[Plasma concentrations of beta-endorphins in the children of alcoholic patients]. / Niveles de beta-endorfinas en hijos de padres alcohólicos.

BACKGROUND: Of the factors identified in different studies as the possible causes of alcoholism, heredity appears to be the most important. However, environmental factors can increase or decrease the risk of an individual developing alcohol dependence. METHOD: To clarify the possible influence of heredity on alcoholism, we studied the plasma concentration of beta-endorphins in 25 families with alcoholic members: 27 children whose father was alcoholic and 7 whose father and mother were both alcoholics. The results were compared with finding in an age-matched control group of no-drinking adults and normal children in non-drinking families. RESULTS: The children of alcoholic parents had significantly lower beta-endorphin levels (p < 0.001) than control individuals, and concentrations were especially low when both parents were alcoholics. CONCLUSION: We conclude that plasma beta-endorphin concentration may have predictive value in identifying persons likely to become alcoholics.

[Splenic abscess: a case report and review of the literature]. / Absceso esplénico: presentación de un caso y revisión de la literatura.

A patients with multiple splenic abscesses of fungal origin ist presented. It is a unusual pathology that generally, only by postmortem ist diagnosed. The etiology, clinical features, diagnostic methods and therapeutic measures are discussed, and the necessity of early and accurate diagnostic and treatment. The prognosis of the splenic abscess is still associated with a high mortality.

Increased peripheral mononuclear cells expression of adhesion molecules in alcoholic cirrhosis: its relation to immune activation.

BACKGROUND/AIMS: Cell adhesion phenomena are relevant in the immune mechanisms leading to organ damage in various diseases. Patients with alcoholic cirrhosis present with immune alterations that include findings of immunodeficiency and indications of an activated immune response. METHODS: In 37 patients with alcoholic cirrhosis we have determined the expression of surface antigens and adhesion molecules on peripheral lymphocytes and monocytes, serum levels of immunoglobulins, circulating cytokines, namely tumor necrosis factor-alpha, interleukin-6, and interleukin-1 beta, serum soluble intercellular adhesion molecule and neopterin. RESULTS: In patients, we found an increased expression of several adhesion molecules ICAM-1, LFA-3 and MAC-1 in lymphocytes, LFA-3 in monocytes and surface activation markers CD71 and DR in lymphocytes, as well as increased concentrations of the serum parameters measured: IgA, IgG, IgM, interleukin-1 beta, interleukin-6, tumor necrosis factor-alpha, soluble ICAM-1 and neopterin, in comparison with controls. CONCLUSIONS: The enhancement of the adhesion phenomena in circulating mononuclear cells of patients with cirrhosis correlates to the severity of the disease and is related to other parameters of immune activation.

[Pleuropericarditis as the only manifestation of Legionella pneumophila infection]. / Pleuropericarditis como manifestación única de infección por Legionella pneumophila.

Pleural effusion caused by Legionella is seen fairly frequently but is hardly ever of great clinical significance. Pericardial involvement has been described only rarely. We present a case of pleuropericarditis as the only sign of infection by Legionella pneumophila in a 66-years-old man with no prior history of disease. The patient came to the hospital with chest pain suggestive of pleurisy, low-grade fever, dry cough and dyspnea. The etiology was not suspected and the diagnosis was made retrospectively based on indirect immunofluorescence. After 3 weeks of treatment with high dose of erythromycin the patient recovered and remains asymptomatic to date. We conclude that infection by Legionella pneumophila should be suspected in patients with pleurisy or pericarditis of unknown cause.

[A retrospective study of alcoholism at the Hospital Universitario de Granada. II. The reasons for admission and associated pathology in these patients]. / Estudio retrospectivo del etilismo en el Hospital Universitario de Granada. II. Causas de ingreso y patología asociada en estos pacientes.

In a retrospective study conducted from 1985 to 1990, the cause of hospitalization and associated pathology of 221 chronic ethylics were investigated. The most frequent cause of hospitalization was neuropsychiatric, followed by digestive pathology. With respect to the most frequent associated pathology, it was mainly digestive, causing multiple hospitalizations in most of the patients. The respiratory, cardiocirculatory and endocrine-metabolic pathologies followed in the frequency rank in these patients, as well as the traumatisms resulting from the ebrietas condition. We also observed gynecological and neonatal pathologies among the alcoholic women. The association of alcohol, tobacco and analgesics and psychodrugs consumption deserves also to be mentioned.

[Lyme disease: a multisystemic condition]. / Enfermedad de Lyme: una afección multisistémica.

While Lyme's Disease is clinically well known since 1920, its complete ascertainment and its etiological agent, as well as the details of its transmission mechanisms and multisystemic clinical manifestations (mainly dermatological, cardiac, neurological and articular) have been only recently known. In Spain, the number of papers published on this affection has increased lately, although its understanding is still not as generalized as it should be. This review focuses mainly on our country's experience, as well as on its clinical characteristics. We think that it is a very important affection, since its estimated incidence is 500 cases per year, a significant figure compared to other European countries.

[A retrospective study of alcoholism at the Hospital Universitario de Granada (1): the sociodemographic and clinical characteristics]. / Estudio retrospectivo del etilismo en el Hospital Universitario de Granada (1): Características sociodemográficas y clínicas.

This work offers the results of a retrospective study carried out on 856 patients diagnosed as suffering from alcoholism and/or other alcohol-related illnesses over 120456 who were admitted at the Granada University Hospital over the period 1985-1990. The patients have been classified in a distribution according to various factors, including age, sex, place of residence, profession and hospital admittance and discharge procedure. We have also taken into account both annual and accumulated incidence, as well as the distribution of those patients in the different hospital services and the evolution of the global average hospital stay. We then offer a study contrasting our results with other national and international studies, taking into account elements such as conceptual diversity and similarities and differences in methodology.

[Dehydroepiandrosterone sulfate and lipids in acute myocardial infarct]. / Dehidroepiandrosterona-sulfato y lípidos en el infarto agudo de miocardio.

To establish the possible relationship between acute myocardial infarction (AMI) and dehydroepiandrosterone-sulfate (DHEA-S) in a group of 15 patients with AMI, blood levels of DHEA-S and certain lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides) were determined at admission in the hospital and after 10 days. As controls a group of healthy individuals or with minor diseases, and a group of 24 severely ill non-cardioischaemic patients have been studied. DHEA-S and HDL-cholesterol levels have been found significantly lowered both in patients with AMI (at 10th day) as well as in the severely ill non-cardioischaemic patients, in comparison with the healthy volunteers group. We conclude, then, than the lowering in DHEA-S and HDL-cholesterol seems not to be specifically relates with AMI but has a certain relationship with severe disorders in general.

[Hematological, biochemical and electroneurophysiological changes in asymptomatic drinkers: a sensitivity study]. / Alteraciones hematológicas, bioquímicas y electroneurofisiológicas en sujetos bebedores asintomáticos: estudio de su sensibilidad.

An electro-neuro-physiological, biochemical and hematological study was carried out in 3 groups of non-symptomatic drinkers: those in group A had a daily alcohol intake of less than 40 grams of alcohol; group B had a daily intake of between 40 and 80 grams of alcohol and those in group C had an intake greater than 80 grams of alcohol per day. The aim of this study was to demonstrate that all the parameters evaluated show quicker alterations when the intake of ethanol is chronic. Electroneuro-physiological parameters were less sensitive than the following indexes: VCM, GGT, GOT, GPT. However, in 50.9% of the patients there were changes in conduction speed, which is an important point to take into account when making a therapeutic decision.

[Derivatives of pro-opiomelanocortin (ACTH and beta-endorphin) in chronic alcoholics]. / Derivados de la pro-opiomelanocortina (ACTH y beta-endorfina) en alcohólicos crónicos.

The plasmatic concentration of beta-endorphins and ACTH were measured in 31 alcoholic patients and in a control group (N = 16), to test the possible relation between chronic alcohol intake and propiomelanocortin production. There were found a decrease of beta-endorphins plasmatic levels in chronic alcoholic group, apart of clinical manifestations or abstinence period (one month maximum). This decrease can be cause by the chronic alcohol intake, and can be mediated by the tetrahydroisoquinolines (TIQs) or otherwise be the cause and not the consequence of alcoholism. The global plasmatic levels of ACTH were decreased but it was significant in the subgroup of alcoholics with liver disfunction, mental illness and those who carry on drinking.

[Evaluation of nutritional status in patients admitted to an internal medicine department. Study of 100 cases]. / Valoración del estado nutricional en pacientes ingresados en un servicio de Medicina Interna. Estudio de 100 casos.

We have confirmed that malnutrition is very frequent in hospitalized patients. There is no agreement about which are the indexes or criteria agreement about which are the indexes or criteria that can be used to define malnutrition, specially in early stages. In the present work, we have studied 100 patients randomly chosen amongst the admissions that occurred in the Internal Medicine Department over a period of one year. The patients were submitted to a protocol which included the following: anthropometric measurements, seric proteins and routine determinations (sugar level, cholesterol, uric acid, etc.) It has been considered as malnourished those patients who presented some marker with a value lower than 90% of the standard value. According to these criteria, 25 of them had a caloric-protein malnutrition, 24 had a proteic malnutrition and 25 of them had mixed malnutrition. The most sensible parameters had been the triceps skin fold and retinal transporting protein.

[Dehydroepiandrosterone sulfate, cortisol and their precursors in severely ill (acute and chronic) patients]. / Dehidroepiandrosterona-sulfato, cortisol y sus precursores en enfermos graves (agudos y crónicos).

This study tries to evaluate the interrelationship amongst certain corticoadrenal hormones (Dehydroepiandrosterones-Sulphate (DHEA-S), progesterone, 17-OH progesterone and cortisol) in male patients with severe organic processes (24 chronic and 22 acutely ill) and comparing them with a control group of 15 healthy male subjects or suffering mild processes. Corticoadrenal hormone behaviour in the presence of a severe disease show marked differences between the androgenic and the glucocorticoid pathways. While DHE-S shows a significant decrease in severe disease, independently of the underlying disease (acute or chronic), the contrary occurs with the glucocorticoid pathway, in which cortisol and specially its precursors, progesterone and 17-OH-progesterone, predominantly present in the acute situation, normal or significantly increased levels. These differences between the two adrenal pathways suggest that apart from ACTH there must be another regulatory mechanism of the androgenic pathway which may facilitate the androgenic adaptation to the situation of severe disease.

[The neurophysiological study of diabetic polyneuritis. Apropos 100 cases]. / Estudio neurofisiológico en la polineuritis diabética. A propósito de 100 casos.

Alterations in nervous transmission might be an early feature of diabetic peripheral polyneuropathy, even in the subclinical stage. We performed a study on 100 diabetic patients. Those with possible endogenous or exogenous causes of neuropathy were not included. We studied the motor distal latency of right peroneal and cubital nerve and the sensory distal latency of median nerve by the use of electromyogram. The neuropathy incidence was 34.3%. One of the results was that conduction in males was slower than in the female control group; this disappeared in diabetic patients.

Plasma beta-endorphin levels in chronic alcoholics.

In order to test the possible relationship between the chronic consumption of alcohol and the opioid system, we have measured the plasma levels of beta-endorphin in a group of 31 alcoholic patients and compared the results with those of a control group of 16 subjects. Our results show that chronic consumption of alcohol induces a significant decrease in beta-endorphin (beta-end) plasma levels regardless of either the disease suffered by the alcoholic patient or of the time of abstinence studied (one month maximum). Thus we believe that the beta-end decrease may well be due to the patients' alcoholism and that it might be mediated by the tetrahydroisoquinoline system, or be a cause of alcoholism rather than a consequence.

[Cerebral atrophy in chronic alcoholism]. / Atrofia cerebral en el alcoholismo crónico.

The brain's morphologic changes induced by chronic abuse of ethanol are studied, using the computerized tomography (CT) of 1005 clinical records reviewed during 1982-1987 at "Hospital Universitario de Granada", only 33 were selected as patients suffering from chronic alcoholism, CTs having been performed. The results were compared with 33 CTs of non-drinking patients. The ventricular index (VI), the evans' index (EI), the transversal diameter of third ventricle (TD) and cerebral sulcus evaluation were the values analysed to estimate the degree of cerebral atrophy. It was proven that a significant decrease of VI, an increase of EI, TD and cerebral sulcus in chronic alcoholic patients exists compared to non-drinkers. 70% of the alcoholic patients had cerebral atrophy. The conclusion of this study is that chronic alcoholism is an important causal factors of the cerebral atrophy process, regardless of age, alcohol intake quantity and/or the existence of other associate pathology.