[Prevalence of ankyloglossia in newborns in Asturias (Spain)]. / Prevalencia de anquiloglosia en recién nacidos en el Principado de Asturias.

INTRODUCTION: The prevalence of ankyloglossia has been estimated at around 4% of live births. Its prevalence at national level is unknown. MATERIAL AND METHODS: Multicenter, prospective observational study. Six hospitals in Asturias took part. All newborns were examined on Sundays, Tuesdays and Thursdays for 3 months. Coryllos and Hazelbaker criteria were used to diagnose ankyloglossia. RESULTS: The prevalence in the 667 newborns examined was 12.11% (95% CI: 9.58 to 14.64), of whom 62% were male. One in 4 children with ankyloglossia had a family history. According to Coryllos' classification, type II was the most common (54%). CONCLUSIONS: The prevalence of ankyloglossia in Asturias was 2 to t3 times higher than expected. The diagnostic criteria for ankyloglossia needs to be unified, and further studies are required to determine the association with breastfeeding difficulties and other health problems.

Oxidative damage increases intracellular free calcium [Ca2+]i concentration in human erythrocytes incubated with lead.

One important effect of lead toxicity in erythrocytes consists of increasing [Ca(2+)](i) which in turn may cause alterations in cell shape and volume and it is associated with cellular rigidity, hemolysis, senescence and apoptosis. In this work, we proposed the use of erythrocytes incubated with Pb(2+) to assess association of the mechanisms of lead erythrocyte oxidative damage and calcium homeostasis. Lead incubation produced an increase in [Ca(2+)](i) dose- and time-dependent, which mainly involved Ca(2+) entry mechanism. Additionally, in this in vitro model alterations similar to erythrocytes of lead-exposed workers were produced: Increase in Ca(2+) influx, decrease in (Ca(2+)-Mg(2+))-ATPase activity and GSH/GSGG ratio; increase in lipoperoxidation, protein carbonylation and osmotic fragility accompanied of dramatic morphological changes. Co-incubation with trolox, a soluble vitamin-E analog is able to prevent these alterations indicating that lead damage mechanism is strongly associated with oxidative damage with an intermediate toxic effect via [Ca(2+)](i) increase. Furthermore, erythrocytes oxidation induced with a free radical generator (APPH) showed effects in [Ca(2+)](i) and oxidative damage similar to those found in erythrocytes incubated with lead. Co-incubation with trolox prevents the oxidative effects induced by AAPH in erythrocytes. These results suggest that increase of [Ca(2+)](i) depends on the oxidative status of the erythrocytes incubated with lead. We consider that this model contributes in the understanding of the relation between oxidative damage induced by lead exposure and Ca(2+) homeostasis, the consequences related to these phenomena and the molecular basis of lead toxicity in no excitable cells.

Intracellular free calcium concentration and calcium transport in human erythrocytes of lead-exposed workers.

Erythrocytes are the route of lead distribution to organs and tissues. The effect of lead on calcium homeostasis in human erythrocytes and other excitable cells is not known. In the present work we studied the effect of lead intoxication on the uptake and efflux (measured as (Ca(2+)-Mg(2+))-ATPase activity) of calcium were studied in erythrocytes obtained from lead-exposed workers. Blood samples were taken from 15 workers exposed to lead (blood lead concentration 74.4+/-21.9 microg/dl) and 15 non-exposed workers (9.9+/-2 microg/dl). In erythrocytes of lead-exposed workers, the intracellular free calcium was 79+/-13 nM, a significantly higher concentration (ANOVA, P<0.01) than the one detected in control (30+/-9 nM). The enhanced intracellular free calcium was associated with a higher osmotic fragility and with important modifications in erythrocytes shape. The high intracellular free calcium in lead-exposed workers was also related to a 100% increase in calcium incorporation and to 50% reduction of (Ca(2+)-Mg(2+))-ATPase activity. Lipid peroxidation was 1.7-fold higher in erythrocytes of lead-exposed workers as compared with control. The alteration on calcium equilibrium in erythrocytes is discussed in light of the toxicological effects in lead-exposed workers.

Evaluación de la natalidad y mortalidad neonatal y perinatal en el Área de Salud El Bierzo: 1992-2004 / Evolution of natality and neonatal and perinatal mortality in the Health Area El Bierzo: 1992-2004

El estudio de los indicadores demográficos básicos de una población es esencial tanto para el conocimiento de su evolución como para el establecimiento de proyecciones demográficas. Ambos aspectos posibilitan una planificación sanitaria adaptada a la realidad. Objetivos: presentamos un estudio de la evolución de la natalidad y de la mortalidad neonatal y perinatal en el Área de Salud del Bierzo, de la provincia de León, desde 1992 a 2004. Pacientes y métodos: Calculamos tasas de natalidad, la incidencia de partos prematuros y de recién nacidos de bajo peso y las tasas de mortalidad a partir de datos obtenidos de los registros del Hospital El Bierzo y de la Clínica Ponferrada (hospitales donde se atienden los partos del Área de Salud del Bierzo). Comparamos nuestros resultados de natalidad con los mismos indicadores de natalidad de la provincia de León, de la comunidad autónoma de Castilla y León, y de España, obtenidos a partir de datos del Instituto Nacional de Estadística. Resultados y conclusiones: observamos un progresivo descenso de la natalidad en el Área de Salud del Bierzo, con valores mínimos en el año 2001, y un pequeño pero mantenido incremento desde esa fecha hasta 2004. Las tasas de natalidad observadas son inferiores a las provinciales, autonómicas y nacionales. La incidencia de partos prematuros y de bajo peso sufre un incremento paralelo a la tendencia nacional y autonómica excepto para el grupo de los muy inmaduros. La mortalidad neonatal y la perinatal mantiene una importante tendencia regresiva

The study of the basic demographic indicators of a population, is essential both for an understanding of its evolution and to establish demographic forecasts. Both aspects allow us to make realistic health plans. Objetive: Our presentation is a study of the evolution of neonatal and perinatal birth and death rates in the health region of Bierzo, in León province between 1992 and 2004. Patients and methods: We have calculated birthrates, incidents of premature births and underweight newborn babies, as well as death rates from statistics obtained from El Bierzo Hospital and the Ponferrada Health Clinic (hospitals that deal with the births in the Bierzo health region). We can compare our birthrate results to the same indicators for birth-rates in the province of León, in the Autonomous Community of Castilla and León, and in Spain, obtained from information of the National Institute of Statistics. Results and conclusions: We have observed a steady decrease in the birthrate for Bierzo, with the lowest figures in 2001, and a small but continuous increase from then until 2004. The birthrates found were less than the Provincial, Autonomous and National ones. The frequency of premature and underweight births experienced an increase parallel to the national and autonomous tendencies except for the group of very immature births. The neonatal and perinatal death rates have maintained an imortant downwards tendency

Niña de 11 años con pérdida ponderal del 12 por ciento en 6 meses / 11-year-old girl 12 por ciento weight loss in 6 months

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A sustained increase in intracellular Ca(2+) is required for the acrosome reaction in sea urchin sperm.

The acrosome reaction (AR), necessary for fertilization in many species, requires an increase in intracellular Ca(2+) ([Ca(2+)](i)). In sea urchin sperm, the AR is triggered by an egg-jelly factor: the associated [Ca(2+)](i) elevation lasts minutes and involves two Ca(2+) permeable channels. Both the opening of the second channel and the onset of the AR occur approximately 5 s after treatment with egg factor, suggesting that these events are linked. In agreement, removal of Ca(2+) from sea water or addition of Ca(2+) channel blockers at the time when opening of the second channel is first detected inhibits AR and causes a "rapid" (t(1/2) = 3--15 s) decrease in [Ca(2+)](i) and partial inhibition of the intracellular pH change associated with the AR. Simultaneous addition of NH(4)Cl and either EGTA, Co(2+), or Ni(2+) 5 s after egg factor prevents the partial inhibition of the evoked pH(i) change observed but does not reverse AR inhibition. Therefore, the sustained increase in [Ca(2+)](i) caused by the second Ca(2+) channel is needed for the sperm AR. Experiments with agents that induce capacitative Ca(2+) uptake (thapsigargin and cyclopiazonic acid) suggest that the second channel opened during the AR could be a store-operated Ca(2+) channel.

Enfermedad por arañazo de gato: un nuevo planteamiento diagnóstico / Cat scratch disease: a new diagnostic assessment

La Enfermedad por Arañazo de Gato (EAG) es una enfermedad autolimitada, relativamente benigna. Sus manifestaciones clínicas presentan una gran variabilidad existiendo una forma típica: linfoade nopatía regional subaguda, y un amplio abanico de formas atípicas con manifestaciones sistémicas.Los estudios microbiológicos, serológicos y moleculares han demostrado que la Bartonella henselae es el agente etiológico de la EAG.Los resultados serológicos, que deben interpre tarse con precaución y cojuntamente con la clínica y epidemiología, posibilitan un diagnóstico rápido, evitando investigaciones invasivas. Su utilización como criterio posibilita el manejo de esta enferme dad desde Atención Primaria.Se presentan dos casos reflejando las consideraciones previas (AU)

Neumomediastino infantil en el Área de Salud del Bierzo, 1989-2000 / Pneunomediastinum in children in the Health Care Area of Bierzo (Spain), 1989-2000

El neumomediastino infantil es una afección aparentemente infrecuente, excepto en el periodo neonatal. Puede aparecer en niños sanos o asociarse a múltiples procesos patológicos. Con el fin de conocer la incidencia acumulada y las características del neumomediastino en nuestra Área de Salud, se realizó un estudio retrospectivo de los casos acaecidos entre 1988 y 2000 en niños. Los síndromes de aire extraalveolar neonatal fueron excluidos. Se diagnosticaron 7 casos de neumomediastino, lo que supone una incidencia acumulada en dicho periodo de 31,69 por 100.000 habitantes, frente a la de 9,05 por 100.000 para los neumotórax .Existió un leve predominio en varones (57 por ciento). Con respecto a la etiología en 4 casos existió asociación con enfermedad respiratoria (bronquiolitis, crisis asmática, aspiración de cuerpo extraño) y en uno de los casos existió antecedente traumático claro. La clínica fue muy variable predominando la disnea y el dolor torácico o cervical. Sólo en dos de los casos se detectó el signo de Hamman. El tratamiento fue siempre conservador y la evolución favorable (AU)

Glucose induces a Na(+),K(+)-ATPase-dependent transient hyperpolarization in human sperm. I. Induction of changes in plasma membrane potential by the proton ionophore CCCP.

When human sperm was incubated in medium deprived of glucose, glucose restoration caused a transient hyperpolarization of the plasma membrane. This hyperpolarization was also induced by fructose but not by 2-deoxyglucose, a substrate that cannot be metabolized. The hyperpolarization was inhibited by NaF, a glycolysis inhibitor, but not by mitochondrial inhibitors (cyanide, rotenone and antimycin), suggesting that it depended on glycolysis. Furthermore, the hyperpolarization was still induced in medium containing a high concentration of KCl and was insensitive to the K(+) channel blocker TEA and the Cl(-) channel blocker niflumic acid, but it was blocked by ouabain. This suggested that upon glucose addition, there was an increase in the concentration of ATP, that in turns increased the Na(+),K(+)-ATPase activity. Since this pump is electrogenic (2K(+)/3Na(+)) the plasma membrane hyperpolarized. On the other hand, CCCP, a proton ionophore, inhibited the hyperpolarization induced by glucose. When CCCP was added to glucose-treated hyperpolarized sperm, it caused a depolarization that triggered a Ca(2+) influx sensitive to nickel, an inhibitor of voltage-dependent calcium channels. Moreover, CCCP caused hyperpolarization in sperm incubated in medium without calcium, a known condition that depolarizes sperm. This indicated that CCCP induced proton permeability in the plasma membrane that was able to change the membrane potential to a value corresponding to the E(H) and that was also able to clamp it, so that it prevented the hyperpolarization induced by glucose.

Lead and calcium transport in human erythrocyte.

In this paper we report the lead (Pb) and calcium (Ca) uptake by erythrocyte ghosts. In both cases the transport was carried out by a passive transport system with two kinetic components (Michaelis-Menten and Hill). Pb and Ca were capable of inhibiting the transport of the other metal in a non-competitive way. Under hyperpolarization, the uptakes of Ca and Pb were enhanced and the Michaelis-Menten component prevailed. Both Ca and Pb uptakes were inhibited by N-ethyl-maleimide to the same extent. These results indicate that Pb and Ca share the same permeability pathway in human erythrocytes and that this transport system is electrogenic.

Effect of lead on the calcium transport in human erythrocyte.

In this paper we study the calcium uptake in the erythrocyte, a non-excitable cell. This uptake is performed through a passive transport system with two kinetic components (Michaelis-Menten and Hill). The uptake of calcium seems to be driven by voltage through its electrophoretical effect. Lead is capable of inhibiting calcium uptake in a non-competitive manner. As it has been described in other systems, lead is also capable of inhibiting calcium efflux by inhibiting Ca(Mg)-ATPase. Under physiological conditions, the function of ATPase reduces the effect of lead on calcium influx. However, in chronic intoxication a small increment of intracellular calcium is observed, indicating that lead is affecting calcium efflux mainly. We discuss the effects of lead on calcium equilibrium in erythrocytes.

Effect of nitric oxide releasers on some metabolic processes of rabbit spermatozoa.

The authors investigated the possible effect of nitric oxide (NO) releasers (the free radical form of nitrogen monoxide, which control some functions of many cells) on rabbit spermatozoa. A significant (P < .01) increment was found in the percentage of the acrosome reaction in rabbit spermatozoa incubated for 30-60 min in presence of the NO releasers sodium nitroprusside (SNP) and N-acetyl-S-nitroso cysteine (NACysSNO), but not with S-nitroso cysteine (CysSNO). This effect was reverted or lowered when the NO scavenger HbO2 was included in the medium. The effects of SNP and NACysSNO on acrosome reaction do not appear to be related to glucose utilization, viability, or lipid peroxidation.

Voltage-dependent calcium influx in human sperm assessed by simultaneous optical detection of intracellular calcium and membrane potential.

There are several physiological and pharmacological evidences indicating that opening of voltage dependent calcium channels play a crucial role in the induction of the acrosome reaction in mammalian sperm. In mature sperm, physiological inductors of the acrosome reaction such as ZP3, a zona pellucida protein, and the steroid hormone progesterone, induce depolarization and calcium influx, which are required for the acrosome reaction. In this paper, we describe a voltage-dependent calcium influx present in human sperm. We report an experimental procedure that allows measurement of intracellular calcium and membrane potential simultaneously using the fluorescent dyes DiSC3(5) and Fura-2. We found that in human uncapacitated sperm, depolarization induces a nifedipine-insensitive calcium influx that, in most cases, was transient. Calcium influx was observed in the range of -60 to -15 mV (the range tested). At resting membrane potential (around -40 mV), potassium addition depolarized and induced calcium influx, but when the depolarization was preceded by a hyperpolarization (induced with valinomycin), calcium influx was remarkably enhanced, suggesting that at -40 mV, channels are in a putative inactivated state. When sperm was incubated in medium without calcium, calcium restoration caused calcium influx that depended on voltage, and decayed between 1 and 2 min after depolarization. Unlike ram, mouse or bovine sperm, in which an alkalinization is required to induce calcium influx with potassium, the voltage-dependent calcium influx observed in human sperm did not require an increase in internal or external pH. However, we observed that ammonium, which increases intracellular pH, enhanced the voltage-dependent calcium influx about 90%. Furthermore, depolarization by itself caused a small increase in intracellular pH suggesting that pH can be regulated by membrane potential in human sperm.

[Psychological alterations in patients with cancer of the larynx before and after laryngectomy]. / Alteraciones psicológicas en pacientes con cáncer de laringe antes y después de la laringectomía.

Our work, about the psychological disorders associated with cancer of the larynx and its therapeutics, study a group of 54 neoplasicos patients who have undergone a laryngectomy, before and after surgical treatment. We analyze in the pre-operation period, the relationship between the cancer and anxiety/state, comparing the patients with a serious neoplasia and those with a more benign pathology. After the operation, we study the relationship between the loss or retention of speech and the existence of anxiety/state and depression. We evaluate anxiety through the (STAI) of Spielberger and depression through the SDS scale of Zung. The pre-operative results indicate that the patients have levels of A/E significantly greater (p < 0.0001) than the mean score in the control group, without there being any significant difference according to the gravity of the cancer. Patients that have lost the capacity to speak after the surgical treatment, have significantly higher levels of anxiety and depression than the control group and those patients that have retained the capacity to speak (p < 0.0005). Other results about the relationship between the two disorders studied and variables of personality, can be found in the analysis section and in the discussion of the results.

A depolarization can trigger Ca2+ uptake and the acrosome reaction when preceded by a hyperpolarization in L. pictus sea urchin sperm.

The acrosome reaction (AR) is an exocytotic event that allows sperm to recognize and fuse with the egg. In the sea urchin sperm this reaction is triggered by the outer investment of the egg, the jelly, which induces ionic movements leading to increases in intracellular Ca2+ ([Ca2+]i) and intracellular pH (pHi), a K(+)-dependent transient hyperpolarization which may involve K+ channels, and a depolarization which depends on external Ca2+. The present paper explores the role of the hyperpolarization in the triggering of the acrosome reaction. The artificial hyperpolarization of Lytechinus pictus sperm with valinomycin in K(+)-free seawater raised the pHi, caused a small increase in 45Ca2+ uptake, and triggered some AR. When the cells were depolarized with KCl (30 mM) 40-60 sec after the induced hyperpolarization, the pHi decreased and there was a significant increase in 45Ca2+ uptake, [Ca2+]i, and the AR. This waiting time was necessary in order to allow the pHi change required for the AR to occur. Thus, the jelly-induced hyperpolarization may lead to the intracellular alkalinization required to trigger the AR, and, on its own or via pHi, may regulate Ca2+ transport systems involved in this process. Because of the key role played by K+ in the triggering of the AR, the presence and characteristics of ion channels in L. pictus isolated sperm plasma membranes are being explored. Planar lipid bilayers into which these membranes were incorporated by fusion displayed 85 pS single channel transitions which were cation selective.

Induction of a latency period in the time-course of phospholipase A2 action on dipalmitoylphosphatidylcholine liposomes in the gel phase.

The hydrolysis of dipalmitoylphosphatidylcholine liposomes by porcine pancreatic phospholipase A2 was studied at 31 degrees C, i.e., with the substrate in the gel phase. Addition of delipidated bovine serum albumin to the assay medium induces the appearance of a latency phase in the time course of the enzymatic action. The lag period can be abolished by addition of free palmitic acid whereas no reversal by lysolecithin is found. The generation of a latency period by albumin appears to be due to its ability to sequester the palmitic acid newly released by the phospholipase A2 catalysis. Thus, the nascent fatty acid seems to be an essential activator of the enzymatic process.

The effect of pH on the phase transition temperature of dipalmitoylphosphatidylcholine-palmitic acid liposomes.

The shift in the gel-liquid crystal phase transition temperature (tm) of dipalmitoylphosphatidylcholine liposomes induced by incorporation of 10 mol% palmitic acid, was measured by 90 degrees light scattering at different bulk pH values. It has been found that the tm shift decreases sigmoidally from 4.7 to -0.3 degrees C as the bulk pH is raised from 5 to 11. Since it is in this range that the carboxyl group of a membrane-bound fatty acid should ionize, our results can be interpreted to mean that there is relationship between the tm shift and the degree of dissociation of palmitic acid, the uncharged fatty acid increasing tm and its conjugate, anionic form, slightly decreasing the transition temperature of dipalmitoylphosphatidylcholine liposomes. The experimental results are fitted by a modified form of the Henderson-Hasselbach equilibrium expression which takes into account the effect of the anionic fatty acid on the surface potential and hence, on the surface pH of liposomes, according to Gouy-Chapman and Boltzmann equations, respectively. Best fit between theory and experiments is found when the intrinsic interfacial pK of palmitic acid is set equal to 7.7. This high pK value can be explained as due to the effect of the lower dielectric constant of the interfacial region, as compared to bulk water, on the acid-base dissociation of the carboxyl group. The results presented here show that upon incorporation of palmitic acid, the phase transition of dipalmitoylphosphatidylcholine bilayers becomes extremely sensitive to changes of pH in the vicinity of the physiological range. This property is not shown by the pure phospholipid bilayers in the same pH range.