RA exerted beneficial effects on the duration and severity of renal damage induced by PD in a model of renal failure resembling ARF in humans. The protective effect of RA may be mediated by diminished lipoperoxidative damage.

This study correlates plasma levels of Zinc (Zn) and some pituitary and testicular hormones in 20 uremic men (aged 17-58 years) on a weekly peritoneal dialysis program. Patients were compared to 12 healthy male volunteers (aged 28-40 years). In uremic men, plasma androstenedione (A) was elevated, while testosterone (T), dihydrotestosterone (DHT), and Zn were low. On a group basis, plasma follicle stimulating hormone (FSH) and luteinizing hormone (LH) were normal while prolactin was increased. A negative correlation was observed between plasma A and LH levels, as well as between the AIT+ DHT ratio and plasma Zn concentrations.Our results suggest a diminished A-to-T conversion and point to the possible role of Zn in the enzyme activity of the 17 Phydroxysteroid dehydrogenase.

Plasma zinc (Zn), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), and androgens concentrations were determined in 15 male patients with chronic renal failure who were successful recipients of kidney transplant. After 25 +/- 8.5 months of the renal transplant, Zn levels were (88 +/- 4 g/dl) lower than in the control group (116 +/- 5 micrograms/dl). Normal concentrations for androstenedione (A) (0.63 +/- 0.05 ng/ml) and testosterone (T) (3.31 +/- 0.15 ng/ml) were found. Dihydrotestosterone (DHT) levels (0.38 +/- 0.01 ng/ml) were lower than normal (1.11 +/- 0.09 ng/ml), suggesting a blockade in the conversion of T to DHT. Eleven of the 15 patients showed higher PRL levels (9.5 +/- 0.8 ng/ml) in contrast with the normal group (3.6 +/- 0.3 ng/ml). Ten patients received orally 2-alpha-bromoergocriptine (BEC) 2.5 mg/day for ten days. Plasma PRL decreased to 2.6 +/- 1.0 ng/ml (p less than 0.001), but A and T levels did not significantly change; however, DHT increased from 0.38 +/- 0.02 ng/ml to 0.72 +/- 0.04 ng/ml (p less than 0.01). All patients showed an increase in both gonadotropins before BEC without significant changes after treatment. The high PRL levels may be responsible for the impaired conversion of T to DHT, possibly by interference with the enzyme 5 alpha-reductase.

In order to evaluate the effect of zinc (Zn) deficiency on thyroid abnormalities in chronic renal failure, a Zn supplement (100 mg/day, p.o.) was given for four weeks to eight uremic patients under peritoneal dialysis. Zn supplementation increased plasma levels of TSH (5.8 +/- 0.7 to 7.4 +/- 0.7 mU/l, p < 0.02), T4 (61.6 +/- 3.9 to 93.9 +/- 6.2 nmol/l, p < 0.01), T3 (1.31 +/- 0.14 to 1.70 +/- 0.18 nmol/l, p < 0.01) and Zn (7.23 +/- 0.45 to 12.27 +/- 0.76 mumol/l, p < 0.01). A close correlation was found between changes in plasma levels of Zn and changes in TSH (r = 0.82), T4 (r = 0.55) and T3 (r = 0.64), suggesting that Zn deficiency may play a role in the biosynthesis or release of hormones of the hypothalamic-pituitary-thyroid axis in chronic renal failure.

The plasma levels of androstenedione (A), testosterone (T), dihydrotestosterone (DHT), follicle stimulating hormone (FSH), luteinizing hormone (LH), and prolactin (PRL) were studied in 15 men (aged 24-50 years) with chronic renal failure under periodic peritoneal dialysis, before and after 50 mg of elemental zinc (Zn) orally, twice a day for three weeks. Before treatment, they were divided into three groups: group I, plasma A above normal and PRL less than 100 ng/ml; group II, low or normal A levels with PRL less than 100 ng/ml; and group III, normal or high A levels with PRL greater than 100 ng/ml. After oral Zn, plasma FSH, LH, and PRL were unchanged in all groups; however, in groups I and II plasma A was within normal T and DHT rose significantly, the A/(T+DHT) ratio decreased to normal, and the T/DHT ratio rose above normal. In group III plasma androgens remained low and androgen ratios were unchanged. Oral Zn seems to improve the conversion of A to T and also uncovered the possibility that plasma PRL levels greater than 100 ng/ml might cause a blockade in the 5 alfa-reductase.

Patients with chronic renal failure often have low plasma zinc (Zn) levels. Some factors that may account for abnormal Zn metabolism in these patients are low dietary Zn intake, a specific Zn transport defect, or absence of intestinal Zn ligand. In this study Zn supplementation and a Zn-chelating drug, diiodohydroxyquinolein (DQ), were used to assess the effects of Zn intake and Zn transporters on Zn plasma levels in patients with chronic renal failure. To meet this objective, 20 uremic patients were randomly assigned to one of the following groups of treatment: group 1 received placebo; group 2 Zn sulfate (100 mg/day p.o.), group 3 DQ (80 mg/day p.o.), and group 4 received Zn sulfate plus DQ at the same dosages as in groups 2 and 3. The Zn plasma levels were measured in venous samples, before and after 1 and 2 weeks of treatment, by atomic absorption spectrophotometry. The Zn plasma levels increased in group 2 patients from 8 ± 0.2 to 10 ± 0.4 and 11 ± 0.9 μmol/l by the end of the 1st and 2nd weeks of treatment, respectively. In group 4 patients, the Zn plasma levels increased even more: from 9 ± 0.1 to 14 ± 1.6 and 13 ± 2.1 μmol/l respectively. The plasma Zn concentration of group 1 and 3 patients remained at basal levels. These results show that DQ, when given along with Zn sulfate supplements, causes a greater increase in plasma Zn levels than that caused by either drug given alone.

To describe the epidemiology, frequency, criteria and implications of the refusal to ICU admission based on futility in an ICU of 18 beds, in Granada, Spain.

Estimación de la sensibilidad y especificidad de dos pruebas diagnósticas para la detección de Mycoplasma suis en Argentina utilizando un modelo bayesianoEstimation of the sensitibity and specificity of two Mycoplasma suis diagnostic tests in Argentina using a Bayesian model SUMMARYA prerequisite for understanding the impact of Mycoplasma suis infection on pig production and its epidemiological dynamics in infected regions, is the development of diagnostic techniques to discriminate infected from non-infected populations. The objectives of this study were to confirm the presence of M. suis infection in Argentina, and to estimate the sensitivity and specificity of both an Indirect Immunofluorescent Assay (IIFA) and a Polymerase Chain Reaction (PCR) for the detection of the agent. Blood was collected from 282 pigs belonging to 38 farms. Sensitivity (Se) and specificity (Sp) of the tests were estimated using a Bayesian model for conditional dependant results and without assuming a gold standard. PCR was estimated to be a highly sensitive (Se = 0.982, CI95% = 0.942-0.997) and highly specific (Sp = 0.946; CI95% = 0.873-0.984) method for diagnosis of M. suis infection in the assessed population. A significantly (P < 0.05) lower sensitivity (Se = 0.682, CI95% = 0.615-0.753) and specificity (Sp = 0.787, CI95% = 0.712-0.863) was estimated for the IIFA. Correlation among tests results was low, both for infected (R = 0.010, CI95% = -0.118-0.195) and non-infected (R = 0.049, CI95% = -0.133-0.407) individuals. The posterior estimate of the probability of finding an infected animal in the study population, which approximates the prevalence of the disease in the sampled animals, was 0.622 (CI95% = 0.554-0.684). The study was successful in confirming the presence of M. suis infection in Argentina and the accuracy of the PCR for the detection of the agent.Palabras clave: Mycoplasma suis, PCR, prueba de inmunofluorescencia indirecta, cerdos.