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Biomedical subjects

L Trujillo

Publications and source records attributed to L Trujillo.

11 recordsLinked to original sources

Sexual practices and prevalence of HIV, HTLV-I/II, and Treponema pallidum among clandestine female sex workers in Lima, Peru.

BACKGROUND AND OBJECTIVES: A survey was conducted to determine the sexual behavior practices and prevalence of HIV-1, HTLV-I/II, and T. pallidum infections among unlicensed female sex workers (FSWs) in Lima, Peru. GOAL OF THIS STUDY: To assess the role of unlicensed FSWs as a potential source of retroviral and T. pallidum infection. STUDY DESIGN: Female sex workers from 15 brothels were enrolled. Sera samples were obtained and tested for antibodies to HIV-1, HTLV-I, and Treponema pallidum. RESULTS: Of 158 FSWs studied, all were negative for HIV-1, 6 were positive for HTLV-I, and 5 were positive for Treponema pallidum. Of their male clients, 75% used condoms, whereas only 3% reported condom use with their steady partners. When condoms were always used by clients, the history of a sexually transmitted disease was significantly reduced (p < 0.01), and the prevalence of HTLV-I (p < 0.05) and syphilis was lower among these workers. CONCLUSION: Data suggested that the low rate of sexually transmitted diseases among FSWs reflected the high rate of condom use by their male clients.

Adult

Prevention of conductive hearing loss in cleft palate patients.

One of the most common complications of cleft palate patients is the high frequency of otitis media episodes that they present, due to eustachian tube dysfunction. This is not only a problem for the otolaryngologist who must handle these patients, but just as well for the phoniatrician, who must evaluate and rehabilitate the speech and language disorders which can be enhanced by conductive hearing loss. Thus, we designed an isometric exercise to achieve an artificial drainage of the secretions produced in the middle ear, by means of opening the lumen of the eustachian tube, which, when done frequently enough, proved to be an excellent way to prevent secretions from remaining long enough in the middle ear cavity so as to have a secondary infection, that would lead to otitis media and subsequent conductive hearing loss. Isometric exercise also develops the muscles of each hemi-uvula.

Audiometry

[Chest pain of esophageal origin in patients with a normal coronary angiogram and ergonovine-induced coronary spasm].

In order to differentiate the cardiac or oesophageal origin of chest pain, 55 patients with chest pain, normal coronary arteriogram and normal left ventricular function, were studied. Patients were evaluated with ergonovine test to induce coronary artery spasm and oesophageal function study (including basal manometry in all cases, ClH acid instillation in 53, manometry during ClH instillation in 32 and edrophonium test in 9). There was coronary artery spasm following ergonovine test in 8 patients (group 1) and negative results in 47 (group 2). There was oesophageal disfunction in 50% patients in group 1 and in 62% patients in group 2 (p = NS). The incidence of motor disorders or chest pain following acid instillation was not significatively different in both groups. Nevertheless, in group 1 a tendency to a greater incidence of oesophageal spasm was observed while in group 2 unspecified disorders were more frequent. Thus, in patients with chest pain and normal coronary arteriogram, we always must discard coronary artery spasm and oesophageal disfunction, because, due to a probably common cause, association between both disorders is frequent.

Adult

Intrauterine diagnosis and treatment of fetal goitrous hypothyroidism.

Newborn screening programs for the detection of congenital hypothyroidism have dramatically shortened the time before treatment is begun. However, concern still exists about central nervous system sequelae which may persist due to a period of untreated intrauterine hypothyroidism. Presence of polyhydramnios led to the ultrasound diagnosis of a fetal goiter. Hypothyroidism was confirmed at 34 weeks gestation by percutaneous fetal blood sampling, which revealed an elevated TSH (186 mU/L) and a low T4 (19.3 nmol/L). Intraamniotic fluid injections of 500 micrograms levothyroxine sodium (T4) every 10-14 days increased fetal serum T4 (59.2 nmol/L), decreased fetal serum TSH (14 mU/L), decreased amniotic fluid TSH, and decreased the size of the fetal goiter. The infant was born at term without perinatal complications. Thyroid function studies on cord blood were normal (T4, 109.4 nmol/L; TSH, 1.3 mU/L), and the infant was discharged on oral T4. Follow-up examination at age 6 weeks revealed that the infant was developmentally normal and clinically and chemically euthyroid. Intrauterine T4 therapy can suppress fetal TSH and treat fetal hypothyroidism despite hypothyroid levels of serum T3. Highly sensitive TSH assays may allow the use of amniotic fluid TSH as a marker for fetal hypothyroidism.

Adult

[Thoracic pain of esophageal origin].

A group of 53 with angina pectoris-like chest pain and normal coronary arteriography was studied. Nine of these patients had a positive ergonovine test and were diagnosed as coronary spasm or vasospastic angina. In four of these nine patients there was evidence of an accessory esophageal disease responsible for the chest pain. In 44 patients organic or functional ischemic heart disease was excluded. The possible esophageal origin of the pain was studied by means of esophageal manometry and acid and endofonium provocation. The final results were that 15 patients had pain of an esophageal origin and 13 had an esophageal disease that made the esophagus a likely, or at least possible, source of pain.

Adult