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Biomedical subjects

H Escobar

Publications and source records attributed to H Escobar.

At least 19 recordsLinked to original sources
PubMed2005

[Cervical cancer prevention: an update].

It has been seen an increase of the cervical cancer and of intraepithelial cancer in the last years. The most important risk factors for cervical cancer are sexual conduct, early of sexual relationships, number of partners, cigarettes, oral anticonceptive, pregnancy, immunosuppression, sexually transmitted illness. And an important role of the Human Papilloma Virus. The HPV has been classified in 3 groups; low risk, the most frequents are 11 and 6, middle risk, tipe 31, 33 and 35, and high risk, 16 and 18, that have frequent association with cervical cancer and with high grade intraepithelial lesions. The cervicovaginal citology is still the most accurate diagnosis method to detect SIL or CIN and invasive cancer in early stages, it is discussed the periodicity and group of women to whom the method must point. There are different options depending if it is a SIL of low or high grade or and cancer. With the possibility of doing follow up or treatment, such as. LLETZ, Laser, Criotraphy, cone and interferon for the preneoplastic lesions. The achievement of a vaccine for HPV could have a significant impact on these pathology.

Female↗
PubMed2001

Nontuberculous mycobacteria in patients with cystic fibrosis.

The prevalence and clinical implications of colonization with nontuberculous mycobacteria were prospectively studied in 37 patients who had cystic fibrosis. Sputum samples were cultured on Coletsos and Löwenstein-Jensen selective media after decontamination with sodium hydroxide and oxalic acid. Oxalic acid-decontaminated fractions were also cultured in selective liquid medium. Nontuberculous mycobacteria were isolated from 6 patients (16.1%). Mycobacterium chelonae and Mycobacterium avium-intracellulare complex were the most common species. Three patients with positive results of culture had at least 1 positive result by acid-fast smear. Oxalic acid decontamination and culture in liquid medium had the lowest contamination rate (6.7%). Colonization with nontuberculous mycobacteria was associated with humoral response to mycobacteria (immunoglobulin G titers against antigen A60) in patients with samples that tested positive by acid-fast smear. An improvement in pulmonary function was observed in 2 patients after they received a course of antimycobacterial therapy. Screening for nontuberculous mycobacteria in patients with cystic fibrosis will contribute to understanding the relevance of these pathogens with regard to deterioration of pulmonary function in patients with cystic fibrosis.

Adolescent↗
PubMed2000

Suspected sexual abuse: an unusual presentation form of congenital myotonic dystrophy.

UNLABELLED: In children, anal abnormalities due to various causes may be confused with sexual abuse. We present the case of a child in whom the suspicion of abuse due to anal dilatation led to the previously unknown diagnosis of myotonic dystrophy. Myopathic involvement of the perianal musculature is a known feature of congenital myotonic dystrophy that usually appears in late childhood or adolescence. CONCLUSION: We stress the importance of considering an underlying myopathic condition in the differential diagnosis of anal laxity. Further studies, such as anal ultrasonography, may help when the diagnosis of abuse is not clear.

Child↗
PubMed2000

A beta-turn rich oats peptide as an antigen in an ELISA method for the screening of coeliac disease in a paediatric population.

BACKGROUND: ELISA methods for the measurement of IgA antigliadin antibodies (AGA), both home-made and commercial systems, routinely employ wheat gliadin fractions as coating antigens. We investigate the sensitivity and specificity for CD diagnosis of a new ELISA method using a highly immunoreactive beta-turn rich gamma3-avenin peptide as an alternative coating antigen. METHODS: The assay was standardized with antihuman IgA peroxidase-conjugated as the second antibody. Alternatively, an ELISA based on the use of protein A-peroxidase was assayed to measure both IgG plus IgA antibodies. Sixty-three sera from healthy controls were analyzed to establish the system's cut-off point. Sera from 103 coeliac and from 65 noncoeliac children were tested; for diagnosis purposes, a small intestinal biopsy had been performed in all of them. RESULTS: For the IgA class antibodies assay a high sensitivity and specificity of 90.3% and 98.5%, respectively, was obtained, comparable to those achieved for IgA antiendomysium antibodies (EmA) with the same sera. CONCLUSIONS: In view of the high sensitivity and specificity obtained together with water solubility of the peptide and easiness for large-scale reproducible synthesis, the new AGA IgA avenin peptide ELISA represents a significant improvement in CD diagnosis in comparison with conventional established AGA IgA ELISA using crude gliadins as coating antigens.

Adolescent↗
PubMed2000

Intraepithelial lymphocytes and coeliac disease: permanent changes in CD3-/CD7+ and T cell receptor gammadelta subsets studied by flow cytometry.

UNLABELLED: Permanent changes in intestinal intraepithelial lymphocytes have been observed in coeliac patients. The aim of this investigation was to study small intestinal intraepithelial lymphocytes by using flow cytometry and to evaluate its diagnostic value in coeliac disease. Three-colour flow cytometry analyses were performed on isolated epithelial cells of 117 intestinal biopsies obtained from 113 children (54 coeliac disease, 4 other enteropathies, 18 Helicobacter pylori associated gastritis and 37 normal controls). A multiple logistic regression model was developed to select the best intraepithelial lymphocytes subset predictor of coeliac disease. Coeliac patients had significant higher levels of T cell receptor gammadelta intraepithelial lymphocytes than control patients (p < 0.01), H. pylori patients (p < 0.01) and other enteropathies (p < 0.05). The density of CD3-/CD7+ intraepithelial lymphocytes, a intraepithelial lymphocyte subset poorly characterized by immunohistochemical methods, was significantly lower in coeliac patients than in the control group (p < 0.01). H. pylori group (p < 0.01) and other enteropathies (p < 0.01). Both changes remained altered independent of the coeliac patient's diet. The data were used on a logistic regression analysis in order to calculate sensitivity [94.4%; 95% confidence interval (CI) 83.7-98.6%], specificity (94.9%; 95% CI 84.9-98.7%) and likelihood ratio for a positive test 18.5 (95% CI 6.1-55.8) in the diagnosis of coeliac disease. CONCLUSION: Changes in T cell receptor gammadelta and CD3-/CD7+ intraepithelial lymphocytes subsets are permanently observed in paediatric coeliac disease. Their assessment, by three-colour flow cytometry on routine diagnostic biopsies, permits a better characterization of coeliac enteropathy and represents a valuable procedure to identify coeliac patients with different clinical presentations.

Adolescent↗
PubMed1999

Anal endosonography in children with chronic constipation.

BACKGROUND: Hypertrophy of the internal anal sphincter may be apparent in some children, but its significance has not yet been determined. OBJECTIVE: To assess anal endosonographic findings in children with chronic constipation. Materials and methods. We performed anal endosonography in 46 children with chronic constipation and compared the results with values considered normal. RESULTS: We did not find a significant relationship between age and thickness of the internal or external anal sphincters. The clinical response to medical management did not differ between patients with or without sphincter hypertrophy. CONCLUSIONS: Although we did not find a significant correlation between sphincter hypertrophy and constipation or age, further studies may clarify its place amongst other techniques which are used in the investigation of anorectal pathology.

Adolescent↗
PubMed1998

Beta structure motif recognition by anti-gliadin antibodies in coeliac disease.

A 20-amino acid synthetic peptide from the N-terminal region of gamma3 avenin yields a surprisingly strong reactivity with anti-gliadin antibodies (AGA) of coeliac sera, comparable to that of a gliadin extract. In contrast, a low reactivity is observed with five similar peptides derived from alpha-gliadin, gamma70 and omega1 secalins. Circular dichroism studies of these peptides show that the avenin peptide displays the highest beta-turn content (30%), while other peptides yield much lower values. In agreement with circular dichroism data, nuclear magnetic resonance data point to the presence of a beta-turn in the avenin peptide DPSEQ segment, a sequence with a high statistical beta-turn preference. A strong linear dependence between AGA reactivity and beta-turn content was observed for these peptides, indicating for the first time a role of beta-turn motifs in anti-gliadin antibodies recognition in coeliac disease. This suggests that circulating AGA in coeliac patients comprise not only linear but also conformational antibodies against beta-turn motifs. Polyclonal antibodies raised against the avenin peptide containing beta-turn motifs react by immunoblotting with all gliadin, hordein and secalin proteins, which are rich in beta-turn conformations, despite that their primary structures are unrelated to that of the peptide.

Antibodies↗
PubMed1997

Use of interferon-alpha in laryngeal papillomatosis: eight years of the Cuban national programme.

Laryngeal papillomatosis is one of the first diseases where interferon (IFN) was found to be effective. In 1983, a programme for the treatment of all such cases started in Cuba. Up to December 1991, 125 patients (92 children, 33 adults) have been treated: 102 with leucocyte IFN-alpha, 12 with recombinant IFN-alpha-2b, and 11 have received both preparations. Case management consisted of surgical removal of the lesions followed by an IFN schedule starting with 10(5) IU/kg of weight in children or 6 x 10(6) IU in adults, i.m. daily. The dose was progressively reduced, as long as no relapses occurred. At the end of the one-year schedule the doses were reduced to 5 x 10(4) IU/kg in children or 3 x 10(6) IU in adults, weekly. If there was a relapse, it was removed surgically and the patient returned to a higher dose level. Most cases (89; 71 per cent) have not relapsed after the treatment; 60 of them have been followed for more than three years. In those with relapses, the frequency of recurrence decreased in all but four patients. The treatment seemed to be more effective if initiated less than three months after the disease onset. The tracheostomy could be removed in five out of seven patients who needed it before the IFN treatment and was necessary in only three new cases during IFN treatment. In two of these, decannulation was possible later on. In a total of 14 patients relapses persisted after several cycles of IFN treatment. They were considered resistant to such treatment. No severe side effects were reported. The most frequent ones were fever, drowsiness, increased bronchial secretion, chills and headache. The establishment of this programme has maintained the disease under control in Cuba.

Adolescent↗
PubMed1996

Luteinizing hormone pulse frequency is increased by arginine infusion in prepubertal sheep.

Puberty in sheep is initiated by a complex neuroendocrine interplay which cascades into an increased LH pulsatility at this time. Blood-borne amino acids have been proposed as metabolic signals for the stimulation of GnRH/LH secretion, a mandatory requirement for pubertal onset. In previous experiments we have demonstrated that a 1 h infusion of L-arginine (ARG) was capable of stimulating the LH secretion in prepubertal ewes. The aim of the present study was to further examine the effect of an intravenous infusion of ARG on LH secretion. Prepubertal ewes were infused for 6 h with 15 (Group ARG15, n = 5) or 30 g (Group ARG30, n = 5) of L-ARG dissolved in 500 mL saline (pH 7.4), while saline was administered as control (Group S, n = 5). Since ARG is metabolized to ornithine (ORN), equimolar doses of L-ORN were additionally tested (Group ORN12 and ORN24, n = 5, respectively). Blood samples were obtained at 15 minute intervals during and after experimental infusions to characterize the LH pulsatile secretion. The resulting hormone data arrays were searched for significant fluctuations by the PULSAR program. The LH pulse frequency was found to be higher in groups of ARG treated than in saline or ORN infused sheep during the 6-h infusion period: 5.6 +/- 1.0 (ARG15) vs. 5.0 +/- 0.5 (ARG30) vs. 2.0 +/- 0.9 (S, p < 0.01) vs. 3.4 +/- 0.9 (ORN12) vs. 3.4 +/- 0.9 pulses/6 h (ORN24, p < 0.05). The total number of pulses was higher in ARG infused lambs than in saline or ORN infused animals: 11.2 +/- 1.2 (ARG15) vs. 10 +/- 1.1 (ARG30) vs. 13.8 +/- 1.4 (S) vs. 5.8 +/- 1.7 (ORN12) vs. 5.8 +/- 2.0 pulses/12h (ORN24), respectively. The LH mean secretion was comparable during both 6-h periods in all groups. Results of our experiments demonstrate increased LH pulse frequencies during ARG infusions, suggesting an action of ARG to stimulate hypothalamic GnRH release. Thus, ARG may be a critical determinant for enhanced LH pulsatility as a prerequirement for the onset of puberty in the sheep.

Analysis of Variance↗
PubMed1996

Long-term persistence of ciprofloxacin-resistant Haemophilus influenzae in patients with cystic fibrosis.

Ciprofloxacin has been a major advance in the treatment of chronic respiratory infections. Three patients with cystic fibrosis and colonized by 5 nontypeable Haemophilus influenzae strains exhibiting low- (MIC, 2 microg/mL) and high-level ciprofloxacin resistance (MICs, 16-32 microg/mL) are described. The patients had received several courses of ciprofloxacin. These MICs represent a decrease in ciprofloxacin susceptibility of 200-3200 times. Molecular epidemiologic methods demonstrated that 2 patients were chronically colonized by their own ciprofloxacin-resistant strains for > or = 15-17 months. Three strains showed simultaneous resistance to ampicillin and chloramphenicol by enzyme inactivation, and 2 had ampicillin resistance without beta-lactamase activity. These data suggest that the emergence and long-term persistence of ciprofloxacin-resistant H. influenzae in patients with cystic fibrosis can be a consequence of antibiotic treatment.

Adult↗