Search

The reduction of resinous species in Portuguese forest areas has caused constraints to wood industry supplies. Portugal represents the extreme southwest of Scots pine (Pinus sylvestris) natural distribution and large gaps exist in the knowledge of its wood-quality characteristics. Understanding the relationship between these traits is important for recognizing which combination of wood properties is the most suitable for specific uses. To address these questions, we assessed wood-quality traits, namely, wood-density components (microdensitometric analysis), chemical composition (NIR spectrometry) and mechanical properties (bending tests) of wood samples collected at five representative forest sites in Portugal. Our results showed that Portuguese Pinus sylvestris has good radial growth and denser wood, higher extractive content and higher stiffness and strength than northern European provenances. The lignin content was within the range attributed to softwoods. Among the Portuguese stands, trees growing at lower-altitude sites exhibited denser wood and higher mechanical properties, while trees from high-elevations showed higher amounts of lignin. Ring density was more strongly correlated with earlywood than latewood density. A negative, non-significant correlation was found between ring density and width, supporting the assumption that the higher radial growth (ring width) does not negatively affect wood quality (density). In general, chemical properties had a weak relationship with physical and mechanical properties (MOE and MOR). Both mechanical traits were positively correlated with density and growth components, supporting the assumption that trees with high radial growth do not exhibit poorer mechanical performances.

Prostate cancer screening based on prostate-specific antigen (PSA) testing has been a matter of controversy. Although screening for prostate cancer was effective in reducing mortality, it resulted in overdiagnosis, which translated into unnecessary treatments and numerous adverse effects. As a result, recommendations from scientific societies became increasingly restrictive. In the recent years, new approaches to prostate cancer screening have been proposed. These new approaches are aimed at solving the controversy between widespread screening vs. no screening, and reconsidering PSA testing as a screening tool with a good benefit/risk balance. In this context, the European Association of Urology submitted a proposal to the European Commission for prostate cancer screening to be performed as a function of baseline PSA concentrations. The European Commission recently recommended the implementation of organized prostate cancer screening programs for men aged ≤70 years based on PSA values in combination with follow-up magnetic resonance imaging., Competing Interests: Competing interests: The authors state no conflict of interest., (© 2023 the author(s), published by De Gruyter, Berlin/Boston.)

The Pinus nigra distribution in Portugal is restricted to six allochthonous populations with unknown origin and infraspecific taxonomy. This work intends to evaluate their genetic diversity, structure and relationships, and to infer about their infraspecific taxonomy by comparing molecular patterns produced by inter-simple sequence repeat and Start Codon Targeted markers among Portuguese and foreign samples with known taxonomy and provenance. 127 Portuguese P. nigra individuals were clustered per population. The genetic differentiation was higher within rather than among populations. The pooled molecular data indicated high genetic proximity among the Portuguese and foreign samples of subspecies laricio . However, the separate analysis per marker system demonstrated that two varieties of subspecies laricio ( corsicana and calabrica ) may have been used in the plantations of the Portuguese P. nigra stands performed in the last century. The genetic characterization and extrapolation of the intraspecific taxonomy of these populations provide useful information for forest management, afforestation and germplasm use., Competing Interests: Conflict of interestThe authors declare that they have no conflicts of interest.

Background: The diagnostic accuracy of the Gaxilose test (GT) for hypolactasia diagnosis has already been proved. The objectives of this clinical trial were to demonstrate the noninferiority of the GT compared to the hydrogen breath test (HBT) on the impact on diagnostic thinking and patient management, to evaluate the GT reproducibility with urine accumulated from 0 to 4 hours and from 0 to 5 hours and to assess test safety., Methods: We conducted a randomized, parallel, noninferiority clinical trial. Patients with clinical symptoms suggestive of lactose intolerance were screened for inclusion and randomly assigned to the GT arm or the HBT arm of the study. The impact on diagnostic thinking and patient management was analyzed with pretest and posttest questionnaires in which the investigators indicated their estimated probability of hypolactasia diagnosis and the intended management before and after the GT or the HBT (noninferiority margin: -10%). The primary outcome of the study was the impact on diagnostic thinking, expressed as the mean of the absolute values of the differences between the pretest and posttest probabilities of hypolactasia diagnosis. Patients randomized to the GT arm performed also the retest to evaluate the reproducibility of the GT., Results: A total of 147 patients were included in the intend-to-treat (ITT) population. Among them, 74 performed the HBT and 73 performed the GT. The results proved the noninferiority of the GT compared to the HBT on the impact on diagnostic thinking (ImpactGT = 31.74 ± 23.30%; ImpactHBT = 24.28 ± 19.87%; ΔGT-HBT = 7.46%; 95% confidence interval of ΔGT-HBT: 1.55%, infinite) and on patient management. The test-retest reproducibility was better for the GT with urine accumulated from 0 to 5 h: the intraclass correlation coefficient (ICC) was 0.5761, and the Kappa coefficient was 0.7548, indicative of substantial agreement between both tests. No serious adverse events were reported during the study., Conclusions: The GT has an impact on diagnostic thinking and patient management noninferior to that of the HBT, is reproducible and well tolerated. These results prove the clinical benefit of its use in the clinical practice (ClinicalTrials.gov identifier: NCT02636413).

Objectives: To determine the face and content validity of items for measuring safe medication practices in Portuguese hospitals., Methods: 128 items were drafted from content analysis of existing questionnaires and the literature, employing preferred terms of the WHO International Classification for Patient Safety (Portuguese version). A two-round e-Delphi was convened, using a purposive multidisciplinary panel. Hospital-based experts were asked to rate the relevance of items on a 7-point Likert scale and to comment on their clarity and completeness., Results: The response rate was similar in both rounds (70.3% and 73.4%, respectively). In the first round 91/128 (71.1%) items reached the predefined level of positive consensus. In the second round 23 additional items reached positive consensus, as well as seven items newly derived by the panel., Conclusions: Most items have face and content validity, indicating relevance and clarity, and can be included in a future questionnaire for measuring safe medication practices in Portuguese hospitals., Competing Interests: Competing interests: None declared.

Pinus sylvestris L. (Scots pine) is the conifer with widest natural distribution area. Portugal constitutes its westernmost limit of distribution. Most of the Portuguese populations were planted but two autochthonous populations were recently ascribed to 'Serra do Gerês' (NW Portugal), and seem to be well adapted to the temperate climate. However, the ongoing climate changes may compromise their survival. With this study we intend to evaluate the anatomic-physiological and genetic responses of Scots pine from five European provenances ('Gerês', 'Puebla de Lillo', 'Montes Universales', Germany and Sweden) to three water availability regimes, in order to determine which one(s) present higher resistance to drought. Individuals from 'Gerês' presented the highest stability in photosynthetic reactions as well as the better photochemical and metabolic behaviours under drought (T3). Hence, the relative expression ratio of three water stress-responsive genes during drought was lower and gradual in 'Gerês', compared to all other provenances, followed by Germany. The results achieved in 'Gerês' and Germany provenances are very interesting since they reflected that the native populations of 'Gerês' along with the Portuguese Scots pine planted populations with a probable German provenance, have ability and high adaptive potential to respond to situations of water deficit. Moreover, the present genetic and physiological data demonstrated the urgent demand for the conservation of Portuguese Scots pine genetic resources as well as its use in plantation/afforestation of areas where the warming and drought has been affecting the survival of this species., (Copyright © 2017 Elsevier GmbH. All rights reserved.)

Hypolactasia, or intestinal lactase deficiency, affects more than half of the world population. Currently, xylose quantification in urine after gaxilose oral administration for the noninvasive diagnosis of hypolactasia is performed with the hand-operated nonautomatable phloroglucinol reaction. This work demonstrates that a new enzymatic xylose quantification method, based on the activity of xylose dehydrogenase from Caulobacter crescentus , represents an excellent alternative to the manual phloroglucinol reaction. The new method is automatable and facilitates the use of the gaxilose test for hypolactasia diagnosis in the clinical practice. The analytical validation of the new technique was performed in three different autoanalyzers, using buffer or urine samples spiked with different xylose concentrations. For the comparison between the phloroglucinol and the enzymatic assays, 224 urine samples of patients to whom the gaxilose test had been prescribed were assayed by both methods. A mean bias of -16.08 mg of xylose was observed when comparing the results obtained by both techniques. After adjusting the cut-off of the enzymatic method to 19.18 mg of xylose, the Kappa coefficient was found to be 0.9531, indicating an excellent level of agreement between both analytical procedures. This new assay represents the first automatable enzymatic technique validated for xylose quantification in urine.

Western Iberia has recently shown increasing frequency of drought conditions coupled with heatwave events, leading to exacerbated limiting climatic conditions for plant growth. It is not clear to what extent wood growth and density of agroforestry species have suffered from such changes or recent extreme climate events. To address this question, tree-ring width and density chronologies were built for a Pinus pinaster stand in southern Portugal and correlated with climate variables, including the minimum, mean and maximum temperatures and the number of cold days. Monthly and maximum daily precipitations were also analyzed as well as dry spells. The drought effect was assessed using the standardized precipitation-evapotranspiration (SPEI) multi-scalar drought index, between 1 to 24-months. The climate-growth/density relationships were evaluated for the period 1958-2011. We show that both wood radial growth and density highly benefit from the strong decay of cold days and the increase of minimum temperature. Yet the benefits are hindered by long-term water deficit, which results in different levels of impact on wood radial growth and density. Despite of the intensification of long-term water deficit, tree-ring width appears to benefit from the minimum temperature increase, whereas the effects of long-term droughts significantly prevail on tree-ring density. Our results further highlight the dependency of the species on deep water sources after the juvenile stage. The impact of climate changes on long-term droughts and their repercussion on the shallow groundwater table and P. pinaster's vulnerability are also discussed. This work provides relevant information for forest management in the semi-arid area of the Alentejo region of Portugal. It should ease the elaboration of mitigation strategies to assure P. pinaster's production capacity and quality in response to more arid conditions in the near future in the region.

Background: Cork oak (Quercus suber) is one of the rare trees with the ability to produce cork, a material widely used to make wine bottle stoppers, flooring and insulation materials, among many other uses. The molecular mechanisms of cork formation are still poorly understood, in great part due to the difficulty in studying a species with a long life-cycle and for which there is scarce molecular/genomic information. Cork oak forests are of great ecological importance and represent a major economic and social resource in Southern Europe and Northern Africa. However, global warming is threatening the cork oak forests by imposing thermal, hydric and many types of novel biotic stresses. Despite the economic and social value of the Q. suber species, few genomic resources have been developed, useful for biotechnological applications and improved forest management., Results: We generated in excess of 7 million sequence reads, by pyrosequencing 21 normalized cDNA libraries derived from multiple Q. suber tissues and organs, developmental stages and physiological conditions. We deployed a stringent sequence processing and assembly pipeline that resulted in the identification of ~159,000 unigenes. These were annotated according to their similarity to known plant genes, to known Interpro domains, GO classes and E.C. numbers. The phylogenetic extent of this ESTs set was investigated, and we found that cork oak revealed a significant new gene space that is not covered by other model species or EST sequencing projects. The raw data, as well as the full annotated assembly, are now available to the community in a dedicated web portal at http://www.corkoakdb.org., Conclusions: This genomic resource represents the first trancriptome study in a cork producing species. It can be explored to develop new tools and approaches to understand stress responses and developmental processes in forest trees, as well as the molecular cascades underlying cork differentiation and disease response.

Understanding the survival capacity of forest trees to periods of severe water stress could improve knowledge of the adaptive potential of different species under future climatic scenarios. In long lived organisms, like forest trees, the combination of induced osmotic stress treatments and field testing can elucidate the role of drought tolerance during the early stages of establishment, the most critical in the life of the species. We performed a Polyethylene glycol-osmotic induced stress experiment and evaluated two common garden experiments (xeric and mesic sites) to test for survival and growth of a wide range clonal collection of Maritime pine. This study demonstrates the importance of additive vs non additive effects for drought tolerance traits in Pinus pinaster, and shows differences in parameters determining the adaptive trajectories of populations and family and clones within populations. The results show that osmotic adjustment plays an important role in population variation, while biomass allocation and hydric content greatly influence survival at population level. Survival in the induced osmotic stress experiment presented significant correlations with survival in the xeric site, and height growth at the mesic site, at population level, indicating constraints of adaptation for those traits, while at the within population level no significant correlation existed. These results demonstrate that population differentiation and within population genetic variation for drought tolerance follow different patterns.

Background: Enterocystoplasties are associated to complications. To avoid them, different types of tissue templates have been used to augment the bladder and induce native bladder regeneration., Materials and Methods: A novel surgical technique for bladder reconstruction using autologous uterine tissue was evaluated in a rat model. Forty-two female Wistar rats were randomly allocated into three groups: sham-operation hysterocystorrhaphy (n = 12), hysterocystoplasty (n = 18), and control (n = 12). Two weeks after surgery, ultrasound examination of the bladder was performed. At 2, 4, or 6 mo after surgery, the rats were anesthetized and blood and urine samples were taken. They were then euthanized and post-mortem and histologic examination were performed. Ultrasound examination, analytical parameters and weight control, as well as gross and histologic examination were performed in all the operated animals. The statistical analysis was performed using Kruskal-Wallis and the extension of Fisher's exact tests. Significance was set at 5% (P < 0.05)., Results: Serum chemistry, blood count and peripheral blood smears, electrolytes, and urinary parameters were all within the normal range for the rat. Histologic sections of the surgically augmented zone between the bladder and uterine horn demonstrated urothelial epithelization, providing adequate coverage of the transition area in 72.22% of the rats that underwent hysterocystoplasty., Conclusions: The hysterocystoplasty was technically viable in all the cases and proved to be an easy and safe surgical model for bladder reconstruction. All animals were healthy after surgery and all systemic parameters analyzed were within normal physiologic range for the rat., (Copyright © 2012 Elsevier Inc. All rights reserved.)

In Portugal, the need for health educational campaigns to reduce antibiotic misuse, and the implementation of handwashing and hygiene measures to reduce cross-transmission have become national priorities. The implementation of the e-Bug Project in our country has been conducted by the Directorate-General for Health as the beneficiary entity of the Project, in partnership with the Ministry of Education. The involvement of the operational structures of both ministries in the development of the Project has been guaranteed from the beginning. We have translated and produced 6000 junior and senior e-Bug packs, and started to distribute them to science teachers, health education coordinators and school health teams from all over the country, who were identified as stakeholders and registered as e-Bug users in an e-learning platform from the Ministry of Education. Portugal is deeply interested in the long-term sustainability of the e-Bug Project. Portuguese schools and the Portuguese e-Bug team will continue to support this initiative to benefit the health education of Portuguese children.

Introduction: Exposure to lead and cadmium is a public health problem due to the broad exposure to these toxic substances among the general population. The objective of this study is to determine blood lead and cadmium concentrations in a working population drawn from six university hospitals in Madrid, Getafe, Cartagena, Santiago de Compostela, Santander and Palma de Mallorca (Spain) and to identify associated factors., Materials and Methods: 951 individuals participated in the study and were administered the standardized PESA® questionnaire regarding exposure to lead and cadmium. The blood lead and cadmium concentrations were measured by electrothermal atomization atomic absorption spectrometry with Zeeman background correction in Perkin-Elmer spectrometers, guaranteeing the transferability of the results., Results: The median overall blood lead concentration was: 1.6 μg/dL (IQR: 0.9-2.7) and that of cadmium was: 0.21 μg/L (IQR: 0.10-0.50). There were significant differences in lead levels between men (2 μg/dL) and women (1.5 μg/dL), postmenopausal (2.6 μg/dL) and premenopausal women (1.1 μg/dL), and between participants who cooked in earthenware (2.1 μg/dL) and those who did not (1.5 μg/dL). The median of cadmium in women (0.24 μg/L) was higher than in men (0.11 μg/L) and was also higher in subjects who smoked (0.70 μg/L) than in non-smokers (0.13 μg/L)., Conclusions: A reduction in blood lead and cadmium levels was observed with respect to previous studies carried out in Spain. Nevertheless, the results suggest there are certain factors which increase risk such as age, gender, menopause, age of housing, cooking in lead-glazed earthenware and exposure to cigarette smoke., (Copyright © 2010 Elsevier GmbH. All rights reserved.)

Objectives: To analyze whether C-reactive protein (CRP) predicts the need for urgent urinary diversion in patients with renal colic and urolithiasis. CRP may help in the differential diagnosis of complicated hydronephrosis., Methods: Prospective study done on 110 consecutive patients with renal colic secondary to upper urinary tract calculi admitted in the emergency room. Clinical and analytical data were collected. Criteria for emergency drainage had been established in advance, based on the risk of sepsis, renal failure, persistence of pain, and findings on computed tomography scan. CRP was blindly determined using immunoturbidimetric assay on the Integra 700 analyzer. Statistical analysis included Mann-Whitney test, Cox multivariate analysis, and receiver operating characteristic curves, to determine optimum cut-off points to decide drainage based on laboratory data., Results: Mean CRP value was 47.6 mg/L (CI, 31.4-63.8), 139.6 mg/L (CI, 13-183.1) in 29 patients treated with diversion and 14.67 mg/L (CI, 6.7-22.5) in the control group (P <.001). Age, sex, rate of patients with hypertension, history of cardiovascular disease, leukocyte total count, and serum creatinine differed between groups (P <.05). Regression analysis revealed CRP (P <.0001) and age (P = .0001) were predictive of urinary diversion. Receiver operating characteristic analysis revealed 68.4% area under the curve for creatinine, 68.8% for leukocytosis, and 86.8% for CRP. A cut-off point for CRP of 28 mg/L achieved optimum sensitivity (75.8%) and specificity (88.9%) for determining the decision for drainage., Conclusions: Determination of CRP in patients with renal colic due to urolithiasis provides an objective and useful parameter for deciding placement of urinary stent, which is even more valuable than leukocytosis or seric creatinine level., (Copyright 2010 Elsevier Inc. All rights reserved.)

The purpose of this study was to quantify the antibiotics prescribed in the outpatient setting of all primary health care professionals in Catalonia during 1992-2007. We calculated prescribed defined daily doses per 1,000 inhabitants and day (DID) from data provided by the Catalonian Health Service. The antibiotics analysed belonged to the J01 group (ATC/DDD classification). The overall prescribing of antibacterials has decreased by 11.9% during this period (1992: 16.75 DID, 2007: 14.75 DID). During this 16-year period, an increase was observed for penicillins (from 46.1% in 1992 to 59.6% in 2007) and for quinolones (from 13.3% to 15.7%). The prescription of cephalosporins remained steady and, conversely, a decrease in macrolides was found (from 14.8% to 12.2%). The leading antibiotic prescribed in 2007 was amoxicillin plus clavulanic acid (5.15 DID), followed by amoxicillin (2.95 DID). The former has increased by 84.4% since 2002. Penicillin V prescribing reached a peak in 2007 with 0.034 DID. There has been a slight reduction in antibiotic prescription in this 16-year study, with an increase of penicillins, mainly at the expense of those of broader antibacterial spectrum. Awareness of the rational use of antibiotics is mandatory, basically aimed at reducing the overall prescribing of antibiotics and encouraging those with a narrower spectrum.

Background: The aim of the present study was to evaluate the diagnostic value of the tumour markers carcinoembryonic antigen (CEA), carbohydrate antigens CA 125, CA 15.3, CA 19.9 and tumor-associated glycoprotein 72 (TAG 72) in the pleural fluid (PF) of patients with pleural effusions of different etiologies., Patients and Methods: One hundred and fifty-five patients with pleural effusions (40 malignant, 84 benign and 31 paraneoplastic) were studied prospectively. The concentration of the tumour markers in serum and PF were measured by magnetic particle enzyme immunoassay. The PF to serum (PF/S) concentration ratios were calculated., Results: The concentrations of CEA, CA 15.3, CA 19.9 and TAG 72 in PF and the PF/serum ratios were significantly higher in effusions of malignant and paraneoplastic origin than in those of benign origin. The receiver operating characteristic (ROC) curves were calculated for each marker and the diagnostic cut-off point was selected as the value that offered a specificity of 100% (CEA: 6.5 ng/ml; CA 15.3:62.4 IU/l; TAG 72:10.9 IU/l). CEA presented the greatest sensitivity [45% in the malignant group, 38.7% in the paraneoplastic group, and 41.4% in the pooled group (combined malignant and paraneoplastic)]. TAG 72 presented the largest area under the curve (0.89 in the malignant group and 0.80 in the pooled group). The diagnostic efficacy of the PF/S ratios was not better than measurement of the tumour markers in pleural fluid. The highest diagnostic accuracy for the diagnosis of malignant pleural effusions was achieved by grouping the markers in a panel comprising CEA, CA 15.3 and TAG 72; this showed a sensitivity of 75% and a negative predictive value of 79.1% . In the subgroup of patients with negative cytology, the sensitivity was 41.2% for CEA, 35.5% for CA 15.3 and 33.3% for TAG 72. The combination of these three markers achieved a sensitivity of 84.6%., Conclusion: The combined measurement of CEA, CA 15.3 and TAG 72 in pleural fluid is a useful complementary test in the differential diagnosis of pleural effusions of malignant origin.

Background: Bariatric operations have varying degrees of effectiveness and different mechanisms of action. Our objective was to evaluate the efficacy of the biliopancreatic diversion (BPD) in reduction of weight and serum lipids., Methods: A prospective study was conducted with follow-up from 12 to 72 months (average 39.4 months) of 58 patients with morbid obesity (10 men, 48 women, mean BMI 49.4 kg/m2). Their lipid levels were generally normal or slightly high. All the patients were subjected to subtotal gastrectomy and BPD with jejunoileostomy 50 cm proximal to the ileocecal valve, and they were instructed to maintain the same hypocaloric diet as before BPD. Serum lipoproteins and apolipoproteins B and A1 were measured before BPD and every 6 months during follow-up., Results: Early and very significant reduction (P<0.001) of total cholesterol (32.8%), LDL (46.3%), total cholesterol/HDL ratio (29.7%) and apolipoprotein B (37%), with more moderate decrease of triglycerides (21.3%, P=0.004), were observed. This lipid decrease was maximum at 1 year after BPD. Important and persistent weight reduction that did not correlate with changes in lipids was observed. The youngest patients and those with high basal lipid levels proved to benefit most from BPD. There were no important side-effects., Conclusion: BPD, with careful selection of patients, is a well tolerated procedure that offers excellent results in the short- and mid-term in reduction in weight and blood levels of most atherogenic lipoproteins.

Background: The aim of the present study was to evaluate the value of serum Carcinoembryonic Antigen (CEA) and CA125 antigen assay for monitoring the activity of non-small cell lung cancer (NSCLC) after curative surgical resection., Patients and Methods: Serum CEA and CA 125 were determined preoperatively and at every postoperative visit, in 113 patients with NSCLC (TNM stages I, II, IIIA). Both markers were assayed by magnetic particle enzyme immunoassay., Results: Tumor recurrence was more frequent in patients with preoperative CA 125 levels above the cut-off (15 U/ml) (28 out of 47) (59.5%) than in those with low values (18 out of 66) (27.2%) (p < 0.001). The 36-month disease-free survival was lower for patients with elevated CA 125 (37%) than among those with low levels (72%) (p = 0.006). High CA 125 was an independent predictor of the risk of postoperative recurrence (Hazard Ratio: 3.02)(95% CI: 1.41-6.49). No relationship was detected between preoperative serum CEA and risk of recurrence. High preoperative CA125 indicated elevated risk for disseminated recurrence (Hazard Ratio: 7) (95% CI: 2.39-20.51), but not for locoregional failure. No significance was detected for CEA, either in locoregional or disseminated recurrence. Forty-six subjects (40.7%) developed tumor recurrence. At the diagnosis of relapse, serum CEA was elevated in 16 patients (34.7%) and CA125 in 26 (56.5%). Sensitivity was higher in the case of disseminated recurrence (63% for CA125 and 43.3% for CEA) and decreased in locoregional relapse (43.7% for CA125 and 18.7% for CEA). The specificity was 97% for CEA and 59% for CA125., Conclusion: Serum CA125 is a useful prognostic marker in NSCLC. The predictive information is especially useful to estimate the risk of disseminated recurrence. Serial determinations of CEA and CA125 during the postoperative follow-up do not show enough sensitivity/specificity to recommend their use for diagnosis of tumor relapse.

Purpose of Investigation: The clinical use of tumor markers during breast cancer follow-up is still surrounded by controversy. The objective of this study consisted of determining the contribution of the CEA marker to CA 15.3 in the follow-up of breast cancer patients as applied to clinical practice., Methods: Three hundred and eighteen cases of women with breast cancer were analyzed retrospectively as far as the sensitivity, the specificity and the positive and negative predictable values of the CA 15.3 and CEA markers., Results: Of the 318 patients, 59 suffered a relapse during the study. After evaluation of both markers the sensitivity was 56.8% (CA 15.3: 47.4%), the specificity 85.3% (CA 15.3: 88.4%), the positive predictable value was 46.4% (CA 15.3: 48.2%) and the negative predictable value was 89.41% (CA 15.3: 88%)., Conclusions: The low sensitivity of studied tumor markers proved of limited use on a clinical scale.

The prognostic value of preoperative serum levels of carcinoembryonic antigen (CEA), CA 19-9 and CA 72-4 tumor markers was investigated in patients with gastric cancer. Eighty-two patients who underwent surgical resection of gastric cancer were entered in the study. Correlation analyses showed that CA 72-4 was more frequently positive in patients with advanced tumors (p = 0.04), lymph node invasion (p = 0.02), liver metastasis (p = 0.02) and peritoneal involvement (p = 0.03). CA 19-9 was more frequently positive in patients with advanced tumors (p = 0.01) and with serosal (p = 0.04), lymph node (p = 0.008) and peritoneal involvement (p = 0.02). CEA was more frequently positive in patients with liver metastasis (p = 0.03). Low 3-year cumulative survival was significantly associated with elevated serum levels of CA 72-4 (p = 0.004), CA 19-9 (p = 0.001) and CEA (p < 0.001). Age, tumor stage and CA 72-4 provided prognostic information in the multivariate analysis. Patients with elevated serum levels of CA 72-4 showed a 4.2 times higher risk of death than patients with low levels of the marker. Our results suggest that CA 72-4 has prognostic value in gastric cancer, and patients with a high preoperative serum level of CA 72-4 have a greater risk of death due to gastric cancer., (Copyright 2001 S. Karger AG, Basel)

Background: PSA (prostatic specific antigen) is the most used tumor marker to monitor prostate cancer (PC). It is an acceptably sensitive test. Molecular forms of PSA give a chance to improve its specificity. We have evaluated the usefulness of the ratio free PSA/total PSA (f-PSA/t-PSA%) to diagnose prostate cancer, in the range between 4 and 20 ng/ml; i.e. the interval in which values overlap for patients with PC and benign prostatic hyperplasia (BPH) in our environment., Patients and Methods: Prospective study on 269 patients, 73 with PC and 196 with BPH. Both t-PSA and f-PSA were determined using microparticles enzyme immune assay (MEIA) with AXSYM (Abbott) analyzer., Results: Statistically significant differences were evidenced in f-PSA/t-PSA% for patients with PC vs. BPH; but that did not happen for t-PSA values. Sensitivity and specificity values were established for different cut-off points. ROC curve analysis proved diagnostic efficacy was better for f-PSA/t-PSA% than for t-PSA., Conclusions: f-PSA/t-PSA percentage is a useful tool for the differential diagnosis between PC and BPH. A ratio lower than 12% selects a population with high risk of cancer. A percentage over 18% is useful to avoid or delay the indication of biopsy.

Background: This study examined the prognostic information regarding the risk of postoperative tumor recurrence obtained by simultaneous determination of preoperative serum carcinoembryonic antigen (CEA) and immunohistochemical expression of p53 protein in tumor tissue from patients with colorectal carcinoma., Methods: A retrospective study of 174 patients (AJCC/UICC Stages I, II and III) was conducted. Serum CEA levels were determined by an enzyme-linked immunoadsorbent assay. Immunohistochemical expression of nuclear p53 protein was assessed in formalin fixed, paraffin embedded archival tumor tissue. The results of both factors were categorized by clinical and histopathologic variables. The relative prognostic significance of all factors with regard to disease free survival was assessed by Cox proportional hazards regression analysis. The stability of the predictive value of both markers was assessed: 1) by splitting the follow-up into three intervals and performing separate analyses for each period and 2) graphically by plotting the corresponding cumulative hazards ratio along the follow-up., Results: Eighty-two (47%) tumors manifested overexpression of p53 protein and 60 tumors (34.4%) exhibited elevated serum CEA levels (cutoff value of 5 ng/mL). p53 positive immunostaining and elevated CEA levels were associated with low cumulative disease free survival at 60 months' of follow-up, and proved to have independent prognostic significance. Analysis performed in different time periods of follow-up showed that the prognostic effect of both markers was not stable over time. The predictive significance of CEA and p53 changed along the study periods. An elevated preoperative CEA level was an indicator of a high risk of recurrence only during the first 2 years after surgery (hazards ratio, 3.26; 95% confidence interval 95% CI, 1.65-6.42). The presence of p53 immunoreactivity in the primary tumor was an indicator of a high risk of recurrence only after the first year of follow-up (hazards ratio, 4.02; 95% CI, 1.68-9.6)., Conclusions: The serum CEA level and expression of p53 protein provide complementary prognostic information. Time-dependency of the prognostic influence of both parameters should be taken into consideration when establishing postoperative predictive estimations., (Copyright 2000 American Cancer Society.)

A study was made into the effect of the age at which meat was first included in the diet on a series of haematological parameters and biochemical indicators of iron status in 94 pre-school children (aged 2-6 years) from Madrid (Spain). Those children who first took meat during their eighth month of life or earlier (Group A) showed better iron status that did those who were introduced to meat later (Group B). Significant differences were found in hemoglobin levels (P < 0.01), mean corpuscular haemoglobin (MCH) (P < 0.05), serum ferritin (P < 0.05), transferrin levels (P < 0.05) and total iron binding capacity (TIBC) (P < 0.001). Some 13.8% of all subjects showed iron deficiency and 5.3% showed ferropenic anaemia. These latter subjects were the last to have meat included in their diets (9.3 +/- 1.2 months compared to 7.4 +/- 2.0 months in those without ferropenic anaemia) (P < 0.05). It would appear that the age at which meat is included in the diet has an important effect on iron status in pre-school children. Delaying its inclusion beyond the age of eight months seems to be associated with an impairment of later iron status.

Aim: To analyze the results of interferon treatment in chronic hepatitis B and C in Catalonia, Spain, during the first two years of the Assessment Board of the therapeutic use of interferon., Material and Methods: A retrospective analysis of the results of 2,142 applications for interferon treatment for chronic hepatitis B (n = 158) and C (n = 1,970) from January, 1993 to December, 1994 presented to the Interferon Assessment Board, was performed by the study of the data of the applications-questionnaires send by the applying physicians., Results: The global rate of response to the questionnaires was of 85%. For chronic hepatitis C, three treatment schedules were evaluated included 936 cases out of the 1,931 authorizations. A sustained response was observed in 20% of the cases treated with 3 MU of interferon for 6 months, in 32% of those treated over 12 months and 20% of those treated with 5-6 MU of interferon for 6 months. The patients with chronic hepatitis B were divided into 2 groups in relation to the presence or absence of HBeAg. Of the 153 applications, 34 belonging to HBeAg positive patients and 52 anti-HBe positive patients who received interferon treatment at 5-10 MU three times per week for 4-6 months were evaluated. Sustained response was observed in 44% of the chronic hepatitis HBeAg positive cases and in 25% of the anti-HBe cases treated. In general, response to treatment was higher in females and in those subjects under the age of 40 years than in male and in older subjects. No differences were observed in the response among the different types of interferon. Withdrawal from treatment due to adverse effects or because of the patient's wish was similar among the patients with chronic hepatitis B (5%) and C (3%), being higher in those undergoing treatment for a longer period of time., Conclusions: The data obtained from the Interferon Assessment Board for the treatment of viral hepatitis demonstrates the use of very variable schedules of this drug, especially in chronic 85% and complete evaluation was achieved in 54% of the chronic hepatitis B and in 48% of the cases of chronic hepatitis C.

The aim of the study was to determine the effects of cholesterol intakes of greater (HC) or less than 300 mg/day (LC) (the upper advisable limit for the control of cholesterolaemia and the risk of cardiovascular disease) on a range of blood parameters, and to determine any influence such intakes might have on the consumption of food, energy and nutrients. The study subjects we one hundred and thirty young women. Food intake was determined using a 7-day dietary record (including a Sunday). A range of serum lipid parameters, and haematological and biochemical indicators of iron status were also determined. The percentage discrepancy between observed energy intake and theoretical energy expenditure was greater amongst LC subjects (9.7 +/- 18.8% compared to 5.5 +/- 24.4% in HC subjects) (P < 0.05). Analysis of covariance was therefore performed with respect to the degree of underestimation/overestimation of intake. The comparison of the adjusted means showed that HC subjects consumed greater quantities of eggs and meat and less alcohol, than did LC subjects. HC subjects also showed greater intakes of protein, carbohydrates, total fats, monounsaturated fatty acids, polyunsaturated fatty acids, saturated fatty acids, cholesterol, riboflavin, niacin, folic acid, vitamin E, zinc and iron. At blood level, HC subjects showed greater quantities of red blood cells, haemoglobin and HDL cholesterol. No significant differences were seen between LC and HC subjects for the remaining blood and biochemical parameters investigated. The development of criteria for the greatest protection against cardiovascular disease whilst maintaining good nutritive condition, is the subject of studies soon to be commenced. Women may need different advice to men, owing to their greater need of iron. Greater quantities of foods rich in haem iron, such as meat and fish, might be appropriate for the female population.

The metabolic consequences of the consumption of a diet depend, in part, on the frequency and distribution of meals. The aim of the present study was to examine the number of meals taken per day by elderly persons, and to analyse the relationship between the number of meals per day on the intake of energy and nutrients, the incidence of obesity/overweight, and different cardiovascular risk factors. Food intake was monitored for five consecutive days using 'precise individual weighing' for institutionalised subjects (n = 58), and by means of a 'food intake record' for independent subjects (n = 92). The number of meals taken per day was recorded, along with anthropometric data, blood pressure and serum lipid and lipoprotein levels. No subject took only one meal per day, 7.3% took two, 56.7% took three, 33.3% took four and 2.7% took five. Only 10% of subjects took a mid-morning meal. Breakfast and merienda (a light evening snack) were the meals most frequently omitted. A positive, significant relationship was found to exist between the number of meals taken per day and the intake of fibre (r = 0.2737), thiamin (r = 0.1671), pyridoxine (r = 0.2060), magnesium (r = 0.2423) and the percentage of energy provided by carbohydrates (r = 0.2144). Women subjects who took 2-3 meals per day showed greater body mass indices and a greater proportion were overweight/obese compared to those who took 4-5 meals per day. Subjects who took 4-5 meals per day showed higher levels of HDL-cholesterol and lower levels of LDL-cholesterol/HDL-cholesterol and cholesterol/HDL-cholesterol than did those who took fewer meals per day. Inverse, significant relationships were also found between the number of meals per day and serum cholesterol (r = 0.2297) and LDL-cholesterol levels (r = 0.1984). Taking into account energy and nutrient intakes, the incidence of obesity/overweight and serum lipid and lipoprotein levels, the consumption of 4-5 meals per day would seem more advisable for the elderly than the taking of fewer meals.

In a group of 130 women of fertile age (24.5 +/- 2.7 years), the consumption of meat and meat products was evaluated in order to determine the effect of this food group on blood and biochemical parameters that act as indicators of iron status, and on a range of serum lipid parameters that indicate cardiovascular risk. Food intake was monitored using a "Food Record" for seven days, including a Sunday. Subjects were divided into two groups: those who took > or = 100 g/day of meat (25th percentile) (high consumption--HC) (n = 102), and those with lesser intakes (low consumption--LC) (n = 28). Dietary data were adjusted to take into account differences in discrepancies in reporting between the two groups. The greater consumption of meat observed in HC subjects, despite its association with greater intakes of lipids (both in g/day and % of energy) and cholesterol (in mg/day and mg/1000 Kcal), did not seem to be related to any impairment of blood lipid profiles. Neither was it seen to be related to increased bodyweight nor raised blood pressure. It should not, therefore, bring about any increased risk of cardiovascular disease. However, the greater intake of thiamine, niacin, zinc and iron (total and haem) in HC subjects suggests that these may have a better nutritive status (with respect to certain nutrients) than do LC subjects. In relation to iron status. HC subjects showed higher levels of haemoglobin, haematocrit and mean corpuscular haemoglobin concentration (MCHC). These results show that restrictive criteria, with respect to the consumption of meat and meat products, could have negative repercussions on the nutritive status and health of certain groups within the population. In the female population, such criteria may be associated with impairment of iron status, without affording any greater level of protection against cardiovascular disease, or be of any help in the control of bodyweight.

We conducted a cross-sectional survey to determine the prevalence of gallstone disease (gallstone or cholecystectomy) in a random sample of the adult population of Guadalajara, Spain. The sample stratified by age and sex was drawn from the municipal census. Stratum sample sizes were proportional to population sizes and to the expected prevalence rates calculated through a meta-analysis of the European literature. The screening protocol included a gallbladder ultrasonography, a questionnaire on personal and family history, a physical examination, and a blood sample for biochemical determinations. The response rate was 61.2%. The overall prevalence of gallstone disease was 9.7% (95% CI, 7.3-12.0). Prevalence was higher (but not statistically significant) in women (11.5%; 95% CI, 8.2-14.7) than in men (7.8%; 95% CI, 4.6-11.1). After controlling for confounding by multiple logistic regression, increasing age, body mass index, dyspeptic symptoms, smoking habit, and use of hypolipidemic drugs were positively associated with gallstone disease. Total serum cholesterol and alcohol consumption were negatively associated.

Iron deficiency is one of the most common nutritional problems in the world. It is frequent in both developed and developing countries and mainly affects women of childbearing age. The aim of the present study was to investigate the prevalence of iron deficiency in a group of young women from Madrid, Spain. The study subjects were a group of 130 women aged between 19 and 35 (24.53 +/- 0.24 years). Measurements were made of iron intake and also of the haematological and biochemical indicators of iron status. 10.7% of subjects showed iron deficiency (defined as the recording of at least two indicator parameters with values below normal). The high incidence of iron deficiency at blood level (10.7%) coincided with the low iron intake of these subjects (11.08 +/- 2.98 mg/day). 98.3% of subjects showed intakes below recommended. Observed intake covered only 61.6% of recommended intake. 3.9% of subjects presented ferropenic anaemia, i.e. they showed both iron deficiency and low haemoglobin levels.

The aim of this investigation was to analyse the influence of the number of meals per day on a range of cardiovascular risk factors and on the energy and nutrient intakes of a group of elderly people. The participants in this study were 150 elderly people (64 men and 86 women) from Madrid. Food intake was followed over a period of 5 days. "Precise individual weighing" was used to determine the intake of institutionalized subjects (n = 58) whilst "food intake records" were used to register the same for independent subjects (n = 92). The nutrient and energy intake of the studied population was then determined from these data. The number of meals taken was also recorded. Serum cholesterol and triacylglycerol levels were determined using enzymatic methods. In this population, the meal most frequently omitted was breakfast. No subject took only one meal per day, though 7.4% took only two. 56.6% took three meals and 36% took four. No subject took more than four meals per day. As the number of meals taken increased, so too the covering of theoretical energy expenditure, and the intakes of a range of nutrients became closer to those recommended e.g. proteins, fibre, vitamin C, thiamin, riboflavin, calcium, magnesium and iodine. As the number of meals taken per day increased, carbohydrate intake (in g/1000 Kcal and as % of energy) also increased, and approached recommended levels more closely. As observed in other studies, blood cholesterol levels were seen to be negatively correlated with increasing number of meals (r = -0.2297, p < 0.05). Further, those subjects who distributed their food intake more evenly throughout the day showed lower serum cholesterol (p < 0.05). VLDL-cholesterol (p < 0.05) and triacylglycerol levels (p < 0.05). The results favour the distribution of energy intake over the day as a method of improving nutritional status and as a factor that might improve blood lipid profiles.

Unlabelled: An adequate intake of folates and vitamin B12 is essential for the rapid growth rates characteristic of infancy. However, little information exists on the prevalence of deficiencies of these nutrients in preschool children. The status of these vitamins was therefore evaluated in a group of 79 children between 2 and 6 years of age. A 5 day dietary record (including a Sunday) was kept for all subjects. All food taken at day care centres was monitored using "Precise individual weighing" and recorded by trained personnel. Measurements were made of serum and erythrocyte folate levels, vitamin B12 levels, number of red blood cells, haemoglobin and haematocrit levels, and mean corpuscular volume. Though the mean intake of folic acid surpassed recommended levels for this age group 31.4% of the subjects showed intakes below those recommended. 7.7% of the subjects showed serum folate levels between 3 and 6 ng/mL, values which indicate a moderate deficiency of this vitamin. A correlation was found between folate intake and serum folate levels r = 0.3654 (P < 0.01). Vitamin B12 intake was 438% that recommended. Only 2.9% of the subjects showed vitamin B12 intake below recommended and none showed serum values below 150 pg/ml, the lower normal limit below which deficiency is considered to exist., Conclusion: Amongst preschool children, folate deficiency is probably much more common than vitamin B12 deficiency. However, its incidence is low, and much lower than that observed in other age groups.

The deterioration of functional and mental capacity is one of the major problems of the elderly. This deterioration may be caused or worsened by folate deficiency. The aim of this investigation was to analyze the relationship between mental and functional capacities and folate status in a group of 177 elderly Spanish people. Folate deficiency is common in the Spanish population. In this study, 48.6% of the elderly subjects had folate intakes below recommended values (200 microg/day), 34.9% had serum concentrations < 14 nmol/L and 6.6% had <360 nmol/L erythrocyte folate. Subjects took part in a series of tests: Katz' scale of activities of daily living, Lawton's scale of instrumental activities of daily living, Pfeiffer's mental status questionnaire, Folstein's Mini-Mental State Test and the Geriatric Depression scale of Yesavage. The results for Lawton's scale of instrumental activities of daily living were significantly better (indicating greater independence and capacity) when folate intake and serum or erythrocyte folate concentrations were adequate (i.e., folate intake no less than recommended, > or = 14 nmol/L serum folate or > or = 360 nmol/L erythrocyte folate). Subjects with adequate Mini-Mental State Exam results (> or = 28 points) had serum and erythrocyte folate concentrations significantly higher than those with less adequate results (<28 points). Thus, there is evidence to suggest that the folate status of the elderly should be monitored and, if possible, improved.

A study was performed on the breakfast habits of 200 schoolchildren between 9 and 13 years of age. The subjects were classified into two groups: group C, children who consumed fortified breakfast cereals (65 boys and 35 girls), and group NC, children who did not (64 boys and 36 girls). The different dietary habits and the nutritional status of the two groups were analyzed. Haematological, biochemical, anthropometric, and dietary data were collected, the latter involving a 5-day food record. The children of the C group were found not only to have a more complete and nutritive breakfast, but also showed better dietary patterns for the rest of the day. Their lipid intake (% kJ) was lower and the carbohydrate intake (g/d and % kJ) higher than in the NC children. The intakes of thiamine, pyridoxine, folates, and beta-carotenes were also higher in group C. Better dietary habits were reflected in higher blood levels of some important compounds. Group C children had higher retinol, serum folate, and riboflavin levels than NC children. The percentage of children with hypercholesterolaemia (serum cholesterol > 4.5 mmol/l) was higher amongst those of the NC group: 37% as compared with 18% of the C children.

An analysis was made of the influence of maternal diet and serum lipids during the third trimester of pregnancy upon cord blood lipids in two populations of Spanish newborns. A significant correlation was found to exist between maternal cholesterol concentrations and those of newborn infants (r = 0.3298). A correlation was also found between maternal cholesterol levels and infant HDL-cholesterol (r = 0.2575) and LDL-cholesterol (r = 0.3053) levels. Further, a positive correlation was seen between maternal LDL-cholesterol and infant cholesterol (r = 0.3204) and LDL-cholesterol (r = 0.3507). The relationship between maternal cholesterol and cord blood cholesterol was independent of participants' dietary, anthropometric and personal data. 3.1% of neonates showed total cord blood cholesterol concentrations of > 2.6 mmol/L. The mothers of these children showed the strongest concentrations of cholesterol and LDL-cholesterol in the third trimester of pregnancy, the shortest pregnancies and the smallest newborns of all subjects. Negative correlations were found between birth weight and cord blood cholesterol levels (r = -0.1475) and LDL-cholesterol (r = -0.1686). It might be deduced from these results that a relationship exists between the maternal blood lipid parameters studied and those of the cord. Inverse relationships were also seen to exist between the lipid parameters of cord blood and weight at birth and length of pregnancy. These data have implications that deserve further study.

It has been analyzed food intake, energy and nutrients, Quetelet index, blood pressure and lipid profile in 180 elderly people from Madrid (71 institutionalized and 109 free-living), in order to get the relationship between meat intake (< 150 or > or = 150 g/day) and the different risk factors from cardiovascular disease and other foodstuff intake. Those elderly people who eat 150 g/day or more (AC) take more food in general. There is a significant difference for meat and cereals, eggs, fruits, beans, and fish products. They have only a poor intake of dairy products when comparing with those who eat less than 150 g/day (BC). As a result of these differences in food habits, the AC group has a superior intake of energy and most part of other nutrients. Nevertheless, it was only significant the difference for the niacin and for percentage of energy derived from saturated fatty acid. There are no significant differences in blood pressure. AC elderly have more Body Mass Index and show serum lipids more satisfactory than the BC ones. High meat intake is not related to high risk from cardiovascular diseases in our elderly people group. The reason is that this high intake is associated with a better intake of other foods which give them, in general, a better nutritional status (with better intake of vitamins related to lipidic metabolism) which may be observed at biochemical level.

The present study examines the influence of parental history of death from cardiovascular disease on dietary habits and nutritional status of a group of seventy-two Spanish elderly. Those with at least one parent who had died of cardiovascular disease (43.1% of the cases) had higher diastolic blood pressure (P < 0.05) and nutrient intakes less favourable from the cardiovascular risk point of view than those whose parents died of other causes. Descendants whose parents died of cardiovascular disease had higher total fat, animal fat, saturated fatty acids, myristic acid and palmitic acid intakes and a lower monounsaturated fatty acids:saturated fatty acids value than descendants of those who died from other causes (all P < 0.05).

Dietary habits were studied in 135 pregnant Spanish women. Their consumption of cereals, sugars, oils, vegetables, legumes and alcoholic drinks was lower, that of meat and eggs similar and that of fruit, milk and fish higher than the Spanish national average. The percentages for intakes lower than 100% of the recommended allowances, taking into account the dietary intake were 12, 23, 88, 8, 12, 34, 94, 2, 71, 98, 97 and 93% for thiamin, riboflavin, folates, vitamin B12, C, A, D, iodine, calcium, zinc magnesium and iron, respectively. If the supplements prescribed halfway through the pregnancy are added to the dietary provisions, the percentages for consumption below 100% of recommendation were considerably reduced. Furthermore, since the supplements prescribed did not include zinc or magnesium, there were 98% and 97% of pregnant women, respectively, with intakes below 100% of recommendations of these minerals. In the other cases the dietary intake plus the supplement are higher than the recommended amount. These imbalances may have harmful effects on the health of the women and their newborns and highlight the need for studying in depth the nutritional problems of pregnant women and for reconsidering the supplements that must be prescribed.

We studied 157 pregnant women living in Merida, Spain, during their third trimester of pregnancy and their newborns at birth, analyzing the mother's and the umbilical cord's blood for hemoglobin, hematocrit, mean corpuscular hemoglobin concentration (MCHC), serum iron and serum ferritin. We observed statistically correlations between hemoglobin and hematocrit values of the mother with erythrocyte count, hemoglobin and hematocrit values of her child and between serum iron of mother and child. The blood levels in the umbilical cord did not decrease until the ferritin value of the mother was < 12 micrograms/l. Under these conditions the ferritin levels in the umbilical cord blood (80.4 micrograms/l) were significantly lower than in those newborn infants whose mother had adequate ferritin levels (123 micrograms/l). We deduce that maternal iron status seems to condition, at least partially, fetal iron status, specially when the mother has some deficiencies. We did not find a lower birth weight in children of anemic mothers. Actually, we found an inverse correlation between maternal hemoglobin values and infant birth weight (r = -0.1731, p < 0.05). It is possible that the demands on the mother are increased in the case of a newborn infant of greater size.

Highly saturated fat and cholesterol intakes elevate serum cholesterol levels, which is a risk factor for suffering from cardiovascular disease, one of the most important death causes in developed countries. Milk and dairy products, because of their high saturated fat and cholesterol levels, are often included among the forbidden foodstuffs for people with high serum cholesterol levels. But our studies demonstrate that dairy products, including the whole cream ones, don't increase total cholesterol but increase HDL-cholesterol levels. The intake of skimmed dairy products seem to have a preventive effect on the developing of atherosclerosis, because they condition decreases in serum cholesterol levels, specially in people with hyperlipemia. Dairy products are also effective for the control of triglyceridemia, hypertension and other cardiovascular risk factors. When the dietitian introduces nutritional measurements to prevent or stop cardiovascular disease, it is important to know the nutritional status of the person, in order that the fight against cardiovascular disease does not lead to nutritional deficiencies with similar or worse sanitary repercussions than cardiovascular disease itself. Dairy products are excellent sources of proteins, vitamins and minerals. Their regular intake can prevent, whereas their restriction can lead to nutritional deficit and pathologies. The results of our study show that it is not advisable to limit the intake of dairy products, not even whole cream ones. Only if there is a pathology, as hypercholesterolemia, it can be beneficial to consume skimmed and semi-skimmed dairy products.

Dietetic, hematologic and biochemical data were used to asses the iron status of a group of 64 adolescents (37 males and 27 females), aged 15 to 18 (mean age 15.94 +/- 0.76 years), who study in a High School in the comunidad Autónoma de Madrid. All were asked to keep a dietary record during 5 days, one of which had to be a sunday. Iron intake was estimated using the Food Composition Tables of the Instituto de Nutrición (1990). The hematologic survey determined hemoglobin hematocrit mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), serum iron and serum ferritin. These data were correlated with the scores obtained in the attention and school capability test (AT), that gave information about the verbal (V), reasoning (R) and calculus (C) capabilities. There is a positive correlation between MCV (r = 0.2705), MCH (r = 0.3370) ferritin (r = 0.3383) and attention. MCV (r = 0.2995), MCH (r = 0.3998), MCHC (r = 0.3134) and ferritin (r = 0.3970) were also correlated with the speed capability shown on the attention test and the hemoglobin level was correlated with the calculus capability (r = 0.2905). The students who obtained higher scores in the school capability test had also better blood parameter values. This was statistically significant for serum ferritin in males students and for hemoglobin and MCHC in female students. 19.6% of the adolescents had ferritin levels lower than 12 ng/ml. Their intelligence test scores were lower to those who had serum ferritin > or = 12 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

The present study analyzes the influence of the nutritional status on the functional capability of 11 institutionalized elderly living in Madrid (Spain). Nutritional status was evaluated by dietetic, anthropometric, hematological and biochemical data and functional status was evaluated considering adiposity, strength in hands and legs bent and stretched and flexibility. The most important nutritional problems that conditional functional wastages are obesity, hypercholesterolemia and protein and micronutrient deficiency. The adverse influence of obesity and hypercholesterolemia on the functional capacity of the elderly is shown by the inverse relationship between flexibility and strength in hands and legs with the adiposity degree, with the thickness of skin folds and the cholesterolemia. In reference to the diet's influence, there are positive correlations between food intake and most of the nutrients with hand and legs strength, and there are statistical significances for proteins, iron, zinc, magnesium and pyridoxine, and also for vitamin C, niacin, thiamin, folic acid and vitamin E. For blood values, the mayor correlation exists between functional parameters and iron, ferritin and vitamin C levels. Our results contribute to confirm the influence of nutrition on the functional capacity of the influence of nutrition on the functional capacity of the elderly and manifest the necessity of improving the elderly's diet, to prevent micronutrient deficiency and also the necessity of increasing their physical activity. Both measures will mean an important help for sanitary and functional improvement of the elderly.

A newly designed framework for starting research projects in an Army family practice residency incorporates a timeline and a Family Practice Research Advisory Committee to stimulate research among residents and staff. Seventy-five percent of second- and third-year residents participated in approved projects compared to none two years ago. Sixty-six percent of the faculty have initiated research projects since implementation of the new guidelines. The combination of the committee and the timeline centralizes research within the family practice department and provides an academic environment for the department.

The initial contractions of uteri in vitro from castrated, estrogen-treated rats, were markedly diminished following replacement with fresh bathing medium. Indomethacin and aspirin (10(-5) to 10(-4)M) strongly stimulated such quiescent preparations and reduced their subsequent responsiveness to Ca++. Reintroducing the initial bathing medium (which contained prostaglandin-like material), or adding prostaglandin F2alpha to the fresh medium, initiated uterine contractions and restored responsiveness to calcium ion. Injections of indomethacin into castrated, estrogen-treated rats reduced initial in vitro uterine motility, abolished production of prostaglandin-like compounds, and prevented either indomethacin, aspirin, or Ca++ from stimulating uterine contractions. Uterine responsiveness to acetylcholine in vitro was significantly reduced in rats pretreated with indomethacin.