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Fernández R, Díaz A, D'Attilio L, Bongiovanni B, Santucci N, Bertola D, Besedovsky H, Del Rey A, Bay ML, Bottasso O. An adverse immune-endocrine profile in patients with tuberculosis and type 2 diabetes. Tuberculosis (Edinb) 2016; 101:95-101. [PMID: 27865406 DOI: 10.1016/j.tube.2016.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 08/22/2016] [Accepted: 09/04/2016] [Indexed: 12/12/2022]
Abstract
Diabetes is a risk factor for the development of pulmonary tuberculosis (TB) and both diseases present endocrine alterations likely to play a role in certain immuno-endocrine-metabolic associated disorders. Patients with TB, or with TB and type 2 diabetes (TB + T2DM) and healthy controls (HCo) were assessed for plasma levels of cortisol, dehydroepiandrosterone (DHEA), estradiol, testosterone, growth hormone (GH), prolactin, insulin-like growth factor-1 (IGF-1), cytokines (IL-6, IL-10, IFN-γ) and the specific lymphoproliferative capacity of peripheral blood mononuclear cells. All patients had higher levels of cortisol with a reduction in DHEA, thus resulting in an increased cortisol/DHEA ratio (Cort/DHEA). Increased prolactin and particularly GH levels were found in both groups of TB patients. This was not paralleled by increased concentrations of IGF, which remained within the levels of HCo. Estradiol levels were significantly augmented in patients TB, and significantly more in TB + T2DM, whereas testosterone levels were decreased in both groups of patients. IFN- γ and IL-6 concentrations were significantly increased in all TB, even further in TB + T2DM; while IL-10 was equally increased in both groups of TB patients. The in vitro specific proliferative capacity was decreased in both groups of patients as compared to that of HCo. The adverse immune-endocrine profile of TB seems to be slightly more pronounced in patients who also have T2DM.
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Affiliation(s)
- R Fernández
- Instituto de Inmunología Clínica y Experimental de Rosario, UNR-CONICET, Suipacha 590, Rosario, 2000, Santa Fe, Argentina
| | - A Díaz
- Instituto de Inmunología Clínica y Experimental de Rosario, UNR-CONICET, Suipacha 590, Rosario, 2000, Santa Fe, Argentina
| | - L D'Attilio
- Instituto de Inmunología Clínica y Experimental de Rosario, UNR-CONICET, Suipacha 590, Rosario, 2000, Santa Fe, Argentina
| | - B Bongiovanni
- Instituto de Inmunología Clínica y Experimental de Rosario, UNR-CONICET, Suipacha 590, Rosario, 2000, Santa Fe, Argentina
| | - N Santucci
- Instituto de Inmunología Clínica y Experimental de Rosario, UNR-CONICET, Suipacha 590, Rosario, 2000, Santa Fe, Argentina
| | - D Bertola
- Servicio de Clínica Médica, Hospital Provincial del Centenario, Rosario, Santa Fe, Argentina
| | - H Besedovsky
- Institute of Physiology and Pathophysiology, Philipps University, Faculty of Medicine, Marburg, Germany
| | - A Del Rey
- Institute of Physiology and Pathophysiology, Philipps University, Faculty of Medicine, Marburg, Germany
| | - M L Bay
- Instituto de Inmunología Clínica y Experimental de Rosario, UNR-CONICET, Suipacha 590, Rosario, 2000, Santa Fe, Argentina
| | - O Bottasso
- Instituto de Inmunología Clínica y Experimental de Rosario, UNR-CONICET, Suipacha 590, Rosario, 2000, Santa Fe, Argentina.
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Albano LM, Zatz M, Kim CA, Bertola D, Sugayama SM, Marques-Dias MJ, Kok F, Ferraretto I, Rosemberg S, Cocozza S, Monticelli A. Friedreich's ataxia: clinical and molecular study of 25 Brazilian cases. Rev Hosp Clin Fac Med Sao Paulo 2001; 56:143-8. [PMID: 11781594 DOI: 10.1590/s0041-87812001000500003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Friedreich's ataxia is a neurodegenerative disorder whose clinical diagnostic criteria for typical cases basically include: a) early age of onset (< 20 or 25 years), b) autosomal recessive inheritance, c) progressive ataxia of limbs and gait, and d) absence of lower limb tendon reflexes. METHODS We studied the frequency and the size of expanded GAA and their influence on neurologic findings, age at onset, and disease progression in 25 Brazilian patients with clinical diagnosis of Friedreich's ataxia - 19 typical and 6 atypical - using a long-range PCR test. RESULTS Abnormalities in cerebellar signs, in electrocardiography, and pes cavus occurred more frequently in typical cases; however, plantar response and speech were more frequently normal in this group when the both typical and atypical cases were compared. Homozygous GAA expansion repeats were detected in 17 cases (68%) - all typical cases. In 8 patients (32%) (6 atypical and 2 typical), no expansion was observed, ruling out the diagnosis of Friedreich's ataxia. In cases with GAA expansions, foot deformity, cardiac abnormalities, and some neurologic findings occurred more frequently; however, abnormalities in cranial nerves and in tomographic findings were detected less frequently than in patients without GAA expansions. DISCUSSION Molecular analysis was imperative for the diagnosis of Friedreich's ataxia, not only for typical cases but also for atypical ones. There was no genotype-phenotype correlation. Diagnosis based only on clinical findings is limited; however, it aids in better screening for suspected cases that should be tested. Evaluation for vitamin E deficiency is recommended, especially in cases without GAA expansion.
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Affiliation(s)
- L M Albano
- Genetic Unit, Infant Neurological Unit of the Children's Institute of Hospital das Clinicas, University of Sao Paulo, Brazil
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Albano LM, Kim CA, Lee VK, Sugayama SM, Barba MF, Utagawa CY, Bertola D, Gonzalez CH. Clinical and radiological aspects in Melnick-Needles syndrome. Rev Hosp Clin Fac Med Sao Paulo 1999; 54:69-72. [PMID: 10513069 DOI: 10.1590/s0041-87811999000200007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Melnick-Needles syndrome is an X-linked dominant bone dysplasia, lethal in males, characterized by a typical facies and characteristic radiological findings: including sclerosis of skull base and mastoids. S-shaped appearance of tibia; cortical irregularities with a ribbon appearance of the ribs. About 48 well-documented cases have been reported, most of them were sporadic. Parental transmission has been published in only 11 kindreds. We are presenting the first Brazilian family with mother-daughter transmission. The proposita presented the typical clinical and radiological features with characteristic facies, severe thoracic cage restriction and pulmonary hypertension. Her mother was more mildly affected.
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Affiliation(s)
- L M Albano
- Infectious Diseases Pathology Laboratory, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
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Poletti T, Bertola D, Pellerito R, Soragna A. [Clinical trial of a new broad-spectrum cephalosporin: HR 756 (cefotaxime)]. Minerva Med 1980; 71:1935-43. [PMID: 6248823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A second-generation cephalosporin (cephotaxime) with a marked resistance to beta-lactamase, a very broad spectrum, and remarkably low renal toxicity was used to treat 47 patients with respiratory, urinary and other infections. The results were excellent in 89.2% and good in 8.5%. The antibiotic proved effective even against germs that are usually resistant to cephalosporins (Pseudomonas, Proteus, Serratia and Enterobacteriaceae). Bacteriuria disappeared in all cases of urinary infection. Local and general tolerance was excellent in all cases but one. Renal tolerance was also excellent in patients with chronic renal failure, for whom the daily dose can be usefully reduced and a check on renal function should be kept.
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