Study of the role of the covalently linked cell wall protein (Ccw14p) and yeast glycoprotein (Ygp1p) within biofilm formation in a flor yeast strain.

Flor yeasts are Saccharomyces cerevisiae strains noted by their ability to create a type of biofilm in the air-liquid interface of some wines, known as 'flor' or 'velum', for which certain proteins play an essential role. Following a proteomic study of a flor yeast strain, we deleted the CCW14 (covalently linked cell wall protein) and YGP1 (yeast glycoprotein) genes-codifying for two cell surface glycoproteins-in a haploid flor yeast strain and we reported that both influence the weight of the biofilm as well as cell adherence (CCW14).

[First pregnancy achieved by modified natural cycle in a low responder patient's in Centro Médico Nacional 20 de Noviembre, ISSSTE]. / Primer embarazo logrado por ciclo natural modificado en una paciente baja respondedora en el Centroo éedicoNacional 20 deNoviembree, ISSSTE.

There was a patient who went to fertilization in vitro, the control ovarian stimulation was using GnRHa in the luteal phase and FSHr 500 IU, she had poor response so she went into a new stimulation protocol using GnRH antagonist. The follow up was made since the 3rd day of menstruation with ultrasound scans, when the follicle reached 14 mm, the antagonist was started with minimal dosage of FSHr until the administration of hCG 10,000 IU. Oocyte retrieval was performed 36 hours later. The embryo transfer was made after 72 hours, was transferred 1 embryo quality 1+, 2 cells, 10% fragmentation. This protocol is named natural cycle modified and is an option to achieve a pregnancy in patients with poor response with their own cells, when the patient refused oocyte donation or if there isn't that kind of program in the reproductive center like us because is not allowed.

Analysis of hepatitis C viral quasispecies in liver transplantation.

The hepatitis C virus (HCV) is an RNA virus that replicates with a high rate of mutation, especially in the hypervariable region 1 (HVR-1). Continuous viral mutations lead to a mixed and changing populations of mutants, called quasispecies. The nature of the HCV quasispecies may have implications for viral persistence and pathogenies. Studies with liver transplant patients suggest a relationship between the degree of immunosuppression and the complexity of the quasispecies. This study evaluated whether immunosuppressive therapy modifies the evolution of HCV quasispecies among liver transplant recipients compared with immunocompetent HCV patients. Two groups were studied: 11 patients who underwent OLT for HCV-related cirrhosis and 10 control group patients. Two serum samples from each patient were obtained to analyze the HCV HVR1 region by RT-PCR. SSCP analysis failed to show statistically significant differences in the number of quasispecies at basal and final time points or at pretransplant versus posttransplant (7.3+/-2 vs 6.7+/-3 in control patients, respectively, and 4.4+/-2 vs 4.1+/-1 in transplanted patients, respectively). No significant difference was observed between missing or new variants in the control (2.8+/-2 vs 2.3+/-2, respectively) or transplanted group (2.5+/-2 vs 2.2+/-1, respectively). Upon sequence analysis, the genetic complexity was significantly lower among samples after OLT in transplanted patients (0.057+/-0.04 [pretransplant] vs 0.035+/-0.02 [posttransplant]; P=.048). However, no significant differences were found among control patients in basal versus final samples (0.04+/-0.03 vs 0.066+/-0.04, respectively). Our findings seem to demonstrate that viral quasispecies diversity is lower among patients receiving a liver transplant.

Prophylaxis of recurrent hepatitis B virus by vaccination after liver transplant: preliminary results.

Liver transplantation for chronic HBV-induced cirrhosis is associated with a high rate of recurrence and poor long-term survival. Prolonged and combined prophylaxis with hepatitis B immunoglobulin (HBIg) and lamivudine has been demonstrated to prevent HBV recurrence, but its lifelong administration is highly expensive. An alternative strategy may be the use of an HBV vaccine after liver transplantation. Herein we report the results of administration of a reinforced recombinant HBV vaccine to liver transplant recipients. Twelve patients transplanted for HBV-related liver disease and treated with HBIg for at least 24 months were administered HBV vaccine (40 microg administered intramuscularly and repeated 1 and 2 months thereafter) 2 months after beginning the last HBIg dose. The response rate to HBV vaccination was 75% (9/12 patients). Serum titers of anti-HBs were considered to be protective when they reached levels >10 IU/L. Responding patients were followed for a median of 43+/-22.5 months; during this period none of the responders showed evidence of HBV recurrence. These results suggest that vaccine administration after liver transplant may avoid HBV recurrence allowing HBIg withdrawal. However, future studies are necessary to define an optimal schedule.

El cumplimiento terapéutico con irbesartán. Influencia en la variabilidad de la presión arterial en el tratamiento de la HTA leve-moderada / Therapeutic compliance with irbesartan influences variability of blood pressure in the treatment of light-moderate hypertension

Objetivo. Analizar la influencia del cumplimiento terapéutico de la hipertensión arterial (HTA), en la variabilidad de la presión arterial (PA) mediante monitorización ambulatoria (MAPA), tras tratamiento con irbesartán. Ámbito. Atención Primaria. Diseño. Estudio prospectivo. Sujetos. Ciento un individuos con HTA leve-moderada cuya MAPA inicial presentó PA sistólica (PAS) y PA diastólica (PAD) medias diurnas > 140 y/o 90 mmHg. Mediciones. Se realizó MAPA (Spacelabs 90207) al inicio y tras 8 semanas. Recibieron 2 visitas domiciliarias por sorpresa (4 y 8 semanas), con recuento de hipotensores y medición de PA. Se prescribió irbesartán 150 mg/día, duplicándose al mes si la PA no estaba controlada. Se calculó el índice de variabilidad (IV) = magnitud de la media de desviaciones estándar en cada parámetro (PAS, PAD, presión arterial media [PAM]) y cada período (global, diurno, nocturno). Se comparó el IV inicial y final según el porcentaje de cumplimiento (PC) por grupos: GA = PC 90 por ciento (PC = comprimidos presumiblemente consumidos/comprimidos que debiera haber consumido × 100).Resultados. Finalizaron 91 individuos (edad media: 55,6 (10) años) (n: GA= 20, GB = 20, GC = 51). El IV inicial y final del GC fue para PAS-24 horas y PAS-diurna de 14,6 (3) y 13 (3) (p < 0,05) y 13,5 (3) y 12,1 (3) (p < 0,05), respectivamente, con descensos significativos. Los IV de PAS, PAD y PAM por períodos y en GA, GB y resto del GC no presentó modificaciones significativas. Conclusiones. La variabilidad de la PAS global y diurna disminuye significativamente al obtener un PC superior al 90 por ciento en el tratamiento con irbesartán (AU)

[An open evaluation of prolonged-release dinoprostone with a retrieval system (a formulation of 1.1 MM) in unfavorable cervical ripening in the induction of labor for medical and obstetrical indications]. / Evaluación abierta de dinoprostona de liberación prolongada con sistema de recuperación (formulación de 1.1 MM) en la maduración del cervix desfavorable en la inducción del parto por indicación médica u obstétrica.

An open prospective study was carried out in order to evaluate controlled-release dinoprostone pessary with retrieval system in 40 patients. The objective of the study was to obtain clinical experience in Mexico and to assess its efficacy and safety during use. The following results were obtained. The Bishop Score before treatment was 2.98 +/- 1.23, and after treatment it was 8.33 +/- 2.81. The difference was significant (P = 0.0001). Twenty-five patients (62.5%) had spontaneous vaginal delivery, and 14 patients (35%) underwent caesarean section. The indications for the withdrawal of the pessary were as follow: start of labor in 19 patients (47.5%), completation of observation period in 17 patients (42.5%), maternal complications in 2 patients (5%) and, maternal and fetal complications in 2 patients (5%). The mean time between pessary insertion and withdrawal was 8.52 hours; the mean time to start of labor was 10:17 hours; the mean time to start of the 2 degrees labor period was 16:25 hours. The mean duration of labor in all 40 patients was 8:48 hours. We conclude that this study confirms the efficacy of controlled-release dinoprostone with retrieval system in cervical ripening, being easy to insert and to withdraw, and well tolerated since adverse events only occurred in 10% of all patients (uterine hyperstimulation and fetal tachycardia which were controlled by merely withdrawing the pessary). Only one patient (2.5%) required beta-mimetic support in order to control the induced uterine hyperstimulation.

[Analysis of arterial pressure variability among individuals with white coat hypertension and essential arterial hypertension using blood pressure ambulatory monitoring]. / Análisis de la variabilidad de la presión arterial entre individuos con hipertensión de bata blanca e hipertensión arterial esencial mediante monitorización ambulatoria de la presión arterial.

OBJECTIVES: To compare patients with "white coat" hypertension (WCH) and essential hypertension for variability in blood pressure (BP) taken in the clinic. DESIGN: Crossover study. SETTING: La Orden Health Centre, Huelva. PATIENTS: 126 people with light-to-moderate hypertension, de novo or not, being monitored but not treated by drugs. Two groups were formed: WCH defined by mean daily systolic and distolic pressures below 135 and 85 mmHg, and hypertension when the BP was over 140 and/or 90 mmHg. MEASUREMENTS AND MAIN RESULTS: BP was taken in the clinic in two periods: by day (7 a.m. to midnight) and at night (00.01 to 06.59), with readings every 15 and 30 minutes, respectively. Variability was compared by analysing: a) variability indices (VI), and b) coefficients of variation (CV) in BP. A regression test and multiple correlation was used. Both groups (hypertension and WCH) contained 63 people (average age: 53.4 +/- 10 and 50 +/- 10). No significant differences between the two groups in the VI were observed, except greater variability in the VI of the nocturnal systolic pressure of the hypertension group. The CV was higher in the WCH group for all pressures, with differences for 24-hour and day-time systolic pressure. The VI of systolic pressure correlated significantly with its overall clinical systolic pressure in the 24-hour period, with the day and night-time readings and with age in the day-time period. CONCLUSIONS: Variability in the blood pressure of people with essential hypertension and WCH does not differ. Variability in systolic pressure shows positive correlation with clinical systolic pressure and, to a lesser extent, with age.

[Therapeutic compliance in dyslipidemias. A trial of the efficacy of health education]. / Cumplimiento terapéutico de las dislipemias. Ensayo sobre la eficacia de la educación sanitaria.

OBJECTIVE: To analyse the efficacy of health education (HE) through group session with postal back-up in furthering compliance with therapy for Lipaemia. DESIGN: Controlled clinical trial, with random distribution. SETTING: Primary care. PATIENTS: 110 patients with Hypercholesterolaemia, with new diagnoses or not in treatment, in which medical treatment with statins was indicated as a start or change in medication. INTERVENTIONS: They were distributed in two groups at random, with observation four months after being included in the study and appointments after one, two and four months. 1. Control group (CG): 55 patients who received HE from their family doctor. 2. Intervention group (IG): 55 patients whose HE was monitored: a) a group HE session and b) back-up by letter sent to their homes. MEASUREMENTS AND RESULTS: Patients whose consumption was between 80 and 110% of the amount prescribed were defined as compliant. The pill count was recorded. The percentages of compliant patients and mean compliance (chi squared, Student's t) were analysed. 108 individuals, 41 men and 67 women, completed the trial. There was no difference between the two groups as to age, sex, evolution time, number of diseases and dosage of medicines consumed. 71.3% were compliant (CI, 62.8-79.8%), CG = 61.8% and IG 81.1% (p < 0.05). The mean percentage of compliance was 86.1 +/- 14.3 overall, with CG = 83.8 +/- 14 and IG 88.5 +/- 14 (p = NS). CONCLUSIONS: The HE intervention with a group session and postal back-up is an effective way of improving therapeutic compliance in cases of hypercholesterolaemia.

[Evaluation of Spacelabs 90207, the noninvasive automatic monitor for ambulatory monitoring of blood pressure]. / Validación del monitor automático no invasivo de monitorización ambulatoria de la presión arterial Spacelabs 90207.

OBJECTIVE: To validate a non-invasive apparatus for non-hospital monitoring of blood pressure, the Spacelabs 90207 model. DESIGN: A comparative cross-sectional study. SETTING: Primary Care. "La Orden" Health Centre in Huelva. PATIENTS: 90 people, 34 men, of all ages, hypertensive or not and without any treatment for Hypertension, and selected at random from the on-demand consulting room. MEASUREMENTS AND MAIN RESULTS: Four blood pressure (BP) readings measured with the standard manual apparatus (mercury sphygmomanometer) were compared with three obtained in sequence with the Spacelabs 90207, validated in line with the recommendations of the British Hypertension Society (BHS) and the Association for the Advancement of Medical Instrumentation (AAMI). Average age was 51.31 +/- 16.5, with SP between 102 and 200 mmHg and DP between 60 and 100 mmHg. Means and standard deviations of manual and automatic BP readings were worked out: 129.13 +/- 19 mmHg and 130.50 +/- 19 for SP, and 77.97 +/- 11 and 76.64 +/- 11 for DP. CONCLUSIONS: Spacelabs 90207 fulfills the validation criteria of the BHS and AAMI.

[Trial of the efficacy of health education programs on therapeutic compliance in arterial hypertension]. / Ensayo sobre la eficacia de los programas de educación para la salud en el cumplimiento terapéutico de la hipertensión arterial.

OBJECTIVE: To analyse by means of a group session and postal support the efficacy of health education (HE) on compliance with therapy for light-to-moderate essential Hypertension. DESIGN: Controlled clinical trial with randomised distribution. SETTING: Primary Care. PATIENTS: 110 hypertense patients with new or uncontrolled Hypertension, for whom treatment with Trandolapril as a start or change of medication was indicated. INTERVENTIONS: The patients were split into two groups at random, with observation for six months after inclusion in the study and monthly attendance: 1) Control group (CG) of 55 patients who received HE from their family doctor; 2) Intervention group (IG) of 55 patients controlled. MEASUREMENTS AND RESULTS: Patients were defined as compliant if their consumption was 80-110% of what was prescribed. The counting of pills was recorded. Percentages of compliant patients and mean compliance were analysed with the Chi squared and Student's t tests. 109 people completed, 77 of them women. Neither group differed as to age, sex, length of evolution, number of diseases or doses of drugs consumed. CONCLUSIONS: Intervening in HE with a group session and postal follow-up is an efficacious measure to improve therapeutic compliance in Hypertension cases.

[Prevalence of hyperalphalipoproteinemia in the general population]. / Prevalencia de las hiperalfalipoproteinemias en población general.

BACKGROUND: Hypercholesterolemia is often incorrectly treated with no normal consensus being followed. The same occurs with hyperalphalipoproteinemias (HAL). The aim of the present was to know the prevalence of HAL in a sample of an adult general population and the theoretical percentage of the same which would be treated as hypercholesterolemia if the above cited entity is not appropriately diagnosed. METHODS: A transversal study (November 1991-March 1992) was performed selecting a randomized sample representative of the adult population (13,224 individuals) from a basic health area (municipal census of 1991), and was stratified by groups of age and sex. The final sample was of 802 individuals who underwent anamnesis and in whom total cholesterol (TC), total triglycerides (TG), cHDL and cLDL were determined. In agreement with the percentile 90 of the results of the Lipid Research Clinic Programs for each group of age and sex with normal number of cLDL (3.84 mmol/l, < 150 mg/dl) and TG (2.27 mmol/l, < 200 mg/dl) the percentage of the population with HAL was established. The theoretical percentage of the population which would be treated as hypercholesterolemia was found following the recommendations of the Spanish consensus without the cHDL and cLDL being calculated. RESULTS: The prevalence of HAL was 7.8%, 92% being primary and 7.9 secondary. By ages the greatest frequency appeared in the group of 20-29 years (15.8%) and 30-39 years (8.4%) with male predominance (9%) with respect to females (6.8%). 63.5% had hypercholesterolemia. Treatment would be recommended to 661 individuals without need. CONCLUSIONS: Hyperalphalipoproteinemia is a frequent entity in general population. Correct diagnosis would avoid unnecessary treatment in 5% of the population. The determination of cHDL is required before any hypolipemic treatment is initiated.