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Biomedical subjects

L M Valdez

Publications and source records attributed to L M Valdez.

6 recordsLinked to original sources
PubMed1998

Combination drug therapy for cryptosporidiosis in AIDS.

Aside from effective antiretroviral therapy, there is no consistently effective antiparasitic therapy for cryptosporidiosis in AIDS. The purpose of this study was to assess safety, efficacy, and durability of combination therapy with paromomycin and azithromycin for chronic cryptosporidiosis. Patients with AIDS, chronic cryptosporidiosis, and < 100 CD4 cells/microL were treated with open-label paromomycin (1.0 g twice a day) plus azithromycin (600 mg once a day) for 4 weeks, followed by paromomycin alone for 8 weeks. In 11 patients, median stool frequency decreased from 6.5/day (baseline) to 4.9/day (week 4) and 3.0/day (week 12). Median reductions in 24-h oocyst excretion were 84%, 95%, and >99% at 2, 4, and 12 weeks, respectively. None of the responses were attributable to antiretrovirals. Of 5 survivors at 12-30 months of follow-up, 3 remain asymptomatic off medications, and 2 have chronic, mild diarrhea. Treatment of cryptosporidiosis with azithromycin and paromomycin was associated with significant reduction in oocyst excretion and some clinical improvement.

AIDS-Related Opportunistic Infections↗
PubMed1998

Prophylactic effect of bovine anti-Cryptosporidium hyperimmune colostrum immunoglobulin in healthy volunteers challenged with Cryptosporidium parvum.

Bovine hyperimmune anti-Cryptosporidium colostrum immunoglobulin (BACI) decreases the intensity of Cryptosporidium parvum infection in vitro. We investigated the prophylactic effect of BACI in healthy adults challenged with C. parvum. After we established an oocyst dose that resulted in 100% infection in four volunteers (baseline group), 16 volunteers were randomized to receive (1) BACI prior to C. parvum challenge (BACI group) and a nonfat milk placebo 30 minutes later, (2) BACI prior to and 30 minutes after challenge (reinforced BACI group), or (3) nonfat milk placebo prior to and 30 minutes after challenge. Subjects received BACI (10 g) or nonfat milk placebo three times a day for a total of 5 days and were followed for clinical symptoms and oocyst excretion for 30 days. A trend toward less diarrhea (P = .08) was observed for subjects receiving BACI in comparison with occurrences in placebo recipients. Subjects receiving BACI or nonfat milk placebo had a 100-fold reduction in oocyst excretion as compared with excretion in the baseline group.

Administration, Oral↗
PubMed1997

Flow cytometric detection of Cryptosporidium oocysts in human stool samples.

Cryptosporidium parvum is an important pathogen that causes diarrhea in virtually all human populations. Improved diagnostic methods are needed to understand the risk factors, modes of transmission, and impact of cryptosporidiosis. In the present study, we fluorescently labeled and counted C. parvum oocysts by flow cytometry (FC) and developed a simple and efficient method of processing human stool samples for FC analysis. Formed stool (suspended in phosphate-buffered saline) from an asymptomatic, healthy individual was seeded with known concentrations of oocysts, and oocysts were labeled with a cell wall-specific monoclonal antibody and detected by FC. The method described herein resulted in a mean oocyst recovery rate of 45% +/- 16% (median, 42%), which consistently yielded a fourfold increase in sensitivity compared to direct fluorescent-antibody assay of seeded stool samples. However, in many instances, FC detected as few as 10(3) oocysts per ml. Thus, FC provides a reproducible and sensitive method for C. parvum oocyst detection.

Animals↗
PubMed1996

Practical guidelines for the treatment of cholera.

Cholera is a dramatic clinical illness that requires rapid diagnosis and aggressive therapy. Clinical signs and symptoms of mild, moderate and severe dehydration must be determined, before beginning fluid therapy. Fluid therapy has 2 phases: rehydration (first 3 to 4 hours to correct deficits) and maintenance (to match continuing losses). The route and speed of fluid administration will depend on the degree of dehydration. Patients with severe dehydration should be treated intravenously, as should those patients who do not tolerate oral rehydration solution (ORS). Ringer's lactate is the preferred intravenous solution, although normal saline may be used along with ORS. For most patients with cholera, an ORS using one of the higher sodium-containing solutions and plain water optimally provide the fluid and salt needed. Close monitoring of intake, outputs and hydration status should be performed for all patients. Antimicrobial therapy should be given to moderately and severely ill patients in order to decrease the volume of fluids lost and to shorten the period of excretion of vibrios.

Anti-Infective Agents↗
PubMedDate not supplied

[The injured pedestrian in motor vehicle traffic accidents: mortality in Mexico, 1985-1996].

OBJECTIVE: To describe the mortality of pedestrians injured at motor vehicle traffic accidents (PIMVTA) in Mexico. METHODS: Analysis of death certificates registered in Mexico (1985-1996), identified by E codes of the International Classification of Diseases, 9th Revision. Mortality rates were stratified by age group. RESULTS: From 1985 to 1996, 60,566 deaths in PIMVTA (rate of 7.42/100,000) were registered: 78.1% in men (11.7/100,000), and 21.9% in women (3.2/100,000). The mortality increased in direct relationship to age, the general mortality trend lightly descending in both sexes, but more marked from the 80 and more years old. The higher rate was is observed for Jalisco (9.7/100,000) and the lower rate was for Coahuila (2.1/100,000). According to the location size, the mortality shows a bimodal distribution: higher for localities of 15.000 to 19.999 and 1,000,000 (8.0/100,000 and 8.2/100,000 person-years, respectively. CONCLUSIONS: The deaths of PLATVM are presented, mainly, in men, their frequency is incremented with the age, they show a tendency lightly descending, and they are observed with greater frequency in urban centers.

Accidents, Traffic↗