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Guevara-Aguirre J, Mishra A, Canepa M, Guevara C, Villacres Á, Guevara A, Peña G, Lescano D, Kopchick JJ, Balasubramanian P, Longo VD. Normal or improved cardiovascular risk factors in IGF-I-deficient adults with growth hormone receptor deficiency. Med 2024:S2666-6340(24)00134-X. [PMID: 38677286 DOI: 10.1016/j.medj.2024.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/16/2023] [Revised: 09/26/2023] [Accepted: 03/28/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Human subjects with generalized growth hormone (GH) insensitivity due to GH receptor deficiency (GHRD)/Laron syndrome display a very low incidence of insulin resistance, diabetes, and cancer, as well as delayed age-related cognitive decline. However, the risk of cardiovascular disease (CVD) in these subjects is poorly understood. Here, we have assessed cardiovascular function, damage, and risk factors in GHRD subjects and their relatives. METHODS We measured markers of CVD in two phases: one in a cohort of 30 individuals (GHRD = 16, control relatives = 14) brought to USC (in Los Angeles, CA) and one in a cohort including additional individuals examined in Ecuador (where the subjects live) for a total of 44 individuals (GHRD = 21, control relatives = 23). Data were collected on GHRD and control groups living in similar geographical locations and sharing comparable environmental and socio-economic circumstances. RESULTS Compared to controls, GHRD subjects displayed lower serum glucose, insulin, blood pressure, smaller cardiac dimensions, similar pulse wave velocity, lower carotid artery intima-media thickness, lower creatinine, and a non-significant but major reduction in the portion of subjects with carotid atherosclerotic plaques (7% GHRDs vs. 36%, Controls p = 0.1333) despite elevated low-density lipoprotein cholesterol levels. CONCLUSION The current study indicates that individuals with GHRD have normal or improved levels of cardiovascular disease risk factors as compared to their relatives. FUNDING This study was funded in part by NIH/NIA grant P01 AG034906 to V.D.L.
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Affiliation(s)
- Jaime Guevara-Aguirre
- College of Medicine, Universidad San Francisco de Quito, Quito, Ecuador; Instituto de Endocrinología IEMYR, Quito, Ecuador; Maastricht University, Maastricht, the Netherlands.
| | - Amrendra Mishra
- Longevity Institute, Davis School of Gerontology and Department of Biological Sciences, University of Southern California, Los Angeles, CA, USA; Department of Life Sciences, GITAM (Deemed to be University), Bengaluru, India
| | - Marco Canepa
- Cardiovascular Unit, Ospedale Policlinico San Martino IRCCS, Genova, Italy; Department of Internal Medicine and Medical Specialities, University of Genova, Genova, Italy
| | - Carolina Guevara
- College of Medicine, Universidad San Francisco de Quito, Quito, Ecuador; Instituto de Endocrinología IEMYR, Quito, Ecuador
| | - Álvaro Villacres
- College of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
| | | | - Gabriela Peña
- College of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
| | - Daniela Lescano
- College of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
| | - John J Kopchick
- Department of Biomedical Sciences, Heritage College of Osteopathic Medicine and Edison Biotechnology Institute, Ohio University, Athens, OH, USA
| | - Priya Balasubramanian
- Longevity Institute, Davis School of Gerontology and Department of Biological Sciences, University of Southern California, Los Angeles, CA, USA
| | - Valter D Longo
- Longevity Institute, Davis School of Gerontology and Department of Biological Sciences, University of Southern California, Los Angeles, CA, USA; IFOM, AIRC Institute of Molecular Oncology, Milan, Italy.
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Troncos G, Popuche D, Adhikari BN, Long KA, Ríos J, Valerio M, Guevara C, Cer RZ, Bishop-Lilly KA, Ampuero JS, Silva M, Cruz CD. Novel Echarate Virus Variant Isolated from Patient with Febrile Illness, Chanchamayo, Peru. Emerg Infect Dis 2023; 29:1908-1912. [PMID: 37610254 PMCID: PMC10461681 DOI: 10.3201/eid2909.230374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
A new phlebovirus variant was isolated from an acute febrile patient in Chanchamayo, Peru. Genome characterization and p-distance analyses based on complete open reading frames revealed that the virus is probably a natural reassortant of the Echarate virus (large and small segments) with a yet-unidentified phlebovirus (M segment).
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Popuche D, Huaman A, Loyola S, Silva M, Jenkins SA, Guevara C. Development and validation of a vero cell-based suspension method for the detection of Zika virus. Rev Peru Med Exp Salud Publica 2023; 40:297-306. [PMID: 37991033 DOI: 10.17843/rpmesp.2023.403.12606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/01/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE. To develop and validate a cell suspension method using Vero 76 cells for culturing Zika virus (ZIKV) based on infection of detached freshly seeded cells. MATERIAL AND METHODS. Three different multiplicities of infection of ZIKV were used to develop and compare this novel method to the standard confluent cell monolayer method. In addition, we preliminary validated the cell suspension method using well-characterized ZIKV positive and negative clinical samples. The standard confluent cell monolayer method was used as the reference method, and viral isolation was confirmed by a ZIKV-specific RT-PCR. The sensitivity and its 95% confidence intervals for the cell suspension method were estimated. Also, a technical comparison of the cell suspension method against the cell monolayer method was performed. RESULTS. Our findings suggested that both the viral load and replication of ZIKV were comparable between both monolayer- and suspension-infection methods. Although both methods were suitable for culturing and isolating ZIKV, the cell suspension method was easier, cheaper, and quicker as well as a sensitive isolation technique. The cell suspension method was significantly more sensitive in detecting Zika in inconclusive cases by RT-PCR, with a fourfold increase compared to the confluent cell monolayer method. CONCLUSION. The cell suspension method has the potential to be an effective method for cultivating and isolating ZIKV and its application is potentially useful in both research and clinical settings.
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Affiliation(s)
- Dina Popuche
- U.S. Naval Medical Research Unit SOUTH, Lima, Perú
| | | | - Steev Loyola
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
- Vysnova Partners Inc., Maryland, EE.UU
| | - María Silva
- U.S. Naval Medical Research Unit SOUTH, Lima, Perú
| | - Sarah A Jenkins
- U.S. Naval Medical Research Unit SOUTH, Lima, Perú
- Naval Medical Research Center, Silver Spring, EE.UU
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Guevara-Aguirre J, Rosenbloom AL, Guevara A, Atkinson MA, Williams MD, Terán E, Posgai AL, Guevara C, Rosado V, Gavilanes AWD, Wasserfall CH. Divergent metabolic phenotypes in two genetic syndromes of low insulin secretion. Diabetes Res Clin Pract 2023; 196:110228. [PMID: 36549505 PMCID: PMC10983787 DOI: 10.1016/j.diabres.2022.110228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/02/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
AIMS We examined the effect of growth hormone (GH) counter-regulation on carbohydrate metabolism in individuals with life-long diminished insulin secretion (DIS). METHODS Adults homozygous for the E180 splice site mutation of GHR [Laron syndrome (LS)], adults with a gain-of-function mutation in CDKN1c [Guevara-Rosenbloom syndrome (GRS)], and controls were evaluated for body composition, leptin, total and high molecular weight (HMW) adiponectin, insulin-like growth factor (IGF) axis molecules, and a 5-hour oral glucose tolerance test (OGTT), with measurements of glucose, insulin, glucagon, ghrelin, pancreatic polypeptide, gastric inhibitory peptide, glucagon-like peptide-1, peptide YY, and islet amyloid polypeptide (IAPP). RESULTS Both syndromic cohorts displayed DIS during OGTT. LS subjects had higher serum concentrations of total and HMW adiponectin, and lower levels of IGF-I, IGF-II, and IGF-Binding Protein-3 than individuals in other study groups. Furthermore, they displayed normal glycemic responses during OGTT with the lowest IAPP secretion. In contrast, individuals with GRS had higher levels of protein glycation, deficient glucose control during OGTT, and increased secretion of IAPP. CONCLUSIONS A distinct metabolic phenotype depending on GH counter-regulatory status, associates with diabetes development and excess glucose-induced IAPP secretion.
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Affiliation(s)
- Jaime Guevara-Aguirre
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito USFQ, Quito 170901, Ecuador; Instituto de Endocrinología IEMYR, Av. La Coruna 1337 and San Ignacio, Quito 170517, Ecuador; Faculty of Health, Medicine & Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, the Netherlands.
| | - Arlan L Rosenbloom
- Department of Pediatrics, College of Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, USA.
| | - Alexandra Guevara
- Instituto de Endocrinología IEMYR, Av. La Coruna 1337 and San Ignacio, Quito 170517, Ecuador.
| | - Mark A Atkinson
- Department of Pediatrics, College of Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, USA; Department of Pathology, Imunology and Laboratory Medicine, College of Medicine, Diabetes Institute, University of Florida, 1275 Center Drive, Gainesville, FL 32610, USA.
| | - MacKenzie D Williams
- Department of Pathology, Imunology and Laboratory Medicine, College of Medicine, Diabetes Institute, University of Florida, 1275 Center Drive, Gainesville, FL 32610, USA.
| | - Enrique Terán
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito USFQ, Quito 170901, Ecuador.
| | - Amanda L Posgai
- Department of Pathology, Imunology and Laboratory Medicine, College of Medicine, Diabetes Institute, University of Florida, 1275 Center Drive, Gainesville, FL 32610, USA.
| | - Carolina Guevara
- Instituto de Endocrinología IEMYR, Av. La Coruna 1337 and San Ignacio, Quito 170517, Ecuador.
| | - Verónica Rosado
- Instituto de Endocrinología IEMYR, Av. La Coruna 1337 and San Ignacio, Quito 170517, Ecuador.
| | - Antonio W D Gavilanes
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito USFQ, Quito 170901, Ecuador; Faculty of Health, Medicine & Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, the Netherlands.
| | - Clive H Wasserfall
- Department of Pathology, Imunology and Laboratory Medicine, College of Medicine, Diabetes Institute, University of Florida, 1275 Center Drive, Gainesville, FL 32610, USA.
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Loyola S, Popuche D, Rios Z, Huaman A, Ampuero JS, Guevara C. Detection of Zika Virus in Oropharyngeal Swabs from Patients with Acute Febrile Illness. Am J Trop Med Hyg 2022; 107:1242-1244. [PMID: 36343593 PMCID: PMC9768257 DOI: 10.4269/ajtmh.22-0292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 09/01/2022] [Indexed: 11/09/2022] Open
Abstract
The isolation of Zika virus (ZIKV) from serum of suspected human cases for diagnostic purposes can be challenging due to infrastructure constraints of laboratory testing technology. Therefore, as an alternative method, the objective of this study was to evaluate a random sample of oropharyngeal swabs for the diagnosis of ZIKV infection among patients with symptoms of arboviral and respiratory illness. The results revealed that ZIKV RNA could be detected by a reverse transcriptase polymerase chain reaction (RT-PCR) assay and isolated from oropharyngeal swabs from five of 38 samples, but serum samples from the same patients were negative for ZIKV by a variety of laboratory diagnostic approaches including RT-PCR and viral isolation followed by immunofluorescence assays. The findings suggested that the molecular detection and isolation of ZIKV in oropharyngeal swab warrants further study for consideration as an improved diagnostic procedure.
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Affiliation(s)
- Steev Loyola
- Grupo de Investigación UNIMOL, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias, Colombia;,Doctorado en Medicina Tropical, Facultad de Medicina, Universidad de Cartagena, Cartagena de Indias, Colombia;,Address correspondence to Steev Loyola, Laboratorio Unidad de Investigación Molecular, Facultad de Medicina, Universidad de Cartagena, Cra. 50 #24120, Cartagena de Indias 130014, Colombia. E-mail:
| | - Dina Popuche
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | - Zonia Rios
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
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Watts DM, Russell KL, Wooster MT, Sharp TW, Morrison AC, Kochel TJ, Bautista CT, Block K, Guevara C, Aguilar P, Palermo PM, Calampa C, Porter KR, Hayes CG, Weaver SC, de Rosa AT, Vinetz JM, Shope RE, Gotuzzo E, Guzman H, Tesh RB. Etiologies of Acute Undifferentiated Febrile Illnesses in and near Iquitos from 1993 to 1999 in the Amazon River Basin of Peru. Am J Trop Med Hyg 2022; 107:1114-1128. [PMID: 36162442 PMCID: PMC9709010 DOI: 10.4269/ajtmh.22-0259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/10/2022] [Indexed: 11/07/2022] Open
Abstract
The objective of this study was to determine the etiology of febrile illnesses among patients from October 1, 1993 through September 30, 1999, in the urban community of Iquitos in the Amazon River Basin of Peru. Epidemiological and clinical data as well as blood samples were obtained from consenting patients at hospitals, health clinics and private residences. Samples were tested for arboviruses in cell cultures and for IgM and IgG antibodies by ELISA. Blood smears were examined for malaria, and sera were tested for antibodies to Leptospira spp. by ELISA and microscopic agglutination. Among 6,607 febrile patients studied, dengue viruses caused 14.6% of the cases, and Venezuelan equine encephalitis virus caused 2.5%, Oropouche virus 1.0%, Mayaro virus 0.4%, and other arboviruses caused 0.2% of the cases. Also, 22.9% of 4,844 patients tested were positive for malaria, and of 400 samples tested, 9% had evidence of acute leptospirosis. Although the study was not designed to assess the importance of these pathogens as a cause of human morbidity in the total population, these results indicate that arboviruses, leptospirosis, and malaria were the cause of approximately 50% of the febrile cases. Although the arboviruses that were diagnosed can produce asymptomatic infections, our findings increased the overall understanding of the relative health burden of these infections, as well as baseline knowledge needed for designing and implementing further studies to better assess the health impact and threat of these pathogens in the Amazon Basin of Peru.
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Affiliation(s)
- Douglas M. Watts
- U.S. Naval Medical Research Unit No. 6, Lima, Peru;,Address correspondence to Douglas M. Watts, Department of Biological Sciences, University of Texas at El Paso, 500 W. University Ave., El Paso, TX 79968. E-mail:
| | | | | | | | - Amy C. Morrison
- University of California, Davis School of Veterinary Medicine Department of Pathology, Microbiology, and Immunology, Davis, California
| | | | | | - Karla Block
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | | | - Patricia Aguilar
- World Reference Center for Emerging Viruses and Arboviruses University of Texas Medical Branch, Galveston, Texas
| | | | - Carlos Calampa
- Peruvian Ministry of Health, Loreto Health Subregion, Iquitos, Peru
| | | | | | - Scott C. Weaver
- World Reference Center for Emerging Viruses and Arboviruses University of Texas Medical Branch, Galveston, Texas
| | - Amelia Travassos de Rosa
- World Reference Center for Emerging Viruses and Arboviruses University of Texas Medical Branch, Galveston, Texas
| | - Joseph M. Vinetz
- World Reference Center for Emerging Viruses and Arboviruses University of Texas Medical Branch, Galveston, Texas
| | - Robert E. Shope
- World Reference Center for Emerging Viruses and Arboviruses University of Texas Medical Branch, Galveston, Texas
| | - Eduardo Gotuzzo
- Department of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hilda Guzman
- World Reference Center for Emerging Viruses and Arboviruses University of Texas Medical Branch, Galveston, Texas
| | - Robert B. Tesh
- World Reference Center for Emerging Viruses and Arboviruses University of Texas Medical Branch, Galveston, Texas
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7
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Bopp NE, Jencks KJ, Siles C, Guevara C, Vilcarromero S, Fernández D, Halsey ES, Ampuero JS, Aguilar PV. Serological Responses in Patients Infected with Mayaro Virus and Evaluation of Cross-Protective Responses against Chikungunya Virus. Am J Trop Med Hyg 2022; 106:607-609. [PMID: 34844213 PMCID: PMC8832936 DOI: 10.4269/ajtmh.21-0579] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/05/2021] [Indexed: 02/03/2023] Open
Abstract
Mayaro virus (MAYV) is an alphavirus endemic to both Latin America and the Caribbean. Recent reports have questioned the ability of MAYV and its close relative, Chikungunya virus (CHIKV), to generate cross-reactive, neutralizing antibodies to one another. Since CHIKV was introduced to South America in 2013, discerning whether individuals have cross-reactive antibodies or whether they have had exposures to both viruses previously has been difficult. Using samples obtained from people infected with MAYV prior to the introduction of CHIKV in the Americas, we performed neutralizing assays and observed no discernable neutralization of CHIKV by sera from patients previously infected with MAYV. These data suggest that a positive CHIKV neutralization test cannot be attributed to prior exposure to MAYV and that previous exposure to MAYV may not be protective against a subsequent CHIKV infection.
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Affiliation(s)
- Nathen E. Bopp
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas
| | - Kara J. Jencks
- School of Medicine, University of Texas Medical Branch, Galveston, Texas
| | | | | | | | - Diana Fernández
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas;,Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas
| | | | | | - Patricia V. Aguilar
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas;,Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas;,Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, Texas,Address correspondence to Patricia V. Aguilar, Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0609. E-mail:
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Gómez-Camargo DE, Egurrola-Pedraza JA, Cruz CD, Popuche D, Ochoa-Díaz MM, Guevara C, Silva M, Abente EJ, Ampuero JS. Evidence of Oropouche Orthobunyavirus Infection, Colombia, 2017. Emerg Infect Dis 2021; 27:1756-1758. [PMID: 34014154 PMCID: PMC8153870 DOI: 10.3201/eid2706.204405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We describe an Oropouche orthobunyavirus infection in a women 28 years of age in Colombia. We confirmed the diagnosis by viral isolation, quantitative reverse transcription PCR, and phylogenetic analysis of the small, medium, and large genomic segments. The virus is related to a strain isolated in Ecuador in 2016.
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Guevara C, Matouk M. In-office 3D printed guide for rhinoplasty. Int J Oral Maxillofac Surg 2021; 50:1563-1565. [PMID: 34092452 DOI: 10.1016/j.ijom.2021.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/22/2021] [Revised: 03/11/2021] [Accepted: 05/11/2021] [Indexed: 11/27/2022]
Abstract
Rhinoplasty is one of the most technically challenging aspects of facial cosmetic surgery. Various versions of predictive computer software have been developed to aid the surgeon in obtaining predictable results. In the rapidly progressing era of three-dimensional (3D) printing, we present an intraoperative technique that has enabled us to reliably monitor planned surgical changes to the nasal form.
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Affiliation(s)
- C Guevara
- South Florida Dental Implant and Facial Surgery Center, Fort Lauderdale, FL, USA.
| | - M Matouk
- South Florida Dental Implant and Facial Surgery Center, Fort Lauderdale, FL, USA
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Crawford D, Kim S, Guevara C. Abstract No. 148 Does transcervical retrograde thoracic duct access improve clinical outcomes of thoracic duct embolization for patients with chyle leak? J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Guevara-Aguirre J, Bautista C, Torres C, Peña G, Guevara C, Palacios C, Guevara A, Gavilanes AWD. Insights from the clinical phenotype of subjects with Laron syndrome in Ecuador. Rev Endocr Metab Disord 2021; 22:59-70. [PMID: 33047268 DOI: 10.1007/s11154-020-09602-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 12/15/2022]
Abstract
The Ecuadorian cohort of subjects with LS has taught us valuable lessons since the late 80's. We have learned about migration of Sephardic Jews to our country, their isolation in remote hamlets and further inbreeding. These geographical, historical and social determinants induced dissemination of a growth hormone (GH) receptor mutation which widely occurred in those almost inaccessible villages. Consequently, the world's largest Laron syndrome (LS) cohort emerged in Loja and El Oro, two of the southern provinces of Ecuador. We have been fortunate to study these patients since 1987. New clinical features derived from GH insensitivity, their growth patterns as well as treatment with exogenous insulin-like growth factor I (IGF-I) have been reported. Novel biochemical characteristics in the field of GH insensitivity, IGFs, IGF binding proteins (BP) and their clinical correlates have also been described. In the last few years, studies on the morbidity and mortality of Ecuadorian LS adults surprisingly demonstrated that despite obesity, they had lower incidence of diabetes and cancer than their relatives. These events were linked to their metabolic phenotype of elevated but ineffective GH concentrations and low circulating IGF-I and IGFBP-3. It was also noted that absent GH counter-regulation induces a decrease in insulin resistance (IR), which results in low but highly efficient insulin levels which properly handle metabolic substrates. We propose that the combination of low IGF-I signaling, decreased IR, and efficient serum insulin concentrations are reasonable explanations for the diminished incidence of diabetes and cancer in these subjects.
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Affiliation(s)
- Jaime Guevara-Aguirre
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Diego de Robles s/n y Pampite, Cumbayá, Quito, Ecuador.
- Instituto de Endocrinología IEMYR, Quito, Ecuador.
- Maastricht University, Maastricht, The Netherlands.
| | - Camila Bautista
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Diego de Robles s/n y Pampite, Cumbayá, Quito, Ecuador
| | - Carlos Torres
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Diego de Robles s/n y Pampite, Cumbayá, Quito, Ecuador
| | - Gabriela Peña
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Diego de Robles s/n y Pampite, Cumbayá, Quito, Ecuador
| | - Carolina Guevara
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Diego de Robles s/n y Pampite, Cumbayá, Quito, Ecuador
- Instituto de Endocrinología IEMYR, Quito, Ecuador
| | - Cristina Palacios
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Diego de Robles s/n y Pampite, Cumbayá, Quito, Ecuador
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Guevara-Aguirre J, Teran E, Lescano D, Guevara C, Guevara A, Saavedra J, Procel P, Wasserfall C, Gavilanes AWD. Assessing insulin sensitivity and resistance in syndromes of severe short stature. Growth Horm IGF Res 2020; 53-54:101339. [PMID: 32763832 DOI: 10.1016/j.ghir.2020.101339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 07/09/2020] [Accepted: 07/20/2020] [Indexed: 11/26/2022]
Abstract
UNLABELLED Individuals affected with two genetic syndromes identified in Ecuador have severe short stature and diminished insulin secretion, along with essentially different GH counterregulatory effects on insulin action, which leads to the appearance of opposing metabolic phenotypes. In the case of Laron syndrome, subjects have enhanced insulin sensitivity and diminished incidence of type 2 diabetes mellitus. In the other clinical entity, individuals have innate insulin resistance, a varying degree of carbohydrate metabolism disturbances, glucose intolerance, and eventually insulin-resistant diabetes mellitus. Since both groups have diminished insulin secretion, the standard homeostatic minimal models for assessment of insulin sensitivity and resistance were used to see if they could properly identify the metabolic status, especially considering that these methodologies are simple and non-invasive procedures. METHODS Fasting insulin concentrations, fasting glucose/fasting insulin ratio and various minimal models were determined in individuals from the two syndromic cohorts, as well as in a control group made of first-degree normal relatives of the insulin-resistant phenotype subjects. RESULTS The metabolic characteristics of enhanced insulin sensitivity in one of the syndromes and innate insulin resistance in the other could not be properly ascertained by the selected methodology. Furthermore, results were confusing and even discrepant with the clinical findings. CONCLUSIONS The standard homeostatic minimal models could not properly identify or discriminate insulin sensitivity and resistance in subjects with inherently diminished secretion. It is thereby suggested that these models should be used with caution in clinical situations where reduced secretion of the metabolic peptide is found or suspected.
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Affiliation(s)
- Jaime Guevara-Aguirre
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador; Department of Pediatrics and Neonatology, Maastricht University Medical Center, Maastricht, The Netherlands; Instituto de Endocrinología IEMYR, Quito, Ecuador.
| | - Enrique Teran
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | - Daniela Lescano
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | - Carolina Guevara
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador; Instituto de Endocrinología IEMYR, Quito, Ecuador
| | | | | | | | - Clive Wasserfall
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Antonio W D Gavilanes
- Department of Pediatrics and Neonatology, Maastricht University Medical Center, Maastricht, The Netherlands
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13
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Guevara-Aguirre J, Teran E, Lescano D, Guevara A, Guevara C, Longo V, Gavilanes AWD. Growth hormone receptor deficiency in humans associates to obesity, increased body fat percentage, a healthy brain and a coordinated insulin sensitivity. Growth Horm IGF Res 2020; 51:58-64. [PMID: 32145513 DOI: 10.1016/j.ghir.2020.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/15/2020] [Accepted: 02/17/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND We have shown that subjects with Laron syndrome (LS) due to growth hormone receptor deficiency (GHRD) and their relatives have comparable brain structure and function; moreover, the brain of individuals affected with GHRD appears like those of younger people. While the functionally absent growth hormone receptor and the diminished concentrations of the insulin-like growth factor-I have been associated to these findings, the role of the insulin-glucose axis is emerging as an unavoidable consideration when determining the aetiology of these observations. In consequence, we decided to search for the potential and discrete associations between the neurological findings and several parameters of carbohydrate metabolism that might exist in the subjects affected with GHRD. SUBJECTS AND METHODS Individuals affected with GHRD were compared to relative controls. Besides standard measures of anthropometry, body composition and brain characteristics, the elements of the carbohydrate metabolism (CHO), including glucose, insulin, triacylglycerol and the free insulin growth factor binding protein 1 (IGFBP1) concentrations were determined. In addition, the correlations existing between the parameters of CHO and brain characteristics were established. RESULTS Besides the phenotypical characteristics of GHRD subjects, including those of brain structure and function, enhanced insulin sensitivity, and other minor, we observed that the insulin-regulated IGFBP1 had a consistent negative correlation with the main elements of the carbohydrate metabolism only in the individuals affected with the disease, and not in their relatives. CONCLUSIONS When compared to their relatives, subjects with GHRD who lack the counter-regulatory effects of GH on the insulin axis, despite their increased risk factor profile due to obesity and increased body fat percentage, have a healthy and younger looking brain associated to an enhanced and coordinated insulin sensitivity. Furthermore, it was observed that in the GHRD subjects IGFBP1 negatively correlates, in a constant and systematic manner, with the main elements of the CHO metabolism. These observations suggest a direct relationship between an efficient insulin sensitivity and a healthy brain.
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Affiliation(s)
- Jaime Guevara-Aguirre
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Diego de Robles s/n y Pampite, Cumbaya, Quito, Ecuador; Instituto de Endocrinología IEMYR, Quito, Ecuador; Maastricht University, Maastricht, The Netherlands..
| | - Enrique Teran
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Diego de Robles s/n y Pampite, Cumbaya, Quito, Ecuador
| | - Daniela Lescano
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Diego de Robles s/n y Pampite, Cumbaya, Quito, Ecuador
| | | | | | - Valter Longo
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
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14
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Siles C, Elson WH, Vilcarromero S, Morrison AC, Hontz RD, Alava F, Valdivia H, Felices V, Guevara C, Jenkins S, Abente EJ, Ampuero JS. Guaroa Virus and Plasmodium vivax Co-Infections, Peruvian Amazon. Emerg Infect Dis 2020; 26:731-737. [PMID: 32186493 PMCID: PMC7101110 DOI: 10.3201/eid2604.191104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
During April–June 2014 in a malaria-endemic rural community close to the city of Iquitos in Peru, we detected evidence of Guaroa virus (GROV) infection in 14 febrile persons, of whom 6 also had evidence of Plasmodium vivax malaria. Cases were discovered through a long-term febrile illness surveillance network at local participating health facilities. GROV cases were identified by using a combination of seroconversion and virus isolation, and malaria was diagnosed by thick smear and PCR. GROV mono-infections manifested as nonspecific febrile illness and were clinically indistinguishable from GROV and P. vivax co-infections. This cluster of cases highlights the potential for GROV transmission in the rural Peruvian Amazon, particularly in areas where malaria is endemic. Further study of similar areas of the Amazon may provide insights into the extent of GROV transmission in the Amazon basin.
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15
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Guevara-Aguirre J, Guevara C, Guevara A, Gavilanes AA. Branding of subjects affected with genetic syndromes of severe short stature in developing countries. BMJ Case Rep 2020; 13:e231737. [PMID: 32041755 PMCID: PMC7021096 DOI: 10.1136/bcr-2019-231737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2020] [Indexed: 01/10/2023] Open
Abstract
In Ecuador, a developing South American country, subjects affected with genetic syndromes of severe short stature are commonly referred to as dwarfs or midgets. Furthermore, and because in earlier studies some patients had evidenced mental retardation, such abnormality is assumed to exist in all affected subjects. Herein, we present two discrete instances in which this type of branding occurs. The first is that of individuals with Laron syndrome who are still called 'dwarfs' and considered as having a degree of mental retardation despite evidence showing otherwise. A similar problem, that of a girl affected with a genetic syndrome of short stature, which might include mental retardation, is also discussed. Considering that stigmatising is a form of discrimination, it concerns us all. Hence, the use of derogatory terms such as midget, dwarf or cretin, that might unintentionally occur even when delivering the best and most devoted medical care, must be eliminated.
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Affiliation(s)
- Jaime Guevara-Aguirre
- College of Medicine, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
- Department of Pediatrics, Maastricht University, Maastricht, Limburg, The Netherlands
- Instituto de Endocrinologia y Metabolismo, IEMYR, Quito, Pichincha, Ecuador
| | - Carolina Guevara
- Instituto de Endocrinologia y Metabolismo, IEMYR, Quito, Pichincha, Ecuador
| | - Alexandra Guevara
- Instituto de Endocrinologia y Metabolismo, IEMYR, Quito, Pichincha, Ecuador
| | - Antonio Awd Gavilanes
- Department of Pediatrics, Maastricht University, Maastricht, Limburg, The Netherlands
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16
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Guevara C, Martinez M, Orellana P, Silva-Rosas C, Diaz V, De Gazia J, Garrido C. Serial decline of no evidence of disease activity-4 status in early disease stages of multiple sclerosis. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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17
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Turell MJ, Gozalo AS, Guevara C, Schoeler GB, Carbajal F, López-Sifuentes VM, Watts DM. Lack of Evidence of Sylvatic Transmission of Dengue Viruses in the Amazon Rainforest Near Iquitos, Peru. Vector Borne Zoonotic Dis 2019; 19:685-689. [PMID: 30964397 PMCID: PMC6716187 DOI: 10.1089/vbz.2018.2408] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Dengue viruses (DENV) are currently responsible for more human morbidity and mortality than any other known arbovirus, and all four DENV are known to exist in sylvatic cycles that might allow these viruses to persist if the urban (Aedes aegypti) cycle could be controlled. To determine whether DENV were being maintained in a sylvatic cycle in a forested area about 14 km southwest of Iquitos, Peru, a city in which all 4 serotypes of DENV circulate, we placed 20 DENV seronegative Aotus monkeys in cages either in the canopy or near ground level for a total of 125.6 months. Despite capturing >66,000 mosquitoes in traps that collected some of the mosquitoes attracted to these monkeys, blood samples obtained once a month from each animal were tested and found to be negative by an enzyme-linked immunosorbent assay for IgM and IgG antibodies to dengue, yellow fever, Venezuelan equine encephalitis, Oropouche, and Mayaro viruses. Although all four DENV serotypes were endemic in nearby Iquitos, the findings of this study did not support a DENV sylvatic maintenance and transmission cycle in a selected area of the Amazon rainforest in northeastern Peru.
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Affiliation(s)
- Michael J. Turell
- Virology Division, U.S. Army Medical Research Institute for Infectious Diseases, Fort Detrick, Maryland
| | - Alfonso S. Gozalo
- Department of Entomology, U.S. Naval Medical Research Unit No. 6, Callao, Peru
| | - Carolina Guevara
- Department of Entomology, U.S. Naval Medical Research Unit No. 6, Callao, Peru
| | - George B. Schoeler
- Department of Entomology, U.S. Naval Medical Research Unit No. 6, Callao, Peru
| | - Faustino Carbajal
- Department of Entomology, U.S. Naval Medical Research Unit No. 6, Callao, Peru
| | | | - Douglas M. Watts
- Department of Viral and Rickettsial Diseases, Naval Medical Research Center, Silver Spring, Maryland
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Abstract
In developed countries, addressing the growing opioid addiction epidemic is focused on preventive measures, developing better overdose-reversal medications and designing newer strategies to treat addiction. Primary prescribers of the therapeutic use of opioids might play a definite role in the aetiology of the epidemics. Developing countries could be affected by similar issues; however, given that no updated statistics are available, it is possible that their populations undergo problems similar to those for which current data is available. Concerns have arisen regarding synthetic opioid tramadol which, given its fast and potent analgesic effects, low cost and easy availability is widely prescribed. A debate remains as to whether tramadol induces addictive effects like those of stronger analogues such as oxycodone or fentanyl. Here we present a case of tramadol dependence in an Ecuadorian patient and find that substance abuse can occur in normal individuals affected by chronic pain, otherwise treatable with standard methods.
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Affiliation(s)
- Jorge A Roa
- Department of Diabetes and Endocrinology, College of Medicine, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
| | - Alexandra Guevara
- Instituto de Endocrinologia y Metabolismo, IEMYR, Quito, Pichincha, Ecuador
| | - Carolina Guevara
- Instituto de Endocrinologia y Metabolismo, IEMYR, Quito, Pichincha, Ecuador
| | - Jaime Guevara-Aguirre
- Department of Diabetes and Endocrinology, College of Medicine, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador.,Instituto de Endocrinologia y Metabolismo, IEMYR, Quito, Pichincha, Ecuador.,Maastricht University Faculty of Health Medicine and Life Sciences, Maastricht, Limburg, The Netherlands
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19
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Juarez D, Guevara C, Wiley M, Torre A, Palacios G, Halsey ES, Ampuero S, Leguia M. Isolation of Complete Equine Encephalitis Virus Genome from Human Swab Specimen, Peru. Emerg Infect Dis 2019; 24:1578-1580. [PMID: 30016240 PMCID: PMC6056129 DOI: 10.3201/eid2408.171274] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
While studying respiratory infections in Peru, we identified Venezuelan equine encephalitis virus (VEEV) in a nasopharyngeal swab, indicating that this alphavirus can be present in human respiratory secretions. Because VEEV may be infectious when aerosolized, our finding is relevant for the management of VEEV-infected patients and for VEEV transmission studies.
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20
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Bernal LJ, Velandia-Romero M, Guevara C, Castellanos JE. Human Metapneumovirus: Laboratory Methods for Isolation, Propagation, and Plaque Titration. Intervirology 2019; 61:301-306. [PMID: 30917376 DOI: 10.1159/000497309] [Citation(s) in RCA: 3] [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: 08/21/2018] [Accepted: 01/24/2019] [Indexed: 11/19/2022] Open
Abstract
The human metapneumovirus (hMPV) is an important viral agent associated with severe infections of the upper and lower airways, especially in young children and immunosuppressed subjects. Nevertheless, in vitro studies of hMPV are very difficult due to the little knowledge we have on its laboratory manipulation. OBJECTIVE The aim of this study was to isolate and propagate hMPV from patients, and to establish a method to quantify the virus by plaque assay. METHOD As part of a Latin American respiratory virus surveillance study, 12 nasal secretion samples - hMPV-positive by direct fluorescence - were inoculated on LLC-MK2 cells to isolate the virus. The supernatants were re-inoculated and the cytopathic effect and syncytium formation were evaluated daily; the infection was confirmed by immunofluorescence and RT-PCR. A protocol to titrate the harvested virus was established inoculating serial dilutions on LLC-MK2 cells, and agarose was then added as an overlay. After different time periods, the monolayers were fixed and stained with Naphthol blue/black or crystal violet and finally the viral titer was obtained. RESULTS Eight out of 12 hMPV-positive respiratory samples were positive for the isolation and confirmed by RT-PCR and immunofluorescence, but the cytopathic effect and syncytium formation were observed only in 5 cultures. One out of 8 viral isolates was used for propagation and plaque assay standardization. We found that incubation for 7 days in the semisolid overlay yielded plaques with appropriate size and shape to be counted, although crystal violet staining showed slightly larger plaques than those seen with Naphthol blue/black staining. CONCLUSIONS The isolation and propagation from patient-derived hMPV and the standardization of a practical, reliable, and inexpensive method of detection and quantification of hMPV were carried out, without the additional use of antibodies that had not been reported previously. These results offer some important insights for future studies of cellular and molecular biology of hMPV.
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Affiliation(s)
- Lilia J Bernal
- Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia
| | | | | | - Jaime E Castellanos
- Facultad de Odontología, Universidad Nacional de Colombia, Bogotá, Colombia, .,Grupo de Virología, Universidad El Bosque, Bogotá, Colombia,
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21
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Patel S, Pillai A, Guevara C, Celii F, Bhatti Z, Wang H. Abstract No. 467 A panel of mRNA molecules as prognostic biomarkers for patients with hepatocellular carcinoma. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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22
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Guevara C, Baabor M. Deep brain stimulation for Parkinson disease with severe axial disability.A Case Report. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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23
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Liu K, Ramaswamy R, Guevara C, Kim S. 04:21 PM Abstract No. 402 Intranodal lymphangiography with thoracic duct embolization for chyle leak after head and neck surgeries. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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24
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Salmón-Mulanovich G, Blazes DL, Guezala V MC, Rios Z, Espinoza A, Guevara C, Lescano AG, Montgomery JM, Bausch DG, Pan WK. Individual and Spatial Risk of Dengue Virus Infection in Puerto Maldonado, Peru. Am J Trop Med Hyg 2018; 99:1440-1450. [PMID: 30298808 DOI: 10.4269/ajtmh.17-1015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Dengue virus (DENV) affects more than 100 countries worldwide. Dengue virus infection has been increasing in the southern Peruvian Amazon city of Puerto Maldonado since 2000. We designed this study to describe the prevalence of past DENV infection and to evaluate risk factors. In 2012, we conducted a cross-sectional serosurvey and administered a knowledge, attitudes, and practices (KAP) questionnaire to members of randomly selected households. Sera were screened for antibodies to DENV by enzyme-linked immunosorbent assay and confirmed by plaque reduction neutralization test. We created indices for KAP (KAPi). We used SaTScan (Martin Kulldorff with Information Management Services Inc., Boston, MA) to detect clustering and created a multivariate model introducing the distance of households to potential vector and infection sources. A total of 505 participants from 307 households provided a blood sample and completed a questionnaire. Fifty-four percent of participants (95% confidence interval [CI]: 49.6; 58.5) had neutralizing antibodies to DENV. Higher values of KAPi were positively associated with having DENV antibodies in the multivariate analysis (odds ratio [ORII]: 1.6, 95% CI: 0.6, 2.4; ORIII: 2.7, 95% CI: 1.3, 5.5; and ORIV: 2.4, 95% CI: 1.2, 5.0). Older groups had lower chances of having been exposed to DENV than younger people (OR20-30: 0.5, 95% CI: 0.2, 0.8; OR31-45: 0.5, 95% CI: 0.3, 0.9; and OR>45: 0.6, 95% CI: 0.3, 1.3). Multivariate data analysis from the 270 households with location information showed male gender to have lower risk of past DENV infection (OR: 0.6, 95% CI: 0.4, 0.9). We conclude that risk of DENV infection in Puerto Maldonado is related to gender, age of the population, and location.
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Affiliation(s)
- Gabriela Salmón-Mulanovich
- U.S. Naval Medical Research Unit No. 6, Lima, Peru.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - David L Blazes
- Global Health Division, Bill & Melinda Gates Foundation, Seattle, Washington.,U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | | | - Zonia Rios
- U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | | | | | - Andrés G Lescano
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.,U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | - Joel M Montgomery
- U.S. Naval Medical Research Unit No. 6, Lima, Peru.,Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Daniel G Bausch
- U.S. Naval Medical Research Unit No. 6, Lima, Peru.,Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - William K Pan
- Duke Global Health Institute and Nicholas School of Environment, Duke University, Durham, North Carolina
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25
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Chen HW, Lukas H, Becker K, Weissenberger G, Halsey ES, Guevara C, Canal E, Hall E, Maves RC, Tilley DH, Kuo L, Kochel TJ, Ching WM. An Improved Enzyme-Linked Immunoassay for the Detection of Leptospira-Specific Antibodies. Am J Trop Med Hyg 2018; 99:266-274. [PMID: 29943710 DOI: 10.4269/ajtmh.17-0057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Leptospirosis is a neglected zoonotic disease with worldwide endemicity and continues to be a significant public health burden on resource-limited populations. Previously, we produced three highly purified recombinant antigens (rLipL32, rLipL41, and rLigA-Rep) and evaluated their performance of detecting Leptospira-specific antibodies in enzyme-linked immunosorbent assay (ELISA) as compared with the microscopic agglutination test (MAT). The overall sensitivity of this assay approached 90%. Recently, another recombinant antigen (rLigB-Rep) was prepared. We tested each individual antigen and a 1:1:1:1 mixture of these four antigens for the detection of Leptospira-specific antibodies in ELISA. The performance of these recombinant antigens was evaluated with a much larger febrile patient panel (337 MAT-confirmed positive sera and 92 MAT-negative sera from febrile patients). Combining the detection results of immunoglobulin M and immunoglobulin G from these four individual antigens, the overall sensitivity was close to 90% but the specificity was only 66%, based on the MAT reference method. The overall sensitivity and specificity of the four-antigen mixture were 82% and 86%, respectively. The mixture of four antigens also exhibited a broader reactivity with MAT-positive samples of 18 serovars from six major pathogenic Leptospira species. Given the limitations of MAT, the data were further analyzed by Bayesian latent class model, showing that ELISA using a 1:1:1:1 mixture still maintained high sensitivity (79%) and specificity (88%) as compared with the sensitivity (90%) and specificity (83%) of MAT. Therefore, ELISA using a mixture of these four antigens could be a very useful test for seroprevalence studies.
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Affiliation(s)
- Hua-Wei Chen
- Naval Medical Research Center, Silver Spring, Maryland
| | - Heather Lukas
- Naval Medical Research Center, Silver Spring, Maryland
| | - Kira Becker
- Naval Medical Research Center, Silver Spring, Maryland
| | | | | | | | | | - Eric Hall
- Naval Medical Research Center, Silver Spring, Maryland
| | - Ryan C Maves
- Naval Medical Center San Diego, San Diego, California.,Naval Medical Research Unit No. 6, Lima, Peru
| | | | - Lynn Kuo
- Department of Statistics, University of Connecticut, Storrs, Connecticut
| | | | - Wei-Mei Ching
- Naval Medical Research Center, Silver Spring, Maryland
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Abstract
Despite the lack of evidence for symptomatic human infection with Maguari virus (MAGV), its close relation to Cache Valley virus (CVV), which does infect humans, remains a concern. We sequenced the complete genome of a MAGV-like isolate (OBS6657) obtained from a febrile patient in Pucallpa, Ucayali, Peru, in 1998. To facilitate its classification, we generated additional full-length sequences for the MAGV prototype strain, 3 additional MAGV-like isolates, and the closely related CVV (7 strains), Tlacotalpan (1 strain), Playas (3 strains), and Fort Sherman (1 strain) viruses. The OBS6657 isolate is similar to the MAGV prototype, whereas 2 of the other MAGV-like isolates are located on a distinct branch and most likely warrant classification as a separate virus species and 1 is, in fact, a misclassified CVV strain. Our findings provide clear evidence that MAGV can cause human disease.
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27
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Charalel R, Akinwande O, Picus D, Som A, Guevara C, Kavali P, Kim S, Giardina J, Darcy M, Ramaswamy R. 3:09 PM Abstract No. 283 Propensity-matched comparison of transjugular intrahepatic portosytemic shunt placement techniques: intravascular ultrasound versus fluoroscopic guidance. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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28
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Smith JL, Pugh CL, Cisney ED, Keasey SL, Guevara C, Ampuero JS, Comach G, Gomez D, Ochoa-Diaz M, Hontz RD, Ulrich RG. Human Antibody Responses to Emerging Mayaro Virus and Cocirculating Alphavirus Infections Examined by Using Structural Proteins from Nine New and Old World Lineages. mSphere 2018; 3:e00003-18. [PMID: 29577083 PMCID: PMC5863033 DOI: 10.1128/msphere.00003-18] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/02/2018] [Indexed: 12/13/2022] Open
Abstract
Mayaro virus (MAYV), Venezuelan equine encephalitis virus (VEEV), and chikungunya virus (CHIKV) are vector-borne alphaviruses that cocirculate in South America. Human infections by these viruses are frequently underdiagnosed or misdiagnosed, especially in areas with high dengue virus endemicity. Disease may progress to debilitating arthralgia (MAYV, CHIKV), encephalitis (VEEV), and death. Few standardized serological assays exist for specific human alphavirus infection detection, and antigen cross-reactivity can be problematic. Therefore, serological platforms that aid in the specific detection of multiple alphavirus infections will greatly expand disease surveillance for these emerging infections. In this study, serum samples from South American patients with PCR- and/or isolation-confirmed infections caused by MAYV, VEEV, and CHIKV were examined by using a protein microarray assembled with recombinant capsid, envelope protein 1 (E1), and E2 from nine New and Old World alphaviruses. Notably, specific antibody recognition of E1 was observed only with MAYV infections, whereas E2 was specifically targeted by antibodies from all of the alphavirus infections investigated, with evidence of cross-reactivity to E2 of o'nyong-nyong virus only in CHIKV-infected patient serum samples. Our findings suggest that alphavirus structural protein microarrays can distinguish infections caused by MAYV, VEEV, and CHIKV and that this multiplexed serological platform could be useful for high-throughput disease surveillance. IMPORTANCE Mayaro, chikungunya, and Venezuelan equine encephalitis viruses are closely related alphaviruses that are spread by mosquitos, causing diseases that produce similar influenza-like symptoms or more severe illnesses. Moreover, alphavirus infection symptoms can be similar to those of dengue or Zika disease, leading to underreporting of cases and potential misdiagnoses. New methods that can be used to detect antibody responses to multiple alphaviruses within the same assay would greatly aid disease surveillance efforts. However, possible antibody cross-reactivity between viruses can reduce the quality of laboratory results. Our results demonstrate that antibody responses to multiple alphaviruses can be specifically quantified within the same assay by using selected recombinant protein antigens and further show that Mayaro virus infections result in unique responses to viral envelope proteins.
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Affiliation(s)
- Jessica L. Smith
- Molecular and Translational Sciences Division, Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Christine L. Pugh
- Molecular and Translational Sciences Division, Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Emily D. Cisney
- Molecular and Translational Sciences Division, Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
| | - Sarah L. Keasey
- Molecular and Translational Sciences Division, Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
- Department of Biology, University of Maryland, Baltimore County, Baltimore, Maryland, USA
| | | | | | - Guillermo Comach
- Laboratorio Regional de Diagnostico e Investigación del Dengue y Otras Enfermedades Virales (LARDIDEV), Instituto de Investigaciones Biomédicas de la Universidad de Carabobo (BIOMED.UC), Maracay, Aragua, Venezuela
| | - Doris Gomez
- Universidad de Cartagena, Doctorado en Medicina Tropical, Grupo UNIMOL, Cartagena, Colombia
| | - Margarita Ochoa-Diaz
- Universidad de Cartagena, Doctorado en Medicina Tropical, Grupo UNIMOL, Cartagena, Colombia
| | - Robert D. Hontz
- U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
| | - Robert G. Ulrich
- Molecular and Translational Sciences Division, Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA
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Guevara-Aguirre J, Guevara A, Guevara C. Treatment of growth failure in the absence of GH signaling: The Ecuadorian experience. Growth Horm IGF Res 2018; 38:53-56. [PMID: 29306560 DOI: 10.1016/j.ghir.2017.12.009] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 12/17/2017] [Accepted: 12/19/2017] [Indexed: 11/22/2022]
Abstract
Recombinant human insulin-like growth factor-1 (rhIGF-1) treatment studies of growth failure in absence of growth hormone (GH) signaling (GH insensitivity -GHI, Laron syndrome -LS, GH Receptor deficiency -GHRD) have taken place in many locations around the globe. Results from these trials are comparable, and slight differences reported can be attributed to specific circumstances at different research sites. rhIGF-I treatment studies of GHI in Ecuador included various trials performed on children belonging to the largest and only homogeneous cohort of subjects with this condition in the world. All trials were performed by the same team of investigators and, during study periods, subjects received similar nutritional, physical activity and medical advice. Combination of these inherent conditions most likely creates less sources of variability during the research process. Indeed, diagnosis, selection and inclusion of research subjects; methodology used; transport, storage and delivery of study drug; data collection, monitoring and auditing; data analysis, discussion of results, conclusion inferences and reporting, etc., were submitted to the same sources of error. For the above-mentioned reasons, we are hereby mainly covering conclusions derived from rhIGF-I treatment studies of Ecuadorian children whit GHRD due to homozygosity of a splice site mutation occurring at GHR gene, whose unaffected parents were both heterozygous for the same mutation. We also describe studies of rhIGF-I administration in adolescent and adult subjects with GHRD, from the same cohort and with the same genetic anomaly.
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Affiliation(s)
- Jaime Guevara-Aguirre
- Universidad San Francisco de Quito, Ecuador; Instituto de Endocrinología IEMYR, Quito, Ecuador.
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McCabe J, Guevara C, Renfroe J, Fattahi T, Salman S, Steinberg B. Quantitative analysis of facial soft tissue perfusion during hypotensive anesthesia using laser-assisted indocyanine green fluorescence angiography. Int J Oral Maxillofac Surg 2017; 47:465-469. [PMID: 29089201 DOI: 10.1016/j.ijom.2017.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/24/2017] [Accepted: 10/05/2017] [Indexed: 11/20/2022]
Abstract
The aim of this study was to quantitatively evaluate the efficacy of induced hypotensive anesthesia in decreasing facial soft tissue perfusion during orthognathic surgery using laser-assisted indocyanine green fluorescence angiography. This retrospective study involved the evaluation of 16 patients who underwent orthognathic surgery. Data collection included facial tissue perfusion of the bilateral cheeks and chin at normotension and with pharmacologically induced hypotensive anesthesia. There were statistically significant differences in the facial tissue perfusion at normal and depressed levels of blood pressure (P<0.001). This study used an objective measure to demonstrate the long-standing belief that hypotensive anesthesia is efficacious in reducing tissue perfusion in the surgical field. The data suggest that pharmacologically depressing the level of mean arterial pressure by 18% may result in a 41-52% decrease in facial soft tissue perfusion. This study reports a novel method of quantitative analysis.
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Affiliation(s)
- J McCabe
- Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, Florida, USA
| | - C Guevara
- Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, Florida, USA
| | - J Renfroe
- Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, Florida, USA
| | - T Fattahi
- Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, Florida, USA
| | - S Salman
- Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, Florida, USA
| | - B Steinberg
- Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, Florida, USA.
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Leguia M, Cruz CD, Felices V, Torre A, Troncos G, Espejo V, Guevara C, Mores C. Full-genome amplification and sequencing of Zika viruses using a targeted amplification approach. J Virol Methods 2017. [PMID: 28633961 DOI: 10.1016/j.jviromet.2017.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
We have developed methods for full-genome sequencing of Zika viruses (ZIKVs) based on a targeted amplification approach. We used alignments of publicly available complete genome data to design a primer set that selectively amplifies ZIKVs. The approach includes amplification strategies for templates present at both high- and low-copy number, and PCR cycling conditions that have been normalized across genome fragments in order to streamline laboratory handling. Abundant templates can be amplified using a strategy that uses 6 overlapping amplicons to cover the complete viral genome, whereas scarce templates can be amplified using a strategy that uses 11 overlapping amplicons of smaller size. The workflow is sequencing platform agnostic, and thus, can be used in low resource settings where access to traditional Sanger sequencing is the only option available. Given the scarcity of tools for ZIKV, this approach should facilitate epidemiological surveillance and other studies that require the generation of complete viral genomic information quickly and cost-effectively.
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Affiliation(s)
- Mariana Leguia
- U.S. Naval Medical Research Unit No.6 (NAMRU-6), Av. Venezuela c36s/n, Bellavista, Callao 2, Peru.
| | - Cristhopher D Cruz
- U.S. Naval Medical Research Unit No.6 (NAMRU-6), Av. Venezuela c36s/n, Bellavista, Callao 2, Peru.
| | - Vidal Felices
- U.S. Naval Medical Research Unit No.6 (NAMRU-6), Av. Venezuela c36s/n, Bellavista, Callao 2, Peru.
| | - Armando Torre
- U.S. Naval Medical Research Unit No.6 (NAMRU-6), Av. Venezuela c36s/n, Bellavista, Callao 2, Peru.
| | - Gilda Troncos
- U.S. Naval Medical Research Unit No.6 (NAMRU-6), Av. Venezuela c36s/n, Bellavista, Callao 2, Peru.
| | - Victoria Espejo
- U.S. Naval Medical Research Unit No.6 (NAMRU-6), Av. Venezuela c36s/n, Bellavista, Callao 2, Peru.
| | - Carolina Guevara
- U.S. Naval Medical Research Unit No.6 (NAMRU-6), Av. Venezuela c36s/n, Bellavista, Callao 2, Peru.
| | - Christopher Mores
- U.S. Naval Medical Research Unit No.6 (NAMRU-6), Av. Venezuela c36s/n, Bellavista, Callao 2, Peru.
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Palermo PM, Aguilar PV, Sanchez JF, Zorrilla V, Flores-Mendoza C, Huayanay A, Guevara C, Lescano AG, Halsey ES. Identification of Blood Meals from Potential Arbovirus Mosquito Vectors in the Peruvian Amazon Basin. Am J Trop Med Hyg 2016; 95:1026-1030. [PMID: 27621304 DOI: 10.4269/ajtmh.16-0167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 07/11/2016] [Indexed: 11/07/2022] Open
Abstract
The transmission dynamics of many arboviruses in the Amazon Basin region have not been fully elucidated, including the vectors and natural reservoir hosts. Identification of blood meal sources in field-caught mosquitoes could yield information for identifying potential arbovirus vertebrate hosts. We identified blood meal sources in 131 mosquitoes collected from areas endemic for arboviruses in the Peruvian Department of Loreto by sequencing polymerase chain reaction amplicons of the cytochrome b gene. Psorophora (Janthinosoma) albigenu, Psorophora (Grabhamia) cingulata, Mansonia humeralis, Anopheles oswaldoi s.l., and Anopheles benarrochi s.l. had mainly anthropophilic feeding preferences; Aedes (Ochlerotatus) serratus, and Aedes (Ochlerotatus) fulvus had feeding preferences for peridomestic animals; and Culex (Melanoconion) spp. fed on a variety of vertebrates, mainly rodents (spiny rats), birds, and amphibians. On the basis of these feeding preferences, many mosquitoes could be considered as potential enzootic and bridge arbovirus vectors in the Amazon Basin of Peru.
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Affiliation(s)
- Pedro M Palermo
- Department of Biological Sciences, Border Biomedical Research Center, University of Texas at El Paso, El Paso, Texas.
| | - Patricia V Aguilar
- Institute for Human Infections and Immunity, Galveston, Texas.,Department of Pathology, University of Texas Medical Branch, Galveston, Texas
| | - Juan F Sanchez
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | | | | | | | | | - Eric S Halsey
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Guevara C, Wallender A, Steinberg B, Ranalli NJ. Primary delayed onset craniosynostosis in a child demonstrated by serial computed tomography imaging. Int J Oral Maxillofac Surg 2016; 45:1347-1350. [PMID: 27267708 DOI: 10.1016/j.ijom.2016.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 04/12/2016] [Accepted: 05/18/2016] [Indexed: 11/19/2022]
Abstract
Primary delayed onset craniosynostosis is a rarely reported phenomenon. The unique case of a 2-year-old boy who had computed tomography (CT) scans performed 20 months apart demonstrating the post-gestational development of sagittal suture craniosynostosis is presented. The otherwise healthy male initially presented to the emergency department at age 7 months with soft tissue swelling over his left parietal region secondary to a fall. A CT scan revealed a possible left parietal skull fracture without intracranial pathology and patent cranial sutures with a normocephalic calvarial configuration. Twenty months later, his paediatrician referred the boy to the craniofacial service for evaluation of progressive dolichocephaly. A new CT scan showed complete fusion of the sagittal suture with resultant biparietal narrowing, frontal bossing, and occipital prominence. The patient subsequently underwent uncomplicated frontoparietal craniotomy with calvarial vault reconstruction. Prior reports in the literature of cases of non-syndromic primary delayed onset craniosynostosis all lack 'pre-synostosis' CT imaging that proves post-birth patency of the cranial sutures. This case report documents CT demonstrating true primary delayed onset craniosynostosis.
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Affiliation(s)
- C Guevara
- Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, FL, USA.
| | - A Wallender
- Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, FL, USA
| | - B Steinberg
- Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, FL, USA
| | - N J Ranalli
- Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, FL, USA; Department of Neurosurgery, Division of Pediatric Neurosurgery, University of Florida, Jacksonville, FL, USA
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34
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Guevara-Aguirre J, Procel P, Guevara C, Guevara-Aguirre M, Rosado V, Teran E. Despite higher body fat content, Ecuadorian subjects with Laron syndrome have less insulin resistance and lower incidence of diabetes than their relatives. Growth Horm IGF Res 2016; 28:76-78. [PMID: 26259979 DOI: 10.1016/j.ghir.2015.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 07/23/2015] [Accepted: 08/03/2015] [Indexed: 11/20/2022]
Abstract
In the present pandemics of obesity and insulin resistant diabetes mellitus (DM), the specific contribution of etiological factors such as shifts in nutritional and exercise patterns, genetic and hormonal, is subject of ongoing research. Among the hormonal factors implicated, we selected obesity-driven insulin resistance for further evaluation. It is known that growth hormone (GH) has profound effects on carbohydrate metabolism. In consequence, we compared the effects of the lack of the counter-regulatory effects of GH, in a group of subjects with GH receptor deficiency (GHRD) due to a mutated GH receptor vs. that of their normal relatives. It was found that, despite their obesity, subjects with GHRD, have diminished incidence of diabetes, lower glucose and insulin concentrations, and lower values of indexes indicative of insulin resistance such as HOMA-IR. The GHRD subjects were also capable of appropriately handling glucose or mixed meal loads despite diminished insulin secretion. These observations allow us to suggest that the association of obesity with increased risk for diabetes appears to be dependent on intact growth hormone signaling.
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Affiliation(s)
- Jaime Guevara-Aguirre
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Ecuador; Instituto de Endocrinología, Metabolismo y Reproducción - IEMYR, Quito, Ecuador.
| | - Patricio Procel
- Instituto de Endocrinología, Metabolismo y Reproducción - IEMYR, Quito, Ecuador
| | - Carolina Guevara
- Instituto de Endocrinología, Metabolismo y Reproducción - IEMYR, Quito, Ecuador
| | | | - Verónica Rosado
- Instituto de Endocrinología, Metabolismo y Reproducción - IEMYR, Quito, Ecuador
| | - Enrique Teran
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Ecuador
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Ronald J, Ronald J, Davis B, Guevara C, Smith T, Kim C. Comparison of patency rates after angioplasty versus secondary stent deployment for treatment of in-stent restenoses of the central veins in hemodialysis patients. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Mesick M, Belikoff B, Guevara C, Fowler K, Saad N. Bland embolization, chemoembolization, and Y-90 embolization of neuroendocrine metastases to the liver. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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37
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Hontz RD, Guevara C, Halsey ES, Silvas J, Santiago FW, Widen SG, Wood TG, Casanova W, Vasilakis N, Watts DM, Kochel TJ, Ebihara H, Aguilar PV. Itaya virus, a Novel Orthobunyavirus Associated with Human Febrile Illness, Peru. Emerg Infect Dis 2016; 21:781-8. [PMID: 25898901 PMCID: PMC4412221 DOI: 10.3201/eid2105.141368] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Analysis of uncharacterized bunyavirus isolates identified a possible reassortant virus. Our genetic analyses of uncharacterized bunyaviruses isolated in Peru identified a possible reassortant virus containing small and large gene segment sequences closely related to the Caraparu virus and a medium gene segment sequence potentially derived from an unidentified group C orthobunyavirus. Neutralization tests confirmed serologic distinction among the newly identified virus and the prototype and Caraparu strains. This virus, named Itaya, was isolated in 1999 and 2006 from febrile patients in the cities of Iquitos and Yurimaguas in Peru. The geographic distance between the 2 cases suggests that the Itaya virus could be widely distributed throughout the Amazon basin in northeastern Peru. Identification of a new Orthobunyavirus species that causes febrile disease in humans reinforces the need to expand viral disease surveillance in tropical regions of South America.
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Leguia M, Loyola S, Rios J, Juarez D, Guevara C, Silva M, Prieto K, Wiley M, Kasper MR, Palacios G, Bausch DG. Full Genomic Characterization of a Saffold Virus Isolated in Peru. Pathogens 2015; 4:816-25. [PMID: 26610576 PMCID: PMC4693166 DOI: 10.3390/pathogens4040816] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/17/2015] [Indexed: 11/16/2022] Open
Abstract
While studying respiratory infections of unknown etiology we detected Saffold virus in an oropharyngeal swab collected from a two-year-old female suffering from diarrhea and respiratory illness. The full viral genome recovered by deep sequencing showed 98% identity to a previously described Saffold strain isolated in Japan. Phylogenetic analysis confirmed the Peruvian Saffold strain belongs to genotype 3 and is most closely related to strains that have circulated in Asia. This is the first documented case report of Saffold virus in Peru and the only complete genomic characterization of a Saffold-3 isolate from the Americas.
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Affiliation(s)
- Mariana Leguia
- Naval Medical Research Unit No. 6 (NAMRU-6), Callao 2, Peru.
| | - Steev Loyola
- Naval Medical Research Unit No. 6 (NAMRU-6), Callao 2, Peru.
| | - Jane Rios
- Naval Medical Research Unit No. 6 (NAMRU-6), Callao 2, Peru.
| | - Diana Juarez
- Naval Medical Research Unit No. 6 (NAMRU-6), Callao 2, Peru.
| | | | - Maria Silva
- Naval Medical Research Unit No. 6 (NAMRU-6), Callao 2, Peru.
| | - Karla Prieto
- Center for Genome Sciences, United States Army Medical Research Institute for Infectious Diseases (USAMRIID), Frederick, MD 21702, USA.
| | - Michael Wiley
- Center for Genome Sciences, United States Army Medical Research Institute for Infectious Diseases (USAMRIID), Frederick, MD 21702, USA.
| | | | - Gustavo Palacios
- Center for Genome Sciences, United States Army Medical Research Institute for Infectious Diseases (USAMRIID), Frederick, MD 21702, USA.
| | - Daniel G Bausch
- Naval Medical Research Unit No. 6 (NAMRU-6), Callao 2, Peru.
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Santiago FW, Halsey ES, Siles C, Vilcarromero S, Guevara C, Silvas JA, Ramal C, Ampuero JS, Aguilar PV. Long-Term Arthralgia after Mayaro Virus Infection Correlates with Sustained Pro-inflammatory Cytokine Response. PLoS Negl Trop Dis 2015; 9:e0004104. [PMID: 26496497 PMCID: PMC4619727 DOI: 10.1371/journal.pntd.0004104] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 08/31/2015] [Indexed: 12/18/2022] Open
Abstract
Mayaro virus (MAYV), an alphavirus similar to chikungunya virus (CHIKV), causes an acute debilitating disease which results in the development of long-term arthralgia in more than 50% of infected individuals. Currently, the immune response and its role in the development of MAYV-induced persistent arthralgia remain unknown. In this study, we evaluated the immune response of individuals with confirmed MAYV infection in a one-year longitudinal study carried out in Loreto, Peru. We report that MAYV infection elicits robust immune responses that result in the development of a strong neutralizing antibody response and the secretion of pro-inflammatory immune mediators. The composition of these inflammatory mediators, in some cases, differed to those previously observed for CHIKV. Key mediators such as IL-13, IL-7 and VEGF were strongly induced following MAYV infection and were significantly increased in subjects that eventually developed persistent arthralgia. Although a strong neutralizing antibody response was observed in all subjects, it was not sufficient to prevent the long-term outcomes of MAYV infection. This study provides initial immunologic insight that may eventually contribute to prognostic tools and therapeutic treatments against this emerging pathogen. Mayaro virus (MAYV) causes an acute debilitating disease which results in the development of long-term arthralgia in more than 50% of infected individuals, similarly to what has been described with CHIKV. In this study, we evaluated the immune response of individuals with confirmed MAYV infection in a one-year longitudinal study carried out in Loreto, Peru. Here, we report that MAYV infection elicits robust immune responses that result in the development of a strong neutralizing antibody response and the secretion of pro-inflammatory immune mediators. These inflammatory mediators, in some cases, differed to those observed by others for CHIKV. We also observed a strong neutralizing antibody response in all the study subjects; however, this response was not sufficient to prevent the long-term outcomes of MAYV infection. Taken together, this study provides initial immunologic insight that may eventually contribute to the development of prognostic tools and potential therapeutic treatments against this emerging pathogen.
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Affiliation(s)
- Felix W. Santiago
- Institute for Human Infections and Immunity, Galveston, Texas, United States of America
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | | | | | | | | | - Jesus A. Silvas
- Institute for Human Infections and Immunity, Galveston, Texas, United States of America
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | | | | | - Patricia V. Aguilar
- Institute for Human Infections and Immunity, Galveston, Texas, United States of America
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America
- Center for Biodefense and Emerging Infectious Diseases, Galveston, Texas, United States of America
- * E-mail:
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Groseth A, Wollenberg KR, Mampilli V, Shupert T, Weisend C, Guevara C, Kochel TJ, Tesh RB, Ebihara H. Spatiotemporal analysis of Guaroa virus diversity, evolution, and spread in South America. Emerg Infect Dis 2015; 21:460-3. [PMID: 25695188 PMCID: PMC4345823 DOI: 10.3201/eid2103.141351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We conducted phylogeographic modeling to determine the introduction and spread of Guaroa virus in South America. The results suggest a recent introduction of this virus into regions of Peru and Bolivia over the past 60–70 years and emphasize the need for increased surveillance in surrounding areas.
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Guevara-Aguirre J, Rosenbloom AL, Balasubramanian P, Teran E, Guevara-Aguirre M, Guevara C, Procel P, Alfaras I, De Cabo R, Di Biase S, Narvaez L, Saavedra J, Longo VD. GH Receptor Deficiency in Ecuadorian Adults Is Associated With Obesity and Enhanced Insulin Sensitivity. J Clin Endocrinol Metab 2015; 100:2589-96. [PMID: 25985182 PMCID: PMC4490304 DOI: 10.1210/jc.2015-1678] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Ecuadorian subjects with GH receptor deficiency (GHRD) have not developed diabetes, despite obesity. OBJECTIVE We sought to determine the metabolic associations for this phenomenon. DESIGN Four studies were carried out: 1) glucose, lipid, adipocytokine concentrations; 2) metabolomics evaluation; 3) metabolic responses to a high-calorie meal; and 4) oral glucose tolerance tests. SETTING Clinical Research Institute in Quito, Ecuador. SUBJECTS Adults homozygous for the E180 splice mutation of the GH receptor (GHRD) were matched for age, gender, and body mass index with unaffected control relatives (C) as follows: study 1, 27 GHRD and 35 C; study 2, 10 GHRD and 10 C; study 3, seven GHRD and 11 C; and study 4, seven GHRD and seven C. RESULTS Although GHRD subjects had greater mean percentage body fat than controls, their fasting insulin, 2-hour blood glucose, and triglyceride levels were lower. The indicator of insulin sensitivity, homeostasis model of assessment 2%S, was greater (P < .0001), and the indicator of insulin resistance, homeostasis model of assessment 2-IR, was lower (P = .0025). Metabolomic differences between GHRD and control subjects were consistent with their differing insulin sensitivity, including postprandial decreases of branched-chain amino acids that were more pronounced in controls. High molecular weight and total adiponectin concentrations were greater in GHRD (P = .0004 and P = .0128, respectively), and leptin levels were lower (P = .02). Although approximately 65% the weight of controls, GHRD subjects consumed an identical high-calorie meal; nonetheless, their mean glucose concentrations were lower, with mean insulin levels one-third those of controls. Results of the 2-hour oral glucose tolerance test were similar. MAIN OUTCOME MEASURES Measures of insulin sensitivity, adipocytokines, and energy metabolites. CONCLUSIONS Without GH counter-regulation, GHRD is associated with insulin efficiency and obesity. Lower leptin levels, despite higher percentage body fat, suggest that obesity-associated leptin resistance is GH dependent. Elevated adiponectin levels not correlated with percentage body fat indicate that GH signaling is necessary for their typical suppression with obesity.
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Affiliation(s)
- Jaime Guevara-Aguirre
- Universidad San Francisco de Quito (J.G.-A., E.T.), Quito, Ecuador; Instituto de Endocrinologia, Metabolismo y Repróduccion (J.G.-A., A.L.R., M.G.-A., C.G., P.P., L.N., J.S.), Quito Ecuador; University of Florida College of Medicine (A.L.R.), Gainesville, Florida 32608; Davis School of Gerontology (P.B., S.D.B., V.D.L.), University of Southern California, Los Angeles, California 90089; Experimental Gerontology Section (I.A., R.D.C.), Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224; and Longevity Institute (V.D.L.), University of Southern California, Los Angeles, California 90089
| | - Arlan L Rosenbloom
- Universidad San Francisco de Quito (J.G.-A., E.T.), Quito, Ecuador; Instituto de Endocrinologia, Metabolismo y Repróduccion (J.G.-A., A.L.R., M.G.-A., C.G., P.P., L.N., J.S.), Quito Ecuador; University of Florida College of Medicine (A.L.R.), Gainesville, Florida 32608; Davis School of Gerontology (P.B., S.D.B., V.D.L.), University of Southern California, Los Angeles, California 90089; Experimental Gerontology Section (I.A., R.D.C.), Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224; and Longevity Institute (V.D.L.), University of Southern California, Los Angeles, California 90089
| | - Priya Balasubramanian
- Universidad San Francisco de Quito (J.G.-A., E.T.), Quito, Ecuador; Instituto de Endocrinologia, Metabolismo y Repróduccion (J.G.-A., A.L.R., M.G.-A., C.G., P.P., L.N., J.S.), Quito Ecuador; University of Florida College of Medicine (A.L.R.), Gainesville, Florida 32608; Davis School of Gerontology (P.B., S.D.B., V.D.L.), University of Southern California, Los Angeles, California 90089; Experimental Gerontology Section (I.A., R.D.C.), Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224; and Longevity Institute (V.D.L.), University of Southern California, Los Angeles, California 90089
| | - Enrique Teran
- Universidad San Francisco de Quito (J.G.-A., E.T.), Quito, Ecuador; Instituto de Endocrinologia, Metabolismo y Repróduccion (J.G.-A., A.L.R., M.G.-A., C.G., P.P., L.N., J.S.), Quito Ecuador; University of Florida College of Medicine (A.L.R.), Gainesville, Florida 32608; Davis School of Gerontology (P.B., S.D.B., V.D.L.), University of Southern California, Los Angeles, California 90089; Experimental Gerontology Section (I.A., R.D.C.), Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224; and Longevity Institute (V.D.L.), University of Southern California, Los Angeles, California 90089
| | - Marco Guevara-Aguirre
- Universidad San Francisco de Quito (J.G.-A., E.T.), Quito, Ecuador; Instituto de Endocrinologia, Metabolismo y Repróduccion (J.G.-A., A.L.R., M.G.-A., C.G., P.P., L.N., J.S.), Quito Ecuador; University of Florida College of Medicine (A.L.R.), Gainesville, Florida 32608; Davis School of Gerontology (P.B., S.D.B., V.D.L.), University of Southern California, Los Angeles, California 90089; Experimental Gerontology Section (I.A., R.D.C.), Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224; and Longevity Institute (V.D.L.), University of Southern California, Los Angeles, California 90089
| | - Carolina Guevara
- Universidad San Francisco de Quito (J.G.-A., E.T.), Quito, Ecuador; Instituto de Endocrinologia, Metabolismo y Repróduccion (J.G.-A., A.L.R., M.G.-A., C.G., P.P., L.N., J.S.), Quito Ecuador; University of Florida College of Medicine (A.L.R.), Gainesville, Florida 32608; Davis School of Gerontology (P.B., S.D.B., V.D.L.), University of Southern California, Los Angeles, California 90089; Experimental Gerontology Section (I.A., R.D.C.), Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224; and Longevity Institute (V.D.L.), University of Southern California, Los Angeles, California 90089
| | - Patricio Procel
- Universidad San Francisco de Quito (J.G.-A., E.T.), Quito, Ecuador; Instituto de Endocrinologia, Metabolismo y Repróduccion (J.G.-A., A.L.R., M.G.-A., C.G., P.P., L.N., J.S.), Quito Ecuador; University of Florida College of Medicine (A.L.R.), Gainesville, Florida 32608; Davis School of Gerontology (P.B., S.D.B., V.D.L.), University of Southern California, Los Angeles, California 90089; Experimental Gerontology Section (I.A., R.D.C.), Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224; and Longevity Institute (V.D.L.), University of Southern California, Los Angeles, California 90089
| | - Irene Alfaras
- Universidad San Francisco de Quito (J.G.-A., E.T.), Quito, Ecuador; Instituto de Endocrinologia, Metabolismo y Repróduccion (J.G.-A., A.L.R., M.G.-A., C.G., P.P., L.N., J.S.), Quito Ecuador; University of Florida College of Medicine (A.L.R.), Gainesville, Florida 32608; Davis School of Gerontology (P.B., S.D.B., V.D.L.), University of Southern California, Los Angeles, California 90089; Experimental Gerontology Section (I.A., R.D.C.), Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224; and Longevity Institute (V.D.L.), University of Southern California, Los Angeles, California 90089
| | - Rafael De Cabo
- Universidad San Francisco de Quito (J.G.-A., E.T.), Quito, Ecuador; Instituto de Endocrinologia, Metabolismo y Repróduccion (J.G.-A., A.L.R., M.G.-A., C.G., P.P., L.N., J.S.), Quito Ecuador; University of Florida College of Medicine (A.L.R.), Gainesville, Florida 32608; Davis School of Gerontology (P.B., S.D.B., V.D.L.), University of Southern California, Los Angeles, California 90089; Experimental Gerontology Section (I.A., R.D.C.), Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224; and Longevity Institute (V.D.L.), University of Southern California, Los Angeles, California 90089
| | - Stefano Di Biase
- Universidad San Francisco de Quito (J.G.-A., E.T.), Quito, Ecuador; Instituto de Endocrinologia, Metabolismo y Repróduccion (J.G.-A., A.L.R., M.G.-A., C.G., P.P., L.N., J.S.), Quito Ecuador; University of Florida College of Medicine (A.L.R.), Gainesville, Florida 32608; Davis School of Gerontology (P.B., S.D.B., V.D.L.), University of Southern California, Los Angeles, California 90089; Experimental Gerontology Section (I.A., R.D.C.), Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224; and Longevity Institute (V.D.L.), University of Southern California, Los Angeles, California 90089
| | - Luis Narvaez
- Universidad San Francisco de Quito (J.G.-A., E.T.), Quito, Ecuador; Instituto de Endocrinologia, Metabolismo y Repróduccion (J.G.-A., A.L.R., M.G.-A., C.G., P.P., L.N., J.S.), Quito Ecuador; University of Florida College of Medicine (A.L.R.), Gainesville, Florida 32608; Davis School of Gerontology (P.B., S.D.B., V.D.L.), University of Southern California, Los Angeles, California 90089; Experimental Gerontology Section (I.A., R.D.C.), Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224; and Longevity Institute (V.D.L.), University of Southern California, Los Angeles, California 90089
| | - Jannette Saavedra
- Universidad San Francisco de Quito (J.G.-A., E.T.), Quito, Ecuador; Instituto de Endocrinologia, Metabolismo y Repróduccion (J.G.-A., A.L.R., M.G.-A., C.G., P.P., L.N., J.S.), Quito Ecuador; University of Florida College of Medicine (A.L.R.), Gainesville, Florida 32608; Davis School of Gerontology (P.B., S.D.B., V.D.L.), University of Southern California, Los Angeles, California 90089; Experimental Gerontology Section (I.A., R.D.C.), Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224; and Longevity Institute (V.D.L.), University of Southern California, Los Angeles, California 90089
| | - Valter D Longo
- Universidad San Francisco de Quito (J.G.-A., E.T.), Quito, Ecuador; Instituto de Endocrinologia, Metabolismo y Repróduccion (J.G.-A., A.L.R., M.G.-A., C.G., P.P., L.N., J.S.), Quito Ecuador; University of Florida College of Medicine (A.L.R.), Gainesville, Florida 32608; Davis School of Gerontology (P.B., S.D.B., V.D.L.), University of Southern California, Los Angeles, California 90089; Experimental Gerontology Section (I.A., R.D.C.), Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224; and Longevity Institute (V.D.L.), University of Southern California, Los Angeles, California 90089
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Dauner AL, Mitra I, Gilliland T, Seales S, Pal S, Yang SC, Guevara C, Chen JH, Liu YC, Kochel TJ, Wu SJL. Development of a pan-serotype reverse transcription loop-mediated isothermal amplification assay for the detection of dengue virus. Diagn Microbiol Infect Dis 2015; 83:30-6. [PMID: 26032430 PMCID: PMC7126901 DOI: 10.1016/j.diagmicrobio.2015.05.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 05/06/2015] [Accepted: 05/11/2015] [Indexed: 10/24/2022]
Abstract
During dengue outbreaks, acute diagnosis at the patient's point of need followed by appropriate supportive therapy reduces morbidity and mortality. To facilitate needed diagnosis, we developed and optimized a reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay that detects all 4 serotypes of dengue virus (DENV). We used a quencher to reduce nonspecific amplification. The assay does not require expensive thermocyclers, utilizing a simple water bath to maintain the reaction at 63 °C. Results can be visualized using UV fluorescence, handheld readers, or lateral flow immunochromatographic tests. We report a sensitivity of 86.3% (95% confidence interval [CI], 72.7-94.8%) and specificity of 93.0% (95% CI, 83.0-98.1%) using a panel of clinical specimens characterized by DENV quantitative reverse transcription-polymerase chain reaction. This pan-serotype DENV RT-LAMP can be adapted to field-expedient formats where it can provide actionable diagnosis near the patient's point of need.
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Affiliation(s)
- Allison L Dauner
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA
| | - Indrani Mitra
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA
| | - Theron Gilliland
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA
| | - Sajeewane Seales
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA
| | - Subhamoy Pal
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA.
| | | | | | | | | | - Tadeusz J Kochel
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA
| | - Shuenn-Jue L Wu
- Naval Medical Research Center, Silver Spring, MD 20910-7500, USA
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Gonzalez G, Saad N, Kim S, Sheybani E, Darcy M, Guevara C. Sclerotherapy for extensive venous malformations of the hand. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Jagait H, Kim S, Guevara C. Transjugular intrahepatic portosystemic shunt (TIPS) versus balloon-occluded retrograde transvenous obliteration (BRTO) for the management of gastric varices: treatment algorithm according to imaging findings and clinical manifestations. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Gonzalez G, Tsai R, Guevara C, Kim S. Efficacy of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) in 31 patients with transjugular intrahepatic portosystemic shunts (TIPS). J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Felices V, Ampuero JS, Guevara C, Caceda ER, Gomez J, Santiago-Maldonado FW, Aguilar PV, Halsey ES. St. Louis encephalitis virus infection in woman, Peru. Emerg Infect Dis 2014; 20:730-2. [PMID: 24655897 PMCID: PMC3966368 DOI: 10.3201/eid2004.131735] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Kerns SL, Guevara-Aguirre J, Andrew S, Geng J, Guevara C, Guevara-Aguirre M, Guo M, Oddoux C, Shen Y, Zurita A, Rosenfeld RG, Ostrer H, Hwa V, Dauber A. A novel variant in CDKN1C is associated with intrauterine growth restriction, short stature, and early-adulthood-onset diabetes. J Clin Endocrinol Metab 2014; 99:E2117-22. [PMID: 25057881 PMCID: PMC4184067 DOI: 10.1210/jc.2014-1949] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT CDKN1C, a cyclin-dependent kinase inhibitor and negative regulator of cellular proliferation, is paternally imprinted and has been shown to regulate β-cell proliferation. CDKN1C mutations are associated with growth disorders, including Beckwith-Wiedemann syndrome and IMAGe syndrome. OBJECTIVE To investigate the genetic basis for a familial disorder characterized by intrauterine growth restriction, short stature, and early-adulthood-onset diabetes. DESIGN, SETTING, AND PARTICIPANTS Genomic DNA samples (15 affected and 26 unaffected from a six-generation pedigree) were analyzed by genome-wide single nucleotide polymorphism arrays, whole exome and Sanger sequencing, and multiplex ligation-dependent probe amplification. MAIN OUTCOME MEASURE(S) Subjects were assessed for height, weight, adrenal gland size, ACTH, diabetes status, and testis volume. Linkage and sequence analyses were performed, and the identified genetic variant was functionally evaluated in reconstitution studies. RESULTS The pedigree followed a paternally imprinted pattern of inheritance, and genetic linkage analysis identified a single significant 2.6-megabase locus on chromosome 11p15, within the imprinting center region 2. Multiplex ligation-dependent probe amplification did not detect copy number variants or methylation abnormalities. Whole exome sequencing revealed a single novel variant in the proliferating cell nuclear antigen-binding region of CDKN1C (c.842G>T, p.R281I) that co-segregated with affected status and, unlike variants found in IMAGe, did not entirely abrogate proliferating cell nuclear antigen binding. Clinical assessments revealed that affected individuals had low testicular volume but normal adrenal function. CONCLUSIONS We report a novel CDKN1C mutation associated with features of IMAGe syndrome, but without adrenal insufficiency or metaphyseal dysplasia, and characterized by early-adulthood-onset diabetes. Our data expand the range of phenotypes observed with CDKN1C defects and suggest that CDKN1C mutations may represent a novel monogenic form of diabetes.
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Halsey ES, Siles C, Guevara C, Vilcarromero S, Jhonston EJ, Ramal C, Aguilar PV, Ampuero JS. Mayaro virus infection, Amazon Basin region, Peru, 2010-2013. Emerg Infect Dis 2014; 19:1839-42. [PMID: 24210165 PMCID: PMC3837653 DOI: 10.3201/eid1911.130777] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
During 2010-2013, we recruited 16 persons with confirmed Mayaro virus infection in the Peruvian Amazon to prospectively follow clinical symptoms and serologic response over a 12-month period. Mayaro virus infection caused long-term arthralgia in more than half, similar to reports of other arthritogenic alphaviruses.
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Sulca J, Guevara C, Halsey ES, Ampuero JS. Aislamiento de los serotipos 1 y 3 del virus dengue por shell vial modificado en un paciente coinfectado. Rev Peru Med Exp Salud Publica 2014. [DOI: 10.17843/rpmesp.2013.302.223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Vasilakis N, Castro-Llanos F, Widen SG, Aguilar PV, Guzman H, Guevara C, Fernandez R, Auguste AJ, Wood TG, Popov V, Mundal K, Ghedin E, Kochel TJ, Holmes EC, Walker PJ, Tesh RB. Arboretum and Puerto Almendras viruses: two novel rhabdoviruses isolated from mosquitoes in Peru. J Gen Virol 2014; 95:787-792. [PMID: 24421116 DOI: 10.1099/vir.0.058685-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Arboretum virus (ABTV) and Puerto Almendras virus (PTAMV) are two mosquito-associated rhabdoviruses isolated from pools of Psorophora albigenu and Ochlerotattus fulvus mosquitoes, respectively, collected in the Department of Loreto, Peru, in 2009. Initial tests suggested that both viruses were novel rhabdoviruses and this was confirmed by complete genome sequencing. Analysis of their 11 482 nt (ABTV) and 11 876 (PTAMV) genomes indicates that they encode the five canonical rhabdovirus structural proteins (N, P, M, G and L) with an additional gene (U1) encoding a small hydrophobic protein. Evolutionary analysis of the L protein indicates that ABTV and PTAMV are novel and phylogenetically distinct rhabdoviruses that cannot be classified as members of any of the eight currently recognized genera within the family Rhabdoviridae, highlighting the vast diversity of this virus family.
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Affiliation(s)
- Nikos Vasilakis
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA.,Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX, USA.,Center for Biodefense and Emerging Infectious Diseases and Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Steven G Widen
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA
| | - Patricia V Aguilar
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA.,Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX, USA.,Center for Biodefense and Emerging Infectious Diseases and Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - Hilda Guzman
- Center for Biodefense and Emerging Infectious Diseases and Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | | | | | - Albert J Auguste
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA.,Center for Biodefense and Emerging Infectious Diseases and Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - Thomas G Wood
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA
| | - Vsevolod Popov
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA.,Center for Biodefense and Emerging Infectious Diseases and Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - Kirk Mundal
- US Naval Medical Research Unit no. 6, Lima, Peru
| | - Elodie Ghedin
- Center for Vaccine Research, Department of Computational and Systems Biology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Edward C Holmes
- Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia
| | - Peter J Walker
- CSIRO Animal, Food and Health Sciences, Australian Animal Health Laboratory, Geelong, VIC 3220, Australia
| | - Robert B Tesh
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA.,Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX, USA.,Center for Biodefense and Emerging Infectious Diseases and Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
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