[Epidemiology of hepatocellular carcinoma in a rural area. Role of hepatotrophic viruses on survival]. / Epidemiología del carcinoma hepatocelular en un área rural. Papel de los virus hepatotropos en la supervivencia.

BACKGROUND: Chronic hepatitis C and B are the main causes of hepatocellular carcinoma (HCC) worldwide. It is not clear whether chronic hepatitis C or B virus (HCV or HBV) infection is a prognostic factor for HCC. This study aimed to asses epidemiology of HCC in a rural area and to determine if chronic HCV or HBV infection had any impact on survival after the diagnosis of HCC. MATERIAL AND METHODS: Fifty-one consecutive patients were retrospectively studied. All of them were diagnosed of HCC between january 1994 and december 2002 in a First Level Hospital. The following variables were analysed: age, sex, HCV and HBV infection, chronic alcohol abuse (daily intake upper 80 g), clinical presentation, Child stage, number ol liver nodules, therapeutic options and survival. RESULTS: The mean age at diagnosis of HCC was 68,5 years old (age range 45-90) and 45 patients (88,6%) were male. Heavy alcohol intake (66%) and chronic HCV infection (42,8%) were the most prevalent etiologic factors. Chronic HBV was found in 11,9%. Chronic HCV or HBV infection was present in 48,9%. Twenty-five percent were asymptomatic and 66% were in Child stage A. The rate single lesion / multilobular HCC was 52/48. Only 6% of all patients could be treated with a curative intention. The mean survival was 10,9 +/- 9,1 months, and there were no differences in age, sex, Child stage and number of nodules. There was a significantly higher survival in patients with chronic HCV or HBV infection (16,7 +/- 13,1 months versus 4,75 +/- 5,3 months in seronegative patients; p=0.02). On multivariate analysis, only chronic HCV or HBV infection was associated with survival longer than 10 months (OR 22,3; CI 95% 1,8-277,9). CONCLUSIONS: In our area, heavy alcohol abuse and HCV infection were the most prevalent etiologic factors of HCC. Chronic HCV or HBV infection was associated with longer survival in patients with HCC.

[Alveolar hemorrhage in mixed cryoglobulinemia associated with hepatitis C virus infection]. / Hemorragia alveolar en el seno de una crioglobulinemia mixta asociada a infección por el virus de la hepatitis C.

Alveolar hemorrhage in mixed cryoglobulinemia associated with hepatitis C virus infection. A 61 year-old woman with type II mixed cryoglobulinemia associated to hepatitis C virus infection has suffered alveolar hemorrhage with multiple pulmonary infiltrates, purpura, glomerulonephritis and polyneuropathy. The respiratory and kidney findings resolved with prednisone, but glomerulonephritis reappeared when interferon-alpha treatment was started and prednisone was reduced. This is the third case of alveolar hemorrhage and glomerulonephritis associated with mixed cryoglobulinemia reported in the literature. The lung involvement in mixed cryoglobulinemia is reviewed. The clinic manifestations (asthma, pleural effusion, hemoptysis or pulmonary fibrosis) are uncommon, but the lung involvement is very frequent if roentgenographic signs and necropsy findings are assessed.

Urinary excretion of digoxin-like immunoreactive factor and arginine-vasopressin in hyper- and hypo-thyroid rats.

1. Urinary excretion of digoxin-like immunoreactive factor and arginine-vasopressin and other parameters related to salt and water metabolism were studied in hyper- and hypo-thyroid rats after different tests. 2. Urinary excretion of arginine-vasopressin was increased in hyperthyroid and reduced in hypothyroid rats with respect to controls, in response to water deprivation or a hypertonic saline load. 3. Control and hypothyroid rats showed the highest urinary excretion of digoxin-like immunoreactive factor after a hypertonic saline load. However, hyperthyroid rats had the highest urinary levels of digoxin-like immunoreactive factor under normal conditions. 4. From these results it is suggested that: (a) hyper- and hypo-thyroid rats exhibit hyper- and hypo-responsiveness of arginine-vasopressin secretion to osmotic stimuli, respectively; (b) an unidentified digoxin-like immunoreactive factor measured in unextracted rat urine may be related to diuresis and natriuresis in control and hypothyroid rats; however, dissociation between this factor and natriuresis is observed in hyperthyroid rats.

[Developement and quality control of a radioimmunoassay for measurement of endogenous digoxin]. / Desarrollo y control de calidad de un radioinmunoensayo para la medida de digoxina endógena.

It has been suggested that sodium renal excretion is regulated, at least partially, by a factor with natriuretic properties called digoxin-like factor (DLF). As this substance crossreacts with digoxin antibodies, it was measured with a radioimmunoassay used to determine exogenous digoxin. Methodological conditions and quality control to determine DLF in plasma and urine have been established. Good correlation coefficients in specificity as well as dilution studies were obtained. Within--and between--assay coefficients of variations indicate good reproducibility. Moreover, changes in plasma DLF levels were detected in patients with cirrhosis or with renal failure, diseases which thrive on alterations in salt and water metabolism. In conclusion, this radioimmunoassay method for measuring DLF may be useful to investigate the role of this factor in several physiological and pathological conditions.