Biochemical markers of bone remodeling and bone sialoprotein in ankylosing spondylitis.

The aim of this work was to determine bone mineral density (BMD) in a group of patients with ankylosing spondylitis (AS) and to study alterations in bone remodeling in these patients. Eighteen patients (16 males and two females) with AS, mean age 44.7, range 21-75, and 18 age- and sex-matched healthy controls were studied. BMD was evaluated by dual energy X-ray absorptiometry. The following biochemical markers of bone remodeling were studied: formation - serum amino and carboxyterminal propeptides of procollagen I (PINP and PICP); resorption - urinary total and free deoxypyridinoline and pyridinoline (TDpyr, FDpyr, TPyr and FPyr), crosslinked aminoterminal telopeptides of collagen I (NTX), carboxyterminal telopeptide of collagen I (CTX) and serum bone sialoprotein (BSP). Receiver operating characteristic (ROC) curves of markers were also performed. We found a decrease of bone mass and an increase in TPyr, FPyr, TDpyr, FDpyr, NTX and BSP in AS, but no significant differences were found in PICP, PINP and CTX. FDpyr, FPyr and TPyr showed the highest discrimination between patients and controls according to the results of the ROC curves. TPyr/TDpyr was higher in AS than in controls. We found osteopenia, with a normal formation and a significant increase in bone resorption in AS. FDpyr, FPyr and TPyr seem to present the best sensitivity for the study of alterations of bone resorption in this pathology, although NTX, TDpyr and BSP also show significant differences. The elevation in the ratio TPyr/TDpyr in AS compared to controls indicates that in AS there is a type I-collagen degradation in tissues different from bone.

[Primary actinomycosis of the abdominal wall. Description of 2 cases and review of the literature]. / Actinomicosis primaria de la pared abdominal. Descripción de dos casos y revisión de la literatura.

We report two cases of isolated abdominal wall actinomycosis and review 18 previously reported cases to further characterize the clinical findings and the therapeutic management of this syndrome. This diagnosis would be advocated in patients with a palpable abdominal mass of subacute appearance with a previous history of digestive medical illness, diabetes, abdominal surgery, or prolonged IUD use. In contrast with other actinomycosis locations, remarkable data were a more elevated mean age of patients; a female predominance; a prevalent location of mass in abdominal lower left quadrant; and a shorter duration of symptomatology before to diagnosis. The CT is the first choice for imaging study and percutaneous needle aspiration would be recommended for definite diagnosis. The long-term antibiotic therapy, with or without percutaneous drainage, is the first treatment choice because is very effective and made unnecessary a more invasive surgical management. The prognosis is excellent with adequated treatment.

Nucleotide sequence of the rhaR-sodA interval specifying rhaT in Escherichia coli.

The precise location of the rhaT gene, encoding rhamnose permease, has been established between sodA and rhaC at 3605-3607 kb of Kohara's physical map, which corresponds to 88.4 min on the Escherichia coli chromosomal map. The dependence of the activity of the rhaT product on the function of rhaC, the rhamnose operon regulatory gene, was established by measuring rhamnose transport in wild-type and rhaC-deficient strains. The sequence of the sodA-rhaC interval displayed a single ORF corresponding to rhaT, which is transcribed counterclockwise on the E. coli chromosome. The ORF was shown to be preceded by a ribosome binding consensus sequence and a catabolite repression protein consensus sequence. The derived amino acid sequence displayed very low homology with any other permease and was clearly dissimilar to the homologous group formed by the xylose, arabinose, galactose and several glucose transporters. Analysis of the rhaT primary sequence identified potential membrane-spanning regions, possibly defining a protein structure model different from the one corresponding to the above-mentioned homologous group.

Hepatic infarction in a pregnant patient with the 'primary' antiphospholipid syndrome.

We describe a patient with previous venous thrombosis while using oral contraceptives and recurrent pregnancy loss, who presented with massive hepatic infarction in the last trimester of the fourth gestation. Thrombocytopenia, the lupus anticoagulant (LA) and the anticardiolipin antibody (aCL) were detected and a diagnosis of a 'primary' antiphospholipid syndrome (APS) was made. The clinical and histological manifestations and the differential diagnosis, especially with DIC and pre-eclampsia, are discussed.

[Incidence and characteristics of Q fever in a community habitat]. / Incidencia y características de la fiebre Q en un hábitat comarcal.

Q fever is more common in our country than is usually thought, as shown by the diagnostic incidence curve, which approached an exponential rather than lineal function. Sixty cases were diagnosed between 1985 and October 1989. The disease predominated in middle aged males. The suspect epidemiologic contacts did not have any significance. Q fever was more frequent during autumn. Its usual clinical presentation was pneumonia (75%), commonly associated with a flu-like syndrome. Liver was commonly involved (66.6%), although in a mild degree. One of the patients had chronic Q fever, with granulomatous and hepatic, but not endocardial, involvement. The diagnosis was based on seroconversion detected by indirect immunofluorescence. As a rule, the course of the disease was favorable independently from therapy.