Free thyroxine levels are associated with cognitive changes in individuals with a first episode of psychosis: A prospective 1-year follow-up study

The results of previous cross-sectional studies suggest that free thyroxine (FT4) levels are associated with cognitive abilities (particularly attention/vigilance) during the early stages of psychosis. We aimed to explore whether hypothalamic-pituitary-thyroid hormones predict cognitive changes in a 1-year longitudinal study following first episodes of psychosis (FEP). We studied 36 FEP patients and a control group of 50 healthy subjects (HS). Plasma levels of thyroid-stimulating hormone (TSH) and FT4 were measured. Cognitive assessment was performed with the MATRICS Cognitive Consensus Cognitive Battery (MCCB). FEP patients were assessed twice (baseline and after 1year), whereas HS were assessed only once. We compared cognitive changes at 1year between three groups based on baseline FT4 levels: 1) lowest quartile (Q1, FT4<1.16ng/dL); 2) medium quartiles (Q2-Q3, FT4 1.16-1.54ng/dL); and 3) highest quartile (Q4, FT4>1.54ng/dL). No differences in TSH or FT4 levels were found between HS and FEP patients. All participants had FT4 levels within the normal range. HS outperformed FEP patients in all cognitive tasks. In relation to the relationship between FT4 levels and cognitive changes, a U-shaped pattern was observed: FEP patients from the middle quartiles (Q2-Q3) improved in attention/vigilance, whereas both extreme quartiles (Q1 and Q4) showed a worsening in this cognitive domain over time. Patients with lower FT4 (Q1) showed poorer baseline attention; therefore, lower baseline FT4 levels predicted a poorer prognosis in terms of attention performance. Our study suggests that baseline FT4 levels are associated with changes in attention and vigilance performance over one year in FEP patients.

Glucogenosis tipo III asociada a carcinoma hepatocelular

Type III glycogen storage disease is a hereditary disorder with autosomal recessive transmission. It is characterized by accumulation of abnormal glycogen in the liver and, in 80% of patients, in muscle. The liver can also show fibrosis and sometimes cirrhosis. Until 2000, 9 cases of cirrhosis had been published, 3 of which showed associated hepatocarcinoma. We present the case of a 31-year-old woman, diagnosed in childhood with type III glycogen storage disease, who 30 years after onset developed a hepatocellular carcinoma with portal thrombosis in the context of advanced cirrhosis. This is the first case to be reported in the Spanish literature of type III glycogen storage disease associated with hepatocellular carcinoma.

Impact of microwave heating on hemagglutinins, trypsin inhibitors and protein quality of selected legume seeds

Selected legume seeds (dry and soaked) including faba beans, peas, chickpeas, soybeans, lentils and common beans containing 8 and 25% moisture, respectively, were subjected to microwave heating, and to a conventional cooking method to determine the heating effect on toxic compounds and protein quality. Trypsin inhibitors, hemagglutinins and available lysine were analyzed, and laboratory rats were used to determine digestibility and protein efficiency ratio (PER). Results indicated that microwaving destroyed trypsin inhibitors to a similar degree to that observed in beans cooked using the conventional method without affecting PER for raw seeds with low antinutrients content (faba beans, peas, chickpeas and lentils). Microwave-heated soaked soybeans had a higher amount of destroyed trypsin inhibitors, along with a higher PER, compared with microwave-heated dry soybeans. Microwave heating of common beans failed to destroy hemagglutinins and trypsin inhibitors, and consequently their digestibility and PER values were poor. Finally it was concluded that microwave heating constitutes an adequate method for destroying hemagglutinins and trypsin inhibitors without affecting protein quality of most legume seeds, except for common beans that despite of this process retained the antinutritional substances.

Treatment of achalasia with botulinum toxin

We studied the efficacy of local injections of botulinum toxin in the treatment of patients with achalasia. Four patients diagnosed of achalasia using manometric, radiologic and endoscopic criteria, were treated with botulinum toxin (80 U) injected directly into lower esophageal sphincter (LES), via a sclerotherapy injector. Response to treatment was assessed by changes in symptom scores and LES pressure. All determinations were repeated after 10, 30, 90, 120 and 180 days of treatment. The patients improved after the initial injection. This improvement was accompanied by improved relaxation of the LES. Two patients relapsed after 30 and 65 days and the other two patients remained symptom-free 5 months after treatment.

CONCLUSION

Botulinum toxin is probably a safe and effective alternative for the treatment of achalasia and should be considered in patients in whom pneumatic dilation has failed or who are poor surgical candidates. Long-term evaluation of the safety and efficacy of botulinum toxin in the treatment of achalasia is required.

Genotyping of hepatitis C virus isolates from Basque Country, Spain

The genotype of HCV was determined in 161 chronic HCV-infected patients. The patients were classified into three groups on the basis of the origin of the HCV infection: 50 patients had a history of intravenous drug use (IVDU) but no HIV infection; 41 patients had received blood transfusions, and 70 patients had no known exposure. The distribution of HCV genotypes was associated with the origin of infection and age of patients: genotype 1b was predominant among patients who had received blood transfusions and those without evidence of parenteral exposure (84.6% and 67.7%, respectively), whereas genotype 3a was present in 65.3% of IVDUs. Patients with genotype 1b were older than those with genotypes 1a or 3a: 50.3 +/- 12 vs. 34.1 +/- 9.9 and 31 +/- 5.4 years, respectively. These findings suggest that the pattern of HCV genotypes in our region is changing and that genotype 1b may be substituted by 3a as the dominant genotype in the future.

[Primary melanoma of the esophagus. 2 new cases]

Primary melanoma of the esophagus is rare. Until 1990, eight cases had been reported in Spain. We report two patients, 50 and 61-year-old men. Melanomas were located in the distal esophagus and were polypoid (5-6 cm), pediculated and pigmented. Endoscopic biopsy was diagnostic in both cases. Fontana staining technique and monoclonal HMB-45 and S-100 antibodies were used. A revision of clinical characteristics, treatment and survival of the patients with primary melanoma of the esophagus in our country is made.

The protein efficiency ratios of 30:70 mixtures of animal:vegetable protein are similar or higher than those of the animal foods alone

Animal foods in general are considered to be foods with high protein qualities, although their qualities are not always similar because of differences in essential amino acids. The purpose of this study was to compare the protein quality of different animal foods and of their mixtures with vegetable foods, mainly cereals, at the 30:70 animal:vegetable protein proportion with experiments performed under the same conditions. The animal foods were eggs, beef, pork, barbecued lamb, chicken, ham, sausage and milk powder. The vegetable foods used in the mixtures were rice, lime-treated corn flour, wheat flour and cooked black beans. The protein concentrations in the raw and cooked materials were analyzed. The protein efficiency ratios (PER) and digestibilities were determined in Fisher 344 weanling rats. Based on the corrected PER, the foods with the best protein quality were egg (3.24), sirloin beef (3.16), lamb (3.11) and chicken breast (3.07), which were significantly different (P < 0.05) from milk powder (2.88) and beef liver and beef round (2.81 and 2.70, respectively). The ham (2.63) and the pork loin (2.57) had a similar protein quality to that of casein (2.50). The lowest protein quality was found in sausages (2.14). In most of the mixtures of animal and vegetable protein (30:70), the PER was similar to or higher than that of the animal food alone. Beans were the vegetable food that showed the lowest response to the addition of animal food. The conclusion of the study is that some 30:70 mixtures of animal:vegetable protein, such as chicken, beef round and pork with cereals could be utilized for regular meals because of their high PER and low cost.

Cytotoxic effects of gossypol and vitamin E on human and rat lymphocytes and spermatozoa

The cytotoxicity of vitamin E, gossypol, and mixture of both was determined in lymphocytes and spermatozoa using different concentrations of the substances. The cellular viability was assessed by means of the trypan blue exclusion test at 0, 60, and 120 minutes. Spermatozoa exhibited a higher sensitivity to these compounds, which was proportional to the length of exposure and the dose.

Modifications in the testis steroidogenic pathways in rats fed with cottonseed flour

Suppression of the testicular T production by effect of the CSF has been previously reported. Changes in the testicular content of intermediates and precursors of T biosynthesis were determined in rats fed during 28 days with diets containing 25,35 and 50% of CSF and compared with a defated cottonseed flour diet group and a control Purina-chow diet group. Also described were modifications during a six wk post CSF diet period. The results showed a diminution in pregnenolone and progesterone testicular content to a third and a half of the control values (21.5 and 19.3 pg/mg of protein respectively). Other compounds in the delta 5 pathway, 17 hidroxypregnenolone and dehydroepiandrosterone were undetectable since the 35% CSF diet, the 17 hidroxyprogesterone diminished to undetectable values only with the maximal (50%) CSF content diet. During the post CSF diet period all the steroids showed a tendency toward the control values. The 25% CSF content diet group reached the initial contents; other groups presented different recovery degrees. The most affected was the 50% diet group with a direct effect of the CSF on the testicular androgen steroidogenesis affecting both the delta 4 and the delta 5 pathways.

Cottonseed flour effects on androgen testicular content and serum levels in rats

Natural gossypol present in the whole cottonseed flour (CSF) has clear antifertility properties, decreasing the number and motility of spermatozoa. In this study the endocrine function of the testes was evaluated, measuring by specific radioimmunoassays the testicular content and the serum levels of androstenedione (A), testosterone (T), and 5 alpha-dihydrotestosterone in male rats fed with different and nontoxic concentrations of CSF along with Purina chow for 4 weeks, followed by 6 weeks of a recovery period. The testicular content of A, T, and DHT decreased 63%, 90%, and 38%, respectively, in comparison with their control. The serum levels of the three androgens diminished as follows: A 74%, T 95%, and DHT 60%. All the steroids measured in the recovery period showed a tendency towards the control values in both testicular content and serum. The most affected steroid was testosterone, which, after the recovery period, did not reach the control values. A also decreased, suggesting a blockade in testicular steroidogenesis caused by the initial diet.

Infertility in male rats induced by diets containing whole cottonseed flour

It has recently been shown that gossypol, a component of the cottonseed, has clear antifertility properties. The present study was planned to determine whether diets containing cottonseed in different proportions and in nontoxic amounts, could produce infertility in male rats. Diets were formulated with different concentrations of whole cottonseed flour and stock diet (Purina Chow). After 4 weeks of feeding these diets, the male rats were mated with virgin female rats in order to test male fertility rate. Thereafter, the male rats went into a recovery period during which they were fed stock diet for 6 weeks and were again mated after 3 and 6 weeks on this diet. The results show that: 1) infertility was produced by cottonseed flour diets even with a low concentration of gossypol (defatted cottonseed flour); 2) this effect was reversible at least after 6 weeks of gossypol-containing diets, even in the groups fed diets with a high gossypol concentration. The gossypol present in the diets decreases the number and motility of spermatozoa, even when present in concentrations below its toxic level, which may have an important deleterious effect on animal reproduction, since cottonseed is frequently used in the preparation of balanced diets mainly for animal consumption.