Prevalence of Coeliac disease in the general population of northern Spain. Strategies of serologic screening

BACKGROUND

Coeliac disease (CD) is common in Western countries. In Spain, however, no studies exist on its prevalence. The best method for serologic screening is also unknown.

METHODS

We determined the IgA and IgG antigliadin antibodies (AGA) and IgA antiendomysium antibodies (AEA) in a sample of 1170 randomly selected subjects from a health area in northern Spain. The prevalence of CD was calculated with a two-step serologic screening method (first IgA and IgG AGA and then AEA in those positive for AGA) or with only one step with AEA determination. Diagnosis was confirmed by small-intestinal biopsy.

RESULTS

When using a two-step strategy, we found 174 (15%) subjects with AGA. Only one of these was confirmed by means of AEA (prevalence of CD = 0.9/1000). Two subjects were found to be positive when a one-step strategy was used (prevalence of CD = 1.7/1000). This yielded an economic saving of 19% with regard to the use of a two-step strategy. One new case of CD in a seronegative subject was diagnosed during the study (real prevalence of CD = 2.6/1000; 95% confidence interval = 0.7-8.2).

CONCLUSIONS

The prevalence of CD in Northern Spain is 2.6/1000 (1:389). One-step serologic screening (AEA) is both more economical and more sensitive than the two-step procedure (first AGA and then AEA if AGA is positive).

[Cancer mortality in Spain, 1955-1994]

BACKGROUND

To analyze the mortality from the eight main cancer sites in men and women from Spain between 1955-1994.

MATERIAL AND METHODS

Age-standardized mortality rates were computed.

RESULTS

In men, an increase in lung cancer mortality as well as in the other 8 sites was registered, except for stomach cancer. In women, breast, ovary, and pancreas cancer mortality continue to increase.

CONCLUSIONS

Cancer mortality in Spain has dismal trends. This fact implies the need of strong interventions.

Adenosine deaminase isoenzymes and neopterin in liver cirrhosis

The aim of this study was to define the pattern of neopterin and ADA isoenzymes in liver cirrhosis. A total of 117 patients with liver cirrhosis were included. Serum levels of ADA were assayed in the presence and absence of a specific inhibitor for ADA1. Serum neopterin was measured using a competitive enzyme-linked immunosorbent assay. The grade of liver insufficiency was assessed according to the Child-Pugh classification and the monoethylglycinexylidide test. Serum ADA, ADA1, ADA2 and neopterin were higher in cirrhotic patients than in control subjects. A stepwise increase in serum ADA level was observed with increasing severity of liver cirrhosis. The probability of ADA2 being greater than the mean was approximately 2.5 times higher (2.48, CI 95%: 1.36-4.52) in patients with liver cirrhosis due to hepatitis C virus (HCV) infection than in those patients with cirrhosis of a different etiology. No correlation was found between ADA2 and neopterin. Our data show that liver insufficiency and HCV infection increase the serum levels of ADA and its major isoenzyme ADA2. Furthermore, ADA isoenzyme determination adds no value to total ADA value. The absence of a correlation between ADA2 and neopterin suggests that different physiologic processes are involved in their increase.

Irregular S-cone mosaics in felid retinas. Spatial interaction with axonless horizontal cells, revealed by cross correlation

In most mammals short-wavelength-sensitive (S) cones are arranged in irregular patterns with widely variable intercell distances. Consequently, mosaics of connected interneurons either may show some type of correlation to photoreceptor placement or may establish an independent lattice with compensatory dendritic organization. Since axonless horizontal cells (A-HC's) are supposed to direct all dendrites to overlying cones, we studied their spatial interaction with chromatic cone subclasses. In the cheetah, the bobcat, and the leopard, anti-S-opsin antibodies have consistently colabeled the A-HC's in addition to the S cones. We investigated the interaction between the two cell mosaics, using autocorrelation and cross-correlation procedures, including a Voronoi-based density probe. Comparisons with simulations of random mosaics show significantly lower densities of S cones above the cell bodies and primary dendrites of A-HC's. The pattern results in different long-wavelength-sensitive-L- and S-cone ratios in the central versus the peripheral zones of A-HC dendritic fields. The existence of a related pattern at the synaptic level and its potential significance for color processing may be investigated in further studies.

[Factors related to drug consumption in children's population]

BACKGROUND

To analyse the correlates of drug consumption in children's population.

METHOD

Analyse interviews corresponding to children younger than 15 years old of the Catalan Health Survey (n = 2,433).

RESULTS

The 25% consumed some drug in the previous 2 days. The factors related to drug consumption were low age, living in Barcelona (OR = 1.3), reporting double coverage (OR = 1.6), physician visits in the past 15 days (OR = 2.4), and reporting health problems.

CONCLUSIONS

Drug consumption in children is high. It seems necessary to improve the education of families and health professionals related to drug consumption.

Electrical and mechanical effects of vasoactive intestinal peptide and pituitary adenylate cyclase-activating peptide in the rat colon involve different mechanisms

This work aimed to study the effects of pituitary adenylate cyclase-activating peptide (PACAP) and vasoactive intestinal peptide (VIP) on the mechanical and electrical activity of the circular muscle of the rat colon and the mechanisms involved in such effects. Spontaneous mechanical activity was studied in vitro in an organ bath and the membrane potential was recorded using the microelectrode technique. Both VIP and PACAP (0.1 microM) caused an immediate, sustained and tetrodotoxin (1 microM)-resistant inhibition of the cyclic spontaneous mechanical activity and hyperpolarization. The small-conductance Ca(2+)-activated K(+) channel blocker, apamin (1 microM), did not change the VIP- and PACAP-induced relaxation but reduced the hyperpolarization induced by PACAP whereas it did not change that induced by VIP. In contrast, the purinoceptor antagonist, suramin (100 microM), blocked the hyperpolarization caused by PACAP and VIP but failed to change their mechanical inhibitory effects. Moreover, the putative PACAP and VIP receptor antagonists, PACAP-(6-38) and VIP-(10-28), respectively, both 3 microM, failed to change the effects of either peptide and modified neither the inhibitory junction potential nor the relaxation induced by electrical-field stimulation. Thus, these results suggest that the mechanisms mediating relaxation are not strictly coupled to the mechanisms mediating hyperpolarization. This could be due to activation of two distinct mechanisms of action after agonist receptor interaction.

Thymocyte development past the CD4(+)CD8(+) stage requires an active p38 mitogen-activated protein kinase

Activation of the p38 mitogen-activated protein kinase (MAPK) pathway is important for some T-cell functions, but its role in intrathymic development is unclear. To investigate the function of p38 MAPK during the late stages of thymocyte differentiation, pharmacologic and genetic manipulations were used to inhibit p38 MAPK activity in developing thymocytes. Ligation of the T-cell antigen receptor (TCR) on either thymocytes or a thymocyte cell line resulted in p38 MAPK activation. Selective pharmacologic inhibition of p38 MAPK activity with the pyridinyl imidazole drug SB203580 severely impaired the development of mature CD4(+) and CD8(+) single positive (SP) thymocytes from their CD4(+)CD8(+) double positive (DP) precursors in fetal thymic organ culture (FTOC). Further, pharmacologic or genetic suppression of p38 MAPK activity, the latter achieved by overexpressing a catalytically inactive p38 MAPK, resulted in a blockade of the DP-to-SP transition of a thymocyte cell line in a novel in vitro differentiation assay. Taken together, these data constitute the first demonstration that p38 MAPK plays a critical role in the DP-to-SP differentiation of thymocytes during late intrathymic development. (Blood. 2000;95:1356-1361)

Characterization of two polyketide methyltransferases involved in the biosynthesis of the antitumor drug mithramycin by Streptomyces argillaceus

A DNA chromosomal region of Streptomyces argillaceus ATCC 12596, the producer organism of the antitumor polyketide drug mithramycin, was cloned. Sequence analysis of this DNA region, located between four mithramycin glycosyltransferase genes, showed the presence of two genes (mtmMI and mtmMII) whose deduced products resembled S-adenosylmethionine-dependent methyltransferases. By independent insertional inactivation of both genes nonproducing mutants were generated that accumulated different mithramycin biosynthetic intermediates. The M3DeltaMI mutant (mtmMI-minus mutant) accumulated 4-demethylpremithramycinone (4-DPMC) which lacks the methyl groups at carbons 4 and 9. The M3DeltaM2 (mtmMII-minus mutant) accumulated 9-demethylpremithramycin A3 (9-DPMA3), premithramycin A1 (PMA1), and 7-demethylmithramycin, all of them containing the O-methyl group at C-4 and C-1', respectively, but lacking the methyl group at the aromatic position. Both genes were expressed in Streptomyces lividans TK21 under the control of the erythromycin resistance promoter (ermEp) of Saccharopolyspora erythraea. Cell-free extracts of these clones were precipitated with ammonium sulfate (90% saturation) and assayed for methylation activity using different mithramycin intermediates as substrates. Extracts of strains MJM1 (expressing the mtmMI gene) and MJM2 (expressing the mtmMII gene) catalyzed efficient transfer of tritium from [(3)H]S-adenosylmethionine into 4-DPMC and 9-DPMA3, respectively, being unable to methylate other intermediates at a detectable level. These results demonstrate that the mtmMI and mtmMII genes code for two S-adenosylmethionine-dependent methyltransferases responsible for the 4-O-methylation and 9-C-methylation steps of the biosynthetic precursors 4-DPMC and 9-DPMA3, respectively, of the antitumor drug mithramycin. A pathway is proposed for the last steps in the biosynthesis of mithramycin involving these methylation events.

Humanized versus murine anti-human epidermal growth factor receptor monoclonal antibodies for immunoscintigraphic studies

The anti-human epidermal growth factor receptor (EGF-R) humanized antibody h-R3 (IgG(1)), which binds to an extracellular domain of EGF-R, was used to evaluate the biodistribution on nude mice xenografted with A431 epidermoid carcinoma cell line. Results are compared with its murine version ior egf/r3 monoclonal antibody (mAb). Twenty-one athymic female 4NMRI nu/nu mice were injected intravenously with 10 microg/100 microCi of (99m)Tc-labeled mAbs. The mAb ior C5 that recognizes an antigen expressed preferentially on the surface of malignant and cytoplasm of normal colorectal cells was used as negative control. Immunoreactivity of (99m)Tc-labeled mAbs was measured by enzyme linked immunosorbent assay on A431 cell line and the immunoreactive fractions determined by Lindmo method. Among all organs significative accumulation was found in tumor (6.14 +/- 2.50 %ID/g, 5.06 +/- 2.61 %ID/g for murine and humanized mAbs, respectively) 4 h after injection. The immunoreactive fractions were found to be 0.88 and 0.81 for murine and humanized mAb, respectively. Thus, we expect better results using the humanized mAb h-R3 for diagnostic immunoscintigraphy.

A high affinity nitrate transport system from Chlamydomonas requires two gene products

A nitrate-regulated cluster of genes involved in nitrate transport and assimilation has been identified in Chlamydomonas reinhardtii. Mutant strains of the alga, which are defective in some aspect of transport and assimilation have been used to assign functions to these genes. This analysis has suggested that two gene products are necessary to obtain a functional high affinity nitrate system in Chlamydomonas [Quesada et al. (1994) Plant J. 5, 407-419]. In this paper we have tested this hypothesis by injecting Xenopus oocytes with mRNA prepared from these two cDNAs, Nrt2;1 and Nar2, and then assaying the oocytes for nitrate transport activity. Oocytes injected with single types of mRNA did not show any nitrate transport activity. Furthermore, Nar2 mRNA was toxic to oocytes, with nearly 60%, of the oocytes dead 3 days after the injection. However, when oocytes were injected with a mixture of two mRNAs prepared from Nrt2;1 and Nar2, a high affinity nitrate transport activity could be measured. However, the Km for nitrate of this transport system was 28 microM which is higher than the value of 1.6 microM which had been obtained by the analysis of mutant phenotypes. The pH-dependence of the nitrate-elicited currents was consistent with a proton-cotransport mechanism. These results prove that two gene products are required to produce a functional high affinity nitrate transport system and that this process does not involve transcriptional regulation.

[Inequalities in health according to social class in Catalonia, 1994]

OBJECTIVE

To study social inequalities in health in Catalonia.

DESIGN

Cross-sectional survey of a representative sample of the population of Catalonia, Spain (Catalan Health Interview Survey, 1994).

PARTICIPANTS

Responses from 5641 males and 6604 women aged 15 years or over were included for analysis.

MEASUREMENTS AND MAIN RESULTS

We analysed the information about self-perceived health, restriction of activity, and presence of chronic conditions according to social class by means of logistic regression models. The proportion of subjects that rated their health as fair or poor was higher in social classes IV-V than in classes I-II (men: 25.0% vs. 14.5%; OR, 1.8, 95% CI, 1.5-2.3; women: 34.4% vs. 21.5%; OR, 1.7, 95% CI, 1.4-2.1). There were differences by social class in respect to restriction of activity and presence of chronic conditions.

CONCLUSIONS

Despite the decrease of social inequalities in accesibility and use of health services due to the universalisation of health coverage, differences by social class remain in the perception of health status. These inequalities should be addressed by the health system within the framework of broad public and social policies.

Nitrite reductase mutants as an approach to understanding nitrate assimilation in Chlamydomonas reinhardtii

We constructed mutant strains lacking the nitrite reductase (NR) gene in Chlamydomonas reinhardtii. Two types of NR mutants were obtained, which either have or lack the high-affinity nitrate transporter (Nrt2;1, Nrt2;2, and Nar2) genes. None of these mutants overexpressed nitrate assimilation gene transcripts nor NR activity in nitrogen-free medium, in contrast to NR mutants. This finding confirms the previous role proposed for NR on its own regulation (autoregulation) and on the other genes for nitrate assimilation in C. reinhardtii. In addition, the NR mutants were used to study nitrate transporters from nitrite excretion. At high CO(2), only strains carrying the above high-affinity nitrate transporter genes excreted stoichiometric amounts of nitrite from 100 microM nitrate in the medium. A double mutant, deficient in both the high-affinity nitrate transporter genes and NR, excreted nitrite at high CO(2) only when nitrate was present at mM concentrations. This suggests that there exists a low-affinity nitrate transporter that might correspond to the nitrate/nitrite transport system III. Moreover, under low CO(2) conditions, the double mutant excreted nitrite from nitrate at micromolar concentrations by a transporter with the properties of the nitrate/nitrite transport system IV.

Characterization of two glycosyltransferases involved in early glycosylation steps during biosynthesis of the antitumor polyketide mithramycin by Streptomyces argillaceus

A 2,580-bp region of the chromosome of Streptomyces argillaceus, the producer of the antitumor polyketide mithramycin, was sequenced. Analysis of the nucleotide sequence revealed the presence of two genes (mtmGIII and mtmGIV) encoding proteins that showed a high degree of similarity to glycosyltransferases involved in the biosynthesis of various antibiotics and antitumor drugs. Independent insertional inactivation of both genes produced mutants that did not synthesize mithramycin but accumulated several mithramycin intermediates. Both mutants accumulated premithramycinone, a non-glycosylated intermediate in mithramycin biosynthesis. The mutant affected in the mtmGIII gene also accumulated premithramycin A1, which contains premithramycinone as the aglycon unit and a D-olivose attached at C-12a-O. These experiments demonstrate that the glycosyltransferases MtmGIV and MtmGIII catalyze the first two glycosylation steps in mithramycin biosynthesis. A model is proposed for the glycosylation steps in mithramycin biosynthesis.

Pollution of soils by the toxic spill of a pyrite mine (Aznalcollar, Spain)

On 25 April 1998 the retention walls broke open in a pond containing the residues from a pyrite mine of Aznalcollar (southern Spain), spilling some 45 x 10(5) m3 of polluted water and toxic tailings into the Agrio and Guadiamar River basin, affecting some 55 km2. On 5 May, seven sectors in the affected area were studied, analysing tailings, polluted water, and contaminated as well as uncontaminated soils. The principal pollutants were: Zn, Pb, Cu, As, Sb, Bi, Cd and Tl. The range of total contamination of each element was extremely broad, as penetration of the tailings depended on the soil characteristics. Most of the Cu, Zn and Cd penetrated the soil in the solution phase of the spill, while the other elements penetrated mostly as part of the solid phase. Zn exceeded the maximum concentrations permitted by the international community in four of the seven sectors studied, As in three, and the other elements only in one sector. Drying and consequent aeration of the tailings rapidly oxidized sulphides to sulphates, lowered the pH and solubilized the pollutants. Therefore, future rains could aggravate the pollution problem, if the tailings are not quickly removed.

Grover's disease in patients with chronic renal failure receiving hemodialysis: clinicopathologic review of 4 cases

In 4 patients undergoing hemodialysis for chronic renal failure, a transient or persistent, papular and keratotic eruption developed on the trunk and arms. Histologic examination disclosed focal acantholysis with dyskeratosis. The lesions were clinically and histologically indistinguishable from those of Grover's disease. A possible association with Grover's disease and chronic renal failure and/or hemodialysis is postulated. Possible implicated pathogenic mechanisms are discussed. We suggest that Grover's disease should be included in the differential diagnosis of cutaneous eruptions in patients with chronic renal failure.

Zirconia-toughened hydroxyapatite ceramic obtained by wet sintering

A toughened hydroxyapatite (HA) ceramic has been obtained through the incorporation of magnesia partially stabilized zirconia (Mg-PSZ) under uniaxial pressing and sintering in wet oxygen at 1250 degrees C for 4 h. The powder X-ray diffraction (XRD) patterns and infrared spectra (FT-IR) show that HA is the only calcium phosphate phase present. The composite (MgPSZ-HA) has a density of 94% the theoretical value. The bending strength and the fracture toughness are around 50% higher for Mg-PSZ reinforced than for HA. The grain size and the fracture surface were studied by scanning electron microscopy (SEM). The influence of the Mg-PSZ particles on the fracture mechanism of the HA ceramic is discussed.

[Liver involvement in coeliac disease]

Coeliac disease is a gluten-sensitive enteropathy in which, genetic, immunologic and environmental factors are implied. Several extradigestive diseases have been described in association with coeliac disease, which share most of the times an immunologic mechanism. The liver is damaged in coeliac disease, and it has been considered by some authors as an extraintestinal manifestation of the disease. In the present revision we discuss the different hepatic diseases related with the coeliac disease, as well as the best approach to diagnosis and therapy of choice. At diagnosis, it is very frequent to find an asymptomatic hipertransaminasemia, which frequently disappears after gluten suppression; the morphological substratum found in this alteration is a non-specific reactive hepatitis in the majority of cases. Coeliac disease is a demonstrated cause of cryptogenic hipertransaminasemia. In a small percentage of patient with coeliac disease an association has been found with other immunological liver diseases, such as primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune hepatitis. Few studies exist that include a large number of patient, and the results on occasions are discordant. Nevertheless, the strongest association is with autoimmune hepatitis and with primary biliary cirrhosis. Several communications of isolated cases of rare hepatic diseases, which probably, only reflect a fortuitous association, have been cited in the literature.

Increased cerebrospinal fluid cAMP levels in Alzheimer's disease

Since increasing evidence suggests that upregulation of the cAMP-second messenger system may be implicated in Alzheimer's disease neurodegeneration, we have compared the cAMP and cGMP levels in cerebrospinal fluid (CSF) from patients with dementia of the Alzheimer type (DAT, n=10) with those from nondemented age-matched controls (n=10). Our results show that cAMP levels, but not cGMP, are significantly (p<0.01) elevated in CSF from patients with DAT compared to those from nondemented controls. Moreover, a linear regression analysis demonstrated a significant correlation (r=0.62; p<0.01) between cAMP and tau protein levels in CSF when controls and patients with DAT were studied together. These results suggest that upregulation of cAMP-signaling pathway is implicated in Alzheimer's disease physiopathology.

[Allelic frequency of the gene of alpha-1-antitrypsin in the general population in a county in Asturias]

BACKGROUND

Severe alpha-1-antitrypsin (ATT) deficiency is an inherited disorder associated with a high risk of developing pulmonary emphysema and several liver diseases. Over 90 different variants of gene which expresses AAT have been described. The commonest defective variants are Z and S. Determination of gene frequencies of abnormal variants is important to estimate the number of subjects at risk of suffering from diseases related with severe AAT deficiency in any given population.

POPULATION AND METHODS

In randomly selected general population, we determined the Pi phenotype to 1,116 subjects enrolled in the municipal population register from the high and middle Nalon basins. Mean age of the collective (male, 45%; female, 55%) was 46.2 (SD 29.9) years (range 4-91). AAT serum levels were determined by immunonephelometry. Pi phenotypes were determined by isoelectrofocusing in polyacrilamide gel.

RESULTS

The phenotypes found were: PiMM, 857 subjects (22.5%); PiMS, 202 (18.1%); PiMZ, 31 (2.8%); PiSZ, 13 (1.2%); PiZZ, 0 (0.0%); PiMF, 5 (0.4%); Piss, 4 (0.4%); PiMN, 2 (0.2%); PiMB, 1 (0.08%); and PiMV, 1 (0.08%). The allelic frequencies were: PiM, 87.6%; PiS, 9.99%; PiZ, 1.97%; PiF, 0.2%; PiN, 0.09%; PiB, = 0.04%, and PiV, 0.04%. Therefore, the ZZ homozygote prevalence is 1 in 2,557, according to the Hardy-Weinberg principle. AAT serum levels (mg/dl) were: PiMM 147.7 (29.9) (89-296); PiMS 123.8 (22.5) (range 76-222); PiMZ 93.9 (18) (60-146); PiSS 107.5 (14.5) (87-121) and PiSZ 71.2 (12.6) (55-94).

CONCLUSIONS

The frequency of Z allele in the analyzed population (19.7 per 1000) is one of the highest in Europe, and in the world. The allelic frequency of S allele (99.9 per 1000) is similar to others found in several regions in the Iberian Peninsula.

Vitamin D receptor genotype influences parathyroid hormone and calcitriol levels in predialysis patients

BACKGROUND

BsmI vitamin D receptor (VDR) gene polymorphism has been associated with the severity of hyperparathyroidism in patients on hemodialysis. The aim of this study was to analyze the influence of this polymorphism on parathyroid function and serum calcitriol levels in patients with different degrees of chronic renal failure (CRF) before dialysis.

METHODS

A total of 248 CRF patients, divided into three groups according to creatinine clearance (CCr; mild CRF group> 60 to </=85 ml/min, N = 54; moderate CRF group> 35 to </=60 ml/min, N = 113; severe CRF group> 10 to </=35 ml/min, N = 81), had their serum intact parathyroid hormone (iPTH) and calcitriol levels measured and BsmI genotype frequencies estimated by polymerase chain reaction (PCR) analysis. Diabetics, those on treatment with steroids, vitamin D or derivatives, and phosphorus binding agents were excluded. All those with serum calcium levels of <2.25 mmol/liter or> 2.5 mmol/liter and serum phosphorus levels of> 1.6 mmol/liter or who needed phosphorus binding agents were excluded. The statistical analysis was done with the general factorial analysis of variance entering first PTH and then calcitriol as the dependent variable; the genotype (BB, Bb and bb), sex and CCr group were defined as factors; and covariables included serum calcium, serum phosphorus, 1/creatinine versus time slope, PTH when calcitriol was the dependent variable, and calcitriol when PTH was the dependent variable.

RESULTS

When serum PTH levels were entered as the dependent variable, serum calcium, CCr group, and the interaction of genotype with the CCr group were found to be significant factors (P = 0.025, P <0.001 and P = 0.039, respectively). When serum calcitriol levels were entered as the dependent variable, genotype, the interaction of genotype with CCr, the CCr group, and the 1/creatine versus time slope were found to be significant (P = 0.027, P = 0.028, P <0.001 and P = 0.044, respectively). The marginal means of PTH, adjusted with the general factorial analysis of variance across the three groups were: (a) mild CRF group, BB 5.3 pmol/liter (CI 0 to 13.8), Bb 5.5 pmol/liter (CI 2 to 9), bb 5.4 pmol/liter (CI 0.6 to 10.2); (b) moderate CRF group, BB 6.2 pmol/liter (CI 1.5 to 10.9), Bb 7.8 pmol/liter (CI 5.3 to 10.3), bb 7.5 pmol/liter (CI 4.8 to 10.1); (c) severe CRF group, BB 9.3 pmol/liter (CI 4.2 to 14.3), Bb 17.1 pmol/liter (CI 13.9 to 20.2), bb 21.9 pmol/liter (CI 18.7 to 25.2). The marginal means of calcitriol adjusted with the general factorial analysis of variance across the three groups were: (a) mild CRF group, BB 47 pg/ml (CI 37 to 57), Bb 40.9 pg/ml (CI 37 to 44.8), bb 32.6 pg/ml (CI 26.8 to 38. 4); (b) moderate CRF group, BB 24.1 pg/ml (CI 18.3 to 29.8), Bb 26.6 pg/ml (CI 23.5 to 29.7), bb 25.3 pg/ml (CI 22 to 28.6); (c) severe CRF group, BB 27.4 pg/ml (CI 21.3 to 33.5), Bb 19.4 pg/ml (CI 15.5 to 23.2), bb 20.4 pg/ml (CI 16.1 to 24.7).

CONCLUSION

The progression of hyperparathyroidism is slower in predialysis patients with BB genotypes than in the other genotypes. Also, calcitriol levels are less reduced in the BB genotype, which may act to lessen the severity of secondary hyperparathyroidism.

Prevalence of pollinosis in the Basque Country

BACKGROUND

The prevalence of allergic diseases, mainly pollinosis, has increased within the last decades. Our study aimed to determine the prevalence of sensitization to Poaceae pollen in the Basque Country. This is a region of northern Spain, with an area of 7261 km2 and a population of 2109009 inhabitants. Two different climatic regions may be distinguished in the Basque Country (the Atlantic and the Oceanic).

METHODS

A transversal study was carried out on 2216 subjects, aged 10-40 years. A personal interviewwas carried out in order to compile study data, by means of a questionnaire that had been previously validated with a clinical history and an allergy study.

RESULTS AND CONCLUSIONS

Our results show the prevalence of pollinosis in the Basque Country to be 10.6% (C.I. 95% 9.35-11.96%) without significant differences between men and women. The prevalence in the Atlantic climate area (9.71%) was lower than in the Oceanic climate area (13.61%). There were no differences between persons living in a rural environment (10.87%) and those living in an urban setting (10.51%). Pollinosis was more frequent in individuals aged 10-20 (11.41%) and 20-30 (12.54%) than those aged 30-40 years (7.43%). Three features significantly distinguished pollinic from nonpollinic patients: 1) a more common complaint of symptoms after ingestion of Rosaceae fruits or nuts (10.2%) 2) a family history of atopy (8.8%) 3) a greater occurrence of bronchial asthmatic symptoms (23%).