Efficacy of alpha 2b versus lymphoblastoid interferon in treatment of chronic hepatitis C. A randomized trial.
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Adult↗
Biomedical subjects
A Palacios
Publications and source records attributed to A Palacios.
Epidemiology and prevalence of seropositivity for hepatitis C virus in pregnant women in Granada.
OBJECTIVES: To study personal and familial antecedents of risk and prevalence of infection by HCV in pregnant women in the south area of Granada. PATIENTS AND METHODS: We included in the study 3003 pregnant women of the south area of Granada during the period from January 1993 to December 1995. Anti-HCV was detected in the third trimester of pregnancy by second and third generation ELISA, and positive results were confirmed by RIBA 3. We also determined HCV-RNA and genotype. Finally, we analyzed ALT levels in 1171 (39%) pregnant women. We carried out an epidemiological survey of all pregnant women, which included the following personal antecedents: transfusion, intravenous drug use, liver diseases, risk profession and sexually transmitted diseases. We studied the same antecedents in the parents, husbands and other relatives. RESULTS: Prevalence of anti-HCV was 0.63% (19 cases) with ELISA and 0.53% with RIBA. HCV-RNA was positive in 14 (74%) genotype 1b (57%) being the most frequent. ALT was increased in 52 (4.4%) pregnant women, 7 (13.5%) of whom were anti-HCV positive, versus 12 women (1%) in the normal ALT group (p < 0.001). In the epidemiological study we observed statistically significant differences in: a) housing characteristics [2125 (71%) anti-HCV negative pregnant women living in occupant-owned housing versus 7 (36%) in anti-HCV-positive group, p < 0.001]; b) personal antecedents of transfusion, chronic or acute hepatitis, or intravenous drug use (p < 0.001) (these factors were confirmed in the multivariable analysis), and c) familial antecedents of the husband (p < 0.05). CONCLUSIONS: In this study we demonstrated that 0.53% of the pregnant women were infected by HCV; most of them were HCV-RNA positive and was genotype 1b was the most frequent. The risk factors most frequently associated with infection were antecedents of transfusion, intravenous drug use and acute or chronic hepatitis.
Female↗
Serum lipids, lipoprotein lp(a), and plasminogen activator inhibitor-1 in patients with Turner's syndrome before and during growth hormone and estrogen therapy.
OBJECTIVE: To evaluate whether girls with Turner's syndrome have an increased risk for cardiovascular disease due to alterations in their lipoprotein metabolism. DESIGN: Controlled clinical study. SETTING: Private academic hospital. PATIENT(S): Fifteen untreated girls with Turner's syndrome were studied initially; 11 of these patients were evaluated further while on therapy. INTERVENTION(S): Serum lipids, lipoprotein lp(a), and plasminogen activator (PA) inhibitor-1 were measured before and during 6 months of either GH or estrogen (E) treatment. MAIN OUTCOME MEASURE(S): Serum lipids, lipoprotein lp(a), and PA inhibitor-1 (PAI-1). RESULT(S): Total and low-density lipoprotein (LDL) cholesterol, triglycerides, lipoprotein lp(a), and PA inhibitor-1 levels were normal in Turner's syndrome patients compared with age-matched controls; HDL cholesterol was increased. During GH treatment, a significant decrease in total and LDL cholesterol was noted, whereas lipids, lipoprotein(a), and PA inhibitor-1 levels did not change with E therapy. CONCLUSION(S): The normal lipoproteins of untreated adolescents with Turner's syndrome, as well as the further decrease of total and LDL cholesterol during GH treatment, would seem to indicate that lipoproteins do not increase the cardiovascular risk of these girls.
Adolescent↗
Effectiveness and limitations of the use of the gonadotropin-releasing hormone agonist leuprolide acetate in the diagnosis of delayed puberty in males.
In order to evaluate the effectiveness of the gonadotropin-releasing hormone agonist leuprolide acetate in distinguishing gonadotropin deficiency from delayed puberty, a single subcutaneous dose of 20 micrograms/kg of leuprolide acetate was administered at 07.00 h to 14 patients with constitutionally delayed puberty and to 8 gonadotropin-deficient subjects, and serum gonadotropin and testosterone levels were determined at baseline and 1,2,3,6,12, and 24 h thereafter. The increase in gonadotropin and testosterone levels was significant in patients with delayed puberty, so that the mean peak luteinizing hormone and to a lesser degree the mean peak testosterone levels clearly differentiated normally delayed from gonadotropin-deficient puberty. However, when the peak gonadotropin and testosterone concentrations were analyzed individually, there was a considerable overlap between the two groups of males, limiting the usefulness of this test.
Adolescent↗
[Endogenous opioid peptides and the immune system].
Several studies have demonstrated that endogenous opioid peptides produced by the neuroendocrine system can modulate several immunological functions. Immune system cells have also been shown to have the ability to synthesize and release such peptides. This would mean that the neuroendocrine and immunological systems share molecules and opioid receptors and it may be that peptides produced by the neuroendocrine system modify immunocompetence and that these same substances released by macrophages that infiltrate inflamed tissue also act on the pain response in the zone of lesions. We aimed to investigate the immunoregulatory function of endogenous opioid peptides and their effects on the complement system's natural "killer" cell activity, chemotaxis, phagocytosis and oat cell activity.
Animals↗
Vitamin A inhibits lipoperoxidation ascorbate-Fe++ dependent of rat kidney microsomes and mitochondria.
In the present study it was investigated if Vitamin A supplementation could protect rat kidney microsomes and mitochondria from in vitro lipoperoxidation. After incubation of rat kidney microsomes and mitochondria in an ascorbate-Fe+2 system, at 37 degrees C during 60 min, it was observed that the total cpm/mg protein originated from light emission (chemiluminescence) was lower in those organelles obtained from the control group when compared with the vitamin A supplemented group. The fatty acid composition of microsomes and mitochondria from control group was profoundly modified when subjected to non-enzymatic lipoperoxidation with a considerable decrease of arachidonic acid, C20:4 (n-6) and docosapentaenoic acid, C22:5 (n-3) in mitochondria and docosahexaenoic acid C22:6 (n-3) in microsomes. As a consequence the peroxidizability index, a parameter based on the maximal rate of oxidation of specific fatty acids was higher in the supplemented animals than in those used as control. These results indicate that Vitamin A may act as antioxidant protecting rat kidney microsomes and mitochondria from deleterious effect.
Animals↗
[Retrospective multicenter study of the efficacy of interferon alpha in chronic hepatitis C].
BACKGROUND: Until very recently, interferon (INF) in Spain was authorized in chronic hepatitis C (C-HCV) at a dosis of 3 megaunits (mu) for 6 months. Nonetheless, the rate of maintained complete response is lower than that obtained with more prolonged treatments. The first aim of this study was to retrospectively know the effectiveness of alpha INF in patients treated for 6 or 12 months with a dosis of 3 or 5-6 MU. The second was to analyze the characteristics of the patients who achieved a maintained complete response. PATIENTS AND METHODS: Patients with C-HCV treated in 9 hospitals in Andalucía, Spain who fulfilled the following conditions were retrospectively analyzed: liver biopsy prior to treatment, positive test for anti HCV and a follow up of at least 6 months after alpha INF treatment. A total of 344 patients were studied: 267 treated with alpha INF-2b, 51 with alpha INF-2a and 26 with lymphoblastoid INF. One hundred ninety-five patients were treated for 6 months and 149 for 12 months. RESULTS: Seventy-seven (22%) of the patients presented maintained complete response, 170 (50%) did not respond and 97 (28%) relapsed. On comparing the three types of interferon used over 6 months, no significant differences were observed. Neither were differences found on comparing the dosis of 3 mu versus 5 or 6 mu. On analyzing the treatments of 6 and 12 months, the following was observed, respectively: maintained complete response 15% vs 32%, relapse 29% vs 30% and non responders 57% vs 38% (p < 0.001). Multivariate analysis demonstrated that the patients who responded the best to INF were those who presented the following characteristics: female sex, age under 40 years last, history of transfusion or IVDA, basal GPT level higher than 145 IU/I, GGT less than 55 IU/I, less evolved histologic lesions and duration of treatment over 12 months. CONCLUSIONS: Of the different treatments analyzed with alpha interferon in chronic hepatitis C, the best was found to be that with 3 mu during 12 months.
Adult↗
Vitamin A supplementation inhibits chemiluminescence and lipid peroxidation in isolated rat liver microsomes and mitochondria.
In the present study we investigated if administration of vitamin A could protect rat liver microsomes and mitochondria from in vitro peroxidation. Appreciable decrease of chemiluminescence and lipid peroxidation was measured in microsomal membranes from rats receiving vitamin A, with respect to control animals. In membranes derived from control animals, the fatty acid composition was profoundly modified when subjected to in vitro peroxidation mediated by ascorbate-Fe++, with a considerable decrease of 20:4 n6 and 22:6 n3 in mitochondria and 18:2 n6 and 20:4 n6 in microsomes. As a consequence the peroxidizability index, a parameter based on the maximal rate of oxidation of specific fatty acids was higher in supplemented animals than in control group when both kind of membranes were analyzed. These changes were less pronounced in membranes derived from rats receiving vitamin A. These results are in agreement with previous results that indicated that vitamin A may act as an antioxidant protecting membranes from deleterious effects.
Animals↗
Epidemiology, serological markers, and hepatic disease of anti-HCV ELISA-2-positive blood donors.
The epidemiology associated with hepatitis C virus (HCV) infection, serologic reactivity, and hepatic disease related to anti-HCV-positive donors of Granada were researched. From 1990 through 1993, medical and epidemiological information and anti-HCV and HCV RNA testing were evaluated in 46,741 blood donors. Serum samples were obtained for anti-HCV ELISA and RIBA and HCV RNA determination. A liver biopsy was conducted in all anti-HCV positives by confirmatory second-generation RIBA to analyze the hepatic lesion and the presence of HCV RNA. The anti-HCV prevalence was 1.12%. A total of 228 anti-HCV second-generation ELISA positive blood donors were analyzed. Intrafamiliar transmission rate was 1.7%. Transfusion and intravenous drug abuse (IVDA) antecedents were associated with a higher risk of seroconversion. A RIBA-positive result was related to high second- and third-generation ELISA ratios (90%), HCV RNA positivity (89%), and elevated alanine aminotransferase (ALT) levels (88%). Approximately 50% of donors with normal ALT levels had high ELISA ratios and second-generation RIBA and HCV RNA positive results. Of the second-generation RIBA indeterminate results, 42% and 82% of the c22 and 33% and 100% of the c100 reactivities were third-generation RIBA and HCV RNA positive, respectively. Liver biopsy was conducted in 85 donors, 74% of whom had a chronic hepatitis and 83% had detectable HCV RNA levels. Chronic hepatitis was diagnosed in 88% vs 43% of donors with elevated and normal alanine aminotransferase levels, respectively. ELISA and confirmatory HCV RNA determinations should be routinely employed in donor screening. A liver biopsy should be conducted in patients with elevated ALT levels and normal ALT levels when viremic.
Adolescent↗
[Epidemiological study of tuberculosis in the health area of Santiago de Compostella in 1992, 1993 and 1994].
An exhaustive search for the clinical records of patients diagnosed with tuberculous disease was done in the hospitals of the area under study, which involves 392,000 population. During the years 1992, 1993 and 1994. There were included: 1) patients who had positive bacilloscopy and/or positive Lowenstein's culture in any specimen: 2) patients younger than 35-years-old who had pleural effusion, significant Mantoux and adenosine deaminase (ADA) over 47 U/I in the pleural effusion. In total 814 patients remained in the study with an average age of 38.39(19.39 DE) in 1992, 39.02 (20.04 DE) in 1993, and 34.1 years-old (19.2 DE) in 1994, with extreme ages of 2 months and 87 years-old. The incidence/100,000 H was: in 1992: 67.86, in 1993: 66.58 and in 1994: 73.2. The contagious forms incidence/100,000 H was: 1.5 in 1992 and 1993; and 1.79 in 1994. The hospital mortality incidence/100,000 H was 2.04 in 1992, 2.30 in 1993 and 2.6 in 1994. We conclude that tuberculosis is endemic in our area with moderately high and stationary incidence.
Adolescent↗
[Prospective study of the incidence of post-transfusion hepatitis after the exclusion of donors positive for anti-HCV ELISA 2].
BACKGROUND: The incidence of post transfusional hepatitis (PTH) after the exclusion of anti-HCV ELISA 2 positive donors is not well known. The aim of this study was to determine the incidence and type of PTH in 113 post transfused patients. METHODS: A post transfusional follow up was performed for at least one year with periodic controls of transaminase levels. When an increase in GPT level compatible with PTH was demonstrated investigation of all the virus related with the transfusion was carried out in both the donor and the transfused subject: HAV, HCV, HEV, HBV and CMV. RESULTS: Four cases (3.5%) were detected which fulfilled the PTH criteria with the following characteristics: short period of time between transfusion and the increase in GPT level, moderate GPT increase, moderate clinical expression and good evolution. In all the cases the viral study was negative and other non viral possibilities were eliminated. CONCLUSIONS: Transfusions are currently relatively safe and the increase in transaminases may not be related with transfusion.
Adolescent↗
[Postoperative infection and anesthesia: analysis of various risk factors].
OBJECTIVES: To study the possible relation between anesthetic techniques and other perioperative circumstances and factors and the presentation of infections after surgery. PATIENTS AND METHODS: We studied 22 patients who suffered infections after surgery and 54 who did not, analyzing the anesthetic technique used as well as other data on age, sex, concomitant disease, toxic habits, practice of invasive procedures, duration and nature of the surgical procedure and the use of antibiotic prophylaxis. Multivariate analysis (logistical regression) was performed in order to identify independent risk factors. RESULTS: None of the anesthetic techniques studied was associated with greater frequency of postoperative infection. Infected patients were significantly older than uninfected patients (75 +/- 9 years versus 61 +/- 18 years). Likewise the number of infections was higher among ASA III and IV (n = 20) patients than among ASA I and II (n = 2). The duration of surgery for infected patients was 4.15 +/- 2.12 hours whereas it was 2.87 +/- 1.86 hours (p < 0.001) for uninfected patients. Placement of a urinary catheter, repeated surgery, diabetes and blood transfusion all signified greater risk of infection, as did prophylaxis with second and third generation cephalosporins (OR = 12.5; 95% CI = 1.8-85.6) or tobramycin (OR = 66.4; 95% CI = 3.5-1,270). CONCLUSION: The risk of postoperative infection increases with age and poor physical status of patients (ASA III and IV), with diabetes, repeated surgery, transfusion of blood products and prophylaxis with third generation cephalosporins and tobramycin.
Aged↗
[Breast cancer, tamoxifen, and uterus].
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Adenocarcinoma↗
Mycobacterium leprae 65hsp antigen expressed from a retroviral vector in a macrophage cell line is presented to T cells in association with MHC class II in addition to MHC class I.
Mycobacterium leprae lives free in the cytoplasm in infected macrophages. To test if an M. leprae antigen released into the cytoplasm would associate with major histocompatibility complex (MHC) class II we introduced the gene encoding the 65 kDa heat-shock protein (ML65hsp) into a retroviral shuttle vector (pZIPNeoSV(X)) and transfected the murine macrophage cell line J774G8. S1 nuclease mapping and Western blot analysis of the transfected cell line (CJ11) showed that specific messenger RNA and ML65hsp antigen were stably expressed. Presence of antigen at the cell surface was demonstrated by flow cytometric analysis with specific monoclonal antibodies (mAb). Antigen-specific T lymphocytes were stimulated by CJ11 cells to proliferate and release interleukins (IL-2 and IL-3). These responses were blocked by mAbs specific for either MHC class II or for the mycobacterial antigen. The endogenous antigen was also recognised by MHC class I-dependent cytotoxic T cells; cytotoxicity was inhibited by mAbs against either MHC class I molecules or ML65hsp. Thus, production of ML65hsp within the host cytoplasm resulted in association of the antigen with both MHC class I and MHC class II antigen-presenting structures and evoked both lymphocyte proliferation and cytotoxicity towards the antigen-presenting cell. These findings may be relevant to the development of recombinant subunit vaccines against intracellular pathogens.
3T3 Cells↗
Muscular involvement in systemic rheumatoid vasculitis.
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Arthritis, Rheumatoid↗
Dapsone induced sulfone syndrome and systemic lupus exacerbation.
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Adult↗
[The liver and AIDS].
Hepatic disorders in AIDS are very common, although the injuries observed are usually non-specific. This is the reason why the real usefulness of hepatic biopsy in this patients is being currently discussed. In this work, such aspect and the hepatic injuries observed in patients with AIDS are discussed. Current indications for hepatic biopsy are summarized, as well as its later manipulation in order to obtain maximum profitability of it.
Acquired Immunodeficiency Syndrome↗
Role of the nucleus geniculatus lateralis ventralis (GLv) in the optokinetic reflex: a lesion study in the pigeon.
Several functions have been proposed for the avian GLv (color vision, pupillary reflex, optomotor mechanisms). In the present paper we have examined the role of the GLv in optomotor responses. For this purpose, horizontal and vertical optokinetic nystagmus (OKN) were quantified in response to different stimulation velocities, before and after chemical (kainic acid) lesions. Unilateral lesion of the GLv produced a marked increase of the horizontal OKN gain when the eye contralateral to the lesion was stimulated in the temporonasal (T-N) direction and, to a lesser extent, when the ipsilateral eye was stimulated in the naso-temporal (N-T) direction. Biocular integration was reduced after the lesion, since the biocular stimulation corresponding to these two monocular stimulations (ipsiversive to the lesion) produced only a moderate gain increase. When stimulations were delivered in the opposite direction (contraversive to the lesion), the horizontal OKN gain was slightly increased for the N-T monocular stimulation of the eye contralateral to the lesion, but was unchanged for other stimulations. A bilateral lesion of the GLv provoked only a slight increase of the horizontal OKN gain. The vertical OKN was not affected by the GLv lesions. Thus, the GLv system is probably involved in the modulation of optomotor responses and could mediate visuo-optokinetic interactions, each nucleus (and its associated system) exerting an inhibitory (or disfacilitatory) effect on the horizontal OKN in one direction.
Animals↗