Risk Factors for Cardiovascular Disease During the First 2 Years After Renal Transplantation

The aim of the present study was to assess the role of cardiovascular risk factors in the occurrence of cardiovascular events among 100 consecutive renal transplant recipients during the first 2 years after transplantation. The following parameters were analyzed: (1) demographic data (gender, age, dialysis duration, preexistent diabetes, and pretransplantation events) as well as (2) basal 1-year, and 2-year posttransplantation data for events, body mass index, arterial hypertension, number of drugs for hypertension control, use of ACE or ARA II inhibitors, treatment with lipid- lowering drugs, de novo diabetes, anemia, immunosuppression with cyclosporine versus tacrolimus, and homocysteine, folic acid, serum creatinine, uric acid, PTH-i, and cholesterol total, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, and triglyceride levels. At the end of the second posttransplantation year, 14 patients versus 86 who did not experience a new cardiovascular event. Patients in the event group had more events pretransplantation and during the first posttransplantation year than those in the non event group (57.1% vs 17.4%; P = .003 and 78.6% vs 2.3%; P = .000, respectively). Furthermore, the former cohort of patients were older, had greater ventricular hypertrophy and had higher triglyceride and serum creatinine concentrations during the 2 years after transplantation. A multiple logistic regression analysis confirmed the relationship between events within 1 year of transplantation and serum creatinine level at the end of 2 years as well as the development of cardiovascular disease within 2 years. In conclusion, our data suggest the need for aggressive intervention during the first year to prevent the development of new cardiovascular events. Renoprotective strategies may also contribute to reduce the cardiovascular risk of renal transplant recipients.

Cytomegalovirus Replication and “Herpesvirus Burden” as Risk Factor of Cardiovascular Events in the First Year After Renal Transplantation

Cytomegalovirus (CMV) infection alone or in combination with other pathogens ("pathogen burden") has been postulated as a factor producing arteriosclerosis in some solid organ transplant recipients. The aim of this study was to assess whether the patients with CMV replication and/or "herpesvirus burden" experienced a greater incidence of cardiovascular events during the first year after kidney transplantation. One hundred twenty-one consecutive transplant recipients were prospectively studied for CMV replication using antigenemia and polymerase chain reaction (PCR) weekly during the 4 first months, and monthly thereafter for 1 year. Simultaneously, nested-PCR for human herpes virus (HHV)-6 and HHV-7 were performed to yield a herpesvirus burden (as determined by seropositivity), including CMV, herpes simplex virus (HSV), varicella-zoster virus (VZV), and Epstein-Barr virus (EBV). The following additional parameters were analyzed: gender, age, smoking, duration of dialysis, preexistent diabetes, and preexistent cardiovascular events. After 1 year posttransplantation cardiovascular events, body mass index, arterial hypertension, number of antihypertensive drugs, use of ACE and/or ARBs inhibitors, diabetes, anemia, homocysteine, creatinine, cholesterol, HDLc, LDLc, PTH-i, proteinuria, and immunosuppression with cyclosporine or tacrolimus. CMV replication was present in 79 (65.3%) patients. Among 121 renal transplant recipients, 13 presented cardiovascular events, all associated with CMV replication (P = .004). Neither HHV-6 or HHV-7 replication influenced this complication. All patients with these events were seropositive for CMV, HSV, VZV, and EBV, as opposed to 64.8% without them (P = .009). Other factors that showed differences between patients with versus without events were as follows: preexistent events (76.9% vs 14.8%; P = .000), age (60 +/- 10 vs 49 +/- 14; P = .002), serum triglyceride value (191 +/- 82 vs 135 +/- 72; P = .02), and anemia (23.1% vs 5.6%; P = .05). Multiple logistic regression analysis for statistically significant variables only showed that preexistent events influenced the development of posttransplantation events (odds ratio, 27; 95% confidence interval, 4.7-154; P = .0005). In conclusion, cardiovascular events within 1 year after transplantation were more frequent among patients with CMV replication and seropositivity for other herpesviruses. An important risk factor was the presence of preexistent events.

The origins of Iberian horses assessed via mitochondrial DNA

Despite a number of recent studies that have focused on the origin of domestic horses, genetic relationships between major geographical clusters still remain poorly understood. In this study we analyzed a 296 bp mtDNA fragment from the HVI region of 171 horses representing 11 native Iberian, Barb, and Exmoor breeds to assess the maternal phylogeography of Iberian horses. The mtDNA haplogroup with a CCG motif (nucleotide position 15,494 to 15,496) was the most frequent in Iberian and Barb breeds (0.42 and 0.57, respectively), regardless of geographic location or group of breeds. This finding supports the close genetic relationship between the ancestral mare populations of the Iberian Peninsula and Northern Africa. Phenotypic differences among the Northern and Southern Iberian groups of breeds are not explained by population subdivision based on maternal lineages. Our results also suggest that Northern Iberian ponies--which are phenotypically close to British ponies, especially Exmoor--are the result of an introgression rather than population replacement.

Isolation of an amikacin-resistant Escherichia coli strain after tobramycin treatment of previous recurrent episodes of respiratory tract infections caused by Pseudomonas aeruginosa

Amikacin-resistant Escherichia coli strains are isolated rarely from clinical samples. In the present study, investigation of an amikacin-resistant clinical isolate of E. coli demonstrated the presence of two class 1 integrons carrying the aacA4 gene plus the aacA7 gene, and the dfrA17 gene plus the aadA5 gene, respectively. Resistance to amikacin in this E. coli isolate was related to the presence of both aacA4 and aacA7.

Oocytes recovered from cows treated with retinol become unviable as blastocysts produced in vitro

Retinoids have been shown to enhance developmental competence of the oocyte in cattle, sheep and pigs. In this study we investigated whether exogenous retinol stimulates the bovine oocyte during its intrafollicular growth and the time limits of exposure to exogenous retinol. In addition, we also determined the efficiency of ovum pick-up techniques in combination with retinol treatment and the viability of embryos after transfer to recipients. In Experiment 1, heifers were injected with retinol or vehicle, and concentrations of retinol in the blood were analysed on Day 0 (prior to injection), Day 1 and, together with follicular fluid, Day 4. Blood retinol increased by Day 1 and cleared on Day 4, but retinol remained higher within the follicle. In Experiment 2, oocyte donors were injected weekly with retinol or vehicle four times during a twice-per-week cycle of eight recovery sessions (starting 4 days before the first session), followed by a second eight-session cycle without treatment. Oocytes recovered were fertilized and culturedin vitro.Retinol treatment yielded higher numbers of low-quality oocytes throughout, although retinol measured during cycles did not change. Total oocytes, and morulae and blastocyst rates, increased during the first five sessions following treatment with retinol. As previously shown with oocytes from slaughterhouse ovaries, retinoic acid stimulated blastocyst development. Following transfer to recipients, blastocysts from oocytes exposed to retinol were unable to establish pregnancy. Our study confirms the existence of an effect of retinol on the intrafollicular oocyte in the cow and provides evidence regarding the teratogenic effect of retinol.

Testing the usefulness of the molecular coancestry information to assess genetic relationships in livestock using a set of Spanish sheep breeds1

Recent studies have proposed the use of molecular coancestry coefficients as a measure of genetic variability and as a useful tool for conservation purposes. Using simulated data, molecular coancestry has been shown to become constant very quickly after separation of populations, leading to population diversity remaining constant. However, the use of molecular coancestry information to study the genetic relationships between breeds has not yet been widely explored. Here we analyze the polymorphism of 14 microsatellites in 222 unrelated individuals belonging to seven native Spanish breeds to ascertain the usefulness of molecular coancestry-based methodologies in providing information on their genetic relationships. Average kinship distance (D(k)) and average molecular coancestry coefficients (f(ij)) were compared with well-known genetic distances, such as between-breed Reynolds' distance (D(R)), Nei's standard distance (D(s)), and shared allele distance (D(AS)). Kinship distance and f(ij) have moderate to low correlations with the other genetic distances, showing that they provide different information: both D(k) and f(ij) account for the allele frequencies in the founder population, whereas D(R), D(s), and D(AS) characterize the short-term evolution of the populations. Furthermore, D(k) and f(ij) were only moderately correlated (-0.500). The present study used field data to confirm previous research pointing out the ability of molecular coancestry coefficients to assess genetic differentiation of an ancestral origin. In this respect, molecular coancestry-based parameters may be used with classical genetic parameters to obtain information on population dynamics in livestock breeds. This study additionally presents reliable evidence on the history of these sheep breeds.

Genetic relationships and admixture among sheep breeds from Northern Spain assessed using microsatellites

Although many research papers have studied diversity and differentiation within livestock species, genetic relationships among neighboring populations remain poorly understood. Here we apply recent methodologies to analyze the polymorphism of 14 microsatellites in 238 unrelated individuals belonging to six sheep breeds from Northern Spain to ascertain their historical relationships and the relative genetic contributions existing between populations. Individual genotypes were analyzed to assess the existence of an underlying genetic structure. Long-term and recent migration rates were estimated to identify patterns of relative genetic contribution among breeds. The complete data set showed a strong population structure derived from both different ancestral origins and some geographical patterns of recent gene flow. Two of the analyzed breeds (Black-faced Latxa and Churra) had a marked genetic background, supporting the hypothesis that, regardless of their phenotypical similarities, they have different ancestral origins. Some of the more presumably related breeds had negative long-term admixture coefficients, showing that they diverged only recently. In addition, we show how methodologies for estimation of long-term gene flow and recent patterns of migration are complementary, providing information about migration rates on different timescales.

High infection rates ofTriatoma dimidiataare associated with low levels ofTrypanosoma cruziseroprevalence in Pedro Carbo, Ecuador. Use of atc24 gene-based PCR approach

In control programs for vectorial transmission of Chagas' disease, conventional microscopic procedures are generally performed to determine baseline levels of infectivity of vectors. Reported here are data using Polymerase Chain Reaction in the detection of Trypanosoma cruzi in Triatoma dimidiata, one of the principal vectors of Chagas' disease in Ecuador. The microscopy and PCR techniques showed a high percentage of vector infection in Pedro Carbo, province of Guayas (Ecuador), with 44.16% and 46.13% positive insects, respectively. This contrasted with the very low Chagas seropositivity recorded (0.5%). Since T. dimidiata was the only vector of the Chagas' disease found in Pedro Carbo and looking at the vector behavior, our data suggest that despite the high T. dimidiata infection, the low Chagas seropositivity detected is closely associated with the epidemiological and ecological context of T. dimidiata in Pedro Carbo.

205 DEVELOPMENT OF OOCYTES FROM COWS TREATED WITH RETINOL IS COMPROMISED PRIOR TO IMPLANTATION

In the cow, sheep, and gilt, a retinoid support enhances the oocyte development (reviewed by Hidalgo C et al. 2003 Reproduction 125, 409–416). The shortest effective time interval for these animals injected with retinol (ROH) is four days, but the reasons for this have not been described. Furthermore, the development after transfer of embryos derived from oocytes of donors treated with ROH is not known. The objective of the present work was to elucidate the two above questions. We analyzed the ROH and retinyl palmitate (REP) contents in plasma and follicular fluid (FF). The estrus cycles of heifers (n = 12) were synchronized with progestagen and PGF2α. Blood samples were taken at progestagen removal (Day 0). Animals were injected with 1 × 106 ROH units (n = 6) or corn oil (vehicle; n = 6) on Days 0, 1, and 4. Contents of follicles between 3 and 10 mm were aspirated on Day 4 by an ultrasound-guided procedure. All samples were analyzed for ROH and REP by HPLC. To produce embryos for transfer, follicles were aspirated from donors treated four times with 1 × 106 ROH units/week or vehicle, starting four days before the first aspiration. Both groups of cumulus-oocyte complexes (COCs) were matured in vitro with or without 5 nM 9-cis-retinoic acid (RA). The presence of RA prolonged the exposure to retinoids (cows treated with ROH) or acted as a positive control (heifers with vehicle). Oocytes were fertilized and cultured in mSOF + 5% FCS. Embryo transfer (ET) to recipients was performed with fresh (one) or vitrified (two) good-morphology Day 7 embryos, and pregnancy monitored on Days 21, 35, and 60. Data analysis was by GLM (ROH and REP concentrations) or CATMOD (pregnancy monitoring), and Duncan's test (a,bP < 0.05; v,x,y,zP < 0.02). Average FF volume recovered were 351 ± 127 μL (controls; range 100–700) and 393 ± 127 μL (ROH; range 80–950). Concentrations of REP were unaffected by timing, follicle or blood, and ROH treatment (data not shown). Concentrations of ROH (μg/dL) for vehicle and ROH-treated cows were (LSM ± SE) 42.0 ± 1.8vx and 42.0 ± 2.4vx (plasma-Day 0, before ROH injection), 37.3 ± 1.8v and 47.64 ± 2.4x (plasma-Day 1), 42.6 ± 1.9vx and 45.5 ± 2.3vx (plasma-Day 4), and 6.1 ± 3.0y and 16.8 ± 2.6z (FF-day 4), respectively. Cumulatively, embryos from donors receiving ROH did not exhibit pregnancy on Day 21 (0/15x; confirmed on Day 35), which differed from vehicle donors on Day 21 (44%, 8/18y) and Day 35 (33%, 6/18y), and tended to differ (P = 0.07) on Day 60 (22%, 4/18). Pregnancy rates were independent of fresh or vitrified embryos within ETs. Injected ROH elevated blood concentrations of ROH, although values became normalized on Day 4. However, a coasting period of 4 days for ROH administration seems to be justified by increased intrafollicular levels of ROH. Development into blastocysts is disrupted before implantation, showing that ROH directly affects the oocyte during its intrafollicular growth. This work was supported by MCYT-AGL-2002-0117.

190 A PROCEDURE TO OBTAIN FIBROBLASTS FROM WILD ANIMALS

The number of wild animals threatened or at risk of extinction constantly increases and, as a result, biodiversity decreases. Therefore, it is necessary to set in motion proceedings to preserve the genetic variability and to overcome factors leading to this situation. Banks of cryopreserved cells, such as skin fibroblasts, from wild animals could be used both for genetic studies and as a cell source for technologies able to reproduce individuals. In this study we report that a single basic protocol provides a method for obtaining, culturing, and cryopreserving skin fibroblasts from a wide range of wild animals. Skin biopsies were taken in Cantabria (Spain) from live, anesthetized brown bear (Ursus arctos, n = 4), and in Asturias (Spain) from carcasses of accidentally killed individuals from the following species: grey wolf (Canis lupus, n = 1), red fox (Vulpes vulpes, n = 1), eurasian badger (Meles meles, n = 1), ermine (Mustela erminea, n = 1), fallow deer (Dama dama, n = 7), pyrenean chamois (Rupicapra pyrenaica, n = 1), western roe deer (Capreolus capreolus, n = 1), wild boar (Sus scrofa, n = 1), striped dolphin (Stenella coeruleoalba, n = 1) and one avian species, capercaillie (Tetrao urogallus, n = 1). Once obtained and transported to the laboratory, all samples were processed identically. Tissue samples were manually cut into small pieces and enzymatically digested with 0.05% trypsin-EDTA (Sigma-Aldrich, Madrid, Spain) for 30 min, and then with collagenase (300 units/mL) (Sigma) for 14 h at 38°C. Disaggregated cells were centrifuged at 1600 rpm for 10 min and the pellet was diluted with D-MEM (Sigma) containing 10% FBS. Cells were counted and a minimum of 3 × 105 cells were placed in a 25 cm2 flask for culture under 5% CO2 in air and high humidity at 37°C (red fox, badger, ermine, western roe deer) or 38°C (brown bear, grey wolf, fallow deer, pyrenean chamois, wild boar, striped dolphin, capercaillie). Confluent fibroblast monolayers were obtained after 5–7 days in culture except for the striped dolphin whose sample was contaminated. Two to three passages were performed using 75 cm2 flasks before freezing fibroblasts in D-MEM containing 10% DMSO (Sigma) and 10% FBS. Total cell yield from a confluent flask was 5–11 × 106 cells, depending on the animal species. Fibroblasts recovered from all thawed samples grew to confluence, and karyotypes were performed at this step. It was possible to obtain, culture, freeze, and thaw skin fibroblasts successfully from all the above-mentioned land species. Although more research is needed, preliminary data suggest that the above-described procedure can be applied to mammals and birds, thus helping to preserve genetic material of wild animals. Grant Support: Consejería de Medio Ambiente, Ordenación del Territorios e Infraestructuras, Asturias, SPAIN. The authors acknowledge CEPESMA, Luarca, Asturias, SPAIN.

Factors associated with erectile dysfunction in male kidney transplant recipients

A transversal study was carried out in order to evaluate the prevalence of erectile dysfunction (ED) in adult kidney transplant patients of our region (N=243), and to investigate the sociodemographic, analytic, and clinical factors associated with it. To evaluate ED, the Spanish five items version of the International Index of Erectile Function (IIEF-5) was employed. Sociodemographic, analytic, and clinical data, including 12 cardiovascular risk factors, were also collected. A total of 199 patients (82%) were included. The median age was 52 y (43-62 y); 106 patients (54.9%) presented with ED. Variables associated with ED were: higher age; longer time on dialysis prior to transplantation; higher comorbidity; presence of diabetes mellitus; had undergone prostatic surgery or peripheric artheriopathy; lower diastolic pressure; and some anti hypertensive drugs. Logistic Regression Model performed step by step showed (R(2)=0.52) that factors independently associated with ED were: age, time on dialysis previous to transplant, and peripheric artheriopathy.

Multisyringe flow injection analysis of stable and radioactive strontium in samples of environmental interest

A multisyringe flow injection (MSFIA) method for the determination of stable and radioactive strontium, using a solid phase resin (Sr-Resin), has been developed. Strontium concentrations are determined by atomic emission spectroscopy and by a low background proportional counter. The method has been applied to different samples (water, milk and soil) of environmental interest. The LLD of the stable and radioactive Sr were 10 microg/l and 0.01 Bq, respectively. The standard deviation of the separation procedure is 2% (n=10).

[Cardiogenic shock associated with inappropriate nutritional regimen: refeeding syndrome]

Situations of cardiac arrest have been reported in under-nourished patients with protein and calorie deficits when the provision of nutrients was initiated in an uncontrolled manner. The recognition of the association between the provision of food in these circumstances and the serious clinical consequences, generally heartbeat disorders, has led this condition to be described as "re-feeding syndrome". The case presented here is of severe acute respiratory failure and cardiogenic shock in a 44-year-old female patient with severe protein and calorie malnutrition associated with the start of hyperproteic nutritional support. Treatment with inotropic-vasoactive drugs and diuretics together with a progressive nutritional programme brought about the complete reversal of her heart failure and the concomitant endocrine-metabolic syndrome.

Influence of erectile dysfunction on health related quality of life of male kidney transplant patients

The objective of the present study was to investigate if a psychological adaptation capacity exists in kidney transplant bearers, even with ageing, in relation to erectile dysfunction (ED). We studied ED using IIEF-5 and health-related quality of life (HRQoL) using the SF-36 Health Survey, in a large sample of male renal transplant patients (n=242), searching for the influence of ED on HRQoL. Patients included 199 patients (82%); the median age was 52 y (43-62); 106 patients (54.9%) presented ED. These patients were divided into four groups according to median age. SF-36 scores were worse for ED vs non-ED patients in the first three age groups, but not in age group 4. SF-36 Mental Component Summary was similar for patients with ED and without ED in all age groups. We confirm the hypothesis that a psychological adaptation occurs in renal transplant patients in all age groups, when suffering ED.

[The 5-HT1A receptors: from molecular biology to neuropsychiatric symptoms]

Among the multiple serotonin receptors identified to date, the 5-hydroxytryptamine (5-HT)1A subtype is among the best known because selective ligands have been available for more than 15 years. Radioactive derivatives of these ligands make it possible to demonstrate the presence of 5-HT1A binding sites mainly in the limbic areas and in the raphe nuclei in the brain, where they correspond to post-synaptic receptors and pre-synaptic autoreceptors respectively. On stimulation of 5-HT1A autoreceptors, they regulate serotonin release in the distal regions of the neuron by inhibitory firing activity. In this way, they help to maintain the serotonin in the terminal regions at physiological levels, which favors correct neuronal functioning. This review article summarizes key data on localization, study technique, molecular biology, signal transduction, differential functional properties of pre-synaptic versus post-synaptic 5-HT1A receptors, and behavioral effects and clinical correlates of their activation, especially cognitive and emotional responses. Mention is made about the role of these receptors in the neurogenesis process of certain brain areas and of the possible clinical and therapeutic implications of these processes.