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Biomedical subjects

C Toledo

Publications and source records attributed to C Toledo.

At least 19 recordsLinked to original sources
PubMed2001

Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases.

In this report we analyse the presenting features of a series of patients diagnosed with Waldenström macroglobulinaemia (WM) in Spain over the last 10 years. Criteria for diagnosis required a serum monoclonal IgM protein > or = 30 g/l and > 20% bone marrow lymphocytes. Two hundred and seventeen patients were included in the study, with a median age of 69 years and male/female ratio of 2:1. The most common symptoms at diagnosis were anaemia (38%), hyperviscosity (31%), B symptoms (23%), bleeding (23%) and neurological symptoms (22%). Sixty-one patients (27%) were asymptomatic at diagnosis and, to date, 32 of them have not received chemotherapy. Variables predicting a shorter survival free of therapy were haemoglobin < 12.5 g/dl and high beta2microglobulin (beta2M). The 83% of patients who did receive treatment were distributed as follows: chlorambucil/prednisone (43%), intermittent chlorambucil (11%), continuous chlorambucil (26%), cyclophosphamide/vincristine/prednisone (COP, 13.5%) and other (6.5%). Response to therapy was complete in 2%, partial in 48% and minor in 10%. Finally, 28% and 13% of patients presented stable and progressive disease, respectively, which was more common among patients treated with COP. Progression-free survival was 43% at 5 years, with three independent predictors for shorter progression-free survival (PFS): COP treatment, age > 65 and B symptoms at diagnosis. The 10-year projected overall survival (OS) was 55%. The two most frequent causes of death were development of second malignancies (31%), or infections (19%). The two main variables predicting a poor OS were hyperviscosity and high beta2M. In summary, this study favours the use of chlorambucil-based therapy as the standard treatment for WM, and describes a subset of patients who should be considered as suffering a smouldering form and who therefore do not require treatment for a long period of time.

Aged↗
PubMed2001

[Acute hepatitis caused by virus A, E and non A-E in Chilean adults].

BACKGROUND: Sanitary and socioeconomic changes and the identification of new causative virus, have changed the epidemiology of hepatitis in Chile. AIM: To study the natural history of acute hepatitis caused by virus A, E and non A-E in Chilean adults. PATIENTS AND METHODS: A special study protocol was followed for patients with a clinical picture of acute hepatitis. Anti HAV IgM, anti HBc IgM, anti HEV IgG and IgM and Anti HCV antibodies were determined by ELISA. RESULTS: Fifty nine patients (30 male), aged 15 to 58 years old were studied. Eighty nine percent had jaundice and 50 to 70% had malaise and abdominal pain. Virus A was positive in 80%, virus E in 7%. In 14% of patients, all viral markers were negative. The evolution was typical in 78%, biphasic in 14% and cholestatic in 5%. One patient had a prolonged and one a fulminant course. Mean ALT was 1148 U/l and mean total bilirubin was 5.5 mg/dl. Seventy three percent of cases occurred during early winter and spring and 27% during summer and early autumn. CONCLUSIONS: The main etiology of acute viral hepatitis in Chile is virus A and most cases occur during the rainy season. Clinical features of hepatitis non A-E are similar to enteral transmission forms.

Acute Disease↗
PubMed2000

Identification of the anterior nucleus of the ansa lenticularis in birds as the homolog of the mammalian subthalamic nucleus.

In mammals, the subthalamic nucleus (STN) is a glutamatergic diencephalic cell group that develops in the caudal hypothalamus and migrates to a position above the cerebral peduncle. By its input from the external pallidal segment and projection to the internal pallidal segment, STN plays a critical role in basal ganglia functions. Although the basal ganglia in birds is well developed, possesses the same major neuron types as in mammals, and plays a role in movement control similar to that in mammals, it has been uncertain whether birds possess an STN. We report here evidence indicating that the so-called anterior nucleus of the ansa lenticularis (ALa) is the avian homolog of mammalian STN. First, the avian ALa too develops within the mammillary hypothalamic area and migrates to a position adjacent to the cerebral peduncle. Second, ALa specifically receives input from dorsal pallidal neurons that receive input from enkephalinergic striatal neurons, as is true of STN. Third, ALa projects back to avian dorsal pallidum, as also the case for STN in mammals. Fourth, the neurons of ALa contain glutamate, and the target neurons of ALa in dorsal pallidum possess AMPA-type glutamate receptor profiles resembling those of mammalian pallidal neurons. Fifth, unilateral lesions of ALa yield behavioral disturbances and movement asymmetries resembling those observed in mammals after STN lesions. These various findings indicate that ALa is the avian STN, and they suggest that the output circuitry of the basal ganglia for motor control is similar in birds and mammals.

Animals↗
PubMed2000

Stress responses of child care providers to classroom activities and childhood behaviors involving HIV/AIDS.

Child care providers in a southeastern state were asked to indicate their level of stress when responding to classroom activities and childhood behaviors involving a child who tests positive for the human immunodeficiency virus (HIV). No significant correlations were found between the providers' stress responses and their professional background. Significant correlations were found between the providers' stress responses and their knowledge of HIV transmission and agreement with HIV child care policies. Follow up chi-square analysis revealed that a majority of providers reported low to slight stress when considering individual classroom activities in association with an HIV-positive (HIV+) child. Likewise, a significant majority of the providers reported low to slight stress when considering low-threat behaviors associated with an HIV+ child. In contrast, a significant majority of the providers reported moderate to great stress when considering high-threat behaviors associated with an HIV+ child. Implications of these findings are addressed for nurse educators who provide training to child care providers regarding young children who are HIV+.

Adult↗
PubMed1999

Growth curves of children with Down syndrome.

Growth curves of 105 children with Down syndrome (50 boys and 55 girls) were established. At birth height, weight and head circumference of Down syndrome children were lower than these parameters in controls. This delay remained stable until puberty. For weight there was no clear-cut pubertal growth spurt. For stature, the prepubertal growth spurt occurred earlier (at the age of 11 years in boys and 9 1/2 years in girls) than in controls but was less marked. As a result, Down syndrome patients had a short stature with a quite normal weight. These reference curves, available since prenatal diagnosis of Down syndrome is performed routinely, are helpful for monitoring normal and abnormal development in Down syndrome patients.

Adolescent↗
PubMed1999

Kyphomelic dysplasia: a report of a family with an autosomal dominant pattern.

Kyphomelic dysplasia (KD) is a rare autosomal recessive entity characterized by shortening and bowing of the limbs, skin dimples, abnormalities of methaphysis and ribs, a short trunk, a narrow thorax, neonatal respiratory distress, platyspondyly, and facial dysceptism with micrognathia, midfacial hypoplasia, and a broad nasal bridge. Some children die in early infancy. The survivors show normal hands, feet, cranium and psychomotor development. The condition varies in severity. The facial features and bowing improve during childhood, and stature remains short during adulthood. We report here a family with KD inherited as an autosomal dominant trait, which appears to be less severe than the autosomal recessive form, without facial and vertebral a favorable outcome and with involvement and final short stature.

Abnormalities, Multiple↗
PubMed1998

Antiinflammatory and antioxidant activity of plants used in traditional medicine in Ecuador.

Ethanolic extracts from 15 plant species, representing eight different families, used in traditional medicine in Ecuador were evaluated for antiinflammatory and antioxidant activities. Conyza floribunda, Eupatorium articulatum, Bonafousia longituba, Bonafousia sananho, Tagetes pusilla and Piper lenticellosum extracts showed a significant antiinflammatory activity in vivo in the carrageenan-induced paw oedema model in mice. The extracts were also tested in vitro for their ability to inhibit lipid peroxidation and to scavenge superoxide and hydroxyl radicals. E. articulatum extract possesses both activities. Baccharis trinervis, E. articulatum and Phytolacca rivinoides extracts were active as antioxidants.

Animals↗
PubMed1997

Innervation of orbital and choroidal blood vessels by the pterygopalatine ganglion in pigeons.

Orbital and choroidal blood vessels in mammals are known to receive a parasympathetic innervation from the pterygopalatine ganglion, which appears to utilize vasoactive intestinal polypeptide (VIP) and nitric oxide (NO) to increase choroidal blood flow. The present studies were undertaken to elucidate the anatomical and neurotransmitter organization of the pterygopalatine ganglion input to orbital and choroidal blood vessels in pigeons. Single- or double-label immunohistochemistry were employed on paraformaldehyde-fixed cryostat sections of the pigeon eye and surrounding orbital tissue to localize 1) VIP+ neurons and fibers; 2) choline acetyltransferase (CHAT)-containing cholinergic neurons and fibers; 3) axons containing the 3A10 neurofilament-associated antigen; and 4) neuronal NO synthase (nNOS)-containing neurons and fibers. NOS+ neurons and fibers were also identified by NADPH-diaphorase histochemistry in sections and whole-mount specimens. The pterygopalatine ganglion was found to consist of an interconnected series of three to four main microganglia of about 50-200 neurons each and numerous lesser microganglia. The major microganglia of the pterygopalatine network in pigeon lie along the superior aspect of the Harderian gland, with many additional fibers and microganglia of the network encircling the gland. Neurons of all microganglia were extremely rich in VIP, nNOS, and NADPH-diaphorase and moderate in CHAT. The majority of the pterygopalatine ganglion neurons were observed to co-contain VIP and nNOS. Axons labeled for VIP, nNOS, NADPH-diaphorase, or the 3A10 antigen could be traced from the pterygopalatine ganglion network to perivascular fiber plexi on orbital blood vessels. These orbital vessels, many of which enter the choroid posteriorly and nasally, appear to be a conduit by which pterygopalatine postganglionic fibers reach the choroid. The pterygopalatine postganglionic fibers were also seen to innervate the Harderian gland and contribute branches to the nearby ophthalmic nerve. Within the choroid, VIP+ fibers were widely scattered and sparse but were most abundant in nasal choroid. A few VIP+ and NADPH- diaphorase+ neurons were also observed in the choroid. These results suggest that pterygopalatine ganglion neurons of birds use VIP and NO to exert vasodilatory control over blood flow to and within the avian choroid.

Animals↗
PubMed1997

Pharmacokinetics and muscle histopathology of intramuscular valproate.

To determine the safety and pharmacokinetics of parenteral sodium valproate healthy mature greyhound dogs, were given intramuscular injections following intravenous injections. Dosings intravenously and intramuscularly were at 20, 40 and 60 mg/kg in the three groups. Intravenous infusion rates were constant. Sodium valproate solution concentrations of 300, 400 and 500 mg/ml were administered. Intramuscular valproate was quickly absorbed. Bio-availability approached 70%. Half life of 120 min was calculated. Toxic muscle necrosis was observed at all concentrations. Dosing valproate intramuscularly in humans is problematic in view of the muscle damage. Despite tissue damage sodium valproate was well absorbed intramuscularly. The intravenous injection of valproate at high concentrations, large doses and fast infusion rates produced no evidence of cardiotoxicity and levels of 180 micrograms/ml.

Animals↗
PubMed1997

[Anomalies of thyroid function in children with Down syndrome].

BACKGROUND: Abnormal thyroid function was shown in children with Down syndrome (DS). This study was undertaken in order to specify these anomalies. POPULATION AND METHODS: Thyroid function of 105 children with DS aged from 3 months to 20 years was studied by evaluation of serum concentration of thyrotropin, free T4 (FT4), free T3 (FT3) and reverse T3 (rT3). Each DS child was matched to a control of the same age. RESULTS: The mean concentration of thyrotropin of children with DS was increased while the mean concentration of rT3 of the DS children was significantly decreased compared with the controls, as was the ratio rT3/TSH. When DS children are split into two groups, those with and those without increased thyrotropinemia, a significant decrease in the ratio rT3/TSH appeared in DS children with increased thyrotropinemia whereas there is no difference between these two groups regarding to level of FT4, FT3, rT3 and zincemia. However, in all DS children serum zinc levels were lower than in controls. Thyrotropin levels rapidly normalized after thyroxin treatment. CONCLUSION: One half of the children with DS have increased thyrotropinemia and all have a decreased rT3.

Adolescent↗
PubMed1997

Changes in body weight with chronic, high-dose gabapentin therapy.

The authors reviewed changes in body weight in 44 patients treated with Gabapentin (GPN) for a period of 12 or more months. All patients had a seizure disorder and the dose of GPN was increased aiming at complete seizure control or until side effects limited further increase. Twenty-eight patients were receiving GPN dosages of > 3000 mg/day. Observed changes in body weight were as follows 10 patients gained more than 10% of their baseline weight, 15 patients gained 5% to 10% of baseline, 16 patients had no change, and 3 patients lost 5% to 10% of their initial weight. Weight increase started between the second and the third months of GPN treatment in most patients and tended to stabilize after 6 to 9 months of treatment, although the doses of GPN remained unchanged. Weight gain occurred in patients taking GPN in combination with each of the major antiepileptic drugs including Felbatol and also occurred with GPN monotherapy.

Acetates↗
PubMed1997

Antagonist-stimulated internalization of the G protein-coupled cholecystokinin receptor.

Receptor-mediated endocytosis has been observed after agonist occupation of several G protein-coupled receptors, which contributes to the desensitization response to agonist stimulation; however, the cellular signals required to initiate this process are unclear. In this study, we developed and characterized a new antagonist analogue of cholecystokinin (D-Tyr-Gly-[(Nle28,31,D-Trp30)cholecystokinin-26-32]-phen eth yl ester) that can be tagged with a fluorescent rhodamine and radioiodinated. This has permitted us to demonstrate that antagonist occupation of the cholecystokinin receptor also results in receptor internalization, which dissociates this response from second messenger signaling activities and receptor phosphorylation. Immunolocalization of this receptor after occupation with an established nonpeptidyl antagonist confirmed this phenomenon. Antagonist-induced receptor internalization probably results from stabilization of the receptor in a conformation that exposes a domain critical to directing it into the clathrin-dependent endocytic pathway. This work provides evidence for a new and independent mechanism for receptor internalization, provides a mechanism for the rarely observed phenomenon of antagonist-induced desensitization, and raises important issues regarding the approach to establish optimal treatment regimens for antagonist drugs.

Binding, Competitive↗
PubMed1997

[Prevalence of hepatitis E virus antibodies in blood donors and other population groups in southern Chile].

Little is known about hepatitis E virus (HEV) prevalence in South American countries. Anti-HEV was studied in 1,773 subjects from 1,360 blood donors of 3 cities in Chile, 72 in health care workers, 241 inmates in state jails, and in 100 Araucanian indians. Anti-HEV was detected in 109 out of 1,360 (8.0%) total donors (6.3%, 6.1%, and 18.8% from the cities of Valdivia, Osorno and Puerto Montt respectively); 9 out of 72 (12.5%) health care workers; 18 out of 241 (7.5%) inmates, and 17 out of 100 (17%) Araucanian indians. Prevalence of anti-HEV was not related to age and sex. Hepatitis E is an endemic infection in some population groups of Southern Chile, associated to environmental pollution, crowding and low socioeconomic level.

Adolescent↗
PubMed1995

[Hepatitis C virus: results of detection in several high risk groups in the X region of Chile].

The aim of this study was to determine the prevalence of hepatitis C virus antibodies in high risk patients coming from Valdivia, Osorno and Puerto Montt. Fifty-six patients in hemodialysis, 51 renal graft recipients, 42 cirrhotics and 14 patients with acute non A non B hepatitis were studied. Antibodies were detected with a second generation ELISA technique and positive cases were confirmed with RIBA. All hemodialysis patients and renal graft recipients were negative for hepatitis C virus antibodies. In one non alcoholic patient with cirrhosis, a positive ELISA was confirmed with RIBA. Six patients with acute hepatitis had positive ELISA tests but none was confirmed with RIBA. It is concluded that the prevalence of hepatitis C virus antibodies in this region of Chile is very low.

Acute Disease↗
PubMed1994

[Bacterial infections in hepatic cirrhosis].

The aim of this work was to study the prevalence of bacterial infections in hospitalized patients with liver cirrhosis and to compare clinical, bacteriological and evolution features of patients with (group 1) and without bacterial infections (group 2). One hundred thirty two hospitalized patients with liver cirrhosis were prospectively studied and 61 episodes of bacterial infections were diagnosed in 52 (27 spontaneous bacterial peritonitis (44.3%), 16 urinary tract infections (26.2%), 10 pneumonias (16.4%), 3 spontaneous bacteremias (4.9%9, and 5 miscellaneous infections (8.2%)). Twenty six percent of infections were nosocomial. Child-Pugh score was 12 +/- 2 in group 1 vs 10 +/- 2 in group 2 (p = 0.047). Sixty five percent of identified microorganisms were gram negative and 61.5% of these were E. coli. Hospital mortality of group 1 was 29% and that of group 2 was 9% (p = 0.002). It is concluded that there is a high prevalence of bacterial infections in hospitalized cirrhotic patients, that is associated to a high mortality.

Adult↗
PubMed1994

[Acute sporadic hepatitis caused by the E virus in Chile. Clinical case].

A 53 year old female nurse presenting with malaise, jaundice and pruritus is reported. Physical examination only disclosed jaundice and laboratory values showed an ALT of 445 U/l, ASAT of 179 U/l, alkaline phosphatases of 455 U/l and a total bilirubin of 7.7 mg/dl. Serological markers for hepatitis virus E were positive and negative for hepatitis virus A, B and C, cytomegalovirus and Epstein Barr virus. The patient recovered fully in 10 weeks and is asymptomatic after 5 years of follow up. Health care workers probably have a higher risk for hepatitis E than the general population and this is the first acute sporadic case described in Chile.

Acute Disease↗