Podoconiosis or endemic non-filarial elephantiasis is produced by deposits of inorganic materials in the lymph node of the lower extremities. The presence of elephantiasis in São Tomé Island and its prevalence in two districts are documented. Epidemiological aspects of the disease as well as clinical and pathological data of some of the cases are illustrated. With all these data and the physical characteristics of the island we suggest that elephantiasis in São Tomé is of geological obstructive origin: podoconiosis. The importance of non-medical measures to eradicate this disease are underlined.

Adolescent↗

PubMed1994

Spatial control of neuronal cell attachment and differentiation on covalently patterned laminin oligopeptide substrates.

The spatial control of neuronal cell attachment and differentiation via specific receptor mediated interactions, may provide an effective means for the in vitro reconstruction of neuronal cell architecture. In this study, receptor-specific oligopeptide sequences derived from the extracellular matrix (ECM) molecule laminin, a potent neural cell attachment and differentiation promoter were covalently bound on fluorinated ethylene propylene (FEP) films. The degree of receptor-specific cell attachment and the ability to spatially control neurite outgrowth by covalently patterning the oligopeptide sequences on the FEP film surface were assessed. FEP films were first chemically activated with a Radio Frequency Glow Discharge (RFGD) process that covalently replaces the surface fluorine atoms with reactive hydroxyl groups. Oligopeptides containing the YIGSR sequence from the B1 chain of laminin and the water soluble oligopeptide containing the IKVAV sequence (CSRARKQAASIKVAVSADR) from the A chain were covalently bound to the hydroxylated FEP films. Electron Spectroscopy for Chemical Analysis (ESCA) verified the covalent attachment of the oligopeptides to the material surface. The degree of receptor mediated NG108-15 cell attachment on immobilized CDPGYIGSR films was determined using competitive binding media. A 78% reduction in cell attachment was observed on films containing CDPGYIGSR in the cell plating medium. Only a 23% reduction in cell attachment was noted on films plated in medium containing a mock CDPGYIGSK sequence. FEP films immobilized with the IKVAV oligopeptide sequence were shown to mediate PC12 cell attachment and a competitive binding medium also significantly attenuated cell attachment on the immobilized films. The spatial patterning of these oligopeptide sequences to the FEP surface was shown to localize cell attachment and neurite extension on the patterned pathways. The surrounding unmodified FEP surface was inhibitory in serum containing medium and prevented cellular interactions outside the oligopeptide modifications. The spatial immobilization of laminin oligopeptides on FEP films provides a means to organize the attachment and differentiation of neuronal cells in a receptor-specific manner.

Animals↗

PubMed1994

A case of conversion from MT-2-positive to MT-2-negative phenotype.

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CD4 Lymphocyte Count↗

PubMed1994

[Imported acute hepatitis in Spanish travelers to tropical countries].

Among the immunizable diseases, viral hepatitis is the most frequently diagnosed in travellers. The epidemiology and the clinical presentation of the imported viral hepatitis among patients in the Tropical Medicine Unit of Hospital Clínic (Barcelona) are studied in this article. A retrospective review of 47 viral hepatitis in Spanish travellers seen during the period 1988-1991 is presented, representing 2.47% of all diagnosis. Only a third of the patients were hepatitis A cases. The duration of the trip was significantly shorter in those who acquired hepatitis of the A and non-A--non-B types. Africa (60% cases), India and South East Asia (17%) and Central America (16%) were considered areas of risk. The B, C and non-A--non-B hepatitis types had a more silent clinical and biological presentation. Gathered data confirm the importance of hepatitis as an imported disease, the partial protection of the Spanish population against hepatitis A and the need to introduce this infection among the advice to be given in a travellers clinic.

Acute Disease↗

PubMed1993

Effects of dothiepin on nociceptive flexion reflex and diffuse noxious inhibitory controls in humans.

The analgesic activity of dothiepin (an antidepressant interacting with serotonin receptors) was studied (double-blind) in humans. A significant increase in nociceptive flexion reflex threshold and subjective pain threshold was observed after a 14-day dothiepin treatment. The effects of dothiepin on diffuse noxious inhibitory controls were also investigated using the cold-pressor test as conditioning stimuli. After dothiepin a reduced inhibition of nociceptive flexion reflex during the cold-pressor test and a significant facilitation immediately after the cold-pressor test were observed, while the subjective pain perception was normally inhibited. Our data suggest a serotonergic modulation of diffuse noxious inhibitory controls in humans.

Adolescent↗

PubMed1993

[Epidemiology of traveler's diarrhea in Spanish tourists travelling in developing countries].

BACKGROUND: Travellers' diarrhea (TD) is the most frequent problem in travellers going to the developing countries. This paper analyses the prevalence of the syndrome by geographical areas as well as the risk factors in 2209 Spanish travellers to 3 continents. METHODS: Epidemiological data were gathered through a personnel interview filled by the travellers during their return trip. Those were introduce in a DbaseIII plus computer program and were evaluated through the Epi Info program. RESULTS: The overall prevalence of TD found was 41%. The Indian subcontinent, the Middle East and Moghreb countries showed a higher prevalence of TD. Trekkers and people on boat cruises (Nile and Amazon) had the highest prevalence of TD. The consumption of non-carbonic drinks and ice creams was significantly associated to TD. Travellers with previous gastrointestinal illnesses suffered more TD than others. CONCLUSIONS: Despite the fact that Spain in considered an area of intermediate risk for TD we found no significant differences in the prevalence of TD in Spanish travellers when compared with other published series from developed countries.

Adolescent↗

PubMed1993

Etiology of traveller's diarrhea in Spanish travellers to developing countries.

A cohort of 337 Spanish travellers to developing countries is presented. They all consulted us for traveller's diarrhea (TD). Bacteriological, parasitological and virological examinations were performed. A bacterial cause was found in 61.65% of travellers. Toxigenic and classical pathogenic Escherichia coli strains were the main bacterial agents. In comparison with other studies, Spanish travellers harboured Y. enterocolitica and EPEC organisms as a cause of TD. G. lamblia and E. histolytica were the most frequently isolated protozoa. Helminths were found in only 9 patients. No rotavirus infections were diagnosed. Previous antibiotic treatment had been taken by 161 patients. The percentage of isolated enteropathogens was similar in travellers who had previously taken antibiotic treatment and those who had not.

Adolescent↗

PubMed1993

The trigemino-pupillary response in cluster headache.

Central impairment of the integrative neural systems controlling vegetative function and pain perception has been demonstrated in cluster headache (CH). Recently, we described the human pupillary response (trigeminal reflex) to quantified (painless and painful) corneal stimulation with a combined neurophysiological and pharmacological technique. In this study, the trigeminal reflex was evaluated in 26 subjects with episodic cluster headache. During the active phase of the disease, on the side of the pain we observed reduced mydriasis to electrical stimuli with an intensity equal to the corneal reflex threshold, and on both sides to stimuli with intensity that equalled the pain threshold. No difference was found when amplitude of the miotic phase was compared in the different groups. These suggest disordered pupillary activation in response to pain, probably sympathetic in origin, which is bilateral, detectable also during the remission phase and which cannot be explained simply by the antidromic release of pain-related peptides.

Adult↗

PubMed1993

Molecular epidemiology and Legionnaire's disease.

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Aged↗

PubMed1993

Typhoid fever in rural Haiti.

A review was made of the clinical characteristics and evolution of all patients over 14 years old with typhoid fever who were treated at the Albert Schweitzer Hospital in Haiti from January 1989 through July 1991. Two hundred and seventeen patients were studied. Their most common symptoms were fever (100%), diarrhea (64.1%), and abdominal pain (51.2%). Splenomegaly and hepatomegaly were rarely noted. Sixty-eight patients (31.3%) were lost to follow-up, 129 (59.4%) were cured, and 20 (9.2%) died. There was a tendency for patients who were ill longer before seeking medical assistance to experience higher mortality. The data also indicate that patients with central nervous system involvement had a less favorable prognosis than other patients. Overall, the high incidence of hospital-reported cases (74 cases per 100,000 inhabitants) shown by these and other data makes it clear that typhoid fever is a highly prevalent infection in rural Haiti. At present, it appears that the only hope for effectively controlling the disease is by educating the population at risk, not only to prevent the disease but also to seek early medical assistance after becoming infected. Typhoid fever patients with a long history of illness before consultation may have a less favorable prognosis than other patients and should be kept under close observation. In addition, any suspected typhoid fever patient with signs of central nervous system involvement should be treated promptly with high-dose steroids, besides receiving an adequate antibiotic regimen.

Adolescent↗

PubMed1993

[Usefulness of the API ZYM system for the identification of Legionella sp].

BACKGROUND: The identification of Legionella genus is usually difficult, time consuming, and expensive. We decided to study the usefulness of API-ZYM system (Biomerieux) for Legionella species identification. METHODS: A total of 96 strains (82 from Legionella genus and 14 from other bacterial genus) were included. We studied 19 different enzyme activities and we proceed following the manufacturers directions, with an incubation time for galleries of 4 hours at 37 degrees C. RESULTS: Seventeen out of the 19 enzyme activities were uniformly positive or negative for Legionella sp. Thus, the sensitivity of these activities was 100% in identifying Legionella sp. Valine and cystine-arylamidase gave variable reactions for Legionella sp. strains. When the results of these enzyme test were compared to those of the control strains (Haemophilus influenzae, Pseudomonas aeruginosa) we observed that alkaline phosphatase, esterase, esterase-lipase, acid phosphatase and naphthol-AS-BI-phosphohydrolase in one side and esterase, esterase-lipase and leucin-arylamidase in the other side were able to differentiate Legionella sp. strains from P. aeruginosa and H. influenzae, respectively. CONCLUSION: API SYM system is a simple, accurate and reproducible method for the identification of Legionella sp.

Bacterial Proteins↗

PubMed1992

[Cutaneous larva migrans in travelers].

Fifteen cases of cutaneous larva migrans (CLM) diagnosed in transcontinental travellers over a period of 4 years in the Department of Tropical Medicine in Hospital Clinic i Provincial of Barcelona were reviewed. The frequency of this disease as an imported pathology is on the increase and is related to the greater mobility of travellers today. Tourism is the main motive of the traveller and the geographic origin of the cases is cosmopolitan. The use of open footwear in 14 of the 15 patients is pointed out. The single lesion on the foot was the most frequent site. Thiabendazole was effective in 14 patients as was albendazole used in one patient. The secondary effects of thiabendazole, principally gastrointestinal disorders, headache, and dizziness are underlined.

Adolescent↗

PubMed1992

Multimodal evoked potentials in myotonic dystrophy (MyD).

By means of multimodal evoked potentials (EPs), we evaluated the central nervous system (CNS) involvement in 25 subjects suffering from myotonic dystrophy: brainstem auditory evoked potentials (BAEPs), middle-latency auditory evoked potentials (MLAEPs) and somatosensory evoked potentials (SEPs) from the upper limb were performed on all subjects, whereas only the 19 patients, whose clinical ocular abnormalities were slight, underwent pattern-electretinograms (PERGs) and pattern visual-evoked potentials (VEPs) in order to identify the site of lesion among visual pathways (retinal and/or retroretinal). PERGs were abnormal in 8/19 subjects, VEPs in 8/19 subjects (the two techniques were simultaneously abnormal in 8 eyes), BAEPs in 7/25 subjects, MLAEPs in 4/25 subjects (in one subject both BAEps and MLAEPs were abnormal) and SEPs were abnormal in 1/25 subjects. 13/25 of our subjects showed at least one EP that revealed a CNS involvement. The electrophysiological alterations were not correlated either with subject age or with disease duration. Multimodal EPs enabled us to demonstrate that CNS involvement in myotonic dystrophy is important and mainly affects the visual and auditory system.

Adult↗

PubMed1992

Schistosomiasis and the Dogon country (Mali)

A previously unknown area of schistosomiasis transmission is reported based on findings from a travelers' clinic in Barcelona. Three species of Schistosoma (S. haematobium, S. mansoni, and S. intercalatum) were diagnosed in a cluster of 43 patients who had been swimming in the Bandiagara and Bankas districts of Mali, where the Dogon people live. Three villages in the Bankas district appear to harbor these three species. The transmission potential of such a focus in this area is outlined. The travelers involved had little or no information on the risks of contracting schistosomiasis in that area. Obtaining a traveler's history, including accurate geographic data, is shown to be a crucial asset for improving epidemiologic research.

Adult↗