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Biomedical subjects

M Toledo

Publications and source records attributed to M Toledo.

14 recordsLinked to original sources
PubMed2005

Safety assessment of the conversion from mycophenolate mofetil to enteric-coated mycophenolate sodium in stable renal transplant recipients.

The immunosuppressant mycophenolate mofetil (MMF; CellCept) has greatly improved transplant recipients' clinical outcomes, but its efficacy may be limited by dose adjustments due to adverse events (AEs). An enteric-coated formulation of mycophenolate sodium (EC-MPS; myfortic), designed to improve gastrointestinal tolerability is now available. This Latin-American, prospective, multicenter, open-label, 6-month trial assessed the safety and tolerability of converting renal transplant recipients from MMF to EC-MPS. In total, 237 renal transplant recipients (stable > or = 3 months' posttransplant) receiving MMF (< or =1000 mg b.i.d.) were enrolled. Adults (n = 218) were converted to EC-MPS 720 mg b.i.d. (equimolar to MMF 1000 mg b.i.d.) even if they were initially receiving <1000 mg MMF b.i.d. (ie, 47 adults received a higher than equimolar dose of EC-MPS). Children (n = 19) were converted to EC-MPS 450 or 432 mg/m2 b.i.d. Patients also received cyclosporine microemulsion (Neoral) and corticosteroids. There were three acute rejections and no graft failures. The incidence of AEs was 59.9% (in those receiving a higher than equimolar EC-MPS dose it was 57.4%). In all, 22% of patients had gastrointestinal AEs, 37% had infections, and 4.8% had hematological AEs. Only 24 patients (10%) had an AE-related dose reduction. Seven of these patients had received higher than equimolar doses of EC-MPS. Patients can be safely converted from different doses of MMF to a standard dose of EC-MPS. The requirement for EC-MPS dose reduction to manage AEs was relatively low. Use of EC-MPS is a valid alternative for renal transplant recipients receiving maintenance MMF treatment.

Adolescent↗
PubMed2001

Tracing sewage in the marine environment: altered signatures in Concepción Bay, Chile.

Lipid biomarkers are now widely used to trace organic matter in the marine environment. Selected compounds and ratios can be used to identify sources or processes. However, in a study of a particularly contaminated area, the expected signatures were not found (Mudge and Seguel, Bol. Soc. Chil. Quím. 42 (1997) 5). This site has been re-examined to determine why they were absent. The concentrations of sterols, fatty acids and alcohol biomarkers of 10 sediment cores from Concepción Bay, Chile, were quantified by capillary gas chromatography-mass spectrometry. The data obtained from 34 fatty acids, 28 fatty alcohols (C12-C30) and 32 sterols from the target study area, indicated that fatty acids from Concepción Bay sediments were the most abundant lipids (range 1.6-307 microg g(-1) dry wt) followed by sterols (range 0.02-25.3 microg g(-1) drywt). The sewage markers 5beta-coprostanol and epi-coprostanol were found in the areas close to the Penco-Lirquen disposal pipe. High bacterial activity was also present as indicated by the cholestanol, 18:1omega7, iso, anteiso and branched fatty acids and enhanced odd/even ratios of fatty alcohol biomarkers. The sediments from the centre of Concepción Bay had a greater marine/algal input characterized by brassicasterol and the marine fatty acids (20:4omega6, 20: 5omega3 22: 6omega3). The terrestrial contribution was mainly characterized by beta-sitosterol, C22-C26 fatty acids and confirmed by short/long chain ratio of the fatty alcohols. The distribution of these two markers indicates that the terrestrial matter passing through the sewage system is deficient in short chain fatty alcohols. The epi-coprostanol/coprostanol versus coprostanol/cholesterol plots also indicated selected removal of the stanols leaving apparently high cholesterol concentrations.

Biomarkers↗
PubMed2000

[Tuberculous meningitis in review].

Tuberculosis meningitis is one of the most dangerous forms of tuberculosis (TB). Due to large waves of immigration, the incidence of TB in Israel has increased in recent years, as has that of TB meningitis. Due to its high mortality, rapid diagnosis of TB meningitis is of paramount importance. We present a patient admitted with a acute febrile disease which was subsequently diagnosed as TB meningitis.

Aged↗
PubMed1994

Enzyme-histochemical profiles of fiber types in mature canine appendicular muscles.

The histochemical characteristics of skeletal muscle were assessed using a range of samples from 7 appendicular muscles taken from adult mixed-breed dogs (1.5 to 3 years of age). Two slow-twitch fiber subtypes (IA and IB) and three II subtypes (IIA, IIB and IIC) were identified according to myofibrillar myosin adenosine triphosphatase reaction after acid and alkaline preincubation. Type IIB fibers were not found in all muscles, and were only biologically significant in m. semitendinosus. The metabolic potential of these fibers is fairly similar to that of IIA fibers, but significantly different to that of IIB fibers in other mammals, suggesting that they may be designed to play a different functional role during locomotion. All canine muscle fibers have moderate to high oxidative capacity, which may be related to the extraordinary athletic capability of the species.

Adenosine Triphosphatases↗
PubMed1991

[AIDS and pregnancy. The clinical management of 2 cases of HIV infection].

Two clinical cases of HIV-infected pregnant women are presented: One with declared AIDS and the other a symptomless carrier. The clinical management of these cases are described; that is, the resolution of the delivery and the clinical measures implemented during their hospitalization. Both, the potential ways of propagating the infection among the health workers as well as the universal precautions which must be taken in order to avoid the risk of infection are discussed. The perinatal transmission of the HIV virus and the possible risk factors are also studied in this presentation. In the heterosexual relations of the couples infected with HIV are considered important their associated risk factors. It appears that education is the primary factor to prevent the infection in obs-gyn patients, more than obtaining resources to do massive serological tests on them.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[ABO materno-fetal incompatibility in the newborn infant: clinical usefulness of Coombs test and elution for the study of hemolytic disease].

A decision to establish early treatment for hemolytic disease in the newborn is usually based upon results of the Coombs test. In order to evaluate a possible advantage of using the Elution test to help in the diagnosis of the hemolytic state, samples of cord blood from 197 consecutive newborns with ABO incompatibility were studied. Hemolysis occurred in 41. Each test (Coombs and Elution) was positive in 26 patients, for a total of 35 positive results and a combined sensitivity of 85%. False positives occurred in 24 of 156 patients with Coombs test and in 30 for the Elution test. Thus, combined results of both test would have suggested a need for phototherapy in 72 of 197 patients when in fact it was needed for only 41. Conversely, 13 patients with hemolytic disease were missed by both tests. The negative predictive value of both tests combined was 95% which is useful for clinical practice.

Coombs Test↗
PubMed1977

Preliminary data on a new method for lithium therapy.

Lithium therapy was assessed using electrosleep on two dogs. Cotton swabs soaked in an aqueous isotonic lithium chloride solution were placed over the eyes and mastoids of the dogs, and connected to the electrosleep apparatus. In two minutes, sleep was induced in both dogs, at point 5 (mA) on the intensity scale (which runs 1 to 9 mA). After two hours, the apparatus was turned off. One of the dogs was put under continuous observation, and the other one was sacrified. Parts of its cortex, subcortex, and cerebellum were processed and fragments were assayed spectrophotometrically for Lithium. Lithium was found in all the material examined. These results suggest a possible technique for Lithium therapy using electrosleep, the ion being carried directly to CNS, avoiding systemic toxicity caused by oral administration.

Animals↗
PubMedDate not supplied

Stable renal transplant recipients can be safely converted from MMF to enteric-coated mycophenolate sodium tablets: Interim results of a multicenter Latin American study.

Enteric-coated mycophenolate sodium (EC-MPS) is designed to reduce mycophenolate acid (MPA)-related upper gastrointestinal (GI) adverse events (AEs). A multicenter, open-label, Latin American study in stable renal transplant patients is ongoing to assess the safety of the conversion from mycophenolate mofetil (MMF) to EC-MPS. An interim analysis was performed when 93 patients had completed 3 months. Prior to conversion, they had received MMF at a dose of 2 g/d, with the exception of eight adult patients who were receiving an average daily dose of 1.25 g. All adult patients were converted to EC-MPS (1.44 g/d; 0.450 g/m(2) bid for children). After conversion, the reported total incidence of AEs was 40.9%, including 28% infections, 1.1% hematologic, 19.4% GI, including 10.8% upper-GI AE (all mild) and 5.4% diarrhea. No patient discontinued the study medication due to adverse events. Only six patients (6%) required a dose adjustment. There were no episodes of acute rejection, death, or graft loss. During the period of analysis, the conversion from MMF to EC-MPS was safe, the enteric-coated tablet formulation prevented release of MPA in the upper GI tract, and only one patient had to reduce the dose due to an upper GI AE, concomitant with diarrhea. EC-MPS offers transplant physicians and their patients an alternative MPA therapy that is as effective and safe as MMF, but in a formulation that may provide GI tolerability benefits.

Administration, Oral↗
PubMedDate not supplied

[Polycythaemia as a ready factor of transitory global amnesia].

Transitory global amnesia (TGA) is an upheaval where the patient has anterograde memory lost of abrupt beginning and an inferior duration to 24 h, that has been related to ischaemic, epileptogenic and migranous ethiology. On the other hand polycythaemia is classified like a prothrombotic disorder that can produce manifold manifestations in the central nervous system, from strokes to psychiatric disturbances of anxious type, and all related to the secondary cerebral hipoperfusión due to hyperviscosity. Two patients, who had a previous diagnostic of polycythaemia suffered an episode of TGA, in addition in one of the two cases a cerebellar hemangioblastoma was found. There are numerous cases reported of brain tumors and other CNS findings diagnosed as a result of an episode of TGA, nevertheless on has not described to the relation between polycythaemia and the TGA. In the TGA a hypoperfusion of the temporal brain hemisphere has been documented and this can be a leading mechanism, so we propose that polycythaemia could ready to suffer a TGA.

Aged↗
PubMedDate not supplied

[A modified Strout test, used as a probe for the diagnosis of transplacental Chagas disease. I. Collection and preservation of the newborn's umbilical cord blood].

Two umbilical cord (UC) blood samples are routinarily taken from each newborn (NB) at the University of Chile Maternity Hospital, to determine blood grouping and for detecting syphilis infection respectively. In august-september 1993, an additional UC blood sample was collected from each of 116 NB (with volumes of whole blood ranging 2.7 - 24.5 ml and a mean of 13.5 ml). In order to determine the persistence of the mobility of Trypanosoma cruzi in blood samples stored at three different temperatures (-2 to -4 degrees C, 4 to 6 degrees C and environmental temperature from 16 to 23 degrees C), two experiments were performed: 1) In three centrifuge microtubes mouse blood (C3H strain) abundant T. cruzi trypomastigotes Tulahuen strain were put. 2) In an other similar number of microtubes, with the same concentration of parasites, human serum from UC was added. During the first 12 h in all the samples trypomastigotes with very active mobility were observed. At 72 h mobility persisted in samples with temperature between 4 and 6 degrees C and between 16 and 23 degrees C. Whereas in the samples maintained at -2 to -4 degrees C with parasites in blood plus serum, an important decrease of T. cruzi mobility was observed. The results of this study suggest that UC blood samples could be collected and maintained between 4 and 6 degrees C or at room temperature up to 48 h to be processed by the modified Strout concentration method (MSCM).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗