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Biomedical subjects

J Sotelo

Publications and source records attributed to J Sotelo.

At least 55 records · Page 3Linked to original sources
PubMed1996

Intramedullary cysticercosis cured with drug treatment. A case report.

STUDY DESIGN: A report of a patient with cervical intramedullary cysticercosis is presented. OBJECTIVES: To report the first case of intramedullary. cysticercosis cured with drug management only, which supports the hypothesis that management with anthelmintics might be successfully used in this form of cysticercosis. SUMMARY OF BACKGROUND DATA: Intramedullary cysticercosis is a rare manifestation of neurocysticercosis. Every treated patient reported to date has undergone surgery, frequently necessary for diagnosis. Since the anthelmintics praziquantel and albendazole were shown to be effective in parenchymal brain cysticercosis, these drugs have been considered potentially useful in patients with intramedullary cysticercosis. Nevertheless, no case yet had been reported to be cared with only medical therapy. METHODS: The treatment of a patient who suffered multiple cysticercal reinfestations of the nervous system is presented. RESULTS: The patient received prolonged treatment with albendazole because of superimposed cerebral reinfestations. During this treatment, she suffered acute paraparesis, and cervical magnetic resonance imaging showed cyst-like lesions with linear gadolinium enhancement and perilesional edema, indicative of dying cysticerci and inflammatory host reaction. Dexamethasone was added, and progressive neurologic improvement followed with complete resolution of intramedullary lesions. CONCLUSIONS: A preoperative diagnostic suspicion of cysticercosis is important in patients with intramedullary cystic lesions because specific drug treatment is available. Treatment with anthelmintics, particularly albendazole, should be considered in patients with intramedullary cysticercosis before surgery. Corticosteroids may be added to the therapeutic regimen because this may reduce the perilesional edema and prevent neurologic deterioration during the course of anthelmintic treatment.

Adult↗
PubMed1996

Cryptococcus neoformans var. gattii among patients with cryptococcal meningitis in Mexico. First observations.

A retrospective study of 20 patients with cryptococcal meningitis and their isolated strains was performed. Cryptococcus neoformans var. neoformans was recovered from 14 (70%) cases, and var. gattii was recovered from six (30%) patients. Twelve patients had AIDS (all carrying var. neoformans), two had other diseases (one with var. neoformans and one var. gattii) and there was no identifiable underlying disease in six (one var. neoformans and five var. gattii). Fourteen patients (11 var. neoformans and three var. gattii) resided in the Mexico City area, where a temperate climate is prevalent, and there were six cases (three var. neoformans and three var. gattii) from states with a tropical/subtropical climate. Although there was no significant statistical difference between the two varieties, the fatal outcome was higher in patients with var. neoformans. The disease caused by var. gattii strains was characterized by a higher opening pressure, more inflamatory changes of CSF and a longer clinical course (delayed clinical and mycological cure). Cryptococcus neoformans var. gattii is a significant cause of cryptococcal meningitis in patients without underlying diseases in Mexico.

AIDS-Related Opportunistic Infections↗
PubMed1996

Increase in the lumen of the femoral artery in dogs with an arteriotomy encircled by glutaraldehyde-tanned calf pericardium.

A fast and simple experimental method of arterioplasty that produces enduring enlargement of the lumen of large arteries is described. We studied the long-term intraluminal patency of femoral arteries of four dogs subjected to a procedure in which a longitudinal 3-cm loophole was made in the artery and left open inside a girdling cylinder of glutaraldehyde-tanned calf pericardium. One year later, Doppler ultrasound and histological studies were performed in the operated and contralateral arteries. Lasting enlargement of the lumen was obtained along the 3-cm arteriotomy. The mean cross-sectional internal diameter in the middle of the surgical area was 2.2 +/- 0.1 mm, in contrast to 1.2 +/- 0.2 mm in the non-operated contralateral artery (P < 0.01). The ultrasound study showed an increase in blood flow and histological analysis demonstrated a threefold increase in the internal area of the arterial lumen, and new endothelium, which fully covered the operated segment. Our results showed an enduring increase in the lumen in segments of large arteries subjected to our new arterioplasty procedure.

Angioplasty↗
PubMed1996

Immunodominant synthetic peptides of Taenia crassiceps in murine and human cysticercosis.

The screening of a cDNA library of Taenia crassiceps revealed a clone designated KETc7 that induced high levels of protection against murine cysticercosis in previous experiments. The molecular structure of the deduced 100-amino acid sequence of the corresponding proline-rich polypeptide was studied to detect potentially immunologically active epitopes. Several candidate epitopes were identified, three of which were synthesized by solid-phase peptide synthesis and used as antigens in enzyme-linked immunosorbent assay (ELISA) for detection of specific antibodies in a selected panel of sera from mice infected with Taenia crassiceps and pigs infected with Taenia solium, as well as in the serum and cerebrospinal fluid of human patients with neurocysticercosis. The three peptides detected antibodies in serum from all infected mice. Seven of nine sera from patients with neurocysticercosis reacted strongly with peptide GK-3, and four of them with peptides GK-1 and GK-2. A lower reactivity was observed in sera from experimentally infected pigs. Peptide GK-3 reacted also with 45 out of 77 cerebrospinal fluids (CSF) from patients with confirmed neurocysticercosis and with 14 out of 68 CSF from control patients with other neurological disorders. This is the first report on synthetic peptides that are prominent in the humoral response of murine, porcine and human cysticercosis. Their identification implies finer molecular tools in the exploration of this form of host-parasite relationship, as well as hints to their application in immunodiagnosis and in vaccine design.

Amino Acid Sequence↗
PubMed1996

Could an aminoacridine interfere with the cellular mechanisms involved in the process of human immunodeficiency virus infection?

Immune activation and synthesis of nucleic acids participate in the course of infection by human immunodeficiency virus. Aminoacridines, formally used as antiparasitic drugs, but almost abandoned nowadays for therapeutic use, are strong deoxyribonucleic acid chemoprotectors and lysosome stabilizers. Theoretically, these actions within the cell and other peculiar pharmacological characteristics of aminoacridines, particularly quinacrine, could pose barriers to human immunodeficiency virus infection and replication.

Aminacrine↗
PubMed1996

Chronic malnutrition caused by a corn-based diet lowers the threshold for pentylenetetrazol-induced seizures in rats.

The incidence of epilepsy is high in developing countries where malnutrition is prevalent. Although malnutrition is not a direct cause of seizures, chronic malnutrition may predispose the brain to seizures. In large undernourished human groups from Latin America, the most common sources of food are corn and corn derivatives. We used a rat model of chronic malnutrition, in which corn tortillas were the only solid food intake, to study the possible influence of malnutrition at late stages of brain development on the dynamics of experimental seizures induced by pentylenetetrazole (PTZ). The threshold and does of PTZ required to produce seizures were greatly reduced in malnourished rats. The model of malnutrition used in the study imitates a form of malnutrition common among large numbers of humans. Our results suggest that chronic malnutrition early in life induces changes that lower the seizure threshold and leave the brain more susceptible to seizures. Whether this observation relates to the high incidence of epilepsy in underdeveloped countries remains to be determined.

Animals↗
PubMed1996

Effects of pentoxifylline or dexamethasone in combination with amphotericin B in experimental murine cerebral cryptococcosis: evidence of neuroexcitatory pathogenic mechanisms.

In a murine model of intracerebral infection by Cryptococcus neoformans the therapeutic effects of pentoxifylline or dexamethasone were studied alone and in combination with amphotericin B. Assessed parameters were mean survival time, brain histopathology index, amounts of glutamate and gamma-aminobutyric acid in the brain, and yeast CFU per brain. Survival increased significantly in mice treated with dexamethasone, amphotericin B, amphotericin B plus dexamethasone, and amphotericin B plus pentoxifylline; the latter had significantly longer survival than other treated groups. Indices of histopathological damage were similar in all treated groups. In infected untreated mice, the amounts of glutamate in the brain were decreased, presumably by depletion. In mice treated with amphotericin B plus dexamethasone, glutamate levels returned to the range of control mice. No differences in the amounts of gamma-aminobutyric acid were found between control and treatment groups. Brain fungal counts were significantly lower in mice treated with amphotericin B, amphotericin B plus dexamethasone, and amphotericin B plus pentoxifylline than in untreated animals. In this model, pentoxifylline in combination with amphotericin B improved survival, decreasing the fungal burden, and has potential as adjuvant therapy in cerebral cryptococcosis.

Amphotericin B↗
PubMed1996

Effects of prednisone on ventriculoperitoneal shunt function in hydrocephalus secondary to cysticercosis: a preliminary study.

In a prospective open study, 15 patients with hydrocephalus secondary to cysticercosis who required insertion of a ventriculoperitoneal (VP) shunt were treated with 50 mg of prednisone given orally three times a week. Treatment began in the 1st postoperative week, with isoniazid and pyridoxine administered daily as antituberculous chemoprophylaxis. The drug regimen was continued with close follow up for 24 months. Clinical status, Karnofsky performance status (KPS) scores, and postoperative course in the prednisone-treated group were compared with 30 control patients with hydrocephalus due to cysticercosis. The control patients were matched by age and sex, underwent surgical shunting in the same period, and were followed routinely by the neurosurgery staff. Lumbar cerebrospinal fluid (CSF) was studied in 2, 16, and 32 weeks postoperatively in the prednisone group. At 24-month follow up two (13%) of 15 patients in the prednisone group and 19 (60%) of 30 patients in the control group required surgical shunt revisions for symptomatic shunt obstruction (p=0.002). Follow-up studies of CSF performed at 32 weeks in the prednisone group revealed improvement of abnormal values with statistically significant differences for glucose (p<0.02). Serial imaging studies in the prednisone group revealed persistence of cysticercal cysts with no change in size. Mean initial KPS scores were similar in both groups. At the end of the follow-up period, the mean KPS score was significantly higher in the prednisone group (p=0.003). Prednisone and chemoprophylactic drugs were well tolerated. These results suggest that in selected patients with hydrocephalus secondary to cysticercosis, intermittent long-term prednisone therapy after VP shunting may reduce shunt malfunction and improve the functional status of the patients.

Adolescent↗
PubMed1996

Colchicine decreases the infection by Toxoplasma gondii in cultured glial cells.

Addition of colchicine (2.5 x 10(-8)-1.25 x 10(-6) M) to cultures of glial cells infected with Toxoplasma gondii decreased the number of parasites up to 80% (P < 0.05) in comparison with controls. Our results indicate that colchicine could interfere with the infectious, or replicative mechanisms, or both, of Toxoplasma and place it as a candidate in the search for additional antitoxoplasmic therapy for those cases where the parasitic load is massive. Further studies in vivo must be made to confirm this finding and provide support for therapeutic trials.

Animals↗
PubMed1996

Cysticercosis.

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Animals↗
PubMed1996

Humoral and cellular immune response within the subarachnoid space of patients with neurocysticercosis.

To study the immune response within the subarachnoid space in patients with neurocysticercosis, we measured the cerebrospinal fluid contents of immunoglobulins A, E, G, and M in 38 patients and the contents of the proinflammatory cytokines TNF-alpha, IL-1b, IL-6 and IFN-gamma in 17 patients. The same measurements were made in 30 neurological patients without inflammatory or immune-mediated disorders. Each immunoglobulin and cytokine, including the gender and age of the patient, was compared by multiple regression analysis with the CSF contents of cells, protein and ELISA for cysticercal antigens. A direct correlation was found of IgM with cell content (p < 0.058) and with ELISA values (p < 0.027); of age with protein content (p < 0.006); of IL-6 with protein content (p < 0.018) and of IL-1b with ELISA values (p < 0.004). An inverse correlation was found of glucose with ELISA values (p < 0.008). A complex function of the immune response within the subarachnoid space was observed: mean values of IgG, IgM, IgE and interleukins 1b and 6 were increased, whereas values of IgA, TNF-alpha and IFN-gamma were similar to those of controls.

Antigens, Helminth↗