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Biomedical subjects

E Cordero

Publications and source records attributed to E Cordero.

30 records · Page 2Linked to original sources
PubMed1997

Pneumocystis carinii meningoradiculitis in a patient with AIDS.

Pneumocystis carinii is a common opportunistic pathogen in patients infected with the human immunodeficiency virus (HIV). Pneumocystis carinii pneumonia is common, while extrapulmonary infections with Pneumocystis carinii have been reported sparingly. The clinical features are frequently nonspecific. The detection of Pneumocystis carinii in cerebrospinal fluid (CSF) has not been reported thus far. In this report, an unusual case of Pneumocystis carinii meningoradiculitis in an HIV-infected patient who had previously received primary prophylaxis with trimethoprim-sulfamethoxazole is presented.

AIDS-Related Opportunistic Infections↗
PubMed1997

Comparisons of cost and accuracy of DNA probe test and culture for the detection of Neisseria gonorrhoeae in patients attending public sexually transmitted disease clinics in Los Angeles County.

BACKGROUND: Strict handling and transport requirements for the successful use of culture in the detection of Neisseria gonorrhoeae warrant investigation of accurate and cost-effective test alternatives such as the Gen-Probe PACE 2 DNA probe assay (Gen-Probe, Inc., San Diego, CA). STUDY DESIGN: The Gen-Probe PACE 2 DNA probe assay for N. gonorrhoeae was compared with conventional culture methods in the principal Los Angeles County (LAC) Department of Health Services (DHS) Public Health Laboratory and three of its branch laboratories. Urethral and endocervical samples were collected from 1,566 patients (921 males; 645 females) attending six LAC DHS sexually transmitted disease clinics. Cost analysis was performed comparing material and labor costs of the two test methods. RESULTS: The overall prevalence based on culture was 11.8% (15.7% for males; 6.4% for females). Nine samples were culture positive, Gen-Probe negative and four samples were culture negative, Gen-Probe positive and remained discordant after discrepant analysis. The sensitivity and specificity were 94.6% and 99.7%, respectively, for the PACE 2 assay compared with culture. The positive and negative predictive values were 97.8% and 99.3%, respectively. No statistically significant difference was found between the two tests. A cost analysis found an average cost of $3.11/test for culture and $3.85/test for PACE 2, given the approximate 12% disease prevalence in this population. CONCLUSIONS: Gen-Probe's PACE 2 assay may provide an acceptable, cost-effective alternative to culture, especially among high-risk males.

Adult↗
PubMed1996

[Usefulness of cerebral biopsy in focal cerebral lesions in patients with human immunodeficiency virus infection].

Brain mass lesions (BML) occurred in 10% of patients infected by the human immunodeficiency virus (HIV), as expression of severe and sometimes treatable diseases. However, the management of them is not well established. We analyzed, retrospectively, 26 brain biopsies (22 estereotaxic) in patients with HIV infection and BML to know their usefulness and safety. The inclusion criteria were: Failure of the anti-Toxoplasma empirical treatment, atypical scan appearance for toxoplasmosis, or severe neurological picture. Brain biopsy yielded a diagnosis in 19 patients (73.1%): Progressive multifocal leukoencephalopathy (n = 8; 30.8%), primary central nervous system lymphoma (n = 6; 23.1%), mycobacteriosis (n = 2; 7.7%), toxoplasmosis (n = 2; 7.7%), criptococcosis (n = 1), cryptosporidiosis (n = 1) and HIV-encephalitis (n = 1). In one case there was a multiple diagnosis: mycobacteriosis, toxoplasmosis, and lymphoma. Brain biopsy results decided a change in therapy in 65.4%, the resolution or improvement of the neurological process in 30.8%, and the determination of the prognosis in 30.8%. In 8 cases (30.7%) there were biopsy complications, with secondary mortality in one. Brain biopsy of BML in HIV-infected patients is a diagnostic method with a high overall diagnostic rentability and uncommon non reversible complications, offering the possibility to prescribe a specific and potentially curative treatment.

Adult↗
PubMed1989

Testosterone replacement with transdermal therapeutic systems. Physiological serum testosterone and elevated dihydrotestosterone levels.

Testosterone was administered transdermally to hypogonadal men under three protocols. In the first protocol, it was shown that peak levels of testosterone were achieved three to eight hours after scrotal application of a transdermal therapeutic system containing 5, 10, or 15 mg of testosterone, and values at 22 hours were greater than 60% of peak values. In the second protocol, patients were treated with 10-mg systems for four weeks followed by 15-mg systems for eight weeks. Serum samples were obtained three to five hours after application of the transdermal therapeutic system. Testosterone increased from a pretreatment level (mean +/- SE) of 1.5 +/- 0.4 nmol/L to 15.2 +/- 3.4 nmol/L at four weeks, 18.6 +/- 3.3 nmol/L at eight weeks, and 17.3 +/- 2.8 nmol/L at 12 weeks. The serum testosterone/dihydrotestosterone (DHT) ratio fell from 4.53 to 2.47 at four weeks and was similar at eight and 12 weeks, reflecting a greater rise in DHT with this route of treatment (normal testosterone/DHT ratio, 9/1 to 12/1). Eight patients were treated with the 15-mg systems for an additional year. Seven of the eight were compliant and maintained serum testosterone levels (at six time points from two to 12 months [mean +/- SE] ) ranging from 11.5 +/- 1.2 to 44.9 +/- 2.4 nmol/L. It was possible to achieve physiological serum levels of testosterone by transdermal administration of testosterone in two thirds of our hypogonadal men.

Administration, Cutaneous↗
PubMed1980

Relationship of dietary intake to subsequent coronary heart disease incidence: The Puerto Rico Heart Health Program.

A study of base-line nutrient intakes of 8218 urban and rural Puerto Rican man aged 45 to 64 years was undertaken in relation to subsequent six year coronary heart disease (CHD) incidence. Urban dietary intakes were significantly higher in total fat and lower in carbohydrate, particularly starch. Average cholesterol intakes were 83 mg/day higher in urban than rural men. Urban serum cholesterol values were significantly higher than rural values. Urban men who developed myocardial infarction or CHD death had significantly lower calorie and carbohydrate intakes i.e., chiefly those derived from rice and legumes. The same association was found in the rural group but failed to reach statistical significance. A very low intake of alcohol was noted in the 73 rural CHD cases. Dietary sucrose intake showed no relationship to CHD incidence. Multivariate analysis, taking relative weight, hematocrit, blood pressure, serum cholesterol, alcohol intake, cigarette smoking, area, and age into account, demonstrated an independent inverse relation of carbohydrate intake from legumes to CHD incidence. The apparent protective effect of complex carbohydrate merits further investigation.

Cholesterol, Dietary↗
PubMed1977

Nutrient intake and serum lipids in urban and rural Puerto Rican men.

Dietary intake information was collected on 2,426 rural and 5,828 urban men free of coronary heart disease in the Pureto Rico Heart Health Program. Serum cholesterol and triglyceride, body weights, and related parameters were measured during a detailed cardiovascular examination. There were statistically significant differences between rural and urban values with respect to lipids, relative weight, and intake of many nutrients. Rural subjects had lower lipids and relative weights. Serum cholesterol was associated with relative weight in both rural and urban areas. In the urban areas, serum cholesterol was associated with intake of total fat, saturated fatty acids, polyunsaturated fatty acids, total carbohydrate, and starch (all measured as percent of calories). It was also related to percent carbohydrate from starch and dietary cholesterol intake, even after relative weight was taken into account. The associations were of a low order, although statistically significant. The association of fasting triglycerides with some of the carbohydrate variables was statistically significant after relative weight was taken into account in the urban area. Overall, diet and relative weight can account for at most 6% of the variability in serum cholesterol observed, with at most 2.5% of the variability due diet alone.

Age Factors↗
PubMedDate not supplied

[Cardiac myxoma. A report of 23 cases].

Twenty-three cases of cardiac myxoma are reviewed during a period of 11 years. Seventeen patients were females and 6 males with an average age of 36 years. All patients were symptomatic for an average period of time of 4 months. Dyspnea was the main symptom (91%), congestive heart failure (52%), murmurs (74%), atypical chest pain (65%), palpitations (52%), constitutional manifestation (48%), congestive heart failure (36%), embolic events (23%) and ventricular tachycardia as a first manifestation of a right ventricular myxoma in one case (4.5). In all patients the diagnosis of cardiac tumor was made during life. Among they, in 83%, by echocardiogram, 14%, by cardiac catheterization, and in one case (4.5%) with both methods. Seventy percent were located in the left atrium, 18% in the right atrium, 9% in the right ventricule and 4.5% to both right cavities. Two patients died while waiting surgery, one due to pulmonary emboli and another due to refractory congestive heart failure. In all 21 patients who were sent to surgery a direct correlation was seen with the echocardiographic findings. All 23 patients had a confirmatory histopathological diagnosis. There were no surgical deaths. Excision of the tumor resulted in marked symptomatic improvement. The follow up by echocardiography showed that surgery has been curative with no recurrence up till now. We consider that this entity, that is capable to simulate multiple cardiovascular diseases must be removed surgically once it has been diagnosed in order to avoid fatal complications.

Adolescent↗
PubMedDate not supplied

[Postangioplasty renal artery thrombosis treated intraluminally with thrombolysis. A case report].

The authors present the clinical case of a 31 year female with systemic vascular hypertension secondary to a 65 percent unilateral fibromuscular renal artery stenosis. The centellographic study demonstrated hypoperfusion on the right kidney and serious functional damage; the patient was subject to intraluminal renal angioplasty resulting in right renal arterial thrombosis, which was treated successfully with intra-arterial and intravenous streptokinase infusion. Following the thrombotic therapy, recanalization of the thrombosed artery and normal renal excretion of the contrast substance was observed.

Acute Disease↗