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Cytarabine (Cyt) is an antimetabolite used primarily in the treatment of leukemia, and both immediate and delayed hypersensitivity reactions have been reported. We studied a 9-year-old girl with lymphoblastic leukemia, who developed three anaphylactoid reactions during Cyt treatment courses over a 1-year period. Three years later, Cyt was required again. Although a skin test was negative to Cyt at the concentration of 4μg/ml, we decided on placebo-controlled administration of the drug. The Cyt was well tolerated, and urine values of N-methylhistamine showed no important variations throughout this period compared to those during the placebo administration. Skin tests carried out 14 days after the study were positive at the concentration of 4 μg/ml. The history of different episodes of allergic reactions to Cyt, the last one being the most severe, indicated the possible participation of an immediate hypersensitivity phenomenon, but because no studies had been carried out initially, we could not establish the presence of IgE antibodies. These results indicate that good tolerance existed after the control administration procedure. The long interval, 3 years, between the allergic episode and our protocol and the appearance of a positive skin test 14 days after the protocol indicated that the subject had lost sensitivity and become resensitized after the controlled administration procedure. [ABSTRACT FROM AUTHOR]

This study analyzes the potential economic benefits of identifying and treating patients with so-called prediabetes and prehypertension through the Mexican prevention program known by its Spanish acronym PREVENIMSS. The results show that for each US dollar invested in prevention, $84--$323 would be saved over a twenty-year period. For this and other reasons, providing preventive care for prediabetes and prehypertension patients is better than the current routine care model, in which care is provided in most cases when the disease has progressed substantially. Yet data show that screening and preventive care services are still not being used widely enough in Mexico, are provided too late, or are not sufficiently targeted to the most at-risk individuals. Investing in preventive care for patients with prediabetes and prehypertension is cost saving. [ABSTRACT FROM AUTHOR]

Objective: Our objective was to investigate enteric los of proteins in a group of selected patients, which frequently is not taken into account in the clinical management of these patients., Patients and Methods: We included 20 healthy children (group I), 10 pediatric patients with heart disease (group II) and 20 pediatric patients with gastrointestinal disease (group III). They were selected because a high percentage of them had high right heart chamber pressure and/or lymphatic anomalies or inflammation and/or ulceration of the gastrointestinal mucosa. A double study method was performed, including excretion of fecal alpha-1-antitrypsin and intestinal clearance of alpha-1-antitrypsin., Results: A high correlation between both methods (r = 0.7542, p < 0.001) was found. Normal values were obtained for the excretion of fecal alpha-1-antitrypsin (< 1.6 mg/g of dry feces) and for clearance (< 26.5 ml/day) in group I. Protein-losing enteropathy was diagnosed in 60% of cardiac patients and 35% of patients with gastrointestinal disease when applying the method of fecal alpha-1-antitrypsin excretion and in 50% and 40%, respectively, when using the clearance method. There is a high correlation between the clearance and plasma protein level (r = -0.7162, p < 0.001 for albumin, r = -0.5239, p < 0.01 for transferrin, r = -0.4609, p < 0.05 for prealbumin). The regression line crosses the albumin concentration of 3 g/dl when the clearance is 176 ml/day, a similar result to that seen in adult patients., Conclusions: Protein-losing enteropathy is detected in a high proportion of pediatric patients affected by cardiac or gastrointestinal disease. There is a close correlation between fecal excretion and intestinal clearance of alpha-1-antitrypsin.

A review of the diagnostic methods of pertussis (clinical, radiological, laboratoryy: 42 case reports in a period of 2 1/2 years, being all hospitalized children with pertussis, aged from 23 days to 7 years. A review of the treatment with hyperimmune globulin, antibiotics, symptomatic treatment, and the results obtained, is presented.

In the past few years there has been a resurgence of interest in the protein composition of human milk. Up to now the influence of maternal diet and of the mothers' nutritional status on the protein composition of human milk have not been fully clarified. We have evaluated the relationship between the mothers' socioeconomic status and weight and the protein composition of human milk. Protein fractions were determined by a polyacrylamide gel electrophoresis method in 181 samples of human milk obtained from voluntary donors. Samples were classified according to the time of lactation and in relation to the socioeconomic status and to the weight of the lactating women. Total protein and non-protein nitrogen decreased with advancing lactation but there were no differences among the socioeconomic and weight groups of mothers who were considered. beta- and kappa-caseins fell during lactation and beta-casein was significantly increased in the milk of the upper socioeconomic class with respect to that of the low one. alpha-lactalbumin increased from transitional to mature milk (16-30 d) and then declined. The milk from the low socioeconomic group presented the lowest levels of this protein. Lysozyme increased during lactation, whereas lactoferrin decreased. Both proteins were significantly influenced by the mothers' socioeconomic status; the highest concentrations for these proteins were found in the milk of the low socioeconomic group. Deficit or excess of mothers' weight did not influence the levels of the different protein fractions of human milk.