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Biomedical subjects

Y Gutierrez

Publications and source records attributed to Y Gutierrez.

At least 19 recordsLinked to original sources
PubMed1996

Extrapulmonary Dirofilaria immitis-like infections in the Western Hemisphere.

One worm recovered from the orbit of a patient in Indiana, and two from the peritoneal cavity of another patient in California are described and classified as Dirofilaria. Both patients were elderly men who have lived all their lives in the United States. The main morphologic feature of these three immature worms is the presence of a smooth cuticle devoid of longitudinal ridges, similar to the cuticle of D. immitis. However, because other dirofilariid with similar cuticular characteristics have been found in animals in the Western Hemisphere, and they cannot be conclusively ruled out as the cause of the infection in our patients, a diagnosis of D. immitis-like organism is proposed for these nematodes. The relationship of these worms to other dirofilariid of animals and humans on the American continent is important because of the diagnostic problems these infections posed to practicing pathologists.

Aged↗
PubMed1996

Strongyloides stercoralis eosinophilic granulomatous enterocolitis.

Six patients suffering from an unusual form of colitis produced by Strongyloides stercoralis hyperinfection are described. In contrast to the usual Strongyloides hyperinfection syndrome, in which small intestinal and pulmonary manifestations are seen in patients with some forms of immunodeficiency, the patients described here presented with only a characteristic transmural eosinophilic granulomatous inflammation affecting mostly the colonic wall and clinically mimicking ulcerative colitis or Crohn's disease. This Strongyloides eosinophilic granulomatous enterocolitis apparently results from a florid inflammatory response by eosinophils, histiocytes, and giant cells with formation of granulomas that destroy the larvae entering the colon. This morphologic picture differs from that of the well-described hyperinfection syndrome, in which the bulk of the larvae pass through the colonic wall to complete the life cycle, with only a few larvae destroyed in the colon. The probable pathophysiologic mechanism of this unusual manifestation of hyperinfection is discussed based on the anatomic and clinical observations of patients who presented at different stages in the evolution of their condition and whose length of follow-up varied.

Aged↗
PubMed1995

Subcutaneous dirofilariasis in Collier County, Florida, USA.

A 10-year review of the surgical pathology files of the Department of Pathology at Naples Community Hospital (Naples, FL, U.S.A.) revealed 10 cases of Dirofilaria tenuis and one of Dirofilaria ursi infection. The review consisted of only those lesions for which the pathologists had recorded the presence of a worm in the lesion. Therefore, an unknown number of subcutaneous lesions without parasites were not reviewed. Nine of the 11 cases of Dirofilaria were diagnosed as Dirofilaria or Dirofilaria tenuis originally. An additional case, previously diagnosed as Dirofilaria, was found to be a sparganum larva on review. This finding indicates that, because of the unfamiliarity of pathologists with the diagnostic characteristics of these nematode parasites, infections with Dirofilaria are underdiagnosed or misdiagnosed. If pathologists were more familiar with these parasites, their prevalence and the medical cost of this zoonosis in the southeastern United States could be determined more accurately.

Adult↗
PubMed1995

Dirofilaria repens infection in northern Israel.

The fourth case of zoonotic Dirofilaria repens infection in Israel is reported, and the diagnostic morphologic characteristics of this filariid are reviewed. The importance of the exact anatomic diagnosis of this filaria is stressed in view of the fact that Israel has pockets of settlers from East Africa, a region endemic for lymphatic filariasis (Wuchereria bancrofti). Since the possibility of introduction of such an infection into the country exists, differentiating this zoonotic Dirofilaria from other filarial worms is essential. The clinicopathological features of a Dirofilaria repens infection are distinct. The patient initially has a painful subcutaneous or conjunctival swelling; the excisional biopsy shows the presence of a dead or alive, usually female worm that measures 220-660 microns across; the central intestine and the genital organs (two uteri) are located in the pseudocoelom; the thick, multilayered cuticle is provided with 95-105 sharp, longitudinal ridges, the latter being separated from each other by a distance of 12 microns; the circumferential muscle cell layer, covering the inner side of the cuticle, is bilaterally interrupted by the large chord cells, two to five nuclei of which are discernible in each cross section.

Animals↗
PubMed1993

Nutrition during teenage pregnancy.

The nutritional needs of pregnant adolescents are the greatest at a time when it is most difficult to meet them. Dieting, skipping meals, snacking, eating away from home, consuming fast foods, and trying unconventional diets are common eating behaviors among adolescents, which relate to their changing lifestyles of increased independence, busy schedules, search for self-identity, peer influence, group conformity, and body image dissatisfaction. Total nutritional needs of pregnant adolescents who are at least 2-year post-menarche are similar to those of pregnant adults. But, because of their poor dietary habits, they usually enter pregnancy with reduced nutrient stores and increased risk of nutritional deficiencies. All pregnant teens, therefore, should have their dietary habits assessed along with special dietary counseling, and vitamin-mineral supplements should be recommended if their usual nutritional intake is below standard. Also, the weight-gain pattern should be monitored to ensure that energy intakes are sufficient to support a gain of about 0.4 kg (1 lb) per week in the second and third trimester.

Adolescent↗
PubMed1991

Correlation between histopathology, immune response, clinical presentation, and evolution in Leishmania braziliensis infection.

Skin biopsies from 221 parasitologically confirmed cases of tegumentary leishmaniasis caused by Leishmania braziliensis spp. were evaluated with respect to histopathology, the qualitative and quantitative nature of the cellular infiltrate, and the presence of Leishmania amastigotes. These variables were cross correlated with the Leishmania-specific immune response, clinical presentation, and response to treatment. Physical evidence of prior leishmanial lesions was associated with the absence of amastigotes (P less than or equal to 0.001) and the presence of giant (P = 0.03) and epitheloid cells (P = 0.03) in the biopsy of the active lesion. The presence of amastigotes was inversely related to the duration of the lesion (P less than or equal to 0.001) and the presence of eosinophils (P less than or equal to 0.01), whereas the presence of adenopathy (P = 0.01), necrosis (P = 0.001), histiocytes (P = 0.001), and increased serum antibody titer (P = 0.02) were directly associated with the presence of amastigotes. The lymphocyte transformation response was correlated with the presence of granulomas (P = 0.001), but showed no correlation with cutaneous delayed type hypersensitivity. The presence of epithelioid (P = 0.04) and giant cells (P = 0.03) was associated with less drug being required to achieve healing. In contrast, necrosis was associated with a greater amount of drug to achieve healing (P = 0.05). The observed correlations between tissue responses and immune and clinical parameters provide further evidence for the role of antibody and other soluble mediators of the cellular immune response in the evolution of disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Laboratory diagnosis of Leishmania.

Leishmaniasis should be considered in the differential diagnosis of individuals living in or with a history of having traveled to known endemic areas and who present with signs and symptoms of visceral infection or with cutaneous or mucosal lesions. Because leishmaniae are capable of producing a wide spectrum of disease in humans, the clinical manifestations overlap with many other diseases. Definitive diagnosis of Leishmania infection in the laboratory requires demonstration of the parasite in smears, in biopsies, or by isolation of the organism in culture media or in experimental animals. Many other methods for demonstration of parasites (histochemical and immunohistochemical) or for detecting the presence of antibodies against leishmaniae (serologic) have been described. Many advances have been made in these areas, but the methodology and the technology involved in immunohistochemistry and serology remain outside the reach of the standard clinical diagnostic laboratory, which both in developed and less developed countries still relies on demonstration of the parasites in smears stained with Giemsa stain and on biopsy specimens processed and stained with hematoxylin and eosin stain. The newer serologic techniques, such as ELISA with several variations, IFAT, and others, are largely research tools with the greatest use in seroepidemiologic surveys.

Animals↗
PubMed1989

Dioctophyme larva in the subcutaneous tissues of a woman in Ohio.

A nematode larva undistinguishable from Dioctophyme renale was found in the subcutaneous tissues of the abdomen of a 23-year-old woman from Ohio. This is the third case of Dioctophyme larva reported in humans. Although it is not known how the infection was acquired, we suggest that ingestion of raw fish was the probable source. We further hypothesize that such a larva could eventually migrate to the kidney and grow to the adult state.

Abdomen↗
PubMed1989

The biology of Pneumocystis carinii.

Some basic biologic aspects of Pneumocystis are reviewed. From the available data, it is evident that only two stages, the trophozoite and the cyst, have been described, but that the complete life cycle is unknown. Both of these two stages are found in the alveoli and other tissues of hosts with some forms of immune suppression, but rarely in healthy ones. The current views of how trophozoites evolve into cysts is outlined. No agreement about the classification of Pneumocystis has been reached, and its protozoan or fungal nature has not been fully confirmed. Recent data obtained with electron microscopy, and biochemical and molecular biologic studies, indicate that Pneumocystis has characteristics more akin to a fungus than to a protozoan. Moreover, the existence of one or of several species of Pneumocystis has not been determined. The mode of transmission of the parasite in nature, between different hosts, remains unconfirmed, although the cyst is believed to play a role.

Animals↗
PubMed1987

Parasitic points.

Explore the source record for details and available documents.

Heterophyidae↗
PubMed1985

Enhancement of experimental bacteremia and endocarditis caused by dysgonic fermenter (DF-2) bacterium after treatment with methylprednisolone and after splenectomy.

The dysgonic fermenter-2 bacterium is a newly recognized fastidious gram-negative bacillus that causes bacteremia and sometimes endocarditis in immunocompromised persons after they are bitten by dogs. To develop an experimental model of this infection, we placed polyethylene catheters across the aortic valves of New Zealand white rabbits, which were inoculated intravenously the next day with dysgonic fermenter-2 bacteria. After 1 week, the rabbits were killed and the endocardial vegetations were homogenized for quantitative culture. Large inocula (1.3 X 10(10) to 2.1 X 10(10) viable bacteria) were required to produce infected vegetations. All infected rabbits had negative blood cultures at the time of autopsy and most developed serum agglutinins against dysgonic fermenter-2 bacteria. Three daily injections of methylprednisolone (30 mg/kg), starting the day before inoculation, significantly increased the incidence of endocarditis and the number of bacteria per gram of infected vegetation (P less than 0.05). Treatment with methylprednisolone prolonged the initial bacteremia and caused significant increases in the numbers of bacteria per gram of blood, spleen, and liver compared with those of untreated controls (P less than 0.05). Rabbits that had previously undergone splenectomy showed prolongation of the initial bacteremia but no significant increase in the incidence of infected vegetations. These results showed that the dysgonic fermenter-2 bacterium is a pathogen that causes endocarditis in rabbits but that it requires a large inoculum and produces blood culture-negative infections. Treatment with methylprednisolone enhances infection by prolonging the initial bacteremia and probably by diminishing bactericidal activity in the vegetations.

Animals↗
PubMed1984

Diagnostic features of zoonotic filariae in tissue sections.

The diagnostic features in tissue sections from patients with zoonotic filarial infections are reviewed. In general, two types of infections are recognized: 1) those presenting radiologically in healthy patients as coin lesions, which are usually removed because a clinical diagnosis of carcinoma of the lung is made and infarcts containing Dirofilaria immitis parasites in pulmonary arteries are found; and 2) those presenting as subcutaneous nodules, in which D. tenuis, a parasite from raccoons, D. repens, from dogs and cats, D. ursi , from bears, and Onchocerca spp, from horses or cattle, require delineation. Moreover, nodules that on microscopic examination are seen to be lymph nodes may harbor Brugia spp. The geographic distribution of these infections, with emphasis on the United States, is discussed.

Animals↗
PubMed1984

Human ectopic fascioliasis in the cecum.

A case of ectopic human Fasciola spp. infection in the cecal wall is reported. The patient, a 27-year-old Korean woman, resident in Seoul, Korea, presented with nausea, vomiting, and epigastric tenderness. One week later a palpable mass was discovered in the right iliac fossa. A clinical diagnosis of a carcinoma of the colon was made and the patient underwent a cecal resection. The mass proved to be an inflammatory reaction containing numerous tracts made by the migrating fluke, Fasciola sp.

Adult↗
PubMed1984

Breast nodule produced by Dirofilaria tenuis.

A case of Dirofilaria tenuis presenting as a breast nodule is reported in a patient who traveled to the southeast United States 6 months before the nodule was noted. It illustrates an unusual diagnostic problem, especially since it presented in a nonendemic area. The morphological criteria for diagnosis of D. tenuis in tissue sections are noted.

Animals↗
PubMed1984

Pathologic changes in murine leishmaniasis (Leishmania donovani) with special reference to the dynamics of granuloma formation in the liver.

The histopathologic changes in liver, spleen, and bone marrow of BALB/c mice infected for 6 months with Leishmania donovani are described. Granulomas were the most important histologic lesions found; and the dynamics of their formation, collagen deposition, and resolution in the liver were studied. The number of hepatic granulomas increased until the eighth week and then decreased steadily. In contrast to the liver granulomas, those of spleen and bone marrow do not mature or show collagen deposition. Actual granuloma counts in the liver support the idea that mature granulomas revert to poorly formed ones and finally resolve without scarring. BALB/c mice are suitable for the study of the dynamics of granuloma formation and resolution and the survival of L donovani in an in vivo system. The relevance of these changes to the pathology of L donovani infection in man are discussed.

Animals↗
PubMed1982

Latin American nursing students in the United States.

The Latino students confront a unique set of difficulties and patterns of adjustment in the majority culture and the educational experiences in the United States. Careful consideration must be given not only to the general characteristics of this group, but also to the individual's history of immigration, socioeconomic status, educational experiences and background. Multicultural education for the international nursing students can benefit all students, but it should not gloss over conflicts of values and beliefs. It must honestly deal with differences and similarities. It must be based on experience, not on stereotypes of root cultures or ethnic characteristics. In addition to addressing the cognitive affect and skill needs of all students, the multicultural education must address the special needs of minorities. Anglo students or majority-group students need realistic opportunities for experience and interaction with minority students and minority-faculty. Every group has something to teach the other. Faculty advisors and majority students should be encouraged to acquaint themselves with the need to establish rapport with the Latino student. There is also a need to develop in the classroom an atmosphere that enhances the learning experiences. The learning experiences should be so designed that all students and school personnel can intellectually, emotionally and socially participate on equal terms in a culturally diverse society.

Acculturation↗
PubMed1982

Brugia infection in Northern Ohio.

A new case of infection with Brugia sp. is recorded from Northern Ohio, increasing the geographical range of this zoonosis, known previously in New England, New York and New Jersey. The patient, a 53-year-old man, had a 7-year history of malignant fibrous histiocytoma of the spermatic cord, for which he received intense chemo- and radiotherapy. The worm found was alive at the time of fixation, allowing a description of the parasite in cross sections.

Animals↗