Biomedical subjects
Publications and source records attributed to R Martínez Zapico.
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BACKGROUND: The early diagnosis of vertically transmitted human immunodeficiency virus infection cannot be based on the presence of specific serum antibodies since those of the maternal IgG class pass the placenta and may be detected in children for up to 18 months. Based on this fact, the aim of this study was to evaluate other techniques for early diagnosis of the infection applicable from birth in 306 children of infected mothers. METHODS: The production of in vitro antibodies, virus culture and polymerase chain reaction (PCR) were used. The sensitivity of the techniques was estimated in the 40 children diagnosed with human immunodeficiency virus infection and specificity was determined in the 266 uninfected children. RESULTS: The sensitivity for the production of in vitro antibodies was 62.0% at 3 months and 94.7% at 6 months; 90.4% and 88.2%, respectively, for the viral culture and 92.3% and 94.1%, respectively, for the PCR. The specificity of all the cases was higher than 89.4% although varied in relation to age. CONCLUSIONS: The combination of several diagnostic techniques provides better performance for the early diagnosis of vertical transmission of the human immunodeficiency virus. Given that viral culture takes longer to provide results and is more expensive, it is less recommendable for routine use, although the form of viral replication may be useful to establish the prognosis.
BACKGROUND: Evaluation of two commercial immunoenzymatic techniques (ELISA) for detection of anti-EBNA-1 IgG and IgM for diagnosis of Epstein-Barr virus mononucleosis. METHODS: Study of anti-EBNA-1 IgG and IgM in infectious mononucleosis and they have been compared with the detection of IgM antibodies to VCA by indirect immunofluorescence as the reference method. RESULTS: The sensitivity of the assay was 87.5%, the specificity was 89.4%, the positive predictive value was 91.4% and the negative predictive value was 85%. CONCLUSIONS: This technique can be useful in laboratories without the necessary equipment and experienced personnel for indirect immunofluorescence. It also can be used as a complementary determination to the anti-VCA IgM in the long lasting infectious mononucleosis, when this marker is negative.
Thirty-five children diagnosed of AIDS were studied in order to evaluate toxicity and efficacy of oral Zidovudine treatment (AZT), as well as to analyze the clinical, biochemical, immunological and virological evolution of HIV infection throughout the treatment. Patients (19 males and 16 females) were studied from April 1988 to May 1990 with a mean follow-up time of 13.5 months (SD = 6.7 months). The mean age of the group was 4.68 years. The means of acquisition of this disease was 71.45 vertical and 28.6% via hemo-derivatives. Tolerance has been good with the main toxicity being hematological (28.5% anemia and/or neutropenia), 23% of which required blood supplements. The presence of neurological involvement and thrombopenia were observed in the incidence of greater toxicity. No influence on weight during AXT treatment was observed and hepatosplenomegalia and adenopathies were not modified. Bacterial and opportunistic infections were observed in 97.1% and 20% of patients, respectively. Neurological evolution was irregular and the improvement observed in some patients was mild and transitory. Three patients died during the follow-up from intercurrent infectious process. A progressive increase in MCV and a tendency towards leucopenia and lymphopenia (mainly in hemo-derivative infected patients) was observed. Neither significant immunological nor virological changes were observed during the treatment (except the tendency to diminish basal hypergammaglobulinemia). The results of this study were compared to other pediatric series treated with AZT.
Sixteen cases of mononucleosis due to cytomegalovirus, are presented. The selection of patients was based on clinical criteria. Symptoms are compared with another series of patients affected with mononucleosis by Epstein-Barr virus. We have not found differences comparing the fever, cervical adenopathies and faringoamigdalitis. Differences were significant in hepatomegaly. We conclude that the clinical picture of cytomegalovirus mononucleosis is very similar to those of the Epstein-Barr mononucleosis.
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