RESUMEN
The present study was performed in order to obtain the thiopurine methyltransferase (TPMT) activity frequency distribution histogram in a Spanish population. A total of 3640 Spanish clinical laboratory samples were evaluated, which included 1249 patients with Crohn's disease, 589 with ulcerative colitis, 348 with multiple sclerosis (MS), 487 with several autoimmune diseases different from the above-mentioned diseases and 967 a donor group. We have measured the TPMT activity in red blood cells (RBCs) by a radiochemical method, using S-adenosyl-L-[methyl-3H]methionine as methyl donor. The different groups present in their entirety a normal distribution histogram and a wide range of TPMT activity from 0 to 41 U/ml RBCs. The differences found between the Spanish population TPMT activity frequency distribution histogram and the pattern previously described in a North American population were not due to azathioprine treatment or gender. The effect of autoimmune diseases on TPMT activity was evaluated: the enzymatic activity was similar in the donor group (19.9 +/- 6.3 U/ml RBCs) and in the patients with Crohn's disease (20.0 +/- 5.8 U/ml RBCs) and ulcerative colitis (19.7 +/- 6.1 U/ml RBCs); however, it decreased significantly (p<0.0001) in MS patients (17.1 +/- 6.1 U/ml RBCs) with respect to the donor group. In conclusion, our results show that the Spanish population TPMT distribution is closer to that of the Jewish population of Israel than to North American populations, and that in MS the enzymatic activity of TPMT decreases significantly. This observation may take into account the usage of azathioprine as therapeutic agent in Spanish MS patients.
Asunto(s)
Metiltransferasas/metabolismo , Esclerosis Múltiple/enzimología , Azatioprina/uso terapéutico , Colitis Ulcerosa/tratamiento farmacológico , Colitis Ulcerosa/enzimología , Enfermedad de Crohn/tratamiento farmacológico , Enfermedad de Crohn/enzimología , Eritrocitos/enzimología , Femenino , Humanos , Inmunosupresores/uso terapéutico , Masculino , Esclerosis Múltiple/tratamiento farmacológico , EspañaRESUMEN
In order to determine the prevalence of iron deficiency among 6-to-24 month-old children in the Cascais county, a cross-sectional study with systematic opportunist sampling of all 6-to-24-month-old children seen for routine immunization or well-child health care at the Public Health Centers in the Cascais county, during the Spring of 1994. All children were submitted to a short nutritional and clinical inquiry. Blood samples to evaluate anemia and iron deficiency were obtained from eligible children after parental consent. Of the 183 children who visited the health centers during the enrollment period, 125 were eligible for blood sampling. Adequate blood samples were obtained from 120; 38 (31.7%) fulfilled the eligibility criteria for the therapeutical trial (polymaltose-ferric hydroxide, 5 mg/kg/day, for 4 weeks). Twenty-six completed the trial and 13 (50%) had a positive response. The prevalence of iron deficiency estimated for this population sample was 15.8% (CI95% = 8.8-22.3), twice the prevalence of iron deficient anemia, presenting only as mild anemia. Nevertheless, for a total population of 3,500 6-24 month old children in the Cascais area, a 15% prevalence means over 500 iron-deficient children (estimated range between 300 and 800) of which 250 are likely to suffer anemia (150-400) and may be at risk of developing a permanent intellectual deficit. The size of the problem as sampled in the Cascais area does not justify recommending the screening of all young children; instead it points to the need to pay special attention to nutritional education in well-child health care visits, and to allow the early detection and treatment of infants with iron deficiency or at risk of becoming iron deficient.
Asunto(s)
Anemia Ferropénica/epidemiología , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Portugal/epidemiología , PrevalenciaRESUMEN
This paper presents scanning electron microscopic features of T and B Lymphocytes in patients affected with AIDS and ARC and compares these results with others obtained in patients showing an immunodeficiencey associated with therapy for oncological diseases and in normal healthy donors. The SEM observations showed some surface alterations of the lymphocytes consisting in protrusions, buddings and characteristic "bowl-shaped" cavities particularly evident on the lymphocytes' surface of end stage patients suffering from AIDS. Similar aspects were not found in the other groups including the healthy donors. These lymphocyte surface alterations might likely correspond to the first sign of cell disfunction and therefore represent an early marker of this complex disease.