α-Glucosidase inhibitory phenolics from Echeveria subrigida (B. L. Rob & Seaton) leaves.

Echeveria subrigida is native to Mexico and its methanol extract (ME) shows relevant biological activities for human health, including the α-glucosidase inhibitory (αGI) activity that suggests its antidiabetic potential. Fractionation of the ME based on the αGI activity (IC50 in µg/mL) showed that quercetin-3-O-ß-glucoside (131.1), isorhamnetin-3-O-ß-glucoside (166.4), and dimers to heptamers proanthocyanidins (9.6) were among the main responsible of αGI activity in the ME. The purified compounds showed better activity than acarbose (IC50 = 4426 µg/mL).

Cystinyl and pyroglutamyl-beta-naphthylamide hydrolyzing activities are modified coordinately between hypothalamus, liver and plasma depending on the thyroid status of adult male rats.

The hypothalamus determinates metabolic processes in liver through endocrine and autonomic control. Hypothalamic neuropeptides, such as thyrotropin releasing hormone or vasopressin, have been involved in liver metabolism. The thyroid status influences metabolic processes including liver metabolism in modulating those hypothalamic peptides whose functional status is regulated in part by aminopeptidase activities. In order to obtain data for a possible coordinated interaction between hypothalamus, plasma and liver, of some aminopeptidase activities that may partially reflect the hydrolysis of those peptides, pyroglutamyl- (pGluAP) and cystinyl- (CysAP) beta-naphthylamide hydrolyzing activities were determined fluorimetrically, both in their soluble and membrane-bound forms, in eu- hypo- and hyperthyroid adult male rats. Hyperthyroidism and hypothyroidism were induced with daily subcutaneous injections of tetraiodothyronine (300 µg/kg/day) or with 0.03% methimazole in drinking water for 6 weeks. Results demonstrated significant changes depending on the type of enzyme and the thyroid status. The most striking changes were observed for CysAP in liver where it was reduced in hypothyroidism and increased in hyperthyroidism. Significant intra- and inter-tissue correlations were observed. While there were positive inter-tissue correlations between liver, plasma and hypothalamus in eu-and hypothyroid rats, a negative correlation between hypothalamus and liver was observed in hyperthyroidism. These results suggest the influence of thyroid hormones and an interactive role for these activities in the control of liver metabolism. The present data also suggest a role for CysAP and pGluAP activities in liver function linked to their activities in hypothalamus.

Diferencias de estado nutricional, control metabólico y tratamiento de la diabetes tipo 1 en dos décadas / Changes in nutritional state, metabolic control and treatment of type 1 diabetes in the last 20 years

Objetivo: Describir los cambios en las características antropométricas, control metabólico, tratamiento y prevalencia de sobrepeso en los niños diabéticos en los últimos 20 años. Pacientes y métodos: Estudio observacional retrospectivo de dos grupos de niños diagnosticados de DM1 (n=90) realizado en dos cortes transversales, 1986 y finales del año 2007. Las variables estudiadas fueron: edad, años de DM1, sexo; peso, talla, IMC y sus valores Z; HbA1c, unidades NGSP/DCCT (%) e IFCC (mmol/mol), y el tratamiento con insulina (tipo, número de dosis, U/día y U/kg/día). Resultados: En relación con el grupo de 1986, en el grupo de 2007 hay un incremento significativo (p=0,001) en las variables Z-peso y Z-IMC. Hay una relación negativa entre los años de DM1 y la talla (Z-talla) en el grupo de 1986 (p<0,05). La HbA1c es menor en el grupo 2007 (p=0,001), pero la dosis de insulina (U/día y U/kg/día) es similar en ambos grupos. El número de dosis diarias de insulina es mayor en el grupo 2007 (p<0,001) y predomina el uso de análogos de la insulina. No se encontró una relación estadísticamente significativa entre la HbA1c y el tratamiento insulínico (dosis, número de inyecciones y tipo de insulina). La prevalencia de sobrepeso (14,6% vs 2,4%) es significativamente mayor en el grupo de 2007 (p=0,001). Conclusiones: El control metabólico ha mejorado y el uso de múltiples dosis diarias de insulina se ha convertido en la norma, pero ha aumentado la prevalencia de sobrepeso que puede incrementar el riesgo cardiovascular de los niños diabéticos (AU)

Objective: The aim of this study is to describe changes in anthropometric characteristics, metabolic control, treatment and prevalence of overweight in diabetic children (DM1) from 2007 compared with another similar group from 1986. Patients and methods: Observational retrospective study of two groups of diabetic children (n=90). The collection of variables has been made at two cross-sections, 1986 and 2007. The studied variables were: age, years of DM1, sex, weight, height, BMI (and their Z values), HbA1c and treatment with insulin (type, number of doses, IU/day and IU/kg/day). Results: In 2007 group there is a significant increase in Z-weight and Z-BMI (P=0.001) when compared with the 1986 group. There was a negative relationship between the years with DM1 and Z-height (P=0.05) in the 1986 group. The value of HbA1c was lower in the 2007 group (P=0.001), but the dose of insulin (IU/day and IU/kg/day) was similar in both groups. The number of daily doses of insulin was higher in the 2007 group (P<0.001), the use of insulin analogues dominated overall. A statistically significant relationship between HbA1c and treatment with insulin (dose injections, insulin type) was not found. The prevalence of overweight (14.6% vs 2.4%) was significantly higher in the 2007 Group (P=0.001). Conclusions: The metabolic control (HbA1c) had improved and the use of multiple daily doses of insulin has been become the standard, but the prevalence of overweight has increased. We must monitor the emergence of insulin resistance and cardiovascular risk factors in this sensitive population to prevent early cardiovascular disease (AU)

[Changes in nutritional state, metabolic control and treatment of type 1 diabetes in the last 20 years]. / Diferencias de estado nutricional, control metabólico y tratamiento de la diabetes tipo 1 en dos décadas.

OBJECTIVE: The aim of this study is to describe changes in anthropometric characteristics, metabolic control, treatment and prevalence of overweight in diabetic children (DM1) from 2007 compared with another similar group from 1986. PATIENTS AND METHODS: Observational retrospective study of two groups of diabetic children (n=90). The collection of variables has been made at two cross-sections, 1986 and 2007. The studied variables were: age, years of DM1, sex, weight, height, BMI (and their Z values), HbA(1c) and treatment with insulin (type, number of doses, IU/day and IU/kg/day). RESULTS: In 2007 group there is a significant increase in Z-weight and Z-BMI (P=.001) when compared with the 1986 group. There was a negative relationship between the years with DM1 and Z-height (P=.05) in the 1986 group. The value of HbA(1c) was lower in the 2007 group (P=.001), but the dose of insulin (IU/day and IU/kg/day) was similar in both groups. The number of daily doses of insulin was higher in the 2007 group (P<.001), the use of insulin analogues dominated overall. A statistically significant relationship between HbA(1c) and treatment with insulin (dose injections, insulin type) was not found. The prevalence of overweight (14.6% vs 2.4%) was significantly higher in the 2007 Group (P=.001). CONCLUSIONS: The metabolic control (HbA(1c)) had improved and the use of multiple daily doses of insulin has been become the standard, but the prevalence of overweight has increased. We must monitor the emergence of insulin resistance and cardiovascular risk factors in this sensitive population to prevent early cardiovascular disease.

Relación entre el diagnóstico clínico preoperatorio y el histopatológico posoperatorio, en pacientes con cáncer prostático localizado / Relationship between clinical preoperative diagnosis and postoperative histology in patients with localized prostate cancer

Introducción: Las variables relevantes preoperatorias con que cuenta el urólogo para una toma de decisión frente a un cáncer prostático localizado son: la edad, el tacto rectal, el antígeno prostático específico (APE) e informe histológico de la biopsia por punción con el Gleason. Además se pueden incluir otras variables como el volumen prostático, número de muestras de biopsias positivas, porcentaje de la muestra comprometida, etc. Nosotros quisimos evaluar el grado de concordancia entre el diagnóstico clínico-patológico preoperatorio con el hallazgo histológico, posoperatorio en pacientes prostatectomizados, debido a la implicancia pronóstica y en la toma de decisión que pudiese tener. Material y Método: Se estudiaron retrospectivamente 119 prostatectomías radicales entre marzo de 2004 y junio de 2009. Se consideraron: edad, tacto, antígeno prostático específico (APE) y score de Gleason. Se excluyeron pacientes con tratamiento antiandrogénico u hormonal neoadjuvante. Resultados: En el preoperatorio la mediana de edad fue de 66 años (61-68), de APE 7,35 ng/ml (5,38-11,8) y de Gleason fue de 6 (5-7). El 87,4 por ciento de los pacientes tenía un APE >4,0 ng/ml. El 54 por ciento (n= 64) tenía un estadio clínico T1c y el 46 por ciento (n= 55) un estadio T2. En el posoperatorio 23,5 por ciento (n= 28) tuvo un estadio pT2 y el 74 por ciento (n= 88) un estadio pT3. En pacientes con estadio pT2 el APE preoperatorio fue de 5,9 ng/ml (4,4-9,4), en el estadio pT3 fue de 7,9 ng/ml (5,7-12,8). El score de Gleason en pT2 fue de 5 (5-6), en el pT3 fue de 6 (5-7). No encontramos diferencia de edad en los estadios pT2 (67 años) y pT3 (68 años). Conclusiones: En el estudio histopatológico posoperatorio de pacientes con estadio clínico T1c y T2, se confirmó un estadio pT2 sólo en 23,5 por ciento, el 74 por ciento tenían un estadio pT3 (a, b). En el cáncer prostático localizado, el tacto rectal no fue útil en su correlación con el estadio histológico...

Introduction: Relevant preoperative variables in patients with localized prostate cancer are: age, digital rectal examination (DRE), prostatic specific antigen (PSA) level and Gleason score in the transrectal biopsy. Other variables include prostate volume, number of positive biopsy samples, percentage of involvement in the biopsy, etc. We evaluated the agreement between the preoperative clinico pathologic diagnosis and the postoperative histology report in patients submitted to prostatectomy. Material and method: This is a retrospective review of 119 radical prostatectomies performed between March 2004 and June 2009. We recorded age, DRE, PSA level, and Gleason score. Patients receiving anti-androgenic treatment or neoadjuvant hormonal treatment were excluded. Results: Preoperative findings: median age was 66 years (61-68), median PSA level was 7.35 ng/ml(5.38-11.8) and median Gleason score was 6 (5-7). PSA level >4 ng/ml was found in 87.4 percent of the patients. Clinical stage T1c was found in 54 percent (n=64) of the cases whereas 46 percent (n=55) were stage T2. Postoperative findings: stage pT2 was found in 23.5 percent (n=28) of the patients whereas 74 percent (n =88)were pT3 stage. In pT2 patients, preoperative PSA was 5,9 ng/ml (4.4-9.4). In pT3 patients, PSA was7.9 ng/ml (5.7-12.8). Gleason score in pT2 was 5 (5-6); in pT3 patients, Gleason score was 6 (5-7). No age difference was found between pT2 stage (67 years) and pT3 stage (68 years).Conclusions: Postoperative histology in patients with T1c and T2 stages confirmed a pT2 stage only in 23.5 percent of the cases; 74 percent of the cases were pT3 (a,b) stage. In localized prostate cancer, DRE was not useful for the correlation with pathologic staging, especially for stage pT3 cases. Preoperative Gleason score was relatively useful; we found understaging 36.2 percent of the cases and overstaging 21.8 percent of the patients. These variables should be considered in the initial evaluation of...

Sensorial evaluation of nutritional supplements (PROGRESA) enriched with 3 different forms of iron in a rural Mexican community.

As part of the efforts to reduce iron deficiency anemia (IDA), the Mexican Federal program PROGRESA distributes complementary foods to toddlers and pregnant women living in extreme poverty. Complementary foods were originally fortified with hydrogen-reduced iron, which proved a limited efficacy. The supplement was reformulated to provide higher iron bioavailability. This investigation aims to assess the sensory changes and the acceptance of new versions of the complementary foods fortified with either reduced iron, ferrous fumarate, or ferrous sulfate, stored at room temperature for 2, 4, and 6 mo. Complementary foods were presented without flavor (plain) or flavored with either chocolate or vanilla. The complementary foods were evaluated in toddlers and their mothers using a hedonic scale. The percentage of overall acceptance for the baby foods was higher in toddlers (80% to 88%) than in their mothers (63% to 68%). The complementary foods with a better acceptance were those fortified with reduced iron (63% to 68%) and ferrous fumarate (61% to 80%) independently of the flavoring added. The acceptance of the beverage intended for women was better for those fortified with reduced iron (52% to 63%) or ferrous fumarate (44% to 63%) in their vanilla-flavored version. For women, the most accepted sources of iron were reduced iron (50% to 60%) and ferrous fumarate (50% to 58%).

Pioglitazone protects against thrombosis in a mouse model of obesity and insulin resistance.

BACKGROUND: As arterial thrombosis accounts for the vast majority of cardiovascular complications in obese, insulin resistant patients, we hypothesized that improving insulin sensitivity may be effective in reducing the thrombotic response following vascular injury. OBJECTIVES: We investigated the effect of the thiazolidinedione drug, pioglitazone, on the thrombotic response to injury in obese, insulin resistant mice. METHODS: Insulin-resistant, obesity-prone mice (KK strain) were treated with pioglitazone, placebo, or the sulfonylurea compound, glipizide, for 2.5 weeks and then subjected to photochemical injury of the carotid artery. RESULTS: KK mice have a significant increase in adiposity (7 weeks: 25.6%; 15 weeks: 34.4%; P < 0.0001) and thrombotic tendency (7 weeks: 21.2 +/- 1.9 min; 15 weeks: 13.7 +/- 1.7 min; P < 0.01) with age. Pioglitazone provided significant protection from thrombosis at both time points, prolonging the time to occlusive thrombosis by 40% and 68%, at 7 and 15 weeks of age, respectively (P < 0.05). Similarly, following a diet-challenge to promote diabetes, pioglitazone provided protection from occlusive thrombus formation (Placebo: 11.3 +/- 1.0 min; Pioglitazone: 22.3 +/- 3.9 min; P < 0.05). However, despite a salient effect of glipizide on the hyperglycemia of the mice, there was no effect on the time to occlusive thrombus formation (13.2 +/- 0.9 min, n = 4) compared with placebo-treated mice. The pioglitazone protection was paralleled by significantly lower soluble P-selectin and platelet P-selectin expression providing evidence of an antiplatelet effect. CONCLUSIONS: We conclude that pioglitazone treatment provides protection against arterial thrombosis in an obese, insulin resistant, prothrombotic mouse model.

Antifungal activity of fruit pulp extract from Psidium sartorianum.

The methanol extract of the fruit pulp of Psidium sartorianum was evaluated against seven Candida spp. and nine other fungal strains that are human pathogens. The extract showed a significant activity against seven Trichophyton species. Candida species were insensitive.

Angiotensinase activity in hypothalamus and pituitary of hypothyroid, euthyroid and hyperthyroid adult male rats.

A local renin-angiotensin system (RAS) that may be involved in their regulatory functions has been identified in hypothalamus and pituitary. Altered thyroid status induces modifications in the secretory function of hypothalamus and pituitary. However, few studies have analyzed the role of the RAS in hypothalamus and, to our knowledge, there is no data on the pituitary RAS during thyroid dysfunction. In the present study, angiotensinase activities (glutamyl, aspartyl and alanyl aminopeptidase: GluAP, AspAP and AlaAP, respectively) were studied in hypothalamus and in the anterior and posterior lobes of pituitary of euthyroid, hypothyroid and hyperthyroid adult male rats. In the anterior pituitary, compared with euthyroid and hyperthyroid rats, hypothyroid animals showed a highly significant increase of GluAP and AspAP activities; the percentage increase in GluAP was markedly higher than the percentage increase in AspAP. This suggests an increased metabolism of angiotensin (Ang) I and Ang II to des-Asp 1-Ang I and Ang III, respectively. We also observed an increase of Ang III-degrading activity (AlaAP) in the hypothalamus of hyperthyroid rats in soluble fraction. Increased Ang I and Ang II metabolism in the anterior pituitary of hypothyroid rats and increased metabolism of Ang III in the hypothalamus of hyperthyroid animals may be related to alterations in the secretory function of hypothalamus and pituitary in these thyroid dysfunctions.

[Association of type 1 neurofibromatosis and primary hyperparathyroidism]. / Association neurofibromatose de type I et hyperparathyroïdie primitive.

INTRODUCTION: The combination of neurofibromatosis type I with hyperparathyroidism is classical but rare. OBSERVATION: Our report is on the original observation of a patient affected with Von Recklinghausen's disease complicated by chronic restrictive breathing deficiency. After an intense breathing decompensation and a spreading convulsive attack, hyperparathyroidism was diagnosed. DISCUSSION: The similarity of the bone lesions seen in type I neurofibromatosis and in hyperparathyroidism strongly suggests a genetic link between these two pathologies. Hence, hyperparathyroidism should be searched for in all patients affected with Von Recklinghausen's disease, since the adjustment of hypercalcemia can lead to partial reversibility of the bone abnormalities.

Antifungal activity of fruit pulp extract from Bromelia pinguin.

The methanol extract of the fruit pulp of Bromelia pinguin was evaluated for its antifungal activity. The extract showed a significant activity against some Trichophyton strains, although Candida strains were generally insensitive.

Enzymatic treatment to enhance carotenoid content in dehydrated marigold flower meal.

The effect of enzymatic treatments using a commercial enzyme (Econase-cep at pH 5.0 and 0.1% w/w concentration) at different levels of dehydrated marigold meal (5, 10, 15 and 20% dry weight), to enhance carotenoid extraction, was evaluated. The AOAC method consisting of a simultaneous extraction and saponification by using hexane-ethanol-acetone-toluene (10:6:7:7 v/v) and metanolic KOH (40% w/v) was used to evaluate the carotenoid content. The measurement of carotenoids was also carried out in samples in which the water soluble compounds were previously eliminated (AOAC-H2O). Total carotenoids ranged from 11.4 to 17.4 g/kg and 18 to 24.7 g/kg of control and treated marigold meal, respectively. Highest amount of carotenoids were noted when 5% level of treated meal was used.

Comparison of silver nitrate and tetracycline as pleural sclerosing agents in rabbits.

The ideal agent to produce pleurodesis has not been identified. Tetracycline, the drug used most commonly in the 1980s, is no longer available. Talc either aerosolized or in a slurry is the agent used just most commonly at the present time, but there are concerns about its safety. Another possibility is silver nitrate, which was widely used in the past, but was abandoned on account of side effects. We hypothesized that lower concentrations of silver nitrate than had been used in the past would be effective in creating a pleurodesis in rabbits. The following medications in a total volume of 2 mL were instilled intrapleurally in three groups of ten anesthetized rabbits: 0.25% or 0.50% silver nitrate and 35 mg/kg tetracycline. Twenty-eight days after the injection, the animals were sacrificed and the pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of fibrosis and inflammation. The intrapleural injection of 0.50% silver nitrate produced an effective pleurodesis. The mean degree of gross pleurodesis in the rabbits that received 0.50% silver nitrate (3.4 +/- 1.2) did not differ significantly from that of the rabbits that received tetracycline (3.5 +/- 0.7) (scale 0 to 4). The mean degree of microscopic pleural fibrosis in the rabbits that received 0.50% silver nitrate (3.4 +/- 0.7) did not differ significantly from that of the rabbits that received tetracycline (3.9 +/- 0.3). However, 0.25% silver nitrate was ineffective in creating pleural fibrosis, either grossly or microscopically. No rabbits died after the intrapleural injection of the drugs. There were no observed side effects after the injection of silver nitrate. The present study demonstrates that 0.50% silver nitrate instilled into the pleural space is an effective agent for producing pleurodesis in the rabbit; its effect is comparable to tetracycline 35 mg/kg. This agent should be compared with tetracycline derivatives and talc in studies in humans.

Effects of chronic increased salt intake on nitric oxide synthesis inhibition-induced hypertension.

OBJECTIVE AND METHOD: Experimental evidence suggests that endogenous nitric oxide plays an important role in the homeostatic response to an increase in sodium intake. In the present study we evaluated the influence of a high sodium intake (1% NaCl as drinking water) on arterial hypertension induced by long-term (6-7 weeks) inhibition of nitric oxide synthesis [NG-nitro-L-arginine methyl ester (L-NAME), 75 mg/100 ml in the drinking fluid] in rats. RESULTS: Treatment with L-NAME induced progressive elevations in tail-cuff systolic blood pressure, but there were no differences between rats drinking tap water and rats drinking 1% NaCl. Direct measurement of blood pressure at the end of the treatment confirmed the hypertension and the lack of differences between the two groups treated with L-NAME. Metabolic studies performed at the end of L-NAME treatment showed a reduced glomerular filtration rate and elevated urinary excretion of immunoreactive endothelin in the two hypertensive groups treated with L-NAME. Drinking intake, diuresis and natriuresis were significantly higher only in the L-NAME group drinking 1% NaCl. Both groups treated with L-NAME showed an accelerated and increased diuretic and natriuretic response to an isotonic 0.9% NaCl load (2.5 ml/100 g body weight, intraperitoneally). At the end of the study ventricular hypertrophy was observed in both L-NAME groups. CONCLUSION: The present results indicate that the time-dependent elevation in blood pressure produced by long-term inhibition of nitric oxide production is not affected by an increased sodium intake. However, salt supplementation induced the development of a polyuria and polydipsia syndrome in rats treated with L-NAME. The elevated excretion of endothelin in both groups treated with L-NAME suggests the possible participation of endothelin in the development of L-NAME hypertension.

Increased endothelium-dependent renal vasodilation in cirrhotic rats.

We have evaluated the renal blood flow (RBF) response of cirrhotic rats to endothelium-dependent [acetylcholine (ACh)] and -independent [sodium nitroprusside (NP)] vasodilators. In anesthetized rats, ACh dose dependently increased RBF, but the response of the cirrhotic rats (n = 6) was significantly higher than that of the controls (n = 6). NP also increased RBF in a dose-dependent manner, but there were no differences between both groups. NG-nitro-L-arginine methyl ester (L-NAME; 10 mg/kg i.v.) significantly reduced the responses to ACh in both groups, but those of the cirrhotic rats were still higher than those of the controls. In experiments performed in isolated perfused kidneys, preconstricted with phenylephrine, dose-response curves for ACh and NP were obtained in the presence of indomethacin. Both ACh and NP decreased renal perfusion pressure dose dependently, but only the response of the cirrhotic rats (n = 5) to ACh was significantly higher than that of the controls (n = 5). L-NAME (100 microM) significantly reduced the responses to ACh and increased those of NP and abolished the differences between groups, except at the high dose of ACh. These results demonstrate an elevated endothelium-dependent vasodilator response in the cirrhotic kidney, which is eliminated by combined prostaglandin and nitric oxide (NO) synthesis inhibition and suggest that increased intrarenal activity of NO may be contributing to the renal alterations of liver cirrhosis.

Effectiveness of bleomycin in comparison to tetracycline as pleural sclerosing agent in rabbits.

The two agents most commonly used for producing a pleurodesis are tetracycline and bleomycin. Tetracycline is no longer available due to more stringent requirements on the manufacturing process. The objective of this project was to determine whether bleomycin is an effective sclerosant in an experimental model in rabbits. The following medications were instilled intrapleurally in anesthetized male rabbits: tetracycline, 35 mg/kg, or bleomycin, 1.5 or 3.0 IU/kg diluted to a total volume of 1 ml with bacteriostatic saline solution. Twenty-eight days after the instillation, the animals were killed, and the pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of fibrosis and inflammation. The intrapleural injection of bleomycin was ineffective in creating pleural fibrosis, either grossly or microscopically. The mean degree of gross pleurodesis in the six rabbits who received tetracycline was 2.7 +/- 1.5 (scale 0 to 4), while that in the rabbits who received the highest dose of bleomycin was 0.0 +/- 0.0. Based on this study, we recommend that bleomycin not be used as a pleural sclerosant in patients with nonneoplastic pleural disease, eg, those with pneumothorax, congestive heart failure or cirrhosis, and pleural effusion.

[Pneumoconiosis in abrasive industry workers]. / Pneumoconiose em trabalhadores de indústria de abrasivos.

Occupational lung disease is uncommon in workers of abrasive industries. Twenty-two workers of these industries presenting radiological lung lesions were analysed. All were males with ages ranging from 29 to 59 years. Nineteen worked in the production of silicon carbide, three in the production of aluminum dioxide and one in both for a period of 8 to 27 years. In 20 patients the predominant radiological changes (ILO-80) were small opacities. Association of small and large opacities was observed in one case and isolated large opacities in another one. The small opacities were predominantly round and diffuse. The large opacities in both patients were classified as being of category B. It is concluded that the workers in abrasive industries are at a higher risk of developing occupational lung disease produced by silicon carbide.

[Vegetable protein diets with or without non-absorbable antibiotics for the treatment of chronic portal systemic encephalopathy]. / Son necesarios los antibioticos inabsorbibles en pacientes con encefalopatía hepática manejados con dieta de proteínas vegetales?

Five patients with mild chronic portal systemic encephalopathy (PSE) were studied. The study was designed in a double cross over fashion in which each patient received during period I a 40 g vegetable protein diet as single treatment. During period II three g/day of oral kanamycin were added and then new periods of single vegetable protein diet (period III) and vegetable protein diet plus kanamycin (period IV) were introduced (identical to periods I and II respectively). Each period lasted two weeks. Several biweekly assessements-tests were determined including: mental state, asterixis grade, electroencephalograms, number connection tests, figure connection tests, blood ammonia levels and stool counts of total aerobes/anaerobes per g/feces were done. During the study none of the patients developed acute encephalopathy. In any case it was detected a significant improvement of the PSE parameters assessed with the addition of oral kanamycin. Fecal counts were very similar during the various periods of the study. We conclude that in mild portal systemic encephalopathy controlled with vegetable protein diet, the addition of non absorbable antibiotics is not mandatory for the management of these patients and may represent a potential risk of serious side effects. At the beginning of treatment vegetable protein diet should be administered and only in case of failure, antibiotics are to be indicated.

[Smoking, consumption of alcoholic beverages and coffee as factors associated with the development of cancer of the pancreas]. / Tabaquismo, consumo de bebidas alcohólicas y café como factores asociados al desarrollo de cáncer de páncreas.

The purpose of this study was to evaluate retrospectively the role of alcohol intake, smoking and coffee consumption as risk factors in the development of cancer of the pancreas. Twenty nine cases with pancreatic cancer and 29 controls matched by sex, socioeconomic status and age were evaluated. Information on alcohol, tobacco and coffee consumption was obtained by specially designed questionnaires. Odds ratios were calculated and analyzed by chi square testing. The combination of the 3 factors gave an odds ratio of 26.3, whereas alcohol and coffee consumption gave an odds ratio of 13.9. Considered independently, only alcohol and coffee consumption were found to be significantly associated with cancer of the pancreas.

Acidifying enemas (lactitol and lactose) vs. nonacidifying enemas (tap water) to treat acute portal-systemic encephalopathy: a double-blind, randomized clinical trial.

A double-blind, controlled trial to study the efficacy of acidifying enemas of lactitol, a new galactoside-sorbitol disaccharide, and lactose vs. nonacidifying tap-water enemas was performed in 45 episodes of acute portal-systemic encephalopathy. At the time of randomization, all patients had encephalopathy of at least Grade 2+ severity, delay in the performance of number connection tests and hyperammonemia. A sequential analysis was performed which revealed after the inclusion of the first 20 patients, a significant failure of the nonacidifying enemas as compared to the lactitol enemas (p less than 0.004). The tap-water enema group was, therefore, suspended but the rest of the study continued after rerandomization for lactose and lactitol groups. A favorable response to treatment was obtained in 19 (86%) of the patients receiving lactitol enemas and in 14 (78%) of those receiving lactose enemas. A similar significant improvement in portal-systemic encephalopathy parameters and index was observed after both treatments. Both types of acidifying enemas induced a significant pH decrease in stool (p less than 0.05). These data suggest that acidifying agents like lactose and lactitol are effective and superior to tap-water enemas for the treatment of acute nitrogenous portal-systemic encephalopathy.