Biomedical subjects
Publications and source records attributed to M Rodríguez.
The study presents four cases of monoclonal gammopathy accidentally detected in anti-HCV-positive blood donors without previously known hepatopathy. A hematological and hepatic studies were performed, including liver biopsy in all the cases, discussing the implications of the association between the two phenomena and the possible false positives of anti-HCV in hypergammaglobulinemias.
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The preliminary results of a prospective and cooperative protocol for the treatment of soft tissue sarcomas of trunk and extremities, stages IB-IIIB are presented. Thirty one patients (17 males, 22 with a tumor larger than 5 cm) aged 16 to 68 years, were treated with one dose of epirubicin 70 mg/m2 i.v. and radiotherapy (3000 rads in 10 fractions) Two or three weeks later an ample surgical complications occurred in 6 patients and were all of infectious origin. The median follow up period has been of 26 months. During this period 5 patients presented late surgical complications (edema in 4 and a pathological fracture in 1), 2 patients had a local tumor recurrence and distant metastases appeared in 7. Actuarial survival was 60% at 48 months. Ninety six percent of surviving patients conserved their extremity. It is concluded that with this treatment modality local recurrence is acceptable, morbidity is low and that the majority of patients do not require amputations or crippling resection.
We describe the case of a patient with non A-non B post-transfusional cirrhosis and type-II mixed cryoglobulinemia, who showed in relation with said processes several acute symptoms of vasculitis, polyarthritis, pericarditis and autoimmune hemolytic anemia, finally dying due to an advanced hepatocellular insufficiency. In this patient the determination of antibodies against hepatitis C virus (anti-HCV) was positive, that is why we assume a possible relationship between both processes and the first literature references, after the clonation of the hepatitis C virus (HCV) genome, are reviewed.
We report the case of a 22-year-old man with a craniopharyngioma, who developed ascites following a ventriculoperitoneal shunt procedure for hydrocephalus. The ascites was resolved with diversion of the distal catheter into the right atrium. A ventriculoperitoneal shunt can cause ascites, even without neurological symptoms suggestive of shunt malfunction.
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We have determined the prevalence of antibodies against hepatitis C virus (anti-HCV) in 45 patients with primary biliary cirrhosis (PBC) and 6 with autoimmune chronic active hepatitis (AI-CAH). Anti-HCV was positive in two cases of PBC, both with a history of previous blood transfusion, and in one patient with AI-CAH, only during an active phase of the disease.
The prevalence of antibodies to hepatitis C virus (HCV) was determined in 65 patients with acute non-A, non-B hepatitis (NANBH). The results suggest that HCV is the most common causative agent in posttransfusion NANBH and in drug-related hepatitis. Detection of HCV antibodies does not appear to be a particularly useful diagnostic criterion due to the kinetics of the immune response in the course of the disease.
Sera from 104 patients with self-limited, acute type B hepatitis were tested for the presence of anti-HCV antibodies. The results show that especially drug users with acute type B (and occasionally coinfected with type D) hepatitis commonly are infected with HCV. Furthermore, HCV infection may have preceded infection with the other agents and may be responsible for high ALT levels.
The presence of the anti-HCV antibody was investigated in sera from 102 chronic HBsAg carriers. The subjects varied as to the characteristics of the clinical states. It was found that HCV coinfection was more common in HBsAg positive intravenous drug addicts than in other parenteral risk groups. It also appears that HCV may be the causative agent of chronic liver disease in HBsAg carriers with undetectable HBV (and possibly HDV) replication.
To investigate the risk of non-parenteral HCV infection, sera from 302 relatives of 120 anti-HCV positive subjects were tested for the presence of anti-HCV antibodies. For the sake of comparison, sera from 17,000 blood donors were also assayed. The prevalence of HCV positivity was 4.3% in household contacts, compared to 0.78% in the donor population, indicating a significantly higher risk of infection for family members. Close personal contact may not be as critical a factor for infection as is duration of the disease.
The age effect on coherence has been studied in control (98) and learning-disabled (LD, 54) school-aged children (from 6.0 to 16.8 years old). The EEG recordings were made at rest in 15 leads, and 105 pairwise combinations for coherence were calculated (each lead was compared with all the rest) for delta, theta, alpha, beta and total frequency bands. A significant increase of coherence with age was found in both groups, with a different pattern of maturation. In the control group, a significant increase with age was found in the coherences between posterior regions and vertex (Cz). A significant decrease with age in the coherence between frontal areas was observed, especially in the theta band. The LD group showed a different pattern: no significant relation with age was found in the coherence between any lead and vertex. A high effect of age on coherence between temporal regions was observed with a predominance of the left side in comparison with the contralateral and the ipsilateral. No decrease in frontal coherence was found: in the same region where the control group showed negative values with age, the LD groups had no age effect. The results obtained are discussed as differences in brain organization, in myelogenesis and synaptogenesis and an explanation of the etiology of LD is proposed.
A crude extract from N. brasiliensis cells grown in brain heart infusion culture was analyzed. It showed a complex mixture of at least 37 bands when resolved with the discontinuous buffer system of Laemmli in a gradient SDS-PAGE. Western blot analysis of 16 sera from N. brasiliensis-infected individuals always showed the recognition of six bands of 61, 49, 45, 42, 26, and 24 kilodaltons (kDa). Some other bands also reacted but with less intensity. Sera from tuberculosis and leprosy patients reacted strongly with the 49, 45, and 42 kDa bands but weakly or not at all with the 61, 26, and 24 kDa. Sera from healthy control volunteers reacted with some bands but little or not at all with those three identified by the sera from mycetoma patients. These three immunodominant antigens (61, 26 and 24 kDa) may be of clinical value in the serodiagnosis of mycetoma by N. brasiliensis.
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A new staging system for intermediate grade lymphomas and immunoblastic lymphomas is described. This system is based on the tumor score which consists of assigning a point to each one of five variables that have been previously shown to have a high prognostic value. Ann Arbor stages III-IV, presence of bulky mass, elevation of B-2 microglobulin and LDH as well as presence of 'B' symptoms are the variables utilized in this system. When we applied this tumor score system to a population of 144 patients uniformly treated with CHOP/Bleo/CMED protocol, we observed that this system can accurately divide the population into two prognostic groups without an intermediate category. The first group is made up of those patients with a score of 0-2 points while the second group consists of patients with a score of > or = 3 points. The first group has a time-to-treatment failure (TTF) of 83% at three years in contrast to the second group whose TTF was 24%. If we compare this system with other commonly used systems in our institution, such as Ann Arbor, M.D. Anderson clinical staging system, and M.D. Anderson serological staging system, we observed that the tumor score system is not only more specific and sensitive than the others but also was capable of eliminating an intermediate risk group, thus facilitating therapeutic choices. This tumor score system is easy to apply and potentially reproducible in any institution.
Insulin-deficient states are associated with an impaired function of the hypothalamic-pituitary-gonadal axis, but the mechanisms underlying hypothalamic alterations in experimental diabetes are still unknown. We investigated the effect of glucose concentrations, in the presence and absence of insulin, on LHRH release from perifused hypothalamic fragments from female adult ovariectomized rats. Glucose and insulin were added to the perifusion medium (Earle's, pH 7.4, gassed with 95% O2/5% CO2, flow rate 50 microliters/min). When glucose was absent (in the presence of insulin 10 mU/l), LHRH release was reduced, peak levels being < 5 pg/100 microliters. The addition of glucose (100 and 300 mg/dl), in the absence of insulin, resulted in peak LHRH levels fluctuating around 35 pg/100 microliters (p < 0.05 vs. glucose 0 mg/dl). When glucose (100 or 300 mg/dl) and insulin (10 mU/l) were combined, an eightfold increase in peak LHRH values was observed, and peak levels reached 300 pg/100 microliters (p < 0.05 vs. glucose 100 and 300 mg/dl alone). In conclusion, LHRH release by perifused hypothalamic fragments is dramatically increased by low concentrations of insulin; this occurs only when glucose is available. Acutely elevated glucose levels (from 100 to 300 mg/dl) do not affect LHRH release.