Glucocorticoids increase IL-10 expression in multiple sclerosis patients with acute relapse

High doses of glucocorticoids (GCs) are widely employed to treat acute attacks in relapsing-remitting multiple sclerosis (MS) patients. Their beneficial effects are partially due to their capacity to regulate the cytokine network. In the present work, we have examined the effect of GCs on the production of the immunosuppressor cytokine IL-10. Blood samples from MS patients suffering an acute relapse were obtained immediately before initiating therapy and after receiving a daily dose of 1 g intravenous methylprednisolone (MP) for four days. Levels of IL-10 mRNA in PBMC were semiquantified by RT-PCR, whereas protein concentration in serum and in cell culture supernatant was measured by ELISA. Our results show that 7 out of the 9 patients studied displayed increased IL-10 mRNA expression as well as higher serum IL-10 concentration following steroid treatment. In contrast, mRNA expression of two inflammatory cytokines, TNFalpha and IFNgamma, decreased following steroid therapy. In vitro experiments employing normal PBMC showed that methylprednisolone (MP) upregulated IL-10 expression as determined by measuring mRNA levels, flow cytometry of intracytoplasmic protein concentration, and the amount of secreted protein. Peak responses of secreted IL-10 by PBMC cultured cells treated with MP were obtained at 48 h. The effect was steroid-specific as IL-10 expression reversed to baseline levels in the presence of the glucocorticoid receptor antagonist RU486. Contrary to the effect of MP on the spontaneous expression of IL-10, this drug downregulated LPS-induced IL-10 synthesis. In fact, the concentration of IL-10 in LPS-induced IL-10 secretion from normal PBMC decreased upon addition of MP to cell cultures. Thus, it seems that MP exerts an opposite effect on the spontaneous and LPS-induced IL-10 production. Our studies indicate that GCs may control inflammatory responses by upregulating production of the immunosuppressor cytokine IL-10.

Tamoxifen does not improve survival of patients with advanced hepatocellular carcinoma

To discover whether tamoxifen is able to extend the survival of patients with advanced hepatocellular carcinoma, we included 80 patients with cirrhosis and advanced hepatocellular carcinoma in a multicenter, double-blind, placebo-controlled trial in order to analyze the influence of treatment with tamoxifen on survival. The patients were randomized to receive tamoxifen, 40 mg/day (group 1), or placebo (group 2). Both groups were similar in age, sex, etiology of cirrhosis, biochemical, hematologic and hormonal parameters, morphology of the tumor (nodular vs multinodular or massive), Child-Pugh's score, and Okuda's stage. The 1-year survival rate was similar in both groups (30% in group 1 vs 37.8% in group 2; p = 0.31). Tamoxifen treatment was well tolerated by the patients. We conclude that tamoxifen does not extend the survival of patients with cirrhosis and advanced hepatocellular carcinoma.

Detection of a t(8;21)(q22;q22) in a case of M5 acute monoblastic leukemia

Although the translocation (8;21) is the single most common structural rearrangement reported in acute myeloblastic leukemia (AML), it is rarely seen in AML FAB type M5. We describe a case of a 51-year-old male with a diagnosis of acute monoblastic leukemia (AML M5b with hemophagocytic component) whose karyotype showed at (8;21)(q22;22). To our knowledge, this is the first report of this translocation in an AML M5b. The t(8;21) has been associated with a good prognosis, but our patient suffered a fast and fatal evolution.

Requirement of a second signal via protein kinase C or protein kinase A for maximal expression of CD40 ligand. Involvement of transcriptional and posttranscriptional mechanisms

High levels of CD40 ligand (CD40L) protein expression are induced on native T cells by increasing the intracellular Ca2+ concentration. In the present study we have shown that ionomycin induces CD40L gene transcription leading to mRNA accumulation which translates to high levels of protein expression. Conversely, agents which increase the intracellular levels of cyclic AMP (cAMP), such as prostaglandin E2 (PGE2) or dibutyryl cyclic AMP (dbcAMP), were unable to induce CD40L expression on T lymphocytes. Cell activation by phorbol 12-myristate 13-acetate (PMA) treatment had a slight effect on increasing CD40L mRNA and protein levels. However, PMA and dbcAMP synergized with ionomycin to significantly increase and to prolong the CD40L expression. Nuclear run-on assays revealed that PMA, but not dbcAMP, increased threefold the CD40L gene transcription rate induced by ionomycin. This effect was independent of de novo protein synthesis. In addition, at a posttranscriptional level, both reagents synergized with the Ca2+ ionophore to prolong the CD40L mRNA half-life by a mechanism which was also independent of de novo protein synthesis. Moreover, when transcription was blocked with actinomycin D, an increment of the CD40L transcript levels induced by PMA or dbcAMP on ionomycin-treated cells was observed in the presence of cycloheximide. This probably means that newly synthesized protein may contribute to the CD40L mRNA destabilization. In summary, these data show that PMA and dbcAMP synergized with ionomycin to increase the CD40L mRNA and protein levels. The up-regulatory effect of PMA was accomplished at a transcriptional and posttranscriptional level, whereas dbcAMP exerted its synergistic effect exclusively at a posttranscriptional level.

[The prevalence of hepatitis A, B and C viral markers in the population of Gijón between 26 and 65 years old]

The aim of this study was to know the prevalence of hepatitis A, B and C markers in an adult population in Gijón, Spain. A randomized, transversal sample according to the census was made in a population between 26 and 65 years of age in Gijón, analyzing demographic, epidemiologic and clinical variables, liver function tests, anti-HAV IgG, anti-HBcore and anti-HCV. Of the 476 individuals included a census error was detected in 26 (5.5%) and 340 (71.4%) were studied. Of these anti-HAV IgG was positive in 210 (61.8%) with prevalences of 17.9% from 26 to 30 years (CI: 95%, 11.1%-27.4%), 54.7% from 31 to 35 years (CI: 95%, 41.8%-67%), 73.6% from 36 to 40 years (CI: 95%, 59.4%-84.3%) and 93% (CI: 95%, 86.7%-96.5%) above 40 years of age (p < 0.001). No other significant variables were found adjusted by age groups. With regard to HBV, of the 331 unvaccinated cases, 35 (10.6, CI 95%, 7.6%-14.5%) presented immune markers and 4 (1.2% CI: 95%, 0.4%-3.3%) HBsAg positivity, with all having normal ALT and no viral replication. Anti-HCV was positive in 1.7% (CI: 95%, 0.7-3.9%), being significantly related to IVDA or tattoos. Hypertransaminasemias were detected in 18 (5.3%) being attributed to virus C (27.8%), alcoholism (27.8%) or obesity (44.4%). History of clinical manifestations of acute hepatitis was collected in 9.7% of the cases with no memory of the episode in 84.3% of the anti-HAV IgG positive cases, 79.5% of the anti-HBcore positive cases and 83.3% of the anti-HCV positive cases. The current curve of prevalence of anti-HAV IgG in the Gijón population varies in the decade from 30 to 40 years in age ranging from values discarding prevaccination screening under the age of 30 to levels of minimum susceptibility to infection above the age of 40. The low prevalence of anti-HBcore underestimates its use as prevaccination screening versus HBV in the population of Gijón. The prevalences of HBsAg or anti-HCV thereby make this area a zone of intermediate endemicity, with around 3% of the population being chronically infected by one of these viruses.

Generation of polyclonal antibodies against a chemically synthesized N-terminal fragment of the bacteriocin pediocin PA-1

Six mice were immunized intraperitoneally (i.p.) with a chemically synthesized 9-mer fragment (PH1) designed from the N-terminal part of the bacteriocin pediocin PA-1 and conjugated to keyhole limpet haemocyanin (KLH). After three doses of the immunogen had been administered, serum-specific antibodies were detected by a competitive direct ELISA. Myeloma cells were injected i.p. into mice in order to obtain ascites polyclonal antibodies. Although four mice developed ascites, only mouse 2 had detectable specific antibodies in the ascites fluid. The serum and ascites antibodies were specific for PH1 but they did not recognize the whole pediocin PA-1 molecule. This is the first attempt to generate antibodies against bacteriocins with a chemically synthesized oligopeptide as immunogen. This approach still remains attractive for detection, quantification, mode of action studies and purification of bacteriocins, especially those for which the purification process is difficult or inefficient at present.

Cardiovascular effects of ethanolic and aqueous extracts of Pimenta dioica in Sprague-Dawley rats

The hypotensive activity of ethanolic and aqueous extracts of Pimenta dioica and several fractions of the aqueous extract was observed in anaesthetized normotensive rats. General effects of the extracts and fractions were assessed through Hippocratic screening showing a central nervous system (CNS) depressant effect. The intravenous (i.v.) administration of the aqueous extract of Pimenta dioica (30, 70, 100 mg/kg) produced a dose-related significant fall in mean arterial blood pressure (MAP). The ED50 was 53.94 mg/kg. The hypotensive effect of identical doses (100 mg/kg) of the aqueous extract (95% decrease) was significantly greater (P < 0.05) than the effect of the ethanolic extract (67% decrease). The final aqueous fraction produced the greatest hypotensive activity compared to the other fractions of the total aqueous extract. There were no significant changes in the heart rate and no abnormalities were observed in the EKG. The mechanisms of action of the extracts have not been determined. Structural elucidation of the compounds responsible for this activity is under investigation.

Antibodies to ribosomal P proteins and hepatic damage in undifferentiated CTD

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[The prevalence of markers for the hepatitis A and B viruses in the population of Gijón between 6 and 25 years old]

BACKGROUND

The aim of this study was to know the prevalence of previous infection markers for hepatitis A and B viruses in a pediatric-juvenile population from Gijón, Spain.

PATIENTS AND METHODS

A representative (according to the census) transversal randomized sample of a population from 6 to 25 years in age from Gijón, Spain, was included in the study analyzing demographic, epidemiologic and clinical variables, liver tests, anti-HAV IgG and anti-HBc.

RESULTS

Of the 630 individuals selected a demographic error was detected in 28 (4.4%) and 453 subjects were studied (71.9%) in whom the anti-HAV IgG was positive in 37 cases (8.75% of prevalence adjusted for age), with 4.4% (12/271) (CI 95% 2.3%-7.6%) for the younger cases and 13.7% (25/182) (CI 95% 9.1%-19.6%) in the group ranging from 18 to 25 years in age (p < 0.001). No anti-HAV IgG positive case was detected in the population under the age of 10 years. Among the young adults the prevalence of anti-HAV IgG positive cases was higher in those born in the south of Spain (2/6, 33.3%) (CI 95% 4.3%-77.7%) with respect to those from the northern regions of Spain (9/259, 3.5%) (CI 95% 1.6%-6.4%). (p = 0.02). With respect to HBV markers, of the 433 unvaccinated cases, 6 (1.4%) presented markers of past infection and 2 (0.46%) HBsAg positivity. Both had normal serum ALT without viral replication. Six cases of hypertransaminasemia levels (1.3%) were detected all being related with obesity or alcoholism. All the cases with previous acute clinical hepatitis were found to be anti-HAV IgG positive and anti-HBc negative.

CONCLUSIONS

The current prevalence of anti-HAV IgG in the population from 6 to 25 years from Gijón, Spain is very low and given the high degree of susceptibility (86%) for HAV infection in the young adult population (18-25 years) the implementation of vaccination programs is recommended even without previous serologic screening. The low prevalence of anti-Hbc would also undervalue its use as prevaccination screening against HB in this geographical area.

Dietary long-chain polyunsaturated fatty acids influence tissue fatty acid composition in rats at weaning

We studied the fatty acid composition of plasma, plasma phospholipids, erythrocyte membrane lipids, liver microsomal phospholipids and brain lipids in rats fed three different diets varying in their (n-3) and (n-6) long-chain polyunsaturated fatty acid (LCP) concentrations for 0, 2 and 4 wk after weaning. The three diets contained 10% fat; diet HO had a high-oleic acid proportion; diet FO was enriched in n-3 LCP provided by fish oil; and diet FO + BPL contained n-3 and n-6 LCP supplied by fish oil and a brain phospholipid concentrate. At 2 and 4 wk after weaning the proportions of oleic acid in all tissues, except in liver microsomes of the FO + BPL group, were significantly higher than in weanling rats. The absence of (n-3) LCP intake resulted in significantly lower levels of docosapentaenoic [20:5(n-3)] and 22:6(n-3) acids in plasma, plasma phospholipids, erythrocyte membrane lipids and liver microsomal phospholipids but not in brain lipids compared with rats at weaning. Dietary supplementation with (n-3) LCP (FO and FO + BPL groups) for 4 wk led to higher levels of 22:6(n-3) in all tissues compared with rats fed the HO fat. The proportions of 20:4(n-6) and total (n-6) LCP were significantly lower in all tissues from rats fed the FO diet than in rats at weaning and rats fed the HO diet. After 2 and 4 wk, rats fed the FO + BPL diet had significantly higher levels of 20:4(n-6) and total (n-6) LCP in plasma, plasma phospholipids, erythrocyte lipids and liver microsomal phospholipids; the brain also showed a higher content of those fatty acids after 4 wk. Our results suggest that dietary supplementation with 20:4(n-6) and 22:6(n-3) influences the concentration of 20:4-(n-6) and 22:6(n-3) in body tissues of rats after weaning.

Dietary long-chain polyunsaturated fatty acids modify heart, kidney, and lung fatty acid composition in weanling rats

The fatty acid composition of heart, kidney, and lung was studied in weanling rats fed three diets differing in their polyunsaturated fatty acid content for 0, 2, and 4 wk. The first group had a 10% w/w fat semipurified diet which consisted of a mixture of olive oil (62.5%), soybean oil (11.1%), and refined coconut oil (26.4%) and provided 18:1n-9, 18:2n-6, and 18:3n-3 in similar amounts to a maternal human milk (diet HO). The second group received 7% of HO fat and 3% fish oil (0.4% 20:4n-6 and 5% 22:6n-3 of total fatty acids) (diet FO), and the third group was fed 7% HO fat, 1.5% of the same fish oil, and 1.5% of a purified pig brain phospholipid concentrate (0.6% 20:4n-6 and 3.5% 22:6n-3 of total fatty acids) (diet FO + BPL). The experimental diets increased tissue monounsaturated fatty acids in comparison with rats at weaning. Tissue lipid content of 20:4n-6 was increased and 22:6n-3 decreased in Group HO compared with weanling rats, whereas opposite changes were observed in Group FO. Feeding diet FO + BPL increased 22:6n:3 in tissue lipids compared with diet HO, and increased 20:4n-6 content in relation to diet FO. Our results indicate that rat heart, kidney, and lung are highly responsive to dietary n-3 and n-6 long-chain polyunsaturated fatty acids during postnatal life.

Sulphonylurea stimulates glucose uptake in rats through an ATP-sensitive K+ channel dependent mechanism

We studied the effect of gliclazide, a second-generation sulphonylurea, on rat skeletal muscle glucose uptake using perfused hindquarter muscle preparations. Gliclazide at concentrations of 10 to 1000 microgram/ml increased (p < 0.05) the basal glucose uptake. The effect of gliclazide on glucose uptake was immediate and dose-dependent, reaching a plateau at a concentration of 300 micrograms/ml; the half-maximal effect was obtained between 25 and 50 micrograms/ml. The glucose uptake stimulated by gliclazide (300-1000 micrograms/ml) did not differ from that achieved by 10(-9) mol/l insulin, and was lower (p < 0.05) than that obtained with 10(-7) mol/l insulin. The combination of gliclazide (300 micrograms/ml) and 10(-9) mol/l insulin produced an increase in glucose uptake (7.7 +/- 0.6 mumol.g-1.h-1, n = 8, mean +/- SEM) which was higher (p < 0.05) than that achieved with 10(-9) mol/l insulin (5.6 +/- 0.7 mumol.g-1.h-1, n = 11) and not different from that obtained with 10(-7) mol/l insulin (9.8 +/- 1.0 mumol.g-1.h-1, n = 11). Diazoxide (100 mumol/l), an ATP-sensitive K+ channel opener, reversed the stimulatory effect of gliclazide (100 microgram/ml) on muscle glucose uptake from 3.1 +/- 0.4 to 0.5 +/- 0.2 mumol.g-1.h-1, (n = 7, p < 0.001). The addition of diazoxide prior to gliclazide into the perfusion medium blocked the gliclazide-induced glucose uptake by the hindquarter muscle preparations. In conclusion, gliclazide alone has an immediate stimulatory effect on glucose uptake by skeletal muscle and together with insulin has an additive effect on muscle glucose uptake. The effect of gliclazide on muscle glucose uptake seems to be due to the inhibition of ATP-sensitive K+ channels.

Impaired tyrosine-kinase activity of muscle insulin receptors from hypomagnesaemic rats

The effect of magnesium deficiency on glucose disposal, glucose-stimulated insulin secretion and insulin action on skeletal muscle was investigated in rats which were fed a low magnesium-containing diet for 4 days. Control rats were fed a standard diet. Compared to the control rats, the rats fed with low magnesium diet presented: 1) lower serum magnesium levels (0.45 +/- 0.02 vs 0.78 +/- 0.01 mmol/l, p < 0.001), 2) higher basal serum glucose (6.8 +/- 0.02 vs 5.5 +/- 0.2 mmol/l, p < 0.05) and similar basal serum insulin, 3) 40% reduction (p < 0.001) in the glucose disappearance rate after its i.v. administration, and 4) 45% reduction (p < 0.05) in the glucose-stimulated insulin secretion. The insulin action upon the glucose uptake by skeletal muscle was determined by means of hindquarter perfusions. Compared with control rats, magnesium-deficient rats presented: 1) normal basal glucose uptake, 2) lower stimulatory effect on the glucose uptake by insulin at the concentrations of 5 x 10(-10) mol/l (3.0 +/- 0.9 vs 5.4 +/- 0.6, p < 0.05) and 5 x 10(-9) mol/l (6.3 +/- 0.5 vs 8.0 +/- 0.5, p < 0.05), 3) normal glucose uptake at a maximal insulin concentration of 1 x 10(-7) mol/l, and 4) 50% reduction in the insulin sensitivity (ED50: 1.3 +/- 0.3 vs 0.55 +/- 0.1 mol/l, p < 0.05). In partially purified insulin receptors prepared from gastrocnemius muscle, 125I-insulin binding was similar in both groups of rats. However, the autophosphorylation of the beta-subunit of the insulin receptor was significantly reduced by 50% in magnesium-deficient rats and the tyrosine kinase activity of insulin receptors toward the exogenous substrate Poly Glu4; Tyr 1 was also reduced (p < 0.05) by hypomagnesaemia. The abundance of the insulin-sensitive glucose transporter protein (muscle/fat GLUT4), measured by Western blot analysis using polyclonal antisera, was similar in muscles of control and hypomagnesaemic rats. These findings indicate that hypomagnesaemia has a deleterious effect on glucose metabolism due to an impairment of both insulin secretion and action. The insulin resistance observed in skeletal muscle of magnesium-deficient rats may be attributed, at least in part, to a defective tyrosine kinase activity of insulin receptors.

Epidemiology of hepatitis D virus infection: changes in the last 14 years

To calculate the prevalence of hepatitis D virus (HDV) superinfection, antibody to HDV (anti-HD) was tested on admission in 696 hepatitis B virus (HBV) chronic carriers diagnosed between 1979 and 1992. Anti-HD was positive in 67 patients (9.6%), and it was more frequently detected in i.v. drug abusers (IVDA) (59/74, 79.7%) than in non-IVDA (8/622, 1.3%) (p = 0.0001). The prevalence of anti-HD was higher in HBV chronic carriers diagnosed between 1979 and 1985 (33/219, 15.1%) than in those diagnosed from 1986 to 1992 (34/477, 7.1%) (p < 0.001). However, these figures were not different when IVDA were analyzed alone; 29/34 (85%) and 30/40 (75%) (p = 0.4) IVDA diagnosed in both time frames were anti-HD-positive. Four hundred and thirty anti-HD-negative HBV carriers were prospectively followed, and serial determinations of anti-HD were made. Seroconversion to anti-HD was observed in only six patients (1.4%), and again the rate of seroconversion was higher in IVDA (5/10, 50%) than in non-IVDA (1/420, 0.2%) (p < 0.0001). These findings show that IVDA HBV chronic carriers are still an extremely high risk group for HDV superinfection in Spain and that this virus has little penetrance in other epidemiological categories of HBV carriers.

Relationship between ERBB2 and E-cadherin expression in human breast cancer

A recent in vitro study has suggested that overexpression of ERBB2 may mediate breast tumour progression and metastasis by inhibiting the transcription of the E-cadherin (E-CD) gene. To test this hypothesis in human breast cancer in vivo, we studied the relationship between the expression of both molecules in 247 breast carcinomas immunohistochemically. Five ductal carcinomas in situ overexpressed ERBB2 and showed preserved E-CD expression. Forty-four of 226 infiltrating ductal carcinomas (19.47%) showed ERBB2 overexpression, and a statistically significant relationship was found between ERBB2 overexpression and high histological grade. E-CD expression was preserved in 111 cases (49.1%) and correlated with the histological grade. However, no significant relationship was found between ERBB2 and E-CD expression. None of the 16 infiltrating lobular carcinomas expressed ERBB2 or E-CD. These observations in different histological types of breast carcinoma strongly argue against a role for ERBB2 as a transcriptional regulator of E-CD expression in most human breast carcinomas in vivo.

PCR detection of the lactocin S structural gene in bacteriocin-producing lactobacilli from meat

The lactocin S structural gene (lasA) in seven bacteriocinogenic lactobacilli isolated from fermented sausages was studied. Two degenerate primers were synthesized to amplify a 75-bp fragment of the gene. Three strains amplified the fragment from their plasmid DNA, and hybridization analysis confirmed these results.

Anomalous expression of P-cadherin in breast carcinoma. Correlation with E-cadherin expression and pathological features

Previous studies on the cell-cell adhesion molecules P- and E-cadherin have shown that P-cadherin is not expressed in breast cancer. In contrast, the expression of E-cadherin is a normal event in these tumors, but a reduction in the levels of this molecule in neoplastic cells is associated with the histological type, high histological grade, greater tumor size, and metastasis. The expression pattern of P- and E-cadherin were immunohistochemically studied in tissue sections from normal breast tissue, benign breast lesions, and 57 infiltrating breast carcinomas. Cadherin expression was analyzed in parallel with pathological features and the immunohistochemical expression of estrogen and progesterone receptors in breast carcinomas. P-cadherin was detected in the myoepithelial cells and E-cadherin in luminal epithelial cells from normal breast and benign breast lesions. P-cadherin expression was detected in 9 of 45 cases (20%) of infiltrating ductal carcinomas of no special type; none of the special histological types that were analyzed (7 infiltrating lobular carcinomas, 3 colloid carcinomas, and 2 infiltrating papillary carcinomas) expressed P-cadherin. In infiltrating ductal carcinomas, P-cadherin expression correlated significantly with a reduction in E-cadherin expression, histological grade (all cases were grade III tumors), and hormone receptor content (8 of 9 cases were estrogen and progesterone receptor negative). Although E-cadherin was not found in the 7 infiltrating lobular carcinomas, it was present in the remaining histological types and was preserved in 15 infiltrating ductal and 3 colloid and 2 papillary carcinomas and was reduced in 30 infiltrating ductal carcinomas. In addition, a reduction in E-cadherin expression was significantly associated with high histological grade and a lack of steroid hormone receptors in infiltrating ductal carcinomas. No apparent relationship was found between P- and E-cadherin expression and tumor size and axillary lymph node metastasis. The distinct patterns of P- and E-cadherin expression observed in this study strongly suggest a differential role for these cadherins in human breast carcinogenesis.

[The prevalence of anti-HCV positivity among blood donors in Asturias. A clinical-epidemiologic study]

BACKGROUND

The aim of this study was to know the prevalence, epidemiology, clinical manifestations and analytical changes present in anti-HCV positive blood donors detected in Asturias.

METHODS

A prospective analysis of the incidence and prevalence of anti-HCV positivity in the blood donations carried out in Asturias from October 1989 to October 1991 was performed, as was a clinical and analytical study of the anti-HCV positive cases who attended a clinic specifically created for the same.

RESULTS

The prevalence of the anti-HCV was 0.87% of the donors (372/42,789) and 0.50% of the donations (372/73,831) being higher among new donors (1.77%, 165/9,322). Of the 288 cases studied (77.4%), only 51 (17.7%) had been transfused and 105 (36.5%) lacked the previous parenteral risk factor. Only 31 (10.8%) presented symptoms or signs of liver disease and the positivity of the anti-HBc was not associated to any relevant analytical change. The existence of previous major surgery or transfusion was variable with the independent predictive value versus a negative anti-HCV control group. The mean follow up was 12.4 +/- 7.3 months (6-30 months) with an increase in aminotransferases (ALT) being detected in 108 cases (52.7%). A good correlation was found between this data, an ELISA-2 score greater than 5 and RIBA-2 positivity: of the 177 cases in whom RIBA-2 was determined this was found to be positive in 109 (61.6%); 84 cases (77.1%) had an increase in ALT and 100 (91.8%) an ELISA-2 score greater than 5.

CONCLUSIONS

In Asturias the prevalence of anti-HCV positivity among blood donors is almost 1% and is greater if new donors are considered, being confirmed by RIBA-2 in 61% of the cases. The subjects are usually asymptomatic and up to one third of the same lack any known risk factor, while almost half have hypertransaminasemia during follow up.

[Campylobacter fetus, an infrequent microbe, as a cause of spontaneous bacterial peritonitis in cirrhosis]

Campylobacter fetus has been implicated in the etiology of sepsis and bacteriemias in immunosupressed subjects. In a few cases, it has also been reported to be responsible for spontaneous bacterial peritonitis in cirrhotic patients. We describe the clinical picture of a woman with terminal liver cirrhosis who had bacteriemia and spontaneous bacterial peritonitis caused by this agent. We argue about the history of cleansing enemas and their probable role in the development of the infection. We stress the excellent response to the antibiotic treatment.