ABSTRACT
INTRODUCCIÓN La enfermedad de Chagas afecta a aproximadamente 1 600 000 personas en Argentina. Las drogas que actualmente tienen efecto tripanocida son el benznidazol (BZN) y nifurtimox (NFX). Sin embargo, la presencia de eventos adversos (EAs) de ambos medicamentos, más predominantes en los pacientes adultos, desalienta a los efectores de salud para el tratamiento etiológico de esta endemia. En consideración a estos antecedentes surge la necesidad de realizar este proyecto de farmacovigilancia activa para ambos tripanocidas. OBJETIVOS Determinar la potencial toxicidad del nuevo benznidazol. MÉTODOS Este estudio de farmacovigilancia se realizó en tres centros, el INP Fatala Chaben, coordinador y eje del mismo, el Hospital Pirovano y el Área de APS de la Dirección de Salud de la Municipalidad de Escobar. Se trataron 107 pacientes con el nuevo BNZ (Abarax®, Laboratorios ELEA, Argentina) a dosis de 5mg/kg/d por 30 días en el área de Escobar y por 60 días por los otros centros. Se realizó tratamiento con BNZ de acuerdo a las Guías de enfermedad de Chagas del Ministerio de Salud. RESULTADOS La farmacodermia, las alteraciones gastrointestinales y las alteraciones del sistema nervioso tuvieron mayor relevancia clínica. A este nivel del análisis, el tratamiento por 60 días del nuevo BZN tuvo mayor impacto clínico negativo en la seguridad que el de 30 días (p<0,0065). Un tratamiento completo se realizó en 70% de los pacientes más allá de la presencia de eventos adversos (EA), 62,7% en esta población. Un 21,5% de los pacientes no completó el tratamiento, ya que fueron excluidos por los EA. La comparación con el estudio TRAENA, efectuado con BNZ de Laboratorio Roche (Radanil®), demostró que el nuevo BNZ sería responsable de mayor frecuencia de farmacodermia, alteraciones gastrointestinales, hepatitis tóxica y neuropatía periférica. Los niveles de intolerancia totales y los niveles de exclusión por los EA no fueron diferentes entre ambos BNZ. DISCUSIÓN En consideración a los límites de esta investigación, el tratamiento de los pacientes durante 30-60 días está en continua revisión. La información proporcionada por este estudio está en consonancia con investigaciones previas realizadas en el INP Fatala Chaben y permitirá generar mayores y más estrictas acciones de prevención en el área de la Salud Pública para mejorar la administración sistemática del tratamiento con BNZ en diferentes poblaciones con enfermedad de Chagas.
Subject(s)
Trypanosoma cruzi , Chagas Disease , PharmacovigilanceABSTRACT
A heightened sensitivity towards negative emotional stimuli has been described for Borderline Personality Disorder (BPD). We investigated whether a faster and more accurate detection of negatively valent information in BPD can be confirmed by means of a visual search task which required subjects to detect a face with an incongruent emotional expression within a crowd of neutral faces. Twenty eight BPD patients and 28 nonpatients were asked to indicate whether a set of schematic neutral faces (3 × 3, 4 × 4 matrices) contained a happy or an angry face. Besides valence, the intensity of the target's emotion was varied in two steps. BPD patients and nonpatients both demonstrated an anger-superiority effect. However, no higher sensitivity towards negative stimuli was observed in BPD compared to nonpatients. BPD patients seem to rely to a stronger extent on controlled, i.e., serial, attention demanding processes when searching more subtle social-emotional information with positive valence.
Subject(s)
Attention/physiology , Borderline Personality Disorder/psychology , Emotions/physiology , Facial Expression , Pattern Recognition, Visual/physiology , Adult , Borderline Personality Disorder/diagnosis , Female , Humans , Male , Photic Stimulation , Reaction Time/physiologyABSTRACT
A new commercially available enzyme-linked immunosorbent assay (ELISA) kit has been evaluated for the measurement of neopterin concentrations in serum, plasma and urine. This competitive ELISA is technically simple, requires only small sample volume and is rapid to perform. The assay procedure consists of sequential 1.5 h and 10 min room temperature incubation steps. The ELISA is accurate, sensitive, specific, and precise. Linear regression analysis of neopterin concentrations measured with the new ELISA and with an established method yielded a highly significant correlation (r = 0.99). The new assay is applicable to ELISA workstations, thus enabling determination of neopterin in large series of samples. The neopterin ELISA kit has been used in routine laboratory testing of blood donations in a blood bank.
Subject(s)
Enzyme-Linked Immunosorbent Assay/methods , Neopterin/blood , Reagent Kits, Diagnostic/standards , Antibody Specificity , Blood Banks , Humans , Immune Sera , Reproducibility of Results , Sensitivity and SpecificitySubject(s)
Health Services for the Aged/organization & administration , Hospital Units/organization & administration , Hospitals, Religious/trends , Population Dynamics , Aged , Equipment and Supplies, Hospital , Facility Design and Construction , Geriatric Nursing , Health Services for the Aged/trends , Hospital Costs , Hospitals, Religious/organization & administration , Humans , New York CityABSTRACT
During a complete estrous cycle Neopterin levels were followed up daily in sera of six healthy female volunteers below 30 years of age. Average values found in these individuals were within the normal range. Only two single data--measured on the 29th and the 30th day of one test person's estrous cycle--out of 145 were elevated (between 10 and 15 nmol/l). Therefore elevated Neopterin values of clinically healthy persons should only be taken as an indicator for pathological activation of the cellular immune system if the elevation continues after repeated confirmation in a possibly different estrous phase.
Subject(s)
Biopterins/analogs & derivatives , Menstrual Cycle , Adult , Biopterins/blood , Clinical Laboratory Techniques , Female , Humans , Immune System Diseases/diagnosis , Immunity, Cellular , NeopterinABSTRACT
In 518 sera from blood donors below 30 years of age Neopterin was determined by radioimmunoassay. 21 of these patients (= 4.05%) showed elevated serum levels for Neopterin. By clinical investigation of these cases viral infections of the upper airways were found. Furthermore after elimination of elevated values significant differences in normal Neopterin serum levels could be demonstrated for female and male blood donors (p less than 0.01). Because elevated Neopterin serum levels indicate immune responses to several antigens, determination of Neopterin from serum may be useful for detection of infectious blood samples.
Subject(s)
Biopterins/blood , Pteridines/blood , Adolescent , Adult , Biopterins/analogs & derivatives , Blood Donors , Female , Humans , Male , Neopterin , Radioimmunoassay , Respiratory Tract Infections/blood , Respiratory Tract Infections/diagnosis , Sex Factors , Virus Diseases/blood , Virus Diseases/diagnosisABSTRACT
A case of an immature female newborn child is reported, with a solitary alveolarcell adenoma rising from the left lower lobe of the lung. The consequences of the congenital blastoma of the lung, which is to be regarded as hamartoma, are Hydrops fetalis, a polyhydramnion, respectively a Respiratory Distress not responding to treatment. Finally a survey of the available literature is given on non-immunologic Hydrops fetalis caused by congenital tumors.
Subject(s)
Adenoma/congenital , Edema/etiology , Lung Neoplasms/congenital , Respiratory Distress Syndrome, Newborn/etiology , Adenoma/complications , Adenoma/pathology , Female , Humans , Infant, Newborn , Lung Neoplasms/complications , Lung Neoplasms/pathologyABSTRACT
The aim of the study was the description of morphological changes in mononukleated cells after short-term stimulation by mitogen and tuberculin visible by light- and electronmicroscopy and in differences between nucleus areas measured by planimetry. Already 1 hr. after p.h.a. stimulation lymphocytes forme clusters in which the mononucleated cells were present mostly as irritated and exhausted cells. In PPD-stimulated lymphocytes clusters were formed after 16 to 24 hrs. These cells were activated. Within clusters strong intercellular contacts were visible using the electron-microscopy. The results of planimetry in regard to nucleus areas of lymphocytes and monocytes were significantly dependent from the kind of mitogen or antigen and the duration of incubation time (analysis of variance).
Subject(s)
Lymphocyte Activation , Lymphocytes/immunology , Mitogens/pharmacology , Tuberculin/immunology , Cell Aggregation , Female , Humans , Lymphocytes/ultrastructure , Male , Monocytes/immunology , Phytohemagglutinins/pharmacology , Time FactorsABSTRACT
The Electrophoresis-Mobility-Test is a modified Macrophage-Electrophoretic-Mobility-Test by using sheep erythrocytes, tanned and stabilized by sulfosalicyl acid. The test is used to demonstrate specific sensibilised T-lymphocytes in cell culture after having them isolated from human venous blood and after stimulation with antigen. 34 tests were done by stimulation with antigen PPD, the lymphocytes having been taken from patients with positive Tuberculin-Tine-Test. All tests were bacteriologically and cytologically controlled and only 9 could be used finally as a base for statistical control by using x2- und t-tests and histogram. A special attention was payed to the aggregation of monocytes and their morphological changes in cell culture. Every single test is not statistically significant, but the results of the whole lot give an attest of the concept of the EM-Test, which can be reproduced with a probability of about 60%.
Subject(s)
Immunoelectrophoresis/methods , Lymphocyte Activation , Tuberculin/immunology , Humans , Monocytes/immunology , T-Lymphocytes/immunology , Tuberculin Test , Tuberculosis, Pulmonary/immunologyABSTRACT
The Pulmonary alveolar microlithiasis is a rare disease of unknown etiology with chronic course. Clinical symptoms are not characteristic or missing completely. The disease is diagnosed by X-ray examination and histologic examination from biopsy specimen of the lung. A report on the first case in Austria is given.
Subject(s)
Calculi/diagnosis , Lung Diseases/diagnosis , Adolescent , Biopsy, Needle , Calculi/pathology , Diagnosis, Differential , Female , Humans , Lung Diseases/pathology , Pulmonary Alveoli/pathologyABSTRACT
Lipomas of bronchus have a special clinical importance because of their predominantly endobronchial growth. Chronic obstruction and stenosis result in irreversible changes of lung. The clinical symptomatology is untypical. The X-ray examination points to the right diagnosis. The tumour can be localized bronchoscopically and recognized macromorphologically. The histological examination of a biopsy results in the exact diagnosis. This is a report of two cases.
Subject(s)
Bronchial Neoplasms/pathology , Lipoma/pathology , Bronchi/pathology , Humans , Lipoma/surgery , Male , Middle Aged , PneumonectomyABSTRACT
Report on three cases of bronchial atresia. Two patients had an atresia of a segmental bronchus with consecutive bronchocele and regional hyperinflation, one patient had an atresia of a lobar bronchus. The diagnosis is made by association of radiologic and bronchologic analysis. Possible pathogenetic mechanisms are briefly discussed.
Subject(s)
Bronchi/abnormalities , Adult , Bronchography , Bronchoscopy , Child , Female , Fiber Optic Technology , Humans , Male , Middle Aged , PneumonectomyABSTRACT
Retroperitoneal and intrathoracic Schwannomas are difficult to diagnose in the preoperative stage. The following methods of examination may be used: 1. X-ray examinations to exclude diseases of the internal organs and to establish displacements.--2. Computertomography to determine localisation and size of the tumour.--3. Immediate section for microscopic examination under surgery to determine the dignity of the tumour and needlebiopsy with histological and cytological examination to obtain an exact diagnosis.
Subject(s)
Neurilemmoma/diagnosis , Retroperitoneal Neoplasms/diagnosis , Thoracic Neoplasms/diagnosis , Adult , Aged , Biopsy, Needle , Female , Humans , Male , Middle Aged , Neurilemmoma/diagnostic imaging , Neurilemmoma/pathology , Retroperitoneal Neoplasms/diagnostic imaging , Retroperitoneal Neoplasms/pathology , Thoracic Neoplasms/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Only the solitary type of bronchiolo-alveolar cell carcinoma has a chance of being healed if surgery is performed in time. This type of tumor is often found as a cicatricial carcinoma in the periphery of the lung. Small tumors do not exhibit any clinical symptoms, they are either detected by mere chance or during radiological check-up or routine medical check-up of healthy persons. In the present case a small posttuberculous scar in the lung had been known to exist for ten years. Only a repeated routine medical check-up including X-ray examination and subsequent tomographic X-ray gave an indication for the performance of thoracotomy. While surgery was being performed the malignancy and the tumor type where cytologically determined and verified by histological examination of the excised tumor.
Subject(s)
Adenocarcinoma, Bronchiolo-Alveolar/pathology , Cicatrix/complications , Lung Neoplasms/pathology , Cicatrix/pathology , Female , Humans , Lung/pathology , Middle Aged , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/pathologySubject(s)
Aneurysm/complications , Colon/blood supply , Aged , Aneurysm/diagnosis , Aneurysm/surgery , Arteries , Humans , Male , Rupture, SpontaneousABSTRACT
The effects of antineoplastic treatment on gliomas are related to tumour cell cycle and proliferation kinetics, glioma tissue architecture, and the surrounding environment. Morphological changes induced by radiation and chemotherapy are characterized by cell necrosis and severe alterations in cell and nuclear morphology caused by changes in the cell kinetic parameters which, however, may also occur spontaneously in untreated anaplastic gliomas. Comparative studies of cytological imprints and routine histological preparations of biopsy and autopsy specimens were performed in four groups of anaplastic astrocytomas and glioblastomas (78 cases) with postsurgical irradiation, combination chemotherapy, and CCNU treatment, and without specific postsurgical treatment (control group). Following radiation and chemotherapy, in addition to increased necrosis and vascular response, a variety of characteristic but nonspecific changes were observed in cell and nuclear morphology with prominent formation of multinucleated giant and monstrous cells, irregular and hyperchromatic nuclei, and severe cytoplasmic degeneration indicating both inhibition of cell division and cell damage. Statistically significant findings were a posttreatment increase in the number of multinucleated giant and monstrous cells and a decrease in the number of mitoses. These changes were more pronounced after chemotherapy than after radiation, while no significant dissimilarities were found between combination chemotherapy and CCNU. The implications of these changes on the mechanisms of antitumour treatment in anaplastic gliomas are discussed.
