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Biomedical subjects

R Blanco

Publications and source records attributed to R Blanco.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Latex allergy in children: a follow-up study.

BACKGROUND: Natural rubber latex allergy is an important health problem. Multiple contacts with latex in childhood are a risk factor. Many aspects of this disease are still unknown, one of which is the clinical outcome of these children. The aim of this study was to evaluate the clinical and epidemiological features of latex allergy and compliance with latex avoidance instructions in allergic children. MATERIAL AND METHODS: Seventeen consecutive patients with a history of latex allergy, fruit allergy or chronic urticaria were selected. The patients underwent a skin prick test and determination of specific-IgE to latex at the start and at end of the study (median follow-up: 3 years). At diagnosis, patients with a positive result to one of the tests and a clinical history of latex allergy were considered allergic; patients with a positive test but without a clinical history suggestive of allergy were considered sensitized. These children were given latex avoidance instructions. RESULTS: Eleven children (64.7 %) were classified as allergic and 6 (35.3 %) as sensitized. Five patients had undergone latex-free surgery after diagnosis without incident. During follow-up, 11 patients (8 allergic and 3 sensitized) had contact with latex. Contact occurred in the home in 10 children, and all were symptomatic. Specific-IgE levels to latex at the end of the study were significantly higher in patients who had contact with latex during the follow-up period than in those without latex contact. CONCLUSIONS: Strict compliance with latex avoidance instructions is essential both inside and outside the hospital. Greater emphasis should be placed on reducing latex exposure in the home and school environments, as such contact could maintain positive IgE-antibody levels.

Adolescent↗
PubMedDate not supplied

Multilobated large B-cell lymphoma diagnosed cytologically. A case report.

BACKGROUND: Fine needle aspiration (FNA) biopsy can be used to reliably classify most conditions involving lymph nodes or, at least, significantly reduce the differential diagnosis. CASE: A 70-year-old male presented with an ulcerated mass arising from the left tonsillar fossa and involving the anterior and posterior pillars. A biopsy of the tonsillar mass performed at an outside hospital was interpreted as a large cell undifferentiated carcinoma. Subsequently the patient developed systemic lymphadenopathy. A bone scan showed intense uptake within the medial tibial plateau of the left knee. FNA biopsy of the right axillary mass was interpreted at University of Cincinnati Medical College as a large cell lymphoma, multilobated type. Histologic and immunohistochemical studies of the lymph node confirmed the presence of multilobated B-cell lymphoma. Lymphoma chemotherapy was initially successful but was discontinued due to toxicity. The patient died two months after the initial cytologic diagnosis of lymphoma. CONCLUSION: Multilobated lymphomas are an unusual variant of non-Hodgkin's lymphomas (mostly B-cell type). Cytology and immunocytochemistry are useful diagnostic procedures that can help to diagnose this relatively uncommon type of lymphoma and significantly reduce the possibility of misdiagnosis.

Aged↗
PubMedDate not supplied

Aplasia of the optic nerve: report of three cases.

Aplasia of the optic nerve is a very rare congenital anomaly characterized by an absence of optic nerve fibers, retinal ganglion cells, and the retinal central blood vessels. It may be associated with a wide range of other congenital abnormalities. In the present article, three cases of aplasia of the optic nerve are described. Its pathology and clinical features are reviewed.

Eye Abnormalities↗
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Cytomegalovirus retinitis in pediatric acquired immunodeficiency syndrome: report of two cases.

Two cases of cytomegalovirus retinitis in pediatric acquired immunodeficiency syndrome (AIDS) are described. The first case was a 7-month-old infant who received an HIV-infected blood transfusion in 1983. The infant was treated with specific anti-cytomegalovirus immunoglobulin. The second case was an 8-year-old hemophiliac child who received HIV-infected factor VIII concentrates. Intravenous ganciclovir therapy resulted in marked improvement of ocular lesions. This is, to our best knowledge, the first report of pediatric AIDS-induced retinopathy resulting from postnatal intravenous causes.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Polymyalgia rheumatica with normal erythrocyte sedimentation rate: clinical aspects.

Polymyalgia rheumatica is a relatively common syndrome of the elderly characterized by severe pain and stiffness in the neck shoulder and pelvic girdles, along with increased acute phase reactants. The current diagnostic criteria include as a requirement an erythrocyte sedimentation rate (ESR) higher than 30 or 40 mm/1 hr. Nevertheless, in several reports, a sizable proportion of patients with PMR, from 7% up to 22%, had an ESR that was either normal or slightly increased at the time of diagnosis, supporting the notion that an increased ESR should not be an absolute requirement for its diagnosis. This subset is characterized by a younger age, a less marked predominance of females, a longer diagnostic delay and a lower frequency of constitutional symptoms such as fever or weight loss. When determined, a majority of these patients had increased levels of C reactive protein. The recognition of this subset of patients with PMR and a low ESR can be very useful to the clinician, avoiding unnecessary suffering of the patients and the risks of ineffective therapy with nonsteroidal antiinflammatory drugs. To avoid the over-diagnosis of PMR in patients with a low ESR, we propose a set of criteria that can be easily applied in daily practice to patients with a clinical picture consistent with PMR but with a normal or slightly increased ESR.

Blood Sedimentation↗
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Familial aggregation of polymyalgia rheumatica and giant cell arteritis: genetic and T cell repertoire analysis.

OBJECTIVE: Several reports of familial aggregation of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) have been described although detailed genetic and immunological studies are scarce. Our aims were to investigate the influence of HLA-DRB1 alleles and to analyze the phenotype and T cell receptor (TCR) usage of circulating T lymphocytes in a familial case of GCA and PMR. METHODS: HLA-DRB1 typing was carried out using polymerase chain reaction amplification with specific primers. The study of the circulating T cell repertoire was performed by staining with specific monoclonal antibodies and flow cytometry analysis. RESULTS: Patient 1 developed GCA at the age of 71, four years prior to the diagnosis of PMR in her older brother. The HLA-DRB1 typing of Patient 1 was DRB1*04 (DRB1*0401)/DRB1*12 and in Patient 2 was DRB1*07/DRB1*12. In our patient population, GCA was associated with an increased frequency of HLA-DRB1*04 compared with PMR patients. Regarding T cell phenotype, the brother with active PMR had a higher expression of surface markers indicating activation in both T cell subsets (CD25 and HLA-DR). The sister with GCA showed a pronounced decrease of CD4+/CD45RA+ T cells with respect to her brother with PMR. Both patients carried a significant depletion of CD28 in both subsets, specially within the CD8+ T cell compartment. The BV gene usage differed from one patient to the other. T cell expansions were identified in both patients but the specificities were different. CONCLUSION: We describe an association of GCA and PMR between two first degree relatives with significant genetic and immunologic differences. Our results suggest that the pathogenic mechanisms leading to the development of GCA and PMR are probably multifactorial, and both genetic and environmental factors may contribute to the development of these diseases.

Aged↗
PubMedDate not supplied

Mycotic (infected) aneurysm of the popliteal artery and arthritis following Salmonella bacteriemia.

We report a case of a mycotic (infected) aneurysm of the popliteal artery due to Salmonella enteritidis. The clinical presentation may be confused with other more common causes of diffuse swollen leg, causing a delay in the diagnosis and proper therapy. Prompt surgical resection of the infected aneurysm together with medical therapy is required for successful treatment.

Aged↗
PubMedDate not supplied

[Digestive tract hemorrhage secondary to jejunal angiodysplasia associated with jejunal diverticulosis].

The most important factor in the management of alimentary tract bleeding is the adequate localization of the lesion. Small bowel bleeding is a rare entity and determination of the specific anatomic site is difficult. Once stomach, duodenum, or colon origin has been discharged through endoscopy, methods such as angiography and Tc99m RBC scans are appropriate. We present a patient with lower gastrointestinal bleeding secondary to jejunal angiodysplasia associated with jejunal diverticular disease. In the present case, Tc99m RBC scans were used to identify the bleeding site. In cases of lower gastrointestinal bleeding of undetermined origin, we suggest the consideration of both diagnoses (angiodysplasia or diverticular disease) with exploratory celiotomy to resolve these pathologies, particularly in the elderly patient.

Aged↗
PubMedDate not supplied

Calcium-permeable glutamate receptors in horizontal cells of the mammalian retina.

Mechanisms that mediate the calcium influx in mammalian horizontal cells were studied. Horizontal cells (HCs) enzymatically dissociated from the rabbit retina were recorded by the whole-cell configuration of the patch-clamp technique and by calcium image ratioespectrophotometry of Fura-2 loaded cells. AMPA-preferring glutamate receptors were shown to permeate Ca2+ in mammalian HCs by ionic substitution experiments. Furthermore, after blocking the L-type calcium current with nifedipine (100 microM), calcium current through the AMPA-preferring glutamate receptors was measured. Calcium image ratioespectrophotometry was performed on the dissociated HCs in order to determine the changes in the intracellular calcium ([Ca2+]i). Fura-2 microspectrophotometry showed that in HCs, K+-induced cell depolarization promoted an increase in [Ca2+]i, mediated by the L-type calcium channels, since it was abolished in the presence of nifedipine. The increase in [Ca2+], upon cell depolarization was observed throughout each cell: however, it was maximal at the cell soma. Activation of glutamate receptors in dissociated HCs by glutamate, AMPA or kainate promoted an increase in [Ca2+]i. This increase in [Ca2+]i, was abolished in nominally Ca2+-free solution (0 mM Ca2+); in contrast, nifedipine decreased the glutamate-induced influx of calcium in ca. 50%. The present study demonstrates that calcium may permeate through glutamate receptors expressed in HCs of the rabbit retina.

Animals↗
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[Acute pancreatitis. The classification of its severity by dynamic pancreatography and the results of surgical treatment].

In acute pancreatitis determination of glandular necrosis has been difficult because of the lack of an objective method; with dynamic enhanced tomography (bolus injection of contrast media) we have reasonably classify 28 patients with acute pancreatitis. With this technique 5 grades of sequelae of acute pancreatitis are identified: I. Non complicated acute pancreatitis; II. pancreatic abscess: III. peripancreatic necrosis; IV. less than 50% pancreatic necrosis and V. more than 50% pancreatic necrosis. A 100% correlation was found between tomography and surgical findings. This is the first report in Mexico of this method to identify pancreatic or peripancreatic necrosis; we also present the surgical results with a programmed pancreatic debridation; mortality has decreased form 80 to 31.9% in our hospital in recent years.

Acute Disease↗
PubMedDate not supplied

[Optimization of the immunoelectrophoresis technic (western blot) for the confirmation of human immunodeficiency virus infection (HIV) in Panama].

The purpose of this study is to report the results of the authors' investigation to apply the western blot technique (WB UP-LCS) in the diagnosis of human immunodeficiency virus type 1 (HIV-1) infection. To do this, the authors separated the proteins of the HIV-1 virus by electrophoresis, based on their molecular weight, in poliacilamide gel with SDS (SDS-PAGE) during 3 hours at 200 volts. Then they electrotransferred these proteins to nitrocellulose paper during four hours at 200 milliamperes, with the aid of external cooling. The nitrocellulose strips were evaluated considering the incubation time (1 and 16 hours), two conjugates (human anti IgG with Peroxidase and human anti IgG Biotin plus Streptatividine with Peroxidase) and two dilutions of the patients' sera (1/50 and 1/100). Based on their results the Authors conclude that, in the first place, the optimal conditions for the test include a dilution of 1/100 of the patients serum, incubation of the serum for 16 hours and the use of the conjugate of anti human IgG with Biotin and Streptavidine with Peroxidase; secondary, that the immunologic reactivity against proteins p24 and gp 160/120 is the most important diagnostic criterion for the confirmation of infection with HIV-1 and that they obtained a diagnostic correlation of 100% at a cost which was 5 to 7 times less than that of the commercial system.

Blotting, Western↗
PubMedDate not supplied

Neuropathology of liver transplantation.

We reviewed retrospectively the clinical records, autopsy protocols and central nervous system tissue sections of 50 patients who underwent orthotopic liver transplantation for end-stage liver disease between 12/83 and 8/93. The postoperative survival period ranged from hours (6), weeks (17), months (17), to years (10). All patients received immunosuppressive drugs from the immediate postoperative period to the time of their death (cyclosporine, steroids; occasionally azathioprine, OKT3, FK506). Nineteen patients had neurological manifestations (hepatic encephalopathy) prior to surgery. Post-transplant neurologic signs and symptoms included: hepatic encephalopathy/altered mental status (11), focal or generalized seizures (9) and stroke (2). In the majority of cases (37) the cause of death was septicemia and/or bleeding diathesis. The neuropathologic findings present in 36 patients could be classified into 3 distinct categories: metabolic disorders: hepatic/anoxic encephalopathy, central pontine myelinolysis (15); cerebrovascular disease: subarachnoid and/or intracerebral hemorrhage, bland or hemorrhagic infarction (23); and infection: bacterial meningitis/cerebritis, multifocal fungal microabscesses, presumptive viral meningitis/encephalomyelitis (10). In conclusion, 72% of 50 patients who came to autopsy after liver transplantation were found to have neuropathologic abnormalities; these abnormalities were predominantly infections and vascular diseases.

Adult↗
PubMedDate not supplied

[Surgical treatment of acute pancreatitis. The Mexican experience].

Acute Pancreatitis is a complex clinical problem. The mexican experience in the Acute Pancreatitis treatment was analyzed, from the papers published between 1970-1990. During the first decades of the 20th century. Acute Pancreatitis was usually diagnosed at operation or at autopsy. Because a significant proportion of those diagnosed at surgery survived, early intervention was recommended. With the introduction of laboratory test, surgical diagnosis was regarded as unnecessary. In the past 30 years in has become clear that patients with severe forms of Pancreatitis do not survive without surgery and interest in the value of surgical measures has been renewed. We reviewed the papers of the surgical treatment of Acute Pancreatitis and its complications, only articles with documented surgical treatment were selected for analysis. From 1970 through 1990, 41 articles were published by Mexican Journals, only 10, fulfill the criteria, 632 patients with operative management. Patients with gall-stone associated Pancreatitis were the most frequent, 70-72%, and alcoholic Pancreatitis the second 20%; significant hospital morbidity occurred, recurrent sepsis was frequently identified; mortality rate was 52.6%. Available data do not provide any reasonable approach, therefore, we urge to develop clinical trials, with control groups for better results.

Acute Disease↗