Susceptibility to type 1 (insulin-dependent) diabetes mellitus in Spanish patients correlates quantitatively with expression of HLA-DQ alpha Arg 52 and HLA-DQ beta non-Asp 57 alleles.

HLA-DQ alpha and beta alleles were chosen as the most sensitive Type 1 (insulin-dependent) diabetes mellitus susceptibility markers for evaluating the disease associations and Type 1 diabetes risk in a population-based registry from Madrid. The absence of aspartic acid in position 57 of the DQ beta chain (non-Asp 57), and the presence of arginine in position 52 of the DQ alpha chain (Arg 52) were found to be reliable markers of Type 1 diabetes susceptibility among the Spanish population, with significantly higher frequencies among the cases of Type 1 diabetes compared to randomly selected non-diabetic control subjects from the general Madrid population. While non-Asp 57 homozygosity conferred an absolute risk of 32.3 per 100,000 per year and Arg 52 of 31.5 per 100,000 per year, the risk for double homozygotes for both non-Asp 57 and Arg 52 was estimated as 101.7 per 100,000 per year. Individuals homozygous for only one of these alleles, and heterozygous at the other locus, had a markedly lower Type 1 diabetes risk (12.8 per 100,000 per year), approximating the general population incidence for Madrid. Thus, susceptibility to Type 1 diabetes in Spanish patients is associated, quantitatively, with non-Asp 57 DQ beta and Arg 52 DQ alpha alleles.

[Adenosine deaminase in pleural effusions. Its usefulness in the diagnosis of tuberculous pleurisy]. / Adenosina desaminasa (ADA) en los derrames pleurales. Su utilidad en el diagnóstico de la pleuresia tuberculosa.

The activity of adenosine deaminase was determined in 79 pleural effusions in order to evaluate the utility and reliability in diagnosing tuberculous effusions. The effusions were grouped by the etiology: 26 were tuberculous (group I); 22 were neoplastic (group II); 11 were pneumonic (group III); 10 were non-infections exudates of different causes (group IV); and 10 transudates (group V). Group I presented the higher median value of AD (MED = 81.92; DE: 29.02) the difference being statistically significant (p less than 0.0001) compared with the results of the other groups. We found 2 cases of pleural tuberculosis histologically demonstrated with AD levels under the amount of 40 U/L. In our experience, AD determination had a sensitivity of 92% and specificity of 94%; with a predictive value of 89% and a negative predictive value of 96%, this being considered useful but non specific of tuberculosis.

[Wilson Jones angiosarcoma of the face and scalp]. / Angiosarcoma de la cara y cuero cabelludo de Wilson Jones.

Because of its rarity and its fast development, we report a case of a 84-year-old woman, who developed all the clinical and histopathological characteristics of the angiosarcoma of face and scalp, with a fatal evolution within four months and metastases to liver, lungs and bone marrow.

Controlled trial of glycerol versus dexamethasone in the treatment of cerebral oedema in acute cerebral infarction.

10 percent glycerol was given for 6 days to 30 patients who had had acute ischaemic cerebral infarction, and the results were compared with those obtained after treating 31 similar patients with dexamethasone (16 mg. per 24 hours for 6 days). 1 patient treated with glycerol died of haemoglobinuria and acute renal failure. 6 patients treated with dexamethasone died--3 from cerebral oedema and 3 from non-neurological complications (pulmonary embolism, myocardial infarction, and aspiration pneumonia). Improvement was significantly greater in the glycerol group after 8 and 15 days. No improvement was noted using either glycerol or dexamethasone in 7 patients with spontaneous intracerebral haemorrhage.