the corresponding protein. However, these data do not exclude the possibility of subtle changes in the protein due to point mutations in critical regions that might trigger an autoimmune response.

Detección del ADN del virus B en suero de niños con hepatitis aguda prolongada, hepatitis crónica activa y portadores asintomáticos / Detection of ADN from virus B in sera of children with protracted ocute hepatitis, active chronic hepatitis and asymptomatic carriers

La hibridación del ADN del virus de la hepatitis B ha mostrado ser un método sensible y específico para medir la replicación viral. En el presente trabajo se reporta la relación entre la presencia del ADN del virus de la hepatitis B y el sistema AgeHB/antieHB en sueros de niños, por los métodos dot-blot y ELISA, cinco de los niños con hepatitis aguda prolongada (HPA), 34 con hepatitis crónica activa (HCA) y en 23 portadores asintomáticos. Se encontró relación entre el ADN viral y el AgeHB positivos (14/17) para el 82 %, y entre el antieHB y el ADN positivos (19/38) para el 50 % de la muestra. En el estudio se demuestra que la hibridación de ADN del virus B nos da una información más útil como marcador de replicación viral que el sistema inmunológico AgeHB/antieHB, lo que constituye el aspecto más relevante del presente trabajo

[Study of lymphocyte subpopulations with monoclonal antibodies in acute hepatitis A and B]. / Estudio de sub-poblaciones linfocitarias mediante anticuerpos monoclonales en hepatitis aguda A y B.

Using monoclonal antibodies, it was determined the T3, T4 and T8 1ym phocyte populations in the blood samples of 40 patients with acute viral hepatitis (20 type A and 20 type B). al patients showed complete remission from it. The results of this study were compared with those of a control group of 20 healthy subjects. There was a non significant decreased of the total number of lymphocytes measured with the T3 monoclonal antibody in both types of hepatitis. The number of T8 lymphocytes was significantly increased (p less than 0.05) when the results were compared with those of the control group. The quotient T4/T8 was diminished in the initial phase of the disease (p less than 0.05). There were no other differences between hepatitis A and hepatitis B. In the follow up of the disease, the results tend to normal values in the whole group of patients.

[Study of lymphocyte subpopulations by means of monoclonal antibodies in acute hepatitis A and B]. / Estudio de sub-poblaciones linfocitarias mediante anticuerpos monoclonales en hepatitis aguda A y B.

We studied T3, T4 and T8 lymphocyte populations in peripheral blood by monoclonal antibodies in 40 patients with acute viral hepatitis (Type A 20; Type B 20) who underwent outcome to complete recovery. We compared the results with 20 healthy subjects (control group). We found a decrease in total lymphocytes measured by T3 monoclonal antibodies and a significant increase in T8 lymphocyte populations compared with control groups. In the early stage the T4/T8 ratio was decreased. Lymphocyte populations and T4/T8 ratio was normal in 3-6 month follow-up for the acute A hepatitis group and 3.6 month to a year follow-up for the B hepatitis group. Results were related to the humoral and clinical outcome.

Evidences that fibroblasts and epithelial cells produce a specific type of macrophage and granulocyte inducer, also known as colony-stimulating factor, and that monocyte-macrophages can produce another factor with proliferative inducing activity on myeloid cells and differentiative activity on macrophages.

Molecules with the property to induce proliferation of bone marrow cells in liquid cultures, and with colony-stimulating activity, were found on media conditioned (MC) by lung fibroblasts and kidney epithelial cells. These factors presented an apparent mol wt of 70,000 and 22,000 d respectively. Also when MC by epithelial cells from lungs was tested for the induction of proliferation of bone marrow cells a molecule with 22,000 d was detected. These molecules are thought to be CSF because they induce colony formation, and they are also similar in mol wt to two of the already known CSF. In fact the GM-CSF obtained from endotoxic lungs with a large epithelial cell content has a mot wt of 22,000 d, and the CSF-1 produced by a fibroblast cell line had 70,000. When the MC by fibroblast was used to induce bone marrow cells to proliferate, three new molecules with colony-stimulating activity were secreted. These molecules with apparent mol wts of 45,000, 30,000 and 17,000 d were also found in the MC by bone marrow cells when induced to proliferate with MC by epithelial cells. When the 45,000-d molecules was used in induced bone marrow cells to proliferate, once again the 30,000- and the 17,000-d molecules were secreted. Evidence is also provided that the 45,000-d molecule is produced by the monocyte-macrophage cells, and that it can induce Fc receptors or resident and elicited peritoneal macrophages. The possibility that the production of CSF is cell specific is discussed together with two models to explain the way in which these molecules can participate as proliferative (MGI-1) and differentiative (MGI-2) function in normal myeloid cell differentiation. Finally, a new terminology is proposed to classify this family of molecules.