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Byline: M. Badia (1), J. Trujillano (1), E. Gasco (1), J. M. Casanova (2), M. Alvarez (1), M. Leon (1) Keywords: Key words Skin diseases; Intensive care; Critical illness; Dermatology Abstract: Objective: The objective of this study is to identify the dermatological disorders (DDs) responsible for the most common skin lesions in the ICU, their incidence and their impact on mortality, degree of severity and length of stay in the ICU.APDesign and setting: We performed a 2-year prospective study in a general medical and surgical ICU including, exceptionally, paediatric cases.APPatients: We included all patients who presented skin lesions upon admission or developed them during their ICU stay.APResults: Forty-six patients (10 % of all admissions) were enrolled, with 51 DDs. SAPS II score (43) and mean length of stay (19 days) were significantly higher than in the general group of ICU admissions. Differences in mortality rates (26 % versus 29 %) were not statistically significant.APConclusions: DDs are entities that should be borne in mind in the critically ill patient their incidence is by no means negligible and makes careful examination of the skin mandatory both on admission and during a patient's ICU stay. Author Affiliation: (1) Intensive Care Unit, Hospital Universitario Arnau de Vilanova, C/ Rovira Roure 80, E-25198 Lleida, Spain e-mail: fiturbe@arnau.scs.es Tel.: + 34-9 73 24 81 00 Fax: + 34-9 73 24 87 54, ES (2) Department of Dermatology, Hospital Universitario Arnau de Vilanova. C/ Rovira Roure 80, E-25198 Lleida, Spain, ES Article note: Received: 7 April 1999/Accepted: 30 August 1999

Fundamento: El hipotiroidismo es una enfermedad frecuente, que cursa con una sintomatología, en ocasiones inespecífica, lo que dificulta el diagnóstico. El objetivo del estudio es estimar la prevalencia de hipotiroidismo en Lleida a través de las prescripciones de la hormona tiroidea y comparar los resultados con los de otras regiones. Métodos: Estudio observacional retrospectivo. 2.854 personas que reciben tratamiento con hormona tiroidea mediante receta de la Seguridad Social. Meses de octubre a diciembre del 2001. Variables: la edad, el sexo y región sanitaria. Resultados: La prevalencia de hipotiroidismo en el 2001 es de 8,4 casos por 1.000 habitantes día (IC 95%:9,23-7,47). La edad media es de 60 años (DS

Abstract Background Gender-related differences are seen in multiple aspects of both health and illness. Ischemic heart disease (IHD) is a pathology in which diagnostic, treatment and prognostic differences are seen between sexes, especially in the acute phase and in the hospital setting. The objective of the present study is to analyze whether there are differences between men and women when examining associated cardiovascular risk factors and secondary pharmacological prevention in the primary care setting. Methods Retrospective descriptive observational study from January to December of 2006, including 1907 patients diagnosed with ischemic heart disease in the city of Lleida, Spain. The clinical data were obtained from computerized medical records and pharmaceutical records of medications dispensed in pharmacies with official prescriptions. Data was analyzed using bivariate descriptive statistical analysis as well as logistic regression. Results There were no gender-related differences in screening percentages for arterial hypertension, diabetes, obesity, dyslipemia, and smoking. A greater percentage of women were hypertensive, obese and diabetic compared to men. However, men showed a tendency to achieve control targets more easily than women, with no statistically significant differences. In both sexes cardiovascular risk factors control was inadequate, between 10 and 50%. For secondary pharmaceutical prevention, the percentages of prescriptions were greater in men for anticoagulants, beta-blockers, lipid-lowering agents and angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, with age group variations up to 10%. When adjusting by age and specific diagnoses, differences were maintained for anticoagulants and lipid-lowering agents. Conclusion Screening of cardiovascular risk factors was similar in men and women with IHD. Although a greater percentage of women were hypertensive, diabetic or obese, their management of risk factors tended to be worse than men. Overall, a poor control of cardiovascular risk factors was noted. Taken as a whole, more men were prescribed secondary prevention drugs, with differences varying by age group and IHD diagnosis.

Ischemia-reperfusion injury associated with liver transplantation remains a serious complication in clinical practice. In the present study the effect of intake of alpha-tocopherol or beta-carotene to limit liver injury by oxidative stress in ischemia and reperfusion was explored. Wistar rats were fed with diets enriched with alpha-tocopherol (20 mg/day) or beta-carotene (3 mg/day) for 21 days. After 21 days, their livers were subjected to 15 and 30 min of ischemia and afterwards were reperfused for 60 min. The recovery of levels of ATP during reperfusion was better in the group of rats whose diets were supplemented with alpha-tocopherol or beta-carotene than in the group control. The supplementation of the diet induced changes in the profile of enzymatic antioxidants. The supplementation with alpha-tocopherol and beta-carotene resulted in a decreased of superoxide dismutase during the ischemia and a recovery was observed after reperfusion. Not changes were observed for the enzymes catalase and glutathione peroxidase and glutathione but their values were higher to those of the group control. In conclusion, the supplementation with alpha-tocopherol and beta-carotene improve the antioxidant and energetic state of liver after ischemia and reperfusion injury.

In order to assess the frequency of autoimmunity markers in hepatitis C virus infection, 229 RIBA 2 HCV positive individuals were tested by ELISA and Immunoblot assay using as antigen rat liver microsomal and cytosolic proteins. Twenty-one out of 229 individuals (9%) showed anti-rat liver microsome antibodies by ELISA, but the titre was low (1:100 to 1:1,600). In Immunoblot, only 5 of these 21 ELISA positive sera recognized also rat liver microsomal proteins (MW between 30 to 64 kDa). Antibodies against rat liver cytosolic proteins were found by ELISA in 14 out of 229 individuals (6%). Three of them showed a reactivity in Immunoblot to 42 kDa or 55 kDA proteins. In conclusion, HCV infection could induce an autoimmune response against rat liver microsomal and cytosolic proteins in a small number of subjects; the titre of antibodies being lower and the pattern of reactivity different in respect to patients with autoimmune hepatitis.

The activity of liver cystathionase (EC 4.4.1.1) was decreased after 3 d of stress induced by surgery. The rate of L-cysteine synthesis from L-methionine was significantly higher in isolated hepatocytes from controls than in hepatocytes from rats suffering from surgical stress. The half-life of L-[2(n)-3H]methionine was significantly higher in rats submitted to surgical stress than in controls. Plasma L-methionine:L-cystine ratio was higher in stressed rats than in controls. L-cystine uptake was significantly increased in the surgically-stressed rats when compared with the controls. All these facts are consistent with the hypothesis that the observed inhibition of cystathionase is physiologically important and that L-cysteine might be considered as an essential amino acid in cases of surgical stress.

The effect of age on the glutathione antioxidant system and its acinar distribution in rat liver was studied. GSH/GSSG ratio in blood and liver was lower in old than in young rats. Hepatic glutathione peroxidase and glutathione S-transferase activities were higher in old than in young rats, whereas hepatic gamma-glutamyl transpeptidase activity was lower in old than in young rats. Glutathione reductase and glucose-6-phosphate dehydrogenase activities did not change with age in rat liver. Total glutathione levels and glutathione peroxidase activity were higher in periportal than in perivenous areas of young rats, but this heterogeneous distribution did not occur in old rats. No change with age was found in hepatic zonation of glutathione reductase and glucose-6-phosphate dehydrogenase.