Biomedical subjects

A M Robles

Publications and source records attributed to A M Robles.

5 recordsLinked to original sources

PubMed1989

Itraconazole in human histoplasmosis.

A non-comparative open trial with itraconazole in progressive forms of human histoplasmosis was carried out. Thirty two patients who completed 6 months of treatment were included; 29 suffered the chronic disseminated form; 2 exhibited a chronic pulmonary histoplasmosis and one patient presented a subacute disseminated form. Thirty patients were males and 2 females; their ages ranged from 37 to 78 years old (average 56.9). The following underlying diseases were registered: hepatopathies: 12 cases; endocrinopathies and steroid therapy: 13 cases; chronic obstructive pulmonary disease: 10 patients; malignancies: 3 cases; long treatment with psychotropic drugs; 2 cases and 1 immunodeficiency of unknown origin. The therapeutic schedule applied was: 100 mg/day, orally, during 2 months, followed by 50 mg/day for another four months. Twenty-nine patients achieved clinical cure, two showed a striking improvement (both had the chronic pulmonary form) and the treatment could not be evaluated in 1 case. A follow-up of longer than a year was registered in 23 cases, one died as a consequence of mesothelioma and another due to renal impairment, and no relapses were observed. A decreasing complement fixation titer (of more than 2-fold) was observed in 19 cases; 8 of 10 patients with negative skin tests turned positive and the erythrocyte sedimentation rate was reduced to more than a half in 24 cases. Concerning side-effects, a mild, transient and asymptomatic rise of the hepatic enzymes was registered in 9 patients. It seems that itraconazole will be the drug of choice in the treatment of human histoplasmosis in immunocompetent patients.

Adult↗

PubMed1976

[Study of the aerobic bacterial flora of onycolysis and paronychia caused by Candida].

The aerobic bacterial flora of 63 cases of onicolysis 78 of paronychis and 5 of onicomadesis produced by yeast-like fungus were studied. Bacterial isolation was carried out in nutrient agar with a concentration of 10 mug/ml of nystatin. These microorganisms were identified following the Otto Bier and Bailey & Scott's techniques (3, 1). Bacterial contamination was very frequent. One species or more were isolated from 93,6% of onicolysis and 97% of paronychis. The onicolysis presented the following flora: "Staphylococcus aureus" in 22 cases, "Staphylococcus epidermidis" in 21, Gram positive sporulated bacilli in 17, "Enterobacteriaceae" in 13, and "Pseudomona aeruginosa" in 6. The paronychial lesions showed the following flora: "Staphylococcus aureus" in 21 cases, "Staphylococcus epidermidis" in 26, Gram positive sporulated bacilli in 17, "Enterobacteriaceae" in 17 and "Pseudomona aeruginosa" in 3. It is important to emphasize that "Pseudomona aeruginosa" was isolated in a few cases of both types of candidal onixis, contrary to usual reports (2, 4, 9). No significant difference between the aerobic bacterial flora of the onicolysis and paronychia was found, that would give an explanation of the existence of these two clinical forms of candidal nails infection.

Bacteria↗

PubMedDate not supplied

[Immunodiffusion tests in gel media with the addition of polyethyleneglycol 6000 for the serodiagnosis of mycoses].

Different immunodiffusion techniques with and without the addition of polyetilenglycol 6000 (PEG), were studied to determine its effect on the sensitivity of these reactions. One hundred thirteen sera from patients who suffered or had suffered deep mycoses (paracoccidioidomycosis: 49, histoplasmosis: 25, aspergillosis: 25, candidiasis: 8 and coccidioidomycosis: 6) were examined by the quantitative Ouchterlony's immunodiffusion procedure. Regular medium and media with 2% and 4% PEG were used. Eighty two out of the one hundred thirteen sera were positive for the regular medium and 91 for the medium containing 2% of PEG; furthermore, an increase of 1 or 2 two fold dilutions in the titers was observed in 40% of the sera, for the later media. Twenty one sera from aspergillosis cases were examined by agarose gel immunoelectrophoresis, 80% had more precipitin bands in the medium with 2% of PEG. Thirty four serum samples of patients suffering aspergillosis, paracoccidioidomycosis and histoplasmosis were studied using the agarose electroosmophoresis with the secondary immunodiffusion test. An increase in the number of the anodic bands were observed in 55% while 64% presented more catodic bands, when the PEG medium was used. This results would indicate that the addition of 2% PEG 6000 to the regular medium improves the sensitivity of the immunodiffusion tests for mycoses.

Antigens↗

PubMedDate not supplied

[Nocardia isolated from the respiratory tract].

Twelve strains of Nocardia isolated from sputa, bronchial washings and pleural fluids, were studied. The classification was based on the following characteristics: a) acid-fastness; 2) ability to disolve crystals of tyrosine and xantine; 3) hydrolysis of casein; 4) growth in dilute gelatin medium (0.4%) and 5) galactose acidification. Direct cultivation of the clinical material in Czapek liquid culture medium without carbon source and containing a paraffin rod (pariffin-bait technic), as well as the routin T.B. sputum digestion and concentration with NaOH solution followed by its cultivation in Loewenstein's medium, were employed for the isolation of Nocardia. The sensitivity of the strains to tuberculostatic drugs was investigated using the Canetti's method, as was the ability to growth in Sabouraud and lactrimel culture media supplemented with 100 mug/ml of rifamycin. Finally the pathogenicity test was carried out by intraperitoneal and intramuscular inoculation in guinea-pigs. All the strains were classified as Nocardia asteroides. Seven starins were isolated from patiens with lung conditions of no nocardial etiology. The diagnosis of nocardiosis of the lung was demonstrated in the remaining five patiens by microscopical observation of Nocardia in clinical specimens, by the repeated cultures obtained from these materials and, finally, by the fact that an improvement of the clinical symptomatology was obtained by sulfa administration.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Study of serologic cross reactions between the antigens of Paracoccidioides brasiliensis and Histoplasma capsulatum].

A comparative study of serologic cross-reactions between histoplasmosis and paracoccidioidomycosis was carried out using complement fixation (CF) and agar gel immunodiffusion (ID) tests. Sera from 77 patients with paracoccidioidomycosis, 38 with histoplasmosis and 50 healthy individuals were studied. The Pan American Health Organization microtiter CF test and the Hupper ID technique were employed. The antigens were prepared by the method of Ajello as modified by Negroni. Paracoccidioidin CF test was positive in all patients with paracoccidioidomycosis; 29 of these (37%) presented serologic cross-reaction with histoplasmin. Histoplasmin CF test was positive in all but one of the patients with histoplasmosis and only 4 of them (10%) showed cross-reaction with paracoccidioidin. Positive reactions with the ID test were registered in 74/77 cases of paracoccidiodomycosis, with only one case of cross-reaction (1,3%). The result for the ID test was positive in all but one of the cases of histoplasmosis, with only one cross-reaction with paracoccidiodin (2,7%). The ID test seemed to be much more specific although it could be less sensitive. It was also easier to perform and less expensive than the CF test. Nevertheless the authors urge that the CF test also be carried out whenever posible, since the information obtained is likely to be of more value in follow-up and control of patients.

Antigens, Fungal↗