[Prevalence of asthma in the city of Porto--regional differences and precipitating factors of asthma].
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Asthma↗
Biomedical subjects
L Delgado
Publications and source records attributed to L Delgado.
Phacolytic glaucoma and lens-induced uveitis.
The pathogenesis of lens-induced uveitis and phacolytic glaucoma is still not fully understood. The authors report a case of a 62-year-old white female, with bilateral lens dislocation into the vitreous, who presented clinical and pathological features of phacolytic glaucoma in the left eye. The ultrastructural study of aqueous and vitreous aspirates showed lenticular fragments and macrophages with lipofuscin granules and phagocytic vacuoles containing lens proteins. Immunocytochemistry revealed foamy macrophages immunoreactive for CD68 and HLA-DR. One year later the right eye disclosed a mild anterior granulomatous uveitis with corneal mutton-fat keratic precipitates that remained unchanged in the course of sixteen months follow-up without further treatment. These findings corroborate the possibility that, besides their mechanical and inflammatory roles in the impairment of the outflow system of the (exciting) left eye, phacolytic macrophages might also have been involved in the afferent phase of the mild chronic uveitis of the (fellow) right eye.
Aqueous Humor↗
Cutaneous T-cell recruitment in toxic epidermal necrolysis. Further evidence of CD8+ lymphocyte involvement.
BACKGROUND: Toxic epidermal necrolysis (TEN) is a life-threatening disease with severe mucocutaneous shedding. Although it is widely accepted that immune mechanisms are at play, the pathophysiology of TEN is still unknown. We studied the blister fluid inflammatory cells in three drug-related cases to further define the suspected T-cell involvement in TEN. OBSERVATIONS: A peripheral blood lymphopenia, especially of CD4+ T lymphocytes, was associated with a high lymphocytic cellularity of the blister fluid. In two cases, immunophenotyping of blister fluid lymphocytes showed a predominance of the CD8 phenotype. Furthermore, using two-color flow cytometry in one patient, we could show the predominance of CD8+ CD29+ lymphocytes and CD45RA- negative cells. CONCLUSIONS: Our findings point to a cutaneous recruitment of antigen-primed and cytotoxic T cells in TEN, further supporting the involvement of CD8+ lymphocytes in TEN pathogenesis and its immune mediation.
Adolescent↗
Severe acute form of adult dermatomyositis treated with cyclosporine.
The classical treatment of severe forms of dermatomyositis includes high doses of steroids and/or cytotoxic agents. Acute forms are frequently life threatening. Because cyclosporine is a fast-acting immunosuppressive drug, it appears to be a good candidate for the treatment of refractory forms of acute dermatomyositis. We report a dramatic improvement of a severe, acute, steroid-resistant adult form after cyclosporine administration. A rapid clinical and biochemical improvement is reported, and the reversibility of immunologic abnormalities is emphasized.
Acute Disease↗
Structure modification and biological activity of some griseofulvin derivatives.
Griseofulvin is an orally acting anti-fungal antibiotic with very limited water solubility. Five chemical modifications were made on the griseofulvin structure in order to evaluate these changes on the antifungal and water solubility properties. Antifungal activity was measured against Tricophyton mentagrophytes, T. rubrum, T. terrestre, and Microsporum canis. The oxime of griseofulvin was the most potent of the five compounds tested, but it was only of equal or less potency than griseofulvin. The somewhat increased water solubility of some of these compounds was offset by the lower anti-fungal potency of the structural modification.
Fungi↗
[Lyell's syndrome and griseofulvin].
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Adult↗
Double-blind comparison of levocabastine eye drops with sodium cromoglycate and placebo in the treatment of seasonal allergic conjunctivitis.
The efficacy and tolerance of topical administration (one drop in each eye q.i.d.) of levocabastine (0.5 mg/ml) was compared with that of sodium cromoglycate (20 mg/ml) and placebo in a 4-week double-blind trial in patients with seasonal allergic conjunctivitis. The investigator rated the treatment as globally good or excellent in significantly more patients treated with levocabastine (89%) than with cromoglycate (67%, P = 0.03) or placebo (48%, P = 0.007). The patients felt that the treatment was more efficacious in 95% (levocabastine), 35% (cromoglycate) and 36% (placebo) of the cases in which they had taken previous antiallergic medication. Total symptom severity according to the patients' diary data was consistently lower with levocabastine than with cromoglycate or placebo for all ocular symptoms. The difference was mainly apparent at the beginning of treatment. The percentage of symptom-free days was higher in the levocabastine group (53%) than in the cromoglycate (31%, P = 0.02) and the placebo group (34%, P = 0.08). Particularly at high-pollen days, levocabastine was superior to cromoglycate in eliminating moderate or severe symptoms. Adverse effects did not occur more frequently with levocabastine or cromoglycate than with placebo. It is concluded that levocabastine is an efficacious, fast-acting and well-tolerated drug in the management of seasonal allergic conjunctivitis.
Adolescent↗
Maternal haemoglobin and pregnancy outcome.
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Female↗
Influence of glucocorticoid and betamimetic therapy on milk secretory IgA concentration produced by mothers delivering preterm infants.
A prospective study was performed to find the possible difference in secretory IgA concentration in milk of mothers with term pregnancy labors and those delivering at earlier gestational ages. Since tocolytic drugs and/or glucocorticoid agents are usually given in cases of threatened premature labor, the pre-term group was divided into mothers with or without medication. Thirty two mothers were distributed in three groups: Group I, mothers with preterm labors without any medication; Group II, preterm labors with previous treatment with betamimetics and glucocorticoids; Group III, term labors (see Tab. I). In each of the three groups, three periods were studied: colostral (4 to 5 days postpartum), transitional (8 to 10 days), and mature (14 to 15 days). All mothers were healthy, with good nutritional state, without local inflammation and membranes had been ruptured 12 hours or less before labor. There was no significant difference in the proportion of primiparas and multiparas in both groups. The gestational age was evaluated by amenorrhea and neonatal examination. In all mothers milk was extracted with a vacuum pump to empty the mammary gland. The determinations were made using a specific antibody against the secretory component. The concentration of free secretory component in these milks was practically insignificant. No differences were found in the concentration of secretory IgA among the three groups (Tab. II, Fig. 1) in the periods that were studied, colostral, transitional or mature. The farther away from labor that milk extraction was made, in the periods considered in our study, there is a progressive decrease in the concentration of secretory IgA (Fig. 2).(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Is Helicobacter pylori infection associated with chronic idiopathic urticaria?
BACKGROUND: Chronic idiopathic urticaria (CIU) is one of the most frequent skin diseases, however its causes remain unknown in the vast majority of cases. There is increasing evidence for systemic effects of gastric Helicobacter pylori infection, which may result in extra gastrointestinal disorders. Although CIU can result from several causes, a possible relationship between chronic urticaria and Helicobacter pylori has been recently suggested. OBJECTIVE: The aim of this study is to determine the prevalence of Helicobacter pylori infection in a series of patients with CIU, and measure the effectiveness of eradication therapy on the skin disease. METHOD: We assess Helicobacter pylori infection by 13C urea breath test (UBT) in 21 CIU patients. Amoxicillin, clarithromycin, and omeprazole were given to infected patients for seven days. The results of therapy were assessed by urea breath test one month after therapy. Urticaria and gastrointestinal symptoms were assessed on enrolment and for six months after eradication. RESULTS: Prevalence of Helicobacter pylori infection was of 71.4 % (15/21). There were no differences concerning age (31.83 vs. 33.82 years) and duration of symptoms (38.40 vs. 35.38 months) in patients with respectively positive and negative UBT. Helicobacter pylori eradication rate was of 80 % (12/14). Three patients had clinical improvement with total resolution of urticaria starting immediately after eradication therapy, being able to completely withdrawn antihistamine and corticosteroids therapy without complaints. In relation to the rest of the patients, these three had smaller duration of urticaria disease (14.3 vs. 43.7 months; p = 0.038) and greater titters in the UBT results (42.39 vs. 25.81; p = 0.073). DISCUSSION: Although some authors found convincing evidence of the involvement of Helicobacter pylori as one possible cause of chronic urticaria, our results have failed to confirm the existence of this etiological association. The most remarkable finding was that those patients who had clinical remission of disease were the ones with greater UBT titters suggesting a role for the amount of colonization by Hp in the pathogenesis of urticaria disease.
Adult↗
[Automatic, implantible cardioverter-defibrillator in a patient with chronic Chagas cardiopathy and sustained ventricular tachycardia].
We studied a 48 years old woman, with chronic Chagasic cardiopathy, manifested with cardiomegaly, heart failure and syncope, due to a sustained ventricular tachycardia (SVT) of two different configurations (left bundle branch block and right bundle branch block). During electrophysiological testing, both types of ventricular tachycardia were reproduced. Successful ablation therapy of the right branch of His was performed due to suspicion of the bundle branch reentrant tachycardia, with a left bundle branch block. The patient continued to show SVT episodes, now with right bundle branch block pattern. Cardioverter Defibrillator was implanted. We report this case due to the rare frequency of Chagas' disease, where it could be a cause of heart disease, since the existence of the parasite (trypanosoma cruzi) and its vector (Triatoma) has been identified in some rural and suburban zones in the state of Aguascalientes, Mexico.
Chagas Cardiomyopathy↗
Circulating immune complexes in Buerger's disease. Endarteritis obliterans in young men.
Auto-antibodies such as anti-elastin, anti-collagen, anti-nuclear and anti-arterial, circulating immune complexes, and cellular responses to collagen I and III are known to be present in Buerger's disease (EO). Deposits of IgG, C3 and C4 have also been found in the vascular lesions of endarteritis obliterans (EO) in young men. The purpose of this study was to correlate clinical evidence of vascular disease with the presence of the circulating immune complexes. Thirty-three patients suffering from Buerger's disease (EO), 20 patients suffering from atherosclerosis (AT) and 20 normal controls (Norm) were studied. All were male, heavy smokers, and age-matched. Five techniques were used: direct nephelometry, nephelometry with protamine, two polyethyleneglycol precipitation methods (PegIgG and PegC4), and an immuno-enzymatic C1q fixation test (C1qE). The results seem to confirm the presence of circulating immune complexes in peripheral arterial disease in young men who are heavy smokers, particularly those suffering from EO.
Adult↗
[Stewart and Bergstrom Syndrome. Contribution of a new observation (author's transl)].
Authors report a new observation to the Stewart and Bergstrom syndrome, which to their knowledge, can be the second case in the medical literature.
Arthrogryposis↗
[Cockroach allergy: a study of its prevalence using skin tests with commercial extracts].
Cockroaches have been increasingly recognized as an important source of indoor allergens. In this study we assessed the prevalence of cockroach sensitization among an outpatient population observed at our Department (155 patients with a mean age of 29 +/- 12 years), based on skin "prick" tests with four commercial cockroach extracts along with a common battery of standardized inhalant allergens. We found a positive wheal to at least one of these four extracts in 27 patients: 26 (96.2%) to Blatta orientalis, 10 (37%) both to Blatella germanica and 1 (3.7%) exclusively to Blatella germanica, with no significant concordance between them. We also observed in patients with cockroach positive skin "prick" test an association with atopy (p < 0.001) and with cutaneous reactivity to other indoor allergens, namely house dust mites (p = 0.02), danders (p = 0.01) and fungi (p = 0.01). These data confirm the higher risk of cockroach sensitization among the atopic population sensitized to indoor allergens. However, the heterogeneity of the positive cutaneous responses obtained in this study, possibly reflecting the incomplete standardization of cockroach extracts, questions the real prevalence and clinical significance of this particular sensitization.
Adolescent↗