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Biomedical subjects

C Arango

Publications and source records attributed to C Arango.

33 records · Page 2Linked to original sources
PubMed1998

Altered cell-mediated immunity in asymptomatic Colombian natives with positive or indeterminate serology for HTLV-I.

Although HTLV-I infection has been associated with immunosuppression in symptomatic patients, no controlled study has been done in asymptomatic carriers. We evaluated delayed-type hypersensitivity (DTH) to seven antigens by multitest cell-mediated immunity (CMI) in 40 Colombian Indians, 10 HTLV-I-seropositive asymptomatic patients, and 30 matched controls. Multitest CMI was placed in the forearm and was read 48 hours later by the same physician. A positive reaction was defined as > or =2 mm. Hypoergic response was defined as <2 of 7 positive reactions per case or control. We found that HTLV-I-seropositive people had fewer positive reactions than matched controls (50% versus 64%, respectively; p < .04) but no significant difference was found in these populations in the evaluation of hypoergic responses. This study suggests the presence in asymptomatic HTLV-I-positive Colombian Indians of a marginal alteration of cell-mediated immunity that cannot be classified as hypoergic.

Adult↗
PubMed1998

Antibiotic prophylaxis after basilar skull fractures: a meta-analysis.

Antibiotic prophylaxis after basilar skull fractures remains controversial. Previous studies have not clearly delineated the utility of prophylactic antibiotics in this setting. We undertook this study to determine if antibiotic prophylaxis after basilar skull fractures prevented meningitis. We performed a formal systematic review of previously published studies after a computerized search with use of the MEDLINE data base (1970-1996). Fourteen studies were identified, and 12 studies met the criteria for inclusion. Study design and quality were assessed by two independent investigators with use of a predetermined protocol. A total of 1,241 patients with basilar skull fractures were included; 719 patients received antibiotics, and 522 patients did not receive antibiotics. Overall results suggest that antibiotic prophylaxis did not prevent meningitis among patients with basilar skull fractures (odds ratio [OR] = 1.15; 95% confidence interval [CI] = 0.68-1.94; P = .678). Patients with basilar skull fractures and cerebrospinal fluid leakage were analyzed separately (OR = 1.34; 95% CI = 0.75-2.41; P = .358), as were children (OR = 1.04; 95% CI = 0.07-14.90; P = 1.000). Antibiotic prophylaxis after basilar skull fractures does not appear to decrease the risk of meningitis.

Antibiotic Prophylaxis↗
PubMed1998

Risk Factors for HTLV-I Mother to Child Transmission: Influence of Genetic Markers.

This study was designed to evaluate the influence of genetic markers on the seropositivity of offspring of HTLV-I positive mothers in Tumaco, Colombia, an endemic area for HTLV-I infection and a site where there exists a racially mixed population of Black and Caucasian ancestors. 33 HTLV-I seropositive women with at least one offspring were studied. A total of 111 offspring were tested using hemaglutination-inhibition for testing sera for the allotypic markers G1m (1, 2, 3, 17) and G3m (5, 6, 13, 21). Potential risk factors such as mother s age at child's birth, mother's age at the time of the study, breastfeeding months, TSP vs. asymptomatic HTLV-I carrier, sibship's size, children's age and sex, were not found to be associated with mother to child transmission. Mother's Negroid genetic marker genotype (1, 17, 5, 13/1, 17, 5, +/- 13) was marginally associated with mother to child transmission of HTLV-I (P=0.0057; OR=11.97; CI=0.92-155.96)

Journal Article↗
PubMed1992

Seroprevalence and cofactors of HTLV-I infection in Tumaco, Colombia.

This study presents an analysis of the factors associated with HTLV-I seroprevalence in the endemic area of Tumaco, Colombia. During June to August 1988, 1,077 individuals were selected at random from a population of 45,594. The overall prevalence rate of HTLV-I antibodies was 2.8%. Among females prevalence was significantly higher (p less than 0.02) than among males. Rates increased substantially with age. HTLV-I prevalence among individuals with history of use of intravenous medications was significantly higher (p less than 0.001) than in those without such history. Logistic regression analysis included age in years, indicators for male gender, and for i.v. injections, and their interactions. Age was very strongly associated to HTLV-I infection among females. At early ages prevalence was not different between sexes, but females presented a significantly higher rate than males after age 42. History of i.v. administered medications was very strongly associated in the univariate analysis and, although significance was borderline in the multivariate analysis, it had the effect of doubling the odds of HTLV-I infection.

Adolescent↗
PubMed1988

Tropical spastic paraparesis in Colombia.

A high-incidence focus of tropical spastic paraparesis (TSP) occurs on the South Pacific coast of Colombia. Of 55 patients studied, 52 (94.5%) had IgG antibodies to the human T-cell lymphotropic virus type I (HTLV-I) in serum and/or cerebrospinal fluid. Control groups did not show similar high positivity. Our results suggest that HTLV-I or other antigenically related retroviruses may be the cause of TSP in Colombia. Similar clinical, laboratory, and epidemiological findings have been reported in widely remote geographical regions of the world, with very similar clinical pictures of TSP in all high-incidence regions. The demonstration of IgG antibodies in serum and cerebrospinal fluid of patients with TSP in the Caribbean and Seychelles Islands, southern Japan, and the Ivory Coast indicate that the HTLV-I retrovirus could be the cause of this "tropical" myeloneuropathy.

Adolescent↗
PubMed1988

Epidemiology of tropical spastic paraparesis in Columbia and associated HTLV-I infection.

The clinical syndrome earlier designated as paraparesia espástica del Pacífico is an isolated form of tropical spastic paraparesis (TSP) that was reported in 1981 in the southern Pacific lowlands of Columbia in and near Tumaco. The clinical features are similar to those of TSP reported in Jamaica, Martinique, the Seychelles, and the Ivory Coast of Africa and resemble also those clinical features of the human T-lymphotropic virus type I (HTLV-I)-associated myelopathy described in southern Japan. Since HTLV-I infection is closely associated with TSP, we conducted a case-control study to evaluate the role of HTLV-I-associated risk factors among patients from the endemic focus in Tumaco, Colombia, and the seroprevalence rates of this virus in other geographical areas of the Pacific Colombian lowlands with and without TSP. From our seroprevalence study of antibodies to HTLV-I among TSP index patients, matched controls, household contacts (first- and second-degree relatives), and healthy controls from these areas, we found a strong association between HTLV-I and TSP. Also, there is a high seroprevalence of HTLV-I among sexual partners of patients and to a lesser extent among their offspring and other relatives some of whom had an early mean acquisition of antibodies to HTLV-I. Heterosexual promiscuity and other close interpersonal contact may play an important role in the transmission of TSP in the Pacific lowlands of Colombia.

Adolescent↗
PubMed1981

Multifocal sporotrichosis presenting with lobar pulmonary consolidation.

A case of multifocal systemic sporotrichosis presenting with lobar pneumonia caused by Sporothrix schenkii is described. While five cases of pulmonary involvement in multifocal sporotrichosis have been previously reported, all had nodular or cavitary apical lesions. Similarly, unifocal pulmonary sporotrichosis usually presents with apical cavitary disease. The presence of skin nodules led to a culture diagnosis of sporotrichosis of the skin and prompted further diagnostic studies to elucidate the etiology of the pneumonia.

Humans↗
PubMedDate not supplied

[Schizophrenia: a brain disease. I. Structural neuroimaging].

Structural neuroimaging has provided some of the most robust evidence of biologic abnormalities in the brains of patients with schizophrenia. Limbic and ventricular abnormalities now have been replicated in many studies. Despite this progress, more than two decades of research in structural neuroimaging have failed to identify the pathophysiology underlying schizophrenia. In this article we review the principal literature on structural neuroimaging, identify methodologic problems and critically evaluate the significance of the results obtained to date. As image resolution and processing ability improves and this line of research is combined with others, we can expect significant advances in our knowledge of the pathophysiology and the importance of brain abnormalities in the life of patients with schizophrenia.

Brain↗
PubMedDate not supplied

[Schizophrenia: a brain disease. II. Functional neuroimaging].

Functional neuroimaging techniques constitute formidable tools to investigate the human brain in vivo. This possibility has led to a growing interest in these techniques in psychiatric research, particularly in the study of neural mechanism involved in schizophrenia. Three main lines of research have been developed in this field: 1. Patterns of brain activity in a rest condition or during cognitive task performance, 2. correlations between psychopathology and brain activity, and 3. investigations of neurochemical characteristics (neurotransmitters and neuroreceptors) of schizophrenic patients. However, despite of the great effort developed lately these studies have yielded little in the way of coherent pathophysiologic theories of schizophrenia. Future studies combining molecular biology and genetic techniques with structural and functional neuroimaging studies are needed in our purpose to explore the neural mechanisms involved in schizophrenia.

Brain↗
PubMedDate not supplied

Evaluation of the continuation of care between psychiatric hospitalization units and the outpatient clinics in the community.

INTRODUCTION: Continuum of care between health institutions is one of the basic elements of healthcare quality. In this article we present a study that was conducted in an acute psychiatric hospitalization unit for adolescent population. The present study analyzes the perception of professionals from community psychiatric care centers on the continuum of care provided to the patients hospitalized in this unit. METHOD: A self-administered and anonymous questionnaire was mailed to each of the mental health centers that refer patients to the unit. The instrument used is a self-created questionnaire, based on previous tools developed for primary healthcare institutions. The data were analyzed and action plans were defined for the improvement of those areas with a lower score. RESULTS: The response rate was 71.4 %. All the items have an average rate higher than 3 on a scale of 1 to 5. The items with a higher score are the possibility to exchange opinions with the professionals of the unit and the knowledge of the doctor responsible for the patient during the hospitalization. The items with a lower level of satisfaction are the referral procedure and the unit's resources. CONCLUSION: The study provides data on the perception that professionals from mental health out-patient centers have about the coordination with the Unit. This data has been found to be useful to define improvement initiatives that will improve the continuum of care.

Attitude of Health Personnel↗
PubMedDate not supplied

MDMA and serotonin: based on two cases.

3,4-methylenedioxyamphetamine (MDMA) or "ecstasy" damages serotonin neurons in all animal species and there is growing evidence that this finding also applies to humans. This fact, together with the increasing extended use in the young population, has important repercussions in the appearance of specific psychopathologic and cognitive disturbances associated to its use. The authors present two clinical cases, in which psychopathological and cognitive symptoms are detected in MDMA users that support this hypothesis. Problems in the diagnosis of psychiatric disorders associated to MDMA and its clinical and therapeutic implications are discussed.

Adolescent↗
PubMedDate not supplied

[The deficit syndrome: a domain of schizophrenia].

Schizophrenia is a heterogeneous clinical syndrome and this variability may reflect differences in etiology and pathophysiology. Such heterogeneity could be responsible for the difficulties in research when all patients with schizophrenia are included in the same group. Subgroups of more clinical homogeneity are more likely to be homogeneous for the presumed pathophysiology of interest. Primary, enduring negative symptoms have been proposed to designate the deficit syndrome. The data obtained in the recent years and summarized in this review show that negative symptoms broadly defined are less effective for subgrouping schizophrenia and that the deficit syndrome is a different domain within schizophrenia.

Cognition Disorders↗