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Biomedical subjects

C Lavalle

Publications and source records attributed to C Lavalle.

At least 55 records · Page 3Linked to original sources
PubMed1983

Hemocytopenia as initial manifestation of systemic lupus erythematosus. Prognostic significance.

In 1960 Rabinowitz and Dameshek emphasized the close relationship between idiopathic thrombocytopenic purpura (ITP) and systemic lupus erythematosus (SLE) and suggested that ITP is often a prodrome of SLE. On the basis of tis observation, the present study was designed to investigate the prevalence of SLE in patients with the initial diagnosis of ITP, autoimmune hemolytic anemia (AIHA), Fisher-Evans' syndrome (F-E) and idiopathic aplastic bone marrow (IABM) and to investigate the salient clinical manifestations and prognosis of these patients. We studied 62 patients, 35 with ITP, 16 with AIHA, 9 with F-E and 2 with IABM. Seventeen developed four or more ARA criteria for SLE within 6 of 14 years after the initial hematologic manfestations (IHM). Mucocutaneous symptoms predominated in all groups. None developed renal failure and only 2 had central nervous system involvement. When these patients were matched by age, sex and duration of illness with 24 SLE patients without hematologic abnormalities, the everity and therapeutic indices of the former showed a significantly (p 0.001) milder course. Eight of the 9 patients that required splenectomy are at present without treatment. SLE patient with IHM have a more benign course which is not worsened by splenectomy.

Anemia, Aplastic↗
PubMed1983

Cell-mediated immunity to myoglobin in polymyositis.

Using the leucocyte migration inhibition (LIF) test we looked for evidence of cell-mediated hypersensitivity against myoglobin in 8 patients with polymyositis (PM) or dermatomyositis (DM). The migration index for PM-DM patients was 47.5 +/- 17%, while in the controls the index was 86 +/- 12% (p less than 0.001). The presence of serum antibodies against myoglobin was also investigated by passive haemagglutination (PH) and counterimmunoelectrophoresis (CIE). By PH the reciprocal titre of antimyoglobin antibodies was 150 +/- 28 in PM-DM compared with 16.2 +/- 15.9 and 8.7 +/- 7.7 in control patients with diseases (p less than 0.01) and negative in normal persons. CIE showed antimyoglobin antibodies in 3 PM-DM patients and in none of controls. Cell-mediated immunity against myoglobin may be implicated in the pathogenesis of PM. The pathological significance of antimyoglobin antibodies remains to be determined.

Cell Migration Inhibition↗
PubMed1979

Protein synthesis and secretion by activated human lymphocytes.

Human peripheral blood mononuclear cells showed increased synthesis and secretion of protein in response to stimulation by mitogens. Protein secretion in response to concanavalin A (Con A) correlated with cellular proliferation and originated from the proliferating cells. Selective depletion of either B lymphocytes or monocytes did not lead to a reduction in the total protein secreted, suggesting that the T lymphocyte was the cell contributing most of the synthetic activity. It is concluded that the measurement of newly synthesized and secreted protein by Con A activated mononuclear cells is a measurement of the T-lymphocyte response.

Agammaglobulinemia↗
PubMedDate not supplied

Reduction in hospitalization costs, morbidity, disability, and mortality in patients with aids treated with protease inhibitors.

BACKGROUND: The objective of this study was to analyze hospitalization costs, morbidity, disability, and mortality in patients with acquired immunodeficiency syndrome (AIDS) treated with protease inhibitors (PI). METHODS: This is a self-controlled, ambispective study of a total of 581 patients with human immunodeficiency virus (HIV)/AIDS seen at the Hospital de Infectología, Centro Médico La Raza, IMSS, in Mexico City during 1997. A total of 210 (36.14%) patients initiated protease inhibitor (PI) treatment at the onset of the study. Thirty-eight patients satisfied the inclusion criteria for this study and were analyzed retrospectively during the year prior to PI treatment, and then prospectively throughout the year on PI treatment. As concerns main outcome measures, financial costs, number of hospitalizations, number of infections, and productivity and laboratory parameters (CD4(+) counts and viral load) were analyzed during the year prior to PI treatment and then prospectively during the year on PI prescription. Our hypothesis was that the hospital costs, morbidity, disability, and mortality of patients with AIDS decreased while on PI treatment. RESULTS: During the year prior to PI prescription, the 38 patients enrolled in the study were admitted on a total of 59 occasions (1.55 hospitalizations/patient), whereas during the year on PI therapy, all 38 patients had only seven admissions (0.18 hospitalizations/patient). Hospitalization costs decreased 35% when annual PI costs for the 38 patients studied were taken into account. The number of microorganisms detected during hospitalization decreased from 24 prior to PI to five on PI. The number of disability days involved in patients on PI decreased significantly (p <0.0002). None of the 38 patients studied died during the year of follow-up under PI treatment. Mortality decreased significantly, from 116/481 (23.2%) in 1996, to 77/581 (13.2%) in 1997, to 40/740 (6.4%) in 1998. There were no deaths among the 38 patients studied during the 1-year follow-up period; when the observation period was extended 1 additional year, only one patient died (2.63%). Only six (3.48%) of the 172 PI-treated patients with AIDS not included in the study died during the same period. CD4(+) cell counts increased from 190.56 +/- 169.5 cells/mm(3) to 235.00 +/- 112.65 cells/mm(3) (p <0.05) after 12 months of PI treatment. Viral loads decreased from 5 logs to 2.4 logs at 12 months of PI treatment (p <0.001). CONCLUSIONS: Introduction of PI to antiretroviral treatment in patients with AIDS was associated with a lower rate of hospital admissions, lower costs, and a lesser number of infections/year, disabilities, and mortalities. Increase of CD4(+) cell counts and decrease in viral loads in the 38 patients were associated with decreased morbility and mortality.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Endomyocardial fibrosis (Davies disease) coincidental with systemic lupus erythematosus.

This is the case of a 27 years-old woman with signs and symptoms of severe untreatable congestive heart failure, anemia, gingival mucosa ulcers, photosensitivity and alopecia. The electrocardiographic, echocardiographic, angiographic and hemodynamic data oriented the diagnosis of restrictive cardiomyopathy, mitral insufficiency secondary to mitral prolapse and bi-atrial dilation. The histologic study of the endomyocardial biopsy, performed during catheterization, showed signs of endomyocardial fibrosis, and immunological analysis was compatible with systemic lupus erythematosus. As far as we know, this is the first case of endomyocardial fibrosis (Davies disease) associated with systemic lupus erythematosus published in the medical literature. The etiology of Davies disease remains unrevealed and its association with systemic lupus erythematosus suggest a probable autoimmune origin.

Adult↗
PubMedDate not supplied

[Polyarteritis nodosa with renal agenesis and immunosuppressive treatment].

A case of a 44 years old man with the unique combination of polyarteritis nodosa (PAN) and the congenital absence of a kidney is presented. The clinical picture consisted of fever, general symptoms, hypertermia, peripheric neuropathy, subcutaneous nodules and renal damage. Laboratory findings included increased WBC, telescoped urinary sediment, renal insufficiency, positive rheumatoid factor, policlonal gammopathy and positive Australia antigen. A review of the pertinent literature and the etiopathogenic role of Australia antigen in PAN is discussed. Efficacy of immunosuppressive therapy was evident in this case.

Adult↗
PubMedDate not supplied

[The heart and rheumatoid arthritis. Prospective study of 100 cases].

We studied one hundred consecutive patients with rheumatoid arthritis from the cardiological point of view through non invasive methods to detect the frequency of cardiovascular complications. Seventy three (73%) were females and twenty seven (27%) males. Mean age, 48.6 years. Mean age of presentation of the disease, 34.2 years. Mean age of duration of the illness, 21.8 years. Fifty seven per cent had some type of cardiopulmonary complication. Clinically 52 per cent referred some type of cardiopulmonary symptoms. The physical examination was abnormal in 27 per cent. Rheumatoid factor (Waaler-Rose) was positive in 82 per cent. The cardiac X ray series was abnormal in 33 per cent, the resting electrocardiogram in 48 per cent and the M mode echocardiogram in 52 per cent of the cases. The complications detected were: pericardial effusion (21%); pleural effusion (9%); pulmonary fibrosis (6%) which represents a higher incidence of previously reported in the literature; congestive heart failure (10%); valvular lesion (9%) among those are included six patients with valvular heart disease of non detectable etiology; ischemic heart disease (8%); myocarditis (6%); rythm disturbances (22%) and conduction defects (20%) including a 46 year old female patient who developed a complete AV block during an exacerbation of her illness, requiring the insertion of definitive pacemaker. Our results showed that some of the detected lesions are in part more frequent and severe than those reported in the literature, probably due to, that on one hand their search was intentional and on the other, our group was constituted by with severe and long standing rheumatoid arthritis.

Adult↗
PubMedDate not supplied

[Serum factors inhibiting cellular immunity in systemic lupus erythematosus].

Forty three patients with systemic lupus erythematosus (SLE) were divided into three groups, inactive, active without treatment and active on treatment with steroids. T lymphocytes from peripheral blood were determined and the results compared with those of twenty five normal individuals. In further experiments, the mitogenic capacity of SLE lymphocytes to Con A and the serum's activity of these patients upon normal lymphocytes were analized. Decreased T lymphocytes were found in all groups of patients with SLE. There were no difference between the mitogenic response of SLE patients and controls when the lymphocytes were incubated with normal human AB serum. When normal lymphocytes were incubated with serum from SLE patients with active disease, and inhibition of mitogenic response to Con A was observed. These results suggests that the decrease cellular immunity observed in SLE is due to serum factors rather than to intrinsic T cell abnormality.

Adult↗