[Biological markers of alcoholism]. / Marcadores biológicos del alcoholismo.

Diagnosis of alcoholism is very important, given its high prevalence and possibility of influencing the disease course. For this reason, the so-called biological markers of alcoholism are useful. These are analytic parameters that alter in the presence of excessive alcohol consumption. The two most relevant markers are the gamma-glutamyltranspeptidase and carbohydrate deficient transferrin. With this clinical comment, we aim to contribute to the knowledge of these tests and promote its use in the clinical practice.

Marcadores biológicos del alcoholismo / Biological markers of alcoholism

El diagnóstico de alcoholismo es de gran importancia, dada su alta prevalencia y la posibilidad de influir sobre el curso de la enfermedad. Para este propósito son útiles los llamados marcadores biológicos del alcoholismo: parámetros analíticos que se alteran en presencia de un consumo excesivo de alcohol. Los dos marcadores más relevantes son la enzima gammaglutamiltranspeptidasa y la transferrina deficiente en carbohidratos. Con este comentario clínico pretendemos contribuir al conocimiento de estas pruebas y fomentar su uso en la práctica clínica (AU)

Diagnosis of alcoholism is very important, given its high prevalence and possibility of influencing the disease course. For this reason, the so-called biological markers of alcoholism are useful. These are analytic parameters that alter in the presence of excessive alcohol consumption. The two most relevant markers are the gamma-glutamyltranspeptidase and carbohydrate deficient transferrin. With this clinical comment, we aim to contribute to the knowledge of these tests and promote its use in the clinical practice (AU)

Pathogenesis of hypersensitivity pneumonitis.

Until a few years ago, the pathogenesis of hypersensitivity pneumonitis was based on epidemiological, clinical and histological data. The introduction of bronchoalveolar lavage as a diagnostic tool in pneumology and the use of monoclonal antibodies have afforded considerable advances in pathogenic studies on this clinical entity. In the present work we review the characteristics of bronchoalveolar lavage in patients suffering from hypersensitivity pneumonitis in order to study the mechanisms through which the disease appears after integrating such characteristics with the classical histological, clinical and biochemical data. Bronchoalveolar lavage in these patients demonstrates the following: An elevation in the number of total cells that is higher than in any other interstitial pathology. Morphological, biochemical and functional data suggestive of activation of alveolar macrophages. An elevation in lymphocyte percentages with data characteristic of activation. The rise occurs in the two lymphocyte subpopulations (CD4 and CD8), although there is a predominance, in the rise in C8 lymphocytes, such that the CD4/CD8 ratio decreases. A rise is also observed in "natural killer" cells. Functionally, there are data that reveal an increase in the inducer potential of T lymphocytes together with an increase in cytotoxic capacity, in all their subpopulations. The results on the lymphocyte count vary broadly according to the course of the disease. Varying increases in neutrophils, eosinophils and mast cells. The rises in the first two kinds of cells indicate recent contact with the antigen, while the rise in mast cells seems to be of pathogenic significance. Different biochemical alterations (complement system, immunoglobulins, lipids, etc.).(ABSTRACT TRUNCATED AT 250 WORDS)

[Round pneumonias]. / Neumonías redondas.

Two cases of pneumonia in which the initial radiologic sign was the solitary nodule are presented. The symptoms associated permitted the infectious origin. The clinical and radiological evolution after antibiotic therapy supported the diagnosis of rounded pneumonia. We highlight the need to discard benign lesions causing the solitary nodule, before trying to diagnose other diseases.

Androgen environment and beta-glucuronidase activity in the human kidney.

Basal beta-glucuronidase activity was measured in the cytosol of renal cortex in 10 women and nine men, and its levels were correlated to the concentrations of the main circulating androgens and to the cytoplasmic androgen receptor content. beta-Glucuronidase activity in women was similar to that found in men, despite blood testosterone levels being higher in the latter. The activity of the enzyme does not appear to be related to circulating levels of either testosterone or androstenedione. Only in men the androgen receptor content and dehydroepiandrosterone-sulphate levels were inversely correlated to beta-glucuronidase. In the human kidney cytosol there is no evidence of sexual dimorphism in basal beta-glucuronidase activity; whereas the total testosterone circulating levels do not seem to control the enzyme activity.

[CRST syndrome and mixed cryoglobulinemia (author's transl)]. / Síndrome CRST y crioglobulinemia mixta.

A case of CRST syndrome associated with a type III mixed cryoglobulinemia according to Seligman's classification is presented. The authors stress the concrete individualization of this syndrome, as well as the importance of the Raynaud's phenomenon as the first and early manifestation in the clinical picture. They state, on the other hand, that the abundance and distribution of the telangiectasias is similar to the hereditary Rendu-Osler telangiectasia. Finally, a possible common physiopathologic basis for the syndrome and the associated cryoglobulinemia in this patient is suggested.