Lyme borreliosis in Spain: a serological survey.
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Antibodies, Bacterial↗
Biomedical subjects
A Guerrero
Publications and source records attributed to A Guerrero.
[Tuberculous meningitis caused by resistant microorganisms. Therapeuticfailure in 2 patients with HIV infection and disseminated tuberculosis].
BACKGROUND: Tuberculosis in HIV infected patients does not carry a worse therapeutic response rate. Treatment failure is usually due to incomplete schedule, with development of acquired resistance. Two patients with HIV infection and disseminated tuberculosis who developed fatal meningitis are presented. METHODS: In vitro studies of sensitivity to anti-tuberculous drugs were carried out, using the proportions method. RESULTS: Following a good initial evolution, both patients were readmitted with tuberculous meningitis resistant to isoniazide in both and to rifampicin in one of the patients. In one patient, the original strain (which was sensitive) was available. In this patient, changes in the treatment were performed in the initial phase. CONCLUSIONS: The importance of anti-tuberculous multiple therapy, particularly in the initial phases, for HIV positive patients is crucial. The lengthen of admission when good patient's compliance is in question, but also to avoid, whenever possible, changes in treatment are important measures in this stage. Meningitis may occur as a form of therapeutic failure and its cure may be difficult if the strains are resistant.
AIDS-Related Opportunistic Infections↗
[Internal carotid artery agenesis and multiple aneurysms in the posterior communicating artery].
Internal carotid artery agenesia is a rare anomaly of the embryonic development. We present a case with this anomaly and a vascular feeding of this territory out of the contralateral carotid system and the posterior vascular system. There were multiple aneurysms in the right posterior communicating artery, never described before in association with carotid agenesia, that are similar to the angiographic image of the fibromuscular dysplasia ("atypical" pattern). We review and discuss the embryonic development of this anomaly and its relationship with the hemodynamic stress and aneurysm formation.
Adult↗
[Lyme borreliosis: how is it manifested in Spain?].
BACKGROUND: Lyme borreliosis is not usually diagnosed in Spanish patients since before 1987. The aim of this study was to know the clinical spectrum of infection by Borrelia burgdorferi in Spain by a prospective epidemiologic study. METHODS: The period of collection of cases was from 1987 to 1989 and the follow-up period was of 2 years following diagnosis. Detection of serum antibodies was performed by indirect immunofluorescence and ELISA to patients with clinical suspicion of Lyme borreliosis established in 17 Spanish hospitals. The clinical and serologic data and the possibility of other disease which could justify the symptoms were evaluated with the doctor responsible for the patient. RESULTS: Fifty-four patients with clinical manifestations and serologic data indicative of the disease and in whom other diagnosis were excluded were detected. Other diseases which could be the cause of the symptomatology were diagnosed in 26 patients with positive serology. Sixty-three percent of the patients had neurologic symptoms, 46% articular symptoms, 44% cutaneous symptoms and 9% cardiac symptoms. CONCLUSIONS: Lyme borreliosis is not exceptional in Spain. Its clinical spectrum may be situated half way between American and European epidemiologic descriptions. Serology must be interpreted by the clinical manifestations.
Adult↗
Faster isolation of Brucella spp. from blood by isolator compared with BACTEC NR.
Brucella spp. was isolated from blood cultures in a mean time of 3.1 days (range, 2-5) in seven cases of human brucellosis processed with the Isolator lysis-centrifugation system. Simultaneous BACTEC NR blood cultures in the same patients were positive in six, with a mean detection time of 20.6 days (range, 17-29). These data suggest a higher speed of recovery of Brucella spp. from blood specimens with the lysis-centrifugation procedure compared with the BACTEC NR system.
Bacteriological Techniques↗
[Community-acquired pneumonia: prospective study of 101 adult, immunocompetent patients for 1 year].
BACKGROUND: A one year prospective study was carried out to assess the etiology of community-acquired pneumonia (CAP), and also to know the incidence, characteristics and evolution of infection by Chlamydia pneumoniae; and the effectiveness of DNA probes in CAP due to Mycoplasma pneumoniae and Legionella. METHODS: One hundred and ten patients with a diagnosis of CAP in the emergency department were studied. Serologic studies were performed, and also tests commonly used for the diagnosis of respiratory tract pathogens in respiratory samples, including serology and culture of Chlamydia pneumoniae and DNA probes for Mycoplasma pneumoniae and Legionella. RESULTS: In 72 cases (71.3%) some pathogen was found and in 5 cases more than one microorganism was involved. The etiology was bacterial in 31% of the cases, with S. pneumoniae being the most frequent (19 cases). Forty percent of the cases were "atypical" pneumonias with 33 cases of M. pneumoniae and 5 by Chlamydia pneumoniae. Diagnostic data of viral pneumonia were found in 2 cases. DNA probes were not useful for the diagnosis of pneumonia by Legionella pneumophila and had low effectiveness (31.8%) in Mycoplasma pneumoniae CAP. CONCLUSIONS: a) M. pneumoniae was the most frequent pathogen (33%). b) DNA probes for M. pneumoniae had low sensitivity in sputum (31.8%) and none in pharyngeal exudate. c) Acute infection by C. pneumoniae was diagnosed in 5 cases. Previous data of infection were recorded in 60.4% of the patients. d) Bacterial pneumonia (31%) was underestimated due to a low rate of bacteremic cases (7.9%) and the low number of positive cultures with definitive diagnostic value. e) The evolution was good except in two cases (death due to staphylococcal pneumonia with alcohol withdrawal syndrome and multiorganic failure by disseminated chicken-pox).
Adult↗
[Epidemiologic study of Lyme disease in Asturias].
BACKGROUND: The aim of this study was to confirm the Sierra del Sueve (Asturias) as an endemic area for Lyme's disease and determine the seroprevalence of this disease in inhabitants of this and other zones of Asturias. METHODS: A taxonomic study of 233 ticks in this county was carried out and the rate of infection by Borrelia burgdorferi was determined by culture in modified Kelly medium. Seroprevalence of Lyme's disease was studied by enzyme-immunoanalysis IgG-IgM in 150 inhabitants from several counties of Asturias. RESULTS: The tick Ixodes ricinus is the most abundant species in the zone. All the cultures of Ixodes for Borrelia burgdorferi were negative. Among the farmers of the area of Sueve, seroprevalence of Lyme's disease was higher than in other population groups. CONCLUSIONS: The Sierra del Sueve is an endemic area of Lyme's disease because of the appropriate vector I. ricinus and the super-population of Fallow deer. In this county the percentage of asymptomatic seropositives for this disease is much higher than that of other zones in Spain.
Animals↗
[Roxithromycin in the treatment of community-acquired pneumonia].
BACKGROUND: The aim of the present study was to prospectively evaluate the efficacy and tolerance of roxithromycin in the empiric treatment of extra-hospitalary pneumonias in immunocompetent adult patients. METHODS: Over a 12 month period 101 patients with extra-hospitalary pneumonia who attended the Emergency Department were studied. Of these, 53 were treated as out patients (5 with amoxicillin-clavulanic, 25 with erythromycin and 23 with roxithromycin at daily doses of 300 mg for 10 days). The treatment was randomly chosen, with no patient selection, thus making heterogeneous groups and, therefore, the study could not be comparative. RESULTS: In patients receiving roxithromycin, an etiologic diagnosis was achieved in 15 cases (65.3%), with Mycoplasma pneumoniae, being the most frequent pathogen (10 cases), followed by Streptococcus pneumoniae (3), Chlamydia pneumoniae (1) and Haemophilus influenzae (1). The mean duration of fever was 1.9 days, 6.7 days for respiratory manifestations and resolution of the radiographic infiltrate 11.6 days. The evolution was good in all the patients with no secondary effects or relapse occurring in any patient. CONCLUSION: Roxithromycin is an effective, safe and comfortable antibiotic in the treatment of infections of the lower respiratory tract acquired in the community.
Adolescent↗
[Spontaneous intrapetrous dissection of the internal carotid in muscular fibrodysplasia].
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Adult↗
[Experimental model of Lyme disease in rats].
BACKGROUND: An experimental model in rats can contribute to the understanding of the pathogenesis and improvement of treatment of Lyme borreliosis. OBJECTIVE: To develop a Lyme arthritis experimental model in Sprague-Davies rats. MATERIAL AND METHODS: An intraperitoneal inoculation of Borrelia burgdorferi in three groups of Sprague-Davies rats was made. The first group was inoculated with dead B. burgdorferi. The second group was inoculated with low virulence B-31 B. burgdorferi. The third group was inoculated with high virulence B-297 B. burgdorferi. RESULTS: After six months of follow-up, none of the rats in the first two groups presented arthritis whereas in the third group 18 rats (72%) developed arthritis in one or more joints. Histologic showed synovial hypertrophy and inflammatory infiltration composed of polymorphonuclear leukocytes, plasma and mast cells in the infected joint. B. burgdorferi was isolated in the liver and spleen cultures taken 14 days after inoculation in 40% of the rats inoculated with B-297 strain. CONCLUSION: An easy and inexpensive experimental model of Lyme arthritis in rats has been developed.
Animals↗
[Are DNA probes useful for the diagnosis of Mycoplasma++ pneumoniae pneumonia?].
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Adult↗
[Lyme disease with exclusively neurologic manifestations].
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Humans↗
Synthesis of biosynthetic inhibitors of the sex pheromone of Spodoptera littoralis. Part II: Acetylenic and cyclopropane fatty acids.
The synthesis of new acetylenic and cyclopropane fatty acids, as potential inhibitors of the beta-oxidation step in the proposed biosynthesis of the sex pheromone of the Egyptian armyworm Spodoptera littoralis, is reported. The biological activity of the compounds has been determined by in vitro and in vivo bioassays, and among all the compounds tested, dichlorocyclopropane acid has shown the highest inhibition activity displayed so far.
Animals↗
A depolarization can trigger Ca2+ uptake and the acrosome reaction when preceded by a hyperpolarization in L. pictus sea urchin sperm.
The acrosome reaction (AR) is an exocytotic event that allows sperm to recognize and fuse with the egg. In the sea urchin sperm this reaction is triggered by the outer investment of the egg, the jelly, which induces ionic movements leading to increases in intracellular Ca2+ ([Ca2+]i) and intracellular pH (pHi), a K(+)-dependent transient hyperpolarization which may involve K+ channels, and a depolarization which depends on external Ca2+. The present paper explores the role of the hyperpolarization in the triggering of the acrosome reaction. The artificial hyperpolarization of Lytechinus pictus sperm with valinomycin in K(+)-free seawater raised the pHi, caused a small increase in 45Ca2+ uptake, and triggered some AR. When the cells were depolarized with KCl (30 mM) 40-60 sec after the induced hyperpolarization, the pHi decreased and there was a significant increase in 45Ca2+ uptake, [Ca2+]i, and the AR. This waiting time was necessary in order to allow the pHi change required for the AR to occur. Thus, the jelly-induced hyperpolarization may lead to the intracellular alkalinization required to trigger the AR, and, on its own or via pHi, may regulate Ca2+ transport systems involved in this process. Because of the key role played by K+ in the triggering of the AR, the presence and characteristics of ion channels in L. pictus isolated sperm plasma membranes are being explored. Planar lipid bilayers into which these membranes were incorporated by fusion displayed 85 pS single channel transitions which were cation selective.
Acrosome↗
IgG anti-ganglioside antibodies and their subclass distribution in two patients with acute and chronic motor neuropathy.
IgG anti-ganglioside antibodies were found in two patients with motor neuropathy. The first patient had a chronic axonal neuropathy with persistently elevated anti-GM1 antibodies. The second patient had an acute axonal neuropathy with anti-GM1, GD1b and asialoGM1 antibodies. In both, the IgG subclass study showed that the antibodies belonged to the IgG1 subclass. An enzyme-linked immunosorbent assay (ELISA) for light chains revealed anti-ganglioside antibodies of the lambda type.
Acute Disease↗
Significant anti-HIV activity of new modified polyanionic polymers in vitro.
The anti-HIV activities of two new polyanionic polymers (AM 242 and AM 612) were investigated in cell culture-based and biochemical antiviral assays. These compounds inhibited the reverse transcriptases from HIV-1 and HIV-2, using enzyme purified from virions and either a ribosomal RNA or gapped duplex DNA as the template. With the ribosomal RNA template, AM 242 and AM 612 had ID50 values of 1.1 and 0.10 micrograms/ml against the HIV-1 reverse transcriptase. In vitro cell based assays determined that both compounds significantly inhibited both the cytopathic effects associated with HIV-1 infection and the replication of virus in infected cells. AM 242 had an IC50 of approximately 1.0 micrograms/ml, while that of AM 612 was 0.19 micrograms/ml. These two active polyanionic polymers were effective in inhibiting the growth of a panel of HIV-1 isolates and were also active against HIV-2. Although the compounds were toxic at high concentration, they had antiviral activity over a wide range of nontoxic concentrations, yielding a high selectivity index. AM 612 was 100% protective for CEM cells from 320 ng/ml to 1 microgram/ml. Both compounds caused a significant increase in cellular proliferation as determined by the concentration-dependent increase in incorporation of radioactive precursors into cellular macromolecules.
Anions↗
[Endocarditis caused by Brucella melitensis on a mitral valve prosthesis presenting as an ischemic cerebrovascular accident].
A new case of endocarditis by Brucella melitensis on a mitral valve prosthesis in a 15 year old patient, whose first manifestation was an ischemic cerebrovascular accident is reported. The patient presented with daily fever only two months later. Medical treatment alone was not sufficient to avoid valvular failure and substitution of the prosthesis was required. The clinical manifestations and complications of this infrequent condition is discussed. Treatment, which often requires the combination of surgery and antibiotics administered over a prolonged period, is highly recommended.
Adolescent↗