Biomedical subjects
Publications and source records attributed to A Cruz.
The chief clinical and analytical aspects of the suicide of a 21-year-old male with psychiatric problems by parenteral administration of a 200 g/l aqueous solution of paraquat are described. Paraquat levels were determined in plasma, urine, kidney, liver and lung after autopsy. Tissue damage was studied by electron microscopy. The death ensued from pulmonary dysfunction 15 days after hospital admission.
One hundred ninety-five male and female patients over 65 years old presenting with urinary incontinence were evaluated by clinical and urodynamics. Urinary incontinence was in the form of urgency-incontinence in 68% of the cases, incontinence at cough in 26%, and urinary incontinence which the patient referred to no specific situation in 6%. Among the different urodynamics data, bladder instability was the most common (73%). Urinary stress incontinence was observed in 35% of the cases. Bladder instability was demonstrated in 77% of the cases with urgency-incontinence and in 69% of the cases with incontinence not referred to a specific situation. All the male patients with lower urinary tract obstruction had urgency-incontinence. Stress incontinence was demonstrated in 60% of the cases with incontinence at cough. Stress incontinence was not observed in male patients without associated diseases. The associated neurological disorder was accompanied by bladder hyperreflexia in 90% of the cases. A prior adenomectomy or hysterectomy was associated with a greater number of cases with stress urinary incontinence, accounting for 62% in both males and females.
Trypanosomatid protozoa frequently cause severe diseases in humans. Many molecules likely to have a role during the infectious cycle have been identified, yet proof of their function is often lacking. We describe studies in Leishmania major of homologous gene targeting, a powerful method for testing gene function in other organisms. Following introduction of a construct containing dihydrofolate reductase-thymidylate synthase (dhfr-ts) flanking sequences fused to neomycin phosphotransferase, 45% of the colonies contained the planned homologous replacement; this frequency rose to nearly 100% in transfections using low amounts of DNA. Integrative transfection in Leishmania thus resembles that of Saccharomyces cerevisiae in giving predominantly homologous events. To facilitate studies of folate metabolism and chemotherapy the sole dhfr-ts copy in a heterozygous deletion line was replaced, yielding lines that were functionally DHFR-TS-. Although most genes are diploid in trypanosomatids, methods exploiting the high frequency of homologous recombination should permit complete replacement of any parasite gene.
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Three cases of rheumatoid neutrophilic dermatitis, a specific entity that occurs in association with rheumatoid arthritis, are presented. Clinically, the condition presents as papules and nodules on the dorsal aspect of the fingers, the extensor aspect of the forearms, and the thighs. Like some other neutrophilic dermatitides, it is characterized histologically by a dense, diffuse infiltrate of neutrophils throughout the dermis. The cause of this neutrophilic infiltrate is not known.
One hundred and one first degree relatives of 35 patients with chondrocalcinosis were examined for the presence of familial disease. Eleven subjects from nine families showed radiological chondrocalcinosis, a prevalence of familial disease of 26%. Two different patterns of disease were noted--the older generation was more commonly affected, and the younger generation and second degree relatives were exempt. Clinical and radiological differences were found between the early and late onset groups, but not between late onset and sporadic forms of chondrocalcinosis. These findings support the suggestion that the true prevalence of familial disease. is underestimated. A dominant, autosomal transmission with variable penetrance is consistent with our findings, which suggests that homozygous patients with familial chondrocalcinosis may present a more severe form of the disease.
This report describes four patients with chronic psoriasiform dermatitis of the palms and soles who developed pigmented macular lesions after localized photochemotherapy (PUVA) to these areas. These lesions had varied histopathologic presentations including lentigines, atypical melanocytic proliferation and a junction nevus suggesting a wide clinico pathologic spectrum in the PUVA-induced pigmented macules.
A retrospective study was carried out to determine the effect of common childhood infectious diseases on the hemoglobin level of a cohort of Alaskan Eskimo children born between 1960 and 1962. Hemoglobin and health records were available on 308 children between 6-11 and 12-17 months of age. Additional records were available on 187 of these children at 18-23 months of age. Episodes of chickenpox, measles, pertussis, and lower respiratory infections were reviewed. Between 38 and 50% of infants between 6 and 23 months of age had hemoglobin levels below 11.0 g/dl. The mean hemoglobin level of infants 6-11 and 12-17 months of age decreased with increasing number of total infectious episodes occurring within the 3 months before hemoglobin measurement. This trend was not apparent for infants in the 18-23 months age interval nor were low hemoglobins predictive of illness during the 3 months after the hemoglobin determination. At the 6-11 and 12-17 month age interval the number of lower respiratory infectious were most significantly associated with a decreased hemoglobin value. These observations are consistent with more recent reports that document iron deficiency anemia among children with antecedent infections and again emphasize the role of infection in the development and maintenance of anemia in children about 1 year of age.
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A fast and sensitive method for the determination of carboxyhemoglobin (COHb) in blood using derivative spectroscopy is described. The addition of sodium dithionite as a reducing agent is not required. The concentration interval studied was from 0.5% to 100% COHb.
In a double-blind study 393 seronegative dogs, residing in a holoendemic area for Leishmania donovani infantum infection, were randomly assigned to an immunization with a partly purified L.d. infantum-derived preparation, or received adjuvant only. During the first year of the study period the rate of infection was significantly higher in the vaccinated group than in the control one (P less than 0.05), but this difference disappeared during the second year (P = 0.44). Since a similar immunization protocol conferred resistance against experimental murine leishmaniasis, these results stress the differences that may exist between the natural hosts of Leishmania parasites and experimental animal substitutes.
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We report a patient that fulfills the clinical features of inflammatory bowel disease (Crohn) who develops papulopustular lesions, some of which evolve into erythematous plaques with pustules and other into superficial ulcers. The different cutaneous manifestations of inflammatory bowel disease, are reviewed, an entity which includes Crohn's disease and ulcerative colitis, as well as the previously reported cases which developed papulopustular lesions emphasizing their similarities and their differences to our patients and also its probable relationship to malignant pyoderma.
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Eight men with complex partial seizures who had frequent focal interictal epileptiform discharges (FIEDs) during routine EEGs were selected for all-night EEG recording before, and after 36 h of sleep deprivation. After sleep deprivation 6 of 8 patients showed increased FIEDs. The pooled mean number of FIEDs was greatest during light non-REM stages of sleep, especially stage II. Thus sleep deprivation is an effective activation method in medicated patients with complex partial seizures. However, a significant activation requires recording stage II sleep after sleep deprivation.
We compared the nocturnal plasma prolactin (PRL) and beta-endorphin (B-E) concentrations prior to and after sleep deprivation (SD) in eight epileptic patients with complex partial seizures. After the period of SD (1) the mean number of interictal epileptiform discharges and the mean plasma PRL levels showed a significant rise during light non-REM stages of sleep, and (2) mean nocturnal plasma PRL and B-E concentrations showed a moderate rise during the first few hours of sleep, significant only for plasma PRL. In a patient with multiple complex partial seizures during sleep, the levels of plasma PRL and B-E concentrations were closely related to ictal discharges. The data obtained in this stress-free environment suggest a centrally mediated interaction between the release of PRL and B-E, in relation to epileptic discharges.
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