Papers by Luis Adolfo Gomez Espinoza
Neural Plasticity, 2020
Adolescent alcohol use demonstrates distinct developmental trajectories with dissimilar times of ... more Adolescent alcohol use demonstrates distinct developmental trajectories with dissimilar times of onset and trajectories. Given the importance of brain-derived neurotrophic factor (mature BDNF) in this development stage, the current study investigated its relationship with alcohol use. It also extends the literature by assessing the role of its precursor (pro-BDNF). Therefore, over the span of 5 years, we enrolled and followed participants to define age-related changes in BDNF levels in healthy adolescents. Then, the onset and frequency of alcohol use from ages 11 to 18 were collected to determine how the relationship between alcohol, pro-BDNF, and m-BDNF unfolds over time. With respect to development, analyses demonstrated that BDNF concentration slowly increases throughout adolescence. However, despite having similar basal BDNF levels, compared to controls, adolescents that started drinking before 15 years of age always exhibited lower BDNF levels. They also had a significant decre...
Lupus, 1996
Of the many clinical manifestations seen in the antiphospholipid antibody syndrome (APAS), two de... more Of the many clinical manifestations seen in the antiphospholipid antibody syndrome (APAS), two deserve major therapeutic consideration: recurrent fetal loss and vascular thromboses. Treatment of these two major complications remain empirical, although recent studies appear to indicate the beneficial use of multiple therapeutic options including low dose aspirin, alone or in combination with a moderate amount of prednisone, heparin and intravenous gammaglobulin for the prevention of fetal loss, and longterm anticoagulation with maintenance of an international normalized ratio (INR) of 3 to 4 as an effective measure in the prevention of vascular thrombosis. The use of interleukin-3 in animal models of the syndrome has been shown to be effective in the prevention of fetal loss, and this therapeutic modality appears promising, particularly because of its recognized low frequency of side effects in therapeutic trials in humans.
Rev Colomb Reumatol, Dec 1, 1997
Revista Medica Herediana, 2014
A sólo ocho años de su primera descripción por el centro de control de enfermedades (CDC) en 1981... more A sólo ocho años de su primera descripción por el centro de control de enfermedades (CDC) en 1981, la infección por el virus de inmunodeficiencia humana (VIH) se ha convertido en una amenaza de creciente diseminación a través de todo el mundo. Para el 1ro. De octubre de 1988 se habían reportado 85,000 casos del síndrome de inmunodeficiencia adquirida (SIDA) solamente en el continente americano (cifra necesariamente menor de la real debido al escaso reporte de la enfermedad en varios países), 133 países habían reportado casos de SIDA a la Organización Mundial de la Salud (OMS), y las cifras continúan mostrando un incremento en el número total de casos.
Rev Bras Reumatol, Feb 1, 1994
Clinical and experimental rheumatology
The Journal of rheumatology, 1992
Clinical Immunology and Immunopathology, 1982
The Journal of rheumatology, 2002
The Journal of rheumatology, 2004
To define the frequency and characteristics of human immunodeficiency virus (HIV)-associated rheu... more To define the frequency and characteristics of human immunodeficiency virus (HIV)-associated rheumatic manifestations in patients receiving highly active antiretroviral therapy (HAART) referred to a rheumatology clinic. A total of 75 patients with HIV infection receiving HAART were prospectively evaluated for the presence of rheumatic complaints. Diagnosis of HIV infection was performed by ELISA and confirmed by Western blot, and all HIV patients were classified according to the US Centers for Disease Control criteria. Seventy-five individuals with HIV infection and musculoskeletal manifestations were evaluated: 65 (86%) men and 10 (14%) women. Mean age was 32 +/- 4.5 years (range 21-58). The group included 40 (53%) heterosexuals, 30 (40%) intravenous drugs users, 9 (12%) homosexuals, 3 (4%) who had received blood transfusion, and 2 (2.6%) with unknown risk factors. Septic manifestations were the most common complications seen in 31 (41%) out of 75, and included septic arthritis, ce...
The AIDS reader, 2004
Various rheumatic manifestations associated with HIV infection have been recognized, ranging from... more Various rheumatic manifestations associated with HIV infection have been recognized, ranging from infectious conditions, such as septic arthritis, to seronegative spondyloarthropathy. Other musculoskeletal manifestations include lupus-like and Sjögren-like diseases and HIV-related malignancy. The introduction of HAART has changed the spectrum of the clinical manifestations of rheumatic disease seen today, with infections and articular involvement being the most frequently observed.
The Journal of rheumatology, 2005
Behçet's disease is a chronic relapsing form of vasculitis affecting multiple organs. Central... more Behçet's disease is a chronic relapsing form of vasculitis affecting multiple organs. Central nervous system involvement is a common presentation. Tumor necrosis factor-alpha (TNF-alpha) is considered to play a major role in the disease pathogenesis. We describe a patient with a long history of neuro-Behçet's disease who showed a remarkable response to infliximab therapy. Given the variable and limited success of other interventions, the use of anti-TNF-alpha therapy seems to be effective for patients with refractory disease.
Seminars in arthritis and rheumatism, 2005
To review the course, predisposing risk factors, treatment employed, and complications of autoimm... more To review the course, predisposing risk factors, treatment employed, and complications of autoimmune hepatitis (AIH) during pregnancy. Maternal and fetal outcomes will be discussed. We reviewed the literature from February 1966 to January 2004 using MEDLINE and the key words autoimmune hepatitis, chronic active hepatitis, lupoid hepatitis, and pregnancy. An additional case of ours was included as she had AIH since childhood with worsening of liver disease during pregnancy. Including the present case, 58 pregnant women with AIH were reported in 17 case reports and series. In the 101 pregnancies documented in these cases, there were 47 flare-ups, 5 clinical improvements, 45 stabilizations of the disease during pregnancy, and 4 cases in which the disease course was not reported. Two maternal deaths occurred. A perinatal mortality of 4% and 19 fetal deaths were described. Most women were treated with prednisone alone; however azathioprine was used in a number of patients. Pregnancy cour...
The Journal of rheumatology, 2007
Colorectal involvement with obstructed defecation is a common complication of progressive systemi... more Colorectal involvement with obstructed defecation is a common complication of progressive systemic sclerosis (pSSc), compromising quality of life and placing patients at risk for life-threatening complications. Treatment for colonic inertia in these patients includes laxatives, prokinetics, and ultimately colectomy, which is associated with high morbidity and mortality in pSSc. We describe a woman with scleroderma and colonic inertia recommended for total abdominal colectomy. As a result of respiratory decompensation, she was placed on oxygen by nasal cannula, after which bowel motility with regularity was restored, obviating the need for colectomy.
Rheumatic diseases clinics of North America, 2009
Current rheumatology reports, 2011
Various infections have been causative in the pathogenesis of systemic vasculitides, and HIV infe... more Various infections have been causative in the pathogenesis of systemic vasculitides, and HIV infection is not spared. In an immunocompromised host, cytomegalovirus, Epstein-Barr virus, varicella zoster virus, herpes simplex virus, hepatitis B and hepatitis C virus, and mycobacteria, along with HIV infection can cause vasculitis. Herein we emphasize the spectrum of vasculitides, their pathogenesis, presentation, course, and therapy in the HIV-infected population. Every spectrum and size of the blood vessel involvement have been seen in HIV-associated vasculitides. We review each spectrum in detail and describe our experience with polyarteritis nodosa, the most common presentation occurring in HIV-infected patients. We also discuss the differences in HIV, hepatitis B, and hepatitis C- related polyarteritis nodosa in detail.
Clinical rheumatology, 2014
Psoriatic arthritis (PsA) is a systemic inflammatory condition associated with psoriasis. Despite... more Psoriatic arthritis (PsA) is a systemic inflammatory condition associated with psoriasis. Despite considerable heterogeneity in clinical presentation, genetic studies and animal models support the notion that PsA is a distinct disease. We aimed to characterize the PsA genotype by gene expression profile and to research the effect in gene modulation of methotrexate (MTX) and TNF-inhibitors (TNF-I) in PsA-treated patients. Nine PsA patients, according to CASPAR criteria, and three healthy controls were recruited from an outpatient rheumatology clinic. Three out of nine PsA patients were naïve to treatment, three received TNF-I, and the remaining three were on MTX-monotherapy. Blood samples were collected and analyzed by human genome U95 Array-Affymetrix (GeneChip® instrument system). Identification of statistically significant differences between differentially expressed genes was determined by Mann-Whitney and t test (p < 0.05). The microarray profile identified a predominance of ...
Future Rheumatology, 2006
Reactive arthritis (ReA) is an inflammatory process triggered by certain Gram-negative bacteria, ... more Reactive arthritis (ReA) is an inflammatory process triggered by certain Gram-negative bacteria, with Chlamydia trachomatis being the most common cause. The pathophysiology of ReA represents the classic interplay between environment (infectious agents) and host responses. The host responses are, at least in part, governed by genetics. These bacteria or bacterial products are trafficked to the target organs, such as the synovial tissue. The bacterial persistence and ensuing inflammatory response lead to the pathogenic sequelae of ReA. This entire process represents a delicate balance of the major histocompatability complex, cellular uptake of the pathogens, chemokine regulation, Toll-like receptors and T-helper (Th)1 versus Th2/Th3 responses. Therapy has had limited success. As our knowledge of the pathophysiology of ReA continues to grow, our therapies can become more focused and efficacious. This review will devote special attention to Chlamydia, since it is the most common cause of ReA.
Clinical Rheumatology, 2015
A retrospective chart review was conducted to detect patients with sarcoidosis seen by pediatric ... more A retrospective chart review was conducted to detect patients with sarcoidosis seen by pediatric rheumatology service from the period of 1992 to 2013 at Children's hospital of New Orleans. Twenty-seven patients were identified. The average duration of symptoms before diagnosis was 5 (range 1-120) months. Five patients had onset before the age of 5 years and were diagnosed with early-onset sarcoidosis. The most common manifestations at presentation were constitutional symptoms (62 %) followed by ocular (38 %). During the course of illness, 19/27 (70 %) had multiorgan involvement. Common manifestations included uveitis/iritis (77 %), fever (50 %), hilar adenopathy (42 %), arthritis (31 %), peripheral lympadenopathy (31 %), hepatosplenomegaly (31 %), parenchymal lung disease (27 %), and skin rash (19 %). Unusual manifestations included granulomatous bone marrow disease (3 cases), hypertension (2), abdominal aortic aneurysm (large vessel vasculitis; 1), granulomatous hepatitis (1), nephrocalcinosis (1), membranous nephropathy (1), refractory granulomatous interstitial nephritis with recurrence in transplanted kidney (1), CNS involvement (2), parotid gland enlargement (1), and sensorineural hearing loss (1). Biopsy specimen was obtained in 21/27 (77 %) patients, and demonstration of noncaseating granuloma associated with negative stains for mycobacteria and fungi was seen in 18 patients. Elevated angiotensin-converting enzyme level was seen in 74 % of patients. Treatment with oral prednisone was initiated in symptomatic patients with significant clinical improvement. Low-dose methotrexate (MTX) 10-15 mg/m 2 /week orally, as steroid-sparing agent, was administered in 14 patients. Other immunomodulators included cyclophosphamide (2 patients), etanercept (2), infliximab (2), mycophenolate mofetil (1), and tacrolimus (1). Childhood sarcoidosis is prevalent in Louisiana. Most of the affected children present with a multisystem disease associated with manifestations similar to those of adult patients. Low-dose MTX seems to be effective, steroid sparing, and safe adjunct to treat sarcoidosis with multiorgan involvement. Early-onset disease is less common and associated with increased morbidity, flares, and poor prognosis.
Uploads
Papers by Luis Adolfo Gomez Espinoza