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C Carrillo

Publications and source records attributed to C Carrillo.

At least 37 records · Page 2Linked to original sources
PubMed1993

The molecular epidemiology of cholera in Latin America.

To explain the sudden appearance and rapid spread of cholera in Latin America in January 1991, molecular techniques were used to define Vibrio cholerae O1 isolates from around the world. Restriction fragment length polymorphisms of rRNA and ctxA genes, DNA sequence of cholera toxin B subunit gene ctxB, and multilocus enzyme electrophoresis data were used to characterize 197 isolates. Worldwide, there are at least four distinct toxigenic El Tor V. cholerae O1 clones: the seventh pandemic (Eastern Hemisphere), US Gulf Coast, Australian, and Latin American. Nontoxigenic V. cholerae O1 previously isolated in Brazil, Mexico, and Peru are unlike current toxigenic isolates. The Latin American clone probably represents an extension of the seventh pandemic into the Western Hemisphere, while the US Gulf Coast clone most likely evolved separately. These data will be useful in monitoring the spread of cholera, determining the origin of outbreaks in both hemispheres, and implicating specific vehicles of transmission.

Alleles↗
PubMed1993

Delayed gastrointestinal reconstruction following massive abdominal trauma.

Routine use of the concepts of expeditious hemostasis including the use of packing and temporizing surgical resection without anastomosis followed by delayed reexploration and reconstruction in victims of major pancreaticoduodenal trauma encouraged us to manage other devastating abdominal injuries in a similar fashion. A variety of multiple organ injuries accompanied by massive blood loss, hypothermia, and acidosis also have been managed with the philosophy that hemostasis and control of continued gastrointestinal soiling were the only necessary initial surgical procedures. Following recovery room or surgical intensive care unit stabilization with full hemodynamic resuscitation and restoration of coagulation variables to normal, delayed definitive reconstruction was done. A summary of our experience and principles of management are presented.

Abdominal Injuries↗
PubMed1993

Sternoclavicular brucellar arthritis: a report of 7 cases and a review of the literature.

OBJECTIVE: To describe the clinical features of sternoclavicular arthritis. METHODS: Medical records review of patients with sternoclavicular brucellar arthritis diagnosed and treated in a University Hospital in Lima, Peru. RESULTS: Over a 21-year period, 1,729 cases of brucellosis were diagnosed and treated. Seven patients with sternoclavicular arthritis were identified; 5 had an acute course with current or past evidence of systemic infection. Four patients had involvement of another joint and one of the 7 developed a chest wall abscess. All patients recovered without sequelae. CONCLUSION: Recovery without sequelae is expected if patients with sternoclavicular brucellar arthritis are promptly diagnosed and treated.

Adult↗
PubMed1992

Comparison of capsid protein VP1 of the viruses used for the production and challenge of foot-and-mouth disease vaccines in Spain.

A significant frequency of amino acid substitutions, that affect important antigenic sites on capsid protein VP1, has been found among viral preparations used for the production and for challenge, in protection assays, of foot-and-mouth disease (FMD) vaccines. The amino acid substitutions present in one of the viruses studied abolished its reactivity with two neutralizing monoclonal antibodies that recognized different epitopes on VP1. Thus, the results obtained illustrate the high potential for antigenic variation introduced by the multiple cycles of growth usually undergone by the strains used for the production and challenge of FMD vaccines.

Amino Acid Sequence↗
PubMed1992

Plasmids in Salmonella typhi in Lima, Peru, 1987-1988: epidemiology and lack of association with severity of illness or clinical complications.

A prospective study was conducted to better characterize the epidemiology of plasmid-bearing strains of Salmonella typhi in an endemic area of Lima, Peru, and to determine if plasmids were associated with specific manifestations of typhoid fever. Of 228 S. typhi isolated from patients at Cayetano Heredia University Hospital in Lima during 1987-1988, 76 (33%) contained plasmids. Ten different plasmid profiles were identified, with ten distinct plasmids present within these profiles. There was significant temporal clustering of isolates having common plasmid profiles. Two plasmids (both from the same isolate) carried antibiotic resistance genes. Two cryptic plasmids with approximate sizes of 55 and 65 kilobases (kb) appeared to be closely related, based on restriction endonuclease digestions and Southern blot analysis. An ampicillin resistance plasmid from a 1989 patient isolate differed by only a single restriction fragment from the cryptic 65-kb plasmid. No association was found between any plasmid or plasmid profile and severity or clinical manifestations of disease.

Blotting, Southern↗
PubMed1991

Fitness alteration of foot-and-mouth disease virus mutants: measurement of adaptability of viral quasispecies.

We document the rapid alteration of fitness of two foot-and-mouth disease virus (FMDV) mutants resistant to a neutralizing monoclonal antibody. Both mutants showed a selective disadvantage in BHK-21 cells when passaged in competition with their parental FMDV. Upon repeated replication of the mutants alone, they acquired a selective advantage over the parental FMDV and fixed additional genomic substitutions without reversion of the monoclonal antibody-resistant phenotype. Thus, variants that were previously kept at low frequency in the mutant spectrum of a viral quasispecies rapidly became the master sequence of a new genomic distribution and dominated the viral population.

Amino Acid Sequence↗
PubMed1991

Association between the acquired immunodeficiency syndrome and infection with Salmonella typhi or Salmonella paratyphi in an endemic typhoid area.

Eight cases of typhoid and paratyphoid fever were identified during a 4-year period in a cohort of 117 patients who were positive for human immunodeficiency virus in Lima, Peru. Asymptomatic patients with human immunodeficiency virus infection and patients with the lymphadenopathy syndrome had a typical clinical presentation and response to therapy. Patients with the acquired immunodeficiency syndrome who were culture positive for Salmonella typhi or Salmonella paratyphi presented with fulminant diarrhea and/or colitis; the two patients for whom at least 2 months of follow-up were available relapsed. In our cohort there were 0.06 cases of typhoid or paratyphoid per patient year of observation; this rate is approximately 60 times that in the general population in Lima, and 25 times that in the 15- to 35-year-old age group. Our data indicate that patients who are positive for human immunodeficiency virus are at significantly increased risk for infection with S typhi and S paratyphi, and suggest that the clinical presentation of these diseases in patients with the acquired immunodeficiency syndrome differs from that seen immunocompetent hosts.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Genetic and phenotypic variability during replication of foot-and-mouth disease virus in swine.

A plaque-purified preparation of foot-and-mouth disease virus (FMDV) of serotype C1 (C-S8c1-1), grown in cell culture, was used to infect nonimmunized pigs. No variant genomes were detected in the average populations of 50 viruses isolated from infected animals by direct RNA sequencing of the carboxy-terminal half of the VP1 gene. However, a mutant with altered phenotypic properties was present in low proportion in an infected animal. The frequency of mutants resistant to neutralization by SD6 monoclonal antibody (MAb) [SD6 epitope MAb-resistant mutants (MARMs)], directly estimated in virus from lesions of infected animals (without passage in cell culture), depended on the procedure used for its determination and ranged from 2.9 x 10(-6) (when the virus was incubated with the MAb prior to plating) to 2.6 x 10(-5) (when incubation with MAb was avoided and the MAb was maintained in the agar overlay of the titration assay). Such a difference was not found for C-S8c1-1, which consistently showed frequencies of about 4 x 10(-5). In addition, the repertoire of amino acid substitutions was similar among SD6 epitope MARMs isolated directly both from vesicles of infected animals and from C-S8c1-1. Thus, in spite of the conservation of the average sequence in the region of VP1 RNA analyzed, antigenic heterogeneity has been found in viral populations of FMDV upon replication in nonimmunized swine.

Animals↗
PubMed1990

Comparison of vaccine strains and the virus causing the 1986 foot-and-mouth disease outbreak in Spain: epizootiological analysis.

RNAs of the most recent foot-and-mouth disease virus isolated in Spain (A5Sp86) during the 1986 outbreak, and of the three vaccine strains in use at that time in that country, have been compared. Although these viruses are serologically indistinguishable, differences have been found among them by T1 fingerprinting. This genetic heterogeneity affects the immunogenic VP1 gene, with amino acid changes located at the carboxyterminal end of the molecule. VP1-coding sequences obtained have been compared with those previously reported for European A5 FMDVs and it has been possible to trace their phylogenetic origin. The most parsimonious evolutionary tree obtained shows that the viruses analyzed are closely related to those previously isolated in 1983 in Spain, Portugal and Morocco. In spite of the VP1 sequence homology shown by this group of viruses, the genetic distances among field isolates and vaccine strains are significantly shorter than the distances found among field isolates. Thus, a significant relationship among virus recovered from recent outbreaks and the vaccine strains in use at that time in Spain, has been obtained.

Amino Acid Sequence↗
PubMed1990

[Evaluation of the bone marrow in patients with brucellosis. Clinico-pathological correlation].

In the present study the 60 patients with brucellosis and evaluation of bone marrow aspirate seen at the Hospital Base Cayetano Heredia from 1980 to 1986 were included. Iron deficiency was found in the bone marrow in 34.5% of patients, 31% in males and 36% in females. No correlation was found between iron deficiency and severity of the hematological or non-hematological clinical features. Bone marrow cytophagocytosis was found in 28.3% of patients. All had moderate to severe clinical features, and it is postulated that this finding may be helpful as a severity marker in patients with brucellosis. Bone marrow cytophagocytosis was significantly associated with the presence of hematologic abnormalities in general; anemia was the most common of these, followed by thrombocytopenia. This finding suggests that cytophagocytosis is an important mechanism in the pathogenesis of these abnormalities in brucellosis. Bone marrow hypercellularity was present in 70% with normocellularity in 28.3% and one case of pure megakaryocytic aplasia. In thirty-five patients pathological study of bone marrow was carried out 10 of these (28.5%) had granulomas. Their presence was not correlated with the clinical severity. Peripheral blood finding were: anemia in 83.3%, with two cases of hemolytic anemia and positive direct Coombs test, one of them associated with thrombocytopenia (Evans syndrome); leukopenia in 21%, basically due to neutropenia; thrombocytopenia in 33.3%, in one case associated with positive antiplatelet antibodies and with pure megakaryocytic aplasia in others; pancytopenia in 13.5% of cases (8 patients) associated to bone marrow cytophagocytosis in 5 cases (64.5%) and thus suggesting that this might be the major underlying pathogenetic mechanism.

Acute Disease↗
PubMed1990

Detection of Salmonella typhi carriers in food handlers by Vi serology in Lima, Peru.

The work described here sought to assess the merits of using an indirect hemagglutination test employing highly purified Vi antigen to screen a high-risk population for chronic S. typhi carriers in Lima, Peru. A total of 1,931 female food handlers over 30 years old were enrolled in the study. Indirect hemagglutination tests performed on these subjects' sera, taking a titer of 1:40 or more as positive, yielded 29 positive results. Subsequent bacteriologic testing performed on 26 of these 29 subjects identified four (15%) as S. typhi carriers. The procedure had a sensitivity of 79%, indicating that the prevalence of S. typhi carriers among the population studied was on the order of 262 per 100,000. It appears that Vi serology employing highly purified Vi antigen offers a practical and cost-effective way of screening for S. typhi carriers in both endemic and nonendemic typhoid fever areas.

Antigens, Bacterial↗
PubMed1989

Antigenic variation of foot-and-mouth disease virus of serotype C during propagation in the field is mainly restricted to only one structural protein (VP1).

The primary structure of VP3, VP2 and VP4 capsid protein genes has been determined for six epizootiologically-related foot-and-mouth disease virus (FMDV) isolates of serotype C1, two of which presented immunogenic differences as determined by a cross-protection assay. The results obtained have been compared with those previously reported for the corresponding VP1 genes Martinez et al. (1988) Gene 62, 75-84. High rates of fixation of mutations have been estimated for the four capsid protein genes that ranged from 3.9 X 10(-4) to 4.5 X 10(-3) substitutions per nucleotide per year, with the highest values corresponding to VP1. Despite this genetic heterogeneity most of the amino acid exchanges are within the VP1 protein. Of the fourteen amino acid substitutions one was located in VP2 and two in VP3. Five out of the eleven amino acid exchanges that affected VP1 were located within residues 138-149, part of a main immunogenic site in FMDV. These results show that in the course of a foot-and-mouth disease outbreak, immunologically relevant amino acid substitutions occur mainly in viral capsid protein VP1.

Amino Acid Sequence↗
PubMed1989

[Epidemiological and clinical features of brucellosis in 39 family groups].

Clinical epidemiological evaluations on brucellosis, done during the last five years in endemic areas in Lima (Peru), in 39 families with 232 members, have let us observe a high rate of symptomatic infection 118/232 (50.9%) and has also let us identify, as risk factors to contract the disease; age older than 10 years 97/190 (56.3%) versus 11/42 (26.1%); in younger than 10 years of age (p less than 0.05) and families with 5 or less members 40/54 (74.0%) versus 78/175 (44.5%) of more numerous families (p less than 0.001), and also to be exposed to a common source as a form to contract the disease. We observed the importance of an adequate treatment in early stages of the disease. We detected major clinical gravity in women 23/55 than in men 5/38 (p less than 0.01), specially in brucellar arthritis (p less than 0.05). Period of time between the appearance of index case and secondary cases was of 33.8 days, but range was of 1-115 days. The heterogeneous aspects of the disease between members of the same family, suggest that response of host, more than bacterial virulence, is so important in the clinical course of the disease.

Adolescent↗
PubMed1989

Septic arthritis due to Mycobacterium phlei presenting as infantile Reiter's syndrome.

We describe a 7-year-old Peruvian boy who presented with a 2 week history of conjunctivitis, urethritis and arthritis, in whom Mycobacterium phlei was the only organism repeatedly isolated from synovial fluid and tissue and who responded to conventional antituberculous therapy. To our knowledge this is the first documented case of human disease caused by this microorganism.

Antitubercular Agents↗
PubMed1988

Genetic and immunogenic variations among closely related isolates of foot-and-mouth disease virus.

Genetic heterogeneity among closely related isolates of foot-and-mouth disease virus (FMDV) has been measured by direct sequencing of the VP1-coding-region RNA for three new FMDVs of serotype C1 and by additional sequences of RNA from previously reported isolates, all belonging to a single episode of disease [Sobrino et al., Gene 50 (1986) 149-159]. In the ten viruses compared, eight different VP1 are represented. The changes include amino acid substitutions at a critical antigenic determinant of VP1. We document that variations present in such natural isolates result in changes of the immunogenic properties of the viruses. Vaccines prepared with two of the FMDV C1 analyzed induce complete protection against an homologous virus but only partial protection against an heterologous virus in swine, the host from which these viruses were isolated.

Animals↗
PubMed1988

Use of norfloxacin to treat chronic typhoid carriers.

High relapse rates and low tolerability to ampicillin characterize present therapy for carriers of Salmonella typhi. Norfloxacin, a carboxyquinolone with a 90% minimum inhibitory concentration for S. typhi of less than or equal to 0.5 micrograms/mL, is a promising alternative. Carriers of S. typhi were treated in a double-blind trial with either norfloxacin (400 mg) or matching placebo given every 12 h for 28 d. Twelve assessable individuals were treated in each group. After therapy, 11 of 12 individuals treated with norfloxacin had negative stool and bile cultures for S. typhi. All placebo-treated carriers still had positive cultures immediately after therapy. Subsequently, 11 individuals were treated openly with norfloxacin. S. typhi was eradicated in seven of 11. Overall, the eradication rate for 23 individuals treated with norfloxacin was 78%. Eighteen individuals were followed up for one year, and their stool and/or bile cultures remained negative. From our results, norfloxacin is an effective and well-tolerated antimicrobial agent for eradicating the chronic typhoid carrier state.

Adolescent↗
PubMed1987

Brucellar arthritis: a study of 39 Peruvian families.

A study was conducted to characterise the articular manifestation of Brucella melitensis within a family in Peru. From January 1981 to June 1986, 39 families with 232 individuals were evaluated. Brucellosis was diagnosed in 118 family members (attack rate of 50.9%). A lower attack rate was observed in children less than 10 years' old compared with other age groups (p less than 0.02). Complete clinical data were available in 92 of the 118 affected members. Moderate and severe forms of the diseases were more prevalent in women than in men (41.8% v 13.5%; p less than 0.001). Twenty eight of the 92 patients developed some brucellar complications; the articular involvement was the most prevalent (23.9%). Arthritis was also more common in women than in men (34.5% v 8.1%; p less than 0.01). Children appeared to have less articular involvement. Overall, the following pattern was observed: peripheral arthritis (54.5%); unilateral sacroiliitis (23.0%); mixed arthritis (4.5%), and spondylitis (9.1%). Spondylitis was seen only in the elderly with chronic brucellosis. Four patients developed extra-articular rheumatism. Within members of family groups, brucellar arthritis occurred less frequently than in individual patients from the same hospital. This suggests that many family cases were diagnosed in the early stages.

Adolescent↗