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Biomedical subjects

S Donoso

Publications and source records attributed to S Donoso.

At least 19 recordsLinked to original sources
PubMed1999

Association of primary Pneumocystis carinii infection and sudden infant death syndrome.

To delineate clinical and histological features of the first Pneumocystis carinii infection affecting the immunocompetent host, P. carinii-specific histological stains were performed on autopsy lung specimens from 534 consecutive pediatric patients (those with AIDS and malignancies were excluded) in Santiago, Chile. P. carinii clusters were found in 4 (25%) of 16 infants who died of no apparent cause at arrival to the emergency department, and in 10 (2.9%) of 342 infants who died of multiple conditions at the hospital (P=.002, Fisher's exact test). This prompted us to analyze additional series of infants with sudden infant death syndrome (SIDS). In 161 additional SIDS cases, 47 (35.1%) of 134 infants from Chile and 4 (14.8%) of 27 infants from Oxford, United Kingdom, were found to have P. carinii clusters in the lungs. The quantity of P. carinii cysts was small compared with the numbers seen in immunocompromised hosts with P. carinii pneumonitis. This study provides histological evidence that primary P. carinii infection is associated with SIDS.

Autopsy↗
PubMed1997

Immunohistochemical detection of hog cholera viral glycoprotein 55 in paraffin-embedded tissues.

Formalin-fixed, paraffin embedded tissues obtained from 40 pigs inoculated with a field isolate of hog cholera virus were examined for the presence of Gp55, a major structural protein of the virus envelope, using a monoclonal antibody-based immunohistochemical test with the avidin-biotin-peroxidase complex method. Immunoreactivity was detected in hog cholera virus-infected tissues but not in control pigs tissues, African swine fever virus-infected tissues, or bovine viral diarrhea virus-infected porcine or bovine tissues. The first positive reactions were seen in lymphatic tissues, digestive tract and skin on postinoculation day (pid) 4, respiratory and urinary tissues on pid 5, nervous tissues on pid 6, and endocrine tissues on pid 7. These staining reactions persisted until the last observation on pid 18. Hog cholera virus antigen was not detected in heart tissue at any time. The highest levels of antigen detection were found in tonsils, spleen, and pancreas, although the esophageal mucosa and skin epithelial cells were also intensely and widely stained. The cellular staining pattern of Gp55 had a ubiquitous distribution. It was found in epithelial cells, macrophages and circulating monocytes, endothelial cells, lymphoid cells, and glial cells. The results showed a high specificity and high sensitivity for detecting hog cholera Gp55 in formalin-fixed, paraffin embedded tissue samples. This method allows precise association of Gp55 with specific cells, tissues, and histologic lesions, making the technique suitable for use in routine diagnosis of hog cholera.

Animals↗
PubMed1994

Acute fatty liver of pregnancy: a clinical study of 12 episodes in 11 patients.

Twelve episodes of acute fatty liver of pregnancy (AFLP) were diagnosed in 11 patients during the past 18 years in a general hospital in Santiago, Chile, with a prevalence of 1 per 15,900 deliveries. Acute fatty liver of pregnancy started between the 31st and 38th weeks of pregnancy, with malaise, vomiting, jaundice, and lethargy as the main clinical manifestations. Polydipsia (in nine episodes) and skin pruritus (in seven episodes) were unusual clinical findings. In two patients, pruritus started two and four weeks before AFLP, suggesting that an intrahepatic cholestasis of pregnancy preceded AFLP in those patients. Considering the current prevalence of both diseases in Chile, their association should be considered fortuitous. In another patient, two consecutive pregnancies were affected by AFLP, raising to three the number of reported patients with recurrent AFLP. In 11 episodes, liver biopsies supported the diagnosis of AFLP by showing small and midsized vacuolar cytoplasmic transformation as the most prominent histopathological feature. Positive intracellular fat staining was found in the four samples analysed. Studies by electron microscopy showed megamitochondria with paracrystalline inclusions in four samples. All the mothers survived, but fetal mortality was 58.3%. Several extrahepatic complications delayed maternal recovery for up to four weeks after delivery. This study confirms an improvement in maternal prognosis in AFLP, discusses the possibility of an epidemiological association with intrahepatic cholestasis of pregnancy, and increases the number of patients reported with recurrent AFLP.

Acute Disease↗
PubMed1993

[Congenital hepatic fibrosis: an uncommon cause of portal hypertension].

Congenital hepatic fibrosis is an autosomic recessive disease, manifested in children or in young adults by hematemesis due to rupture of esophageal varices. Bacterial cholangitis may occur in some patients. Early diagnosis and treatment with portosystemic anastomosis and/or antibiotics may lead to a long survival with a good quality of life. Diagnosis requires histologic confirmation: normal hepatic lobules are surrounded by broad fibrous bands, and an increased number of bile ducts is usually seen in the portal tracts. Liver function remains well preserved. This report consists of 3 patients: a 17-year-old woman, a 10-year-old boy and a 24-year-old woman who developed severe upper GI bleeding due to ruptured esophageal varices. The first two patients were successfully operated on using the Sugiura technique for portal decompression. Their current survival after surgery is 3 and 9 years, respectively, with normal physical examination and liver function tests. The third patient died shortly after admission, due to the concurrence of a severe suppurative cholangitis.

Adolescent↗
PubMed1990

[Incidence of myocarditis in patients with dilated cardiomyopathy].

We performed right ventricular endomyocardial biopsies in 23 patients with dilated cardiomyopathy aged 45 +/- 14 years. All patients had congestive heart failure of unknown etiology dating up to one year before the procedure (57% less than 3 months). NYHA functional class was II in 5, III in 12 and IV in 6 patients. All patients had evidence of systolic dysfunction and a dilated left ventricle (LV diastolic dimension 68 +/- 11 and systolic dimension 55 +/- 11). Definite evidence of myocarditis, based on findings of inflammatory infiltrate and cellular damage, was found in 6 patients (26%), borderline myocarditis in 9 and abnormalities consistent with dilated cardiomyopathy in 8. The incidence of myocarditis here reported is lower than previously figures based on findings of more than 5 lymphocytes per high power field. In this series, clinical and functional aspects of heart failure did not differ in patients with or without evidence of myocarditis.

Adolescent↗
PubMed1990

[Wegener's granulomatosis: clinical and pathological report of 22 cases].

We report clinical and pathologic findings in 22 patients with Wegener's granulomatosis collected from 1966 to 1989. Ten cases were analyzed retrospectively. Organs affected included the lungs (n = 18), upper airways (16), kidneys (15), musculo-skeletal system (10), eyes (8), skin (7) and ear (5). Clinical manifestations of airway involvement included nasal obstruction, dysphonia and epistaxis. Lung involvement was evident in chest X-rays in 18 patients, 14 with a nodular aspects. Histologic study in 14 of these patients showed necrotizing and granulomatous vasculitis. Clinical evidence of nephropathy was evident in 15 patients and led to rapidly progressive renal failure in 8. Biopsy in this group (n = 14) revealed focal glomerulonephritis in 6 and diffuse disease in 8. Overall, 13 patients died: 5 without diagnosis, 4 from renal failure, 2 from sepsis, 1 from a lymphoma developing 3 years after immune suppressive therapy and 1 from unknown causes. Among survivors, one received a renal transplant and one remains in chronic dialysis. The diagnosis of Wegener's granulomatosis is therefore based on clinical findings including rhino pharyngeal, pulmonary and renal manifestations.

Adult↗
PubMed1990

[Primary biliary cirrhosis. The clinical experience in 31 patients].

We analyzed 31 patients with a diagnosis of primary biliary cirrhosis, 29 of them males, aged 23 to 72 years. Liver biopsy was diagnostic in all showing initial findings of the disease in 5. Echotomography and cholangiography demonstrated a patent biliary, tract. Anti-mitochondrial antibodies were present in 94% of patients. Alkaline phosphatase and biliary acid levels were useful for diagnosis. Pruritus was present with varying intensity in all patients, with premenstrual exacerbations in 5 females who had cholestasis of pregnancy or hepatitis caused by progestin drugs before developing cirrhosis. Recurrent urinary tract infection was present in 8 patients, osteoporosis in 24, Sjogren's syndrome in 24 and Crest syndrome in 4. Survival ranged from 1 to 12 years, death being caused by ruptured esophageal varices in 12 patients and by liver failure in 7. Persistence of pruritus and altered liver function tests after cholestasis of pregnancy or hepatitis caused by progestins should lead to investigation of biliary cirrhosis.

Adult↗
PubMed1978

Clinical and pathological study of asymptomatic HBsAg carriers in Chile.

A clinical, biochemical, and pathological study was performed in 38 chronic HBsAg carriers. The study group is a part of 393 carriers found among 117 705 voluntary blood donors at the National Blood Bank, Hospital del Salvador, Santiago, Chile. None of the 38 carriers had a past history of illicit drug abuse, hepatitis, or work involving a high risk of hepatitis B virus infection. Ten individuals had a normal liver biopsy, 17 reactive non-specific hepatitis, one fatty changes, four chr onic persistent hepatitis, one aggressive hepatitis, two post-necrotic cirrhosis, and three alcoholic cirrhosis. There was not a close correlation between liver function test and liver histology. The most significant laboratory finding was the postivity of alpha fetoprotein in two cases. During the follow-up the two alpha fetoprotein patients presented a hepatocarcinoma 12 and 14 months after admission to the study.

Adolescent↗