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Biomedical subjects

I Santos

Publications and source records attributed to I Santos.

At least 55 records · Page 3Linked to original sources

Calcium acetate versus calcium carbonate as phosphate binders in hemodialysis patients.

We conducted a randomized unblinded parallel clinical trial to compare the effectiveness, side effects and tolerance between calcium acetate (CA) and calcium carbonate (CC) in 80 stable chronic hemodialysis patients selected on the basis of their acceptable control of serum phosphorus (P) levels with aluminum hydroxide (AH). All patients were dialyzed against the same calcium dialyzate (1.62 mmol/l). The serum analytical tests included: calcium corrected to total protein, P, PTH (intact molecule) and bicarbonate. The study was divided into the following periods: P0: baseline measurements; P1: washout (withdrawal of AH for 15 days); P2: random allocation to CA and CC treatment at doses equivalent to 75 mEq of elemental calcium, stratified according to previous doses of AH (2 months); P3: adjustment of doses until control P (2 months). CA was poorly tolerated in 7 patients and CC in 2 (NS). The changes in serum P levels between P0 and P2 periods were lower in the CA group (1.73 +/- 0.25 vs. 1.80 +/- 0.50 mmol/l; p = 0.26) than in the CC group (1.77 +/- 0.35 vs. 1.93 +/- 0.48 mmol/l; p = 0.03, paired t test). Serum calcium was hardly modified by CA (2.42 +/- 0.20 vs. 2.47 +/- 0.17 mmol/l; NS) while in the CC group, it rose significantly (2.40 +/- 0.12 vs. 2.55 +/- 0.22 mmol/l; p = 0.0004). There were no differences in the control of PTH or bicarbonate.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetates↗

Lymphadenopathy associated with Leishmania braziliensis cutaneous infection.

Lymph node involvement by Leishmania during human cutaneous leishmaniasis was reported more than 90 years ago, but the importance of certain Leishmania strains in such dissemination remains largely speculative. We have examined 36 consecutively untreated cutaneous leishmaniasis patients early in their disease; 66.7% had enlarged lymph nodes. Patients with enlarged lymph nodes had higher anti-Leishmania immune responses than patients without such involvement, both at the IgG antibody level (mean +/- SD optical density at 492 nm = 0.163 +/- 0.089 versus 0.098 +/- 0.086; P = 0.009) and in skin test responses (12.4 +/- 10.2 mm versus 5.7 +/- 7.3; P = 0.03). Thirteen (62%) of 21 lymph node cultures and 16 (53%) of 30 cultures from cutaneous sites were positive for Leishmania. Eleven of 13 isolates from lymph nodes were characterized by a panel of monoclonal antibodies, and all were typed as L. braziliensis. Our findings stress the importance of L. braziliensis as an agent involved in the early invasion of the lymphatic system.

Adolescent↗

Increased frequency of HLA-DR3 in Mexican mestizo pediatric patients with amebic liver abscess (ALA).

Mexican mestizo pediatric patients with ALA revealed a significantly increased frequency of HLA-DR3 alone, or in its haplotype form HLA-A2, DR3, which confirms our previous observation in adult patients with ALA in the same ethnic group. However, the relative increase in these HLA specificities in pediatric ALA patients when compared to adult patients was not statistically significant, and calls for an enlargement of the population studied.

Adolescent↗

Fiberoptic bronchoscopic diagnosis of pulmonary disease in 151 HIV-infected patients with pneumonitis.

In a prospective study the efficacy of fiberoptic bronchoscopy was evaluated in the diagnosis of infections with opportunistic pathogens, Kaposi's sarcoma and nonspecific interstitial pneumonitis in 171 episodes of pneumonitis in 151 HIV-infected patients. Samples were collected by suction through the inner aspiration channel of the bronchoscope (n = 164), telescoping plugged catheter (n = 117) and transbronchial lung biopsy (n = 82). A high incidence of infections with pyogenic bacteria (12%), Legionella spp. (5 %) and Mycobacterium tuberculosis were diagnosed (9%). Bronchoalveolar lavage demonstrated a high diagnostic rate in bacterial pneumonia (significance level greater than 10(5) cfu/ml) and a low degree (10%) of contamination (less than 1% squamous epithelial cells). Bronchoalveolar lavage was more effective than the telescoping plugged catheter in yielding a significant number of colonies in patients with bacterial pneumonia previously treated with antibiotics. Nondiagnosed pneumonitis was more frequent in intravenous drug abusers than in homosexual men (p less than 0.001).

Adult↗

[Anomalous origin of the right coronary artery from the left sinus of Valsalva. Apropos of 2 cases].

Anomalous origin of right coronary artery from the left sinus of Valsalva is a uncommon congenital anomaly which is difficult to demonstrate angiographically. For many years pathologists classified it as a minor anomaly of no clinical significance. It has only recently been associated with significant manifestations of myocardial ischemia. These manifestations have included acute myocardial infarction, angina pectoris, syncope, ventricular tachycardia and fibrillation, and sudden death. Two patients with this anomaly are reported. One patient had angina pectoris in the absence of significant atheromatous coronary lesions. In the second patient the aberrant origin of the right coronary artery was associated to aortic valve disease. The possible physiopathology mechanisms responsible for manifestations of myocardial ischemia in patients with this anomaly are analyzed.

Angina Pectoris↗

[Diabetes mellitus induced by pentamidine, without previous episodes of hypoglycemia, in patients with AIDS].

The onset of a pneumonia by P. carinii in AIDS patients have force scientist to look for others therapies against this parasite. It is more necessary when the first line treatment which is cotrimoxazol produced secondary effects or not therapeutic effects. Pentamidine which is an agent usually used to treat leishmaniasis and trypanosomiasis, but it is an alternative for P. carinii infection. The problems are the frequent and severe secondary effects when administered by continuous infusions and less when it is inhaled. Between those effects are the changes in carbohydrate metabolism which are 9% of them. It is frequent observe hypoglycemia during infusion following by hyperglycemia in 5% of the cases which convert the patients in diabetic insulinodependent. A case of a patient who developed diabetes mellitus insulinodependent, 10 days after the end of pentamidine treatment, without previous episodes of hypoglycemia, is presented. The medical literature is reviewed.

Acquired Immunodeficiency Syndrome↗

[Changes in the cerebrospinal fluid in patients with HIV infection].

Spinal fluid from 53 HIV infected patients has been reviewed. A diagnosis was made exclusively from the spinal fluid exam in 15 cases while in 15 others it contributed to diagnosis together with other exams. The exam did not contribute any positive data in 23 cases. AIDS diagnosis was obtained in 11 patients by the spinal fluid exam. The most frequently occurring disease was infectious meningitis (10 cases) being 3 of them HIV aseptic meningitis. In our experience, a spinal fluid exam in HIV infected patients and fever of unknown origin did contribute useful data for the diagnosis of AIDS in a large number of cases.

Acquired Immunodeficiency Syndrome↗

Serum CK-BB as a tumor marker in patients with carcinoma confirmed histologically.

We determined serum CK-BB mass concentration using a specific RIA method, in 267 patients with carcinoma confirmed histologically distributed as follows: 46 prostatic adenocarcinoma, 52 lung neoplasies, 70 colon carcinoma, 52 breast carcinoma and 41 gastric carcinoma; and also in 135 patients with histologically proved non-neoplastic diseases distributed as follows: 28 prostatic hyperplasy, 31 lung tuberculosis, 29 inflammatory bowel disease, 27 fibrocystic mastopathy and 20 gastroduodenal ulcer. Reference values in healthy subjects (n = 360) were 5.46 +/- 2.68 (SD) ng/ml. We found that serum CK-BB mass concentration is not a specific tumor marker but it is a valuable indicator of responsing to therapy and metastatic widespread. However, in prostatic carcinoma--prevalence 0.25, predictive positive value (PPV) 0.51 and predictive negative value (PNV) 0.88--and breast carcinoma--prevalence 0.32, PPV 0.60 and PNV 0.87--serum CK-BB can be used as a tumor marker. Only 12 over 268 patients with different neoplastic disease (4.47%) showed detectable serum CK-BB catalytic concentrations.

Adult↗

[Tuberculosis in patients with HIV infection].

28 cases of tuberculosis in patients infected with HIV, 22 of them having AIDS criteria (CDC 87), are presented. Tuberculosis was the first diagnosis criteria in 34% of the cases 68% were I.V.U., 25% homosexuals and 7% heterosexual. Half of the patients had disseminated tuberculosis and the other half had localised disease with a high frequency of pulmonary setting. The most frequent symptoms were fever and constitutional syndrome (92% and 91%). The patient's chest X-rays showed few cavitations and infiltrates and frequently had mediastinal and/or hilar (22%) lymphatic gland enlargement. The study of lymphocyte populations showed levels of CD4 lower than 400 in 79% of the cases. The response to treatment was favorable in 16 patients and only 3 died of tuberculosis.

Acquired Immunodeficiency Syndrome↗

Arylsulfatase A in urine of patients with urothelial tumors.

A significant increase in urine arylsulfatase A activity (p less than 0.01) was found in patients with urothelial tumors. Arylsulfatase A activity was 1.36 +/- 1.10 U/24-h urine in control specimens, 1.90 +/- 1.66 U/24-h urine in various genitourinary tract disorders, and 3.90 +/- 1.98 U/24-h urine in transitional cell carcinoma specimens. Surgical treatment of the neoplastic patients lowered the arylsulfatase A activity found in urine to within reference values. The arylsulfatase A excreted by patients with these tumors was highly sensitive to thermal inactivation while the enzyme activity in the control urines was less affected by the heat treatment. The time course of the arylsulfatase A reaction with 4-nitrocatechol sulfate was not linear in normal individuals, while it was linear in 90% of patients with urothelial tumors. This difference in the kinetic pattern of the enzyme could be used to increase the diagnostic specificity of the determination.

Adult↗

Activities of creatine kinase and its isoenzymes in serum in various skeletal muscle disorders.

We studied possible correlations between anatomopathological and clinical features and the values for total creatine kinase (CK; EC 2.7.3.2) and its isoenzymes, including the proportion of CK-MB, in a population displaying several neuromuscular pathologies. Although we observed no specific isoenzyme pattern associated with the different myopathies, we found isoenzyme analysis useful in studying the histopathological evolution of illness. We also considered whether the pathology was regenerative or nonregenerative, and what type of fiber (I or II) was involved. High CK-MB percentages (greater than 6%) were associated with regenerative and type I fiber myopathies, with regenerative type tissues being the principal factor associated with an increasing proportion of CK-MB. Studying the changes in CK-MB percentage in serum appears to be useful in discriminating neuromuscular from myocardial pathologies.

Adolescent↗

Catalytic concentrations of amylase isoenzymes: an assay with wheat-germ inhibitor and 4-nitrophenylmaltopentaoside plus 4-nitrophenylmaltohexaoside as substrate.

We coupled a kinetic procedure to a selective inhibiting method for determining amylase isoenzymes in biological samples, using 4-nitrophenylmaltopentaoside plus 4-nitrophenylmaltohexaoside as substrate and a wheat-germ selective inhibitor with the Gilford S-III spectrophotometer. On plotting remaining amylase activities/total amylase activities (R/T) vs pancreatic amylase activities/salivary amylase activities (P/S) ratios, we found the curve to be linear for P/S ratios from 0.2 to 5. The inhibition rate of amylase inhibitor was constant in solutions having total amylase activities between 20 and (at least) 900 U/L. CVs were 3.1 to 7.1% for pancreatic amylase and 2.0 to 12.9% for salivary amylase in serum. Correlation with the Phadebas method was excellent (r = 0.99) for both pancreatic and salivary amylase. We also automated this procedure in an Hitachi 705 analyzer and correlated the results (r = 0.99) with those by our manual method.

Amylases↗