Systemic sclerosis, pulmonary fibrosis and anti-MPO antibodies.
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Biomedical subjects
Publications and source records attributed to L Jaimez.
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In this work the presence of gamma-glutamyltransferase (GGT), leucine amino-peptidase (LAP) and alkaline phosphatase (AP) is shown in human tear fluid. We studied these levels according to sex, age and some eye refraction defects. The differences between the levels for both sexes are not significant. LAP and AP do not show any differences in either age groups or individuals with some refraction defects. The average level of GGT is higher from 40 years of age upwards (p less than 0.005). In individuals with refraction defects, the enzymatic activity is significantly higher (p less than 0.05) than the activities found in normal subjects. The levels of the three enzymes in serum and tear fluid do not show a significant correlation nor are they significantly modified after the samples have been frozen for a month at -20 degrees C.
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Salivary gamma-glutamyl transferase (GGT) activity was measured in 116 patients with several diseases that involved the hepatobiliary tract, pancreas, and miscellaneous disorders and in 20 normal subjects. We have found significantly elevated values of salivary GGT in cirrhosis of the liver (8.3 +/- 0.9 [mean +/- SEM] units/L), hepatic tumors (10.4 +/- 1.3 units/L), acute cholecystitis (18.3 +/- 2 units/L), acute pancreatitis (15.1 +/- 2.4 units/L), diabetic ketoacidosis (11.6 +/- 1 units/L), and Sjögren's syndrome (19.6 +/- 4.8 units/L). Salivary GGT activities were unmodified in fatty liver, infectious hepatitis, silent cholelithiasis, and mumps. Several mechanisms explain high salivary GGT activity. Measurement of salivary GGT activity in internal medicine merits further investigations to determine its potential diagnostic value.
The authors have previously described the presence of gammaglutamyl transferase and alkaline phosphatase in the saliva of healthy individuals and of patients with hepatobiliary and pancreatic diseases. The authors show in this work the values of said enzymes in the blood serum and saliva of 23 cases of liver cirrhosis and 17 patients with liver tumors. Both enzymes increase significantly in the serum of liver tumor patients with respect to the amounts found in liver cirrhosis patients (p less than 0.005). Alkaline phosphatase increased significantly in the saliva of patients with liver cirrhosis (p less than 0.005), where as no differences were found between the two groups of patients with liver cirrhosis (p less than 0.005), where as no differences were found between the two groups of patients for the salivary gamma-glutamyl transferase. The determination of seric alkaline phosphatase and gamma-glutamyl transferase, and of salivary alkaline phosphatase may be useful for the differential diagnosis between liver cirrhosis and liver tumor.
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Some authors have suggested that carbohydrates can induce hepatic microsomal enzymes, resulting in increased serum gamma-glutamyltransferase (GGT) in diabetes mellitus. Previously we demonstrated the lack of serum GGT increases in patients with acute diabetic crises. In this work we studied serum GGT activity, blood glucose levels and glycosylated hemoglobin levels (HB A1) in 35 patients with diabetes mellitus and 27 healthy volunteers. We did not see differences in the serum GGT activity among controlled (25.05 +/- 2.72 U/l) and uncontrolled (26.44 +/- 4.05 U/l) diabetics and the control group (22.51 +/- 2.95 U/l). Also, there was no significant correlation between serum GGT and HB A1 levels in diabetic patients (r = 0.279). We think that our observations may be relevant because they support the hypothesis that hyperglycemia does not act as an enzyme-inducing agent in chronically uncontrolled diabetics and, furthermore, they indicate that in the presence of abnormal serum GGT levels in diabetics it is necessary to investigate other associated diseases.
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Serotonin is involved in the control of ACTH secretion, possibly by stimulating corticotropin releasing factor secretion from the hypothalamus. Cushing's disease seems to be due to defective hypothalamic regulation of ACTH release from the pituitary gland. Cyproheptadine is a potent antagonist of serotonin and has been used successfully in some patients with Cushing's disease, although, generally, in women without radiological evidence of pituitary tumors. We report the successful use of cyproheptadine in a 54-year-old man with Cushing's disease due to pituitary basophil adenoma. Significant clinical and biochemical improvement was noted 45 days after treatment began. The results in this patient support our findings that cyproheptadine can be effective in patients with Cushing's disease due to pituitary tumors, as well as in preparing very ill patients for surgery or managing such patients until radiotherapy takes effect.
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Chronic mucocutaneous candidiasis is a rare cellular immunodeficiency disease, characterized by persistent infections of the mucous membranes, nails, skin and scalp. Candidal granuloma is an uncommon form of mucocutaneous candidiasis of early onset which may ne associated with hypothyroidism. It is difficult to manage as so far no truly effective treatment has been found. We present a 13-year old boy with candidal granuloma associated with primary hypothyroidism who had a favorable response to treatment with thyroid hormone and miconazole. The fungicide was given in tablet form, a single dose per day and patient kept it in his mouth and in contact with his lips for 15 minutes. One and a half year later clinical evolution is good and no side effects related to the miconazole have been observed.
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