PAHs and trace metals in marine surficial sediments from the Porcupine Bank (NE Atlantic): A contribution to establishing background concentrations

Little is known about pollutant concentrations in marine remote areas such as the Porcupine Bank in the NE Atlantic Ocean. Remote locations are much less studied than the more readily accessible coastal areas, nevertheless, are of great importance both to unveil how far human influence has reached and, are more challenging, to infer background concentrations (BCs) of naturally occurring and/or anthropogenic pollutants. Knowledge of contaminant background levels are critical for establishing remediation and management strategies; in addition, background assessment is heavily emphasised in legislative monitoring requirements. Obtaining suitable sampling locations to assess background concentrations can be challenging, as samples should match characteristics to the target area and not be impacted by historical or current inputs of the chemical substances of study. Anthropogenic impacts generally deem local-based sampling to be unsuitable to infer background pollution values. Sampling in remote areas such as the Porcupine Bank better fulfils low impact and pressure requirements making them more suitable for the derivation of background concentration estimates for organic compounds and metals. The total concentrations of polycyclic aromatic hydrocarbons (PAHs) and metal(loid)s in deep sea sediments were evaluated and both an environmental status and a set of concentration data were adequate to derive BCs concentrations is presented. Concentration data indicated, in comparison with previous published data, trace level presence of PAHs and metal(loids) in sediments from the Porcupine Bank. These values will provide a valuable tool to identify the natural presence of organic and inorganic compounds and be the basis to perform a sound environmental assessment.

AB0124 EFFECTS OF INHIBITOR K-CARRAGEENAN ON HAECs INFLAMMATORY RESPONSE TO LDLs ISOLATED FROM SLE PATIENTS

Background

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with a high risk of atherosclerosis and cardiovascular events. It was previously reported by our group that low-density lipoprotein (LDL) particles isolated from SLE patients, during an active state of the disease (‘flare’), promoted an exaggerated inflammatory response in human aortic endothelial cells (HAECs). However, the molecular mechanisms underlying this response still remain elusive.

Objectives

The hypothesis of this study is that these SLE-LDLs would be using receptor LOX-1, associated with inflammatory conditions and altered lipoproteins, to generate the proatherogenic response in HAECs.

Methods

LOX-1 pharmacological inhibitor k-carrageenan was used before the stimulation of HAECs with LDLs isolated from healthy controls (10), non-active (13), or active-SLE patients (13). Gene expression, protein, and cell migration assays were performed to evaluate HAECs inflammatory response.

Results

LOX-1 inhibition with k-carrageenan significantly reduced the expression of vascular cell adhesion molecule 1 (VCAM-1) and restored the gene expression of endothelial nitric oxide synthase (eNOS) in HAECs incubated with non-active SLE LDLs.

Conclusion

While VCAM-1 down-regulation was expected, the immediate next step derived from the observed results will be a deeper understanding of how LOX-1 inhibition may restore the endothelial ability to synthetize NO in the presence of altered LDL. This will allow gaining insight not only on the development of atherosclerosis but also on the clue mechanisms involved in the pathogenesis of SLE.

Disclosure of Interests

None declared

Copper impair autophagy on zebrafish (Danio rerio) gill epithelium

Copper (Cu) is an essential element for organism's metabolism, being controversially listed as a priority pollutant. Importantly, the toxicity of Cu has been linked to several cell death pathways. Thus, this study aimed to assess if macroautophagic pathways are triggered by Cu in zebrafish gill, the main target of waterborne pollutants. The electron microscopy findings indicated that Cu induced profound impacts on zebrafish gill structure and functions, being this tissue a biomarker sensitive enough to indicate early toxic effects. The findings also support a clear impairment of autophagy, througth the absence of phagossomes and the significant down-regulation mRNA transcript levels of microtubule-associated protein light chain 3 (LC3). The reduction of LC3 levels was often associated to an increase of apoptotic activation, indicating that the inhibition of macroautophagy triggers apoptosis in zebrafish gills. This study highlighted that the autophagic down-regulation might be affected through the activation of other cell death signaling pathway.

HDL-c levels predict the presence of pleural effusion and the clinical outcome of community-acquired pneumonia

Objectives

To investigate if HDL cholesterol (HDL-c) could be a biomarker of the degree of severity according to prognostic prediction scores in community-acquired pneumonia (CAP) or the development of clinical complications such as pleural effusion.

Methods

We included in a retrospective study 107 patients admitted to the hospital that fulfilled diagnostic criteria for CAP between the 30th October 2011 and 1st September 2012. HDL-c levels at admission, CAP prognosis scores (PSI and CURB65) and clinical outcomes were recorded for the study.

Results

Basal HDL-c levels were not statistically different according to prognostics scores neither PSI nor CURB-65. Significantly lower levels of HDL-c were also associated to the development of septic shock and admission to the intensive care unit. HDL-c were inversely correlated with acute phase reactants CRP (r = −0.585, P < 0.001), ESR (r = −0.477, P < 0.001), and leukocytes cell count (r = −0.254, P < 0.009). Patients with pleural effusion showed significant lower levels of HDL-c [28.9 (15.5) mg/dl vs. 44.6 (21.1) mg/dl]; P = 0.007. HDL-c is a good predictor of the presence of pleural effusion in multivariate analyses and using ROC analyses [AUC = 0.712 (0.591–0.834), P = 0.006]. HDL-c levels of 10 mg/dl showed a sensitivity of 97.6 % and a specificity of 82.4 % for the presence of pleural effusion.

Conclusion

Monitoring HDL-c in CAP is an useful serum marker of acute phase response, clinical outcome and the presence of pleural effusion.

β-Blockers have differential effects on the murine asthma phenotype

BACKGROUND AND PURPOSE

Our previous studies have shown the β2 -adrenoceptor and its endogenous ligand, adrenaline, are required for development of the asthma phenotype in murine asthma models. Chronic administration of some, but not other, β-blockers attenuated the asthma phenotype and led us to hypothesize that biased signalling was the basis of their differential effects, experimentally and clinically.

EXPERIMENTAL APPROACH

We used mice with no detectable systemic adrenaline (PNMT(-/-) ) and wild-type (WT) mice to study the effects of four β-blockers, alprenolol, carvedilol, propranolol and nadolol, in an ovalbumin sensitization and challenge (Ova S/C) murine model of asthma. The parameters measured were inflammatory cell infiltration, mucous metaplasia and airway hyperresponsiveness. To interpret the pharmacological action of these ligands quantitatively, we conducted computer simulations of three-state models of receptor activation.

KEY RESULTS

Ova S/C PNMT(-/-) mice do not develop an asthma phenotype. Here, we showed that administration of alprenolol, carvedilol or propranolol in the absence of interference from adrenaline using Ova S/C PNMT(-/-) mice resulted in the development of an asthma phenotype, whereas nadolol had no effect. Ova S/C WT mice did develop an asthma phenotype, and administration of alprenolol, propranolol and carvedilol had no effect on the asthma phenotype. However, nadolol prevented development of the asthma phenotype in Ova S/C WT mice. Computer simulations of these four ligands were consistent with the isolated three-state receptor model.

CONCLUSION AND IMPLICATIONS

β-Blockers have different effects on the murine asthma phenotype that correlate with reported differences in activation or inhibition of downstream β2 -adrenoceptor signalling pathways.

Circulating FABP4 is a marker of metabolic and cardiovascular risk in SLE patients

The aim of this study is to determine if circulating fatty acid-binding protein 4 (FABP4) plasma levels are a possible marker of metabolic risk in SLE patients. Circulating levels of adipose FABP4 are associated with adiposity, insulin resistance (IR), metabolic syndrome, diabetes and cardiovascular diseases. Patients affected by systemic lupus erythematosus (SLE) show an accelerated atherosclerosis that cannot be entirely explained by traditional cardiovascular risk factors. Sixty consecutive patients with SLE and 34 non-SLE age-matched controls were recruited for the study. Total plasma lipids and circulating FABP4 were determined. Subclinical atherosclerosis was evaluated by measuring carotid intimae-media thickness (c-IMT) by sonography, and the distribution of lipoprotein subclasses was analysed by nuclear magnetic resonance (NMR) spectroscopy. In the SLE group, FABP4 was associated with IR, atherogenic dyslipidaemia, as measured by NMR, and the presence of subclinical atherosclerosis. In multivariate analyses FABP4 was associated with increased c-IMT independent of the inflammatory state of the patient. In sum, circulating FABP4 is involved in the metabolic disturbances of SLE affecting lipid metabolism and IR, and it could be a biomarker of atherosclerosis in this population.

Linking chemical contamination to biological effects in coastal pollution monitoring

To establish the connection between pollutant levels and their harmful effects on living resources, coastal monitoring programmes have incorporated biological tools, such as the scope for growth (SFG) in marine mussels and benthic macrofauna community indices. Although the relation between oxygen-depleting anthropogenic inputs and the alteration of benthic communities is well described, the effects of chemical pollutants are unknown because they are not expected to favour any particular taxa. In this study, the combined efforts of five research teams involved in the investigative monitoring of marine pollution allowed the generation of a multiyear data set for Ría de Vigo (NW Iberian Peninsula). Multivariate analysis of these data allowed the identification of the chemical-matrix combinations responsible for most of the variability among sites and the construction of a chemical pollution index (CPI) that significantly (P < 0.01) correlated with biological effects at both the individual and the community levels. We report a consistent reduction in the physiological fitness of local populations of mussels as chemical pollution increases. The energy balance was more sensitive to pollution than individual physiological rates, but the reduction in the SFG was primarily due to significantly decreased clearance rates. We also found a decrease in benthic macrofauna diversity as chemical pollution increases. This diversity reduction resulted not from altered evenness, as the classic paradigm might suggest, but from a loss of species richness.

Nonconcordance between subclinical atherosclerosis and the calculated Framingham risk score in HIV-infected patients: relationships with serum markers of oxidation and inflammation

OBJECTIVES

HIV-infected patients show an increased cardiovascular disease (CVD) risk resulting, essentially, from metabolic disturbances related to chronic infection and antiretroviral treatments. The aims of this study were: (1) to evaluate the agreement between the CVD risk estimated using the Framingham risk score (FRS) and the observed presence of subclinical atherosclerosis in HIV-infected patients; (2) to investigate the relationships between CVD and plasma biomarkers of oxidation and inflammation.

METHODS

Atherosclerosis was evaluated in 187 HIV-infected patients by measuring the carotid intima-media thickness (CIMT). CVD risk was estimated using the FRS. We also measured the circulating levels of interleukin-6, monocyte chemoattractant protein-1 (MCP-1) and oxidized low-density lipoprotein (LDL), and paraoxonase-1 activity and concentration.

RESULTS

There was a weak, albeit statistically significant, agreement between FRS and CIMT (kappa=0.229, P<0.001). A high proportion of patients with an estimated low risk had subclinical atherosclerosis (n=66; 56.4%). In a multivariate analysis, the presence of subclinical atherosclerosis in this subgroup of patients was associated with age [odds ratio (OR) 1.285; 95% confidence interval (CI) 1.084-1.524; P=0.004], body mass index (OR 0.799; 95% CI 0.642-0.994; P=0.044), MCP-1 (OR 1.027; 95% CI 1.004-1.050; P=0.020) and oxidized LDL (OR 1.026; 95% CI 1.001-1.051; P=0.041).

CONCLUSION

FRS underestimated the presence of subclinical atherosclerosis in HIV-infected patients. The increased CVD risk was related, in part, to the chronic oxidative stress and inflammatory status associated with this patient population.

Influence of a monocyte chemoattractant protein 1 mutated allele on the response to protease inhibitor-based antiretroviral therapy

BACKGROUND

Antiretroviral drug efficacy has been widely studied in relation to viral factors. Mutations in the HIV co-receptors and their natural chemokines, however, may be critical in HIV infection and treatment response. We compared the efficacy of protease inhibitor (PI) treatment among PI-naïve patients grouped according to whether they carried the chemokine CC motif receptor 2 (CCR-2) 64I and monocyte chemoattractant protein 1 (MCP-1)-2518G alleles.

METHODS AND RESULTS

HIV-infected patients who were PI-naive were selected for the study (n=164) but there was no restriction on lymphocyte CD4 count or plasma HIV viral load. Follow-up was for the first 24 months of treatment. Clinical and laboratory data were obtained every 3 months. All the participants were genotyped for the MCP-1-2518G, CCR-2 64I, CCR-5Delta32 and stromal derived factor 1 (SDF1) 3'A mutated alleles. The results indicated that patients carrying the mutated allele of MCP-1 had a higher mean CD4 cell count throughout the follow-up period than those with the common allele (P=0.01). Also, patients with the MCP-1 and CCR-2 mutated alleles were more likely to continue to have an undetectable viral load following treatment (P=0.05).

CONCLUSION

A better response to PI treatment appears to be conferred by mutations in the host MCP-1 and CCR-2 genes, and may be related to the cellular axis-of-entry used by the retrovirus.

Spatial and temporal changes in benthic communities of the Galician continental shelf after the Prestige oil spill

Two years after the Prestige oil spill (POS) an assessment of the effects on benthic fauna was carried out using the data obtained in five multidisciplinary surveys. Otter trawl, beam trawl, suprabenthic sled and box corer were used to study the main benthic compartments, along eight transects perpendicular to the coastline. Beam trawl was also employed to quantify the amount of tar aggregates on the continental shelf. No significant correlations between tar aggregates and species richness, biomass and diversity of benthic communities were found. This result was corroborated when the role of depth, season, latitude and sediment characteristics was examined by canonical ordination, in which POS-related variables had low influence on spatial distribution patterns. Depth and sediment grain diameter profoundly influence epibenthic communities. Sediment organic content is a third key variable for the infaunal, suprabenthic and lower-sized epibenthic communities, but not for the larger epibenthic communities. Nevertheless, a decrease in the densities of several epibenthic indicators was detected the first year after spill, followed by a noteworthy recovery in 2004. Non-macroscopic toxicity and some oceanographic agents are suggested as possible causes of these shifts.

Synthesis, testing, and characterization of a novel Nafion membrane with superior performance in photoassisted immobilized Fenton catalysis

A new type of Nafion/Fe structured membrane ensuring faster kinetics, higher efficiency, and mechanical properties has been prepared and will be compared in its performance with the Fe-exchanged commercial Dupont 117 Nafion/Fe membrane during the abatement of model organic compounds. During the casting of the laboratory Nafion sample, the iron ions were introduced directly into the Nafion oligomer solution. This novel laboratory Nafion/Fe was tested as an immobilized catalyst in the degradation of several toxic pollutants showing a faster photoassisted degradation kinetics and a wider effective photocatalytic pH range compared to the Fe-exchanged commercial Dupont 117 Nafion/Fe membrane. When carrying out Ar ion sputtering of the 50 topmost catalyst layers, evidence is presented by X-ray photoelectron spectroscopy that Fe ions are found in the inner Nafion layers and seem to be responsible for the immobilized photoassisted Fenton processes leading to the degradation of 4-chorophenol (4-CP) taken as a model organic pollutant for the degradation process reported in this study. In the laboratory sample, the iron oxy/hydroxy Nafion moiety undergoes a transition to a more stable Nafion/Fe species during 4-CP degradation as determined by X-ray diffraction. This more stable form shows a higher iron dispersion and crystallinity compared to the fresh sample and is stabilized by the Nafion matrix avoiding the formation of separate iron phases. By infrared absorption (Fourier transform infrared), evidence is presented for the band of akaganeite-like species at 870 cm(-1) on the laboratory Nafion/Fe sample. This band disappears after 4-CP degradation because of the formation of the more highly dispersed iron species. Sputtering experiments show a decrease of F-containing groups in the laboratory Nafion/Fe samples closer to the catalyst upper layer while the amounts of Fe, C, and in particular O species increase in the topmost layer(s). In particular, the oxygenated species develop in the Nafion/Fe up to approximately 50 A below the catalyst surface. These species remain stable during the long-term Nafion/Fe degradation of 4-CP. Dynamo-mechanical analysis performed on laboratory Nafion/ Fe membrane samples revealed that these membranes possessed a greater mechanical modulus and resistance than the commercial Dupont 117 Nafion membrane.

BOD5 measurements of water presenting inhibitory Cu2+. Implications in using of BOD to evaluate biodegradability of industrial wastewaters

In industrial effluents, the presence of an infinite number of possible mixtures of substances and the high variability of chemical conditions ask for an evaluation of biodegradability by a global and simple method. Biological oxygen demand after five days (BOD5) using synthetic wastewater was studied by two different ways: dilution and manometric methods. It can therefore be established that BOD5 obtained by adding manufactured inocula to the synthetic medium (effluent containing known and easily biodegradable substances) is close to the values obtained with inocula taken from the treated effluent of an urban and a rural purification plant. It was found that BOD5 measurement of effluents presenting factors affecting biodegradation, similar of those found in industrial effluents, is very questionable. The BOD is in this case influenced by the synergic and antagonist interactions between numerous and variable parameters like as pH, nature and concentration of inoculum, concentration of nutriments, amount and nature of assimilable substances, presence of toxicants, and presence of nitrification inhibitors, which are typical of real industrial wastewaters.

Plasmatic homocysteine concentration and its relationship with complications associated to diabetes mellitus

BACKGROUND AND METHODS

In the search for new factors of cardiovascular risk associated to diabetes mellitus (DM), special attention has been paid in recent years to hyperhomocysteinaemia. Therefore, we have established the concentration of homocysteine (Hcy) and other biochemical parameters in the plasma of a group of 57 type 1 and 32 type 2 diabetic patients and 54 control subjects and studied whether plasmatic homocysteinaemia was related to macroangiopathy, nephropathy, retinopathy and neuropathy. Because of significant differences for plasma Hcy values between men and women in the control group, we distinguished between both groups throughout the study.

RESULTS

Patients with DM had higher Hcy than control subjects (11.7+/-5.4 vs. 10.1+/-2.4 micromol/l, p<0.05). Fasting hyperhomocysteinaemia was considered as the mean of the plasma Hcy for control subjects+2 SD (14.9 micromol/l in total group, 15.6 micromol/l in males and 13.9 micromol/l in females). In the studied groups with complications, we found significant differences between normohomocysteinaemic type 1 diabetic patients and those considered hyperhomocysteinaemic by us. On the other hand, patients having type 1 DM and complications had higher plasmatic Hcy concentration than those with no complications.

CONCLUSIONS

We have found a relationship between high Hcy levels and prevalence of macroangiopathy, retinopathy and nephropathy in the type 1 diabetic patients, which was not been observed in the type 2 diabetic patients of our study. As a result, we consider plasmatic Hcy a complication-risk indicator in type 1 DM, and we recommend its use together with already established biochemical parameters in the control of the evolution of the disease.

Reducing infections among women undergoing cesarean section in Colombia by means of continuous quality improvement methods

BACKGROUND

Improving obstetric care in resource-limited countries is a major international health priority.

OBJECTIVE

To reduce infection rates after cesarean section by optimizing systems of obstetric care for low-income women in Colombia by means of quality improvement methods.

METHODS

Multidisciplinary teams in 2 hospitals used simple methods to improve their systems for prescribing and administering perioperative antibiotic prophylaxis. Process indicators were the percentage of women in whom prophylaxis was administered and the percentage of these women in whom it was administered in a timely fashion. The outcome indicator was the surgical site infection rate.

RESULTS

Before improvement, prophylaxis was administered to 71% of women in hospital A; 24% received prophylaxis in a timely fashion. Corresponding figures in hospital B were 36% and 50%. Systems improvements included implementing protocols to administer prophylaxis to all women and increasing the availability of the antibiotic in the operating room. These improvements were associated with increases in overall and timely administration of prophylaxis (P<.001) in both hospitals by time series analysis, with adjustment for volume and case mix. After improvement, overall and timely administration of prophylaxis was 95% and 96% in hospital A and 89% and 96% in hospital B. In hospital A, the surgical site infection rate decreased immediately after the improvements (P<.001). In hospital B, the infection rate began a downward trend before the improvements that continued after their implementation (P =.04).

CONCLUSION

Simple quality improvement methods can be used to optimize obstetric services and improve outcomes of care in resource-limited settings.

Imidazo[1,2-a]quinoxalines: synthesis and cyclic nucleotide phosphodiesterase inhibitory activity

A group of imidazo[1,2-a]quinoxalines have been synthesised from quinoxaline by condensation of an appropriate haloester or intramolecular cyclisation of a keto moiety on an intracyclic nitrogen atom. The reactivity of the heterocycle was explored through diverse reactions such as electrophilic substitution, lithiation and halogen-metal exchange to give access to a new series of derivatives. Confirmation of their structure was mainly performed by NMR, after careful assignment of the signals in comparison to previous attributions made on the parent imidazo[1,2-a]quinoxaline and discussion of available data in the literature. The cyclic nucleotide phosphodiesterase inhibitor activity of some of these derivatives has been assessed on isoenzymes type III and type lV. Compound 15, 4-(methylamino)imidazo[1,2-a]quinoxaline-2-carbonitrile, exhibited potent relaxant activity on smooth muscle, with a potency similar to the one measured with SCA 40, its structural analogue in the imidazo[1,2-a]pyrazine series.

Photochemical-biological treatment of a real industrial biorecalcitrant wastewater containing 5-amino-6-methyl-2-benzimidazolone

5-amino-6-methyl-2-benzimidazolone (AMBI), used in the manufacture of dyes, was characterised as a biorecalcitrant compound by means of different biodegradability tests. In order to enhance the biodegradability of this important pollutant, the application of Advanced Oxidation Process (AOPs) as a pretreatment was explored. Some experiments were addressed to find the most efficient AOP. The systems H2O2/hv, TiO2/H2O2/hv, Fe3+/hv, Fe3+/H2O2 and Fe3+/H2O2/hv were compared. The photo-Fenton system was the most efficient and the optimal conditions (AMBI, Fe3+, H2O2 concentrations) for the degradation of AMBI were found. During the photo-Fenton degradation, experiments were also made to obtain information concerning the evolution of: (a) organic carbon and initial compound concentration; (b) the oxidation state; (c) the toxicity; (d) the biodegradability; and (e) the chemical nature of the intermediates. These analyses show that the solution resulting from the treatment of AMBI is biologically compatible and complete mineralisation can be performed by biological means. A combined photochemical (Fenton) and biological flow reactor for the degradation of AMBI was successfully operated in continuous mode at laboratory scale. 100% of the initial concentration of AMBI and 80.3% of Dissolved Organic Carbon (DOC) were removed in 3.5 hours of total residence time. Finally, some field experiments under direct sunlight carried out at the Plataforma Solar de Almeria, Spain, demonstrated that this solar catalytic system is an effective treatment for this kind of industrial wastewater.

Concentrating versus non-concentrating reactors for solar photocatalytic degradation of p-nitrotoluene-o-sulfonic acid

The photocatalytic oxidation of the non-biodegradable p-nitrotoluene-o-sulfonic acid (p-NTS) in homogeneous (photo-Fenton reactions) and heterogeneous (with TiO2) solutions has been studied at a pilot-scale under solar irradiation at the Plataforma Solar de Almeria (PSA). In this study two different reactors were tested: a medium concentrating radiation system (Heliomans, HM) and a non-concentrating radiation system (CPC). Their advantages and disadvantages for p-NTS degradation have been compared and discussed. The degradation rates obtained in the CPC collector are around three times more efficient than in the HM collectors. However, in both systems, 100% of the initial concentration of p-NTS was removed. Kinetic experiments were performed in both systems using TiO2 suspensions. During the photodegradation, the disappearance of p-NTS was followed by HPLC, the mineralization of the solution by the TOC technique, the evolution of NO3-, NO2-, and SO4(2-) concentration by ionic chromatography, the toxicity by the standard Microtox test, and the biodegradability by BOD5 and COD measurements. The obtained results demonstrated the utility of the heterogeneous catalysis (using TiO2 as catalyst) as a pretreatment method that can be followed by a biological process.

[Detection of antibodies to beta-amyloid in carriers of E280A mutation in the presenilin-1 gene]

OBJECTIVE

To investigate some immune component that could contribute to the pathogenesis of Alzheimer's disease associated with the E280A mutation of the presenilin-1 gene (PS-1).

PATIENTS AND METHODS

Serum antibodies against both cardiolipin and beta-amyloid peptides (beta 1-40 and beta 1-42) were quantitated by means of an indirect ELISA technique in carriers of the mutation, either healthy or with Alzheimer's disease, as well as in normal controls without the mutation.

RESULTS

Out of 19 patients with Alzheimer's disease only 2 had increased values of antibodies to cardiolipin, namely: one with 14.58 micrograms/ml of IgM and the other with 36.16 micrograms/ml of IgG. The remaining individuals revealed values under 10 micrograms/ml, considered normal, and there was no significant difference between the groups. Significant serum reactivity (p < 0.001) was detected against both beta-amyloid peptides in the mutation carriers, either with or without Alzheimer's disease, as compared to the control group. No correlation was detected between this antibody response and the mental or functional situation of the patients.

CONCLUSION

beta-amyloid antibodies, present in the mutation carriers, may simply represent a marker of immune activation induced by beta-amyloid with no in vivo effect; however, despite the results, the possibility can not be ruled out of a pathogenic role of these antibodies in early onset Alzheimer's disease.

Association of maternal short stature with stunting in Mexican children: common genes vs common environment

OBJECTIVE

To evaluate the association between stunting in children and maternal short stature, controlling for potential environmental confounders.

DESIGN

1988 Mexico National Nutrition Survey.

SETTING

Mexico

SUBJECTS

The final sample size was 4663 pairs of children (<5 y) and their mothers (12-49 y) from a total of 13 236 surveyed houses.

MAIN OUTCOME MEASURES

Stunting (height-for-age Z-scores <-2).

RESULTS

The prevalence of stunting in children was 19%, and 10% of the mothers exhibited short stature (<145 cm). In the crude analysis, mothers with short stature were significantly more likely to have stunted children (odds ratio (OR)=4.0; 95% confidence interval (CI)=3.2-4.8; P-value <0.001). In a multiple logistic regression model the OR for child stunting was reduced, but remained significant OR=2.0; 95% CI=1.6-2.6; P-value <0.001) after adjustment for region, urban/rural residence, socio-economic status, household size, child age and presence of infection in the past 14 d, and maternal age, body mass index (BMI), and educational level. Adjusted ORs varied between regions (Mexico City, OR=3.9; North Mexico, OR=3. 1; Central Mexico, OR=2.0; South Mexico, OR=1.6. Comparison of crude vs adjusted estimates pointed to regional differences in the proportion of association between maternal and child short statures explained by environmental determinants.

CONCLUSIONS

Maternal stature, reflecting her potential height and early environment, appeared to contribute to child height independently of the shared risk factors that could affect stature. Nonetheless, we could explain much of the association between stunting in children and maternal short stature by environmental factors, and part of the residual variability may be due to unmeasured determinants. Regional differences pointed to a predominance of environmental factors in explaining child stunting in poorer regions.

Questionnaire assessment of antioxidants and retinol intakes in Mexican women

BACKGROUND

In order to assess intake of antioxidants and retinol, we evaluated the validity and reproducibility of a semiquantitative food frequency questionnaire.

METHODS

Data were collected from 110 women, aged 15-54 years, who resided in the southern part of Mexico City. Study participants were asked to complete the food frequency questionnaire before and after completing four series of 4 days of 24-h diet recalls. We obtained the 24-h recalls at 3-month intervals designed to account for seasonal variability. In addition, we measured serum blood levels of retinol and various carotenoids at 3 and 9 months after baseline.

RESULTS

Intraclass correlation coefficients for intake of energy-adjusted daily nutrients, assessed by the questionnaires 1 year apart, ranged from 0.23 for lutein/zeaxanthin to 0.50 for total carotenes. Correlation coefficients between energy-adjusted nutrient intakes were measured by means of the sixteen 24-h dietary recalls, and the second questionnaire ranged from 0.09 for lutein/zeaxanthin to 0.45 for total carotenes. These correlations were higher after adjusting for day-to-day variations in diets ranging from 0.11 for lutein/zeaxanthin to 0.49 for vitamin C. Correlation coefficients between intake and biochemical measures were 0.32 for alpha-carotene, 0.34 for beta-carotene, and 0.40 for total carotene after adjusting for age, body mass index, cholesterol and triglyceride plasma levels, smoking status, and caloric intake.

CONCLUSIONS

These data support the ability of our food frequency questionnaire to provide valid information on the relative intake of these nutrients and to confirm its usefulness in epidemiological studies of diet-disease relations. However, its application outside Mexico City or in different age or gender populations will require additional modifications and validation efforts.

Validity and reproducibility of a food frequency questionnaire to assess dietary intake of women living in Mexico City

OBJECTIVE

To assess the reproducibility and validity of a 116 item semi-quantitative food frequency questionnaire (FFQ), designed to assess the relation between dietary intake and chronic diseases.

MATERIAL AND METHODS

To test the reproducibility of the FFQ questionnaire, the FFQ was administered twice to 134 women residing in Mexico City at an interval of approximately one year; to assess the validity we compared results obtained by the FFQs with those obtained by four 4-day 24-hour recalls at three month intervals. Validity and reproducibility were evaluated using regression analysis and Pearson and intraclass correlation coefficients of log-e and calorie-adjusted nutrient scores.

RESULTS

Mean values for intake of most nutrients assessed by the two food frequency questionnaires were similar. However, means for the 24-hr recall were significantly lower. Intraclass correlation coefficients for nutrient intakes, assessed by questionnaires, administered one year apart, ranged from 0.38 for cholesterol to 0.54 for crude fiber. Correlation coefficients between energy-adjusted nutrient intakes, measured by diet recalls, and the first FFQ ranged from 0.12 for polyunsaturated fatty acids to 0.67 for saturated fatty acids. Regression coefficients between 24-hr recall and FFQ,s were all significant were significant for all nutrients, except for polyunsaturated fat, folic acid, vitamin E and Zinc.

CONCLUSIONS

These data indicate that this semi-quantitative FFQ is reproducible and provides a useful estimate by which to categorize individuals by level of past nutrient intake. However, its application outside Mexico City or in different age and gender populations will require additional modifications and validation efforts.

Dietary studies in countries experiencing a health transition: Mexico and Central America

Several countries, including Mexico, are experiencing changes in health patterns that are characterized by an increase in the prevalence of chronic diseases and changes in the principal causes of death, coexisting with deficiencies in the intake of energy and micronutrients, particularly in children. Several factors may explain these changes, including dietary habits. To evaluate food consumption in a population undergoing a health transition, a food-frequency questionnaire was developed, validated, and used to study the dietary determinants of chronic diseases in Mexico. Nutrient deficiency and the relation between maternal child-feeding behaviors and dietary intake by the child were evaluated with use of 24-h recalls, food-frequency methods. and estimation of food intake by observation. The observation method was extremely useful for studies in rural areas.

[Reproducibility of a questionnaire for studying climacteric]

OBJECTIVE

This study evaluated the reproducibility of a questionnaire concerned with the clinical and epidemiological aspects of menopause.

MATERIAL AND METHODS

The study population consisted of a hundred perimenopausal Mexican women seeking care at gynecology and obstetric health care services. Their participation was voluntary and they answered the same questionnaire two times with a 15-30 day lag between each application.

RESULTS

The Kappa coefficient was high (0.81-1.0) for categorical variables such as: type of menstrual cycles, type of menopause, breast-feeding, use of estrogen during menopause and use of hormonal contraceptives. The Kappa coefficient was moderate (0.7-0.8) for symptoms related to menopause such as hot flashes, sweating, painful coitus, vaginal dryness and a decrease in libido. Mean differences were calculated for continuous variables such as age at menarche, age at menopause, time using estrogen and the duration of breast-feeding, the majority had a value of zero and 95% confidence intervals for these mean differences included the null value. The questionnaire also included other characteristics such as tobacco consumption and a short food frequency questionnaire, which showed high concordance (Kappa 0.7-1.0).

CONCLUSIONS

The results of this study show that this questionnaire has a high level of reproducibility and can be useful as a research tool to explore menopause in Mexican women.

[Familial hyperphosphatasemia of intestinal origin]

To clarify the diagnostic laboratory procedures before a case of unknown origin hyperphosphatasemia, we have studied the electrophoretic separation of serum alkaline phosphatase activity on agarose gel with and without neuraminidase. Sera were collected from a family, four of whom showed hyperphosphatasemia. Alkaline phosphatase isoenzyme patterns on agarose gel electrophoresis demonstrated that two persons out of the six members tested had unusual isozymes, the hydrophilic and the hydrophobic intestinal isozyme representing more than 50% of total alkaline phosphatase. The advantages of this method are its simplicity and low cost. The early recognition of this benign abnormality should help to avoid unnecessary diagnostic tests (i.e. image or radioisotopic examination).

[Natural killer cytolytic activity in renal and prostatic cancer]

Natural killer cytolytic activity, the basis of cancer immunotherapy that uses cytolytic cells, may be impaired in cancer. The aim of this work was to study in vitro the natural killer cytolytic activity and its response to the immunomodulators interleukin-2, interferon and phytohemagglutinin stimulated lymphocyte proliferation in a group of 9 patients with renal cell cancer and 6 with prostatic cancer. The results were compared with those of 20 normal volunteers. Twelve patients were operated and were studied twice 48 h and 14 days after surgery. Natural killer cytolytic activity was significantly lower in renal cell and prostatic cancer patients than controls (3.3 +/- 1.6, 4.9 +/- 2.2 and 20.6 +/- 3.7% of specific lysis respectively). This activity was not modified in cancer patients by interleukin-2 50 UI/ml or interferon 3000 UI/ml and did not differ in the two postoperative periods. Phytohemagglutinin stimulated lymphocyte proliferation was also lower in cancer patients, compared to controls (stimulation index of 18 +/- 3 and 26.5 +/- 5 respectively). It is concluded that these patients have a low immunological level and that this study is the first step towards an immunological characterization of cancer patients that are candidate to adoptive immunotherapy.

Enhancement of natural killer cell activity in septic shock patients by a mixture of the calcium ionophore A23187 and the phorbol ester TPA: in vitro studies

Preincubation of peripheral blood lymphocytes from drug-free, healthy volunteers with a mixture of the calcium ionophore A23187 (Io) and the phorbol ester TPA (12-O-tetradecanoylphorbol-13-acetate) consistently resulted in a significant enhancement (dose-dependent; maximum immunostimulation obtained with the Io + TPA final mixture concentration of 10 uM + 250 ng/ml, respectively) of natural killer cell activity (NKCA) (n = 8; mean +/- SD of 16.8 +/- 8.9 and 52.0 +/- 18.0, paired Student's t-test p < 0.005; effector-to-target cell ratio of 30:1). Results from the same protocol, but using samples from septic shock patients followed a similar trend; however, and perhaps reflecting the significantly lower baseline NKCA in this group of individuals (n = 7), the mean value reached for this cellular immune function after incubation with Io + TPA was significantly lower than that of the treated controls' group (mean +/- SD of 19.8 +/- 11.6 and 52.0 +/- 18.0, respectively, Student's t-test p < 0.005). As expected from the role of calcium in the activation of NKCA, incubation with the Io significantly increased baseline NKCA, which was largely unchanged by TPA. Expression of the CD56+ and CD16+ phenotypes in septic shock patients did not correlate directly with NKCA, suggesting that this condition may be associated with changes in the function rather than the quantity of these cellular markers.(ABSTRACT TRUNCATED AT 250 WORDS)

In vitro studies of natural killer cell activity in septic shock patients. Response to a challenge with alpha-interferon and interleukin-2

Natural killer cell activity (NKCA) in patients with septic shock was statistically significantly lower than the value recorded for a group of drug-free, healthy volunteers [9.1 +/- 7.8 (n = 20) and 20.6 +/- 16.6 (n = 15), respectively; Student's test, p < 0.05]. As expected, preincubation of peripheral blood lymphocytes from samples taken from a group of controls with either alpha-interferon or interleukin -2 resulted in an enhancement of NKCA for each and everyone of the subjects studied; however, results from a similar protocol using patient samples showed a lack of consistency, both in the direction and magnitude, in the elicited changes in NK lytic function. Whereas samples from same patient responded with either an increase or a decrease in NKCA to preincubation with both immunostimulators, others responded with NKCA upmodulation to one and downmodulation to other of these test substances. A better knowledge of the mechanism(s) responsible for the depressed expression of NKCA in septic shock patients, and its altered response to alpha-interferon and interleukin-2, could generate new modalities in the diagnosis and therapy of this condition.