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Mexico City, Mexico

Esteve-Gassent M.D.,Texas A&M University | Grover A.,Texas A&M University | Feria-Arroyo T.P.,University of Texas-Pan American | Castro-Arellano I.,Texas State University | And 3 more authors.
Parasites and Vectors | Year: 2015

In a recent Letter to the Editor, Norris et al. questioned the validity of some of our data reported by Feria-Arroyo et al. The main issue investigated by us was the potential impact of climate change on the probable distribution of the tick vector Ixodes scapularis in the Texas-Mexico transboundary region. As an ancillary issue, an analysis of sequence data for the intergenic spacer of Borrelia burgdorferi was conducted. In the present letter, we provide further evidence supporting our original results, and advocate that extensive study of the population genetics of B. burgdorferi is needed in the Texas-Mexico transboundary region. © 2015 Esteve-Gassent et al.; licensee BioMed Central. Source

Espinosa De Los Monteros A.L.,Centro Medico Nacional SXXI | Carrasco C.A.,University of Santiago de Chile | Albarran A.A.R.,Instituto Nacional Of Ciencias Medicas Y Nutricion Salvador Zubiran | Gadelha M.,Federal University of Rio de Janeiro | And 3 more authors.
Pituitary | Year: 2014

Background and objectives: Primary pharmacological therapy may be the only viable treatment option for many patients with acromegaly, especially those presenting with advanced disease with large inoperable tumors. Long-acting somatostatin analogs are currently the first-line treatment of choice in this setting, where they provide biochemical control and reduce tumor size in a significant proportion of patients. We herein present a brief overview of the role of primary pharmacological therapy in the treatment of acromegaly within the context of Latin America and support this with a representative case study. Case description: A 20 year old male presented with clinical and biochemical evidence of acromegaly. The glucose-suppressed growth hormone (GH) was 5.3 μg/L, his insulin-like growth factor-1(IGF-1) was 3.5 times the ULN and serum prolactin greater than 4,000 μg/L. Pituitary MRI revealed a large and invasive mass, extending superiorly into the optic chiasm and laterally into the left cavernous sinus. He was treated with a combination of octreotide and cabergoline with remarkable clinical improvement, normalization of GH and IGF-1 values and striking shrinkage of the adenoma. Conclusion: This case illustrates how effective the pharmacological therapy of acromegaly can be and yet at the same time, raises several important issues such as the need for lifelong treatment with costly medications such as the somatostatin analogs. Access to these agentsmay be limited in regions where resources are restricted and clinicians face challenges in order to make the most efficient use of available options. © The Author(s) 2013. Source

Guitelman M.,Hospital Carlos G. Durand | Abreu A.,Centro Medico Imbanaco | Espinosa-De-Los-Monteros A.L.,Centro Medico Nacional SXXI | Mercado M.,National Autonomous University of Mexico | Mercado M.,Instituto Mexicano del Seguro Social
Pituitary | Year: 2014

Background: Health-related quality of life (QoL) is severely impaired in acromegaly due to the physical and psychological consequences of the disease. Pharmacological and surgical treatments, when available, can improve QoL and life expectancy. Case description: A 34-year-old male with uncontrolled acromegaly due to a large and invasive macroadenoma, which could not be resected by transsphenoidal surgery. Over 9 years, he had limited access to pharmacological interventions and persisted with clinically and biochemically active disease, with severe co-morbidities and a poor QoL, which eventually lead to a premature sudden death. Conclusion: This case highlights the impact that active acromegaly has when treatment resources are limited. We review the factors contributing to poor QoL in this disease, with special reference to the Latin American scenario. © The Author(s) 2013. Source

Feria-Arroyo T.P.,University of Texas-Pan American | Castro-Arellano I.,Texas State University | Gordillo-Perez G.,Centro Medico Nacional SXXI | Cavazos A.L.,University of Texas-Pan American | And 6 more authors.
Parasites and Vectors | Year: 2014

Background: Disease risk maps are important tools that help ascertain the likelihood of exposure to specific infectious agents. Understanding how climate change may affect the suitability of habitats for ticks will improve the accuracy of risk maps of tick-borne pathogen transmission in humans and domestic animal populations. Lyme disease (LD) is the most prevalent arthropod borne disease in the US and Europe. The bacterium Borrelia burgdorferi causes LD and it is transmitted to humans and other mammalian hosts through the bite of infected Ixodes ticks. LD risk maps in the transboundary region between the U.S. and Mexico are lacking. Moreover, none of the published studies that evaluated the effect of climate change in the spatial and temporal distribution of I. scapularis have focused on this region. Methods. The area of study included Texas and a portion of northeast Mexico. This area is referred herein as the Texas-Mexico transboundary region. Tick samples were obtained from various vertebrate hosts in the region under study. Ticks identified as I. scapularis were processed to obtain DNA and to determine if they were infected with B. burgdorferi using PCR. A maximum entropy approach (MAXENT) was used to forecast the present and future (2050) distribution of B. burgdorferi-infected I. scapularis in the Texas-Mexico transboundary region by correlating geographic data with climatic variables. Results: Of the 1235 tick samples collected, 109 were identified as I. scapularis. Infection with B. burgdorferi was detected in 45% of the I. scapularis ticks collected. The model presented here indicates a wide distribution for I. scapularis, with higher probability of occurrence along the Gulf of Mexico coast. Results of the modeling approach applied predict that habitat suitable for the distribution of I. scapularis in the Texas-Mexico transboundary region will remain relatively stable until 2050. Conclusions: The Texas-Mexico transboundary region appears to be part of a continuum in the pathogenic landscape of LD. Forecasting based on climate trends provides a tool to adapt strategies in the near future to mitigate the impact of LD related to its distribution and risk for transmission to human populations in the Mexico-US transboundary region. © 2014 Feria-Arroyo et al.; licensee BioMed Central Ltd. Source

Illoldi-Rangel P.,University of Texas at Austin | Rivaldi C.-L.,University of Texas at Austin | Sissel B.,University of Texas at Austin | Trout Fryxell R.,University of California at Davis | And 6 more authors.
Journal of Tropical Medicine | Year: 2012

Species distribution models were constructed for ten Ixodes species and Amblyomma cajennense for a region including Mexico and Texas. The model was based on a maximum entropy algorithm that used environmental layers to predict the relative probability of presence for each taxon. For Mexico, species geographic ranges were predicted by restricting the models to cells which have a higher probability than the lowest probability of the cells in which a presence record was located. There was spatial nonconcordance between the distributions of Amblyomma cajennense and the Ixodes group with the former restricted to lowlands and mainly the eastern coast of Mexico and the latter to montane regions with lower temperature. The risk of Lyme disease is, therefore, mainly present in the highlands where some Ixodes species are known vectors; if Amblyomma cajennense turns out to be a competent vector, the area of risk also extends to the lowlands and the east coast. Copyright 2012 Patricia Illoldi-Rangel et al. Source

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