It is known that the Harderian gland of male Syrian hamster synthesizes a much smaller amount of porphyrins than the gland of the female and that castration greatly increases this synthesis. We have studied in this experimental model the behavior of the different classes of secretory cells and their role in the synthesis of porphyrins, attempting to clarify the participation of these compounds in the cell damage leading to the formation of clear cells previously described in the gland of females. We have also investigated the mechanism underlying the death of these secretory cells after porphyrin accumulation (necrosis vs apoptosis). To achieve this, we have utilized the following techniques: (a) morphometrical; (b) ultrastructural; (c) biochemical (fluorescence spectrophotometry); and (d) molecular (DNA nick-end labeling in methacrylate sections and dot blot analysis). The glands from male hamsters (serving as control) present a very low rate of damaged cells that progressively rises after castration. This rise runs parallel to that of porphyrin synthesis, porphyrin deposits, and the decrease of Type II secretory cells. The damage and subsequent death of the secretory cells in the gland is produced by the deposit of porphyrins in the mitochondrial membrane. This porphyrin accumulation leads to a complete mitochondrial destruction that finally results in cell death and its secretion into the lumen. We finally conclude that this event is not a physiological cell death (apoptosis) but the consequence of the toxic accumulation of porphyrins (necrosis).

5-Aminolevulinate Synthetase↗

PubMedDate not supplied

Chronopharmacokinetic behaviour of cyproterone acetate in rabbits.

Cyproterone acetate (CPA) is an antiandrogenic compound that shows a rhythmic toxicologic behaviour. The purpose of this study was to determine whether CPA pharmacokinetics in the rabbit were influenced by the administration time of day. Previously synchronised rabbits received a single intravenous dose of 4 mg kg(-1) of CPA at two hours after light onset (2 HALO) and 14 hours (14 HALO) after light onset. The drug concentration in plasma samples was determined by high performance liquid chromatography. The mean concentrations in plasma were significantly higher (P<0.05) in 2 HALO than in 14 HALO animals at five, 15 and 30 minutes after dosing. Both plasma concentration profiles were fitted to two-compartment open models. Mean A, Vc and Vss differed significantly between 2 and 14 HALO dosage (P<0.005). Temporal variations in plasma protein binding, drug distribution and in drug elimination may play an important role in explaining these results.

Animals↗

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[HIV seroprevalence and exposure categories among adolescents tested at a sexually transmitted clinic diseases. Madrid, 1986-2000].

OBJECTIVE: To describe the time-trend in exposure categories and HIV seroprevalence among adolescents who underwent to voluntary testing in the period 1986-2000. METHODS: This study covered all adolescents, aged 13 to 19 years, at their first test for HIV in a sexually transmitted disease clinic in Madrid. Gender, age and HIV risk behaviours were collected. HIV diagnosis relies on ELISA test and Western blot confirmation. Time trends in HIV seroprevalence and exposure categories were analysed. RESULTS: A total of 1327 adolescents, 52% women and 22% under 18 years, were studied. The annual number of adolescents remained through the time, but injecting drug users (IDU) and IDU partners declined and female sex workers rose. 108 adolescents were diagnosed with HIV infection -71% were IDU-. HIV seroprevalence was 8.1% -31.3% in IDU-. It declined from 18.2% in 1986 to 1.5% in 1995, and after then it held steady under 4%. This decline involved several risk categories and was statistically significant in homo/bisexual men and female sex workers. The logistic regression analysis, adjusting for changes in exposure categories, showed an annual reduction in HIV seroprevalence (OR = 0.87; 95% CI, 0.81-0.94). CONCLUSIONS: HIV seroprevalence has decreased due to the fall of new young IDU and the decrease of seroprevalence within several exposure categories. HIV infections and risk behaviours continue happened among adolescents.

Adolescent↗

PubMedDate not supplied

[Influence of burnout on pharmaceutical expediture among primary care physicians].

OBJECTIVE: To determine the influence of various factors related to primary care physicians and their level of burnout on pharmaceutical expenditure per policy-holder (PEP-H). METHOD: We performed a cross-sectional study of 220 primary care physicians in the province of Barcelona in 2000. A structured and validated questionnaire was administered through direct interview. The questionnaire was divided into two parts: general sociodemographic and professional data, and the Maslach Burnout Inventory (MBI). At the same time, data on primary care physicians' pharmaceutical expenditure was collected from their corresponding health districts. RESULTS: The mean pharmaceutical expenditure was 264,627.22 euros (95% CI, 252,669.82-276,584.63) and the PEP-H was 152,36 euros (95% CI, 145,73-158,99). The variables associated with greater PEP-H were older age of the primary care physician, greater number of years of service in primary care, permanent work contract, primary care physicians who worked in several centers at the same time, primary care physicians who did not work in accredited teaching centers, urban centers, and high levels of emotional exhaustion in the MBI. CONCLUSIONS: Primary care physicians are subject to various degrees of stress in their daily work. Accumulation of these psychological stressors provokes emotional exhaustion, which complicates decision making when writing prescriptions and tends to lead to a vicious circle. Thus, primary care physicians with a high level of burnout could, on a variety of occasions, compensate for this lack of psychological resources by less efficient management of pharmaceutical expenditure when prescribing.

Burnout, Professional↗

PubMedDate not supplied

[The quality of the basic cause of death in the Statistical Bulletin of Mortality. Spain, 1985].

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Adolescent↗

PubMedDate not supplied

[An evaluation of the statistical significance and calculation of the confidence interval for the standardized mortality ratio].

The standardized mortality ratio (SMR) is the ratio of the number of deaths observed (D) to the number expected (E), on the basis of the mortality rates of some reference population. Several procedures have been proposed in order to test its significance and to estimate its confidence intervals. In this study, the SMR of two causes of death in 27 health areas of Castilla-La Mancha have been calculated. The significance has been evaluated by exact Poisson test and by four methods approximating the Poisson distribution by the normal: 1) a Z statistic based on the assumption that a Poisson variate with expectation E has a standard deviation equal to square root of E; 2) the Z statistic with a continuity correction; 3) a Z statistic based on the square root transformation of a Poisson variable and 4) an approximation of the exact test by Byar. Also, the confidence intervals have been estimated by exact method and by three approximate procedures: 1) by Byar; 2) by Z statistic uncorrected and 3) by the square root transformation of the Poisson distribution. With the exact methods and Byar procedure the results were very similar; therefore, using the last to testing significance and estimate the confidence intervals of SMR, is suggested.

Confidence Intervals↗

PubMedDate not supplied

Repeated sequences in bacterial chromosomes and plasmids: a glimpse from sequenced genomes.

To gain insight into the extent of exact DNA repeats in sequenced bacterial genomes and their plasmids, we analyzed the collection of completely sequenced bacterial genomes available at GenBank using the program Miropeats. This program draws graphical representations of exact DNA repeats in whole genomes. In this work, we present maps showing the extent and type (inverted or direct) of exact DNA repeats longer than 300 bp for the whole collection. These repeats may participate in a variety of events relevant for bacterial genome plasticity, such as amplifications, deletions, inversions, and translocations (via homologous recombination), as well as transposition. Additionally, we review recent data showing that high-frequency architectural variations in genomic structure occur at both the interspecies and interstrain levels.

Bacteria↗

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Effect of verapamil and sodium nitroprusside on the potassium contracture of smooth muscle strips from the reticular groove of adult cattle.

The effects of verapamil and sodium nitroprusside on smooth muscle strips from the floor of the reticular groove of adult cattle were studied. The mechanical activity of the muscle strips was recorded isometrically. Depolarization was induced with cumulative KCl concentrations (8.8-42.4 mmol/l) in Tyrode solution. This response was extracellular Ca2+ dependent. Verapamil and sodium nitroprusside caused a concentration dependent reduction of the KCl-induced contraction of the reticular groove muscle preparations; their IC50 were 3.9 x 10(-6) mol/l and 1.4 x 10(-4) mol/l, respectively. Pre-incubation with both antagonists (30 min) before KCl addition showed that sodium nitroprusside (10(-6) mol/l) did not affect, but verapamil (10(-6) mol/l) inhibited the KCl response of the muscle preparations. CaCl2 caused a concentration dependent (0.25-7 mmol/l) contraction of the KCl-depolarized muscle strips. Pre-incubation with verapamil (10(-6) mol/l) and sodium nitroprusside (10(-6) mol/l) before CaCl2 addition inhibited the response for about 80% and 20% respectively. These results indicate that action of verapamil may be related to voltage-dependent channel blockade. However, the nitroprusside action could not be completely attributed to these channels.

Animals↗

PubMedDate not supplied

In vitro susceptibility of 545 isolates of Candida spp. to four antifungal agents.

The in vitro susceptibility to amphotericin B, fluconazole, itraconazole and ketoconazole of 545 Candida strains from patients treated at the University Hospital of the Canaries was determined by means of a microdilution test. The distribution of the species was as follows: Candida albicans (342), Candida tropicalis (70), Candida glabrata (68), Candida parapsilosis (65). Of Candida albicans isolates, 8.5% and 7.6% showed resistance to itraconazole and fluconazole respectively. Of C. tropicalis isolates 34.3%, 27.1% and 2.9% were resistant to itraconazole, fluconazole and ketaconazole respectively. For C. glabrata, 10.3% and 4.4% of the isolates under study demonstrated resistance to fluconazole and itraconazole respectively. Only 4.6% and 1.5% of C. parapsilosis isolates demonstrated resistance to fluconazole and itraconazole respectively. C. tropicalis was the most resistant strain and C. parapsilosis the most sensitive. The greatest percentages of resistance in vitro were seen with the triazoles.

Amphotericin B↗

PubMedDate not supplied

Candida glabrata: in vitro susceptibility of 84 isolates to eight antifungal agents.

The in vitro susceptibility of 84 isolates of Candida glabrata from patients treated at the University Hospital of the Canary islands to eight antifungal agents (amphotericin B, itraconazole, fluconazole, miconazole, clotrimazole, tioconazole and econazole) has been studied using the broth dilution micro-method. Among the eight antifungal agents tested, the smaller geometric mean corresponded to tioconazole, econazole, clotrimazole and miconazole. In contrast with fluconazole, a greater geometric mean has been achieved. All the C. glabrata isolates tested were sensitive to concentrations of 3.125 micrograms/ml of clotrimazole and miconazole, 6.25 micrograms/ml of amphotericin and ketoconazole. Concentrations of 12.5 micrograms/ml were needed to obtain 100% inhibition of isolates for econazole and tioconazole and concentrations of 25 and 50 micrograms/ml, respectively for itraconazole and fluconazole. Among our C. glabrata isolates, 2.4% were found to be resistant to amphotericin B. For fluconazole and itraconazole, 19.1% and 7.9% of isolates, respectively, were resistant. With reference to imidazoles, we obtained 2.4% and 3.6% resistance for tioconazole and econazole, respectively. No isolates were found to be resistant to ketoconazole, miconazole and clotrimazole. The results have shown a high activity of amphotericin B and itraconazole, observing a similar response with the five imidazole antifungals tested. The highest rate of resistance was found when fluconazole was used.

Antifungal Agents↗

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[Continuous quality improvement in the control of the type2 diabetes in Navarra. GEDAPSNA study 1996].

Diabetes mellitus type 2 constitutes one of the principal public health problems today, representing an important burden on care and involving extremely high economic costs, both direct and indirect. To provide an adequate response from the different public health systems, the St. Vincent Declaration was drawn up containing certain recommendations on the protocol of care and the carrying out of controls of continuous quality improvement, since it is a chronic pathology that requires a proactive health policy, which prevents, and provides early detection of its complications. In the present work we set out the results of the first study carried out in Navarra on the indicators of quality in the care provided to diabetics in Primary Health care, carried out by the Study Group on Diabetes Mellitus in Primary Care (GEDAPSNA). The study was made of an aleatory sample of 496 patients, by means of gathering data about their clinical records for the year 1996. 12 process indicators and 12 indicators of intermediate and final results were used. The results detect some important deficiencies that require early intervention: lack of exploration and management of the lesions that make up so-called diabetic foot; low achievement of results in the control of arterial hypertension in this group of patients; and absence of exploration of the lesions of the fundus of the eye in more than 50% of type 2 diabetics.

English Abstract↗

PubMedDate not supplied

[Peritoneal pseudomyxoma].

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Journal Article↗

PubMedDate not supplied

[A comparison of clinical and angiographic outcome after implantation of a Wiktor stent in large and small coronary arteries].

UNLABELLED: The objective of this study was to investigate the mid term influence of vessel size in clinical and angiographic outcome, after Wiktor stent implantation in arteries larger and smaller than 3 mm. METHOD: A total of 188 stents were implanted in 167 patients divided in two groups. Group 1: stents implanted in arteries smaller than 3 mm, 40 stents in 38 patients. Group 2: in arteries larger than 3 mm. 148 stents in 129 patients. Clinical follow up and a repeated coronary angiographic study were carried out after six months. RESULTS: Angiographic success was achieved in 97% and 98% cases, with clinical success in 92% and 95% respectively. Acute occlusion occurred in 2 patients of group 1 (5%), and in four patients in group 2 (2.7%); one patient died and four patients suffered a non-fatal myocardial infarction. During clinical follow up, nine patients presented a major complication, two in group 1 and seven in group 2 (5.5% vs. 5.6%). Asymptomatic survival was 86% and 84% respectively. In angiographic follow up we observed a restenosis rate of 41% of the patients in group 1 and 25% of those in group 2. Immediate gain was similar in both groups, but late loss (1.06 +/- 0.85 vs 0.97 +/- 0.86) and loss rate (0.60 vs 0.46) were greater in group 1. CONCLUSION: The frequency of stent thrombosis as well as the incidence of restenosis were higher in arteries smaller than 3 mm. No differences were observed in the incidence of major ischemic events.

Aged↗

PubMedDate not supplied

[Hereditary thrombocytopathic thrombocytopenia. Report of 2 cases transmitted with dominant character].

Hereditary thrombocytopathic thrombocytopenia is reported in a family (mother and son) and is transmitted with dominant character of moderate to severe intensity (platelets fluctuated from less than 5,000 per mm-3 to 20,000 with sporadic higher rises), normal survivorhship, larger than normal diameter and abnormal platelet 3 factor. Comments are made on its resemblance to idiopathic thrombocytopenic purpura and stress is placed on the importance of its identification through the decision of splenectomy with negative results in these patients.

Autopsy↗