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Biomedical subjects

M Espino

Publications and source records attributed to M Espino.

9 recordsLinked to original sources
PubMed2001

[Clinical and virological correlation between the cerebrospinal fluid and blood of HIV-infected children].

BACKGROUND: Although the neurological manifestations of HIV infection occur at any age, children with perinatal AIDS are affected earlier and with greater impact. There are no published data about a potential association between HIV encephalopathy and viral load in THE CSF OF the pediatric population. DESIGN: Twenty-three children, aged 7 months to 10 years, were studied as part of a multicenter international study that evaluated double versus triple antiretroviral therapy. Samples of CSF and plasma were collected for HIV RNA measurements on day 0 and on follow-up weeks 8, 16, and 48. Neurological assessments, psychological evaluations, and CT scans were done on admission and at study end. Viral isolates were processed for genotypic resistance. RESULTS: No correlation between viral load in CSF and plasma was detected at study onset. Eighty percent of children had >2 log HIV RNA in CSF at day 0 but only 30% at week 16. Eight subjects responded favorably to therapy and their CSF had undetectable viral load during follow-up determinations. On day 0, 72% of children had identical patterns of genotypic resistance in CSF and plasma samples. At week 48, however, only 11% of these subjects had identical patterns. On day 0, 83% of children had abnormal neurological findings but these alterations declined to 35% at week 48 (p = 0.004). Most children with neurological abnormalities had detectable CSF viral loads (65% vs 17%, p = 0.04). CONCLUSIONS: The data generated in this study suggest that CSF and plasma behave as two different body compartments in terms of HIV dynamics and resistance mutants. Presence of neurological abnormalities correlate with detection of HIV in CSF and these alterations improve as therapy decreases CSF viral load. These results underscore the importance of using ARV drugs with good CNS penetration for optimal management of HIV-infected young children.

AIDS Dementia Complex↗
PubMed1997

Effect of Depo-Provera or Microgynon on the painful crises of sickle cell anemia patients.

Forty-three homozygous (SS) female sickle cell anemic patients with a history of at least one painful crisis per month and desiring a reversible contraceptive were administered DMPA/3 months or Microgynon monthly. A third group of 16 surgically sterilized patients served as control. Patients were followed for 1 year to assess possible effects of the contraceptives on the patients' painful crises. No changes were observed in any of the groups in the hematological parameters. At the end of the study, 70% of the patients receiving DMPA were pain-free and only 16% of those still reporting painful crises rated them as intense. Patients receiving Microgynon also had an amelioration of the painful crises, although at a lower rate; after 12 months, 45.5% still experienced some crises. Although less marked than in the other groups, 50.5% of the control patients also reported an improvement of their painful crisis, which may be a result of closer medical care.

Adolescent↗
PubMed1995

A spectrum in the pathology of toxoplasmosis in patients with acquired immunodeficiency syndrome.

We describe a variety of toxoplasmic lesions in seven patients with the acquired immunodeficiency syndrome. The first patient had multiple small-intestinal ulcers associated with Toxoplasma tachyzoites and high antibody titers; he died of disseminated histoplasmosis. The second patient, who died of tuberculosis, also had an inactive chronic Toxoplasma infection, with tissue cysts in the brain that were associated with glial nodules. A third patient died of Toxoplasma encephalitis, manifested by multiple foci of necrosis associated with Toxoplasma tachyzoites, cysts, and hypertrophic arteritis. A fourth patient had been treated for toxoplasmic encephalitis with co-trimoxozol (trimethoprim-sulfamethoxazole combination) for 3 to 4 days and showed degenerating tachyzoites associated with necrotic areas. A fifth patient, treated for toxoplasmic encephalitis with co-trimoxazol for 14 days, had necrotic lesions associated with Toxoplasma antigen and a few cysts. A sixth patient with encephalitis and Toxoplasma tachyzoites and young cysts in the biopsy showed healed brain lesions after 22 days of treatment. A seventh patient, diagnosed radiologically and serologically with Toxoplasma encephalitis, was treated for 7 months; his ring-enhancing lesions subsided, and he died of a central nervous system lymphoma. Toxoplasma could not be isolated from the brain, although toxoplasmic DNA was detected in the brain and heart by polymerase chain reaction. The pathogenesis of the range of these lesions, their diagnosis, and the possibility of terminating Toxoplasma infection by prolonged chemotherapy are discussed.

AIDS-Related Opportunistic Infections↗
PubMed1994

Hodgkin's disease masquerading as sclerosing mediastinitis.

Cases in which fibrotic variants of Hodgkin's disease have been confused with sclerosing mediastinitis have rarely been reported. Sclerosing mediastinitis typically involves the superior/middle mediastinum and, in the United States, is most commonly due to histoplasmosis. We describe the case of a patient who came to us with fevers, a mixed anemia, and a posterior mediastinal mass that on pathologic examination appeared to be due to idiopathic sclerosing mediastinitis. Only inclusion of a biopsy specimen from a local celiac node, after a new porta hepatis mass was found, revealed the correct diagnosis of Hodgkin's disease of the nodular sclerosing type. With the correct diagnosis, early intervention and appropriate therapy resulted in clinical cure.

Adult↗
PubMed1994

[The syndrome of renal and pulmonary vasculitis with positive neutrophil anticytoplasmic antibodies and antibasement membrane antibodies. A case report].

The authors present a case of Goodpasture's syndrome with necrotizing vasculitis of spleen and appendix. Serological examination shows antiglomerular basement membrane antibodies and antineutrophil cytoplasmic antibodies. The authors review the literature to establish if this or other similar cases can be considered a distinct disease entity. The authors also mention the laboratory methods that are currently being used to classify more precisely the vasculitides associated with glomerulonephritis.

Adult↗
PubMedDate not supplied

[Pseudotumor cerebri associated with maxillary sinusitis: clinico-pathological study].

INTRODUCTION: The pseudotumor cerebri is characterized by increased intracranial pressure in the absence of a space occupying lesions or obstruction to the circulation of cerebrospinal fluid (CSF). Increased pressure but normal composition of the CSF is the diagnostic criterion. Ear infections and other infections such as sinusitis have been cited as possible, but rare, causes. CLINICAL CASE: A 12 year old girl presented with diplopia 10 days after starting treatment for sinusitis. On examination there was paresia of the VI cranial nerve to the left eye and marked bilateral papilledema. She had normal visual acuity with visual field measurements showing increased blind spot field in both eyes. Resonance studies only showed maxillary sinusitis. CSF pressure was 35 cm H2O, with 40 lymphomonocytes and normal biochemical findings. After 15 cm of CSF had been removed treatment was started with acetazolamide, dexamethasone and cefotaxime. A week later the diplopia had disappeared and the CSF pressure was 25, with no cells present. Two months later the visual fields and fundus oculi were normal. After follow-up for one year there was no recurrence. CONCLUSIONS: We describe a case of pseudotumor cerebri associated with maxillary sinusitis. We do not know whether this is a chance association or whether there was a pathophysiological basis. The possibility should be considered so as to treat the cause or predisposing factor. The initial CSF pleocytosis would support the possibility of a relationship of the pseudotumor with an infectious condition (meningeal irritation or para-infectious pleocytosis meningeal irritation or para-infections pleocytosis in the context of an ENT infection), which might have precipitated the problem by interfering with the reabsorption of CSF.

Acetazolamide↗
PubMedDate not supplied

[Carcinoid tumor in the anterior mediastinum. Report of a case and review of the literature].

The Carcinoide tumors are infrequent. The come from neuroendocrine argentafine cells, probably related to cells of the APUD system. They are rarely found in the mediastinum. We are reporting a case, and bringing forward some biological, epidemiological and clinical characteristics. We also emphasize over the diagnosis and treatment, and the basics to evaluate the prognosis.

Aged↗