Browsing by Author "BERRIOS, X"

Now showing 1 - 5 of 5
  • No Thumbnail Available
    Item
    ACUTE RHEUMATIC-FEVER AND POSTSTREPTOCOCCAL GLOMERULONEPHRITIS IN AN OPEN POPULATION - COMPARATIVE-STUDIES OF EPIDEMIOLOGY AND BACTERIOLOGY
    (1986) BERRIOS, X; QUESNEY, F; MORALES, A; BLAZQUEZ, J; LAGOMARSINO, E; BISNO, AL
    We conducted epidemiologic and bacteriologic studies of 104 cases of acute rheumatic fever (ARF) and 84 cases of poststreptococcal acute glomerulonephritis (AGN) occurring in the southeast health district of Santiago, Chile, between March 1978, and February 1982. The AGN cases were both postpharyngeal and postpyodermol in origin. Despite the fact tht ARF and AGN were occurring in the same neighborhoods and among families of equivalent size and socioeconomic status, the pharyngeal isolation rates of group A streptococci were significantly lower among patients with ARF and their household contacts than among patients with AGN and their contacts. Moreover, the streptococcal throat colonization rates and geometric mean anti-streptolysin O titers were similar in ARF families and the families of noninfected controls. Streptococci of M-type 5, a highly rheumatogenic type, were isolated from three patients with ARF (representing 36% of group A isolates from this group) and one ARF contact but never from patients with AGN, control subjects, or their respective contacts. These observations suggest possible differences in the streptococcal milieus from which ARF and AGN cases emerge. The nature of such differences requires further exploration.
  • Thumbnail Image
    Item
    ANTICARDIOLIPIN ANTIBODIES IN ACUTE RHEUMATIC-FEVER
    (J RHEUMATOL PUBL CO, 1992) FIGUEROA, F; BERRIOS, X; GUTIERREZ, M; CARRION, F; GOYCOLEA, JP; RIEDEL, I; JACOBELLI, S
    Recent reports describe the association of antiphospholipid antibodies (aPL) with chorea or severe heart valve lesions in systemic lupus erythematosus, lupus-like disease, or the primary antiphospholipid antibody syndrome. We conducted a case series and a case-control investigation of patients with rheumatic fever with Sydenham chorea or other manifestations of rheumatic fever for anticardiolipin antibodies (aCL) during the acute attack and disease remission. Eighty percent of patients were positive for aCL during the rheumatic fever attack vs 40% when inactive (p = 0.035); IgG and IgM aCL increased significantly with disease activity. Individuals with or without Sydenham chorea were equally positive for aCL (76 and 83%, respectively). A significant association was found between IgM aCL and carditis: All patients with valvulitis had IgM aCL (100%) vs 37% of patients without valvular involvement (p = 0.02). aPL may play a role in the pathogenesis of some clinical manifestations of acute rheumatic fever.
  • No Thumbnail Available
    Item
    ARE ALL RECURRENCES OF PURE SYDENHAM CHOREA TRUE RECURRENCES OF ACUTE RHEUMATIC-FEVER
    (1985) BERRIOS, X; QUESNEY, F; MORALES, A; BLAZQUEZ, J; BISNO, AL
    We are conducting prospective studies of patients in Santiago, Chile, who have had an attack of rheumatic fever and are receiving continuous secondary prophylaxis with monthly injections of benzathine penicillin G. Throat cultures are obtained just prior to injection each month, and serum antistreptococcal antibody titers (antistreptolysin O and antideoxyribonuclease B) are performed at least every 3 months. During the course of these studies we have observed 17 recurrences of "pure" chorea in 10 patients (six girls). In four recurrences the timing of serologic studies and onset of chorea appeared to exclude the occurrence of an immunologically significant group A streptococcal infection within the preceding 6 to 9 months. In one case the period of serologic follow-up was too brief to allow a definite determination. In the remaining 12 recurrences serologic evidence was suggestive or confirmatory of recent streptococcal infection; however, in several instances the titer elevations were quite modest. Our data suggest that in certain chorea-prone patients. Sydenham chorea may recur after streptococcal infections too weak and transient to be readily detectable or, alternatively, after stimuli other than streptococcal infection.
  • No Thumbnail Available
    Item
    PHARMACOKINETICS OF BENZATHINE PENICILLIN-G - SERUM LEVELS DURING THE 28 DAYS AFTER INTRAMUSCULAR INJECTION OF 1,200,000 UNITS
    (1989) KAPLAN, EL; BERRIOS, X; SPETH, J; SIEFFERMAN, T; GUZMAN, B; QUESNY, F
    Because of published data suggesting the inadequacy of once-every-4-weeks intramuscular injections of benzathine penicillin G for secondary rheumatic fever prevention, serum penicillin levels were determined at 1, 3, 10, 21 and 28 days after administration of 1,200,000 units of this repository penicillin. A total of 193 samples were studied. Mean serum penicillin levels remained .gtoreq. 0.02 .mu.g/ml for 21 days, but by 28 days only 44% of the serum samples had detectable levels of penicillin and only 36% had levels .gtoreq. 0.02 .mu.g/ml. Patients weighing more than 45 kg had significantly lower serum penicillin levels than did those who weighed less. There were similar correlations with body surface area and with age. These data indicate that a significant percentage of patients receiving benzathine penicillin G prophylaxis for prevention of recurrent attacks of rheumatic fever are not protected during the fourth week. More frequent administration of benzathine penicillin G should be considered in instances of high risk of recurrence of rheumatic fever.
  • No Thumbnail Available
    Item
    TYPE-SPECIFIC ANTIBODIES TO STRUCTURALLY DEFINED FRAGMENTS OF STREPTOCOCCAL M-PROTEINS IN PATIENTS WITH ACUTE RHEUMATIC-FEVER
    (1982) BISNO, AL; BERRIOS, X; QUESNEY, F; MONROE, DM; DALE, JB; BEACHEY, EH
    Group A streptococci of M protein type 5 were epidemiologically related to acute rheumatic fever in a number of reported outbreaks. Preliminary bacteriological evidence suggests that M5 may be an important rheumatogenic type in Santiago, Chile. To assess further the relationship of this streptococcal serotype to rheumatic fever in Chile, sera of 34 patients with rheumatic fever and an equal number of age-, sex- and race-matched controls were assayed for antibodies to types 5, 6 and 24 in an enzyme-linked immunosorbent assay with purified pepsin extracts of the respective M proteins as solid-phase antigens. Sera of 11 rheumatic fever patients (32%) were positive (titer > 1:800) for type 5 antibodies, but only 1 (3%) of the matched controls was positive (P < 0.01). Neither the patients nor the controls had antibodies to type 24. Although 38% of the patient sera contained antibodies to type 6, 29% of the control sera also had such antibodies (P > 0.20). The enzyme-linked immunosorbent assay served as an accurate predictor of which sera contained type 5 opsonic antibodies as measured by the opsonophagocytic test. Although antigenic cross-reactivity exists between M protein type 5 and type 6 group A streptococci, this phenomenon is unlikely to have accounted for the preferential occurrence of type 5 antibodies in rheumatic fever sera. The enzyme-linked immunosorbent assay and opsonic antibody results suggest that M5 is an important rheumatogenic type in Chile.