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H Cuervo

Publications and source records attributed to H Cuervo.

8 recordsLinked to original sources

Clinical and immunological characteristics of type 1 diabetes mellitus in a northwestern Colombian population.

We underwent a project aimed to define the clinical and immunological characteristics of type 1 diabetes (T1D) in a Colombian population. This was a multicenter and cross-sectional study. Patients were systematically interviewed and their medical records reviewed, using a questionnaire that sought information about demographic, clinical and immunological characteristics. Glutamic acid decarboxylase antibodies (GADA), tyrosine phosphatase antibodies (IA-2A) and insulin antibodies (IAA) were examined by radioimmunoassay. There were 107 patients with T1D. Male:female ratio was 1:1. Half of the patients developed diabetes ketoacidosis at onset. GADA, IA-2A, and IAA were detected in 45%, 40%, and 69% of the cases, respectively. GADA positive patients were older and had a less duration of disease than patients without these autoantibodies (p<0.01). Association between breast feeding with the presence of antibodies or clinical characteristics was not observed. The results highlight some differences of T1D expression according to geographic location and ethnicity. Differences in age at onset and clinical variables may point to an environmental factor or deficient access to health care system. Genetic studies underway will provide important information in this population. These results might help to define public health policies in our population to improve T1D diagnosis, patients' quality of life and their outcome.

Adult↗

Trypanosoma cruzi-induced molecular mimicry and Chagas' disease.

Chagas' disease, caused by Trypanosoma cruzi, has been considered a paradigm of infection-induced autoimmune disease. Thus, the scarcity of parasites in the chronic phase of the disease contrasts with the severe cardiac pathology observed in approximately 30% of chronic patients and suggested a role for autoimmunity as the origin of the pathology. Antigen-specific and antigen-non-specific mechanisms have been described by which T. cruzi infection might activate T and B cells, leading to autoimmunity. Among the first mechanisms, molecular mimicry has been claimed as the most important mechanism leading to autoimmunity and pathology in the chronic phase of this disease. In this regard, various T. cruzi antigens, such as B13, cruzipain and Cha, cross-react with host antigens at the B or T cell level and their role in pathogenesis has been widely studied. Immunization with those antigens and/or passive transfer of autoreactive T lymphocytes in mice lead to clinical disturbances similar to those found in Chagas' disease patients. On the other hand, the parasite is becoming increasingly detected in chronically infected hosts and may also be the cause of pathology either directly or through parasite-specific mediated inflammatory responses. Thus, the issue of autoimmunity versus parasite persistence as the cause of Chagas' disease pathology is hotly debated among many researchers in the field. We critically review here the evidence in favor of and against autoimmunity through molecular mimicry as responsible for Chagas' disease pathology from clinical, pathological and immunological perspectives.

Animals↗

Primary idiopathic optic neuritis in U.S. Air Force Aviators.

The records of 31 male aviators seen at the Ophthalmology Branch of the USAF Aeromedical Consultation Service (formerly the USAF School of Aerospace Medicine) for a diagnosis of primary idiopathic optic neuritis (PION) were reviewed. Each subject received comprehensive ophthalmologic and neurologic examinations. The long-term follow-up data were collected through repeat examinations and by survey. Despite 39% of aviators being grounded due to complications of their PION or multiple sclerosis (MS), many aviators diagnosed with PION may be safely returned to flying duties. However, any aviator diagnosed with PION has a risk of recurrence or a potential to develop systemic MS and must be carefully reevaluated and followed to ensure they remain a viable asset and do not compromise flight safety or mission completion.

Adult↗

Traumatic vertebral artery occlusion in an aviator: case report and update on diagnostic technologies.

Traumatic vertebral artery injuries are relatively rare. Until recently, insufficient neurodiagnostic technology and a lack of normative data for the population of USAF aviators prevented recommending flying waivers following such vascular injuries. We report the case of an aviator who experienced a traumatic right vertebral artery occlusion with distal embolization. Timely access to a state-of-the-art neurodiagnostic evaluation, which included time-of-flight magnetic resonance angiography (MRA), and standard contrast angiography, provided anatomic imaging at the time of injury and during the recuperative period. Sophisticated neurologic testing protocols at the Armstrong Laboratory's Aeromedical Clinical Sciences Division, Brooks Air Force Base, TX, assessed in-depth this individual's functional status. Consult Service evaluators then compared his performance data with current data in the Head Injury Study in Aviators (HISA) data base. MRA, in comparison with standard contrast angiography, demonstrated anatomic stability of his vascular and neurologic lesions. He demonstrated a functional capacity consistent with normal neurologic functioning in aviators which permitted recommending an occupational (flying) waiver. This case exemplified application of sophisticated ACS neurologic testing protocols to aeromedical evaluations and the use of MRA technology as a vascular screening tool during medical followup.

Adult↗

Hyperpathia and sensory level due to parietal lobe arteriovenous malformation.

A 30-year-old man experienced the sudden onset of prickly dysesthesia in the perineum followed by a "heavy" sensation in the left lower extremity. There was no headache. He had a hyperpathic response to pinprick and temperature testing below the T-6 dermatome on the left and a decrease of light touch below T-10, also on the left. A small ruptured arteriovenous malformation was found in the right parietal lobe, medially, well above the thalamus, and in the region of the postcentral gyrus. The case provides rare and precise clinicoanatomic correlation of the discrete somatotopic organization of the sensory cortex. Furthermore, it indicates that sensory disturbances, characterized by a segmental level of abnormal sensation suggestive of a spinal cord or medullary lesion and by hyperpathia suggestive of a spinal, medullary, or thalamic localization, can be caused by a suprathalamic parietal deficit.

Adult↗

Morphological aspect of the skin terminal corpuscles, previous corrosion with pancreatin.

The capsulated corpuscles of the skin have been studied by pancreatin corrosion methods. With this corrosion, Meissner's corpuscles disappear while those, whose fundamental structure is collagenous, remain intact. We have observed structural differences in these collagenous corpuscles, some being formed as a fine reticulum or with longitudinal or concentric sheaths. Within the corpuscle, there is a totally vascular compartment, the 'vascular hill', which is easily differentiated from the other laminar or reticular segment which is the 'nerve hill'. We conclude that the connective tissue arrangement and the vascular content of the corpuscles contribute to the regulation of the different degrees of sensations perceived by these corpuscles. The tendency that these corpuscles show to unite may be caused because the places, where they are grouped, are the points of greatest sensory perception.

Collagen↗

Roux-en-Y hepaticojejunostomy with subcutaneous access and the use of Gianturco stents for the management of biliary tract strictures.

The need to control recurrent biliary strictures implies the practice of repeated major surgical procedures. The hepaticojejunostomy with subcutaneous jejunal access (Chen's procedure) allows the permanent option of a non-operative management of recurrent biliary tract anastomosis complications. Through the subcutaneous jejunal access, the application of a Gianturco metallic prosthesis is permitted and the correction of biliary-intestinal anastomosis strictures with non-operative methods is possible. This report is a review of a series of 20 patients treated with the Chen procedure, of whom 3 patients also had implantation of Gianturco stents via hepaticojejunostomy with subcutaneous access.

Adult↗