[Liver abscess caused by enteric Staphylococcus aureus].
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Female↗
Biomedical subjects
A Bacaicoa
Publications and source records attributed to A Bacaicoa.
[Antithrombotic treatment in non-rheumatic atrial fibrillation. Do we follow the recommendations of clinical trials?].
OBJECTIVES: Several clinical trials have demonstrated that antithrombotic treatment may be effective in prevention of stroke in nonrheumatic atrial fibrillation (AF). The aim of this study was to assess if we follow clinical trial recommendations in community practice. METHODS: We analyzed 225 medical records of patients diagnosed of nonrheumatic AF in Cáceres, during February and March 1998. Patients who were contraindicated to follow antiagreggation or anti-coagulation treatment were excluded. We compared patients with and without antithrombotic treatment with different demographic characteristics and embolic risk factors. RESULTS: 205 patients were included in the study, 149 (72.6%) had high embolic risk. 62 (30.2%) followed anticoagulation, 94 (45.8%) antiaggregation treatment, 5 (2.4%) both treatment and 49 (24%) were not receiving therapy. We didn't findings differences between age, sex, presence of ischemic heart disease, hypertension and congestive heart failure in last three months compared with the patients in respect to the group of patients with anticoagulation and antiaggregation therapy or without it. We determinate as well that previous stroke and echocardiographical finds (valve disease, valve calcification, ventricular dysfunction) were more frequent in the anticoagulation and antiaggregate patients than in those without therapy. CONCLUSION: A high range of nonrheumatic AF patients take any kind of antithrombotic preventive therapy, though a great number of patients with high embolic risk could still get benefits from anticoagulation therapy. We should considerate in the therapy assessment some other clinical characteristics as hypertension, isquemic heart disease and heart failure apart from echocardiographical findings.
Aged↗
[Chlamydia psittaci and Chlamydia pneumoniae infection in Caceres].
OBJECTIVE: The study of the clinical and epidemiological characteristics of infectious process caused by Chlamydia pneumoniae and Chlamydia psittaci in our medium, Cáceres. METHOD: We are reviewed retrospectively clinical aspects of the patients with infections due to Chlamydia in the las five years. We accepted patients with compatible symptoms and serologic demonstration of recent infection with conventional complement fixation and/or microimmunofluorescence assay, the last used to distinguish Chlamydia pneumoniae. RESULTS: We are studied sixteen patients (9 males and 7 females), sixth median age 46.6 (26-70). Fifteen patients was diagnosed in winter. We found five cases of Chlamydia pneumoniae and three of Chlamydia psittaci. In the other eight cases we didn't distinguish between Chlamydia pneumoniae and Chlamydia psittaci. All patients had fever, accompanied by lung symptoms and pulmonary infiltrates in the 75% of them. The most frequent clinical information was the discord between the pulse and temperature (81%). Splenomegaly was observed in three patients (19%) being the diagnosis of them psitacosis. Nine patients had respiratory insufficiency and eight (50%) disturbance in hepatic enzymes. The clinical presentation in one patients was as unknown origin fever. CONCLUSIONS: The infection produced by Chlamydia in the hospitalary medium isn't much diagnosed in our unit. The months of winter favour the infection. We think that splenomegaly is the only different characteristic in these infections, suggesting psitacosis.
Adult↗
[Diagnosis of primary biliary cirrhosis in an 84-year-old man].
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Age Factors↗
[Nocardiosis in patients with human immunodeficiency virus infection in Spain].
BACKGROUND: Nocardia usually infects immunosuppressed patients, particularly with cellular immunity deficiency. Nevertheless, despite severe immunosuppression in patients infected with HIV, nocardiosis is rare among these patients. We report here two cases of nocardiosis in patients with HIV infection and review spanish literature up to 1993, with an analysis of the characteristics of this infection in our country. METHODS AND RESULTS: The two patients consumed drugs parenterally and Nocardia organism were recovered in blood cultures after 48 hours of inoculation in standard culture media. The source of the infection was cutaneous in one patient, over an area of venipuncture, and pulmonary in the other patient. Previously, eleven cases of nocardiosis had been reported in the spanish literature in patients infected with HIV. Eighty-four percent were males, and all of them consumed drugs parenterally and displayed a severe cellular immunodepression; the total CD4 lymphocyte count was lower than 100/mm3 in patients when this finding was available (6/13). At diagnosis only one patient received prophylaxis against other type of infection with antibiotics theoretically effective against Nocardia at diagnosis. The Nocardia species recovered more frequently was asteroides (77%) and the most common location was the skin (54%). Treatments more frequently employed were sulfametoxazole-trimethoprim (45%) and sulfadiazine (36%), with a good response except in those with cerebral involvement. CONCLUSIONS: Nocardiosis in patients with HIV infection is rare in Spain. In contrast with other geographical areas skin involvement was the more common form of infection. Prophylaxis with sulfametoxazole-trimethoprim against other infections could be responsible for a lower than expected incidence among this type of patients.
AIDS-Related Opportunistic Infections↗
[The assessment and nutritional support of patients with the acquired immunodeficiency syndrome].
Given the negative effect of malnutrition on the immune function, the possibility must be considered that this also affects the clinical progression of AIDS patients. This study was aimed at assessing the state and nutritional support indicated for patients diagnosed as having AIDS. 114 patients admitted to our hospital in the period 1990-1991 were studied, with assessment of the nutritional state by means of anthropometric parameters (weight, size, tricipital fold, arm muscle circumference), biochemical parameters (albumin, lymphocytes, transferrin, RBP) and the treatment prescribed. Average age was 31.44 +/- years, 81.5% were male, 68% parenteral drug addicts. 71% had a stage IV C diagnosis. 37.72% had diarrhea before beginning treatment. The malnutrition diagnosed was as follows: moderate, 50.89%, severe 36%, slight, 12.5%, and mixed (calorific-protein), 62.5%, calorific 34.8%, and protein 2.6% of cases, 33% of the patients received dietary supplements, 33.84% enteral alimentation and 33% parenteral alimentation. Nutritional support was suspended as follows: improvement, 54.46%; transfers, 1.79%; death, 27.68%, and terminal situation, 16.07%. Deceased or terminal patients were more severely malnourished (p < 0.001) than the remainder. AIDS patients are studied and treated nutritionally in a very advanced stage of the illness, with severe malnutrition which conditions a poorer evolutive diagnosis. This suggests a change of attitude, with assessment being necessary of nutritional state and the appropriate therapy at the time of diagnosis, in order to slow the progression of the illness.
AIDS-Related Opportunistic Infections↗