Low CYP1A2 activity in rural Shona children of Zimbabwe.

Caffeine is increasingly used as a biochemical probe for liver function, in cancer epidemiology, and in pharmacogenetics, with its recognized ability to assess the activities of CYP1A2, xanthine oxidase, and N-acetyltransferase-2. The activity of these hepatic enzymes was tested in 45 Shona children from a rural area of Zimbabwe with use of caffeine as a probe. Many of these rural black children had lower indexes of CYP1A2 activity than otherwise on our extensive records; the average value (3.78 +/- 2.9) was significantly (p < 0.001) lower than that of healthy white urban children from Zimbabwe (8.86 +/- 3.36) or from Canada (7.92 +/- 1.88), or that of healthy Canadian adults (5.96 +/- 2.4). A higher CYP1A2 activity in children than in adults is usual. The low CYP1A2 activity of the children from rural Zimbabwe calls for medical studies and suggests a widespread and perhaps serious impairment of certain liver functions. Causes could be parasitic infections with Schistosoma mansoni, causing schistosomiasis, which are endemic, in addition to generally poor nutrition and frequent iodine deficiency. By contrast, the xanthine oxidase activity in rural Shona children was slightly higher than that reported for a healthy Canadian adult population. The N-acetyltransferase activities were comparable in both the rural and urban children and were also similar to those reported in a population study of healthy adult Canadians.

[Primary care for diabetic patients: a quality improvement cycle]. / Evaluación de la calidad en cuidados médicos prestados a pacientes diabéticos: un ciclo de mejora.

OBJECTIVE: The aim of this study was to evaluate and improve the quality of medical care provided to diabetic patients following the standards proposed by the American Diabetes Association. MATERIAL AND METHODS: The study was conducted in three phases by analyzing data from the computerized clinical history of a sample of 340 patients. First phase (2010): cross-sectional, descriptive study which assessed the proportion of patients who met the standards related to the screening of diabetes, and goals of control and treatment. Subsequently, health professionals reviewed the results in order to promote the implementation of corrective action. Finally (2012), a new assessment with the same standards was performed. RESULTS: An increase in the number of patients treated with insulin (12.7% in 2010 and 20.2% in 2012) was observed (P < .01). There were also percentage increases in the number of patients who met the screening standards as regards analytical determinations: glycosylated hemoglobin (from 44.4% to 68.2%), lipid profile (47.6%-73.8%), creatinine (32.5% - 73.5%), and albumin-creatinine ratio (9.2%-24.4%) (P < .001). Only 6.4% (CI: 3.2- 9.8) of diabetic patients attained the composite target of glycosylated hemoglobin < 7%, blood pressure < 130/80 mmHg and low-density lipoprotein cholesterol < 100 mg/dl in 2012. CONCLUSIONS: This study shows that medical care has improved the goals related to analytical determinations and the number of insulin-treated diabetic type 2 patients. An optimal level was also maintained in metabolic control of diabetes, but there was still poor control of risk factors for cardiovascular disease.

Effect of Paxirasol aerosol on the clinical condition and objective functional respiratory parameters of obstructive respiratory tract disease patients.

Paxirasol aerosol applied in daily 3 x 5-puff doses was well tolerated by the examined patients. In the course of the 21-day therapy the laboratory findings did not change-haemopoetic or liver injury was not observed. On two-thirds of the patients the amount of sputum decreased in response to Paxirasol aerosol but the symptoms accompanying expectoration did not change notably. Among the objective respiratory parameters FEV1 values increased and Rtot values decreased. These changes may be observed during the first third of therapy. There was a continuous and linear increase in FEV values characteristic of respiratory pressure conditions. This phenomenon is not characteristic alone of the changes of values of obstructive diseases patients. The authors recommend the use of Paxirasol aerosol for the treatment of respiratory tract disease patients.

Studies on the Synthesis of Morphine VI*.

Experiments to find a biomimetic route for synthesizing morphine are summarized. Systematic investigations on the phenolic oxidative coupling have been revised and evaluated.