Public health problems due to Dirofilaria: the Spanish situation.
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Biomedical subjects
Publications and source records attributed to M Cordero.
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The usefulness of excretory/secretory (E/S) products of adult Dirofilaria immitis for the diagnosis of human dirofilariosis was evaluated in 97 human sera using an ELISA and a Western Blot analysis with E/S antigens. Results of the ELISA analysis show that in healthy individuals from an endemic area seropositivity is high (22%). Immuno Blot analysis shows that the reaction pattern with E/S antigens differentiates healthy seropositives, which recognize a 43 kDa band, from patients with pulmonary dirofilariosis, which specifically recognize bands between 22-28 kDa.
We present serological evidence that Dirofilaria immitis was the causative agent of subcutaneous nodules in two patients. ELISA and enzyme-linked immunoblot analysis showed that the two human sera had a reactivity pattern similar to that of D. immitis rabbit immune serum. The reaction pattern of the human sera was very different to that of Dirofilaria repens rabbit immune serum. In the light of our findings, the traditional view that subcutaneous filarial nodules are due to D. repens has to be revised.
The aim of this work was to study the prevalence of smoking in an urban population from cities with low environmental pollution. From a sampling of basic and high school children, 1959 subjects coming from 406 homes were selected for the study and answered a questionnaire about smoking. The adjusted prevalence of smoking among subjects older than 10 years old was 36.5% and 40.8% in subjects older than 15 years old. Prevalence in males was 49.4% and 35% in female. However among subjects between 10 and 15 years old, females had a higher prevalence of smoking. Most subjects smoked 1 to 9 cigarettes/day, always aspirated smoke and consumed all the cigarette. The prevalence of passive smokers was 65.5%. It is concluded that the prevalence of smoking is high, that women are starting to smoke earlier than men and that no effort is being made to stop this habit.
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The synthesis of halogenated prostaglandins at position C(10), starting from prostaglandin A2, has been accomplished, as well as an efficient regioselective hydroxylation of the upper chain of the prostanoid structure. Evaluation of the inhibitory effects on the proliferation of the K-562 cell line in vitro is presented. When the prostaglandin was modified in the upper chain, the antimitotic activity for bromo derivatives 4b, c and iodo derivative 5b had shown substantial improvements in their activities according to their ID50 values (28, 25, and 22 micrograms/mL, respectively). Attention is called to the significance of chloro derivative 3a in terms of its high potency, determined by its ID50 value (0.06 micrograms/mL).
The case of a patient with acute brucellosis presenting as lower dysphagia from a paracardial esophageal mass is described. Brucella melitensis biotype 3 was isolated from cultured esophageal biopsy material. This is the first case of esophageal brucellosis described in the literature.
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Human pulmonary dirofilariosis usually appears as a solitary pulmonary nodule. A 22 kDa antigen from Dirofilaria immitis adult worms specifically recognized by three sera from individuals diagnosed with pulmonary dirofilariosis was identified by enzyme-linked-immunoelectrotransfer blot. This antigen was purified by elution from acrylamide gels and evaluated in enzyme-linked immunoassay using sera from 92 patients with pulmonary dirofilariosis and other pulmonary and parasitic diseases. Its use in the diagnosis of human pulmonary dirofilariosis should be considered.
BACKGROUND: Dirofilaria immitis is a nematode parasite of canids that, in endemic areas, can infect humans. The use of adult somatic antigens for the diagnosis of human dirofilariasis has the disadvantage of a low sensibility because of cross-reactivity with other helminths, specially with IgM antibodies. We describe in this work proteins of the adult somatic antigenic complex that are specifically recognized by human IgM. METHODS: Human sera with different characteristics were analyzed by an enzyme-linked immunosorbent assay (ELISA) for the detection of anti-D. immitis IgM seropositive individuals. Moreover, an enzyme-linked immuno-electro-transfer blot (EITB) was performed for the detection of polypeptides that specifically react with IgM anti-D. immitis. RESULTS: EITB analysis shows that 2 proteins of 44 and 18 kD are recognized by IgM in human sera from an endemic area with a high antibody titer against D. immitis measured by ELISA. Sera from a non-endemic area and from patients suffering from other parasitic and non-parasitic diseases did not recognize these antigens. CONCLUSIONS: We believe that the 44 kD protein could be a good marker of recent D. immitis infection.
In the present study, two alternative methods for the enumeration of PB CD4+ lymphocytes are compared with conventional flow cytometry (FCM): the TRAX CD4 tm enzyme immunoassay test kit and a new method using an internal biological standard (liophilized lymphocytes) for the direct enumeration of total PB CD4+ T-cells. Both methods showed an overall high degree of correlation with conventional FCM. However, the TRAxCD4 tm enzyme immunoassay showed a significant overestimation of PB CD4+ T-cells that was not only due to monocyte-derived CD4 molecules and the use of liophilized lymphocytes as an internal biological standard showed a low level of correlation for patients displaying low CD4 counts.
STUDY OBJECTIVE: To demonstrate that a complete and rapid clinical history can be obtained using a self-administered, bilingual questionnaire. DESIGN: A post-test experimental design was used to evaluate time spent obtaining the history and information completeness for the two groups. SETTING: Urban county emergency department. PARTICIPANTS: All patients were non-English-speaking Hispanic women who presented with gynecologic complaints. METHODS: Fifty-five patients completed a history questionnaire in Spanish on a form that displayed their responses in English on the carbon copy. In the control group, a history was obtained using a bilingual interpreter. RESULTS: Average completion time was significantly less (t = 14.38; P < .0001) for the experimental group (chi 2 = 5.67 minutes; SD, 1.89) than for controls (chi 2 = 14.58 minutes; SD, 4.19). There was no statistical difference in review criteria for documentation between groups. CONCLUSION: Using a bilingual questionnaire to obtain a clinical history results in more rapid patient evaluation without affecting the quality of information obtained.
The seroprevalence of seasonal variation of human anti-Dirofilaria immitis IgE levels were studied in an area where specific IgM and IgG had been previously investigated. An antibody capture ELISA assay was used to detect specific IgE. The IgE seroprevalence observed in the whole population was 12.6%. No specific IgE was detected in atopic individuals or in sera from people suffering other helminthiases. The distribution of the IgE anti-D. immitis seroprevalence by age groups did not show differences. Females had significantly higher levels than males. This isotype of immunoglobulin peaks in July, decreasing sharply in October, and persisting at a level similar to that of a non exposed population during the rest of the year. No specific IgE were detected in subjects with pulmonary alterations related to the parasite, suggesting a possible relationship between the clinico-radiological status and the type of immunoglobulin synthesized in subjects infected by D. immitis.
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Infection by Dirofilaria immitis is a rare cause of solitary pulmonary nodule. We describe the second case of transitory pulmonary nodule found by us in the course of a case-finding study, the third one reported in the literature. The detection of cases of transient pulmonary dirofilariotic nodules suggests that human infection is more prevalent than usually thought, and that this kind of manifestation is frequent in human dirofilariosis. Greater awareness is warranted in endemic areas.
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Preliminary data are presented on the differential recognition of Dirofilaria immitis antigens by sera positive for IgG and IgM (detected by enzyme linked immunosorbent assay, ELISA) using the enzyme-linked immunoelectrotransfer technique (EITB). The sera were followed prospectively over a year to detect seasonal variations. IgG mainly recognized antigens with a molecular weight (MW) lower than 74 kDa, while IgM recognized those with a MW higher than 43 kDa. The antigens with MW between 74 and 61 kDa were recognized by both isotypes. In IgG positive sera all bands were recognized throughout the year, albeit more mildly in summer. For IgM it is noteworthy that antigens with a MW between 43 and 20 kDa were not recognized in spring. These data are in accordance with those obtained with ELISA in the seasonal follow-up of positive sera.
An unusual tumor was observed in a 67-year-old man. Microscopically, the tumor was composed of epithelial cells forming glands (CEA, EMA-positive) and spindle-shaped cells (vimentin-positive). A third component was a cell population ultrastructurally characterized by intracytoplasmic granules surrounded by a membrane; these proved to be chromogranin A-positive in the immunoperoxidase study.