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1.
J Parasitol ; 107(4): 600-605, 2021 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-34343317

RESUMEN

Under Wisconsin state law, the greater prairie chicken (GRPC; Tympanuchus cupido pinnatus) has been listed as a threatened species since 1976. In 2014-15, we conducted a pilot study to determine the prevalence and intensity of gapeworms (Syngamus spp.) in female Wisconsin GRPCs collected from 2 monitored populations. We captured 62 female GRPCs using walk-in-style traps for females and night lighting for juveniles ≥45 days of age. From these individuals, we collected 15 carcasses of radio-marked birds, most of whom died due to predation events. Through dissection, we identified gapeworm in 20% of examined carcasses and report an intensity ranging between 4 and 74 worms.


Asunto(s)
Enfermedades de las Aves/epidemiología , Enfermedades de las Aves/parasitología , Galliformes/parasitología , Infecciones por Strongylida/veterinaria , Strongyloidea/aislamiento & purificación , Animales , Femenino , Masculino , Proyectos Piloto , Prevalencia , Infecciones por Strongylida/epidemiología , Infecciones por Strongylida/parasitología , Strongyloidea/anatomía & histología , Strongyloidea/clasificación , Strongyloidea/genética , Wisconsin/epidemiología
2.
Opt Lett ; 42(12): 2255-2258, 2017 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-28614325

RESUMEN

We present a simple technique that significantly enhances the interaction of pump pulses with a supercontinuum Stokes generated by a particular nonlinear fiber for time-gated experiments such as coherent anti-Stokes Raman scattering (CARS). The enhancement is achieved through a synchronized power-tuning/time delay scheme that we call spectral surfing. In this Letter, we introduce spectral surfing and demonstrate how its application to an economical CARS hypermicroscopy scheme increases the brightness, contrast, and spectral scanning range, while potentially reducing sample light exposure.

3.
J Helminthol ; 91(4): 479-490, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27460259

RESUMEN

We examined the associations between intestinal helminth infracommunity structure and infection parameters and the age, size, and year and region of collection of 130 female lesser scaup (Aythya affinis) during their 2014-2015 spring migrations through the upper Midwest, USA. We identified a total of 647,174 individual helminths from 40 taxa, including 20 trematodes, 14 cestodes, 4 nematodes and 2 acanthocephalans parasitizing lesser scaup within the study area. Lesser scaup were each infected with 2-23 helminth taxa. One digenean, Plenosoma minimum, is reported for the first time in lesser scaup and in the Midwest. Mean trematode abundance and total helminth abundance was significantly less in 2015 than 2014, and we suspect that colder weather late in 2015 impacted the intermediate host fauna and caused the observed differences. Brillouin's species diversity of helminths was greatest in the northernmost region of the study area, which coincides with the range of a non-indigenous snail that indirectly causes annual mortality events of lesser scaup. While host age and size were not determined to be influential factors of helminth infracommunity structure, non-parametric ordination and permutational analysis of co-variance revealed that year and region of collection explained differences in helminth infracommunities. Our results suggest that spatiotemporal variations play an important role in the structure of intestinal helminth infracommunities found in migrating lesser scaup hosts, and may therefore impact host ability to build endogenous reserves at certain stopover locations in the Midwest.


Asunto(s)
Anseriformes/parasitología , Enfermedades de las Aves/epidemiología , Enfermedades de las Aves/parasitología , Helmintos/clasificación , Helmintos/aislamiento & purificación , Parasitosis Intestinales/veterinaria , Animales , Biodiversidad , Femenino , Helmintiasis/epidemiología , Helmintiasis/parasitología , Parasitosis Intestinales/epidemiología , Parasitosis Intestinales/parasitología , Medio Oeste de Estados Unidos/epidemiología , Carga de Parásitos , Análisis Espacio-Temporal
4.
Vet Parasitol ; 151(2-4): 125-32, 2008 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-18155841

RESUMEN

Sea otters (Enhydra lutris) have been reported to become infected with Toxoplasma gondii and at times succumb to clinical disease. Here, we determined genotypes of 39 T. gondii isolates from 37 sea otters in two geographically distant locations (25 from California and 12 from Washington). Six genotypes were identified using 10 PCR-RFLP genetic markers including SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and Apico, and by DNA sequencing of loci SAG1 and GRA6 in 13 isolates. Of these 39 isolates, 13 (33%) were clonal Type II which can be further divided into two groups at the locus Apico. Two of the 39 isolates had Type II alleles at all loci except a Type I allele at locus L358. One isolate had Type II alleles at all loci except the Type I alleles at loci L358 and Apico. One isolate had Type III alleles at all loci except Type II alleles at SAG2 and Apico. Two sea otter isolates had a mixed infection. Twenty-one (54%) isolates had an unique allele at SAG1 locus. Further genotyping or DNA sequence analysis for 18 of these 21 isolates at loci SAG1 and GRA6 revealed that there were two different genotypes, including the previously identified Type X (four isolates) and a new genotype named Type A (14 isolates). The results from this study suggest that the sea otter isolates are genetically diverse.


Asunto(s)
Variación Genética , Nutrias/parasitología , Toxoplasma/genética , Toxoplasmosis Animal/parasitología , Animales , Anticuerpos Antiprotozoarios/sangre , California , Genes Protozoarios/genética , Genotipo , Ratones , Reacción en Cadena de la Polimerasa/veterinaria , Polimorfismo de Longitud del Fragmento de Restricción , Toxoplasma/clasificación , Toxoplasma/aislamiento & purificación , Toxoplasma/patogenicidad , Washingtón
5.
J Comp Pathol ; 137(2-3): 102-21, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17692867

RESUMEN

Protozoal meningoencephalitis is considered to be an important cause of mortality in the California sea otter (Enhydra lutris). Thirty nine of 344 (11.3%) California (CA) and Washington state (WA) sea otters examined from 1985 to 2004 had histopathological evidence of significant protozoal meningoencephalitis. The aetiological agents and histopathological changes associated with these protozoal infections are described. The morphology of the actively multiplicative life stages of the organisms (tachyzoites for Toxoplasma gondii and merozoites for Sarcocystis neurona) and immunohistochemical labelling were used to identify infection with S. neurona (n=22, 56.4%), T. gondii (n=5, 12.8%) or dual infection with both organisms (n=12, 30.8%). Active S. neurona was present in all dual infections, while most had only the latent form of T. gondii. In S. neurona meningoencephalitis, multifocal to diffuse gliosis was widespread in grey matter and consistently present in the molecular layer of the cerebellum. In T. gondii meningoencephalitis, discrete foci of gliosis and malacia were more widely separated, sometimes incorporated pigment-laden macrophages and mineral, and were found predominantly in the cerebral cortex. Quiescent tissue cysts of T. gondii were considered to be incidental and not a cause of clinical disease and mortality. Protozoal meningoencephalitis was diagnosed more frequently in the expanding population of WA sea otters (10 of 31, 32.3%) than in the declining CA population (29 of 313, 9.3%). Among sea otters with protozoal meningoencephalitis, those that had displayed neurological signs prior to death had active S. neurona encephalitis, supporting the conclusion that S. neurona is the most significant protozoal pathogen in the central nervous system of sea otters.


Asunto(s)
Encéfalo/patología , Encéfalo/parasitología , Infecciones Protozoarias del Sistema Nervioso Central/veterinaria , Nutrias/parasitología , Sarcocistosis/veterinaria , Toxoplasmosis Animal/patología , Animales , Anticuerpos Antiprotozoarios/metabolismo , Antígenos de Protozoos/metabolismo , Encéfalo/metabolismo , Células Cultivadas , Infecciones Protozoarias del Sistema Nervioso Central/metabolismo , Infecciones Protozoarias del Sistema Nervioso Central/patología , Corazón/parasitología , Pulmón/metabolismo , Pulmón/parasitología , Pulmón/patología , Músculo Esquelético/metabolismo , Músculo Esquelético/parasitología , Músculo Esquelético/patología , Miocardio/metabolismo , Miocardio/patología , Estudios Retrospectivos , Sarcocystis/inmunología , Sarcocystis/patogenicidad , Sarcocistosis/metabolismo , Sarcocistosis/patología , Toxoplasma/inmunología , Toxoplasma/patogenicidad , Toxoplasmosis Animal/metabolismo
6.
Vet Parasitol ; 125(1-2): 131-5, 2004 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-24937884

RESUMEN

This collection of abstracts provides an account of four presentations at the 19th International Conference of the World Association for the Advancement of Veterinary Parasitology (WAAVP)(held in New Orleans, LA, USA from 10­14 August 2003) in a symposium session on zoonotic protozoan parasites found in the marine environment and chaired by Ronald Fayer and David Lindsay.The focus was on three genera of parasites of veterinary and public health concern­Toxoplasma,Giardia, and Cryptosporidium with emphasis on their epidemiology in the marine environment.


Asunto(s)
Organismos Acuáticos/parasitología , Eucariontes/fisiología , Enfermedades Parasitarias/parasitología , Salud Pública , Zoonosis/parasitología , Animales , Humanos
7.
Am J Gastroenterol ; 96(6): 1741-5, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11419823

RESUMEN

OBJECTIVE: The U.S. standard 13C-urea breath test (13C-UBT) has proven to be extremely reliable but entails several complicated performance requirements and a test period of approximately 1 h. The aim of this study was to compare the standard 13C-UBT with a simplified version embodying modifications of test meal, duration of fasting, amount of 13C-urea, method of breath collection, and duration of test. METHODS: This was a randomized, three-way, crossover study of the standard U.S. 13C-UBT, which contains 125 mg of 13C-urea and a pudding test meal. The final breath sample is taken 30 min after urea ingestion. This test was compared with a formulation containing 75 mg of 13C-urea, a 2.5-g citric acid test meal (UBT-Lite), and a final breath sample taken by direct exhalation into tubes 15 min after urea ingestion. We also compared the effect of prior meals versus fasting on the test outcome with the UBT-Lite. RESULTS: A total of 259 subjects were enrolled in the trial, and 249 completed all three urea breath tests. There was excellent agreement between the three versions of the UBT with >98% of subjects having concordant results. Using predetermined criteria, there was substantial equivalence between the tests. Neither solid and/or liquid food up to 1 h before performing the UBT-Lite affected outcome. CONCLUSION: The UBT-Lite formulation of the 13C-UBT proved to be an improved version of the U.S. standard 13C-UBT offering less expensive ingredients, shorter test duration, and a simplified breath test collection method, without sacrificing accuracy.


Asunto(s)
Pruebas Respiratorias/métodos , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori , Urea , Adolescente , Adulto , Anciano , Radioisótopos de Carbono , Ácido Cítrico/administración & dosificación , Estudios Cruzados , Ayuno , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estándares de Referencia , Sensibilidad y Especificidad , Factores de Tiempo
8.
J Parasitol ; 86(3): 526-30, 2000 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-10864250

RESUMEN

Toxoplasma gondii was isolated from brain or heart tissue from 15 southern sea otters (Enhydra lutris nereis) in cell cultures. These strains were used to infect mice that developed antibodies to T. gondii as detected in the modified direct agglutination test and had T. gondii tissue cysts in their brains at necropsy. Mouse brains containing tissue cysts from 4 of the strains were fed to 4 cats. Two of the cats excreted T. gondii oocysts in their feces that were infectious for mice. Molecular analyses of 13 strains indicated that they were all type II strains, but that they were genetically distinct from one another.


Asunto(s)
Antígenos de Protozoos , Encéfalo/parasitología , Nutrias/parasitología , Toxoplasma/clasificación , Toxoplasmosis Animal/parasitología , Pruebas de Aglutinación/veterinaria , Alelos , Animales , Anticuerpos Antiprotozoarios/sangre , Encéfalo/patología , Gatos , Bovinos , Línea Celular , Femenino , Genotipo , Humanos , Masculino , Ratones , Reacción en Cadena de la Polimerasa/veterinaria , Polimorfismo de Longitud del Fragmento de Restricción , Proteínas Protozoarias/genética , Toxoplasma/genética , Toxoplasma/inmunología , Toxoplasma/patogenicidad
9.
J Wildl Dis ; 35(1): 1-7, 1999 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-10073340

RESUMEN

Epizootics of scaly leg disease caused by infection with the submacroscopic mite Knemidokoptes jamaicensis (Acari: Knemidokoptidae) in migratory American robins (Turdus migratorius) from a residential area of Tulsa (Oklahoma, USA) are documented during the winters (December through February) of 1993-94 and 1994-95. Estimates of 60 to > 80% of the birds in several different flights arriving in the area had lesions consistent with knemidokoptic mange. Epizootic occurrence of K. jamaicensis also is confirmed incidentally in American robins from Georgia (USA) in 1995 and 1998 and in Florida (USA) in 1991. These are the first confirmed epizootics of scaly leg attributed to infections with mites specifically identified as K. jamaicensis in North America. Severity of observed lesions in American robins ranged from scaly hyperkeratosis of the feet and legs to extensive proliferative lesions with loss of digits or the entire foot in some birds. Histologically, there was severe diffuse hyperkeratosis of the epidermis which contained numerous mites and multifocal aggregates of degranulating to degenerating eosinophilic heterophils; there was mild to severe superficial dermatitis with aggregates of eosinophilic heterophils and some mononuclear cells. Based on limited data from affected captive birds in Florida, we questioned the efficacy of ivermectin as an effective acaricide for knemidokoptiasis and propose that conditions associated with captivity may exacerbate transmission of this mite among caged birds. While knemidokoptic mange apparently can result in substantial host morbidity and possibly mortality, the ultimate impact of these epizootics on American robin populations presently is unknown.


Asunto(s)
Enfermedades de las Aves/epidemiología , Brotes de Enfermedades/veterinaria , Infestaciones por Ácaros/veterinaria , Pájaros Cantores/parasitología , Animales , Epidermis/parasitología , Epidermis/patología , Miembro Posterior/parasitología , Miembro Posterior/patología , Infestaciones por Ácaros/epidemiología , Ácaros/crecimiento & desarrollo , Oklahoma/epidemiología , Estaciones del Año
10.
Gastrointest Endosc ; 49(2): 177-83, 1999 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-9925695

RESUMEN

BACKGROUND: A large variety of endoscopic biopsy forceps are commercially available. However, little is known regarding the influence of forceps characteristics such as disposability, size, shape, and presence of a needle on the adequacy of the specimens for histologic diagnosis. Our aim was to analyze in a prospective, randomized, pathologist-blinded study the performance of different biopsy forceps. METHODS: Twelve biopsy forceps were tested, 6 each at upper endoscopy and colonoscopy. Two biopsy specimens were obtained with each forceps, for a total of 12 specimens per patient. The tissue samples were examined for the following parameters: weight (mg), size (mm3), depth, crush artifact, sheering effect, and adequacy of the specimens for histologic information (0 = inadequate, 1 = suboptimal, and 2 = adequate). RESULTS: Fifty-five patients undergoing routine upper or lower gastrointestinal endoscopy were included in the study, and a total of 624 tissue samples were available for analysis. Overall, disposable forceps provided specimens of greater size and depth. At upper endoscopy, alligator-shaped forceps improved the depth of the sample as did the absence of a needle within the cup. These factors, however, had no impact on the specimens obtained at colonoscopy. When the adequacy of the specimens was assessed for histologic diagnosis, no significant difference was noted between any of the individual forceps, although collectively oval-shaped forceps were superior to alligator-shaped forceps at colonoscopy. CONCLUSIONS: The biopsy forceps currently available in the market are equally efficient in providing histologic diagnosis. The primary consideration when selecting an endoscopic biopsy forceps, therefore, should be the cost and ease of use and not any perceived advantage in performance.


Asunto(s)
Biopsia/instrumentación , Endoscopios Gastrointestinales , Tecnología de Fibra Óptica/instrumentación , Enfermedades Gastrointestinales/patología , Instrumentos Quirúrgicos/clasificación , Adulto , Biopsia/métodos , Colonoscopios , Colonoscopía/métodos , Técnicas de Cultivo , Método Doble Ciego , Endoscopía Gastrointestinal/métodos , Diseño de Equipo , Seguridad de Equipos , Femenino , Enfermedades Gastrointestinales/diagnóstico , Humanos , Masculino , Estudios Prospectivos , Sensibilidad y Especificidad , Estadísticas no Paramétricas
11.
J Med Entomol ; 34(4): 411-6, 1997 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-9220674

RESUMEN

New host, geographic records, or both are established for 14 species of hypoderatid deutonymphs from 14 species of birds in North America. Ten of these records are regarded as examples of a potential host colonization event where these hypopi have become established in hosts other than those with which they are normally associated. Herein, potential host colonization events by hypoderatid deutonymphs are regarded as more of an ecologically determined than physiologically specific phenomenon, often specifically related to sharing of nesting sites in the same rookeries by different host taxa. Neottialges ibisicola Young & Pence is placed as a junior synonym of Neottialges plegadicola Fain. The taxonomic status of Hypodectes propus from columbid versus ardeid hosts needs further study.


Asunto(s)
Enfermedades de las Aves/parasitología , Infestaciones por Ácaros/veterinaria , Ácaros/clasificación , Enfermedades de la Piel/veterinaria , Animales , Aves , Infestaciones por Ácaros/parasitología , Ácaros/anatomía & histología , América del Norte , Enfermedades de la Piel/parasitología , Especificidad de la Especie
12.
J Parasitol ; 83(3): 540-1, 1997 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-9194845

RESUMEN

Examination of bald eagles (Haliaeetus leucocephalus) collected from several locations in North America contributed new information concerning the acanthocephalan fauna of this host. Representatives of Arythmorhynchus brevis, representing a new host record, were collected from eagles in Florida, New Hampshire, and Wisconsin. Plagiorhynchus sp. was collected from an eagle in Florida. Corynosoma strumosum was collected from an eagle in Alaska. Andracantha phalacrocoracis, representing a new host record, was collected from an eagle in Alaska. Southwellina hispida, representing a new host record, was collected from eagles in Maine and Virginia. The occurrence of gravid or mature females of A. brevis, Plagiorhynchus sp., and S. hispida suggests that the bald eagle may serve as a competent definitive host for these species.


Asunto(s)
Acantocéfalos/aislamiento & purificación , Enfermedades de las Aves/parasitología , Helmintiasis Animal , Acantocéfalos/anatomía & histología , Acantocéfalos/clasificación , Animales , Enfermedades de las Aves/epidemiología , Aves , Femenino , Helmintiasis/epidemiología , Helmintiasis/parasitología , Masculino , América del Norte/epidemiología , Estudios Retrospectivos
13.
Am J Gastroenterol ; 92(6): 997-9, 1997 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-9177518

RESUMEN

OBJECTIVE: Rapid urease tests (RUTs) are used commonly as a convenient method to detect Helicobacter pylori infection. New rapid tests have been commercially available with promotional literature suggesting enhanced utility. We compared CLOtest to a new reagent strip RUT, PyloriTek. METHODS: Gastric antral mucosal biopsy specimens were obtained from 102 patients for comparison between CLOtest and PyloriTek (204 specimens). Biopsy specimens obtained from a nearby area were stained using the Genta stain for determination of H. pylori status. The RUT to be used first was selected randomly. RESULTS: Sixty-five of the 102 patients had peptic ulcer disease, two had gastric cancer, and 35 had dyspepsia; 61 patients had active H. pylori infection. There were one false-negative and three false-positive CLOtest results, compared with one false-negative and 13 false-positive PyloriTek results (p < 0.02 for incorrect categorization with PyloriTek). Sensitivity and specificity were 98 and 92% compared with 98 and 68% for CLOtest and PyloriTek, respectively. An erroneous categorization of H. pylori status occurred in 3.9% (95% confidence interval [CI]: 1-9.7%) with CLOtest compared with 13.7% (95% CI: 7.7 -22%) with PyloriTek. When the PyloriTek was scored at 1 h (0-1 h) after obtaining the specimen, the accuracy improved; erroneous categorization of H. pylori status occurred in only 2.9% (95% CI: 0.6-8.3%). CONCLUSION: Used according to manufacturer instructions, the new reagent strip RUT PyloriTek has too many false-positive results for use in a clinical situation. In contrast, when the test was interpreted within 1 h, accuracy was comparable to that of CLOtest.


Asunto(s)
Agar , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori , Tiras Reactivas , Ureasa , Adulto , Anciano , Biopsia , Colorantes , Intervalos de Confianza , Dispepsia/diagnóstico , Reacciones Falso Negativas , Reacciones Falso Positivas , Femenino , Mucosa Gástrica/microbiología , Mucosa Gástrica/patología , Reflujo Gastroesofágico/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Úlcera Péptica/diagnóstico , Estudios Prospectivos , Antro Pilórico/microbiología , Antro Pilórico/patología , Sensibilidad y Especificidad , Neoplasias Gástricas/diagnóstico
14.
Gastrointest Endosc ; 45(5): 354-9, 1997 May.
Artículo en Inglés | MEDLINE | ID: mdl-9165314

RESUMEN

BACKGROUND: The usual end point for defining success of dilation is subjective (relief of dysphagia). In most patents thus managed strictures recur. We asked whether an objective end point would improve outcome. METHODS: After dilation to 15 mm, patients were randomized into subjective and objective groups. In subjective group patients, end point for dilation was alleviation of dysphagia; in objective group patients, passing the 12 mm barium pill test. Objective group patients who failed underwent redilation until they passed the pill or failed three times. During Part 1 of the study, patients received ranitidine, during Part 2 they received omeprazole. RESULTS: In part 1, dysphagia was alleviated in 7 of 8 subjective group patients. Only 2 of 10 objective group patients passed the pill test and no additional patients passed after 3 sessions, although most had no dysphagia. In Part 2, 19 subjective groups and 15 objective group patients were studied. End point was not achieved in 3 objective group patients. Over long-term follow-up, objective group patients had less recurrent dysphagia (p = 0.02) and required fewer redilation sessions (p < 0.05). Overall, the pill test correlated with the presence or absence of dysphagia (P < 0.001). Predictive value of passing the pill 1 week after dilation for the absence of dysphagia was 100%, but of failing the pill test and the presence of dysphagia was only 18%. CONCLUSIONS: Achieving an objective end point reduces stricture recurrence and the need for subsequent dilation. Initial subjective improvement does not predict long-term success.


Asunto(s)
Cateterismo , Estenosis Esofágica/terapia , Esofagitis Péptica/terapia , Adulto , Anciano , Sulfato de Bario , Cateterismo/instrumentación , Cateterismo/métodos , Cateterismo/estadística & datos numéricos , Trastornos de Deglución/diagnóstico , Trastornos de Deglución/etiología , Trastornos de Deglución/terapia , Estenosis Esofágica/diagnóstico , Estenosis Esofágica/etiología , Esofagitis Péptica/complicaciones , Esofagitis Péptica/diagnóstico , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Recurrencia , Resultado del Tratamiento
15.
Hepatology ; 25(1): 71-4, 1997 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-8985267

RESUMEN

Patients who have bled from varices remain at risk for rebleeding. There is interest in methods that would enable rapid eradication of varices. The present trial was designed to study whether combining ligation with sclerotherapy will allow quicker eradication of varices than either modality alone. Patients with bleeding esophageal varices were randomized into ligation or combination therapy groups. Patients in the ligation group were treated with endoscopic rubber band ligation alone. In combination group patients, each variceal column was ligated distally and 1 mL of ethanolamine was injected proximal to each ligated site. Subsequent treatment sessions were at 7- to 14-day intervals until varices were eradicated. The clinical and endoscopic characteristics of 25 patients in the ligation group were similar to those of 22 patients in the combination group. Follow-up was up to 30 months. Active bleeding was controlled in 100% of patients in the ligation group and 75% of those in combination group (P = NS). It took 3.3 +/- .4 (range, 1-7) sessions to eradicate varices with ligation and 4.1 +/- .6 (1-7) with combination therapy (P = NS). Survival (four deaths in ligation group, 8 in combination group), rebleeding rate (25% vs. 36%), and varix recurrence (16% vs. 23%) also were similar. There were more complications with combination therapy, including deep ulcers (65% vs. 20%; P < .05); dysphagia (30% vs. 0%; P < .05), with three strictures requiring dilation; and pain (30% vs. 10%; P = NS). Our results show that sclerotherapy combined with ligation offers no benefit over ligation alone. The higher complication rate with combination therapy does not warrant this approach.


Asunto(s)
Várices Esofágicas y Gástricas/terapia , Escleroterapia , Adulto , Anciano , Endoscopía , Várices Esofágicas y Gástricas/mortalidad , Femenino , Estudios de Seguimiento , Hemorragia Gastrointestinal/terapia , Humanos , Ligadura , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Recurrencia , Escleroterapia/efectos adversos , Tasa de Supervivencia
16.
Aliment Pharmacol Ther ; 10(6): 1001-4, 1996 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-8971301

RESUMEN

BACKGROUND: The combination of 120 mg of omeprazole (40 mg t.d.s.) and amoxycillin has been reported to be effective for treating H. pylori infections. METHODS: Normal volunteers with H. pylori infection received high-dose omeprazole (40 mg t.d.s.) or lansoprazole (60 mg t.d.s.) plus amoxycillin 750 mg t.d.s. for 14 days. The studies were open label and not randomized as those receiving omeprazole plus amoxycillin had previously failed lower dose omeprazole (20 mg b.d.) plus amoxycillin therapy more than 6 months previously. Those receiving lansoprazole plus amoxycillin had not been previously treated. Four to 6 weeks after ending antimicrobial therapy, H. pylori status was determined by Genta stain of gastric mucosal biopsies. RESULTS: Forty-three volunteers entered the study and 41 completed it. The overall success with high-dose proton pump inhibitor plus amoxycillin was 34.9%. For the individual regimens the per-protocol results were 48% (95% CI = 28-69%) with lansoprazole and 12.5% (95% CI = 2-38%) with omeprazole. Compliance was > 95% for both regimens. Side-effects were experienced by four lansoprazole and three omeprazole subjects, and caused two omeprazole subjects to withdraw. Cure rates were similar among different races and ethnic groups, between men and women, and between smokers and non-smokers. The level of the pre-treatment urea breath test also did not predict outcome. CONCLUSION: High-dose proton pump inhibitor plus amoxycillin combinations for treatment of H. pylori infection yielded unacceptable results, as the 95% confidence intervals did not include an 80% cure rate. These combinations do not yield consistent results worldwide and cannot be recommended as primary therapy.


Asunto(s)
Amoxicilina/uso terapéutico , Antiulcerosos/uso terapéutico , Inhibidores Enzimáticos/uso terapéutico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Omeprazol/uso terapéutico , Penicilinas/uso terapéutico , Inhibidores de la Bomba de Protones , 2-Piridinilmetilsulfinilbencimidazoles , Adulto , Anciano , Amoxicilina/efectos adversos , Antiulcerosos/efectos adversos , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Inhibidores Enzimáticos/efectos adversos , Femenino , Humanos , Lansoprazol , Masculino , Persona de Mediana Edad , Omeprazol/efectos adversos , Omeprazol/análogos & derivados , Penicilinas/efectos adversos
17.
Tuber Lung Dis ; 77(4): 363-8, 1996 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-8796254

RESUMEN

SETTING: A rapid membrane-based antibody assay capable of diagnosing pulmonary tuberculosis within 15 min has been developed using the 38 kDa antigen from Mycobacterium tuberculosis. OBJECTIVE: To determine the specificity and sensitivity of this assay and evaluate its usefulness in a clinical setting. DESIGN: Sera from patients with active pulmonary tuberculosis were obtained from three hospitals in China. The control groups consisted of patients who were diagnosed with lung diseases other than tuberculosis and healthy subjects. RESULTS: Antibody was detected in 54 of 61 (89%) sputum positive patients and 67 of 91 (74%) sputum negative patients who had been clinically diagnosed as having active pulmonary tuberculosis. Five out of 56 (9%) patients with respiratory diseases other than tuberculosis and 1 out of 30 (3%) healthy controls had a positive antibody response. The overall specificity of the assay was 93% and the positive predictive value was 95%. We conclude that this assay is rapid, sensitive and specific and will be a valuable aid in the clinical diagnosis of pulmonary tuberculosis.


Asunto(s)
Antígenos Bacterianos/análisis , Inmunoensayo/métodos , Mycobacterium tuberculosis/inmunología , Tuberculosis Pulmonar/diagnóstico , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/aislamiento & purificación , Valor Predictivo de las Pruebas , Enfermedades Respiratorias/inmunología , Sensibilidad y Especificidad , Esputo/microbiología , Factores de Tiempo , Tuberculosis Pulmonar/microbiología
18.
J Clin Gastroenterol ; 23(1): 53-4, 1996 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-8835902

RESUMEN

Although there have been several reports of hyperplastic gastric polyps associated with persistent Helicobacter pylori gastritis, the association of H. pylori infection with metaplastic polyps in the duodenum has not hitherto been described. After a 52-year-old man had a single episode of hematemesis, endoscopy showed a smooth polyp 1 cm in greatest dimension formed by a proliferation of gastric epithelial cells of fundic and antral type found in the duodenal bulb. The outer surface was entirely covered with a single layer of hyperplastic columnar epithelium with many H. pylori organisms. After administration of metronidazole 500 mg, omeprazole 20 mg for 4 weeks, and clarithromycin 250 mg twice a day for 2 weeks, endoscopy showed a decrease in size of the duodenal polyp. At 12 weeks there was complete regression of the polyp. This report documents a new and unusual finding: resolution of a gastric metaplastic polyp in the duodenum associated with cure of H. pylori.


Asunto(s)
Neoplasias Duodenales/microbiología , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Pólipos Intestinales/microbiología , Antibacterianos/uso terapéutico , Antiulcerosos/uso terapéutico , Claritromicina/uso terapéutico , Neoplasias Duodenales/prevención & control , Humanos , Pólipos Intestinales/prevención & control , Masculino , Metronidazol/uso terapéutico , Persona de Mediana Edad , Omeprazol/uso terapéutico , Ranitidina/uso terapéutico , Factores de Tiempo
19.
Clin Diagn Lab Immunol ; 3(3): 337-41, 1996 May.
Artículo en Inglés | MEDLINE | ID: mdl-8705680

RESUMEN

A rapid membrane-based serologic assay using the 38-kDa antigen from Mycobacterium tuberculosis for the diagnosis of tuberculosis (TB) was evaluated with 201 patients with pulmonary TB, 67 patients with extrapulmonary TB, 79 Mycobacterium bovis BCG-vaccinated healthy controls, and 77 non-TB respiratory patients. The overall sensitivities, specificities, and positive and negative predictive values were, respectively, 92, 92, 84, and 96% for sputum-positive TB patients; 70, 92, 87, and 79% for sputum-negative TB patients; and 76, 92, 80, and 90% for extrapulmonary-TB patients. Only 2% (1 of 44) of the healthy control BCG-vaccinated subjects gave weak positive signals in the assay, indicating that this rapid serological assay is a valuable aid in clinical diagnosis for both pulmonary and extrapulmonary TB.


Asunto(s)
Antígenos Bacterianos/inmunología , Mycobacterium tuberculosis/inmunología , Tuberculosis Pulmonar/inmunología , Adolescente , Adulto , Anciano , Anticuerpos Antibacterianos/metabolismo , China , Humanos , Immunoblotting , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Sensibilidad y Especificidad , Tuberculosis/inmunología
20.
J Bacteriol ; 178(7): 2102-7, 1996 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-8606190

RESUMEN

O antigen is the major cell surface antigen of gram-negative bacteria, and the genes responsible for its synthesis are located in a single gene cluster. The wzx (rbfX) gene, which is characteristic of the major class of O-antigen gene clusters, encodes a hydrophobic protein with 12 potential transmembrane segments. We demonstrate that a wzx mutant accumulates undecaprenol pyrophosphate-linked O units which appear to be on the cytoplasmic side of the cytoplasmic membrane, suggesting that the wzx gene encodes a flippase for O-unit translocation across that membrane.


Asunto(s)
Proteínas Bacterianas/metabolismo , Proteínas Portadoras/metabolismo , Proteínas de la Membrana/metabolismo , Proteínas de Transporte de Membrana , Antígenos O/biosíntesis , Proteínas de Transferencia de Fosfolípidos , Proteínas Bacterianas/genética , Secuencia de Carbohidratos , Regulación Bacteriana de la Expresión Génica , Proteínas de la Membrana/genética , Datos de Secuencia Molecular , Familia de Multigenes , Mutación
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