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Biomedical subjects

M Alvarez

Publications and source records attributed to M Alvarez.

At least 199 records · Page 11Linked to original sources

[Cervical polyadenopathy due to Kikuchi and Fujimoto disease].

Kikuchi and Fujimoto disease is a benign subacute necrotizing lymphadenitis, probably associated to a viral infection, that affects mostly young Asian women. We report a 19 years old women, with a vast familiar history of thyroid disease (three uncles with papillary thyroid carcinoma and one with a Hashimoto thyroiditis). After an upper respiratory infection, she presented with painless cervical adenopathies. Cervical ultrasound examination detected an 8 mm thyroidal nodule. She was operated with the diagnosis of thyroidal cancer. The pathological examination confirmed that the nodule was a papillary thyroidal cancer, but the study of the resected lymph nodes, revealed a Kikuchi and Fujimoto disease.

Adult↗

[Intrasphincteric injection of botulinum toxin in patients with esophageal achalasia].

BACKGROUND: Intrasphincteric injection of botulinum toxin (BoTx) has demonstrated to be effective in the short-term treatment of achalasia. AIM: To assess the efficacy, safety and long-term outcome of BoTx injection into the lower esophageal sphincter (LES) of patients with achalasia. PATIENTS AND METHODS: Eight patients received 80 units of BoTx. Assessment of response was based on changes in the symptom scores (0-9) and esophageal manometric studies. RESULTS: Six out of 8 patients (75%) had sustained clinical improvement after therapy. This effect was maintained for a mean time of 17.8 months. The symptom score decreased from a mean of 6.7 to 0.5 (p < 0.01) and after treatment, LES pressure decreased from 63 to 25.5 mm Hg (p = 0.07). There were no serious adverse effects. Five of the six responders have relapsed. Two of these patients received a second BoTx injection with satisfactory results, two went to surgery and one refused other type of therapy and died of pneumonia. CONCLUSIONS: Intrasphincteric BoTx injection is a simple, safe and effective method of treatment in patients with achalasia, with a duration of response averaging 1.5 years. Its use may be suggested in some patients with high surgical risk and those who refuse a more invasive therapy. It is also useful in malnourished patients to attain an adequate nutritional status before surgery.

Adolescent↗

[Virological diagnosis of an outbreak of fever and rashes caused by parvovirus B19, Cuba, 1995].

The results obtained in the study of an a outbreak of fever and rash occurred in Havana City in March, 1995, are reported. Dengue, measles, rubella, herpes simplex, and Epstein Barr were discarded as causal agents of the outbreak in the samples of 35 patients. Parvovirus B19 was identified as the causing agent of the outbreak by the detection of IgM antibodies and the polymerase chain reaction technique (PCR). The infection produced by this agent was confirmed in 14/18 samples (77.7%) by some of the techniques used. This study makes reference to the first outbreak of Parvovirus B19 that was proved in Cuba.

Adult↗

[Western blot study of sera from patients with epidemic neuropathy].

The immune response of a group of patients with epidemical neuropathy and of controls was studied by the immunoblotting technique against proteins of the Coxsackie virus and the proteins of slow effect isolated in our laboratory. 13 sera of patients with epidemical neuropathy and 9 sera of controls were studied. Of the 13 sera studied, 8 (61.5%) recognized protein VPI and 2 sera (15.3%) protein VP0 of the strain 47.93. Of the 9 controls studied, 4 (44.4%) recognized protein VPI and 3 (33.3%) protein VP0 only. With the antigen prepared from the slow effect strain it was obtained a specific signal in 5 (38.5%) sera of patients and in 2 sera (22.5%) of controls. It should be stressed that in this last case the protein observed had a molecular weight of 41,300 D, and that its size was smaller than that of the preceding protein detected against the strain 47.93 was of 45,000 D.

Animals↗

[Mechanism of Enterovirus participation in epidemic neuropathy. Physiopathological hypothesis].

During the epidemic neuropathy occurred in Cuba from 1992 to 1993, viral isolations antigenically connected with Coxsackie viruses were obtained from the cerebrospinal fluid of patients. Virological, epidemiological, toxicologic, nutritional, immunological and histopathological investigations were made. Though the disease was related to toxic and nutritional factors, it has been impossible to identify the cause of the epidemic. Taking into consideration the results of the different investigations, we have formulated a comprehensive and multifactorial hypothesis to explain the physiopathological mechanism of the participation of the isolated viruses as mediators in a process of autoimmunity of the pathogeny of the disease.

Animals↗

Oxaliplatin, tetraplatin, cisplatin, and carboplatin: spectrum of activity in drug-resistant cell lines and in the cell lines of the National Cancer Institute's Anticancer Drug Screen panel.

The present study was designed to explore the activity of platinum compounds in cisplatin-resistant cell lines, the unselected cell lines of the National Cancer Institute's Anticancer Drug Screen, and the potential for use in combination. The activities of four platinum compounds in cisplatin-resistant KB and A2780 cells were investigated. The cells were highly resistant to cisplatin and cross-resistant to carboplatin, but less than one-tenth as resistant to oxaliplatin and tetraplatin. Cellular accumulation of all platinum compounds was decreased in both resistant cell lines. When the activities of cisplatin and oxaliplatin were evaluated in the National Cancer Institute's Anticancer Drug Screen, marked differences were observed. Evaluation of the activity profile using the COMPARE program revealed a different pattern for both agents: the cisplatin activity profile was similar to those of other diamine-platinum compounds, alkylating agents including melphalan, and camptothecin analogs, whereas the activity profile of oxaliplatin resembled those of other "dach" (diaminocyclohexane) platinum compounds and of acridine derivatives. The sensitivity profiles are influenced by the target(s)/mechanism(s) of action and the mechanism(s) of resistance of a drug. The dissimilarity in profiles suggests that these two platinum compounds have a different target(s)/mechanism(s) of action, a different mechanism(s) of resistance, or most likely both. Studies evaluating combinations of cisplatin/oxaliplatin suggest that the activities of these two agents are at least additive and possibly synergistic. Oxaliplatin has a different spectrum of activity and low cross-resistance to cisplatin and should be valuable in cisplatin refractory patients or in combination with cisplatin.

Antineoplastic Agents↗

Study of in vivo and in vitro resting vasodilator nitric oxide tone in normotensive and genetically hypertensive rats.

The effects of NG-nitro-L-arginine (L-NNA) on mean arterial pressure and the effects of both L-NNA and methylene blue on isolated aorta tone, were studied in order to elucidate potential alterations in vasodilator resting nitric oxide (NO) tone in genetic hypertension. L-NNA produced a significantly greater increase of mean arterial pressure in spontaneously hypertensive rats (SHR) than in Wistar Kyoto (WKY) rats; in both cases, L-arginine completely inhibited the L-NNA hypertensive effect. Neither ganglion blockade with hexamethonium nor cyclooxygenase inhibition with indomethacin significantly modified the effect of L-NNA in both rat strains. In intact aorta rings, after submaximally contraction with KCI (25 mM), both L-NNA and methylene blue induced strong dose-dependent contractions. The maximum contractions were, however, significantly greater in WKY rats than in SHR. The mechanical elimination of endothelium markedly inhibited both L-NNA and methylene blue maximum contractions. In intact rings, L-arginine completely inhibited the L-NNA effects in both rat strains; in rubbed rings, the L-arginine inhibitory effects were strong in WKY rats but not important and erratic in SHR. L-Arginine had no effect on the contractions induced only by KCI in any of the preparations. In WKY rat-rubbed rings, sodium nitroprusside was significantly more effective in relaxing the contractions in response to 25 mM KCI than the contractions in response to methylene blue. These results indicate that contractions induced by L-NNA and methylene blue in isolated aorta are principally due to the inhibition of an important endothelial resting vasodilator NO tone. They also show that hypertension reduces the resting vasodilator NO tone in isolated rat aorta, in spite of enhancing the total vasodilator NO tone in anaesthetized rat.

Animals↗

Clinical reversal of multidrug resistance.

Reversal of drug resistance offers the hope of increasing the efficacy of conventional chemotherapy. We tested dexverapamil as a P-glycoprotein antagonist in combination with EPOCH chemotherapy in refractory non-Hodgkin's lymphoma. In a cross-over design, dexverapamil was added to EPOCH after disease stabilization or progression occurred. Objective responses were observed in 10 of 41 assessable patients. Biopsies for mdr-1 were obtained before EPOCH treatment and at the time of cross-over to dexverapamil. Levels of mdr-1 were low before EPOCH, but increased four-fold or more in 42% of patients in whom serial samples were obtained. Pharmacokinetic analysis revealed median peak concentrations of dexverapamil and its metabolite, nor-dexverapamil, of 1.66 mumol/l and 1.58 mumol/l, respectively. Since both are comparable antagonists, a median peak total reversing concentration of 3.24 mumol/l was achieved. Pharmacokinetic analysis of doxorubicin and etoposide levels confirmed a delay in the clearance of doxorubicin ranging from 5% to 24%; no change in the pharmacokinetics of etoposide was observed. This study provides sufficient rationale for testing dexverapamil in a randomized clinical trial.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Allelic diversity at the primate Mhc-G locus: exon 3 bears stop codons in all Cercopithecinae sequences.

Twenty-seven major histocompatibility complex (Mhc)-G exon 2, exon 3, and exon 2 and 3 allelic sequences were obtained together with 12 different intron 2 sequences. Homo sapiens, Pan troglodytes, Pan paniscus, Gorilla gorilla, Pongo pygmaeus, Macaca fascicularis, Macaca mulatta, and Cercopithecus aethiops individuals were studied. Polymorphism does not follow the classical pattern of three hypervariable regions per domain and is found in all species studied; exon 3 (equivalent to the alpha 2 protein domain) shows stop codons in the Cercopithecinae group but not in the Pongidae and human groups. Dendrograms show that cotton top tamarin (Saguinus oedipus) Mhc-G sequences are closer to Homo sapiens and Pongidae than to Cercopithecinae, probably due to the stop codons existing at exon 3 of the latter. There is a clear trans-species evolution of allelism in Cercopithecinae and also in exon 2 of all the other apes studied, but a generation of allelism within each species may be present on exon 3 sequences. This discrepancy may be due to the preferential use of exon 2 over exon 3 at the mRNA splicing level within each species in order to obtain the appropriate functional G product. Mhc-G intron 2 shows conserved motifs in all species studied, particularly a 23 base pair deletion between positions 161 and 183 which is locus specific, and some of the invariant residues, important for peptide presentation, conserved in classical class I molecules from fish and reptiles to humans were not found in Mhc-G alleles; the intron 2 dendrogram also shows a particular pattern of allelism within each species. In summary, Mhc-G has substantial differences from other classical class I genes: polymorphism patterns, tissue distribution, gene structure, splicing variability, and probably an allelism variability within each species at exon 3. The G proteins may also be different. This indicates that the Mhc-G function may not be peptide presentation to the clonotypic T-cell receptor.

Alleles↗

Preterm delivery after selective termination in twin pregnancies.

OBJECTIVE: To determine the effect of selective termination of an abnormal twin on the rate of preterm delivery. METHODS: The study group consisted of 69 patients with twin pregnancies who underwent selective termination between 1987-1994. The comparison groups consisted of singleton (n = 42,362) and twin pregnancies (n = 825) delivered at our institution during the same period. The data were analyzed by Chi2 and Fisher exact test, as appropriate. P < .05 was considered significant. Adjusted odds ratios(OR) and 95% confidence intervals (CI) were calculated by multiple logistic regression. RESULTS: Terminating the presenting twin was associated with a significantly higher risk of delivery before 37 weeks (adjusted OR 4.1, 95% CI 1.4-12.3) and low birth weight (adjusted OR 3.8, 95% CI 1.3-11.4) compared with terminating the nonpresenting twin. When the termination was performed at or after 20 weeks' gestation, only the risk of preterm premature rupture of the membranes or preterm labor was significantly increased (adjusted OR 3.7, 95% CI 1.2-11.5). Selective termination patients had a lower rate of preterm delivery than twin pregnancies (40 versus 58%, P < .005) but higher than singleton pregnancies (40 versus 10%,P < .001). CONCLUSION: Selective termination of the presenting twin at 20 weeks or later was associated with a worse perinatal outcome than terminating the nonpresenting twin or performing the procedure before 20 weeks.

Adult↗

bcl-2 protein downregulation is not required for differentiation of multidrug resistant HL60 leukemia cells.

Parental and multidrug resistant HL60 leukemia cell lines were used to study coupling of expression of apoptotic/cytostatic (bcl-2, bax, bclxL, p21/Waf1, and c-myc) genes during differentiation. The multidrug resistant HL60 cell line, HL60/ADR, was less sensitive than parental cells to cytostatic activity of low (0.4-2 ng/ml) doses of PMA. However, during treatment with standard differentiating doses of PMA (10 ng/ml), no difference between the two cell lines in cytostasis and differentiation was found. Downregulation of c-myc and upregulation of p21/Waf1 proteins showed the same time-course in both cell lines. The bcl-2 mRNA was rapidly downregulated while bax and bclxL gene expression was not altered in both differentiating HL60 and HL60/ADR cells. Significant downregulation of bcl-2 protein occurred only in parental HL60 cells. In HL60/ADR, despite rapid cessation of bcl-2 protein synthesis, almost no change in steady-state bcl-2 protein level was found. The lack of bcl-2 protein downregulation was a result of the prolonged half-life of this protein in HL60/ADR cells. Thus, although downregulation of bcl-2 mRNA is coupled to differentiation, actual loss of bcl-2 protein is not required for accomplishment of the differentiation program.

Blotting, Western↗

Description of a novel HLA-B35 (B*3514) allele found in a Mexican family of Nahua Aztec descent.

A new allele, HLA-B*3514, has been found in a Mexican family from Nahua descent. Its exon 2 is identical to that of B*3501 allele, but exon 3 bears a 3-base difference at codons 152 and 156, which results in Val-->Glu and Leu-->Trp changes, respectively, in the corresponding HLA molecule at the peptide-binding site. These substitutions may have originated from a DNA stretch donation from an allele belonging to the B15 group, enabling HLA-B*3514 to cope with the presentation of a new set of antigenic peptides. The high frequency of serologic B35 in Amerindians, together with the variety of B35 alleles detected by DNA sequencing in these populations, suggest that a frequent B35 subtype was present in the founder population and that several B35 subtypes may have been recently generated, probably due to the abrupt arrival of new pathogens following European invasions.

Alleles↗

The current status of multifetal pregnancy reduction.

The number of women conceiving three or more fetuses has increased dramatically as a result of successful infertility therapy with ovulation-inducing agents and assisted reproductive technology. Higher-order multiple gestations have an increased risk of premature delivery and its attendant sequelae of increased neonatal mortality or irreversible morbidity. Multifetal pregnancy reduction is a procedure designed to decrease the increased propensity to deliver very prematurely in these patients by reducing the number of live fetuses they are carrying. The procedure has proved to be both safe and effective, and pregnancies reduced to twins proceed as if that were the number of fetuses originally conceived. Nevertheless, this invasive procedure does have the potential to result in loss of the entire pregnancy and causes considerable emotional distress for some couples who view it as their "least bad" alternative. The medical benefits of performing multifetal pregnancy reduction in women with four or more fetuses seem fairly well established, but this is less true for triplets. Serious attention should be paid to reducing the number of higher-order multiple pregnancies resulting from infertility therapy. In the meantime, when three or more fetuses have been conceived, multifetal pregnancy reduction offers a reasonable option to patients whose only choices in the past were either to accept the risk of delivering extremely prematurely or to terminate the entire pregnancy.

Ethics↗

Role of enteric pathogens in the aetiology of neonatal diarrhoea in lambs and goat kids in Spain.

Faeces samples from diarrhoeic and non-diarrhoeic lambs and goat kids aged 1-45 days were examined for enteric pathogens. Cryptosporidium parvum was detected in both diarrhoeic lambs (45%) and goat kids (42%) but not in non-diarrhoeic animals. F5+ (K99+) and/or F41+ Escherichia coli strains were isolated from 26% and 22% of the diarrhoeic lambs and goat kids, respectively, although these strains, which did not produce enterotoxins ST I or LT I, were found with similar frequencies in non-diarrhoeic animals. A F5-F41-ST I+ E. coli strain was isolated from a diarrhoeic lamb (0.6%). Verotoxigenic E. coli was isolated from both diarrhoeic and non-diarrhoeic lambs (4.1% and 8.2%, respectively) and there was no association between infection and diarrhoea. The prevalence of group A rotavirus infection in diarrhoeic lambs was very low (2.1%). Groups A and B rotaviruses were detected in three (8.1%) and five (13.5%) diarrhoeic goat kids from two single outbreaks. Group C rotaviruses were detected in four non-diarrhoeic goat kids. An association of diarrhoea and infection was demonstrated only for group B rotavirus. Clostridium perfringens was isolated from 10.8% of the diarrhoeic goat kids but not from non-diarrhoeic goat kids or lambs. Salmonella arizonae was isolated from a diarrhoeic goat kid (2.7%) and the clinical characteristics of the outbreaks where these two latter enteropathogens were found different from the rest. Picobirnaviruses were detected in a diarrhoeic lamb. No coronaviruses were detected using a bovine coronavirus ELISA. No evidence was found of synergistic effect between the agents studied. Enteric pathogens were not found in four (8.7%) and three (20%) outbreaks of diarrhoea in lambs and goat kids, respectively.

Age Factors↗

AIDS prevention training for pharmacy workers in Mexico City.

Mexican pharmacies play an important adjunct health care role in sexually transmitted disease prevention and treatment. In light of the rapid spread of the AIDS pandemic, research was initiated in 1989 to investigate the feasibility of pharmacies assisting in AIDS and STD prevention and control through community education and condom promotion. This study was implemented in three stages: a needs assessment, development of a training course and complementary materials, and an evaluation of the course and materials. The instruments used in the needs assessment were a KAP questionnaire and 'mystery shopper' visits to pharmacies. The evaluation design utilized pre- and post-tests, condom sales tracking and 'mystery shopper' visits. The needs assessment found that pharmacy employees have some basic knowledge about AIDS and STDs, but lack important information and do not communicate effectively with clients in spite of client interest in these topics. Pharmacy workers expressed great in learning more about AIDS and STDs. The evaluation of the intensive 8-hour course and supporting materials showed that, when given together, the course and materials increased short term knowledge about AIDS and condom use. However, the interventions were less successful in achieving longer term information retention, transfer of knowledge to clients or in influencing condom sales. Adjustments in the training course content and in participant recruitment strategies are recommended.

Acquired Immunodeficiency Syndrome↗