Widespread circulation of a B/F intersubtype recombinant form among HIV-1-infected individuals in Buenos Aires, Argentina.
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Adult↗
Biomedical subjects
G Contreras
Publications and source records attributed to G Contreras.
Effect of hemodialysis on the signal-averaged electrocardiogram.
The presence of late potentials (LPs) on signal-averaged electrocardiography (SAECG) is predictive of ventricular tachycardia. The effect of hemodialysis (HD) on SAECG has not been well studied. SAECG was evaluated in 28 patients with chronic renal failure immediately before and after HD. In each SAECG, QRS duration, low-amplitude signal duration (LASd), and root-mean-square voltage of the terminal 40 milliseconds of the QRS (RMS40) were measured. To evaluate the effect of fluid removal on SAECG, the last 12 patients were studied during two different HD sessions, one with and one without fluid removal. Two-dimensional echocardiography was performed before and after HD on these 12 patients. At baseline, four patients met the criteria for LPs on SAECG. Only one patient met the criteria for LPs on SAECG after HD. After HD, the mean LASd decreased (28.3 +/- 12.9 to 24.9 +/- 10.1 milliseconds; P = 0.041) and RMS40 increased (63.0 +/- 56.9 to 79.0 +/- 59.2 microV; P = 0. 006). Among the 12 patients who underwent HD with and without fluid removal, left ventricular end-diastolic dimension decreased with (5. 4 +/- 0.6 to 5.1 +/- 0.6 cm; P = 0.024) but not without fluid removal (5.2 +/- 0.3 to 5.1 +/- 0.4 cm; P = not significant [NS]). RMS40 improved with (43.8 +/- 23.1 to 53.2 +/- 22.6 microV; P = 0. 03) but not without fluid removal (51.0 +/- 26.5 to 51.5 +/- 24.2 microV; P = NS). A significant negative correlation was found between change in body weight and change in RMS40 parameter (r = 0. 456; P = 0.0381). SAECG parameters are abnormal in a significant proportion of patients with chronic renal failure and improve with HD despite electrolyte and other proarrhythmic changes. Decreased left ventricular dimension because of fluid removal during HD is one possible explanation for this improvement.
Electrocardiography↗
Sequence analysis of the polymerase domain of HIV-1 reverse transcriptase in naive and zidovudine-treated individuals reveals a higher polymorphism in alpha-helices as compared with beta-strands.
We report a statistical analysis of genetic heterogeneity of the reverse transcriptase (RT)-coding region of human immunodeficiency virus type 1. Both newly determined sequences and sequences contained in the data banks have been examined. For the calculations, the viral samples and the regions within the RT molecule were divided in two groups. The viral samples were split into those from patients not subjected to antiretroviral therapy and those from patients treated with zidovudine (AZT, 3'-azido-3'-deoxythymidine) alone or in combination with other RT inhibitors. The RT-coding region was divided into segments encoding beta-strands and segments encoding alpha-helices. A significantly lower heterogeneity was observed in beta-strands relative to the alpha-helix coding segments. Application of the D test of Tajima has provided evidence of operation of negative (or purifying) selection in sequences from viruses of patients not subjected to antiretroviral treatment as well as in treated patients. In the group of untreated individuals, regions encoding beta-strands are subjected to stronger negative selection than those encoding alpha-helices. It is likely that the observed differences reflect stronger functional constraints in beta-strands than in alpha-helices of RT.
Adolescent↗
[Expression of different HIV-1 phenotypic subpopulations through the natural history of the infection].
BACKGROUND: Multiple viral subpopulations coexist in an HIV infected patient with dynamics of selection established between them. In order to get insight on the phenotype of these subpoblations, and its relation with disease progression, we have studied the biological variability of HIV-1 in 113 patients. Variability was related with CD4+ T lymphocyte counts, clinical status, way of viral transmission and antiretroviral treatment. PATIENTS AND METHODS: 113 patients (80 adults and 33 children) were studied for HIV-1 isolation in cocultures of infected and non infected lymphocytes. Viral replication was evaluated as rapid (R)/slow (S) or high (H)/low (L). Syncytia formation was estimated in MT2 cell line (SI/NSI). The tropism toward lymphocytes and monocytes (LM) was studied on H9 and U937 cell lines. RESULTS: Up to 86.7% of viral isolates were R, 56.6% were H and 49.6% were SI. These percentages increased with disease progression. Eight viral strains were R/H/NSI cocultivated in MT2 cells and SI in cocultured lymphocytes (NSI/SI), which may be considered as a new phenotype. All the SI isolates and all the R/H (SI and NSI) isolates were LM. Three categories were established: R/H/SI/LM, R/H/NSI/LM and S/L/NSI/NLM. The first two categories corresponded to patients with CD4+ T lymphocytes <200 x 10(6)/I (56%, 50%). The third category corresponded to patients with > 500 x 10(6)/I (53.3%). CONCLUSIONS: Viral replication and SI phenotype, independently, are useful markers for severity of HIV infection. The biological differences among NSI of the 3 viral phenotype categories, including the new subgroup NSI/SI, may indicate the existence of more pathogenic NSI subpopulations.
Adolescent↗
Evaluation of mixtures of wild-type HIV-1 and HIV-1 with resistance point mutations against reverse transcriptase inhibitors.
The presence of resistance-related mutations in 185 serial proviral DNA samples from 108 HIV-infected patients was monitored using the line probe assay (LiPA). The proportions of wild-type and mutant virus in each sample were determined. Subsequent samples from the same patient were analysed. Resistance mutations were detected in 58 of 108 patients studied (53.7%), 53 of 73 (72.6%) treated with antivirals and 5 of 35 (14.2%) untreated. The mutations were against zidovudine (51), lamivudine (1), zidovudine and lamivudine (4), zidovudine and zalcitabine (1) and zidovudine and didanosine (1). Among the 58 patients with resistant virus, 168 related mutations were observed: 161 to zidovudine (90 in codon 70, 25 in codon 41 and 46 in codon 215), 5 to lamivudine (codon 184), 1 to zalcitabine (codon 69) and 1 to didanosine (codon 74). Mixtures of wild-type and resistant mutants were detected in 76 of 90 (84.4%) mutated at codon 70, 28 of 46 (60.8%) mutated at codon 215 and in 21 of 25 (84%) mutated at codon 41. The mutations at codon 184 were mixtures of wild-type and resistant in 4 of 5 samples. The agreement between LiPA and sequencing was 96.5%. LiPA was more sensitive for the detection of mutants that were present at low frequency. The analysis of sequential samples from the same patient allowed evaluation of the dynamics of appearance of the resistant mutants.
Anti-HIV Agents↗
Effects of hemodialysis on left ventricular diastolic filling.
Diastolic Doppler filling parameters were measured before and after hemodialyses, performed once with and once without fluid removal. Changes occurred only with fluid removal and correlated with weight loss, indicating that they are the result of reduction in preload.
Aged↗
Laboratory and clinical evaluation of a portable computerized peak flow meter.
A mini-Wright based peak flow meter (VMX Mini-Log), which stores the readings together with the time and date of each measurement, has recently been marketed but has not yet been evaluated. The accuracy, reproducibility, and interdevice variability of this instrument were investigated using a pneumotachograph connected in series as a standard. Flows from 100 to 700 L/min were generated by an explosive decompression chamber. The performance of this instrument was also tested in 20 normal subjects and in 20 patients with airflow obstruction. The accuracy of the instrument was expressed as the percentage of error, and reproducibility and interdevice variability were assessed using the coefficient of variation. In the laboratory evaluation, all devices recorded flow rates that were within +/-10% of the pneumotachograph readings at flows between 200 and 600 L/min. At the extreme flow rates of 100 and 700 L/min, the mean error was higher than 10%. The reproducibility of the VMX was within +/-5% at all the flows tested. The interdevice variability was less than 5% at flow rates between 200 and 700 L/min. When tested on normal subjects with PEF between 400 and 700 L/min, the VMX performed well. In patients with airflow obstruction, four devices had greater than 10% error. The largest error was observed in those patients with PEF below 200 L/min. The VMX Mini-Log peak flow meter is accurate and precise in the flow range between 200 and 600 L/min. Its performance, however, may be affected in subjects with airflow obstruction and PEF below 200 L/min.
Adolescent↗
Cytoplasmic DNA in Entamoeba histolytica: its biological significance.
We report a study on the DNA organization in Entamoeba histolytica using a ribosomal DNA probe. The rDNA genes were found forming mers which were separated in a typical ladder pattern by pulse field electrophoresis. DNA rosette structures were visualized through electron microscopy in DNA eluted from bands recognized by the ribosomal probe. The in situ hybridization experiments using a DNA probe suggested that the rDNA genes are portioned between the nucleus and a cytoplasmic structure. These findings provide new data on DNA organization in E. histolytica and open the question concerning the presence of a novel organelle in this eukaryotic parasite.
Animals↗
Systemic lupus erythematosus in two adults with human immunodeficiency virus infection.
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AIDS-Associated Nephropathy↗
Diazepam induces tolerance in the isolated skin of Pleurodema thaul.
The effects of the long-term administration of diazepam on the potential difference and short-circuit current of the isolated skin of the toad Pleurodema thaul (P. thaul) were investigated. Diazepam applied in a concentration range of 4.6 x 10(-6) to 5.2 x 10(-5) M decreased both electrical parameters. This response was unaffected by flumazenil indicating that the action of diazepam is not induced through benzodiazepine receptors. Induction of tolerance to diazepam on its observed effects on potential difference and short-circuit current was obtained by the administration of a single dose of the drug in a slow release preparation. Skins tolerant to diazepam were also tolerant to the acute effects of verapamil on both electric parameters. Tolerance to diazepam effects was partly reversed by increasing Ca2+ concentration in the inner bathing solution. The results are consistent with a Ca2+ channel blocking effect of diazepam in the P. thaul skin.
Animals↗
Diazepam decreases the response to the electrical stimulation of the nerve-skin preparation of the toad Caudiverbera caudiverbera.
1. The effect of diazepam was examined in the nerve skin preparation of the toad Caudiverbera caudiverbera. 2. Nerve stimulation was followed immediately by a transient increase in short-circuit current (SCC) and in the potential difference (PD), which consisted of a rapid and then a slow component. 3. Diazepam concentrations from 5.0 x 10(-5)M to 5.1 x 10(-4)M caused a dose-dependent block of both components to a 30% of their control values and also reduced the stimulatory responses to noradrenaline in this preparation. 4. Diazepam antagonized the potassium blocking effect of barium. 5. These results, based on electrophysiological and pharmacological evidence, are consistent with a calcium and sodium blocking effect of diazepam on the nerve skin junction of C. caudiverbera.
Adrenergic alpha-Agonists↗
Peak expiratory flow monitoring is not a reliable method for establishing the diagnosis of occupational asthma.
This is a study of the reliability of peak expiratory flow (PEF) monitoring using a portable computerized peak flow meter, the VMX Mini-log, in 17 subjects referred for suspected occupational asthma. Subjects were requested to monitor their PEF six times daily using the VMX Mini-Log for 2 wk at work and at least 10 d away from work. They were unaware that their readings were stored by the flow meter in addition to the digital readout. Four subjects (22%) were unable to complete the monitoring. The results recorded by the subjects were compared with the results recorded by the VMX. Of those who completed the monitoring, only 55.3% of the records were completely accurate in terms of the value and the timing of the measurements, 23.3% were inaccurate either in terms of the recorded value or of the timing of the measurement, and the remainder were fabricated results (not recorded by the Mini-Log). Our results suggest that PEF monitoring using ordinary peak flow meters for assessment of work-relatedness of asthma has limitations and is not reliable.
Adult↗
Nephrotic syndrome in autosomal dominant polycystic kidney disease.
Urinary protein excretion is generally less than 1 g/24 h in autosomal dominant polycystic kidney disease (ADPKD), and the association of the nephrotic syndrome with this condition is considered rare. A patient with ADPKD associated with nephrotic-range proteinuria is described. She exhibited a relatively rapid impairment of her renal function. An open renal biopsy revealed focal segmental glomerulosclerosis (FGS) with features consistent with secondary FGS. Twenty-one patients with ADPKD and nephrotic syndrome were retrieved from the literature. Fourteen of them (including this case) had a histopathologic evaluation, and FGS was the dominant diagnoses (five patients). Next in frequency were minimal-change disease and membranous nephropathy, with two patients each. Five other patients had a variety of diagnoses. Thus, it is difficult to ascertain if these associations are coincidental or represent a specific pathogenetic relationship. The evaluation of the data also suggests that the presence of proteinuria and nephrotic syndrome accelerates the course of ADPKD toward ESRD.
Aged↗
[Complicated placental chorioangioma: infrequent cause of premature labor].
We report a case of a 32 week pregnant patient who was admitted to our ward in preterm labor. After delivery, the examination of the placental tissue showed a large pedunculated tumor, complicated with torsion. Histology of the tumor revealed a placental chorioangioma. We propose that the complication of the tumor is the etiologic factor that brought about preterm labor in this patient.
Adult↗
[Association of cholesterolosis and cholelithiasis: pathogenic implications and effects of the natural history of cholelithiasis].
We studied 793 patients subjected to cholecystectomy to determine a) the relative frequency of cholesterolosis and cholelithiasis, b) the effects of their association on the natural history of biliary disease, c) the characteristics of gallstones associated to cholesterolosis and d) factors potentially associated to their pathogenesis. The gallbladders of all patients were examined and in 289 subjects a preoperative clinical history was taken. We observed that cholesterolosis is associated to earlier clinical manifestations of biliary disease and cholecystectomy, to a greater frequency of single calculus and to a higher weight/height index. It is concluded that there are relationships between the pathogenesis of cholesterolosis and cholelithiasis and that their association favors the development of clinical manifestations.
Adult↗
[Adult T-cell lymphoma and Reed-Sternberg cells. A clinical case].
Adult T-cell lymphoma (ATL) is a neoplastic disease associated in 80% of cases with HTLV-I (Human T Lymphotropic virus type I) infection. 1-2% of HTLV-I carriers may develop the disease during their lives. In our country, the prevalence of HTLV-I infection is about 1%. We report a 72 y.o. woman HTLV-I positive, confirmed by Western-Blot. presenting with massive adenopathies, cutaneous tumor involvement, acute course and showing Reed-Sternberg cells (RSCs) in lymph node biopsy. The response to chemotherapy was poor, with the patient dying seven months after diagnosis. ATL and Hodgkin's disease (HD) are discussed highlighting that RSCs are not pathognomonic of HD though in their absence such diagnosis can not be made. RSCs are found in other benign and malignant disorders and it is especially important to differentiate HD from the other processes in order to dispense the appropriate treatment. This is the first case of ATL with RSCs reported in Chile. Hence, in our country we suggest systematic determination of the presence of HTLV infection when histopathology is compatible with HD and Non Hodgkin Lymphoma.
Aged↗
Calcium channel blockers apparently decrease noradrenaline release from nerve-skin terminals in Caudiverbera caudiverbera.
1. The effects of three calcium channel blockers, verapamil, diltiazem and nifedipine were examined on the response of the skin neuroepithelial synapse of the toad Caudiverbera caudiverbera to electrical stimulation. 2. The stimulus induced a significant rise in potential difference (PD) and short-circuit current (SCC). The three calcium antagonists reduced the responses in a dose-dependent manner. The greatest reduction was induced by verapamil followed by diltiazem and nifedipine. 3. Amiloride treatment did not affect the responses to electrical stimulation, indicating that the response to nerve stimulation is not due to current flowing through sodium channels. 4. When the preparation was blocked by either of the three antagonists, the skin response to noradrenaline was not affected. 5. It may be concluded that verapamil, diltiazem or nifedipine reduce the release of noradrenaline at the neuroepithelial synapse of C. caudiverbera.
Amiloride↗
Some aspects of the monkey neurovirulence test used for the assessment of oral poliovirus vaccines.
Twelve years of experience in three control laboratories with 8,000 macaca monkeys for the testing of 204 monovalent lots of the three types of oral poliovirus vaccine (OPV), have shown that the new monkey neurovirulence test (MNVT) adopted by the World Health Organization (WHO) is a reproducible and sensitive assay likely to ensure the safety of this vaccine in humans. When the test vaccine and the appropriate homotypic reference vaccine were tested in a single group of monkeys, the concurrent use of the reference vaccine considerably increased the reproducibility of the test. The usefulness of the WHO MNVT was further demonstrated in our laboratory when the test was applied to types 1 and 3 vaccine strains that were passaged serially in the intestinal tract of infants. The test was suitable for detecting increased monkey neurovirulence in these human passage strains that did not reach the level of neurovirulence of the "wild" types 1 and 3 strains tested concurrently (except human passage no. 7 of the type 3 vaccine that multiplied for a cumulative 109 days in seven infants). The statistical analysis of the data showed that the old intrathalamic (IT) assay used for many years in our laboratory was considerably less sensitive than the intraspinal WHO MNVT; a test vaccine with a two-fold increase in monkey neurovirulence showed a 41% chance of failing in the IT test (using 30 monkeys per vaccine), while this chance increased to 99% in the WHO assay (using 12 monkeys for types 1 and 2 vaccines and 20 monkeys for type 3 vaccine). Indeed, three of seven type 3 lots tested in our laboratory with both assays failed in the WHO assay but all lots passed in the IT test. Since the introduction of the WHO MNVT in Canada and the United Kingdom, the number of vaccine-associated paralytic poliomyelitis cases in the population continued to remain at a low level.
Animals↗