Transmission of tropical and geographically restricted infections during solid-organ transplantation

In recent years, the increasing number of donors from different regions of the world is providing a new challenge for the management and selection of suitable donors. This is a worldwide problem in most countries with transplantation programs, especially due to the increase in immigration and international travel. This paper elaborates recommendations regarding the selection criteria for donors from foreign countries who could potentially transmit tropical or geographically restricted infections to solid-organ transplant recipients. For this purpose, an extensive review of the medical literature focusing on viral, fungal, and parasitic infections that could be transmitted during transplantation from donors who have lived or traveled in countries where these infections are endemic has been performed, with special emphasis on tropical and imported infections. The review also includes cases described in the literature as well as risks of transmission during transplantation, microbiological tests available, and recommendations for each infection. A table listing different infectious agents with their geographic distributions and specific recommendations is included.

p16/INK4a gene inactivation by hypermethylation is associated with aggressive variants of monoclonal gammopathies

INTRODUCTION

A model of a stepwise malignant transformation has been proposed for the pathogenesis of monoclonal gammopathies. In this model, cell cycle regulators play a central role as a source of genetic events; particularly, p16/INK4a gene acts as a tumoral suppressor gene and, recently, inactivation of this gene through a methylation mechanism, has been observed in multiple myeloma patients. Under the diagnosis of monoclonal gammopathies there is a broad spectrum of disorders with very different outcomes, ranging from indolent courses, such as those of monoclonal gammopathy of undetermined significance, Waldeströn macroglobulinemia and smoldering multiple myeloma, to aggressive diseases such as symptomatic MM and primary plasma cell leukemia. To the best of our knowledge, the activity of p16 gene has not been evaluated and compared in these different subtypes of monoclonal gammopathies.

MATERIALS AND METHODS

The methylation status of the p16 gene was analysed in a group of 159 patients with monoclonal gammopathies (40 monoclonal gammopathy of uncertain significance, eight Waldenström Macroglobulinemia, eight smoldering multiple myeloma, 98 symptomatic multiple myeloma and five primary plasma cell leukemia) using three different assays (restriction enzymes and PCR or S-B and modification by sodium bisulphite).

RESULTS

Forty-one of 98 MM patients (41.8%) as well as four of the five (80%) primary PCL patients showed methylation of the p16 gene, while none of the patients with monoclonal gammopathy of undetermined significance, Waldenström Macroglobulinemia or smoldering multiple myeloma displayed a methylation status.

CONCLUSION

These findings suggest that the methylation of the p16 gene could be a relevant oncogenic event in the monoclonal gammopathies evolution being associated with the most aggressive forms.

Bacterial inhibition produced by substances for dentin pretreatment

Dentin treatment before adhesion of composites is performed both to enhance adhesion and to remove the microbial contents of the smear layer. The purpose of these experiments was to evaluate the germicide potential of several dentin treatments used in adhesive systems and of some cleansing solutions. Different germs involved in caries processes were used (Candida Albicans, Streptococcus mutans and Actinomyces naeslundii) to prepare suspensions. Half a milliliter of each of the suspensions was transferred to test tubes and an equal volume of the following substances was added: Scotch Prep Dentin Primer (P), Gluma Cleanser (G), Cleaner Sol. (C), Tubulicid Blue (TB) and Red Label (TR), Blue Experimental Solution (SB) and Red Experimental Solution (SR) and sterile distilled water (control). The preparation was incubated at 37 degrees C for seven days to test viability. P, TR, TB and SB produced complete inhibition of germs tested. The results reveal that, "in vitro", not all the substances tested exert a germicide effect on the microorganisms analyzed.

[Candida carriage in the oral mucosa of a student population: adhesiveness of the strains and predisposing factors]

The aim of this study was to establish oral carriage of Candida and possible factors associated to their virulence in young adults and their relation with local and general situations considered as predisposing factors. Samples were obtained from dorsum tongue in 70 students attending the Faculty of Dentistry (University of Buenos Aires) average age: 23, all in healthy oral conditions. Of these, 21.42% were Candida positive. These samples were seeded in CHROMagar. Candida identification was completed in milk agar and Fungichrom 1. The following species were identified: 11 Candida albicans (C.a), 2 Candida parapsilosis (C.p) and 1 Candida glabrata (C.g). In one case, 2 species (C.a and C.g) were isolated in the same sample. Virulence was determined as adherence capacity by biofilm or in vitro plaque formation and hydrophobicity. Different host factors were analyzed statistically to establish their importance as predisposing factors to allow Candida colonization. Adherence of C.a. was found to be similar in all C.a. strains, whereas significant differences were found between C.a. and C.p. and between C.a. and C.g. Only the antiseptic mouthrinse and the diet were significant among the considered factors.

Correlation between cytogenetic abnormalities and disease characteristics in multiple myeloma: monosomy of chromosome 13 and structural abnormalities of 11q are associated with a high percentage of S-phase plasma cells

BACKGROUND AND OBJECTIVES

Cytogenetic studies in multiple myleoma (MM) are limited by the difficulties in obtaining metaphases that can be investigated and few studies have analyzed the relationship between cytogenetics and clinical disease characteristics. The aim of our study was to analyze the recurrent cytogenetic changes in MM and to correlate them with clinical and biological characteristics including the percentage of S-phase plasma cells (PCs).

DESIGN AND METHODS

Chromosomal abnormalities were analyzed in 86 patients with MM. In all patients, two types of cultures (5 d culture with interleukin-4 and unstimulated 72 h culture) were used for cytogenetic analysis. DNA content analysis (ploidy and cell cycle analysis) together with the most relevant clinical and biological disease features were studied.

RESULTS

Cytogenetic analysis was successful in 72 of the 86 patients (84%). Forty-seven patients (65%) had an abnormal karyotype. The most frequent trisomies involved chromosomes 3, 5, 9, 11, 15, 19, 22, 1, 7, 17, 18, and 21, and monosomies affected chromosomes 13 and 8, while structural changes involved chromosomes 1, 11, 14q32, 4p16 and 16q22-23. Patients with abnormal karyotype displayed a poor performance status, advanced stage, anemia and a high percentage of bone marrow plasma cells. In addition, MM patients with -13/13q- and 11q abnormalities showed a significantly higher proportion of S-phase PCs (p=0.02).

INTERPRETATION AND CONCLUSIONS

In summary, our study shows a relationship between unfavorable cytogenetics (-13/13q-/11q abnormalities) and a high percentage of S-phase PCs, a well-known adverse prognostic factor.

Pathologic rupture of the spleen during induction with ATRA in a patient with acute promyelocytic leukemia

Pathological rupture of the spleen is a rare but well recognized complication in hematological malignancies. Early clinical recognition of this life-threatening complication is necessary for rapid intervention. Here, we report on the case of a 26-year-old woman with acute promyelocytic leukemia who presented rupture of the spleen on day +2 of treatment with ATRA plus idarrubicin. In patients with acute leukemia, the presence of a painful abdomen and a sudden drop in hemoglobin levels, should alert of a possible splenic rupture, even without additional symptoms. This would facilitate an early treatment intervention with no modification to the chemotherapy schedule.

Cerebral toxoplasmosis and Guillain-Barré syndrome after allogeneic peripheral stem cell transplantation

We report an unusual case of cerebral toxoplasmosis associated with Guillain-Barré syndrome (GBS) in a 25-year-old patient diagnosed with chronic myelogenous leukaemia (CML), who underwent a mismatched allogeneic peripheral stem cell transplantation (PSCT). On day +83 he started with fever, and 7 days later tremor, muscular weakness, diplopia, dysarthria, respiratory difficulty, and universal arreflexia appeared, compatible with GBS. As the patient had a positive cytomegalovirus (CMV) antigenemia, this was the aetiology suspected for his neurologic findings, but specific treatment failed to improve his clinical situation, and he died on day +123. Necropsy demonstrated cerebral toxoplasmosis and axonal degeneration of nerve roots compatible with the axonal form of GBS. Interestingly, the polymerase chain reaction (PCR) signal for Toxoplasma gondii in two different cerebrospinal fluid (CSF) samples had been negative. In addition, this case showed unique magnetic resonance imaging (MRI) abnormalities. We conclude that a negative PCR on CSF cannot exclude toxoplasmosis in a transplant patient, and we emphasise the importance of considering Toxoplasma as an aetiology of fever and neurological symptoms in the transplant setting.

Regulation of high-affinity glutamate uptake activity in Bergmann glia cells by glutamate

The effect of glutamate receptor activation on the high-affinity sodium-dependent glutamate transport expressed in chick Bergmann glia cells was examined. Pre-exposure to glutamate produced a time- and dose-dependent decrease in 3H-labeled D-aspartate uptake. This effect could not be reproduced by selective glutamate receptor agonists. Furthermore, it was insensitive to both ionotropic and metabotropic glutamate receptor antagonists. Replacement of extracellular sodium ions with choline in the preincubation media, abolished the reduction of the uptake. When the cells were pre-exposed to competitive transportable inhibitors of the transporter, such as D-aspartate, DL-threo-hydroxyaspartate (DL-THA), and aspartate-beta-hydroxamate (ABH), the glutamate effect was mimicked. From saturation experiments, it was found that the reduction on the uptake, after glutamate treatment, is related to an increase in K(m). Interestingly, the effect is blocked by staurosporine, a Ca(2+)/diacylglycerol-dependent protein kinase (PKC) inhibitor. The present findings suggest that glutamate regulates its transport in a non-receptor fashion, a phenomena that is most probably linked to changes induced by the translocation process of the substrate through the transporter.

Allogeneic peripheral stem cell transplantation in a case of hereditary sideroblastic anaemia

We report on a case of pyridoxine refractory hereditary sideroblastic anaemia (HSA) in a 19-year-old man who underwent peripheral blood stem cell transplantation (PBSCT) from his HLA-identical brother. By using short tandem repeat polymorphism, 100% donor cells were observed in peripheral blood on day +21; bone marrow showed mixed chimaerism from day +21 to day +221, when 100% cells of donor origin were observed. The patient developed extensive chronic graft-versus-host disease with favourable response to treatment. When the haemoglobin range was normal, a programme of phlebotomies reduced serum ferritin levels. Three years after transplantation, the patient has an ECOG rating of 0, with completely normal haemoglobin values (15 g/dl). To our knowledge, this is the first PBSCT reported in a case of hereditary sideroblastic anaemia.

Factor analysis shows that female rat behaviour is characterized primarily by activity, male rats are driven by sex and anxiety

This experiment explored sex differences in behaviour using factor analysis to describe the relationship between different behavioral variables. A principal component solution with an orthogonal rotation of the factor matrix was used, ensuring that the extracted factors are independent of one another, and thus reflect separate processes. In the elevated plus-maze test of anxiety, in male rats factor 1 accounted for 75% of the variance and reflected anxiety, factor 2 represented activity, and accounted for 24% of the variance. This contrasted with the finding in female rats in which factor 1 was activity, accounting for 57% of the variance, with the anxiety factor accounting for only 34% of the variance. When behaviour in both the plus-maze and holeboard were analysed, a similar sex difference was found with anxiety emerging as factor 1 in males and holeboard activity as factor 1 in females. Locomotor activity in the inner portion of the holeboard loaded on the anxiety factor for males, but on activity for females. When behaviours in the plus-maze and sexual orientation tests were analysed, anxiety emerged as factor 1 in males, sexual preferences factor 2, and activity factor 3. In females, activity was factor 1, sexual preference factor 2, anxiety factor 3, and social interest factor 4. These results suggest caution should be exercised in interpreting the results from female rats in tests validated on males because the primary controlling factor may be different.

Sodium-dependent glutamate transport in Müller glial cells: regulation by phorbol esters

The regulation of the Na(+)-dependent high affinity glutamate/aspartate transporter system expressed in cultured Müller glia cells from chick retina was studied. Treatment of the cells with the Ca(2+)/diacylglycerol dependent protein kinase C (PKC) activator, phorbol 12-tetradecanoil-13-acetate (TPA) produced a decrease in [(3)H]D-aspartate uptake which was reversed by staurosporine and partially by H7 [1-(5-isoquinolinesulfonyl)-2-methylpiperazine dihydrochoride], two PKC inhibitors. Long-term treatment with TPA resulted in a drastic decrease in the uptake activity, correlated with a substantial fall in the expression of the transporter protein. These findings suggest that PKC is involved in transport modulation at two different levels: phosphorylation and transporter expression in retinal Müller glial cells.

Oral microbiota and implant type membranes

Candida albicans (Ca), Staphylococcus aureus (Sa), Streptococcus sanguis (Ss), Actinomyces naeslundii (An), Actinomyces odontolyticus (Ao), Porphyromona spp (P spp), Candida glabrata (Cg), Candida krusei (Ck), and Rhodotorula spp (R spp) were tested with equal pieces of biodegradable membranes. Membranes pretreated with saliva or clorhexidine and nontreated control membranes were tested in three different culture media containing 0.1 mL homologous suspension for each strain under study. Incubation was performed at 37 degrees C for 48 hours for aerobiosis and for five days for anaerobiosis. Macroscopy and microscopy were carried out. Membranes were removed, washed, and resuspended. Samples were sonicated, and the supernatant was disseminated on brain heart infusion broth or blood agar. Incubation was repeated, colony-forming unit counts were performed, and statistical analysis was carried out using analysis of variance transforming results to Log10 (x + 1), the highest interaction level was used to calculate standard error. Orthogonal contrast was used to compare the different microorganisms under study. Highest adhesion was found with Ca, Cg, Ck, Sa, and Ss. A sufficient quantity of Actinomyces could not be recovered from the membranes. Results with P spp were poor, confirming lower gram-negative adhesion. Replicate flasks with Ss and Ca were cultivated. Membranes were removed after washing and subjected to scanning electron microscopy, as were untreated control pieces. A cavelike surface was observed. Streptococcus sanguis adhering to the membranes showed extracellular projections. Candida and gram-positive cocci showed great recovery capacity.

[Microbiologic depuration of Anadara tuberculosa (Mollusca: Arcidae)]

In Costa Rica the mollusk Anadara tuberculosa represents a risk for human health due to the contamination of the growing waters and the fact that its is consumed raw. The families depending on the income obtained through commercialization of these animals have a low education and economic status. Therefore, it is of great importance to develop and evaluate simple methods of depuration that could be easily used by these families to make these mollusks safe for consumption. Bottles containing 11 of saline solution (25g/l) were prepared in duplicates to test the bactericidal effect of acetic acid. The solution in each bottle was adjusted to ph 4.5, 5.0 or 5.5 or held at ph of 7.0 or 8.0 for the controls. The solution in each bottle was then inoculated with approximately 1 X 104 cfu/ml of coliforms. Counts of coliforms were determined for each bottle 0, 1, 2, 4 and 8 hours after inoculation. For the depuration studies, specimens with diameters ranging from 4.0 to 4.5 cm were collected from a harvester at the estuary of Puntarenas, Gulf of Nicoya. Fifty specimens each were depurated in separate tanks containing 25 1 of oxygenated saline solution adjusted with acetic acid to an initial ph of 4.5 (treatment) or non adjusted ph of 8.0 (control). Counts of Enterobacteriaceae were determined, in duplicates, every 12 hr for 48 hr. An additional fifty animals were depurated using the defined method and tested to determine if they met international standards of microbiological quality for aerobic plate count, Enterobacteriaceae count, Escherichia coli count and presence of Salmonella. A sensory evaluation using a triangle test was performed to compare a typical dish prepared with depurated or non-depurated animals. A significant coliform reduction was determined in a saline solution (25 g/l) at a pH range of 4.5 to 5.5. This reduction, during 8 hr, was higher in the acid treatments compared to the controls. During depuration, the elimination of Enterobacteriaceae bacteria was faster when acetic was used (initial ph = 4.5) than when it was not. This elimination was more important the first 24 hr, time defined as adequate for the application of the method. The method has the advantage of transforming the bivalve in a product that is safe for human consumption, since it guarantees that the international standards of microbiological quality, for raw and depurated mollusks, are reached. On the other hand, the sensory qualities of a typical dish prepared with depurated animals are not affected by the method, which can be easily implemented and applied by the people that work in the extraction of this mollusk.

Regulation of the Na+-dependent high affinity glutamate/aspartate transporter in cultured Bergmann glia by phorbol esters

The effects of phorbol 12-tetradecanoyl-13-acetate (TPA) and dibutyryl cAMP on the glutamate transport present in chick Bergmann glial cell (BGC) cultures were examined. TPA produced a significant decrease in [3H]-D-aspartate uptake, while dibutyryl cAMP treatment elicited a slight reduction in the transport. This effect was dose and time dependent and sensitive to staurosporine, a Ca2+/diacylglycerol-dependent protein kinase C (PKC) inhibitor. Long-term exposure of the culture to TPA results in a dramatic fall of the transporter activity and a decrease in the amount of the transporter protein. These findings suggest that PKC is involved in transport modulation and possibly in the regulation of the transporter gene expression.

Effect of maternal delta 9-tetrahydrocannabinol on developing serotonergic system

In this study we investigated the effects of maternal delta 9-tetrahydrocannabinol on the developing serotonergic system. A daily dose of delta 9-tetrahydrocannabinol (5 mg/kg body weight) was administered p.o. to pregnant rats from gestational day 5 to postnatal day 1. Levels of indolamines were measured in four brain areas of the offspring on the day before or after birth. Levels of indolamines depended on the cerebral area, sex and pre- or postnatal age. Maternal exposure to delta 9-tetrahydrocannabinol decreased diencephalic levels of 5-hydroxytryptamine (5-HT), males being more susceptible than females. These perinatal changes could be responsible for the long-term neurophysiological alterations produced by cannabinoids.

Neonatal organizational effects of the 5-HT2 and 5-HT1A subsystems on adult behavior in the rat

Males, females, neonatally androgenized females, and neonatally castrated males were treated over the second week of life with 0.25 mg/kg of either the 5-HT2 agonist 1-(2,5-dimethoxy-3-iodophenyl)-2-aminopropane HCl (DOI), the 5-HT2 antagonist ritanserin (Rit), the 5-HT1A agonist 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT), or the 5-HT1A antagonist WAY100135 (WAY). Exploration, anxiety, sociosexual preferences, and sexual behavior were measured in adulthood. Agents acting on 5-HT1A receptors do not appear to affect organization of any of the behavioral systems studied. DOI increased exploratory activity but in females only, which suggests that testosterone antagonizes the stimulatory effect of 5-HT2 activity on exploration. Neonatal ritanserin selectively reduced anxiety in females, and DOI had a similar effect in androgenized females. This indicates that neonatal 5-HT2 activity is anxiogenic in normal females, anxiolytic in androgenized females, and has no effect on anxiety in males. Males and androgenized females both showed a preference for the female teaser that was abolished by the 5-HT2 agonist, DOI. These results point out that 5-HT2 activity selectively suppresses heterosexual preference induced in the presence of neonatal testosterone. DOI also reduced both male sexual behavior in males and female sexual behavior in androgenized females. Thus, the 5-HT2 system antagonizes the action of testosterone in stimulating heterosexual orientation and sexual activity, and this is independent of genetic sex.

Involvement of the 5-HT1A subtype receptor in the neonatal organization of agonistic behaviour in the rat

5-hydroxytryptamine (5-HT) interacts with testosterone (T) in the development of a number of neuronal systems controlling sexually dimorphic adult behaviours. In this report, we investigated this interaction on the organization of agonistic behaviour in males, females, androgenized females (250 micrograms/pup of T proprionate on the day of birth), and males castrated on the day of birth. We have shown previously that manipulating 5-HT2 activity over the 2nd week of life modulates adult agonistic behaviour, depending on genetic sex and the presence of T. In this report, we investigated the effects seen in adulthood of a 5-HT1A agonist [8-OH-DPAT, 0.25 mg/kg, intraperitoneally (i.p.)] and antagonist (WAY100135, 0.25 mg/kg, i.p.) given over days 8-16 postpartum. The test for agonistic behaviour was carried out in a neutral territory against a matched conspecific, and introductory, offensive and defensive activities were note. Results show that neonatal administration of the 5-HT1A antagonist WAY100135 increases introductory activity and defense in the presence of neonatal T, independent of genetic sex, because these effects were seen in sham-castrated males and androgenized females. Offence followed a similar pattern, in that it was increased by WAY100135, but only in males. In the case of defence, the effects of the antagonist were reinforced by the action of the agonist (8-OH-DPAT) in both males and females, indicating an inhibitory role of 5-HT1A perinatal activity on defence in the presence of malelike levels of circulating T and a facilitatory role when levels of T are low or negligible. These findings indicate that 5-HT1A activity is involved in the development of agonistic behaviour and the effects are influenced by T. The results also show that the offensive and defensive facets of agonistic activity are controlled differently.

Effect of delta 9-tetrahydrocannabinol on short-term memory in the rat

We have reported that marihuana and its principal psycoactive compound, delta 9-tetrahydrocannabinol (delta 9-THC) produce alterations in several cerebral areas after acute treatment. Based on the involvement of 5-hydroxytryptamine (5-HT) on memory and learning and the reported effects of delta 9-THC on short-term memory, we designed an experiment to evaluate the memory performance and its possible relationship with serotonergic alterations after delta 9-THC administration. Male Wistar rats received an acute oral dose of THC (5 mg/kg). Short-Term memory was tested on a radial 8-arm maze with a 5 s delay, after 35 days of training. The animals were food deprived and adjusted for growth. 5-HT and its metabolite, 5-HIAA, levels were measured in cerebral cortex, dorsal hippocampus, ventral hippocampus, rostral neoestriatum and amygdala basal nucleus, by HPLC-ED. The experiment indicates an impairment of short-term memory in the radial maze test after delta 9-THC administration. The control group performed the test without errors, while the treated group made a significant number of errors (Z = 0.019, Mann-Whitney test). This behavioral effect did not seem to be related to serotonergic alterations, as the 5-HT turnover rate was not different between treated and control animals.

The effect of perinatal exposure to estrogens on the sexually dimorphic response to novelty

In this study we investigated the sexually dimorphic anxiety response to a novel environment in the absence of estrogens neonatally or in adulthood. There was a sexual dimorphism in the plus-maze test after the open-field test, females being more active and less anxious. In the absence of estrogens neonatally but not in the adulthood, the activity levels were similar to those shown by females, while the anxiety level was similar to males. These results suggest the need of a normal estrogen environment during the critical period of development for the normal differentiation of female anxiety responses to a novel environment.

Distribution of indoleamines and [3H]paroxetine binding in rat brain regions following acute or perinatal delta 9-tetrahydrocannabinol treatments

The effects of delta 9-tetrahydrocannabinol (delta 9-THC) administration on the central serotoninergic system were evaluated by biochemical assays of tissue levels of indoleamines; a measure of the serotonin (5-HT) innervation was obtained by using [3H]paroxetine as a marker of 5-HT uptake sites. Two different delta 9-THC treatments were chosen, i.e.: acute and chronic perinatal maternal exposure. Following acute treatment (5 mg/kg), the 5-HT content increased in dorsal hippocampus (+35%), Substantia nigra (+61%) and neostriatum (+62%) but remained unchanged in cingulate cortex, Raphe nuclei, Locus coeruleus and anterior hypothalamus. Endogenous 5-hydroxyindole-3-acetic acid (5-HIAA) decreased in anterior hypothalamus (-23%) and Raphe nuclei (-21%). Following maternal exposure to delta 9-THC (5 mg/kg per day; from gestational day 13 to postnatal day 7), levels of 5-HT were increased in the neostriatum (+22%) but decreased in anterior hypothalamus (-25%), Raphe nuclei (-29%) and Locus coeruleus (-20%) of the litters. Tissue 5-HIAA was increased in anterior hypothalamus (+23%) and Substantia nigra (+48%). There were no changes in 5-HT uptake site density, determined by [3H]paroxetine binding, except for an increase (+50%) in the cingulate cortex of perinatal-treated rats when compared to acutely-treated animals. The present results show that acute and maternal exposure to delta 9-THC produced different effects on the central 5-HT system of the offspring, with a clear regional specificity, but with no changes in the densities of 5-HT uptake sites.

Effect of maternal adrenal deprivation on the content of catecholamines in fetal brain

Previous studies performed in our laboratory showed the importance of the effects that the absence of maternal adrenal hormones have on fetal brain. In the present study we investigated the effect of adrenal deprivation during gestation on the fetal catecholamines development in several cerebral areas. Fetuses from both control and adrenalectomized mothers from the first day of gestation were removed on the 20th embryonary day. Plasma corticosterone levels were significantly lower in the maternal serum of adrenalectomized rats, while the contents were non significantly higher in the adrenalectomized-mothers group of fetuses. Catecholamine contents in diencephalon, metencephalon, mesencephalon and telencephalon were measured by HPLC-ED. The results obtained showed that when the development of the catecholaminergic systems was previous enough to the fetal adrenal function, and under maternal adrenal deprivation conditions, the lack of corticosterone promotes an increase in the level of the catecholamines, as observed in the diencephalic NA, the earlier in maturational process. In those areas where the maturation starts at the same time than the fetal adrenal hypersecretion, no changes were observed. In the cortex, where both DA and NA develop later, the corticosterone produces an inhibition in the proliferation of the catecholaminergic neurons, showing decreased telencephalic levels of both catecholamines.

[Persistent microalbuminuria in insulin-dependent diabetics and cardiovascular risk factors]

A possible association of cardiovascular risk factors and early diabetic nephropathy was investigated in 32 patients. Microalbuminuria (radioimmunoassay), total and HDL cholesterol and triglycerides (enzymatic methods), glycosylated hemoglobin (colorimetric methods), Apo A1 and B (immunonephelometric) and LDL were measured. Microalbuminuria was present in 28% of patients. Compared to subjects with no microalbuminuria they had increased levels of cholesterol (200.2 +/- 13.5 (SE) vs 168.6 +/- 9.4 mg/dl, p < 0.025) and LDL cholesterol (171.9 +/- 14.1 vs 137.4 +/- 9.1 mg/dl, p < 0.025). Systolic blood pressure was also higher in patients with microalbuminuria (127.8 +/- 3.9 vs 114.5 +/- 2.8 mmHg, p < 0.01). Microalbuminuria was correlated to the level of diastolic blood pressure (r = 0.74, p < 0.025). Thus, persistent microalbuminuria in insulin dependent diabetic patients is associated to cardiovascular risk factors which may explain the increased cardiovascular morbidity and mortality in these patients.