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Biomedical subjects

A Belda

Publications and source records attributed to A Belda.

At least 19 recordsLinked to original sources
PubMed1999

Treatment of community-acquired pneumonia in outpatients: randomized study of clarithromycin alone versus clarithromycin and cefuroxime.

OBJECTIVE: To evaluate the efficacy of clarithromycin alone in comparison with the combination of clarithromycin and cefuroxime in the treatment of nonhospitalized patients with community-acquired pneumonia (CAP) in a Mediterranean population. METHODS: CAP was defined as the acute onset of fever (>38 degrees C) with pulmonary opacity on chest roentgenogram. The American Thoracic Society (ATS) criteria (1993) were used to decide on patient hospitalization. Ninety subjects, of whom 53 (59%) were men, with a mean age (+/-SD) of 38+/-15 years, were randomized: 45 received clarithromycin 500 mg b.i.d. orally for 14 days (CL group), and 45 received clarithromycin plus cefuroxime 500 mg b.i.d. orally for 7 days (CLCE group). Patients were monitored with clinical, radiological, and laboratory controls at 3 and 21 days. There were no significant differences between the two groups with regard to demographic, clinical, physical and laboratory data. RESULTS: The mean time to defervescence was 2.4+/-1.4 and 2.4+/-1.5 days, respectively. Chest roentgenogram clearance was complete in all cases, without statistically significant differences in the time to resolution between both arms. Side effects were mild (no significant differences between groups): 5 patients in the CL group and 3 in the CLCE group showed gastrointestinal symptoms. Two patients (2.2%), both in the CLCE group, needed hospital admission during follow-up, but all 90 patients showed an excellent outcome. A causative agent was determined in 25 cases (28%). Legionella pneumophila, Streptococcus pneumoniae, and Mycoplasma pneumoniae were the most frequent pathogens. CONCLUSION: Empirical treatment of outpatient CAP with clarithromycin can be considered adequate in the Mediterranean area, independently of the microbiological etiology. ATS criteria for admitting patients with CAP are appropriate in this population.

Adult↗
PubMed1998

[Clinical manifestations of Stenotrophomas (Xanthomonas) maltophilia infection].

OBJECTIVE: Stenotrophomonas maltophilia (SM) is a gram-negative bacillus whose incidence like nosocomial pathogen has been incremented in the last years, especially in immunocompromised patients, subjected to invasive procedures and those receiving broad-spectrum antimicrobial therapy. METHOD: We report 15 isolations of SM between 1994-1996. RESULTS: The criteria for SM infection were fulfilled by 9 patients (60%), and 6 patients (40%) were colonized. The mean age of the patient was 60 +/- 12 years. Major predisposing factors in infections included venous catheterization (100%), prior surgery (86%), residence in ICU (80%), prior antibiotic therapy (80%) and intubation (66%). The most common underlying disease were heart disease (60%), treatment with immunosuppressors and/or steroids (46%) and chronic lung disease (46%). Ten cases (66%) had polymicrobial culture. The mortality rate was 40%. Risk factors associated with fatal outcome included the following: chronic lung disease (p = 0.043), nasogastric catheterization (p = 0.01), urinary tract catheterization (p = 0.02), intubation (p = 0.04) and the presence of pneumonia or sepsis by SM (p = 0.02). The most active agents were colistina (100%), cotrimoxazol (71%) and ceftazidima (53%). The isolates were highly resistant to first and second-generation cephalosporins (100%) tetracyclines (86%), aztreonam (91%) and imipenem (71%). CONCLUSION: SM cause a wide range of clinical syndromes and is more likely to cause infection or colonization in patients who have underlying disease. Due to its inherent multiple-antimicrobial resistance, it would appear its potential as a nosocomial pathogen will continue to increase. Therapy of patients should include cotrimoxazole.

Cross Infection↗
PubMed1996

[Langerhans cell histiocytosis of lymph node].

Langerhans cell Histiocytosis or Histiocytosis X encompasses the syndromes of Letterer-Siwe disease, Hand-Schuller-Christian disease and eosinophilic granuloma. The localized disease usually consisted of isolated bone involvement as osteolytic areas. The isolated lymph node disease is uncommon. A case study of eosinophilic granuloma of lymph node in a 27 years-old woman who underwent several recurrences as lymphadenitis is presented. This case is presented in light of the cytologic, histologic and immunohistochemical findings of node-based eosinophilic granuloma and the favorable prognosis of this localized form treated with steroids.

Adult↗
PubMed1995

[The prognostic value of plasma triglycerides in human immunodeficiency virus infection].

BACKGROUND: Infection with the human immunodeficiency virus (HIV) is associated with an increased prevalence of hypertriglyceridemia, which is more common in advanced stages of disease. Nevertheless, the role of hypertriglyceridemia as a predictive marker of progression of disease and/or mortality is not fully elucidated. METHODS: One-hundred nineteen patients with HIV infection attended at our Outpatient Clinic or hospitalized in our Service were retrospectively studied. At the beginning of the study and every six months a complete medical history and physical examination were obtained, with a complete blood count, serum biochemistry, total lymphocytes and CD4 subpopulations, cholesterol, triglycerides and IgA. With comparative purposes cholesterol and triglyceride values were also determined in a control group of healthy subjects with the same age and gender. The relationship between triglyceride levels and the other clinical and analytical parameters was evaluated by means of the Pearson linear correlation. The risk for developing clinical disease and survival were studied by the method proposed by Kaplan and Meier. RESULTS: The mean age of patients was 27 +/- 6 years and the male/female ratio was 86/33. Eighty-three percent (99) of patients consumed drugs parenterally. Compared with the control group, patients with HIV infection had hypertriglyceridemia (159 +/- 80 mg/dl vs 79 +/- 53 mg/dl) and hypocholesterolemia (143 +/- 41 mg/dl vs 174 +/- 36 mg/dl) (p < 0.05). There was a positive correlation between triglycerides and IgA levels (p < 0.01) and a negative correlation with serum albumin (p < 0.05). A higher risk towards progression of disease was not observed among patients with hypertriglyceridemia (TG > 143 mg/dl) in non-AIDS infected patients, nor mortality in the overall group. CONCLUSIONS: HIV infected patients have a higher prevalence of hypertriglyceridemia and hypocholesterolemia. Plasma triglycerides were not useful as a prognostic factor for the development of disease nor as mortality risk.

Adult↗
PubMed1990

[Acute rhabdomyolysis. A study of 44 cases].

Fourty four patients suffering non traumatic rhabdomyolysis (RM) are studied. The most frequently encountered etiologies were neurologic abnormalities in 26 patients, followed by infections in 7 patients and metabolic abnormalities in four cases. Eleven patients (25%) presented several associated factors. The clinical manifestations of RM were not very significant, with only 18% of patients presenting muscle pain, 38.6% proteinuria and 36.4% hematuria. A significant increase in K, CPK, LDH, and ASAT values was observed after the RM episode (p less than 0.05). Those patients with an infectious RM were older (p less than 0.05) and presented higher urea (p less than 0.01) and creatinine (p less than 0.05) values. Only two patients presented renal failure. One patient with septic shock died. RM is a relatively common condition, often secondary to multiple systemic processes, which can go unnoticed due to the underlying disease.

Acute Disease↗
PubMed1987

Drug fever.

Explore the source record for details and available documents.

Azathioprine↗
PubMed1985

Increased numbers of circulating basophil progenitors in atopic patients.

Recruitment of basophils to sites of homocytotropic antibody-mediated hypersensitivity reactions has been well documented in both experimental and clinical situations. Mechanisms underlying tissue basophil accumulation, however, remain unclear and may involve chemotaxis, cell proliferation, or both. We have recently reported the presence in human blood of circulating basophil/mast cell progenitors on the basis of histamine content of granulocyte colonies grown in methylcellulose. In the current studies we have analyzed the peripheral blood of 30 patients with atopy and 25 comparable control subjects for frequency of basophil/mast cell progenitors by analysis of the histamine content of individual granulocyte colonies. Forty percent of granulocyte colonies in cultures of atopic patients contained histamine in comparison to only 11% in cultures of control subjects (p less than 0.001). Histamine content per colony as well as mean histamine per cell in each colony was higher in granulocyte colonies of atopic subjects and could not be related to colony size or culture conditions. Granulocyte colony growth was enhanced by antigen-stimulated, peripheral blood lymphomononuclear cell--conditioned media of atopic patients. Histamine-positive colonies were found more frequently in active versus quiescent atopic disease (p less than 0.05). These results are consistent with the hypothesis that basophils accumulate at sites of allergic reactions at least in part by recruitment of progenitors from circulation and subsequent differentiation in situ in response to lymphokines. Further studies by use of hemopoietic assays could elucidate the contribution of basophil production to the development of allergic conditions.

Adolescent↗
PubMed1985

Associated cutaneous findings in nickel contact sensitivity.

A clinical survey of patients with nickel dermatitis has provided evidence of a significant association with one or more of the following reactions: contact reaction from adhesive tape, reaction from mosquito bites which lasts 1 week or longer, and a history of hives. The association of nickel contact dermatitis with at least one of the other reactions is termed contact sensitivity syndrome.

Adult↗