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Biomedical subjects

E A Gomez

Publications and source records attributed to E A Gomez.

At least 19 recordsLinked to original sources

Rapid identification of Leishmania species from formalin-fixed biopsy samples by polymorphism-specific polymerase chain reaction.

The precise identification and classification of Leishmania species is important for public health surveillance since different species cause different clinical features of the disease. A highly specific polymerase chain reaction (PCR) panel was developed to enable the identification of the five major Leishmania species that cause New World cutaneous leishmaniases. The primers used for this panel were designed to distinguish the polymorphism in sequences of commonly amplified DNA bands of the parasites produced by arbitrarily primed PCR. These polymorphism-specific PCR diagnoses were performed with formalin-fixed biopsy specimens of the leishmanial lesions from four patients in Ecuador and one hamster skin lesion, and these lesions were determined to be caused by Leishmania (Viannia) panamensis, L. (Leishmania) mexicana, and L. (L.) amazonensis. The PCR panel may offer an important and practical approach to the standardized identification of Leishmania species in field examinations.

Animals↗

A preliminary study aimed at the detection of Leishmania parasites in subjects with cutaneous leishmaniasis using polymerase chain reaction.

As a basic study for future diagnosis of cutaneous leishmaniasis, we tried to detect Leishmania parasites representing different species in the subgenera Leishmania and Viannia from subject patients with cutaneous leishmaniasis by using the polymerase chain reaction (PCR) with the subgenus Viannia specific primer. Four out of the 14 specimens revealed an amplified DNA of 70 bp specific for the subgenus Viannia (L. braziliensis complex). No bands were detected in the rest of the specimens belonging to the subgenus Leishmania and unclassified groups. The base sequences of the amplified DNA corresponded with those of the L. (V). braziliensis kinetoplast minicircle. We concluded that PCR using the present primer specific for the subgenus Viannia would be useful in detecting Leishmania parasites in lesions of cutaneous leishmaniasis caused by the L. braziliensis complex.

Animals↗

Histopathological and electron microscopical features of skin lesions in a patient with bartonellosis (verruga peruana).

Chronic verruga nodules taken from a patient with Bartonellosis (verruga peruana) were studied. Histologically, specimens of all the verruga nodules had features consistent with granulomatous lesions with extensive infiltration of various types of cells along with the proliferation of capillaries. The sections were predominantly infiltrated with neutrophils and endothelial cells; histiocytes, plasma cells, lymphocytes and mast cells were also visible to some extent. The blood vessels were dilated, and many rounded and swollen endothelial cells were located peripherally; a huge number of neutrophils invaded the vessels. Electron microscopically, large number of organisms were seen in different stages of the life cycle in the stroma. Furthermore, organisms were regularly seen either in close contact or existing inside the cytoplasm of neutrophils, suggesting the phagocytic role of these cells. No organism was found inside any endothelial cells or histiocytes.

Bartonella Infections↗

The use of psychotropic drugs to treat anxiety in the elderly.

Great care in prescribing and monitoring psychotropic medications for elderly patients must be taken because of their increased sensitivity to toxic side effects; their decreased physical resiliency, as compared to younger patients; and the risk of dependency and withdrawal when taking psychotropic medication. Psychosocial and psychotherapeutic interventions should be administered concurrently if pharmacotherapy is needed. When psychotropic medication is called for, the agent of choice should be that which results in the least amount of autonomic nervous system toxicity and sedation. Short half-life benzodiazepines in low doses are generally the best options for elderly patients in need of psychotropic medication. Unlike benzodiazepines with longer half-lives, they cause no metabolite accumulation and have a lower potential for toxicity.

Aged↗

Depression in the elderly.

1. Depression in the elderly is a major health concern that can be life threatening if not recognized and treated. An untreated depression may result in needless suffering, institutionalization, and suicide. Lack of treatment may occur because the signs and symptoms of depression in the elderly are different from those in the young, and because depressive symptoms may be viewed by the older person, the family, and the physician as a normal part of aging. 2. Depression can occur secondarily to physical illness. Because physical illnesses occur frequently in the older population, the combination of physical illness and depression is common. 3. Through noninvasive procedures, such as positron emission tomography (PET), a greater understanding of depression will be achieved that will result in development of more specific and effective treatment. Accurate and early diagnosis and adequate treatment favor a good prognosis.

Aged↗

Molecular karyotype characterization of Leishmania panamensis, Leishmania mexicana, and Leishmania major-like parasites: agents of cutaneous leishmaniasis in Ecuador.

Molecular karyotypes of Leishmania isolates from patients with cutaneous leishmaniasis in Ecuador were analyzed by pulsed-field gel electrophoresis (PFGE) and Southern blot hybridization. The DNA karyotypes of L. major-like parasites were similar between two human isolates from a lowland coastal and a highland Andean region, but were apparently different from those of eleven World Health Organization reference strains including L. major. The smallest chromosome of 240 kilobases in L. major-like parasites was found to belong to the 715-class of small linear chromosomal DNAs, which have been shown to appear in some lines of Leishmania. Chromosome banding patterns of L. mexicana isolates exhibited a novel, ordered, chromosomal ladder, and were identical among four human isolates and one canine isolate from a restricted geographic region in the Andes. On the other hand, minor chromosome size polymorphisms were observed among three L. panamensis isolates from different endemic regions near the Pacific Coast. Chromosomal locations of dihydrofolate reductase-thymidylate synthetase and P-glycoprotein genes revealed further differences in chromosomal organizations among these Leishmania species in Ecuador. These results indicate that karyotype analysis by PFGE is useful for epidemiologic studies of leishmaniasis in Ecuador.

Animals↗

The use of antidepressants with elderly patients.

If we are to prevent treatment failures, we should eliminate the schism between psychosocial and biological treatments. Most depressed patients require both psychosocial and biological treatments. The patient who responds to biological treatment but does not make appropriate corrections regarding current environmental factors is at an increased risk for relapse. A strong support system can have an important preventive effect without the risks involved in long-term medication maintenance therapy. After a correct diagnosis of a major depressive disorder is made in elderly patients, the dosage of antidepressants should only be about half of the standard adult dose. Preference should be given to those antidepressants with a therapeutic profile appropriate to each particular patient. The antidepressant should have few side effects. Although antidepressant drugs are effective in treating depression, their demonstrable efficacy is surprisingly limited. Because of suicide risk and physical illnesses, older patients are more likely to require electroconvulsive therapy than younger patients. The presence of somatic delusion is a good predictor of positive response. Newer antidepressants have not been proven more effective than the older agents, such as imipramine or amitriptyline, in treating mild or severe depressions. However, they have fewer or varied side effects and therefore they are better tolerated by elderly patients (Figure 6). The consideration of side effects is a major determinant in choosing an antidepressant for a specific elderly patient. Research into the effectiveness of antidepressants has been limited by the existence of heterogeneous groups of depression and by the different therapeutic responses.(ABSTRACT TRUNCATED AT 250 WORDS)

Antidepressive Agents↗

Chronic schizophrenia: the major mental health problem of the century.

Research now shows that schizophrenia is a disease of the brain as well as the mind and, as such, must be treated in ways other than by drugs alone. Psychopharmacology is helpful in controlling the positive symptoms, but does not eliminate aspects of the disease such as apathy and withdrawal. Studies show the structure and blood flow of the schizophrenic brain is very different from the normal brain. Families of schizophrenic individuals are forming support groups to share their feelings of suddenly being cast in the role of caregivers. Additionally, the schizophrenic individual needs to be placed in a comfortable social and vocational setting to increase the chance of improvement.

Family↗

Andean leishmaniasis in Ecuador caused by infection with Leishmania mexicana and L. major-like parasites.

Between 1986 and 1988, epidemiologic studies were carried out in a small rural community in an Andean region of Ecuador, where cutaneous leishmaniasis is highly endemic. A total of 25 human cases, positive for Leishmania parasites by culture and/or smear, were examined. Fourteen of the cases were in infants less than one year of age, suggesting intradomiciliary transmission of the disease. Clinically, many of these cases were similar to descriptions of "uta," a form of cutaneous leishmaniasis which occurs in Andean regions of Peru and is reported caused by L. peruviana. Of the 11 positive cultures obtained from human cases in the present study, eight were identified by molecular characterization as L. mexicana and three were identified as L. major-like. Two additional isolates of L. mexicana were also made from an infected dog and from a sand fly, Lutzomyia ayacuchensis, living in the region, thus implicating the latter species as possible reservoir and vector, respectively, of L. mexicana in this highland community. The significance and validity of recent isolates of L. major-like parasites from the New World are also discussed.

Animals↗

Identification, using isoenzyme electrophoresis and monoclonal antibodies, of Leishmania isolated from humans and wild animals of Ecuador.

Six strains of Leishmania isolated from wild mammals and humans on the Pacific Coast of Ecuador were identified by isoenzyme electrophoresis and by their reactivity patterns to a cross-panel of specific monoclonal antibodies using a radioimmune binding assay. Single isolates from Sciurus vulgaris, Potos flavus, and Tamandua tetradactyla were identified as Leishmania amazonensis. Three other strains, isolated from cutaneous lesions of humans, were identified as Leishmania panamensis.

Animals↗