International Archives of Medicine - Latest articles

The variant Creutzfeldt-Jakob Disease: Risk, uncertainty or safety in the use of blood and blood derivatives?

Antonio Liras — 2008-06-23

It has been long since French physician Jean-Baptiste Denys carried out the first successful blood transfusion to a human being. Using bird feathers as canules, sheep blood was transfused to a young man. The patient died soon after Denys' treatment and Denys was accused of murder. In the XXI century, known as the biotechnology century, we face new challenges in Medicine. New emerging and reemerging diseases, such as Creutzfeldt-Jakob disease (CJD) or "mad cow disease" and its human variant (vCJD), challenge the biosafety aspects of a widely extended and extremely useful technique, that is, the perfusion of blood, of its derived components and of other pharmacological products obtained from plasma. To face these new challenges we need innovative prevention strategies.

Correlates of cigarette smoking among school-going adolescents in Thailand: findings from the Thai global youth tobacco survey 2005

Emmanuel Rudatsikira, Adamson S Muula, Seter Siziya and Ronald H Mataya — 2008-06-11

Background: Many studies examining the social correlates of tobacco use among adolescents fail to recognise theories of health behaviour and health promotion in their analysis. Using the Socio-Ecologiocal Model (SEM) we assessed the demographic and social factors associated with current cigarette smoking among adolescents in Thailand.MethodA secondary analysis of cross-sectional data from the Thai Global Youth Tobacco Survey (Thai GYTS) 2005 was analysed to obtain prevalence of selected attributes and assess factors associated with current cigarette smoking. Current cigarette smoking was defined as having smoked a cigarette, even a single puff, in the last 30 days. Logistic regression was conducted to estimate the level of association between the explanatory variables and current smoking. Results: Of the 18,368 respondents, 22.0% males and 5.2% females reported being current smokers (p < 0.001). In multivariate logistic regression analysis, current smoking was negatively associated with the perception that smoking is harmful to health (OR = 0.47; 95% CI [0.33, 0.66]) and positively associated with male gender (OR = 3.46; 95% CI [2.72, 4.86]) and having smoking parents (OR = 1.62; 95% CI [1.25, 2.11]) and friends (OR = 5.07; 95% CI [3.54, 7.25]) for some friends smokers and OR = 26.71; 95% CI [18.26, 39.06] for most or all friends smokers. Compared to subjects 11 = 12 year olds, those who were older were less likely to report smoking (OR = 0.49; 95% CI [0.36, 0.66] for 13 years olds, OR = 0.56; 95% CI [0.40, 0.79] for 14 years olds, OR = 0.59; 95% CI [0.41, 0.86] for 15 years olds). Conclusion: Current cigarette smoking was associated with male gender, smoking parents or closest peers. Perception that smoking was harmful to health was associated with less likelihood of being a current smoker.

Fat feeding potentiates the diabetogenic effect of dexamethasone in Wistar rats

Shanmugam Sivabalan, Shanmugam Renuka and Venugopal P Menon — 2008-05-23

Background: The role of cortisol and its increased action/availability is implicated in the pathogenesis of insulin resistance associated with obesity and metabolic syndrome but the mechanism of increased action/availability is not known. Availability of several other lipophilic hormones, drugs and pollutants are also reported to be increased in obesity. Increased lipids in the circulation are reported to alter the fluidity and permeability of membranes. Hyperlipidemia is also reported to alter the pharmacokinetics and pharmacodynamics of lipophilic molecules and also membrane fluidity and permeability. In this context we assumed that the hyperlipidemia associated with human obesity might play a role in the altered action/availability of cortisol and this in turn might have initiated the metabolic complications. To evaluate our assumption we have administered dexamethasone [low [50 μg/kg/day] or high [250 μg/kg/day] dose] to high-fat [coconut oil & vanaspati] fed rats and the results were compared with rats administered with either dexamethasone or high-fat.Results and DiscussionWithin two weeks, the rats co-administered with high-fat and dexamethasone developed severe hyperglycemia, hyperlipidemia and insulin resistance compared to rats treated either of them alone. High-fat fed rats treated with higher dose of dexamethasone were presented with severe hyperglycemia, insulin resistance and also severe glycosuria. The hyperlipidemia caused by high-fat feeding might have altered the transport and distribution of dexamethasone, probably by altering the physical state of membranes and transport proteins. Conclusion: From the results obtained, it can be speculated that the altered lipid and cortisol metabolism could affect one another, forming a vicious cycle.

Eruptive xanthomas and acute pancreatitis in a patient with hypertriglyceridemia

2008-05-12

Acute pancreatitis and eruptive xanthomas are the only recognised direct complications of severe hypertriglyceridaemia. We present the case of a 33-years old male patient in whom the onset of a type 2 diabetes, added to an unknown familial hyperlipidemia, precipitated a dramatic raise of serum triglyceride levels, that cause in turn an acute pancreatitis and the appearance of dermic eruptive xanthomas.TranslationThis article is translated from Spanish, originally published in Archivos de Medicina. The original work is at doi:10.3823/001

Partial trisomy 13q22-qter associated to leukoencephalopathy and late onset generalised epilepsy

2008-04-29

The partial trisomy 13q.22 is an uncommon chromosomopathy. We present a case with a partial trisomic component 13q22 and a monosomic component 5p15 from paternal origin. This patient developed early menopause and major neurological disorders as leukoencephalopathy, late onset generalised epilepsy and stroke. She also had fatty acids disturbances and their potential relation to the neurological disorders and early menopause is discussed. The presented case illustrates the phenotype of 13q22-qter in adult age and reaffirms the importance of studying the karyotype of any patient with seizures or leukoencephalopathy particularly when there are associated other clinical features including stroke at a young age, fatty acids disturbances, microcephaly, hypotelorism, short neck, hemangiomata, short fingers or distal swell in thumbs.

Recombinant proteins in therapeutics: haemophilia treatment as an example

Antonio Liras — 2008-04-28

One of the most spectacular advances in the history of scientific knowledge was the discovery of deoxyribonucleic acid (DNA) by Watson and Crick in 1953. This enabled certain proteins to be prepared in this way for their therapeutic use in clinical practice. Today, in the first decade of the 21st century, hundreds of therapeutic proteins have been produced recombinantly and about 50 of them have been approved for clinical use. Because of the specific procedure used for obtaining these products, which is based on expressing a atherapeutica gene from a fragment of DNA in a cell to produce a functional protein that is free from any human or animal component, they are especially acleana and thus the therapy of choice for many current diseases. The immediate question is: why are recombinant products not used more extensively given their high efficacy and maximum safety? In short, we are faced with an interesting but also unfortunate paradox of pharmacology that greater progress in therapeutic procedures is not always associated with greater introduction of those resources that are safest, for the simple reason that they are more costly.

A case of lactic acidosis complicating assessment and management of asthma

Tonny V Veenith and Abigail Pearce — 2008-04-15

IntroductionLactic acidosis often occurs in severely unwell patients presenting to Accident and Emergency. It is commonly associated with either hypoxia or decreased tissue perfusion secondary due to cardiovascular collapse or sepsis.Case presentationWe present a case of severe lactic acidosis in the presence of normal tissue perfusion and oxygenation in a 31-year-old patient with poorly-controlled asthma. Acidosis promptly reversed on discontinuation of inhaled beta-agonists. Conclusion: Lactic acidosis secondary to inhaled beta-agonist administration may be a common scenario which can be misinterpreted very easily and can confuse the clinical picture. Further studies will be needed to establish the exact aetiology of this lactic acid production.

Basic mechanisms of rTMS: Implications in Parkinson's disease

Oscar Arias-Carrión — 2008-04-15

Background: Basic and clinical research suggests a potential role for repetitive transcranial magnetic stimulation (rTMS) in the treatment of Parkinson's disease. However, compared to the growing number of clinical studies on its putative therapeutic properties, the studies on the basic mechanisms of rTMS are surprisingly scarce. Results: Animal studies have broadened our understanding of how rTMS affects brain circuits and the causal chain in brain-behavior relationships. The observed changes are thought to be to neurotransmitter release, transsynaptic efficiency, signaling pathways and gene transcription. Furthermore, recent studies suggest that rTMS induces neurogenesis, neuronal viability and secretion of neuroprotective molecules. Conclusion: The mechanisms underlying the disease-modifying effects of these and related rTMS in animals are the principle subject of the current review. The possible applications for treatment of Parkinson's disease are discussed.

Defining the profile of International Archives of Medicine

Manuel Menendez-Gonzalez — 2008-04-15

This editorial accompanies the launch of International Archives of Medicine, a novel scientific journal born in response to the new needs that have emerged as a result of globalization.