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Biomedical subjects

B Morales

Publications and source records attributed to B Morales.

18 recordsLinked to original sources
PubMed1992

Acute Chagas' disease (Trypanosomiasis americana) in acquired immunodeficiency syndrome: report of two cases.

Two heterosexual men, aged 31 and 40 years, with the acquired immunodeficiency syndrome and presenting with the acute form of Chagas' disease are reported. The first patient, a carrier of hemophilia A, was treated for 20 years with Chilean and Brazilian cryoprecipitates. This patient acquired both diseases through this medium. The second patient, an inhabitant of northern Chile (fourth region), was allegedly bitten by Triatoma infestans and was an intravenous drug addict. The hemophilic patient presented with a neurologic syndrome; a brain biopsy showed a necrotizing encephalitis with an obliterative angiitis and abundant macrophages. The second patient developed intractable congestive heart failure; necropsy showed a dilated myocarditis with rupture of myofibers and an inflammatory infiltrate rich in plasma cells, lymphocytes, and macrophages. Using light and electron microscopy, abundant amastigotes of Trypanosoma cruzi were seen in brain tissue, especially in the cytoplasm of macrophages, as well as in some myocardial fibers. In both cases, determination of anti-T cruzi antibodies (indirect hemagglutination technique) and xenodiagnosis were positive.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Parkinsonism associated with calcium channel blockers: a prospective follow-up study.

Parkinsonism is a well-known side effect of some calcium channel blockers (CCB). Its long-term evolution, however, is unknown. To clarify this issue, we performed a prospective follow-up study involving 32 patients diagnosed with CCB-induced parkinsonism. After the baseline examination, the CCB were discontinued and serial evaluations were carried out according to the same protocol. Despite a global improvement, cognitive and mood disturbances subsided slowly, and tremor persisted in most patients. After 18 months of CCB withdrawal, 44% of patients had depression, 88% had tremor, and 33% still had criteria for diagnosis of parkinsonism. During the survey, only three patients were found to be fully recovered. The improvement of some clinical symptoms was related to age: Patients younger than 73 years recovered better than older patients did. Our data indicate that CCB-induced parkinsonism is not the benign condition previously thought, and suggest an age-related prognosis of this entity.

Adrenergic beta-Antagonists↗
PubMed1992

[Correlation between ultrasound and pathology of the gallbladder].

Ultrasound is a sensible and specific method for the diagnosis, study of natural course and follow up of medical treatment of gallstones. Thus it is important to specify the concordance between echographic and pathological findings of the gallbladder. Ninety one patients were subjected to an ultrasound gallbladder examination immediately before elective surgery and the excised organ was pathologically examined right after the operation. The number and size of stones, the diameters and wall thickness of the gallbladder and the presence of polyps and septa were compared with both methods. The correlation was fair for the number or size of the stones considered separately; however the correct diagnosis of both parameters was obtained in only a third of the cases. Diameters of the gallbladder were underestimated by ultrasound; wall thickness measurement showed a very good correlation with both methods. No correlation was found for polyps or septa. Although ultrasound is excellent for the diagnosis of gallstones, its precision, is insufficient to determine the exact number and size of the stones.

Cholelithiasis↗
PubMed1991

Matrix engineering.

Matrix engineering is a technology that utilizes hyaluronan (HA, hyaluronic acid) based matrices to control, direct or augment tissue regenerative processes. Hyaluronan and the concept of matrix engineering have become established tools in ophthalmic and orthopaedic medicine. The clinical indications for HA are limited by the physical properties and short residence time of the natural HA molecule. To expand and improve upon its current medical applications, a family of HA derivatives was prepared by chemical modification and cross-linking. Relative to the non-modified HA molecule, the hylan family of polymers provides more versatile physical forms, improved mechanical properties and an extended residence time. Hylan can also be used as a surface coating to improve blood compatibility. The chemical, physical and biological properties of hylans will be reviewed, focusing on the specific therapeutic indications they enable.

Animals↗
PubMed1991

[Craniocervical dystonia and facial hemispasm: clinical and pharmacological characteristics of 52 patients].

The results obtained in a retrospective study on clinical and pharmacological aspects of 41 patients suffering craniocervical dystonia (24 with blepharospasm, 17 with torticollis) and 11 with spasm are here presented. Mean age of symptoms onset was 57.4, 43.8 and 55.8 years old respectively; this variable was comparatively higher in females than in males with torticollis. The prevalence of blepharospasm and hemifacial spasm was higher in females. A 38.7% of patients suffering blepharospasm also presented oromandibular dystonia (Meige's syndrome). Other abnormal movements less frequently associated were cephalic tremor, postural hand tremor and larynx dystonia. In three cases with blepharospasm there was family history of Parkinson's disease and in two cases with torticollis there was family history of essential tremor. The mean age of onset was lower in patients with clonic torticollis and the evolution time of symptoms was longer than in those who presented the tonic type. Clonic torticollis were less frequently associated to pain. Trihexyphenidyl (anticholinergic) was the most efficient drug in craniocervical dystonia, and clonazepam in facial hemispasm. In general, as earliest the age of onset was, as better the therapeutical response was.

Adolescent↗
PubMed1991

[Focal dystonias and facial hemispasm: treatment with botulinum A toxin].

We report the results of the treatment of 80 patients with various idiopathic focal dystonia and essential hemifacial spasm with Botulinum A toxin. A statistically significant improvement was obtained in our 34 patients with blepharospasm, 19 patients with hemifacial spasm, 59% of 22 patients with cervical dystonia and 60% of 5 patients with hand dystonia. Mean duration of the benefit of each injection was 15.3, 16.3, 7.6 and 8.7 weeks respectively. Adverse effects were local and transient. We concluded that botulinum A toxin is a safe and effective therapy for patients with focal dystonia and hemifacial spasm.

Blepharospasm↗
PubMed1989

[Brucellosis and acute inflammatory polyradiculoneuropathy].

Three patients with Guillain-Barré syndrome (GBS) during active brucellosis are reported: in one of them, who had an unfavorable outcome, the clinical features, the neurophysiological studies and the sural nerve biopsy were consistent with the axonal form of GBS. In the remaining two patients, who had a satisfactory course, the neurophysiological studies and the sural nerve biopsy disclosed the demyelinating character of the disease. We agree with other authors that the axonal and demyelinating forms of GBS should be separated, in view of their different clinical and possibly pathogenetic implications, both in GBS in general and in the form associated with brucellosis.

Adult↗
PubMedDate not supplied

[Focal dystonias and facial hemispasm: treatment with botulinum A toxin].

We report the results of the treatment of 80 patients with various idiopathic focal dystonia and essential hemifacial spasm with Botulinum A toxin. A statistically significant improvement was obtained in our 34 patients with blepharospasm, 19 patients with hemifacial spasm, 59% of 22 patients with cervical dystonia and 60% of 5 patients with hand dystonia. Mean duration of the benefit of each injection was 15.3, 16.3, 7.6 and 8.7 weeks respectively. Adverse effects were local and transient. We concluded that botulinum A toxin is a safe and effective therapy for patients with focal dystonia and hemifacial spasm.

Blepharospasm↗
PubMedDate not supplied

[Effect of a controlled low-protein diet on the pharmacological response to levodopa and on the plasma levels of L-dopa and amino acids in patients with Parkinson's disease].

Levodopa is the treatment of choice in Parkinson's disease, but a high percentage of patients develop complications in the response, including fluctuations, after some years of treatment. Although the origin of fluctuations is unknown, these could be, at least partly, attributed to pharmacokinetic factors. Aromatic aminoacids interfere in the absorption and brain penetration of levodopa, and lowering protein intake improves the quality of the response. The continuation of a low-protein diet is difficult for some patients. In this way, to know if these diet effects are noticeable in an acute period would be interesting, in order to select groups of patients who were susceptible to improve with this treatment. In this report we have studied the acute effect of a low protein diet on the pharmacological response to levodopa, and the plasmatic levels of L-Dopa, 3-OM-Dopa and large neutral aminoacids. Protein restriction improves clinical response to levodopa, although the mechanisms of this improvement remain unknown.

Adult↗
PubMedDate not supplied

[Clinical and epidemiologic characteristics of familial Parkinson disease].

We have studied 44 patients diagnosed of idiopathic Parkinson disease included in our database of rigid-akinetic syndromes. We have compared their demographic, environmental and clinical features with the ones that presented a group on 22 patients diagnosed of idiopathic Parkinson disease and had some first degree relatives with the same disease. Patients with familial Parkinson disease are distinguished from the ones that suffer from sporadic Parkinson disease because of an early start, greater consanguinity rate and greater frequency of a similar disease in their parents. Moreover, we have seen that familial Parkinson disease patients have drunk more water from wells during their lives than the ones that suffer sporadic Parkinson disease, present greater frequency of wide motoricity disorders, dystonia, night hypokinesia, fluctuations in relation to L-DOPA and greater frequency of early going grey. We have not found either epidemiologic data which could explain the appearance of familial cases or environmental causes which could produce familial Parkinson disease. Clinical differences between the two groups are likely due to an early start of symptoms in familial Parkinson disease cases. According to our data we could not conclude that between familial and sporadic Parkinson disease are significant differences in to justify two well-defined diseases. Even, the familial presentation of idiopathic Parkinson disease could be the normal form of Parkinson disease if long survival was a favourable factor of disease onset in pre-symptomatic persons.

Aged↗
PubMedDate not supplied

[Renal artery thrombosis in newborn infants undergoing umbilical artery catheterization].

A prospective study to detect renal artery thrombosis by radionuclide renal scintigraphy in newborn infants who underwent umbilical arterial catheterization over a one year period was done: 62 babies were catheterized, 92% were preterm and 85% had severe respiratory distress syndrome that required mechanical ventilation, 25/62 (40.3%) survived and in all of them Tc-99m DMSA scans were taken at a median of 5 days after withdrawal of the umbilical artery catheters (range 9 h to 29 days). A baby with renovascular hypertension had a DMSA scan which showed segmental vascular defect in one kidney. Another patient had left iliac artery thrombosis and two others showed evidence of transient vasospasm. Death occurred in 37/62 (59.7%), 92% of whom underwent autopsy studies which showed aortoiliac thrombosis in 8.8%, all of them without clinical symptoms. Other 12 newborn infants who died without previous umbilical artery catheterization had no evidence of thrombosis at autopsy.

Catheterization↗