Primary abscess of the psoas muscle caused by Streptococcus milleri.
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Aged↗
Biomedical subjects
R Martinez
Publications and source records attributed to R Martinez.
Adrenocortical dysfunction in paracoccidioidomycosis: comparison between plasma beta-lipotrophin/adrenocorticotrophin levels and adrenocortical tests.
OBJECTIVE: Paracoccidioidomycosis is an important cause of Addison's disease in South America. We have carried out an extensive and prospective study on paracoccidioidomycosis comparing glucocorticoid, mineralocorticoid and androgen function with adrenal regulators, ACTH/beta-LPH and plasma renin activity (PRA). PATIENTS AND METHODS: Forty-seven male patients with active paracoccidioidomycosis were studied consecutively together with 20 healthy controls. On day 1, plasma aldosterone and PRA levels were measured in blood samples obtained from patients in the supine and erect position. On day 2 at 0900 h, baseline plasma samples were taken for ACTH, beta-lipotrophin (beta-LPH), cortisol, corticosterone, aldosterone, androstenedione (delta 4-A) and dehydroepiandrosterone sulphate (DHEA-S). ACTH 1-24 (250 micrograms) was given i.v. and blood samples for these steroid assays were taken at 1 and 2 hours. RESULTS: Five patients (10%) had Addison's disease with high basal plasma ACTH and beta-LPH, and low cortisol levels after the ACTH test. In the remaining 42 patients, baseline ACTH and beta-LPH levels and plasma cortisol after ACTH were within the normal range. A high percentage of patients presented with reduced corticosterone (21% of patients) and aldosterone (23%) secretion and increased PRA (31%). Plasma delta 4-A (19%) and DHEA-S (50%) levels were also reduced. CONCLUSIONS: The frequency of Addison's disease among our patients with paracoccidioidomycosis was 10%. In addition, a subset of patients presented with adrenal dysfunction detected by mineralocorticoid or androgen tests. In parallel to pathological lesions a functional adaptation may occur during adrenal involvement in paracoccidioidomycosis.
Addison Disease↗
The conserved helicase motifs of the herpes simplex virus type 1 origin-binding protein UL9 are important for function.
The UL9 gene of herpes simplex virus encodes a protein that specifically recognizes sequences within the viral origins of replication and exhibits helicase and DNA-dependent ATPase activities. The specific DNA binding domain of the UL9 protein was localized to the carboxy-terminal one-third of the molecule (H. M. Weir, J. M. Calder, and N. D. Stow, Nucleic Acids Res. 17:1409-1425, 1989). The N-terminal two-thirds of the UL9 gene contains six sequence motifs found in all members of a superfamily of DNA and RNA helicases, suggesting that this region may be important for helicase activity of UL9. In this report, we examined the functional significance of these six motifs for the UL9 protein through the introduction of site-specific mutations resulting in single amino acid substitutions of the most highly conserved residues within each motif. An in vivo complementation test was used to study the effect of each mutation on the function of the UL9 protein in viral DNA replication. In this assay, a mutant UL9 protein expressed from a transfected plasmid is used to complement a replication-deficient null mutant in the UL9 gene for the amplification of herpes simplex virus origin-containing plasmids. Mutations in five of the six conserved motifs inactivated the function of the UL9 protein in viral DNA replication, providing direct evidence for the importance of these conserved motifs. Insertion mutants resulting in the introduction of two alanines at 100-residue intervals in regions outside the conserved motifs were also constructed. Three of the insertion mutations were tolerated, whereas the other five abolished UL9 function. These data indicate that other regions of the protein, in addition to the helicase motifs, are important for function in vivo. Several mutations result in instability of the mutant products, presumably because of conformational changes in the protein. Taken together, these results suggest that UL9 is very sensitive to mutations with respect to both structure and function, perhaps reflecting its multifunctional character.
Amino Acid Sequence↗
Low molecular weight heparin (CY-216) versus unfractionated heparin in chronic hemodialysis.
In 14 patients undergoing chronic hemodialysis, we investigated the safety and efficacy of the low molecular fragment (CY-216) in comparison to unfractionated heparin (UFH) in the prevention of clotting in the extracorporeal circuit (ECC). In this study, 168 hemodialysis sessions were undertaken with UFH in 2 bolus doses (5,437 +/- 1,477 SD IU) and 231 with CY-216 in a single bolus dose [initial dose 150 anti-Xa U Institut Choay (IC)/kg]. There were no clots in the bubble trap in any UFH sessions, and 14.8% had coagulated fibers in the dialyzer. Clotting in the bubble trap was observed in 2 CY-216 sessions (0.8%) and coagulated fibers in 22.6% of the sessions. At the end of the study, the mean dose of CY-216 was 250 anti-Xa UIC/kg but a dose of 350 anti-Xa UIC/kg was needed in the 2 patients treated by recombinant human erythropoietin. Anti-Xa levels at the end of the runs were higher (0.47 +/- 0.1 U/ml) in the CY-216 group than in the UFH group (0.28 +/- 0.1 U/ml). There was a correlation between anti-Xa levels and efficacy in the CY-216 group. An anti-Xa activity above 0.4 U/ml was needed in order to minimize thrombus formation. Antithrombin III-protease complexes (ATM) and D dimer fibrin derivatives (D dimer) were used as thrombotic markers but they were of little value for the detection of fibrin formation in the ECC. Our findings suggest that CY-216 administered as a single bolus dose seems to be of similar effectiveness to UFH.
Aged↗
[The relationship between paracoccidioidomycosis and alcoholism].
The relationship between alcoholism and paracoccidioidomycosis was evaluated by the case-control method. The alcohol consumption of 4 groups of patients was compared: 50 patients with chronic paracoccidioidomycosis, 20 patients with the acute or subacute form of this mycosis and their respective control groups of hospitalized patients, each case matched by sex and age. Between September 1986 and July 1988 the cases and their controls were interviewed by one and the same investigator using a questionnaire on drinking habits: quantity and type of beverage consumed, time of onset and frequency of use and whether they had manifested symptoms of inebriation or of alcohol dependence previously. As compared with control patients, the mean daily ingestion of alcohol in excess of 60 ml was more frequent in the chronic paracoccidioidomycosis group (50.0% x 30.0%). These patients also preferred to drink sugar cane brandy more frequently (89.4% x 68.3%). When the average daily consumption of ethyl alcohol exceeded 100 ml, most patients presented a recurrence of infection during or after antifungal therapy. In the acute-subacute paracoccidioidomycosis group, 64.3% of the patients reported inebriation on one or more occasions, versus 17.6% in the respective control group. The results suggest that alcoholism can be a predisposing factor to paracoccidioidomycosis and, probably, accounts for a worse prognosis for this infection.
Adolescent↗
Super Bowl safety.
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Anniversaries and Special Events↗
A strategy of "combination chemotherapy" in Alzheimer's disease: rationale and preliminary results with physostigmine plus deprenyl.
Although the central cholinergic deficits are still considered to be of primary importance in Alzheimer's disease, there is great need for an expansion of the pharmacological approach in this illness beyond the simple cholinergic replacement hypothesis. This report focuses on the concept of "combination chemotherapy" in Alzheimer's disease as the next generation of therapeutic strategies. Based on earlier positive findings in Alzheimer patients with the monoamine oxidase B inhibitor, 1-deprenyl, the authors speculate that a combination of physostigmine, the short-acting cholinesterase inhibitor, and 1-deprenyl might be more beneficial than either agent alone. The authors outline a sample paradigm for such combination studies, report preliminary data on the first 16 Alzheimer subjects to have received an initial combination of physostigmine and deprenyl, and point to other possible "combination chemotherapy" strategies for future study.
Aged↗
Laboratory colonization and maintenance of Toxorhynchites moctezuma.
A colony of Toxorhynchites moctezuma was established at the Caribbean Epidemiology Centre in Trinidad in 1984. Toxorhynchites moctezuma was maintained in cages with high humidities. Eggs were deposited most frequently in a cut bicycle tire containing water. A minimum of 42 h was required for hatching, but 94% hatched between 43 and 51 h. Aedes aegypti larvae were supplied as prey. Larval development times varied with the quantity of prey offered, but when fed ad lib, peak developmental time was 18 days. Mean pupal developmental time was 5.5 days. Although only 12% of larvae survived to pupation in 3 years of production, our experience indicates this species would be a likely candidate for mass production and release.
Animals↗
Effects of the bromophenyl-dihidro-2H-1,5-benzodiazepine-2-thione on sleep.
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Animals↗
Anticonvulsant effect of the 7-(p-chlorophenyl)-8-phenoxy-4,5-benzo-3-aza-2-nonem.
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Animals↗
Paraquat poisoning in children: survival of three cases.
Five children with paraquat poisoning are presented. Three were diagnosed early, treated and survived; the other 2 arrived 1-2 days after paraquat ingestion and died subsequently from respiratory failure due to pulmonary fibrosis.
Accidents↗
[Microcirculatory changes in mitral prolapse as an expression of a systemic change in the connective tissue].
Many authors hypothesize that mitral valve prolapse (MVP) can be, in most cases, only a clinical sign of a primitive and systemic disorder of the connective tissue, like in Marfan Syndrome (MS). In our previous works we supported the presence of morphological and functional alterations of the microcirculation in patients affected by MS. In order to characterize a possible common denominator between these pathologies we have studied the cutaneous microcirculation in a group of patients affected by MVP, divided into 2 groups: anatomic MVP (MVP) and MVP syndrome (MVPS). The morphologic parameters have been investigated by nailfold capillaroscopy while digital laser-Doppler was used to study skin flowmetry. The results have been compared with a control group. Capillaroscopic remarkers showed an architecturally disorganized microvasculature with aspects related to a reduced compactness of the microvasculature unit with a significatively higher score compared with controls (7.3 +/- 2.9 vs 3.6 +/- 1 p less than 0.0005). Laser-Doppler flowmetry showed a significatively reduced rest flow; ischemic test showed: spike time 48.9 +/- 36.9 vs 15.3 +/- 7.7 s (p less than 0.0005), hyperemic acme 6.6 +/- 2.7 vs 12.5 +/- 8.4 UP (p less than 0.002); % increase 32.1 +/- 20.2 vs 51.5 +/- 15.4 (p less than 0.002). Thermic test showed a significatively higher thermic acme 8.7 +/- 4.2 vs 12.6 +/- 9.11 UP (p less than 0.05). These results appeared to be correlated with stage pathology as it was observed a severe microvasculature disorders in MVPS. Therefore we suppose that a phenotypic continuum may exist between MS and MVP.
Adult↗
[Cardiac involvement in pheochromocytoma. A report of 6 cases].
Pheochromocytoma is a rare case of sustained hypertension or hypertensive crisis: sometimes it may occur with several aspecific symptoms or hypotension. The literature reports frequent myocardial involvement in patients affected by pheochromocytoma. Adrenergic hormone effects are responsible for a functional coronary insufficiency which causes myocardial damage. The cardiac involvement may appear with symptoms of different severity that sometimes represent the only symptoms of the neoplasia. Clinical and instrumental cardiac alterations observed in 6 patients suffering from pheochromocytoma are reported. Electrocardiographic abnormalities were found in 5 out of 6 patients. Inferior myocardial infarct was present in one case; in two patients electrocardiogram showed left ventricular hypertrophy and negative T wave; frequent ventricular extrasystoles in one case and complete atrio-ventricular block in another were found during the hypertensive crisis; in one patient the electrocardiogram showed STT changes and in the last one, left ventricular hypertrophy, more evident in the interventricular septum, was present at the echocardiogram. All subjects underwent surgical treatment after a period of drug therapy. To date surgery is the only possibility to eliminate myocardial malignant effects of catecholamines.
Acute Disease↗
Clinical clearance of the cervical spine.
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Cervical Vertebrae↗
The TRH stimulation test in Alzheimer's disease and major depression: relationship to clinical and CSF measures.
A blunted thyroid-stimulating hormone (TSH) response to exogenous thyrotropin-releasing hormone (TRH) has been reported to occur consistently in patients with major depression and less consistently in patients with Alzheimer's disease (AD). In this study we compared the TSH response to TRH in a large group (n = 40) of AD patients, elderly patients with major depression (n = 17), and age-matched controls (n = 14) to further characterize how it may relate to clinical variables, baseline thyroid function tests, and cerebrospinal fluid measures. Comparisons of TRH stimulation test response across all three groups revealed that patients with major depression had lower stimulated TSH levels (delta maxTSH) (p less than 0.02) and higher (though still within normal limits) mean thyroxine (T4) levels (p less than 0.05) than the AD patients or controls. AD patients with a blunted TSH response had a significantly higher mean free T4 (FT4) level (p less than 0.03) and tended to be more severely demented (p less than 0.01) than those with a nonblunted response.
Aged↗
A pilot placebo-controlled study of chronic m-CPP administration in Alzheimer's disease.
Meta-Chlorophenylpiperazine (m-CPP), a serotonin agonist and metabolite of the anti-depressant trazodone, was administered chronically to eight moderate to severely affected Alzheimer patients to determine whether it would produce improvement in behavioral symptoms complicating this illness. In doses up to 80 mg/day for 16 days, m-CPP was well tolerated and resulted in small but significant increases in anergy and depression-related symptoms compared with placebo. The effects of chronic m-CPP in this study contrast with the reported beneficial effects of the parent compound trazodone and selective 5-HT reuptake inhibitors in treating behavioral symptoms in Alzheimer patients.
Aged↗
Effect of hyperkalemia on insulin secretion.
The effect of hyperkalemia on insulin secretion remains undefined. We evaluated portal and peripheral insulin levels in anesthetized dogs after infusions of KCl. The mean maximal increase in peripheral plasma potassium at infusion rates of 0.2 mEq/kg/h was 0.68 +/- 0.20 mEq/l. There were no significant increases in either portal or peripheral insulin levels. In contrast, in six dogs whose plasma potassium concentration increased in each case by more than 2.0 mEq/l (infusion rate of 0.5 mEq/kg/h), portal insulin levels increased fivefold (p less than 0.05). We concluded that only marked increases in plasma potassium concentration stimulate pancreatic insulin secretion.
Animals↗