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UNLABELLED: Hypercholesterolemia is a well known risk factor for coronary cardiovascular disease (CVD). However, the role of triglycerides in CVD risk remains controversial. OBJECTIVE: to study triglyceride level and its relationship with Cholesterol, HDL and LDL Cholesterol level, obesity and overweight in patients with and without CVD. MATERIAL AND METHODS: we retrospectively studied patients with and without CVD who attended to Córdoba Hospital and Cardiology unit of Clínica Sucre at Córdoba city between 1st January to 31 st of December of 2009. We included patients with age between 30 to 60 years old with CVD and a control group. RESULTS: 100 patients were included, 64 with CVD and 36 as a control group. 74% were male and 68% older than 50 years old. Lipid values were not statistically significant in both groups. Triglyceride level was higher in the control group, although the difference was not statistically significant (p=0, 7162). CONCLUSION: Triglyceride level was not higher in patients with CVD.

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The role of gonadotrophin-inhibitory hormone (GnIH) in the inhibition of the reproductive axis has been well-established in birds and mammals. However, its role in other vertebrates, such as the teleost fish, remains controversial. In this context, the present study aimed to evaluate whether GnIH modulates the release of gonadotrophins and growth hormone (GH) in the cichlid fish Cichlasoma dimerus. First, we partially sequenced the precursor polypeptide for GnIH and identified three putative GnIH peptides. Next, we analysed the expression of this precursor polypeptide via a polymerase chain reaction in the reproductive axis of both sexes. We found a high expression of the polypeptide in the hypothalamus and gonads of males. Immunocytochemistry allowed the observation of GnIH-immunoreactive somata in the nucleus posterioris periventricularis and the nucleus olfacto-retinalis, with no differences between the sexes. GnIH-immunoreactive fibres were present in all brain regions, with a high density in the nucleus lateralis tuberis and at both sides of the third ventricle. Finally, we performed in vitro studies on intact pituitary cultures to evaluate the effect of two doses (10(-6)  m and 10(-8)  m) of synthetic C. dimerus (cd-) LPQRFa-1 and LPQRFa-2 on the release of gonadotrophins and GH. We observed that cd-LPQRFa-1 decreased ß-luteinising hormone (LH) and ß-follicle-stimulating hormone (FSH) and also increased GH release to the culture medium. The release of ß-FSH was increased only when it was stimulated with the higher cd-LPQRFa-2 dose. The results of the present study indicate that cd-LPQRFa-1, the cichlid fish GnIH, inhibits ß-LH and ß-FSH release and stimulates GH release in intact pituitary cultures of C. dimerus. The results also show that cd-LPQRF-2 could act as an ß-FSH-releasing factor in this fish species.

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Neuropeptide Y (NPY) is considered the most potent orexigenic peptide, increasing before meal time and during fasting. In teleost, most studies on NPY action upon growth hormone (GH) and luteinizing hormone (LH) were conducted in females or group of animals without sex discrimination. The aim of this study was to evaluate whether NPY modulates the expression and release of GH and gonadotropins in both sexes of Cichlasoma dimerus. By double-label immunofluorescence, we first determined the association between NPY fibers and pituitary cells. In addition, we performed in vitro studies to evaluate the effect of NPY on GH and gonadotropins expression by real-time PCR, and release by Western blot, in males and females separately. Contacts between NPY fibers and GH and follicle-stimulating hormone (FSH)-producing cells were detected, indicating possible functional relationships. We observed an increase in GH release in the culture medium at 2 nM for males (p = 0.043) and 20 nM for females (p = 0.028). Pituitary FSH release was stimulated at 20 nM (p = 0.026) and 200 nM (p = 0.033) for males and females, respectively. Finally, NPY only increased ß-LH mRNA expression at 20 nM in females (p = 0.028) and its release at 2 nM (p = 0.049) and 200 nM for males (p = 0.005) and 200 nM for females (p = 0.018). In conclusion, NPY acts as a GH-, LH- and FSH-releasing factor, in a dose- and sex-dependent way.

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In this study, we investigated the effect of leptin on the ovarian metalloproteinase system in the rat during the ovulatory process. Ovulation was induced in immature rats primed with gonadotropins. In both in vitro and in vivo experiments, we measured i) the protein expression of the ovarian metalloproteinases (matrix metalloproteinases, MMPs) and their tissue inhibitors (TIMPs) by western blot; ii) the gelatinase activity of the ovarian MMPs by zymography; and iii) the inhibitory action of TIMPs by reverse zymography. Using cultures of ovarian explants, leptin increased the activity but not the protein expression of MMP-2 and MMP-9 in both culture medium and ovarian tissue, and the protein expression of TIMPs, without a higher inhibitory action of the gelatinase activity. These results suggest either that the increase in TIMP proteins was not sufficient or that the inhibitory actions of TIMPs were impaired to suppress the MMP activity when the ovaries were directly exposed to leptin. To study the in vivo effect, rats received an acute treatment with high doses of leptin to inhibit ovulation. This treatment increased the expression of both the latent and the active forms of MMP-2 but did not result in a greater activity of MMP-2. In addition, the inhibitory action of TIMP-2 was also increased by this treatment. These results suggest that the administration of high doses of leptin could be regulating the follicle wall degradation, at least in part, by increasing the action of the ovarian TIMP-2 as a result of an extraovarian mechanism or signaling pathway.

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To investigate the expression of leptin receptors (Ob-R) in the rat hypothalamus-pituitary-ovarian axis, immature rats were treated with eCG/hCG and Ob-R expression was evaluated by western blot analysis. The Ob-R expression increased 24 h after eCG administration in all the tissues assayed. In the hypothalamus, these levels immediately decreased to those obtained without treatment. In the pituitary, the Ob-R expression continued to be elevated 48 h after eCG administration, whereas the hCG injection did not modify these levels. Similar results were obtained with the ovarian long isoform. To assess the effect of leptin on its receptors, Ob-R was assessed in hypothalamus, pituitary and ovarian explants cultured in the presence or absence of leptin (0.3-500 ng/ml). In the hypothalamus, we found a biphasic effect: the Ob-R expression was either reduced or increased at low or high concentrations of leptin respectively. LH-releasing hormone secretion increased at 1 ng/ml. In the pituitary, Ob-R increased at 10 or 30 ng/ml of leptin for the long and short isoforms respectively. Leptin also induced an increase in LH release at 30 ng/ml. In the ovarian culture, the presence of leptin produced an increase in Ob-R expression at different ranges of concentrations and a dose-dependent biphasic effect on the progesterone production. In conclusion, all these results clearly suggest that leptin is able to modulate the expression of its own receptors in the reproductive axis in a differential way. Moreover, the positive or negative effect that leptin exerts on the ovulatory process may be dependent on this regulation.

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The aims of this study were to investigate the negative action of leptin on some intraovarian ovulatory mediators during the ovulatory process and to assess whether leptin is able to alter the expression of its ovarian receptors. Immature rats primed with gonadotrophins were used to induce ovulation. Serum leptin concentration was diminished 4 h after human chorionic gonadotrophin (hCG) administration, whereas the ovarian expression of leptin receptors, measured by western blot, was increased by the gonadotrophin treatment. Serum progesterone level, ovulation rate and ovarian prostaglandin E (PGE) content were reduced in rats primed with equine chorionic gonadotrophin (eCG)/hCG and treated with acute doses of leptin (five doses of 5 mug each). These inhibitory effects were confirmed by in vitro studies, where the presence of leptin reduced the concentrations of progesterone, PGE and nitrites in the media of both ovarian explants and preovulatory follicle cultures. We also investigated whether these negative effects were mediated by changes in the expression of the ovarian leptin receptors. Since leptin treatment did not alter the expression of ovarian leptin receptor, the inhibitory effect of leptin on the ovulatory process may not be mediated by changes in the expression of its receptors at ovarian level, at least at the concentrations assayed. In summary, the ovulatory process was significantly inhibited in response to an acute treatment with leptin, and this effect may be due, at least in part, to the direct or indirect impairment of some ovarian factors, such as prostaglandins and nitric oxide.

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Evaluamos pacientes para identifica factores determinantes de estadía hospitalaria prolongada y complicaciones de la misma. MATERIAL Y MÉTODO: estudio retrospectivo descriptivo. Los datos se procesaron utilizando Chi' , Test de Fisher y Test T según variables. Definimos internación prolongada (IP) estadía hospitalaria igual o mayor a 10 días. RESULTADOS: se analizaron 322 pacientes. Cincuenta (15.5%) presentaron IP y 272 (84.5%) estadía < 10 días. El promedio de edad fue 63.8 para < 10 días y 66 para IP . Presentaron comorbilidades 87% en <10 días y 86% IP. Los diagnósticos de ingreso más frecuentes en < 10 días fueron patología respiratoria (25%). incluyendo neumonía (10%), infección urinaria e insuficiencia cardiaca; y en IP neumonía (20%) y patología neurológica aguda (18%) . El 46% de IP requirió cirugía vs 20.6% (p

In order to identify determining factors and complications in illness, we evaluated patients under long period hospitalization, in a Clinical Service. METHODS: retrospective and descriptive studies. Figures were evaluated by Chi-, Fisher T and Test T, thrue variables. We call long period hospitalization to a staying of 10 days or longer. RESULTS: 322 patients were evaluated. 50 (15,5%) presented (LS) and 272 < 10 days staying. Age average was 63,8 for < 10 days and 66 for (LS). Mostly of diagnosis at admission for < 10 days were respiratory dysfunction (25%) including pneumonia (10%), urinary infection and heart failure, and for LS pneumonia 20%, acute neurological disease 18 %. The 46 % of LS required surgery vs. 20,6% (p < 1,01). The LS needed parenteral nutrition 26 % vs. 12,5% (p < 0,02). The average of maximum amount of drugs/day in staying was: 5,8 for < 10 days and 8,76 for LS (p < 0,01). Hospital complications in LS were 28 % vs. 11% (p < 0,01), mainly nosocomial pneumonia (p < 0,01) and endovascular infections (p < 0,01). Staying in ICU was 54% for LS vs. 19% (p < 0,01), and average of days in intensive care unit (ICU) was 8 in LS vs. 3 (p < 0,01). There wasn't any difference in mortality. CONCLUSION: the admission's diagnosis and the ICU's staying were the main causes of LS, but not so age and co-morbilities studied. The LS patients require more complex and expensive staying. They present more hospital complications.

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Evaluamos pacientes para identifica factores determinantes de estadía hospitalaria prolongada y complicaciones de la misma. MATERIAL Y METODO: estudio retrospectivo descriptivo. Los datos se procesaron utilizando Chi , Test de Fisher y Test T según variables. Definimos internación prolongada (IP) estadía hospitalaria igual o mayor a 10 días. RESULTADOS: se analizaron 322 pacientes. Cincuenta (15.5%) presentaron IP y 272 (84.5%) estadía < 10 días. El promedio de edad fue 63.8 para < 10 días y 66 para IP . Presentaron comorbilidades 87% en <10 días y 86% IP. Los diagnósticos de ingreso más frecuentes en < 10 días fueron patología respiratoria (25%). incluyendo neumonía (10%), infección urinaria e insuficiencia cardiaca; y en IP neumonía (20%) y patología neurológica aguda (18%) . El 46% de IP requirió cirugía vs 20.6% (p

In order to identify determining factors and complications in illness, we evaluated patients under long period hospitalization, in a Clinical Service. METHODS: retrospective and descriptive studies. Figures were evaluated by Chi-, Fisher T and Test T, thrue variables. We call long period hospitalization to a staying of 10 days or longer. RESULTS: 322 patients were evaluated. 50 (15,5%) presented (LS) and 272 < 10 days staying. Age average was 63,8 for < 10 days and 66 for (LS). Mostly of diagnosis at admission for < 10 days were respiratory dysfunction (25%) including pneumonia (10%), urinary infection and heart failure, and for LS pneumonia 20%, acute neurological disease 18 %. The 46 % of LS required surgery vs. 20,6% (p < 1,01). The LS needed parenteral nutrition 26 % vs. 12,5% (p < 0,02). The average of maximum amount of drugs/day in staying was: 5,8 for < 10 days and 8,76 for LS (p < 0,01). Hospital complications in LS were 28 % vs. 11% (p < 0,01), mainly nosocomial pneumonia (p < 0,01) and endovascular infections (p < 0,01). Staying in ICU was 54% for LS vs. 19% (p < 0,01), and average of days in intensive care unit (ICU) was 8 in LS vs. 3 (p < 0,01). There wasnt any difference in mortality. CONCLUSION: the admissions diagnosis and the ICUs staying were the main causes of LS, but not so age and co-morbilities studied. The LS patients require more complex and expensive staying. They present more hospital complications.(AU)

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A 66 years female, who was since last year under astenia, arthralgias, pimply lesions in spread plates and tests showing eritrosedimentation over 100 mm, anemi, leucocitosis with neutrofilia, policlonal hypergammaglobulinemia, slight proteinuria and IgE on 900. This patient was sporadically treated with corticoids. When made the medical consult had lost 34lb., was under anorexy, as well as dyspepsia. Hemoglobyn 6.9 gr/dl, leucocytes 20000/mm3, neutrofils at 90%, proteinogram the same as former, with hypoalbuminemia. She was taking prednisona, 16 mg/day. When examined showed depress of conscience, astenia, and dermic lesions already quoted. 4 cm nonpainful right axillary adenopaty adhered to deep planes. Medulogram with increased iron, hyperegenerative. Ganglionar biopsia: linfoid hyperplasic process linked to inmune response. Toracoabdominal tomography with adenomegalia in torax and retroperitoneo. Skin biopsia: neutrofilic vasculitis. The patient suspends the 16 mg of prednisona and fever as well as generalized adenopatias come up. After laying aside other ethiologies, and understanding as Castleman Multicentric disease, it is started to supply prednisona 1 mg/kg of weight with a clinical and biochemical fast and outstanding response. After 7 months it was progressively suspended the esteroids and 60 days later, the process fall back; for that, corticoids are restarted, with a good evolution. The illness of Castleman although it is not very frequent, it should be considered as differential diagnosis in those clinical cases that are accompanied with important general commitment, linphadenopaties and respons to steroid therapy.

Mujer de 66 años que un año previo a la consulta presentaba astenia, artralgias, lesiones pruriginosas y eritematosas en placa diseminadas. Eritrosedimentación mayor de 100mm, anemia, leucocitosis con neutrofilia, hipergammaglobulinemia policlonal, proteinuria leve e IgE de 900. Fue tratada esporádicamente con corticoides. Llega a la consulta con pérdida de 15kg de peso, anorexia y dispepsia. Hemoglobina 6.9gr/dl, leucocitos 20000/mm3, neutrófilos 90%, proteinograma similar al previo mas hipoalbuminemia. Recibía prednisona 16mg;día. Al examen bradipsíquica, asténica, lesiones dérmicas ya descritas, adenopatía axilar derecha de 4cm no dolorosa adherida a planos profundos. Medulograma con hierro aumentado, hiperregenerativa. Biopsia ganglionar: proceso hiperplásico linfoide relacionado a respuesta inmune. Tomografía tóracoabdominal con adenomegalias en medias tino y retroperitoneo. Biopsia de piel: vasculitis neutrofílica. Suspende el corticoide y aparece fiebre y adenopatías generalizadas. Tras descartar otras etiologías, se interpreta como Enfermedad de Castleman. Inicia prednisona a lmg/kg/ día con favorable, rápida y llamativa respuesta clínica y bioquímica. Luego de 7 meses se suspende de manera progresiva los esteroides, y a los 60 días presenta recaída por lo que se reinicia la terapéutica con una nueva favorable evolución. La enfermedad de Castleman si bien es poco frecuente, debe ser considerada como diagnóstico diferencial en aquellos cuadros clínicos que se acompañan de importante compromiso general. adenomegalias y respuesta a terapia con corticoides.

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Upper gastrointestinal bleeding--UGB-, as a complication, is well studied at intensive care units (ICU), but is less known in non ICU settings. Objectives: To determine incidence and risk factors of this entity at clinical hospitalization. MATERIALS AND METHODS: A case-control study of patients with gastric ulcer disease diagnosed by endoscopy who presented with melena and hematemesis. Ten controls were taken for each case, matching sex, age and prophylaxis for gastric hemorrhage. Demographic data and other know risks factors were analyzed. RESULT: We found ten bleeding case among 35070 discharges (incidence: 2.8/10000 discharges). Mortality was not increased but the number of transfusion was higher in the bleeding group. We found an assocciation betwen UGB and systemic inflammatory response syndrome--SIRS-(OR: 9.22 IC 95% 2.98-28.17) and diabetes (OR: 7.8 IC 95% 2.3-26.8). The rest of the factors studied did not rich a statistical significance. CONCLUSIONS: UGB during clinical hospitalization is a rare complication that requires an increased staying at hospital and a great number of transfusions. It may be probably associated in a positive way with diabetes and SIRS.

La hemorragia digestiva alta durante la internación es una complicación estudiada en unidades de cuidados críticos, pero se sabe poco de esta complicación en sala común. Objetivos: determinar la incidencia y factores de riesgo de esta patología en sala común. Materiales y Métodos: Estudio casocontrol. Definimos casos, pacientes con endoscopía digestiva realizada por melena o hematemesis, con diagnóstico de enfermedad ulcerosa, se tomaron 10 controles por caso, controlando edad, sexo y uso de profilaxis ulcerosa. Se analizaron datos demográficos y factores de riesgo conocidos para esta patología y se determinó la incidencia en sala común. Resultados: Se produjeron 10 episodios de sangrado sobre 35070 altas (Incidencia 2.8110.000 altas). No hubo mayor mortalidad en los casos pero si requirieron mayor número de transfusiones (1.2 versus (vs) 0.07 paquetes de glóbulos rojos sedimentados en el grupo control. P=O.OOl) y tuvieron una mayor estadía hospitalaria (13.6 vs 6.8 días en el grupo control. P=O.OOl). Existió una asociación significativa entre hemorragia digestiva y presentar SIRS (aR: 9.22 IC95%: 2.9828.17) o Diabetes (aR: 7.8 IC95%: 2.326.8), el resto de los factores no alcanzaron significancia estadística. Conclusión: La hemorragia digestiva durante la internación es una entidad poco frecuente que requiere mayor estadía hospitalaria y necesidad de transfusiones. Asociada posiblemente en forma positiva al ingreso con SIRS, Diabetes, leucocitosis y taquicardia.

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A 66 years female, who was since last year under astenia, arthralgias, pimply lesions in spread plates and tests showing eritrosedimentation over 100 mm, anemi, leucocitosis with neutrofilia, policlonal hypergammaglobulinemia, slight proteinuria and IgE on 900. This patient was sporadically treated with corticoids. When made the medical consult had lost 34lb., was under anorexy, as well as dyspepsia. Hemoglobyn 6.9 gr/dl, leucocytes 20000/mm3, neutrofils at 90%, proteinogram the same as former, with hypoalbuminemia. She was taking prednisona, 16 mg/day. When examined showed depress of conscience, astenia, and dermic lesions already quoted. 4 cm nonpainful right axillary adenopaty adhered to deep planes. Medulogram with increased iron, hyperegenerative. Ganglionar biopsia: linfoid hyperplasic process linked to inmune response. Toracoabdominal tomography with adenomegalia in torax and retroperitoneo. Skin biopsia: neutrofilic vasculitis. The patient suspends the 16 mg of prednisona and fever as well as generalized adenopatias come up. After laying aside other ethiologies, and understanding as Castleman Multicentric disease, it is started to supply prednisona 1 mg/kg of weight with a clinical and biochemical fast and outstanding response. After 7 months it was progressively suspended the esteroids and 60 days later, the process fall back; for that, corticoids are restarted, with a good evolution. The illness of Castleman although it is not very frequent, it should be considered as differential diagnosis in those clinical cases that are accompanied with important general commitment, linphadenopaties and respons to steroid therapy.(AU)

Mujer de 66 años que un año previo a la consulta presentaba astenia, artralgias, lesiones pruriginosas y eritematosas en placa diseminadas. Eritrosedimentación mayor de 100mm, anemia, leucocitosis con neutrofilia, hipergammaglobulinemia policlonal, proteinuria leve e IgE de 900. Fue tratada esporádicamente con corticoides. Llega a la consulta con pérdida de 15kg de peso, anorexia y dispepsia. Hemoglobina 6.9gr/dl, leucocitos 20000/mm3, neutrófilos 90%, proteinograma similar al previo mas hipoalbuminemia. Recibía prednisona 16mg;día. Al examen bradipsíquica, asténica, lesiones dérmicas ya descritas, adenopatía axilar derecha de 4cm no dolorosa adherida a planos profundos. Medulograma con hierro aumentado, hiperregenerativa. Biopsia ganglionar: proceso hiperplásico linfoide relacionado a respuesta inmune. Tomografía tóracoabdominal con adenomegalias en medias tino y retroperitoneo. Biopsia de piel: vasculitis neutrofílica. Suspende el corticoide y aparece fiebre y adenopatías generalizadas. Tras descartar otras etiologías, se interpreta como Enfermedad de Castleman. Inicia prednisona a lmg/kg/ día con favorable, rápida y llamativa respuesta clínica y bioquímica. Luego de 7 meses se suspende de manera progresiva los esteroides, y a los 60 días presenta recaída por lo que se reinicia la terapéutica con una nueva favorable evolución. La enfermedad de Castleman si bien es poco frecuente, debe ser considerada como diagnóstico diferencial en aquellos cuadros clínicos que se acompañan de importante compromiso general. adenomegalias y respuesta a terapia con corticoides. (AU)

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Upper gastrointestinal bleeding--UGB-, as a complication, is well studied at intensive care units (ICU), but is less known in non ICU settings. Objectives: To determine incidence and risk factors of this entity at clinical hospitalization. MATERIALS AND METHODS: A case-control study of patients with gastric ulcer disease diagnosed by endoscopy who presented with melena and hematemesis. Ten controls were taken for each case, matching sex, age and prophylaxis for gastric hemorrhage. Demographic data and other know risks factors were analyzed. RESULT: We found ten bleeding case among 35070 discharges (incidence: 2.8/10000 discharges). Mortality was not increased but the number of transfusion was higher in the bleeding group. We found an assocciation betwen UGB and systemic inflammatory response syndrome--SIRS-(OR: 9.22 IC 95% 2.98-28.17) and diabetes (OR: 7.8 IC 95% 2.3-26.8). The rest of the factors studied did not rich a statistical significance. CONCLUSIONS: UGB during clinical hospitalization is a rare complication that requires an increased staying at hospital and a great number of transfusions. It may be probably associated in a positive way with diabetes and SIRS.(AU)

La hemorragia digestiva alta durante la internación es una complicación estudiada en unidades de cuidados críticos, pero se sabe poco de esta complicación en sala común. Objetivos: determinar la incidencia y factores de riesgo de esta patología en sala común. Materiales y Métodos: Estudio casocontrol. Definimos casos, pacientes con endoscopía digestiva realizada por melena o hematemesis, con diagnóstico de enfermedad ulcerosa, se tomaron 10 controles por caso, controlando edad, sexo y uso de profilaxis ulcerosa. Se analizaron datos demográficos y factores de riesgo conocidos para esta patología y se determinó la incidencia en sala común. Resultados: Se produjeron 10 episodios de sangrado sobre 35070 altas (Incidencia 2.8110.000 altas). No hubo mayor mortalidad en los casos pero si requirieron mayor número de transfusiones (1.2 versus (vs) 0.07 paquetes de glóbulos rojos sedimentados en el grupo control. P=O.OOl) y tuvieron una mayor estadía hospitalaria (13.6 vs 6.8 días en el grupo control. P=O.OOl). Existió una asociación significativa entre hemorragia digestiva y presentar SIRS (aR: 9.22 IC95%: 2.9828.17) o Diabetes (aR: 7.8 IC95%: 2.326.8), el resto de los factores no alcanzaron significancia estadística. Conclusión: La hemorragia digestiva durante la internación es una entidad poco frecuente que requiere mayor estadía hospitalaria y necesidad de transfusiones. Asociada posiblemente en forma positiva al ingreso con SIRS, Diabetes, leucocitosis y taquicardia.(AU)

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The plasmatic activities of total alkaline phosphatase (ALP) (E.C. 3.1.3.1), high molecular weight-ALP (high Mr-ALP) and bone-ALP isoenzymes, were determined in healthy individuals and in patients with: neoplasia without metastases, hepatic metastases, bone metastases and mixed metastases (hepatic and bone). Variables were individually used to assess incidence of metastases and percentages of false negative and false positive results were calculated. The three values were then used together to assess metastases incidence and sensitivity, specificity, positive predictive value, negative predictive value and predictive capacity were estimated. We conclude that none of the variables per se are reliable for the diagnosis of metastases. On the other hand, the three values show high percentages of sensitivity, specificity, positive predictive value, negative predictive value and a high probability (0.93) of accurate diagnosis when applied to a larger population, with similar prevalence values.

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The plasmatic activities of total alkaline phosphatase (ALP) (E.C. 3.1.3.1), high molecular weight-ALP (high Mr-ALP) and bone-ALP isoenzymes, were determined in healthy individuals and in patients with: neoplasia without metastases, hepatic metastases, bone metastases and mixed metastases (hepatic and bone). Variables were individually used to assess incidence of metastases and percentages of false negative and false positive results were calculated. The three values were then used together to assess metastases incidence and sensitivity, specificity, positive predictive value, negative predictive value and predictive capacity were estimated. We conclude that none of the variables per se are reliable for the diagnosis of metastases. On the other hand, the three values show high percentages of sensitivity, specificity, positive predictive value, negative predictive value and a high probability (0.93) of accurate diagnosis when applied to a larger population, with similar prevalence values.

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