Serum concentration of homocysteine in spontaneous feline chronic kidney disease.

Serum homocysteine (Hcy) increases in people and dogs with chronic kidney disease (CKD). Hyperhomocysteinemia (HHcy) has also been associated with CKD-related hypertension and proteinuria. The aims of this study were to: (1) validate an enzymatic method for quantification of Hcy in feline serum; (2) evaluate whether HHcy was associated with the presence and severity of CKD, proteinuria or hypertension; and (3) determine whether HHcy could predict disease progression. The intra- and inter-assay coefficients of variation (CVs) and the recovery rates of linearity under dilution and spiking recovery tests of the enzymatic method were 3.1-6.7%, 11.6-12.5%, 96.9±5.4% and 96.9±5.4%, respectively. Healthy cats at risk of CKD (n=17) and cats with CKD (n=19) were sampled over a 6-month period (63 samples in total). Cats with CKD had significantly higher Hcy concentrations (P=0.005) than cats at risk. The concentration of Hcy was higher (P=0.002) in moderate-severe CKD than in mild CKD and correlated moderately with serum creatinine (P<0.0001; r=0.51). The concentration of Hcy increased with the magnitude of proteinuria and correlated weakly with urinary protein to creatinine ratio (P=0.045; r=0.26). HHcy was not associated with hypertension. At the time of enrollment, Hcy concentration was significantly higher (P=0.046) in cats that developed CKD compared to cats that remained stable. The enzymatic method for Hcy measurement in feline serum was precise and accurate. HHcy was relatively common in cats with advanced CKD and seemed to predict disease progression, but further studies are warranted.

Toxoplasma infection in individuals in central Italy: does a gender-linked risk exist?

An accurate estimate of the impact of toxoplasmosis on the population in Italy is not available. We performed a cross-sectional study on individuals living in Italy to assess: (1) differences in access to Toxo testing and in the prevalence of recent and past Toxoplasma gondii infection according to gender and age, and (2) the clinical impact of disease burden on the male patient subset. Reason for testing, condition of in- or outpatient and clinical data were analysed. Between-gender differences were observed in access to the test. Immunoglobulin M (IgM) prevalence was increased in males in the age range 5-34 years [odds ratio (OR) = 2.03, 95% confidence interval (CI) 1.18-3.49, p = 0.01), with a peak at 25-34 years. In females, it decreased in the age range 20-39 years (OR = 0.49, 95% CI 0.32-0.74, p = 0.0008). The attack rate of recent infection was twice as high for males than for females. Estimates pointed out 3.3 and 1.7 events in 1000 at-risk person-years in the male and female cohorts, respectively. Most IgM-positive subjects did not experience severe forms of toxoplasmosis, with 35% having lymphadenopathy. Chorioretinitis, systemic and neurological manifestations were also observed. Our findings suggest that the acute phase of toxoplasmosis is largely unapparent or clinically mild in this area. It is also possible that the disease burden for Toxoplasma infection in Italy is underestimated. Further study should focus on information acquisition and Toxo test access in hospital units for a better estimation of the real burden of mild and severe forms of the disease.

Effects of small-scale turbulence on bacteria: a matter of size.

We examined the influence of small-scale turbulence and its associated shear on bacterioplankton abundance and cell size. We incubated natural microbial assemblages and bacteria-only fractions and subjected them to treatments with turbulence and additions of mineral nutrients and/or organic carbon. Bacterial abundance was not affected directly by turbulence in bacteria-only incubations. In natural microbial assemblage incubations, bacterial concentrations were higher under turbulence than in still-water controls when nutrients were added. In general, in the turbulence treatments bacteria increased significantly in size, mainly due to elongation of cells. The addition of inorganic nutrients had a negative effect on bacterial size, but a significantly positive effect on abundance independently of other factors such as turbulence and the presence of predators. Flagellate grazing did not trigger an increase in bacterial size as a grazing resistance response in unmixed containers. With the addition of organic carbon, bacteria elongated and partly settled to the bottom of the containers, in both the turbulent and still treatment, but bacterial abundance did not further increase. Furthermore, bacteria aggregated in the turbulence treatments after the second day of incubation even in the absence of other components of the microbial community. We found that turbulence and the associated shear increase bacterial size and change bacterial morphology, at least under certain nutrient conditions. This might be due to a physiological response (enhanced growth rate and/or unbalanced growth) or due to the selection of opportunistic strains when organic carbon is in excess compared to mineral nutrients. We suggest that shear associated with turbulent flow enhances the DOM flux to bacteria directly as well as indirectly through enhanced grazing activity and photosynthetic release. The formation of bacterial aggregates and filaments under turbulence might give selective advantage to bacteria in terms of nutrient uptake and grazing resistance.

[Gastroesophageal reflux, pulmonary and gastric function in patients with cystic fibrosis. Results of a randomized trial]. / Reflujo gastroesofágico, función pulmonar y función gástrica en pacientes con fibrosis quística. Resultados de un estudio randomizado.

We studied ten patients with Cystic fibrosis. The purposes of this study were to investigate the presence of gastroesophageal reflux and establish the probable association between gastroesophageal reflux and pulmonary and gastric involvement. All 10 patients underwent 24-hour esophageal pH recording, spirometry and gastric function. Abnormal reflux index was found in all these patients. Lung function was pathologic in the 3 older children. There were no relationship between the severity of the gastroesophageal reflux and the degree of pulmonary damage. No patient has gastric acid hypersecretion. Eight of 10 patients had steatorrhea. Our findings confirm the high frequence of gastroesophageal reflux in cystic fibrosis.

[A measure of productivity in cardiology based on medical acts]. / Una misura di produttività in cardiologia basata sugli atti medici.

BACKGROUND: The decreased availability of economic resources, opposed to the increased demand for medical assistance, requires the use of methods to assess hospital efficiency. Purpose of our study was to evaluate and quantify the "products" of a cardiology department, as well as the changes in time of their production, by means of a catalogue of medical acts, set up for the French health system (CdAM). METHODS: The study includes the 224 admissions occurring in October 1987 and the 209 admissions of October 1992. Medical acts were recorded for all admissions, by number of acts as well as by weight of acts; this weight (expressed as complexity/cost index or ICR) takes into account the use of resources in terms of medical staff and nursing staff, together with technical resources, for each act. In 1987 and 1992, 1736 and 1603 acts were performed respectively, corresponding to a total weight of 24308 and 32194 ICR. RESULTS: The increased ICR appears to be related to an increase of invasive procedures, particularly of interventional electrophysiology and haemodynamics. By considering case mix, we observed an increment of ICR for the diagnosis of angina (from 194.3 to 227.4 ICR per patient), of arrhythmias (from 178.0 to 273.1) and of cardiomyopathy (from 95.6 to 179.7). CONCLUSIONS: In conclusion, CdAM allows to evaluate the cardiologic activity also in the Italian situation; the ICR of each act permits to estimate the human and technical burden, with subsequent easy internal and external comparisons.

[Study of intestinal permeability in celiac disease with 51 Cr-EDTA]. / Estudio de la permeabilidad intestinal en enfermos celiacos con EDTA-CR51.

Intestinal permeability was studied in a group of 10 children diagnosed of coeliac disease either when they presented an intestinal villi atrophy while receiving a gluten-containing diet and after, when they had a normal mucosa with the withdrawal of gluten from the diet. Ten healthy children served as controls. The 51 Cr-EDTA (51 Cr-ethylenediaminetetraacetate) was used as probe molecule and it was administered orally. Its urinary excretion showed clear differences between patients with an altered intestinal biopsy and those with a normal histopathology. The excretion of 51 Cr-EDTA remained elevated in celiac patients with a gluten-free diet and normal villi.

Estudio de la permeabilidad intestinal en enfermos celíacos con EDTA-Cr51 / Study of intestinal permeability in celiac disease with 51 Cr-EDTA

Presentamos un estudio sobre la permeabilidad intestinal en una serie de diez niños diagnosticados de enfermedad celiaca cuando tomaban una dieta con gluten y tenían una atrofia severa de las vellosidades intestinales y posteriormente durante un período con dieta sin gluten y vellosidades intestinales normales. Tomamaos como grupo control a diez niños sanos. Se utilizó como marcador el EDTA-Cr51 (Etiléndiaminotetracetato Cr51) administrado por vía oral. Su excreción urinaria estaba signficativamente elevada en los pacientes con biopsia alterada, manteniéndose una moderada elevación en los pacientes celiacos con dieta exenta de gluten y sin atrofia de las vellosidades

Estudio de la permeabilidad intestinal en enfermos celíacos con EDTA-Cr51 / Study of intestinal permeability in celiac disease with 51 Cr-EDTA

Presentamos un estudio sobre la permeabilidad intestinal en una serie de diez niños diagnosticados de enfermedad celiaca cuando tomaban una dieta con gluten y tenían una atrofia severa de las vellosidades intestinales y posteriormente durante un período con dieta sin gluten y vellosidades intestinales normales. Tomamaos como grupo control a diez niños sanos. Se utilizó como marcador el EDTA-Cr51 (Etiléndiaminotetracetato Cr51) administrado por vía oral. Su excreción urinaria estaba signficativamente elevada en los pacientes con biopsia alterada, manteniéndose una moderada elevación en los pacientes celiacos con dieta exenta de gluten y sin atrofia de las vellosidades (AU)

Estudio de la permeabilidad intestinal en enfermos celiacos con EDTA-CR51. / [Study of intestinal permeability in celiac disease with 51 Cr-EDTA]

Intestinal permeability was studied in a group of 10 children diagnosed of coeliac disease either when they presented an intestinal villi atrophy while receiving a gluten-containing diet and after, when they had a normal mucosa with the withdrawal of gluten from the diet. Ten healthy children served as controls. The 51 Cr-EDTA (51 Cr-ethylenediaminetetraacetate) was used as probe molecule and it was administered orally. Its urinary excretion showed clear differences between patients with an altered intestinal biopsy and those with a normal histopathology. The excretion of 51 Cr-EDTA remained elevated in celiac patients with a gluten-free diet and normal villi.

[Prevalence of hepatitis B virus in a sample of healthy children in Madrid]. / Prevalencia del virus de la hepatitis B en una muestra de la población infantil sana de Madrid.

In order to determine the prevalence of hepatitis B virus (HBV) markers, we studied 375 healthy children, 242 males and 113 females, with age ranged between 6 to 14 years, from different schools at the Tetuán district (Madrid). We sent a questionnaire to the parents to investigate the presence of risk factor in the children and/or their parents. All children were screened for hepatitis B markers in serum. Our results shown the existence of HBV markers in 22 (5.9%) children. No major incidence of risk factors was found in the children with serologic evidence of HBV infection.

[Duodenal ulcer in children. Apropos of 28 cases]. / Ulcera duodenal en niños. A propósito de 28 casos.

We present 28 children, 4 to 14 year-old, with duodenal ulcer; there were 21 males and 7 females. In 16 cases, after stimulation with pentagastrin, basal pepsinogen I (PG1), basal gastrinemia and basal acid output (BAO) and maximal acid output (MAO) were measured. Compared to controls, the mean levels of PG1 and gastrin were significantly higher in the patients; 12 children (80%) had high levels of PG1 and the remaining 3 (20%) had normal levels. The blood group O was the most prevalent: 64% of the cases.

[Oral vaccination with live attenuated rotavirus]. / Vacunaciíon oral con rotavirus vivo atenuado.

A randomized, double-blind trial was performed to assess serological response and clinical protection for acute gastroenteritis due to rotavirus in 103 children aged 6 to 18 months, after a single dose of RIT 4237 live attenuated bovine rotavirus vaccine or placebo. Seroconversion, determined by enzyme-linked immunoabsorbent assay (ELISA), was significantly greater in initially seronegative vaccines compared with control group (p less than 0.0001); clinical protection rate was low in this study group and it is therefore concluded that seroconversion by itself is not sufficient to measure vaccine efficacy.