[LH-FSH ratio and Polycystic Ovary Syndrome: A forgotten test?]. / Proporción LH-FSH y síndrome de ovario poliquístico: ¿prueba olvidada o no útil?

OBJECTIVE: To identify the predictive value of LH-FSH ratio in the Polycystic Ovary Syndrome diagnosis and to evaluate its role according PCOS phenotypes. MATERIAL AND METHOD: A descriptive, comparative, observational, prospective study of PCOS patients and its controls. All participants received a questionnaire and underwent a physical and transvaginal ultrasound examination. Blood samples were also collected for analysis of metabolic markers and hormones. PCOS was diagnosed according to Rotterdam criteria. RESULTS: A total of 267 women were included into the study. PCOS was diagnosed in 162 patients. There was statistical difference in: HOMA, 1.43 ± 1.06, 2.09 ± 1.96; Total Testosterone, 0.31 ± 0.14, 0.41 ± 0.19; and free Androgen index, 1.17 ± 1.30, 1.69 ± 1.18; for control and PCOS group, respectively. FSH, 6.55 ± 2.43 in controls and 5.30 ± 1.66 in PCOS patients (p = 0.001); LH, 4.34 ± 2.12 controls, 6.36 ± 4.61 PCOS patients (p = 0.001). LH-FSH ratio was 0.71 ± 0.39 for control group and 1.25 ± 0.85 in PCOS group, p = 0.001. A correlation was observed between LH-FSH ratio and total antral follicle count (p < 0.001) and with insulin resistance (p = 0.022). CONCLUSION: LH-FSH ratio, although it is a valuable test, it is not diagnostic of PCOS. A correlation was found with LH-FSH ratio and insulin resistance but we must not forget about its association with hyperandrogenism.

Management of strabismus related to infantile glaucoma: Case series.

OBJECTIVE: To evaluate the different modalities of treatment of the strabismus related to infantile glaucoma, its complications, and results. METHODS: The clinical history of 7 patients with infantile glaucoma which required strabismus surgical treatment were analyzed. Age at onset of glaucoma, type of glaucoma, glaucoma surgeries, type of strabismus, strabismus surgical treatment and postoperative results were studied. RESULTS: Four patients required strabismus surgery, two were treated with botulinum toxin and one required both. Primary congenital glaucoma was the most common (71,42%), 14,28% had an anterior segment dysgenesis and 14,28% had secondary glaucoma. Regarding strabismus, 4 patients had exotropia and 3 had esotropia. The main difficulty involved the management of the conjunctiva and the filtering blebs. CONCLUSION: Strabismus is a frequent complication in infantile glaucoma. The management of these patients should be individualized. In our case series, treatment of strabismus improved eye alignment. Surgery should be the mainstay of treatment while preserving the conjunctiva and interfere the less with glaucoma surgeries. Botulinum toxin is a reasonable option when conservative treatment is needed.

Correlation study in the measurements of oblique passive ductions and cyclorotation. / Estudio de correlación en las medidas de ducciones pasivas oblicuas y de ciclorrotación.

PURPOSE: To evaluate intraoserver and inteobserver repeatability of the "exaggerated forced duction test" or "oblique traction test" and the "excyclo and incyclo passive rotation test" or "cyclorotation traction test". METHODS: 44 eyes of 22 patients were evaluated under deep general anesthesia. Passive duction was tested on supraduction and infraduction by the "exaggerated duction test". The limitation on movement was graduated from 0 to - 4. Passive cyclorotation test was evaluated with retropulsion of the globe until the first resistance is noted. We used the Mendez ring and blue dots marked on the limbus to measure the amount of cyclorotation. The results obtained of excyclo and incyclorotation were recorded. All measurements were made in duplicate for each of the two observers. RESULTS: The intraclass correlation of the "oblique traction test" coefficient between the two observers was for the IO was 0,738 (95% confidence interval, 0,62-0,83) and 0,910 for the superior oblique (SO) (95% confidence interval, 0,85-0,94). The "cyclorotation traction test" intraclass correlation coefficient of the between the two observers was 0,827 (95% confidence interval, 0,74-0,89) for exclycloduction and 0,792 (95% confidence interval, 0,67-0,85) for inclycloduction. The percentage of patients within 5° of rotation interobserver was 84,1% for excyclorotation and 81,8% for inclyclorotation. Both tests had better correlation on the intraobserver than interobserver evaluation. CONCLUSIONS: Evaluation of the "oblique traction test" and "cyclorotation traction test" had moderate to good correlation between the two observers and good to excellent on the intraobserver evaluation.

[Spinal granuloma in a patient receiving a spinal infusion of morphine and clonidine]. / Granuloma intradural en un paciente con infusión espinal de morfina y clonidina.

Patients treated with long-term spinal infusion of high doses of morphine develop a granuloma at the location of the catheter tip. Diagnosis is based on a steady increase in intrathecal morphine dosage after a relatively prolonged period of stability, on the gradual development of neurologic signs and symptoms suggesting radicular or spinal cord compression, and on magnetic resonance images. We describe a man with central neuropathic pain after removal of a tumor. The presence of all 3 of the aforementioned diagnostic criteria led to suspicion of a spinal granuloma.

[Efficacy of virtual reality on balance and gait in multiple sclerosis. Systematic review of randomized controlled trials]. / Eficacia de la realidad virtual sobre el equilibrio y la marcha en esclerosis multiple. Revision sistematica de ensayos controlados aleatorizados.

INTRODUCTION: Multiple sclerosis (MS) is a neurodegenerative disease that causes gait abnormalities and a deficit in balance control in the vast majority of people affected by it. Virtual reality has been proposed as a complementary approach to conventional physiotherapeutic treatment as a way of improving these variables. AIM: To assess the real efficacy of this approach compared to other neurorehabilitation therapies, or no intervention, in MS. PATIENTS AND METHODS: A systematic review of randomized controlled trials was conducted. Studies of the last five years that compare virtual reality with conventional treatment or no intervention, on balance and/or gait, in adults with MS, were included. PEDro scale was used to assess methodological quality and the Oxford scale to determine the level of evidence and grades of recommendations. RESULTS: Eight studies met the eligibility criteria. For balance, the efficacy of virtual reality is, at least, comparable as conventional training. For gait, virtual reality seems not to be superior in improving the speed, compared with the other types of interventions assessed. Methodological quality of studies was low-moderate. CONCLUSIONS: Virtual reality is as effective as conventional training for improving balance in people with MS. No data suggests that virtual reality is superior to other interventions in improving gait speed. For other gait parameters, virtual reality's efficacy remains unknown.

TITLE: Eficacia de la realidad virtual sobre el equilibrio y la marcha en esclerosis multiple. Revision sistematica de ensayos controlados aleatorizados.Introduccion. La esclerosis multiple (EM) es una enfermedad neurodegenerativa que produce alteraciones en el equilibrio y la marcha en la mayoria de los pacientes. La realidad virtual se ha propuesto como un abordaje complementario al tratamiento rehabilitador convencional como medio para mejorar dichas alteraciones. Objetivo. Evaluar la eficacia del abordaje mediante realidad virtual, en comparacion con otras intervenciones de neurorrehabilitacion o la no intervencion, en la EM. Pacientes y metodos. Se realiza una revision sistematica de ensayos controlados aleatorizados. Se incluyeron estudios de los ultimos cinco años que comparasen la intervencion de realidad virtual frente al tratamiento convencional o la no intervencion sobre el equilibrio y la marcha en personas adultas con EM. Se utilizo la escala PEDro para evaluar la calidad metodologica de los estudios incluidos y la escala de Oxford para evaluar el nivel de evidencia y el grado de recomendacion. Resultados. Ocho estudios cumplieron los criterios de elegibilidad. Para el equilibrio, la eficacia de la realidad virtual es, al menos, comparable a la del entrenamiento convencional. Para la marcha, la realidad virtual parece no ser superior en el parametro velocidad, en comparacion con el resto de intervenciones evaluadas. La calidad metodologica de los estudios fue moderada-baja. Conclusiones. La realidad virtual es igual de eficaz que el entrenamiento rehabilitador convencional para mejorar el equilibrio en personas con EM. No se han hallado datos que sugieran que la realidad virtual sea superior a otras intervenciones en la mejora de la velocidad de la marcha, y su eficacia sobre otros parametros de la marcha es aun incierta.

Liver Transplantation in Patients With Hepatocellular Carcinoma Outside the Milan Criteria After Downstaging: Is It Worth It?

BACKGROUND: The outcome of orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) is excellent if it is performed within the Milan criteria (ie, single tumor less than 5 cm or 3 tumors less than 3 cm each one and no macrovascular invasion). However, after a few studies, it has become possible to have a similar survival expanding those criteria. The aim of this study is to evaluate the survival of patients with advanced HCC who, after downstaging, did not met the Milan criteria although they were within the "up to seven" benchmark, and were transplanted at our center in the last 5 years. PATIENTS AND METHODS: This is a retrospective study of patients who underwent OLT for HCC in the last 5 years in our center exceeding Milan criteria despite remaining within the "up to seven" benchmark. An observational study of associated factors with overall survival based on patient characteristics after OLT was performed. For the statistical study, the statistical program SPSS v. 17.0 (Chicago, Illinois, United States) was used. RESULTS: We studied 95 patients who had been transplanted for HCC in this period, 11 of whom met the study requirements. There were 10 (91%) males and 1 female. The mean age of the patients was 54.73 ± 8.75 years, with an average waiting list time of 279 days. Nine patients had a Child A status, with a mean Model for End-stage Liver Disease score of 9.64 (range, 6 to 16). The most frequent etiology of cirrhosis was hepatitis C virus infection in 6 patients (50%) followed by hepatitis B virus infection and ethanolic and cryptogenic cirrhosis. Ten patients (91%) had at least one pretransplantation transarterial chemoembolization. The survival of patients after 1 year was 75%, whereas after 4 years that rate decreases to 25%. At this time, we do not have any patients with a 5-year survival rate. The longest survival rate is 55 months. CONCLUSIONS: Although the expanded indication of transplantation in HCC raises controversies, especially after downstaging, it is possible to provide acceptable survival rates for patients within the expanded criteria of "up to seven" after locoregional therapies. The performance of a liver transplant in the patient profile shown in this article should also be evaluated from the perspective of the relative lack of organs for transplantation.

Long-term Survival and Evolution of the Kidney Function for Liver Transplant Patients Who Required Postoperative Dialysis.

Patients who underwent orthotopic liver transplantation (OLT) frequently develop chronic kidney disease, with those who present postoperative acute kidney failure and require renal replacement therapy (RRT) at higher risk. The objective of the study was to assess the kidney function and long-term survival of patients who underwent OLT and required RRT during or in the immediate postoperative period. Medical records of OLT and postoperative RRT patients with over 6-month survival were reviewed between January 1, 2005, and December 31, 2015. A variance analysis was carried out for repeated measurements to compare the estimate glomerular filtration rate (eGFR) baseline with the different periods (statistical significance level P < .05). Kaplan-Meier estimator was used to estimate the survival rate. Of 539 patients, 20 (3.7%) met the selection criteria. The basal eGFR at 6 months and 1, 3, 5, and 7 years was 93.41 ± 25, 78.28 ± 33, 73.06 ± 29, 65.96 ± 19, 79.81 ± 28, and 59.06 ± 24 mL/min/1.73 m2, respectively. The comparison of the eGFR baseline within the different periods was statistically significant at 1 year and at 3 years. Four patients died, 3 of them due to sepsis and 1 due to recurrence of hepatitis C virus infection. The average survival was 28 months. The probability of surviving at 1 year was 100%, at 3 years was 84.21% (95% confidence interval: 58.65-94.62), and at 5 and 10 years was 78.6% (95% confidence interval: 52.49-91.39). In conclusion, we have found a progressive worsening of the kidney function in the long term in patients who required postoperative dialysis. However, actuarial survival of these patients was very successful.

Orthotopic Liver Transplantation With Elderly Donors (Over 80 Years of Age): A Prospective Evaluation.

BACKGROUND: Our main objective was to assess the clinical outcomes obtained in a single orthotopic liver transplant (OLT) hospital with donors ≥80 years of age compared to a control group of patients subjected to OLT during the same period of time with donors who were under 65 years of age. METHODS: A prospective analysis was carried out on all the OLTs performed using liver grafts from donors in a state of brain death and with an age of ≥80 years (study group) between April 2007 and January 2015. The results of the study group (n = 36) were compared with those of a control group of patients less than 65 years of age receiving transplants with grafts. RESULTS: A total of 51 potential donors ≥80 years were assessed, with a total of 36 liver transplants being carried out and their results were compared with a control group of 283 patients receiving transplants. The median follow-up time of the patients in the series was 36 months (range: 24-120 months). Graft survival at 1, 2, and 3 years was 77%, 72%, and 62%, respectively, among the patients in the study group and 79%, 73%, and 65% among the patients in the control group, and there were no statistically significant differences. Patient survival at 1, 2, and 3 years was 86%, 82%, and 75%, respectively, among the patients in the study group and 82%, 76%, and 72% among the patients in the control group, also without there being any statistically significant differences. CONCLUSIONS: There is no age limit for liver transplant donors. The use of octogenarian donors makes it possible to increase the pool of donors while providing enough safety for the recipient.

Donors Older Than 75 Years Do Not Influence the Appearance of Biliary Complications After Liver Transplantation.

BACKGROUND: In recent years, several studies have shown that the age of the donor may be related to an increase in the occurrence of biliary complications (BCs), which remain the main cause of morbidity after liver transplantation. This study analyzed the type and management of these BCs, the impact of BCs on graft and patient survival rates, and the influence of some characteristics of donors and recipients on BC appearance in patients transplanted with donors 75 years of age or older. PATIENTS AND METHODS: From 2003 to 2016, 100 liver transplantations with donors 75 years of age or older (15.6%) were performed in our hospital. The data were compared with a control group of 400 patients with younger donors (case-control 1:4 per chronology). RESULTS: The BC rate in the group of patients transplanted with organs from elderly donors was 18%, compared to 21.5% in the control group. Specifically, in the immediate post-transplantation period, 14% of the elderly donor group and 13.8% of the control group presented some BCs, with no statistically significant differences in the incidence, type, and treatment of BCs between the two groups. The occurrence of BCs was not a factor associated with graft and patient survival rates. In the global population, donor death by cerebral vascular accident and male donors have influenced the occurrence of BCs. CONCLUSIONS: The advanced age of the donor has not influenced BC rates after transplantation.

The effect of furanoheliangolides from Tithonia diversifolia on superoxide anion generation in human neutrophils.

Four known lactones were isolated from Tithonia diversifolia: furanoheliangolides 1,3-dihydroxy-3,10-epoxy-8-(-2-methylpropanoyloxy)-germacra-11(13)-ene-6,12-olide (1), 1,3-dihydroxy-3,10-epoxy-8-(2-methylpropanoyloxy)-germacra-4,11(13)-diene-6,12-olide (2), 1,3-dimethoxy-3,10-epoxy-8-(2-methylpropanoyloxy)-germacra-4,11(13)-diene-6,12-olide (3) and, observed in natural source for the first time, furanoheliangolide 1-hydroxy-3-methoxy-3,10-epoxy-8-(2-methylpropanoyloxy)-germacra-4,11(13)-diene-6,12-olide (4). The activity of sesquiterpene lactones on superoxide anion (O(2)(o)(-)) generation from PMA-activated neutrophils was evaluated. Compound 1 did not show a full dose dependent behavior. The IC(100) was 8+/-1, 12+/-1, and 17+/-3 microM for 2 to 4, respectively.

Oncological Evaluation by Positron-emission Tomography, Circulating Tumor Cells and Alpha Fetoprotein in Patients With Hepatocellular Carcinoma on the Waiting List for Liver Transplantation.

INTRODUCTION: The objectives of this study are the determination of the number of circulating tumor cells (CTCs), by means of the IsoFlux enrichment system (Fluxion Biosciences Inc, San Francisco, California, United States) in patients with hepatocellular carcinoma (HCC) in compliance with the Milan criteria and on the waiting list for hepatic transplantation, as well as the study of its relation with the of α-fetoprotein levels (AFP) and positron-emission tomography-computed tomography (PET-CT) findings. PATIENTS AND METHODS: An oncologycal evaluation with PET-CT, CTCs, and AFP was conducted in 24 consecutive patients with HCC eligible for orthotopic liver transplantation according to the Milan criteria. The diagnosis of HCC was made according to clinical, biological, and radiological findings. RESULTS: We detected CTCs in peripheral blood in 21 of 24 patients (87.5%) before liver transplantation, with a mean number CTCs of 156 ± 370 (range, 2 to 1768) with statistically significant association between number of CTCs detected in peripheral blood and the time within the waiting list (P < .05), but not betwen AFP levels and standard uptake value and time to orthotopic liver transplantation (P > .05). CONCLUSIONS: PET-TC, CTCs, and AFP levels could be an essential key for the correct management of the patients with HCC on the waiting list for liver transplantation.

Effects of aspirin or basic amino acids on collagen cross-links and complications in NIDDM.

OBJECTIVE: To determine if long-term therapy with aspirin or basic amino acids for subjects with NIDDM reduces the severity of clinical complications and/or reduces tissue levels of markers of glycooxidative damage. RESEARCH DESIGN AND METHODS: Subjects with NIDDM were administered either aspirin (100 mg/day) or a combination of basic amino acids consisting of L-arginine (2 g/day) plus L-lysine (0.5 g/day) for 1 year. The study was double-blind and placebo-controlled. The presence and severity of retinopathy, nephropathy, and neuropathy were assessed in all subjects at 4-month intervals, as were serum blood glucose, glycohemoglobin levels, and presence of albuminuria. Collagen cross-linking and collagen glycation were measured in skin collagen obtained by biopsy at the beginning and the end of the study. Skin biopsies were also obtained from age-matched control subjects. RESULTS: Skin samples obtained from NIDDM subjects at the beginning of the study had significantly increased levels of glucitolyllysine, pentosidine, and hydroxypyridinium, as compared with age-matched control subjects. Pentosidine levels were significantly correlated with severity of retinopathy and neuropathy, but not nephropathy. Subjects receiving aspirin, but not amino acids or placebo, had significantly decreased levels of skin pentosidine after 1 year of therapy. CONCLUSIONS: It is concluded that 1) low-dose aspirin may reduce glycooxidative damage in people with NIDDM, and 2) treatment may need to continue for more than 1 year before clinical status improves.

Characteristics of bombesin-induced inhibition of intake of ethanol.

The temporal and neural dependencies of the inhibitory effect of the administration of bombesin tetradecapeptide (BBS) on the intake of ethanol were assessed in the water-deprived rat. Variation of the intraperitoneal (i.p.) injection of neuropeptide--5% ethanol access interval (0-20 min), revealed that suppression induced by bombesin (0.5-4.0 micrograms/kg) was significantly greater and more potent at shorter intervals. The intake of ethanol was less in rats with subdiaphragmatic vagotomies, but bombesin equivalently suppressed the intake. Intracerebroventricular injection of bombesin more potently and completely inhibited the intake of ethanol but bombesin injected intraventricularly, unlike that given intraperitoneally, elicited excessive grooming and scratching behavior. The suppressant effect of bombesin, given intraperitoneally, requires close temporal contiguity of administration and caloric solution access, which is consistent with a satiety action of a neuropeptide. This satiation effect to ethanol of peripherally administered bombesin appears to reflect a non-vagal, extra-ventricular neural action.

Antigenic characterization of Plasmodium vivax with monoclonal antibodies.

Monoclonal antibodies were produced against Plasmodium vivax obtained from patients living in southeastern Mexico, where P. vivax malaria is endemic. Nine hybridomas specific for this parasite were obtained. By an indirect immunofluorescence assay, seven antibodies were found to react with epitopes present in the cytoplasm of the infected erythrocyte and two with the parasite itself. By immunoblotting, five monoclonal antibodies reacted with a 17-kD protein band, three with an 85-kD band, and two with one of 45 kD. By immunogold electron microscopy, two antibodies that reacted with the cytoplasm of infected erythrocytes by immunofluorescence also labeled cytoplasmic clefts, and one, in addition, recognized caveola-vesicle complexes and the parasite matrix. These results demonstrate the value of monoclonal antibodies in identifying P. vivax antigens and disclosing their subcellular distribution.

Antibody response to Plasmodium vivax antigens in human malaria.

The present study investigated the serum antibody response to parasite antigens involved in human Plasmodium vivax malaria. Analysis was performed by protein immunoblotting of a pool of P. vivax preparations obtained from blood of patients from Tapachula, Chiapas (southeastern Mexico), and sera from local malarious patients. Patient sera recognized 19 P. vivax antigens with molecular sizes between 17 and 170 kD. The most frequently recognized antigens were proteins of 19, 31, 43, 72, 93, and 97 kD. These proteins could be useful in diagnostic methods and possibly relevant in vaccine design.

Bombesin and litorin inhibit ethanol intake.

Twenty-three hr water-deprived rats received access to 5% ethanol solution for 30 min daily. Intraperitoneal injection of bombesin (4.0-16.0 micrograms/kg) or litorin (16.0 micrograms/kg) significantly inhibited ethanol intake. Litorin (32.0 micrograms/kg) equivalently suppressed the intakes of 5% ethanol and 8.9% dextrose solutions. The results are consistent with previous reports that administration of bombesin-like peptides selectively inhibits caloric intake in the rat. Injection of bombesin-like peptides may affect ethanol and dextrose intake by eliciting a satiety signal that governs caloric intake.

The cutaneous manifestations of violence and poverty.

BACKGROUND: Violence is a public health issue that disproportionately affects the poor. Homelessness, drug abuse, and physical violence are seen with increasing frequency in poor communities. This article reviews the cutaneous manifestations of violence and the dermatologic problems commonly seen in the homeless. Particular emphasis is placed on the experience of municipal hospitals serving the urban poor. OBSERVATIONS: Dermatologic diseases are common in the homeless, and foot-related problems such as cellulitis and pyodermas are frequent causes of hospitalization. Unusual patterns of scarring and bruises in different stages of healing are seen in victims of physical violence. Trauma and sexually transmitted diseases result from sexual abuse. Serious skin infection and self-mutilating scarring are seen in intravenous drug abusers. CONCLUSION: Dermatologists are able to diagnose and treat the many skin problems seen in the poor and to identify the physical manifestations of abuse during routine skin examination. Findings of violence should be documented and reported to the appropriate investigational agencies.

Incidence of alopecia areata in lupus erythematosus.

BACKGROUND: A small percentage of patients with alopecia areata have connective diseases such as systemic lupus erythematosus, discoid lupus erythematosus, rheumatoid arthritis, and scleroderma. Lupus erythematosus is associated with a number of different types of alopecia, but the incidence of alopecia areata in lupus erythematosus has not been examined. OBSERVATIONS: Of our cohort of 39 patients with lupus erythematosus, alopecia areata developed in 10% (four patients), in contrast to 0.42% of general dermatologic patients. Biopsy specimens of alopecia areata lesions in each of our patients showed continuous granular deposition of IgG at the dermoepidermal junction, a finding usually found in only a minority of alopecia areata cases. Intralesional injections of corticosteroids were effective treatment. CONCLUSIONS: The incidence of alopecia areata in patients with lupus erythematosus is increased. Recognition of this form of alopecia allows for specific therapy with intralesional corticosteroids.

Cholecystokinin antagonizes morphine induced hypoactivity and hyperactivity in hamsters.

Three experimental replications were used to test the effects of three doses (25, 50 or 75 micrograms/kg) of cholecystokinin octapeptide (CCK-8) on morphine induced changes in activity. For each dose of CCK-8, running wheel activity of golden Syrian hamsters was monitored for three hours following a series of two injections. The first injection consisted of either saline or CCK-8, the second of either saline or morphine sulfate (15 mg/kg). Thus, in each replication four groups were created: Group SAL/SAL (n = 8) received two saline injections, Group CCK/SAL (n = 8) an injection of CCK-8 followed by an injection of saline, Group SAL/MS (n = 8) an injection of saline followed by an injection of morphine and Group CCK/MS (n = 8) an injection of CCK-8 followed by an injection of morphine. Results indicated that a 25 micrograms/kg dose of CCK-8 blocked the hypoactivity elicited by morphine 40-60 min after opiate injection, whereas a 75 micrograms/kg dose of CCK-8 blocked the hyperactivity elicited by morphine 80-100 min after opiate injection. These findings are consistent with previous reports that CCK-8 antagonizes the effects of opiate agonists on a variety of behaviors and is supportive of the hypothesis that endogenous CCK-8 may antagonize endogenous opioid peptides in the control of behavior.

Bombesin reduces alcohol choice in nutritive expectancy and limited-access procedures.

Bombesin is a bioactive tetradecapeptide found in nerves of the brain and gut and previously shown to inhibit intake of ethanol in forced-choice, one-bottle tests in water-deprived rats. In the present experiments, intraperitoneal bombesin (4-100 micrograms/kg) reduced selection of alcohol in two-bottle choice tests with water. In an application of the "nutritive expectancy" procedure, weight-reduced rats received access to 4% w/v ethanol and water. Bombesin injection suppressed the intake of ethanol, but not of water, in rats with prior ethanol experience. In an application of the "limited access" procedure, nondeprived rats received access to 6% w/v ethanol and water in nonhome cages during either the light or the dark phase of a 12:12 h lighting cycle. Bombesin injection lowered the intake of ethanol, but not of water, in both phases of the lighting cycle and in both sexes. Water deprivation is not necessary for bombesin to inhibit alcohol intake and this effect cannot be explained by hypodipsia, nonspecific debilitation, or conditioned aversion. Endogenous bombesin-like neuropeptides may specifically reduce choice of alcohol by signaling satiation with ethanol.