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Biomedical subjects

M A Guzmán

Publications and source records attributed to M A Guzmán.

At least 19 recordsLinked to original sources
PubMed1999

[Meningitis in subjects with human immunodeficiency virus infection].

BACKGROUND: Neurological complications are frequently observed in HIV-1 patients. Lumbar puncture (LP) and LSF analysis are two key diagnostic procedures. AIM: To describe the etiology meningeal syndromes in a hospital series of HIV patients. RESULTS: In this study, we present the different meningeal complications from 198 HIV-1 patients referred, for the last five years, to the HIV Center of the Hospital of University of Chile. The diagnosis of HIV-1 was done clinically plus a positive ELISA test, and confirmed by Western blot and/or PCR. In all cases with a possible neurological complication (52/198), a LP was performed. Cytochemical and microbiological studies, were done in each CSF sample. Serum CD4/CD8 lymphocytes number were determined by flow cytometry, and brain CT scan and/or MRI were obtained. From the 52 patients in whom a LP was done, 24 showed an abnormal CSF, compatible with the diagnosis of meningitis. The most frequent etiology (11/24) was infection by Cryptococcus neoformans, followed by Treponema pallidum (7/24). There were 3 cases of HIV-1 meningitis, and 3 other cases with lymphoma, varicella zoster and cytomegalovirus meningitis. The frequency of cryptococcal infection was similar to that reported in the literature, but two interesting observations were the high frequency of neurosyphilis and the absence of TBC meningitis. In our country, the VDRL/FTA-ABS serum tests are mandatory in HIV patients. If these tests were positive a LP was performed, and this could partially explain the high number of cases coinfected with neurosyphilis. There is an important prevalence of lung TBC in our country, and as a consequence there is a policy of immunization to all newborn. It is possible that the high prevalence of TBC "promotes" a more actively search for TBC infection, with an early diagnosis and treatment of pulmonary TBC, and so a more frequent prophylaxis therapy in HIV patients, without the development of TBC meningitis.

Adult↗
PubMed1994

[Neurosyphilis and human immunodeficiency virus (HIV-1)infection. Experience with 6 cases].

HIV infected population has a higher incidence of syphilis, being this an independent risk factor for HIV infection. We report 88 HIV infected patients seen during the last three years. Fourteen (16%) had reactive serum VDRL and FTA-ABS and neurosyphilis was diagnosed in six (6.8%). Three had a treponemal uveitis-retinitis, one a meningovascular syphilis and one a secondary syphilis with meningeal and otological involvement. Patients were treated with penicillin 20 million UI/day for 14 days with good clinical and laboratory response and CSF normalization in those subjected to a second lumbar puncture. It is concluded that neurosyphilis must be considered in the differential diagnosis of neurological complications of HIV infections.

Acquired Immunodeficiency Syndrome↗
PubMed1983

[Basic procedures in data registers and processing].

This paper describes the general principles that must be used as a frame of reference to identify the appropriate procedures for the management of data collected in large scale studies. It has two parts: 1) Data recording and, 2) data processing. In the first part (data recording), the various steps required for the preparation of forms and/or questionnaires and for the recollection of data are discussed. In the second part (data processing), the steps to achieve real quality control, proper coding and data entry for analysis are described. For the latter case, an outline of continuous general steps is proposed, and some statistical procedures commonly used for testing different hypotheses are identified. The overall process is illustrated through flow charts, emphasizing the fact that the processing and analysis of data, must be a continuous action which requires careful definition in the standard protocol of operations.

Data Collection↗
PubMed1981

Community pathology of atherosclerosis and coronary heart disease: post mortem serum cholesterol and extent of coronary atherosclerosis.

Little is known about the direct relationship between serum cholesterol and the extent of coronary atherosclerosis in human populations even though the association of serum cholesterol levels with risk of developing coronary heart disease (CHD) is well documented. The results of this study of men 25-44 years of age, residents of Orleans Parish, Louisiana, show a significant relationship between post mortem serum cholesterol levels and extent of more advanced lesions (raised lesions) in the coronary arteries in 110 autopsied white men, but not in the cases of 221 autopsied black men. When disease categories comprising CHD cases and non-CHD cases (basal group) were evaluated, the racial difference in the cholesterol-lesion associations persisted. The reason for the racial difference in the observed cholesterol-lesion association is not clear. Additional research, where younger age groups are included, and considering earlier lesions and other risk factors in different environments may help in clearing this question.

Adult↗
PubMed1980

Sudden death, coronary heart disease, atherosclerosis and myocardial lesions in young men.

A standardized method for examining hearts and coronary arteries was applied in a study of sudden deaths in 227 autopsies of New Orleans men aged 25-49 years. Of these autopsies, 102 deaths were due to external violence, 125 were from natural causes and 45 occurred suddenly. Of the sudden natural deaths, 14 (31%) were due to coronary heart disease (CHD), seven (16%) were possibly due to CHD and 24 (53%) were due to other causes without evidence of CHD. Large recent myocardial lesions (greater than or equal to 1 cm) were present in 19 (95%) of 20 CHD deaths and in 16 (18%) of 91 non-CHD deaths. The myocardial lesions in sudden CHD deaths were subendocardial involving preferentially the posterior septum and the apex of the heart. The lesions in non-sudden CHD deaths were transmural involving preferentially the anterior, lateral and posterior left ventricle and the base of the heart. Men who died of CHD had extensive coronary atherosclerosis, while those who died of other causes had minimal coronary atherosclerosis. The large proportion of CHD deaths which occurred suddenly (70%) reaffirms the need for primary prevention and the need for improved predictive factors for early detection of CHD.

Adult↗
PubMed1980

Decrease in coronary atherosclerosis in New Orleans.

We compared age- and race-specific data from two autopsy studies conducted 10 years apart on 25- to 44-year-old New Orleans men. The per cent of coronary intimal surface having raised atherosclerotic lesions was substantially less for white men in the later study. For black men of the same age group, however, the mean extent of raised atherosclerotic lesions in the coronary arteries changed only slightly. Fatty streaks were less extensive in both races in the second study period. Thus, the total surface involvement with coronary atherosclerosis in both black and white men was less in the second study. This apparent reduction in coronary atherosclerosis is consistent with recent evidence of diminishing coronary heart disease mortality in the United States. These findings suggest that surveillance of the extent of atherosclerotic lesions measured at autopsy may be an effective indicator of secular trends in coronary heart disease.

Adult↗
PubMed1979

Geographic comparisons of diffuse intimal thickening of the aorta.

Aortic intimal thickness was measured microscopically in samples taken from areas grossly free of atherosclerotic lesions of 2,472 subjects aged 15 through 64 years collected during the first year of the International Atherosclerosis Project (IAP). Results indicate that there is progressive increase in aortic intimal thickness with increasing age in both sexes. No differences were observed between the upper thoracic and abdominal aorta. Mean intimal thickness does not appear to be consistently thicker in males than in females. Some differences were found in mean thickness among the 19 location--race groups included; however, such differences did not parallel those observed among the same location--race groups by the mean level of atherosclerosis. A few subjects with Coronary Heart Disease (CHD) and atherosclerosis-related cases had slightly thicker intimas. Diffuse Intimal Thickening (DIT) detected grossly correlates well with thicker means of intimal thickness in both sexes in the abdominal aorta and the thoracic aorta in females. DIT appears to be a universal phenomenon mainly age-dependent; it also appears to be increased in some (CHD) and atherosclerosis-related conditions.

Adolescent↗
PubMed1976

Dietary-atherosclerosis study on deceased persons. Relation of selected dietary components to raised coronary lesions.

Dietary histories for 253 deceased New Orleans men were obtained retrospectively by interviewing respondents who had shared the household with these men for an average of eighteen years. Each respondent answered a detailed questionnaire designed to elicit the usual twenty-eight-day pattern of food intake of the subject during the terminal year of his life. This information was then used to calculate the average daily intake of selected dietary components. The cases included in the dietary studies were a sub-sample of cases in the International Atherosclerosis Project and were also studied for cigarette smoking habits. Analyses were performed to determine possible associations of nutrient intakes during the terminal year of life with the extent of raised lesion involvement in the three main coronary arteries measured at autopsy. These analyses indicated that higher intakes of protein of vegetal origin, total carbohydrate, starch, and crude fiber are associated with less atherosclerotic lesion involvement. For other components (total calories, total protein, animal protein, total fat, animal or vegetal fat, saturated or unsaturated fatty acids, total sugars, and cholesterol), there were no indications that the daily consumption was related to atherosclerotic lesions found at autopsy. When the diet-lesion relationships were examined on the basis of nutrient-to-calorie ratios, starch and vegetal protein were associated with less atherosclerotic lesion involvement in the coronaries, while animal protein and fat, regardless of source, were associated with greater atherosclerotic lesion involvement. These results suggest that, in general, the consumption of more foods of vegetal origin may be related to a lesser degree of atherosclerotic involvement.

Adult↗
PubMed1976

[Socioeconomic level of the family and nutrition in the rural area of Central America and Panama].

During the nutrition survey carried out in Central America and Panama in 1965-1967, information was obtained on the diets and nutrient intake of the rural populations, and on their anthropometric and nutritional-biochemical characteristics. Simultaneously, data were collected for each family studied, which permitted their categorization according to a scale of socioeconomic index. The findings of these studies demonstrate a direct relationship between the socioeconomic level of the families and their dietary and nutritional characteristics. The different types of data, that is, dietary, biochemical, anthropometric and socioeconomic, were all collected at the same time in order to avoid seasonal differences as a confounding factor. Restriction of the sample studied to the rural area of the six countries makes each population rather homogeneous with respect to environmental, genetic and cultural characteristics. Under these conditions, the direct association found between the socioeconomic index of the families and nutritional status acquires more meaning. The design of the study does not permit to determine the direction of a cause-effect relationship, that is, which is the cause of the other. Nevertheless, the findings lend themselves to interesting speculation in this regard.

Central America↗