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Biomedical subjects

E Acosta

Publications and source records attributed to E Acosta.

7 recordsLinked to original sources

[Esophageal achalasia: 20 years' experience with non surgical treatment].

The purpose of this paper is to report the experience acquired in pneumatic dilatation in achalasia of the esophagus up to 1990. Two hundred and six patients were studied in that period (X 50, 7 years, M/F 1:1). According to X Rays the distribution was: grade I 17.4%, grade II 54.8%, grade III 14% and grade IV 13.5%. The associated esophageal pathology was: hiatus hernia 9.7%, esophagitis 5.8%, benign stenosis 2.4%, cancer 1.4%, ulcer and diverticula 0.9% and Schatzki's ring and leiomyoma 0.4% respectively Serology for Chagas disease was positive in 23% Chagasic megacolon was more frequent than chagasic heart disease (4.3% Vs. 1.4%). Out of these, one hundred and twenty patients were treated by pneumatic dilatation. To this group we shall refer in more detail. One hundred ant two patients were dilated once and the remaining 18 twice. Esophageal manometry showed a vigorous pattern in 7.7%. The LES' pressure pre-treatment was 24.5 mm Hg and post-dilatation 13.7 mm Hg in 75.8% of the cases the result was good. The morbidity was 5% and the mortality 0.7%. Relapse was seen in 25.8% of the cases. The follow-up was X 38 months. We conclude that pneumatic dilatation is the election procedure in the treatment of achalasia since it offers good results with low morbimortality. Surgery is indicated after failure of 2 dilatations, in children, and association with esophageal neoplasms, hiatus hernia and esophageal diverticula.

Adolescent

Antibodies to the metacestode of Taenia solium in the saliva from patients with neurocysticercosis.

IgG antibodies to antigens of Taenia solium metacestodes were detected in saliva samples from patients with intracerebral cysticercosis by means of an enzyme-linked immunosorbent assay (ELISA). When compared for IgG antibody activity, saliva samples from patients with various nonparasitic neurological disorders and from clinically healthy individuals yielded significantly lower (p less than 0.001) absorbance values than saliva samples from patients with neurocysticercosis. However, no differences were observed in IgA anti-T. solium activity between patients with neurocysticercosis and controls. These results indicate that the detection of anticysticercus IgG antibodies in saliva by means of ELISA may be of value in the diagnosis of neurocysticercosis. Moreover, collection of saliva provides a noninvasive sampling method for immunoepidemiological surveys on this disease.

Animals

Diagnosis of intestinal amebiasis using salivary IgA antibody detection.

This investigation sought to determine whether detection of salivary IgA antibodies to Entamoeba histolytica could identify intestinal amebic infections among 223 school children. Four groups of children were identified through coproparasitoscopic examination: E. histolytica as other parasites only (20%); and parasite-free (25%). The diagnostic accuracy of salivary IgA antibodies to an E. histolytica membrane extract was 91.5% (sensitivity, 85%; specificity, 98%), maintaining high predictive value at different prevalences. Also, a positive correlation (r = .753, P less than .001) was observed between fecal E. histolytica membrane antigen levels and salivary IgA antibody activity. Measurement of IgA antibodies in saliva may be useful in diagnosing intestinal infections with E. histolytica within a wide range of prevalences. Moreover, sampling of saliva may be a useful non invasive test for immunoepidemiologic surveys.

Adolescent

Pimozide therapy for trigeminal neuralgia.

Pimozide was compared with carbamazepine in a double-blind crossover trial in 48 patients with trigeminal neuralgia who were refractory to medical therapy. Pimozide treatment produced greater reduction in trigeminal neuralgia symptoms than carbamazepine treatment. All of the pimozide-treated patients improved, while only 56% of carbamazepine-treated patients were relieved of their pain. Although both drugs provoked some adverse effects, it was not necessary to interrupt the trial in any case. After this 24-week trial, all patients began receiving pimozide and were followed up according to an open-label study design. In all cases, the pimozide dosage was progressively reduced until the minimal effective dose was reached. Central and peripheral mechanisms that may underlie pimozide-induced improvement are discussed.

Carbamazepine

HIV disease and pregnancy. Part 2. Antepartum and intrapartum care.

The spread of human immunodeficiency virus (HIV) disease among childbearing women presents a unique nursing challenge in the delivery of specialized antepartum and intrapartum care. The nurse must be competent in the delivery of psychosocial and physical care to these women, as well as assume a pivotal role as a member of the multidisciplinary health-care team. Aspects of care, from the diagnosis of pregnancy through delivery of the neonate, that are unique to women with HIV disease are described.

Antiviral Agents