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Biomedical subjects

D Muñoz

Publications and source records attributed to D Muñoz.

At least 19 recordsLinked to original sources
PubMed2003

Systemic reactions to immunotherapy: influence of composition and manufacturer.

BACKGROUND: Although immunotherapy clearly demonstrated the benefit of reducing allergic symptoms, it has the drawback of adverse events, mainly systemic reactions that could be very inconvenient for patients and even life-threatening. OBJECTIVE: The aim of the present study was to assess the incidence of systemic reactions to immunotherapy in a large number of patients, and its potential relationship with the characteristics of therapy, such as allergen composition or manufacturing laboratory. METHODS: This study analysed the administration of specific immunotherapy during a period of 5 years, involving 1212 patients affected by respiratory hypersensitivity or hymenoptera venom anaphylaxis. Commercial extracts were supplied by five different laboratories. All the patients were attended at an out-clinic immunotherapy unit by the same experienced staff. Immunotherapy was given following a conventional schedule, modified according the usual recommendations. RESULTS: A total of 250 adverse reactions have been recorded, resulting in a frequency of 0.84% over the total number of injections. Seventy-nine of them (32%) were systemic reactions (0.27% SR/injection). The 79 systemic reactions were observed in 60 patients (5% of the patients). The frequency of systemic reactions was significantly lower (P < 0.01) on the group of mites than on the other groups. The frequency of systemic reactions varies according to the manufacturing laboratory. In the case of mite extracts, although one of the laboratories had a lower frequency of adverse systemic reactions, it did not reach the level of statistical significance. However, in relation to pollen extracts, preparations of one of the manufacturers had a significantly lower frequency of systemic reactions. Concerning the time of occurrence, 27% of systemic reactions were delayed, thus they appeared at least 30 min after the vaccine injection, most of them due to pollen extracts. CONCLUSION: This is a preliminary study to evaluate the factors that could facilitate the appearance of systemic reactions demonstrating that not only the composition but also the manufacturer is connected to systemic reactions. Although further studies are needed to clearly establish the influence of manufacturer on frequency and time of appearance of systemic reactions, it seems necessary to reach a wide consensus on allergen extract standardization methods.

Allergens↗
PubMed2003

Hereditary angioedema and pneumomediastinum.

Gastrointestinal and respiratory involvement is common in hereditary angioedema, laryngeal edema being the main cause of mortality in these patients. We report the case of an 18 year-old woman with a history of hereditary angioedema, who presented an episode of coughing and vomiting the night before, and who was diagnosed with pneumomediastinum as a complication of an episode of angioedema. We review the causes and pathogenesis of the mediastinic emphysema.

Adolescent↗
PubMed2001

A phase II study of gemcitabine and cisplatin combination as induction chemotherapy for untreated locally advanced cervical carcinoma.

BACKGROUND: Cisplatin-based chemoradiation for locally advanced cervical carcinoma is now the standard of care for most patients with cervical carcinoma. However, induction chemotherapy followed by surgery, particularly with newer agents or combinations remains to be explored. This study was undertaken to evaluate the antitumor activity and toxicity of gemcitabine in combination with cisplatin for untreated locally advanced cervical carcinoma. PATIENTS AND METHODS: Open-label, single center, phase II, non-randomized study of neoadjuvant gemcitabine plus cisplatin. Forty-one patients with histologic diagnosis of cervical carcinoma, with no previous treatment and staged as IB2 to IIIB, were treated with three 21-day courses of cisplatin 100 mg/m2 day I and gemcitabine 1000 mg/m2 days 1 and 8, followed by locoregional treatment with either surgery or concomitant chemoradiation. Response and toxicity were evaluated before each course and at the end of chemotherapy. RESULTS: All patients were evaluated for toxicity and 40 for response. The overall objective response rate was 95% (95% confidence interval (CI): 88%-100%) being complete in 3 patients (7.5%) and partial in 35 (87.5%). A complete pathological response was found in 6 (26%) of the 23 patients that underwent surgery. Granulocytopenia grades 3-4 occurred in 13.8% and 3.4% of the courses, respectively, whereas non-hematological toxicity was mild. CONCLUSIONS: Induction chemotherapy with the combination of gemcitabine and cisplatin is highly active for untreated cervical cancer patients and has an acceptable toxicity profile.

Adenocarcinoma↗
PubMed2000

An assistive device for the treatment of positional plagiocephaly.

An assistive device (AD) was used to treat 122 infants with moderate-to-severe positional plagiocephaly. Clinical evaluations indicate that the AD provided the most benefit when applied to 2- to 8-month-old children. Our results suggest that the AD may join molding helmets and physical therapy as a treatment for moderate-to-severe positional plagiocephaly in infants under the age of 1 year.

Craniosynostoses↗
PubMed1999

Four genotypic variants of a Spodoptera exigua Nucleopolyhedrovirus (Se-SP2) are distinguishable by a hypervariable genomic region.

Four genotypes named SP2A, SP2B, SP2C and SP2D were obtained in vivo by infecting S. exigua larvae with limiting dilutions of the Spanish field isolate Spodoptera exigua Nucleopolyhedrovirus (Se-SP2) of SeMNPV. The cloning of variants SP2A, SP2B and SP2C took 1, 6, and 3 passages, respectively, before the DNA profiles showed all bands in equimolar concentrations, and they remained constant for at least six further passages indicating the stability of their genotypes. The SP2D variant isolation took over ten passages and it was genetically less stable. Physical maps of their genomes were constructed for the restriction enzymes BamHI, BglII, PstI, and XbaI. The region between 8-10 m.u. was highly variable and characteristic of each cloned genotype and, hence, can be used as RFLP markers for all four genotypic variants. This region, included in the PstI-MB fragment, was cloned and sequenced showing that all the Se-SP2 variants contained a homologous region (hr) with a variable number of 98 bp sequences tandemly repeated, which were used to distinguish genotypic variants from each other. The biological activity of the genotypic variants SP2A, SP2B, and SP2C when compared in terms of LD50 and LT50, were not significantly different. However, the SP2D genotypic variant was found to be significantly less infective (higher LD50). The emergence of new genotypes in the Se-SP2 field populations is discussed.

Animals↗
PubMed1999

Sexual practices and prevalence of HIV, HTLV-I/II, and Treponema pallidum among clandestine female sex workers in Lima, Peru.

BACKGROUND AND OBJECTIVES: A survey was conducted to determine the sexual behavior practices and prevalence of HIV-1, HTLV-I/II, and T. pallidum infections among unlicensed female sex workers (FSWs) in Lima, Peru. GOAL OF THIS STUDY: To assess the role of unlicensed FSWs as a potential source of retroviral and T. pallidum infection. STUDY DESIGN: Female sex workers from 15 brothels were enrolled. Sera samples were obtained and tested for antibodies to HIV-1, HTLV-I, and Treponema pallidum. RESULTS: Of 158 FSWs studied, all were negative for HIV-1, 6 were positive for HTLV-I, and 5 were positive for Treponema pallidum. Of their male clients, 75% used condoms, whereas only 3% reported condom use with their steady partners. When condoms were always used by clients, the history of a sexually transmitted disease was significantly reduced (p < 0.01), and the prevalence of HTLV-I (p < 0.05) and syphilis was lower among these workers. CONCLUSION: Data suggested that the low rate of sexually transmitted diseases among FSWs reflected the high rate of condom use by their male clients.

Adult↗
PubMed1999

[Encephalopathy with focal lesions due to Mycoplasma pneumoniae].

Mycoplasma pneumoniae infections usually produce respiratory symptoms, that only exceptionally involve the nervous system. In this case, the infection generally causes an encephalitic picture characterized by impaired consciousness and seizures, and by normal or non-specific neuroradiological findings. However, four cases of M. pneumoniae infection associated with symmetrical lesions in the putamen and its external surrounding areas, and with extrapiramidal symptoms, have been recently published. We present the case of a patient with a clinical picture characterized by confusion, fever, and seizures, associated with a M. pneumoniae infection. The MRI study showed two symmetrical lesions that involved the areas just outside the putamen and disappeared coinciding with her clinical improvement. The present case would support that the encephalopathy associated with the M. pneumoniae infection shows a tendency to involve a particular region of the brain. Our case might represent the minimal expression of these characteristic lesions, which in the most benign cases would involve the areas immediately outside the putamen, and in other instances the putamen as well.

Adult↗
PubMed1998

Traumatic renal artery thrombosis.

We report the case of a unilateral traumatic thrombosis of the renal artery. Revascularization was not performed because the diagnosis was made more than 24 h after the injury. Early diagnosis and prompt surgical repair are the keys to successful management of this complication.

Adolescent↗
PubMed1997

The use of IgE immunoblotting as a diagnostic tool in Anisakis simplex allergy.

BACKGROUND: The fish parasite Anisakis simplex is the etiologic agent of anisakiasis and induces IgE-mediated reactions. Skin prick tests (SPTs) and the measurement of specific IgE to A. simplex were, in our experience, not valid tools with which to discriminate between allergic and nonallergic patients because many control subjects also had positive results. OBJECTIVE: The study was carried out to assess the usefulness of IgE immunoblotting in the diagnosis of allergy to A. simplex. METHODS: We have studied 61 patients with acute symptoms of urticaria, angioedema, or anaphylaxis and positive specific IgE to A. simplex. According to the anamnesis, time interval between ingestion of fish and clinical onset of symptoms, and exclusion of other causes of allergy, three different groups of patients were established: group A (allergic), group NA (non-allergic), and group D (doubtful). Fifty-one healthy donors were included as control subjects (group C). IgE immunoblotting with A. simplex whole-body extract was performed in all patients and control subjects. RESULTS: Four patterns of immunoblotting were observed: type 1, with a group of several bands of medium molecular weight and others of low molecular weight; type 2, two or more bands of medium molecular weight; type 3, only one band of medium molecular weight; type 4, without any band. There was a significant predominance of blotting type 1 in group A and type 4 in group C. CONCLUSION: These data suggest that IgE immunoblotting is the most useful approach to A. simplex allergy diagnosis.

Acute Disease↗
PubMed1997

In vivo recombination between two strains of the genus Nucleopolyhedrovirus in its natural host, Spodoptera exigua.

The DNA restriction map for the enzymes BamHI, BglII, PstI, and XbaI of SeMNPV-US (Se-US), the best-studied Nucleopolyhedrovirus strain isolated from Spodoptera exigua in California, was used as a reference to construct that of SeMNPV-SP2 (Se-SP2), a closely related Spanish strain of the same virus. After coinfection of S. exigua with both the Se-US and Se-SP2 strains per os, a recombinant virus (SeMNPV-SUR1 [Se-SUR1]) was detected after one passage which quickly replaced the parental viruses. A physical map of Se-SUR1 DNA was constructed for BamHI, BglII, PstI, and XbaI and compared to that of the parental viruses, Se-US and Se-SP2. Se-SUR1 is the result of at least four crossover events between Se-US and Se-SP2 and not of selection of a minor variant in one of the parental viruses. Bioassays of the recombinant and parental strains against L2 beet armyworm larvae demonstrated that their 50% lethal dose values were not significantly different. The differences in median lethal time values are too small to explain the replacement of the parental viruses by the recombinant virus upon successive passage in vivo, although it cannot be ruled out as an explanation for the selective advantage of the recombinant strain, Se-SUR1. The consequences of the release of nonindigenous or recombinant baculovirus strains in agro-ecosystems are discussed.

Animals↗
PubMed1996

Laboratory determinations in Anisakis simplex allergy.

BACKGROUND: Anaphylactic reactions caused by the fish nematode, Anisakis simplex, after ingestion of parasitized fish, have been described. OBJECTIVE: This study was undertaken to confirm, by histamine release tests, that A. simplex is able to trigger IgE-mediated reactions and to describe the serologic profiles in this sensitization. METHODS: Twelve patients who had anaphylactic symptoms after ingestion of cooked fish and positive prick test results and determinations of IgE to A. simplex were studied by indirect IgG ELISA and IgG and IgE immunoblotting. Sera from subjects parasitized with other nematodes, patients with fish allergy, and healthy donors were included as controls. A histamine release test was performed in a representative case. RESULTS: IgE immunoblotting was a specific test to detect A. simplex allergy. IgE-reacting bands were found in serum samples from 11 of our patients. Specific IgG antibodies were found by ELISA and immunoblotting, but this response was less specific. Histamine release was positive with A. simplex extract and negative with fish. CONCLUSION: A specific and intense immune response to an A. simplex extract was found in our patients. A. simplex is able to elicit anaphylactic reactions, and A. simplex allergy should be suspected in patients with allergic symptoms after ingestion of fish. A positive prick test response to A. simplex and a negative response to fish is a good indication for a diagnosis of A. simplex allergy.

Adult↗
PubMed1996

Relation between flexion angle and intraarticular pressure during active and passive movement of the normal knee.

OBJECTIVE: To determine the effect of full active and passive flexion and extension at physiological rates of movement on intraarticular pressure of the normal knee. METHODS: A 22 gauge Intracath catheter was introduced into 7 clinically normal knees and one abnormal knee in 4 subjects. Pressures were recorded via a pressure transducer and correlated with simultaneous recordings of flexion angle from an electronic goniometer while the subject's knees were traverse through active and passive horizontal flexion at a rate of 1 cycle/2 s. RESULTS: The technique produced 6 satisfactory records over mean active and passive flexion ranges of 135 degrees and 148 degrees. On passive movement, pressures remained negative through most of the cycle, rising to main maximum pressures of 10 mm Hg after about 110 degrees of flexion. On active movement, the most common result was a U shaped curve rising from negative in midflexion to positive on full flexion and extension. The mean maximum pressures recorded on active movement were 38 mm Hg on flexion and 18 mm Hg on extension. CONCLUSION: There is no linear correlation between flexion angle and pressure. Under dynamic conditions at zero gravity intraarticular pressure shows a moderate rise on full passive flexion and in most subjects a substantial rise on active flexion and extension. These differences are significant. The factor governing pressure is not the flexion angle but the accompanying soft tissue changes. Failure to use the full movement range could reduce the efficiency of trans-synovial flux.

Adult↗