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Biomedical subjects

A A Cruz

Publications and source records attributed to A A Cruz.

At least 19 recordsLinked to original sources
PubMed2006

Pharmacologic and anti-IgE treatment of allergic rhinitis ARIA update (in collaboration with GA2LEN).

The pharmacologic treatment of allergic rhinitis proposed by ARIA is an evidence-based and step-wise approach based on the classification of the symptoms. The ARIA workshop, held in December 1999, published a report in 2001 and new information has subsequently been published. The initial ARIA document lacked some important information on several issues. This document updates the ARIA sections on the pharmacologic and anti-IgE treatments of allergic rhinitis. Literature published between January 2000 and December 2004 has been included. Only a few studies assessing nasal and non-nasal symptoms are presented as these will be discussed in a separate document.

Animals↗
PubMed2005

Association between atopy and recurrent vaginal candidiasis.

To determine whether there is an association between atopy and recurrent vaginal candidiasis (RVC) and to evaluate the type-2 immune response in patients with RVC. Evaluation of immediate hypersensitivity skin tests to aeroallergens, measurement of total IgE and Candida albicans specific IgE and levels of IL-5 in 44 women with RVC and 26 with sporadic vaginal candidiasis (SVC). Statistical analyses were performed by Mann-Whitney test and chi(2) test with Yates correction. History of atopy (68%) and positive skin test (42%) were higher (P < 0.05) in RVC than in patients with SVC. No significant difference was found in total IgE, C. albicans specific IgE and IL-5 levels. There was a strong association between atopy and RVC, but type-2 immune response to C. albicans antigen was absent or similar in the two groups of patients.

Adolescent↗
PubMed2005

Skin reactivity to aeroallergens is reduced in human T-lymphotropic virus type I-infected healthy blood-donors (asymptomatic carriers).

BACKGROUND: A type 2 immune response, characterized by high levels of interleukin-4 and immunoglobulin E synthesis is a hallmark of respiratory allergic diseases. Individuals infected with human T-lymphotropic virus type I (HTLV-I) virus have spontaneous T-cell proliferation and increased interferon gamma production, which are immunological functions associated with a type 1 immune response. OBJECTIVE: To determine the frequency of asthma and rhinitis symptoms and immediate skin reactivity to aeroallergens in HTLV-I infected individuals, compared with noninfected subjects. METHODS: Cross sectional study of 101 HTLV-I infected and 101 control uninfected blood donors, assessed by enzyme-linked immunosorbent assay and Western blot assays. The subjects were age and sex-matched, identified as presenting allergy history by questionnaire, which was complemented by a complete clinical examination and skin prick tests for aeroallergens. RESULTS: The frequency of atopy was lower in infected than uninfected subjects, 14.9 and 29.7% (P = 0.017), respectively. Skin reactivity to Dermatophagoides pteronissynus, Dermatophagoides farinae and Blomia tropicalis were the most frequently observed among all the tested antigens in both groups. Skin reactivity to histamine was also reduced in the infected individuals compared with uninfected subjects (medians 4.0 vs 5.0, respectively; P < 0.0001). Infection by HTLV-I was found to be a factor of protection to atopy (RP 0.44; P = 0.005). CONCLUSIONS: The HTLV-I infection reduces the frequency of respiratory allergy and skin reactivity to aeroallergens.

Adult↗
PubMed2004

Lower prevalence of reported asthma in adolescents with symptoms of rhinitis that received neonatal BCG.

BACKGROUND: BCG is a vaccine used against tuberculosis and leprosy and is an immunostimulant that primes T(H)1 lymphocytes to produce cytokines that antagonize atopy both in animal models and in man. Considering that atopy is the main risk factor for asthma, one can hypothesize that vaccination inducing T(H)1 responses, such as BCG, can be protective against asthma. METHODS OBJECTIVE: To estimate the association between neonatal BCG vaccination and prevalence of asthma among adolescents. STUDY DESIGN: Cross-sectional study with schoolchildren aged 12-16 years. The presence of a scar compatible with BCG was used as a surrogate of neonatal vaccination. A self administered structured questionnaire was prepared based on that used by the International Study of Asthma and Allergies in Childhood. The prevalence of asthma was categorized according to the report of lifetime wheeze, lifetime asthma, lifetime asthma among those referring allergy and among those referring allergy and sneezing. RESULTS: Neonatal BCG vaccination was not associated with the overall prevalence of reported wheezing or asthma. However, in the subgroup reporting current allergy and sneezing, neonatal BCG was associated with a 37% reduction of prevalence of lifetime asthma. CONCLUSIONS: In the population we surveyed, neonatal BCG scar was associated with a reduction in the risk of asthma only in individuals with a past history suggestive of allergic rhinitis.

Adolescent↗
PubMed2004

Paradoxical coexistence of atopic asthma and Human T-Lymphotropic Virus Type I (HTLV-I) infection: a case report.

In this case report, the authors report the presence of two supposedly antagonic immune diseases in the same patient. The patient is a 45-year-old white woman with a history of asthma and allergic rhinitis for the last 10 years. Asthmatic symptoms were present and were triggered after exposure to dust and mold. Her Human T-Lymphotropic Virus Type I (HTLV-I) seropositive status was detected by chance five years ago during a routine screening for blood donation. Skin prick tests were positive for Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis. Cytokine levels in unstimulated cultures were: IFNgamma= 1195 pg/ ml, TNFalpha = 460 pg/ml, IL5 = 41 pg/ml and IL10 = 265 pg/ml.

Asthma↗
PubMed2001

Neonatal orbital abscess.

PURPOSE: To describe two cases of orbital abscess in neonates and to review the literature of orbital cellulitis in neonates. DESIGN: Two interventional case reports. METHODS: Photographs, orbital computed tomography scans, and full pediatric examination were obtained in two cases of orbital abscess in neonates. RESULTS: Acute ethmoiditis with orbital abscess formation was found in both infants. In one of them, Staphylococcus aureus was identified as the source of infection. CONCLUSIONS: The clinical findings of our cases concur with the literature (eight cases) indicating that orbital abscess caused by Staphylococcal ethmoiditis is the most common form of orbital cellulitis in neonates.

Abscess↗
PubMed2001

Delayed retrobulbar hematoma after blepharoplasty.

PURPOSE: To describe a case of late orbital hematoma after blepharoplasty and review the literature on this subject. METHODS: A healthy woman developed an orbital hematoma and loss of vision 7 days after an elective blepharoplasty. Computed tomography and magnetic resonance images of the orbits were obtained 1 day after the vascular accident. RESULTS: Computed tomography and magnetic resonance images clearly demonstrated that the site of the hemorrhage was the superior nasal fat pad. Blood from this region molded the globe and accumulated in the intraconal space behind the posterior sclera. The patient was successfully treated with conservative measures only. CONCLUSIONS: Orbital hematoma, which is the main cause of loss of vision after blepharoplasty, can be a late postoperative complication.

Adult↗
PubMed2001

Comparison of palpebral fissure obliquity in three different racial groups.

PURPOSE: To compare the obliquity of the palpebral fissures of three different racial populations. METHODS: Prospective observational study. Frontal views of the palpebral fissures of three different groups of subjects (Brazilian whites, Brazilian Japanese, and Brazilian Indians from the Upper Rio Negro Basin of the Amazonas State) were acquired with a photographic camera and transferred to a Macintosh computer. Using the National Institutes of Health Image software (NIH Image), the angle formed by the inner and the outer canthi was measured for all images. RESULTS: The mean fissure angle of the Japanese (9.39 degrees) was not statistically different from the mean angle of the Indians (9.64 degrees). On the other hand, both were significantly greater than the mean angle of the whites (4.60 degrees). CONCLUSIONS: Marked fissure obliquity is found more frequently among Asians than among whites.

Adolescent↗
PubMed2001

Successful treatment of refractory mucosal leishmaniasis with pentoxifylline plus antimony.

Mucosal leishmaniasis is characterized by an intense inflammatory reaction and tissue damage with few parasites in the lesion. On the basis of previous observations that suggest a possible role of tumor necrosis factor alpha (TNF-alpha) in the pathology of this disease, an open-label study was performed to evaluate the efficacy of the treatment with an inhibitor of TNF-alpha (pentoxifylline) associated to antimony therapy in 10 patients with refractory mucosal leishmaniasis. Patients were treated with pentavalent antimony (20 mg per kilogram of body weight per day) plus orally administered pentoxifylline 400 mg 3 times daily for 30 days. Nine of 10 patients fulfilled the criteria for cure: they experienced complete reepithelization of the mucosal tissue 90 days after therapy and displayed no evidence of relapse at 1 year of follow-up. The TNF-alpha levels before therapy (776 +/- 342 pg/mL) fell to 94 +/- 57 pg/mL (P < 0.05) within 60 days after therapy. Our results indicate that pentoxifylline plus antimony therapy should be considered in all patients with mucosal leishmaniasis that is refractory to treatment.

Administration, Oral↗
PubMed2000

Ablepharon-macrostomia syndrome: first report of familial occurrence.

Ablepharon-macrostomia syndrome (AMS) is a rare condition comprising severe deficiency of the anterior lamella of both eyelids, abnormal ears, macrostomia, anomalous genitalia, redundant skin, and absence of lanugo. There is no agreement about cause; some authors suggest autosomal recessive inheritance. We describe familial occurrence of AMS in a girl, sister of a previously reported patient. The father has facial anomalies that suggest autosomal dominant inheritance. Am. J. Med. Genet. 94:281-283, 2000.

Abnormalities, Multiple↗
PubMed2000

Eyelid abnormalities in lamellar ichthyoses.

PURPOSE: To describe eyelid abnormalities in lamellar ichthyoses (LI). DESIGN: Retrospective observational case series. PARTICIPANTS: Eight patients with classic LI and two patients with congenital ichthyosiform erythroderma. METHODS: Results of eyelid and corneal examinations of 10 patients with LI were reviewed and analyzed with emphasis on the relationship between eyelid ectropion and corneal damage. RESULTS: All patients presented with cicatricial lagophthalmos. Of the eight patients with classic LI, five had ectropion of the four eyelids, one had only lower ectropion, and two had no degree of ectropion. Two patients with congenital ichthyosiform erythroderma had distinct eyelid abnormalities, including madarosis and eyelash retraction. Loss of vision caused by corneal damage was found in three patients with classic LI. Of these three patients, two did not have upper eyelid ectropion. CONCLUSIONS: Severe corneal damage can occur in LI even if there is no upper or lower eyelid ectropion.

Adolescent↗
PubMed2000

The geometrical basis of the eyelid contour.

PURPOSE: To derive a two-dimensional, frontal-view model of eyelid contour. METHODS: Observational study. Palpebral fissure images of 110 normal subjects were acquired with a charge-coupled device camera and processed with National Institutes of Health Image software on a Macintosh computer. Monocular frontal-view images of the palpebral fissures were recorded and second-degree polynomial functions were fitted to both upper and lower eyelid contours for two areas: the whole eyelid margin (ciliated and inner canthal portions) and the ciliated portion alone. In addition, frontal and lateral palpebral fissure images were obtained. From the frontal view, the upper and lower ciliated contours were fitted with quadratic functions. From the lateral view, the upper and lower lateral angles, formed by the upper and lower eyelid margins and the axial axis, were measured. RESULTS: Exclusion of the inner canthal portion of the eyelid contour led to a much better quadratic fit for the contours. The sine (sin) of the upper lateral angle was strongly correlated with the parameter A of the quadratic function fitted to the upper eyelid (the parameter A determines the curvature of the function around its extremum point). For the lower eyelid, this correlation was not significant. CONCLUSIONS: The parabolic shape of the upper ciliated contour seen in two-dimensional images can be justified geometrically in a simple way, allowing a precise quantification of its shape. The same was not true for the lower eyelid. The parabolic shape of the upper eyelid can be demonstrated, using the Taylor series, to be a close approximation of the arc of a circle.

Adolescent↗
PubMed2000

Inverse association between skin response to aeroallergens and Schistosoma mansoni infection.

BACKGROUND: Helminthic infections and allergic disease are highly prevalent in many areas of the world. It is known that IgE antibodies are involved in the pathogenesis of both helminthiasis and atopy. However, the consequences of the presence of helminthic infections in atopic patients are still not completely understood. METHODS: Subjects infected by Schistosoma mansoni with more than 200 eggs/g of feces (n = 42) and uninfected subjects (n = 133) were selected from an endemic area of schistosomiasis. The history of allergy and results of the immediate hypersensitivity prick tests with inhalant allergen extracts were registered. Total IgE and IgE specific to S. mansoni and aeroallergens were measured in serum by ELISA. RESULTS: The proportion of individuals with a positive skin test to allergens was higher in the uninfected group (24.3%) than in the group with more than 200 eggs/g of feces (4.8%). The odds of atopy (defined as a positive test for at least one of the antigens) were 5 times higher (odds ratio = 7.0; 95% confidence interval = 1.6-31.1%; p = 0.01) in the uninfected group, after taking into account the potential influence of gender and age. While there was a tendency for higher total and S. mansoni-specific IgE levels in infected patients, an opposite trend, that is higher aeroallergen-specific IgE, was observed in uninfected subjects. CONCLUSIONS: There was a strong and statistically significant inverse association between the immediate skin test response to common aeroallergens and infection by S. mansoni. The results indicate that immediate hypersensitivity reactions may be suppressed in S. mansoni-infected individuals.

Adolescent↗
PubMed2000

Mucosal leishmaniasis: quantitative nasal cytology as a marker of disease activity and indicator of healing.

Mucosal leishmaniasis (ML) follow-up is based on subjective parameters. Using simplified quantitative cytology of nasal lavages (QNCs), we studied 20 ML patients, 10 patients with cutaneous leishmaniasis (CL), and 10 healthy subjects. Patients with ML were treated with antimony and followed up with otolaryngological examination plus QNCs for 6 months. At the first evaluation, the median total number of cells in ML patients (1,540,000) was greater than that in CL patients (215,000) or that in healthy subjects (250,000). Neutrophils were predominant in ML patients, in contrast to both sets of controls, in whom epithelial cells were more frequent. During treatment, we found a significant reduction in total nasal cell counts in ML patients who were cured, and encountered a switch in predominant cell type. The cytology of 2 patients who did not respond to antimony remained the same. It is therefore possible to detect nasal inflammation in ML patients through QNCs, which may indicate extension of mucosal involvement, providing an objective parameter to monitor therapy.

Adolescent↗
PubMed1999

Quantification of palpebral fissure shape in severe congenital blepharoptosis.

PURPOSE: To measure palpebral fissure morphology in patients with severe congenital blepharoptosis. METHODS: The palpebral fissure shape of 20 patients (30 eyes) with severe congenital blepharoptosis (levator excursion < or = 4 mm) was quantified with digital image processing in a cross-sectional design. Several variables related to the morphology of the palpebral fissure were measured: (a) upper and lower eyelid curvature, (b) palpebral fissure angle, and (c) position of the upper maximum and lower minimum eyelid contour. RESULTS: Patients with severe congenital blepharoptosis often show a moderate degree of antimongoloid palpebral fissure orientation and eyelid drooping that is greater temporally than nasally. CONCLUSIONS: Contour adjustment in severe congenital blepharoptosis surgery is better when it is not centered on the midline, but rather has a slight lateral displacement.

Adolescent↗